CHARIS HEALTH CENTER: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- CHARIS HEALTH CENTER (EIN 35-2298919)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-06-16
- IRS object ID
- 202231679349301138
- 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 | 2022-06-16T13:55:38-07:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 261482900 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Gammon & Drueck CPAs PLLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3618 B North Mount Juliet Road | AddressLine1Txt |
| City | Mount Juliet | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37122 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 352298919 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHARIS HEALTH CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CHAR | BusinessNameControlTxt |
| Phone | 6157735785 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2620 N MOUNT JULIET ROAD | AddressLine1Txt |
| City | MOUNT JULIET | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37122 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MARTIN CROW | PersonNm |
| Person Title | TREASURER | PersonTitleTxt |
| Phone | 6157735785 | PhoneNum |
| Signature | 2022-06-13 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | MARTIN | PersonFirstNm |
| Person Last | CROW | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | XXX-XX-XXXX | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Danielle E Drueck | PreparerPersonNm |
| PTIN | P00079573 | PTIN |
| Phone | 6157580481 | PhoneNum |
| Preparation | 2022-06-16 | 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
Principal Ofcr Business Name PrincipalOfcrBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MARTIN CROW | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1476 N MOUNT JULIET RD | AddressLine1Txt |
| City | MOUNT JULIET | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37122 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $475,879 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.CHARISHEALTHCENTER.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2007 | FormationYr |
| Legal Domicile State | TN | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE EFFECTIVE & AFFORDABLE HEALTH CARE TO ADULTS & CHILDREN WHO ARE VULNERABLE & MEDIALLY UNINSURED; SERVICES INCLUDE OFFICE VISITS, WELL-WOMAN VISITS, MAMMOGRAMS, AND REFERRALS FOR LABORATORY WORK AND MEDICAL SPECIALIST SERVICES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 13 | VotingMembersIndependentCnt |
| Total Employee | 10 | TotalEmployeeCnt |
| Total Volunteers | 12 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $337,417 | PYContributionsGrantsAmt |
| CY Contributions Grants | $384,201 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $71,223 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $82,040 | CYProgramServiceRevenueAmt |
| PY Investment Income | $239 | PYInvestmentIncomeAmt |
| CY Investment Income | $206 | CYInvestmentIncomeAmt |
| PY Other Revenue | $7,040 | PYOtherRevenueAmt |
| CY Other Revenue | $2,299 | CYOtherRevenueAmt |
| PY Total Revenue | $415,919 | PYTotalRevenueAmt |
| CY Total Revenue | $468,746 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $231,763 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $285,548 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $109,496 | PYOtherExpensesAmt |
| CY Other Expenses | $116,468 | CYOtherExpensesAmt |
| PY Total Expenses | $341,259 | PYTotalExpensesAmt |
| CY Total Expenses | $402,016 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $74,660 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $66,730 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $219,645 | TotalAssetsBOYAmt |
| Total Assets EOY | $246,039 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $42,300 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $0 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $177,345 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $246,039 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO PROVIDE EFFECTIVE & AFFORDABLE HEALTH CARE TO ADULTS & CHILDREN WHO ARE VULNERABLE & MEDIALLY UNINSURED; SERVICES INCLUDE OFFICE VISITS, WELL-WOMAN VISITS, MAMMOGRAMS, AND REFERRALS FOR LABORATORY WORK AND MEDICAL SPECIALIST SERVICES. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $364,586 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $389,579 | RevenueAmt |
| Desc | PRIMARY HEALTH CARE FOR UNINSURED RESIDENTS:CHARIS HEALTH CARE PROVIDES AFFORDABLE PRIMARY HEALTH CARE SERVICES TO MEDICALLY UNINSURED INDIVIDUALS. SERVICES INCLUDE OFFICE VISITS, WELL-WOMAN VISITS, MAMMOGRAMS, AND REFERRALS FOR LABORATORY WORK AND MEDICAL SPECIALIST SERVICES. CHARIS PROVIDES THESE SERVICES IN THE WILSON COUNTY, TN AREA BY UTILIZING BOTH PAID MEDICAL PROFESSIONALS AND PROFESSIONAL VOLUNTEERS, INCLUDING MEDICAL DOCTORS, NURSES AND NURSE PRACTITIONERS. IN 2021, CHARIS SERVED 1,449 PATIENTS AND PROVIDED 3,466 INDIVIDUAL SERVICES TO THOSE PATIENTS. SERVICES DURING THIS YEAR AND VOLUNTEERS DONATED 3,942 HOURS OF SERVICE IN SUPPORT OF CLINIC OPERATIONS. CHARIS ALSO RECEIVED $14,400 WORTH OF DONATED CLINIC SPACE AND $15,985.79 WORTH OF DONATED SUPPLIES, $14,606 DONATED FUNDRAISER ITEMS AND $601,242.70 IN DONTATED MEDICATIONS. | Desc |
| Total Program Service Expenses | $364,586 | 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 | false | 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 | Yes (true) | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | false | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | Yes (true) | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 10 | 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 | Yes (true) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (true) | QuidProQuoContriDisclInd |
| 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 |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 13 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | false | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | TN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TERESA SCOTT | PersonNm |
| Phone | 6157735785 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2620 N MT JULIET ROAD | AddressLine1Txt |
| City | MOUNT JULIET | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37122 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Key EmployeeKeyEmployeeInd |
|---|---|---|---|---|---|---|---|
| BONNIE RYAN | |||||||
| PAST PRESIDENT | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| GENE JONES | |||||||
| PRESIDENT | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| LYNN TURNER | |||||||
| SECRETARY | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| MARTIN CROW | |||||||
| TREASURER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| SCOTT FAW | |||||||
| DIRECTOR | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| RYAN MORRIS | |||||||
| VICE PRESIDENT | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| TERESA LAWSON | |||||||
| DIRECTOR | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| DON MURRAY | |||||||
| DIRECTOR | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| DR BERNIE SY | |||||||
| MEDICAL DIRECTOR | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| LINDSEY COVINGTON | |||||||
| DIRECTOR | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| CHRISTI GRIFFIN | |||||||
| DIRECTOR | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| ASHLEY MCCORMACK | |||||||
| DIRECTOR | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| SUANNE BONE | |||||||
| DIRECTOR | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| LAUREN SMITH | |||||||
| EXECUTIVE DIRECTOR | 40.00 | $50,000 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $50,000 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $0 | TotalOtherCompensationAmt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | false | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| Government Grants | $216,468 | GovernmentGrantsAmt |
| All Other Contributions | $167,733 | AllOtherContributionsAmt |
| Total Contributions | $384,201 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT FEES | Desc |
| Business | 621400 | BusinessCd |
| Total Revenue Column | $82,040 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $82,040 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $206 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $206 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $7,030 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $7,133 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$103 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$103 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $2,402 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $2,402 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $2,402 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $468,746 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $82,040 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $2,505 | ExclusionAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $221,273 | TotalAmt |
| Program Services | $209,353 | ProgramServicesAmt |
| Management And General | $11,920 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $64,275 | TotalAmt |
| Program Services | $62,365 | ProgramServicesAmt |
| Management And General | $1,910 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $150 | TotalAmt |
| Program Services | $150 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,447 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $4,447 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,178 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $10,178 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,993 | TotalAmt |
| Program Services | $800 | ProgramServicesAmt |
| Management And General | $2,193 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $46,377 | TotalAmt |
| Program Services | $43,151 | ProgramServicesAmt |
| Management And General | $3,226 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,387 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $1,387 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,966 | TotalAmt |
| Program Services | $1,966 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,520 | TotalAmt |
| Program Services | $10,520 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| PATIENT SERVICES | $33,665 | $33,665 | $0 | $0 |
| VOLUNTEER EXPENSES | $682 | $682 | $0 | $0 |
| TAXES AND LICENSES | $4,324 | $2,155 | $2,169 | $0 |
| MISCELLANEOUS | -$221 | -$221 | $0 | $0 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $402,016 | TotalAmt |
| Program Services | $364,586 | ProgramServicesAmt |
| Management And General | $37,430 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $194,211 | BOYAmt |
| EOY | $220,605 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $865 | BOYAmt |
| EOY | $865 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $46,918 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $22,349 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,569 | BOYAmt |
| EOY | $24,569 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $219,645 | BOYAmt |
| EOY | $246,039 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $42,300 | BOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $42,300 | 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 | $87,959 | BOYAmt |
| EOY | $163,885 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $89,386 | BOYAmt |
| EOY | $82,154 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $177,345 | BOYAmt |
| EOY | $246,039 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $219,645 | BOYAmt |
| EOY | $246,039 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $66,730 | ReconcilationRevenueExpnssAmt |
| Prior Period Adjustments | $1,964 | PriorPeriodAdjustmentsAmt |
| Method Of Accounting Cash | Yes (X) | MethodOfAccountingCashInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | false | FSAuditedInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
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 | $228,052 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $210,734 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $247,247 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $337,417 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $297,901 | CurrentTaxYearAmt |
| Total | $1,321,351 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $57,785 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $77,717 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $76,189 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $71,223 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $82,040 | CurrentTaxYearAmt |
| Total | $364,954 | 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 | $285,837 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $288,451 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $323,436 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $408,640 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $379,941 | CurrentTaxYearAmt |
| Total | $1,686,305 | 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 | $1,686,305 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $257 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $305 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus1 Year | $239 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $206 | CurrentTaxYearAmt |
| Total | $1,007 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $257 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $305 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus1 Year | $239 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $206 | CurrentTaxYearAmt |
| Total | $1,007 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,687,312 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99940 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99940 | PublicSupportPY509Pct |
| Investment Income CY | 0.00060 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00060 | 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 D IRS990ScheduleD
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $46,918 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $22,349 | DepreciationAmt |
| Book Value | $24,569 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $24,569 | TotalBookValueLandBuildingsAmt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SUSAN G KOMEN CTR TN | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4009 HILLSBORO PIKE STE 209 | AddressLine1Txt |
| City | NASHVILLE | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37215 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 912049420 | RecipientEIN |
| Purpose Of Grant | MAMMOGRAMS FOR UNINSURED | PurposeOfGrantTxt |
Schedule M IRS990ScheduleM
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | false | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | false | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Pt VI, Line 11b | THE BOARD TREASURER WILL REVIEW THE PREPARED FORM 990 AND SCHEDULES FOR ACCURACY AND THEN WILL PRESENT THE RETURN TO THE FULL BOARD FOR REVIEW AND APPROVAL. |
| Pt VI, Line 12c | OFFICERS AND DIRECTORS COMPLETE CONFLICT OF INTEREST FORMS ANNUALLY. THE FORM STATES THAT ANY CONFLICTS OF INTEREST, INCLUDING ANY THAT ARISE DURING THE YEAR, BE REPORTED PROMPTLY TO THE BOARD. |
| Pt VI, Line 15a | COMPENSATION FOR THE EXECUTIVE DIRECTOR IS REVIEWED AND APPROVED BY THE FULL BOARD OF DIRECTORS ANNUALLY, BASED ON A PERFORMANCE EVALUATION CONDUCTED BY THE EXECUTIVE COMMITTEE. BOARD MEMBERS WHO VOTE ON THE COMPENSATION PACKAGE ARE INDEPENDENT, AND THE DECISTION IS DOCUMENTED CONTEMPORANEOUSLY. |
| Pt VI, Line 19 | COPIES OF ORGANIZATIONAL DOCUMENTS ARE PROVIDED UPON REQUEST AND MAY ALSO BE FOUND AT WWW.GIVINGMATTERS.COM |
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