TUG RIVER HEALTH ASSOCIATION INC: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- TUG RIVER HEALTH ASSOCIATION INC (EIN 31-0889458)
- Tax period
- 2020-02-01 to 2021-01-31
- Filed
- 2021-12-15
- IRS object ID
- 202113499349301756
- 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 | 2021-12-15T15:00:11-06:00 | ReturnTs |
| Tax Period End | 2021-01-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 550596200 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HERMAN & CORMANY CPAS AC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 8 CAPITOL STREET STE 600 | AddressLine1Txt |
| City | CHARLESTON | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 25301 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-02-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 310889458 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TUG RIVER HEALTH ASSOCIATION INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | TUGR | BusinessNameControlTxt |
| Phone | 3044482101 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 507 | AddressLine1Txt |
| City | GARY | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 24836 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TIM CROFTON | PersonNm |
| Person Title | COO | PersonTitleTxt |
| Phone | 3044482101 | PhoneNum |
| Signature | 2021-12-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | TIM | PersonFirstNm |
| Person Last | CROFTON | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | XXX-XX-XXXX | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DEREK S GODWIN | PreparerPersonNm |
| PTIN | P00617370 | PTIN |
| Phone | 3043452320 | PhoneNum |
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 | TIM CROFTON | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | WV ROUTE 103 | AddressLine1Txt |
| City | GARY | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 24836 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $9,277,426 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.TUGRIVERMEDICAL.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1976 | FormationYr |
| Legal Domicile State | WV | LegalDomicileStateCd |
| Activity Or Mission | TO ASSURE THE AVAILABILITY OF AFFORDABLE, QUALITY HEALTH CARE SERVICES AND CONTINUAL EDUCATION AND SOCIAL SERVICE INTERVENTIONS TO THE RESIDENTS OF MCDOWELL AND WYOMING COUNTIES AND THEIR CONTIGUOUS AREAS IN SOUTHERN, WV. THE ORGANIZATION IS ALSO DEDICATED TO ESTABLISHING TEACHING HEALTH CENTERS FOR THE TRAINING OF PRIMARY CARE MEDICAL RESIDENTS | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 69 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $2,748,016 | PYContributionsGrantsAmt |
| CY Contributions Grants | $4,008,308 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $4,634,317 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $5,166,349 | CYProgramServiceRevenueAmt |
| PY Investment Income | $74,176 | PYInvestmentIncomeAmt |
| CY Investment Income | $102,769 | CYInvestmentIncomeAmt |
| PY Other Revenue | $392,115 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $7,848,624 | PYTotalRevenueAmt |
| CY Total Revenue | $9,277,426 | 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 | $3,362,692 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $4,044,450 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $2,097,531 | PYOtherExpensesAmt |
| CY Other Expenses | $2,716,969 | CYOtherExpensesAmt |
| PY Total Expenses | $5,460,223 | PYTotalExpensesAmt |
| CY Total Expenses | $6,761,419 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $2,388,401 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $2,516,007 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $10,964,814 | TotalAssetsBOYAmt |
| Total Assets EOY | $14,290,262 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $535,290 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,323,805 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $10,429,524 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $12,966,457 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE PROVISION OF PRIMARY CARE SERVICES, INCLUDING PREVENTIVE CARE, WELLNESS, DENTAL AND DIAGNOSTIC SERVICES TO THE RURAL POPULATION OF SOUTHERN WEST VIRGINIA, AND TO ADDITIONALLY TO PROVIDE QUALITY HEALTH CARE TO PATIENTS THAT HAVE A LIMITED ABILITY TO PAY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $4,720,518 | ExpenseAmt |
| Revenue | $5,166,349 | RevenueAmt |
| Desc | PROVIDE COMPREHENSIVE HEALTH CARE FOR THE TOTAL PERSON THROUGH THE MEDIUM OF MANAGING AND OPERATING A COORDINATED HEALTH SYSTEM AND RELATED PROGRAMS. | Desc |
| Total Program Service Expenses | $4,720,518 | 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 | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | 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 | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | Yes (1) | 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 | 10 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 69 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| 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 | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | 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 | 0 | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BILLY CLICK | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3044482101 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | WV ROUTE 103 | AddressLine1Txt |
| City | GARY | CityNm |
| State Abbreviation | WV | StateAbbreviationCd |
| ZIP | 24836 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| DAVID DUNSON | |||||||
| TREASURER | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| MICHAEL LUSHBAUGH | |||||||
| PRESIDENT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| WILLIAM SPENCER | |||||||
| VICE PRESIDENT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| RHONDA SUE ROSE | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| LANA KIBBEY | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| ELLIS RAY WILLIAMS | |||||||
| SECRETARY | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| JOHN J SIDOTE | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| CLARA THOMPSON | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JAMES MATTHEWS | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| MICHAEL EVANS | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| GAIL DAVIDSON | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| BILLY CLICK | |||||||
| CFO (FORMER) | 40.00 | Yes (X) | Yes (X) | $63,000 | $0 | $0 | |
| ANDREA CLINE | |||||||
| COO | 40.00 | Yes (X) | Yes (X) | $94,573 | $0 | $0 | |
| TIM CROFTON | |||||||
| CEO | 50.00 | Yes (X) | Yes (X) | $96,130 | $0 | $0 | |
| JENNY COLE | |||||||
| CFO (CURRENT) | 40.00 | Yes (X) | Yes (X) | $40,848 | $0 | $0 | |
| JOHN FOREHAND | |||||||
| MD | 50.00 | $252,948 | $0 | $0 | Yes (X) | ||
| SANDRA ESTEP | |||||||
| NURSE PRACTITIONER | 50.00 | $156,053 | $0 | $0 | Yes (X) | ||
| JOANNA BAILEY | |||||||
| MD | 40.00 | $241,592 | $0 | $0 | Yes (X) | ||
| MONIQUE RASH | |||||||
| NURSE PRACTITIONER | 50.00 | $125,900 | $0 | $0 | Yes (X) | ||
| MATTHEW DELLACONA | |||||||
| MD | 40.00 | $343,063 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,414,107 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $0 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 7 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $3,770,913 | GovernmentGrantsAmt |
| All Other Contributions | $237,395 | AllOtherContributionsAmt |
| Total Contributions | $4,008,308 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENU | 621400 | $3,417,797 | $3,417,797 |
| 340B DRUG PRICING PROG | 446110 | $1,748,552 | $1,748,552 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $5,166,349 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $102,769 | TotalRevenueColumnAmt |
| Exclusion | $102,769 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $9,277,426 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $5,166,349 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $102,769 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,414,107 | TotalAmt |
| Program Services | $1,119,556 | ProgramServicesAmt |
| Management And General | $294,551 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,016,267 | TotalAmt |
| Program Services | $1,413,291 | ProgramServicesAmt |
| Management And General | $602,976 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $381,079 | TotalAmt |
| Program Services | $281,350 | ProgramServicesAmt |
| Management And General | $99,729 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $232,997 | TotalAmt |
| Program Services | $172,022 | ProgramServicesAmt |
| Management And General | $60,975 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $237 | TotalAmt |
| Management And General | $237 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $41,306 | TotalAmt |
| Management And General | $41,306 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $73,867 | TotalAmt |
| Program Services | $28,997 | ProgramServicesAmt |
| Management And General | $44,870 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,834 | TotalAmt |
| Management And General | $6,834 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $249,776 | TotalAmt |
| Management And General | $249,776 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $129,170 | TotalAmt |
| Program Services | $129,170 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $34,059 | TotalAmt |
| Program Services | $5,637 | ProgramServicesAmt |
| Management And General | $28,422 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $122,059 | TotalAmt |
| Program Services | $46,559 | ProgramServicesAmt |
| Management And General | $75,500 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,088 | TotalAmt |
| Program Services | $6,088 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $69,018 | TotalAmt |
| Management And General | $69,018 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,855 | TotalAmt |
| Program Services | $2,884 | ProgramServicesAmt |
| Management And General | $27,971 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| 340B DRUG PRICING PROGR | $679,269 | $679,269 | |
| MEDICAL SUPPLIES AND PH | $648,546 | $648,546 | |
| REPAIRS AND MAINTENANCE | $322,117 | $88,299 | $233,818 |
| TELEPHONE AND UTILITIES | $180,412 | $54,588 | $125,824 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $123,356 | TotalAmt |
| Program Services | $44,262 | ProgramServicesAmt |
| Management And General | $79,094 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,761,419 | TotalAmt |
| Program Services | $4,720,518 | ProgramServicesAmt |
| Management And General | $2,040,901 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,942,399 | BOYAmt |
| EOY | $6,475,840 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $972,326 | BOYAmt |
| EOY | $1,132,793 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,678 | BOYAmt |
| EOY | $329,851 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $359,088 | BOYAmt |
| EOY | $403,419 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $58,467 | BOYAmt |
| EOY | $56,654 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,387 | BOYAmt |
| EOY | $24,688 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $2,480,910 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,906,257 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $453,708 | BOYAmt |
| EOY | $574,653 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,092,489 | BOYAmt |
| EOY | $5,259,725 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $35,272 | BOYAmt |
| EOY | $32,639 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,964,814 | BOYAmt |
| EOY | $14,290,262 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $303,362 | BOYAmt |
| EOY | $374,823 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $231,928 | BOYAmt |
| EOY | $336,482 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $612,500 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $535,290 | BOYAmt |
| EOY | $1,323,805 | 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 | $10,429,524 | BOYAmt |
| EOY | $12,966,457 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,429,524 | BOYAmt |
| EOY | $12,966,457 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,964,814 | BOYAmt |
| EOY | $14,290,262 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $2,516,007 | ReconcilationRevenueExpnssAmt |
| Prior Period Adjustments | $1,571 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | $19,355 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
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 | $2,222,044 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,196,439 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,487,732 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,748,016 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,008,308 | CurrentTaxYearAmt |
| Total | $13,662,539 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,222,044 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,196,439 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,487,732 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,748,016 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,008,308 | CurrentTaxYearAmt |
| Total | $13,662,539 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $13,662,539 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $7,305 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $12,446 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $17,065 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $74,176 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $102,769 | CurrentTaxYearAmt |
| Total | $213,761 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $63,750 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $537,246 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,425,546 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,844,359 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,748,552 | CurrentTaxYearAmt |
| Total | $5,619,453 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $19,495,753 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $15,234,910 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.70080 | PublicSupportCY170Pct |
| Public Support PY170 | 0.74740 | 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
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $121,250 | OtherCostOrOtherBasisAmt |
| Book Value | $121,250 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,605,851 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,406,153 | DepreciationAmt |
| Book Value | $199,698 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $753,809 | OtherCostOrOtherBasisAmt |
| Depreciation | $500,104 | DepreciationAmt |
| Book Value | $253,705 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $574,653 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp (2 entries)
| DescDesc | Book ValueBookValueAmt | Method ValuationMethodValuationCd |
|---|---|---|
| BROKERED CERTIFICATES OF DEPOSIT | $4,840,370 | F |
| ANNUITIES - CASH SURRENDER VALUE | $419,355 | F |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $5,259,725 | TotalBookValueSecuritiesAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PAYCHECK PROTECTION LOAN | Desc |
| Amt | $612,500 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $612,500 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $9,296,781 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | $19,355 | OtherRevenueAmt |
| Revenue Not Reported | $19,355 | RevenueNotReportedAmt |
| Revenue Subtotal | $9,277,426 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $9,277,426 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $6,761,419 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $6,761,419 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $6,761,419 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | AS OF JANUARY 31, 2020, THE TAX YEARS THAT REMAIN SUBJECT TO EXAMINATION BY TAXING AUTHORITIES BEGIN WITH 2017. TAX RETURNS FOR 2017, 2018 AND 2019 REMAIN OPEN TO EXAMINATION BY TAXING AUTHORITIES. MANAGEMENT BELIEVES THAT ALL POSITIONS TAKEN IN THOSE RETURNS WOULD BE SUSTAINED IF EXAMINED BY TAXING AUTHORITIES. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | CHANGE IN CASH SURRENDER VALUE OF ANNUITIES 19,355. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 entries)
| TitleTitleTxt | 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MATTHEW DELLACONA | ||||||||||||||
| MD | $343,063 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $343,063 | $0 | $0 | $0 |
| JOHN FOREHAND | ||||||||||||||
| MD | $252,948 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $252,948 | $0 | $0 | $0 |
| JOANNA BAILEY | ||||||||||||||
| MD | $241,592 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $241,592 | $0 | $0 | $0 |
| SANDRA ESTEP | ||||||||||||||
| NURSE PRACTITIONER | $156,053 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $156,053 | $0 | $0 | $0 |
Schedule L IRS990ScheduleL
Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JUDY HALL | PersonNm |
| Loan Purpose | OWED TO ORGANIZATION DUE TO DIVERSION OF ASSETS BY FORMER EMPLOYEE | LoanPurposeTxt |
| Loan From Organization | Yes (X) | LoanFromOrganizationInd |
| Original Principal | $0 | OriginalPrincipalAmt |
| Balance Due | $56,654 | BalanceDueAmt |
| Default | 0 | DefaultInd |
| Board Or Committee Approval | 0 | BoardOrCommitteeApprovalInd |
| Written Agreement | 0 | WrittenAgreementInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | $56,654 | TotalBalanceDueAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | MEMBERS OF THE BOARD OF DIRECTORS HAVE BUSINESS RELATIONSHIPS WITH OTHER BOARD MEMBERS IN THE NORMAL COURSE OF THEIR JOB AND ITS FUNCTIONS. |
| FORM 990, PART VI, SECTION B, LINE 11B | BOARD MEMBERS CONDUCTED A TELECONFERENCE PRIOR TO THE ISSUANCE OF THE RETURN TO DISCUSS THE FORM 990 AND THE VARIOUS ITEMS LISTED ON THE RETURN BEFORE IT WAS FILED. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION ON A REGULAR BASIS ENCOURAGES THE BOARD TO DISCLOSE ANY CONFLICTS OF INTEREST AND DISCUSSES AT MEETINGS NEW BUSINESS RELATIONSHIPS IN ORDER FOR DISCLOSURE TO BE ALLOWED. |
| FORM 990, PART VI, SECTION B, LINE 15B | THE CEO'S SALARY WAS DISCUSSED AND APPROVED BY THE BOARD OF DIRECTORS PRIOR TO EMPLOYMENT AND IS CONSIDERED ON AN ANNUAL BASIS. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE FORM 990 IS AVAILABLE FOR REVIEW AT ITS MAIN OFFICE LOCATION UPON REQUEST. |
| FORM 990, PART XI, LINE 9: | CHANGE IN CASH SURRENDER VALUE OF ANNUITIES 19,355. |
| FORM 990, PART XII, LINE 2C: | THE BOARD OF DIRECTOR'S ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT |