STRATEGY STUDIO / PUBLIC DATA EXPLORER

THIBODAUX REGIONAL MEDICAL CENTER EMPLOYEE RELIEF FUND INC: Form 990EZ, tax year 2021

View the entire original 990 at ProPublica ↗

Organization
THIBODAUX REGIONAL MEDICAL CENTER EMPLOYEE RELIEF FUND INC (EIN 27-3160403)
Tax period
2021-01-01 to 2021-12-31
Filed
2022-04-06
IRS object ID
202240969349200119
Schema version
2021v4.2
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)
Return2022-04-06T10:44:24-05:00ReturnTs
Tax Period End2021-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN201941244PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1HORNE LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1661 SUNNYBROOK ROAD STE 100AddressLine1Txt
CityRIDGELANDCityNm
State AbbreviationMSStateAbbreviationCd
ZIP39157ZIPCd
FieldValueIRS element (for citing)
Return Type990EZReturnTypeCd
Tax Period Begin2021-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN273160403EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1THIBODAUX REGIONAL MEDICAL CENTERBusinessNameLine1Txt
Business Name Line2EMPLOYEE RELIEF FUND INCBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlTHIBBusinessNameControlTxt
Phone9854475500PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1602 NORTH ACADIA ROADAddressLine1Txt
CityTHIBODAUXCityNm
State AbbreviationLAStateAbbreviationCd
ZIP70301ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonCASEY PELTIERPersonNm
Person TitleSECRETARYPersonTitleTxt
Phone9854475500PhoneNum
Signature2022-03-22SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstCASEYPersonFirstNm
Person LastPELTIERPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonAMIE T WHITTINGTON CPAPreparerPersonNm
PTINP01082167PTIN
Phone6013261000PhoneNum
Preparation2022-03-22PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

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

Form 990-EZ IRS990EZ

FieldValueIRS element (for citing)
Method Of Accounting CashYes (X)MethodOfAccountingCashInd
Website AddressWWW.THIBODAUX.COMWebsiteAddressTxt
Organization501c3Yes (X)Organization501c3Ind
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Gross Receipts$144,222GrossReceiptsAmt
Info In Schedule O Part IYes (X)InfoInScheduleOPartIInd
Contributions Gifts Grants Etc$144,222ContributionsGiftsGrantsEtcAmt
Total Revenue$144,222TotalRevenueAmt
Grants And Similar Amounts Paid$138,200GrantsAndSimilarAmountsPaidAmt
Other Expenses Total$48OtherExpensesTotalAmt
Total Expenses$138,248TotalExpensesAmt
Excess Or Deficit For Year$5,974ExcessOrDeficitForYearAmt
Net Assets Or Fund Balances BOY$58,596NetAssetsOrFundBalancesBOYAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Net Assets Or Fund Balances EOY$64,570NetAssetsOrFundBalancesEOYAmt

Cash Savings And Investments CashSavingsAndInvestmentsGrp

FieldValueIRS element (for citing)
BOY$58,596BOYAmt
EOY$64,570EOYAmt

Form990 Total Assets Form990TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$58,596BOYAmt
EOY$64,570EOYAmt

Sum Of Total Liabilities SumOfTotalLiabilitiesGrp

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

Net Assets Or Fund Balances NetAssetsOrFundBalancesGrp

FieldValueIRS element (for citing)
BOY$58,596BOYAmt
EOY$64,570EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
Primary Exempt PurposeTHE ORGANIZATION WAS FORMED IN ORDER TO RECEIVE DONATIONS TO BENEFIT THE CHARITABLE NEEDS OF THE EMPLOYEES OF THIBODAUX REGIONAL MEDICAL CENTER. THE ORGANIZATION WILL OPERATE IN THIBODAUX, LOUISIANA FOR THE SOLE PURPOSE OF BENEFITTING THOSE MEMBERS OF THE MEDICAL CENTER THAT ARE IN NEED.PrimaryExemptPurposeTxt

Program Srvc Accomplishment ProgramSrvcAccomplishmentGrp (2 entries)

Description Program Srvc AccomDescriptionProgramSrvcAccomTxtGrants And AllocationsGrantsAndAllocationsAmtProgram Service ExpensesProgramServiceExpensesAmt
ON AUGUST 29, 2021 HURRICANE IDA HIT THE LOUISIANA COAST AND CREATED A NEED FOR THOSE HOSPITAL EMPLOYEES IMPACTED BY THE STORM. SOME MEDICAL CENTER EMPLOYEES SUFFERED AN EMERGENCY HARDSHIP/FINANCIAL LOSS DUE TO THE HURRICANE DAMAGE. THE FUNDS GRANTED TO INDIVIDUALS WERE BASED UPON THE NEED AND SPECIFIC HARDSHIP THE APPLICANT CLAIMED.$133,200$133,200
TO BENEFIT INDIVIDUAL EMPLOYEES WHO HAVE BEEN IMPACTED BY FINANCIAL HARDSHIP. THE FUNDS GRANTED TO INDIVIDUALS WERE BASED UPON THE NEED AND SPECIFIC HARDSHIP THE APPLICANT CLAIMED.$5,000$5,000
FieldValueIRS element (for citing)
Total Program Service Expenses$138,200TotalProgramServiceExpensesAmt

Officer Director Trustee Empl OfficerDirectorTrusteeEmplGrp (3 entries)

TitleTitleTxtAverage Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRtCompensationCompensationAmtEmployee Benefit ProgramEmployeeBenefitProgramAmtExpense Account Other AllwncExpenseAccountOtherAllwncAmt
GREG STOCK
DIRECTOR0.00$0$0$0
ERIC DEGRAVELLE
DIRECTOR0.00$0$0$0
CASEY PELTIER
SECRETARY0.00$0$0$0
FieldValueIRS element (for citing)
Info In Schedule O Part VYes (X)InfoInScheduleOPartVInd
Activities Not Previously Rpt0ActivitiesNotPreviouslyRptInd
Chg Made To Orgnzng Doc Not Rpt0ChgMadeToOrgnzngDocNotRptInd
Organization Had UBI0OrganizationHadUBIInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Organization Dissolved Etc0OrganizationDissolvedEtcInd
Direct Indirect Pltcl Expend$0DirectIndirectPltclExpendAmt
Made Loans To From Officers0MadeLoansToFromOfficersInd
Tax Imposed Under IRC4911$0TaxImposedUnderIRC4911Amt
Tax Imposed Under IRC4912$0TaxImposedUnderIRC4912Amt
Tax Imposed Under IRC4955$0TaxImposedUnderIRC4955Amt
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
Tax Imposed On Organization Mgr$0TaxImposedOnOrganizationMgrAmt
Tax Reimbursed By Organization$0TaxReimbursedByOrganizationAmt
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
States Where Copy Of Return Is FldLAStatesWhereCopyOfReturnIsFldCd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1JAKE L THIBODAUX CPA MBABusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1602 N ACADIA ROADAddressLine1Txt
CityTHIBODAUXCityNm
State AbbreviationLAStateAbbreviationCd
ZIP70301ZIPCd
FieldValueIRS element (for citing)
Phone9854934532PhoneNum
FieldValueIRS element (for citing)
Foreign Financial Account0ForeignFinancialAccountInd
Foreign Office0ForeignOfficeInd
Donor Advised Fnds0DonorAdvisedFndsInd
Operate Hospital0OperateHospitalInd
Tanning Services Provided0TanningServicesProvidedInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
School Operating0SchoolOperatingInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Part VI Of Comp Of Hghst Pd EmplNONEPartVIOfCompOfHghstPdEmplTxt
Part VI Hghst Pd Cntrct Prof SrvcNONEPartVIHghstPdCntrctProfSrvcTxt
Filed Schedule AYes (1)FiledScheduleAInd

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$11,638CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$14,394CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$8,605CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$16,642CurrentTaxYearMinus1YearAmt
Current Tax Year$144,222CurrentTaxYearAmt
Total$195,501TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$11,638CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$14,394CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$8,605CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$16,642CurrentTaxYearMinus1YearAmt
Current Tax Year$144,222CurrentTaxYearAmt
Total$195,501TotalAmt
FieldValueIRS element (for citing)
Public Support Total170$195,501PublicSupportTotal170Amt
Total Support$195,501TotalSupportAmt
Public Support CY1701.00000PublicSupportCY170Pct
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 O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAIDACTIVITY CLASSIFICATION: DONATION TO INDIVIDUALS - HOUSE FIRE - 1. GRANTEE NAME: ANONYMOUS. GRANTEE RELATIONSHIP: NONE. DATE OF GIFT: 12/31/21. AMOUNT GIVEN: 5,000.
FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAIDACTIVITY CLASSIFICATION: DONATION TO INDIVIDUALS - HURRICANE IDA - 35. GRANTEE NAME: ANONYMOUS. GRANTEE RELATIONSHIP: NONE. DATE OF GIFT: 12/31/21. AMOUNT GIVEN: 133,200. TOTAL INCLUDED ON FORM 990-EZ, LINE 10: 138,200.
FORM 990-EZ, PART I, LINE 16 - OTHER EXPENSESDESCRIPTION: CHECK ORDER. AMOUNT: 48.

Transfer Prsnl Bnft Contracts Decl TransferPrsnlBnftContractsDecl

FieldValueIRS element (for citing)
DeclarationTHE ORGANIZATION DID NOT, DURING THE YEAR, RECEIVE ANY FUNDS, DIRECTLY,OR INDIRECTLY, TO PAY PREMIUMS ON A PERSONAL BENEFIT CONTRACT.THE ORGANIZATION, DID NOT, DURING THE YEAR, PAY ANY PREMIUMS, DIRECTLY,OR INDIRECTLY, ON A PERSONAL BENEFIT CONTRACT.DeclarationDesc