PARTNERS IN EXCEPTIONAL CARE: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- PARTNERS IN EXCEPTIONAL CARE (EIN 39-1904074)
- Tax period
- 2020-07-01 to 2021-06-30
- Filed
- 2022-05-13
- IRS object ID
- 202221339349308827
- Schema version
- 2020v4.2
- 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 | 2022-05-13T15:54:15-05:00 | ReturnTs |
| Tax Period End | 2021-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 476097913 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SEIM JOHNSON LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 18081 BURT STREET SUITE 200 | AddressLine1Txt |
| City | OMAHA | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 680224722 | 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 | 391904074 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PARTNERS IN EXCEPTIONAL CARE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PART | BusinessNameControlTxt |
| Phone | 7125422176 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 17TH AND WELLS STREETS PO BOX 217 | AddressLine1Txt |
| City | CLARINDA | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 51632 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | RANDY WALTERS | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 7125422176 | PhoneNum |
| Signature | 2022-05-12 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | RANDY | PersonFirstNm |
| Person Last | WALTERS | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MEGAN L KOZIOL | PreparerPersonNm |
| PTIN | P01544037 | PTIN |
| Phone | 4023302660 | PhoneNum |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | RANDY WALTERS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 17TH AND WELLS STREETS PO BOX 217 | AddressLine1Txt |
| City | CLARINDA | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 51632 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $222,679 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.CLARINDAHEALTH.COM/GIVING | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1996 | FormationYr |
| Legal Domicile State | IA | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE SUPPORT AND FURTHER THE MISSION AND VISION OF CLARINDA REGIONAL HEALTH CENTER THROUGH VOLUNTEERED TIME AND FUNDRAISING EFFORTS TO ENHANCE THE HEALTH AND WELFARE OF THE COMMUNITIES IT SERVES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 6 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 6 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 85 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $121,649 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | $8,350 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $7,513 | CYOtherRevenueAmt |
| PY Total Revenue | $0 | PYTotalRevenueAmt |
| CY Total Revenue | $137,512 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $33,410 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $0 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $0 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $1,346 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $1,346 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $0 | PYOtherExpensesAmt |
| CY Other Expenses | $21,648 | CYOtherExpensesAmt |
| PY Total Expenses | $0 | PYTotalExpensesAmt |
| CY Total Expenses | $56,404 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $0 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $81,108 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $411,295 | TotalAssetsBOYAmt |
| Total Assets EOY | $533,289 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $0 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $0 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $411,295 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $533,289 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE MISSION OF THE PARTNERS IN EXCEPTIONAL CARE ORGANIZATION IS TO PROVIDE SUPPORT AND FURTHER THE MISSION AND VISION OF CLARINDA REGIONAL HEALTH CENTER THROUGH VOLUNTEERED TIME AND FUNDRAISING EFFORTS TO ENHANCE THE HEALTH AND WELFARE OF THE COMMUNITIES IT SERVES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $55,058 | ExpenseAmt |
| Grant | $33,410 | GrantAmt |
| Revenue | $145 | RevenueAmt |
| Desc | PARTNERS IN EXCEPTIONAL CARE MANAGES THE COLLECTION AND DISBURSEMENT OF CONTRIBUTIONS FOR CLARINDA REGIONAL HEALTH CENTER. | Desc |
| Total Program Service Expenses | $55,058 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | 0 | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | 0 | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 0 | EmployeeCnt |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 6 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 6 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | 0 | WhistleblowerPolicyInd |
| Document Retention Policy | 0 | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JEN MCCALL | PersonNm |
| Phone | 7125422176 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 220 ESSIE DAVISON DRIVE | AddressLine1Txt |
| City | CLARINDA | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 51632 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (13 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|---|
| RANDY WALTERS | |||||||
| PRESIDENT | 0.30 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| RITA SHULL | |||||||
| VICE PRESIDENT | 0.30 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| BRITTANY HILL | |||||||
| SECRETARY/TREASURER | 0.30 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| PAM CLEMONS | |||||||
| BOARD MEMBER | 0.30 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| SANDY HOOKHAM | |||||||
| BOARD MEMBER | 0.30 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| BONNY WILLIAMS | |||||||
| BOARD MEMBER | 0.30 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| MELISSA GARNER | |||||||
| BOARD MEMBER (THROUGH 08/20) | 0.30 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| JUDY CLARK | |||||||
| BOARD MEMBER (THROUGH 08/20) | 0.30 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| SHARI GREENWOOD | |||||||
| BOARD MEMBER (THROUGH 08/20) | 0.30 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| DEB CARLSON | |||||||
| BOARD MEMBER (THROUGH 08/20) | 0.30 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| TONJA DOWNEY | |||||||
| BOARD MEMBER (THROUGH 08/20) | 0.30 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| MOLLY GILMORE | |||||||
| BOARD MEMBER (THROUGH 08/20) | 0.30 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| JEN MCCALL | |||||||
| FOUNDATION DIRECTOR | 40.00 | 0.00 | Yes (X) | $0 | $89,500 | $39,366 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $89,500 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $39,366 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | 0 | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Membership Dues | $2,230 | MembershipDuesAmt |
| Fundraising | $30,478 | FundraisingAmt |
| All Other Contributions | $88,941 | AllOtherContributionsAmt |
| Total Contributions | $121,649 | TotalContributionsAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,459 | TotalRevenueColumnAmt |
| Exclusion | $1,459 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $52,794 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $45,903 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $6,891 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $6,891 | TotalRevenueColumnAmt |
| Exclusion | $6,891 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $4,454 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $30,478 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $13,148 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$8,694 | TotalRevenueColumnAmt |
| Exclusion | -$8,694 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $42,178 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $26,116 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $16,062 | TotalRevenueColumnAmt |
| Exclusion | $16,062 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $145 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $145 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $145 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $137,512 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $145 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $15,718 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,910 | TotalAmt |
| Program Services | $30,910 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,500 | TotalAmt |
| Program Services | $2,500 | ProgramServicesAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,346 | TotalAmt |
| Fundraising | $1,346 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,786 | TotalAmt |
| Program Services | $1,786 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,474 | TotalAmt |
| Program Services | $9,474 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,835 | TotalAmt |
| Program Services | $1,835 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (2 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| MISCELLANEOUS | $8,493 | $8,493 |
| MEMBERSHIPS & DUES | $60 | $60 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $56,404 | TotalAmt |
| Program Services | $55,058 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $1,346 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $256,066 | BOYAmt |
| EOY | $52,373 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $277,911 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $311 | BOYAmt |
| EOY | $311 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,136 | BOYAmt |
| EOY | $2,136 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $152,782 | BOYAmt |
| EOY | $200,558 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $411,295 | BOYAmt |
| EOY | $533,289 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | 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 | $411,295 | BOYAmt |
| EOY | $533,289 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $411,295 | BOYAmt |
| EOY | $533,289 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $411,295 | BOYAmt |
| EOY | $533,289 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $81,108 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $40,886 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $20,478 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $27,924 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $31,856 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $48,638 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $121,649 | CurrentTaxYearAmt |
| Total | $250,545 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | $18,409 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $42,178 | CurrentTaxYearAmt |
| Total | $60,587 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $20,478 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $27,924 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $31,856 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $67,047 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $163,827 | CurrentTaxYearAmt |
| Total | $311,132 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $300 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $942 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $820 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year | $1,200 | CurrentTaxYearAmt |
| Total | $3,262 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $300 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $942 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $820 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year | $1,200 | CurrentTaxYearAmt |
| Total | $3,262 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $307,870 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,643 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,752 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,971 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,369 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,459 | CurrentTaxYearAmt |
| Total | $10,194 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,643 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,752 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,971 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,369 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,459 | CurrentTaxYearAmt |
| Total | $10,194 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,570 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,627 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus1 Year | $1,162 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,599 | CurrentTaxYearAmt |
| Total | $8,958 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $23,691 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $31,303 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $34,827 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $70,578 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $169,885 | CurrentTaxYearAmt |
| Total | $330,284 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.93210 | PublicSupportCY509Pct |
| Public Support PY509 | 0.89880 | PublicSupportPY509Pct |
| Investment Income CY | 0.03090 | InvestmentIncomeCYPct |
| Investment Income PY | 0.05220 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | PLATINUM BALL | Event1Nm |
| Gross Receipts Event1 | $34,932 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $30,478 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $4,454 | GrossRevenueEvent1Amt |
| Cash Prizes Event1 | $200 | CashPrizesEvent1Amt |
| Non Cash Prizes Event1 | $4,748 | NonCashPrizesEvent1Amt |
| Food And Beverage Event1 | $2,262 | FoodAndBeverageEvent1Amt |
| Other Direct Expenses Event1 | $5,938 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $34,932 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $30,478 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $4,454 | GrossRevenueTotalEventsAmt |
| Cash Prizes Total Events | $200 | CashPrizesTotalEventsAmt |
| Non Cash Prizes Total Events | $4,748 | NonCashPrizesTotalEventsAmt |
| Food And Beverage Total Events | $2,262 | FoodAndBeverageTotalEventsAmt |
| Oth Direct Expnss Total Events | $5,938 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $13,148 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$8,694 | NetIncomeSummaryAmt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLARINDA REGIONAL HEALTH CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 220 ESSIE DAVISON DR | AddressLine1Txt |
| City | CLARINDA | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 51635 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 426005819 | RecipientEIN |
| IRC Section | GOVERNMENTAL | IRCSectionDesc |
| Cash Grant | $30,365 | CashGrantAmt |
| Purpose Of Grant | SUPPLIES AND EQUIPMENT TO SUPPORT HOSPITAL OPERATIONS | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION PROVIDES FUNDS TO CLARINDA REGIONAL HEALTH CENTER, A RELATED ENTITY. THE FUNDS ARE UTILIZED FOR ASSET PURCHASES AND OPERATIONS OF THE HOSPITAL. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | MEMBERSHIP IN THE CORPORATION SHALL BE OPEN TO ALL INDIVIDUALS WHO ARE DEDICATED TO THE CHARITABLE PURPOSES OF THE COPRPORATION, AND WHO SUCCSESSFULLY APPLY FOR MEMBERSHIP THEREIN. NO PERSON SHALL BE ADMITTED AS A MEMBER WITHOUT THE PERSON'S CONSENT OR AFFIRMATIVE ACTION EVIDENCING CONSENT. |
| FORM 990, PART VI, SECTION A, LINE 7A | ALL MEMBERS SHALL HAVE THE RIGHT TO HOLD OFFICE. THOSE MEMBERS WITH VOTING RIGHTS AND IN GOOD STANDING SHALL HAVE THE RIGHT TO VOTE. |
| FORM 990, PART VI, SECTION A, LINE 7B | MAJORITY OF THOSE PRESENT ARE ENTITLED TO VOTE AND CONSTITUTE A QUORUM FOR THE TRANSACTION OF ANY BUSINESS AT THE MEETING OF THE MEMBERSHIP. EACH MEMBER SHALL BE ENTITLED TO ONE VOTE ON EACH MATTER SUBMITTED TO A VOTE OF THE MEMBERS. THE AFFIRMATIVE VOTE OF A MAJORITY OF THE MEMBERS PRESENT IN PERSON SHALL BE THE ACT OF THE MEMBERS. |
| FORM 990, PART VI, SECTION B, LINE 11B | WHEN THE FORM 990 IS PREPARED, IT IS DISTRIBUTED TO THE BOARD OF DIRECTORS FOR THEIR REVIEW AND ACCEPTANCE PRIOR TO FILING WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION REQUIRES ALL BOARD MEMBERS REVIEW THE CONFLICT OF INTEREST STATEMENT IN THE ORGANIZATION BYLAWS AND SIGN A STATEMENT TESTIFYING TO SUCH UPON INDUCTION TO THE BOARD. MEMBERS WITH A DIRECT OR INDIRECT CONFLICT OF INTEREST MUST ABSTAIN FROM AUTHORIZING, APPROVING OR RATIFYING THE TRANSACTION. PARTNERS IN EXCEPTIONAL CARE HAS NOT FORMALLY ADOPTED THE WHISTLEBLOWER AND DOCUMENT RETENTION AND DESTRUCTION POLICIES OF CLARINDA REGIONAL HEALTH CENTER, HOWEVER, THE ORGANIZATION DOES ADHERE TO THESE POLICIES. |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART XII, LINE 2C: | THE BOARD OF DIRECTORS OF CLARINDA REGIONAL HEALTH CENTER, A RELATED ORGANIZATION, IS RESPONSIBLE FOR THE OVERSIGHT OF THE AUDIT AND THE SELECTION OF THE INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLARINDA REGIONAL HEALTH CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 220 ESSIE DAVISON DRIVE | AddressLine1Txt |
| City | CLARINDA | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 51635 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 426005819 | EIN |
| Primary Activities | HOSPITAL | PrimaryActivitiesTxt |
| Legal Domicile State | IA | LegalDomicileStateCd |
| Exempt Code Section | GOVERNMENTAL | ExemptCodeSectionTxt |
| Public Charity Status | N/A | PublicCharityStatusTxt |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |