BATTENKILL VALLEY HEALTH CENTER INC: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- BATTENKILL VALLEY HEALTH CENTER INC (EIN 27-2759990)
- Tax period
- 2016-07-01 to 2017-06-30
- Filed
- 2018-01-23
- IRS object ID
- 201830239349300763
- Schema version
- 2016v3.0
- 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 | 2018-01-23T10:58:12-06:00 | ReturnTs |
| Tax Period End | 2017-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 010523282 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BERRY DUNN MCNEIL & PARKER LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1000 ELM STREET 15TH FLOOR | AddressLine1Txt |
| City | MANCHESTER | CityNm |
| State Abbreviation | NH | StateAbbreviationCd |
| ZIP | 03101 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 272759990 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BATTENKILL VALLEY HEALTH CENTER INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | BATT | BusinessNameControlTxt |
| Phone | 8023756566 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 61 | AddressLine1Txt |
| City | ARLINGTON | CityNm |
| State Abbreviation | VT | StateAbbreviationCd |
| ZIP | 05250 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | GRACE GILBERT-DAVIS | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 8023756566 | PhoneNum |
| Signature | 2018-01-22 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DIMITRIOS PANACOPOULOS | PreparerPersonNm |
| PTIN | P01603705 | PTIN |
| Phone | 6036697337 | PhoneNum |
| Preparation | 2018-01-22 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 69.49.157.66 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2018-01-22 | IPDt |
| IP Tm | 13:46:04 | IPTm |
| IP Timezone | ES | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 110E64D7D7C632CB204D3607306484447A51AD6C | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 6971107187481D7C4A4F60AF4C2AC661EC781045 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | GRACE GILBERT-DAVIS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 61 | AddressLine1Txt |
| City | ARLINGTON | CityNm |
| State Abbreviation | VT | StateAbbreviationCd |
| ZIP | 05250 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $3,087,141 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.BATTENKILLVALLEYHEALTHCENTER.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2010 | FormationYr |
| Legal Domicile State | VT | LegalDomicileStateCd |
| Activity Or Mission | BATTENKILL VALLEY HEALTH CENTER PROVIDES COMPREHENSIVE HEALTHCARE TO ARLINGTON, VT AND SURROUNDING AREAS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 18 | TotalEmployeeCnt |
| Total Volunteers | 10 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,284,520 | PYContributionsGrantsAmt |
| CY Contributions Grants | $2,118,943 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $885,318 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $952,542 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$75,440 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $6,867 | CYOtherRevenueAmt |
| PY Total Revenue | $2,094,398 | PYTotalRevenueAmt |
| CY Total Revenue | $3,078,352 | 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 | $1,111,847 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $1,725,656 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $8,789 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $608,446 | PYOtherExpensesAmt |
| CY Other Expenses | $603,727 | CYOtherExpensesAmt |
| PY Total Expenses | $1,720,293 | PYTotalExpensesAmt |
| CY Total Expenses | $2,329,383 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $374,105 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $748,969 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $1,434,830 | TotalAssetsBOYAmt |
| Total Assets EOY | $3,067,282 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $182,604 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,066,087 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,252,226 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $2,001,195 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | BATTENKILL VALLEY HEALTH CENTER, A COMMUNITY RESOURCE, PROVIDES COMPASSIONATE, RESPONSIVE, COMPREHENSIVE HEALTHCARE THROUGH A COMMITTED TEAM OF PROFESSIONALS ENSURING AFFORDABLE ACCESS TO ALL. | MissionDesc |
| Significant New Program Srvc | Yes (1) | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $1,669,019 | ExpenseAmt |
| Revenue | $952,542 | RevenueAmt |
| Desc | BATTENKILL VALLEY HEALTH CENTER PROVIDES COMPREHENSIVE HEALTHCARE TO ARLINGTON, VERMONT AND SURROUNDING COMMUNITIES THROUGH THE FOLLOWING SERVICES OFFERED:-PRIMARY AND PREVENTATIVE HEALTH CARE-BEHAVIORAL HEALTH SCIENCES-DIETITIAN SERVICES-SOCIAL WORK-NURSE CASE MANAGEMENT-LABORATORY SERVICES-DENTAL SERVICES | Desc |
| Total Program Service Expenses | $1,669,019 | 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 | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 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 | 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 | 5 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 18 | 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 |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | 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 | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | 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 | VT | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GRACE GILBERT-DAVIS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8023756566 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 61 | AddressLine1Txt |
| City | ARLINGTON | CityNm |
| State Abbreviation | VT | StateAbbreviationCd |
| ZIP | 05250 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (12 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|---|
| MARY ANN CARLSON | |||||||
| CHAIR | 2.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| LEE SPIVEY | |||||||
| VICE CHAIR | 2.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| DENISE COLETY | |||||||
| SECRETARY | 2.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| GEORGE CARPENTER | |||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| BRIAN CUNNINGHAM | |||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| JAN NOLAN | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| LYNN WILLIAMS | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| EDWARD SARGOOD | |||||||
| TREASURER | 2.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| SCOTT SEIDEL | |||||||
| PAST DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| OLAVI WIRKKI | |||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| GRACE GILBERT-DAVIS | |||||||
| CEO | 40.00 | 0.00 | Yes (X) | $162,149 | $0 | $7,583 | |
| JEANNINE RILEY | |||||||
| CFO | 40.00 | 0.00 | Yes (X) | $85,319 | $0 | $2,048 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $247,468 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $9,631 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 1 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BARTON ASSOCIATES | BusinessNameLine1Txt |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 417844 | AddressLine1Txt |
| City | BOSTON | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 02441 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | MEDICAL STAFF | ServicesDesc |
| Compensation | $196,047 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $1,173,900 | GovernmentGrantsAmt |
| All Other Contributions | $945,043 | AllOtherContributionsAmt |
| Total Contributions | $2,118,943 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NET PATIENT SERVICE RE | Desc |
| Business | 624110 | BusinessCd |
| Total Revenue Column | $952,542 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $952,542 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $952,542 | TotalProgramServiceRevenueAmt |
| Fundraising Gross Income | $15,656 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $8,789 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $6,867 | TotalRevenueColumnAmt |
| Exclusion | $6,867 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,078,352 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $952,542 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $6,867 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $257,099 | TotalAmt |
| Management And General | $257,099 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,159,062 | TotalAmt |
| Program Services | $1,011,525 | ProgramServicesAmt |
| Management And General | $147,537 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $31,163 | TotalAmt |
| Program Services | $22,411 | ProgramServicesAmt |
| Management And General | $8,752 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $176,810 | TotalAmt |
| Program Services | $127,156 | ProgramServicesAmt |
| Management And General | $49,654 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $101,522 | TotalAmt |
| Program Services | $73,011 | ProgramServicesAmt |
| Management And General | $28,511 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,484 | TotalAmt |
| Management And General | $21,484 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $103,930 | TotalAmt |
| Program Services | $74,743 | ProgramServicesAmt |
| Management And General | $29,187 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,644 | TotalAmt |
| Management And General | $8,644 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,616 | TotalAmt |
| Program Services | $10,511 | ProgramServicesAmt |
| Management And General | $4,105 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $54,385 | TotalAmt |
| Program Services | $39,111 | ProgramServicesAmt |
| Management And General | $15,274 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $53,246 | TotalAmt |
| Program Services | $38,293 | ProgramServicesAmt |
| Management And General | $14,953 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,414 | TotalAmt |
| Program Services | $13,243 | ProgramServicesAmt |
| Management And General | $5,171 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,968 | TotalAmt |
| Program Services | $13,641 | ProgramServicesAmt |
| Management And General | $5,327 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $63,177 | TotalAmt |
| Program Services | $45,434 | ProgramServicesAmt |
| Management And General | $17,743 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $34,988 | TotalAmt |
| Program Services | $25,162 | ProgramServicesAmt |
| Management And General | $9,826 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| PROGRAM SUPPLIES | $102,284 | $102,284 | |
| EQUIPMENT RENTAL/REPAIR | $38,378 | $27,600 | $10,778 |
| TELEPHONE | $28,568 | $20,546 | $8,022 |
| PRINTING AND PUBLICATIO | $17,480 | $12,571 | $4,909 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,165 | TotalAmt |
| Program Services | $11,777 | ProgramServicesAmt |
| Management And General | $4,599 | ManagementAndGeneralAmt |
| Fundraising | $8,789 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,329,383 | TotalAmt |
| Program Services | $1,669,019 | ProgramServicesAmt |
| Management And General | $651,575 | ManagementAndGeneralAmt |
| Fundraising | $8,789 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $838,555 | BOYAmt |
| EOY | $249,225 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $91,992 | BOYAmt |
| EOY | $126,159 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $75,377 | BOYAmt |
| EOY | $157,173 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,119 | BOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,521 | BOYAmt |
| EOY | $4,310 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $2,536,848 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $83,571 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $324,266 | BOYAmt |
| EOY | $2,453,277 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $73,000 | BOYAmt |
| EOY | $77,138 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,434,830 | BOYAmt |
| EOY | $3,067,282 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $179,205 | BOYAmt |
| EOY | $160,327 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,399 | BOYAmt |
| EOY | $905,760 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $182,604 | BOYAmt |
| EOY | $1,066,087 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,240,876 | BOYAmt |
| EOY | $2,001,195 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,350 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,252,226 | BOYAmt |
| EOY | $2,001,195 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,434,830 | BOYAmt |
| EOY | $3,067,282 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $748,969 | ReconcilationRevenueExpnssAmt |
| 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 | 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 | $114,000 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $660,084 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $923,953 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,284,520 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,118,943 | CurrentTaxYearAmt |
| Total | $5,101,500 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $114,000 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $660,084 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $923,953 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,284,520 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,118,943 | CurrentTaxYearAmt |
| Total | $5,101,500 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $5,101,500 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus3 Years | $39 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $113 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $126 | CurrentTaxYearMinus1YearAmt |
| Total | $278 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $5,101,778 | TotalSupportAmt |
| Public Support CY170 | 0.99990 | PublicSupportCY170Pct |
| Public Support PY170 | 0.96970 | 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 | $33,000 | OtherCostOrOtherBasisAmt |
| Book Value | $33,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,256,998 | OtherCostOrOtherBasisAmt |
| Depreciation | $55,280 | DepreciationAmt |
| Book Value | $2,201,718 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $246,850 | OtherCostOrOtherBasisAmt |
| Depreciation | $28,291 | DepreciationAmt |
| Book Value | $218,559 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $2,453,277 | TotalBookValueLandBuildingsAmt |
| Total Rev Etc Audited Fincl Stmt | $3,086,848 | TotalRevEtcAuditedFinclStmtAmt |
| Donated Services And Use Fclts | $8,496 | DonatedServicesAndUseFcltsAmt |
| Revenue Not Reported | $8,496 | RevenueNotReportedAmt |
| Revenue Subtotal | $3,078,352 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $3,078,352 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $2,337,879 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $8,496 | DonatedServicesUseFcltsAmt |
| Expenses Not Reported | $8,496 | ExpensesNotReportedAmt |
| Expenses Subtotal | $2,329,383 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $2,329,383 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | FORM 990 LINE 11F | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION IS A PUBLIC CHARITY UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. AS A PUBLIC CHARITY, THE ORGANIZATION IS EXEMPT FROM STATE AND FEDERAL INCOME TAXES ON INCOME EARNED IN ACCORDANCE WITH ITS TAX-EXEMPT PURPOSE. UNRELATED BUSINESS INCOME IS SUBJECT TO STATE AND FEDERAL INCOME TAX. MANAGEMENT HAS EVALUATED THE ORGANIZATION'S TAX POSITIONS AND CONCLUDED THAT THE ORGANIZATION HAS NO UNRELATED BUSINESS INCOME OR UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENT TO THE FINANCIAL STATEMENTS. | ExplanationTxt |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | GOLF | Event1Nm |
| Gross Receipts Event1 | $15,656 | GrossReceiptsEvent1Amt |
| Gross Revenue Event1 | $15,656 | GrossRevenueEvent1Amt |
| Rent Facility Costs Event1 | $8,006 | RentFacilityCostsEvent1Amt |
| Other Direct Expenses Event1 | $783 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $15,656 | GrossReceiptsTotalAmt |
| Gross Revenue Total Events | $15,656 | GrossRevenueTotalEventsAmt |
| Rent Fclty Costs Total Events | $8,006 | RentFcltyCostsTotalEventsAmt |
| Oth Direct Expnss Total Events | $783 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $8,789 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $6,867 | NetIncomeSummaryAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | GRACE GILBERT-DAVIS | PersonNm |
| Title | CEO | TitleTxt |
| Base Compensation Filing Org | $162,149 | BaseCompensationFilingOrgAmt |
| Compensation Based On Rltd Orgs | $0 | CompensationBasedOnRltdOrgsAmt |
| Bonus Filing Organization | $0 | BonusFilingOrganizationAmount |
| Bonus Related Organizations | $0 | BonusRelatedOrganizationsAmt |
| Other Compensation Filing Org | $0 | OtherCompensationFilingOrgAmt |
| Other Compensation Rltd Orgs | $0 | OtherCompensationRltdOrgsAmt |
| Deferred Compensation Flng Org | $7,583 | DeferredCompensationFlngOrgAmt |
| Deferred Comp Rltd Orgs | $0 | DeferredCompRltdOrgsAmt |
| Nontaxable Benefits Filing Org | $0 | NontaxableBenefitsFilingOrgAmt |
| Nontaxable Benefits Rltd Orgs | $0 | NontaxableBenefitsRltdOrgsAmt |
| Total Compensation Filing Org | $169,732 | TotalCompensationFilingOrgAmt |
| Total Compensation Rltd Orgs | $0 | TotalCompensationRltdOrgsAmt |
| Comp Report Prior990 Filing Org | $0 | CompReportPrior990FilingOrgAmt |
| Comp Report Prior990 Rltd Orgs | $0 | CompReportPrior990RltdOrgsAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART III, LINE 2 | STARTED DENTAL CLINIC. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. MEMBERS OF THE FINANCE COMMITTEE AND MANAGEMENT REVIEW THE FORM 990 PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION HAS A CONFLICT OF INTEREST POLICY COVERING DIRECTORS, OFFICERS AND EMPLOYEES. THE BOARD WILL ESTABLISH, ADOPT AND PERIODICALLY UPDATE A WRITTEN STANDARDS OF CONDUCT POLICY THAT ESTABLISHES PROCEDURES FOR DISCLOSURE AND ADDRESSING CONFLICTS OF INTEREST OR THE APPEARANCE OF CONFLICTS OF INTEREST. THE DIRECTORS WILL ANNUALLY COMPLETE A CERTIFICATION OF COMMITMENT TO COMPLY WITH STANDARDS OF CONDUCT AND A CONFLICT OF INTEREST DISCLOSURE STATEMENT. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |