HIGH COUNTRY COMMUNITY HEALTH: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- HIGH COUNTRY COMMUNITY HEALTH (EIN 27-3033445)
- Tax period
- 2020-05-01 to 2021-04-30
- Filed
- 2021-08-31
- IRS object ID
- 202102439349300720
- Schema version
- 2020v4.1
- 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 | 2021-08-31T14:02:48-07:00 | ReturnTs |
| Tax Period End | 2021-04-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
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 | 2020-05-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 273033445 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HIGH COUNTRY COMMUNITY HEALTH INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | HIGH | BusinessNameControlTxt |
| Phone | 8282623886 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1490 | AddressLine1Txt |
| City | BOONE | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28607 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ALICE SALTHOUSE | PersonNm |
| Person Title | CHIEF EXECUTIVE OFFICER | PersonTitleTxt |
| Phone | 8282623886 | PhoneNum |
| Signature | 2021-08-31 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | ALICE | PersonFirstNm |
| Person Last | SALTHOUSE | 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 | 2021-08-31 | 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 | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ALICE SALTHOUSE | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 108 DOCTORS DRIVE | AddressLine1Txt |
| City | BOONE | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28607 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $14,198,577 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2011 | FormationYr |
| Legal Domicile State | NC | LegalDomicileStateCd |
| Activity Or Mission | THIS 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 | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 13 | VotingMembersIndependentCnt |
| Total Employee | 147 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $3,251,864 | PYContributionsGrantsAmt |
| CY Contributions Grants | $5,984,666 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $5,812,312 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $8,213,719 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,530 | PYInvestmentIncomeAmt |
| CY Investment Income | $192 | CYInvestmentIncomeAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $9,065,706 | PYTotalRevenueAmt |
| CY Total Revenue | $14,198,577 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $5,422,595 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $6,841,697 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $2,071,171 | PYOtherExpensesAmt |
| CY Other Expenses | $3,610,752 | CYOtherExpensesAmt |
| PY Total Expenses | $7,493,766 | PYTotalExpensesAmt |
| CY Total Expenses | $10,452,449 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,571,940 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $3,746,128 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $5,532,200 | TotalAssetsBOYAmt |
| Total Assets EOY | $10,762,472 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,787,703 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $4,206,849 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $2,744,497 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $6,555,623 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THIS 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 | $7,524,212 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $8,213,719 | RevenueAmt |
| Desc | THE ORGANIZATION PROVIDES HEALTH CARE REGARDLESS OF 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 42,300 VISITS WERE PROVIDED DURING THE YEAR. | Desc |
| Total Program Service Expenses | $7,524,212 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 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 |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 37 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 147 | 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 |
| 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 | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 13 | 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 | TIFFANY MELCHERS | PersonNm |
| Phone | 8287735785 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1490 | AddressLine1Txt |
| City | BOONE | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 38607 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (24 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 |
|---|---|---|---|---|---|---|---|
| YOLANDA ADAMS | |||||||
| CHAIR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| CHARLIE BRADY | |||||||
| TREASURER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| CYNTHIA DILLON | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DAVID DIXON | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| ANDI GELSTHORPE | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| NICOLE HIEGL | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| KAT ELLER | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JOE LANDOWNE | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| KATIE LANGLEY | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| TINA HOUSTON | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| KEVIN WHITE | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| SARAH STAMEY | |||||||
| SECRETARY | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| CHIP WATKINS | |||||||
| EX-OFFICIO | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| ALICE SALTHOUSE | |||||||
| CHIEF EXECUTIVE OFFICER | 40.00 | $155,310 | $0 | $6,915 | Yes (X) | ||
| TIFFANY MELCHERS | |||||||
| CHIEF FINANCIAL OFFICER | 40.00 | $106,157 | $0 | $4,609 | Yes (X) | ||
| ALYSIA HOOVER - THOMPSON | |||||||
| DIRECTOR OF BEHAVIORAL HEALTH | 40.00 | $102,006 | $0 | $7,724 | Yes (X) | ||
| LEIGH ANN BYRD | |||||||
| CHIEF OPERATIONAL OFFICER | 40.00 | $92,571 | $0 | $9,742 | Yes (X) | ||
| LARRY ELKINS | |||||||
| MEDICAL DIRECTOR | 40.00 | $138,269 | $0 | $1,313 | Yes (X) | ||
| JENNIFER PIERCE | |||||||
| DENTAL DIRECTOR | 40.00 | $140,888 | $0 | $5,959 | Yes (X) | ||
| GLEN LIESEGANG | |||||||
| PHYSICIAN | 40.00 | $126,050 | $0 | $11,362 | Yes (X) | ||
| RICHARD GREENE | |||||||
| DENTIST | 40.00 | $136,993 | $0 | $3,313 | Yes (X) | ||
| WILLIAM JOHANSON | |||||||
| PHYSICIAN | 40.00 | $162,011 | $0 | $5,681 | Yes (X) | ||
| MARY JO MCDONNELL | |||||||
| PHYSICIAN | 40.00 | $164,963 | $0 | $4,477 | Yes (X) | ||
| COLEEN DAVIS | |||||||
| DENTIST | 40.00 | $130,429 | $0 | $5,891 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,455,647 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $66,986 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 10 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| ECLINICALWORKS LLC | |||||
| PO BOX 847950 | BOSTON | MA | 02284 | CONTRACT BILLING SERVICES/SUPPORT | $126,919 |
| CHARTSPAN MEDICAL | |||||
| 411 UNIVERSITY RIDGE SUITE 220 | GREENVILLE | SC | 29601 | CONTRACT CHRONIC CARE MANAGEMENT SERVICES | $200,062 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $5,114,021 | GovernmentGrantsAmt |
| All Other Contributions | $870,645 | AllOtherContributionsAmt |
| Noncash Contributions | $719,726 | NoncashContributionsAmt |
| Total Contributions | $5,984,666 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT FEES | Desc |
| Business | 621111 | BusinessCd |
| Total Revenue Column | $8,213,719 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $8,213,719 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $192 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $192 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $14,198,577 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $8,213,719 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $192 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $735,301 | TotalAmt |
| Program Services | $607,832 | ProgramServicesAmt |
| Management And General | $127,469 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,114,032 | TotalAmt |
| Program Services | $3,131,889 | ProgramServicesAmt |
| Management And General | $1,982,143 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $76,090 | TotalAmt |
| Program Services | $48,698 | ProgramServicesAmt |
| Management And General | $27,392 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $505,324 | TotalAmt |
| Program Services | $323,407 | ProgramServicesAmt |
| Management And General | $181,917 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $410,950 | TotalAmt |
| Program Services | $263,008 | ProgramServicesAmt |
| Management And General | $147,942 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $39,349 | TotalAmt |
| Program Services | $29,512 | ProgramServicesAmt |
| Management And General | $9,837 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $31,855 | TotalAmt |
| Program Services | $23,891 | ProgramServicesAmt |
| Management And General | $7,964 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $368,634 | TotalAmt |
| Program Services | $280,579 | ProgramServicesAmt |
| Management And General | $88,055 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,561 | TotalAmt |
| Program Services | $8,005 | ProgramServicesAmt |
| Management And General | $4,556 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $259,535 | TotalAmt |
| Program Services | $166,564 | ProgramServicesAmt |
| Management And General | $92,971 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $250,707 | TotalAmt |
| Program Services | $188,030 | ProgramServicesAmt |
| Management And General | $62,677 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $435,469 | TotalAmt |
| Program Services | $326,603 | ProgramServicesAmt |
| Management And General | $108,866 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $77,260 | TotalAmt |
| Program Services | $19,999 | ProgramServicesAmt |
| Management And General | $57,261 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $200,316 | TotalAmt |
| Program Services | $183,449 | ProgramServicesAmt |
| Management And General | $16,867 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $49,278 | TotalAmt |
| Program Services | $36,958 | ProgramServicesAmt |
| Management And General | $12,320 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| CONTRACT 340B ADMIN & DISPENSING FEES | $763,624 | $763,624 | $0 | $0 |
| PHARMACEUTICALS | $664,934 | $664,934 | $0 | $0 |
| MEDICAL SUPPLIES | $457,230 | $457,230 | $0 | $0 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,452,449 | TotalAmt |
| Program Services | $7,524,212 | ProgramServicesAmt |
| Management And General | $2,928,237 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $707,665 | BOYAmt |
| EOY | $10,178 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $808,808 | BOYAmt |
| EOY | $3,593,828 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $113,586 | BOYAmt |
| EOY | $168,992 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $642,114 | BOYAmt |
| EOY | $1,112,710 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $110,831 | BOYAmt |
| EOY | $52,595 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $6,609,725 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $796,056 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,138,696 | BOYAmt |
| EOY | $5,813,669 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $10,500 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,500 | BOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,532,200 | BOYAmt |
| EOY | $10,762,472 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $351,558 | BOYAmt |
| EOY | $772,420 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,600 | BOYAmt |
| EOY | $4,600 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,431,545 | BOYAmt |
| EOY | $3,429,829 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,787,703 | BOYAmt |
| EOY | $4,206,849 | 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 | $2,744,497 | BOYAmt |
| EOY | $6,490,623 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $65,000 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,744,497 | BOYAmt |
| EOY | $6,555,623 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,532,200 | BOYAmt |
| EOY | $10,762,472 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $3,746,128 | ReconcilationRevenueExpnssAmt |
| Prior Period Adjustments | -$2 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | $65,000 | OtherChangesInNetAssetsAmt |
| 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 | $1,900,986 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,283,853 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,358,628 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,251,864 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $5,984,666 | CurrentTaxYearAmt |
| Total | $15,779,997 | 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 | $1,900,986 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,283,853 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,358,628 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,251,864 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $5,984,666 | CurrentTaxYearAmt |
| Total | $15,779,997 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $0 | SubstantialContributorsTotAmt |
| Public Support Total170 | $15,779,997 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $74 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $56 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,530 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $192 | CurrentTaxYearAmt |
| Total | $1,854 | 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 | $15,781,851 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $23,832,039 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.99990 | PublicSupportCY170Pct |
| Public Support PY170 | 0.99980 | 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 | $1,587,052 | InvestmentCostOrOtherBasisAmt |
| Book Value | $1,587,052 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $4,242,579 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $324,550 | DepreciationAmt |
| Book Value | $3,918,029 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $780,094 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $471,506 | DepreciationAmt |
| Book Value | $308,588 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $5,813,669 | TotalBookValueLandBuildingsAmt |
| Total Rev Etc Audited Fincl Stmt | $14,198,577 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Subtotal | $14,198,577 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $14,198,577 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $10,452,449 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $10,452,449 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $10,452,449 | 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 (3 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ALICE SALTHOUSE | |||||||||||||
| $155,310 | $0 | $0 | $0 | $0 | $0 | $4,332 | $0 | $2,583 | $0 | $162,225 | $0 | $0 | $0 |
| WILLIAM JOHANSON | |||||||||||||
| $162,011 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $5,681 | $0 | $167,692 | $0 | $0 | $0 |
| MARY JO MCDONNELL | |||||||||||||
| $164,963 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $4,477 | $0 | $169,440 | $0 | $0 | $0 |
Schedule M IRS990ScheduleM
Real Estate Commercial RealEstateCommercialGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $561,776 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenuesTxt |
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 10530 | ContributionCnt |
| Noncash Contributions Rpt F990 | $157,950 | 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 (17 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 PERFORMED ANNUALLY |
| Pt VI, Line 15b | AND SALARY INCREASES ARE BOARD APPROVED. |
| Pt VI, Line 11b | THE FORM 990 IS PREPARED BY THE CENTER'S INDEPENDENT AUDITOR WITH REVIEW AND |
| Pt VI, Line 11b | INFORMATION PROVIDED BY THE CEO AND CFO. A COPY OF THE FORM 990 WILL BE GIVEN |
| Pt VI, Line 11b | AND REVIEWED WITH THE BOARD AFTER COMPLETION AND SUBMISSION BY THE AUDITOR. |
| Pt VI, Line 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND FORM 990 AVAILABLE UPON |
| Pt VI, Line 19 | WRITTEN REQUEST. |
| Pt VI, Line 12c | LEADERSHIP STAFF MEMBERS RETAIN AWARENESS OF BOARD MEMBER'S INTERIM |
| Pt VI, Line 12c | ACTIVITIES AND REPORT TO CEO ANY FINDINGS THAT MAY INTERFERE WITH ORGANIZATION'S |
| Pt VI, Line 12c | POLICY. THE CEO ADDRESSES SUCH ISSUES BY DISCUSSING SAME WITH APPLICABLE |
| Pt VI, Line 12c | BOARD MEMBER AND PRESENTS ACTION, IF NECESSARY, TO THE ENTIRE BOARD. THE |
| Pt VI, Line 12c | BOARD MEETING MINUTES REFLECT THESE ACTIONS. IF SUCH ISSUES WERE TO ARISE, |
| Pt VI, Line 12c | SUCH STAFF MEMBER WOULD THEN REPORT THEIR FINDINGS |
| Pt VI, Line 12c | TO THE BOARD'S EXECUTIVE COMMITTEE. |
| Pt XI | LINE 9 REPRESENTS THE NET CHANGE IN NET ASSETS WITH |
| Pt XI | DONOR RESTRICTIONS FOR THE YEAR. |