CITIZENS OF LAKE COUNTY FOR HEALTH CARE INC: Form 990, tax year 2022

View the entire original 990 at ProPublica ↗

Organization: CITIZENS OF LAKE COUNTY FOR HEALTH CARE INC (EIN 62-1026947)
Tax period: 2022-02-01 to 2023-01-31
Filed: 2023-03-24
IRS object ID: 202320839349301572
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
Form 990
Schedule A
Schedule B
Schedule D
Schedule O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2023-03-24T14:17:30-07:00	ReturnTs
Tax Period End	2023-01-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	621867889	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	Terry Horne CPA Inc	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	732 West Main Street	AddressLine1Txt
City	Lebanon	CityNm
State Abbreviation	TN	StateAbbreviationCd
ZIP	37087	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2022-02-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	621026947	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	CITIZENS OF LAKE COUNTY FOR HEALTH CARE INC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	CITI	BusinessNameControlTxt
Phone	7312536690	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	710 CARL PERKINS PKWY	AddressLine1Txt
City	TIPTONVILLE	CityNm
State Abbreviation	TN	StateAbbreviationCd
ZIP	38079	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	GAYANNE WILLIAMS	PersonNm
Person Title	CHIEF EXECUTIVE OFFICER	PersonTitleTxt
Phone	7312536690	PhoneNum
Signature	2023-03-24	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

Field	Value	IRS element (for citing)
Person First	GAYANNE	PersonFirstNm
Person Last	WILLIAMS	PersonLastNm

Field	Value	IRS element (for citing)
SSN	XXX-XX-XXXX	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	TERRY HORNE CPA	PreparerPersonNm
PTIN	P00120946	PTIN
Phone	6154447293	PhoneNum
Preparation	2023-03-24	PreparationDt

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
Federated Assurance Level	FAL1	FederatedAssuranceLevelCd

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	GAYANNE WILLIAMS	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	710 CARL PERKINS PKWY	AddressLine1Txt
City	TIPTONVILLE	CityNm
State Abbreviation	TN	StateAbbreviationCd
ZIP	38079	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$4,366,342	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	N/A	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1982	FormationYr
Legal Domicile State	TN	LegalDomicileStateCd
Activity Or Mission	THE ORGANIZATION PROVIDES HEALTH CARE TO INDIVIDUALS REGARDLESS OF THEIR ABILITY TO PAY. THIS IS A DIRECT FULFILLMENT OF THEIR TAX EXEMPT PURPOSE.	ActivityOrMissionDesc
Voting Members Governing Body	10	VotingMembersGoverningBodyCnt
Voting Members Independent	10	VotingMembersIndependentCnt
Total Employee	52	TotalEmployeeCnt
Total Volunteers	0	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$2,818,420	PYContributionsGrantsAmt
CY Contributions Grants	$3,262,298	CYContributionsGrantsAmt
PY Program Service Revenue	$1,295,809	PYProgramServiceRevenueAmt
CY Program Service Revenue	$1,096,546	CYProgramServiceRevenueAmt
PY Investment Income	$7,323	PYInvestmentIncomeAmt
CY Investment Income	$7,498	CYInvestmentIncomeAmt
CY Other Revenue	$0	CYOtherRevenueAmt
PY Total Revenue	$4,121,552	PYTotalRevenueAmt
CY Total Revenue	$4,366,342	CYTotalRevenueAmt
CY Grants And Similar Paid	$0	CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$2,601,949	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$2,828,629	CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$1,265,556	PYOtherExpensesAmt
CY Other Expenses	$1,308,785	CYOtherExpensesAmt
PY Total Expenses	$3,867,505	PYTotalExpensesAmt
CY Total Expenses	$4,137,414	CYTotalExpensesAmt
PY Revenues Less Expenses	$254,047	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$228,928	CYRevenuesLessExpensesAmt
Total Assets BOY	$4,583,640	TotalAssetsBOYAmt
Total Assets EOY	$4,586,332	TotalAssetsEOYAmt
Total Liabilities BOY	$684,444	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$606,115	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$3,899,196	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$3,980,217	NetAssetsOrFundBalancesEOYAmt
Mission	THE ORGANIZATION PROVIDES HEALTH CARE TO INDIVIDUALS REGARDLESS OF THEIR ABILITY TO PAY. THIS IS A DIRECT FULFILLMENT OF THEIR TAX EXEMPT PURPOSE.	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$2,903,738	ExpenseAmt
Grant	$0	GrantAmt
Revenue	$1,096,546	RevenueAmt
Desc	THE ORGANIZATION PROVIDES HEALTH CARE REGARDLESS OF THE INDIVIDUALS ABILITY TO PAY. THESE MEDICAL SERVICES ARE PROVIDED IN AREAS THAT HAVE A SHORTAGE OF HEALTH CARE PROVIDERS. THIS IS A DIRECT FULFILLMENT OF THEIR TAX EXEMPT PURPOSE. OVER 11,200 VISITS WERE PROVIDED THIS YEAR.	Desc
Total Program Service Expenses	$2,903,738	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	false	LobbyingActivitiesInd
Subject To Proxy Tax	false	SubjectToProxyTaxInd
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	Yes (true)	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	false	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
Transaction With Control Ent	false	TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
IRP Document	17	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	52	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
DAF Excess Business Holdings	false	DAFExcessBusinessHoldingsInd
Taxable Distributions	false	TaxableDistributionsInd
Distribution To Donor	false	DistributionToDonorInd
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	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (true)	CompensationProcessCEOInd
Compensation Process Other	Yes (true)	CompensationProcessOtherInd
Investment In Joint Venture	false	InvestmentInJointVentureInd
Other Website	Yes (X)	OtherWebsiteInd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	DAWN DEAN	PersonNm
Phone	7312536690	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	710 CARL PERKINS PKWY	AddressLine1Txt
City	TIPTONVILLE	CityNm
State Abbreviation	TN	StateAbbreviationCd
ZIP	38079	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	OfficerOfficerInd	Highest Compensated EmployeeHighestCompensatedEmployeeInd
ROSE CURRIN
CHAIRPERSON	1.00	Yes (X)	$0	$0	$0
CRAIG CLAY
VICE CHAIRPERSON	1.00	Yes (X)	$0	$0	$0
DEBBIE BEASLEY
TREASURER	1.00	Yes (X)	$0	$0	$0
LINDA LEDUKE
SECRETARY	1.00	Yes (X)	$0	$0	$0
OZELLA GARLAND
BOARD MEMBER	1.00	Yes (X)	$0	$0	$0
LINDA COOK
BOARD MEMBER	1.00	Yes (X)	$0	$0	$0
MARY REID
BOARD MEMBER	1.00	Yes (X)	$0	$0	$0
RHONDA BATTEE
BOARD MEMBER	1.00	Yes (X)	$0	$0	$0
WILL JACKSON
BOARD MEMBER	1.00	Yes (X)	$0	$0	$0
JOYCE BARNES
BOARD MEMBER	1.00	Yes (X)	$0	$0	$0
GAYANNE WILLIAMS
CHIEF EXECUTIVE OFFICER	40.00		$64,900	$0	$11,649	Yes (X)
DAWN DEAN
CHIEF FINANCIAL OFFICER	40.00		$42,813	$0	$10,202	Yes (X)
JAMES OAKS
MEDICAL DIRECTOR	40.00		$91,165	$0	$0	Yes (X)
TERRA KING
NURSE PRACTITIONER	40.00		$91,574	$0	$12,521		Yes (X)
KATRINA KORSZOLOSKI
NURSE PRACTITIONER	40.00		$99,715	$0	$11,768		Yes (X)
COURTNEY FAUGHT
NURSE PRACTITIONER	40.00		$123,294	$0	$13,473		Yes (X)
KRISTEN DEATON
MENTAL HEALTH NURSE PRACTITIONER	40.00		$124,885	$0	$10,929		Yes (X)
DEBORAH NALE
NURSE PRACTITIONER	40.00		$99,360	$0	$12,755		Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$737,706	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$83,297	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	2	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	false	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	false	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	OSIS	BusinessNameLine1Txt

Contractor Address ContractorAddress

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	8790 GOVERNORS HILL DRIVE SUITE 202	AddressLine1Txt
City	CINCINNATI	CityNm
State Abbreviation	OH	StateAbbreviationCd
ZIP	45249	ZIPCd

Field	Value	IRS element (for citing)
Services	EHR SUPPORT/TRAINING	ServicesDesc
Compensation	$191,154	CompensationAmt

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	1	CntrctRcvdGreaterThan100KCnt
Government Grants	$3,259,173	GovernmentGrantsAmt
All Other Contributions	$3,125	AllOtherContributionsAmt
Total Contributions	$3,262,298	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

Field	Value	IRS element (for citing)
Desc	PATIENT REVENUE	Desc
Business	621111	BusinessCd
Total Revenue Column	$1,096,546	TotalRevenueColumnAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$0	ExclusionAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$1,096,546	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$7,498	TotalRevenueColumnAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$7,498	ExclusionAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$4,366,342	TotalRevenueColumnAmt
Related Or Exempt Func Income	$1,096,546	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$7,498	ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$207,725	TotalAmt
Program Services	$135,021	ProgramServicesAmt
Management And General	$72,704	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$2,005,876	TotalAmt
Program Services	$1,297,028	ProgramServicesAmt
Management And General	$708,848	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$40,322	TotalAmt
Program Services	$26,086	ProgramServicesAmt
Management And General	$14,236	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$419,479	TotalAmt
Program Services	$271,374	ProgramServicesAmt
Management And General	$148,105	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$155,227	TotalAmt
Program Services	$100,421	ProgramServicesAmt
Management And General	$54,806	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$2,253	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$2,253	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$34,296	TotalAmt
Program Services	$0	ProgramServicesAmt
Management And General	$34,296	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$200,160	TotalAmt
Program Services	$150,164	ProgramServicesAmt
Management And General	$49,996	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$9,873	TotalAmt
Program Services	$9,348	ProgramServicesAmt
Management And General	$525	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$173,212	TotalAmt
Program Services	$101,413	ProgramServicesAmt
Management And General	$71,799	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$244,972	TotalAmt
Program Services	$244,972	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$153,878	TotalAmt
Program Services	$123,102	ProgramServicesAmt
Management And General	$30,776	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$9,805	TotalAmt
Program Services	$4,444	ProgramServicesAmt
Management And General	$5,361	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$185,891	TotalAmt
Program Services	$148,713	ProgramServicesAmt
Management And General	$37,178	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$13,967	TotalAmt
Program Services	$11,174	ProgramServicesAmt
Management And General	$2,793	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Other Expenses OtherExpensesGrp

Field	Value	IRS element (for citing)
Desc	MEDICAL SUPPLIES & PHARMACEUTICALS	Desc
Total	$280,478	TotalAmt
Program Services	$280,478	ProgramServicesAmt
Management And General	$0	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$4,137,414	TotalAmt
Program Services	$2,903,738	ProgramServicesAmt
Management And General	$1,233,676	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$392,606	BOYAmt
EOY	$423,198	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$51,073	BOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$97,665	BOYAmt
EOY	$68,259	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$164,360	BOYAmt
EOY	$145,042	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$21,318	BOYAmt
EOY	$46,403	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$4,269,124	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$1,327,716	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$2,953,167	BOYAmt
EOY	$2,941,408	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$903,451	BOYAmt
EOY	$962,022	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$4,583,640	BOYAmt
EOY	$4,586,332	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$210,549	BOYAmt
EOY	$366,376	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$473,895	BOYAmt
EOY	$239,739	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$684,444	BOYAmt
EOY	$606,115	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	$3,896,071	BOYAmt
EOY	$3,980,217	EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$3,125	BOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$3,899,196	BOYAmt
EOY	$3,980,217	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$4,583,640	BOYAmt
EOY	$4,586,332	EOYAmt

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	Yes (X)	InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss	$228,928	ReconcilationRevenueExpnssAmt
Prior Period Adjustments	-$144,782	PriorPeriodAdjustmentsAmt
Other Changes In Net Assets	-$3,125	OtherChangesInNetAssetsAmt
Info In Schedule O Part XII	Yes (X)	InfoInScheduleOPartXIIInd
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)
Consolidated Basis Fincl Stmt	Yes (X)	ConsolidatedBasisFinclStmtInd

Field	Value	IRS element (for citing)
Audit Committee	Yes (true)	AuditCommitteeInd
Federal Grant Audit Required	Yes (true)	FederalGrantAuditRequiredInd
Federal Grant Audit Performed	Yes (true)	FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Public Organization170	Yes (X)	PublicOrganization170Ind
Other Support Sum	$0	OtherSupportSumAmt

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$1,532,598	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$1,617,254	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$3,184,449	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$2,818,420	CurrentTaxYearMinus1YearAmt
Current Tax Year	$3,262,298	CurrentTaxYearAmt
Total	$12,415,019	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	$1,532,598	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$1,617,254	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$3,184,449	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$2,818,420	CurrentTaxYearMinus1YearAmt
Current Tax Year	$3,262,298	CurrentTaxYearAmt
Total	$12,415,019	TotalAmt

Field	Value	IRS element (for citing)
Substantial Contributors Tot	$0	SubstantialContributorsTotAmt
Public Support Total170	$12,415,019	PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$14,511	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$17,148	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$14,761	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$7,323	CurrentTaxYearMinus1YearAmt
Current Tax Year	$7,498	CurrentTaxYearAmt
Total	$61,241	TotalAmt

Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Other Income170 OtherIncome170Grp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Field	Value	IRS element (for citing)
Total Support	$12,476,260	TotalSupportAmt
Gross Receipts Rltd Activities	$5,209,212	GrossReceiptsRltdActivitiesAmt
Public Support CY170	0.99510	PublicSupportCY170Pct
Public Support PY170	0.99400	PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170	Yes (X)	ThirtyThrPctSuprtTestsCY170Ind
Public Support Total509	$0	PublicSupportTotal509Amt
Public Support CY509	0	PublicSupportCY509Pct
Investment Income CY	0	InvestmentIncomeCYPct

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)
Investment Cost Or Other Basis	$89,551	InvestmentCostOrOtherBasisAmt
Book Value	$89,551	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$2,819,384	InvestmentCostOrOtherBasisAmt
Depreciation	$557,789	DepreciationAmt
Book Value	$2,261,595	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$1,297,647	InvestmentCostOrOtherBasisAmt
Depreciation	$769,927	DepreciationAmt
Book Value	$527,720	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$62,542	InvestmentCostOrOtherBasisAmt
Book Value	$62,542	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$2,941,408	TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp (2 entries)

DescDesc	Book ValueBookValueAmt	Method ValuationMethodValuationCd
LONG-TERM CERTIFICATES OF DEPOSIT	$727,357	F
BANCORP ANNUITY	$234,665	F

Field	Value	IRS element (for citing)
Total Book Value Securities	$962,022	TotalBookValueSecuritiesAmt
Total Rev Etc Audited Fincl Stmt	$4,366,342	TotalRevEtcAuditedFinclStmtAmt
Revenue Subtotal	$4,366,342	RevenueSubtotalAmt
Total Revenue Per Form990	$4,366,342	TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt	$4,137,414	TotExpnsEtcAuditedFinclStmtAmt
Expenses Subtotal	$4,137,414	ExpensesSubtotalAmt
Total Expenses Per Form990	$4,137,414	TotalExpensesPerForm990Amt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Pt VI, Line 11b	THE CEO, CFO AND THE FINANCE COMMITTEE REVIEWS THE FORM 990.
Pt VI, Line 19	THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FORM 990 AVAILABLE UPON WRITTEN REQUEST.
Pt VI, Line 12c	ANNUALLY THE CONFLICT OF INTEREST STATEMENT IS SIGNED BY BOARD MEMBERS AND REVIEWED BY THE ENTIRE BOARD. BOARD MEMBERS SHALL EXCUSE THEMSELVES FROM ISSUES THAT ENHANCE THE PROBABILITY OF THEIR OWN PERSONAL AND PRIVATE GAIN.
Pt VI, Line 15a	STATE AND NATIONAL SALARY COMPARISONS ARE USED TO ESTABLISH SALARY LIMITS
Pt VI, Line 15b	FOR TOP MANAGEMENT OFFICIALS. PERFORMANCE EVALUATION ARE PERFORMED ANNUALLY AND SALARY INCREASES ARE BOARD APPROVED.
Pt XII, Line 2c	THE CEO AND CFO OVERSEE FINANCIAL STATEMENT PREPARATION AND AUDIT ENGAGEMENT.
Pt XI	LINE 9 REPRESENTS THE NET CHANGE IN NET ASSETS WITH DONOR
Pt XI	RESTRICTIONS FOR THE YEAR.