EASTPORT HEALTH CARE INC: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- EASTPORT HEALTH CARE INC (EIN 01-0354589)
- Tax period
- 2018-07-01 to 2019-06-30
- Filed
- 2019-11-07
- IRS object ID
- 201933119349301103
- 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 | 2019-11-07T08:45:19-06:00 | ReturnTs |
| Tax Period End | 2019-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 010411241 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHESTER M KEARNEY PA | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1550 | AddressLine1Txt |
| City | PRESQUE ISLE | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 04769 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2018-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 010354589 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EASTPORT HEALTH CARE INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | EAST | BusinessNameControlTxt |
| Phone | 2078536001 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 30 BOYNTON STREET | AddressLine1Txt |
| City | EASTPORT | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 04631 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | HOLLY M GARTMAYER-DEYOUNG | PersonNm |
| Person Title | EXECUTIVE DIRECTOR | PersonTitleTxt |
| Phone | 2078536001 | PhoneNum |
| Signature | 2019-10-05 | SignatureDt |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | TIMOTHY P POITRAS | PreparerPersonNm |
| PTIN | P00542788 | PTIN |
| Phone | 2077643171 | PhoneNum |
| Preparation | 2019-11-07 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 64.89.241.30 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2019-11-07 | IPDt |
| IP Tm | 08:45:19 | IPTm |
| IP Timezone | CS | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | A5BAE26B8730DD96AB5224EC72C46CD2F0EAC8A7 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | A5BAE26B8730DD96AB5224EC72C46CD2F0EAC8A7 | 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 | HOLLY M GARTMAYER-DEYOUNG | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 30 BOYNTON STREET | AddressLine1Txt |
| City | EASTPORT | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 04631 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $5,495,749 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.EASTPORTHEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1976 | FormationYr |
| Legal Domicile State | ME | LegalDomicileStateCd |
| Activity Or Mission | HEALTH SERVICES TO LOW INCOME INDIVIDUALS IN THE AREA | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 68 | TotalEmployeeCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $1,469,205 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,513,112 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $3,821,773 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $3,944,787 | CYProgramServiceRevenueAmt |
| PY Investment Income | $23,911 | PYInvestmentIncomeAmt |
| CY Investment Income | $37,850 | CYInvestmentIncomeAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $5,314,889 | PYTotalRevenueAmt |
| CY Total Revenue | $5,495,749 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $3,843,322 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $3,826,397 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,434,544 | PYOtherExpensesAmt |
| CY Other Expenses | $1,442,907 | CYOtherExpensesAmt |
| PY Total Expenses | $5,277,866 | PYTotalExpensesAmt |
| CY Total Expenses | $5,269,304 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $37,023 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $226,445 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $2,644,142 | TotalAssetsBOYAmt |
| Total Assets EOY | $2,795,115 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $659,933 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $573,774 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,984,209 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $2,221,341 | NetAssetsOrFundBalancesEOYAmt |
| Mission | HEALTH SERVICES TO LOW INCOME INDIVIDUALS IN THE AREA | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $3,923,886 | ExpenseAmt |
| Revenue | $3,943,171 | RevenueAmt |
| Desc | TO PROVIDE HEALTH CARE SERVICES TO UNDERSERVED POPULATIONS IN THE DOWNEAST MAINE AREA. SERVICES ARE PRIMARILY PROVIDED TO LOW INCOME HOUSEHOLDS. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $17,500 | ExpenseAmt |
| Revenue | $1,616 | RevenueAmt |
| Desc | PROVIDE SCHOLARSHIPS TO LOCAL STUDENTS IN THE ORGANIZATION'S SERVICE AREA WHO ARE ATTENDING COLLEGE TO STUDY THE MEDICAL FIELD | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $3,941,386 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 21 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 68 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | false | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CAMELA DESCHENE | PersonNm |
| Phone | 2078536001 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 30 BOYNTON STREET | AddressLine1Txt |
| City | EASTPORT | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 04631 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (17 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 |
|---|---|---|---|---|---|---|---|
| BRIAN FRUTCHEY | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| SUZANNE O'CONNOR | |||||||
| PRESIDENT | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| TAMMY DENNING | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JOHN VENSKUS | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| ANN SKRILETZ | |||||||
| VICE PRESIDE | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| JOHN FOSTER | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JOHN FOSTER | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| MOLLY MCDONALD | |||||||
| SECRETARY | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| JOHN HAWKES | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| STEPHANIE PAGE | |||||||
| TREASURER | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| HOLLY M GARTMAYER-DEYOUNG | |||||||
| EXECUTIVE DI | 40.00 | $126,929 | $0 | $0 | Yes (X) | ||
| CAMELA DESCHENE | |||||||
| CFO | 40.00 | $98,005 | $0 | $0 | Yes (X) | ||
| CYNTHIA SAMMIS MD | |||||||
| MD | 40.00 | $205,018 | $0 | $0 | Yes (X) | ||
| LAURIE CHURCHILL | |||||||
| MD | 40.00 | $199,076 | $0 | $0 | Yes (X) | ||
| ABHAY EKTARE | |||||||
| DDS | 40.00 | $165,094 | $0 | $0 | Yes (X) | ||
| SUSAN LUTHIN | |||||||
| MD | 40.00 | $124,385 | $0 | $0 | Yes (X) | ||
| JASON GREEN | |||||||
| DPM | 40.00 | $121,935 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,040,442 | TotalReportableCompFromOrgAmt |
| Indiv Rcvd Greater Than100 K | 6 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (3 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| UNITED HEALTHCARE | |||||
| 9900 BREN ROAD | MINNETONKA | MN | 55343 | INSURANCE | $303,433 |
| CARDINAL HEALTH | |||||
| 7000 CARDINAL PLACE | DUBLIN | OH | 43017 | MEDICAL | $168,247 |
| ATHENA HEALTH | |||||
| 311 ARSENAL ST | WATERTOWN | MA | 02472 | SOFTWARE | $133,053 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 3 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $168,922 | GovernmentGrantsAmt |
| All Other Contributions | $1,344,190 | AllOtherContributionsAmt |
| Total Contributions | $1,513,112 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|
| FEE FOR SERVICE | $3,157,746 | $3,157,746 |
| 340B PROGRAM | $1,324,762 | $1,324,762 |
| MEDICARE REIMBURSEMENT | $21,746 | $21,746 |
| OTHER SERVICE REVENUE | $19,749 | $19,749 |
| LESS: CONTRACTUAL ADJUSTMENT | -$579,216 | -$579,216 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $3,944,787 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $37,850 | TotalRevenueColumnAmt |
| Exclusion | $37,850 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,495,749 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,944,787 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $37,850 | ExclusionAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,168,417 | TotalAmt |
| Program Services | $2,372,878 | ProgramServicesAmt |
| Management And General | $795,539 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $396,565 | TotalAmt |
| Program Services | $276,838 | ProgramServicesAmt |
| Management And General | $119,727 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $261,415 | TotalAmt |
| Program Services | $188,838 | ProgramServicesAmt |
| Management And General | $72,577 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,000 | TotalAmt |
| Management And General | $15,000 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $74,515 | TotalAmt |
| Program Services | $45,670 | ProgramServicesAmt |
| Management And General | $28,845 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $101,324 | TotalAmt |
| Program Services | $65,815 | ProgramServicesAmt |
| Management And General | $35,509 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,405 | TotalAmt |
| Program Services | $14,619 | ProgramServicesAmt |
| Management And General | $8,786 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,563 | TotalAmt |
| Management And General | $16,563 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $91,557 | TotalAmt |
| Program Services | $23,195 | ProgramServicesAmt |
| Management And General | $68,362 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $35,262 | TotalAmt |
| Program Services | $13,856 | ProgramServicesAmt |
| Management And General | $21,406 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| SUPPLIES | $392,037 | $351,941 | $40,096 |
| 340B PROGRAM ADMINS | $330,749 | $330,537 | $212 |
| COMPUTER OPERATIONS | $161,505 | $156,456 | $5,049 |
| TELECOMMUNICATIONS | $48,768 | $31,360 | $17,408 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $152,222 | TotalAmt |
| Program Services | $69,383 | ProgramServicesAmt |
| Management And General | $82,839 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,269,304 | TotalAmt |
| Program Services | $3,941,386 | ProgramServicesAmt |
| Management And General | $1,327,918 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $552,779 | BOYAmt |
| EOY | $692,754 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,995 | BOYAmt |
| EOY | $18,119 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,288 | BOYAmt |
| EOY | $23,564 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $194,417 | BOYAmt |
| EOY | $149,432 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $91,950 | BOYAmt |
| EOY | $5,250 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $55,248 | BOYAmt |
| EOY | $29,262 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $2,069,019 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,476,339 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $670,180 | BOYAmt |
| EOY | $592,680 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,036,285 | BOYAmt |
| EOY | $1,284,054 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,644,142 | BOYAmt |
| EOY | $2,795,115 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $265,267 | BOYAmt |
| EOY | $241,800 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $394,666 | BOYAmt |
| EOY | $331,974 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $659,933 | BOYAmt |
| EOY | $573,774 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,782,518 | BOYAmt |
| EOY | $2,035,534 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $201,691 | BOYAmt |
| EOY | $185,807 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,984,209 | BOYAmt |
| EOY | $2,221,341 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,644,142 | BOYAmt |
| EOY | $2,795,115 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $226,445 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $10,687 | NetUnrlzdGainsLossesInvstAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | 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 (true) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | 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 | $1,240,764 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,434,844 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,583,503 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,469,205 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,513,112 | CurrentTaxYearAmt |
| Total | $7,241,428 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,240,764 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,434,844 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,583,503 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,469,205 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,513,112 | CurrentTaxYearAmt |
| Total | $7,241,428 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $7,241,428 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $20,712 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | -$784 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $86,973 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $23,911 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $37,850 | CurrentTaxYearAmt |
| Total | $168,662 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $7,410,090 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $7,766,560 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.97720 | PublicSupportCY170Pct |
| Public Support PY170 | 0.95700 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II, LINE 10 | FormAndLineReferenceDesc |
| Explanation | OTHER INCOME 0 | ExplanationTxt |
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 | $20,245 | OtherCostOrOtherBasisAmt |
| Book Value | $20,245 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,048,774 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,476,339 | DepreciationAmt |
| Book Value | $572,435 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $592,680 | TotalBookValueLandBuildingsAmt |
| Total Rev Etc Audited Fincl Stmt | $5,495,749 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Subtotal | $5,495,749 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $5,495,749 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $5,269,304 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $5,269,304 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $5,269,304 | TotalExpensesPerForm990Amt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (3 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt |
|---|---|---|
| CYNTHIA SAMMIS MD | ||
| MD | $205,018 | $205,018 |
| LAURIE CHURCHILL | ||
| MD | $199,076 | $199,076 |
| ABHAY EKTARE | ||
| DDS | $165,094 | $165,094 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 6, PART VI, LINE 11B | THE FORM 990 IS PRESENTED TO THE FINANCE COMMITTEE FOR REVIEW WITH THE FINANCIAL OFFICER AND WHEN IN AGREEMENT REGARDING THE ACCURACY OF SAID RETURN IT IS PRESENTED TO THE FULL BOARD OF DIRECTORS FOR THEIR REVIEW AND ACCEPTANCE |
| FORM 990, PAGE 6, PART VI, LINE 12C | EMPLOYEES AND BOARD MEMBERS MUST ADVISE THE BOARD OF ANY CONFLICTS OF INTEREST AND RELATED ISSUES. THE BOARD THEN ADDRESSES THE ISSUES AS A UNIT. |
| FORM 990, PAGE 6, PART VI, LINE 15A | REVIEWED BY INDEPENDENT PERSONS, COMPARABILITY DATA AND SUSTANTIATION OF THE THE DELIBERATION AND DECISION PROCESS. |
| FORM 990, PAGE 6, PART VI, LINE 15B | REVIEWED BY INDEPENDENT PERSONS, COMPARABILITY DATA AND SUSTANTIATION OF THE DELIBERATION AND DECISION PROCESS. |
| FORM 990, PAGE 6, PART VI, LINE 19 | THE FINANCIAL STATEMENTS AND PERSONNEL POLICY HANDBOOKS ARE AVAILABLE TO THE PUBLIC UPON REQUEST |