SACRED HEART COMMUNITY CLINIC INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- SACRED HEART COMMUNITY CLINIC INC (EIN 27-2901548)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-09-02
- IRS object ID
- 202242459349300419
- Schema version
- 2021v4.2
- 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 | 2022-09-02T10:37:41-05:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 272901548 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Sacred Heart Community Clinic | BusinessNameLine1Txt |
| Business Name Line2 | Sacred Heart Community Clinic | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % Jody Posluszny | InCareOfNm |
| Business Name Control | SACR | BusinessNameControlTxt |
| Phone | 5127163929 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 620 Round Rock West Dr Ste BLD 8 | AddressLine1Txt |
| City | Round Rock | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 78681 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JODY POSLUSZNY | PersonNm |
| Person Title | Treasurer | PersonTitleTxt |
| Phone | 5127163929 | PhoneNum |
| Signature | 2022-09-02 | SignatureDt |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | JODY | PersonFirstNm |
| Person Last | POSLUSZNY | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | XXX-XX-XXXX | SSN |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 1 | TrustedCustomerCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Sacred Heart Community Clinic | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | DEBORAH HOPPS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 620 Round Rock West Dr Ste Bld 8 | AddressLine1Txt |
| City | Round Rock | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 78681 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $857,012 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.sacredheartclinic.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2010 | FormationYr |
| Legal Domicile State | TX | LegalDomicileStateCd |
| Activity Or Mission | To provide nocost outpatient health and dental services to the uninsured and underinsured of Williamson County TX | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 19 | TotalEmployeeCnt |
| Total Volunteers | 100 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $817,032 | PYContributionsGrantsAmt |
| CY Contributions Grants | $792,952 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $230 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $363 | CYProgramServiceRevenueAmt |
| PY Investment Income | $10,195 | PYInvestmentIncomeAmt |
| CY Investment Income | $11,892 | CYInvestmentIncomeAmt |
| PY Other Revenue | $111,161 | PYOtherRevenueAmt |
| CY Other Revenue | $39,683 | CYOtherRevenueAmt |
| PY Total Revenue | $938,618 | PYTotalRevenueAmt |
| CY Total Revenue | $844,890 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $374,963 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $379,121 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $68,519 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $349,915 | PYOtherExpensesAmt |
| CY Other Expenses | $391,461 | CYOtherExpensesAmt |
| PY Total Expenses | $724,878 | PYTotalExpensesAmt |
| CY Total Expenses | $770,582 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $213,740 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $74,308 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $1,223,144 | TotalAssetsBOYAmt |
| Total Assets EOY | $1,306,466 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $26,027 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $22,763 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,197,117 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $1,283,703 | NetAssetsOrFundBalancesEOYAmt |
| Mission | To provide no-cost outpatient basic health and dental services, and nutrition and diabetic education to low-income, uninsured and under- insured adult residents of Williamson County, Texas | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $513,089 | ExpenseAmt |
| Revenue | $363 | RevenueAmt |
| Desc | Basic outpatient health and dental services, diabetic and nutritional education to qualifying low-income adult residents of Williamson County, Texas | Desc |
| Total Program Service Expenses | $513,089 | 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 | Yes (true) | 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 |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 10 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | false | BackupWthldComplianceInd |
| Employee | 19 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | false | Form990TFiledInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Excs Tax Sect4951 Or4952 Or4953 | false | ExcsTaxSect4951Or4952Or4953Ind |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | 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 | false | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | 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 | JODY POSLUSZNY | PersonNm |
| Phone | 5127163929 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 620 Round Rock West Dr Ste Bld 8 | AddressLine1Txt |
| City | Round Rock | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 78681 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | Yes (X) | NoListedPersonsCompensatedInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (10 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|
| DEBORAH HOPPS | ||||||
| President | 3.000 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| ISAAC KORENSTEIN | ||||||
| Vice President | 2.000 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| NORMA RODRIGUEZ | ||||||
| Secretary | 2.000 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| JODY POSLUSZNY | ||||||
| Treasurer | 4.000 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| KATE WALTERS | ||||||
| Director | 0.500 | Yes (X) | $0 | $0 | $0 | |
| CAROLINE HILBERT | ||||||
| Director | 1.000 | Yes (X) | $0 | $0 | $0 | |
| REV DAVID KOPPEL | ||||||
| Director | 0.500 | Yes (X) | $0 | $0 | $0 | |
| TINO HERNANDEZ | ||||||
| Past President | 0.500 | Yes (X) | $0 | $0 | $0 | |
| REV FRANCISCO RODRIGUEZ | ||||||
| Director | 0.200 | Yes (X) | $0 | $0 | $0 | |
| RUDOLFO URIEGAS | ||||||
| Past Vice President | 0.500 | Yes (X) | $0 | $0 | $0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | false | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| Federated Campaigns | $25,000 | FederatedCampaignsAmt |
| Government Grants | $131,486 | GovernmentGrantsAmt |
| All Other Contributions | $636,466 | AllOtherContributionsAmt |
| Noncash Contributions | $54,477 | NoncashContributionsAmt |
| Total Contributions | $792,952 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Record requests | Desc |
| Business | 621110 | BusinessCd |
| Total Revenue Column | $363 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $363 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $363 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $11,892 | TotalRevenueColumnAmt |
| Exclusion | $11,892 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $48,262 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $12,122 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $36,140 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Recemption credit | Desc |
| Business | 621110 | BusinessCd |
| Total Revenue Column | $3,543 | TotalRevenueColumnAmt |
| Exclusion | $3,543 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $3,543 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $844,890 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $363 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $15,435 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $352,179 | TotalAmt |
| Program Services | $170,237 | ProgramServicesAmt |
| Management And General | $118,542 | ManagementAndGeneralAmt |
| Fundraising | $63,400 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,942 | TotalAmt |
| Program Services | $12,932 | ProgramServicesAmt |
| Management And General | $8,891 | ManagementAndGeneralAmt |
| Fundraising | $5,119 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,166 | TotalAmt |
| Management And General | $8,166 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $134,399 | TotalAmt |
| Program Services | $134,399 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,420 | TotalAmt |
| Management And General | $13,420 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,532 | TotalAmt |
| Management And General | $10,532 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,172 | TotalAmt |
| Management And General | $19,172 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $839 | TotalAmt |
| Management And General | $839 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,295 | TotalAmt |
| Program Services | $27,197 | ProgramServicesAmt |
| Management And General | $2,098 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,500 | TotalAmt |
| Management And General | $2,500 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| Pharmaceuticals | $74,036 | $74,036 |
| Ancillary Med. Services | $37,619 | $37,619 |
| Med & Dental Supplies | $38,386 | $38,386 |
| Release of funds | $15,000 | $15,000 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,097 | TotalAmt |
| Program Services | $3,283 | ProgramServicesAmt |
| Management And General | $4,814 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $770,582 | TotalAmt |
| Program Services | $513,089 | ProgramServicesAmt |
| Management And General | $188,974 | ManagementAndGeneralAmt |
| Fundraising | $68,519 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $364,903 | BOYAmt |
| EOY | $408,132 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $54,082 | BOYAmt |
| EOY | $106,250 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $3,519 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $697,228 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $162,470 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $559,352 | BOYAmt |
| EOY | $534,758 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $244,807 | BOYAmt |
| EOY | $253,807 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,223,144 | BOYAmt |
| EOY | $1,306,466 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,527 | BOYAmt |
| EOY | $22,763 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,500 | BOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,027 | BOYAmt |
| EOY | $22,763 | 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 | $1,182,117 | BOYAmt |
| EOY | $1,264,953 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,000 | BOYAmt |
| EOY | $18,750 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,197,117 | BOYAmt |
| EOY | $1,283,703 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,223,144 | BOYAmt |
| EOY | $1,306,466 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $74,308 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $12,278 | NetUnrlzdGainsLossesInvstAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $879,223 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $702,801 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $670,269 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $928,193 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $829,092 | CurrentTaxYearAmt |
| Total | $4,009,578 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $879,223 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $702,801 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $670,269 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $928,193 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $829,092 | CurrentTaxYearAmt |
| Total | $4,009,578 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $4,009,578 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,667 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,384 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $4,477 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $5,447 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $6,314 | CurrentTaxYearAmt |
| Total | $22,289 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $4,031,867 | TotalSupportAmt |
| Public Support CY170 | 0.99447 | PublicSupportCY170Pct |
| Public Support PY170 | 0.99492 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Disclosed Org Leg Ctrl | false | DisclosedOrgLegCtrlInd |
| Disclosed For Charitable Prps | false | DisclosedForCharitablePrpsInd |
| Written Policy Monitoring | false | WrittenPolicyMonitoringInd |
| Section170h Rqr Stsfd | false | Section170hRqrStsfdInd |
| Solicited Assets Sale | false | SolicitedAssetsSaleInd |
| Agent Trustee Etc | false | AgentTrusteeEtcInd |
| Incl Escrow Custodial Acct Liab | false | InclEscrowCustodialAcctLiabInd |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $557,893 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $74,906 | DepreciationAmt |
| Book Value | $482,987 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $139,335 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $87,564 | DepreciationAmt |
| Book Value | $51,771 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $534,758 | TotalBookValueLandBuildingsAmt |
| Total Rev Etc Audited Fincl Stmt | $1,111,640 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $12,278 | NetUnrealizedGainsInvstAmt |
| Donated Services And Use Fclts | $240,200 | DonatedServicesAndUseFcltsAmt |
| Other Revenue | $14,272 | OtherRevenueAmt |
| Revenue Not Reported | $266,750 | RevenueNotReportedAmt |
| Revenue Subtotal | $844,890 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $844,890 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $1,025,054 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $240,200 | DonatedServicesUseFcltsAmt |
| Other Expenses Included | $14,272 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $254,472 | ExpensesNotReportedAmt |
| Expenses Subtotal | $770,582 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $770,582 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| P11, Ln 2d | Fund raising expenses netted in 990 revenue |
| P11, Ln 2d | Investment fees netted in 990 revenue |
| P12, Ln 2d | Investment fees netted in 990 revenue |
| P12, Ln 2d | Fund raising expenses netted in 990 revenue |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | Cocktail Ga | Event1Nm |
| Gross Receipts Event1 | $24,448 | GrossReceiptsEvent1Amt |
| Gross Revenue Event1 | $24,448 | GrossRevenueEvent1Amt |
| Rent Facility Costs Event1 | $4,501 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $5,500 | FoodAndBeverageEvent1Amt |
| Other Direct Expenses Event1 | $441 | OtherDirectExpensesEvent1Amt |
| Event2 | Gala | Event2Nm |
| Gross Receipts Event2 | $21,701 | GrossReceiptsEvent2Amt |
| Gross Revenue Event2 | $21,701 | GrossRevenueEvent2Amt |
| Entertainment Event2 | $3,400 | EntertainmentEvent2Amt |
| Other Direct Expenses Event2 | $294 | OtherDirectExpensesEvent2Amt |
| Gross Receipts Total | $46,149 | GrossReceiptsTotalAmt |
| Gross Revenue Total Events | $46,149 | GrossRevenueTotalEventsAmt |
| Rent Fclty Costs Total Events | $4,501 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $5,500 | FoodAndBeverageTotalEventsAmt |
| Entertainment Total Events | $3,400 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $735 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $14,136 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $32,013 | NetIncomeSummaryAmt |
Schedule M IRS990ScheduleM
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Noncash Contributions Rpt F990 | $54,447 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FMV | 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 |
|---|---|
| Part VI Line 1a | The Board of Directors delegates fund management to a Fund Management Comt. |
| Part VI Line 11b | Reviewed with Exec. Dir. and President, with board at following meeting. |
| Part VI Line 12c | Reviewed by board as discovered |
| Part VI Line 19 | Provided upon request. No requests made in 2021. |
| Part IX Line 11g | Licensed med professional Total expenses - $134399.00 Program service expenses - $134399.00 Mgmt and general expenses - $0.00 Fundraising expenses - $0.00 |
| part IX line 24E | Mobile clinic, misc |
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