ST GABRIEL HEALTH CLINIC INC: Form 990, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- ST GABRIEL HEALTH CLINIC INC (EIN 72-1241592)
- Tax period
- 2022-03-01 to 2023-02-28
- Filed
- 2023-09-08
- IRS object ID
- 202322519349300317
- Schema version
- 2022v5.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-09-08T10:19:12-04:00 | ReturnTs |
| Tax Period End | 2023-02-28 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 854373220 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Steven M DeRouen & Associates LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | P O Box 4265 | AddressLine1Txt |
| City | Lake Charles | CityNm |
| State Abbreviation | LA | StateAbbreviationCd |
| ZIP | 70606 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2022-03-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 721241592 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | St Gabriel Health Clinic Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | STGA | BusinessNameControlTxt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5760 Monticello Drive | AddressLine1Txt |
| City | Saint Gabriel | CityNm |
| State Abbreviation | LA | StateAbbreviationCd |
| ZIP | 70776 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Estelle Afome Pullen | PersonNm |
| Person Title | Interim CEO | PersonTitleTxt |
| Phone | 2256429676 | PhoneNum |
| Signature | 2023-09-07 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | Estelle | PersonFirstNm |
| Person Last | Afome Pullen | PersonLastNm |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Steven M DeRouen | PreparerPersonNm |
| PTIN | P01050140 | PTIN |
| Phone | 3375134915 | PhoneNum |
| Preparation | 2023-09-08 | PreparationDt |
| Self Employed | Yes (X) | SelfEmployedInd |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 0 | TrustedCustomerCd |
| OOB Security Verification | 00 | OOBSecurityVerificationCd |
| Authentication Assurance Level | AAL2 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2022 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $2,938,908 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.stgabrielchc.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1993 | FormationYr |
| Legal Domicile State | LA | LegalDomicileStateCd |
| Activity Or Mission | To provide primary preventive health services to the medically insured, underinsured & underserved population of Iberville and surrounding areas regardless of ability to pay and increase the span of healthy life, reduce hlth disparities and achieve access to comp health services. | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 13 | VotingMembersIndependentCnt |
| Total Employee | 42 | TotalEmployeeCnt |
| Total Volunteers | 13 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $2,044,706 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,975,652 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $1,103,723 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $1,012,635 | CYProgramServiceRevenueAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $80,399 | PYOtherRevenueAmt |
| CY Other Revenue | -$49,379 | CYOtherRevenueAmt |
| PY Total Revenue | $3,228,828 | PYTotalRevenueAmt |
| CY Total Revenue | $2,938,908 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $1,653,202 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $1,903,680 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $980,056 | PYOtherExpensesAmt |
| CY Other Expenses | $1,147,765 | CYOtherExpensesAmt |
| PY Total Expenses | $2,633,258 | PYTotalExpensesAmt |
| CY Total Expenses | $3,051,445 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $595,570 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$112,537 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $1,414,410 | TotalAssetsBOYAmt |
| Total Assets EOY | $1,866,031 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $348,186 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $795,863 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,066,224 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $1,070,168 | NetAssetsOrFundBalancesEOYAmt |
| Mission | To provide primary preventive health services to the medically insured, underinsured & underserved population of Iberville and surrounding areas regardless of ability to pay and increase the span of healthy life, reduce hlth disparities and achieve access to comp health services. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $2,420,935 | ExpenseAmt |
| Revenue | $1,012,635 | RevenueAmt |
| Desc | To provide primary preventive health services to the medically insured, underinsured, uninsured and underserved population of Iberville and surrounding areas regardless of ability to pay and to increase the span of healthy life, reduce health disparities and achieve access to comprehensive health services. | Desc |
| Total Program Service Expenses | $2,420,935 | 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 | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | 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 | 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 |
| 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 | 16 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 42 | 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 |
| 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 | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 13 | 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 | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Freida Morris | PersonNm |
| Phone | 2256429676 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5760 Monticello St | AddressLine1Txt |
| City | Saint Gabriel | CityNm |
| State Abbreviation | LA | StateAbbreviationCd |
| ZIP | 70776 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|
| Shirley Wade | |||||||
| CEO | 40.00 | 0.00 | Yes (X) | $160,970 | $0 | $5,413 | |
| Freida Morris | |||||||
| CFO | 40.00 | 0.00 | Yes (X) | $61,417 | $0 | $0 | |
| William Covington | |||||||
| CFO | 16.00 | 0.00 | Yes (X) | $32,348 | $0 | $0 | |
| Charlotte Wilson | |||||||
| Board Member | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Denise Johnson | |||||||
| Board Member | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Lloyd Snowten | |||||||
| Board Member | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Grace Marcell | |||||||
| Board Member | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Julia Scarnato | |||||||
| Board Member | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Annette Martin | |||||||
| Board Member | 0.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Nancy Broussard | |||||||
| Board Member | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Karen Bess | |||||||
| Board Member | 1.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |
| Hazel Schexnayder | |||||||
| Vice President | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| Deshonna Jackson | |||||||
| Treasurer | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| David Lodge | |||||||
| Chaplin | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| Leatha Veal | |||||||
| Secretary | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| Jackie Darville | |||||||
| President | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $254,735 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $5,413 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 1 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Greenway | PersonNm |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 203658 | AddressLine1Txt |
| City | Dallas | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 753203658 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | IT | ServicesDesc |
| Compensation | $104,740 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $1,956,084 | GovernmentGrantsAmt |
| All Other Contributions | $19,568 | AllOtherContributionsAmt |
| Total Contributions | $1,975,652 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Patient Service Revenue | Desc |
| Business | 621110 | BusinessCd |
| Total Revenue Column | $1,012,635 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,012,635 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $1,012,635 | TotalProgramServiceRevenueAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Miscellaneous | 900099 | $5,000 | $5,000 |
| Loss on Deposit | 621110 | -$54,379 | -$54,379 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | -$49,379 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,938,908 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $963,256 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $260,148 | TotalAmt |
| Program Services | $210,200 | ProgramServicesAmt |
| Management And General | $49,948 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,577,992 | TotalAmt |
| Program Services | $1,274,809 | ProgramServicesAmt |
| Management And General | $303,183 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $65,540 | TotalAmt |
| Program Services | $53,087 | ProgramServicesAmt |
| Management And General | $12,453 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,469 | TotalAmt |
| Program Services | $4,839 | ProgramServicesAmt |
| Management And General | $20,630 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $47,899 | TotalAmt |
| Program Services | $8,687 | ProgramServicesAmt |
| Management And General | $39,212 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $261,490 | TotalAmt |
| Program Services | $254,460 | ProgramServicesAmt |
| Management And General | $7,030 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $43,938 | TotalAmt |
| Program Services | $43,938 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,070 | TotalAmt |
| Program Services | $27,070 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $104,504 | TotalAmt |
| Program Services | $84,648 | ProgramServicesAmt |
| Management And General | $19,856 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,045 | TotalAmt |
| Program Services | $14,703 | ProgramServicesAmt |
| Management And General | $11,342 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,867 | TotalAmt |
| Program Services | $6,867 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $70,916 | TotalAmt |
| Program Services | $57,442 | ProgramServicesAmt |
| Management And General | $13,474 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $56,581 | TotalAmt |
| Program Services | $17,590 | ProgramServicesAmt |
| Management And General | $38,991 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Supplies | $268,223 | $217,413 | $50,810 |
| Repairs and Maintenance | $17,064 | $5,581 | $11,483 |
| Continuing Education | $24,104 | $19,017 | $5,087 |
| Licenses and Fees | $61,861 | $61,861 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $105,734 | TotalAmt |
| Program Services | $58,723 | ProgramServicesAmt |
| Management And General | $47,011 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,051,445 | TotalAmt |
| Program Services | $2,420,935 | ProgramServicesAmt |
| Management And General | $630,510 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $836,235 | BOYAmt |
| EOY | $781,403 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $59,625 | BOYAmt |
| EOY | $35,520 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $81,761 | BOYAmt |
| EOY | $88,159 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $37,071 | BOYAmt |
| EOY | $18,449 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $1,996,828 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,114,707 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $393,718 | BOYAmt |
| EOY | $882,121 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,000 | BOYAmt |
| EOY | $60,379 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,414,410 | BOYAmt |
| EOY | $1,866,031 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,994 | BOYAmt |
| EOY | $143,286 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $165,573 | BOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $130,896 | BOYAmt |
| EOY | $58,500 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $39,723 | BOYAmt |
| EOY | $594,077 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $348,186 | BOYAmt |
| EOY | $795,863 | 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 | $821,630 | BOYAmt |
| EOY | $1,070,168 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $244,594 | BOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,066,224 | BOYAmt |
| EOY | $1,070,168 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,414,410 | BOYAmt |
| EOY | $1,866,031 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$112,537 | ReconcilationRevenueExpnssAmt |
| Prior Period Adjustments | $116,481 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| 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) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| 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 |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,294,572 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,486,034 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,901,227 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,044,706 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,975,652 | CurrentTaxYearAmt |
| Total | $8,702,191 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,294,572 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,486,034 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,901,227 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,044,706 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,975,652 | CurrentTaxYearAmt |
| Total | $8,702,191 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $8,702,191 | PublicSupportTotal170Amt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | $80,399 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | -$49,379 | CurrentTaxYearAmt |
| Total | $31,020 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $8,733,211 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $4,718,413 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.99640 | PublicSupportCY170Pct |
| Public Support PY170 | 0.63180 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Other income Part II line 10 or Part III line 12 | FormAndLineReferenceDesc |
| Explanation | Loss on Fixed Asset Deposit $(54,379)Other Revenue 5,000Total $(49,379) | ExplanationTxt |
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 | $15,000 | OtherCostOrOtherBasisAmt |
| Book Value | $15,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $805,582 | OtherCostOrOtherBasisAmt |
| Depreciation | $480,791 | DepreciationAmt |
| Book Value | $324,791 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $585,669 | OtherCostOrOtherBasisAmt |
| Depreciation | $525,158 | DepreciationAmt |
| Book Value | $60,511 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $590,577 | OtherCostOrOtherBasisAmt |
| Depreciation | $108,758 | DepreciationAmt |
| Book Value | $481,819 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $882,121 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| Deposit Receivable | $54,379 |
| Deposits | $6,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $60,379 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Operating Right of Use Lease Liab | Desc |
| Amt | $594,077 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $594,077 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $2,938,908 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Subtotal | $2,938,908 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $2,938,908 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $3,051,445 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $3,051,445 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $3,051,445 | TotalExpensesPerForm990Amt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| 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 | Yes (true) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Shirley Wade | PersonNm |
| Title | CEO | TitleTxt |
| Base Compensation Filing Org | $148,552 | BaseCompensationFilingOrgAmt |
| Bonus Filing Organization | $12,418 | BonusFilingOrganizationAmount |
| Deferred Compensation Flng Org | $2,586 | DeferredCompensationFlngOrgAmt |
| Nontaxable Benefits Filing Org | $2,827 | NontaxableBenefitsFilingOrgAmt |
| Total Compensation Filing Org | $166,383 | TotalCompensationFilingOrgAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Other non-fixed payments (Part I, line 7) | FormAndLineReferenceDesc |
| Explanation | The Organization provides non-fixed payments in the form of bonuses when senior management employees meet specific annual performance goals. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990 governing body review Part VI line 11 | The Form 990 is reviewed by the Board of Directors prior to issuance. |
| Conflict of interest policy compliance Part VI line 12c | The Board of Directors, key employees and management are required to disclose any conflicts of interest annually by completing a conflict of interest statement. |
| CEO executive director top management comp Part VI line 15a | The Board of Director performs a comparability study of similar organizations to determine the salary levels of key employees. |
| Governing documents etc available to public Part VI line 19 | The Clinics governing documents, conflict of interest policy and financial statements are made available to the public upon request. |
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