LUMINA HOSPICE AND PALLIATIVE CARE: Form 990, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- LUMINA HOSPICE AND PALLIATIVE CARE (EIN 93-0742686)
- Tax period
- 2022-01-01 to 2022-12-31
- Filed
- 2023-11-15
- IRS object ID
- 202303199349309540
- 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 | 2023-11-15T11:20:54-06:00 | ReturnTs |
| Tax Period End | 2022-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 813917978 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CAPSTONE CPAS | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 735 SW 9TH STREET | AddressLine1Txt |
| City | REDMOND | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97756 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2022-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 930742686 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LUMINA HOSPICE AND PALLIATIVE CARE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | LUMI | BusinessNameControlTxt |
| Phone | 5417579616 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 740 SW 4TH ST | AddressLine1Txt |
| City | CORVALLIS | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97333 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | AMY BAIRD | PersonNm |
| Person Title | EXECUTIVE DIRECTOR | PersonTitleTxt |
| Phone | 5417579616 | PhoneNum |
| Signature | 2023-11-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | AMY | PersonFirstNm |
| Person Last | BAIRD | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | Yes (1) | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | ZACHARY L HARMON | PreparerPersonNm |
| PTIN | P01247333 | PTIN |
| Phone | 5415483569 | PhoneNum |
| Preparation | 2023-11-14 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2022 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | SAME AS ABOVE | PrincipalOfficerNm |
| Gross Receipts | $4,492,287 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.LUMINAHOSPICE.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1979 | FormationYr |
| Legal Domicile State | OR | LegalDomicileStateCd |
| Activity Or Mission | SUPPORT FOR THE TERMINALLY ILL. | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 14 | VotingMembersIndependentCnt |
| Total Employee | 50 | TotalEmployeeCnt |
| Total Volunteers | 80 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $819,115 | PYContributionsGrantsAmt |
| CY Contributions Grants | $463,958 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $4,834,649 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $3,920,854 | CYProgramServiceRevenueAmt |
| PY Investment Income | $240,302 | PYInvestmentIncomeAmt |
| CY Investment Income | $33,213 | CYInvestmentIncomeAmt |
| PY Other Revenue | $9,884 | PYOtherRevenueAmt |
| CY Other Revenue | $74,262 | CYOtherRevenueAmt |
| PY Total Revenue | $5,903,950 | PYTotalRevenueAmt |
| CY Total Revenue | $4,492,287 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $4,465,573 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $3,487,854 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $57,354 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,675,223 | PYOtherExpensesAmt |
| CY Other Expenses | $1,372,923 | CYOtherExpensesAmt |
| PY Total Expenses | $6,140,796 | PYTotalExpensesAmt |
| CY Total Expenses | $4,860,777 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$236,846 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$368,490 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $6,763,686 | TotalAssetsBOYAmt |
| Total Assets EOY | $5,832,808 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $718,502 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $523,943 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $6,045,184 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $5,308,865 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | SUPPORT FOR THE TERMINALLY ILL. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $3,648,959 | ExpenseAmt |
| Revenue | $3,920,854 | RevenueAmt |
| Desc | HOSPICE: LUMINA HOSPICE AND PALLIATIVE CARE IS AN INDEPENDENT, NON-PROFIT COMMUNITY RESOURCE PROVIDING RESPONSIVE CARE FOR LOCAL RESIDENTS NEARING THE END OF LIFE. FOUNDED AS BENTON HOSPICE SERVICE IN 1908, WE ARE THE RECOGNIZED REGIONAL SOURCE FOR THE CONTINUUM OF END-OF-LIFE SERVICES IN THE MID-WILLAMETTE VALLEY. WE BUILT OUR REPUTATION ON A COMMITMENT TO PROMOTE DIGNITY, RESPECT CHOICES, EASE SUFFERING AND HONOR THE GRIEVING PROCESS. OUR TEAM-BASED APPROACH INCLUDES PHYSICIANS, NURSES, SOCIAL WORKERS, CHAPLAINS, PHYSICAL THERAPISTS, BEREAVEMENT SPECIALISTS AND TRAINED VOLUNTEERS, ENHANCING OUR ABILITY TO PROVIDE RESPONSIVE, PERSONALIZED CARE TO PATIENTS AND THEIR FAMILIES. MEDICAL EQUIPMENT, SUPPLIES AND MEDICATION RELATED TO THE TERMINAL ILLNESS ARE ALL COVERED WITHIN HOSPICE CARE. HOSPICE IS FOR ANYONE WITH ANY LIFE-LIMITING ILLNESS, INCLUDING CANCER, HEART OR LUNG DISEASE, AIDS, ALZHEIMER'S, AND OTHER END-STAGE DISEASES. CARE IS AVAILABLE FOR PEOPLE OF ALL AGES, INCLUDING INFANTS AND CHILDREN, AND FOR PERSONS OF ANY RACE OR ETHNICITY. U.S. CITIZENSHIP IS NOT A REQUIREMENT, NOR IS THE ABILITY TO SPEAK ENGLISH. MEDICARE, MEDICAID, AND MOST PRIVATE INSURANCE COVERS THE COST OF HOSPICE FOR PATIENTS. INABILITY TO PAY WILL NEVER PREVENT A PATIENT FROM RECEIVING THE BEST CARE. DONATIONS HELP COVER CHARITY CARE AS WELL AS MANY AUXILIARY SERVICES NOT REQUIRED BY MEDICARE. DONOR-SUPPORTED PROGRAMS INCLUDE CHARITY CARE, TRANSITIONS, CAREGIVER SUPPORT, COMMUNITY GRIEF SUPPORT, WE HONOR VETERANS, ART AND MUSIC TREATMENTS, VOLUNTEER SERVIES, AND CARE FOR PATIENTS' PETS (FOOD, VET TREATMENT, FINDING A NEW HOME FOR A PET THAT HAS LOST IT'S OWNER, FINDING A TEMPORARY HOME FOR A PET WHEN THEIR OWNER NEEDS TO GO TO A FACILITY FOR A SHORT STAY, GOOMING, AND WALKING DOGS.)PALLIATIVE CARE: LUMINA OFFERS TWO TYPES OF PALLIATIVE CARE SERVICES DESCRIBED BELOW. PALLIATIVE CARE CASE MANAGEMENT: PALLITATIVE CARE CASE MANAGEMENT FOCUSES ON IMPROVING THE PATIENT'S QUALITY OF LIFE AND COMFORT WHEN THEY FACE A SERIOUS ILLNESS OR COMPLICATED MEDICAL DECISION. IT IS A MEDICAL PROGRAM FOR INDIVIDUALS WHO ARE NOT UNDER HOSPICE CARE BUT ARE LIVING WITH SERIOUS OR CHRONIC ILLNESS. OUR INTERDISCIPLINARY PALLIATIVE CARE TEAM WORKS WITH THE PATIENT AND THEIR PROVIDER(S) TO HELP RELIEVE PAIN AND EASE OTHER UNCOMFORTABLE SYMPTOMS DURING THE COURSE OF A PATIENT'S PRIMARY CARE, INCLUDING CURATIVE CARE. PALLIATIVE CARE CONSULTS: PALLIATIVE CARE CONSULTS PROVIDE CLINICAL GUIDANCE FOR PATIENTS TO ASSIST WITH SYMPTOM MANAGEMENT AND ADVANCE CARE PLANNING. PALLIATIVE CARE CONSULTS ARE PROVIDED BY BOARD CERTIFIED PALLIATIVE CARE PHYSICIANS AND NURSE PRACTITIONERS TO PATIENTS IN THE COMFORT OF THEIR OWN REISDENCE. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $20,270 | ExpenseAmt |
| Desc | TRANSITIONS: TRANSITIONS IS A NON-MEDICAL PROGRAM FOR INDIVIDUALS WHO ARE LIVING WITH SERIOUS ILLNESS. WE OFFER ASSISTANCE NAVIGATING THIS DIFFICULT TIME, WITH COMPANIONSHIP, COMPASSION, AND CONNECTION TO COMMUNITY RESOURCES. THE PROGRAM IS PROVIDED FREE OF CHARGE. IT IS FUNDED THROUGH GRANTS AND DONATIONS, AND A COMMUNITY OF VOLUNTEERS WHO HELP SUPPORT THE TRANSITIONS PROGRAM. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $3,669,229 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 17 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 50 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 14 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | OR | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MIKE KALKOFEN | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5417579616 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 740 SW 4TH ST | AddressLine1Txt |
| City | CORVALLIS | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97330 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| JOAN HAYES | ||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| BARBARA TRIONE | ||||||||
| TREASURER | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| TAMARA SCOVILLE | ||||||||
| CHAIR | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| COURTNEY CAMPBELL | ||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| MARNIE NOBLE | ||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| JILL MCALLISTER | ||||||||
| SECRETARY | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| TAMINA TORAY | ||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| KAY SCHAFFER | ||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| SETH BERNSTEIN | ||||||||
| PAST CHAIR | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| JILL SCHUSTER | ||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| ANNE DELANDER | ||||||||
| VICE CHAIR | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| GREG BACHMAN | ||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| DAVID CUTSFORTH | ||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| DAVID LERMAN | ||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| REV LESLIE CHARTIER | ||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| DANIEL HARRIS | ||||||||
| MEDICAL DIRECTOR | 20.00 | $160,342 | $0 | $0 | Yes (X) | |||
| HELEN SIAOLAN KAO | ||||||||
| PHYSICIAN | 20.00 | $140,093 | $0 | $0 | Yes (X) | |||
| TRACY CALHOUN | ||||||||
| RN | 40.00 | $130,671 | $0 | $0 | Yes (X) | |||
| SANDRA ALEEN-HALLFORD | ||||||||
| AFTER HOURS NURSE | 40.00 | $103,179 | $0 | $0 | Yes (X) | |||
| JODY BUKTENICA | ||||||||
| RN CASE MANAGER | 40.00 | $114,957 | $0 | $0 | Yes (X) | |||
| SUSAN SPARKS | ||||||||
| RN CASE MANAGER | 40.00 | $110,176 | $0 | $0 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $759,418 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $0 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 7 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $30,030 | GovernmentGrantsAmt |
| All Other Contributions | $433,928 | AllOtherContributionsAmt |
| Total Contributions | $463,958 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT SERVICES INCOM | Desc |
| Business | 624100 | BusinessCd |
| Total Revenue Column | $3,920,854 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,920,854 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $3,920,854 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $33,213 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $33,213 | RelatedOrExemptFuncIncomeAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|
| GAIN ON SALE OF ASSET | $66,099 | $66,099 |
| MISCELLANEOUS | $8,163 | $8,163 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $74,262 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,492,287 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $4,028,329 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,901,882 | TotalAmt |
| Program Services | $2,399,628 | ProgramServicesAmt |
| Management And General | $466,905 | ManagementAndGeneralAmt |
| Fundraising | $35,349 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $438,340 | TotalAmt |
| Program Services | $227,780 | ProgramServicesAmt |
| Management And General | $210,560 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $147,632 | TotalAmt |
| Program Services | $147,632 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $86,741 | TotalAmt |
| Management And General | $82,536 | ManagementAndGeneralAmt |
| Fundraising | $4,205 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $242,867 | TotalAmt |
| Program Services | $104,208 | ProgramServicesAmt |
| Management And General | $134,842 | ManagementAndGeneralAmt |
| Fundraising | $3,817 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $60,309 | TotalAmt |
| Program Services | $60,309 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $68,501 | TotalAmt |
| Program Services | $30,939 | ProgramServicesAmt |
| Management And General | $36,348 | ManagementAndGeneralAmt |
| Fundraising | $1,214 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $76,480 | TotalAmt |
| Program Services | $75,136 | ProgramServicesAmt |
| Management And General | $1,255 | ManagementAndGeneralAmt |
| Fundraising | $89 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,048 | TotalAmt |
| Program Services | $10,551 | ProgramServicesAmt |
| Management And General | $10,497 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $148,826 | TotalAmt |
| Program Services | $49,988 | ProgramServicesAmt |
| Management And General | $95,996 | ManagementAndGeneralAmt |
| Fundraising | $2,842 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $32,372 | TotalAmt |
| Management And General | $32,372 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| RESPITE AND OUTPATIENT | $166,334 | $166,334 | |
| PHARMACEUTICALS | $153,605 | $153,605 | |
| PROFESSIONAL SERVICES | $101,911 | $57,863 | $44,048 |
| EQUIPMENT RENT | $86,622 | $85,928 | $694 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $127,307 | TotalAmt |
| Program Services | $99,328 | ProgramServicesAmt |
| Management And General | $18,141 | ManagementAndGeneralAmt |
| Fundraising | $9,838 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,860,777 | TotalAmt |
| Program Services | $3,669,229 | ProgramServicesAmt |
| Management And General | $1,134,194 | ManagementAndGeneralAmt |
| Fundraising | $57,354 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $465,539 | BOYAmt |
| EOY | $333,654 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,838 | BOYAmt |
| EOY | $26,755 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,245 | BOYAmt |
| EOY | $29,879 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $323,817 | BOYAmt |
| EOY | $787,387 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,534 | BOYAmt |
| EOY | $5,401 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $4,376,959 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $742,283 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,783,901 | BOYAmt |
| EOY | $3,634,676 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,062,053 | BOYAmt |
| EOY | $935,500 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $68,759 | BOYAmt |
| EOY | $79,556 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,763,686 | BOYAmt |
| EOY | $5,832,808 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $384,458 | BOYAmt |
| EOY | $240,685 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $334,044 | BOYAmt |
| EOY | $283,258 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $718,502 | BOYAmt |
| EOY | $523,943 | 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 | $6,009,390 | BOYAmt |
| EOY | $5,273,071 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $35,794 | BOYAmt |
| EOY | $35,794 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,045,184 | BOYAmt |
| EOY | $5,308,865 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,763,686 | BOYAmt |
| EOY | $5,832,808 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$368,490 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$367,829 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | 0 | FSAuditedInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $263,043 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $347,870 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,507,868 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $819,115 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $463,958 | CurrentTaxYearAmt |
| Total | $3,401,854 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $5,018,677 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $5,144,358 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $5,296,318 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $4,834,649 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,920,854 | CurrentTaxYearAmt |
| Total | $24,214,856 | TotalAmt |
Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $31,961 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $54,912 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $523,213 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $9,884 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $7,010 | CurrentTaxYearAmt |
| Total | $626,980 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $5,313,681 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $5,547,140 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7,327,399 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $5,663,648 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,391,822 | CurrentTaxYearAmt |
| Total | $28,243,690 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $8,770 | CurrentTaxYearMinus4YearsAmt |
| Total | $8,770 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $8,770 | CurrentTaxYearMinus4YearsAmt |
| Total | $8,770 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $28,234,920 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $248,233 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $234,084 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $32,389 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $240,302 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $33,213 | CurrentTaxYearAmt |
| Total | $788,221 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $248,233 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $234,084 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $32,389 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $240,302 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $33,213 | CurrentTaxYearAmt |
| Total | $788,221 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $5,561,914 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $5,781,224 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7,359,788 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $5,903,950 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,425,035 | CurrentTaxYearAmt |
| Total | $29,031,911 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.97250 | PublicSupportCY509Pct |
| Investment Income CY | 0.02720 | InvestmentIncomeCYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
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 | $344,004 | OtherCostOrOtherBasisAmt |
| Book Value | $344,004 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,374,689 | OtherCostOrOtherBasisAmt |
| Depreciation | $282,969 | DepreciationAmt |
| Book Value | $3,091,720 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $395,456 | OtherCostOrOtherBasisAmt |
| Depreciation | $337,684 | DepreciationAmt |
| Book Value | $57,772 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $262,810 | OtherCostOrOtherBasisAmt |
| Depreciation | $121,630 | DepreciationAmt |
| Book Value | $141,180 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $3,634,676 | TotalBookValueLandBuildingsAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DANIEL HARRIS | PersonNm |
| Title | MEDICAL DIRECTOR | TitleTxt |
| Base Compensation Filing Org | $160,342 | BaseCompensationFilingOrgAmt |
| Compensation Based On Rltd Orgs | $0 | CompensationBasedOnRltdOrgsAmt |
| Bonus Filing Organization | $0 | BonusFilingOrganizationAmount |
| Bonus Related Organizations | $0 | BonusRelatedOrganizationsAmt |
| Other Compensation Filing Org | $0 | OtherCompensationFilingOrgAmt |
| Other Compensation Rltd Orgs | $0 | OtherCompensationRltdOrgsAmt |
| Deferred Compensation Flng Org | $0 | DeferredCompensationFlngOrgAmt |
| Deferred Comp Rltd Orgs | $0 | DeferredCompRltdOrgsAmt |
| Nontaxable Benefits Filing Org | $0 | NontaxableBenefitsFilingOrgAmt |
| Nontaxable Benefits Rltd Orgs | $0 | NontaxableBenefitsRltdOrgsAmt |
| Total Compensation Filing Org | $160,342 | TotalCompensationFilingOrgAmt |
| Total Compensation Rltd Orgs | $0 | TotalCompensationRltdOrgsAmt |
| Comp Report Prior990 Filing Org | $0 | CompReportPrior990FilingOrgAmt |
| Comp Report Prior990 Rltd Orgs | $0 | CompReportPrior990RltdOrgsAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | LINE 11B EXPLANATION - THE FORM 990 IS REVIEWED BY THE EXECUTIVE DIRECTOR AND SENIOR FINANCIAL STAFF MEMBER PRIOR TO ITS FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | BOARD MEMBERS AND THE EXECUTIVE DIRECTOR ARE REQUIRED TO ANNUALLY DISCLOSE IN A SIGNED DOCUMENT A CONFLICT OF INTEREST STATEMENT. POTENTIAL CONFLICTS ARE BROUGHT TO THE ATTENTION OF THE CHAIR WHO IN TURN INFORMS THE BAORD. |
| FORM 990, PART VI, SECTION B, LINE 15A | BOARD COMMITTEE MEETS WITH THE LEADERSHIP TEAM FOR REVIEW. ANY INCREASE DEPENDS ON THE PERFORMANCE OF THE AGENCY. |
| FORM 990, PART VI, SECTION C, LINE 19 | NO OTHER DOCUMENTS MADE AVAILABLE TO THE PUBLIC |
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