HARDEMAN COUNTY COMMUNITY HEALTH CENTER: Form 990, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- HARDEMAN COUNTY COMMUNITY HEALTH CENTER (EIN 58-1995646)
- Tax period
- 2022-07-01 to 2023-06-30
- Filed
- 2023-11-30
- IRS object ID
- 202313349349301031
- 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 | 2023-11-30T12:51:14-08:00 | ReturnTs |
| Tax Period End | 2023-06-30 | 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 | 2022-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 581995646 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HARDEMAN COUNTY COMMUNITY HEALTH CENTER INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | HARD | BusinessNameControlTxt |
| Phone | 7316583388 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 720 | AddressLine1Txt |
| City | BOLIVAR | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 38008 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MARLITA WHITE | PersonNm |
| Person Title | CHIEF EXECUTIVE OFFICER | PersonTitleTxt |
| Phone | 7316583388 | PhoneNum |
| Signature | 2023-11-29 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | MARLITA | PersonFirstNm |
| Person Last | WHITE | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | XXX-XX-XXXX | SSN |
| 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 | 2023-11-30 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Federated Assurance Level | FAL1 | FederatedAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2022 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MARLITA WHITE | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 720 | AddressLine1Txt |
| City | BOLIVAR | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 38008 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $8,147,575 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1992 | FormationYr |
| Legal Domicile State | TN | LegalDomicileStateCd |
| Activity Or Mission | THE ORGANIZATION PROVIDES HEALTH CARE TO INDIVIDUALS REGARDLESS OF THEIR ABILITY TO PAY. THIS IS A DIRECT FULFILLMENT OF THEIR TAX EXEMPT PURPOSE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 91 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $4,158,301 | PYContributionsGrantsAmt |
| CY Contributions Grants | $4,426,211 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $3,811,268 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $3,694,019 | CYProgramServiceRevenueAmt |
| PY Investment Income | $14,934 | PYInvestmentIncomeAmt |
| CY Investment Income | $27,345 | CYInvestmentIncomeAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $7,984,503 | PYTotalRevenueAmt |
| CY Total Revenue | $8,147,575 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $4,966,075 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $4,956,089 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $2,821,964 | PYOtherExpensesAmt |
| CY Other Expenses | $2,835,432 | CYOtherExpensesAmt |
| PY Total Expenses | $7,788,039 | PYTotalExpensesAmt |
| CY Total Expenses | $7,791,521 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $196,464 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $356,054 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $6,616,339 | TotalAssetsBOYAmt |
| Total Assets EOY | $6,929,715 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $373,894 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $316,342 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $6,242,445 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $6,613,373 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE ORGANIZATION PROVIDES HEALTH CARE TO INDIVIDUALS REGARDLESS OF THEIR ABILITY TO PAY. THIS IS A DIRECT FULFILLMENT OF THEIR TAX EXEMPT PURPOSE. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $5,569,104 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $3,694,019 | RevenueAmt |
| Desc | THE ORGANIZATION PROVIDES HEALTH CARE REGARDLESS OF THE INDIVIDUALS' ABILITY TO PAY. THESE MEDICAL SERVICES ARE PROVIDED IN AREAS THAT HAVE A SHORTAGE OF HEALTH CARE PROVIDERS. THIS IS A DIRECT FULFILLMENT OF THEIR TAX EXEMPT PURPOSE. OVER 22,400 VISITS WERE PROVIDED DURING THE YEAR. | Desc |
| Total Program Service Expenses | $5,569,104 | 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 | false | ReportOtherAssetsInd |
| Report Other Liabilities | false | 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 |
| Transaction With Control Ent | false | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 5 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 91 | 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 |
| DAF Excess Business Holdings | false | DAFExcessBusinessHoldingsInd |
| Taxable Distributions | false | TaxableDistributionsInd |
| Distribution To Donor | false | DistributionToDonorInd |
| 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 | 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 |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | LINDA LOVELACE | PersonNm |
| Phone | 7316583388 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 629 NUCKOLLS ROAD | AddressLine1Txt |
| City | BOLIVAR | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 38008 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (20 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 |
|---|---|---|---|---|---|---|---|
| BARBARA HUDSON | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DONNA PINNER | |||||||
| CHAIR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| ERMA WILLIAMS | |||||||
| VICE-CHAIR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| RICHARD TEUBNER | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| EVELYN C ROBERTSON JR | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DELPHUS HICKS | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| LINDA JONES | |||||||
| SECRETARY | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| OCIE HOLMES | |||||||
| TREASURER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| LINDA PATTERSON | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| ROSIE PERRY | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| ANITA JO PARKS | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| MARLITA WHITE | |||||||
| CHIEF EXECUTIVE OFFICER | 40.00 | $124,358 | $0 | $11,460 | Yes (X) | ||
| LINDA LOVELACE | |||||||
| CHIEF FINANCIAL OFFICER | 40.00 | $105,002 | $0 | $10,507 | Yes (X) | ||
| ROBERT DAVIS | |||||||
| CHIEF OPERATIONAL OFFICER | 40.00 | $76,290 | $0 | $9,601 | Yes (X) | ||
| THOMAS CARUTHERS | |||||||
| MEDICAL DIRECTOR | 40.00 | $178,941 | $0 | $7,336 | Yes (X) | ||
| RICHARD REINHARD | |||||||
| PHYSICIAN | 40.00 | $194,138 | $0 | $14,615 | Yes (X) | ||
| ERIC FOLK | |||||||
| PHARMACIST | 40.00 | $140,440 | $0 | $13,399 | Yes (X) | ||
| JUDITH TESSEMA | |||||||
| PHYSICIAN | 40.00 | $149,414 | $0 | $7,336 | Yes (X) | ||
| LAURA MELARO | |||||||
| PSYCHIATRIC NURSE PRACTITIONER | 40.00 | $162,923 | $0 | $736 | Yes (X) | ||
| JOHN BLANKENSHIP | |||||||
| PHYSICIAN | 40.00 | $156,514 | $0 | $7,336 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,288,020 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $82,326 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 8 | 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 |
|---|---|---|---|---|---|
| LABORATORY CORPORATION OF AMERICA HOLDINGS | |||||
| PO BOX 12140 | BURLINGTON | NC | 27216 | CONTRACT LAB SERVICES | $242,123 |
| NEXTGEN HEALTHCARE INC | |||||
| PO BOX 809390 | CHICAGO | IL | 60680 | CONTRACT BILLING SERVICES | $173,568 |
| TLM ASSOCIATES INC | |||||
| 117 E LAFAYETTE STREET | JACKSON | TN | 38301 | CONTRACT CONSTRUCTION SERVICES | $103,966 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 3 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $3,753,206 | GovernmentGrantsAmt |
| All Other Contributions | $673,005 | AllOtherContributionsAmt |
| Noncash Contributions | $673,005 | NoncashContributionsAmt |
| Total Contributions | $4,426,211 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT FEES | Desc |
| Business | 621111 | BusinessCd |
| Total Revenue Column | $3,694,019 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $3,694,019 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $27,345 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $27,345 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $8,147,575 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,694,019 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $27,345 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $529,343 | TotalAmt |
| Program Services | $364,519 | ProgramServicesAmt |
| Management And General | $164,824 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,700,595 | TotalAmt |
| Program Services | $2,548,326 | ProgramServicesAmt |
| Management And General | $1,152,269 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $89,272 | TotalAmt |
| Program Services | $57,020 | ProgramServicesAmt |
| Management And General | $32,252 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $402,994 | TotalAmt |
| Program Services | $257,401 | ProgramServicesAmt |
| Management And General | $145,593 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $233,885 | TotalAmt |
| Program Services | $149,388 | ProgramServicesAmt |
| Management And General | $84,497 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,976 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $8,976 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $34,373 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $34,373 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $297,575 | TotalAmt |
| Program Services | $216,516 | ProgramServicesAmt |
| Management And General | $81,059 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $86,059 | TotalAmt |
| Program Services | $71,866 | ProgramServicesAmt |
| Management And General | $14,193 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $436,524 | TotalAmt |
| Program Services | $186,274 | ProgramServicesAmt |
| Management And General | $250,250 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $97,673 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $97,673 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $147,228 | TotalAmt |
| Program Services | $114,273 | ProgramServicesAmt |
| Management And General | $32,955 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $133,261 | TotalAmt |
| Program Services | $103,158 | ProgramServicesAmt |
| Management And General | $30,103 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $158,072 | TotalAmt |
| Program Services | $67,593 | ProgramServicesAmt |
| Management And General | $90,479 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,472 | TotalAmt |
| Program Services | $16,551 | ProgramServicesAmt |
| Management And General | $2,921 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Expenses OtherExpensesGrp (2 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| CONTRACT 340B PHARMACY FEES | $51,610 | $51,610 | $0 | $0 |
| DRUGS AND MEDICAL SUPPLIES | $1,364,609 | $1,364,609 | $0 | $0 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,791,521 | TotalAmt |
| Program Services | $5,569,104 | ProgramServicesAmt |
| Management And General | $2,222,417 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $195,264 | BOYAmt |
| EOY | $721,638 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,674,593 | BOYAmt |
| EOY | $2,099,011 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $129,152 | BOYAmt |
| EOY | $164,475 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $481,656 | BOYAmt |
| EOY | $738,306 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,711 | BOYAmt |
| EOY | $23,823 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $86,769 | BOYAmt |
| EOY | $107,501 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $4,138,903 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,981,394 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,200,210 | BOYAmt |
| EOY | $2,157,509 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $825,984 | BOYAmt |
| EOY | $917,452 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,616,339 | BOYAmt |
| EOY | $6,929,715 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $373,894 | BOYAmt |
| EOY | $252,046 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $64,296 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $373,894 | BOYAmt |
| EOY | $316,342 | 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 | $6,242,445 | BOYAmt |
| EOY | $6,613,373 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,242,445 | BOYAmt |
| EOY | $6,613,373 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,616,339 | BOYAmt |
| EOY | $6,929,715 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $356,054 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $14,874 | NetUnrlzdGainsLossesInvstAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| 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) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| 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 | $2,756,759 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,529,028 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $5,496,815 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $4,158,301 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,426,211 | CurrentTaxYearAmt |
| Total | $19,367,114 | 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 | $2,756,759 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,529,028 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $5,496,815 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $4,158,301 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,426,211 | CurrentTaxYearAmt |
| Total | $19,367,114 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $0 | SubstantialContributorsTotAmt |
| Public Support Total170 | $19,367,114 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $10,520 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $24,855 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $19,373 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $14,934 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $27,345 | CurrentTaxYearAmt |
| Total | $97,027 | 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 | $19,464,141 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $17,809,980 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.99500 | PublicSupportCY170Pct |
| Public Support PY170 | 0.99530 | PublicSupportPY170Pct |
| 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 | $143,030 | InvestmentCostOrOtherBasisAmt |
| Book Value | $143,030 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $2,610,344 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $981,931 | DepreciationAmt |
| Book Value | $1,628,413 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $1,145,649 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $999,463 | DepreciationAmt |
| Book Value | $146,186 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $239,880 | InvestmentCostOrOtherBasisAmt |
| Book Value | $239,880 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $2,157,509 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | INVESTMENTS-CDS | Desc |
| Book Value | $917,452 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $917,452 | TotalBookValueSecuritiesAmt |
| Total Rev Etc Audited Fincl Stmt | $8,337,929 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $14,874 | NetUnrealizedGainsInvstAmt |
| Donated Services And Use Fclts | $175,480 | DonatedServicesAndUseFcltsAmt |
| Revenue Not Reported | $190,354 | RevenueNotReportedAmt |
| Revenue Subtotal | $8,147,575 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $8,147,575 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $7,967,001 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $175,480 | DonatedServicesUseFcltsAmt |
| Expenses Not Reported | $175,480 | ExpensesNotReportedAmt |
| Expenses Subtotal | $7,791,521 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $7,791,521 | TotalExpensesPerForm990Amt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 (6 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| THOMAS CARUTHERS | |||||||||||||
| $178,941 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $7,336 | $0 | $186,277 | $0 | $0 | $0 |
| RICHARD REINHARD | |||||||||||||
| $194,138 | $0 | $0 | $0 | $0 | $0 | $7,763 | $0 | $6,852 | $0 | $208,753 | $0 | $0 | $0 |
| ERIC FOLK | |||||||||||||
| $140,440 | $0 | $0 | $0 | $0 | $0 | $6,063 | $0 | $7,336 | $0 | $153,839 | $0 | $0 | $0 |
| JUDITH TESSEMA | |||||||||||||
| $149,414 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $7,336 | $0 | $156,750 | $0 | $0 | $0 |
| LAURA MELARO | |||||||||||||
| $162,923 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $7,336 | $0 | $170,259 | $0 | $0 | $0 |
| JOHN BLANKENSHIP | |||||||||||||
| $156,514 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $7,336 | $0 | $163,850 | $0 | $0 | $0 |
Schedule M IRS990ScheduleM
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 44867 | ContributionCnt |
| Noncash Contributions Rpt F990 | $673,005 | 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 (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Pt VI, Line 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST |
| Pt VI, Line 19 | POLICY AND FORM 990 AVAILABLE UPON WRITTEN REQUEST. |
| Pt XII, Line 2c | THE CEO AND CFO OVERSEE FINANCIAL STATEMENT PREPARATION AND AUDIT ENGAGEMENT. |
| Pt VI, Line 11b | THE CEO, CFO AND FINANCE COMMITTEE REVIEW THE FORM 990. |
| Pt VI, Line 12c | ANNUALLY THE CONFLICT OF INTEREST STATEMENT IS SIGNED BY BOARD MEMBERS AND |
| Pt VI, Line 12c | REVIEWED BY THE ENTIRE BOARD. BOARD MEMBERS SHALL EXCUSE THEMSELVES FROM |
| Pt VI, Line 12c | ISSUES THAT ENHANCE THE PROBABILITY OF THEIR OWN PERSONAL AND PRIVATE GAIN. |
| Pt VI, Line 15a | STATE AND NATIONAL SALARY COMPARISONS ARE USED TO ESTABLISH SALARY LIMITS |
| Pt VI, Line 15b | FOR TOP MANAGEMENT OFFICIALS. PERFORMANCE EVALUATIONS ARE PREFORMED ANNUALLY |
| Pt VI, Line 15b | AND SALARY INCREASES ARE BOARD APPROVED. |