CABUN RURAL HEALTH SERVICES INC: Form 990, tax year 2023
View the entire original 990 at ProPublica ↗
- Organization
- CABUN RURAL HEALTH SERVICES INC (EIN 71-0487596)
- Tax period
- 2023-04-01 to 2024-03-31
- Filed
- 2025-02-03
- IRS object ID
- 202540349349301244
- Schema version
- 2023v6.0
- 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 | 2025-02-03T12:50:50+00:00 | ReturnTs |
| Tax Period End | 2024-03-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 440160260 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Forvis Mazars LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 3667 | AddressLine1Txt |
| City | Little Rock | CityNm |
| State Abbreviation | AR | StateAbbreviationCd |
| ZIP | 722033667 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2023-04-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 710487596 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CABUN RURAL HEALTH SERVICES INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CABU | BusinessNameControlTxt |
| Phone | 8707984064 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1196 | AddressLine1Txt |
| City | HAMPTON | CityNm |
| State Abbreviation | AR | StateAbbreviationCd |
| ZIP | 71744 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JUDY SOUTHHALL | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Signature | 2025-02-03 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | Yes (true) | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Amber Sherrill | PreparerPersonNm |
| PTIN | P00748683 | PTIN |
| Phone | 5013721040 | PhoneNum |
| Preparation | 2025-01-31 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2023 | TaxYr |
| Build TS | 2025-03-06 01:10:19Z | BuildTS |
Form 990 IRS990
Principal Ofcr Business Name PrincipalOfcrBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MELANIE SHEPPARD | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 986 AUSTIN STREET | AddressLine1Txt |
| City | CAMDEN | CityNm |
| State Abbreviation | AR | StateAbbreviationCd |
| ZIP | 71701 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $11,040,826 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.CABUN.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1977 | FormationYr |
| Legal Domicile State | AR | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE SERVICES TO PERSONS IN NEED OF MEDICAL CARE AND WORK WITH OTHER HEALTH CENTER PROVIDERS IN THE AREA TO FORM AN INTEGRATED SYSTEM FOR DELIVERY OF HEALTH CARE SERVICES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 104 | TotalEmployeeCnt |
| Total Volunteers | 12 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $4,429,160 | PYContributionsGrantsAmt |
| CY Contributions Grants | $4,206,673 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $6,025,409 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $6,796,993 | CYProgramServiceRevenueAmt |
| PY Investment Income | $6,401 | PYInvestmentIncomeAmt |
| CY Investment Income | $36,263 | CYInvestmentIncomeAmt |
| PY Other Revenue | $299 | PYOtherRevenueAmt |
| CY Other Revenue | $897 | CYOtherRevenueAmt |
| PY Total Revenue | $10,461,269 | PYTotalRevenueAmt |
| CY Total Revenue | $11,040,826 | 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 | $6,457,076 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $6,145,307 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $39,807 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $3,591,150 | PYOtherExpensesAmt |
| CY Other Expenses | $4,197,295 | CYOtherExpensesAmt |
| PY Total Expenses | $10,048,226 | PYTotalExpensesAmt |
| CY Total Expenses | $10,342,602 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $413,043 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $698,224 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $7,879,821 | TotalAssetsBOYAmt |
| Total Assets EOY | $8,412,161 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $794,640 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $628,756 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $7,085,181 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $7,783,405 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO MEET THE NEEDS AND PROVIDE SERVICES TO PERSONS IN NEED OF PRIMARY MEDICAL CARE AND WORK WITH OTHER HEALTH CENTER PROVIDERS IN THE AREA TO FORM AN INTEGRATED SYSTEM FOR DELIVERY OF HEALTH CARE SERVICES. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $8,245,171 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $6,796,993 | RevenueAmt |
| Desc | CABUN RURAL HEALTH SERVICES, INC. HAS CLINIC SITES IN HAMPTON, STRONG, BEARDEN, LEWISVILLE, HOPE, EL DORADO AND AMITY TO PROVIDE MEDICAL SERVICES TO PEOPLE IN THE SURROUNDING AREAS. DISCOUNTED SERVICES AND PRESCRIPTION ASSISTANCE ARE PROVIDED TO THOSE WHO QUALIFY. CABUN WORKS WITH OTHER HEALTH CARE PROVIDERS FOR SPECIALIZED SERVICES THROUGH REFERRAL. | Desc |
| Total Program Service Expenses | $8,245,171 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| 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 | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 17 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 104 | 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 |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | 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 | false | 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 | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | AR | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JUDY SOUTHALL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8709182344 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1783 E AR 274 HWY | AddressLine1Txt |
| City | HAMPTON | CityNm |
| State Abbreviation | AR | StateAbbreviationCd |
| ZIP | 71744 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (23 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 | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| ADAM BAILEY | ||||||||
| BOARD VICE CHAIR | 1.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| JUANET GASKIN | ||||||||
| BOARD SECRETARY/TREASURER | 1.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| LILLIE RANDALL | ||||||||
| BOARD CHAIR | 1.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| B J JOHNS | ||||||||
| DIRECTOR | 1.0 | 1.0 | Yes (X) | $0 | $0 | $0 | ||
| CRYSTAL DONJUAN | ||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| DON CAIN | ||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| JAMES RAWLS | ||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| JOE MCNEIL | ||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| KENDRICK JUNIEL | ||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| LEANNE MCGOOGAN | ||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| MARSHA LUNA | ||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| VESTER LAMBERT | ||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| Judy Southall | ||||||||
| CHIEF FINANCIAL OFFICER | 36.0 | 0.0 | Yes (X) | $48,045 | $0 | $12,050 | ||
| MELANIE JONES | ||||||||
| MEDICIAL DIRECTOR THROUGH 10-20-2023 | 36.0 | 0.0 | Yes (X) | $129,934 | $0 | $5,620 | ||
| MELANIE SHEPPARD | ||||||||
| CHIEF EXECUTIVE OFFICER | 36.0 | 0.0 | Yes (X) | $145,739 | $0 | $19,136 | ||
| PATRICIA ELETHORP | ||||||||
| CHIEF MEDICAL OFFICER | 36.0 | 0.0 | Yes (X) | $131,319 | $0 | $9,588 | ||
| SUSAN JOHNSTON | ||||||||
| CHIEF INFORMATION OFFICER | 36.0 | 0.0 | Yes (X) | $74,176 | $0 | $12,911 | ||
| TRACY MADLOCK | ||||||||
| CHIEF OPERATION OFFICER | 36.0 | 0.0 | Yes (X) | $78,362 | $0 | $8,125 | ||
| CHARLYN HACKETT | ||||||||
| APRN | 36.0 | 0.0 | $120,035 | $0 | $8,677 | Yes (X) | ||
| JAMES ARRINGTON MD | ||||||||
| PHYSICIAN | 36.0 | 0.0 | $207,828 | $0 | $14,514 | Yes (X) | ||
| JAMES MOORE DDS | ||||||||
| DENTIST | 36.0 | 0.0 | $217,142 | $0 | $14,510 | Yes (X) | ||
| LISA JACKSON | ||||||||
| APRN | 36.0 | 0.0 | $119,336 | $0 | $8,677 | Yes (X) | ||
| SCHASTA HIBBS | ||||||||
| APRN | 36.0 | 0.0 | $122,125 | $0 | $8,677 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,394,041 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $122,485 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 15 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| EMD'S | |||||
| PO BOX 679493 | DALLAS | TX | 75276 | PATIENT MANAGEMENT SYSTEM | $123,642 |
| FORVISLLP | |||||
| PO BOX 3667 | LITTLE ROCK | AR | 72203 | ACCOUNTING | $119,238 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $4,206,673 | GovernmentGrantsAmt |
| Total Contributions | $4,206,673 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT REVENUE | 621400 | $3,851,669 | $3,851,669 |
| 340B REVENUE | 621400 | $2,944,383 | $2,944,383 |
| MOB RENTAL REVENUE | 621400 | $941 | $941 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $6,796,993 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $36,263 | TotalRevenueColumnAmt |
| Exclusion | $36,263 | ExclusionAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | REFUNDS & REBATES | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $897 | TotalRevenueColumnAmt |
| Exclusion | $897 | ExclusionAmt |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $897 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $11,040,826 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $6,796,993 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $37,160 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $870,813 | TotalAmt |
| Management And General | $870,813 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,918,614 | TotalAmt |
| Program Services | $3,239,531 | ProgramServicesAmt |
| Management And General | $639,276 | ManagementAndGeneralAmt |
| Fundraising | $39,807 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,002,291 | TotalAmt |
| Program Services | $837,101 | ProgramServicesAmt |
| Management And General | $165,190 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $353,589 | TotalAmt |
| Program Services | $295,313 | ProgramServicesAmt |
| Management And General | $58,276 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,901 | TotalAmt |
| Program Services | $5,764 | ProgramServicesAmt |
| Management And General | $1,137 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $204,618 | TotalAmt |
| Program Services | $170,894 | ProgramServicesAmt |
| Management And General | $33,724 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $603,357 | TotalAmt |
| Program Services | $503,916 | ProgramServicesAmt |
| Management And General | $99,441 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,574 | TotalAmt |
| Program Services | $5,491 | ProgramServicesAmt |
| Management And General | $1,083 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $231,930 | TotalAmt |
| Program Services | $193,705 | ProgramServicesAmt |
| Management And General | $38,225 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $97,813 | TotalAmt |
| Program Services | $81,692 | ProgramServicesAmt |
| Management And General | $16,121 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $129,966 | TotalAmt |
| Program Services | $108,546 | ProgramServicesAmt |
| Management And General | $21,420 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,706 | TotalAmt |
| Program Services | $15,623 | ProgramServicesAmt |
| Management And General | $3,083 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $32,152 | TotalAmt |
| Program Services | $26,853 | ProgramServicesAmt |
| Management And General | $5,299 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,938 | TotalAmt |
| Program Services | $4,959 | ProgramServicesAmt |
| Management And General | $979 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $227,248 | TotalAmt |
| Program Services | $189,795 | ProgramServicesAmt |
| Management And General | $37,453 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $54,250 | TotalAmt |
| Program Services | $45,309 | ProgramServicesAmt |
| Management And General | $8,941 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| 340B PRESCRIPTION EXPENSE | $1,785,724 | $1,785,724 | |
| MEDICAL SUPPLIES | $445,277 | $445,277 | |
| REPAIRS & MAINTENANCE | $128,896 | $107,652 | $21,244 |
| DUES & MEMBERSHIPS | $70,377 | $58,778 | $11,599 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $147,568 | TotalAmt |
| Program Services | $123,248 | ProgramServicesAmt |
| Management And General | $24,320 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,342,602 | TotalAmt |
| Program Services | $8,245,171 | ProgramServicesAmt |
| Management And General | $2,057,624 | ManagementAndGeneralAmt |
| Fundraising | $39,807 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $162,696 | BOYAmt |
| EOY | $199,818 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,805,009 | BOYAmt |
| EOY | $4,962,201 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $271,091 | BOYAmt |
| EOY | $692,588 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $580,468 | BOYAmt |
| EOY | $755,018 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $189,288 | BOYAmt |
| EOY | $164,335 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,704 | BOYAmt |
| EOY | $2,704 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $3,740,424 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $2,108,321 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,859,351 | BOYAmt |
| EOY | $1,632,103 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,214 | BOYAmt |
| EOY | $3,394 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,879,821 | BOYAmt |
| EOY | $8,412,161 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $691,934 | BOYAmt |
| EOY | $574,526 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $92,481 | BOYAmt |
| EOY | $49,095 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,225 | BOYAmt |
| EOY | $5,135 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $794,640 | BOYAmt |
| EOY | $628,756 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,799,070 | BOYAmt |
| EOY | $7,505,627 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $286,111 | BOYAmt |
| EOY | $277,778 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,085,181 | BOYAmt |
| EOY | $7,783,405 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,879,821 | BOYAmt |
| EOY | $8,412,161 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $698,224 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $5,398,257 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $6,018,107 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $5,110,428 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $4,301,842 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,206,673 | CurrentTaxYearAmt |
| Total | $25,035,307 | TotalAmt |
Tax Rev Levied Orgnztnl Bnft170 TaxRevLeviedOrgnztnlBnft170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $5,398,257 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $6,018,107 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $5,110,428 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $4,301,842 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,206,673 | CurrentTaxYearAmt |
| Total | $25,035,307 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $0 | SubstantialContributorsTotAmt |
| Public Support Total170 | $25,035,307 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $24,039 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $15,151 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $5,108 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $15,218 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $36,263 | CurrentTaxYearAmt |
| Total | $95,779 | TotalAmt |
Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $8,173 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $9,105 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $14,650 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $299 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $897 | CurrentTaxYearAmt |
| Total | $33,124 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $25,164,210 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $26,208,413 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.9949 | PublicSupportCY170Pct |
| Public Support PY170 | 0.9946 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule A, Part II, Line 10 Other Income | FormAndLineReferenceDesc |
| Explanation | DESCRIPTION - REFUNDS & REBATES, COLUMN A - 8173.0, COLUMN B - 9105.0, COLUMN C - 14650.0, COLUMN D - 299.0, COLUMN E - 897.0, COLUMN F - 33124.0; | ExplanationTxt |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $95,049 | OtherCostOrOtherBasisAmt |
| Book Value | $95,049 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,361,661 | OtherCostOrOtherBasisAmt |
| Depreciation | $964,419 | DepreciationAmt |
| Book Value | $1,397,242 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $700,348 | OtherCostOrOtherBasisAmt |
| Depreciation | $689,668 | DepreciationAmt |
| Book Value | $10,680 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $583,366 | OtherCostOrOtherBasisAmt |
| Depreciation | $454,234 | DepreciationAmt |
| Book Value | $129,132 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,632,103 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | ROU LEASE LIABILITY | Desc |
| Amt | $5,135 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $5,135 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $11,177,358 | TotalRevEtcAuditedFinclStmtAmt |
| Donated Services And Use Fclts | $128,199 | DonatedServicesAndUseFcltsAmt |
| Other Revenue | $8,333 | OtherRevenueAmt |
| Revenue Not Reported | $136,532 | RevenueNotReportedAmt |
| Revenue Subtotal | $11,040,826 | RevenueSubtotalAmt |
| Other Revenues Not Included | $0 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $11,040,826 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $10,470,801 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $128,199 | DonatedServicesUseFcltsAmt |
| Other Expenses Included | $0 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $128,199 | ExpensesNotReportedAmt |
| Expenses Subtotal | $10,342,602 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $0 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $10,342,602 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule D, Part X, Line 2 | MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. |
| Schedule D, Part XI, Line 2(d) Other revenues in audited financial statements not in form 990 | NET ASSETS RELEASED FROM RESTRICTIONS - 8333 |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | Yes (true) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (3 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MELANIE SHEPPARD | ||||||||||||||
| CHIEF EXECUTIVE OFFICER | $106,799 | $0 | $0 | $0 | $38,940 | $0 | $0 | $0 | $19,136 | $0 | $164,875 | $0 | $0 | $0 |
| JAMES MOORE DDS | ||||||||||||||
| DENTIST | $211,789 | $0 | $0 | $0 | $5,353 | $0 | $0 | $0 | $14,510 | $0 | $231,652 | $0 | $0 | $0 |
| JAMES ARRINGTON MD | ||||||||||||||
| PHYSICIAN | $202,475 | $0 | $0 | $0 | $5,353 | $0 | $0 | $0 | $14,514 | $0 | $222,342 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule J, Part I, Line 4a Severance or change-of-control payment | FormAndLineReferenceDesc |
| Explanation | MELANIE JONES RECEIVED A SEVERANCE PAYMENT OF $30,540. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Line 8b Documentation of meetings held by committees of governing body | THE GOVERNING BOARD SERVES AS ALL COMMITTEES. |
| Form 990, Part VI, Line 11b Review of form 990 by governing body | FORM 990 WAS REVIEWED BY THE CEO AND CFO BEFORE IT WAS FILED. THE BOARD IS PROVIDED A COPY OF THE RETURN FOR REVIEW PRIOR TO FILING. |
| Form 990, Part VI, Line 12c Conflict of interest policy | BOARD APPLICANTS FILL OUT A QUESTIONNAIRE THAT INCLUDES ANY INTERESTS IN THE COMPANY. IF THE CLINIC WANTS TO USE ANY SERVICES THAT HAVE A CONTACT TO AN EMPLOYEE, THE BOARD REVIEWS THE REQUEST AND MAY GIVE APPROVAL. THE CLINIC HAS AN ANTI-NEPOTISM POLICY THAT PREVENTS HIRING ANYONE WHO IS IMMEDIATELY RELATED TO AN EMPLOYEE. IF THERE ARE NO OTHER QUALIFIED APPLICANTS, THE BOARD MAY APPROVE HIRING. |
| Form 990, Part VI, Line 15a Process to establish compensation of top management official | THE CEO'S SALARY IS SET BY THE BOARD. THE BOARD REVIEWS SALARIES OF COMPARABLE POSITIONS IN THIS AREA AND NACHA HEALTH CENTER SALARY & BENEFIT REPORT. |
| Form 990, Part VI, Line 19 Required documents available to the public | All documents are made available upon request. |