SAPPHIRE COMMUNITY HEALTH INC: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- SAPPHIRE COMMUNITY HEALTH INC (EIN 81-0542716)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-08-14
- IRS object ID
- 201212279349302691
- Schema version
- 2011v1.2
- 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 | 2012-08-14T12:27:17-07:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CPR ACCOUNTING PLLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 4325 | AddressLine1 |
| City | MISSOULA | City |
| State | MT | State |
| ZIP Code | 59806 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 810542716 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SAPPHIRE COMMUNITY HEALTH INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | SAPP | NameControl |
| Phone | 4067283710 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 303 N 3RD | AddressLine1 |
| City | HAMILTON | City |
| State | MT | State |
| ZIP Code | 59840 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JIM MORTON | Name |
| Title | BOARD MEMBER | Title |
| Phone | 4067283710 | Phone |
| Date Signed | 2012-08-02 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | LOREN W RANDALL CPA | Name |
| Phone | 4067285539 | Phone |
| Date Prepared | 2012-08-14 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | JIM MORTON | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 303 N THIRD | AddressLine1 |
| City | HAMILTON | City |
| State | MT | State |
| ZIP Code | 59840 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 251682 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.sapphirechc.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 2001 | YearFormation |
| State Legal Domicile | MT | StateLegalDomicile |
| Activity Or Mission Description | HEALTH CARE IMPROVE THE OVERALL HEALTH STATUS OF ADULTS AND CHILDREN IN RAVALLI COUNTY BY PROVIDING QUALITY PRIMARY AND PREVENTATIVE HEALTH SERVICES TO THE MEDICALLY UNDERSERVED POPULATION. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 9 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 9 | NbrIndependentVotingMembers |
| Total Nbr Employees | 7 | TotalNbrEmployees |
| Total Nbr Volunteers | 5 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 700146 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 152066 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 91448 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 89838 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 59 | InvestmentIncomePriorYear |
| Investment Income Current Year | -47572 | InvestmentIncomeCurrentYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 791653 | TotalRevenuePriorYear |
| Total Revenue Current Year | 194332 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 283790 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 223219 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 764 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 297952 | OtherExpensePriorYear |
| Other Expenses Current Year | 160016 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 581742 | TotalExpensesPriorYear |
| Total Expenses Current Year | 383235 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 209911 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -188903 | RevenuesLessExpensesCY |
| Total Assets BOY | 288124 | TotalAssetsBOY |
| Total Assets EOY | 75237 | TotalAssetsEOY |
| Total Liabilities BOY | 25982 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 1998 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 262142 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 73239 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | HEALTH CARE | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | true | SignificantChange |
| Expense | 377971 | Expense |
| Revenue | 89838 | Revenue |
| Description | PROVIDING COMPREHENSIVE PRIMARY CARE AND PREVENTIVE HEALTH CARE SERVICES THAT WILL IMPROVE THE HEALTH STATUS AND DECREASE HEALTH DISPARITIES OF THE MEDICALLY UNDERSERVED POPULATIONS OF RAVALLI COUNTY MONTANA. THIS IS ACCOMPLISHED BY PROVIDING A PHYSICIAN, SUPPORT STAFF, AND PROVISION AND ACCESS TO LABORATORY SERVICES, REFERRALS TO SPECIALTY CARE, AND ACCESS TO PHARMACOLOGICAL SERVICES. | Description |
| Total Program Service Expense | 377971 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | false | 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 | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | 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 | true | 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 | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | false | Hospital |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | false | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| 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 |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 0 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 7 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| 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 |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 9 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 9 | 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 | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HUMAN RESOURCE COUNCIL INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 4067283710 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1801 S HIGGINS | AddressLine1 |
| City | MISSOULA | City |
| State | MT | State |
| ZIP Code | 59801 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | X | NoListedPersonsCompensated |
Form990 Part VII Section A Form990PartVIISectionA (9 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation |
|---|---|---|---|---|---|
| CARLOTTA GRANDSTAFF | |||||
| HAMILTON, MT | 1.00 | X | 0 | 0 | 0 |
| DIXIE STARK | |||||
| DARBY, MT | 1.00 | X | 0 | 0 | 0 |
| EDITH WARK | |||||
| STEVENSVILLE, MT | 1.00 | X | 0 | 0 | 0 |
| JAMES WALKER | |||||
| HAMILTON, MT | 1.00 | X | 0 | 0 | 0 |
| JERI DRAKE | |||||
| HAMILTON, MT | 1.00 | X | 0 | 0 | 0 |
| JIM MORTON | |||||
| MISSOULA, MT | 1.00 | X | 0 | 0 | 0 |
| KAREN TINNEY | |||||
| DARBY, MT | 1.00 | X | 0 | 0 | 0 |
| MARGARET ENNES | |||||
| HAMILTON, MT | 1.00 | X | 0 | 0 | 0 |
| PATTI NELSON | |||||
| HAMILTON, MT | 1.00 | 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 |
| Government Grants | 151458 | GovernmentGrants |
| All Other Contributions | 608 | AllOtherContributions |
| Total Contributions | 152066 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | HEALTH SERVICES | Description |
| Business Code | 621498 | BusinessCode |
| Total Revenue Column | 89838 | TotalRevenueColumn |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 89838 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 52 | TotalRevenueColumn |
| Exclusion | $52 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 9726 | Other |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 57350 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -47624 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -47624 | TotalRevenueColumn |
| Exclusion | -$47,624 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 194332 | TotalRevenueColumn |
| Related Or Exempt Function Income | 89838 | RelatedOrExemptFunctionIncome |
| Exclusion | -$47,572 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 182909 | Total |
| Program Services | 182245 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 664 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7424 | Total |
| Program Services | 7391 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 33 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 16215 | Total |
| Program Services | 16215 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 16671 | Total |
| Program Services | 16604 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 67 | Fundraising |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 21109 | Total |
| Program Services | 21109 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1005 | Total |
| Program Services | 1005 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4500 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 4500 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3692 | Total |
| Program Services | 3692 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13194 | Total |
| Program Services | 13194 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 42092 | Total |
| Program Services | 42092 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 513 | Total |
| Program Services | 513 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2606 | Total |
| Program Services | 2606 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 18220 | Total |
| Program Services | 18220 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 27126 | Total |
| Program Services | 27126 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| OUTREACH SERVICES | 1412 | 1412 | 0 | 0 |
| SUPPLIES AND LAB FEES | 22261 | 22261 | 0 | 0 |
| LICENSES | 45 | 45 | 0 | 0 |
| BAD DEBTS | 2241 | 2241 | 0 | 0 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 383235 | Total |
| Program Services | 377971 | ProgramServices |
| Management And General | 4500 | ManagementAndGeneral |
| Fundraising | 764 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 104675 | BOY |
| EOY | 47856 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 50797 | BOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 15475 | BOY |
| EOY | 471 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9500 | BOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7557 | BOY |
| EOY | 2359 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 40918 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 16367 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 100120 | BOY |
| EOY | 24551 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 288124 | BOY |
| EOY | 75237 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 25982 | BOY |
| EOY | 1998 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 25982 | BOY |
| EOY | 1998 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 262142 | BOY |
| EOY | 73239 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 262142 | BOY |
| EOY | 73239 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 288124 | BOY |
| EOY | 75237 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | -188903 | ReconcilationRevenueExpenses |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | false | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
| Public Support Total170 | 0 | PublicSupportTotal170 |
Gross Investment Income170 GrossInvestmentIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Pertcentage170 | 0 | PublicSupportPertcentage170 |
| Public Support Total509 | 0 | PublicSupportTotal509 |
| Public Support Percentage509 | 0 | PublicSupportPercentage509 |
| Investment Income Percentage | 0 | InvestmentIncomePercentage |
Schedule D IRS990ScheduleD
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 40918 | OtherCostOrOtherBasis |
| Depreciation | 16367 | Depreciation |
| Book Value | 24551 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 24551 | TotalOfBookValueLandBuildings |
| Total Revenue | 194332 | TotalRevenue |
| Total Expenses | 383235 | TotalExpenses |
| Excess Or Deficit For Year | -188903 | ExcessOrDeficitForYear |
| Excess Or Deficit Per FS | -188903 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 241956 | TotRevenueEtcAuditedFinclStmt |
| Other Revenues | 47624 | OtherRevenues |
| Revenue Not Rptd F990 | 47624 | RevenueNotRptdF990 |
| Revenue Subtotal | 194332 | RevenueSubtotal |
| Total Revenue Per Form990 | 194332 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 430859 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 47624 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 47624 | ExpensesNotRptdF990 |
| Expenses Subtotal | 383235 | ExpensesSubtotal |
| Total Expenses Per Form990 | 383235 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| Pt XII Line 2d | LOSS ON DISPOSAL OF ASSETS: $47,624 |
| Pt XIII Line 2d | LOSS ON DISPOSAL OF ASSETS: $47,624 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (19 entries)
| IdentifierIdentifier | ExplanationExplanation |
|---|---|
| Pt VI, Line 11a | THE ORGANIZATION PROVIDES A COPY OF THE DRAFT FORM 990 |
| TO BOARD MEMBERS FOR REVIEW PRIOR TO FILING. A DETAIL | |
| REVIEW IS CONDUCTED BY THE AGENCY FISCAL STAFF. | |
| Pt VI, Line 12c | THE BOARD OF DIRECTORS ANNUALLY REVIEWS ITS CONFLICT OF |
| INTEREST POLICIES. SHOULD A CONFLICT BE NOTED DURING | |
| A MEETING, THE MEMBER REPORTS THE CONFLICT AND EXCUSES | |
| THEMSELVES FROM FURTHER DISCUSSION OF THE MATTER. | |
| Pt VI, Line 15 | EMPLOYEE COMPENSATION IS DETERMINED BY THE BOARD OF DIRECTORS |
| BASED UPON PREVAILING WAGES FOR SIMILAR POSITIONS IN | |
| THE AREA AND PERFORMANCE. | |
| Pt III, Line 3 | THE AGENCY FORMALLY CLOSED OPERATIONS OF THE HEATH |
| CLINIC ON JUNE 30, 2011 DUE TO DELAY OF FEDERAL GRANT | |
| APPROPRIATIONS. AS OF THAT DATE, THE AGENCY IS CONSIDERED | |
| DORMANT UNTIL FUNDING IS SECURED TO CONTINUE OPERATIONS | |
| OF THE CLINIC | |
| Pt VI, Line 19 | THE AGENCY MAKES ITS GOVERNING DOCUMENTS, POLICIES, AND |
| FINANCIAL STATEMENTS AVAILABLE BY REQUEST. THE AGENCY'S | |
| FORM 990 IS AVAILABLE AT GUIDESTAR.ORG. | |
| Form 990, Part IX, Line 24f | OTHER MISCELLANEOUS |