Form 990, Part VI, Section A, Line 7A
“Members: per article iii, section 2 of the organization's bylaws, advance community health inc shall appoint a majority of the board members, one of which sahll be the ceo of advnace community health inc.”
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Balance Sheet
Assets
Down$0
Down $9,287,313 (-100%) from 2020
Net Assets
Up$0
Up $902,517 (+100%) from 2020
Liabilities
Down$0
Down $10,189,830 (-100%) from 2020
Revenue And Expenses
Revenue
Up$2,947,353
Up $2,208,863 (+299%) from 2020
Expenses
Down$944,012
Down $291,355 (-24%) from 2020
Net Income
Up$2,003,341
Up $2,500,218 (+503%) from 2020
Historical Trend
Jump To
Filing Snapshot
- Filing Period
- Apr 1, 2021 to Oct 25, 2021
- Signed
- Dec 15, 2022
- Return Version
- 2021v4.2
- Gross Receipts
- $2,947,353
Mission and Program Overview
Mission
To support wake health services so long as such organization continues to be created and organized for exempt purposes within the meaning of 501(c)(3) of the internal revenue code.
Emerald quarry received loan funds and constructed a 35,000 sq ft medical and dental office building to expand services for current patients of advance community health.
Balance Sheet Detail
| Line | Beginning | End | Change |
|---|---|---|---|
| Assets | |||
| Land, Buildings, and Equipment, Net | $8,438,853 | $0 | ▼ $8,438,853 |
| Cash and Non-Interest-Bearing Accounts | $1,643 | $0 | ▼ $1,643 |
| Savings and Temporary Cash Investments | $0 | $0 | → $0 |
| Accounts Receivable | $0 | $0 | → $0 |
| Other Notes and Loans Receivable, Net | $0 | $0 | → $0 |
| Pledges and Grants Receivable | $0 | $0 | → $0 |
| Receivable From Disqualified Prsn | $0 | $0 | → $0 |
| Receivables From Officers Etc | $0 | $0 | → $0 |
| Investments Other Securities | $0 | $0 | → $0 |
| Investments Program Related | $0 | $0 | → $0 |
| Investments in Publicly Traded Securities | $0 | $0 | → $0 |
| Intangible Assets | $0 | $0 | → $0 |
| Inventories for Sale or Use | $0 | $0 | → $0 |
| Loans From Officers Directors | $0 | $0 | → $0 |
| Prepaid Expenses and Deferred Charges | $0 | $0 | → $0 |
| Total Assets | $8,493,012 | $0 | ▼ $8,493,012 |
| Other Assets Total | $52,516 | $0 | ▼ $52,516 |
| Liabilities | |||
| Mortgage Notes Payable Secured by Investment Property | $9,736,539 | $0 | ▼ $9,736,539 |
| Other Liabilities | $37,149 | $0 | ▼ $37,149 |
| Accounts Payable and Accrued Expenses | $0 | $0 | → $0 |
| Grants Payable | $0 | $0 | → $0 |
| Unsecured Notes Loans Payable | $0 | $0 | → $0 |
| Deferred Revenue | $0 | $0 | → $0 |
| Escrow Account Liability | $0 | $0 | → $0 |
| Tax Exempt Bond Liabilities | $0 | $0 | → $0 |
| Total Liabilities | $9,773,688 | $0 | ▼ $9,773,688 |
| Net Assets / Fund Balance | |||
| Net Assets With Donor Restrictions | $0 | $0 | → $0 |
| Net Assets Without Donor Restrictions | $-1,280,676 | $0 | ▲ $1,280,676 |
| Total Net Assets Fund Balance | $-1,280,676 | $0 | ▲ $1,280,676 |
| Total Liabilities and Net Assets / Fund Balance | $8,493,012 | $0 | ▼ $8,493,012 |
Compensation and Service Providers
Employees
| Name | Title | Other | Total |
|---|---|---|---|
| Penella Washington | CEO End 04/21 | $96,294 | $96,294 |
Board Members and Trustees
| Name | Title |
|---|---|
| James W Teagle Iii | Trustee |
| Scot Mccray | CEO |
| Steven Shelton | CFO |
Revenue and Support
Revenue Composition
- Contributions and Grants
- $0
- Program Service Revenue
- $491,818
- Investment Income
- $0
- Other Revenue
- $2,455,535
- Change in Net Assets
- $2,003,341
Expenses and Functional Allocation
Major Expense Lines
| Line Item | Amount |
|---|---|
| Other Expenses | $944,012 |
| Grants and Similar Amounts Paid | $0 |
| Professional Fundraising Fees | $0 |
| Salaries, Compensation, and Employee Benefits | $0 |
| Total Fundraising Expense | $0 |
Functional Expense Allocation
| Line Item | Program | Management | Fundraising | Total |
|---|---|---|---|---|
| Depreciation Depletion | $512,185 | - | - | $512,185 |
| Interest | $357,117 | - | - | $357,117 |
| Fees for Services Other | - | $62,832 | - | $62,832 |
| Insurance | $10,658 | - | - | $10,658 |
| Office Expenses | $1,220 | - | - | $1,220 |
| Total Functional Expenses | $881,180 | $62,832 | $0 | $944,012 |
Fundraising, Events, and Gaming
- Fundraising activities
- No
- Gaming activities
- No
- Professional fundraiser used
- No
Fundraising and Gaming Totals
| Line Item | Amount |
|---|---|
| Fundraising Direct Expenses | $0 |
| Fundraising Gross Income | $0 |
| Gaming Direct Expenses | $0 |
| Gaming Gross Income | $0 |
| Professional Fundraising Fees | $0 |
Political and Lobbying Activity
- Political campaign activity
- No
- Lobbying activity
- No
- Subject to proxy tax
- No
Insider Transactions and Loans
Loans and Receivables
| Line Item | Beginning | End | Change |
|---|---|---|---|
| Loans from Officers, Directors, Trustees, and Key Employees | $0 | $0 | → $0 |
| Receivables from Disqualified Persons | $0 | $0 | → $0 |
| Receivables from Officers, Directors, Trustees, and Key Employees | $0 | $0 | → $0 |
Governance and Compliance
Governance Checklist
- Compiled or reviewed by an accountant
- No
- Annual disclosure for covered persons
- Yes
- Audit committee
- Yes
- Business relationship with 35% controlled entity
- No
- Business relationship with family members
- No
- Business relationship with organization members
- No
- Material changes to governing documents
- No
- Compensation from other sources disclosed
- No
- CEO compensation reviewed
- Yes
- Other officer compensation reviewed
- Yes
- Conflict-of-interest policy
- Yes
- Audited financial statements prepared
- Yes
- Key decisions subject to board approval
- No
- Management duties delegated
- No
Governance Explanations
Form 990, Part VI, Section B, Line 11B
“Review of the form 990: form 990 is prepared by an independent accounting firm based on the audited financials statements and information provided by the accounting department of the organization. A copy of the form 990 was provided to the organization's board of directors for review prior to the return being filed.”
Form 990, Part VI, Section B, Line 12C
“Conflict of interest policy: the organization's conflict of interest policy is included in its standards of conduct policy and governing bylaws. The process of monitoring compliance with this policy includes providing conflict of interest disclosure statements to every employee and board member. The disclosure statement is required to be updated annually. The following describes the disclosure of potential conflicts of interest among different positions within the organization. Members of, and candidates for membership on, the board of trustees must make disclosures to the chair of the board of trustees. If the chair has an interest to disclose, he or she must make disclosure to the vice chair who will in turn be responsible for advising the board. The ceo must make disclosures to the chair of the board who will in turn be responsible for advising the board of such disclosure. Staff engaged in the award of administration of contracts must make disclosures in writing to the ceo. If a potential conflict of interest is identified with a board member, the board member may make a presentation to the board regarding whether or not he or she has a conflict of interest, and may repsond to related questions from the board. However, he or she shall leave the meeting during any discussion of, or voting on, whether the conflict of interest exists. If such conflict is determined to exist, he or she shall leave the meeting during any discussion of, or voting on, the transaction or arrangement that involves the conflict of interest. If a potential conflict of interest is identified with a person who is not a board member, the ceo shall make the determination.”
Form 990, Part VI, Lines 15A & 15B
“Compensation review: the compensation of the organization's ceo was compiled by the hr executive using national and local data for salary and benefit comparison. The full board of trustees reviews and approves any compensation changes. The most recent review was december 2020. The compensation for other officers is based on board approved salary ranges. The hr executive uses national and local comparative data to determine ranges. Ranges are then brought to the business strategy committee for review and then to the full board for final review and approval. The most recent review was march 2021.”
Form 990, Part VI, Section C, Line 19
“Document disclosure: the organization makes its governing documents, conflict of interest policy, and financial statements available to the public for inspection upon request.”
Filing and Contact Details
Filer
- Filer Name
- Emerald Quarry
- EIN
- 47-1270222
- In Care Of
- % STEVEN SHELTON
- Phone
- 9192502939
- Address
- 1001 ROCK QUARRY RD, RALEIGH, NC 27610
Signing Officer
- Name
- Scot Mccray
- Title
- CEO
- Phone
- 4178658701
- Signed
- 2022-12-15
- Discuss with paid preparer
- Yes
Organization Details
- Principal Officer
- Scot Mccray
- Formed
- 2014
- Legal Domicile
- Nc
- Voting Board Members
- 3
- Independent Board Members
- 1
- Employees
- 0
- Volunteers
- 0
Preparer
- Firm
- Forvis Llp
- Address
- 910 E ST LOUIS 200/PO BOX 1190, SPRINGFIELD, MO 65806-2523
- Preparer
- Krystal K Creach
- Phone
- 4178658701
Supplemental Narrative
Additional Explanations
Form 990, Part XI, Line 9
“Other changes in net assets: $(722,665) transfer to affiliate”
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| IRS990ScheduleJ/RltdOrgOfficerTrstKeyEmplGrp/PersonNm | 1 | STEVEN SHELTON |
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| IRS990ScheduleJ/SupplementalInformationDetail/ExplanationTxt | 0 | EXECUTIVE COMPENSATION: INDIVIDUALS LISTED ON SCHEDULE J, PART II ARE COMPENSATED BY A RELATED ORGANIZATION, ADVANCE COMMUNITY HEALTH, INC. ADVANCE COMMUNITY HEALTH, INC. USES A WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY, FORM 990 OF OTHER ORGANIZATIONS, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE TO DETERMINE EXECUTIVE COMPENSATION. |
| IRS990ScheduleJ/SupplementalInformationDetail/ExplanationTxt | 1 | NON-FIXED PAYMENTS: INDIVIDUALS LISTED ON SCHEDULE J, PART II RECEIVED BONUS FROM A RELATED ORGANIZATION, ADVANCE COMMUNITY HEALTH, INC. ADVANCE COMMUNITY HEALTH, INC. HAS A PROVIDER INCENTIVE PROGRAM THAT IS MADE UP OF THREE COMPONENTS: - PRODUCTIVITY INCENTIVE - STEWARDSHIP INCENTIVE - QUALITY INCENTIVE THE PROVIDER INCENTIVE PLAN APPLIES TO ALL LICENSED INDEPENDENT PRACTITIONERS (LIPS) EMPLOYED BY THE ORGANIZATION, WHICH INCLUDES: - MEDICAL DOCTORS (MD) - DOCTOR OF OSTEOPATHIC MEDICINE (DO) - PHYSICIAN ASSISTANTS (PA) - NURSE PRACTITIONERS (NPS INCLUDING FNP, PNP, PSYCHNP) - DOCTOR OF NURSING PRACTICE (DNP) - DOCTOR OF DENTAL SURGERY (DDS) - DOCTOR OF MEDICINE IN DENTISTRY (DMD) |
| IRS990ScheduleJ/SupplementalInformationDetail/FormAndLineReferenceDesc | 0 | SCHEDULE J, PART I, LINE 3 |
| IRS990ScheduleJ/SupplementalInformationDetail/FormAndLineReferenceDesc | 1 | SCHEDULE J, PART I, LINE 7 |
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| IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/DistributionDt | 0 | 2021-10-25 |
| IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/EIN | 0 | 561004791 |
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| IRS990ScheduleN/LiquidationOfAssetsTableGrp/LiquidationOfAssetsDetail/PersonNm | 0 | ADVANCE COMMUNITY HEALTH |
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| IRS990ScheduleN/SupplementalInformationDetail/ExplanationTxt | 0 | OFFICERS, DIRECTORS AND KEY EMPLOYEES: OFFICERS, DIRECTORS AND KEY EMPLOYEES OF THE ORGANIZATION ARE EMPLOYEES OR DIRECTORS OF ADVANCE COMMUNITY HEALTH INC. |
| IRS990ScheduleN/SupplementalInformationDetail/ExplanationTxt | 1 | DISCHARGE OF DEBTS: THE AMOUNT OF INTERCOMPANY DEBT DISCHARGED OR ASSUMED BY ADVANCE COMMUNITY HEALTH INC IS $7,204,005. |
| IRS990ScheduleN/SupplementalInformationDetail/FormAndLineReferenceDesc | 0 | FORM 990, SCHEDULE N, PART I, LINES 2A & 2B |
| IRS990ScheduleN/SupplementalInformationDetail/FormAndLineReferenceDesc | 1 | FORM 990, SCHEDULE N, PART 1, LINE 5 |
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| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 0 | MEMBERS: PER ARTICLE III, SECTION 2 OF THE ORGANIZATION'S BYLAWS, ADVANCE COMMUNITY HEALTH INC SHALL APPOINT A MAJORITY OF THE BOARD MEMBERS, ONE OF WHICH SAHLL BE THE CEO OF ADVNACE COMMUNITY HEALTH INC. |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 1 | REVIEW OF THE FORM 990: FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIALS STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. A COPY OF THE FORM 990 WAS PROVIDED TO THE ORGANIZATION'S BOARD OF DIRECTORS FOR REVIEW PRIOR TO THE RETURN BEING FILED. |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 2 | CONFLICT OF INTEREST POLICY: THE ORGANIZATION'S CONFLICT OF INTEREST POLICY IS INCLUDED IN ITS STANDARDS OF CONDUCT POLICY AND GOVERNING BYLAWS. THE PROCESS OF MONITORING COMPLIANCE WITH THIS POLICY INCLUDES PROVIDING CONFLICT OF INTEREST DISCLOSURE STATEMENTS TO EVERY EMPLOYEE AND BOARD MEMBER. THE DISCLOSURE STATEMENT IS REQUIRED TO BE UPDATED ANNUALLY. THE FOLLOWING DESCRIBES THE DISCLOSURE OF POTENTIAL CONFLICTS OF INTEREST AMONG DIFFERENT POSITIONS WITHIN THE ORGANIZATION. MEMBERS OF, AND CANDIDATES FOR MEMBERSHIP ON, THE BOARD OF TRUSTEES MUST MAKE DISCLOSURES TO THE CHAIR OF THE BOARD OF TRUSTEES. IF THE CHAIR HAS AN INTEREST TO DISCLOSE, HE OR SHE MUST MAKE DISCLOSURE TO THE VICE CHAIR WHO WILL IN TURN BE RESPONSIBLE FOR ADVISING THE BOARD. THE CEO MUST MAKE DISCLOSURES TO THE CHAIR OF THE BOARD WHO WILL IN TURN BE RESPONSIBLE FOR ADVISING THE BOARD OF SUCH DISCLOSURE. STAFF ENGAGED IN THE AWARD OF ADMINISTRATION OF CONTRACTS MUST MAKE DISCLOSURES IN WRITING TO THE CEO. IF A POTENTIAL CONFLICT OF INTEREST IS IDENTIFIED WITH A BOARD MEMBER, THE BOARD MEMBER MAY MAKE A PRESENTATION TO THE BOARD REGARDING WHETHER OR NOT HE OR SHE HAS A CONFLICT OF INTEREST, AND MAY REPSOND TO RELATED QUESTIONS FROM THE BOARD. HOWEVER, HE OR SHE SHALL LEAVE THE MEETING DURING ANY DISCUSSION OF, OR VOTING ON, WHETHER THE CONFLICT OF INTEREST EXISTS. IF SUCH CONFLICT IS DETERMINED TO EXIST, HE OR SHE SHALL LEAVE THE MEETING DURING ANY DISCUSSION OF, OR VOTING ON, THE TRANSACTION OR ARRANGEMENT THAT INVOLVES THE CONFLICT OF INTEREST. IF A POTENTIAL CONFLICT OF INTEREST IS IDENTIFIED WITH A PERSON WHO IS NOT A BOARD MEMBER, THE CEO SHALL MAKE THE DETERMINATION. |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 3 | COMPENSATION REVIEW: THE COMPENSATION OF THE ORGANIZATION'S CEO WAS COMPILED BY THE HR EXECUTIVE USING NATIONAL AND LOCAL DATA FOR SALARY AND BENEFIT COMPARISON. THE FULL BOARD OF TRUSTEES REVIEWS AND APPROVES ANY COMPENSATION CHANGES. THE MOST RECENT REVIEW WAS DECEMBER 2020. THE COMPENSATION FOR OTHER OFFICERS IS BASED ON BOARD APPROVED SALARY RANGES. THE HR EXECUTIVE USES NATIONAL AND LOCAL COMPARATIVE DATA TO DETERMINE RANGES. RANGES ARE THEN BROUGHT TO THE BUSINESS STRATEGY COMMITTEE FOR REVIEW AND THEN TO THE FULL BOARD FOR FINAL REVIEW AND APPROVAL. THE MOST RECENT REVIEW WAS MARCH 2021. |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 4 | DOCUMENT DISCLOSURE: THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC FOR INSPECTION UPON REQUEST. |
| IRS990ScheduleO/SupplementalInformationDetail/ExplanationTxt | 5 | OTHER CHANGES IN NET ASSETS: $(722,665) TRANSFER TO AFFILIATE |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 0 | FORM 990, PART VI, SECTION A, LINE 7A |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 1 | FORM 990, PART VI, SECTION B, LINE 11B |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 2 | FORM 990, PART VI, SECTION B, LINE 12C |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 3 | FORM 990, PART VI, LINES 15A & 15B |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 4 | FORM 990, PART VI, SECTION C, LINE 19 |
| IRS990ScheduleO/SupplementalInformationDetail/FormAndLineReferenceDesc | 5 | FORM 990, PART XI, LINE 9 |
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| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/DisregardedEntityName/BusinessNameLine1Txt | 0 | ADVANCE COMMUNITY HEALTH INC |
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| IRS990ScheduleR/IdRelatedTaxExemptOrgGrp/ExemptCodeSectionTxt | 0 | 501(C)(3) |
Document Assets
No mirrored PDF or thumbnail assets are attached yet.
Filings
Displayed year
2021 • Form 990Detailed filing. Detailed filing data is available for this year.
- Assets
- $0
- Liabilities
- $0
- Net assets
- $0
- Revenue
- $2,947,353
- Expenses
- $944,012
- Net income
- $2,003,341