FAMILY HEALTH CENTER OF CLARK COUNTY INC: Form 990, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- FAMILY HEALTH CENTER OF CLARK COUNTY INC (EIN 35-1842342)
- Tax period
- 2022-07-01 to 2023-06-30
- Filed
- 2024-05-10
- IRS object ID
- 202421319349303182
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2024-05-10T12:25:28-05:00 | ReturnTs |
| Tax Period End | 2023-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FORVIS LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1222 Demonbreun Street Suite 950 | AddressLine1Txt |
| City | NASHVILLE | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 372033357 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2022-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 351842342 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FAMILY HEALTH CENTER OF CLARK COUNTY INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % GLEN GIRDLER | InCareOfNm |
| Business Name Control | FAMI | BusinessNameControlTxt |
| Phone | 8122832338 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1319 DUNCAN AVENUE | AddressLine1Txt |
| City | JEFFERSONVILLE | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 47130 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | LORI HARRIS | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 8122832338 | PhoneNum |
| Signature | 2024-05-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | LORI | PersonFirstNm |
| Person Last | HARRIS | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JEFF SMITH | PreparerPersonNm |
| PTIN | P00289876 | PTIN |
| Phone | 6159883600 | PhoneNum |
| Preparation | 2024-05-15 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2022 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FAMILY HEALTH CENTERS OF SOUTHERN IN | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | LORI HARRIS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1319 DUNCAN AVENUE | AddressLine1Txt |
| City | JEFFERSONVILLE | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 47130 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $4,552,774 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | HTTP://WWW.FHCENTERS.ORG/ | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1992 | FormationYr |
| Legal Domicile State | IN | LegalDomicileStateCd |
| Activity Or Mission | THE MISSION OF FAMILY HEALTH CENTERS OF SOUTHERN INDIANA IS TO PROVIDE QUALITY HEALTH CARE TO THE LOW-INCOME, UNDERINSURED, AND UNINSURED RESIDENTS OF THE AREA. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 42 | TotalEmployeeCnt |
| Total Volunteers | 12 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $3,487,551 | PYContributionsGrantsAmt |
| CY Contributions Grants | $3,528,069 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $721,871 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $1,014,237 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$6,746 | PYInvestmentIncomeAmt |
| CY Investment Income | $9,788 | CYInvestmentIncomeAmt |
| PY Other Revenue | $534 | PYOtherRevenueAmt |
| CY Other Revenue | $680 | CYOtherRevenueAmt |
| PY Total Revenue | $4,203,210 | PYTotalRevenueAmt |
| CY Total Revenue | $4,552,774 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $2,274,495 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $2,735,905 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $95,266 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,671,969 | PYOtherExpensesAmt |
| CY Other Expenses | $1,836,022 | CYOtherExpensesAmt |
| PY Total Expenses | $3,946,464 | PYTotalExpensesAmt |
| CY Total Expenses | $4,571,927 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $256,746 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$19,153 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $5,934,601 | TotalAssetsBOYAmt |
| Total Assets EOY | $5,871,647 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $466,556 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $422,332 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $5,468,045 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $5,449,315 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE MISSION OF THE FAMILY HEALTH CENTERS OF SOUTHERN INDIANA IS TO PROVIDE QUALITY HEALTH CARE TO THE LOW-INCOME, UNDERINSURED, AND UNINSURED RESIDENTS OF THE AREA. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $1,828,402 | ExpenseAmt |
| Revenue | $827,942 | RevenueAmt |
| Desc | THE FAMILY HEALTH CENTER PROVIDES COMPREHENSIVE INTERNAL MEDICINE AND FAMILY PRACTICE, ACUTE CARE, IMMUNIZATIONS, PREVENTATIVE HEALTH SCREENINGS, OFFICE BASED GYNECOLOGY PROCEDURES, CASE MANAGEMENT, INTEGRATED BEHAVIORAL HEALTH SERVICES, PREGNANCY TESTS, MATERNAL/CHILD HEALTH CLINIC (CLARK AND FLOYD COUNTIES), AND CHIROPRACTIC SERVICES. THE CLINIC WAS ABLE TO SERVE 2,882 MEMBERS OF THE COMMUNITY IN 2023. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $494,254 | ExpenseAmt |
| Revenue | $174,203 | RevenueAmt |
| Desc | THE FAMILY HEALTH CENTER PROVIDES PREVENTATIVE AND RESTORATIVE DENTAL SERVICES, SUCH AS CLEANINGS, EXTRACTIONS, AND FILLINGS. THE CLINIC WAS ABLE TO PROVIDE DENTAL SERVICES TO 1,267 MEMBERS OF THE COMMUNITY IN 2023. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $264,426 | ExpenseAmt |
| Revenue | $12,092 | RevenueAmt |
| Desc | THE FAMILY HEALTH CENTER PROVIDES DISCOUNTED PRESCRIPTION DRUG ASSISTANCE PROGRAMS SUCH AS 340B, INDIGENT DRUG PROGRAM, AND FREE SAMPLES/DONATED MEDICATION. THE CLINIC WAS ABLE TO ASSIST 2,334 MEMBERS OF THE COMMUNITY WITH MEDICATION PRESCRIPTIONS AND DISCOUNTED DRUG ASSISTANCE IN 2023. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $182 | TotalOtherProgSrvcExpenseAmt |
| Total Program Service Expenses | $2,587,264 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | Yes (true) | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 25 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 42 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | false | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | IN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | GLEN GIRDLER | PersonNm |
| Phone | 8129202851 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1319 DUNCAN AVENUE | AddressLine1Txt |
| City | JEFFERSONVILLE | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 47130 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|---|
| LORI HARRIS | ||||||||
| CHIEF EXECUTIVE OFFICER | 42.0 | 0.0 | Yes (X) | $231,752 | $0 | $18,375 | ||
| ERIKA WHITE | ||||||||
| DENTIST | 38.0 | 0.0 | $131,482 | $0 | $11,370 | Yes (X) | ||
| JUNICE JOHNSON | ||||||||
| NURSE PRACTITIONER | 36.0 | 0.0 | $102,240 | $0 | $10,328 | Yes (X) | ||
| STACY JACOBS | ||||||||
| NURSE PRACTITIONER | 40.0 | 0.0 | $97,562 | $0 | $10,442 | Yes (X) | ||
| ELLIOTT DAY | ||||||||
| PHYSICIAN ASSISTANT | 40.0 | 0.0 | $97,018 | $0 | $8,442 | Yes (X) | ||
| BOB LANE | ||||||||
| CHAIRMAN | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| KEITH LIEBER | ||||||||
| TREASURER | 4.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| CATHY GRANINGER | ||||||||
| SECRETARY | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| JENA HILLIKER | ||||||||
| DIRECTOR | 1.0 | 0.0 | $0 | $0 | $0 | Yes (X) | ||
| KELLY JONES | ||||||||
| DIRECTOR | 1.0 | 0.0 | $0 | $0 | $0 | Yes (X) | ||
| RAMONA PHILLIPS | ||||||||
| DIRECTOR | 1.0 | 0.0 | $0 | $0 | $0 | Yes (X) | ||
| REBECCA MORALES | ||||||||
| DIRECTOR | 1.0 | 0.0 | $0 | $0 | $0 | Yes (X) | ||
| ANN DAY | ||||||||
| DIRECTOR | 1.0 | 0.0 | $0 | $0 | $0 | Yes (X) | ||
| CHARLOTTE BASS | ||||||||
| DIRECTOR | 1.0 | 0.0 | $0 | $0 | $0 | Yes (X) | ||
| CHRIS HOLTMAN | ||||||||
| SECRETARY | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| DAMON ELLIS | ||||||||
| DIRECTOR | 1.0 | 0.0 | $0 | $0 | $0 | Yes (X) | ||
| MANDY RHOADS | ||||||||
| DIRECTOR | 1.0 | 0.0 | $0 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $660,054 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $58,957 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 3 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| SEVEN COUNTIES | |||||
| 10401 LINN STATION RD SUITE 100 | LOUISVILLE | KY | 40223 | PHYSICIAN SERVICES | $148,110 |
| LEVERAGE IT GROUP LLC | |||||
| 235 RIDGE RD STE 203 | ROCKWALL | TX | 75097 | IT | $116,047 |
| LINCOLN FINANCIAL GROUP | |||||
| PO BOX 2212 | FORT WAYNE | IN | 46801 | 403(B) | $110,741 |
| ECLINICALWORKS LLC | |||||
| TWO TECHNOLOGY DR | WESTBOROUGH | MA | 015811727 | EMR AND PM SOFTWARE | $108,116 |
| MOBILE SPECIALTY VECHICLES | |||||
| 1025 E WATERFORD STREET | WAKARUSA | IN | 46573 | MOBILE UNITE CONSTRU | $105,700 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Federated Campaigns | $31,751 | FederatedCampaignsAmt |
| Government Grants | $2,715,127 | GovernmentGrantsAmt |
| All Other Contributions | $781,191 | AllOtherContributionsAmt |
| Noncash Contributions | $96,951 | NoncashContributionsAmt |
| Total Contributions | $3,528,069 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT SERVICE | Desc |
| Business | 621990 | BusinessCd |
| Total Revenue Column | $1,014,237 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,014,237 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $1,014,237 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $9,606 | TotalRevenueColumnAmt |
| Exclusion | $9,606 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $182 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $182 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $182 | TotalRevenueColumnAmt |
| Exclusion | $182 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $0 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $0 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $0 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $0 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| MEDICAL RECORD FEES | 621990 | $645 | $645 |
| OTHER MISC. INCOME | 621990 | $35 | $35 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $680 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,552,774 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,014,237 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $10,468 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $290,753 | TotalAmt |
| Management And General | $203,531 | ManagementAndGeneralAmt |
| Fundraising | $87,222 | FundraisingAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,040,181 | TotalAmt |
| Program Services | $1,408,924 | ProgramServicesAmt |
| Management And General | $631,257 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $32,287 | TotalAmt |
| Program Services | $23,940 | ProgramServicesAmt |
| Management And General | $8,347 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $206,134 | TotalAmt |
| Program Services | $150,850 | ProgramServicesAmt |
| Management And General | $56,990 | ManagementAndGeneralAmt |
| Fundraising | -$1,706 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $166,550 | TotalAmt |
| Program Services | $104,284 | ProgramServicesAmt |
| Management And General | $57,827 | ManagementAndGeneralAmt |
| Fundraising | $4,439 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $91 | TotalAmt |
| Management And General | $91 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $58,691 | TotalAmt |
| Management And General | $58,691 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $476,443 | TotalAmt |
| Program Services | $262,924 | ProgramServicesAmt |
| Management And General | $213,519 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,526 | TotalAmt |
| Program Services | $1,711 | ProgramServicesAmt |
| Management And General | $3,525 | ManagementAndGeneralAmt |
| Fundraising | $5,290 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $118,669 | TotalAmt |
| Program Services | $10,890 | ProgramServicesAmt |
| Management And General | $107,779 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $264,616 | TotalAmt |
| Program Services | $178,954 | ProgramServicesAmt |
| Management And General | $85,662 | ManagementAndGeneralAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $146,506 | TotalAmt |
| Program Services | $99 | ProgramServicesAmt |
| Management And General | $146,407 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,703 | TotalAmt |
| Program Services | $4,969 | ProgramServicesAmt |
| Management And General | $10,734 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $32,763 | TotalAmt |
| Program Services | $9,804 | ProgramServicesAmt |
| Management And General | $22,959 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,269 | TotalAmt |
| Management And General | $3,269 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $257,091 | TotalAmt |
| Program Services | $56,627 | ProgramServicesAmt |
| Management And General | $200,443 | ManagementAndGeneralAmt |
| Fundraising | $21 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,130 | TotalAmt |
| Management And General | $27,130 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| DONATED DRUGS & SUPPLIES | $96,952 | $96,952 | |
| PATIENT DRUG EXPENSE | $167,474 | $167,474 | |
| MEDICAL & DENTAL SUPPLIES | $91,638 | $92,295 | -$657 |
| DUES | $17,593 | $17,593 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $50,867 | TotalAmt |
| Program Services | $16,567 | ProgramServicesAmt |
| Management And General | $34,300 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,571,927 | TotalAmt |
| Program Services | $2,587,264 | ProgramServicesAmt |
| Management And General | $1,889,397 | ManagementAndGeneralAmt |
| Fundraising | $95,266 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,063 | BOYAmt |
| EOY | $112,764 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,494,770 | BOYAmt |
| EOY | $1,988,261 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $317,983 | BOYAmt |
| EOY | $488,948 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $85,353 | BOYAmt |
| EOY | $113,903 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,548 | BOYAmt |
| EOY | $14,495 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $73,100 | BOYAmt |
| EOY | $90,475 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $4,635,298 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,646,504 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,901,280 | BOYAmt |
| EOY | $2,988,794 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $33,504 | BOYAmt |
| EOY | $33,927 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $40,080 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,934,601 | BOYAmt |
| EOY | $5,871,647 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $383,904 | BOYAmt |
| EOY | $308,397 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,711 | BOYAmt |
| EOY | $22,779 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $64,941 | BOYAmt |
| EOY | $51,076 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $40,080 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $466,556 | BOYAmt |
| EOY | $422,332 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,468,045 | BOYAmt |
| EOY | $5,415,388 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $33,927 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,468,045 | BOYAmt |
| EOY | $5,449,315 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,934,601 | BOYAmt |
| EOY | $5,871,647 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$19,153 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $423 | NetUnrlzdGainsLossesInvstAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,539,652 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,773,579 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,281,090 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,487,551 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,528,069 | CurrentTaxYearAmt |
| Total | $15,609,941 | TotalAmt |
Tax Rev Levied Orgnztnl Bnft170 TaxRevLeviedOrgnztnlBnft170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,539,652 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,773,579 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,281,090 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,487,551 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,528,069 | CurrentTaxYearAmt |
| Total | $15,609,941 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $0 | SubstantialContributorsTotAmt |
| Public Support Total170 | $15,609,941 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,884 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $10,658 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $4,353 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,756 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $9,788 | CurrentTaxYearAmt |
| Total | $31,439 | TotalAmt |
Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,836 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,332 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,248 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $534 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $680 | CurrentTaxYearAmt |
| Total | $5,630 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $15,647,010 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $4,686,468 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.99763 | PublicSupportCY170Pct |
| Public Support PY170 | 0.99800 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $448,500 | OtherCostOrOtherBasisAmt |
| Book Value | $448,500 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,414,501 | OtherCostOrOtherBasisAmt |
| Depreciation | $916,727 | DepreciationAmt |
| Book Value | $1,497,774 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $30,680 | OtherCostOrOtherBasisAmt |
| Depreciation | $18,775 | DepreciationAmt |
| Book Value | $11,905 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,727,537 | OtherCostOrOtherBasisAmt |
| Depreciation | $711,002 | DepreciationAmt |
| Book Value | $1,016,535 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $14,080 | OtherCostOrOtherBasisAmt |
| Book Value | $14,080 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $2,988,794 | TotalBookValueLandBuildingsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | CURRENT PORTION OPERATING LEASE | Desc |
| Amt | $40,080 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $40,080 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $4,553,015 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $423 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | $423 | RevenueNotReportedAmt |
| Revenue Subtotal | $4,552,592 | RevenueSubtotalAmt |
| Other Revenues Not Included | $182 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $182 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $4,552,774 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $4,571,745 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | -$182 | OtherExpensesIncludedAmt |
| Expenses Not Reported | -$182 | ExpensesNotReportedAmt |
| Expenses Subtotal | $4,571,927 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $4,571,927 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCH D, PART X, LINE 2 | INCOME TAXES ------------ THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS DID NOT INCLUDE A FOOTNOTE THAT ADDRESSED THE ORGANIZATION'S LIABILITY FOR UNCERTAIN TAX POSITIONS UNDER FIN 48 (ASC 740). MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE UNDER ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. |
| SCH D, PART XI, LINE 2B & PART XII, LINE 2A | DONATED SERVICES ---------------- A NUMBER OF VOLUNTEER AND HOSPITAL SERVICES ARE CONTRIBUTED TO THE HEALTH CENTER. HOSPITAL SERVICES, VOLUNTEER DOCTORS', NURSESOTHER HEALTH PROFESSIONALS' SERVICES ARE RECORDED AT ESTIMATED FAIR VALUE. |
| SCH D, PART XI, LINE 4B | ------------------------- LOSS ON DISPOSAL OF ASSETS INCLUDED IN EXPENSE PER AUDIT: $ 182 |
| SCH D, PART XII, LINE 2D | ------------------------- LOSS ON DISPOSAL OF ASSETS INCLUDED IN EXPENSE PER AUDIT: $(182) |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | LORI HARRIS | PersonNm |
| Title | CHIEF EXECUTIVE OFFICER | TitleTxt |
| Base Compensation Filing Org | $207,275 | BaseCompensationFilingOrgAmt |
| Bonus Filing Organization | $10,000 | BonusFilingOrganizationAmount |
| Other Compensation Filing Org | $14,477 | OtherCompensationFilingOrgAmt |
| Deferred Compensation Flng Org | $4,777 | DeferredCompensationFlngOrgAmt |
| Nontaxable Benefits Filing Org | $13,598 | NontaxableBenefitsFilingOrgAmt |
| Total Compensation Filing Org | $250,127 | TotalCompensationFilingOrgAmt |
Schedule M IRS990ScheduleM
| Field | Value | IRS element (for citing) |
|---|---|---|
| Works Of Art | WorksOfArtGrp | |
| Art Historical Treasures | ArtHistoricalTreasuresGrp | |
| Art Fractional Interest | ArtFractionalInterestGrp | |
| Books And Publications | BooksAndPublicationsGrp | |
| Clothing And Household Goods | ClothingAndHouseholdGoodsGrp | |
| Cars And Other Vehicles | CarsAndOtherVehiclesGrp | |
| Boats And Planes | BoatsAndPlanesGrp | |
| Intellectual Property | IntellectualPropertyGrp | |
| Securities Publicly Traded | SecuritiesPubliclyTradedGrp | |
| Securities Closely Held Stock | SecuritiesCloselyHeldStockGrp | |
| Secur Prtnrshp Trust Intrsts | SecurPrtnrshpTrustIntrstsGrp | |
| Securities Miscellaneous | SecuritiesMiscellaneousGrp | |
| Qualified Contrib Hist Struct | QualifiedContribHistStructGrp | |
| Qualified Contrib Other | QualifiedContribOtherGrp | |
| Real Estate Residential | RealEstateResidentialGrp | |
| Real Estate Commercial | RealEstateCommercialGrp | |
| Real Estate Other | RealEstateOtherGrp | |
| Collectibles | CollectiblesGrp | |
| Food Inventory | FoodInventoryGrp |
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $96,951 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Taxidermy | TaxidermyGrp | |
| Historical Artifacts | HistoricalArtifactsGrp | |
| Scientific Specimens | ScientificSpecimensGrp | |
| Archaeological Artifacts | ArchaeologicalArtifactsGrp | |
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | false | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | false | ThirdPartiesUsedInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCH M, PART I, LINE 20 | FormAndLineReferenceDesc |
| Explanation | NONCASH CONTRIBUTIONS --------------------- THE ORGANIZATION RECEIVES DONATED PHARMACEUTICAL DRUGS FROM VARIOUS PHARMACEUTICAL COMPANIES. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 8B | DOCUMENTATION OF MEETINGS/ACTIONS --------------------------------- THE ORGANIZATION DOES NOT HAVE COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY THAT ARE NOT COMMITTEES WITHIN THE GOVERNING BODY. |
| FORM 990, PART VI, SECTION B, LINE 11B | REVIEW OF FORM 990 ------------------ THE FORM 990 IS REVIEWED BY THE FINANCE COMMITTEE AND THEN DISTRIBUTED TO THE ENTIRE BOARD OF DIRECTORS VIA EMAIL PRIOR TO FILING WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | MONITORING THE CONFLICT OF INTEREST POLICY ------------------------------------- THE OFFICERS AND DIRECTORS ARE REQUIRED TO ANNUALLY SIGN A NEW CONFLICT OF INTEREST QUESTIONNAIRE EVERY DECEMBER. THE CEO REGULARLY MONITORS ITEMS THAT MIGHT CAUSE A CONFLICT OF INTEREST WITH THE OFFICERS AND DIRECTORS OF THE ORGANIZATION AND BRINGS THOSE ITEMS TO THE ATTENTION OF THE BOARD OF DIRECTORS AT BOARD MEETINGS. BOARD MEMBERS ABSTAIN FROM VOTING ON ANY CONFLICT OF INTEREST MATTER THAT COMES BEFORE THE BOARD. ALL CONFLICT OF INTEREST QUESTIONNAIRES ARE PRESENTED TO THE BOARD ANNUALLY. |
| FORM 990, PART VI, SECTION B, LINE 15A | COMPENSATION REVIEW ------------------- THE BOARD OF DIRECTORS REVIEWS AND APPROVES THE USE OF THE ANNUAL NACHC HEALTH CENTER SALARY AND BENEFITS REPORT IN SETTING COMPENSATION OF THE ORGANIZATION'S CEO, OTHER OFFICERS, AND ALL EMPLOYEES. A COMMITTEE MADE UP OF BOARD MEMBERS REVIEWS PAY SCALES FOR ALL EMPLOYEES, INCLUDING THE CEO AND OTHER OFFICERS, BASED ON THE SALARY AND BENEFITS REPORT. OTHER RESOURCES THAT COULD BE USED, INCLUDING BUT ARE NOT LIMITED TO GUIDESTAR, WHERE THE COMMITTEE IS ABLE TO REVIEW OTHER 990S. THE COMMITTEE WILL THEN MAKE RECOMMENDATIONS TO THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION C, LINE 19 | MAKING DOCUMENTS AVAILABLE TO THE PUBLIC ---------------------------------------- THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST AFTER BEING REVIEWED BY IN HOUSE COUNCIL AND/OR FINANCIAL ADVISORS. |
| FORM 990 PART IX LINE 11G | DESCRIPTION:OTHER FEES FOR SERVICES TOTAL FEES:476443 |