GREENVILLE FREE MEDICAL CLINIC: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- GREENVILLE FREE MEDICAL CLINIC (EIN 57-0855205)
- Tax period
- 2020-07-01 to 2021-06-30
- Filed
- 2022-05-11
- IRS object ID
- 202201319349305010
- Schema version
- 2020v4.0
- 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 | 2022-05-11T15:00:20-05:00 | ReturnTs |
| Tax Period End | 2021-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 570661343 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JENNINGS COOK & CO CPA'S PA | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 25937 | AddressLine1Txt |
| City | GREENVILLE | CityNm |
| State Abbreviation | SC | StateAbbreviationCd |
| ZIP | 29616 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 570855205 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GREENVILLE FREE MEDICAL CLINIC INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | GREE | BusinessNameControlTxt |
| Phone | 8642321470 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 ARLINGTON AVENUE | AddressLine1Txt |
| City | GREENVILLE | CityNm |
| State Abbreviation | SC | StateAbbreviationCd |
| ZIP | 29601 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SUZIE J FOLEY | PersonNm |
| Person Title | EXECUTIVE DIRECTOR | PersonTitleTxt |
| Phone | 8642321470 | PhoneNum |
| Signature | 2022-04-27 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | SUZIE J | PersonFirstNm |
| Person Last | FOLEY | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 000002071 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DOUGLAS P SCHMIEDING | PreparerPersonNm |
| PTIN | P00101637 | PTIN |
| Phone | 8642974700 | PhoneNum |
| Preparation | 2022-05-10 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | SUZIE J FOLEY | PrincipalOfficerNm |
| Gross Receipts | $8,027,823 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | GREENVILLEFREECLINIC.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1987 | FormationYr |
| Legal Domicile State | SC | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE AN EQUITABLE BRIDGE TO QUALITY HEALTH CARE FOR GREENVILLE COUNTY RESIDENTS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 16 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 16 | VotingMembersIndependentCnt |
| Total Employee | 26 | TotalEmployeeCnt |
| Total Volunteers | 301 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $8,147,649 | PYContributionsGrantsAmt |
| CY Contributions Grants | $7,958,303 | CYContributionsGrantsAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $23,323 | PYInvestmentIncomeAmt |
| CY Investment Income | $16,678 | CYInvestmentIncomeAmt |
| PY Other Revenue | $59,321 | PYOtherRevenueAmt |
| CY Other Revenue | $34,827 | CYOtherRevenueAmt |
| PY Total Revenue | $8,230,293 | PYTotalRevenueAmt |
| CY Total Revenue | $8,009,808 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $988,739 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $990,656 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $86,409 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $7,368,914 | PYOtherExpensesAmt |
| CY Other Expenses | $6,344,164 | CYOtherExpensesAmt |
| PY Total Expenses | $8,357,653 | PYTotalExpensesAmt |
| CY Total Expenses | $7,334,820 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$127,360 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $674,988 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $1,526,264 | TotalAssetsBOYAmt |
| Total Assets EOY | $2,418,426 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $185,003 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $191,883 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,341,261 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $2,226,543 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO PROVIDE AN EQUITABLE BRIDGE TO QUALITY HEALTH CARE FOR GREENVILLE COUNTY RESIDENTS. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $7,046,344 | ExpenseAmt |
| Desc | SEE MISSION STATEMENT 7/1/20 - 6/30/21 ACCOMPLISHMENTS: 6,012 MEDICAL CARE VISITS 501 DENTAL CLINIC VISITS 29,171 PRECRIPTIONS/REFILLS DISPENSED 1,256 NURSE CONSULTS,HEALTH PRESENTATIONS, AND OUTSIDE REFERRALS 2,921 DIAGNOSTICS | Desc |
| Total Program Service Expenses | $7,046,344 | 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 | Yes (true) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (true) | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | false | 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 | 12 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 26 | 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 |
| 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 | 16 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 16 | 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 | Yes (true) | LocalChaptersInd |
| Policies Reference Chapters | Yes (true) | PoliciesReferenceChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SUZIE J FOLEY | PersonNm |
| Phone | 8642321470 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 ARLINGTON AVE | AddressLine1Txt |
| City | GREENVILLE | CityNm |
| State Abbreviation | SC | StateAbbreviationCd |
| ZIP | 29601 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|
| SUZIE J FOLEY | ||||||
| EXECUTIVE DI | 40.00 | Yes (X) | $102,886 | $0 | $20,608 | |
| DR MARCUS BLACKSTONE | ||||||
| CHAIR | 2.00 | $0 | $0 | $0 | Yes (X) | |
| DR JIM BLOODWORTH | ||||||
| DIRECTOR | 2.00 | $0 | $0 | $0 | Yes (X) | |
| HARVEY CLEVELAND | ||||||
| DIRECTOR | 2.00 | $0 | $0 | $0 | Yes (X) | |
| JOHN COLLIER | ||||||
| VICE CHAIR | 2.00 | $0 | $0 | $0 | Yes (X) | |
| REP CHANDRA DILLARD | ||||||
| DIRECTOR | 2.00 | $0 | $0 | $0 | Yes (X) | |
| SALLY FOISTER | ||||||
| DIRECTOR | 2.00 | $0 | $0 | $0 | Yes (X) | |
| JAY HOLLOWAY | ||||||
| DIRECTOR | 2.00 | $0 | $0 | $0 | Yes (X) | |
| CAROLINE VAN HOOK | ||||||
| AUDIT CHAIR | 2.00 | $0 | $0 | $0 | Yes (X) | |
| DR WILLIAM JACKSON | ||||||
| DIRECTOR | 2.00 | $0 | $0 | $0 | Yes (X) | |
| DONNA JOHNSTON | ||||||
| DIRECTOR | 2.00 | $0 | $0 | $0 | Yes (X) | |
| STEPHEN ZINKANN RPH | ||||||
| DIRECTOR | 2.00 | $0 | $0 | $0 | Yes (X) | |
| DR SARIA SACCOCIO | ||||||
| DIRECTOR | 2.00 | $0 | $0 | $0 | Yes (X) | |
| MICHELLE TAYLOR-SMITH | ||||||
| IMMEDIATE PA | 2.00 | $0 | $0 | $0 | Yes (X) | |
| JOSH TEW | ||||||
| SECRETARY | 2.00 | $0 | $0 | $0 | Yes (X) | |
| DR ELLEN THRAIKILL | ||||||
| DIRECTOR | 2.00 | $0 | $0 | $0 | Yes (X) | |
| LISSETTE TREANOR | ||||||
| DIRECTOR | 2.00 | $0 | $0 | $0 | Yes (X) | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $102,886 | TotalReportableCompFromOrgAmt |
| Total Other Compensation | $20,608 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 1 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | false | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| Government Grants | $715,001 | GovernmentGrantsAmt |
| All Other Contributions | $7,243,302 | AllOtherContributionsAmt |
| Noncash Contributions | $5,916,414 | NoncashContributionsAmt |
| Total Contributions | $7,958,303 | TotalContributionsAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $15,869 | TotalRevenueColumnAmt |
| Exclusion | $15,869 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $6,231 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $5,422 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $809 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $809 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $809 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $47,420 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $12,593 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $34,827 | TotalRevenueColumnAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $8,009,808 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $809 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $15,869 | ExclusionAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $829,295 | TotalAmt |
| Program Services | $703,433 | ProgramServicesAmt |
| Management And General | $62,931 | ManagementAndGeneralAmt |
| Fundraising | $62,931 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $96,716 | TotalAmt |
| Program Services | $81,242 | ProgramServicesAmt |
| Management And General | $7,737 | ManagementAndGeneralAmt |
| Fundraising | $7,737 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $64,645 | TotalAmt |
| Program Services | $54,301 | ProgramServicesAmt |
| Management And General | $5,172 | ManagementAndGeneralAmt |
| Fundraising | $5,172 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,815 | TotalAmt |
| Management And General | $13,655 | ManagementAndGeneralAmt |
| Fundraising | $1,160 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $49,687 | TotalAmt |
| Program Services | $25,320 | ProgramServicesAmt |
| Management And General | $20,138 | ManagementAndGeneralAmt |
| Fundraising | $4,229 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $59,188 | TotalAmt |
| Program Services | $47,350 | ProgramServicesAmt |
| Management And General | $11,838 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,330 | TotalAmt |
| Management And General | $21,330 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| DONATED MATERIALS | $5,916,414 | $5,916,414 | |
| PRESCRIPTIONS | $90,201 | $90,201 | |
| MEDICAL & DENTAL SUPPLIES | $56,105 | $56,105 | |
| CONTRACTED SERVICES | $46,402 | $24,127 | $22,275 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $90,022 | TotalAmt |
| Program Services | $47,851 | ProgramServicesAmt |
| Management And General | $36,991 | ManagementAndGeneralAmt |
| Fundraising | $5,180 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,334,820 | TotalAmt |
| Program Services | $7,046,344 | ProgramServicesAmt |
| Management And General | $202,067 | ManagementAndGeneralAmt |
| Fundraising | $86,409 | FundraisingAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $170,420 | BOYAmt |
| EOY | $658,245 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,428 | BOYAmt |
| EOY | $5,980 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,294 | BOYAmt |
| EOY | $13,428 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $2,305,526 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,597,761 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $517,329 | BOYAmt |
| EOY | $707,765 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $812,793 | BOYAmt |
| EOY | $1,033,008 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,526,264 | BOYAmt |
| EOY | $2,418,426 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $185,003 | BOYAmt |
| EOY | $191,883 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $185,003 | BOYAmt |
| EOY | $191,883 | 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 | $1,171,201 | BOYAmt |
| EOY | $1,835,891 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $170,060 | BOYAmt |
| EOY | $390,652 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,341,261 | BOYAmt |
| EOY | $2,226,543 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,526,264 | BOYAmt |
| EOY | $2,418,426 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $674,988 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $210,294 | NetUnrlzdGainsLossesInvstAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $11,079,353 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $8,166,855 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $9,502,101 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $8,147,649 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $7,958,303 | CurrentTaxYearAmt |
| Total | $44,854,261 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $11,079,353 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $8,166,855 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $9,502,101 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $8,147,649 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $7,958,303 | CurrentTaxYearAmt |
| Total | $44,854,261 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $44,854,261 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $21,001 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $16,061 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $22,545 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $22,852 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $15,869 | CurrentTaxYearAmt |
| Total | $98,328 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $44,952,589 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $265,872 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.99780 | PublicSupportCY170Pct |
| Public Support PY170 | 0.99770 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
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
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $812,837 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $226,446 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $6,275 | AdministrativeExpensesAmt |
| End Year Balance | $1,033,008 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $799,363 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $19,030 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $5,556 | AdministrativeExpensesAmt |
| End Year Balance | $812,837 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $766,567 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $38,132 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $5,336 | AdministrativeExpensesAmt |
| End Year Balance | $799,363 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $716,910 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $54,933 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $5,276 | AdministrativeExpensesAmt |
| End Year Balance | $766,567 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $845,444 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $88,223 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $209,000 | OtherExpendituresAmt |
| Administrative Expenses | $7,757 | AdministrativeExpensesAmt |
| End Year Balance | $716,910 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.85480 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.14520 | PrmnntEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | Yes (true) | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | false | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $20,000 | OtherCostOrOtherBasisAmt |
| Book Value | $20,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,247,822 | OtherCostOrOtherBasisAmt |
| Depreciation | $871,201 | DepreciationAmt |
| Book Value | $376,621 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $950,005 | OtherCostOrOtherBasisAmt |
| Depreciation | $640,386 | DepreciationAmt |
| Book Value | $309,619 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $87,699 | OtherCostOrOtherBasisAmt |
| Depreciation | $86,174 | DepreciationAmt |
| Book Value | $1,525 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $707,765 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| PAYROLL PROTECTION PROGRAM LOAN | $191,337 |
| PAYROLL WITHHOLDINGS | $546 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $191,883 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $11,472,695 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $210,294 | NetUnrealizedGainsInvstAmt |
| Donated Services And Use Fclts | $3,252,593 | DonatedServicesAndUseFcltsAmt |
| Revenue Not Reported | $3,462,887 | RevenueNotReportedAmt |
| Revenue Subtotal | $8,009,808 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $8,009,808 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $10,587,413 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $3,252,593 | DonatedServicesUseFcltsAmt |
| Expenses Not Reported | $3,252,593 | ExpensesNotReportedAmt |
| Expenses Subtotal | $7,334,820 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $7,334,820 | TotalExpensesPerForm990Amt |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | WALK WITH THE D | Event1Nm |
| Gross Receipts Event1 | $19,268 | GrossReceiptsEvent1Amt |
| Gross Revenue Event1 | $19,268 | GrossRevenueEvent1Amt |
| Other Direct Expenses Event1 | $1,106 | OtherDirectExpensesEvent1Amt |
| Event2 | PAR-TEE @ TOPGO | Event2Nm |
| Gross Receipts Event2 | $28,152 | GrossReceiptsEvent2Amt |
| Gross Revenue Event2 | $28,152 | GrossRevenueEvent2Amt |
| Other Direct Expenses Event2 | $11,487 | OtherDirectExpensesEvent2Amt |
| Other Events Total | 1 | OtherEventsTotalCnt |
| Gross Receipts Total | $47,420 | GrossReceiptsTotalAmt |
| Gross Revenue Total Events | $47,420 | GrossRevenueTotalEventsAmt |
| Oth Direct Expnss Total Events | $12,593 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $12,593 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $34,827 | NetIncomeSummaryAmt |
Schedule M IRS990ScheduleM
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $5,906,414 | NoncashContributionsRptF990Amt |
Other Non Cash Contri Table OtherNonCashContriTableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Desc | SUPPLIES | Desc |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $10,000 | NoncashContributionsRptF990Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | false | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | false | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 6, PART VI, LINE 11B | THE AUDIT COMMITTEE REVIEWS FORM 990. AFTER THE COMMITTEE'S REVIEW THE FORM 990 IS SUBMITTED TO THE ENTIRE BOARD OF DIRECTORS FOR FINAL APPROVAL. |
| FORM 990, PAGE 6, PART VI, LINE 12C | POLICY: 4.5 POLICY TITLE: BOARD MEMBER'S CODE OF CONDUCT PROCEDURES FOR ADDRESSING THE CONFLICT OF INTEREST: THE CHAIR OF THE BOARD OR COMMITTEE SHALL, IF APPROPRIATE, APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT. AFTER EXERCISING DUE DILIGENCE, THE BOARD OR COMMITTEE SHALL DETERMINE WHETHER THE CLINIC CAN OBTAIN A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. |
| FORM 990, PAGE 6, PART VI, LINE 15A | THE CEO COMMITTEE REVIEWS THE EXECUTIVE DIRECTOR'S PERFORMANCE ANNUALLY TO DETERMINE IF THE EXECUTIVE DIRECTOR IS IN COMPLIANCE WITH THE CLINIC'S STATED POLICIES. THE COMMITTEE MAKES RECOMMENDATIONS OF COMPENSATION TO THE BOARD BASED ON THE RESULTS OF THE THEIR PERFORMANCE REVIEW. THE BOARD OF DIRECTORS GIVES FINAL APPROVAL OF THE EXECUTIVE DIRECTOR'S COMPENSATION. THE CEO EVALUATION COMMITTEE CONSISTS OF THREE BOARD MEMBERS. |
| FORM 990, PAGE 6, PART VI, LINE 19 | THE PUBLIC IS INVITED TO ALL BOARD MEETINGS AND MAY REVIEW ALL DOCUMENTS. ALL DOCUMENTS ARE ALSO AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST. |
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