VIDA Y SALUD-HEALTH SYSTEMS INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- VIDA Y SALUD-HEALTH SYSTEMS INC (EIN 74-1715419)
- Tax period
- 2021-04-01 to 2022-03-31
- Filed
- 2022-08-24
- IRS object ID
- 202202369349301905
- 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 | 2022-08-24T14:33:01-07:00 | ReturnTs |
| Tax Period End | 2022-03-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 741867466 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GARZA GONZALEZ AND ASSOCIATES | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 207 ARDEN GROVE | AddressLine1Txt |
| City | SAN ANTONIO | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 78215 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-04-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 741715419 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Vida Y Salud Health Systems Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | VIDA | BusinessNameControlTxt |
| Phone | 8303742301 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 308 Cesar Chavez Avenue | AddressLine1Txt |
| City | Crystal City | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 78839 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Nora Tellez | PersonNm |
| Person Title | Chief Executive Officer | PersonTitleTxt |
| Phone | 8303742301 | PhoneNum |
| Signature | 2022-08-11 | SignatureDt |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | Nora | PersonFirstNm |
| Person Last | Tellez | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | XXX-XX-XXXX | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Gregory R Garza | PreparerPersonNm |
| PTIN | P01511204 | PTIN |
| Phone | 2102271389 | PhoneNum |
| Preparation | 2022-08-24 | 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 | Nora Tellez | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 308 Cesar Chavez Avenue | AddressLine1Txt |
| City | Crystal City | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 78839 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $6,792,028 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | http://www.vidaysalud.org/ | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1972 | FormationYr |
| Legal Domicile State | TX | LegalDomicileStateCd |
| Activity Or Mission | Provides health services to the people of Zavala,Dimmit,LaSalle,Uvalde and surrounding counties. Services include medical,dental,food and nutrition education,immunizations, and glaucoma screening | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 96 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $5,155,395 | PYContributionsGrantsAmt |
| CY Contributions Grants | $4,909,517 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $1,383,917 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $1,742,326 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$118 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,581 | CYInvestmentIncomeAmt |
| PY Other Revenue | $209,177 | PYOtherRevenueAmt |
| CY Other Revenue | $138,604 | CYOtherRevenueAmt |
| PY Total Revenue | $6,748,371 | PYTotalRevenueAmt |
| CY Total Revenue | $6,792,028 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $3,990,348 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $4,009,784 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,738,973 | PYOtherExpensesAmt |
| CY Other Expenses | $1,680,076 | CYOtherExpensesAmt |
| PY Total Expenses | $5,729,321 | PYTotalExpensesAmt |
| CY Total Expenses | $5,689,860 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,019,050 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,102,168 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $6,135,766 | TotalAssetsBOYAmt |
| Total Assets EOY | $6,983,119 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $460,879 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $206,064 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $5,674,887 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $6,777,055 | NetAssetsOrFundBalancesEOYAmt |
| Mission | Vida Y Salud-Health Systems, Inc. was founded in 1972 and provides health services to the people of Zavala,Dimmit,LaSalle,Uvalde and surrounding counties. The clinic maintains four program/service delivery sites and provides services such as laboratory, pharmacy, immunization,dental,WIC,radiology, social services,family planning and OB, and family medicine for all age groups. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $3,466,467 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $1,742,326 | RevenueAmt |
| Desc | The Center provides comprehensive medical care to domestic agricultural migratory workers and seasonal agricultural workers who reside in Zavala County. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $378,433 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $0 | RevenueAmt |
| Desc | Women, Infants and Children program provides supplemental food and nutrition education to those families whose children are under 5 years of age. Additionally, imunization services are provided as well. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $3,844,900 | 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 | 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 |
| Transaction With Control Ent | false | TransactionWithControlEntInd |
| 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 |
| Employee | 96 | 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 |
| 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 | Yes (true) | 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 | false | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | false | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | 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 | Nora Tellez | PersonNm |
| Phone | 8303742301 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 308 Cesar Chavez | AddressLine1Txt |
| City | Crystal City | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 78839 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Key EmployeeKeyEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| Santos Camarillo | ||||||||
| Chairperson | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Connie Narvaez | ||||||||
| Vice-Chairperson | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Martina Delgado | ||||||||
| Secretary | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Elizabeth Betty Avila | ||||||||
| Treasurer | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Maria Del Rosario Amoles | ||||||||
| Board Member | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| Robert L Hernandez | ||||||||
| Board Member | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| Eusevio E Salinas Jr | ||||||||
| Board Member | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| Faviola Martinez | ||||||||
| Board Member | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| Jose Uribe | ||||||||
| Board Member | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| Oluyemisi O Laditan | ||||||||
| Dental Director | 40.00 | $145,484 | $0 | $16,785 | Yes (X) | |||
| Steven P Garza | ||||||||
| Physician Assistant | 40.00 | $122,230 | $0 | $9,636 | Yes (X) | |||
| Tony T Moreno | ||||||||
| PA-C | 40.00 | $110,728 | $0 | $26,000 | Yes (X) | |||
| Nora Tellez | ||||||||
| Chief Executive Officer | 40.00 | Yes (X) | $123,381 | $0 | $12,724 | |||
| Rosanna G Caballero | ||||||||
| Family Nurse Practitioner | 40.00 | $114,915 | $0 | $7,955 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $616,738 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $73,100 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 5 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | false | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Remiguis Okea | PersonNm |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3126 Rio Cordillera | AddressLine1Txt |
| City | Boerne | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 78006 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | Medical Director | ServicesDesc |
| Compensation | $199,500 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $4,711,763 | GovernmentGrantsAmt |
| All Other Contributions | $197,754 | AllOtherContributionsAmt |
| Noncash Contributions | $37,400 | NoncashContributionsAmt |
| Total Contributions | $4,909,517 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Patient Fees | Desc |
| Business | 621111 | BusinessCd |
| Total Revenue Column | $1,742,326 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $1,742,326 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,581 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,581 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Other Revenue | Desc |
| Business | 621498 | BusinessCd |
| Total Revenue Column | $138,604 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $138,604 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $138,604 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $6,792,028 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,880,930 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,581 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $689,838 | TotalAmt |
| Program Services | $553,733 | ProgramServicesAmt |
| Management And General | $136,105 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,661,218 | TotalAmt |
| Program Services | $1,853,987 | ProgramServicesAmt |
| Management And General | $807,231 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $77,576 | TotalAmt |
| Program Services | $40,403 | ProgramServicesAmt |
| Management And General | $37,173 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $337,783 | TotalAmt |
| Program Services | $213,013 | ProgramServicesAmt |
| Management And General | $124,770 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $243,369 | TotalAmt |
| Program Services | $173,556 | ProgramServicesAmt |
| Management And General | $69,813 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $84,735 | TotalAmt |
| Program Services | $39,511 | ProgramServicesAmt |
| Management And General | $45,224 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,090 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $38,090 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $115,513 | TotalAmt |
| Program Services | $51,285 | ProgramServicesAmt |
| Management And General | $64,228 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $186,509 | TotalAmt |
| Program Services | $7,017 | ProgramServicesAmt |
| Management And General | $179,492 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $103,093 | TotalAmt |
| Program Services | $52,865 | ProgramServicesAmt |
| Management And General | $50,228 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,589 | TotalAmt |
| Program Services | $4,776 | ProgramServicesAmt |
| Management And General | $2,813 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $158,612 | TotalAmt |
| Program Services | $109,883 | ProgramServicesAmt |
| Management And General | $48,729 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $34,370 | TotalAmt |
| Program Services | $34,183 | ProgramServicesAmt |
| Management And General | $187 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| Maintenance/Repairs | $29,866 | $21,105 | $8,761 | $0 |
| Other | $142,270 | $4,473 | $137,797 | $0 |
| Patient Care Services | $291,044 | $291,044 | $0 | $0 |
| Supplies | $470,228 | $382,175 | $88,053 | $0 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,157 | TotalAmt |
| Program Services | $11,891 | ProgramServicesAmt |
| Management And General | $6,266 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,689,860 | TotalAmt |
| Program Services | $3,844,900 | ProgramServicesAmt |
| Management And General | $1,844,960 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,149,831 | BOYAmt |
| EOY | $3,222,483 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $413,570 | BOYAmt |
| EOY | $664,894 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,362 | BOYAmt |
| EOY | $16,444 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $319,953 | BOYAmt |
| EOY | $4,498 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $5,986,221 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $2,911,421 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,231,050 | BOYAmt |
| EOY | $3,074,800 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,135,766 | BOYAmt |
| EOY | $6,983,119 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $460,879 | BOYAmt |
| EOY | $206,064 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $460,879 | BOYAmt |
| EOY | $206,064 | 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 | $5,674,887 | BOYAmt |
| EOY | $6,777,055 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,674,887 | BOYAmt |
| EOY | $6,777,055 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,135,766 | BOYAmt |
| EOY | $6,983,119 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $1,102,168 | ReconcilationRevenueExpnssAmt |
| 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 | false | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
| Other Support Sum | $0 | OtherSupportSumAmt |
| Public Support CY170 | 0 | PublicSupportCY170Pct |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,641,532 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,766,964 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $4,039,664 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $5,155,395 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,909,517 | CurrentTaxYearAmt |
| Total | $21,513,072 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,764,665 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,742,648 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,775,757 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,383,917 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,742,326 | CurrentTaxYearAmt |
| Total | $8,409,313 | TotalAmt |
Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Tax Rev Levied Orgnztnl Bnft509 TaxRevLeviedOrgnztnlBnft509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $5,406,197 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $5,509,612 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $5,815,421 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $6,539,312 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $6,651,843 | CurrentTaxYearAmt |
| Total | $29,922,385 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $29,922,385 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,056 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $5,562 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $9,052 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,177 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,581 | CurrentTaxYearAmt |
| Total | $22,428 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,056 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $5,562 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $9,052 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,177 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,581 | CurrentTaxYearAmt |
| Total | $22,428 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $71,201 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $28,563 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $111,749 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $209,177 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $138,604 | CurrentTaxYearAmt |
| Total | $559,294 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,504,107 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.98090 | PublicSupportCY509Pct |
| Public Support PY509 | 0.98170 | PublicSupportPY509Pct |
| Investment Income CY | 0.00070 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00080 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Pt III Ln 12 | FormAndLineReferenceDesc |
| Explanation | Other Income Part III, Line 12 Description: Other Income 2017: 71201. 2018: 28563. 2019: 111749. 2020: 209177. 2021: 138604. | ExplanationTxt |
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 | $0 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $21,292 | OtherCostOrOtherBasisAmt |
| Book Value | $21,292 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,568,455 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,886,875 | DepreciationAmt |
| Book Value | $1,681,580 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $103,515 | OtherCostOrOtherBasisAmt |
| Book Value | $103,515 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,249,838 | OtherCostOrOtherBasisAmt |
| Depreciation | $981,425 | DepreciationAmt |
| Book Value | $1,268,413 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $43,121 | OtherCostOrOtherBasisAmt |
| Depreciation | $43,121 | DepreciationAmt |
| Book Value | $0 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $3,074,800 | TotalBookValueLandBuildingsAmt |
| Total Rev Etc Audited Fincl Stmt | $6,792,028 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Subtotal | $6,792,028 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $6,792,028 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $5,689,860 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $5,689,860 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $5,689,860 | TotalExpensesPerForm990Amt |
Schedule M IRS990ScheduleM
Cars And Other Vehicles CarsAndOtherVehiclesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $37,400 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | Book Value | MethodOfDeterminingRevenuesTxt |
| 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 (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Pt VI, Line 11b | The Chief Financial Officer reviews the Form 990 in its entirety before signing. The Form 990 will be presented to the Board of Directors as well for their review. |
| Pt VI, Line 12c | Through training, emails, letters, and disciplinary measures when violations occur. |
| Pt VI, Line 15a | Through the National Association of Community Health Centers benefits and yearly surveys in the area. |
| Pt VI, Line 19 | Through Board of Directors meetings which are open to the public. |
| Pt VI, Line 6 | The Organization has Board Members are the governing body that provides oversight of management decisions |
| Pt VI, Line 15b | Through the National Association of Community Health Centers benefits and yearly surveys in the area. |
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