ROY H LAIRD MEMORIAL HOSPITAL FOUNDATION INC: Form 990, tax year 2015
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- Organization
- ROY H LAIRD MEMORIAL HOSPITAL FOUNDATION INC (EIN 75-2660554)
- Tax period
- 2015-01-01 to 2015-12-31
- Filed
- 2016-07-22
- IRS object ID
- 201602049349300645
- Schema version
- 2015v2.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-07-22T13:59:34-05:00 | ReturnTs |
| Tax Period End | 2015-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 752378622 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BROWN BRONSTAD HABENICHT & ROSSON | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1775 | AddressLine1Txt |
| City | KILGORE | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 756631775 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 752660554 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ROY H LAIRD MEMORIAL | BusinessNameLine1Txt |
| Business Name Line2 | HOSPITAL FOUNDATION INC | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | ROYH | BusinessNameControlTxt |
| Phone | 9039862265 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1610 | AddressLine1Txt |
| City | KILGORE | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 756631610 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | PAM DECEAULT | PersonNm |
| Person Title | TREASURER | PersonTitleTxt |
| Phone | 9039862265 | PhoneNum |
| Signature | 2016-07-22 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | LYNDA R NEWSOME | PreparerPersonNm |
| PTIN | P01233123 | PTIN |
| Phone | 9039832051 | PhoneNum |
| Preparation | 2016-07-22 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2016-12-15 16:53:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | PAM DECEAULT | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 118 KING RANCH ROAD | AddressLine1Txt |
| City | KILGORE | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 75662 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $1,215,139 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1994 | FormationYr |
| Legal Domicile State | TX | LegalDomicileStateCd |
| Activity Or Mission | PROMOTING, FOSTERING, FACILITATING, AND SUPPORTING INDIGENT AND GENERAL HEALTH CARE SERVCIES IN THE CITY OF KILGORE AND ITS SURROUNDING AREAS, IN THE NAME OF ROY H. LAIRD, DECEASED. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $1,032,457 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,083,930 | CYContributionsGrantsAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $116,909 | PYInvestmentIncomeAmt |
| CY Investment Income | $127,812 | CYInvestmentIncomeAmt |
| PY Other Revenue | $6,312 | PYOtherRevenueAmt |
| CY Other Revenue | $3,397 | CYOtherRevenueAmt |
| PY Total Revenue | $1,155,678 | PYTotalRevenueAmt |
| CY Total Revenue | $1,215,139 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $206,127 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $268,257 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| CY Salaries Comp Emp Bnft Paid | $0 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $19,489 | PYOtherExpensesAmt |
| CY Other Expenses | $29,551 | CYOtherExpensesAmt |
| PY Total Expenses | $225,616 | PYTotalExpensesAmt |
| CY Total Expenses | $297,808 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $930,062 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $917,331 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $3,710,684 | TotalAssetsBOYAmt |
| Total Assets EOY | $4,428,801 | TotalAssetsEOYAmt |
| Total Liabilities EOY | $0 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $3,710,684 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $4,428,801 | NetAssetsOrFundBalancesEOYAmt |
| Mission | PROMOTING, FOSTERING, FACILITATING, AND SUPPORTING INDIGENT AND GENERAL HEALTH CARE SERVICES IN THE CITY OF KILGORE AND ITS SURROUNDING AREAS, IN THE NAME OF ROY H. LAIRD, DECEASED. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $85,174 | ExpenseAmt |
| Grant | $85,174 | GrantAmt |
| Desc | REIMBURSEMENT TO THE CITY OF KILGORE FOR THE FORMER LAIRD MEMORIAL HOSPITAL'S PORTION OF RETIREMENT BENEFITS FOR FORMER EMPLOYEES OF THE HOSPITAL. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $183,083 | ExpenseAmt |
| Grant | $183,083 | GrantAmt |
| Desc | GRANT TO GOOD SHEPHERD MEDICAL CENTER FOR EMERGENCY DEARTMENT OPERATING EXPENSES. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $268,257 | 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 | false | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | false | 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 | Yes (true) | 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 | 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 | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 0 | EmployeeCnt |
| 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 |
| DAF Excess Business Holdings | false | DAFExcessBusinessHoldingsInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 8 | 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 | false | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | false | ConflictOfInterestPolicyInd |
| Whistleblower Policy | false | WhistleblowerPolicyInd |
| Document Retention Policy | false | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | PAM DECEAULTTREASURER | PersonNm |
| Phone | 9039862265 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 410 N KILGORE ST | AddressLine1Txt |
| City | KILGORE | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 75662 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | Yes (X) | NoListedPersonsCompensatedInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (9 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|
| THOMAS H BROWN | ||||||
| PRESIDENT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| PAT MCCRORY | ||||||
| VICE-PRESIDE | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| PAM DECEAULT | ||||||
| TREASURER | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| EVELYN BOLDING | ||||||
| SECRETARY | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| JANIE EDMONDS | ||||||
| TRUSTEE | Yes (X) | $0 | $0 | $0 | ||
| JANIE DICKERSON | ||||||
| TRUSTEE | Yes (X) | $0 | $0 | $0 | ||
| WILBUR YATES | ||||||
| TRUSTEE | Yes (X) | $0 | $0 | $0 | ||
| FRANCISCO CIBELE | ||||||
| TRUSTEE | Yes (X) | $0 | $0 | $0 | ||
| SHERRY BUSTIN | ||||||
| TRUSTEE | Yes (X) | $0 | $0 | $0 | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | false | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| All Other Contributions | $1,083,930 | AllOtherContributionsAmt |
| Total Contributions | $1,083,930 | TotalContributionsAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $127,812 | TotalRevenueColumnAmt |
| Exclusion | $127,812 | ExclusionAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,397 | TotalRevenueColumnAmt |
| Exclusion | $3,397 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,215,139 | TotalRevenueColumnAmt |
| Exclusion | $131,209 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $268,257 | TotalAmt |
| Program Services | $268,257 | ProgramServicesAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,000 | TotalAmt |
| Management And General | $2,000 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,233 | TotalAmt |
| Management And General | $24,233 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,328 | TotalAmt |
| Management And General | $2,328 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | FOREIGN TAXES | Desc |
| Total | $990 | TotalAmt |
| Management And General | $990 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $297,808 | TotalAmt |
| Program Services | $268,257 | ProgramServicesAmt |
| Management And General | $29,551 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $208,523 | BOYAmt |
| EOY | $112,667 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $680,031 | BOYAmt |
| EOY | $521,123 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,822,130 | BOYAmt |
| EOY | $3,795,011 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,710,684 | BOYAmt |
| EOY | $4,428,801 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,710,684 | BOYAmt |
| EOY | $4,428,801 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,710,684 | BOYAmt |
| EOY | $4,428,801 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,710,684 | BOYAmt |
| EOY | $4,428,801 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $917,331 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$199,214 | NetUnrlzdGainsLossesInvstAmt |
| 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 | false | FederalGrantAuditRequiredInd |
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 | $820,873 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $917,470 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $956,904 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,032,457 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,083,930 | CurrentTaxYearAmt |
| Total | $4,811,634 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $820,873 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $917,470 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $956,904 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,032,457 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,083,930 | CurrentTaxYearAmt |
| Total | $4,811,634 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $4,811,634 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $14,761 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $35,296 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $75,336 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $116,909 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $131,209 | CurrentTaxYearAmt |
| Total | $373,511 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $5,185,145 | TotalSupportAmt |
| Public Support CY170 | 0.92800 | PublicSupportCY170Pct |
| Public Support PY170 | 0.94090 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Rev Etc Audited Fincl Stmt | $1,015,925 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$199,214 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | -$199,214 | RevenueNotReportedAmt |
| Revenue Subtotal | $1,215,139 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $1,215,139 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $297,808 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $297,808 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $297,808 | TotalExpensesPerForm990Amt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|
| CITY OF KILGORE TEXAS | ||||||
| 815 N KILGORE STREET | KILGORE | TX | 75662 | 766000576 | $85,174 | RETIREE BENEFTIS |
| GOOD SHEPHERD MEDICAL CENTER | ||||||
| 700 E MARSHALL AVENUE | LONGVIEW | TX | 75601 | 751041154 | $183,083 | ER OPERATING EXP |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 2 | Total501c3OrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE I, PAGE 1, PART I, LINE 2 | FormAndLineReferenceDesc |
| Explanation | SPECIFIC EXPENDITURES SUCH AS REIMBURSEMENTS TO THE CITY OF KILGORE FOR RETIREMENT BENEFITS, ARE SUBSTANTIATED BY INSPECTION OF SUPPORTING DOCUMENTATION PROVIDED BY THE CITY OF KILGORE (I.E. INVOICES, NOTICES OF PAYMENTS DUE, ETC.). GOOD SHEPHERD MEDICAL CENTER SUBSTANTIATES THE RECEIPT AND USE OF GRANT FUNDS BY CONTINUING TO SUCCESSFULLY OPERATE AN EMERGENCY DEPARTMENT. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 6, PART VI, LINE 11B | TREASURER REVIEWS THE FORM 990 PRIOR TO FILING. |
| FORM 990, PAGE 6, PART VI, LINE 19 | UPON REQUEST, THE FOUNDATION MAKES GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. |