STRATEGY STUDIO / PUBLIC DATA EXPLORER

CARESTL HEALTH: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
CARESTL HEALTH (EIN 43-0917230)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-05-15
IRS object ID
201321359349306552
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

FieldValueIRS element (for citing)
Timestamp2013-05-15T12:07:21-07:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Schmersahl Treloar & Co PCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line110805 Sunset Office Drive Ste 400AddressLine1
CitySt LouisCity
StateMOState
ZIP Code63127ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN430917230EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1MYRTLE HILLIARD DAVIS COMPREHENSIVEBusinessNameLine1
Business Name Line2HEALTH CENTERS INCBusinessNameLine2
FieldValueIRS element (for citing)
Name ControlMYRTNameControl
Phone3143675820Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line15471 DR MARTIN LUTHER KING DRIVEAddressLine1
CityST LOUISCity
StateMOState
ZIP Code63112ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameANGELA ARCHIBALDName
TitleCFOTitle
Date Signed2013-05-15DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameRoger G Toennies CPAName
PTINP00019708PTIN
Phone3149662727Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonANGELA ARCHIBALDNameOfPrincipalOfficerPerson
Gross Receipts18334408GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
All Affiliates IncludedfalseAllAffiliatesIncluded
Organization501c3XOrganization501c3
Web Sitewww.mhdchc.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1969YearFormation
State Legal DomicileMOStateLegalDomicile
Activity Or Mission DescriptionTO PROVIDE HEALTHCARE SERVICES, MEDICAL COUNSELING, AND EDUCATION FOR LOW INCOME INDIVIDUALS.ActivityOrMissionDescription
Nbr Voting Members Governing Body14NbrVotingMembersGoverningBody
Nbr Independent Voting Members14NbrIndependentVotingMembers
Total Nbr Employees274TotalNbrEmployees
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year3264878ContributionsGrantsPriorYear
Contributions Grants Current Year3151042ContributionsGrantsCurrentYear
Program Service Revenue Prior Year16592929ProgramServiceRevenuePriorYear
Program Service Revenue CY14602357ProgramServiceRevenueCY
Investment Income Prior Year124634InvestmentIncomePriorYear
Investment Income Current Year7970InvestmentIncomeCurrentYear
Other Revenue Prior Year72545OtherRevenuePriorYear
Other Revenue Current Year100002OtherRevenueCurrentYear
Total Revenue Prior Year20054986TotalRevenuePriorYear
Total Revenue Current Year17861371TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year14223489SalariesEtcPriorYear
Salaries Etc Current Year14619714SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year5387279OtherExpensePriorYear
Other Expenses Current Year6021810OtherExpensesCurrentYear
Total Expenses Prior Year19610768TotalExpensesPriorYear
Total Expenses Current Year20641524TotalExpensesCurrentYear
Revenues Less Expenses Prior Year444218RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-2780153RevenuesLessExpensesCY
Total Assets BOY7996859TotalAssetsBOY
Total Assets EOY5187712TotalAssetsEOY
Total Liabilities BOY1518360TotalLiabilitiesBOY
Total Liabilities EOY1520115TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY6478499NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY3667597NetAssetsOrFundBalancesEOY
Mission DescriptionTO PROVIDE HEALTHCARE SERVICES, MEDICAL COUNSELING, AND EDUCATION FOR LOW INCOME INDIVIDUALS.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense16604856Expense
Revenue14602357Revenue
DescriptionOUTPATIENT HEALTHCARE SERVICES TO LOW INCOME RESIDENTS OF THE ST. LOUIS METROPOLITAN AREA. MYRTLE HILLIARD DAVIS COMPREHENSIVE HEALTH CENTER ENCOUNTERED 99,153 VISITS BY PATIENTS IN 2012.Description
Total Program Service Expense16604856TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetstrueReportOtherAssets
Report Other LiabilitiesfalseReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntityfalseRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10969NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees274NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Form990-T FiledfalseForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Number Of8282 Filed0NumberOf8282Filed
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Form8899 FiledfalseForm8899Filed
Form1098 C FiledfalseForm1098CFiled
Excess Business HoldingsfalseExcessBusinessHoldings
Taxable DistributionsfalseTaxableDistributions
Distribution To DonorfalseDistributionToDonor
Filed Lieu1041falseFiledLieu1041
Licensed More Than One StatefalseLicensedMoreThanOneState
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members14NbrVotingGoverningBodyMembers
Number Independent Voting Members14NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonANGELA ARCHIBALD-CLABONNamePerson
Telephone Number3143675820TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line15471 MARTIN LUTHER KINGAddressLine1
CityST LOUISCity
StateMOState
ZIP Code63112ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (21 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekAverage Hours Per Week RelatedAverageHoursPerWeekRelatedIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployee
MELVIN L RAYMOND
VICE CHAIR2.000.00XX000
PATRICIA FOSTER
Secretary3.000.00XX000
ALVIN DUNHAM
Treasurer2.000.00XX000
THEONIS GUYTON
CHAIRPERSON5.000.00XX000
JETHRO FORTENBERRY
MEMBER2.000.00X000
ALTA C RIVERS
MEMBER2.000.00X000
WILLIAM WINFREY
MEMBER3.000.00X000
RANDY BARNES
MEMBER2.000.00X000
MARIE BONDS
MEMBER3.000.00X000
MATTIE STANTON
MEMBER2.000.00X000
KAREN JONES
MEMBER2.000.00X000
LULA HALL
MEMBER3.000.00X000
INA BOON
MEMBER3.000.00X000
EUNICE ATKINSON
MEMBER3.000.00X000
ANGELA ARCHIBALD-CLABON
CFO45.000.00X13327504769
ARCHIE GRIFFIN
CEO45.000.00X536939022165
ORAMA NWANODI
PHYSICIAN40.000.00250404014933X
KEVIN TURNER
PHYSICIAN40.000.00203387023788X
ARAVINDAKSHA MENON
PHYSICIAN40.000.00185645010994X
CAROL HORTON-HENLEY
DENTIST40.000.00171361011555X
MANOHARA MUNIMUDDAPPA
PHYSICIAN40.000.0019745809360X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1678469TotalReportableCompFromOrg
Total Other Compensation97564TotalOtherCompensation
Number Individuals GT100 K32NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
Government Grants2979523GovernmentGrants
All Other Contributions171519AllOtherContributions
Total Contributions3151042TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
PRIVATE PAY FEES62411064770846477084
OTHER CONTRACTS62411018681171868117
FEES & CONTRACTS GOV AGEN62411046946564694656
DISPROPORTIONATE SHARE62411015625001562500
FieldValueIRS element (for citing)
Total Program Service Revenue14602357TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column5008TotalRevenueColumn
Exclusion$5,008ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities475999Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities473037Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities2962Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column2962TotalRevenueColumn
Exclusion$2,962ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionMISCELLANEOUS INCOMEDescription
Total Revenue Column100002TotalRevenueColumn
Exclusion$100,002ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue100002TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column17861371TotalRevenueColumn
Related Or Exempt Function Income14602357RelatedOrExemptFunctionIncome
Exclusion$107,972ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total670214Total
Program Services549575ProgramServices
Management And General120639ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total11942877Total
Program Services9818908ProgramServices
Management And General2123969ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total0Total

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total2006623Total
Program Services1646463ProgramServices
Management And General360160ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total0Total

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total0Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total0Total

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total566243Total
Program Services134211ProgramServices
Management And General432032ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total225234Total
Program Services41037ProgramServices
Management And General184197ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total0Total

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total0Total

Travel Travel

FieldValueIRS element (for citing)
Total93198Total
Program Services50964ProgramServices
Management And General42234ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total0Total

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total724608Total
Program Services595658ProgramServices
Management And General128950ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total0Total

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
TELEPHONE26214520777854367
UTILITIES & INSURANCE27926720705972208
CONTRACT SERVICES969208759232209976
SUPPLIES25485172403097145420

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total353390Total
Program Services190874ProgramServices
Management And General162516ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total20641524Total
Program Services16604856ProgramServices
Management And General4036668ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1468088BOY
EOY940111EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
EOY0EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
EOY0EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY2734177BOY
EOY1140042EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY174260BOY
EOY171514EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY102828BOY
EOY100705EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis11203937LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec8740634LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY3175909BOY
EOY2463303EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY341597BOY
EOY372037EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY7996859BOY
EOY5187712EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY1470362BOY
EOY1520115EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY47998BOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY1518360BOY
EOY1520115EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY6478499BOY
EOY3667597EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY6478499BOY
EOY3667597EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY7996859BOY
EOY5187712EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses-2780153ReconcilationRevenueExpenses
Reconciliation Unrealized Invest40302ReconciliationUnrealizedInvest
Reconcilation Other Changes-71051ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement SeparateXFinancialStatementSeparate
FieldValueIRS element (for citing)
Audit CommitteetrueAuditCommittee
Federal Grant Audit RequiredtrueFederalGrantAuditRequired
Federal Grant Audit PerformedtrueFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org170b1 AviXPubliclySupportedOrg170b1Avi

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years3918443CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years4093718CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years3429228CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year3264878CurrentTaxYearMinus1Year
Current Tax Year3151042CurrentTaxYear
Total17857309Total

Tax Rev Levied For Org Benefit170 TaxRevLeviedForOrgBenefit170

FieldValueIRS element (for citing)
Total0Total

Value Srvc Fclts Furnished By Govt ValueSrvcFcltsFurnishedByGovt

FieldValueIRS element (for citing)
Total0Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years3918443CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years4093718CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years3429228CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year3264878CurrentTaxYearMinus1Year
Current Tax Year3151042CurrentTaxYear
Total17857309Total
FieldValueIRS element (for citing)
Amounts Subst Contributors Total0AmountsSubstContributorsTotal
Public Support Total17017857309PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years-281870CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years19881CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years30368CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year20280CurrentTaxYearMinus1Year
Current Tax Year5008CurrentTaxYear
Total-206333Total

Net UBI NetUBI

FieldValueIRS element (for citing)
Total0Total

Other Income170 OtherIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years53239CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years63357CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years60891CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year72545CurrentTaxYearMinus1Year
Current Tax Year100002CurrentTaxYear
Total350034Total
FieldValueIRS element (for citing)
Total Support18001010TotalSupport
Gross Receipts From Admissions Etc77589836GrossReceiptsFromAdmissionsEtc
Public Support Pertcentage1700.99200PublicSupportPertcentage170
Public Support Pertcent Prior Year0.99150PublicSupportPertcentPriorYear
Thirty Three Percnt Tests CY170XThirtyThreePercntTestsCY170

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis159426OtherCostOrOtherBasis
Book Value159426BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis5419690OtherCostOrOtherBasis
Depreciation4017053Depreciation
Book Value1402637BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis5624821OtherCostOrOtherBasis
Depreciation4723581Depreciation
Book Value901240BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings2463303TotalOfBookValueLandBuildings

Other Assets OtherAssets (2 entries)

DescriptionDescriptionBook ValueBookValue
PENSION ASSET2977
INVESTMENTS369060
FieldValueIRS element (for citing)
Total Book Value Other Assets372037TotalBookValueOtherAssets
Tot Revenue Etc Audited Fincl Stmt19260253TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments40302NetUnrealizedGainsInvestments
Other Revenues1358580OtherRevenues
Revenue Not Rptd F9901398882RevenueNotRptdF990
Revenue Subtotal17861371RevenueSubtotal
Total Revenue Per Form99017861371TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt22071155TotExpensesEtcAuditedFinclStmt
Other Expenses Included1429631OtherExpensesIncluded
Expenses Not Rptd F9901429631ExpensesNotRptdF990
Expenses Subtotal20641524ExpensesSubtotal
Total Expenses Per Form99020641524TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Part XII, Line 2dPart XII, Line 2d: Other expenses and losses per audited F/SIN-KIND SUPPLIES $1358580 BAD DEBT EXPENSE $71051
Part XI, Line 2dPart XI, Line 2d: Other revenue amounts included in F/S but not included on form 990IN-KIND SUPPLIES $1358580

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException
Rebuttable Presumption ProcedurefalseRebuttablePresumptionProcedure

Form990 Schedule J Part II Form990ScheduleJPartII (6 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgDeferred Comp Filing OrgDeferredCompFilingOrgNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgTotal Compensation Filing OrgTotalCompensationFilingOrg
ORAMA NWANODI
PHYSICIAN25040461638770265337
MANOHARA MUNIMUDDAPPA
PHYSICIAN19745849234437206818
KEVIN TURNER
PHYSICIAN203387513718651227175
CAROL HORTON-HENLEY
DENTIST17136140587497182916
ARCHIE GRIFFIN
CEO536939638415781559104
ARAVINDAKSHA MENON
PHYSICIAN18564545786416196639

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Form 990, Part XI, Line 9Other Changes In Net Assets Or Fund Balances - Other DecreasesBAD DEBT EXPENSE = -$71051
Form 990, Part VI, Line 19Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailableIf a member of the public wishes to view the organization's documents and policies they can request to do so at the facility.
Form 990, Part VI, Line 15bForm 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key EmployeesThe CEO reviews and decides officers' salaries yearly. The CEO's salary is evaluated annually by the board of directors and the salary is negotiated.
Form 990, Part VI, Line 12cForm 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of ConflictsWhen a new board member or executive employee is hired, a conflict of interest policy must be completed.
Form 990, Part VI, Line 11bForm 990, Part VI, Line 11b: Form 990 Review ProcessThe Interim Financial CEO and Accounting Manager must review and appprove the 990. After their review, it is submitted to the Board for review and approval.