STRATEGY STUDIO / PUBLIC DATA EXPLORER

ROY H LAIRD MEMORIAL HOSPITAL FOUNDATION INC: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization
ROY H LAIRD MEMORIAL HOSPITAL FOUNDATION INC (EIN 75-2660554)
Tax period
2021-01-01 to 2021-12-31
Filed
2022-08-18
IRS object ID
202232309349300008
Schema version
2021v4.0
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

FieldValueIRS element (for citing)
Return2022-08-18T06:16:37-07:00ReturnTs
Tax Period End2021-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN463680200PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Mays & Associates PLLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1410 W Erwin StAddressLine1Txt
CityTylerCityNm
State AbbreviationTXStateAbbreviationCd
ZIP77520ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2021-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN752660554EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ROY HLAIRD MEMORIAL HOSPITALBusinessNameLine1Txt
Business Name Line2FOUNDATION INCBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlROYHBusinessNameControlTxt
Phone9034524472PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 1610AddressLine1Txt
CityKILGORECityNm
State AbbreviationTXStateAbbreviationCd
ZIP75663ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonPAM DECEAULTPersonNm
Person TitleTreasurerPersonTitleTxt
Signature2022-08-17SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstPAMPersonFirstNm
Person LastDECEAULTPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonBrandon L Mays CPAPreparerPersonNm
PTINP01274188PTIN
Phone9039832051PhoneNum

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer0TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
Federated Assurance LevelFAL1FederatedAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2021TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerPAM DECEAULTPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1118 KING RANCH ROADAddressLine1Txt
CityKILGORECityNm
State AbbreviationTXStateAbbreviationCd
ZIP75662ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$806,351GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressN/AWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1994FormationYr
Legal Domicile StateTXLegalDomicileStateCd
Activity Or MissionPROMOTING, FOSTERING, FACILITATING, AND SUPPORTING INDIGENT AND GENERAL HEALTH CARE SERVICES IN THE CITY OF KILGORE AND ITS SURROUNDING AREAS, IN THE NAME OF ROY H. LAIRD, DECEASED.ActivityOrMissionDesc
Voting Members Governing Body8VotingMembersGoverningBodyCnt
Voting Members Independent8VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$781,261PYContributionsGrantsAmt
CY Contributions Grants$482,408CYContributionsGrantsAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$360,501PYInvestmentIncomeAmt
CY Investment Income$321,477CYInvestmentIncomeAmt
PY Other Revenue$2,220PYOtherRevenueAmt
CY Other Revenue$2,466CYOtherRevenueAmt
PY Total Revenue$1,143,982PYTotalRevenueAmt
CY Total Revenue$806,351CYTotalRevenueAmt
PY Grants And Similar Paid$55,592PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$70,614CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$69,735PYOtherExpensesAmt
CY Other Expenses$69,175CYOtherExpensesAmt
PY Total Expenses$125,327PYTotalExpensesAmt
CY Total Expenses$139,789CYTotalExpensesAmt
PY Revenues Less Expenses$1,018,655PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$666,562CYRevenuesLessExpensesAmt
Total Assets BOY$9,373,830TotalAssetsBOYAmt
Total Assets EOY$10,885,918TotalAssetsEOYAmt
Total Liabilities EOY$0TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$9,373,830NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$10,885,918NetAssetsOrFundBalancesEOYAmt
MissionPROMOTING, FOSTERING, FACILITATING, AND SUPPORTING INDIGENT AND GENERAL HEALTH CARE SERVICES IN THE CITY OF KILGORE AND ITS SURROUNDING AREAS, IN THE NAME OF ROY H. LAIRD, DECEASED.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$70,614ExpenseAmt
Grant$70,614GrantAmt
DescREIMBURSEMENT TO THE CITY OF KILGORE FOR THE FORMER LAIRD MEMORIAL HOSPITAL'S PORTION OF RETIREMENT BENEFITS FOR FORMER EMPLOYEES OF THE HOSPITAL.Desc
Total Program Service Expenses$70,614TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsfalseDonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentfalseReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (true)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsYes (true)GrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredfalseScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld CompliancefalseBackupWthldComplianceInd
Employee0EmployeeCnt
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Form8282 Filed0Form8282FiledCnt
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Form8899 FiledindfalseForm8899Filedind
Form1098 C FiledfalseForm1098CFiledInd
DAF Excess Business HoldingsfalseDAFExcessBusinessHoldingsInd
Taxable DistributionsfalseTaxableDistributionsInd
Distribution To DonorfalseDistributionToDonorInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members8GoverningBodyVotingMembersCnt
Independent Voting Member8IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyfalseForm990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyfalseConflictOfInterestPolicyInd
Whistleblower PolicyfalseWhistleblowerPolicyInd
Document Retention PolicyfalseDocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonPAM DECEAULT TREASURERPersonNm
Phone9039862265PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1118 KING RANCH ROADAddressLine1Txt
CityKILGORECityNm
State AbbreviationTXStateAbbreviationCd
ZIP75662ZIPCd
FieldValueIRS element (for citing)
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (8 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
THOMAS H BROWN
President2.000.00Yes (X)Yes (X)$0$0$0
PAT MCCRORY
Vice President1.000.00Yes (X)Yes (X)$0$0$0
PAM DECEAULT
Treasurer3.000.00Yes (X)Yes (X)$0$0$0
EVELYN BOLDING
Secretary1.000.00Yes (X)Yes (X)$0$0$0
JANIE EDMONDS
Trustee1.000.00Yes (X)$0$0$0
JANIE DICKERSON
Trustee1.000.00Yes (X)$0$0$0
WILBUR YATES
Trustee1.000.00Yes (X)$0$0$0
SHERRY BUSTIN
Trustee1.000.00Yes (X)$0$0$0
FieldValueIRS element (for citing)
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KfalseTotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
All Other Contributions$482,408AllOtherContributionsAmt
Total Contributions$482,408TotalContributionsAmt
Total Program Service Revenue$0TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$178,828TotalRevenueColumnAmt
Exclusion$178,828ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,466TotalRevenueColumnAmt
Exclusion$2,466ExclusionAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Other$142,649OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other$142,649OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$142,649TotalRevenueColumnAmt
Exclusion$142,649ExclusionAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Other Revenue Total$0OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$806,351TotalRevenueColumnAmt
Exclusion$323,943ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$70,614TotalAmt
Program Services$70,614ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$11,585TotalAmt
Management And General$11,585ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$53,448TotalAmt
Management And General$53,448ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,300TotalAmt
Management And General$1,300ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$100TotalAmt
Management And General$100ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Expenses OtherExpensesGrp

FieldValueIRS element (for citing)
DescForeign Taxes - CNB CODesc
Total$2,742TotalAmt
Management And General$2,742ManagementAndGeneralAmt

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$139,789TotalAmt
Program Services$70,614ProgramServicesAmt
Management And General$69,175ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$1,106,601BOYAmt
EOY$1,560,179EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$397BOYAmt
EOY$0EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$8,266,832BOYAmt
EOY$9,325,738EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
EOY$1EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$9,373,830BOYAmt
EOY$10,885,918EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$9,373,830BOYAmt
EOY$10,885,918EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$9,373,830BOYAmt
EOY$10,885,918EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$9,373,830BOYAmt
EOY$10,885,918EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$666,562ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$845,526NetUnrlzdGainsLossesInvstAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$602,667CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$986,831CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$726,217CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$781,261CurrentTaxYearMinus1YearAmt
Current Tax Year$482,408CurrentTaxYearAmt
Total$3,579,384TotalAmt

Tax Rev Levied Orgnztnl Bnft170 TaxRevLeviedOrgnztnlBnft170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$602,667CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$986,831CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$726,217CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$781,261CurrentTaxYearMinus1YearAmt
Current Tax Year$482,408CurrentTaxYearAmt
Total$3,579,384TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$0SubstantialContributorsTotAmt
Public Support Total170$3,579,384PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$166,699CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$186,891CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$196,325CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$125,614CurrentTaxYearMinus1YearAmt
Current Tax Year$175,975CurrentTaxYearAmt
Total$851,504TotalAmt

Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Income170 OtherIncome170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Total Support$4,430,888TotalSupportAmt
Public Support CY1700.80780PublicSupportCY170Pct
Public Support PY1700.82520PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Total Rev Etc Audited Fincl Stmt$1,651,877TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$845,526NetUnrealizedGainsInvstAmt
Revenue Not Reported$845,526RevenueNotReportedAmt
Revenue Subtotal$806,351RevenueSubtotalAmt
Total Revenue Per Form990$806,351TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$139,789TotExpnsEtcAuditedFinclStmtAmt
Expenses Subtotal$139,789ExpensesSubtotalAmt
Total Expenses Per Form990$139,789TotalExpensesPerForm990Amt

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedfalseGrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1CITY OF KILGOREBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1815 N KILGORE STAddressLine1Txt
CityKILGORECityNm
State AbbreviationTXStateAbbreviationCd
ZIP75662ZIPCd
FieldValueIRS element (for citing)
Recipient EIN766000576RecipientEIN
Cash Grant$70,614CashGrantAmt
Non Cash Assistance$0NonCashAssistanceAmt
Purpose Of GrantRETIREE BENEFITSPurposeOfGrantTxt
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceAdditional Supplemental InformationFormAndLineReferenceDesc
ExplanationPART I, LINE 2 - PROCEDURES FOR MONITORING THE USE OF GRANT FUNDSSPECIFIC EXPENDITURES, SUCH AS REIMBURSEMENTS TO THE CITY OF KILGORE FOR RETIREMENT BENEFITS, ARE SUBSTANTIATED BY INSPECTION OF SUPPORTING DOCUMENTATION PROVIDED BY THE CITY OF KILGORE. (I.E. INVOICES, NOTICES OF PAYMENTS DUE, ETC.)GOOD SHEPHERD MEDICAL CENTER SUBSTNTIATES THE RECEIPT AND USE OF GRANT FUNDS BY CONTINUING TO SUCCESSFULLY OPERATE AN EMERGENCY DEPARTMENT.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Line 11b: Form 990 Review ProcessNo review was or will be conducted.
Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailableNo documents available to the public.
FORM 990, PART VI, LINE 11BORGANIZATION'S PROCESS TO REVIEW FORM 990 TREASURER REVIEWS THE FORM 990 PRIOR TO FILING.
FORM 990, PART VI, LINE 19GOVERNING DOCUMENTS DISCLOSURE EXPLANATION UPON REQUEST, THE FOUNDATION MAKES GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC.