SACRED HEART COMMUNITY CLINIC INC: Form 990, tax year 2022

View the entire original 990 at ProPublica ↗

Organization
SACRED HEART COMMUNITY CLINIC INC (EIN 27-2901548)
Tax period
2022-01-01 to 2022-12-31
Filed
2023-08-30
IRS object ID
202312429349300626
Schema version
2022v5.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2023-08-30T13:00:34-05:00ReturnTs
Tax Period End2022-12-31TaxPeriodEndDt
Return Type990ReturnTypeCd
Tax Period Begin2022-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN272901548EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Sacred Heart Community ClinicBusinessNameLine1Txt
Business Name Line2Sacred Heart Community ClinicBusinessNameLine2Txt
FieldValueIRS element (for citing)
In Care Of% Jody PoslusznyInCareOfNm
Business Name ControlSACRBusinessNameControlTxt
Phone5127163929PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1620 Round Rock West Dr Ste BLD 8AddressLine1Txt
CityRound RockCityNm
State AbbreviationTXStateAbbreviationCd
ZIP78681ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJODY POSLUSZNYPersonNm
Person TitleTreasurerPersonTitleTxt
Phone5127163929PhoneNum
Signature2023-08-30SignatureDt

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstJODYPersonFirstNm
Person LastPOSLUSZNYPersonLastNm
FieldValueIRS element (for citing)
SSNXXX-XX-XXXXSSN
FieldValueIRS element (for citing)
IRS Responsible Prty Info CurrfalseIRSResponsiblePrtyInfoCurrInd

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer1TrustedCustomerCd
Authentication Assurance LevelAAL2AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2022TaxYr
Build TS2023-04-26 12:10:37ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1Sacred Heart Community ClinicBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerDEBORAH HOPPSPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1620 Round Rock West Dr Ste Bld 8AddressLine1Txt
CityRound RockCityNm
State AbbreviationTXStateAbbreviationCd
ZIP78681ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$763,756GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.sacredheartclinic.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2010FormationYr
Legal Domicile StateTXLegalDomicileStateCd
Activity Or MissionTo provide nocost outpatient health and dental services to the uninsured and underinsured of Williamson County TXActivityOrMissionDesc
Voting Members Governing Body10VotingMembersGoverningBodyCnt
Voting Members Independent10VotingMembersIndependentCnt
Total Employee16TotalEmployeeCnt
Total Volunteers100TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$792,952PYContributionsGrantsAmt
CY Contributions Grants$588,435CYContributionsGrantsAmt
PY Program Service Revenue$363PYProgramServiceRevenueAmt
CY Program Service Revenue$163CYProgramServiceRevenueAmt
PY Investment Income$11,892PYInvestmentIncomeAmt
CY Investment Income$10,567CYInvestmentIncomeAmt
PY Other Revenue$39,683PYOtherRevenueAmt
CY Other Revenue$114,765CYOtherRevenueAmt
PY Total Revenue$844,890PYTotalRevenueAmt
CY Total Revenue$713,930CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$379,121PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$393,521CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$79,057CYTotalFundraisingExpenseAmt
PY Other Expenses$391,461PYOtherExpensesAmt
CY Other Expenses$381,407CYOtherExpensesAmt
PY Total Expenses$770,582PYTotalExpensesAmt
CY Total Expenses$774,928CYTotalExpensesAmt
PY Revenues Less Expenses$74,308PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$60,998CYRevenuesLessExpensesAmt
Total Assets BOY$1,306,466TotalAssetsBOYAmt
Total Assets EOY$1,272,597TotalAssetsEOYAmt
Total Liabilities BOY$22,763TotalLiabilitiesBOYAmt
Total Liabilities EOY$78,078TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$1,283,703NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$1,194,519NetAssetsOrFundBalancesEOYAmt
MissionTo provide no-cost outpatient basic health and dental services, and nutrition and diabetic education to low-income, uninsured and under- insured adult residents of Williamson County, TexasMissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$497,157ExpenseAmt
Revenue$163RevenueAmt
DescProvided basic outpatient health and dental services, diabetic and nutritional education to qualifying low-income adult residents of Williamson County, TexasDesc
Total Program Service Expenses$497,157TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsfalseDonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (true)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesYes (true)FundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredfalseScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContriYes (true)DeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document10IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld CompliancefalseBackupWthldComplianceInd
Employee16EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Form990 T FiledfalseForm990TFiledInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Excs Tax Sect4951 Or4952 Or4953falseExcsTaxSect4951Or4952Or4953Ind
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members10GoverningBodyVotingMembersCnt
Independent Voting Member10IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyfalseForm990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonJODY POSLUSZNYPersonNm
Phone5127163929PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1620 Round Rock West Dr Ste Bld 8AddressLine1Txt
CityRound RockCityNm
State AbbreviationTXStateAbbreviationCd
ZIP78681ZIPCd
FieldValueIRS element (for citing)
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (10 entries)

TitleTitleTxtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
DEBORAH HOPPS
PresidentYes (X)Yes (X)$0$0$0
ISAAC KORENSTEIN
Vice PresidentYes (X)Yes (X)$0$0$0
NORMA RODRIGUEZ
SecretaryYes (X)Yes (X)$0$0$0
JODY POSLUSZNY
TreasurerYes (X)Yes (X)$0$0$0
KATE WALTERS
DirectorYes (X)$0$0$0
CAROLINE HILBERT
DirectorYes (X)$0$0$0
REV DAVID KOPPEL
DirectorYes (X)$0$0$0
TINO HERNANDEZ
Past PresidentYes (X)$0$0$0
REV FRANCISCO RODRIGUEZ
DirectorYes (X)$0$0$0
RUDOLFO URIEGAS
Past Vice PresidentYes (X)$0$0$0
FieldValueIRS element (for citing)
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KfalseTotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
Federated Campaigns$22,500FederatedCampaignsAmt
Fundraising$17,856FundraisingAmt
Government Grants$161,282GovernmentGrantsAmt
All Other Contributions$386,797AllOtherContributionsAmt
Noncash Contributions$59,406NoncashContributionsAmt
Total Contributions$588,435TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescRecord requestsDesc
Business621110BusinessCd
Total Revenue Column$163TotalRevenueColumnAmt
Related Or Exempt Func Income$163RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$163TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$10,567TotalRevenueColumnAmt
Exclusion$10,567ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$162,391FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$17,856ContriRptFundraisingEventAmt
Fundraising Direct Expenses$49,826FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$112,565TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescRedemption creditDesc
Business621110BusinessCd
Total Revenue Column$2,200TotalRevenueColumnAmt
Exclusion$2,200ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$2,200OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$713,930TotalRevenueColumnAmt
Related Or Exempt Func Income$163RelatedOrExemptFuncIncomeAmt
Exclusion$12,767ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$365,498TotalAmt
Program Services$175,439ProgramServicesAmt
Management And General$120,614ManagementAndGeneralAmt
Fundraising$69,445FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$28,023TotalAmt
Program Services$13,451ProgramServicesAmt
Management And General$9,248ManagementAndGeneralAmt
Fundraising$5,324FundraisingAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$8,998TotalAmt
Program Services$848ProgramServicesAmt
Management And General$8,150ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$2,321TotalAmt
Management And General$2,321ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$126,829TotalAmt
Program Services$126,829ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$10,426TotalAmt
Program Services$700ProgramServicesAmt
Management And General$9,726ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$14,160TotalAmt
Management And General$14,160ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$19,713TotalAmt
Management And General$19,713ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$3,458TotalAmt
Management And General$3,458ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$27,643TotalAmt
Program Services$25,708ProgramServicesAmt
Management And General$1,935ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$4,428TotalAmt
Management And General$4,428ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
Donated Pharmaceuticals$72,520$72,520
Dental & Medical supplies$49,115$49,115
Ancillary Medical services$29,480$29,480
Fees & Dues$9,249$4,961$4,288

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$3,067TotalAmt
Program Services$3,067ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$774,928TotalAmt
Program Services$497,157ProgramServicesAmt
Management And General$198,714ManagementAndGeneralAmt
Fundraising$79,057FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$408,132BOYAmt
EOY$183,827EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
EOY$327,792EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$106,250BOYAmt
EOY$18,750EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$3,519BOYAmt
EOY$8,124EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$698,596LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$190,113LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$534,758BOYAmt
EOY$508,483EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$253,807BOYAmt
EOY$225,621EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$1,306,466BOYAmt
EOY$1,272,597EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$22,763BOYAmt
EOY$24,244EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
EOY$53,834EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$22,763BOYAmt
EOY$78,078EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,264,953BOYAmt
EOY$1,177,644EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$18,750BOYAmt
EOY$16,875EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,283,703BOYAmt
EOY$1,194,519EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,306,466BOYAmt
EOY$1,272,597EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$60,998ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$28,186NetUnrlzdGainsLossesInvstAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$702,801CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$670,269CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$928,193CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$829,092CurrentTaxYearMinus1YearAmt
Current Tax Year$701,000CurrentTaxYearAmt
Total$3,831,355TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$702,801CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$670,269CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$928,193CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$829,092CurrentTaxYearMinus1YearAmt
Current Tax Year$701,000CurrentTaxYearAmt
Total$3,831,355TotalAmt
FieldValueIRS element (for citing)
Public Support Total170$3,831,355PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$3,384CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$4,477CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$5,447CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$6,314CurrentTaxYearMinus1YearAmt
Current Tax Year$8,346CurrentTaxYearAmt
Total$27,968TotalAmt
FieldValueIRS element (for citing)
Total Support$3,859,323TotalSupportAmt
Public Support CY1700.99275PublicSupportCY170Pct
Public Support PY1700.99447PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Disclosed Org Leg CtrlfalseDisclosedOrgLegCtrlInd
Disclosed For Charitable PrpsfalseDisclosedForCharitablePrpsInd
Written Policy MonitoringfalseWrittenPolicyMonitoringInd
Section170h Rqr StsfdfalseSection170hRqrStsfdInd
Solicited Assets SalefalseSolicitedAssetsSaleInd
Agent Trustee EtcfalseAgentTrusteeEtcInd
Incl Escrow Custodial Acct LiabfalseInclEscrowCustodialAcctLiabInd

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$557,893InvestmentCostOrOtherBasisAmt
Depreciation$90,877DepreciationAmt
Book Value$467,016BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$140,703InvestmentCostOrOtherBasisAmt
Depreciation$99,236DepreciationAmt
Book Value$41,467BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$508,483TotalBookValueLandBuildingsAmt
Total Rev Etc Audited Fincl Stmt$1,073,552TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst-$28,186NetUnrealizedGainsInvstAmt
Donated Services And Use Fclts$337,982DonatedServicesAndUseFcltsAmt
Other Revenue$49,826OtherRevenueAmt
Revenue Not Reported$359,622RevenueNotReportedAmt
Revenue Subtotal$713,930RevenueSubtotalAmt
Total Revenue Per Form990$713,930TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$1,162,736TotExpnsEtcAuditedFinclStmtAmt
Donated Services Use Fclts$337,982DonatedServicesUseFcltsAmt
Other Expenses Included$49,826OtherExpensesIncludedAmt
Expenses Not Reported$387,808ExpensesNotReportedAmt
Expenses Subtotal$774,928ExpensesSubtotalAmt
Total Expenses Per Form990$774,928TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
P12, Ln 2dFund raising expense netted in 990 revenue
P11, Ln 2dFund raising expense netted in 990 revenue

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1GalaEvent1Nm
Gross Receipts Event1$162,791GrossReceiptsEvent1Amt
Gross Revenue Event1$162,791GrossRevenueEvent1Amt
Cash Prizes Event1$5,710CashPrizesEvent1Amt
Rent Facility Costs Event1$7,754RentFacilityCostsEvent1Amt
Food And Beverage Event1$29,621FoodAndBeverageEvent1Amt
Entertainment Event1$7,200EntertainmentEvent1Amt
Other Direct Expenses Event1$3,943OtherDirectExpensesEvent1Amt
Gross Receipts Total$162,791GrossReceiptsTotalAmt
Gross Revenue Total Events$162,791GrossRevenueTotalEventsAmt
Cash Prizes Total Events$5,710CashPrizesTotalEventsAmt
Rent Fclty Costs Total Events$7,754RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events$29,621FoodAndBeverageTotalEventsAmt
Entertainment Total Events$7,200EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events$3,943OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$54,228DirectExpenseSummaryEventsAmt
Net Income Summary$108,563NetIncomeSummaryAmt

Schedule M IRS990ScheduleM

Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Noncash Contributions Rpt F990$59,406NoncashContributionsRptF990Amt
Method Of Determining RevenuesFMVMethodOfDeterminingRevenuesTxt
FieldValueIRS element (for citing)
Any Property That Must Be HeldfalseAnyPropertyThatMustBeHeldInd
Review Process Unusual NC GiftsfalseReviewProcessUnusualNCGiftsInd
Third Parties UsedfalseThirdPartiesUsedInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part VI Line 11bIf the board doesn't meet before the 990 is complete, it is reviewed by the
Part VI Line 11bexecutive director, board president and vice president.
Part VI Line 12cReviewed by board as discovered.
Part VI Line 19Provided upon request.
Part IX Line 11gMedical professionls Total expenses - $126829.00 Program service expenses - $126829.00 Mgmt and general expenses - $0.00 Fundraising expenses - $0.00

Comments

Anonymous: no account or email. Up to 2,000 characters, at most one link. Comments are checked automatically; some wait for review.