DIVERSITY HEALTH CENTER INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- DIVERSITY HEALTH CENTER INC (EIN 20-5746618)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-03-11
- IRS object ID
- 202200709349301640
- Schema version
- 2021v4.1
- 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 | 2022-03-11T14:26:03-08:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 621867889 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Terry Horne CPA Inc | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 732 West Main Street | AddressLine1Txt |
| City | Lebanon | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37087 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 205746618 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DIVERSITY HEALTH CENTER INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | DIVE | BusinessNameControlTxt |
| Phone | 9123183971 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1520 | AddressLine1Txt |
| City | HINESVILLE | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 31310 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | STEPHANIE JONES-HEATH | PersonNm |
| Person Title | CHIEF EXECUTIVE OFFICER | PersonTitleTxt |
| Phone | 9123183971 | PhoneNum |
| Signature | 2022-03-10 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | STEPHANIE | PersonFirstNm |
| Person Last | JONES-HEATH | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | XXX-XX-XXXX | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Terry Horne CPA | PreparerPersonNm |
| PTIN | P00120946 | PTIN |
| Phone | 6154447293 | PhoneNum |
| Preparation | 2022-03-11 | 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 |
| Federated Assurance Level | FAL1 | FederatedAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | STEPHANIE JONES-HEATH | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1520 | AddressLine1Txt |
| City | HINESVILLE | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 31310 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $7,740,365 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2006 | FormationYr |
| Legal Domicile State | GA | LegalDomicileStateCd |
| Activity Or Mission | THE ORGANIZATION PROVIDES HEALTH CARE TO INDIVIDUALS REGARDLESS OF THEIR ABILITY TO PAY. THIS IS A DIRECT FULFILLMENT OF THEIR TAX EXEMPT PURPOSE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 108 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $3,278,112 | PYContributionsGrantsAmt |
| CY Contributions Grants | $4,210,545 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $2,626,300 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $3,520,814 | CYProgramServiceRevenueAmt |
| PY Investment Income | $6,030 | PYInvestmentIncomeAmt |
| CY Investment Income | $5,116 | CYInvestmentIncomeAmt |
| CY Other Revenue | $3,890 | CYOtherRevenueAmt |
| PY Total Revenue | $5,910,442 | PYTotalRevenueAmt |
| CY Total Revenue | $7,740,365 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $3,261,921 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $3,995,595 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $2,252,350 | PYOtherExpensesAmt |
| CY Other Expenses | $1,952,243 | CYOtherExpensesAmt |
| PY Total Expenses | $5,514,271 | PYTotalExpensesAmt |
| CY Total Expenses | $5,947,838 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $396,171 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,792,527 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $4,975,133 | TotalAssetsBOYAmt |
| Total Assets EOY | $6,032,138 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,541,661 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,810,965 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $2,433,472 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $4,221,173 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE ORGANIZATION PROVIDES HEALTH CARE TO INDIVIDUALS REGARDLESS OF THEIR ABILITY TO PAY. THIS IS A DIRECT FULFILLMENT OF THEIR TAX EXEMPT PURPOSE. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $4,263,211 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $3,520,814 | RevenueAmt |
| Desc | THE HEALTH CARE PROVIDES HEALTH CARE REGARDLESS OF THE INDIVIDUALS ABILITY TO PAY. THESE MEDICAL SERVICES ARE PROVIDED IN AREAS THAT HAVE A SHORTAGE OF HEALTH CARE PROVIDERS. THIS IS A DIRECT FULFILLMENT OF THEIR TAX EXEMPT PURPOSE. OVER 21,100 VISITS WERE PROVIDED DURING THE YEAR. | Desc |
| Total Program Service Expenses | $4,263,211 | 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 | false | 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 | Yes (true) | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 17 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 108 | 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 | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | 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 | false | 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 | MATT SICKMEIER | PersonNm |
| Phone | 9123183971 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1520 | AddressLine1Txt |
| City | HINESVILLE | CityNm |
| State Abbreviation | GA | StateAbbreviationCd |
| ZIP | 31310 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| REV HERMON SCOTT | |||||||
| TREASURER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| PAULETTE S ROBERTSON | |||||||
| CHAIR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JUSTIN ZIEMAN | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DAISY JONES | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| GWEN STEWART | |||||||
| SECRETARY | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| CONNIE THRIFT | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DR JUANITA SMITH | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| BRIGITTE CABEZA- SHANKEN | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JANELLE JOHNS | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| STEPHANIE JONES-HEATH | |||||||
| CHIEF EXECUTIVE OFFICER | 40.00 | $228,735 | $0 | $23,001 | Yes (X) | ||
| MATT SICKMEIER | |||||||
| CHIEF FINANCIAL OFFICER | 40.00 | $65,718 | $0 | $3,017 | Yes (X) | ||
| SHARIFA ABOU-MEDIENE | |||||||
| MEDICAL DIRECTOR | 40.00 | $203,338 | $0 | $12,713 | Yes (X) | ||
| MARY ALLEN | |||||||
| PROVIDER | 40.00 | $164,154 | $0 | $13,113 | Yes (X) | ||
| ANNABETH SUTTER | |||||||
| PHARMACIST | 40.00 | $94,928 | $0 | $12,965 | Yes (X) | ||
| HOLLIE MANNING | |||||||
| PHARMACIST | 40.00 | $94,236 | $0 | $12,707 | Yes (X) | ||
| ANDRE SINGLETON | |||||||
| DENTIST | 40.00 | $149,745 | $0 | $27,984 | Yes (X) | ||
| DAVID NUSSBAUM | |||||||
| PROVIDER | 40.00 | $102,065 | $0 | $309 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,102,919 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $105,809 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 5 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ECLINICAL WORKS | BusinessNameLine1Txt |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 847950 | AddressLine1Txt |
| City | BOSTON | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 02294 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | CONTRACT BILLING SERVICES | ServicesDesc |
| Compensation | $109,002 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $3,824,352 | GovernmentGrantsAmt |
| All Other Contributions | $386,193 | AllOtherContributionsAmt |
| Noncash Contributions | $103,177 | NoncashContributionsAmt |
| Total Contributions | $4,210,545 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT FEES | Desc |
| Business | 621111 | BusinessCd |
| Total Revenue Column | $3,520,814 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $3,520,814 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,116 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $5,116 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $3,890 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $3,890 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,890 | TotalRevenueColumnAmt |
| Exclusion | $3,890 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $7,740,365 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,520,814 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $9,006 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $497,791 | TotalAmt |
| Program Services | $412,400 | ProgramServicesAmt |
| Management And General | $85,391 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,874,673 | TotalAmt |
| Program Services | $1,978,506 | ProgramServicesAmt |
| Management And General | $896,167 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,103 | TotalAmt |
| Program Services | $25,633 | ProgramServicesAmt |
| Management And General | $10,470 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $351,711 | TotalAmt |
| Program Services | $249,060 | ProgramServicesAmt |
| Management And General | $102,651 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $235,317 | TotalAmt |
| Program Services | $167,075 | ProgramServicesAmt |
| Management And General | $68,242 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,455 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $15,455 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $466,548 | TotalAmt |
| Program Services | $257,729 | ProgramServicesAmt |
| Management And General | $208,819 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $308,116 | TotalAmt |
| Program Services | $154,129 | ProgramServicesAmt |
| Management And General | $153,987 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $100,832 | TotalAmt |
| Program Services | $100,832 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $311,168 | TotalAmt |
| Program Services | $223,057 | ProgramServicesAmt |
| Management And General | $88,111 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,269 | TotalAmt |
| Program Services | $10,857 | ProgramServicesAmt |
| Management And General | $9,412 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $122,577 | TotalAmt |
| Program Services | $91,933 | ProgramServicesAmt |
| Management And General | $30,644 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,058 | TotalAmt |
| Program Services | $18,017 | ProgramServicesAmt |
| Management And General | $1,041 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| CONTRACT 340B ADMIN AND DISPENSING FEES | $58,742 | $58,742 | $0 | $0 |
| RECRUITMENT AND RETENTION | $26,987 | $12,750 | $14,237 | $0 |
| MEDICAL SUPPLIES AND PHARMACEUTICALS | $502,491 | $502,491 | $0 | $0 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,947,838 | TotalAmt |
| Program Services | $4,263,211 | ProgramServicesAmt |
| Management And General | $1,684,627 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $896,518 | BOYAmt |
| EOY | $1,484,843 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $275,322 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $56,677 | BOYAmt |
| EOY | $11,875 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $302,023 | BOYAmt |
| EOY | $279,959 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,160 | BOYAmt |
| EOY | $29,632 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $53,408 | BOYAmt |
| EOY | $64,953 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $4,599,611 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $714,057 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,485,352 | BOYAmt |
| EOY | $3,885,554 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $161,995 | BOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,975,133 | BOYAmt |
| EOY | $6,032,138 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $248,430 | BOYAmt |
| EOY | $215,320 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $134,713 | BOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,158,518 | BOYAmt |
| EOY | $1,595,645 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,541,661 | BOYAmt |
| EOY | $1,810,965 | 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 | $2,380,775 | BOYAmt |
| EOY | $4,168,132 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $52,697 | BOYAmt |
| EOY | $53,041 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,433,472 | BOYAmt |
| EOY | $4,221,173 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,975,133 | BOYAmt |
| EOY | $6,032,138 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $1,792,527 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$4,995 | NetUnrlzdGainsLossesInvstAmt |
| Investment Expense | -$175 | InvestmentExpenseAmt |
| Other Changes In Net Assets | $344 | 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) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| 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 |
| Other Support Sum | $0 | OtherSupportSumAmt |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,098,323 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,258,533 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,825,511 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,278,112 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,210,545 | CurrentTaxYearAmt |
| Total | $14,671,024 | TotalAmt |
Tax Rev Levied Orgnztnl Bnft170 TaxRevLeviedOrgnztnlBnft170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,098,323 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,258,533 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,825,511 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,278,112 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,210,545 | CurrentTaxYearAmt |
| Total | $14,671,024 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $0 | SubstantialContributorsTotAmt |
| Public Support Total170 | $14,671,024 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $218 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $8,531 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $11,664 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $6,030 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $9,006 | CurrentTaxYearAmt |
| Total | $35,449 | TotalAmt |
Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $14,706,473 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $10,150,293 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.99760 | PublicSupportCY170Pct |
| Public Support PY170 | 0.99790 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
| Public Support Total509 | $0 | PublicSupportTotal509Amt |
| Public Support CY509 | 0 | PublicSupportCY509Pct |
| Investment Income CY | 0 | InvestmentIncomeCYPct |
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) |
|---|---|---|
| Investment Cost Or Other Basis | $447,431 | InvestmentCostOrOtherBasisAmt |
| Book Value | $447,431 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $3,522,998 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $425,056 | DepreciationAmt |
| Book Value | $3,097,942 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $595,952 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $289,001 | DepreciationAmt |
| Book Value | $306,951 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $33,230 | InvestmentCostOrOtherBasisAmt |
| Book Value | $33,230 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $3,885,554 | TotalBookValueLandBuildingsAmt |
| Total Rev Etc Audited Fincl Stmt | $7,735,195 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$4,995 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | -$4,995 | RevenueNotReportedAmt |
| Revenue Subtotal | $7,740,190 | RevenueSubtotalAmt |
| Investment Expenses Not Incld | $175 | InvestmentExpensesNotIncldAmt |
| Revenue Not Reported Fincl Stmt | $175 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $7,740,365 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $5,947,838 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $5,947,838 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $5,947,838 | TotalExpensesPerForm990Amt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| STEPHANIE JONES-HEATH | |||||||||||||
| $228,735 | $0 | $0 | $0 | $16,086 | $0 | $6,914 | $0 | $0 | $0 | $251,735 | $0 | $0 | $0 |
| SHARIFA ABOU-MEDIENE | |||||||||||||
| $203,338 | $0 | $0 | $0 | $12,713 | $0 | $0 | $0 | $0 | $0 | $216,051 | $0 | $0 | $0 |
| MARY ALLEN | |||||||||||||
| $164,154 | $0 | $0 | $0 | $13,113 | $0 | $0 | $0 | $0 | $0 | $177,267 | $0 | $0 | $0 |
| ANDRE SINGLETON | |||||||||||||
| $149,745 | $0 | $0 | $0 | $27,984 | $0 | $0 | $0 | $0 | $0 | $177,729 | $0 | $0 | $0 |
Schedule M IRS990ScheduleM
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 4143 | ContributionCnt |
| Noncash Contributions Rpt F990 | $103,177 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | Yes (true) | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | false | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Pt VI, Line 11b | ORGANIZATION'S PROCESS TO REVIEW FOR 990 REVIEWED BY CEO AND CFO AND A COPY IS PROVIDED TO THE BOARD MEMBERS. |
| Pt VI, Line 12c | POLICY REQUIRES IMMEDIATE DISCLOSURE OF CONFLICT WHEN THE INCIDENT OCCURS. |
| Pt XI | LINE 9 REPRESENTS THE CHANGE IN NET ASSETS WITH DONOR |
| Pt XI | RESTRICTIONS FOR THE YEAR. |