FOOTHILLS COMMUNITY HEALTH CARE: Form 990, tax year 2023
View the entire original 990 at ProPublica ↗
- Organization
- FOOTHILLS COMMUNITY HEALTH CARE (EIN 26-2735317)
- Tax period
- 2023-05-01 to 2024-04-30
- Filed
- 2024-09-05
- IRS object ID
- 202422499349301577
- Schema version
- 2023v5.1
- 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 | 2024-09-05T11:59:18-07:00 | ReturnTs |
| Tax Period End | 2024-04-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 621867889 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Terry Horne CPA Inc | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 732 West Main Street | AddressLine1Txt |
| City | Lebanon | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37087 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2023-05-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 262735317 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FOOTHILLS COMMUNITY HEALTH CARE INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | FOOT | BusinessNameControlTxt |
| Phone | 8647220283 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 311 | AddressLine1Txt |
| City | CLEMSON | CityNm |
| State Abbreviation | SC | StateAbbreviationCd |
| ZIP | 29633 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MARK RAJKOWSKI | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 8647220283 | PhoneNum |
| Signature | 2024-09-05 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | Yes (true) | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | TERRY HORNE CPA | PreparerPersonNm |
| PTIN | P00120946 | PTIN |
| Phone | 6154447293 | PhoneNum |
| Preparation | 2024-09-05 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2023 | TaxYr |
| Build TS | 2024-08-08 14:25:15Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MARK RAJKOWSKI | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 311 | AddressLine1Txt |
| City | CLEMSON | CityNm |
| State Abbreviation | SC | StateAbbreviationCd |
| ZIP | 29633 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $7,787,323 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.myfchc.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2008 | FormationYr |
| Legal Domicile State | SC | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE AFFORDABLE PRIMARY AND PREVENTATIVE HEALTHCARE SERVICES TO UNINSURED AS WELL AS FULLY INSURED CITIZENS OF PICKENS COUNTY SOUTH CAROLINA AND SURROUNDING AREAS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 13 | VotingMembersIndependentCnt |
| Total Employee | 51 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $3,240,945 | PYContributionsGrantsAmt |
| CY Contributions Grants | $2,458,862 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $4,051,344 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $5,228,288 | CYProgramServiceRevenueAmt |
| PY Investment Income | $24,112 | PYInvestmentIncomeAmt |
| CY Investment Income | $100,173 | CYInvestmentIncomeAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $7,316,401 | PYTotalRevenueAmt |
| CY Total Revenue | $7,787,323 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $3,405,179 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $4,004,722 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $2,310,073 | PYOtherExpensesAmt |
| CY Other Expenses | $3,295,447 | CYOtherExpensesAmt |
| PY Total Expenses | $5,715,252 | PYTotalExpensesAmt |
| CY Total Expenses | $7,300,169 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,601,149 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $487,154 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $5,838,687 | TotalAssetsBOYAmt |
| Total Assets EOY | $7,786,373 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $658,805 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $2,168,354 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $5,179,882 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $5,618,019 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO PROVIDE AFFORDABLE PRIMARY AND PREVENTATIVE HEALTHCARE SERVICES TO UNINSURED AS WELL AS FULLY INSURED CITIZENS OF PICKENS COUNTY SOUTH CAROLINA AND SURROUNDING AREAS. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $5,418,194 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $5,228,288 | RevenueAmt |
| Desc | FOOTHILLS COMMUNITY HEALTHCARE PROVIDED OVER 23,900 VISITS DURING THE YEAR. FCHC HAS A POLICY OF PROVIDING CHARITY CARE TO PATIENTS WHO ARE FINANCIALLY UNABLE TO PAY FOR SERVICES. | Desc |
| Total Program Service Expenses | $5,418,194 | 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 | Yes (true) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | 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 | 2 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 51 | 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 |
| Form8899 Filedind | false | Form8899Filedind |
| Form1098 C Filed | false | Form1098CFiledInd |
| 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 | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 13 | 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 | Yes (true) | 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 | SC | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MARK RAJKOWSKI | PersonNm |
| Phone | 8647220283 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 311 | AddressLine1Txt |
| City | CLEMSON | CityNm |
| State Abbreviation | SC | StateAbbreviationCd |
| ZIP | 29633 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (22 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| VIVEK SHARMA | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| PATRICIA MATTISON | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JANET MARSH | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| LEAH SANDERS | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| ELEANOR TAYLOR | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| CINDY TRIMMIER LEE | |||||||
| VICE BOARD CHAIR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| PETER SPARKS | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| KEITH MOODY | |||||||
| BOARD CHAIR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| WILLIAM WALKER | |||||||
| TREASURER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| LUCILA BEATON | |||||||
| SECRETARY | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| CHRIS BENSON | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| TRECA DESHIELDS | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| BOYD OWENS | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| MARK RAJKOWSKI | |||||||
| CHIEF EXECUTIVE OFFICER | 40.00 | $185,561 | $0 | $79,482 | Yes (X) | ||
| LAURA SUTTER | |||||||
| FORMER CHIEF FINANCIAL OFFICER | 40.00 | $118,498 | $0 | $21,398 | Yes (X) | ||
| CLARISSA CLINKSCALES | |||||||
| CHIEF OPERATIONAL OFFICER | 40.00 | $107,537 | $0 | $5,224 | Yes (X) | ||
| MANJU LAKRA | |||||||
| MEDICAL DIRECTOR | 40.00 | $199,696 | $0 | $39,316 | Yes (X) | ||
| RACHEL HUNT | |||||||
| PHARMACIST | 40.00 | $135,915 | $0 | $32,921 | Yes (X) | ||
| KATRINA MAXWELL | |||||||
| NURSE PRATITIONER | 40.00 | $105,717 | $0 | $22,380 | Yes (X) | ||
| JEFFREY NATIONS | |||||||
| PHYSICIAN | 40.00 | $184,547 | $0 | $30,671 | Yes (X) | ||
| JILL NEWMAN | |||||||
| NURSE PRATITIONER | 40.00 | $106,098 | $0 | $10,980 | Yes (X) | ||
| TIMOTHY SANDERS | |||||||
| PHYSICIAN | 40.00 | $190,588 | $0 | $10,980 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,334,157 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $253,352 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 9 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (3 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| EMD'S | |||||
| PO BOX 679493 | DALLAS | TX | 75267 | CONTRACT EMR SERVICES | $134,109 |
| H3 MARKETING | |||||
| PO BOX 1374 | ANDERSON | SC | 29622 | CONTRACT MARKETING SERVICES | $172,181 |
| MUHA - CENTER FOR TELEHEALTH | |||||
| 1 POSTON ROAD MSC 819 SUITE 315 | CHARLESTON | SC | 29425 | CONTRACT TELEHEALTH SERVICES | $107,985 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 3 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $2,288,491 | GovernmentGrantsAmt |
| All Other Contributions | $170,371 | AllOtherContributionsAmt |
| Noncash Contributions | $80,324 | NoncashContributionsAmt |
| Total Contributions | $2,458,862 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT SERVICE REVENUE | Desc |
| Business | 621400 | BusinessCd |
| Total Revenue Column | $5,228,288 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $5,228,288 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $100,173 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $100,173 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $7,787,323 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $5,228,288 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $100,173 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $652,975 | TotalAmt |
| Program Services | $430,964 | ProgramServicesAmt |
| Management And General | $222,011 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,646,731 | TotalAmt |
| Program Services | $1,738,478 | ProgramServicesAmt |
| Management And General | $908,253 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $52,390 | TotalAmt |
| Program Services | $34,577 | ProgramServicesAmt |
| Management And General | $17,813 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $418,381 | TotalAmt |
| Program Services | $276,132 | ProgramServicesAmt |
| Management And General | $142,249 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $234,245 | TotalAmt |
| Program Services | $154,602 | ProgramServicesAmt |
| Management And General | $79,643 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,731 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $15,731 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $54,812 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $54,812 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $474,402 | TotalAmt |
| Program Services | $357,804 | ProgramServicesAmt |
| Management And General | $116,598 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $135,479 | TotalAmt |
| Program Services | $92,126 | ProgramServicesAmt |
| Management And General | $43,353 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $211,228 | TotalAmt |
| Program Services | $100,526 | ProgramServicesAmt |
| Management And General | $110,702 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $81,002 | TotalAmt |
| Program Services | $81,002 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $263,263 | TotalAmt |
| Program Services | $179,019 | ProgramServicesAmt |
| Management And General | $84,244 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $105,145 | TotalAmt |
| Program Services | $71,499 | ProgramServicesAmt |
| Management And General | $33,646 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $142,897 | TotalAmt |
| Program Services | $97,170 | ProgramServicesAmt |
| Management And General | $45,727 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,479 | TotalAmt |
| Program Services | $15,286 | ProgramServicesAmt |
| Management And General | $7,193 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| BILLING AND EMR FEES | $228,446 | $228,446 | $0 | $0 |
| CONTRACT 340B FEES | $168,629 | $168,629 | $0 | $0 |
| DRUGS AND MEDICAL SUPPLIES | $1,391,934 | $1,391,934 | $0 | $0 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,300,169 | TotalAmt |
| Program Services | $5,418,194 | ProgramServicesAmt |
| Management And General | $1,881,975 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,577,012 | BOYAmt |
| EOY | $1,068,986 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,374,092 | BOYAmt |
| EOY | $610,675 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $203,882 | BOYAmt |
| EOY | $341,570 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $169,998 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $131,048 | BOYAmt |
| EOY | $98,730 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $3,202,070 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $826,394 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,445,482 | BOYAmt |
| EOY | $2,375,676 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $1,993,356 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $370,233 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,000 | BOYAmt |
| EOY | $1,000 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $106,171 | BOYAmt |
| EOY | $756,149 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,838,687 | BOYAmt |
| EOY | $7,786,373 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $380,909 | BOYAmt |
| EOY | $368,091 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $277,896 | BOYAmt |
| EOY | $983,320 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $816,943 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $658,805 | BOYAmt |
| EOY | $2,168,354 | 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 | $5,179,882 | BOYAmt |
| EOY | $5,605,933 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $12,086 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,179,882 | BOYAmt |
| EOY | $5,618,019 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,838,687 | BOYAmt |
| EOY | $7,786,373 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $487,154 | ReconcilationRevenueExpnssAmt |
| Prior Period Adjustments | -$8,936 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | -$40,081 | OtherChangesInNetAssetsAmt |
| 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 |
| Other Support Sum | $0 | OtherSupportSumAmt |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,120,241 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,532,508 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,739,587 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,240,945 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,458,862 | CurrentTaxYearAmt |
| Total | $14,092,143 | 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 | $2,120,241 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,532,508 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,739,587 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,240,945 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,458,862 | CurrentTaxYearAmt |
| Total | $14,092,143 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $0 | SubstantialContributorsTotAmt |
| Public Support Total170 | $14,092,143 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $0 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $0 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $0 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $100,173 | CurrentTaxYearAmt |
| Total | $100,173 | TotalAmt |
Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $14,192,316 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $14,493,209 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.99290 | PublicSupportCY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
| Public Support Total509 | $0 | PublicSupportTotal509Amt |
| Public Support CY509 | 0 | PublicSupportCY509Pct |
| Investment Income CY | 0 | InvestmentIncomeCYPct |
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
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $43,061 | InvestmentCostOrOtherBasisAmt |
| Book Value | $43,061 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $1,474,576 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $412,256 | DepreciationAmt |
| Book Value | $1,062,320 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $704,856 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $414,138 | DepreciationAmt |
| Book Value | $290,718 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $979,577 | InvestmentCostOrOtherBasisAmt |
| Book Value | $979,577 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $2,375,676 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | LONG-TERM INVESTMENTS | Desc |
| Book Value | $370,233 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $370,233 | TotalBookValueSecuritiesAmt |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OPERATING LEASE RIGHT-OF-USE ASSETS | Desc |
| Book Value | $756,149 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $756,149 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OPERATING LEASE LIABILITIES | Desc |
| Amt | $816,943 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $816,943 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $7,787,323 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Subtotal | $7,787,323 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $7,787,323 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $7,300,169 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $7,300,169 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $7,300,169 | TotalExpensesPerForm990Amt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 (5 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MARK RAJKOWSKI | |||||||||||||
| $185,561 | $0 | $0 | $0 | $0 | $0 | $5,086 | $0 | $74,396 | $0 | $265,043 | $0 | $0 | $0 |
| MANJU LAKRA | |||||||||||||
| $199,696 | $0 | $0 | $0 | $0 | $0 | $5,836 | $0 | $33,480 | $0 | $239,012 | $0 | $0 | $0 |
| RACHEL HUNT | |||||||||||||
| $135,915 | $0 | $0 | $0 | $0 | $0 | $4,086 | $0 | $28,835 | $0 | $168,836 | $0 | $0 | $0 |
| JEFFREY NATIONS | |||||||||||||
| $184,547 | $0 | $0 | $0 | $0 | $0 | $2,000 | $0 | $28,671 | $0 | $215,218 | $0 | $0 | $0 |
| TIMOTHY SANDERS | |||||||||||||
| $190,588 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $10,980 | $0 | $201,568 | $0 | $0 | $0 |
Schedule M IRS990ScheduleM
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 5355 | ContributionCnt |
| Noncash Contributions Rpt F990 | $80,324 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | Yes (true) | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | false | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (20 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Pt VI, Line 11b | THE FORM 990 IS REVIEWED IN DETAIL WITH THE FINANCE |
| Pt VI, Line 11b | COMMITEE AND IS THEN PROVIDED TO ALL BOARD MEMBERS |
| Pt VI, Line 11b | FOR DISCUSSION AND QUESTIONS. |
| Pt VI, Line 12c | BOARD MEMBERS AND OFFICERS ARE REQUIRED TO DISCLOSE ANY |
| Pt VI, Line 12c | POTENTIAL CONFLICTS OF INTEREST ANNUALLY. IF A CONFLICT |
| Pt VI, Line 12c | ARISES IT IS PRESENTED TO THE BOARD OF DIRECTORS FOR |
| Pt VI, Line 12c | DISCUSSION AND A VOTE ON AN APPROPRIATE ACTION TO BE |
| Pt VI, Line 12c | TAKEN. CONFLICT OF INTEREST QUESTIONAIRES ARE COMPILED |
| Pt VI, Line 12c | AND PRESENTED TO THE BOARD OF DIRECTORS FOR RESOLUTION. |
| Pt VI, Line 15a | COMPENSATION FOR THE CEO IS DETERMINED AND VOTED ON BY |
| Pt VI, Line 15a | THE EXECUTIVE COMMITTEE AFTER A THOROUGH REVIEW AND |
| Pt VI, Line 15a | RESEARCH OF SIMILAR POSITIONS WITHIN THE INDUSTRY AND |
| Pt VI, Line 15a | REGION. |
| Pt VI, Line 15b | COMPENSATION FOR OTHER OFFICERS, KEY EMPLOYEES, AND |
| Pt VI, Line 15b | STAFF ARE DETERMINED BY HR AND THE CEO. |
| Pt VI, Line 19 | GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND |
| Pt VI, Line 19 | FINANCIAL STATEMENTS ARE AVAILABLE AT THE ORGANIZATIONS |
| Pt VI, Line 19 | OFFICE BY REQUEST. |
| Pt XI | LINE 9 REPRESENTS THE NET CHANGE IN NET ASSETS WITH |
| Pt XI | DONOR RESTRICTIONS FOR THE YEAR. |