POTOMAC HEALTHCARE FOUNDATION: Form 990PF, tax year 2023
View the entire original 990 at ProPublica ↗
- Organization
- POTOMAC HEALTHCARE FOUNDATION (EIN 52-1116578)
- Tax period
- 2023-07-01 to 2024-06-30
- Filed
- 2025-05-13
- IRS object ID
- 202511339349100216
- Schema version
- 2023v6.0
- 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
- Form 990-PF
- Accounting Fees Schedule
- Depreciation Schedule
- Legal Fees Schedule
- Other Assets Schedule
- Other Expenses Schedule
- Other Income Schedule2
- Other Liabilities Schedule
- Taxes Schedule
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2025-05-13T06:43:14-05:00 | ReturnTs |
| Tax Period End | 2024-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BDO USA | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10200 Grand Central Ave Suite 320 | AddressLine1Txt |
| City | Owings Mills | CityNm |
| State Abbreviation | MD | StateAbbreviationCd |
| ZIP | 21117 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990PF | ReturnTypeCd |
| Tax Period Begin | 2023-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 521116578 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | POTOMAC HEALTHCARE FOUNDATIONINC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % GARY GAGNON | InCareOfNm |
| Business Name Control | POTO | BusinessNameControlTxt |
| Phone | 3017500017 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 136 | AddressLine1Txt |
| City | Emmitsburg | CityNm |
| State Abbreviation | MD | StateAbbreviationCd |
| ZIP | 21727 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Leonard Sacks | PersonNm |
| Person Title | Chairman | PersonTitleTxt |
| Phone | 3017500017 | PhoneNum |
| Signature | 2025-05-15 | 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 | Brian J Ray | PreparerPersonNm |
| PTIN | P01278507 | PTIN |
| Phone | 4103633200 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2023 | TaxYr |
| Build TS | 2025-03-06 01:10:19Z | BuildTS |
Form 990-PF IRS990PF
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Change | Yes (X) | AddressChangeInd |
| Organization501c3 Exempt PF | Yes (X) | Organization501c3ExemptPFInd |
| FMV Assets EOY | $11,970,048 | FMVAssetsEOYAmt |
| Method Of Accounting Other | Yes (X) | MethodOfAccountingOtherInd |
Analysis Of Revenue And Expenses AnalysisOfRevenueAndExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contri Rcvd Rev And Expnss | $5,157,879 | ContriRcvdRevAndExpnssAmt |
| Schedule B Not Required | Yes (X) | ScheduleBNotRequiredInd |
| Interest On Sav Rev And Expnss | $63,510 | InterestOnSavRevAndExpnssAmt |
| Interest On Sav Net Invst Incm | $63,510 | InterestOnSavNetInvstIncmAmt |
| Interest On Savings Adj Net Incm | $63,510 | InterestOnSavingsAdjNetIncmAmt |
| Other Income Rev And Expnss | $7,052,529 | OtherIncomeRevAndExpnssAmt |
| Other Income Adj Net Incm | $7,052,529 | OtherIncomeAdjNetIncmAmt |
| Total Rev And Expnss | $12,273,918 | TotalRevAndExpnssAmt |
| Total Net Invst Incm | $63,510 | TotalNetInvstIncmAmt |
| Total Adj Net Incm | $7,116,039 | TotalAdjNetIncmAmt |
| Comp Ofcr Dir Trst Rev And Expnss | $0 | CompOfcrDirTrstRevAndExpnssAmt |
| Oth Empl Slrs Wgs Rev And Expnss | $2,105,314 | OthEmplSlrsWgsRevAndExpnssAmt |
| Oth Empl Slrs Wgs Adj Net Incm | $9,132 | OthEmplSlrsWgsAdjNetIncmAmt |
| Oth Empl Slrs Wgs Dsbrs Chrtbl | $2,096,182 | OthEmplSlrsWgsDsbrsChrtblAmt |
| Pension Empl Bnft Rev And Expnss | $109,992 | PensionEmplBnftRevAndExpnssAmt |
| Pension Empl Bnft Adj Net Incm | $477 | PensionEmplBnftAdjNetIncmAmt |
| Pension Empl Bnft Dsbrs Chrtbl | $109,515 | PensionEmplBnftDsbrsChrtblAmt |
| Legal Fees Rev And Expnss | $4,920 | LegalFeesRevAndExpnssAmt |
| Legal Fees Net Invst Incm | $0 | LegalFeesNetInvstIncmAmt |
| Legal Fees Adj Net Incm | $21 | LegalFeesAdjNetIncmAmt |
| Legal Fees Dsbrs Chrtbl | $4,899 | LegalFeesDsbrsChrtblAmt |
| Accounting Fees Rev And Expnss | $67,360 | AccountingFeesRevAndExpnssAmt |
| Accounting Fees Net Invst Incm | $0 | AccountingFeesNetInvstIncmAmt |
| Accounting Fees Adj Net Incm | $292 | AccountingFeesAdjNetIncmAmt |
| Accounting Fees Chrtbl Prps | $67,068 | AccountingFeesChrtblPrpsAmt |
| Interest Rev And Expnss | $290,891 | InterestRevAndExpnssAmt |
| Interest Adj Net Incm | $1,262 | InterestAdjNetIncmAmt |
| Interest Dsbrs Chrtbl | $289,629 | InterestDsbrsChrtblAmt |
| Taxes Rev And Expnss | $163,661 | TaxesRevAndExpnssAmt |
| Taxes Adj Net Incm | $709 | TaxesAdjNetIncmAmt |
| Taxes Dsbrs Chrtbl | $162,648 | TaxesDsbrsChrtblAmt |
| Deprec And Dpltn Rev And Expnss | $342,220 | DeprecAndDpltnRevAndExpnssAmt |
| Deprec And Dpltn Adj Net Incm | $1,484 | DeprecAndDpltnAdjNetIncmAmt |
| Occupancy Rev And Expnss | $1,352,771 | OccupancyRevAndExpnssAmt |
| Occupancy Adj Net Incm | $5,868 | OccupancyAdjNetIncmAmt |
| Occupancy Dsbrs Chrtbl | $1,346,903 | OccupancyDsbrsChrtblAmt |
| Other Expenses Rev And Expnss | $8,001,946 | OtherExpensesRevAndExpnssAmt |
| Other Expenses Adj Net Incm | $6,538,902 | OtherExpensesAdjNetIncmAmt |
| Other Expenses Dsbrs Chrtbl | $1,222,105 | OtherExpensesDsbrsChrtblAmt |
| Tot Opr Expenses Rev And Expnss | $12,439,075 | TotOprExpensesRevAndExpnssAmt |
| Tot Opr Expenses Net Invst Incm | $0 | TotOprExpensesNetInvstIncmAmt |
| Tot Opr Expenses Adj Net Incm | $6,558,147 | TotOprExpensesAdjNetIncmAmt |
| Tot Opr Expenses Dsbrs Chrtbl | $5,298,949 | TotOprExpensesDsbrsChrtblAmt |
| Contri Paid Rev And Expnss | $0 | ContriPaidRevAndExpnssAmt |
| Contri Paid Dsbrs Chrtbl | $0 | ContriPaidDsbrsChrtblAmt |
| Total Expenses Rev And Expnss | $12,439,075 | TotalExpensesRevAndExpnssAmt |
| Total Expenses Net Invst Incm | $0 | TotalExpensesNetInvstIncmAmt |
| Total Expenses Adj Net Incm | $6,558,147 | TotalExpensesAdjNetIncmAmt |
| Total Expenses Dsbrs Chrtbl | $5,298,949 | TotalExpensesDsbrsChrtblAmt |
| Excess Revenue Over Expenses | -$165,157 | ExcessRevenueOverExpensesAmt |
| Net Investment Income | $63,510 | NetInvestmentIncomeAmt |
| Adjusted Net Income | $557,892 | AdjustedNetIncomeAmt |
Form990 PF Balance Sheets Form990PFBalanceSheetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cash BOY | $2,857,002 | CashBOYAmt |
| Cash EOY | $2,013,742 | CashEOYAmt |
| Cash EOYFMV | $2,013,742 | CashEOYFMVAmt |
| Sav And Temp Cash Invst BOY | $1,214,491 | SavAndTempCashInvstBOYAmt |
| Sav And Temp Cash Invst EOY | $1,527,368 | SavAndTempCashInvstEOYAmt |
| Sav And Temp Cash Invst EOYFMV | $1,527,368 | SavAndTempCashInvstEOYFMVAmt |
| Acct Rcvbl | $366,059 | AcctRcvblAmt |
| Acct Rcvbl Allwnc Dbtfl Acct | $25,794 | AcctRcvblAllwncDbtflAcctAmt |
| Acct Rcvbl BOY | $317,298 | AcctRcvblBOYAmt |
| Acct Rcvbl EOY | $340,265 | AcctRcvblEOYAmt |
| Acct Rcvbl EOYFMV | $340,265 | AcctRcvblEOYFMVAmt |
| Grants Receivable BOY | $132,931 | GrantsReceivableBOYAmt |
| Grants Receivable EOY | $175,087 | GrantsReceivableEOYAmt |
| Grants Receivable EOYFMV | $175,087 | GrantsReceivableEOYFMVAmt |
| Land Bldg Equip Cost Or Other Bss | $9,151,457 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,744,437 | LandBldgEquipAccumDeprecAmt |
| Land BOY | $7,749,779 | LandBOYAmt |
| Land EOY | $7,407,020 | LandEOYAmt |
| Land EOYFMV | $7,407,020 | LandEOYFMVAmt |
| Other Assets BOY | $747,015 | OtherAssetsBOYAmt |
| Other Assets EOY | $506,566 | OtherAssetsEOYAmt |
| Other Assets EOYFMV | $506,566 | OtherAssetsEOYFMVAmt |
| Total Assets BOY | $13,018,516 | TotalAssetsBOYAmt |
| Total Assets EOY | $11,970,048 | TotalAssetsEOYAmt |
| Total Assets EOYFMV | $11,970,048 | TotalAssetsEOYFMVAmt |
| Accounts Payable BOY | $227,888 | AccountsPayableBOYAmt |
| Accounts Payable EOY | $264,703 | AccountsPayableEOYAmt |
| Mortgages And Notes Payable BOY | $5,122,905 | MortgagesAndNotesPayableBOYAmt |
| Mortgages And Notes Payable EOY | $5,009,141 | MortgagesAndNotesPayableEOYAmt |
| Other Liabilities BOY | $2,427,862 | OtherLiabilitiesBOYAmt |
| Other Liabilities EOY | $1,621,500 | OtherLiabilitiesEOYAmt |
| Total Liabilities BOY | $7,778,655 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $6,895,344 | TotalLiabilitiesEOYAmt |
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
| No Donor Rstr Net Assests BOY | $4,319,861 | NoDonorRstrNetAssestsBOYAmt |
| No Donor Rstr Net Assests EOY | $4,208,037 | NoDonorRstrNetAssestsEOYAmt |
| Donor Rstr Net Assets BOY | $920,000 | DonorRstrNetAssetsBOYAmt |
| Donor Rstr Net Assets EOY | $866,667 | DonorRstrNetAssetsEOYAmt |
| Tot Net Ast Or Fund Balances BOY | $5,239,861 | TotNetAstOrFundBalancesBOYAmt |
| Tot Net Ast Or Fund Balances EOY | $5,074,704 | TotNetAstOrFundBalancesEOYAmt |
| Total Liabilities Net Ast BOY | $13,018,516 | TotalLiabilitiesNetAstBOYAmt |
| Total Liabilities Net Ast EOY | $11,970,048 | TotalLiabilitiesNetAstEOYAmt |
Chg In Net Assets Fund Balances ChgInNetAssetsFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tot Net Ast Or Fund Balances BOY | $5,239,861 | TotNetAstOrFundBalancesBOYAmt |
| Excess Revenue Over Expenses | -$165,157 | ExcessRevenueOverExpensesAmt |
| Subtotal | $5,074,704 | SubtotalAmt |
| Tot Net Ast Or Fund Balances EOY | $5,074,704 | TotNetAstOrFundBalancesEOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cap Gains Loss Tx Invst Incm Detail | CapGainsLossTxInvstIncmDetail |
Excise Tax Based On Invst Incm ExciseTaxBasedOnInvstIncmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Income Excise Tax | $883 | InvestmentIncomeExciseTaxAmt |
| Subtotal | $883 | SubtotalAmt |
| Tax Based On Investment Income | $883 | TaxBasedOnInvestmentIncomeAmt |
| Estimated Plus Ovpmt Incm Tx | $0 | EstimatedPlusOvpmtIncmTxAmt |
| Exempt Frgn Org Tax Wthld At Srce | $0 | ExemptFrgnOrgTaxWthldAtSrceAmt |
| Total Payments And Credits | $0 | TotalPaymentsAndCreditsAmt |
| Es Penalty | $53 | EsPenaltyAmt |
| Tax Due | $936 | TaxDueAmt |
Statements Regarding Acty StatementsRegardingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Legislative Political Acty | false | LegislativePoliticalActyInd |
| More Than100 Spent | false | MoreThan100SpentInd |
| Form1120 POL Filed | false | Form1120POLFiledInd |
| Activities Not Previously Rpt | false | ActivitiesNotPreviouslyRptInd |
| Changes To Articles Or Bylaws | false | ChangesToArticlesOrBylawsInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Organization Dissolved Etc | false | OrganizationDissolvedEtcInd |
| Section508e Rqr Satisfied | Yes (true) | Section508eRqrSatisfiedInd |
| At Least5000 In Assets | Yes (true) | AtLeast5000InAssetsInd |
| Org Report Or Register State | DC | OrgReportOrRegisterStateCd |
| Org Report Or Register State | MD | OrgReportOrRegisterStateCd |
| Form990 PF Filed With Atty Gen | Yes (true) | Form990PFFiledWithAttyGenInd |
| Private Operating Foundation | Yes (true) | PrivateOperatingFoundationInd |
| New Substantial Contributors | false | NewSubstantialContributorsInd |
| Own Controlled Entity | false | OwnControlledEntityInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Comply With Public Insp Rqr | Yes (true) | ComplyWithPublicInspRqrInd |
| Website Address | N/A | WebsiteAddressTxt |
Persons With Books Name PersonsWithBooksName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GARY GAGNON | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3017500017 | PhoneNum |
Location Of Books US Address LocationOfBooksUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 136 | AddressLine1Txt |
| City | EMMITSBURG | CityNm |
| State Abbreviation | MD | StateAbbreviationCd |
| ZIP | 21727 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Foreign Accounts Question | false | ForeignAccountsQuestionInd |
Statements Regarding Acty4720 StatementsRegardingActy4720Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Sale Or Exch Disqualified Prsn | false | SaleOrExchDisqualifiedPrsnInd |
| Brrw Or Lend Disqualified Prsn | false | BrrwOrLendDisqualifiedPrsnInd |
| Furn Goods Disqualified Prsn | false | FurnGoodsDisqualifiedPrsnInd |
| Pay Comp Disqualified Prsn | Yes (true) | PayCompDisqualifiedPrsnInd |
| Transfer Ast Disqualified Prsn | false | TransferAstDisqualifiedPrsnInd |
| Payment To Government Official | false | PaymentToGovernmentOfficialInd |
| Acts Fail To Qlfy As Exceptions | false | ActsFailToQlfyAsExceptionsInd |
| Uncorrected Prior Acts | false | UncorrectedPriorActsInd |
| Undistributed Income PY | false | UndistributedIncomePYInd |
| Business Holdings | false | BusinessHoldingsInd |
| Jeopardy Investments | false | JeopardyInvestmentsInd |
| Uncorrected PY Jeopardy Invst | false | UncorrectedPYJeopardyInvstInd |
| Influence Legislation | false | InfluenceLegislationInd |
| Influence Election | false | InfluenceElectionInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Noncharitable Purpose | false | NoncharitablePurposeInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
Officer Dir Trst Key Empl Info OfficerDirTrstKeyEmplInfoGrp
Officer Dir Trst Key Empl OfficerDirTrstKeyEmplGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | TitleTitleTxt | Average Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRt | CompensationCompensationAmt | Employee Benefit ProgramEmployeeBenefitProgramAmt | Expense Account Other AllwncExpenseAccountOtherAllwncAmt |
|---|---|---|---|---|---|---|---|---|
| Leonard Sacks | ||||||||
| PO Box 136 | Emmitsburg | MD | 21727 | Chairman/Treasurer/Trustee | 1.0 | $0 | $0 | $0 |
| BARBARA GROVES | ||||||||
| PO Box 136 | Emmitsburg | MD | 21727 | President/SECRETARY/TRUSTEE | 1.0 | $0 | $0 | $0 |
| Helen Stefan Moreau | ||||||||
| PO Box 136 | Emmitsburg | MD | 21727 | Trustee | 1.0 | $0 | $0 | $0 |
| Harold Joyce | ||||||||
| PO Box 136 | Emmitsburg | MD | 21727 | Trustee | 1.0 | $0 | $0 | $0 |
| Jonathan Novak | ||||||||
| PO Box 136 | Emmitsburg | MD | 21727 | Trustee | 1.0 | $0 | $0 | $0 |
Compensation Highest Paid Empl CompensationHighestPaidEmplGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | TitleTitleTxt | Average Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRt | CompensationCompensationAmt |
|---|---|---|---|---|---|---|
| ROBY WILLIAM | ||||||
| PO BOX 136 | EMMITSBURG | MD | 21727 | CFO | 40.0 | $253,154 |
| DIOMI CHIMENE | ||||||
| PO BOX 136 | EMMITSBURG | MD | 21727 | REGISTERED NURSE | 40.0 | $163,612 |
| MARTIN AMY | ||||||
| PO BOX 136 | EMMITSBURG | MD | 21727 | CRNP | 27.0 | $133,705 |
| STAHLEY PHYLLIS | ||||||
| PO BOX 136 | EMMITSBURG | MD | 21727 | DIRECTOR OF ADMISSIO | 40.0 | $128,000 |
| GAGNON GARY | ||||||
| PO BOX 136 | EMMITSBURG | MD | 21727 | CONTROLLER | 40.0 | $92,500 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Employee Paid Over50k | 12 | OtherEmployeePaidOver50kCnt |
Compensation Of Hghst Pd Cntrct CompensationOfHghstPdCntrctGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Service TypeServiceTypeTxt | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Sysco | |||||
| PO Box 3641 | HARRISBURG | PA | 17105 | Food Service | $178,669 |
| Netsmart Tech | |||||
| PO Box 713519 | PHILADELPHIA | PA | 19171 | Elect. Health Record | $165,862 |
| Potomac Edison | |||||
| PO Box 3615 | AKRON | OH | 44309 | Utility | $78,182 |
| Staples Advantage | |||||
| PO Box 70242 | PHILADELPHIA | PA | 19176 | Office Supplies | $67,012 |
| BDO | |||||
| PO Box 642743 | PITTSBURGH | PA | 15264 | Auditors | $63,064 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contractor Paid Over50k | 6 | ContractorPaidOver50kCnt |
Summary Of Direct Chrtbl Acty SummaryOfDirectChrtblActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description1 | THE FOUNDATION PROVIDES RESIDENTIAL TREATMENT AND SERVICES FOR ALCOHOL AND/OR DRUG DEPENDENT PREGNANT AND POSTPARTUM WOMEN ALONG WITH THEIR CHILDREN. | Description1Txt |
| Expenses1 | $5,298,948 | Expenses1Amt |
Sum Of Program Related Invst SumOfProgramRelatedInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description1 | . | Description1Txt |
Minimum Investment Return MinimumInvestmentReturnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Average Monthly FMV Of Sec | $0 | AverageMonthlyFMVOfSecAmt |
| Average Monthly Cash Balances | $3,320,874 | AverageMonthlyCashBalancesAmt |
| FMV All Other Noncharitable Ast | $0 | FMVAllOtherNoncharitableAstAmt |
| Total FMV Of Unused Assets | $3,320,874 | TotalFMVOfUnusedAssetsAmt |
| Acquisition Indebtedness | $0 | AcquisitionIndebtednessAmt |
| Adjusted Total FMV Of Unused Ast | $3,320,874 | AdjustedTotalFMVOfUnusedAstAmt |
| Cash Deemed Charitable | $49,813 | CashDeemedCharitableAmt |
| Net Vl Noncharitable Assets | $3,271,061 | NetVlNoncharitableAssetsAmt |
| Minimum Investment Return | $163,553 | MinimumInvestmentReturnAmt |
Distributable Amount DistributableAmountGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Sect4942j3j5 Fndtn And Frgn Org | Yes (X) | Sect4942j3j5FndtnAndFrgnOrgInd |
PF Qualifying Distributions PFQualifyingDistributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expenses And Contributions | $5,298,949 | ExpensesAndContributionsAmt |
| Program Related Invst Total | $0 | ProgramRelatedInvstTotalAmt |
| Charitable Assets Acquis Paid | $0 | CharitableAssetsAcquisPaidAmt |
| Set Aside Suitability Test | $0 | SetAsideSuitabilityTestAmt |
| Set Aside Cash Distri Test | $0 | SetAsideCashDistriTestAmt |
| Qualifying Distributions | $5,298,949 | QualifyingDistributionsAmt |
Private Operating Foundations PrivateOperatingFoundationsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Private Operating Fndtn Ruling | 2022-07-26 | PrivateOperatingFndtnRulingDt |
| Section4942j3 | Yes (X) | Section4942j3Ind |
Lessor Adj Net Incm Min Invst Ret LessorAdjNetIncmMinInvstRetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year | $163,553 | CurrentYearAmt |
| Year1 | $188,606 | Year1Amt |
| Year2 | $389,323 | Year2Amt |
| Year3 | $261 | Year3Amt |
| Total | $741,743 | TotalAmt |
Pct85 Lessor Adj Incm Or Min Ret Pct85LessorAdjIncmOrMinRetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year | $139,020 | CurrentYearAmt |
| Year1 | $160,315 | Year1Amt |
| Year2 | $330,925 | Year2Amt |
| Year3 | $222 | Year3Amt |
| Total | $630,482 | TotalAmt |
Qualifying Distributions QualifyingDistributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year | $5,298,949 | CurrentYearAmt |
| Year1 | $5,053,430 | Year1Amt |
| Year2 | $4,890,562 | Year2Amt |
| Year3 | $5,342,759 | Year3Amt |
| Total | $20,585,700 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Qualifying Distri Not Used Drt | QualifyingDistriNotUsedDrtGrp |
Qualifying Distri Made Drt QualifyingDistriMadeDrtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year | $5,298,949 | CurrentYearAmt |
| Year1 | $5,053,430 | Year1Amt |
| Year2 | $4,890,562 | Year2Amt |
| Year3 | $5,342,759 | Year3Amt |
| Total | $20,585,700 | TotalAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year | $0 | CurrentYearAmt |
| Year1 | $0 | Year1Amt |
| Year2 | $0 | Year2Amt |
| Total | $0 | TotalAmt |
Total Assets Sect4942j3 Bi TotalAssetsSect4942j3BiGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Two Thirds Minimum Invst Ret TwoThirdsMinimumInvstRetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year | $109,035 | CurrentYearAmt |
| Year1 | $125,737 | Year1Amt |
| Year2 | $259,549 | Year2Amt |
| Year3 | $262,841 | Year3Amt |
| Total | $757,162 | TotalAmt |
Total Support TotalSupportGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Public Support Type PublicSupportType
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Largest Support From EO LargestSupportFromEOGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Gross Investment Income GrossInvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Supplementary Information SupplementaryInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Only Contri To Preselected | Yes (X) | OnlyContriToPreselectedInd |
Analysis Income Producing Acty AnalysisIncomeProducingActyGrp
Program Service Revenue Dtl ProgramServiceRevenueDtl (2 entries)
| DescDesc | BusinessBusinessCd | Related Or Exempt Function IncmRelatedOrExemptFunctionIncmAmt |
|---|---|---|
| PATIENT REVENUE | 623990 | $6,873,535 |
| OUTPATIENT RENT | 623990 | $178,994 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fees Contracts From Govt Ag | FeesContractsFromGovtAgGrp | |
| Membership Dues And Assmnt | MembershipDuesAndAssmntGrp |
Int On Sav And Temp Cash Invst IntOnSavAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | 14 | ExclusionCd |
| Exclusion | $63,510 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Dividends And Interest From Sec Dtl | DividendsAndInterestFromSecDtl | |
| Net Rntl Incm Re Debt Fincd Prop | NetRntlIncmReDebtFincdPropGrp | |
| Net Rntl Incm Re Not Debt Fincd Prop | NetRntlIncmReNotDebtFincdProp | |
| Net Rental Income Personal Prop | NetRentalIncomePersonalPropGrp | |
| Other Investment Income | OtherInvestmentIncomeGrp | |
| Gain Sales Ast Oth Than Invntry | GainSalesAstOthThanInvntryGrp | |
| Net Income Loss From Special Evt | NetIncomeLossFromSpecialEvtGrp | |
| Gross Profit Loss Sls Of Invntry | GrossProfitLossSlsOfInvntryGrp |
Subtotals Incm Producing Acty SubtotalsIncmProducingActyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Exclusion | $63,510 | ExclusionAmt |
| Related Or Exempt Function Incm | $7,052,529 | RelatedOrExemptFunctionIncmAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Income Producing Acty | $7,116,039 | TotalIncomeProducingActyAmt |
Rln Of Acty To Accom Of Exmpt Prps RlnOfActyToAccomOfExmptPrpsGrp
Rln Of Acty To Accom Of Exmpt Prps RlnOfActyToAccomOfExmptPrpsGrp (2 entries)
| Line NumberLineNumberTxt | Relationship StatementRelationshipStatementTxt |
|---|---|
| 1A | PATIENT INCOME |
| 1B | OUTPATIENT INCOME |
Trnsfr Trans Rln Nonchrtbl EO TrnsfrTransRlnNonchrtblEOGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trnsfr Of Cash To Nonchrtbl EO | false | TrnsfrOfCashToNonchrtblEOInd |
| Trnsfr Other Asset Nonchrtbl EO | false | TrnsfrOtherAssetNonchrtblEOInd |
| Sales Or Exchanges Of Assets | false | SalesOrExchangesOfAssetsInd |
| Purchase Of Assets Nonchrtbl EO | false | PurchaseOfAssetsNonchrtblEOInd |
| Rental Of Facilities Oth Assets | false | RentalOfFacilitiesOthAssetsInd |
| Reimbursement Arrangements | false | ReimbursementArrangementsInd |
| Loans Or Loan Guarantees | false | LoansOrLoanGuaranteesInd |
| Performance Of Services Etc | false | PerformanceOfServicesEtcInd |
| Sharing Of Facilities Etc | false | SharingOfFacilitiesEtcInd |
| Relationships Nonchrtbl EO | false | RelationshipsNonchrtblEOInd |
Accounting Fees Schedule AccountingFeesSchedule
Accounting Fees Detail AccountingFeesDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | ACCOUNTING FEES | CategoryTxt |
| Amt | $67,360 | Amt |
| Net Investment Income | $0 | NetInvestmentIncomeAmt |
| Adjusted Net Income | $292 | AdjustedNetIncomeAmt |
| Disbursements Charitable Prps | $67,068 | DisbursementsCharitablePrpsAmt |
Depreciation Schedule DepreciationSchedule
Legal Fees Schedule LegalFeesSchedule
Legal Fees LegalFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Category | LEGAL | CategoryTxt |
| Legal Fees | $4,920 | LegalFeesAmt |
| Net Investment Income | $0 | NetInvestmentIncomeAmt |
| Adjusted Net Income | $21 | AdjustedNetIncomeAmt |
| Disbursements Charitable Prps | $4,899 | DisbursementsCharitablePrpsAmt |
Other Assets Schedule OtherAssetsSchedule
Other Assets Schedule OtherAssetsScheduleGrp (3 entries)
| DescDesc | BOY Book ValueBOYBookValueAmt | EOY Book ValueEOYBookValueAmt | EOYFMVEOYFMVAmt |
|---|---|---|---|
| RIGHT OF USE LEASE ASSETS | $590,764 | $355,747 | $355,747 |
| DEFFERED FINANCING COSTS | $152,737 | $146,305 | $146,305 |
| SECURITY DEPOSITS | $3,514 | $4,514 | $4,514 |
Other Expenses Schedule OtherExpensesSchedule
Other Expenses Schedule OtherExpensesScheduleGrp (13 entries)
| DescDesc | Revenue And Expenses Per BooksRevenueAndExpensesPerBooksAmt | Adjusted Net IncomeAdjustedNetIncomeAmt | Disbursements Charitable PrpsDisbursementsCharitablePrpsAmt |
|---|---|---|---|
| PURCHASED SERVICES ARTC | $6,532,528 | $6,532,528 | |
| MANAGEMENT FEES | $606,357 | $2,630 | $603,727 |
| SUPPLIES | $337,548 | $1,464 | $336,084 |
| AMORTIZATION | $241,989 | $1,050 | |
| BAD DEBTS | $89,250 | $387 | $88,863 |
| PURCHASED SERVICES - OTHER | $85,057 | $369 | $84,688 |
| INSURANCE | $38,078 | $165 | $37,913 |
| CONSULTING FEES | $36,927 | $160 | $36,767 |
| TRANSPORTATION | $25,653 | $111 | $25,542 |
| DRUGS AND MEDICINE | $5,493 | $24 | $5,469 |
| MINOR EQUIPMENT | $1,506 | $7 | $1,499 |
| ADVERTISING | $808 | $4 | $804 |
| BANK CHARGES | $752 | $3 | $749 |
Other Income Schedule2 OtherIncomeSchedule2
Other Income Detail OtherIncomeDetail (2 entries)
| DescDesc | Revenue And Expenses Per BooksRevenueAndExpensesPerBooksAmt | Adjusted Net IncomeAdjustedNetIncomeAmt |
|---|---|---|
| Patient Revenue | $6,873,535 | $6,873,535 |
| Out patient rent | $178,994 | $178,994 |
Other Liabilities Schedule OtherLiabilitiesSchedule
Other Liabilities Detail OtherLiabilitiesDetail (2 entries)
| DescDesc | BOY Book ValueBOYBookValueAmt | EOY Book ValueEOYBookValueAmt |
|---|---|---|
| DUE TO RELATED PARTIES | $1,837,098 | $1,265,753 |
| RIGHT OF USE LEASE LIABILITY | $590,764 | $355,747 |
Taxes Schedule TaxesSchedule
Taxes Detail TaxesDetail (2 entries)
| CategoryCategoryTxt | AmtAmt | Adjusted Net IncomeAdjustedNetIncomeAmt | Disbursements Charitable PrpsDisbursementsCharitablePrpsAmt |
|---|---|---|---|
| PAYROLL TAXES | $163,357 | $709 | $162,648 |
| FEDERAL TAX | $304 |