PUBLIC HEALTH PERSONAL SUPPORT SERVICES INC: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization
PUBLIC HEALTH PERSONAL SUPPORT SERVICES INC (EIN 58-2109983)
Tax period
2020-07-01 to 2021-06-30
Filed
2022-05-13
IRS object ID
202231339349302833
Schema version
2020v4.0
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2022-05-13T12:29:59-05:00ReturnTs
Tax Period End2021-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN582464887PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1TILLMAN & TILLMAN LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 3488AddressLine1Txt
CityVALDOSTACityNm
State AbbreviationGAStateAbbreviationCd
ZIP316043488ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2020-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN582109983EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1PUBLIC HEALTH PERSONAL SUPPORTBusinessNameLine1Txt
Business Name Line2SERVICES INCBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlPUBLBusinessNameControlTxt
Phone9122631165PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line13169 INNER PERIMTER ROADAddressLine1Txt
CityVALDOSTACityNm
State AbbreviationGAStateAbbreviationCd
ZIP31604ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDENISE RETTERBUSHPersonNm
Person TitleCEOPersonTitleTxt
Phone2292531242PhoneNum
Signature2022-05-10SignatureDt

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstDENISEPersonFirstNm
Person LastRETTERBUSHPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonERIC M TILLMAN CPAABVPreparerPersonNm
PTINP00950986PTIN
Phone2292599490PhoneNum
Preparation2022-05-13PreparationDt
FieldValueIRS element (for citing)
Tax2020TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerDON PEARSON JRPrincipalOfficerNm
Gross Receipts$1,739,991GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressN/AWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Activity Or MissionHOME HEALTH CAREActivityOrMissionDesc
Voting Members Governing Body5VotingMembersGoverningBodyCnt
Voting Members Independent5VotingMembersIndependentCnt
Total Employee164TotalEmployeeCnt
Total Gross UBI$0TotalGrossUBIAmt
CY Contributions Grants$64,999CYContributionsGrantsAmt
PY Program Service Revenue$1,775,663PYProgramServiceRevenueAmt
CY Program Service Revenue$1,674,992CYProgramServiceRevenueAmt
CY Investment Income$0CYInvestmentIncomeAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$1,775,663PYTotalRevenueAmt
CY Total Revenue$1,739,991CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$1,350,867PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$1,254,314CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$433,379PYOtherExpensesAmt
CY Other Expenses$444,621CYOtherExpensesAmt
PY Total Expenses$1,784,246PYTotalExpensesAmt
CY Total Expenses$1,698,935CYTotalExpensesAmt
PY Revenues Less Expenses-$8,583PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$41,056CYRevenuesLessExpensesAmt
Total Assets BOY$916,158TotalAssetsBOYAmt
Total Assets EOY$790,905TotalAssetsEOYAmt
Total Liabilities BOY$284,955TotalLiabilitiesBOYAmt
Total Liabilities EOY$118,646TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$631,203NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$672,259NetAssetsOrFundBalancesEOYAmt
MissionHOME HEALTH CAREMissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$1,402,366ExpenseAmt
Revenue$1,739,991RevenueAmt
DescPROVIDE HOME HEALTH AIDE SERVICES.Desc
Total Program Service Expenses$1,402,366TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsfalseDonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentfalseReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
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 IndividualsfalseGrantsToIndividualsInd
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 ContrifalseDeductibleNonCashContriInd
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 RequiredfalseScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee164EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
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 Members5GoverningBodyVotingMembersCnt
Independent Voting Member5IndependentVotingMemberCnt
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 PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonLYNNE BONNERPersonNm
Phone2292531242PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line13169 INNER PERIMETER ROADAddressLine1Txt
CityVALDOSTACityNm
State AbbreviationGAStateAbbreviationCd
ZIP31604ZIPCd
FieldValueIRS element (for citing)
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (6 entries)

TitleTitleTxtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
NORMAN BENNETT
SECRETARYYes (X)Yes (X)$0$0$0
RICK BOSTLEMAN
BOARD MEMBERYes (X)$0$0$0
DON PEARSON JR
CHAIRPERSONYes (X)Yes (X)$0$0$0
GREG BEALE MD
MEDICAL DIREYes (X)$0$0$0
LYNNE FELDMAN MD
BOARD MEMBERYes (X)$0$0$0
DENISE RETTERBUSH
CEOYes (X)$0$0$0
FieldValueIRS element (for citing)
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KfalseTotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
Government Grants$64,999GovernmentGrantsAmt
Total Contributions$64,999TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescNET PATIENT REVENUEDesc
Total Revenue Column$1,674,992TotalRevenueColumnAmt
Related Or Exempt Func Income$1,674,992RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$1,674,992TotalProgramServiceRevenueAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,739,991TotalRevenueColumnAmt
Related Or Exempt Func Income$1,674,992RelatedOrExemptFuncIncomeAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$1,093,272TotalAmt
Program Services$984,609ProgramServicesAmt
Management And General$108,663ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$81,050TotalAmt
Program Services$80,593ProgramServicesAmt
Management And General$457ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$79,992TotalAmt
Program Services$70,417ProgramServicesAmt
Management And General$9,575ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$115,397TotalAmt
Management And General$115,397ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$42,158TotalAmt
Program Services$31,618ProgramServicesAmt
Management And General$10,540ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$27,026TotalAmt
Program Services$20,269ProgramServicesAmt
Management And General$6,757ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$135,526TotalAmt
Program Services$135,526ProgramServicesAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$70TotalAmt
Program Services$70ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
TELEPHONE$44,096$33,072$11,024
TAXES AND LICENSES$28,292$21,219$7,073
SUPPLIES$21,810$11,580$10,230
EQUIPMENT RENTAL & MAINT.$12,479$9,359$3,120

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$17,767TotalAmt
Program Services$4,034ProgramServicesAmt
Management And General$13,733ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$1,698,935TotalAmt
Program Services$1,402,366ProgramServicesAmt
Management And General$296,569ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$469,128BOYAmt
EOY$498,637EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$438,437BOYAmt
EOY$289,905EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$8,593BOYAmt
EOY$2,363EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$916,158BOYAmt
EOY$790,905EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$28,766BOYAmt
EOY$86,186EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$256,189BOYAmt
EOY$32,460EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$284,955BOYAmt
EOY$118,646EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$631,203BOYAmt
EOY$672,259EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$631,203BOYAmt
EOY$672,259EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$916,158BOYAmt
EOY$790,905EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$41,056ReconcilationRevenueExpnssAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedfalseFSAuditedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year$64,999CurrentTaxYearAmt
Total$64,999TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,095,839CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,707,970CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,883,724CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,775,663CurrentTaxYearMinus1YearAmt
Current Tax Year$1,674,992CurrentTaxYearAmt
Total$9,138,188TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,095,839CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,707,970CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,883,724CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,775,663CurrentTaxYearMinus1YearAmt
Current Tax Year$1,739,991CurrentTaxYearAmt
Total$9,203,187TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$9,203,187PublicSupportTotal509Amt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,095,839CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,707,970CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,883,724CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,775,663CurrentTaxYearMinus1YearAmt
Current Tax Year$1,739,991CurrentTaxYearAmt
Total$9,203,187TotalAmt
FieldValueIRS element (for citing)
Public Support CY5091.00000PublicSupportCY509Pct
Public Support PY5091.00000PublicSupportPY509Pct
Investment Income CY0.00000InvestmentIncomeCYPct
Investment Income PY0.00000InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule D IRS990ScheduleD

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescACCURED LIABILITIESDesc
Amt$32,460Amt
FieldValueIRS element (for citing)
Total Liability$32,460TotalLiabilityAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PAGE 6, PART VI, LINE 11BNO REVIEW WAS OR WILL BE CONDUCTED.
FORM 990, PAGE 6, PART VI, LINE 12CANY TRANSACTIONS THAT MAY APPEAR TO BE WITH RELATED PARTIES ARE REVIEWED TO COMPLY WITH THE CONFLICT OF INTEREST POLICY.
FORM 990, PAGE 6, PART VI, LINE 15ACEO COMPENSATION REVIEWED BY THE BOARD.
FORM 990, PAGE 6, PART VI, LINE 19GOVERNING DOCUMENTS PROVIDED TO THE PUBLIC UPON REQUEST.

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