COMMUNITY HEALTHCARE FOUNDATION INC: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- COMMUNITY HEALTHCARE FOUNDATION INC (EIN 83-0289853)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-05-02
- IRS object ID
- 201321229349301082
- Schema version
- 2012v2.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-05-02T14:38:38-07:00 | Timestamp |
| Tax Period End Date | 2012-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Dana F Cole & Company LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 121 E 20TH AVE | AddressLine1 |
| City | TORRINGTON | City |
| State | WY | State |
| ZIP Code | 822402811 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 830289853 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY HEALTHCARE FOUNDATION INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | COMM | NameControl |
| Phone | 3075324181 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2000 CAMPBELL DRIVE | AddressLine1 |
| City | TORRINGTON | City |
| State | WY | State |
| ZIP Code | 82240 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | DARIN YATES | Name |
| Title | President | Title |
| Date Signed | 2013-05-02 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | CAROL S CLARK | Name |
| PTIN | P00249548 | PTIN |
| Phone | 3075324511 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | DARIN YATES | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2935 WEST A | AddressLine1 |
| City | TORRINGTON | City |
| State | WY | State |
| ZIP Code | 82240 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 47954 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| All Affiliates Included | false | AllAffiliatesIncluded |
| Organization501c3 | X | Organization501c3 |
| Web Site | N/A | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1989 | YearFormation |
| State Legal Domicile | WY | StateLegalDomicile |
| Activity Or Mission Description | THE PRIMARY EXEMPT PURPOSE IS TO RECEIVE AND ADMINISTER FUNDS FOR SCIENTIFIC, EDUCATIONAL, AND CHARITABLE PURPOSES TO SUPPORT AND BENEFIT THE SICK, ILL, AGED, AND INFIRMED AND TO IMPROVE THE HEALTH CARE SERVICES AVAILABLE TO THESE PEOPLE. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 14 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 14 | NbrIndependentVotingMembers |
| Total Nbr Employees | 0 | TotalNbrEmployees |
| Total Nbr Volunteers | 20 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 10588 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 30700 | ContributionsGrantsCurrentYear |
| Program Service Revenue CY | 0 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 5911 | InvestmentIncomePriorYear |
| Investment Income Current Year | 4755 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 15619 | OtherRevenuePriorYear |
| Other Revenue Current Year | 745 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 32118 | TotalRevenuePriorYear |
| Total Revenue Current Year | 36200 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 3494 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 56815 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Current Year | 0 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 375 | OtherExpensePriorYear |
| Other Expenses Current Year | 490 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 3869 | TotalExpensesPriorYear |
| Total Expenses Current Year | 57305 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 28249 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -21105 | RevenuesLessExpensesCY |
| Total Assets BOY | 232088 | TotalAssetsBOY |
| Total Assets EOY | 210983 | TotalAssetsEOY |
| Total Liabilities EOY | 0 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 232088 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 210983 | NetAssetsOrFundBalancesEOY |
| Mission Description | THE PRIMARY EXEMPT PURPOSE IS TO RECEIVE AND ADMINISTER FUNDS FOR SCIENTIFIC, EDUCATIONAL, AND CHARITABLE PURPOSES TO SUPPORT AND BENEFIT THE SICK, ILL, AGED, AND INFIRMED AND TO IMPROVE THE HEALTH CARE SERVICES AVAILABLE TO THESE PEOPLE. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 56815 | Expense |
| Grants | 56815 | Grants |
| Description | EQUIPMENT, CASH GRANTS, AND FURNISHINGS PURCHASED FOR COMMUNITY HOSPITAL (NON-PROFIT HOSPITAL),GOSHEN CARE CENTER (COUNTY OWNED NURSING HOME), COMMUNITY HOSPITAL AUXILIARY(VOLUNTEER SERVICE GROUP), TORRINGTON AMBULANCE SERVICE (CITY OPERATED AMBULANCE SERVICE), AND SAINT JOSEPH'S CHILDRENS HOME (NON-PROFIT ORGANIZATION). | Description |
| Total Program Service Expense | 56815 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | true | TermOrPermanentEndowments |
| Report Land Bldg Equip | false | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | false | ReportOtherLiabilities |
| Report Fin48 Footnote | false | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | false | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | true | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | false | Hospital |
| Grants To Organizations | true | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | false | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBonds |
| Escrow Account | false | EscrowAccount |
| On Behalf Of Issuer | false | OnBehalfOfIssuer |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | false | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transaction Related Entity | false | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 0 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | false | ComplianceWithBackupWitholding |
| Number Of Employees | 0 | NumberOfEmployees |
| Employment Tax Returns Filed | false | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Form990-T Filed | false | Form990-TFiled |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Number Of8282 Filed | 0 | NumberOf8282Filed |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Form8899 Filed | false | Form8899Filed |
| Form1098 C Filed | false | Form1098CFiled |
| Excess Business Holdings | false | ExcessBusinessHoldings |
| Taxable Distributions | false | TaxableDistributions |
| Distribution To Donor | false | DistributionToDonor |
| Filed Lieu1041 | false | FiledLieu1041 |
| Licensed More Than One State | false | LicensedMoreThanOneState |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 14 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 14 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | false | MembersOrStockholders |
| Election Of Board Members | false | ElectionOfBoardMembers |
| Decisions Subject To Approval | false | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | false | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | false | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | false | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | false | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | false | RegularMonitoringEnforcement |
| Whistleblower Policy | false | WhistleblowerPolicy |
| Document Retention Policy | false | DocumentRetentionPolicy |
| Compensation Process CEO | false | CompensationProcessCEO |
| Compensation Process Other | false | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | CAROL CLARK | NamePerson |
| Telephone Number | 3075324511 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 121 EAST 20TH AVENUE | AddressLine1 |
| City | TORRINGTON | City |
| State | WY | State |
| ZIP Code | 82240 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | X | NoListedPersonsCompensated |
Form990 Part VII Section A Form990PartVIISectionA (14 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation |
|---|---|---|---|---|---|---|---|
| DARIN YATES | |||||||
| President | 1.00 | 0.00 | X | X | 0 | 0 | 0 |
| KENDRA STEINMETZ | |||||||
| Secretary | 1.00 | 0.00 | X | X | 0 | 0 | 0 |
| JAMIE SCHANEMAN | |||||||
| Director | 1.00 | 0.00 | X | 0 | 0 | 0 | |
| EILEEN PATTERSON | |||||||
| Vice President | 2.00 | 0.00 | X | X | 0 | 0 | 0 |
| WADE BRUCH | |||||||
| Director | 1.00 | 0.00 | X | 0 | 0 | 0 | |
| BRIDGET SPENCER | |||||||
| Director | 1.00 | 0.00 | X | 0 | 0 | 0 | |
| MIKE RAFFERTY | |||||||
| Director | 1.00 | 0.00 | X | 0 | 0 | 0 | |
| TENA BALDWIN | |||||||
| Director | 1.00 | 0.00 | X | 0 | 0 | 0 | |
| RONDA MEYER | |||||||
| Director | 1.00 | 0.00 | X | 0 | 0 | 0 | |
| NATE HIBBEN | |||||||
| Director | 1.00 | 0.00 | X | 0 | 0 | 0 | |
| CAROL CLARK | |||||||
| Treasurer | 1.00 | 0.00 | X | X | 0 | 0 | 0 |
| TERRY WAGNER | |||||||
| Director | 1.00 | 0.00 | X | 0 | 0 | 0 | |
| LUCAS MOORE | |||||||
| Director | 1.00 | 0.00 | X | 0 | 0 | 0 | |
| STEVE FEAGLER | |||||||
| Director | 1.00 | 0.00 | X | 0 | 0 | 0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | false | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
| Number Of Contractors GT100 K | 0 | NumberOfContractorsGT100K |
| Fundraising Events | 6500 | FundraisingEvents |
| All Other Contributions | 24200 | AllOtherContributions |
| Total Contributions | 30700 | TotalContributions |
| Total Program Service Revenue | 0 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 4755 | TotalRevenueColumn |
| Exclusion | $4,755 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 12493 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 6500 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 11754 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 739 | TotalRevenueColumn |
| Exclusion | $739 | ExclusionAmount |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | CASH BACK REWARDS | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 6 | TotalRevenueColumn |
| Exclusion | $6 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 6 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 36200 | TotalRevenueColumn |
| Exclusion | $5,500 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 56815 | Total |
| Program Services | 56815 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 400 | Total |
| Management And General | 400 | ManagementAndGeneral |
Other Expenses OtherExpenses (3 entries)
| DescriptionDescription | TotalTotal | Management And GeneralManagementAndGeneral |
|---|---|---|
| BANK SERVICE CHARGES | 15 | 15 |
| CORPORATION LICENSE | 25 | 25 |
| BOARD EXPENSES | 50 | 50 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 57305 | Total |
| Program Services | 56815 | ProgramServices |
| Management And General | 490 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 232088 | BOY |
| EOY | 210983 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 0 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 232088 | BOY |
| EOY | 210983 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 82088 | BOY |
| EOY | 60983 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 150000 | BOY |
| EOY | 150000 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 232088 | BOY |
| EOY | 210983 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 232088 | BOY |
| EOY | 210983 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | -21105 | ReconcilationRevenueExpenses |
| Method Of Accounting Cash | X | MethodOfAccountingCash |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | false | FSAudited |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org170b1 Avi | X | PubliclySupportedOrg170b1Avi |
Gifts Grants Contrib Received170 GiftsGrantsContribReceived170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 178250 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 23596 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 7764 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 10588 | CurrentTaxYearMinus1Year |
| Current Tax Year | 30700 | CurrentTaxYear |
| Total | 250898 | Total |
Tax Rev Levied For Org Benefit170 TaxRevLeviedForOrgBenefit170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Value Srvc Fclts Furnished By Govt ValueSrvcFcltsFurnishedByGovt
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Total170 Total170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 178250 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 23596 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 7764 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 10588 | CurrentTaxYearMinus1Year |
| Current Tax Year | 30700 | CurrentTaxYear |
| Total | 250898 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Amounts Subst Contributors Total | 0 | AmountsSubstContributorsTotal |
| Public Support Total170 | 250898 | PublicSupportTotal170 |
Gross Investment Income170 GrossInvestmentIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 811 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 6597 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 6442 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 5911 | CurrentTaxYearMinus1Year |
| Current Tax Year | 4755 | CurrentTaxYear |
| Total | 24516 | Total |
Net UBI NetUBI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Other Income170 OtherIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 1080 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 8746 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 6111 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 15619 | CurrentTaxYearMinus1Year |
| Current Tax Year | 745 | CurrentTaxYear |
| Total | 32301 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | 307715 | TotalSupport |
| Public Support Pertcentage170 | 0.81540 | PublicSupportPertcentage170 |
| Public Support Pertcent Prior Year | 0.78120 | PublicSupportPertcentPriorYear |
| Thirty Three Percnt Tests CY170 | X | ThirtyThreePercntTestsCY170 |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| 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) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 150000 | BeginningOfYearBalance |
| End Of Year Balance | 150000 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 150000 | BeginningOfYearBalance |
| End Of Year Balance | 150000 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 150000 | BeginningOfYearBalance |
| End Of Year Balance | 150000 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 150000 | BeginningOfYearBalance |
| End Of Year Balance | 150000 | EndOfYearBalance |
Current Year Minus4 Years CurrentYearMinus4Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 150000 | BeginningOfYearBalance |
| End Of Year Balance | 150000 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Permanent Endowment EOY Balance | 1.00000 | PermanentEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | false | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | false | EndowmentsHeldByRelatedOrgs |
| Are Related Orgs Listed Schedule R | false | AreRelatedOrgsListedScheduleR |
Schedule G IRS990ScheduleG
| Field | Value | IRS element (for citing) |
|---|---|---|
| Special Fundraising Events | X | SpecialFundraisingEvents |
| Agreement Ref Fundraising | false | AgreementRefFundraising |
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | SILENT AUCTION/COMEDY NIGHT | NameOfEvent1 |
| Gross Receipts Event1 | 18993 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 6500 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 12493 | GrossRevenueEvent1 |
| Cash Prizes Event1 | 500 | CashPrizesEvent1 |
| Non Cash Prizes Event1 | 1792 | NonCashPrizesEvent1 |
| Rent Facility Costs Event1 | 1340 | RentFacilityCostsEvent1 |
| Food And Beverage Event1 | 3076 | FoodAndBeverageEvent1 |
| Entertainment Event1 | 2113 | EntertainmentEvent1 |
| Other Direct Expenses Event1 | 2933 | OtherDirectExpensesEvent1 |
| Gross Receipts Total | 18993 | GrossReceiptsTotal |
| Charitable Contributions Total | 6500 | CharitableContributionsTotal |
| Gross Revenue Total Events | 12493 | GrossRevenueTotalEvents |
| Cash Prizes Total Events | 500 | CashPrizesTotalEvents |
| Non Cash Prizes Total Events | 1792 | NonCashPrizesTotalEvents |
| Rent Facility Costs Total Events | 1340 | RentFacilityCostsTotalEvents |
| Food And Beverage Total Events | 3076 | FoodAndBeverageTotalEvents |
| Entertainment Total Events | 2113 | EntertainmentTotalEvents |
| Other Direct Expenses Total Events | 2933 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 11754 | DirectExpenseSummaryEvents |
| Net Income Summary | 739 | NetIncomeSummary |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | true | RecordsMaintained |
Recipient Table RecipientTable (3 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EIN Of RecipientEINOfRecipient | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Amount Of Non Cash AssistanceAmountOfNonCashAssistance | Purpose Of GrantPurposeOfGrant | Method Of ValuationMethodOfValuation | Description Of Non Cash AssistanceDescriptionOfNonCashAssistance |
|---|---|---|---|---|---|---|---|---|---|---|
| HOSPITAL AUXILIARY | ||||||||||
| 2000 CAMPBELL DRIVE | TORRINGTON | WY | 82240 | 830268787 | 170(b)(1)(A)(vi) | 13076 | 0 | LIFELINE COST ASSISTANCE | ||
| GOSHEN CARE CENTER | ||||||||||
| 2009 LARAMIE STREET | TORRINGTON | WY | 82240 | 363386410 | 170(b)(1)(A)(iii) | 5000 | 9658 | ACCESS FOR RESIDENTS | COST | SELF-SERVE KITCHEN |
| COMMUNITY HOSPITAL | ||||||||||
| 2000 CAMPBELL DRIVE | TORRINGTON | WY | 82240 | 510147309 | 170(b)(1)(A)(iii) | 0 | 21587 | SUPPLEMENT HOSPITAL NEEDS | COST | ER SUPPLIES, OB FURNITURE |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 3 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 0 | TotalNbrOfOtherOrganizations |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | Grantmaker's Description of How Grants are Used | Identifier |
| Explanation | APPLICANTS MUST SHOW IN THEIR APPLICATION FOR SUPPORT THAT GRANT FUNDS WILL BE USED TO PURCHASE EQUIPMENT TO BE USED FOR HEALTH CARE OR SUPPLEMENT HEALTH CARE SERVICES IN GOSHEN COUNTY, WYOMING. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (3 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| Form 990, Part VI, Line 19 | Form 990, Part VI, Line 19: Other Organization Documents Publicly Available | PROVIDED UPON WRITTEN REQUEST |
| Form 990, Part VI, Line 11b | Form 990, Part VI, Line 11b: Form 990 Review Process | 990 REVIEWED BY BOARD TREASURER |
| Form 990, Part VI, Line 8 | Form 990, Part VI, Line 8: Explanation of No Contemporaneously Documentation of Meetings | NO COMMITTEES HAVE AUTHOITY TO ACT ON BEHALF OF GOVERNING BODY |