MATAGORDA EPISCOPAL HEALTH OUTREACH PROGRAM: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- MATAGORDA EPISCOPAL HEALTH OUTREACH PROGRAM (EIN 20-0537948)
- Tax period
- 2016-01-01 to 2016-12-31
- Filed
- 2017-09-15
- IRS object ID
- 201742589349300344
- 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 | 2017-09-15T10:40:50-05:00 | ReturnTs |
| Tax Period End | 2016-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 421655494 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KENNEMER MASTERS & LUNSFORD LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 8 WEST WAY COURT | AddressLine1Txt |
| City | LAKE JACKSON | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 77566 | 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 | 200537948 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MATAGORDA EPISCOPAL HEALTH OUTREACH | BusinessNameLine1Txt |
| Business Name Line2 | PROGRAM CORPORATION | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MATA | BusinessNameControlTxt |
| Phone | 9792452008 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 AVENUE F NORTH | AddressLine1Txt |
| City | BAY CITY | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 77414 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CELESTE HARRISON | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 9792452008 | PhoneNum |
| Signature | 2017-08-16 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | VARENIA O'QUINN | PreparerPersonNm |
| PTIN | P00179447 | PTIN |
| Phone | 9792974075 | PhoneNum |
| Preparation | 2017-09-15 | PreparationDt |
Filing Security Information FilingSecurityInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| At Submission Creation Device Id | 566662EEA606C088219A9B6BB24B096111B22042 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | EFE6C4DD2C83711CBCC247C6A3FF1ABADAD31356 | 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 | CELESTE HARRISON | PrincipalOfficerNm |
| Gross Receipts | $5,593,347 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | HTTP://WWW.MEHOP.ORG/ | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1998 | FormationYr |
| Legal Domicile State | TX | LegalDomicileStateCd |
| Activity Or Mission | IMPROVE THE HEALTH STATUS OF PEOPLE BY PROVIDING QUALITY PRIMARY HEALTH CARE SERVICES AND SPIRITUAL CARE TO PEOPLE IN THE COMMUNITIES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 12 | VotingMembersIndependentCnt |
| Total Employee | 88 | TotalEmployeeCnt |
| Total Volunteers | 88 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $2,238,573 | PYContributionsGrantsAmt |
| CY Contributions Grants | $2,064,476 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $3,150,260 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $3,283,584 | CYProgramServiceRevenueAmt |
| PY Investment Income | $337 | PYInvestmentIncomeAmt |
| CY Investment Income | $228 | CYInvestmentIncomeAmt |
| PY Other Revenue | $162,888 | PYOtherRevenueAmt |
| CY Other Revenue | $230,661 | CYOtherRevenueAmt |
| PY Total Revenue | $5,552,058 | PYTotalRevenueAmt |
| CY Total Revenue | $5,578,949 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $3,658,270 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $3,962,455 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,710,666 | PYOtherExpensesAmt |
| CY Other Expenses | $1,791,370 | CYOtherExpensesAmt |
| PY Total Expenses | $5,368,936 | PYTotalExpensesAmt |
| CY Total Expenses | $5,753,825 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $183,122 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$174,876 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $2,661,471 | TotalAssetsBOYAmt |
| Total Assets EOY | $2,500,375 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $625,714 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $639,494 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $2,035,757 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $1,860,881 | NetAssetsOrFundBalancesEOYAmt |
| Mission | IMPROVE THE HEALTH STATUS OF PEOPLE BY PROVIDING QUALITY PRIMARY HEALTH CARE SERVICES AND SPIRITUAL CARE TO PEOPLE IN THE COMMUNITIES. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $5,053,705 | ExpenseAmt |
| Revenue | $3,283,584 | RevenueAmt |
| Desc | PROVIDE DENTAL AND HEALTH SERVICES TO PEOPLE IN MATAGORDA COUNTY. APPROXIMATELY 8,168 PEOPLE WERE SERVED DURING THE CURRENT YEAR. | Desc |
| Total Program Service Expenses | $5,053,705 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (true) | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 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 | 6 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 88 | 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 |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Form8899 Filedind | false | Form8899Filedind |
| Form1098 C Filed | false | Form1098CFiledInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 12 | 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 | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MEHOP | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 9792452008 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 AVENUE F NORTH | AddressLine1Txt |
| City | BAY CITY | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 77414 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)
| TitleTitleTxt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per WeekAverageHoursPerWeekRt | OfficerOfficerInd | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| JOHN SCHMERMUND | ||||||||
| DIRECTOR | Yes (X) | $0 | $0 | $0 | ||||
| KELLI HUNT | ||||||||
| DIRECTOR | Yes (X) | $0 | $0 | $0 | ||||
| CAROLYN VAUGHAN | ||||||||
| SECRETARY | Yes (X) | $0 | $0 | $0 | ||||
| GAYLE BLACKMON | ||||||||
| TREASURER | Yes (X) | $0 | $0 | $0 | ||||
| MARTHA JOHNSON | ||||||||
| DIRECTOR | Yes (X) | $0 | $0 | $0 | ||||
| MARY HELEN NELSON | ||||||||
| DIRECTOR | Yes (X) | $0 | $0 | $0 | ||||
| BARBARA GORDON | ||||||||
| VICE PRESIDE | Yes (X) | $0 | $0 | $0 | ||||
| ERIC M WRIGHT | ||||||||
| PRESIDENT | Yes (X) | $0 | $0 | $0 | ||||
| EDWIN HAWES DICKERSON | ||||||||
| DIRECTOR | Yes (X) | $0 | $0 | $0 | ||||
| EVA PETERSON | ||||||||
| DIRECTOR | Yes (X) | $0 | $0 | $0 | ||||
| DAWN POWELL | ||||||||
| DIRECTOR | Yes (X) | $0 | $0 | $0 | ||||
| LINDA SMITH | ||||||||
| DIRECTOR | Yes (X) | $0 | $0 | $0 | ||||
| CELESTE HARRISON | ||||||||
| CEO | $86,997 | $0 | $0 | 40.00 | Yes (X) | |||
| EVE CHEN | ||||||||
| CFO | $74,013 | $0 | $0 | 40.00 | Yes (X) | |||
| FARHANA AMBREEN | ||||||||
| CHIEF MED. O | $173,984 | $0 | $0 | 40.00 | Yes (X) | |||
| LADONNA P RUTLEDGE | ||||||||
| DOCTOR | $264,117 | $0 | $0 | 40.00 | Yes (X) | |||
| JOANNA R FIELDS | ||||||||
| DOCTOR | $175,842 | $0 | $0 | 40.00 | Yes (X) | |||
| KIM CHAU | ||||||||
| DOCTOR | $155,771 | $0 | $0 | 40.00 | Yes (X) | |||
| JOHN FERGUSON | ||||||||
| DOCTOR | $141,816 | $0 | $0 | 40.00 | Yes (X) | |||
| OLAMIDE O ATANDA | ||||||||
| DOCTOR | $129,891 | $0 | $0 | 40.00 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,202,431 | TotalReportableCompFromOrgAmt |
| Indiv Rcvd Greater Than100 K | 8 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RAKESH DESAI MD PA | BusinessNameLine1Txt |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5602 REGENCY DR | AddressLine1Txt |
| City | SUGARLAND | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 77479 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation | $105,817 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $1,394,449 | GovernmentGrantsAmt |
| All Other Contributions | $670,027 | AllOtherContributionsAmt |
| Noncash Contributions | $46,582 | NoncashContributionsAmt |
| Total Contributions | $2,064,476 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MEDICAL AND DENTAL SERVICES | Desc |
| Total Revenue Column | $3,283,584 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,283,584 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $3,283,584 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $228 | TotalRevenueColumnAmt |
| Exclusion | $228 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $44,800 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $44,800 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $44,800 | TotalRevenueColumnAmt |
| Exclusion | $44,800 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $42,783 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $14,398 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $28,385 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|
| 340 B PROGRAM | $149,327 | $149,327 |
| LABCORP | $2,825 | $2,825 |
| ELIGIBILITY SERVICES | $2,480 | $2,480 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,844 | TotalRevenueColumnAmt |
| Exclusion | $2,844 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $157,476 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,578,949 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,283,584 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $202,504 | ExclusionAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,435,000 | TotalAmt |
| Program Services | $3,028,325 | ProgramServicesAmt |
| Management And General | $406,675 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $284,513 | TotalAmt |
| Program Services | $217,823 | ProgramServicesAmt |
| Management And General | $66,690 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $242,942 | TotalAmt |
| Program Services | $210,653 | ProgramServicesAmt |
| Management And General | $32,289 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,023 | TotalAmt |
| Management And General | $9,023 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,051 | TotalAmt |
| Program Services | $4,465 | ProgramServicesAmt |
| Management And General | $18,586 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $298,447 | TotalAmt |
| Program Services | $298,447 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,983 | TotalAmt |
| Program Services | $4,123 | ProgramServicesAmt |
| Management And General | $3,860 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $45,553 | TotalAmt |
| Program Services | $33,973 | ProgramServicesAmt |
| Management And General | $11,580 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $171,462 | TotalAmt |
| Program Services | $129,351 | ProgramServicesAmt |
| Management And General | $42,111 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,019 | TotalAmt |
| Program Services | $11,922 | ProgramServicesAmt |
| Management And General | $7,097 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,175 | TotalAmt |
| Program Services | $11,330 | ProgramServicesAmt |
| Management And General | $18,845 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,107 | TotalAmt |
| Program Services | $10,631 | ProgramServicesAmt |
| Management And General | $476 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $82,191 | TotalAmt |
| Program Services | $82,191 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $80,330 | TotalAmt |
| Program Services | $65,114 | ProgramServicesAmt |
| Management And General | $15,216 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $264,634 | $264,634 | |
| LEASE | $208,825 | $203,130 | $5,695 |
| MAINTENANCE AND REPAIRS | $122,714 | $112,669 | $10,045 |
| LAB EXPENSES | $87,844 | $87,844 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $329,012 | TotalAmt |
| Program Services | $277,080 | ProgramServicesAmt |
| Management And General | $51,932 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,753,825 | TotalAmt |
| Program Services | $5,053,705 | ProgramServicesAmt |
| Management And General | $700,120 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $202,993 | BOYAmt |
| EOY | $143,778 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $197,950 | BOYAmt |
| EOY | $278,907 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $917,426 | BOYAmt |
| EOY | $703,999 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $35,495 | BOYAmt |
| EOY | $38,569 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $2,111,173 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $776,051 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,307,607 | BOYAmt |
| EOY | $1,335,122 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,661,471 | BOYAmt |
| EOY | $2,500,375 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $250,885 | BOYAmt |
| EOY | $318,438 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $243,485 | BOYAmt |
| EOY | $189,712 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $131,344 | BOYAmt |
| EOY | $131,344 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $625,714 | BOYAmt |
| EOY | $639,494 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,953,092 | BOYAmt |
| EOY | $1,463,974 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $82,665 | BOYAmt |
| EOY | $396,907 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,035,757 | BOYAmt |
| EOY | $1,860,881 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,661,471 | BOYAmt |
| EOY | $2,500,375 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$174,876 | ReconcilationRevenueExpnssAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
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 | $144,556 | OtherCostOrOtherBasisAmt |
| Book Value | $144,556 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,054,661 | OtherCostOrOtherBasisAmt |
| Depreciation | $181,096 | DepreciationAmt |
| Book Value | $873,565 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $84,649 | OtherCostOrOtherBasisAmt |
| Depreciation | $72,768 | DepreciationAmt |
| Book Value | $11,881 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $380,633 | OtherCostOrOtherBasisAmt |
| Depreciation | $294,452 | DepreciationAmt |
| Book Value | $86,181 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $446,674 | OtherCostOrOtherBasisAmt |
| Depreciation | $227,735 | DepreciationAmt |
| Book Value | $218,939 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,335,122 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | COMPENSATED ABSENCES | Desc |
| Amt | $131,344 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $131,344 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $5,598,229 | TotalRevEtcAuditedFinclStmtAmt |
| Donated Services And Use Fclts | $19,280 | DonatedServicesAndUseFcltsAmt |
| Revenue Not Reported | $19,280 | RevenueNotReportedAmt |
| Revenue Subtotal | $5,578,949 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $5,578,949 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $5,773,105 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $19,280 | DonatedServicesUseFcltsAmt |
| Expenses Not Reported | $19,280 | ExpensesNotReportedAmt |
| Expenses Subtotal | $5,753,825 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $5,753,825 | TotalExpensesPerForm990Amt |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | SPECIAL EVENT | Event1Nm |
| Gross Receipts Event1 | $42,783 | GrossReceiptsEvent1Amt |
| Gross Revenue Event1 | $42,783 | GrossRevenueEvent1Amt |
| Other Direct Expenses Event1 | $14,398 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $42,783 | GrossReceiptsTotalAmt |
| Gross Revenue Total Events | $42,783 | GrossRevenueTotalEventsAmt |
| Oth Direct Expnss Total Events | $14,398 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $14,398 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $28,385 | NetIncomeSummaryAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt |
|---|---|---|
| FARHANA AMBREEN | ||
| CHIEF MED. OFFICER | $173,984 | $173,984 |
| LADONNA P RUTLEDGE | ||
| DOCTOR | $264,117 | $264,117 |
| JOANNA R FIELDS | ||
| DOCTOR | $175,842 | $175,842 |
| KIM CHAU | ||
| DOCTOR | $155,771 | $155,771 |
Schedule M IRS990ScheduleM
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $46,582 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | MARKET VALUE | MethodOfDeterminingRevenuesTxt |
| 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 6, PART VI, LINE 11B | FORM 990 IS PRESENTED TO THE BOARD AT A REGULARLY SCHEDULED MEETING AND IS APPROVED BY THE BOARD PRIOR TO BEING FILED. |
| FORM 990, PAGE 6, PART VI, LINE 12C | THE BOARD REVIEWS ALL POTENTIAL CONFLICTS OF INTEREST AND ULTIMATELY AGREES AS TO WHETHER A CONFLICT OF INTEREST EXISTS AND THE CORRECT PATH FORWARD FOR DEALING WITH THE CONFLICT. |
| FORM 990, PAGE 6, PART VI, LINE 15A | COMPENSATION IS REVIEWED AND APPROVED BY THE BOARD. |
| FORM 990, PAGE 6, PART VI, LINE 15B | COMPENSATION IS REVIEWED AND APPROVED BY THE BOARD. |
| FORM 990, PAGE 6, PART VI, LINE 19 | INFORMATION IS MADE AVAILABLE UPON REQUEST. |