CHARLOTTE NEUROSCIENCE ASSOCIATION INC: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- CHARLOTTE NEUROSCIENCE ASSOCIATION INC (EIN 46-4329944)
- Tax period
- 2020-07-01 to 2021-06-30
- Filed
- 2022-03-09
- IRS object ID
- 202200689349301720
- Schema version
- 2020v4.0
- 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 | 2022-03-09T15:05:19-08:00 | ReturnTs |
| Tax Period End | 2021-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 561688300 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | C DeWitt Foard & Co PA CPAs | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 817 E Morehead Street Ste 100 | AddressLine1Txt |
| City | Charlotte | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28202 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 464329944 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Charlotte Neuroscience Foundation | BusinessNameLine1Txt |
| Business Name Line2 | DBA Memory and Movement Charlotte | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CHAR | BusinessNameControlTxt |
| Phone | 7045773186 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 300 Billingsley Road 108 | AddressLine1Txt |
| City | Charlotte | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28211 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Brian Jones | PersonNm |
| Person Title | Current Treasurer | PersonTitleTxt |
| Signature | 2022-03-09 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | Brian | PersonFirstNm |
| Person Last | Jones | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Garrett Summers | PreparerPersonNm |
| PTIN | P02001620 | PTIN |
| Phone | 7043721515 | PhoneNum |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Federated Assurance Level | FAL1 | FederatedAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Janet LeClair | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 300 Billingsley Road 108 | AddressLine1Txt |
| City | Charlotte | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28211 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $2,731,013 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | memorycentercharlotte.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2013 | FormationYr |
| Legal Domicile State | NC | LegalDomicileStateCd |
| Activity Or Mission | To impact the lives of individuals living with cognitive impairment and movement disorders as well as those who care for them, to provide patients with specialized medical care through an in-depth assessment of the medical, safety and behavioral needs of the patients and to support caregivers and the whole family with education, counseling, and improved access to services. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 21 | TotalEmployeeCnt |
| Total Volunteers | 10 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $818,007 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,191,372 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $1,053,705 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $1,520,044 | CYProgramServiceRevenueAmt |
| PY Investment Income | $6,679 | PYInvestmentIncomeAmt |
| CY Investment Income | $3,531 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$7,407 | PYOtherRevenueAmt |
| CY Other Revenue | $16,066 | CYOtherRevenueAmt |
| PY Total Revenue | $1,870,984 | PYTotalRevenueAmt |
| CY Total Revenue | $2,731,013 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $1,548,620 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $1,597,838 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $102,841 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $627,261 | PYOtherExpensesAmt |
| CY Other Expenses | $764,864 | CYOtherExpensesAmt |
| PY Total Expenses | $2,175,881 | PYTotalExpensesAmt |
| CY Total Expenses | $2,362,702 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$304,897 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $368,311 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $1,077,791 | TotalAssetsBOYAmt |
| Total Assets EOY | $1,381,981 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $384,441 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $320,320 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $693,350 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $1,061,661 | NetAssetsOrFundBalancesEOYAmt |
| Mission | To impact the lives of individuals living with cognitive impairment and movement disorders as well as those who care for them, to provide patients with specialized medical care through an in-depth assessment of the medical, safety and behavioral needs of the patients and to support caregivers and the whole family with education, counseling, and improved access to services. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $1,950,468 | ExpenseAmt |
| Desc | Charlotte Neuroscience Foundation (DBA Memory & Movement Charlotte) is a non-profit medical practice that offers treatment and support to patients and their families battling Alzheimers Disease, Parkinsons Disease, and related disorders. Using a time-and-attention model, Memory & Movement Charlotte is devoted to meeting the medical, safety and behavioral needs of patients and develops a patient-centric care plan as a roadmap to address every aspect of the patients needs. In concert with patient care, caregivers receive continuing education, time to ask questions and express concern throughout the caregiving journey. Memory & Movement Charlotte has three physician led clinical teams caring for over 900 patients and 2700 caregivers. | Desc |
| Total Program Service Expenses | $1,950,468 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | 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 | Yes (true) | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | Yes (true) | 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 | 6 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 21 | 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 |
| Form8282 Filed | 0 | Form8282FiledCnt |
| 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 | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | 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 | false | CompensationProcessCEOInd |
| Compensation Process Other | false | 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 | Janet LeClair | PersonNm |
| Phone | 7045773186 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 300 Billingsley Rd Suite 108 | AddressLine1Txt |
| City | Charlotte | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28205 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|
| Sanjay Iyer | |||||||
| Medical Director | 40.00 | 0.00 | $301,160 | $0 | $19,026 | ||
| Aristides Chaconas | |||||||
| Physician | 40.00 | 0.00 | $238,460 | $0 | $0 | ||
| Melissa Shepard | |||||||
| Physician | 40.00 | 0.00 | $194,981 | $0 | $10,000 | ||
| Charles Edwards II | |||||||
| Physician | 32.00 | 0.00 | $128,848 | $0 | $0 | ||
| Connie Bonebrake | |||||||
| Executive Dir. | 40.00 | 0.00 | $87,492 | $0 | $2,884 | Yes (X) | |
| Janet LeClair | |||||||
| Executive Dir. | 40.00 | 0.00 | $19,912 | $0 | $1,298 | Yes (X) | |
| Nancy Downing | |||||||
| Chair | 0.50 | 0.00 | $0 | $0 | $0 | Yes (X) | Yes (X) |
| John Chanon | |||||||
| Vice Chairman | 0.50 | 0.00 | $0 | $0 | $0 | Yes (X) | Yes (X) |
| Cynthia Grim | |||||||
| Treasurer | 0.50 | 0.00 | $0 | $0 | $0 | Yes (X) | Yes (X) |
| Teresa Starr | |||||||
| Secretary | 0.50 | 0.00 | $0 | $0 | $0 | Yes (X) | Yes (X) |
| Bill Crowder | |||||||
| Director | 0.50 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Mary Lou Daly | |||||||
| Director | 0.50 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Jenny Longshore | |||||||
| Director | 0.50 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Brian Jones | |||||||
| Director | 0.50 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Scott Kerr | |||||||
| Director | 0.50 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Mark McAlister | |||||||
| Director | 0.50 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $970,853 | TotalReportableCompFromOrgAmt |
| Total Other Compensation | $33,208 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 4 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $1,191,372 | AllOtherContributionsAmt |
| Noncash Contributions | $161,241 | NoncashContributionsAmt |
| Total Contributions | $1,191,372 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Patient Annual Fees | 621110 | $541,502 | $541,502 |
| Patient Revenue | 621110 | $978,542 | $978,542 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $1,520,044 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,531 | TotalRevenueColumnAmt |
| Exclusion | $3,531 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $1,250 | FundraisingGrossIncomeAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,250 | TotalRevenueColumnAmt |
| Exclusion | $1,250 | ExclusionAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Other | Desc |
| Total Revenue Column | $14,816 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $14,816 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $14,816 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,731,013 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,534,860 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $4,781 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $875,213 | TotalAmt |
| Program Services | $753,925 | ProgramServicesAmt |
| Management And General | $87,812 | ManagementAndGeneralAmt |
| Fundraising | $33,476 | FundraisingAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $559,576 | TotalAmt |
| Program Services | $498,001 | ProgramServicesAmt |
| Management And General | $39,979 | ManagementAndGeneralAmt |
| Fundraising | $21,596 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $72,622 | TotalAmt |
| Program Services | $63,367 | ProgramServicesAmt |
| Management And General | $6,468 | ManagementAndGeneralAmt |
| Fundraising | $2,787 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $90,427 | TotalAmt |
| Program Services | $78,902 | ProgramServicesAmt |
| Management And General | $8,054 | ManagementAndGeneralAmt |
| Fundraising | $3,471 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $107,455 | TotalAmt |
| Program Services | $21,491 | ProgramServicesAmt |
| Management And General | $84,889 | ManagementAndGeneralAmt |
| Fundraising | $1,075 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,510 | TotalAmt |
| Fundraising | $28,510 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,727 | TotalAmt |
| Program Services | $12,850 | ProgramServicesAmt |
| Management And General | $1,312 | ManagementAndGeneralAmt |
| Fundraising | $565 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $122,112 | TotalAmt |
| Program Services | $96,468 | ProgramServicesAmt |
| Management And General | $18,317 | ManagementAndGeneralAmt |
| Fundraising | $7,327 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,448 | TotalAmt |
| Management And General | $5,448 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $47,194 | TotalAmt |
| Program Services | $37,283 | ProgramServicesAmt |
| Management And General | $7,079 | ManagementAndGeneralAmt |
| Fundraising | $2,832 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,601 | TotalAmt |
| Program Services | $18,033 | ProgramServicesAmt |
| Management And General | $1,568 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| Medical Supplies | $243,080 | $243,080 | ||
| Electronic health records | $57,361 | $28,681 | $28,680 | |
| Cognision | $34,850 | $34,850 | ||
| Computer and Internet | $31,308 | $27,318 | $2,788 | $1,202 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $53,218 | TotalAmt |
| Program Services | $36,219 | ProgramServicesAmt |
| Management And General | $16,999 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,362,702 | TotalAmt |
| Program Services | $1,950,468 | ProgramServicesAmt |
| Management And General | $309,393 | ManagementAndGeneralAmt |
| Fundraising | $102,841 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $191,481 | BOYAmt |
| EOY | $345,803 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $329,075 | BOYAmt |
| EOY | $297,905 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,000 | BOYAmt |
| EOY | $100,000 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $197,183 | BOYAmt |
| EOY | $336,918 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $42,001 | BOYAmt |
| EOY | $9,832 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,144 | BOYAmt |
| EOY | $15,116 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $333,631 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $71,670 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $251,170 | BOYAmt |
| EOY | $261,961 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,343 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,494 | BOYAmt |
| EOY | $11,130 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,900 | BOYAmt |
| EOY | $3,316 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,077,791 | BOYAmt |
| EOY | $1,381,981 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $122,663 | BOYAmt |
| EOY | $55,577 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $261,778 | BOYAmt |
| EOY | $264,743 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $384,441 | BOYAmt |
| EOY | $320,320 | 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 | $633,797 | BOYAmt |
| EOY | $544,155 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $59,553 | BOYAmt |
| EOY | $517,506 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $693,350 | BOYAmt |
| EOY | $1,061,661 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,077,791 | BOYAmt |
| EOY | $1,381,981 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $368,311 | ReconcilationRevenueExpnssAmt |
| 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 | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $811,869 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $504,659 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $617,326 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $818,007 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,191,372 | CurrentTaxYearAmt |
| Total | $3,943,233 | 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 | $811,869 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $504,659 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $617,326 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $818,007 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,191,372 | CurrentTaxYearAmt |
| Total | $3,943,233 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $800,833 | SubstantialContributorsTotAmt |
| Public Support Total170 | $3,142,400 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $369 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $699 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $11,303 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $6,679 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,531 | CurrentTaxYearAmt |
| Total | $22,581 | TotalAmt |
Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $108 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $434 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,065 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,707 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $14,816 | CurrentTaxYearAmt |
| Total | $18,130 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $3,983,944 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $3,860,563 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.78880 | PublicSupportCY170Pct |
| Public Support PY170 | 0.71540 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $30,000 | OtherCostOrOtherBasisAmt |
| Book Value | $30,000 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $166,009 | OtherCostOrOtherBasisAmt |
| Depreciation | $20,568 | DepreciationAmt |
| Book Value | $145,441 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $68,159 | OtherCostOrOtherBasisAmt |
| Depreciation | $20,897 | DepreciationAmt |
| Book Value | $47,262 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $69,463 | OtherCostOrOtherBasisAmt |
| Depreciation | $30,205 | DepreciationAmt |
| Book Value | $39,258 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $261,961 | TotalBookValueLandBuildingsAmt |
| Total Rev Etc Audited Fincl Stmt | $2,731,013 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Subtotal | $2,731,013 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $2,731,013 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $2,362,702 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $2,362,702 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $2,362,702 | TotalExpensesPerForm990Amt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 (3 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt |
|---|---|---|---|
| Aristides Chaconas | |||
| Physician | $238,460 | $238,460 | |
| Melissa Shepard | |||
| Physician | $194,981 | $204,981 | $10,000 |
| Sanjay Iyer | |||
| Medical Director | $301,160 | $320,186 | $19,026 |
Schedule L IRS990ScheduleL
Disqualified Person Ex Bnft Tr DisqualifiedPersonExBnftTrGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Charles Edwards II MD | PersonNm |
| Rln Disqualified Person Org | Substantial Contributor | RlnDisqualifiedPersonOrgTxt |
| Transaction | Purchased books | TransactionDesc |
| Transaction Corrected | false | TransactionCorrectedInd |
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Charles Edwards II MD | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | Substantial Cont | RelationshipDescriptionTxt |
| Transaction | $11,386 | TransactionAmt |
| Transaction | Books purchased | TransactionDesc |
| Sharing Of Revenues | false | SharingOfRevenuesInd |
Schedule M IRS990ScheduleM
Securities Publicly Traded SecuritiesPubliclyTradedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 2 | ContributionCnt |
| Noncash Contributions Rpt F990 | $84,080 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenuesTxt |
Other Non Cash Contri Table OtherNonCashContriTableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $77,161 | NoncashContributionsRptF990Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | false | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | false | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Line 11b: Form 990 Review Process | The 990 is reviewed by the Executive Director, Treasurer, and the Controller before filing. |
| Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts | Annual conflict of interest disclosures required of all board members |
| Form 990, Part VI, Line 19: Other Organization Documents Publicly Available | Available upon request |