ALLIANCE MEDICAL MINISTRY INC: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- ALLIANCE MEDICAL MINISTRY INC (EIN 56-2168673)
- Tax period
- 2015-01-01 to 2015-12-31
- Filed
- 2016-07-08
- IRS object ID
- 201621909349300212
- 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 | 2016-07-08T10:23:40-05:00 | ReturnTs |
| Tax Period End | 2015-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 562344058 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GOSPODAREK & DREHER CPA PA | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4101 LAKE BOONE TRL STE 215 | AddressLine1Txt |
| City | RALEIGH | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27607 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 562168673 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ALLIANCE MEDICAL MINISTRY INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | ALLI | BusinessNameControlTxt |
| Phone | 9192503320 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 DONALD ROSS DRIVE | AddressLine1Txt |
| City | RALEIGH | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27610 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MARGARET P RADER | PersonNm |
| Person Title | EXECUTIVE DIRECTOR | PersonTitleTxt |
| Phone | 9192503320 | PhoneNum |
| Signature | 2016-06-29 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DOUG DREHER | PreparerPersonNm |
| PTIN | P00543597 | PTIN |
| Phone | 9195109399 | PhoneNum |
| Preparation | 2016-06-29 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2016-09-27 15:27:22Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MARGARET P RADER | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 DONALD ROSS DRIVE | AddressLine1Txt |
| City | RALEIGH | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27610 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $2,146,980 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.ALLIANCEMEDICALMINISTRY.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2000 | FormationYr |
| Legal Domicile State | NC | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE AFFORDABLE PRIMARY MEDICAL CARE TO LOW INCOME, UNINSURED WORKING FAMILIES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 17 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 16 | VotingMembersIndependentCnt |
| Total Employee | 18 | TotalEmployeeCnt |
| Total Volunteers | 250 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $923,712 | PYContributionsGrantsAmt |
| CY Contributions Grants | $960,120 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $492,184 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $525,926 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$212 | PYInvestmentIncomeAmt |
| CY Investment Income | -$28,470 | CYInvestmentIncomeAmt |
| PY Other Revenue | $148,982 | PYOtherRevenueAmt |
| CY Other Revenue | $61,857 | CYOtherRevenueAmt |
| PY Total Revenue | $1,564,666 | PYTotalRevenueAmt |
| CY Total Revenue | $1,519,433 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $1,234,071 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $1,161,400 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $166,438 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $440,711 | PYOtherExpensesAmt |
| CY Other Expenses | $443,807 | CYOtherExpensesAmt |
| PY Total Expenses | $1,674,782 | PYTotalExpensesAmt |
| CY Total Expenses | $1,605,207 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$110,116 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$85,774 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $4,407,252 | TotalAssetsBOYAmt |
| Total Assets EOY | $3,863,485 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $602,157 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $144,164 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $3,805,095 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $3,719,321 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO PROVIDE AFFORDABLE PRIMARY MEDICAL CARE TO LOW INCOME, UNINSURED WORKING FAMILIES. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $1,291,645 | ExpenseAmt |
| Revenue | $525,926 | RevenueAmt |
| Desc | PROVIDE MEDICAL SERVICES FOR UNINSURED LOW INCOME INDIVIDUALS. A TOTAL OF 371,356 WAS DONATED TO THE ORGANIZATION IN THE FORM OF PROFESSIONAL SERVICES (132,227)AND LAB WORK AND MAMMOGRAPHY SERVICES FROM REX HOSPITAL(239,129). | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PROVIDE MEDICAL SERVICES FOR UNINSURED LOW INCOME INDIVIDUALS | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $1,291,645 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | Yes (true) | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 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 | false | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | Yes (true) | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 7 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | false | BackupWthldComplianceInd |
| Employee | 18 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 17 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 16 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | false | ConflictOfInterestPolicyInd |
| Whistleblower Policy | false | WhistleblowerPolicyInd |
| Document Retention Policy | false | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MARGARET P RADER | PersonNm |
| Phone | 9192503394 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 DONALD ROSS DRIVE | AddressLine1Txt |
| City | RALEIGH | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27610 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|
| RICK MARCOTTE | ||||||
| CHAIR | 4.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| KATHLEEN GORMLEY | ||||||
| SECRETARY | 4.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| GERALD PETKAU | ||||||
| TREASURER | 4.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| MARGARET P RADER | ||||||
| EXECUTIVE DI | 40.00 | Yes (X) | Yes (X) | $107,299 | $0 | $7,802 |
| MARY RIBANDO | ||||||
| FINANCE MANA | 15.00 | Yes (X) | $29,733 | $0 | $0 | |
| REBECCA ANDREWS | ||||||
| DIRECTOR | 3.00 | Yes (X) | $0 | $0 | $0 | |
| MARINA CALABRESE | ||||||
| DIRECTOR | 3.00 | Yes (X) | $0 | $0 | $0 | |
| S TODD HEMPHILL | ||||||
| DIRECTOR | 3.00 | Yes (X) | $0 | $0 | $0 | |
| EILEEN HENDREN | ||||||
| DIRECTOR | 3.00 | Yes (X) | $0 | $0 | $0 | |
| NEIL MORRIS | ||||||
| DIRECTOR | 3.00 | Yes (X) | $0 | $0 | $0 | |
| STEVEN PEEDIN | ||||||
| DIRECTOR | 3.00 | Yes (X) | $0 | $0 | $0 | |
| JR SHEARIN | ||||||
| DIRECTOR | 3.00 | Yes (X) | $0 | $0 | $0 | |
| JEFFREY SIMMS | ||||||
| DIRECTOR | 3.00 | Yes (X) | $0 | $0 | $0 | |
| DR MICHAEL D SPIRITOS | ||||||
| DIRECTOR | 3.00 | Yes (X) | $0 | $0 | $0 | |
| TAMMIE STANTON | ||||||
| DIRECTOR | 3.00 | Yes (X) | $0 | $0 | $0 | |
| KEITH WALLACE | ||||||
| DIRECTOR | 3.00 | Yes (X) | $0 | $0 | $0 | |
| DAVID WILSON | ||||||
| DIRECTOR | 3.00 | Yes (X) | $0 | $0 | $0 | |
| LISA NAA-SHORMEY YEBUAH | ||||||
| DIRECTOR | 3.00 | Yes (X) | $0 | $0 | $0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $137,032 | TotalReportableCompFromOrgAmt |
| Total Other Compensation | $7,802 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 1 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | false | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| Fundraising | $114,965 | FundraisingAmt |
| Government Grants | $48,571 | GovernmentGrantsAmt |
| All Other Contributions | $796,584 | AllOtherContributionsAmt |
| Noncash Contributions | $290,357 | NoncashContributionsAmt |
| Total Contributions | $960,120 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| REVENUE:CONTRACT FEES | 621110 | $372,125 | $372,125 |
| REVENUE:PATIENT FEES | 621110 | $151,774 | $151,774 |
| REVENUE:MEDICAL RECORDS | 621110 | $2,027 | $2,027 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $525,926 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $377 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $377 | RelatedOrExemptFuncIncomeAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $91,244 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $14,330 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $76,914 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $76,914 | TotalRevenueColumnAmt |
| Exclusion | $76,914 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $2,103 | SecuritiesAmt |
| Other | $547,500 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $2,208 | SecuritiesAmt |
| Other | $576,242 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -$105 | SecuritiesAmt |
| Other | -$28,742 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$28,847 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | -$28,847 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $17,982 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $114,965 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $34,767 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$16,785 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| THIRD PARTY EVENTS | 900099 | $1,634 | $1,634 |
| OTHER INCOME | $95 | $95 | |
| OTHER INCOME:OTHER INCOME - M | -$1 | -$1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $1,728 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,519,433 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $499,184 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $76,914 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $144,834 | TotalAmt |
| Program Services | $38,367 | ProgramServicesAmt |
| Management And General | $68,100 | ManagementAndGeneralAmt |
| Fundraising | $38,367 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $856,834 | TotalAmt |
| Program Services | $776,425 | ProgramServicesAmt |
| Fundraising | $80,409 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $37,126 | TotalAmt |
| Program Services | $32,859 | ProgramServicesAmt |
| Management And General | $1,729 | ManagementAndGeneralAmt |
| Fundraising | $2,538 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $52,403 | TotalAmt |
| Program Services | $45,729 | ProgramServicesAmt |
| Management And General | $5,897 | ManagementAndGeneralAmt |
| Fundraising | $777 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $70,203 | TotalAmt |
| Program Services | $59,139 | ProgramServicesAmt |
| Management And General | $2,604 | ManagementAndGeneralAmt |
| Fundraising | $8,460 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,800 | TotalAmt |
| Program Services | $14,240 | ProgramServicesAmt |
| Management And General | $3,560 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,546 | TotalAmt |
| Program Services | $2,037 | ProgramServicesAmt |
| Management And General | $509 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,584 | TotalAmt |
| Program Services | $3,646 | ProgramServicesAmt |
| Fundraising | $10,938 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,389 | TotalAmt |
| Program Services | $1,791 | ProgramServicesAmt |
| Management And General | $299 | ManagementAndGeneralAmt |
| Fundraising | $299 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $108,665 | TotalAmt |
| Program Services | $91,789 | ProgramServicesAmt |
| Management And General | $8,438 | ManagementAndGeneralAmt |
| Fundraising | $8,438 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,137 | TotalAmt |
| Program Services | $1,603 | ProgramServicesAmt |
| Management And General | $267 | ManagementAndGeneralAmt |
| Fundraising | $267 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,216 | TotalAmt |
| Program Services | $8,412 | ProgramServicesAmt |
| Management And General | $1,402 | ManagementAndGeneralAmt |
| Fundraising | $1,402 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $105,720 | TotalAmt |
| Program Services | $79,290 | ProgramServicesAmt |
| Management And General | $13,215 | ManagementAndGeneralAmt |
| Fundraising | $13,215 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $34,524 | TotalAmt |
| Program Services | $31,669 | ProgramServicesAmt |
| Management And General | $2,183 | ManagementAndGeneralAmt |
| Fundraising | $672 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $34,708 | $34,708 | |
| TEMPORARY STAFF | $33,765 | $32,752 | $1,013 |
| CLINIC EXPENSE | $29,302 | $29,302 | |
| BANK AND MISC FEES | $25,796 | $25,796 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,655 | TotalAmt |
| Program Services | $7,887 | ProgramServicesAmt |
| Management And General | $12,112 | ManagementAndGeneralAmt |
| Fundraising | $656 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,605,207 | TotalAmt |
| Program Services | $1,291,645 | ProgramServicesAmt |
| Management And General | $147,124 | ManagementAndGeneralAmt |
| Fundraising | $166,438 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $219,414 | BOYAmt |
| EOY | $396,763 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $233,745 | BOYAmt |
| EOY | $105,047 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $94,879 | BOYAmt |
| EOY | $63,102 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,354 | BOYAmt |
| EOY | $4,375 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $4,085,133 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $790,935 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,851,875 | BOYAmt |
| EOY | $3,294,198 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $985 | BOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,407,252 | BOYAmt |
| EOY | $3,863,485 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,558 | BOYAmt |
| EOY | $24,236 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $40,000 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $574,599 | BOYAmt |
| EOY | $79,928 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $602,157 | BOYAmt |
| EOY | $144,164 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,571,350 | BOYAmt |
| EOY | $3,614,024 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $233,745 | BOYAmt |
| EOY | $105,297 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,805,095 | BOYAmt |
| EOY | $3,719,321 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,407,252 | BOYAmt |
| EOY | $3,863,485 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$85,774 | 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 | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,309,866 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $721,890 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,297,277 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $923,712 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $960,120 | CurrentTaxYearAmt |
| Total | $6,212,865 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $588,966 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $600,215 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $594,008 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $599,408 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $543,908 | CurrentTaxYearAmt |
| Total | $2,926,505 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,898,832 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,322,105 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,891,285 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,523,120 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,504,028 | CurrentTaxYearAmt |
| Total | $9,139,370 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | $356,322 | CurrentTaxYearAmt |
| Total | $356,322 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | $356,322 | CurrentTaxYearAmt |
| Total | $356,322 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $8,783,048 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $458 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $805 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $572 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $630 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $377 | CurrentTaxYearAmt |
| Total | $2,842 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $458 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $805 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $572 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $630 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $377 | CurrentTaxYearAmt |
| Total | $2,842 | TotalAmt |
Net Income From Other UBI NetIncomeFromOtherUBIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $86,650 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $81,531 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $95,311 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $60,353 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $75,914 | CurrentTaxYearAmt |
| Total | $399,759 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,985,940 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,404,441 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,987,168 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,584,103 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,580,319 | CurrentTaxYearAmt |
| Total | $9,541,971 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.92050 | PublicSupportCY509Pct |
| Public Support PY509 | 0.96080 | PublicSupportPY509Pct |
| Investment Income CY | 0.00000 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00000 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | false | AgentTrusteeEtcInd |
| Incl Escrow Custodial Acct Liab | false | InclEscrowCustodialAcctLiabInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $580,100 | OtherCostOrOtherBasisAmt |
| Book Value | $580,100 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,359,364 | OtherCostOrOtherBasisAmt |
| Depreciation | $667,256 | DepreciationAmt |
| Book Value | $2,692,108 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $145,669 | OtherCostOrOtherBasisAmt |
| Depreciation | $123,679 | DepreciationAmt |
| Book Value | $21,990 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $3,294,198 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| LINE OF CREDIT PARAGON | $76,277 |
| ACCRUED EXPENSES | $3,651 |
| NOTE PAYABLE PARAGON | |
| NOTE PAYABLE DELL |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $79,928 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $1,890,789 | TotalRevEtcAuditedFinclStmtAmt |
| Donated Services And Use Fclts | $371,356 | DonatedServicesAndUseFcltsAmt |
| Revenue Not Reported | $371,356 | RevenueNotReportedAmt |
| Revenue Subtotal | $1,519,433 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $1,519,433 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $1,976,563 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $371,356 | DonatedServicesUseFcltsAmt |
| Expenses Not Reported | $371,356 | ExpensesNotReportedAmt |
| Expenses Subtotal | $1,605,207 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $1,605,207 | TotalExpensesPerForm990Amt |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | FARM TO TABLE | Event1Nm |
| Gross Receipts Event1 | $118,543 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $110,873 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $7,670 | GrossRevenueEvent1Amt |
| Other Direct Expenses Event1 | $27,109 | OtherDirectExpensesEvent1Amt |
| Event2 | SHARE THE PIE | Event2Nm |
| Gross Receipts Event2 | $10,312 | GrossReceiptsEvent2Amt |
| Gross Revenue Event2 | $10,312 | GrossRevenueEvent2Amt |
| Other Direct Expenses Event2 | $7,302 | OtherDirectExpensesEvent2Amt |
| Gross Receipts Total | $128,855 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $110,873 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $17,982 | GrossRevenueTotalEventsAmt |
| Oth Direct Expnss Total Events | $34,411 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $34,411 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$16,429 | NetIncomeSummaryAmt |
Schedule M IRS990ScheduleM
Securities Publicly Traded SecuritiesPubliclyTradedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $250,694 | NoncashContributionsRptF990Amt |
Other Non Cash Contri Table OtherNonCashContriTableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 3 | ContributionCnt |
| Noncash Contributions Rpt F990 | $39,663 | NoncashContributionsRptF990Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | false | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | false | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 2, PART III, LINE 4D | PROVIDE MEDICAL SERVICES FOR UNINSURED LOW INCOME INDIVIDUALS |
| FORM 990, PAGE 6, PART VI, LINE 11B | THE 990 WILL BE DISTRIBUTED TO THE BOARD FOR REVIEW AND COMMENT AT THE BOARD MEETING FOLLOWING DISTRIBUTION. |
| FORM 990, PAGE 6, PART VI, LINE 15A | THE BOARD HAS OVERSIGHT AND APPROVES EXECUTIVE DIRECTOR COMPENSATION. THE EXECUTIVE DIRECTOR MAKES RECOMMENDATIONS ON KEY EMPLOYEE COMPENSATION WHICH IS APPROVED DURING THE BUDGET PROCESS. |
| FORM 990, PAGE 6, PART VI, LINE 15B | THE BOARD HAS OVERSIGHT AND APPROVES EXECUTIVE DIRECTOR COMPENSATION. THE EXECUTIVE DIRECTOR MAKES RECOMMENDATIONS ON KEY EMPLOYEE COMPENSATION WHICH IS APPROVED DURING THE BUDGET PROCESS. |
| FORM 990, PAGE 6, PART VI, LINE 19 | THE GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST FOR INSPECTION. ALSO THE FINANCIAL STATEMENTS ARE INCLUDED IN THE ANNUAL REPORT SENT IN A NEWSLETTER TO SUPPORTERS(ALSO AVAILABLE UPON REQUEST). THE NEWSLETTER WITH THE ANNUAL REPORT MAY BE DOWNLOADED FROM THE ORGANIZATION'S WEBSITE. |