FREDERICKSBURG COMMUNITY HEALTH CTR: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- FREDERICKSBURG COMMUNITY HEALTH CTR (EIN 91-2129853)
- Tax period
- 2020-01-01 to 2020-12-31
- Filed
- 2021-10-14
- IRS object ID
- 202102879349301030
- Schema version
- 2020v4.0
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-10-14T13:13:33-05:00 | ReturnTs |
| Tax Period End | 2020-12-31 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 912129853 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Fredericksburg Community Health Center | BusinessNameLine1Txt |
| Business Name Line2 | The Good Samaritan Center | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % John D Willome | InCareOfNm |
| Business Name Control | FRED | BusinessNameControlTxt |
| Phone | 8309908651 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 140 Idustrial Loop Ste 100 | AddressLine1Txt |
| City | Fredericksburg | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 78624 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JOHN D WILLOME | PersonNm |
| Person Title | Executive Director | PersonTitleTxt |
| Phone | 8309908651 | PhoneNum |
| Signature | 2021-10-14 | SignatureDt |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | JOHN | PersonFirstNm |
| Person Last | WILLOME | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | XXX-XX-XXXX | SSN |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 0 | TrustedCustomerCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| 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) |
|---|---|---|
| Initial Return | Yes (X) | InitialReturnInd |
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | The Good Samaritan Center | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JOHN D WILLOME | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 608 Courtney St | AddressLine1Txt |
| City | Fredericksburg | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 78624 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $1,871,153 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.goodsamfbg.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2002 | FormationYr |
| Legal Domicile State | TX | LegalDomicileStateCd |
| Activity Or Mission | To provide a safe Christcentered environment that gives our patients quality coordinated and affordable healthcare | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 13 | VotingMembersIndependentCnt |
| Total Employee | 16 | TotalEmployeeCnt |
| Total Volunteers | 40 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $1,522,779 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,707,730 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $198,058 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $108,114 | CYProgramServiceRevenueAmt |
| PY Investment Income | $15,160 | PYInvestmentIncomeAmt |
| CY Investment Income | $7,193 | CYInvestmentIncomeAmt |
| PY Other Revenue | $43,411 | PYOtherRevenueAmt |
| CY Other Revenue | $48,116 | CYOtherRevenueAmt |
| PY Total Revenue | $1,779,408 | PYTotalRevenueAmt |
| CY Total Revenue | $1,871,153 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $841,740 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $799,967 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $86,617 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $886,201 | PYOtherExpensesAmt |
| CY Other Expenses | $806,319 | CYOtherExpensesAmt |
| PY Total Expenses | $1,727,941 | PYTotalExpensesAmt |
| CY Total Expenses | $1,606,286 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $51,467 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $264,867 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $1,844,764 | TotalAssetsBOYAmt |
| Total Assets EOY | $2,142,902 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $4,804 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $4,374 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,839,960 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $2,138,528 | NetAssetsOrFundBalancesEOYAmt |
| Mission | The mission of the Good Samaritan Center is to provide a safe, Christ- Centered environment that gives our patients quality, coordinated and affordable healthcare. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $1,306,236 | ExpenseAmt |
| Grant | $132,500 | GrantAmt |
| Revenue | $105,708 | RevenueAmt |
| Desc | The Center provides medical appointments and specialist referrals for over 1,000 unduplicated individuals who are low-income and uninsured. We serve Gillespie, Blanco, Kimble and Llano Counties as well as the towns of Comfort and Brady. Medical services also include prescription assistance, financial assistance in acquiring complicated medical procedures, one-on-one diabetes education, public health screenings, and home visits. Partnerships include Hill Country Memorial Health System, nearly every specialist in town, Methodist Healthcare Ministries, Prevent Blindness Texas, and Kidney Foundation of Texas. We also address nutrition by partnering with First Baptist church to host the monthly food truck from Central Texas Food Bank. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $246,513 | ExpenseAmt |
| Grant | $1,000 | GrantAmt |
| Revenue | $21,785 | RevenueAmt |
| Desc | The Center provides basic dental care, including fillings, extractions and cleanings for 550 unduplicated low-income, uninsured individuals. This includes seniors who have Medicare, but no dental coverage. We employ a part-time dentist three days a week, and then enjoy the volunteer services of four local dentists and two local hygienists on the fourth day. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $53,533 | ExpenseAmt |
| Desc | The Center offers patients jthe opportunity to meet with a bilingual LPC. Patients often have circumstances in their lives when they need to meet with a counselor and work through the challenges they have faced, are facing, or a combination of both. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $1,606,282 | 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 | Yes (true) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | false | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | 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 | false | 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 | 17 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 16 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | false | Form990TFiledInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | Yes (true) | NondeductibleContributionsInd |
| Nondeductible Contri Discl | Yes (true) | NondeductibleContriDisclInd |
| Quid Pro Quo Contributions | Yes (true) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (true) | QuidProQuoContriDisclInd |
| 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 | WENDY BUSH | PersonNm |
| Phone | 8304562171 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 412 S Adams Ste 1165 | AddressLine1Txt |
| City | Fredericksburg | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 78624 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd |
|---|---|---|---|---|---|---|
| SHARON JOSEPH | ||||||
| Board President | 2.000 | Yes (X) | $0 | $0 | $0 | |
| PHILIP MAPLE | ||||||
| Board Vice President | 2.000 | Yes (X) | $0 | $0 | $0 | |
| JAMES HEUPEL | ||||||
| Board Secretary | 2.000 | Yes (X) | $0 | $0 | $0 | |
| ANN HOCH | ||||||
| Board Treasurer | 2.000 | Yes (X) | $0 | $0 | $0 | |
| JILL CARR | ||||||
| Board Member | 1.000 | Yes (X) | $0 | $0 | $0 | |
| RUTHANN HOOVER | ||||||
| Board Member | 1.000 | Yes (X) | $0 | $0 | $0 | |
| JOHN R KOTHMANN | ||||||
| Board Member | 1.000 | Yes (X) | $0 | $0 | $0 | |
| BRENNA NANCE | ||||||
| Board Member | 1.000 | Yes (X) | $0 | $0 | $0 | |
| JIM OVERMAN | ||||||
| Board Member | 1.000 | Yes (X) | $0 | $0 | $0 | |
| KENDRA PESEK | ||||||
| Board Member | 1.000 | Yes (X) | $0 | $0 | $0 | |
| CYNTHIA SCROGGINS | ||||||
| Board Member | 1.000 | Yes (X) | $0 | $0 | $0 | |
| MARCUS VIDRINE | ||||||
| Board Member | 1.000 | Yes (X) | $0 | $0 | $0 | |
| JOHN YOUNGBLOOD | ||||||
| Board Member | 1.000 | Yes (X) | $0 | $0 | $0 | |
| JOHN D WILLOME | ||||||
| Executive Director | 40.00 | $118,552 | $0 | $0 | Yes (X) | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $118,552 | TotalReportableCompFromOrgAmt |
| Indiv Rcvd Greater Than100 K | 2 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | false | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Rachel Myers MD | |||||
| 140 Industrial Lp Ste 100 | Fredericksburg | TX | 78624 | Healthcare Provider | $141,040 |
| Patricia Garza LPC | |||||
| 140 Industrial Lp Ste 100 | Fredericksburg | TX | 78624 | Mental Health Counseling | $27,600 |
| Hill Country Memorial Hosp | |||||
| PO Box 835 | Fredericksburg | TX | 78624 | Blood Work Imaging | $48,695 |
| South Texas Radiology | |||||
| PO Box 29490 | San Antonio | TX | 78229 | Radiology Interpretation | $21,931 |
| Quest Diagnostics | |||||
| PO Box 822510 | Philadelphia | PA | 19182 | Blood Work Services | $18,989 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $3,288 | FundraisingAmt |
| All Other Contributions | $1,704,442 | AllOtherContributionsAmt |
| Noncash Contributions | $464,107 | NoncashContributionsAmt |
| Total Contributions | $1,707,730 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Patient Appt Fees | 621110 | $55,459 | $55,459 |
| Lab Imaging Fees | 621500 | $52,313 | $52,313 |
| Requested Records | 621110 | $342 | $342 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $108,114 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $7,193 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $7,193 | RelatedOrExemptFuncIncomeAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $48,116 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $48,116 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $48,116 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $48,116 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contri Rpt Fundraising Event | $3,288 | ContriRptFundraisingEventAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,871,153 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $163,423 | RelatedOrExemptFuncIncomeAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $115,380 | TotalAmt |
| Program Services | $23,076 | ProgramServicesAmt |
| Management And General | $57,690 | ManagementAndGeneralAmt |
| Fundraising | $34,614 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $613,411 | TotalAmt |
| Program Services | $554,972 | ProgramServicesAmt |
| Management And General | $33,200 | ManagementAndGeneralAmt |
| Fundraising | $25,239 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,440 | TotalAmt |
| Program Services | $21,306 | ProgramServicesAmt |
| Management And General | $3,180 | ManagementAndGeneralAmt |
| Fundraising | $954 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $45,736 | TotalAmt |
| Program Services | $34,998 | ProgramServicesAmt |
| Management And General | $7,078 | ManagementAndGeneralAmt |
| Fundraising | $3,660 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,028 | TotalAmt |
| Management And General | $7,028 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,861 | TotalAmt |
| Fundraising | $14,861 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $58,807 | TotalAmt |
| Program Services | $24,151 | ProgramServicesAmt |
| Management And General | $29,355 | ManagementAndGeneralAmt |
| Fundraising | $5,301 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,591 | TotalAmt |
| Program Services | $7,304 | ProgramServicesAmt |
| Management And General | $299 | ManagementAndGeneralAmt |
| Fundraising | $1,988 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,975 | TotalAmt |
| Program Services | $5,352 | ProgramServicesAmt |
| Management And General | $4,623 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $35,911 | TotalAmt |
| Program Services | $3,950 | ProgramServicesAmt |
| Management And General | $31,961 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,915 | TotalAmt |
| Program Services | $9,717 | ProgramServicesAmt |
| Management And General | $15,198 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Management And GeneralManagementAndGeneralAmt | Program ServicesProgramServicesAmt |
|---|---|---|---|
| Utilities | $15,393 | $15,393 | |
| Medical/Dental Supp & Svcs | $68,338 | $68,338 | |
| Lab & Imaging | $508,708 | $508,708 | |
| In-Kind Volunteer Hours | $52,792 | $8,697 | $44,095 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,606,286 | TotalAmt |
| Program Services | $1,305,967 | ProgramServicesAmt |
| Management And General | $213,702 | ManagementAndGeneralAmt |
| Fundraising | $86,617 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $94,448 | BOYAmt |
| EOY | $229,125 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $512,684 | BOYAmt |
| EOY | $646,651 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $1,245,478 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $530,727 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $750,662 | BOYAmt |
| EOY | $714,751 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $486,970 | BOYAmt |
| EOY | $552,375 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,844,764 | BOYAmt |
| EOY | $2,142,902 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,804 | BOYAmt |
| EOY | $4,374 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,804 | BOYAmt |
| EOY | $4,374 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Org Does Not Follow FASB117 | Yes (X) | OrgDoesNotFollowFASB117Ind |
Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,987 | BOYAmt |
| EOY | $2,987 | EOYAmt |
Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,836,973 | BOYAmt |
| EOY | $2,135,541 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,839,960 | BOYAmt |
| EOY | $2,138,528 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,844,764 | BOYAmt |
| EOY | $2,142,902 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $264,867 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $33,701 | NetUnrlzdGainsLossesInvstAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | Yes (true) | AccountantCompileOrReviewInd |
Acct Compile Or Review Basis AcctCompileOrReviewBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,254,115 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,422,950 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,321,826 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,562,779 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,430,229 | CurrentTaxYearAmt |
| Total | $6,991,899 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,254,115 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,422,950 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,321,826 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,562,779 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,430,229 | CurrentTaxYearAmt |
| Total | $6,991,899 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $2,929,248 | SubstantialContributorsTotAmt |
| Public Support Total170 | $4,062,651 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $80,511 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $55,799 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $55,462 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $58,571 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $55,308 | CurrentTaxYearAmt |
| Total | $305,651 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $7,297,550 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $661,653 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.55671 | PublicSupportCY170Pct |
| Public Support PY170 | 0.55000 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Disclosed Org Leg Ctrl | false | DisclosedOrgLegCtrlInd |
| Disclosed For Charitable Prps | false | DisclosedForCharitablePrpsInd |
| Written Policy Monitoring | false | WrittenPolicyMonitoringInd |
| Section170h Rqr Stsfd | false | Section170hRqrStsfdInd |
| Solicited Assets Sale | false | SolicitedAssetsSaleInd |
| Agent Trustee Etc | false | AgentTrusteeEtcInd |
| Incl Escrow Custodial Acct Liab | false | InclEscrowCustodialAcctLiabInd |
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $486,970 | BeginningYearBalanceAmt |
| Contributions | $31,702 | ContributionsAmt |
| Investment Earnings Or Losses | $33,703 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $552,375 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $424,578 | BeginningYearBalanceAmt |
| Contributions | $22,378 | ContributionsAmt |
| Investment Earnings Or Losses | $40,014 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $486,970 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $403,555 | BeginningYearBalanceAmt |
| Contributions | $16,800 | ContributionsAmt |
| Investment Earnings Or Losses | $10,623 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $6,400 | GrantsOrScholarshipsAmt |
| End Year Balance | $424,578 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $363,579 | BeginningYearBalanceAmt |
| Contributions | $20,350 | ContributionsAmt |
| Investment Earnings Or Losses | $29,626 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $10,000 | GrantsOrScholarshipsAmt |
| End Year Balance | $403,555 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $313,911 | BeginningYearBalanceAmt |
| Contributions | $17,050 | ContributionsAmt |
| Investment Earnings Or Losses | $32,618 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $363,579 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.73000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.27000 | PrmnntEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | Yes (true) | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | false | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $72,162 | OtherCostOrOtherBasisAmt |
| Book Value | $72,162 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,152,730 | OtherCostOrOtherBasisAmt |
| Depreciation | $519,167 | DepreciationAmt |
| Book Value | $633,563 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $20,586 | OtherCostOrOtherBasisAmt |
| Depreciation | $11,560 | DepreciationAmt |
| Book Value | $9,026 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $714,751 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (3 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| Operating Endowment | $286,088 |
| Designated Operating Endowment | $96,421 |
| Building Maintenance Endowment | $169,866 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $552,375 | TotalBookValueOtherAssetsAmt |
Schedule M IRS990ScheduleM
Other Non Cash Contri Table OtherNonCashContriTableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Desc | Lab & Image | Desc |
| Noncash Contributions Rpt F990 | $411,314 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | Half Retail Valu | 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 (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part VI Line 11b | The Center distributes the 990 and accompanying schedules to the board, |
| Part VI Line 11b | giving them 10 days to respond before submitting. |
| Part VI Line 12c | Only one potential conflict existed, and the board member was asked to |
| Part VI Line 12c | leave the room while that topic was discussed or voted upon. |
| Part VI Line 15a or b | The ED completes a self-evaluation. A board committee reviews it and |
| Part VI Line 15a or b | performs its own evaluation. Entire board votes on committee recommendation |
| Part VI Line 19 | Available upon request. |
| Part VI Line 11b | The Center distributes the 990 and accompanying schedules to the board, |
| Part VI Line 11b | giving them 10 days to respond before submitting |
| Part VI Line 12c | One one potential conflict existed, and the board member was asked to |
| Part VI Line 12c | leave the room while that topic was discussed or voted upon |
| Part VI Line 15a or b | The ED completes a self-evaluation. A board committee reviews it and |
| Part VI Line 15a | performs its own evaluation. Entire board votes on committee recommendation |
| Part VI Line 19 | Available upon request |