LAKE AREA FREE CLINIC INC: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- LAKE AREA FREE CLINIC INC (EIN 39-2006388)
- Tax period
- 2018-01-01 to 2018-12-31
- Filed
- 2019-11-14
- IRS object ID
- 201913189349308791
- Schema version
- 2018v3.1
- 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 | 2019-11-14T14:07:41-06:00 | ReturnTs |
| Tax Period End | 2018-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 410746749 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10401 WEST INNOVATION DRIVE SUITE | AddressLine1Txt |
| Address Line2 | 300 | AddressLine2Txt |
| City | WAUWATOSA | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53226 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2018-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 392006388 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LAKE AREA FREE CLINIC INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | LAKE | BusinessNameControlTxt |
| Phone | 2625694990 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 856 ARMOUR ROAD | AddressLine1Txt |
| City | OCONOMOWOC | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53066 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | RYAN BRASCH | PersonNm |
| Person Title | TREASURER | PersonTitleTxt |
| Phone | 2625694990 | PhoneNum |
| Signature | 2019-11-13 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | PAUL SENGER | PreparerPersonNm |
| PTIN | P00005154 | PTIN |
| Phone | 4144761880 | PhoneNum |
| Preparation | 2019-11-13 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 67.137.57.251 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2019-11-13 | IPDt |
| IP Tm | 15:15:43 | IPTm |
| IP Timezone | CS | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 881C010501BB4845839A6AC332C322706247B87E | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | F1CC80EFD774C86FD16F60A970859B9D0B21DEFE | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2020-03-31 21:24:44Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MARY REICH | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 856 ARMOUR ROAD | AddressLine1Txt |
| City | OCONOMOWOC | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53066 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $1,121,267 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.LAKEAREAFREECLINIC.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2001 | FormationYr |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Activity Or Mission | PROVIDES HIGH-QUALITY MEDICAL AND DENTAL CARE TO LOW-INCOME RESIDENTS OF WAUKESHA COUNTY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 22 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 0 | VotingMembersIndependentCnt |
| Total Employee | 22 | TotalEmployeeCnt |
| Total Volunteers | 318 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $471,603 | PYContributionsGrantsAmt |
| CY Contributions Grants | $986,391 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $5,670 | PYInvestmentIncomeAmt |
| CY Investment Income | $3,053 | CYInvestmentIncomeAmt |
| PY Other Revenue | $114,256 | PYOtherRevenueAmt |
| CY Other Revenue | $109,360 | CYOtherRevenueAmt |
| PY Total Revenue | $591,529 | PYTotalRevenueAmt |
| CY Total Revenue | $1,098,804 | 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 | $351,557 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $804,450 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $83,123 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $244,238 | PYOtherExpensesAmt |
| CY Other Expenses | $389,861 | CYOtherExpensesAmt |
| PY Total Expenses | $595,795 | PYTotalExpensesAmt |
| CY Total Expenses | $1,194,311 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$4,266 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$95,507 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $1,649,626 | TotalAssetsBOYAmt |
| Total Assets EOY | $1,567,016 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $205,213 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $23,207 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,444,413 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $1,543,809 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE LAKE AREA FREE CLINIC IS THE MEDICAL AND DENTAL HOME TO LOW-INCOME RESIDENTS OF WAUKESHA COUNTY. THE MISSION IS TO PROVIDE HIGH-QUALITY COMPREHENSIVE HEALTH CARE TO THOSE IN NEED. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $975,852 | ExpenseAmt |
| Desc | LAKE AREA FREE CLINIC IS THE MEDICAL HOME TO ADULTS AND PROVIDES ACUTE AND CHRONIC CARE SERVICES AND SPECIALITIES INCLUDE: CARDIOLOGY, DERMATOLOGY, INTERNAL MEDICINE, GYNECOLOGY, HEPATOLOGY, HEMATOLOGY, RHEUMATOLOGY, NEPHROLOGY, NEUROLOGY, PHYSICAL THERAPY, MENTAL HEALTH, ORTHOPEDICS, WELLNESS, AND COMPREHENSIVE DIABETES CLINIC. LAKE AREA FREE CLINIC IS THE 6-CHAIR DENTAL HOME TO ADULTS WHO ARE UNINSURED OR WHO HAVE MEDICAID. | Desc |
| Total Program Service Expenses | $975,852 | 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 |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| 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 | 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 With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| 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 | 8 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 22 | 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 |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| 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 | 22 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 0 | 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 | 0 | RegularMonitoringEnfrcInd |
| Whistleblower Policy | 0 | WhistleblowerPolicyInd |
| Document Retention Policy | 0 | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | WI | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RYAN BRASCH | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2625676540 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 856 ARMOUR RD | AddressLine1Txt |
| City | OCONOMOWOC | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53066 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (22 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|
| NICK ARGEROUDIS | ||||||
| VICE PRESIDENT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| LISA DREW | ||||||
| PRESIDENT | 5.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| LINDA MORONEY | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| RYAN BRASCH | ||||||
| TREASURER | 5.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| CHRIS BOTH | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| NANCY BRADT | ||||||
| SECRETARY | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| VICKI DALLMANN-PAPKE | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| GINA MAGNUS | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| DR ROBERT SCHWADE | ||||||
| DENTAL DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| JULIE JACKSON | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| TERRY LADWIG | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| KATHY MCCANN | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| DR ROB PANTHER | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| MARY RODE | ||||||
| DIRECTOR | 5.00 | Yes (X) | $0 | $0 | $0 | |
| MICHAEL RODE | ||||||
| DIRECTOR | 5.00 | Yes (X) | $0 | $0 | $0 | |
| DR PETER GEISS | ||||||
| MEDICAL DIR | 5.00 | Yes (X) | $0 | $0 | $0 | |
| DR ERIC RUIZ | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| LISA DAWES | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| DR ROBERT STUART | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| MARY JO O'MALLEY | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| MARY REICH | ||||||
| EXECUTIVE DIREC | 40.00 | Yes (X) | $88,849 | $0 | $0 | |
| MEGAN WELSH | ||||||
| DIRECTOR | 20.00 | Yes (X) | $65,693 | $0 | $0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $154,542 | 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 | $986,391 | AllOtherContributionsAmt |
| Total Contributions | $986,391 | TotalContributionsAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,053 | TotalRevenueColumnAmt |
| Exclusion | $3,053 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $131,823 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $22,463 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $109,360 | TotalRevenueColumnAmt |
| Exclusion | $109,360 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,098,804 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $112,413 | ExclusionAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $748,568 | TotalAmt |
| Program Services | $625,683 | ProgramServicesAmt |
| Management And General | $70,331 | ManagementAndGeneralAmt |
| Fundraising | $52,554 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,396 | TotalAmt |
| Program Services | $5,198 | ProgramServicesAmt |
| Management And General | $5,198 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $45,486 | TotalAmt |
| Program Services | $36,389 | ProgramServicesAmt |
| Management And General | $9,097 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $43,985 | TotalAmt |
| Program Services | $14,661 | ProgramServicesAmt |
| Management And General | $14,662 | ManagementAndGeneralAmt |
| Fundraising | $14,662 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,031 | TotalAmt |
| Fundraising | $14,031 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,223 | TotalAmt |
| Program Services | $7,111 | ProgramServicesAmt |
| Management And General | $7,112 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $86,715 | TotalAmt |
| Program Services | $65,037 | ProgramServicesAmt |
| Management And General | $21,678 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,996 | TotalAmt |
| Program Services | $4,996 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $56,086 | TotalAmt |
| Program Services | $56,086 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,164 | TotalAmt |
| Program Services | $5,373 | ProgramServicesAmt |
| Management And General | $1,791 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| MEDICAL SUPPLIES | $136,508 | $136,508 | ||
| REPAIRS & MAINTENANCE | $10,908 | $10,908 | ||
| POSTAGE | $4,390 | $1,317 | $1,317 | $1,756 |
| DUES AND SUBSCRIPTIONS | $4,253 | $4,253 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,602 | TotalAmt |
| Program Services | $2,332 | ProgramServicesAmt |
| Management And General | $4,150 | ManagementAndGeneralAmt |
| Fundraising | $120 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,194,311 | TotalAmt |
| Program Services | $975,852 | ProgramServicesAmt |
| Management And General | $135,336 | ManagementAndGeneralAmt |
| Fundraising | $83,123 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $993,111 | BOYAmt |
| EOY | $958,614 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $84,409 | BOYAmt |
| EOY | $38,284 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,695 | BOYAmt |
| EOY | $48,453 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $37,458 | BOYAmt |
| EOY | $15,432 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $50 | BOYAmt |
| EOY | $4,813 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $641,621 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $140,376 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $528,778 | BOYAmt |
| EOY | $501,245 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $125 | BOYAmt |
| EOY | $175 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,649,626 | BOYAmt |
| EOY | $1,567,016 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $205,213 | BOYAmt |
| EOY | $23,207 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $205,213 | BOYAmt |
| EOY | $23,207 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,329,473 | BOYAmt |
| EOY | $1,485,397 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $114,940 | BOYAmt |
| EOY | $58,412 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,444,413 | BOYAmt |
| EOY | $1,543,809 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,649,626 | BOYAmt |
| EOY | $1,567,016 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$95,507 | ReconcilationRevenueExpnssAmt |
| Donated Services And Use Fclts | $194,903 | DonatedServicesAndUseFcltsAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| 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 | 0 | AuditCommitteeInd |
| 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 | $245,207 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $351,239 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $930,796 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $459,959 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $945,210 | CurrentTaxYearAmt |
| Total | $2,932,411 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $245,207 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $351,239 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $930,796 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $459,959 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $945,210 | CurrentTaxYearAmt |
| Total | $2,932,411 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $2,932,411 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $6,175 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,501 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $4,531 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $5,670 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,053 | CurrentTaxYearAmt |
| Total | $23,930 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $2,956,341 | TotalSupportAmt |
| Public Support CY170 | 0.99190 | PublicSupportCY170Pct |
| Public Support PY170 | 0.99040 | 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
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $462,595 | OtherCostOrOtherBasisAmt |
| Depreciation | $77,532 | DepreciationAmt |
| Book Value | $385,063 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $177,008 | OtherCostOrOtherBasisAmt |
| Depreciation | $60,826 | DepreciationAmt |
| Book Value | $116,182 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,018 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,018 | DepreciationAmt |
| Book Value | $0 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $501,245 | TotalBookValueLandBuildingsAmt |
| Total Rev Etc Audited Fincl Stmt | $1,293,707 | TotalRevEtcAuditedFinclStmtAmt |
| Donated Services And Use Fclts | $194,903 | DonatedServicesAndUseFcltsAmt |
| Revenue Not Reported | $194,903 | RevenueNotReportedAmt |
| Revenue Subtotal | $1,098,804 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $1,098,804 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $1,194,311 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $1,194,311 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $1,194,311 | TotalExpensesPerForm990Amt |
Schedule G IRS990ScheduleG
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agrmt Prof Fundraising Acty | 0 | AgrmtProfFundraisingActyInd |
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | GALA | Event1Nm |
| Gross Receipts Event1 | $131,823 | GrossReceiptsEvent1Amt |
| Gross Revenue Event1 | $131,823 | GrossRevenueEvent1Amt |
| Other Direct Expenses Event1 | $22,463 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $131,823 | GrossReceiptsTotalAmt |
| Gross Revenue Total Events | $131,823 | GrossRevenueTotalEventsAmt |
| Oth Direct Expnss Total Events | $22,463 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $22,463 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $109,360 | NetIncomeSummaryAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | FORM 990 IS SUBMITTED TO & REVIEWED BY THE GOVERNING BODY AT A BOARD MEETING. |
| FORM 990, PART VI, SECTION C, LINE 18 | ALL DOCUMENTS & STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART VI, SECTION C, LINE 19 | ALL DOCUMENTS & STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. |