VOLUNTEER HEALTHCARE CLINIC INC: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization
VOLUNTEER HEALTHCARE CLINIC INC (EIN 74-6082464)
Tax period
2021-01-01 to 2021-12-31
Filed
2022-06-17
IRS object ID
202201689349300610
Schema version
2021v4.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2022-06-17T07:22:08-07:00ReturnTs
Tax Period End2021-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN742981758PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Dunagan Jack LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line14833 Spicewood Springs Rd Ste 102AddressLine1Txt
CityAustinCityNm
State AbbreviationTXStateAbbreviationCd
ZIP78759ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2021-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN746082464EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Volunteer Healthcare Clinic IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlVOLUBusinessNameControlTxt
Phone5124596002PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line14215 Medical ParkwayAddressLine1Txt
CityAustinCityNm
State AbbreviationTXStateAbbreviationCd
ZIP78756ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonSamantha O'MearaPersonNm
Person TitleTreasurerPersonTitleTxt
Signature2022-06-17SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstSamanthaPersonFirstNm
Person LastOMearaPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonGary Joseph JackPreparerPersonNm
PTINP00184408PTIN
Phone5124208997PhoneNum
Self EmployedYes (X)SelfEmployedInd

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer2TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
Federated Assurance LevelFAL1FederatedAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2021TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerMarci RoePrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line14215 Medical ParkwayAddressLine1Txt
CityAustinCityNm
State AbbreviationTXStateAbbreviationCd
ZIP78756ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$1,159,886GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.volclinic.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1966FormationYr
Legal Domicile StateTXLegalDomicileStateCd
Activity Or MissionOur mission is to improve the health of the uninsured and working poor by providing access to high quality health care and prevention education. Our vision is to help create and sustain a healthy community where all people have access to healthcare and personal well-being.ActivityOrMissionDesc
Voting Members Governing Body17VotingMembersGoverningBodyCnt
Voting Members Independent17VotingMembersIndependentCnt
Total Employee24TotalEmployeeCnt
Total Volunteers398TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$1,112,913PYContributionsGrantsAmt
CY Contributions Grants$1,146,668CYContributionsGrantsAmt
PY Program Service Revenue$7,666PYProgramServiceRevenueAmt
CY Program Service Revenue$5,781CYProgramServiceRevenueAmt
PY Investment Income$4,039PYInvestmentIncomeAmt
CY Investment Income$158CYInvestmentIncomeAmt
PY Other Revenue$7,646PYOtherRevenueAmt
CY Other Revenue$7,279CYOtherRevenueAmt
PY Total Revenue$1,132,264PYTotalRevenueAmt
CY Total Revenue$1,159,886CYTotalRevenueAmt
CY Grants And Similar Paid$39,965CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$373,573PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$436,831CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$33,628CYTotalFundraisingExpenseAmt
PY Other Expenses$524,996PYOtherExpensesAmt
CY Other Expenses$771,276CYOtherExpensesAmt
PY Total Expenses$898,569PYTotalExpensesAmt
CY Total Expenses$1,248,072CYTotalExpensesAmt
PY Revenues Less Expenses$233,695PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$88,186CYRevenuesLessExpensesAmt
Total Assets BOY$1,724,675TotalAssetsBOYAmt
Total Assets EOY$1,773,696TotalAssetsEOYAmt
Total Liabilities BOY$1,232TotalLiabilitiesBOYAmt
Total Liabilities EOY$3,732TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$1,723,443NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$1,769,964NetAssetsOrFundBalancesEOYAmt
MissionOur mission is to improve the health of the uninsured and working poor by providing access to high quality health care and prevention education. Our vision is to help create and sustain a healthy community where all people, especially the indigent, have access to healthcare and personal well-being.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$1,157,433ExpenseAmt
Grant$39,965GrantAmt
Revenue$5,781RevenueAmt
DescThe Clinic provided walk-in clinics for adults and children seeking medical attention for primary, acute care needs and a chronic disease management clinic for patients with diabetes, hypertension, and endocrine disorders. The Clinic offered social service referrals, limited mental health services, and healthy lifestyle counseling as well. The Clinic also maintained an onsite pharmacy and lab. The Clinic offered care to people with no health insurance who are living at or below 200% of the U.S. Federal Poverty Level.Desc
Total Program Service Expenses$1,157,433TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsYes (true)DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecYes (true)ReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (true)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsYes (true)GrantsToIndividualsInd
Schedule J RequiredfalseScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContriYes (true)DeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld CompliancefalseBackupWthldComplianceInd
Employee24EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Form8282 Filed0Form8282FiledCnt
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Form8899 FiledindfalseForm8899Filedind
Form1098 C FiledfalseForm1098CFiledInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members17GoverningBodyVotingMembersCnt
Independent Voting Member17IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyfalseForm990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnfalseAnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcfalseRegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonMarci RoePersonNm
Phone5124596002PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line14215 Medical ParkwayAddressLine1Txt
CityAustinCityNm
State AbbreviationTXStateAbbreviationCd
ZIP78756ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorInd
Marci Roe
Exec Director40.000.00Yes (X)$81,120$0$2,434
Ranjit Nayak
President1.000.00Yes (X)$0$0$0Yes (X)
Davika Reid
Vice President1.000.00Yes (X)$0$0$0Yes (X)
Christopher Spencer
Secretary1.000.00Yes (X)$0$0$0Yes (X)
Samantha O'Meara
Treasurer1.000.00Yes (X)$0$0$0Yes (X)
Tom McHorse
Med Director1.000.00Yes (X)$0$0$0Yes (X)
Allen Busch
Director1.000.00$0$0$0Yes (X)
Candice Chavez-Fischer
Director1.000.00$0$0$0Yes (X)
Ellee Cochran
Director1.000.00$0$0$0Yes (X)
Lora Ann Gerson
Director1.000.00$0$0$0Yes (X)
Tom Hassell
Director1.000.00$0$0$0Yes (X)
Sheldon Markowitz
Director1.000.00$0$0$0Yes (X)
Amu Patel
Director1.000.00$0$0$0Yes (X)
Avi Santos
Director1.000.00$0$0$0Yes (X)
Beth Schlechter
Director1.000.00$0$0$0Yes (X)
Lynda Shanblum
Director1.000.00$0$0$0Yes (X)
Sunaina Suhag
Director1.000.00$0$0$0Yes (X)
Aurora Trahan
Director1.000.00$0$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$81,120TotalReportableCompFromOrgAmt
Total Other Compensation$2,434TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KfalseTotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Government Grants$184,960GovernmentGrantsAmt
All Other Contributions$961,708AllOtherContributionsAmt
Noncash Contributions$606,827NoncashContributionsAmt
Total Contributions$1,146,668TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPatient feesDesc
Business621300BusinessCd
Total Revenue Column$5,781TotalRevenueColumnAmt
Related Or Exempt Func Income$5,781RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$5,781TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$158TotalRevenueColumnAmt
Exclusion$158ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescOther revenuesDesc
Business900099BusinessCd
Total Revenue Column$7,279TotalRevenueColumnAmt
Exclusion$7,279ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$7,279OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,159,886TotalRevenueColumnAmt
Related Or Exempt Func Income$5,781RelatedOrExemptFuncIncomeAmt
Exclusion$7,437ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$39,965TotalAmt
Program Services$39,965ProgramServicesAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$81,120TotalAmt
Program Services$56,784ProgramServicesAmt
Management And General$8,112ManagementAndGeneralAmt
Fundraising$16,224FundraisingAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$319,738TotalAmt
Program Services$303,988ProgramServicesAmt
Management And General$13,935ManagementAndGeneralAmt
Fundraising$1,815FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$5,307TotalAmt
Program Services$3,715ProgramServicesAmt
Management And General$531ManagementAndGeneralAmt
Fundraising$1,061FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$30,666TotalAmt
Program Services$27,599ProgramServicesAmt
Management And General$1,687ManagementAndGeneralAmt
Fundraising$1,380FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$7,511TotalAmt
Management And General$7,511ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$949TotalAmt
Management And General$949ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$6,490TotalAmt
Program Services$4,921ProgramServicesAmt
Management And General$1,374ManagementAndGeneralAmt
Fundraising$195FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$10,509TotalAmt
Program Services$9,353ProgramServicesAmt
Management And General$578ManagementAndGeneralAmt
Fundraising$578FundraisingAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$19,273TotalAmt
Program Services$17,153ProgramServicesAmt
Management And General$1,060ManagementAndGeneralAmt
Fundraising$1,060FundraisingAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$10,066TotalAmt
Management And General$10,066ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
Medical supplies$614,681$614,681
Medicines$39,009$39,009
Miscellaneous$33,420$24,947$5,062$3,411
Other personnel expenses$16,055$15,318$644$93

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$13,313TotalAmt
Management And General$5,502ManagementAndGeneralAmt
Fundraising$7,811FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$1,248,072TotalAmt
Program Services$1,157,433ProgramServicesAmt
Management And General$57,011ManagementAndGeneralAmt
Fundraising$33,628FundraisingAmt
FieldValueIRS element (for citing)
Joint CostsYes (X)JointCostsInd

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$266,458BOYAmt
EOY$143,440EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$403,687BOYAmt
EOY$241,301EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$625,471LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$345,484LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$292,733BOYAmt
EOY$279,987EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
EOY$100,014EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$761,797BOYAmt
EOY$1,008,954EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$1,724,675BOYAmt
EOY$1,773,696EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,232BOYAmt
EOY$3,732EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,232BOYAmt
EOY$3,732EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,425,300BOYAmt
EOY$1,486,691EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$298,143BOYAmt
EOY$283,273EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,723,443BOYAmt
EOY$1,769,964EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,724,675BOYAmt
EOY$1,773,696EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$88,186ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$134,707OtherChangesInNetAssetsAmt
Method Of Accounting CashYes (X)MethodOfAccountingCashInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$574,311CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$474,535CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$616,019CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,112,913CurrentTaxYearMinus1YearAmt
Current Tax Year$1,146,668CurrentTaxYearAmt
Total$3,924,446TotalAmt

Tax Rev Levied Orgnztnl Bnft170 TaxRevLeviedOrgnztnlBnft170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$574,311CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$474,535CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$616,019CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,112,913CurrentTaxYearMinus1YearAmt
Current Tax Year$1,146,668CurrentTaxYearAmt
Total$3,924,446TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$521,949SubstantialContributorsTotAmt
Public Support Total170$3,402,497PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$451CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$3,471CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$3,311CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$4,039CurrentTaxYearMinus1YearAmt
Current Tax Year$158CurrentTaxYearAmt
Total$11,430TotalAmt

Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Income170 OtherIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$542CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$6,208CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$3,073CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$7,646CurrentTaxYearMinus1YearAmt
Current Tax Year$7,279CurrentTaxYearAmt
Total$24,748TotalAmt
FieldValueIRS element (for citing)
Total Support$3,960,624TotalSupportAmt
Gross Receipts Rltd Activities$95,606GrossReceiptsRltdActivitiesAmt
Public Support CY1700.85910PublicSupportCY170Pct
Public Support PY1700.79550PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$761,797BeginningYearBalanceAmt
Contributions$112,800ContributionsAmt
Investment Earnings Or Losses$134,707InvestmentEarningsOrLossesAmt
End Year Balance$1,009,304EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$635,084BeginningYearBalanceAmt
Contributions$50,350ContributionsAmt
Investment Earnings Or Losses$80,363InvestmentEarningsOrLossesAmt
Grants Or Scholarships$4,000GrantsOrScholarshipsAmt
End Year Balance$761,797EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$513,519BeginningYearBalanceAmt
Contributions$30,263ContributionsAmt
Investment Earnings Or Losses$91,302InvestmentEarningsOrLossesAmt
End Year Balance$635,084EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$515,494BeginningYearBalanceAmt
Contributions$39,219ContributionsAmt
Investment Earnings Or Losses-$41,194InvestmentEarningsOrLossesAmt
End Year Balance$513,519EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$329,736BeginningYearBalanceAmt
Contributions$138,718ContributionsAmt
Investment Earnings Or Losses$47,040InvestmentEarningsOrLossesAmt
End Year Balance$515,494EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.75900BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.24100PrmnntEndowmentBalanceEOYPct
Endowments Held Unrelated OrgYes (true)EndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgfalseEndowmentsHeldRelatedOrgInd
Related Org List Sch RfalseRelatedOrgListSchRInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$50,000OtherCostOrOtherBasisAmt
Book Value$50,000BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$508,195OtherCostOrOtherBasisAmt
Depreciation$288,809DepreciationAmt
Book Value$219,386BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$27,801OtherCostOrOtherBasisAmt
Depreciation$20,235DepreciationAmt
Book Value$7,566BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$39,475OtherCostOrOtherBasisAmt
Depreciation$36,440DepreciationAmt
Book Value$3,035BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$279,987TotalBookValueLandBuildingsAmt
Total Book Value Securities$100,014TotalBookValueSecuritiesAmt

Other Assets Org OtherAssetsOrgGrp

FieldValueIRS element (for citing)
DescBeneficial interest in funds held at ACFDesc
Book Value$1,008,954BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Other Assets$1,008,954TotalBookValueOtherAssetsAmt
Total Rev Etc Audited Fincl Stmt$687,766TotalRevEtcAuditedFinclStmtAmt
Other Revenue$134,707OtherRevenueAmt
Revenue Not Reported$134,707RevenueNotReportedAmt
Revenue Subtotal$553,059RevenueSubtotalAmt
Other Revenues Not Included$606,827OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$606,827RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$1,159,886TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$641,245TotExpnsEtcAuditedFinclStmtAmt
Expenses Subtotal$641,245ExpensesSubtotalAmt
Other Expenses Not Included$606,827OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$606,827ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$1,248,072TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part V, Line 4: Intended uses of the endowment fund.To provide general support to the Organization.
Part XI, Line 2d: Other revenue amounts included in F/S but not included on form 990Change in value of beneficial interests $134707
Part XI, Line 4b: Other revenue amounts included on 990 but not included in F/SDonated medical supplies $606827
Part XII, Line 4b: Other revenue amounts included on 990 but not included in F/SDonated medical supplies $606827

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (true)GrantRecordsMaintainedInd
Total501c3 Org0Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

FieldValueIRS element (for citing)
Grant TypeGift cards for patientsGrantTypeTxt
Recipient99RecipientCnt
Cash Grant$39,965CashGrantAmt
Valuation Method UsedCostValuationMethodUsedDesc
Non Cash AssistanceGift cardsNonCashAssistanceDesc

Schedule M IRS990ScheduleM

Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Noncash Contributions Rpt F990$606,827NoncashContributionsRptF990Amt
Method Of Determining RevenuesFMVMethodOfDeterminingRevenuesTxt
FieldValueIRS element (for citing)
Any Property That Must Be HeldfalseAnyPropertyThatMustBeHeldInd
Review Process Unusual NC GiftsfalseReviewProcessUnusualNCGiftsInd
Third Parties UsedfalseThirdPartiesUsedInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Line 11b: Form 990 Review ProcessThe Clinic's CPA prepares a draft of the return. The Executive Director and Treasurer review the draft before it is filed.
Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key EmployeesThe Clinic has a personnel committee, which is a sub-committee of the Board of Directors, comprised of 5 directors, which includes the Treasurer. This committee oversaw the hiring of the Executive Director and reviews compensation changes for new and existing staff members. When determining a new leased employee's salary, efforts are made to bench mark against other similar positions in similar organizations. This might take the form of speaking with other non-profit leaders within the community, reviewing on-line salary reporting sites/or reviewing available compensation reports. Other factors, such as experience and knowledge, are also taken into consideration.
Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailableCertain other documents available upon request.
Other Changes In Net Assets Or Fund Balances - Other IncreasesChange in value of beneficial interests = $134707

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