STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

GOOD SAMARITAN HEALTH CENTER INC: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization
GOOD SAMARITAN HEALTH CENTER INC (EIN 58-2373395)
Tax period
2021-01-01 to 2021-12-31
Filed
2022-11-09
IRS object ID
202233139349303173
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)
Return2022-11-09T10:20:34-08:00ReturnTs
Tax Period End2021-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN582157642PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BLAD & ASSOCIATES PCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line11832 Independence Square Ste AAddressLine1Txt
CityDunwoodyCityNm
State AbbreviationGAStateAbbreviationCd
ZIP30338ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2021-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN582373395EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1THE GOOD SAMARITAN HEALTH CENTER INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlGOODBusinessNameControlTxt
Phone6785534902PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11015 DONALD LEE HOLLOWELL PKWYAddressLine1Txt
CityATLANTACityNm
State AbbreviationGAStateAbbreviationCd
ZIP30318ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonWILLIAM WARREN IVPersonNm
Person TitleFOUNDER & CEOPersonTitleTxt
Signature2022-11-09SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstWILLIAM WARRENPersonFirstNm
Person LastIVPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonRobert S Blad CPAPreparerPersonNm
PTINP00197666PTIN
Phone7705127600PhoneNum
Self EmployedYes (X)SelfEmployedInd

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer2TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
Federated Assurance LevelFAL1FederatedAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2021TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

Principal Ofcr Business Name PrincipalOfcrBusinessName

FieldValueIRS element (for citing)
Business Name Line1WILLIAM WARREN IVBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11015 DONALD LEE HOLLOWELL PKWYAddressLine1Txt
CityATLANTACityNm
State AbbreviationGAStateAbbreviationCd
ZIP30318ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$5,718,617GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.GOODSAMATLANTA.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1998FormationYr
Legal Domicile StateGALegalDomicileStateCd
Activity Or MissionThe mission of the Organization is spreading Christs love through quality healthcare to those in need. The Organization provides comprehensive primary care to low-income, uninsured individuals in greater metropolitan Atlanta.ActivityOrMissionDesc
Voting Members Governing Body21VotingMembersGoverningBodyCnt
Voting Members Independent19VotingMembersIndependentCnt
Total Employee69TotalEmployeeCnt
Total Volunteers110TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$4,109,935PYContributionsGrantsAmt
CY Contributions Grants$4,277,877CYContributionsGrantsAmt
PY Program Service Revenue$778,801PYProgramServiceRevenueAmt
CY Program Service Revenue$1,006,405CYProgramServiceRevenueAmt
PY Investment Income$148,002PYInvestmentIncomeAmt
CY Investment Income$432,426CYInvestmentIncomeAmt
PY Other Revenue$37,023PYOtherRevenueAmt
CY Other Revenue$301CYOtherRevenueAmt
PY Total Revenue$5,073,761PYTotalRevenueAmt
CY Total Revenue$5,717,009CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$2,722,653PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$3,018,159CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$275,993CYTotalFundraisingExpenseAmt
PY Other Expenses$1,804,086PYOtherExpensesAmt
CY Other Expenses$2,056,800CYOtherExpensesAmt
PY Total Expenses$4,526,739PYTotalExpensesAmt
CY Total Expenses$5,074,959CYTotalExpensesAmt
PY Revenues Less Expenses$547,022PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$642,050CYRevenuesLessExpensesAmt
Total Assets BOY$14,292,988TotalAssetsBOYAmt
Total Assets EOY$14,990,056TotalAssetsEOYAmt
Total Liabilities BOY$666,023TotalLiabilitiesBOYAmt
Total Liabilities EOY$253,300TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$13,626,965NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$14,736,756NetAssetsOrFundBalancesEOYAmt
MissionSpreading Christs love through quality healthcare to those in need. We are a non-profit 501(c)(3) organization that is a health care home providing comprehensive primary care to low-income, uninsured individuals in greater metropolitan Atlanta.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$4,422,148ExpenseAmt
Revenue$1,006,405RevenueAmt
DescThe Good Samaritan Health Center provides comprehensive primary medical care for the medically underserved working poor, uninsured, and homeless. Services are provided by staff and volunteer medical professionals. Medical services provided include comprehensive pediatric and adult primary care, diagnostic and referral services, mammograms, laboratory services, vaccines, well prenatal care, internal medicine, chronic disease management, and nutrition counseling. Specialty care services are also provided and include cardiology, gastroenterology, pulmonology, gynecology, diabetes foot care, ophthalmology, optometry, orthopedics, and radiology. Specialty clinics are offered for prosthetics and orthotics and for pediatric developmental care.The Good Samaritan Health Center provides comprehensive primary dental care for the underserved working poor, uninsured, and homeless. Services are provided by staff and volunteer dental professionals. Dental services include preventative and restorative care including general family and preventative dentistry, endodontics, oral surgery, and prosthodontics. The Good Samaritan Health Center provides mental health counseling care for the underserved working poor, uninsured, and homeless. Services are provided by staff licensed professional counselors and volunteer mental health professionals. Services include individual and family mental health counseling, play therapy, and group therapy.The Good Samaritan Health Center provides health education for the underserved working poor, uninsured, and homeless. Health education is provided by a staff registered dietitian, staff and volunteer healthcare professionals, and graduate student programs. Health education services include healthy cooking classes in an on-site teaching kitchen, diabetes education and management courses, and childbirth education.To quality for services, patients must be uninsured with a household income at or below 200% of the federal poverty level or eligible for Medicaid/Medicare. Patients pay for services on a reduced sliding fee scale that is based on income and household size. Those who are unable to pay receive care at no charge.Desc
Total Program Service Expenses$4,422,148TotalProgramServiceExpensesAmt
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 EndowmentsYes (true)DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
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 OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
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 Document30IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee69EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsYes (true)QuidProQuoContributionsInd
Quid Pro Quo Contri DisclYes (true)QuidProQuoContriDisclInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Form8282 Filed0Form8282FiledCnt
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Form8899 FiledindfalseForm8899Filedind
Form1098 C FiledfalseForm1098CFiledInd
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 Members21GoverningBodyVotingMembersCnt
Independent Voting Member19IndependentVotingMemberCnt
Family Or Business RlnYes (true)FamilyOrBusinessRlnInd
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 BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldGAStatesWhereCopyOfReturnIsFldCd
Own WebsiteYes (X)OwnWebsiteInd
Other WebsiteYes (X)OtherWebsiteInd
Upon RequestYes (X)UponRequestInd
OtherYes (X)OtherInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonNOVLETTE HENRYPersonNm
Phone6785534902PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11015 DONALD LEE HOLLOWELL PKWYAddressLine1Txt
CityATLANTACityNm
State AbbreviationGAStateAbbreviationCd
ZIP30318ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndIndividual Trustee Or DirectorIndividualTrusteeOrDirectorInd
DR JOHN SIEWEKE
Dental Serv Dir.40.000.00$169,546$0$14,508
BREANNA LATHROP
COO40.000.00$153,620$0$2,916Yes (X)
DR MELISSA SANCHEZ
Family Physician40.000.00$120,801$0$18,443
VERONICA SQUIRES
CAO40.000.00$28,448$0$569Yes (X)
PEYTON MCWHIRTER
Chairman1.000.00$0$0$0Yes (X)Yes (X)
BEN WILLS
VICE CHAIR1.000.00$0$0$0Yes (X)Yes (X)
JEFFREY ADAMS
Treasurer1.000.00$0$0$0Yes (X)Yes (X)
GLENN WARREN
Secretary1.000.00$0$0$0Yes (X)Yes (X)
WILLIAM WARREN IV
FOUNDER & CEO40.000.00$0$0$0Yes (X)Yes (X)
KATHRYN B MILLER
Director0.500.00$0$0$0Yes (X)
STUDIE YOUNG
Director0.500.00$0$0$0Yes (X)
MATT COLE
Director0.500.00$0$0$0Yes (X)
MARK BRYANT CHANDLER SR
Director0.500.00$0$0$0Yes (X)
JAMES WELLMAN
Director0.500.00$0$0$0Yes (X)
DAN CALLAHAN
Director0.500.00$0$0$0Yes (X)
DOUG WILLIAMS
Director0.500.00$0$0$0Yes (X)
KIRK MCALPIN JR
Director0.500.00$0$0$0Yes (X)
S DOUGLAS KING
Director0.500.00$0$0$0Yes (X)
KERI NORIS
Director0.500.00$0$0$0Yes (X)
DR MONICA PARKER
Director0.500.00$0$0$0Yes (X)
DAVID PATTILLO
Director0.500.00$0$0$0Yes (X)
ANNE CULBERSON
Director0.500.00$0$0$0Yes (X)
WILLIAM HOYT
Director0.500.00$0$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$472,415TotalReportableCompFromOrgAmt
Total Other Compensation$36,436TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K3IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Government Grants$564,108GovernmentGrantsAmt
All Other Contributions$3,713,769AllOtherContributionsAmt
Total Contributions$4,277,877TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescHEALTHCARE SERVICESDesc
Total Revenue Column$1,006,405TotalRevenueColumnAmt
Related Or Exempt Func Income$1,006,405RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$1,006,405TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$432,426TotalRevenueColumnAmt
Exclusion$432,426ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

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

Royalties Revenue RoyaltiesRevenueGrp

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

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

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

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$1,809FundraisingGrossIncomeAmt
Fundraising Direct Expenses$1,608FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$201TotalRevenueColumnAmt
Exclusion$201ExclusionAmt

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

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescOTHER REVENUEDesc
Total Revenue Column$100TotalRevenueColumnAmt
Related Or Exempt Func Income$100RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$100OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$5,717,009TotalRevenueColumnAmt
Related Or Exempt Func Income$1,006,505RelatedOrExemptFuncIncomeAmt
Exclusion$432,627ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

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$186,223TotalAmt
Program Services$171,999ProgramServicesAmt
Management And General$7,112ManagementAndGeneralAmt
Fundraising$7,112FundraisingAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$2,324,382TotalAmt
Program Services$2,061,938ProgramServicesAmt
Management And General$164,362ManagementAndGeneralAmt
Fundraising$98,082FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$38,161TotalAmt
Program Services$33,956ProgramServicesAmt
Management And General$2,606ManagementAndGeneralAmt
Fundraising$1,599FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$256,344TotalAmt
Program Services$228,095ProgramServicesAmt
Management And General$17,508ManagementAndGeneralAmt
Fundraising$10,741FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$213,049TotalAmt
Program Services$189,571ProgramServicesAmt
Management And General$14,551ManagementAndGeneralAmt
Fundraising$8,927FundraisingAmt

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$30,584TotalAmt
Management And General$30,584ManagementAndGeneralAmt

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$36,594TotalAmt
Management And General$36,594ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$369,035TotalAmt
Program Services$272,980ProgramServicesAmt
Management And General$3,207ManagementAndGeneralAmt
Fundraising$92,848FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$18,862TotalAmt
Program Services$892ProgramServicesAmt
Fundraising$17,970FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$107,080TotalAmt
Program Services$95,279ProgramServicesAmt
Management And General$7,314ManagementAndGeneralAmt
Fundraising$4,487FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$35,273TotalAmt
Program Services$31,386ProgramServicesAmt
Management And General$2,409ManagementAndGeneralAmt
Fundraising$1,478FundraisingAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$256,112TotalAmt
Program Services$240,747ProgramServicesAmt
Management And General$5,121ManagementAndGeneralAmt
Fundraising$10,244FundraisingAmt

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$426,561TotalAmt
Program Services$400,968ProgramServicesAmt
Management And General$8,531ManagementAndGeneralAmt
Fundraising$17,062FundraisingAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$69,436TotalAmt
Program Services$61,783ProgramServicesAmt
Management And General$4,743ManagementAndGeneralAmt
Fundraising$2,910FundraisingAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
SUPPLIES$414,184$414,184
CLIENT ASSISTANCE$154,276$154,276
OTHER$84,814$60,989$21,438$2,387
BAD DEBT EXPENSE$50,500$50,500

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$3,489TotalAmt
Program Services$3,105ProgramServicesAmt
Management And General$238ManagementAndGeneralAmt
Fundraising$146FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$5,074,959TotalAmt
Program Services$4,422,148ProgramServicesAmt
Management And General$376,818ManagementAndGeneralAmt
Fundraising$275,993FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,336,490BOYAmt
EOY$1,234,688EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$515,308BOYAmt
EOY$680,413EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$228,561BOYAmt
EOY$519,000EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$146,551BOYAmt
EOY$22,604EOYAmt

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)
BOY$15,001BOYAmt
EOY$15,006EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$9,123BOYAmt
EOY$0EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$11,673,099LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$5,348,454LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$6,389,693BOYAmt
EOY$6,324,645EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$5,609,539BOYAmt
EOY$6,190,978EOYAmt

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)
BOY$42,722BOYAmt
EOY$2,722EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$14,292,988BOYAmt
EOY$14,990,056EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$296,023BOYAmt
EOY$253,300EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$370,000BOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$666,023BOYAmt
EOY$253,300EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$12,704,578BOYAmt
EOY$13,293,010EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$922,387BOYAmt
EOY$1,443,746EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$13,626,965BOYAmt
EOY$14,736,756EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$14,292,988BOYAmt
EOY$14,990,056EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$642,050ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$467,741NetUnrlzdGainsLossesInvstAmt
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$2,435,834CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$3,100,326CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$2,569,035CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$4,109,935CurrentTaxYearMinus1YearAmt
Current Tax Year$4,277,877CurrentTaxYearAmt
Total$16,493,007TotalAmt

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$2,435,834CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$3,100,326CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$2,569,035CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$4,109,935CurrentTaxYearMinus1YearAmt
Current Tax Year$4,277,877CurrentTaxYearAmt
Total$16,493,007TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$1,316,063SubstantialContributorsTotAmt
Public Support Total170$15,176,944PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$91,428CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$87,057CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$121,239CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$110,510CurrentTaxYearMinus1YearAmt
Current Tax Year$95,410CurrentTaxYearAmt
Total$505,644TotalAmt

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$16,998,651TotalSupportAmt
Gross Receipts Rltd Activities$281,226GrossReceiptsRltdActivitiesAmt
Public Support CY1700.89280PublicSupportCY170Pct
Public Support PY1700.89210PublicSupportPY170Pct
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

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$5,656,919BeginningYearBalanceAmt
Investment Earnings Or Losses$881,316InvestmentEarningsOrLossesAmt
Other Expenditures$227,107OtherExpendituresAmt
Administrative Expenses$35,068AdministrativeExpensesAmt
End Year Balance$6,276,060EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$5,533,632BeginningYearBalanceAmt
Investment Earnings Or Losses$701,568InvestmentEarningsOrLossesAmt
Other Expenditures$549,197OtherExpendituresAmt
Administrative Expenses$29,084AdministrativeExpensesAmt
End Year Balance$5,656,919EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$4,540,558BeginningYearBalanceAmt
Contributions$450,000ContributionsAmt
Investment Earnings Or Losses$999,108InvestmentEarningsOrLossesAmt
Other Expenditures$425,167OtherExpendituresAmt
Administrative Expenses$30,867AdministrativeExpensesAmt
End Year Balance$5,533,632EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$5,209,017BeginningYearBalanceAmt
Investment Earnings Or Losses-$327,504InvestmentEarningsOrLossesAmt
Other Expenditures$308,634OtherExpendituresAmt
Administrative Expenses$32,321AdministrativeExpensesAmt
End Year Balance$4,540,558EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$4,757,863BeginningYearBalanceAmt
Investment Earnings Or Losses$717,457InvestmentEarningsOrLossesAmt
Other Expenditures$232,780OtherExpendituresAmt
Administrative Expenses$33,523AdministrativeExpensesAmt
End Year Balance$5,209,017EndYearBalanceAmt
FieldValueIRS element (for citing)
Endowments Held Unrelated OrgfalseEndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgfalseEndowmentsHeldRelatedOrgInd
Related Org List Sch RfalseRelatedOrgListSchRInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,668,824OtherCostOrOtherBasisAmt
Book Value$2,668,824BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$6,724,965OtherCostOrOtherBasisAmt
Depreciation$3,468,458DepreciationAmt
Book Value$3,256,507BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,994,267OtherCostOrOtherBasisAmt
Depreciation$1,643,321DepreciationAmt
Book Value$350,946BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$285,043OtherCostOrOtherBasisAmt
Depreciation$236,675DepreciationAmt
Book Value$48,368BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$6,324,645TotalBookValueLandBuildingsAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$8,284,622TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$467,741NetUnrealizedGainsInvstAmt
Donated Services And Use Fclts$2,136,466DonatedServicesAndUseFcltsAmt
Revenue Not Reported$2,604,207RevenueNotReportedAmt
Revenue Subtotal$5,680,415RevenueSubtotalAmt
Investment Expenses Not Incld$36,594InvestmentExpensesNotIncldAmt
Revenue Not Reported Fincl Stmt$36,594RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$5,717,009TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$7,174,831TotExpnsEtcAuditedFinclStmtAmt
Donated Services Use Fclts$2,136,466DonatedServicesUseFcltsAmt
Expenses Not Reported$2,136,466ExpensesNotReportedAmt
Expenses Subtotal$5,038,365ExpensesSubtotalAmt
Investment Expenses Not Incld2$36,594InvestmentExpensesNotIncld2Amt
Expenses Not Rpt Fincl Stmt$36,594ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$5,074,959TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart X : FIN48 FootnoteFormAndLineReferenceDesc
ExplanationThe Organization recognizes the tax benefit from an uncertain tax position only if it is more likely than not that the tax position will be sustained on examination by the taxing authority, based on the technical merits of the position. As of December 31, 2021 and 2020, there are no known items which would result in a material accrual related to where the Organization has federal or state attributable tax positions. Generally, the taxing authorities have three years to examine a tax return from the later of the filing date or the extended due date.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Written Employment ContractYes (X)WrittenEmploymentContractInd
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt
BREANNA LATHROP
COO$153,620$2,916$156,536
DR JOHN SIEWEKE
Dental Serv Dir.$169,546$3,253$184,054$11,255

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Line 2: Description of Business or Family Relationship of Officers, Directors, EtDR. WILLIAM WARREN, IV AND GLENN D. WARREN ARE BROTHERS. BOTH INDIVIDUALS SERVE ON THE ORGANIZATION'S BOARD.
Form 990, Part VI, Line 11b: Form 990 Review ProcessTHE ORGANIZATION PROVIDES A COPY OF FORM 990 TO THE BOARD OF DIRECTORS FOR REVIEW AND APPROVAL PRIOR TO FILING.
Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of ConflictsALL BOARD MEMBERS MUST SIGN THE CONFLICT OF INTEREST POLICY & DUTY TO DISCLOSE WHICH STATES "IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICT OF INTEREST, AN INTERESTED PERSON MUST DISCLOSE THE EXISTANCE OF THE FINANCIAL INTEREST AND BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE DIRECTORS AND MEMBERS OF COMMITTEES WITH GOVERNING BOARD DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT."POLICY COMPLIANCE IS MONITORED BY THE ORGANIZATION'S GOVERNANCE AND EXECUTIVE COMMITTEE.
Form 990, Part VI, Line 15a: Compensation Review & Approval Process - CEO, Top ManagementTHESE SALARIES ARE REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS ON AN ANNUAL BASIS.
Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key EmployeesTHESE SALARIES ARE REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS ON AN ANNUAL BASIS.
Form 990, Part VI, Line 18: Explanation of Other Means Forms Available For Public InspectionTHE ORGANIZATION PROVIDES A COPY OF THE FORM 990 SPECIFICALLY FOR PUBLIC INSPECTION. THIS COPY IS AVAILABLE ON THE ORGANIZATION'S WEBSITE AS WELL AS UPON REQUEST. THE ORGANIZATION ALSO POSTS A COPY OF FORM 990 ON THE GUIDESTAR WEBSITE.
Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailableAVAILABLE UPON REQUEST.