HARDEMAN COUNTY COMMUNITY HEALTH CENTER: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- HARDEMAN COUNTY COMMUNITY HEALTH CENTER (EIN 58-1995646)
- Tax period
- 2021-07-01 to 2022-06-30
- Filed
- 2022-11-16
- IRS object ID
- 202233209349302438
- Schema version
- 2021v4.1
- 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 | 2022-11-16T12:57:53-08:00 | ReturnTs |
| Tax Period End | 2022-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 621867889 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Terry Horne CPA Inc | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 732 West Main Street | AddressLine1Txt |
| City | Lebanon | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37087 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 581995646 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HARDEMAN COUNTY COMMUNITY HEALTH CENTER INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | HARD | BusinessNameControlTxt |
| Phone | 7316583388 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 720 | AddressLine1Txt |
| City | BOLIVAR | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 38008 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MARLITA WHITE | PersonNm |
| Person Title | CHIEF EXECUTIVE OFFICER | PersonTitleTxt |
| Phone | 7316583388 | PhoneNum |
| Signature | 2022-11-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | MARLITA | PersonFirstNm |
| Person Last | WHITE | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | XXX-XX-XXXX | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Terry Horne CPA | PreparerPersonNm |
| PTIN | P00120946 | PTIN |
| Phone | 6154447293 | PhoneNum |
| Preparation | 2022-11-16 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Federated Assurance Level | FAL1 | FederatedAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MARLITA WHITE | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 720 | AddressLine1Txt |
| City | BOLIVAR | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 38008 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $7,984,503 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1992 | FormationYr |
| Legal Domicile State | TN | LegalDomicileStateCd |
| Activity Or Mission | THE ORGANIZATION PROVIDES HEALTH CARE TO INDIVIDUALS REGARDLESS OF THEIR ABILITY TO PAY. THIS IS A DIRECT FULFILLMENT OF THEIR TAX EXEMPT PURPOSE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 89 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $5,496,815 | PYContributionsGrantsAmt |
| CY Contributions Grants | $4,158,301 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $3,390,022 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $3,811,268 | CYProgramServiceRevenueAmt |
| PY Investment Income | $19,373 | PYInvestmentIncomeAmt |
| CY Investment Income | $14,934 | CYInvestmentIncomeAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $8,906,210 | PYTotalRevenueAmt |
| CY Total Revenue | $7,984,503 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $4,818,896 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $4,966,075 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $2,426,195 | PYOtherExpensesAmt |
| CY Other Expenses | $2,821,964 | CYOtherExpensesAmt |
| PY Total Expenses | $7,245,091 | PYTotalExpensesAmt |
| CY Total Expenses | $7,788,039 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,661,119 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $196,464 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $6,631,282 | TotalAssetsBOYAmt |
| Total Assets EOY | $6,616,339 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $561,954 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $373,894 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $6,069,328 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $6,242,445 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE ORGANIZATION PROVIDES HEALTH CARE TO INDIVIDUALS REGARDLESS OF THEIR ABILITY TO PAY. THIS IS A DIRECT FULFILLMENT OF THEIR TAX EXEMPT PURPOSE. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $5,605,950 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $3,811,268 | RevenueAmt |
| Desc | THE ORGANIZATION PROVIDES HEALTH CARE REGARDLESS OF THE INDIVIDUALS' ABILITY TO PAY. THESE MEDICAL SERVICES ARE PROVIDED IN AREAS THAT HAVE A SHORTAGE OF HEALTH CARE PROVIDERS. THIS IS A DIRECT FULFILLMENT OF THEIR TAX EXEMPT PURPOSE. OVER 26,500 VISITS WERE PROVIDED DURING THE YEAR. | Desc |
| Total Program Service Expenses | $5,605,950 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (true) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | Yes (true) | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | false | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 5 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 89 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| DAF Excess Business Holdings | false | DAFExcessBusinessHoldingsInd |
| Taxable Distributions | false | TaxableDistributionsInd |
| Distribution To Donor | false | DistributionToDonorInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | LINDA LOVELACE | PersonNm |
| Phone | 7316583388 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 629 NUCKOLLS ROAD | AddressLine1Txt |
| City | BOLIVAR | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 38008 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| BARBARA HUDSON | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DONNA PINNER | |||||||
| CHAIR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| ERMA WILLIAMS | |||||||
| VICE-CHAIR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| RICHARD TEUBNER | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| EVELYN C ROBERTSON JR | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DELPHUS HICKS | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| LINDA JONES | |||||||
| SECRETARY | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| OCIE HOLMES | |||||||
| TREASURER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| LINDA PATTERSON | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| ROSIE PERRY | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| ANITA JO PARKS | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| MARLITA WHITE | |||||||
| CHIEF EXECUTIVE OFFICER | 40.00 | $119,013 | $0 | $11,649 | Yes (X) | ||
| LINDA LOVELACE | |||||||
| CHIEF FINANCIAL OFFICER | 40.00 | $101,744 | $0 | $10,752 | Yes (X) | ||
| ROBERT DAVIS | |||||||
| CHIEF OPERATIONAL OFFICER | 40.00 | $73,795 | $0 | $2,301 | Yes (X) | ||
| THOMAS CARUTHERS | |||||||
| MEDICAL DIRECTOR | 40.00 | $178,657 | $0 | $7,636 | Yes (X) | ||
| RICHARD REINHARD | |||||||
| PHYSICIAN | 40.00 | $193,621 | $0 | $7,794 | Yes (X) | ||
| ERIC FOLK | |||||||
| PHARMACIST | 40.00 | $136,442 | $0 | $13,566 | Yes (X) | ||
| KAREN SALVAGGIO | |||||||
| NURSE PRACTITIONER | 40.00 | $117,542 | $0 | $12,198 | Yes (X) | ||
| LAURA MELARO | |||||||
| PSYCHIATRIC NURSE PRACTITIONER | 40.00 | $140,333 | $0 | $7,673 | Yes (X) | ||
| JOHN BLANKENSHIP | |||||||
| PHYSICIAN | 40.00 | $154,318 | $0 | $7,673 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,215,465 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $81,242 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 8 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (3 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| LABORATORY CORPORATION OF AMERICA HOLDINGS | |||||
| PO BOX 12140 | BURLINGTON | NC | 27216 | CONTRACT LAB SERVICES | $165,621 |
| NEXTGEN HEALTHCARE INC | |||||
| PO BOX 809390 | CHICAGO | IL | 60680 | CONTRACT BILLING SERVICES | $176,414 |
| VC3 INC | |||||
| 1301 GERVAIS ST SUITE 1800 | COLUMBIA | SC | 29201 | CONTRACT IT SERVICES | $113,286 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 3 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $3,519,999 | GovernmentGrantsAmt |
| All Other Contributions | $638,302 | AllOtherContributionsAmt |
| Noncash Contributions | $638,302 | NoncashContributionsAmt |
| Total Contributions | $4,158,301 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT FEES | Desc |
| Business | 621111 | BusinessCd |
| Total Revenue Column | $3,811,268 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $3,811,268 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $14,934 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $14,934 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $7,984,503 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,811,268 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $14,934 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $501,838 | TotalAmt |
| Program Services | $405,577 | ProgramServicesAmt |
| Management And General | $96,261 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,722,941 | TotalAmt |
| Program Services | $2,535,217 | ProgramServicesAmt |
| Management And General | $1,187,724 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $87,545 | TotalAmt |
| Program Services | $55,153 | ProgramServicesAmt |
| Management And General | $32,392 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $434,313 | TotalAmt |
| Program Services | $270,306 | ProgramServicesAmt |
| Management And General | $164,007 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $219,438 | TotalAmt |
| Program Services | $138,246 | ProgramServicesAmt |
| Management And General | $81,192 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $34,150 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $34,150 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $367,128 | TotalAmt |
| Program Services | $279,762 | ProgramServicesAmt |
| Management And General | $87,366 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $354,601 | TotalAmt |
| Program Services | $147,325 | ProgramServicesAmt |
| Management And General | $207,276 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $94,655 | TotalAmt |
| Program Services | $69,258 | ProgramServicesAmt |
| Management And General | $25,397 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $118,964 | TotalAmt |
| Program Services | $95,492 | ProgramServicesAmt |
| Management And General | $23,472 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,079 | TotalAmt |
| Program Services | $12,283 | ProgramServicesAmt |
| Management And General | $23,796 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $156,172 | TotalAmt |
| Program Services | $71,588 | ProgramServicesAmt |
| Management And General | $84,584 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,265 | TotalAmt |
| Program Services | $16,375 | ProgramServicesAmt |
| Management And General | $2,890 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| CONTRACT 340B PHARMACY FESS | $69,733 | $69,733 | $0 | $0 |
| MEDICAL SUPPLIES & PHARMACEUTICALS | $1,315,679 | $1,315,679 | $0 | $0 |
| EHR SYSTEM FEES | $121,432 | $0 | $121,432 | $0 |
| RECRUITMENT AND PATIENT EDUCATION | $134,106 | $123,956 | $10,150 | $0 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,788,039 | TotalAmt |
| Program Services | $5,605,950 | ProgramServicesAmt |
| Management And General | $2,182,089 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $188,191 | BOYAmt |
| EOY | $195,264 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,763,278 | BOYAmt |
| EOY | $2,674,593 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $104,024 | BOYAmt |
| EOY | $129,152 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $568,415 | BOYAmt |
| EOY | $481,656 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,072 | BOYAmt |
| EOY | $22,711 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $144,496 | BOYAmt |
| EOY | $86,769 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $4,023,532 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,823,322 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,158,611 | BOYAmt |
| EOY | $2,200,210 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $681,195 | BOYAmt |
| EOY | $825,984 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,631,282 | BOYAmt |
| EOY | $6,616,339 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $561,954 | BOYAmt |
| EOY | $373,894 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $561,954 | BOYAmt |
| EOY | $373,894 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,069,328 | BOYAmt |
| EOY | $6,242,445 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,069,328 | BOYAmt |
| EOY | $6,242,445 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,631,282 | BOYAmt |
| EOY | $6,616,339 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $196,464 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$23,347 | NetUnrlzdGainsLossesInvstAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
| Other Support Sum | $0 | OtherSupportSumAmt |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,594,681 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,756,759 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,529,028 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $5,496,815 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,158,301 | CurrentTaxYearAmt |
| Total | $17,535,584 | TotalAmt |
Tax Rev Levied Orgnztnl Bnft170 TaxRevLeviedOrgnztnlBnft170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,594,681 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,756,759 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,529,028 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $5,496,815 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,158,301 | CurrentTaxYearAmt |
| Total | $17,535,584 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $0 | SubstantialContributorsTotAmt |
| Public Support Total170 | $17,535,584 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $12,293 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $10,520 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $24,855 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $19,373 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $14,934 | CurrentTaxYearAmt |
| Total | $81,975 | TotalAmt |
Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $17,617,559 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $17,039,957 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.99530 | PublicSupportCY170Pct |
| Public Support PY170 | 0.99530 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
| Public Support Total509 | $0 | PublicSupportTotal509Amt |
| Public Support CY509 | 0 | PublicSupportCY509Pct |
| Investment Income CY | 0 | InvestmentIncomeCYPct |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $143,030 | InvestmentCostOrOtherBasisAmt |
| Book Value | $143,030 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $2,610,344 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $1,075,770 | DepreciationAmt |
| Book Value | $1,534,574 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $1,133,226 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $747,552 | DepreciationAmt |
| Book Value | $385,674 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $136,932 | InvestmentCostOrOtherBasisAmt |
| Book Value | $136,932 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $2,200,210 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | INVESTMENTS-CDS | Desc |
| Book Value | $825,984 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $825,984 | TotalBookValueSecuritiesAmt |
| Total Rev Etc Audited Fincl Stmt | $8,099,063 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$23,347 | NetUnrealizedGainsInvstAmt |
| Donated Services And Use Fclts | $137,907 | DonatedServicesAndUseFcltsAmt |
| Revenue Not Reported | $114,560 | RevenueNotReportedAmt |
| Revenue Subtotal | $7,984,503 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $7,984,503 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $7,925,946 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $137,907 | DonatedServicesUseFcltsAmt |
| Expenses Not Reported | $137,907 | ExpensesNotReportedAmt |
| Expenses Subtotal | $7,788,039 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $7,788,039 | TotalExpensesPerForm990Amt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| THOMAS CARUTHERS | |||||||||||||
| $178,657 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $7,636 | $0 | $186,293 | $0 | $0 | $0 |
| RICHARD REINHARD | |||||||||||||
| $193,621 | $0 | $0 | $0 | $0 | $0 | $7,686 | $0 | $108 | $0 | $201,415 | $0 | $0 | $0 |
| ERIC FOLK | |||||||||||||
| $136,442 | $0 | $0 | $0 | $0 | $0 | $5,893 | $0 | $7,673 | $0 | $150,008 | $0 | $0 | $0 |
| JOHN BLANKENSHIP | |||||||||||||
| $154,318 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $7,673 | $0 | $161,991 | $0 | $0 | $0 |
Schedule M IRS990ScheduleM
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 42553 | ContributionCnt |
| Noncash Contributions Rpt F990 | $638,302 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | Yes (true) | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | false | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Pt VI, Line 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST |
| Pt VI, Line 19 | POLICY AND FORM 990 AVAILABLE UPON WRITTEN REQUEST. |
| Pt XII, Line 2c | THE CEO AND CFO OVERSEE FINANCIAL STATEMENT PREPARATION AND AUDIT ENGAGEMENT. |
| Pt VI, Line 11b | THE CEO, CFO AND FINANCE COMMITTEE REVIEW THE FORM 990. |
| Pt VI, Line 12c | ANNUALLY THE CONFLICT OF INTEREST STATEMENT IS SIGNED BY BOARD MEMBERS AND |
| Pt VI, Line 12c | REVIEWED BY THE ENTIRE BOARD. BOARD MEMBERS SHALL EXCUSE THEMSELVES FROM |
| Pt VI, Line 12c | ISSUES THAT ENHANCE THE PROBABILITY OF THEIR OWN PERSONAL AND PRIVATE GAIN. |
| Pt VI, Line 15a | STATE AND NATIONAL SALARY COMPARISONS ARE USED TO ESTABLISH SALARY LIMITS |
| Pt VI, Line 15b | FOR TOP MANAGEMENT OFFICIALS. PERFORMANCE EVALUATIONS ARE PREFORMED ANNUALLY |
| Pt VI, Line 15b | AND SALARY INCREASES ARE BOARD APPROVED. |