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KNOX WINAMAC COMMUNITY HEALTH CENTERS INC: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization
KNOX WINAMAC COMMUNITY HEALTH CENTERS INC (EIN 87-0778393)
Tax period
2018-01-01 to 2018-12-31
Filed
2019-07-23
IRS object ID
201902049349300805
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

FieldValueIRS element (for citing)
Return2019-07-23T08:57:25-05:00ReturnTs
Tax Period End2018-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN352102008PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CNA TAX PROFESSIONALS INCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line18606 ALLISONVILLE RD STE 120AddressLine1Txt
CityINDIANAPOLISCityNm
State AbbreviationINStateAbbreviationCd
ZIP46250ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2018-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN870778393EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1KNOX WINAMAC COMMUNITY HEALTHBusinessNameLine1Txt
Business Name Line2CENTERS INCBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlKNOXBusinessNameControlTxt
Phone5747726030PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11002 SOUTH EDGEWOOD DRAddressLine1Txt
CityKNOXCityNm
State AbbreviationINStateAbbreviationCd
ZIP46534ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonKATHY ROBBPersonNm
Person TitleEXECUTIVE DIRECTORPersonTitleTxt
Phone5747726030PhoneNum
Signature2019-07-23SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonSHAWN D DREIMAN CPAPreparerPersonNm
PTINP00380913PTIN
Phone3178413393PhoneNum
Preparation2019-07-17PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address23.25.48.193IPv4AddressTxt
FieldValueIRS element (for citing)
IP2019-07-23IPDt
IP Tm09:57:15IPTm
IP TimezoneEDIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id40404695BA1382DBF6CFF4F53CBDC00D8996B33BAtSubmissionCreationDeviceId
At Submission Filing Device Id40404695BA1382DBF6CFF4F53CBDC00D8996B33BAtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2018TaxYr
Build TS2019-02-21 02:37:17ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerKATHY ROBBPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11002 SOUTH EDGEWOOD DRAddressLine1Txt
CityKNOXCityNm
State AbbreviationINStateAbbreviationCd
ZIP46534ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$2,650,557GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressNAWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2006FormationYr
Legal Domicile StateINLegalDomicileStateCd
Activity Or MissionTHE ORGANIZATION PROVIDES PRIMARY AND PREVENTIVE HEALTH SERVICES TO THE AREA'S UNDER-SERVED AND MOST VULNERABLE POPULATIONS THROUGH HIGH QUALITY CLINICAL CARE WITH A DEMONSTRATED IMPACT ON THE HEALTH OUTCOMES OF THE COMMUNITIES WE SERVE.ActivityOrMissionDesc
Voting Members Governing Body9VotingMembersGoverningBodyCnt
Voting Members Independent9VotingMembersIndependentCnt
Total Employee31TotalEmployeeCnt
Total Volunteers2TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$2,629,833PYProgramServiceRevenueAmt
CY Program Service Revenue$2,620,369CYProgramServiceRevenueAmt
PY Investment Income$0PYInvestmentIncomeAmt
CY Investment Income-$4,320CYInvestmentIncomeAmt
PY Other Revenue$97,201PYOtherRevenueAmt
CY Other Revenue$30,188CYOtherRevenueAmt
PY Total Revenue$2,727,034PYTotalRevenueAmt
CY Total Revenue$2,646,237CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$1,260,665PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$1,338,619CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$1,072,729PYOtherExpensesAmt
CY Other Expenses$898,536CYOtherExpensesAmt
PY Total Expenses$2,333,394PYTotalExpensesAmt
CY Total Expenses$2,237,155CYTotalExpensesAmt
PY Revenues Less Expenses$393,640PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$409,082CYRevenuesLessExpensesAmt
Total Assets BOY$514,505TotalAssetsBOYAmt
Total Assets EOY$708,745TotalAssetsEOYAmt
Total Liabilities BOY$935,642TotalLiabilitiesBOYAmt
Total Liabilities EOY$755,209TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY-$421,137NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY-$46,464NetAssetsOrFundBalancesEOYAmt
MissionTHE ORGANIZATION PROVIDES PRIMARY AND PREVENTIVE HEALTH SERVICES TO THE AREA'S UNDER-SERVED AND MOST VULNERABLE POPULATIONS THROUGH HIGH QUALITY CLINICAL CARE WITH A DEMONSTRATED IMPACT ON THE HEALTH OUTCOMES OF THE COMMUNITIES WE SERVE.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$1,626,189ExpenseAmt
Revenue$2,620,369RevenueAmt
DescTHE ORGANIZATION PROVIDES AN ARRAY OF HEALTH CARE SERVICES THAT ARE AVAILABLE TO ALL PERSONS, REGARDLESS OF THE ABILITY TO PAY. WE HAVE A TEAM OF DOCTORS AND NURSE PRACTITIONERS WHO STAFF OUR OFFICE IN KNOX. OUR TEAM OF PROFESSIONALS OFFERS LOCAL ACCESS TO A COMPREHENSIVE RANGE OF AFFORDABLE PREVENTIVE AND PRIMARY HEALTH CARE SERVICES. ADDITIONALLY, THE ORGANIZATION PROVIDES MENTAL HEALTH CARE SERVICES, WHICH ENCOMPASSES, AMONG OTHER THINGS, SUBSTANCE ABUSE. THE ORGANIZATION ALSO PROVIDES SERVICES FOR MOTHERS AND MOTHERS-TO-BE. DURING CALENDAR YEAR 2018, OUR OFFICE PROVIDED CARE FOR 2,998 PERSONS, OF WHOM 986 WERE MEDICAID ELIGIBLE, 907 WERE MEDICARE ELIGIBLE, 757 WERE COVERED UNDER SOME FORM OF INSURANCE, AND 338 WERE UNINSURED.Desc
Total Program Service Expenses$1,626,189TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org MemYes (1)BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document4IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee31EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Form8899 Filedind0Form8899Filedind
Form1098 C Filed0Form1098CFiledInd
DAF Excess Business Holdings0DAFExcessBusinessHoldingsInd
Taxable Distributions0TaxableDistributionsInd
Distribution To Donor0DistributionToDonorInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members9GoverningBodyVotingMembersCnt
Independent Voting Member9IndependentVotingMemberCnt
Family Or Business RlnYes (1)FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldINStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1EILEEN BLANKEBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone5747726030PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11002 SOUTH EDGEWOOD DRAddressLine1Txt
CityKNOXCityNm
State AbbreviationINStateAbbreviationCd
ZIP46534ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (12 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
JUDY CAUDILL
DIRECTOR1.00Yes (X)$0$0$0
PAUL LISOWSKI
DIRECTOR1.00Yes (X)$0$0$0
KATHRYN LARSON
DIRECTOR1.00Yes (X)$0$0$0
HAROLD WELTER
DIRECTOR1.00Yes (X)$0$0$0
DEBRA TROIKE
DIRECTOR1.00Yes (X)$0$0$0
RUTH ANN CONNER
SECRETARY1.00$0$0$0Yes (X)
ROSEANNE VONBAMPUS
TREASURER1.00$0$0$0Yes (X)
GAYLE SMITH
PRESIDENT1.00$0$0$0Yes (X)
NANCY DEMBOWSKI
VICE PRESIDENT1.00$0$0$0Yes (X)
KATHLEEN ROBB
EXECUTIVE DIR.40.00$75,188$0$7,718Yes (X)
EILEEN BLANKE
CFO40.00$69,161$0$7,718Yes (X)
DR WALTER E FRITZ
PHYSICIAN40.00$188,970$0$15,436Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$333,319TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$30,872TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K1IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (4 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
DR ALEXANDER GATZIMOS
212 W EDISON RDMISHAWAKAIN46545PROFESSIONAL SERV.$187,875
OMEGA HEALTHCARE INVESTORS
200 INTL CIRCLE STE 3500HUNT VALLEYMD21030RENT$160,851
NORTH AMERICAN HEALTHCARE MANAGEMENT SER
9245 WATSON INDUSTRIAL PARKST LOUISMO63126BILLING SERVICE$148,341
CARDINAL HEALTH
7000 CARDINAL PLACEDUBLINOH43017340 B DRUG VENDOR$107,322
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K4CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPATIENT SERVICE FEEDesc
Business900099BusinessCd
Total Revenue Column$2,620,369TotalRevenueColumnAmt
Related Or Exempt Func Income$2,620,369RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$2,620,369TotalProgramServiceRevenueAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$4,320OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other-$4,320OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$4,320TotalRevenueColumnAmt
Exclusion-$4,320ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescOTHER INCOMEDesc
Business900099BusinessCd
Total Revenue Column$30,188TotalRevenueColumnAmt
Exclusion$30,188ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$30,188OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,646,237TotalRevenueColumnAmt
Related Or Exempt Func Income$2,620,369RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$25,868ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$364,191TotalAmt
Program Services$255,132ProgramServicesAmt
Management And General$109,059ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$974,428TotalAmt
Program Services$682,630ProgramServicesAmt
Management And General$291,798ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$17,313TotalAmt
Program Services$17,313ProgramServicesAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$18,410TotalAmt
Program Services$18,410ProgramServicesAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$169,042TotalAmt
Program Services$169,042ProgramServicesAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$11,447TotalAmt
Management And General$11,447ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$26,127TotalAmt
Management And General$26,127ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$197,254TotalAmt
Program Services$135,620ProgramServicesAmt
Management And General$61,634ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$7,288TotalAmt
Program Services$5,789ProgramServicesAmt
Management And General$1,499ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$2,285TotalAmt
Management And General$2,285ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$18,639TotalAmt
Management And General$18,639ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$102,401TotalAmt
Program Services$48,709ProgramServicesAmt
Management And General$53,692ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
CONTRACT LABOR$170,411$154,453$15,958
MISCELLANEOUS$59,433$41,635$17,798
MEDICAL LAB FEES$58,351$58,351$0
EQUIPMENT$15,348$15,348$0

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$24,787TotalAmt
Program Services$23,757ProgramServicesAmt
Management And General$1,030ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$2,237,155TotalAmt
Program Services$1,626,189ProgramServicesAmt
Management And General$610,966ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$197,150BOYAmt
EOY$408,171EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$283,394BOYAmt
EOY$246,307EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$13,390BOYAmt
EOY$13,465EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$70,748LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$29,946LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$20,571BOYAmt
EOY$40,802EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$514,505BOYAmt
EOY$708,745EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$187,171BOYAmt
EOY$208,750EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$460,692BOYAmt
EOY$341,231EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$287,779BOYAmt
EOY$205,228EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$935,642BOYAmt
EOY$755,209EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY-$421,137BOYAmt
EOY-$46,464EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY-$421,137BOYAmt
EOY-$46,464EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$514,505BOYAmt
EOY$708,745EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$409,082ReconcilationRevenueExpnssAmt
Prior Period Adjustments-$34,409PriorPeriodAdjustmentsAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule D IRS990ScheduleD

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$21,772OtherCostOrOtherBasisAmt
Depreciation$21,772DepreciationAmt
Book Value$0BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$48,976OtherCostOrOtherBasisAmt
Depreciation$8,174DepreciationAmt
Book Value$40,802BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$40,802TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescOTHER LONG-TERM LIABILITIESDesc
Amt$205,228Amt
FieldValueIRS element (for citing)
Total Liability$205,228TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$2,681,334TotalRevEtcAuditedFinclStmtAmt
Donated Services And Use Fclts$35,097DonatedServicesAndUseFcltsAmt
Revenue Not Reported$35,097RevenueNotReportedAmt
Revenue Subtotal$2,646,237RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$2,646,237TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$2,272,252TotExpnsEtcAuditedFinclStmtAmt
Donated Services Use Fclts$35,097DonatedServicesUseFcltsAmt
Expenses Not Reported$35,097ExpensesNotReportedAmt
Expenses Subtotal$2,237,155ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$2,237,155TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationFIN 48 FOOTNOTE THE ORGANIZATION ADOPTED THE ACCOUNTING POLICY TO RECOGNIZE A TAX BENEFIT ONLY IF IT IS MORE LIKELY THAN NOT THE TAX POSITION WOULD BE SUSTAINED IN A TAX EXAMINATION, WITH A TAX EXAMINATION BEING PRESUMED TO OCCUR. THE AMOUNT RECOGNIZED WILL BE THE LARGEST AMOUNT OF TAX BENEFIT THAT IS GREATER THAN 50% LIKELY OF BEING REALIZED ON EXAMINATION. FOR TAX POSITIONS NOT MEETING THE MORE LIKELY-THAN-NOT TEST, NO TAX BENEFIT WILL BE RECORDED. THE ORGANIZATION HAS EXAMINED THIS ISSUE AND HAS DETERMINED THERE ARE NO MATERIAL CONTINGENT TAX LIABILITIES. THE ORGANIZATIONS FEDERAL EXEMPT ORGANIZATION INCOME TAX RETURNS (FORM 990) ARE SUBJECT TO EXAMINATION BY THE IRS, GENERALLY FOR THREE YEARS AFTER THEY ARE FILED.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp

FieldValueIRS element (for citing)
PersonDR WALTER E FRITZPersonNm
TitlePHYSICIANTitleTxt
Base Compensation Filing Org$188,970BaseCompensationFilingOrgAmt
Compensation Based On Rltd Orgs$0CompensationBasedOnRltdOrgsAmt
Bonus Filing Organization$0BonusFilingOrganizationAmount
Bonus Related Organizations$0BonusRelatedOrganizationsAmt
Other Compensation Filing Org$0OtherCompensationFilingOrgAmt
Other Compensation Rltd Orgs$0OtherCompensationRltdOrgsAmt
Deferred Compensation Flng Org$0DeferredCompensationFlngOrgAmt
Deferred Comp Rltd Orgs$0DeferredCompRltdOrgsAmt
Nontaxable Benefits Filing Org$15,436NontaxableBenefitsFilingOrgAmt
Nontaxable Benefits Rltd Orgs$0NontaxableBenefitsRltdOrgsAmt
Total Compensation Filing Org$204,406TotalCompensationFilingOrgAmt
Total Compensation Rltd Orgs$0TotalCompensationRltdOrgsAmt
Comp Report Prior990 Filing Org$0CompReportPrior990FilingOrgAmt
Comp Report Prior990 Rltd Orgs$0CompReportPrior990RltdOrgsAmt

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SEE BELOWBusinessNameLine1Txt
FieldValueIRS element (for citing)
Relationship DescriptionFAMILY OF BOARD MEMBERS OR MANAGEMENTRelationshipDescriptionTxt
Transaction$7,334TransactionAmt
TransactionSEE BELOWTransactionDesc
Sharing Of Revenues0SharingOfRevenuesInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART IV, LN 1FormAndLineReferenceDesc
ExplanationAT TIMES, THE ORGANIZATION OBTAINS MANUAL LABOR SERVICES FROM OUTSIDE VENDORS THAT ARE FAMILY MEMBERS TO BOARD MEMBERS OR MANAGEMENT. AMOUNTS PAID TO SUCH VENDORS, IN AGGREGATE, WERE $7,334 AND $3,036 FOR THE YEARS ENDED DECEMBER 31, 2018 AND 2017, RESPECTIVELY.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 2AT TIMES, THE ORGANIZATION OBTAINS MANUAL LABOR SERVICES FROM OUTSIDE VENDORS THAT ARE FAMILY MEMBERS TO BOARD MEMBERS OR MANAGEMENT. AMOUNTS PAID TO SUCH VENDORS, IN AGGREGATE, WERE $7,334 AND $3,036 FOR THE YEARS ENDED DECEMBER 31, 2018 AND 2017, RESPECTIVELY.
FORM 990, PART VI, SECTION B, LINE 11BLINE 11B EXPLANATION - COPIES OF THE FINAL FORM 990 ARE PROVIDED TO THE BOARD MEMBERS THROUGH EMAIL WITH INSTRUCTIONS THAT THEY ARE TO RESPOND IMMEDIATELY WITH QUESTIONS DUE TO TIMELINESS OF FILING THE RETURN.
FORM 990, PART VI, SECTION B, LINE 12CEACH YEAR THE CFO PROVIDES CONFLICT OF INTEREST STATEMENTS TO ALL BOARD MEMBERS FOR THEIR REVIEW AND SIGNATURES. THE CORPORATION AVOIDS ACTIVE PARTICIPATION OF ANY DIRECTOR IN A MANNER THAT POSES A CONFLICT OF INTEREST WITH RESPECT TO THAT DIRECTOR.
FORM 990, PART VI, SECTION B, LINE 15THE BOARD OF DIRECTORS USES COMPARATIVE COMPENSATION DATA AND HISTORICAL FINANCIAL DATA FROM THE CLINIC TO DETERMINE AN APPROPRIATE SALARY FOR THE ORGANIZATION OFFICERS. THE BOARD OF DIRECTORS USES COMPARATIVE COMPENSATION DATA AND HISTORICAL FINANCIAL DATA FROM THE CLINIC TO DETERMINE AN APPROPRIATE SALARY FOR THE ORGANIZATION OFFICERS.
FORM 990, PART VI, SECTION C, LINE 19UPON REQUEST.