BULLHOOK COMMUNITY HEALTH CENTER INC: Form 990, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- BULLHOOK COMMUNITY HEALTH CENTER INC (EIN 20-5970239)
- Tax period
- 2022-07-01 to 2023-06-30
- Filed
- 2024-03-28
- IRS object ID
- 202440889349301854
- 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 | 2024-03-28T16:57:31-05:00 | ReturnTs |
| Tax Period End | 2023-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 410746749 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10700 NORTHUP WAY SUITE 200 | AddressLine1Txt |
| City | BELLEVUE | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98004 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2022-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 205970239 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BULLHOOK COMMUNITY HEALTH CENTER INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | BULL | BusinessNameControlTxt |
| Phone | 4063954305 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 521 4TH STREET | AddressLine1Txt |
| City | HAVRE | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59501 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MICHAEL RAPPOLD | PersonNm |
| Person Title | BOARD CHAIR | PersonTitleTxt |
| Phone | 4063954305 | PhoneNum |
| Signature | 2024-03-18 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | MICHAEL | PersonFirstNm |
| Person Last | RAPPOLD | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | 0 | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KURT BENNION CPA | PreparerPersonNm |
| PTIN | P01469618 | PTIN |
| Phone | 4252506100 | PhoneNum |
| Preparation | 2024-03-18 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2022 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | KYNDRA HALL | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 521 4TH STREET | AddressLine1Txt |
| City | HAVRE | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59501 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $8,130,806 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.BULLHOOK.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2007 | FormationYr |
| Legal Domicile State | MT | LegalDomicileStateCd |
| Activity Or Mission | INSPIRING A HEALTHY COMMUNITY THROUGH PATIENT-CENTERED CARE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 12 | VotingMembersIndependentCnt |
| Total Employee | 78 | TotalEmployeeCnt |
| Total Volunteers | 16 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $2,625,819 | PYContributionsGrantsAmt |
| CY Contributions Grants | $3,443,555 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $4,521,926 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $4,424,768 | CYProgramServiceRevenueAmt |
| PY Investment Income | $16,599 | PYInvestmentIncomeAmt |
| CY Investment Income | $137,826 | CYInvestmentIncomeAmt |
| PY Other Revenue | $230,610 | PYOtherRevenueAmt |
| CY Other Revenue | $123,254 | CYOtherRevenueAmt |
| PY Total Revenue | $7,394,954 | PYTotalRevenueAmt |
| CY Total Revenue | $8,129,403 | 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 | $4,020,649 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $3,938,439 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $77 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $2,074,743 | PYOtherExpensesAmt |
| CY Other Expenses | $2,988,167 | CYOtherExpensesAmt |
| PY Total Expenses | $6,095,392 | PYTotalExpensesAmt |
| CY Total Expenses | $6,926,606 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,299,562 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,202,797 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $12,316,579 | TotalAssetsBOYAmt |
| Total Assets EOY | $13,593,299 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $396,383 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $470,306 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $11,920,196 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $13,122,993 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | INSPIRING A HEALTHY COMMUNITY THROUGH PATIENT-CENTERED CARE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $5,346,729 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $4,424,768 | RevenueAmt |
| Desc | BULLHOOK COMMUNITY HEALTH CENTER'S MISSION IS TO INSPIRE A HEALTHY COMMUNITY THROUGH PATIENT-CENTERED CARE.OUR VISION:- WE ARE A COMMUNITY LEADER IN HEALTHCARE.- PEOPLE TRUST US.- WE RESPECT ALL CULTURES.- WE ARE FINANCIALLY VIABLE.- WE ARE COMMITTED TO UTILIZING HEALTHCARE EFFICIENTLY.- OUR PROVIDERS ARE CHAMPIONS OF PATIENT-CENTERED CARE. - OUR STAFF IS COMPETENT, CARING AND HAPPY.(CONTINUED ON SCHEDULE O)BULLHOOK COMMUNITY HEALTH CENTER IS A FEDERALLY QUALIFIED HEALTH CENTER (FQHC). HEALTH CENTERS ARE IMPORTANT SAFETY NET PROVIDERS IN RURAL AND URBAN AREAS. IN ORDER TO QUALIFY AS A FQHC, AN ORGANIZATION MUST: 1. PROVIDE SERVICES TO ALL PERSONS, REGARDLESS OF THE PERSON'S ABILITY TO PAY;2. ESTABLISH A SLIDING FEE DISCOUNT PROGRAM;3. BE A NONPROFIT OR PUBLIC ORGANIZATION;4. BE COMMUNITY-BASED, WITH THE MAJORITY OF THEIR GOVERNING BOARD OF DIRECTORS COMPOSED OF THEIR PATIENTS;5. SERVE A MEDICALLY UNDERSERVED AREA OR POPULATION;6. PROVIDE COMPREHENSIVE PRIMARY CARE SERVICES; AND7. HAVE AN ONGOING QUALITY ASSURANCE PROGRAM.BULLHOOK COMMUNITY HEALTH CENTER'S COMMITMENT TO QUALITY CARE MAKES A DIFFERENCE IN THE LIVES OF THE COMMUNITY. OUR COMMITMENT STEMS FROM OUR GOAL TO PROVIDE COMPLETE HEALTHCARE FOR OUR PATIENTS AND THEIR FAMILIES, REGARDLESS OF ABILITY TO PAY. AS A CERTIFIED PATIENT CENTERED MEDICAL HOME (PCMH) WE PUT YOU, THE PATIENT, AT THE CENTER OF THE HEALTHCARE SYSTEM. OUR TEAM OF FAMILY PHYSICIANS AND FAMILY NURSE PRACTITIONERS, DENTISTS, PHARMACISTS, ADDICTION COUNSELORS, LICENSED CLINICAL SOCIAL WORKERS, AND THEIR STAFF, ARE TRAINED IN PROVIDING HEALTHCARE SERVICES TO PEOPLE OF ALL AGES. WE PROVIDE A WIDE RANGE OF SERVICES INCLUDING ROUTINE PREVENTATIVE CARE, INCLUDING IMMUNIZATIONS, EDUCATION, WELL CHILD CHECKS, AND MEN'S AND WOMEN'S HEALTH PHYSICALS, AS WELL AS MANAGEMENT OF ACUTE AND CHRONIC DISEASES, DENTAL CARE, MENTAL HEALTH COUNSELING, ADDICTION COUNSELING, AND PHARMACY SERVICES INCLUDING DIABETIC EDUCATION AND MEDICATION MANAGEMENT. WE PROVIDE THESE SERVICES TO ENSURE THAT OUR PATIENTS AND THEIR FAMILIES HAVE THE INFORMATION AND TOOLS NECESSARY TO TAKE CONTROL OF THEIR HEALTH AND INCREASE THEIR QUALITY OF LIFE.BULLHOOK HAS HELPED THROUGH THE COVID PANDEMIC IN PROVIDING COVID TESTING DRIVE-THROUGH EVENTS AND ON-SITE COVID TESTING FOR PATIENTS AND THOSE WHO HAVE BEEN IDENTIFIED THROUGH CONTRACT TRACING. BULLHOOK HAS ALSO PLAYED IN INTEGRAL PART IN GETTING VACCINATIONS OUT IN OUR COMMUNITY. WE PARTICIPATED IN SEVERAL MASS VACCINATION CLINICS AND ALSO OFFERED VACCINATIONS IN-HOUSE TO PATIENTS AND NON-PATIENTS ALIKE, THANKS TO VACCINATIONS SUPPLIED THROUGH THE STATE. | Desc |
| Total Program Service Expenses | $5,346,729 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 3 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 78 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 12 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MARIE GILLETT | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 4063954305 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 521 4TH STREET | AddressLine1Txt |
| City | HAVRE | CityNm |
| State Abbreviation | MT | StateAbbreviationCd |
| ZIP | 59501 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|
| DEE ALTHOUSE | |||||||
| PHYSICIAN | 40.00 | Yes (X) | $199,605 | $0 | $14,448 | ||
| KYNDRA HALL | |||||||
| CEO | 55.00 | $170,021 | $0 | $5,101 | Yes (X) | ||
| CRAIG KANESHIRO | |||||||
| DENTIST (THROUGH OCTOBER 2022) | 40.00 | Yes (X) | $155,188 | $0 | $13,116 | ||
| JAMES CONRAD KUSEL | |||||||
| CDO & DENTIST (THROUGH OCTOBER 2022) | 40.00 | Yes (X) | $152,228 | $0 | $13,027 | ||
| CINDY BRANDON | |||||||
| PHARMACIST | 40.00 | Yes (X) | $147,093 | $0 | $12,873 | ||
| DARIN MILLER | |||||||
| PHARMACIST | 40.00 | Yes (X) | $137,422 | $0 | $12,583 | ||
| MARIE GILLETT | |||||||
| CFO | 40.00 | $107,350 | $0 | $3,221 | Yes (X) | ||
| MICHAEL RAPPOLD | |||||||
| CHAIR | 2.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | |
| WILLIAM LANIER | |||||||
| VICE-CHAIR | 2.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | |
| DEBI RHINES | |||||||
| TREASURER | 2.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | |
| CAROL REIFSCHNEIDER | |||||||
| SECRETARY | 2.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | |
| BONNITA BERNHARDT | |||||||
| DIRECTOR | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| ASHLEY BIRDTAIN | |||||||
| DIRECTOR (THROUGH JULY 2022) | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| COREY CRAWFORD | |||||||
| DIRECTOR | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| JAMIE DUKE | |||||||
| DIRECTOR | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| BETH DURODOYE | |||||||
| DIRECTOR | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| JOHN KELLEHER | |||||||
| DIRECTOR | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| WILL RAWN | |||||||
| DIRECTOR (THROUGH JUNE 2023) | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| BRENDA SKORNOGOSKI | |||||||
| DIRECTOR | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| KRISTA SOLOMON | |||||||
| DIRECTOR | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| CAITLIN TESKE | |||||||
| DIRECTOR | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| JENNIFER THOMPSON | |||||||
| DIRECTOR (THROUGH JANUARY 2023) | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| FRANK ZUCCALA | |||||||
| DIRECTOR (THROUGH FEBRUARY 2023) | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,068,907 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $74,369 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 8 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ECLINICAL WORKS | BusinessNameLine1Txt |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 847950 | AddressLine1Txt |
| City | BOSTON | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 02284 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | ELECTRONIC MEDICAL RECORD SERVICES | ServicesDesc |
| Compensation | $109,900 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $4,604 | FundraisingAmt |
| Government Grants | $3,210,606 | GovernmentGrantsAmt |
| All Other Contributions | $228,345 | AllOtherContributionsAmt |
| Noncash Contributions | $15,000 | NoncashContributionsAmt |
| Total Contributions | $3,443,555 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICES | 621400 | $2,280,591 | $2,280,591 |
| PHARMACY REVENUE | 624100 | $2,144,177 | $2,144,177 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $4,424,768 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $137,826 | TotalRevenueColumnAmt |
| Exclusion | $137,826 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $4,604 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $1,403 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$1,403 | TotalRevenueColumnAmt |
| Exclusion | -$1,403 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS INCOME | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $124,657 | TotalRevenueColumnAmt |
| Exclusion | $124,657 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $124,657 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $8,129,403 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $4,424,768 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $261,080 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $292,613 | TotalAmt |
| Management And General | $292,613 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,932,574 | TotalAmt |
| Program Services | $2,427,030 | ProgramServicesAmt |
| Management And General | $505,544 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $75,359 | TotalAmt |
| Program Services | $62,155 | ProgramServicesAmt |
| Management And General | $13,204 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $382,792 | TotalAmt |
| Program Services | $284,324 | ProgramServicesAmt |
| Management And General | $98,468 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $255,101 | TotalAmt |
| Program Services | $189,480 | ProgramServicesAmt |
| Management And General | $65,621 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $50,688 | TotalAmt |
| Management And General | $50,688 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,200 | TotalAmt |
| Management And General | $18,200 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $772,233 | TotalAmt |
| Program Services | $490,960 | ProgramServicesAmt |
| Management And General | $281,273 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $245,985 | TotalAmt |
| Program Services | $229,079 | ProgramServicesAmt |
| Management And General | $16,906 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $76,436 | TotalAmt |
| Program Services | $10,113 | ProgramServicesAmt |
| Management And General | $66,323 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,575 | TotalAmt |
| Program Services | $12,575 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $68,975 | TotalAmt |
| Program Services | $43,326 | ProgramServicesAmt |
| Management And General | $25,649 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,178 | TotalAmt |
| Program Services | $2,756 | ProgramServicesAmt |
| Management And General | $422 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $77,444 | TotalAmt |
| Program Services | $67,154 | ProgramServicesAmt |
| Management And General | $10,290 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $334,884 | TotalAmt |
| Program Services | $267,907 | ProgramServicesAmt |
| Management And General | $66,977 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $51,770 | TotalAmt |
| Management And General | $51,770 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | FundraisingFundraisingAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|---|
| MEDICAL SUPPLIES | $1,122,150 | $1,122,073 | $77 | |
| MAINTENANCE | $78,733 | $62,986 | $15,747 | |
| DUES & SUBSCRIPTIONS | $68,853 | $68,748 | $105 | |
| MISCELLANEOUS EXPENSES | $6,063 | $6,063 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,926,606 | TotalAmt |
| Program Services | $5,346,729 | ProgramServicesAmt |
| Management And General | $1,579,800 | ManagementAndGeneralAmt |
| Fundraising | $77 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $93,249 | BOYAmt |
| EOY | $205,368 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,338,108 | BOYAmt |
| EOY | $6,771,486 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $289,503 | BOYAmt |
| EOY | $266,929 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $212,080 | BOYAmt |
| EOY | $277,938 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,575 | BOYAmt |
| EOY | $8,669 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $8,714,028 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $2,738,583 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,276,139 | BOYAmt |
| EOY | $5,975,445 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $86,925 | BOYAmt |
| EOY | $87,464 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,316,579 | BOYAmt |
| EOY | $13,593,299 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $396,383 | BOYAmt |
| EOY | $470,306 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $396,383 | BOYAmt |
| EOY | $470,306 | 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 | $11,913,419 | BOYAmt |
| EOY | $13,106,505 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,777 | BOYAmt |
| EOY | $16,488 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,920,196 | BOYAmt |
| EOY | $13,122,993 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,316,579 | BOYAmt |
| EOY | $13,593,299 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $1,202,797 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | 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 (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,311,869 | OtherCostOrOtherBasisAmt |
| Book Value | $1,311,869 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,360,891 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,921,024 | DepreciationAmt |
| Book Value | $3,439,867 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,041,268 | OtherCostOrOtherBasisAmt |
| Depreciation | $817,559 | DepreciationAmt |
| Book Value | $1,223,709 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $5,975,445 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $7,984,145 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | $2,566 | OtherRevenueAmt |
| Revenue Not Reported | $2,566 | RevenueNotReportedAmt |
| Revenue Subtotal | $7,981,579 | RevenueSubtotalAmt |
| Other Revenues Not Included | $147,824 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $147,824 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $8,129,403 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $6,929,172 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $2,566 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $2,566 | ExpensesNotReportedAmt |
| Expenses Subtotal | $6,926,606 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $6,926,606 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | THE CLINIC IS TAX-EXEMPT FROM FEDERAL AND STATE INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC) AND COMPARABLE STATE LAW. ACCORDINGLY, NO PROVISION FOR INCOME TAX IS INCLUDED IN THE FINANCIAL STATEMENTS. MANAGEMENT EVALUATED THE CLINIC'S TAX POSITIONS AND CONCLUDED THAT THE CLINIC HAD TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENTS TO THE FINANCIAL STATEMENTS TO COMPLY WITH THE PROVISIONS OF TOPIC 740 OF THE ACCOUNTING STANDARDS CODIFICATION. THE CLINIC'S FEDERAL EXEMPT ORGANIZATION INCOME TAX RETURNS (FORM 990) ARE SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE, GENERALLY FOR THREE YEARS AFTER THEY WERE FILED. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | FUNDRAISING EVENT EXPENSES 1,403. PATIENT ASSISTANCE 1,163. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | INTEREST INCOME 137,824. CONTRIBUTIONS WITH DONOR RESTRICTIONS 10,000. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | PATIENT ASSISTANCE 1,163. FUNDRAISING EVENT EXPENSES 1,403. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DEE ALTHOUSE | ||||||||||||||
| PHYSICIAN | $199,605 | $0 | $0 | $0 | $0 | $0 | $5,988 | $0 | $8,460 | $0 | $214,053 | $0 | $0 | $0 |
| KYNDRA HALL | ||||||||||||||
| CEO | $170,021 | $0 | $0 | $0 | $0 | $0 | $5,101 | $0 | $0 | $0 | $175,122 | $0 | $0 | $0 |
| CRAIG KANESHIRO | ||||||||||||||
| DENTIST (THROUGH OCTOBER 2022) | $155,188 | $0 | $0 | $0 | $0 | $0 | $4,656 | $0 | $8,460 | $0 | $168,304 | $0 | $0 | $0 |
| JAMES CONRAD KUSEL | ||||||||||||||
| CDO & DENTIST (THROUGH OCTOBER 2022) | $152,228 | $0 | $0 | $0 | $0 | $0 | $4,567 | $0 | $8,460 | $0 | $165,255 | $0 | $0 | $0 |
| CINDY BRANDON | ||||||||||||||
| PHARMACIST | $147,093 | $0 | $0 | $0 | $0 | $0 | $4,413 | $0 | $8,460 | $0 | $159,966 | $0 | $0 | $0 |
| DARIN MILLER | ||||||||||||||
| PHARMACIST | $137,422 | $0 | $0 | $0 | $0 | $0 | $4,123 | $0 | $8,460 | $0 | $150,005 | $0 | $0 | $0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 1A | THE EXECUTIVE COMMITTEE CONSISTS OF THE OFFICERS OF THE BOARD OF DIRECTORS AND THE PAST-CHAIR IF THEY REMAIN A CURRENT BOARD MEMBER. THE EXECUTIVE COMMITTEE CONVENES AS NECESSARY AND, UNDER THE DIRECTION OF THE BOARD, ACTS FOR THE ORGANIZATION IN ALL MATTERS DURING THE INTERIM PERIOD BETWEEN BOARD MEETINGS. THE EXECUTIVE COMMITTEE CONDUCTS THE PRELIMINARY EVALUATION OF THE CEO AND MAKES RECOMMENDATIONS TO THE FULL BOARD ACCORDINGLY. |
| FORM 990, PART VI, SECTION B, LINE 11B | PRIOR TO FILING, THE FORM 990 WAS REVIEWED BY THE ORGANIZATION'S CFO AND CEO, BY THE FINANCE COMMITTEE, AND BY THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION'S CONFLICT OF INTEREST POLICY APPLIES TO ALL BOARD MEMBERS, MEMBERS OF A COMMITTEE WITH BOARD-DELEGATED POWERS, AND OFFICERS. IF A PERSON HAS AN ACTUAL OR POTENTIAL CONFLICT, THEY DISCLOSE ITS EXISTENCE AND ALL MATERIAL FACTS. THAT INDIVIDAUL THEN LEAVES THE MEETING WHILE THE REMAINING INDIVIDUALS VOTE ON WHETHER A CONFLIC EXISTS. IF A CONFLICT EXISTS, THE BOARD OR A COMMITTEE TAKES APPROPRIATE STEPS TO DETERMINE WHETHER THE TRANSACTION WOULD BE IN THE ORGANIZATION'S BEST INTEREST. IF NO BETTER TRANSACTION CAN BE IDENTIFIED, THE DISINTERESTED BOARD OF COMMITTEE MEMBERS VOTE ON WHETHER TO ENTER THE TRANSACTION. IF AN INDIVIDUAL VIOLATES THE CONFLICT OF INTEREST POLICY, THE BOARD OF DIRECTORS WILL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTIONS. EACH INDIVIDUAL IS REQUIRED TO SIGN A STATEMENT WHEN THEY ARE ELECTED OR APPOINTED TO THE POSITION. PERIODIC REVIEWS ARE CONDUCTED. |
| FORM 990, PART VI, SECTION B, LINE 15A | TO EVALUATE THE CEO'S COMPENSATION, THE BOARD OF DIRECTORS REVIEWS THE CHAMPS SALARY SURVERY. THE PROCESS AND CONCLUSIONS ARE DOCUMENTED. THE REVIEW PROCESS LAST OCCURED IN 2023. TO EVALUATE THE OTHER OFFICERS' COMPENSATION, THE CEO REVIEWS THE CHAMPS SALARY SURVEY. THE PROCESS AND CONCLUSIONS ARE DOCUMENTED. THE REVIEW PROCESS LAST OCCURRED IN 2023. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S MAIN OFFICE. |
| FORM 990, PART IX, LINE 11G | OTHER SERVICES: PROGRAM SERVICE EXPENSES 490,960. MANAGEMENT AND GENERAL EXPENSES 281,273. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 772,233. |