ALLIANCE MEDICAL MINISTRY INC: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- ALLIANCE MEDICAL MINISTRY INC (EIN 56-2168673)
- Tax period
- 2013-01-01 to 2013-12-31
- Filed
- 2014-11-10
- IRS object ID
- 201413149349302391
- Schema version
- 2013v3.1
- 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 | 2014-11-10T14:46:21-06:00 | ReturnTs |
| Tax Period End | 2013-12-31 | 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 | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4101 LAKE BOONE TRL STE 215 | AddressLine1 |
| City | RALEIGH | City |
| State | NC | State |
| ZIP Code | 27607 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-01-01 | 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 | BusinessNameLine1 |
| 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 | AddressLine1 |
| City | RALEIGH | City |
| State | NC | State |
| ZIP Code | 27610 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MARGARET P RADER | PersonNm |
| Person Title | EXECUTIVE DIRECTOR | PersonTitleTxt |
| Phone | 9192503320 | PhoneNum |
| Signature | 2014-11-15 | 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 | 2014-11-10 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2015-11-30 17:44:51Z | 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 | AddressLine1 |
| City | RALEIGH | City |
| State | NC | State |
| ZIP Code | 27610 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $1,988,990 | 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 | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 14 | VotingMembersIndependentCnt |
| Total Employee | 23 | TotalEmployeeCnt |
| Total Volunteers | 152 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $721,890 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,297,277 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $567,752 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $531,446 | CYProgramServiceRevenueAmt |
| PY Investment Income | $251 | PYInvestmentIncomeAmt |
| CY Investment Income | $572 | CYInvestmentIncomeAmt |
| PY Other Revenue | $82,531 | PYOtherRevenueAmt |
| CY Other Revenue | $127,592 | CYOtherRevenueAmt |
| PY Total Revenue | $1,372,424 | PYTotalRevenueAmt |
| CY Total Revenue | $1,956,887 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $1,302,134 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $1,340,584 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $156,995 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $554,811 | PYOtherExpensesAmt |
| CY Other Expenses | $456,139 | CYOtherExpensesAmt |
| PY Total Expenses | $1,856,945 | PYTotalExpensesAmt |
| CY Total Expenses | $1,796,723 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$484,521 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $160,164 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $4,412,456 | TotalAssetsBOYAmt |
| Total Assets EOY | $4,654,303 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $626,126 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $739,092 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $3,786,330 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $3,915,211 | 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 | $1,447,607 | ExpenseAmt |
| Revenue | $531,446 | RevenueAmt |
| Desc | PROVIDE MEDICAL SERVICES FOR UNINSURED LOW INCOME INDIVIDUALS. A TOTAL OF 243,574 WAS DONATED TO THE ORGANIZATION IN THE FORM OF PROFESSIONAL SERVICES (79,429)AND LAB WORK FROM REX HOSPITAL (164,145). | 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 | $1,447,607 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | 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 | 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 | 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 | 5 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | false | BackupWthldComplianceInd |
| Employee | 23 | 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 | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 14 | 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 | AddressLine1 |
| City | RALEIGH | City |
| State | NC | State |
| ZIP Code | 27610 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (15 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|
| MARGARET P RADER | ||||||
| EXECUTIVE DI | 40.00 | Yes (X) | Yes (X) | $123,125 | $0 | $0 |
| SEAN HARRISON | ||||||
| DIRECTOR | 3.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| DAVID WILSON | ||||||
| BOARD CHAIR | 5.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| SUSAN T WEAVER MD | ||||||
| CHAIR-ELECT | 3.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| RICK GANNOTTA | ||||||
| DIRECTOR | 3.00 | Yes (X) | $0 | $0 | $0 | |
| NEIL MORRIS | ||||||
| DIRECTOR | 5.00 | Yes (X) | $0 | $0 | $0 | |
| DANA SIMPSON JD | ||||||
| SECRETARY | 3.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| JR SHEARIN | ||||||
| DIRECTOR | 3.00 | Yes (X) | $0 | $0 | $0 | |
| EILEEN HENDREN | ||||||
| DIRECTOR | 3.00 | Yes (X) | $0 | $0 | $0 | |
| MARC NEWMAN | ||||||
| DIRECTOR | 3.00 | Yes (X) | $0 | $0 | $0 | |
| RICK MARCOTTE | ||||||
| DIRECTOR | 3.00 | Yes (X) | $0 | $0 | $0 | |
| STEVEN PEEDIN | ||||||
| DIRECTOR | 3.00 | Yes (X) | $0 | $0 | $0 | |
| GERALD PETKAU | ||||||
| TREASURER | 3.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| BOB VAN WORMER | ||||||
| DIRECTOR | 3.00 | Yes (X) | $0 | $0 | $0 | |
| TAMMIE STANTON | ||||||
| DIRECTOR | 3.00 | Yes (X) | $0 | $0 | $0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $123,125 | TotalReportableCompFromOrgAmt |
| 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 | $89,114 | FundraisingAmt |
| All Other Contributions | $1,208,163 | AllOtherContributionsAmt |
| Noncash Contributions | $9,107 | NoncashContributionsAmt |
| Total Contributions | $1,297,277 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| CONTRACT FEES | 621110 | $372,595 | $372,595 |
| PATIENT FEES | 621110 | $158,851 | $158,851 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $531,446 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $572 | TotalRevenueColumnAmt |
| Exclusion | $572 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $78,243 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $822 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $77,421 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $77,421 | TotalRevenueColumnAmt |
| Exclusion | $77,421 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $62,562 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $89,114 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $31,281 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $31,281 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $18,890 | TotalRevenueColumnAmt |
| Exclusion | $18,890 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $18,890 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,956,887 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $531,446 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $96,883 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $123,125 | TotalAmt |
| Program Services | $101,349 | ProgramServicesAmt |
| Management And General | $10,888 | ManagementAndGeneralAmt |
| Fundraising | $10,888 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,021,864 | TotalAmt |
| Program Services | $841,140 | ProgramServicesAmt |
| Management And General | $88,279 | ManagementAndGeneralAmt |
| Fundraising | $92,445 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,955 | TotalAmt |
| Program Services | $24,322 | ProgramServicesAmt |
| Management And General | $2,027 | ManagementAndGeneralAmt |
| Fundraising | $2,606 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $77,559 | TotalAmt |
| Program Services | $64,374 | ProgramServicesAmt |
| Management And General | $10,083 | ManagementAndGeneralAmt |
| Fundraising | $3,102 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $89,081 | TotalAmt |
| Program Services | $66,811 | ProgramServicesAmt |
| Management And General | $11,135 | ManagementAndGeneralAmt |
| Fundraising | $11,135 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,300 | TotalAmt |
| Management And General | $22,300 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,322 | TotalAmt |
| Management And General | $8,322 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,792 | TotalAmt |
| Program Services | $20,094 | ProgramServicesAmt |
| Management And General | $3,349 | ManagementAndGeneralAmt |
| Fundraising | $3,349 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $104,973 | TotalAmt |
| Program Services | $78,731 | ProgramServicesAmt |
| Management And General | $13,120 | ManagementAndGeneralAmt |
| Fundraising | $13,122 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,898 | TotalAmt |
| Program Services | $10,705 | ProgramServicesAmt |
| Management And General | $1,677 | ManagementAndGeneralAmt |
| Fundraising | $516 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| TEMPORARY STAFF | $80,923 | $78,495 | $2,428 | |
| UTILITIES | $49,665 | $37,249 | $6,208 | $6,208 |
| REPAIRS & MAINTENANCE | $49,606 | $49,606 | ||
| JANITORAL | $19,200 | $14,400 | $2,400 | $2,400 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $81,460 | TotalAmt |
| Program Services | $60,331 | ProgramServicesAmt |
| Management And General | $9,905 | ManagementAndGeneralAmt |
| Fundraising | $11,224 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,796,723 | TotalAmt |
| Program Services | $1,447,607 | ProgramServicesAmt |
| Management And General | $192,121 | ManagementAndGeneralAmt |
| Fundraising | $156,995 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $290,543 | BOYAmt |
| EOY | $195,531 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $50,000 | BOYAmt |
| EOY | $496,988 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $857 | BOYAmt |
| EOY | $5,403 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,260 | BOYAmt |
| EOY | $6,559 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $4,624,775 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $674,953 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,054,796 | BOYAmt |
| EOY | $3,949,822 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,412,456 | BOYAmt |
| EOY | $4,654,303 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $51,250 | BOYAmt |
| EOY | $164,216 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $574,876 | BOYAmt |
| EOY | $574,876 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $626,126 | BOYAmt |
| EOY | $739,092 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,716,238 | BOYAmt |
| EOY | $3,426,241 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $70,092 | BOYAmt |
| EOY | $488,970 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,786,330 | BOYAmt |
| EOY | $3,915,211 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,412,456 | BOYAmt |
| EOY | $4,654,303 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $160,164 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$31,283 | 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 | 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 | $2,048,726 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,687,760 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,309,866 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $721,890 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,297,277 | CurrentTaxYearAmt |
| Total | $8,065,519 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus3 Years | $616,226 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $588,966 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $600,215 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $594,008 | CurrentTaxYearAmt |
| Total | $2,399,415 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,048,726 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,303,986 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,898,832 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,322,105 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,891,285 | CurrentTaxYearAmt |
| Total | $10,464,934 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $10,464,934 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,694 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $944 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $458 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $805 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $572 | CurrentTaxYearAmt |
| Total | $5,473 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,694 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $944 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $458 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $805 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $572 | CurrentTaxYearAmt |
| Total | $5,473 | TotalAmt |
Net Income From Other UBI NetIncomeFromOtherUBIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus3 Years | $78,500 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $86,650 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $81,531 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $95,311 | CurrentTaxYearAmt |
| Total | $341,992 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,051,420 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,383,430 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,985,940 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,404,441 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,987,168 | CurrentTaxYearAmt |
| Total | $10,812,399 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.96790 | PublicSupportCY509Pct |
| Public Support PY509 | 0.97710 | PublicSupportPY509Pct |
| Investment Income CY | 0.00000 | InvestmentIncomeCYPct |
| 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
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $675,000 | OtherCostOrOtherBasisAmt |
| Book Value | $675,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,809,364 | OtherCostOrOtherBasisAmt |
| Depreciation | $567,645 | DepreciationAmt |
| Book Value | $3,241,719 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $140,411 | OtherCostOrOtherBasisAmt |
| Depreciation | $107,308 | DepreciationAmt |
| Book Value | $33,103 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $3,949,822 | TotalBookValueLandBuildingsAmt |
| Total Rev Etc Audited Fincl Stmt | $2,169,180 | TotalRevEtcAuditedFinclStmtAmt |
| Donated Services And Use Fclts | $243,574 | DonatedServicesAndUseFcltsAmt |
| Revenue Not Reported | $243,574 | RevenueNotReportedAmt |
| Revenue Subtotal | $1,925,606 | RevenueSubtotalAmt |
| Other Revenues Not Included | $31,281 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $31,281 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $1,956,887 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $2,040,299 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $243,574 | DonatedServicesUseFcltsAmt |
| Other Expenses Included | $2 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $243,576 | ExpensesNotReportedAmt |
| Expenses Subtotal | $1,796,723 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $1,796,723 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE D, PAGE 4, PART XI, LINE 4B | DIRECT FUNDRAISING EXPENSES 31,281 |
| SCHEDULE D, PAGE 4, PART XII, LINE 2D | ROUNDING ADJUSTMENT 2 |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | 10TH ANNIVERSAR | NameOfEvent1Amt |
| Gross Receipts Event1 | $124,912 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $64,701 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $60,211 | GrossRevenueEvent1Amt |
| Other Direct Expenses Event1 | $28,930 | OtherDirectExpensesEvent1Amt |
| Name Of Event2 | AMBASSADOR EVEN | NameOfEvent2Amt |
| Gross Receipts Event2 | $26,764 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $24,413 | CharitableContriEvent2Amt |
| Gross Revenue Event2 | $2,351 | GrossRevenueEvent2Amt |
| Other Direct Expenses Event2 | $2,351 | OtherDirectExpensesEvent2Amt |
| Gross Receipts Total | $151,676 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $89,114 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $62,562 | GrossRevenueTotalEventsAmt |
| Oth Direct Expnss Total Events | $31,281 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $31,281 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $31,281 | NetIncomeSummaryAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 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. |
| FORM 990, PART XI, LINE 9 | DIRECT FUNDRAISING EXPENSES -31,281 ROUNDING ADJUSTMENT -2 |