GREENE COUNTY HEALTH INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- GREENE COUNTY HEALTH INC (EIN 47-4673365)
- Tax period
- 2021-07-01 to 2022-06-30
- Filed
- 2023-05-10
- IRS object ID
- 202311309349303216
- Schema version
- 2021v4.0
- 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 | 2023-05-10T13:48:46-04:00 | ReturnTs |
| Tax Period End | 2022-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BRADLEY & ASSOCIATES INC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 201 S CAPITOL AVE SUITE 700 | AddressLine1Txt |
| City | INDIANAPOLIS | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46225 | 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 | 474673365 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GREENE COUNTY HEALTH INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | GREE | BusinessNameControlTxt |
| Phone | 8126694153 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1600 A ST NE SUITE 9 | AddressLine1Txt |
| City | LINTON | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 47441 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CRYSTAL PLANO | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 8126694153 | PhoneNum |
| Signature | 2023-05-10 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | CRYSTAL | PersonFirstNm |
| Person Last | PLANO | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | SKANDER NASSER III | PreparerPersonNm |
| PTIN | P00236505 | PTIN |
| Phone | 3172375500 | PhoneNum |
| Preparation | 2023-05-10 | PreparationDt |
| 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 | CRYSTAL PLANO | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1600 A ST NE SUITE 9 | AddressLine1Txt |
| City | LINTON | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 47441 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $3,565,185 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.GC-HEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2015 | FormationYr |
| Legal Domicile State | IN | LegalDomicileStateCd |
| Activity Or Mission | THE ORGANIZATION PROVIDES MEDICAL SERVICES TO AREA RESIDENTS. WITH TWO LOCATIONS IN GREENE COUNTY, INDIANA, THE PHYSICIANS, ADVANCE PRACTICE PROVIDERS AND OTHER HEALTHCARE PROFESSIONALS PROVIDE FAMILY PRACTICE CARE FOR THE AREA'S RESIDENTS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 27 | TotalEmployeeCnt |
| Total Volunteers | 10 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $413,343 | PYContributionsGrantsAmt |
| CY Contributions Grants | $867,789 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $2,426,006 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $2,059,275 | CYProgramServiceRevenueAmt |
| CY Investment Income | $254 | CYInvestmentIncomeAmt |
| PY Other Revenue | $569,176 | PYOtherRevenueAmt |
| CY Other Revenue | $637,867 | CYOtherRevenueAmt |
| PY Total Revenue | $3,408,525 | PYTotalRevenueAmt |
| CY Total Revenue | $3,565,185 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $1,566,904 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $1,660,196 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,468,473 | PYOtherExpensesAmt |
| CY Other Expenses | $791,587 | CYOtherExpensesAmt |
| PY Total Expenses | $3,035,377 | PYTotalExpensesAmt |
| CY Total Expenses | $2,451,783 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $373,148 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,113,402 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $1,224,880 | TotalAssetsBOYAmt |
| Total Assets EOY | $2,230,284 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $6,020,708 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $5,756,275 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$4,795,828 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$3,525,991 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE ORGANIZATION PROVIDES MEDICAL SERVICES TO AREA RESIDENTS. WITH TWO LOCATIONS IN GREENE COUNTY, INDIANA, THE PHYSICIANS, ADVANCE PRACTICE PROVIDERS AND OTHER HEALTHCARE PROFESSIONALS PROVIDE FAMILY PRACTICE CARE FOR THE AREA'S RESIDENTS. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $1,925,505 | ExpenseAmt |
| Revenue | $2,059,275 | RevenueAmt |
| Desc | THE ORGANIZATION PROVIDES MEDICAL SERVICES TO AREA RESIDENTS. WITH TWO LOCATIONS IN GREENE COUNTY, INDIANA, THE PHYSICIANS, ADVANCE PRACTICE PROVIDERS AND OTHER HEALTHCARE PROFESSIONALS PROVIDE FAMILY PRACTICE CARE FOR THE AREA'S RESIDENTS. | Desc |
| Total Program Service Expenses | $1,925,505 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | false | 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 | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | 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 | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 3 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 27 | 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 |
| 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 | false | 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 |
| States Where Copy Of Return Is Fld | IN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CRYSTAL PLANO | PersonNm |
| Phone | 8126694153 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1600 A ST NE SUITE 9 | AddressLine1Txt |
| City | LINTON | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 47441 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (13 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 |
|---|---|---|---|---|---|---|---|
| DEREK PARKES | |||||||
| PHYSICIAN | 36.00 | Yes (X) | $203,385 | $0 | $11,363 | ||
| CORIANNE VANDERKOLK | |||||||
| CEO | 40.00 | $139,050 | $0 | $6,952 | Yes (X) | ||
| CRYSTAL PLANO | |||||||
| CFO | 40.00 | $96,657 | $0 | $4,601 | Yes (X) | ||
| SUE ANN JOHNSON | |||||||
| SECRETARY | 2.00 | $0 | $0 | $0 | Yes (X) | ||
| SUSIE LEIGH | |||||||
| DIRECTOR | 2.00 | $0 | $0 | $0 | Yes (X) | ||
| MARY LOU QUIEL | |||||||
| CHAIRMAN | 2.00 | $0 | $0 | $0 | Yes (X) | ||
| MIKE SCHANTZ | |||||||
| DIRECTOR | 2.00 | $0 | $0 | $0 | Yes (X) | ||
| MARGARET SIMON | |||||||
| VICE CHAIRMA | 2.00 | $0 | $0 | $0 | Yes (X) | ||
| SUSIE SLINKARD | |||||||
| DIRECTOR | 2.00 | $0 | $0 | $0 | Yes (X) | ||
| CHRISTA TURPIN | |||||||
| DIRECTOR | 2.00 | $0 | $0 | $0 | Yes (X) | ||
| SHERRY VANDEVENTER | |||||||
| DIRECTOR | 2.00 | $0 | $0 | $0 | Yes (X) | ||
| LIANNE WILSON | |||||||
| TREASURER | 2.00 | $0 | $0 | $0 | Yes (X) | ||
| JATHAN WRIGHT | |||||||
| DIRECTOR | 2.00 | $0 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $439,092 | TotalReportableCompFromOrgAmt |
| Total Other Compensation | $22,916 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 2 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| Government Grants | $866,562 | GovernmentGrantsAmt |
| All Other Contributions | $1,227 | AllOtherContributionsAmt |
| Total Contributions | $867,789 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT SERVICE REVENUE | Desc |
| Business | 621110 | BusinessCd |
| Total Revenue Column | $2,059,275 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $2,059,275 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $2,059,275 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $254 | TotalRevenueColumnAmt |
| Exclusion | $254 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| 340B REVENUE | 900099 | $603,055 | $603,055 |
| VACCINE REVENUE | 900099 | $15,712 | $15,712 |
| MISCELLANEOUS INCOME | 900099 | $14,652 | $14,652 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,448 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $4,448 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $637,867 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,565,185 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $2,697,142 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $254 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $244,601 | TotalAmt |
| Program Services | $183,451 | ProgramServicesAmt |
| Management And General | $61,150 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,098,483 | TotalAmt |
| Program Services | $823,862 | ProgramServicesAmt |
| Management And General | $274,621 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $183,929 | TotalAmt |
| Program Services | $137,947 | ProgramServicesAmt |
| Management And General | $45,982 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $133,183 | TotalAmt |
| Program Services | $99,887 | ProgramServicesAmt |
| Management And General | $33,296 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $376 | TotalAmt |
| Management And General | $376 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,239 | TotalAmt |
| Management And General | $14,239 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $240,530 | TotalAmt |
| Program Services | $228,504 | ProgramServicesAmt |
| Management And General | $12,026 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,673 | TotalAmt |
| Management And General | $8,673 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $62,743 | TotalAmt |
| Program Services | $47,057 | ProgramServicesAmt |
| Management And General | $15,686 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $131,316 | TotalAmt |
| Program Services | $131,316 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,773 | TotalAmt |
| Program Services | $1,886 | ProgramServicesAmt |
| Management And General | $1,887 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,445 | TotalAmt |
| Program Services | $722 | ProgramServicesAmt |
| Management And General | $723 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19 | TotalAmt |
| Management And General | $19 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,976 | TotalAmt |
| Management And General | $9,976 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $46,839 | TotalAmt |
| Management And General | $46,839 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| 340B EXPENSE | $128,253 | $128,253 | |
| MEDICAL SUPPLIES | $72,085 | $72,085 | |
| VACCINATION EXPENSE | $68,184 | $68,184 | |
| MISCELLANEOUS | $3,136 | $2,351 | $785 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,451,783 | TotalAmt |
| Program Services | $1,925,505 | ProgramServicesAmt |
| Management And General | $526,278 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,029,401 | BOYAmt |
| EOY | $1,996,922 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $8,408 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $92,549 | BOYAmt |
| EOY | $121,435 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,395 | BOYAmt |
| EOY | $31,492 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $103,775 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $31,748 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $74,535 | BOYAmt |
| EOY | $72,027 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,224,880 | BOYAmt |
| EOY | $2,230,284 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,234,990 | BOYAmt |
| EOY | $1,227,152 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,785,718 | BOYAmt |
| EOY | $4,529,123 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,020,708 | BOYAmt |
| EOY | $5,756,275 | 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 | -$4,795,828 | BOYAmt |
| EOY | -$3,525,991 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$4,795,828 | BOYAmt |
| EOY | -$3,525,991 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,224,880 | BOYAmt |
| EOY | $2,230,284 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $1,113,402 | ReconcilationRevenueExpnssAmt |
| Prior Period Adjustments | $156,435 | PriorPeriodAdjustmentsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | false | FSAuditedInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule D IRS990ScheduleD
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $67,317 | OtherCostOrOtherBasisAmt |
| Depreciation | $18,911 | DepreciationAmt |
| Book Value | $48,406 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $36,458 | OtherCostOrOtherBasisAmt |
| Depreciation | $12,837 | DepreciationAmt |
| Book Value | $23,621 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $72,027 | TotalBookValueLandBuildingsAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DEREK PARKES | PersonNm |
| Title | PHYSICIAN | TitleTxt |
| Base Compensation Filing Org | $203,385 | BaseCompensationFilingOrgAmt |
| Deferred Compensation Flng Org | $10,226 | DeferredCompensationFlngOrgAmt |
| Nontaxable Benefits Filing Org | $1,137 | NontaxableBenefitsFilingOrgAmt |
| Total Compensation Filing Org | $214,748 | TotalCompensationFilingOrgAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990 - ORGANIZATION'S MISSION | THE ORGANIZATION PROVIDES MEDICAL SERVICES TO AREA RESIDENTS. WITH TWO LOCATIONS IN GREENE COUNTY, INDIANA, THE PHYSICIANS, ADVANCE PRACTICE PROVIDERS AND OTHER HEALTHCARE PROFESSIONALS PROVIDE FAMILY PRACTICE CARE FOR THE AREA'S RESIDENTS. |
| FORM 990, PAGE 6, PART VI, LINE 11B | THE FORM 990 WILL BE PROVIDED TO THE BOARD FOR REVIEW AND TO SOLICIT THEIR INPUT. THE FORM 990 WILL NOT BE FILED UNTIL ALL FEEDBACK IS RECEIVED AND THE APPROPRIATE CHANGES, IF ANY, ARE MADE. THE FORM 990 IS ALSO REVIEWED BY AN INDEPENDENT ACCOUNTING FIRM PRIOR TO FILING. |
| FORM 990, PAGE 6, PART VI, LINE 12C | EACH EMPLOYEE AND BOARD MEMBER IS REQUIRED TO COMPLETE A NEW CONFLICT OF INTEREST FORM ANNUALLY. THESE ARE REVIEWED BY THE COMPLIANCE OFFICE WHO CONTINUES TO MONITOR FOR COMPLIANCE ISSUES. |
| FORM 990, PAGE 6, PART VI, LINE 15A | THE AGENCY HAS AN AGREEMENT WITH SULLIVAN COUNTY HOSPITAL FOR THEIR HR SERVICES. THE AGENCY WORKS WITH THEIR HR PERSONNEL TO REVIEW MARKET COMPENSATION FOR ALL EMPLOYEES, INCLUDING KEY EMPLOYEES. THE AGENCY USES THE DATA OBTAINED FROM SULLIVAN COUNTY HOSPITAL HR TO DETERMINE COMPENSATION. |
| FORM 990, PAGE 6, PART VI, LINE 15B | THE AGENCY HAS AN AGREEMENT WITH SULLIVAN COUNTY HOSPITAL FOR THEIR HR SERVICES. THE AGENCY WORKS WITH THEIR HR PERSONNEL TO REVIEW MARKET COMPENSATION FOR ALL EMPLOYEES, INCLUDING KEY EMPLOYEES. THE AGENCY USES THE DATA OBTAINED FROM SULLIVAN COUNTY HOSPITAL HR TO DETERMINE COMPENSATION. |
| FORM 990, PAGE 6, PART VI, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST ONLY AND WITH BOARD APPROVAL. |
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