MIRASOL HEALTH INC: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- MIRASOL HEALTH INC (EIN 57-0774530)
- Tax period
- 2020-01-01 to 2020-12-31
- Filed
- 2021-06-30
- IRS object ID
- 202111819349300711
- Schema version
- 2020v4.1
- Note
- A later return for the same period supersedes this one.
- 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 | 2021-06-30T12:17:55-05:00 | ReturnTs |
| Tax Period End | 2020-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 570776381 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WEBSTERROGERS LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1999 | AddressLine1Txt |
| City | BLUFFTON | CityNm |
| State Abbreviation | SC | StateAbbreviationCd |
| ZIP | 29910 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 570774530 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOSPICE CARE OF THE LOWCOUNTRY INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | HOSP | BusinessNameControlTxt |
| Phone | 8437062296 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7 PLANTATION PARK DRIVE | AddressLine1Txt |
| City | BLUFFTON | CityNm |
| State Abbreviation | SC | StateAbbreviationCd |
| ZIP | 29910 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | RAYMOND ANDREWS | PersonNm |
| Person Title | TREASURER | PersonTitleTxt |
| Phone | 8437062296 | PhoneNum |
| Signature | 2021-06-29 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | RAYMOND | PersonFirstNm |
| Person Last | ANDREWS | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | TAMARA L THOMPSON CPA | PreparerPersonNm |
| PTIN | P00841562 | PTIN |
| Phone | 8437068440 | PhoneNum |
| Preparation | 2021-06-03 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| 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) |
|---|---|---|
| Principal Officer | JENNY BRASINGTON | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7 PLANTATION PARK DRIVE | AddressLine1Txt |
| City | BLUFFTON | CityNm |
| State Abbreviation | SC | StateAbbreviationCd |
| ZIP | 29910 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $3,029,478 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.HOSPICECARELC.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1982 | FormationYr |
| Legal Domicile State | SC | LegalDomicileStateCd |
| Activity Or Mission | PROVIDE SUPPORT AND HOME CARE FOR TERMINALLY ILL PATIENTS OF BEAUFORT CO.,SC | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $175,398 | PYContributionsGrantsAmt |
| CY Contributions Grants | $537,042 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $2,217,292 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $2,233,676 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,354 | PYInvestmentIncomeAmt |
| CY Investment Income | $17,936 | CYInvestmentIncomeAmt |
| PY Other Revenue | $515,294 | PYOtherRevenueAmt |
| CY Other Revenue | $219,558 | CYOtherRevenueAmt |
| PY Total Revenue | $2,909,338 | PYTotalRevenueAmt |
| CY Total Revenue | $3,008,212 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $1,834,856 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $1,936,809 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $261,311 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $896,241 | PYOtherExpensesAmt |
| CY Other Expenses | $868,571 | CYOtherExpensesAmt |
| PY Total Expenses | $2,731,097 | PYTotalExpensesAmt |
| CY Total Expenses | $2,805,380 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $178,241 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $202,832 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $3,741,179 | TotalAssetsBOYAmt |
| Total Assets EOY | $4,445,338 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $77,594 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $542,697 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $3,663,585 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $3,902,641 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO PROMOTE VOLUNTEER SUPPORTING SERVICES AND HOME CARE FOR THE TERMINALLY ILL AND OTHER ILLNESSES WHERE HOSPICE CARE IS DEEMED APPROPRIATE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $2,077,334 | ExpenseAmt |
| Revenue | $2,233,676 | RevenueAmt |
| Desc | HOSPICE CARE/HOME HEALTH CARE - SUPPORT FOR TERMINALLY ILL PATIENTS AND THEIR FAMILIES | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $14,054 | ExpenseAmt |
| Desc | BEREAVEMENT - SUPPORT FOR FAMILIES OF TERMINALLY ILL PATIENTS | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $141,867 | ExpenseAmt |
| Desc | EDUCATION - PROVIDING TRAINING AND SEMINARS FOR COMMUNITY AND OTHER HEALTH CARE GROUPS, TO EDUCATE THEM ON CARING FOR TERMINALLY ILL PATIENTS | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OTHER MISCELLANEOUS REVENUE | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $2,233,255 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | 0 | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | SC | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RAYMOND ANDREWS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8437062296 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7 PLANTATION PARK DRIVE | AddressLine1Txt |
| City | BLUFFTON | CityNm |
| State Abbreviation | SC | StateAbbreviationCd |
| ZIP | 29910 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | Yes (X) | NoListedPersonsCompensatedInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (12 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|
| JANET PORTER | ||||||
| CHAIRMAN | 5.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| JACKIE DOUT | ||||||
| VICE CHAIRMAN | 5.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| DONNA BAFUNDO | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| RAYMOND ANDREWS | ||||||
| TREASURER | 5.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| SUSAN ALLHUSEN | ||||||
| SECRETARY | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| MICHELLE WYCOFF | ||||||
| MEMBER AT LARGE | 1.00 | Yes (X) | $0 | $0 | $0 | |
| PHIL HARTMAN | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| DR MELISSA BROWN | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| JIM IRWIN | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| JOHN HOWE | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| JANET GORTON | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| JENNY BRASINGTON | ||||||
| EXECUTIVE DIRECTOR | 40.00 | Yes (X) | $0 | $0 | $0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $0 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | 0 | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $537,042 | AllOtherContributionsAmt |
| Total Contributions | $537,042 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | INSURANCE PAYMENTS | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $2,233,676 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $2,233,676 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $2,233,676 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $17,936 | TotalRevenueColumnAmt |
| Exclusion | $17,936 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $240,824 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $21,266 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $219,558 | TotalRevenueColumnAmt |
| Exclusion | $219,558 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,008,212 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $2,233,676 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $237,494 | ExclusionAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,594,341 | TotalAmt |
| Program Services | $1,263,954 | ProgramServicesAmt |
| Management And General | $193,287 | ManagementAndGeneralAmt |
| Fundraising | $137,100 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,445 | TotalAmt |
| Program Services | $17,292 | ProgramServicesAmt |
| Management And General | $5,730 | ManagementAndGeneralAmt |
| Fundraising | $1,423 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $171,652 | TotalAmt |
| Program Services | $140,457 | ProgramServicesAmt |
| Management And General | $21,764 | ManagementAndGeneralAmt |
| Fundraising | $9,431 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $146,371 | TotalAmt |
| Program Services | $120,424 | ProgramServicesAmt |
| Management And General | $14,336 | ManagementAndGeneralAmt |
| Fundraising | $11,611 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $51,352 | TotalAmt |
| Program Services | $41,534 | ProgramServicesAmt |
| Management And General | $6,927 | ManagementAndGeneralAmt |
| Fundraising | $2,891 | FundraisingAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,582 | TotalAmt |
| Program Services | $4,466 | ProgramServicesAmt |
| Management And General | $614 | ManagementAndGeneralAmt |
| Fundraising | $502 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $127,376 | TotalAmt |
| Program Services | $127,376 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $74,359 | TotalAmt |
| Program Services | $19,801 | ProgramServicesAmt |
| Fundraising | $54,558 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $62,445 | TotalAmt |
| Program Services | $27,795 | ProgramServicesAmt |
| Management And General | $17,448 | ManagementAndGeneralAmt |
| Fundraising | $17,202 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $60,758 | TotalAmt |
| Program Services | $29,012 | ProgramServicesAmt |
| Management And General | $22,414 | ManagementAndGeneralAmt |
| Fundraising | $9,332 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $43,010 | TotalAmt |
| Program Services | $20,537 | ProgramServicesAmt |
| Management And General | $15,867 | ManagementAndGeneralAmt |
| Fundraising | $6,606 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $57,158 | TotalAmt |
| Program Services | $55,723 | ProgramServicesAmt |
| Fundraising | $1,435 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,403 | TotalAmt |
| Program Services | $16,403 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,232 | TotalAmt |
| Program Services | $7,593 | ProgramServicesAmt |
| Fundraising | $3,639 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,663 | TotalAmt |
| Program Services | $18,684 | ProgramServicesAmt |
| Management And General | $1,984 | ManagementAndGeneralAmt |
| Fundraising | $995 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| MEDICAL EQUIPMENT & SUP | $122,586 | $122,586 | ||
| PHARMACEUTICAL | $96,088 | $96,088 | ||
| OTHER EXPENSE | $80,672 | $65,643 | $10,443 | $4,586 |
| HOSPITAL AND LAB WORK | $34,689 | $34,689 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,198 | TotalAmt |
| Program Services | $3,198 | ProgramServicesAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,805,380 | TotalAmt |
| Program Services | $2,233,255 | ProgramServicesAmt |
| Management And General | $310,814 | ManagementAndGeneralAmt |
| Fundraising | $261,311 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $147,353 | BOYAmt |
| EOY | $969,725 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $135,115 | BOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $590,186 | BOYAmt |
| EOY | $426,814 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $681,820 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $305,550 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $387,502 | BOYAmt |
| EOY | $376,270 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,481,023 | BOYAmt |
| EOY | $2,672,529 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,741,179 | BOYAmt |
| EOY | $4,445,338 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $77,594 | BOYAmt |
| EOY | $78,379 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $464,318 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $77,594 | BOYAmt |
| EOY | $542,697 | 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 | $3,630,545 | BOYAmt |
| EOY | $3,855,809 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $33,040 | BOYAmt |
| EOY | $46,832 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,663,585 | BOYAmt |
| EOY | $3,902,641 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,741,179 | BOYAmt |
| EOY | $4,445,338 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $202,832 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $36,224 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | 0 | FSAuditedInd |
| Federal Grant Audit Required | 0 | 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 | $331,372 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $285,869 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,465,089 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $143,508 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $537,042 | CurrentTaxYearAmt |
| Total | $2,762,880 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $331,372 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $285,869 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,465,089 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $143,508 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $537,042 | CurrentTaxYearAmt |
| Total | $2,762,880 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $2,762,880 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $271,841 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $458,423 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $213,346 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $516,847 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $48,578 | CurrentTaxYearAmt |
| Total | $1,509,035 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $8,246 | CurrentTaxYearMinus3YearsAmt |
| Total | $8,250 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $4,280,165 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $8,355,998 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.64550 | PublicSupportCY170Pct |
| Public Support PY170 | 0.61180 | 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
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $545,611 | BeginningYearBalanceAmt |
| Contributions | $300 | ContributionsAmt |
| Investment Earnings Or Losses | $43,687 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $135,115 | OtherExpendituresAmt |
| Administrative Expenses | $4,247 | AdministrativeExpensesAmt |
| End Year Balance | $450,236 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $465,736 | BeginningYearBalanceAmt |
| Contributions | $100 | ContributionsAmt |
| Investment Earnings Or Losses | $84,871 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $5,096 | AdministrativeExpensesAmt |
| End Year Balance | $545,611 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $503,217 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | -$32,425 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $5,056 | AdministrativeExpensesAmt |
| End Year Balance | $465,736 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $400,802 | BeginningYearBalanceAmt |
| Contributions | $42,964 | ContributionsAmt |
| Investment Earnings Or Losses | $63,904 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $4,453 | AdministrativeExpensesAmt |
| End Year Balance | $503,217 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $384,006 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $20,684 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $3,888 | AdministrativeExpensesAmt |
| End Year Balance | $400,802 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Endowments Held Unrelated Org | Yes (1) | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $449,279 | OtherCostOrOtherBasisAmt |
| Depreciation | $73,009 | DepreciationAmt |
| Book Value | $376,270 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $170,633 | OtherCostOrOtherBasisAmt |
| Depreciation | $170,633 | DepreciationAmt |
| Book Value | $0 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $61,908 | OtherCostOrOtherBasisAmt |
| Depreciation | $61,908 | DepreciationAmt |
| Book Value | $0 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $376,270 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| PPP LOAN | $335,972 |
| HHS REFUNDABLE ADVANCE | $128,346 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $464,318 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $3,123,337 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $36,224 | NetUnrealizedGainsInvstAmt |
| Other Revenue | $84,483 | OtherRevenueAmt |
| Revenue Not Reported | $120,707 | RevenueNotReportedAmt |
| Revenue Subtotal | $3,002,630 | RevenueSubtotalAmt |
| Investment Expenses Not Incld | $5,582 | InvestmentExpensesNotIncldAmt |
| Revenue Not Reported Fincl Stmt | $5,582 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $3,008,212 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $2,884,281 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $84,483 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $84,483 | ExpensesNotReportedAmt |
| Expenses Subtotal | $2,799,798 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $5,582 | InvestmentExpensesNotIncld2Amt |
| Expenses Not Rpt Fincl Stmt | $5,582 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $2,805,380 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | TO PROVIDE SUPPORTING SERVICES TO THOSE INDIVIDUALS WHO ARE UNABLE TO PROVIDE THEIR OWN SUPPORT OR WHO DO NOT QUALIFY FOR THIRD PARTY REIMBURSEMENT. |
| PART X, LINE 2: | THERE WERE NONE. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | REVENUE TO PROVIDE SUPPORT TO THOSE WHO ARE UNABLE TO PAY OR W/O INSURANCE 84,483. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | EXPENSES TO PROVIDE SUPPORT TO THOSE WHO ARE UNABLE TO PAY OR W/O INSURANCE 84,483. |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | APPEAL | Event1Nm |
| Gross Receipts Event1 | $240,824 | GrossReceiptsEvent1Amt |
| Gross Revenue Event1 | $240,824 | GrossRevenueEvent1Amt |
| Other Direct Expenses Event1 | $21,266 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $240,824 | GrossReceiptsTotalAmt |
| Gross Revenue Total Events | $240,824 | GrossRevenueTotalEventsAmt |
| Oth Direct Expnss Total Events | $21,266 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $21,266 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $219,558 | NetIncomeSummaryAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | THE TREASURER DISTRIBUTES THE TAX RETURN AND AUDITED FINANCIAL REPORT TO ALL BOARD MEMBERS FOR THEIR REVIEW, WHICH IS FOLLOWED BY A BOARD MEETING FOR QUESTONS AND ANSWERS, AND APPROVAL. |
| FORM 990, PART VI, SECTION B, LINE 12C | ANNUALLY, THE ORGANIZATION NOTIFIES ALL OFFICERS AND DIRECTORS THAT A CONFLICT OF INTEREST POLICY IS IN EXISTENCE, AND REMINDS EACH PARTY THAT ANY CONFLICT IS REQUIRED TO BE DISCLOSED TO ALL OF THOSE IN CHARGE OF GOVERNANCE. |
| FORM 990, PART VI, SECTION B, LINE 15A | THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS DECIDES COMPENSATION FOR THE EXECUTIVE DIRECTOR BY COMPARING MARKET DATA FOR THE POSITION IN SIMILAR ORGANIZATIONS. |
| FORM 990, PART VI, SECTION C, LINE 19 | FINANCIAL INFORMATION IS PROVIDED UPON REQUEST FROM ANY OUTSIDE PARTY. |