FREE MEDICAL CLINIC OF OAK RIDGE INC: Form 990, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- FREE MEDICAL CLINIC OF OAK RIDGE INC (EIN 90-0715369)
- Tax period
- 2022-01-01 to 2022-12-31
- Filed
- 2024-03-19
- IRS object ID
- 202430799349300523
- Schema version
- 2022v5.0
- 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) |
|---|---|---|
| Return | 2024-03-19T12:48:39+00:00 | ReturnTs |
| Tax Period End | 2022-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 363990892 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Capin Crouse LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 345 Massachusetts Avenue Suite 300 | AddressLine1Txt |
| City | Indianapolis | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46204 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2022-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 900715369 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Free Medical Clinic of Oak Ridge | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | FREE | BusinessNameControlTxt |
| Phone | 8654833904 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 116 East Division Rd | AddressLine1Txt |
| City | Oak Ridge | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37830 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Billy Edmonds | PersonNm |
| Person Title | Executive Director | PersonTitleTxt |
| Phone | 8654833904 | PhoneNum |
| Signature | 2024-03-19 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | Billy | PersonFirstNm |
| Person Last | Edmonds | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | Yes (true) | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Daren Daiga | PreparerPersonNm |
| PTIN | P01074795 | PTIN |
| Phone | 5055022746 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2022 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
Principal Ofcr Business Name PrincipalOfcrBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Billy Edmonds | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 116 East Division Rd | AddressLine1Txt |
| City | Oak Ridge | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37830 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $1,995,566 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.fmcor.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2011 | FormationYr |
| Legal Domicile State | TN | LegalDomicileStateCd |
| Activity Or Mission | To provide no charge primary care to the low-income and uninsured residents of Anderson, Morgan, and Roane Counites of Tennessee and any partnership related to our medical programs. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 19 | TotalEmployeeCnt |
| Total Volunteers | 92 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $963,755 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,987,263 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $543 | PYInvestmentIncomeAmt |
| CY Investment Income | $2,896 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$2,215 | PYOtherRevenueAmt |
| CY Other Revenue | -$13,871 | CYOtherRevenueAmt |
| PY Total Revenue | $962,083 | PYTotalRevenueAmt |
| CY Total Revenue | $1,976,288 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $583,319 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $677,582 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $41,958 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $308,254 | PYOtherExpensesAmt |
| CY Other Expenses | $373,601 | CYOtherExpensesAmt |
| PY Total Expenses | $891,573 | PYTotalExpensesAmt |
| CY Total Expenses | $1,051,183 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $70,510 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $925,105 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $454,824 | TotalAssetsBOYAmt |
| Total Assets EOY | $1,569,029 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $0 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $30,952 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $454,824 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $1,538,077 | NetAssetsOrFundBalancesEOYAmt |
| Mission | To provide no charge primary care to the low-income and uninsured residents of Anderson, Morgan, and Roane counties of Tennessee and any partnership related to our medical programs. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $924,606 | ExpenseAmt |
| Revenue | $3,607 | RevenueAmt |
| Desc | In 2022, Free Medical Clinic of Oak Ridge (FMC) provided over 8,500 patients with primary, preventative, and specialty care, including diagnostics, vaccinations, immunizations, and medical events in our community to reach rural, minority, low-income, and uninsured residents in our service area. Total value of medical provided is estimated to be over 5,100,000. | Desc |
| Total Program Service Expenses | $924,606 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| 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 With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| 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 | 4 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 19 | 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 |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | 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 | false | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | false | WhistleblowerPolicyInd |
| Document Retention Policy | false | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | TN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Billy Edmonds | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8654833904 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 116 East Division Rd | AddressLine1Txt |
| City | Oak Ridge | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37830 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (11 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|
| Ben Stephens | ||||||
| Vice-President | 1.0 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| Carolyn Henderson | ||||||
| Treasurer | 3.0 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| Janis Williams | ||||||
| Secretary | 1.0 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| Stephen Whitson | ||||||
| President | 1.0 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| Angela Richardson | ||||||
| Member | 1.0 | Yes (X) | $0 | $0 | $0 | |
| Charlotte O'Neil | ||||||
| Member | 1.0 | Yes (X) | $0 | $0 | $0 | |
| Garfield Adams | ||||||
| Member | 1.0 | Yes (X) | $0 | $0 | $0 | |
| Karen Wilken | ||||||
| Member | 2.0 | Yes (X) | $0 | $0 | $0 | |
| Mireya Carnes | ||||||
| Member | 1.0 | Yes (X) | $0 | $0 | $0 | |
| Rick Carringer | ||||||
| Member | 1.0 | Yes (X) | $0 | $0 | $0 | |
| Billy J Edmonds Jr | ||||||
| Executive Director | 40.0 | Yes (X) | $91,611 | $0 | $7,546 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $91,611 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $7,546 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | false | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Federated Campaigns | $201,951 | FederatedCampaignsAmt |
| Fundraising | $120,596 | FundraisingAmt |
| Government Grants | $1,427,032 | GovernmentGrantsAmt |
| All Other Contributions | $237,684 | AllOtherContributionsAmt |
| Total Contributions | $1,987,263 | TotalContributionsAmt |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $0 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,896 | TotalRevenueColumnAmt |
| Exclusion | $2,896 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $1,800 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $1,800 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,800 | TotalRevenueColumnAmt |
| Exclusion | $1,800 | ExclusionAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $0 | OtherAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $120,596 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $19,278 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$19,278 | TotalRevenueColumnAmt |
| Exclusion | -$19,278 | ExclusionAmt |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,607 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,607 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $3,607 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,976,288 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,607 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$14,582 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $99,157 | TotalAmt |
| Program Services | $89,495 | ProgramServicesAmt |
| Management And General | $4,857 | ManagementAndGeneralAmt |
| Fundraising | $4,805 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $490,271 | TotalAmt |
| Program Services | $440,353 | ProgramServicesAmt |
| Management And General | $21,410 | ManagementAndGeneralAmt |
| Fundraising | $28,508 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,109 | TotalAmt |
| Program Services | $10,837 | ProgramServicesAmt |
| Management And General | $1,411 | ManagementAndGeneralAmt |
| Fundraising | $1,861 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $34,735 | TotalAmt |
| Program Services | $32,361 | ProgramServicesAmt |
| Management And General | $971 | ManagementAndGeneralAmt |
| Fundraising | $1,403 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $39,310 | TotalAmt |
| Program Services | $37,962 | ProgramServicesAmt |
| Management And General | $1,348 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,000 | TotalAmt |
| Management And General | $5,000 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,279 | TotalAmt |
| Program Services | $5,053 | ProgramServicesAmt |
| Management And General | $4,226 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,524 | TotalAmt |
| Management And General | $16,143 | ManagementAndGeneralAmt |
| Fundraising | $5,381 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,109 | TotalAmt |
| Program Services | $32,994 | ProgramServicesAmt |
| Management And General | $115 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,240 | TotalAmt |
| Program Services | $17,240 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $73,923 | TotalAmt |
| Program Services | $70,687 | ProgramServicesAmt |
| Management And General | $3,236 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,577 | TotalAmt |
| Program Services | $6,577 | ProgramServicesAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,468 | TotalAmt |
| Program Services | $1,468 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,332 | TotalAmt |
| Program Services | $16,465 | ProgramServicesAmt |
| Management And General | $867 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,395 | TotalAmt |
| Management And General | $14,395 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Covid vax outreach | $97,186 | $97,186 | |
| Donor management online fees | $27,275 | $24,407 | $2,868 |
| Volunteer support | $19,899 | $15,402 | $4,497 |
| Primary care medical | $20,877 | $20,877 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,517 | TotalAmt |
| Program Services | $5,242 | ProgramServicesAmt |
| Management And General | $3,275 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,051,183 | TotalAmt |
| Program Services | $924,606 | ProgramServicesAmt |
| Management And General | $84,619 | ManagementAndGeneralAmt |
| Fundraising | $41,958 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,195 | BOYAmt |
| EOY | $100,208 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $392,468 | BOYAmt |
| EOY | $834,163 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $313,582 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,076 | BOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $374,875 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $53,799 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $60,085 | BOYAmt |
| EOY | $321,076 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $454,824 | BOYAmt |
| EOY | $1,569,029 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $30,952 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $30,952 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $428,875 | BOYAmt |
| EOY | $1,204,495 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,949 | BOYAmt |
| EOY | $333,582 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $454,824 | BOYAmt |
| EOY | $1,538,077 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $454,824 | BOYAmt |
| EOY | $1,569,029 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $925,105 | ReconcilationRevenueExpnssAmt |
| Prior Period Adjustments | $158,148 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | $0 | 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) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $285,625 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $297,632 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $773,018 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $958,002 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,987,263 | CurrentTaxYearAmt |
| Total | $4,301,540 | TotalAmt |
Tax Rev Levied Orgnztnl Bnft170 TaxRevLeviedOrgnztnlBnft170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $285,625 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $297,632 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $773,018 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $958,002 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,987,263 | CurrentTaxYearAmt |
| Total | $4,301,540 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $0 | SubstantialContributorsTotAmt |
| Public Support Total170 | $4,301,540 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $565 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,227 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,253 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $543 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,696 | CurrentTaxYearAmt |
| Total | $10,284 | TotalAmt |
Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $97,727 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $83,445 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,595 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $7,403 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,607 | CurrentTaxYearAmt |
| Total | $195,777 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $4,507,601 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $0 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.9543 | PublicSupportCY170Pct |
| Public Support PY170 | 0.9024 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule A, Part II, Line 10 Other Income | FormAndLineReferenceDesc |
| Explanation | DESCRIPTION - MISCELLANEOUS INCOME, COLUMN A - 97727.0, COLUMN B - 83445.0, COLUMN C - 3595.0, COLUMN D - 7403.0, COLUMN E - 3607.0, COLUMN F - 195777.0; | ExplanationTxt |
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
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $14,977 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,992 | DepreciationAmt |
| Book Value | $9,985 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $87,375 | OtherCostOrOtherBasisAmt |
| Depreciation | $44,265 | DepreciationAmt |
| Book Value | $43,110 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $272,523 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,542 | DepreciationAmt |
| Book Value | $267,981 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $321,076 | TotalBookValueLandBuildingsAmt |
| Total Rev Etc Audited Fincl Stmt | $1,995,566 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | $19,278 | OtherRevenueAmt |
| Revenue Not Reported | $19,278 | RevenueNotReportedAmt |
| Revenue Subtotal | $1,976,288 | RevenueSubtotalAmt |
| Other Revenues Not Included | $0 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $1,976,288 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $1,070,461 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $19,278 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $19,278 | ExpensesNotReportedAmt |
| Expenses Subtotal | $1,051,183 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $0 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $1,051,183 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule D, Part XI, Line 2(d) Other revenues in audited financial statements not in form 990 | Fundraising event expenses - 19278 |
| Schedule D, Part XII, Line 2(d) Other expenses in audited financial statements not in form 990 | Fundraising event expenses - 19278 |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | The Bash | Event1Nm |
| Gross Receipts Event1 | $113,501 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $113,501 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $0 | GrossRevenueEvent1Amt |
| Food And Beverage Event1 | $6,668 | FoodAndBeverageEvent1Amt |
| Other Direct Expenses Event1 | $8,322 | OtherDirectExpensesEvent1Amt |
| Event2 | Golf Tournament | Event2Nm |
| Gross Receipts Event2 | $7,095 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $7,095 | CharitableContriEvent2Amt |
| Gross Revenue Event2 | $0 | GrossRevenueEvent2Amt |
| Other Direct Expenses Event2 | $4,288 | OtherDirectExpensesEvent2Amt |
| Gross Revenue Other Events | $0 | GrossRevenueOtherEventsAmt |
| Gross Receipts Total | $120,596 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $120,596 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $0 | GrossRevenueTotalEventsAmt |
| Food And Beverage Total Events | $6,668 | FoodAndBeverageTotalEventsAmt |
| Oth Direct Expnss Total Events | $12,610 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $19,278 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$19,278 | NetIncomeSummaryAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Line 15b | The organization does not compensate any other officers or key employees. Therefore, this line was answered no in accordance with the instructions. |
| Form 990, Part VI, Line 1a Delegate broad authority to a committee | The organization has an executive committee that consists of the President, Vice President, Treasurer, Secretary, and Medical Committee Lead. This committee's authority includes but is not limited to: Bylaws, policy review, board selection, and governing processes. |
| Form 990, Part VI, Line 11b Review of form 990 by governing body | Form 990 is prepared by an independent CPA firm and reviewed in detail by the executive committee. |
| Form 990, Part VI, Line 12c Conflict of interest policy | Board members and officers sign annual conflict of interest statements which are reviewed by the Board Chair and President. Should any potential conflicts of interest be disclosed, the board member or officer would be asked to refrain from participation in any deliberation or decision with regard to matters affected by the relationship. |
| Form 990, Part VI, Line 15a Process to establish compensation of top management official | The Executive Committee conducts an annual performance review. The Committee gathers information as from a variety of sources, self-evaluations, board evaluations, staff input, goals met, industry standards, compensation surveys, etc.) and prepares the evaluation report and compensation recommendation. The full board votes on the salary recommendation of the Executive Committee. A formal report is prepared for signature by the President and Board Chair. |
| Form 990, Part VI, Line 19 Required documents available to the public | The organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon request. |
| Form 990, Part VIII, Line 11d Other Miscellaneous Revenue | Miscellaneous income - Total Revenue: 3607, Related or Exempt Function Revenue: 3607, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ; |
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