STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

COMMUNITY HEALTH FREE CLINIC: Form 990, tax year 2022

View the entire original 990 at ProPublica ↗

Organization
COMMUNITY HEALTH FREE CLINIC (EIN 13-4228071)
Tax period
2022-07-01 to 2023-06-30
Filed
2024-04-23
IRS object ID
202421309349302047
Schema version
2022v5.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2024-04-23T11:06:18-07:00ReturnTs
Tax Period End2023-06-30TaxPeriodEndDt
Return Type990ReturnTypeCd
Tax Period Begin2022-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN134228071EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1COMMUNITY HEALTH FREE CLINICBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlCOMMBusinessNameControlTxt
Phone3193630416PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1947 14th Avenue SEAddressLine1Txt
CityCedar RapidsCityNm
State AbbreviationIAStateAbbreviationCd
ZIP52401ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonEthan BentonPersonNm
Person TitleBoard TreasurerPersonTitleTxt
Phone3193630416PhoneNum
Signature2024-04-23SignatureDt

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstEthanPersonFirstNm
Person LastBentonPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN
FieldValueIRS element (for citing)
IRS Responsible Prty Info CurrYes (1)IRSResponsiblePrtyInfoCurrInd

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer1TrustedCustomerCd
OOB Security Verification11OOBSecurityVerificationCd
Last Submission Rqr OOB1LastSubmissionRqrOOBCd
Authentication Assurance LevelAAL2AuthenticationAssuranceLevelCd
Profile Password ChangeYes (X)ProfilePasswordChangeInd
FieldValueIRS element (for citing)
Tax2022TaxYr
Build TS2023-04-26 12:10:37ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerEthan BentonPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1947 14th Ave SEAddressLine1Txt
CityCedar RapidsCityNm
State AbbreviationIAStateAbbreviationCd
ZIP52401ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$5,088,602GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.COMMUNITYHFC.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2002FormationYr
Legal Domicile StateIALegalDomicileStateCd
Activity Or MissionTO ALLEVIATE HUMAN PAIN AND SUFFERING BY PROVIDING ACCESS TO AND THE DELIVERY OF COMPASSIONATE HEALTHCARE.ActivityOrMissionDesc
Voting Members Governing Body14VotingMembersGoverningBodyCnt
Voting Members Independent14VotingMembersIndependentCnt
Total Employee22TotalEmployeeCnt
Total Volunteers172TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$5,253,948PYContributionsGrantsAmt
CY Contributions Grants$5,087,167CYContributionsGrantsAmt
PY Program Service Revenue$0PYProgramServiceRevenueAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$43,826PYInvestmentIncomeAmt
CY Investment Income$1,435CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$5,297,774PYTotalRevenueAmt
CY Total Revenue$5,088,602CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$318,936PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$365,499CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$60,107CYTotalFundraisingExpenseAmt
PY Other Expenses$4,836,121PYOtherExpensesAmt
CY Other Expenses$4,870,102CYOtherExpensesAmt
PY Total Expenses$5,155,057PYTotalExpensesAmt
CY Total Expenses$5,235,601CYTotalExpensesAmt
PY Revenues Less Expenses$142,717PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$146,999CYRevenuesLessExpensesAmt
Total Assets BOY$3,516,367TotalAssetsBOYAmt
Total Assets EOY$3,464,143TotalAssetsEOYAmt
Total Liabilities BOY$0TotalLiabilitiesBOYAmt
Total Liabilities EOY$0TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$3,516,367NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$3,464,143NetAssetsOrFundBalancesEOYAmt
MissionTO ALLEVIATE HUMAN PAIN AND SUFFERING BY PROVIDING ACCESS TO AND THE DELIVERY OF COMPASSIONATE HEALTHCARE.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$4,986,117ExpenseAmt
Grant$0GrantAmt
Revenue$5,088,602RevenueAmt
DescProvided Free Health Care Services, including medical, dental and vision care for underserved and uninsured individuals in need of health care. Approximately 133 new patients were seen per month. The total of new and existing individuals served during the year was 4,348 with over 16,166 services provided. The Community Health Free Clinic served individuals all over the East Central Iowa area.Desc
Total Other Prog Srvc Expense$0TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Grant$0TotalOtherProgSrvcGrantAmt
Total Other Prog Srvc Revenue$0TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses$4,986,117TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi EndowmentsYes (1)DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J Required0ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash ContriYes (1)DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld Compliance0BackupWthldComplianceInd
Employee22EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members14GoverningBodyVotingMembersCnt
Independent Voting Member14IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldCOStatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is FldFLStatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is FldMNStatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is FldMOStatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is FldNJStatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is FldNVStatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is FldWAStatesWhereCopyOfReturnIsFldCd
States Where Copy Of Return Is FldWIStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonMARTY MILLERPersonNm
Phone3192002540PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1715 10TH AVENUE SEAddressLine1Txt
CityCEDAR RAPIDSCityNm
State AbbreviationIAStateAbbreviationCd
ZIP52401ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (15 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtKey EmployeeKeyEmployeeIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerInd
DARLENE SCHMIDT
CEO400Yes (X)$86,576$0$0
JEANETTE WERLING
President2.00$0$0$0Yes (X)Yes (X)
Dave Muller
Vice President2.00$0$0$0Yes (X)Yes (X)
Sue Lowder
SECRETARY2.00.0$0$0$0Yes (X)Yes (X)
Ethan Benton
Treasurer2.00$0$0$0Yes (X)Yes (X)
Amy Vaske
Assistant Treasurer2.00$0$0$0Yes (X)Yes (X)
Thomas Schroeder
Medical Director2.00$0$0$0Yes (X)Yes (X)
Terri Christoffersen
Director11$0$0$0Yes (X)
Aimee Lenton
Director1.00.0$0$0$0Yes (X)
Jill Mast
Director1.00.0$0$0$0Yes (X)
Janet McGrath Saterlee
Director1.00$0$0$0Yes (X)
Mike Moran
Director10$0$0$0Yes (X)
Dennis Naughton
Director1.01.0$0$0$0Yes (X)
Nic Olberding
Director1.00.0$0$0$0Yes (X)
Kevin Techau
Director1.01.0$0$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$86,576TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$0TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K0TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Federated Campaigns$225,585FederatedCampaignsAmt
Membership Dues$0MembershipDuesAmt
Fundraising$0FundraisingAmt
Related Organizations$0RelatedOrganizationsAmt
Government Grants$4,900GovernmentGrantsAmt
All Other Contributions$4,856,682AllOtherContributionsAmt
Noncash Contributions$4,186,452NoncashContributionsAmt
Total Contributions$5,087,167TotalContributionsAmt
Total Program Service Revenue$0TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$17,697TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$17,697ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$0RealAmt
Personal$0PersonalAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities-$16,262SecuritiesAmt
Other$0OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt
Other$0OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities-$16,262SecuritiesAmt
Other$0OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$16,262TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion-$16,262ExclusionAmt
FieldValueIRS element (for citing)
Contri Rpt Fundraising Event$0ContriRptFundraisingEventAmt
Other Revenue Total$0OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$5,088,602TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$1,435ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$86,576TotalAmt
Program Services$64,932ProgramServicesAmt
Management And General$17,315ManagementAndGeneralAmt
Fundraising$4,329FundraisingAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$252,949TotalAmt
Program Services$162,367ProgramServicesAmt
Management And General$70,142ManagementAndGeneralAmt
Fundraising$20,440FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$25,974TotalAmt
Program Services$17,388ProgramServicesAmt
Management And General$6,691ManagementAndGeneralAmt
Fundraising$1,895FundraisingAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$12,075TotalAmt
Program Services$0ProgramServicesAmt
Management And General$12,075ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$8,791TotalAmt
Program Services$0ProgramServicesAmt
Management And General$8,791ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$16,603TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$16,603FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$30,639TotalAmt
Program Services$11,365ProgramServicesAmt
Management And General$16,564ManagementAndGeneralAmt
Fundraising$2,710FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$30,378TotalAmt
Program Services$20,337ProgramServicesAmt
Management And General$7,825ManagementAndGeneralAmt
Fundraising$2,216FundraisingAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$81,621TotalAmt
Program Services$54,642ProgramServicesAmt
Management And General$21,024ManagementAndGeneralAmt
Fundraising$5,955FundraisingAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$57,892TotalAmt
Program Services$38,757ProgramServicesAmt
Management And General$14,912ManagementAndGeneralAmt
Fundraising$4,223FundraisingAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$11,984TotalAmt
Program Services$0ProgramServicesAmt
Management And General$11,984ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
Donated Medications$4,186,452$4,186,452$0$0
Medications - RX$94,458$94,458$0$0
Medical Services$330,083$330,083$0$0
Miscellaneous Fees Service Txn Fees$9,126$5,336$2,054$1,736

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$5,235,601TotalAmt
Program Services$4,986,117ProgramServicesAmt
Management And General$189,377ManagementAndGeneralAmt
Fundraising$60,107FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$237,712BOYAmt
EOY$140,822EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$590,647BOYAmt
EOY$594,556EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$2,083,210LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$1,041,382LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$1,072,049BOYAmt
EOY$1,041,828EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$1,615,959BOYAmt
EOY$1,686,937EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$3,516,367BOYAmt
EOY$3,464,143EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$2,959,996BOYAmt
EOY$2,989,836EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$556,371BOYAmt
EOY$474,307EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$3,516,367BOYAmt
EOY$3,464,143EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$3,516,367BOYAmt
EOY$3,464,143EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$146,999ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$94,775NetUnrlzdGainsLossesInvstAmt
Donated Services And Use Fclts$0DonatedServicesAndUseFcltsAmt
Investment Expense$0InvestmentExpenseAmt
Prior Period Adjustments$0PriorPeriodAdjustmentsAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting CashYes (X)MethodOfAccountingCashInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$4,234,957CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$5,054,446CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$6,540,587CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$5,253,948CurrentTaxYearMinus1YearAmt
Current Tax Year$5,087,167CurrentTaxYearAmt
Total$26,171,105TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$4,234,957CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$5,054,446CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$6,540,587CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$5,253,948CurrentTaxYearMinus1YearAmt
Current Tax Year$5,087,167CurrentTaxYearAmt
Total$26,171,105TotalAmt
FieldValueIRS element (for citing)
Public Support Total170$26,171,105PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$38,643CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$35,169CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$26,385CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$43,756CurrentTaxYearMinus1YearAmt
Current Tax Year$17,697CurrentTaxYearAmt
Total$161,650TotalAmt

Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$0CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$0CurrentTaxYearMinus3YearsAmt
Total$0TotalAmt

Other Income170 OtherIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$0CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$0CurrentTaxYearMinus3YearsAmt
Total$0TotalAmt
FieldValueIRS element (for citing)
Total Support$26,332,755TotalSupportAmt
Gross Receipts Rltd Activities$0GrossReceiptsRltdActivitiesAmt
Public Support CY1700.99386PublicSupportCY170Pct
Public Support PY1700.99308PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,474,516BeginningYearBalanceAmt
Contributions$6,000ContributionsAmt
Investment Earnings Or Losses$86,473InvestmentEarningsOrLossesAmt
Grants Or Scholarships$17,337GrantsOrScholarshipsAmt
Other Expenditures$0OtherExpendituresAmt
Administrative Expenses$8,790AdministrativeExpensesAmt
End Year Balance$1,540,862EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,452,292BeginningYearBalanceAmt
Contributions$166,000ContributionsAmt
Investment Earnings Or Losses-$120,368InvestmentEarningsOrLossesAmt
Grants Or Scholarships$15,747GrantsOrScholarshipsAmt
Other Expenditures$0OtherExpendituresAmt
Administrative Expenses$7,661AdministrativeExpensesAmt
End Year Balance$1,474,516EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,067,954BeginningYearBalanceAmt
Contributions$175,000ContributionsAmt
Investment Earnings Or Losses$230,956InvestmentEarningsOrLossesAmt
Grants Or Scholarships$15,069GrantsOrScholarshipsAmt
Other Expenditures$0OtherExpendituresAmt
Administrative Expenses$6,549AdministrativeExpensesAmt
End Year Balance$1,452,292EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,081,358BeginningYearBalanceAmt
Contributions$10,000ContributionsAmt
Investment Earnings Or Losses-$3,598InvestmentEarningsOrLossesAmt
Grants Or Scholarships$13,814GrantsOrScholarshipsAmt
Other Expenditures$0OtherExpendituresAmt
Administrative Expenses$5,992AdministrativeExpensesAmt
End Year Balance$1,067,954EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,010,118BeginningYearBalanceAmt
Contributions$40,435ContributionsAmt
Investment Earnings Or Losses$49,560InvestmentEarningsOrLossesAmt
Grants Or Scholarships$12,935GrantsOrScholarshipsAmt
Other Expenditures$0OtherExpendituresAmt
Administrative Expenses$5,820AdministrativeExpensesAmt
End Year Balance$1,081,358EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.7BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.3PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0TermEndowmentBalanceEOYPct
Endowments Held Unrelated OrgYes (1)EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$0InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$27,160OtherCostOrOtherBasisAmt
Book Value$27,160BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$0InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$1,825,081OtherCostOrOtherBasisAmt
Depreciation$832,135DepreciationAmt
Book Value$992,946BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$0InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$0OtherCostOrOtherBasisAmt
Depreciation$0DepreciationAmt
Book Value$0BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$0InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$230,969OtherCostOrOtherBasisAmt
Depreciation$209,247DepreciationAmt
Book Value$21,722BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$0InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$0OtherCostOrOtherBasisAmt
Depreciation$0DepreciationAmt
Book Value$0BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$1,041,828TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (3 entries)

DescDescBook ValueBookValueAmt
Beneficial Interest in Assets Held at GCRCF$1,540,862
CSV Life Insurance$28,783
Certificates of Deposit$117,292
FieldValueIRS element (for citing)
Total Book Value Other Assets$1,686,937TotalBookValueOtherAssetsAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)

DescDescAmtAmt
Federal Income Taxes$0
Other Liabilities$0
FieldValueIRS element (for citing)
Total Liability$0TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$988,131TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$94,771NetUnrealizedGainsInvstAmt
Donated Services And Use Fclts$0DonatedServicesAndUseFcltsAmt
Recoveries Prior Year Grants$0RecoveriesPriorYearGrantsAmt
Other Revenue$0OtherRevenueAmt
Revenue Not Reported$94,771RevenueNotReportedAmt
Revenue Subtotal$893,360RevenueSubtotalAmt
Investment Expenses Not Incld$8,790InvestmentExpensesNotIncldAmt
Other Revenues Not Included$4,186,452OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$4,195,242RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$5,088,602TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$1,040,355TotExpnsEtcAuditedFinclStmtAmt
Donated Services Use Fclts$0DonatedServicesUseFcltsAmt
Prior Year Adjustments$0PriorYearAdjustmentsAmt
Losses Reported$0LossesReportedAmt
Other Expenses Included$0OtherExpensesIncludedAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$1,040,355ExpensesSubtotalAmt
Investment Expenses Not Incld2$8,794InvestmentExpensesNotIncld2Amt
Other Expenses Not Included$4,186,452OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$4,195,246ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$5,235,601TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule D, Part V, Line 4CHFC intends to use earnings from the endowment funds for long term financial support of the clinic.
Schedule D, Part X, Line 2The clinic is a 401(c)3 charity with no federal tax obligations.
Schedule D, Part XI, Line 4bDonated Medications are not included in the audited financial revenue and expenses. The estimated value of the donated medications is included with the audited financials in a separate supplementary schedule of donated goods and services. The supplementary schedule is compiled by the clinic and is meant as a complement to the audited financials.
Schedule D, Part XII, Line 4bDonated Medications are not included in the audited financial statement of income and expense and change in net assets. these are instead included in an independent schedule of donated goods and services provided by the clinic with no audit opinion (on the schedule). The schedule is intended as a complement to the audited financials. donated services are also not included in the audited financials or 990 information.

Schedule M IRS990ScheduleM

Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Contribution360ContributionCnt
Noncash Contributions Rpt F990$4,186,452NoncashContributionsRptF990Amt
Method Of Determining RevenuesFMVMethodOfDeterminingRevenuesTxt
FieldValueIRS element (for citing)
Form8283 Received0Form8283ReceivedCnt
Any Property That Must Be Held0AnyPropertyThatMustBeHeldInd
Review Process Unusual NC GiftsYes (1)ReviewProcessUnusualNCGiftsInd
Third Parties Used0ThirdPartiesUsedInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule M, Part I, Line 20FormAndLineReferenceDesc
ExplanationDonated Prescription Medications at Fair Market Value from Pharmaceutical Companies. Column B is an estimate of the number of donations in this category.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section B, Line 11bThe federal form 990 is prepared by the clinic's Director of Finance and then reviewed by the CHFC board treasurer; any necessary changes are made. the draft document is then sent to all board members for comment. Comments are addressed by the director of Finance before the federal form 990 is filed.
Form 990, Part VI, Section B, Line 12cUpon first being elected to the board of directors, appointed to a board committee or elected as an officer, the board member is required to complete the conflict of interest disclosure statement and submit the statement to the board president. If there are concerns about the statement, the disclosure statement is submitted the executive committed and resubmitted until a resolution is made. the are retained by the CEO at clinic offices.
Form 990, Part VI, Section B, Line 15In April of each year a budget is prepared for the following fiscal year by the Director of Finance and CEO incorporating any new goals and including any annual increases in wages for CEO and staff. A budget of projected income and expenses for the coming year along with a budget narrative explain any new goals and wage increases for the new budget is presented to the Finance committee. The Finance committee reviews and/or suggests changes. Once the Finance committee approves the new budget it is presented to the Board for final approval.
Form 990, Part VI, Section C, Line 19CHFC makes its governing documents, conflict of interest policy and financial statements available to the public upon request ay hard copy or electronic means.
Schedule B, Part IFor contributions greater than the 2% test GCRCF consists for Quarton Fund and Friends Funds and other DAV's managed and held by GCRCF and designated for the benefit of CHFC. NovoNordisk supplies insulin and other brand name prescription medications samples. Safe Net supplies prescription medications.