ALLIANCE MEDICAL MINISTRY INC: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- ALLIANCE MEDICAL MINISTRY INC (EIN 56-2168673)
- Tax period
- 2016-01-01 to 2016-12-31
- Filed
- 2017-10-25
- IRS object ID
- 201722989349301372
- 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 | 2017-10-25T15:30:42-04:00 | ReturnTs |
| Tax Period End | 2016-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 562344058 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DREHER MARTIN CPAS PA | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4101 LAKE BOONE TRL STE 215 | AddressLine1Txt |
| City | RALEIGH | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27607 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 562168673 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ALLIANCE MEDICAL MINISTRY INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | ALLI | BusinessNameControlTxt |
| Phone | 9192503320 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 DONALD ROSS DRIVE | AddressLine1Txt |
| City | RALEIGH | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27610 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MARGARET P RADER | PersonNm |
| Person Title | EXECUTIVE DIRECTOR | PersonTitleTxt |
| Phone | 9192503320 | PhoneNum |
| Signature | 2017-10-25 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DOUG DREHER | PreparerPersonNm |
| PTIN | P00543597 | PTIN |
| Phone | 9195109399 | PhoneNum |
| Preparation | 2017-10-25 | PreparationDt |
Filing Security Information FilingSecurityInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| At Submission Creation Device Id | BA24F935BB1BC4D4243162E9284C3AE76B957495 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 7ED8333607F08C5A3E798CE16FB4BFD50A5DA94A | 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 | MARGARET P RADER | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 DONALD ROSS DRIVE | AddressLine1Txt |
| City | RALEIGH | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27610 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $1,538,143 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.ALLIANCEMEDICALMINISTRY.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2000 | FormationYr |
| Legal Domicile State | NC | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE AFFORDABLE PRIMARY MEDICAL CARE TO LOW INCOME, UNINSURED WORKING FAMILIES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 17 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 16 | VotingMembersIndependentCnt |
| Total Employee | 20 | TotalEmployeeCnt |
| Total Volunteers | 247 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $960,120 | PYContributionsGrantsAmt |
| CY Contributions Grants | $904,338 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $525,926 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $524,301 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$28,470 | PYInvestmentIncomeAmt |
| CY Investment Income | -$2 | CYInvestmentIncomeAmt |
| PY Other Revenue | $61,857 | PYOtherRevenueAmt |
| CY Other Revenue | $60,209 | CYOtherRevenueAmt |
| PY Total Revenue | $1,519,433 | PYTotalRevenueAmt |
| CY Total Revenue | $1,488,846 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $1,161,400 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $1,049,679 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $154,547 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $443,807 | PYOtherExpensesAmt |
| CY Other Expenses | $462,601 | CYOtherExpensesAmt |
| PY Total Expenses | $1,605,207 | PYTotalExpensesAmt |
| CY Total Expenses | $1,512,280 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$85,774 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$23,434 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $3,863,485 | TotalAssetsBOYAmt |
| Total Assets EOY | $3,803,469 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $144,164 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $107,582 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $3,719,321 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $3,695,887 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO PROVIDE AFFORDABLE PRIMARY MEDICAL CARE TO LOW INCOME, UNINSURED WORKING FAMILIES. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $1,240,569 | ExpenseAmt |
| Revenue | $524,301 | RevenueAmt |
| Desc | PROVIDE MEDICAL SERVICES FOR UNINSURED LOW INCOME INDIVIDUALS. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PROVIDE MEDICAL SERVICES FOR UNINSURED LOW INCOME INDIVIDUALS | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $1,240,569 | 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 | Yes (true) | 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 | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | 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 | Yes (true) | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | false | 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 | Yes (true) | 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 | 2 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | false | BackupWthldComplianceInd |
| Employee | 20 | 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 |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 17 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 16 | 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 | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | false | ConflictOfInterestPolicyInd |
| Whistleblower Policy | false | WhistleblowerPolicyInd |
| Document Retention Policy | false | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | NC | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MARGARET P RADER | PersonNm |
| Phone | 9192503394 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 DONALD ROSS DRIVE | AddressLine1Txt |
| City | RALEIGH | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27610 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|
| RICK MARCOTTE | ||||||
| CHAIR | 5.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| KATHLEEN GORMLEY | ||||||
| SECRETARY | 6.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| GERALD PETKAU | ||||||
| TREASURER | 6.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| DANA SIMPSON JD | ||||||
| IMMEDIATE PA | 3.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| MARGARET P RADER | ||||||
| EXECUTIVE DI | 40.00 | Yes (X) | Yes (X) | $104,971 | $0 | $10,694 |
| REBECCA ANDREWS | ||||||
| DIRECTOR | 3.00 | Yes (X) | $0 | $0 | $0 | |
| S TODD HEMPHILL | ||||||
| DIRECTOR | 3.00 | Yes (X) | $0 | $0 | $0 | |
| JAMES KAY | ||||||
| DIRECTOR | 3.00 | Yes (X) | $0 | $0 | $0 | |
| NEIL MORRIS | ||||||
| DIRECTOR | 3.00 | Yes (X) | $0 | $0 | $0 | |
| STEVEN PEEDIN | ||||||
| DIRECTOR | 3.00 | Yes (X) | $0 | $0 | $0 | |
| JR SHEARIN | ||||||
| DIRECTOR | 3.00 | Yes (X) | $0 | $0 | $0 | |
| JEFFREY SIMMS | ||||||
| DIRECTOR | 3.00 | Yes (X) | $0 | $0 | $0 | |
| DR MICHAEL D SPIRITOS | ||||||
| DIRECTOR | 3.00 | Yes (X) | $0 | $0 | $0 | |
| TAMMIE STANTON | ||||||
| DIRECTOR | 3.00 | Yes (X) | $0 | $0 | $0 | |
| KEITH WALLACE | ||||||
| DIRECTOR | 3.00 | Yes (X) | $0 | $0 | $0 | |
| DAVID WILSON | ||||||
| DIRECTOR | 3.00 | Yes (X) | $0 | $0 | $0 | |
| LISA NAA-SHORMEY YEBUAH | ||||||
| DIRECTOR | 3.00 | Yes (X) | $0 | $0 | $0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $104,971 | TotalReportableCompFromOrgAmt |
| Total Other Compensation | $10,694 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 1 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | false | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| Fundraising | $74,553 | FundraisingAmt |
| Government Grants | $62,299 | GovernmentGrantsAmt |
| All Other Contributions | $767,486 | AllOtherContributionsAmt |
| Noncash Contributions | $64,780 | NoncashContributionsAmt |
| Total Contributions | $904,338 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| REVENUE:CONTRACT FEES | 621110 | $372,604 | $372,604 |
| REVENUE:PATIENT FEES | 621110 | $150,142 | $150,142 |
| REVENUE:MEDICAL RECORDS | 621110 | $1,555 | $1,555 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $524,301 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $510 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $510 | RelatedOrExemptFuncIncomeAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $49,034 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $49,034 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $49,034 | TotalRevenueColumnAmt |
| Exclusion | $49,034 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $35,838 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $36,040 | SecuritiesAmt |
| Other | $310 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -$202 | SecuritiesAmt |
| Other | -$310 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$512 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | -$512 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $17,540 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $74,553 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $12,947 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,593 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| OTHER INCOME | 900099 | $4,445 | $4,445 |
| THIRD PARTY EVENTS | 900099 | $2,134 | $2,134 |
| OTHER INCOME:OTHER INCOME - M | 900099 | $3 | $3 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $6,582 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,488,846 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $530,881 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $49,034 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $118,401 | TotalAmt |
| Program Services | $39,467 | ProgramServicesAmt |
| Management And General | $39,467 | ManagementAndGeneralAmt |
| Fundraising | $39,467 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $783,894 | TotalAmt |
| Program Services | $708,840 | ProgramServicesAmt |
| Fundraising | $75,054 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,087 | TotalAmt |
| Program Services | $18,526 | ProgramServicesAmt |
| Management And General | $546 | ManagementAndGeneralAmt |
| Fundraising | $1,015 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $59,360 | TotalAmt |
| Program Services | $52,960 | ProgramServicesAmt |
| Management And General | $6,206 | ManagementAndGeneralAmt |
| Fundraising | $194 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $67,937 | TotalAmt |
| Program Services | $56,747 | ProgramServicesAmt |
| Management And General | $2,736 | ManagementAndGeneralAmt |
| Fundraising | $8,454 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $120 | TotalAmt |
| Program Services | $96 | ProgramServicesAmt |
| Management And General | $24 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,000 | TotalAmt |
| Program Services | $14,400 | ProgramServicesAmt |
| Management And General | $3,600 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $98,949 | TotalAmt |
| Program Services | $72,998 | ProgramServicesAmt |
| Management And General | $25,951 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,875 | TotalAmt |
| Program Services | $2,719 | ProgramServicesAmt |
| Fundraising | $8,156 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $288 | TotalAmt |
| Program Services | $216 | ProgramServicesAmt |
| Management And General | $36 | ManagementAndGeneralAmt |
| Fundraising | $36 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $119,953 | TotalAmt |
| Program Services | $102,795 | ProgramServicesAmt |
| Management And General | $8,579 | ManagementAndGeneralAmt |
| Fundraising | $8,579 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $230 | TotalAmt |
| Program Services | $173 | ProgramServicesAmt |
| Management And General | $29 | ManagementAndGeneralAmt |
| Fundraising | $28 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,046 | TotalAmt |
| Program Services | $3,034 | ProgramServicesAmt |
| Management And General | $506 | ManagementAndGeneralAmt |
| Fundraising | $506 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $94,152 | TotalAmt |
| Program Services | $70,614 | ProgramServicesAmt |
| Management And General | $11,769 | ManagementAndGeneralAmt |
| Fundraising | $11,769 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,612 | TotalAmt |
| Program Services | $24,267 | ProgramServicesAmt |
| Management And General | $1,793 | ManagementAndGeneralAmt |
| Fundraising | $552 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $38,359 | $38,359 | |
| CLINIC EXPENSE | $27,864 | $27,864 | |
| SUPPLIES-OFFICE | $8,869 | $8,869 | |
| TRAINING | $4,754 | $4,754 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,530 | TotalAmt |
| Program Services | $1,740 | ProgramServicesAmt |
| Management And General | $7,053 | ManagementAndGeneralAmt |
| Fundraising | $737 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,512,280 | TotalAmt |
| Program Services | $1,240,569 | ProgramServicesAmt |
| Management And General | $117,164 | ManagementAndGeneralAmt |
| Fundraising | $154,547 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $396,763 | BOYAmt |
| EOY | $402,218 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $105,047 | BOYAmt |
| EOY | $63,580 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $63,102 | BOYAmt |
| EOY | $129,249 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,375 | BOYAmt |
| EOY | $4,984 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $4,062,380 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $858,942 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,294,198 | BOYAmt |
| EOY | $3,203,438 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,863,485 | BOYAmt |
| EOY | $3,803,469 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,236 | BOYAmt |
| EOY | $13,023 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $40,000 | BOYAmt |
| EOY | $17,475 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $79,928 | BOYAmt |
| EOY | $77,084 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $144,164 | BOYAmt |
| EOY | $107,582 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,614,024 | BOYAmt |
| EOY | $3,632,306 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $105,297 | BOYAmt |
| EOY | $63,581 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,719,321 | BOYAmt |
| EOY | $3,695,887 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,863,485 | BOYAmt |
| EOY | $3,803,469 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$23,434 | ReconcilationRevenueExpnssAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | false | FSAuditedInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $721,890 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,297,277 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $923,712 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $960,120 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $904,338 | CurrentTaxYearAmt |
| Total | $4,807,337 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $600,215 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $594,008 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $599,408 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $543,908 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $541,841 | CurrentTaxYearAmt |
| Total | $2,879,380 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,322,105 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,891,285 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,523,120 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,504,028 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,446,179 | CurrentTaxYearAmt |
| Total | $7,686,717 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | $356,322 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $357,657 | CurrentTaxYearAmt |
| Total | $713,979 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | $356,322 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $357,657 | CurrentTaxYearAmt |
| Total | $713,979 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $6,972,738 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $805 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $572 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $630 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $377 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $510 | CurrentTaxYearAmt |
| Total | $2,894 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $805 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $572 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $630 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $377 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $510 | CurrentTaxYearAmt |
| Total | $2,894 | TotalAmt |
Net Income From Other UBI NetIncomeFromOtherUBIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $81,531 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $95,311 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $60,353 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $75,914 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $48,034 | CurrentTaxYearAmt |
| Total | $361,143 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,404,441 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,987,168 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,584,103 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,580,319 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,494,723 | CurrentTaxYearAmt |
| Total | $8,050,754 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.86610 | PublicSupportCY509Pct |
| Public Support PY509 | 0.92050 | PublicSupportPY509Pct |
| Investment Income CY | 0.00000 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00000 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | false | AgentTrusteeEtcInd |
| Incl Escrow Custodial Acct Liab | false | InclEscrowCustodialAcctLiabInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $580,100 | OtherCostOrOtherBasisAmt |
| Book Value | $580,100 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,363,067 | OtherCostOrOtherBasisAmt |
| Depreciation | $744,853 | DepreciationAmt |
| Book Value | $2,618,214 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $119,213 | OtherCostOrOtherBasisAmt |
| Depreciation | $114,089 | DepreciationAmt |
| Book Value | $5,124 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $3,203,438 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| LINE OF CREDIT PARAGON | $76,277 |
| DEFERRED INCOME | $807 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $77,084 | TotalLiabilityAmt |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | WOMEN'S LUNCHEO | Event1Nm |
| Gross Receipts Event1 | $73,394 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $55,854 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $17,540 | GrossRevenueEvent1Amt |
| Other Direct Expenses Event1 | $10,752 | OtherDirectExpensesEvent1Amt |
| Event2 | SHARE THE PIE | Event2Nm |
| Gross Receipts Event2 | $13,892 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $13,892 | CharitableContriEvent2Amt |
| Other Direct Expenses Event2 | $1,140 | OtherDirectExpensesEvent2Amt |
| Gross Receipts Total | $87,286 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $69,746 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $17,540 | GrossRevenueTotalEventsAmt |
| Oth Direct Expnss Total Events | $11,892 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $11,892 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $5,648 | NetIncomeSummaryAmt |
Schedule M IRS990ScheduleM
Securities Publicly Traded SecuritiesPubliclyTradedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 5 | ContributionCnt |
| Noncash Contributions Rpt F990 | $36,040 | NoncashContributionsRptF990Amt |
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $24,481 | NoncashContributionsRptF990Amt |
Other Non Cash Contri Table OtherNonCashContriTableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $4,259 | NoncashContributionsRptF990Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | false | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | false | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 2, PART III, LINE 4D | PROVIDE MEDICAL SERVICES FOR UNINSURED LOW INCOME INDIVIDUALS |
| FORM 990, PAGE 6, PART VI, LINE 11B | THE 990 WILL BE DISTRIBUTED TO THE BOARD FOR REVIEW AND COMMENT AT THE BOARD MEETING FOLLOWING DISTRIBUTION. |
| FORM 990, PAGE 6, PART VI, LINE 15A | THE BOARD HAS OVERSIGHT AND APPROVES EXECUTIVE DIRECTOR COMPENSATION. THE EXECUTIVE DIRECTOR MAKES RECOMMENDATIONS ON KEY EMPLOYEE COMPENSATION WHICH IS APPROVED DURING THE BUDGET PROCESS. |
| FORM 990, PAGE 6, PART VI, LINE 15B | THE BOARD HAS OVERSIGHT AND APPROVES EXECUTIVE DIRECTOR COMPENSATION. THE EXECUTIVE DIRECTOR MAKES RECOMMENDATIONS ON KEY EMPLOYEE COMPENSATION WHICH IS APPROVED DURING THE BUDGET PROCESS. |
| FORM 990, PAGE 6, PART VI, LINE 19 | THE GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST FOR INSPECTION. ALSO THE FINANCIAL STATEMENTS ARE INCLUDED IN THE ANNUAL REPORT SENT IN A NEWSLETTER TO SUPPORTERS(ALSO AVAILABLE UPON REQUEST). THE NEWSLETTER WITH THE ANNUAL REPORT MAY BE DOWNLOADED FROM THE ORGANIZATION'S WEBSITE. |