GRACEMED HEALTH CLINIC INC: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- GRACEMED HEALTH CLINIC INC (EIN 48-1159633)
- Tax period
- 2020-01-01 to 2020-12-31
- Filed
- 2021-10-15
- IRS object ID
- 202142889349301819
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule G
- Schedule J
- Schedule L
- Schedule M
- Schedule O
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-10-15T15:19:36-05:00 | ReturnTs |
| Tax Period End | 2020-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 481032601 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ALLEN GIBBS & HOULIK LC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 301 N MAIN SUITE 1700 | AddressLine1Txt |
| City | WICHITA | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 672024868 | 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 | 481159633 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GRACEMED HEALTH CLINIC INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | GRAC | BusinessNameControlTxt |
| Phone | 3168662000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1150 N BROADWAY AVE | AddressLine1Txt |
| City | WICHITA | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 67214 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | VENUS LEE | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 3168662011 | PhoneNum |
| Signature | 2021-10-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | VENUS | PersonFirstNm |
| Person Last | LEE | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | D SHAWN SULLIVAN | PreparerPersonNm |
| PTIN | P00287292 | PTIN |
| Phone | 3162677231 | 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 | VENUS LEE | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1150 N BROADWAY AVE | AddressLine1Txt |
| City | WICHITA | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 67214 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $41,820,721 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.GRACEMED.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1979 | FormationYr |
| Legal Domicile State | KS | LegalDomicileStateCd |
| Activity Or Mission | TO SHOW AND SHARE THE LOVE OF JESUS CHRIST BY PROVIDING COMPASSIONATE, ACCESSIBLE, HIGH-QUALITY HEALTH CARE FOR RESIDENTS IN THE COMMUNITIES WE SERVE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 450 | TotalEmployeeCnt |
| Total Volunteers | 80 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $9,531,593 | PYContributionsGrantsAmt |
| CY Contributions Grants | $13,492,489 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $18,811,832 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $17,383,630 | CYProgramServiceRevenueAmt |
| PY Investment Income | $234,118 | PYInvestmentIncomeAmt |
| CY Investment Income | $75,675 | CYInvestmentIncomeAmt |
| PY Other Revenue | $62,768 | PYOtherRevenueAmt |
| CY Other Revenue | $2,800,417 | CYOtherRevenueAmt |
| PY Total Revenue | $28,640,311 | PYTotalRevenueAmt |
| CY Total Revenue | $33,752,211 | 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 | $18,809,036 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $20,048,438 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $211,351 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $7,725,625 | PYOtherExpensesAmt |
| CY Other Expenses | $8,374,013 | CYOtherExpensesAmt |
| PY Total Expenses | $26,534,661 | PYTotalExpensesAmt |
| CY Total Expenses | $28,422,451 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $2,105,650 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $5,329,760 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $29,108,064 | TotalAssetsBOYAmt |
| Total Assets EOY | $34,999,936 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,760,704 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $3,005,474 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $26,347,360 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $31,994,462 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO SHOW AND SHARE THE LOVE OF JESUS CHRIST BY PROVIDING COMPASSIONATE, ACCESSIBLE, HIGH-QUALITY HEALTH CARE FOR RESIDENTS IN THE COMMUNITIES WE SERVE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $23,247,440 | ExpenseAmt |
| Revenue | $20,186,987 | RevenueAmt |
| Desc | PROVIDING PRIMARY HEALTH AND DENTAL CARE TO KANSANS WITHOUT HEALTH INSURANCE OR ADEQUATE FINANCIAL RESOURCES TO SECURE TRADITIONAL HEALTH CARE SERVICES | Desc |
| Total Program Service Expenses | $23,247,440 | 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 | 0 | 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 | Yes (1) | 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 | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | Yes (1) | 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 | 44 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 450 | 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 | 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 | 0 | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | 0 | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | KS | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DAVID WUTHNOW | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3168662049 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1150 N BROADWAY AVE | AddressLine1Txt |
| City | WICHITA | CityNm |
| State Abbreviation | KS | StateAbbreviationCd |
| ZIP | 67214 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| ROB DAKIN | |||||||
| BOARD MEMBER | 4.00 | Yes (X) | $0 | $0 | $0 | ||
| MARLON KING | |||||||
| TREASURER | 4.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| FRANK CHORIEGO | |||||||
| BOARD MEMBER | 4.00 | Yes (X) | $0 | $0 | $0 | ||
| FRED ERVIN | |||||||
| BOARD MEMBER | 4.00 | Yes (X) | $0 | $0 | $0 | ||
| JULIE HEDRICK | |||||||
| SECRETARY | 4.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| TIM NORTON | |||||||
| BOARD MEMBER | 4.00 | Yes (X) | $0 | $0 | $0 | ||
| RON STEPHEN | |||||||
| PRESIDENT | 4.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| LAZARO VASQUEZ | |||||||
| VICE PRESIDENT | 4.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| RICK WOODS | |||||||
| BOARD MEMBER | 4.00 | Yes (X) | $0 | $0 | $0 | ||
| MORLEY HEALY | |||||||
| BOARD MEMBER | 4.00 | Yes (X) | $0 | $0 | $0 | ||
| CAROLYN WARD | |||||||
| BOARD MEMBER | 4.00 | Yes (X) | $0 | $0 | $0 | ||
| JULIE A ELDER | |||||||
| CHIEF MEDICAL OFFICER | 40.00 | $264,039 | $0 | $16,215 | Yes (X) | ||
| VENUS L LEE | |||||||
| CEO FROM 1/23/20 TO 12/31/20 | 40.00 | $203,091 | $0 | $6,557 | Yes (X) | ||
| DAVID WUTHNOW | |||||||
| CHIEF FINANCIAL OFFICER | 40.00 | $122,841 | $0 | $14,898 | Yes (X) | ||
| DAVID SANFORD | |||||||
| CEO FROM 1/1/20 TO 1/22/20 | 40.00 | $70,537 | $0 | $939 | Yes (X) | ||
| ERIC DESHAZER | |||||||
| CHIEF DENTAL OFFICER | 40.00 | $184,410 | $0 | $16,709 | Yes (X) | ||
| FARIBA BEHZADPOUR | |||||||
| HIGHLY COMPENSATED EMPLOYEE | 40.00 | $165,402 | $0 | $15,607 | Yes (X) | ||
| BILLY RICHARDSON | |||||||
| HIGHLY COMPENSATED EMPLOYEE | 40.00 | $211,345 | $0 | $16,424 | Yes (X) | ||
| REGAN M DEHART | |||||||
| HIGHLY COMPENSATED EMPLOYEE | 40.00 | $189,422 | $0 | $14,951 | Yes (X) | ||
| LANCE A JEPSON | |||||||
| HIGHLY COMPENSATED EMPLOYEE | 40.00 | $191,128 | $0 | $11,868 | Yes (X) | ||
| JOYCE M ALLEN | |||||||
| HIGHLY COMPENSATED EMPLOYEE | 40.00 | $212,825 | $0 | $13,107 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,815,040 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $127,275 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 27 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| HENRY SCHEIN INC | |||||
| DEPT CH 10241 | PALATINE | IL | 600550241 | MEDICAL/DENTAL EQUIPMENT AND SUPPLIES | $616,759 |
| MCKESSON | |||||
| PO BOX 848442 | DALLAS | TX | 752848442 | 340B PHARMACEUTICALS | $461,979 |
| SINOCHIPS KANSAS LLC | |||||
| 2002 W 39TH AVE SUITE G029 | KANSAS CITY | KS | 66103 | COVID TESTING | $328,226 |
| QUEST DIAGNOSTICS | |||||
| PO BOX 772976 | CHICAGO | IL | 60677 | MEDICAL LAB | $319,714 |
| COX COMMUNICATIONS | |||||
| PO BOX 248871 | OKLAHOMA CITY | OK | 73124 | PHONE & DATA COMMUNICATIONS | $234,607 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 12 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $69,221 | FundraisingAmt |
| Government Grants | $10,270,269 | GovernmentGrantsAmt |
| All Other Contributions | $3,152,999 | AllOtherContributionsAmt |
| Noncash Contributions | $1,745,578 | NoncashContributionsAmt |
| Total Contributions | $13,492,489 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MEDICAL & DENTAL SERVICES | Desc |
| Business | 621110 | BusinessCd |
| Total Revenue Column | $17,383,630 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $17,383,630 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $17,383,630 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $209,197 | TotalRevenueColumnAmt |
| Exclusion | $209,197 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $7,923,895 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $8,057,417 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -$133,522 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$133,522 | TotalRevenueColumnAmt |
| Exclusion | -$133,522 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $8,153 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $69,221 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $11,093 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$2,940 | TotalRevenueColumnAmt |
| Exclusion | -$2,940 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PPP LOAN REVENUE | 900099 | $2,521,500 | $2,521,500 |
| COVID CREDITS | 900099 | $186,516 | $186,516 |
| OTHER MISC REVENUE | 900099 | $95,341 | $95,341 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $2,803,357 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $33,752,211 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $20,186,987 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $72,735 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $900,236 | TotalAmt |
| Program Services | $734,459 | ProgramServicesAmt |
| Management And General | $165,777 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,393,977 | TotalAmt |
| Program Services | $14,041,195 | ProgramServicesAmt |
| Management And General | $3,170,032 | ManagementAndGeneralAmt |
| Fundraising | $182,750 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $265,315 | TotalAmt |
| Program Services | $219,307 | ProgramServicesAmt |
| Management And General | $42,321 | ManagementAndGeneralAmt |
| Fundraising | $3,687 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,488,910 | TotalAmt |
| Program Services | $1,222,551 | ProgramServicesAmt |
| Management And General | $254,620 | ManagementAndGeneralAmt |
| Fundraising | $11,739 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $108,987 | TotalAmt |
| Management And General | $108,987 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $52,509 | TotalAmt |
| Management And General | $52,509 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,094,098 | TotalAmt |
| Program Services | $1,051,899 | ProgramServicesAmt |
| Management And General | $42,199 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $174,257 | TotalAmt |
| Management And General | $174,257 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $179,351 | TotalAmt |
| Program Services | $98,756 | ProgramServicesAmt |
| Management And General | $80,595 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $796,531 | TotalAmt |
| Program Services | $630,143 | ProgramServicesAmt |
| Management And General | $166,388 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $757,264 | TotalAmt |
| Program Services | $661,334 | ProgramServicesAmt |
| Management And General | $95,930 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $65,977 | TotalAmt |
| Program Services | $20,727 | ProgramServicesAmt |
| Management And General | $45,250 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,137,713 | TotalAmt |
| Program Services | $912,507 | ProgramServicesAmt |
| Management And General | $225,206 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $84,148 | TotalAmt |
| Program Services | $1,023 | ProgramServicesAmt |
| Management And General | $83,125 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| MEDICAL SUPPLIES | $3,299,431 | $3,227,818 | $71,613 | |
| REPAIRS | $338,853 | $290,867 | $47,986 | |
| MISCELLANEOUS | $135,910 | $8,780 | $113,955 | $13,175 |
| CONTINUING EDUCATION | $85,789 | $78,545 | $7,244 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $63,195 | TotalAmt |
| Program Services | $47,529 | ProgramServicesAmt |
| Management And General | $15,666 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,422,451 | TotalAmt |
| Program Services | $23,247,440 | ProgramServicesAmt |
| Management And General | $4,963,660 | ManagementAndGeneralAmt |
| Fundraising | $211,351 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $544,467 | BOYAmt |
| EOY | $144,671 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,160,923 | BOYAmt |
| EOY | $10,012,210 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $454,350 | BOYAmt |
| EOY | $312,069 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,175,589 | BOYAmt |
| EOY | $1,150,733 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,126 | BOYAmt |
| EOY | $12,216 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $76,503 | BOYAmt |
| EOY | $98,728 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $21,198,454 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $6,340,415 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,754,128 | BOYAmt |
| EOY | $14,858,039 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,652,321 | BOYAmt |
| EOY | $6,384,023 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,273,393 | BOYAmt |
| EOY | $2,024,357 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,264 | BOYAmt |
| EOY | $2,890 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,108,064 | BOYAmt |
| EOY | $34,999,936 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,788,594 | BOYAmt |
| EOY | $1,449,777 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $972,110 | BOYAmt |
| EOY | $1,555,697 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,760,704 | BOYAmt |
| EOY | $3,005,474 | 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 | $26,256,126 | BOYAmt |
| EOY | $31,918,300 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $91,234 | BOYAmt |
| EOY | $76,162 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,347,360 | BOYAmt |
| EOY | $31,994,462 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,108,064 | BOYAmt |
| EOY | $34,999,936 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $5,329,760 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $317,342 | NetUnrlzdGainsLossesInvstAmt |
| Donated Services And Use Fclts | $98,217 | DonatedServicesAndUseFcltsAmt |
| Other Changes In Net Assets | -$98,217 | 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 | $9,487,166 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $11,113,551 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $10,130,406 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $9,490,711 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $13,492,489 | CurrentTaxYearAmt |
| Total | $53,714,323 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $9,487,166 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $11,113,551 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $10,130,406 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $9,490,711 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $13,492,489 | CurrentTaxYearAmt |
| Total | $53,714,323 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $53,714,323 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $19,328 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $49,734 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $146,131 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $243,162 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $209,197 | CurrentTaxYearAmt |
| Total | $667,552 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $54,381,875 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $77,536,180 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.98770 | PublicSupportCY170Pct |
| Public Support PY170 | 0.98920 | 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 | $622,330 | OtherCostOrOtherBasisAmt |
| Book Value | $622,330 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $10,471,389 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,241,213 | DepreciationAmt |
| Book Value | $9,230,176 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,266,270 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,705,791 | DepreciationAmt |
| Book Value | $3,560,479 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,781,376 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,393,411 | DepreciationAmt |
| Book Value | $1,387,965 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $57,089 | OtherCostOrOtherBasisAmt |
| Book Value | $57,089 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $14,858,039 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | CERTIFICATES OF DEPOSIT | Desc |
| Book Value | $2,024,357 | BookValueAmt |
| Method Valuation | C | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $2,024,357 | TotalBookValueSecuritiesAmt |
| Total Rev Etc Audited Fincl Stmt | $34,126,354 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $317,342 | NetUnrealizedGainsInvstAmt |
| Donated Services And Use Fclts | $98,217 | DonatedServicesAndUseFcltsAmt |
| Other Revenue | $11,093 | OtherRevenueAmt |
| Revenue Not Reported | $426,652 | RevenueNotReportedAmt |
| Revenue Subtotal | $33,699,702 | RevenueSubtotalAmt |
| Investment Expenses Not Incld | $52,509 | InvestmentExpensesNotIncldAmt |
| Revenue Not Reported Fincl Stmt | $52,509 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $33,752,211 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $28,479,252 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $98,217 | DonatedServicesUseFcltsAmt |
| Other Expenses Included | $11,093 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $109,310 | ExpensesNotReportedAmt |
| Expenses Subtotal | $28,369,942 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $52,509 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $52,509 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $28,422,451 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | EXPENSES REPORTED ON SCH G WHICH ARE NETTED WITH INCOME ON THE 990 11,093. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | EXPENSES REPORTED ON SCH G WHICH ARE NETTED WITH INCOME ON THE 990 11,093. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | INVESTMENT EXPENSES REPORTED AS INCOME ON FINANCIAL STATEMENTS 52,509. |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | 5K RACE | Event1Nm |
| Gross Receipts Event1 | $39,928 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $31,775 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $8,153 | GrossRevenueEvent1Amt |
| Non Cash Prizes Event1 | $5,990 | NonCashPrizesEvent1Amt |
| Other Direct Expenses Event1 | $938 | OtherDirectExpensesEvent1Amt |
| Event2 | HOTCAKES FUNDRAISER | Event2Nm |
| Gross Receipts Event2 | $37,446 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $37,446 | CharitableContriEvent2Amt |
| Other Direct Expenses Event2 | $4,165 | OtherDirectExpensesEvent2Amt |
| Gross Receipts Total | $77,374 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $69,221 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $8,153 | GrossRevenueTotalEventsAmt |
| Non Cash Prizes Total Events | $5,990 | NonCashPrizesTotalEventsAmt |
| Oth Direct Expnss Total Events | $5,103 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $11,093 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$2,940 | NetIncomeSummaryAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | Yes (1) | 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 (8 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JULIE A ELDER | ||||||||||||||
| CHIEF MEDICAL OFFICER | $264,039 | $0 | $0 | $0 | $0 | $0 | $8,160 | $0 | $8,055 | $0 | $280,254 | $0 | $0 | $0 |
| BILLY RICHARDSON | ||||||||||||||
| HIGHLY COMPENSATED EMPLOYEE | $211,345 | $0 | $0 | $0 | $0 | $0 | $5,551 | $0 | $10,873 | $0 | $227,769 | $0 | $0 | $0 |
| JOYCE M ALLEN | ||||||||||||||
| HIGHLY COMPENSATED EMPLOYEE | $212,825 | $0 | $0 | $0 | $0 | $0 | $6,601 | $0 | $6,506 | $0 | $225,932 | $0 | $0 | $0 |
| VENUS L LEE | ||||||||||||||
| CEO FROM 1/23/20 TO 12/31/20 | $203,091 | $0 | $0 | $0 | $0 | $0 | $6,143 | $0 | $414 | $0 | $209,648 | $0 | $0 | $0 |
| REGAN M DEHART | ||||||||||||||
| HIGHLY COMPENSATED EMPLOYEE | $189,422 | $0 | $0 | $0 | $0 | $0 | $5,957 | $0 | $8,994 | $0 | $204,373 | $0 | $0 | $0 |
| LANCE A JEPSON | ||||||||||||||
| HIGHLY COMPENSATED EMPLOYEE | $191,128 | $0 | $0 | $0 | $0 | $0 | $995 | $0 | $10,873 | $0 | $202,996 | $0 | $0 | $0 |
| ERIC DESHAZER | ||||||||||||||
| CHIEF DENTAL OFFICER | $184,410 | $0 | $0 | $0 | $0 | $0 | $5,836 | $0 | $10,873 | $0 | $201,119 | $0 | $0 | $0 |
| FARIBA BEHZADPOUR | ||||||||||||||
| HIGHLY COMPENSATED EMPLOYEE | $165,402 | $0 | $0 | $0 | $0 | $0 | $4,734 | $0 | $10,873 | $0 | $181,009 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 4A | FormAndLineReferenceDesc |
| Explanation | DAVID SANFORD RECEIVED $46,027.20 OF SEVERANCE PAY IN 2020. | ExplanationTxt |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CHAD SANFORD | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | SON OF CEO | RelationshipDescriptionTxt |
| Transaction | $61,447 | TransactionAmt |
| Transaction | CHAD SANFORD IS THE SON OF DAVID SANFORD, CEO OF GRACEMED UNTIL 1/22/2020. CHAD IS AN EMPLOYEE OF GRACEMED. | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Schedule M IRS990ScheduleM
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 38138 | ContributionCnt |
| Noncash Contributions Rpt F990 | $1,728,420 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | AVG. PER UNIT CDC PRICE | MethodOfDeterminingRevenuesTxt |
Other Non Cash Contri Table OtherNonCashContriTableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Desc | DENTAL KITS & SUPPLIES | Desc |
| Contribution | 10080 | ContributionCnt |
| Noncash Contributions Rpt F990 | $17,157 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FAIR MARKET VALUE | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | THE ORGANIZATION HIRES AN OUTSIDE CPA TO PREPARE THE FINANCIAL STATEMENT AUDIT AND THE FORM 990 EACH YEAR. AFTER THE CPA HAS COMPLETED BOTH THE AUDIT AND FORM 990, THE CFO FOR THE ORGANIZATION AND THE CPA REVIEW THE INITIAL DRAFT OF THE RETURN TO ENSURE ITS COMPLETENESS AND ACCURACY. FOLLOWING THE REVIEW, THE FORM 990 IS COMPLETED AND THE ORGANIZATION FILES THE RETURN. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES THE GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICIES, AND AUDITED FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | PROFESSIONAL & CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 1,051,899. MANAGEMENT AND GENERAL EXPENSES 42,199. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,094,098. |
| FORM 990, PART IX, LINE 24E | DUES & SUBSCRIPTIONS: PROGRAM SERVICE EXPENSES 20,057. MANAGEMENT AND GENERAL EXPENSES 14,919. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 34,976. STAFF RECRUITING: PROGRAM SERVICE EXPENSES 27,472. MANAGEMENT AND GENERAL EXPENSES 747. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 28,219. |
| FORM 990, PART XI, LINE 9: | DONATED SERVICES AND USE OF FACILITIES EXPENSES -98,217. |
| FORM 990, PART XII, LINE 2C | THIS POLICY HAS NOT CHANGED SINCE THE PRIOR YEAR. |
| FORM 990, PART XI, LINE 5 & SCH D, PART XI, LINE 2A | REALIZED/UNREALIZED GAIN LOSS ON AUDIT REPORT FOOTNOTE AND THE AMOUNTS REPORTED ON FORM 990 DO NOT MATCH DUE TO THE USE OF DIFFERENT REPORTING METHODS BETWEEN THE AUDIT REPORT AND THE 990. |