MERCY HEALTH SERVICES INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- MERCY HEALTH SERVICES INC (EIN 62-1781969)
- Tax period
- 2021-07-01 to 2022-06-30
- Filed
- 2023-03-30
- IRS object ID
- 202310899349300331
- Schema version
- 2021v4.2
- 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) |
|---|---|---|
| Return | 2023-03-30T12:13:08-05:00 | ReturnTs |
| Tax Period End | 2022-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 882730877 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHERRY BEKAERT ADVISORY LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 222 SECOND AVE SOUTH STE 1240 | AddressLine1Txt |
| City | NASHVILLE | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37201 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 621781969 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MERCY HEALTH SERVICES INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MERC | BusinessNameControlTxt |
| Phone | 6157900567 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1113 MURFREESBORO ROAD 319 | AddressLine1Txt |
| City | FRANKLIN | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37064 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | RHONDA SIZEMORE | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 6157900567 | PhoneNum |
| Signature | 2023-03-29 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | RHONDA | PersonFirstNm |
| Person Last | SIZEMORE | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | LAUREN MOSES | PreparerPersonNm |
| PTIN | P02156583 | PTIN |
| Phone | 6153836592 | PhoneNum |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | CINDY SILER | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1113 MURFREESBORO ROAD 319 | AddressLine1Txt |
| City | FRANKLIN | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37064 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $16,634,871 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.MERCYCOMMUNITYHEALTHCARE.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1999 | FormationYr |
| Legal Domicile State | TN | LegalDomicileStateCd |
| Activity Or Mission | MERCY HEALTH SERVICES, INC. REFLECTS THE LOVE OF JESUS CHRIST BY PROVIDING QUALITY HEALTHCARE TO THE INSURED AND UNINSURED. | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 14 | VotingMembersIndependentCnt |
| Total Employee | 229 | TotalEmployeeCnt |
| Total Volunteers | 25 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $6,637,682 | PYContributionsGrantsAmt |
| CY Contributions Grants | $6,274,916 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $9,211,794 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $10,103,572 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | $16,724 | CYInvestmentIncomeAmt |
| PY Other Revenue | $58,085 | PYOtherRevenueAmt |
| CY Other Revenue | $117,641 | CYOtherRevenueAmt |
| PY Total Revenue | $15,907,561 | PYTotalRevenueAmt |
| CY Total Revenue | $16,512,853 | 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 | $8,555,808 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $9,699,942 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $779,709 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $2,633,511 | PYOtherExpensesAmt |
| CY Other Expenses | $3,316,162 | CYOtherExpensesAmt |
| PY Total Expenses | $11,189,319 | PYTotalExpensesAmt |
| CY Total Expenses | $13,016,104 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $4,718,242 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $3,496,749 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $9,222,485 | TotalAssetsBOYAmt |
| Total Assets EOY | $12,768,568 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,015,349 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,595,661 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $8,207,136 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $11,172,907 | NetAssetsOrFundBalancesEOYAmt |
| Mission | MERCY HEALTH SERVICES, INC. REFLECTS THE LOVE OF JESUS CHRIST BY PROVIDING QUALITY HEALTHCARE TO THE INSURED AND UNINSURED SERVING WILLIAMSON COUNTY AND SURROUNDING COUNTIES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $5,899,453 | ExpenseAmt |
| Revenue | $6,935,569 | RevenueAmt |
| Desc | MERCY'S FRANKLIN CLINIC IS OPEN 6 DAYS A WEEK (MONDAY-SATURDAY) AND PROVIDES GENERAL MEDICAL SERVICES FOR CHILDREN AND ADULTS, INCLUDING ANNUAL PHYSICALS, WALK-IN APPOINTMENTS, AND VACCINATIONS (INCLUDING COVID-19). THE FRANKLIN CLINIC ALSO PROVIDES COUNSELING, PSYCHIATRY AND BEHAVIORAL HEALTH SERVICES FOR PATIENTS. THE CLINIC ALSO HAS A CARE COORDINATION DEPARTMENT THAT ASSIST PATIENTS IN OVERCOMING BARRIERS TO HEALTHCARE, SUCH AS OBTAINING INSURANCE, FINDING TRANSPORTATION AND NAVIGATING REFERRALS. IN THE 2021-2022 FISCAL YEAR THE FRANKLIN CLINIC SAW A TOTAL OF 12,860 UNIQUE PATIENTS AND 62,877 TOTAL VISITS. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,952,880 | ExpenseAmt |
| Revenue | $1,989,466 | RevenueAmt |
| Desc | MERCY'S SCHOOL-BASED COUNSELING PROGRAM IS OPERATING IN 17 SCHOOLS ACROSS WILLIAMSON AND MARSHALL COUNTIES. THE 2021-2022 FISCAL YEAR OUR COUNSELORS SAW, 443 UNIQUE PATIENTS AND 12,769 TOTAL VISITS. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,323,173 | ExpenseAmt |
| Revenue | $1,178,537 | RevenueAmt |
| Desc | MERCY'S LEWISBURG CLINIC WAS IN ITS SECOND FULL YEAR OF OPERATION FOR THE 2021-2022 FISCAL YEAR AND CONTINUED GROWING DESPITE THE LINGERING AFFECTS OF THE PANDEMIC. THE LEWISBURG CLINIC IS OPEN 5 DAYS A WEEK (MONDAY-FRIDAY) AND OFFERS GENERAL MEDICAL SERVICES FOR BOTH CHILDREN AND ADULTS, AS WELL AS COUNSELING SERVICES (BOTH ON-SITE AND VIA TELEHEALTH). THE LEWISBURG CLINIC SAW 1,515 UNIQUE PATIENTS AND 6,050 TOTAL VISITS. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $9,175,506 | 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 | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | 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 | Yes (1) | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | 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 | Yes (1) | 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 | 40 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 229 | 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 | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| 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 | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 14 | 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 | 0 | MinutesOfCommitteesInd |
| Officer Mailing Address | Yes (1) | 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 | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | 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 | RHONDA SIZEMORE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6157900567 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1113 MURFREESBORO ROAD STE 319 | AddressLine1Txt |
| City | FRANKLIN | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37064 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (26 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| VALERIE WILSON | ||||||||
| CHAIR | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| MIKE REN | ||||||||
| VICE CHAIR | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| JANE ALLEN | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| ROBIN BALDREE | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| PHIL CLARK | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| LACRETIA CROSBY | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| TANIA DAVILA | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| GONZALO ELORZA | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| HERBERT JOHNSON | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| DORIS MCMILLAN | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| NALAKA MENDIS | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| CHRISTIAN NELSON | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| LINDA NORMAN | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JULIA STUMP | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| CINDY SILER | ||||||||
| CEO | 40.00 | Yes (X) | $155,345 | $0 | $14,517 | |||
| WILLIAM GIBSON | ||||||||
| CMO | 40.00 | Yes (X) | $276,211 | $0 | $2,128 | |||
| MARGARET OWENS | ||||||||
| CCO | 16.00 | Yes (X) | $59,796 | $0 | $7,899 | |||
| MARI GARNER | ||||||||
| COO | 40.00 | Yes (X) | $91,016 | $0 | $21,525 | |||
| DOROTHY BULLARD | ||||||||
| CAO | 40.00 | Yes (X) | $103,478 | $0 | $6,788 | |||
| RHONDA SIZEMORE | ||||||||
| CFO | 40.00 | Yes (X) | $108,457 | $0 | $16,976 | |||
| JON BOYE | ||||||||
| CBHO | 40.00 | Yes (X) | $122,185 | $0 | $23,057 | |||
| ALEXANDER BRUNNER | ||||||||
| PHYSICIAN | 32.00 | $177,038 | $0 | $20,602 | Yes (X) | |||
| ANNE FOTTRELL | ||||||||
| PSCHIATRIST | 8.00 | $146,642 | $0 | $9,220 | Yes (X) | |||
| DENNA BROWN | ||||||||
| PEDIATRICIAN | 32.00 | $109,408 | $0 | $14,320 | Yes (X) | |||
| AMY VEHEC | ||||||||
| PEDIATRICIAN | 32.00 | $107,413 | $0 | $5,709 | Yes (X) | |||
| SAM PARIS | ||||||||
| PEDIATRIC NP | 32.00 | $101,937 | $0 | $14,755 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,558,926 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $157,496 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 10 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $179,360 | FundraisingAmt |
| Government Grants | $3,446,916 | GovernmentGrantsAmt |
| All Other Contributions | $2,648,640 | AllOtherContributionsAmt |
| Noncash Contributions | $70,523 | NoncashContributionsAmt |
| Total Contributions | $6,274,916 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | SERVICE REVENUE | Desc |
| Business | 624100 | BusinessCd |
| Total Revenue Column | $10,103,572 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $10,103,572 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $10,103,572 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $16,724 | TotalRevenueColumnAmt |
| Exclusion | $16,724 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $173,625 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $179,360 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $122,018 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $51,607 | TotalRevenueColumnAmt |
| Exclusion | $51,607 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $66,034 | TotalRevenueColumnAmt |
| Exclusion | $66,034 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $66,034 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $16,512,853 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $10,103,572 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $134,365 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,189,450 | TotalAmt |
| Program Services | $366,263 | ProgramServicesAmt |
| Management And General | $706,889 | ManagementAndGeneralAmt |
| Fundraising | $116,298 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,074,651 | TotalAmt |
| Program Services | $5,584,840 | ProgramServicesAmt |
| Management And General | $1,220,850 | ManagementAndGeneralAmt |
| Fundraising | $268,961 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $57,996 | TotalAmt |
| Program Services | $44,640 | ProgramServicesAmt |
| Management And General | $11,032 | ManagementAndGeneralAmt |
| Fundraising | $2,324 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $799,406 | TotalAmt |
| Program Services | $615,305 | ProgramServicesAmt |
| Management And General | $152,065 | ManagementAndGeneralAmt |
| Fundraising | $32,036 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $578,439 | TotalAmt |
| Program Services | $428,584 | ProgramServicesAmt |
| Management And General | $121,830 | ManagementAndGeneralAmt |
| Fundraising | $28,025 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $295,384 | TotalAmt |
| Program Services | $94,758 | ProgramServicesAmt |
| Management And General | $199,964 | ManagementAndGeneralAmt |
| Fundraising | $662 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $201,820 | TotalAmt |
| Program Services | $1,240 | ProgramServicesAmt |
| Fundraising | $200,580 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $296,734 | TotalAmt |
| Program Services | $148,712 | ProgramServicesAmt |
| Management And General | $126,660 | ManagementAndGeneralAmt |
| Fundraising | $21,362 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $617,383 | TotalAmt |
| Program Services | $500,603 | ProgramServicesAmt |
| Management And General | $108,775 | ManagementAndGeneralAmt |
| Fundraising | $8,005 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $511,467 | TotalAmt |
| Program Services | $418,249 | ProgramServicesAmt |
| Management And General | $37,074 | ManagementAndGeneralAmt |
| Fundraising | $56,144 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,222 | TotalAmt |
| Program Services | $5,536 | ProgramServicesAmt |
| Management And General | $4,488 | ManagementAndGeneralAmt |
| Fundraising | $198 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $150,872 | TotalAmt |
| Management And General | $150,872 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $73,594 | TotalAmt |
| Program Services | $50,573 | ProgramServicesAmt |
| Management And General | $22,771 | ManagementAndGeneralAmt |
| Fundraising | $250 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| MEDICAL SUPPLIES | $493,945 | $484,546 | $9,399 | |
| REPAIRS & MAINTENANCE | $159,937 | $116,300 | $34,526 | $9,111 |
| CONTRACT LABOR | $119,920 | $56,134 | $63,786 | |
| BAD DEBT EXPENSE | $100,982 | $100,564 | $418 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $283,902 | TotalAmt |
| Program Services | $158,659 | ProgramServicesAmt |
| Management And General | $89,490 | ManagementAndGeneralAmt |
| Fundraising | $35,753 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,016,104 | TotalAmt |
| Program Services | $9,175,506 | ProgramServicesAmt |
| Management And General | $3,060,889 | ManagementAndGeneralAmt |
| Fundraising | $779,709 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $405,721 | BOYAmt |
| EOY | $175,159 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,280,024 | BOYAmt |
| EOY | $4,737,609 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $50,000 | BOYAmt |
| EOY | $181,990 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,239,810 | BOYAmt |
| EOY | $2,462,114 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $42,845 | BOYAmt |
| EOY | $91,588 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $6,566,972 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,454,979 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,195,970 | BOYAmt |
| EOY | $5,111,993 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,115 | BOYAmt |
| EOY | $8,115 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,222,485 | BOYAmt |
| EOY | $12,768,568 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $924,870 | BOYAmt |
| EOY | $1,578,166 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $47,106 | BOYAmt |
| EOY | $8,820 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $43,373 | BOYAmt |
| EOY | $8,675 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,015,349 | BOYAmt |
| EOY | $1,595,661 | 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 | $8,157,136 | BOYAmt |
| EOY | $10,990,917 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $50,000 | BOYAmt |
| EOY | $181,990 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,207,136 | BOYAmt |
| EOY | $11,172,907 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,222,485 | BOYAmt |
| EOY | $12,768,568 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $3,496,749 | ReconcilationRevenueExpnssAmt |
| Prior Period Adjustments | -$530,978 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| 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) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,692,403 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,242,933 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,743,034 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $6,637,682 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $6,274,916 | CurrentTaxYearAmt |
| Total | $21,590,968 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,692,403 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,242,933 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,743,034 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $6,637,682 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $6,274,916 | CurrentTaxYearAmt |
| Total | $21,590,968 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $66,799 | SubstantialContributorsTotAmt |
| Public Support Total170 | $21,524,169 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,505 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year | $16,724 | CurrentTaxYearAmt |
| Total | $18,229 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $98,748 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $22,885 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $74,659 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $29,937 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $66,034 | CurrentTaxYearAmt |
| Total | $292,263 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $21,901,460 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $41,049,590 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.98280 | PublicSupportCY170Pct |
| Public Support PY170 | 0.97600 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
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 | $2,400,000 | OtherCostOrOtherBasisAmt |
| Book Value | $2,400,000 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,420,194 | OtherCostOrOtherBasisAmt |
| Depreciation | $804,179 | DepreciationAmt |
| Book Value | $616,015 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $958,019 | OtherCostOrOtherBasisAmt |
| Depreciation | $559,527 | DepreciationAmt |
| Book Value | $398,492 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,788,759 | OtherCostOrOtherBasisAmt |
| Depreciation | $91,273 | DepreciationAmt |
| Book Value | $1,697,486 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $5,111,993 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DEFERRED LEASE LIABILITY | Desc |
| Amt | $8,675 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $8,675 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $16,664,365 | TotalRevEtcAuditedFinclStmtAmt |
| Donated Services And Use Fclts | $29,494 | DonatedServicesAndUseFcltsAmt |
| Other Revenue | $122,018 | OtherRevenueAmt |
| Revenue Not Reported | $151,512 | RevenueNotReportedAmt |
| Revenue Subtotal | $16,512,853 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $16,512,853 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $13,167,616 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $29,494 | DonatedServicesUseFcltsAmt |
| Other Expenses Included | $122,018 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $151,512 | ExpensesNotReportedAmt |
| Expenses Subtotal | $13,016,104 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $13,016,104 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | SPECIAL EVENT EXPENSES 122,018. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | SPECIAL EVENT EXPENSES 122,018. |
Schedule G IRS990ScheduleG
| Field | Value | IRS element (for citing) |
|---|---|---|
| Special Fundraising Events | Yes (X) | SpecialFundraisingEventsInd |
| Agrmt Prof Fundraising Acty | Yes (1) | AgrmtProfFundraisingActyInd |
Fundraiser Activity Info FundraiserActivityInfoGrp
Organization Business Name OrganizationBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LIGHTHOUSE COUNSEL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 381 RIVERSIDE DR 190 | AddressLine1Txt |
| City | FRANKLIN | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37064 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activity | CAPITAL CAMPAIGN CONSULTING | ActivityTxt |
| Fundraiser Control Of Funds | 0 | FundraiserControlOfFundsInd |
| Gross Receipts | $1,356,442 | GrossReceiptsAmt |
| Retained By Contractor | $145,000 | RetainedByContractorAmt |
| Net To Organization | $1,211,442 | NetToOrganizationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Gross Receipts | $1,356,442 | TotalGrossReceiptsAmt |
| Total Retained By Contractors | $145,000 | TotalRetainedByContractorsAmt |
| Total Net To Organization | $1,211,442 | TotalNetToOrganizationAmt |
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | FRANKLIN CLASSIC | Event1Nm |
| Gross Receipts Event1 | $172,760 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $103,260 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $69,500 | GrossRevenueEvent1Amt |
| Other Direct Expenses Event1 | $56,052 | OtherDirectExpensesEvent1Amt |
| Event2 | PRAYER DINNER | Event2Nm |
| Gross Receipts Event2 | $52,166 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $16,791 | CharitableContriEvent2Amt |
| Gross Revenue Event2 | $35,375 | GrossRevenueEvent2Amt |
| Other Direct Expenses Event2 | $9,371 | OtherDirectExpensesEvent2Amt |
| Other Events Total | 2 | OtherEventsTotalCnt |
| Gross Receipts Other Events | $128,059 | GrossReceiptsOtherEventsAmt |
| Charitable Contri Other Events | $59,309 | CharitableContriOtherEventsAmt |
| Gross Revenue Other Events | $68,750 | GrossRevenueOtherEventsAmt |
| Oth Direct Expnss Other Events | $56,595 | OthDirectExpnssOtherEventsAmt |
| Gross Receipts Total | $352,985 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $179,360 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $173,625 | GrossRevenueTotalEventsAmt |
| Oth Direct Expnss Total Events | $122,018 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $122,018 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $51,607 | NetIncomeSummaryAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 (4 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| WILLIAM GIBSON | ||||||||||||||
| CMO | $275,000 | $0 | $1,211 | $0 | $0 | $0 | $2,128 | $0 | $0 | $0 | $278,339 | $0 | $0 | $0 |
| ALEXANDER BRUNNER | ||||||||||||||
| PHYSICIAN | $175,835 | $0 | $1,203 | $0 | $0 | $0 | $0 | $0 | $20,602 | $0 | $197,640 | $0 | $0 | $0 |
| CINDY SILER | ||||||||||||||
| CEO | $140,122 | $0 | $15,223 | $0 | $0 | $0 | $2,831 | $0 | $11,686 | $0 | $169,862 | $0 | $0 | $0 |
| ANNE FOTTRELL | ||||||||||||||
| PSCHIATRIST | $145,417 | $0 | $1,225 | $0 | $0 | $0 | $2,432 | $0 | $6,788 | $0 | $155,862 | $0 | $0 | $0 |
Schedule M IRS990ScheduleM
Food Inventory FoodInventoryGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 23 | ContributionCnt |
| Noncash Contributions Rpt F990 | $16,560 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenuesTxt |
Other Non Cash Contri Table OtherNonCashContriTableGrp (3 entries)
| Non Cash CheckboxNonCashCheckboxInd | DescDesc | ContributionContributionCnt | Noncash Contributions Rpt F990NoncashContributionsRptF990Amt | Method Of Determining RevenuesMethodOfDeterminingRevenuesTxt |
|---|---|---|---|---|
| Yes (X) | OTHER ITEMS | 23 | $23,241 | FMV |
| Yes (X) | AUCTION ITEMS | 49 | $19,383 | FMV |
| Yes (X) | FURNITURE | 1 | $11,340 | FMV |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 8B | N/A - THERE ARE NO COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. |
| FORM 990, PART VI, SECTION B, LINE 11B | A DRAFT OF FORM 990 WILL BE SENT ELECTRONICALLY TO THE BOARD OF DIRECTORS PRIOR TO FILING. ADDITIONALLY, IT IS REVIEWED IN DETAIL BY THE EXECUTIVE COMMITTEE WHICH REPORTS ITS FINDINGS TO THE FULL BOARD. |
| FORM 990, PART VI, SECTION B, LINE 12C | POLICIES AND PROCEDURES FOR ALL PROCUREMENT ARE IN PLACE TO DISCOVER ANY POTENTIAL CONFLICTS OF INTEREST FOR ALL PURCHASES AND CONTRACTS. ANNUALLY FORMS ARE SIGNED TO STATE THERE IS NO CONFLICT OF INTEREST. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE COMPENSATION OF THE CEO IS REVIEWED AND DETERMINED EACH YEAR BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS OF MERCY. PRIMARILY, THE COMMITTEE USES THE COMPENSATION REPORT DONE EVERY TWO YEARS BY THE TENNESSEE PRIMARY CARE ASSOCIATION OF ALL THE FEDERALLY QUALIFIED HEALTH CENTERS IN TENNESSEE. THIS REPORT IS VERY HELPFUL IN COMPARING THE BUDGET SIZES, PATIENT ENCOUNTER NUMBERS, AND STAFFING SIZES OF THESE CENTERS IN ORDER TO REACH A COMPETITIVE SALARY RANGE. THE REMAINDER OF THE TOP MANAGEMENT OFFICIALS' COMPENSATION IS DETERMINED, PRIMARILY USING THE SAME COMPENSATION REPORT BY THE CEO OF MERCY. EACH YEAR, BUDGET PERMITTING, A COST OF LIVING RAISE IS IMPLEMENTED. |
| FORM 990, PART VI, SECTION C, LINE 19 | DOCUMENTS ARE MADE AVAILABLE UPON REQUEST. |
| FORM 990, PART VII CONTACT ADDRESSES FOR OFFICERS, DIRECTORS, ETC | MARI GARNER - 7102 DONALD WILSON DR, FAIRVIEW, TN 37062. JON BOYE - 5710 QUEST RIDGE RD, FRANKLIN, TN 37064. |
| FROM 990, PART XI, LINE 8 | EFFECTIVE JULY 1, 2020, THE ORGANIZATION RESTATED ACCRUED LIABILITIES AND NET ASSETS BY $530,978 TO RESTATE PATIENT SERVICE REVENUE OVERBILLINGS DURING THE FISCAL YEAR ENDED JUNE 30, 2021. |
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