COMPASSION HEALTH TOLEDO: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- COMPASSION HEALTH TOLEDO (EIN 47-3197108)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-10-18
- IRS object ID
- 202212919349301306
- Schema version
- 2021v4.0
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-10-18T15:25:34-04:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 382706146 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | YEO & YEO PC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 3275 | AddressLine1Txt |
| City | SAGINAW | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48605 | 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 | 473197108 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMPASSION HEALTH TOLEDO | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | COMP | BusinessNameControlTxt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1638 BROADWAY ST | AddressLine1Txt |
| City | TOLEDO | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 43609 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ANNE RUCH MD | PersonNm |
| Person Title | EXECUTIVE DIRECTOR | PersonTitleTxt |
| Signature | 2022-10-15 | SignatureDt |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | ANNE | PersonFirstNm |
| Person Last | RUCH | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | BRIAN R DIXON | PreparerPersonNm |
| PTIN | P01321580 | PTIN |
| Phone | 9897939830 | PhoneNum |
| Preparation | 2022-10-18 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ANNE RUCH MD | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1638 BROADWAY ST | AddressLine1Txt |
| City | TOLEDO | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 43609 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $928,207 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | HTTP://WWW.COMPASSIONHEALTHTOLEDO.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2017 | FormationYr |
| Legal Domicile State | OH | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE CHRIST CENTERED INTEGRATED AFFORDABLE AND QUALITY HEALTH CARE TO THOSE WHO NEED IT. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 12 | VotingMembersIndependentCnt |
| Total Employee | 21 | TotalEmployeeCnt |
| Total Volunteers | 12 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $481,822 | PYContributionsGrantsAmt |
| CY Contributions Grants | $511,874 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $387,450 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $378,470 | CYProgramServiceRevenueAmt |
| PY Investment Income | $950 | PYInvestmentIncomeAmt |
| CY Investment Income | $560 | CYInvestmentIncomeAmt |
| PY Other Revenue | $14,477 | PYOtherRevenueAmt |
| CY Other Revenue | $37,303 | CYOtherRevenueAmt |
| PY Total Revenue | $884,699 | PYTotalRevenueAmt |
| CY Total Revenue | $928,207 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $3,333 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $4,270 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $479,408 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $813,963 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $1,711 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $246,735 | PYOtherExpensesAmt |
| CY Other Expenses | $183,988 | CYOtherExpensesAmt |
| PY Total Expenses | $729,476 | PYTotalExpensesAmt |
| CY Total Expenses | $1,002,221 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $155,223 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$74,014 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $898,504 | TotalAssetsBOYAmt |
| Total Assets EOY | $799,071 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $21,165 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $21,220 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $877,339 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $777,851 | NetAssetsOrFundBalancesEOYAmt |
| Mission | PROVIDE CHRIST CENTERED INTEGRATED AFFORDABLE AND QUALITY HEALTH CARE TO THOSE WHO NEED IT. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $844,900 | ExpenseAmt |
| Revenue | $378,470 | RevenueAmt |
| Desc | COMPASSION HEALTH TOLEDO OPENED IN JULY 2017. CHT PROVIDES CHRIST CENTERED INTEGRATED AFFORDABLE AND QUALITY HEALTH CARE TO THOSE WHO NEED IT. | Desc |
| Total Program Service Expenses | $844,900 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 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 | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | 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 | 1 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 21 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Form8899 Filedind | false | Form8899Filedind |
| Form1098 C Filed | false | Form1098CFiledInd |
| 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 | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 12 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (true) | 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 | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (true) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | false | WrittenPolicyOrProcedureInd |
| States Where Copy Of Return Is Fld | OH | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ANNE RUCH MD | PersonNm |
| Phone | 5676610565 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1638 BROADWAY ST | AddressLine1Txt |
| City | TOLEDO | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 43609 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|
| LORI JOHNSTON | ||||||
| CHAIR | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| DINA VILLA | ||||||
| VICE CHAIR | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| KENETTA JONES | ||||||
| SECRETARY | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| BILL ROUDOLPH | ||||||
| TREASURER | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| LAURA RUDOLPH | ||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| KEITH SCHLENDER | ||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| CALVIN SWEENEY | ||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| RENEE HARRIS | ||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| CELESTE TAYLOR | ||||||
| SPIRITUAL DI | 1.00 | Yes (X) | $0 | $0 | $0 | |
| JOHN GRAHAM | ||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| SALLY BINARD | ||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| AVERY COOPER | ||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| NATALIE KING | ||||||
| CHIEF MEDICA | 40.00 | Yes (X) | $158,268 | $0 | $0 | |
| ANNE RUCH MD | ||||||
| EXECUTIVE DI | 40.00 | Yes (X) | $2,500 | $0 | $0 | |
| MARK JACKOBY | ||||||
| CFO | 40.00 | Yes (X) | $2,500 | $0 | $0 | |
| ANNE BAUMAN | ||||||
| COO | 40.00 | Yes (X) | $75,577 | $0 | $0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $238,845 | TotalReportableCompFromOrgAmt |
| Indiv Rcvd Greater Than100 K | 1 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| Government Grants | $295,539 | GovernmentGrantsAmt |
| All Other Contributions | $216,335 | AllOtherContributionsAmt |
| Noncash Contributions | $121,680 | NoncashContributionsAmt |
| Total Contributions | $511,874 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MEDICAL SERVICES | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $378,470 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $378,470 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $378,470 | TotalProgramServiceRevenueAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $560 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $560 | RelatedOrExemptFuncIncomeAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISC. | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $37,303 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $37,303 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $37,303 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $928,207 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $416,333 | RelatedOrExemptFuncIncomeAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,500 | TotalAmt |
| Program Services | $1,500 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,770 | TotalAmt |
| Program Services | $2,770 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $238,845 | TotalAmt |
| Program Services | $164,850 | ProgramServicesAmt |
| Management And General | $73,995 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $501,102 | TotalAmt |
| Program Services | $501,102 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,075 | TotalAmt |
| Program Services | $25,601 | ProgramServicesAmt |
| Management And General | $474 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $47,941 | TotalAmt |
| Program Services | $43,147 | ProgramServicesAmt |
| Management And General | $4,794 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $34,381 | TotalAmt |
| Management And General | $34,381 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,904 | TotalAmt |
| Management And General | $6,654 | ManagementAndGeneralAmt |
| Fundraising | $250 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,477 | TotalAmt |
| Program Services | $3,762 | ProgramServicesAmt |
| Management And General | $1,254 | ManagementAndGeneralAmt |
| Fundraising | $1,461 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $47,673 | TotalAmt |
| Program Services | $35,755 | ProgramServicesAmt |
| Management And General | $11,918 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,838 | TotalAmt |
| Program Services | $3,628 | ProgramServicesAmt |
| Management And General | $1,210 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,893 | TotalAmt |
| Program Services | $11,920 | ProgramServicesAmt |
| Management And General | $3,973 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,555 | TotalAmt |
| Program Services | $19,166 | ProgramServicesAmt |
| Management And General | $6,389 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $33,530 | $25,147 | $8,383 |
| DUES AND SUBSCRIPTIONS | $8,690 | $6,517 | $2,173 |
| MISC | $47 | $35 | $12 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,002,221 | TotalAmt |
| Program Services | $844,900 | ProgramServicesAmt |
| Management And General | $155,610 | ManagementAndGeneralAmt |
| Fundraising | $1,711 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $293,480 | BOYAmt |
| EOY | $521,282 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $303,941 | BOYAmt |
| EOY | $1,495 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $90,362 | BOYAmt |
| EOY | $108,231 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,340 | BOYAmt |
| EOY | $8,545 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $212,357 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $52,839 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $198,381 | BOYAmt |
| EOY | $159,518 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $898,504 | BOYAmt |
| EOY | $799,071 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,165 | BOYAmt |
| EOY | $21,220 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,165 | BOYAmt |
| EOY | $21,220 | 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 | $842,225 | BOYAmt |
| EOY | $753,026 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $35,114 | BOYAmt |
| EOY | $24,825 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $877,339 | BOYAmt |
| EOY | $777,851 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $898,504 | BOYAmt |
| EOY | $799,071 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$74,014 | ReconcilationRevenueExpnssAmt |
| Prior Period Adjustments | -$25,474 | PriorPeriodAdjustmentsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | Yes (true) | AccountantCompileOrReviewInd |
Acct Compile Or Review Basis AcctCompileOrReviewBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| FS Audited | false | FSAuditedInd |
| Audit Committee | false | AuditCommitteeInd |
| Federal Grant Audit Required | false | 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 | $318,758 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $255,806 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $537,736 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $481,822 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $511,874 | CurrentTaxYearAmt |
| Total | $2,105,996 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $29,469 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $351,155 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $614,930 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $387,450 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $378,470 | CurrentTaxYearAmt |
| Total | $1,761,474 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $348,227 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $606,961 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,152,666 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $869,272 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $890,344 | CurrentTaxYearAmt |
| Total | $3,867,470 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $3,867,470 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | $950 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $560 | CurrentTaxYearAmt |
| Total | $1,510 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | $950 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $560 | CurrentTaxYearAmt |
| Total | $1,510 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | $37,303 | CurrentTaxYearAmt |
| Total | $37,303 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $348,227 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $606,961 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,152,666 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $870,222 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $928,207 | CurrentTaxYearAmt |
| Total | $3,906,283 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99010 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99480 | PublicSupportPY509Pct |
| Investment Income CY | 0.00000 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00000 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART III, LINE 12 | FormAndLineReferenceDesc |
| Explanation | 37,303 | ExplanationTxt |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $55,606 | OtherCostOrOtherBasisAmt |
| Depreciation | $15,997 | DepreciationAmt |
| Book Value | $39,609 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $156,751 | OtherCostOrOtherBasisAmt |
| Depreciation | $36,842 | DepreciationAmt |
| Book Value | $119,909 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $159,518 | TotalBookValueLandBuildingsAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | NATALIE KING | PersonNm |
| Title | CHIEF MEDICAL OFFICE | TitleTxt |
| Base Compensation Filing Org | $158,268 | BaseCompensationFilingOrgAmt |
| Total Compensation Filing Org | $158,268 | TotalCompensationFilingOrgAmt |
Schedule M IRS990ScheduleM
Other Non Cash Contri Table OtherNonCashContriTableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Desc | PROVIDER SERVIC | Desc |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $121,680 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | MARKET VALUE OF SERVICES | 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 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE M, PAGE 2, PART II | FormAndLineReferenceDesc |
| Explanation | FORM 990, PART 1 LINE 25 REVENUE CONSISTS OF DONATED TIME OF HEALTHCARE PROVIDER SERVICES. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 6, PART VI, LINE 2 | BILL RUDOLPH LAURA RUDOLPH TREASURER MEMBER MARRIED |
| FORM 990, PAGE 6, PART VI, LINE 11B | THE FULL 990 IS PROVIDED TO EACH BOARD MEMBER. IT IS THEN DISCUSSED AND APPROVED BEFORE FILING. |
| FORM 990, PAGE 6, PART VI, LINE 12C | THE BOARD AT THE ANNUAL MEETING SIGN A NEW COI FOR FILE AND THE CFO REVIEWS. THE FORM IS FOR POTENTIAL CONFLICTS AND IT MONITORS THOSE ACTIVITIES. |
| FORM 990, PAGE 6, PART VI, LINE 15A | ANNE RUCH IS A LICENSED OBGYN AND DONATES HER TIME TO THE CENTER. NOMINAL COMPENSATION IS THERE TO PROVIDE COMPLIANCE FOR INSURANCE PURPOSES. |
| FORM 990, PAGE 6, PART VI, LINE 19 | GOVERNING DOCUMENTS, FINANCIAL STATEMENTS, AND ALL REQUIRED DOCUMENTS ARE KEPT IN A COMMON PLACE AND INSPECTION IS ALLOWED BY APPOINTMENT ONLY. |
Comments