ST GABRIEL HEALTH CLINIC INC: Form 990, tax year 2023

View the entire original 990 at ProPublica ↗

Organization
ST GABRIEL HEALTH CLINIC INC (EIN 72-1241592)
Tax period
2023-03-01 to 2024-02-29
Filed
2025-01-15
IRS object ID
202540159349302514
Schema version
2023v6.0
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)
Return2025-01-15T13:41:33-05:00ReturnTs
Tax Period End2024-02-29TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN854373220PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Steven M DeRouen & Associates LLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1P O Box 4265AddressLine1Txt
CityLake CharlesCityNm
State AbbreviationLAStateAbbreviationCd
ZIP70606ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2023-03-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN721241592EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1St Gabriel Health Clinic IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlSTGABusinessNameControlTxt

US Address USAddress

FieldValueIRS element (for citing)
Address Line15760 Monticello DriveAddressLine1Txt
CitySaint GabrielCityNm
State AbbreviationLAStateAbbreviationCd
ZIP70776ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonAshley LevyPersonNm
Person TitleChief ExecutivePersonTitleTxt
Phone2256429676PhoneNum
Signature2005-01-09SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd
FieldValueIRS element (for citing)
IRS Responsible Prty Info CurrYes (true)IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonSteven M DeRouenPreparerPersonNm
PTINP01050140PTIN
Phone3375134915PhoneNum
Preparation2025-01-15PreparationDt
Self EmployedYes (X)SelfEmployedInd
FieldValueIRS element (for citing)
Tax2023TaxYr
Build TS2024-10-15 13:58:12ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerJackie DarvillePrincipalOfficerNm
Gross Receipts$3,739,130GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.stgabrielchc.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1993FormationYr
Legal Domicile StateLALegalDomicileStateCd
Activity Or MissionTo 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 Body10VotingMembersGoverningBodyCnt
Voting Members Independent10VotingMembersIndependentCnt
Total Employee35TotalEmployeeCnt
Total Volunteers10TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$1,975,652PYContributionsGrantsAmt
CY Contributions Grants$2,495,503CYContributionsGrantsAmt
PY Program Service Revenue$1,012,635PYProgramServiceRevenueAmt
CY Program Service Revenue$1,178,356CYProgramServiceRevenueAmt
CY Investment Income$65,271CYInvestmentIncomeAmt
PY Other Revenue-$49,379PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$2,938,908PYTotalRevenueAmt
CY Total Revenue$3,739,130CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$1,903,680PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$2,132,131CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$1,147,765PYOtherExpensesAmt
CY Other Expenses$1,182,513CYOtherExpensesAmt
PY Total Expenses$3,051,445PYTotalExpensesAmt
CY Total Expenses$3,314,644CYTotalExpensesAmt
PY Revenues Less Expenses-$112,537PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$424,486CYRevenuesLessExpensesAmt
Total Assets BOY$1,866,031TotalAssetsBOYAmt
Total Assets EOY$2,299,124TotalAssetsEOYAmt
Total Liabilities BOY$795,863TotalLiabilitiesBOYAmt
Total Liabilities EOY$741,699TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$1,070,168NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$1,557,425NetAssetsOrFundBalancesEOYAmt
MissionTo 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 SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$2,443,305ExpenseAmt
Revenue$1,178,356RevenueAmt
DescTo 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$2,443,305TotalProgramServiceExpensesAmt
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 SecYes (true)ReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
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 ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
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 ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Transaction With Control EntfalseTransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee35EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
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 BodyYes (true)Form990ProvidedToGvrnBodyInd
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 CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonDonald FordPersonNm
Phone2256429676PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line15760 Monticello StAddressLine1Txt
CitySaint GabrielCityNm
State AbbreviationLAStateAbbreviationCd
ZIP70776ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (15 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorInd
Shirley Wade
Chief Executive Officer40.000.00Yes (X)$154,828$0$6,362
Estelle Pullen
Chief Operating Officer40.000.00Yes (X)$98,880$0$3,496
Charles Williams
Chief Executive Officer40.000.00Yes (X)$76,928$0$0
Freida Morris
Chief Financial Officer40.000.00Yes (X)$74,031$0$0
William Covington
Chief Financial Officer16.000.00Yes (X)$18,401$0$0
Charlotte Wilson
Board Member1.000.00$0$0$0Yes (X)
Gwendolyn Bush
Board Member1.000.00$0$0$0Yes (X)
Lloyd Snowten
Board Member1.000.00$0$0$0Yes (X)
Julia Scarnato
Board Member1.000.00$0$0$0Yes (X)
David Lodge
Board Member1.000.00$0$0$0Yes (X)
Denise Johnson
Board Member1.000.00$0$0$0Yes (X)
Jackie Darville
President1.000.00Yes (X)$0$0$0Yes (X)
Hazel Schexnayder
Vice President1.000.00Yes (X)$0$0$0Yes (X)
Deshonna Jackson
Treasurer1.000.00Yes (X)$0$0$0Yes (X)
Leatha Veal
Secretary1.000.00Yes (X)$0$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$423,068TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$9,858TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K1IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

FieldValueIRS element (for citing)
PersonGreenwayPersonNm

Contractor Address ContractorAddress

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO Box 203658AddressLine1Txt
CityDallasCityNm
State AbbreviationTXStateAbbreviationCd
ZIP753203658ZIPCd
FieldValueIRS element (for citing)
ServicesInformation TechServicesDesc
Compensation$144,492CompensationAmt
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K1CntrctRcvdGreaterThan100KCnt
Government Grants$2,495,503GovernmentGrantsAmt
Total Contributions$2,495,503TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Patient Service Revenue621110$995,917$995,917
Contract Income621110$182,439$182,439
FieldValueIRS element (for citing)
Total Program Service Revenue$1,178,356TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$65,271TotalRevenueColumnAmt
Exclusion$65,271ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$3,739,130TotalRevenueColumnAmt
Related Or Exempt Func Income$1,178,356RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$65,271ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$432,926TotalAmt
Program Services$313,669ProgramServicesAmt
Management And General$119,257ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$1,444,366TotalAmt
Program Services$1,046,489ProgramServicesAmt
Management And General$397,877ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$17,139TotalAmt
Program Services$12,511ProgramServicesAmt
Management And General$4,628ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$98,602TotalAmt
Program Services$71,929ProgramServicesAmt
Management And General$26,673ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$139,098TotalAmt
Program Services$100,781ProgramServicesAmt
Management And General$38,317ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$38,793TotalAmt
Program Services$7,371ProgramServicesAmt
Management And General$31,422ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$50,868TotalAmt
Program Services$9,665ProgramServicesAmt
Management And General$41,203ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$223,308TotalAmt
Program Services$212,874ProgramServicesAmt
Management And General$10,434ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$23,878TotalAmt
Program Services$23,878ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$24,534TotalAmt
Program Services$24,006ProgramServicesAmt
Management And General$528ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$108,942TotalAmt
Program Services$79,528ProgramServicesAmt
Management And General$29,414ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$20,395TotalAmt
Program Services$11,037ProgramServicesAmt
Management And General$9,358ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$1,728TotalAmt
Program Services$1,728ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$117,381TotalAmt
Program Services$85,688ProgramServicesAmt
Management And General$31,693ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$57,213TotalAmt
Program Services$29,226ProgramServicesAmt
Management And General$27,987ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Supplies$305,282$259,617$45,665
Repairs and Maintenance$15,861$7,601$8,260
Continuing Education$36,653$22,060$14,593
Licenses and Fees$59,332$59,332

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$98,345TotalAmt
Program Services$64,315ProgramServicesAmt
Management And General$34,030ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$3,314,644TotalAmt
Program Services$2,443,305ProgramServicesAmt
Management And General$871,339ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$781,403BOYAmt
EOY$672,552EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$35,520BOYAmt
EOY$25,365EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$88,159BOYAmt
EOY$130,387EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$18,449BOYAmt
EOY$16,998EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$2,551,869LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$1,232,089LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$882,121BOYAmt
EOY$1,319,780EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
EOY$128,042EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$60,379BOYAmt
EOY$6,000EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$1,866,031BOYAmt
EOY$2,299,124EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$143,286BOYAmt
EOY$225,746EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$58,500BOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$594,077BOYAmt
EOY$515,953EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$795,863BOYAmt
EOY$741,699EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,070,168BOYAmt
EOY$1,557,425EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,070,168BOYAmt
EOY$1,557,425EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,866,031BOYAmt
EOY$2,299,124EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$424,486ReconcilationRevenueExpnssAmt
Prior Period Adjustments$62,771PriorPeriodAdjustmentsAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
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 RequiredYes (true)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (true)FederalGrantAuditPerformedInd

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$1,486,034CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,901,227CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$2,044,706CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,975,652CurrentTaxYearMinus1YearAmt
Current Tax Year$2,495,503CurrentTaxYearAmt
Total$9,903,122TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,486,034CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,901,227CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$2,044,706CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,975,652CurrentTaxYearMinus1YearAmt
Current Tax Year$2,495,503CurrentTaxYearAmt
Total$9,903,122TotalAmt
FieldValueIRS element (for citing)
Public Support Total170$9,903,122PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year$65,271CurrentTaxYearAmt
Total$65,271TotalAmt

Other Income170 OtherIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years$80,399CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year-$49,379CurrentTaxYearMinus1YearAmt
Total$31,020TotalAmt
FieldValueIRS element (for citing)
Total Support$9,999,413TotalSupportAmt
Gross Receipts Rltd Activities$5,182,445GrossReceiptsRltdActivitiesAmt
Public Support CY1700.99040PublicSupportCY170Pct
Public Support PY1700.99640PublicSupportPY170Pct
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

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$15,000OtherCostOrOtherBasisAmt
Book Value$15,000BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$805,582OtherCostOrOtherBasisAmt
Depreciation$510,488DepreciationAmt
Book Value$295,094BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,224,834OtherCostOrOtherBasisAmt
Depreciation$612,843DepreciationAmt
Book Value$611,991BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$506,453OtherCostOrOtherBasisAmt
Depreciation$108,758DepreciationAmt
Book Value$397,695BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$1,319,780TotalBookValueLandBuildingsAmt

Closely Held Equity Interests CloselyHeldEquityInterestsGrp

FieldValueIRS element (for citing)
Book Value$128,042BookValueAmt
Method ValuationFMethodValuationCd
FieldValueIRS element (for citing)
Total Book Value Securities$128,042TotalBookValueSecuritiesAmt

Other Assets Org OtherAssetsOrgGrp

FieldValueIRS element (for citing)
DescDepositsDesc
Book Value$6,000BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Other Assets$6,000TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescOperating Right of Use Lease LiabDesc
Amt$515,953Amt
FieldValueIRS element (for citing)
Total Liability$515,953TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$3,739,130TotalRevEtcAuditedFinclStmtAmt
Revenue Subtotal$3,739,130RevenueSubtotalAmt
Total Revenue Per Form990$3,739,130TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$3,314,644TotExpnsEtcAuditedFinclStmtAmt
Expenses Subtotal$3,314,644ExpensesSubtotalAmt
Total Expenses Per Form990$3,314,644TotalExpensesPerForm990Amt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (true)AnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp

FieldValueIRS element (for citing)
PersonShirley WadePersonNm
TitleChief Executive OfficerTitleTxt
Base Compensation Filing Org$142,883BaseCompensationFilingOrgAmt
Bonus Filing Organization$11,945BonusFilingOrganizationAmount
Deferred Compensation Flng Org$6,362DeferredCompensationFlngOrgAmt
Total Compensation Filing Org$161,190TotalCompensationFilingOrgAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceOther non-fixed payments (Part I, line 7)FormAndLineReferenceDesc
ExplanationThe 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 ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990 governing body review Part VI line 11The Form 990 is reviewed by the Board of Directors prior to issuance.
Conflict of interest policy compliance Part VI line 12cThe 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 15aThe 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 19The Clinics governing documents, conflict of interest policy and financial statements are made available to the public upon request.

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