CHARITABLE HEALTHCARE NETWORK INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- CHARITABLE HEALTHCARE NETWORK INC (EIN 22-3769296)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-11-03
- IRS object ID
- 202223079349301682
- 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 | 2022-11-03T11:33:07-05:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 310800053 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLARK SCHAEFER HACKETT & CO | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 14 EAST MAIN STREET SUITE 500 | AddressLine1Txt |
| City | SPRINGFIELD | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45502 | 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 | 223769296 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHARITABLE HEALTHCARE NETWORK INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CHAR | BusinessNameControlTxt |
| Phone | 6149146458 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 88 EAST BROAD STREET 1475 | AddressLine1Txt |
| City | COLUMBUS | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 43215 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JASON KOMA | PersonNm |
| Person Title | EXECUTIVE DIRECTOR | PersonTitleTxt |
| Phone | 6149146458 | PhoneNum |
| Signature | 2022-11-01 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | JASON | PersonFirstNm |
| Person Last | KOMA | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JESSE YOUNG CPA | PreparerPersonNm |
| PTIN | P01236247 | PTIN |
| Phone | 9373992000 | PhoneNum |
| Preparation | 2022-11-01 | 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 |
| 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 | JASON KOMA | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 88 EAST BROAD STREET 1475 | AddressLine1Txt |
| City | COLUMBUS | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 43215 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $1,218,819 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.OHIOFREECLINICS.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2002 | FormationYr |
| Legal Domicile State | OH | LegalDomicileStateCd |
| Activity Or Mission | TO IMPROVE ACCESS TO HEALTH CARE FOR THE UNINSURED AND UNDERINSURED PEOPLE IN OHIO, TO STRENGTHEN THE CAPACITY OF OHIO'S FREE CLINCS, TO BUILD A NETWORK AMONG FREE CLINICS AND TO BE AN ADVOCATE FOR FREE CLINICS AND THE PEOPLE THEY SERVE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 14 | VotingMembersIndependentCnt |
| Total Employee | 9 | TotalEmployeeCnt |
| Total Volunteers | 14 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,898,054 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,195,498 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $18,333 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $22,855 | CYProgramServiceRevenueAmt |
| PY Investment Income | $93 | PYInvestmentIncomeAmt |
| CY Investment Income | $48 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $418 | CYOtherRevenueAmt |
| PY Total Revenue | $1,916,480 | PYTotalRevenueAmt |
| CY Total Revenue | $1,218,819 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $1,526,271 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $935,199 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $198,202 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $240,376 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $7,509 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $82,525 | PYOtherExpensesAmt |
| CY Other Expenses | $114,853 | CYOtherExpensesAmt |
| PY Total Expenses | $1,806,998 | PYTotalExpensesAmt |
| CY Total Expenses | $1,290,428 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $109,482 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$71,609 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $790,360 | TotalAssetsBOYAmt |
| Total Assets EOY | $419,675 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $467,134 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $168,058 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $323,226 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $251,617 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO BE THE VOICE AND CONNECTOR FOR MEMBERS BY PROVIDING RESOURCES, EDUCATION AND ADVOCACY TO STRENGTHEN AND ENSURE HIGH QUALITY HEALTH CARE FOR PEOPLE WHO ARE VULNERABLE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $1,182,534 | ExpenseAmt |
| Grant | $935,199 | GrantAmt |
| Revenue | $23,273 | RevenueAmt |
| Desc | COLLECT AND DISTRIBUTE FUNDS TO FREE CLINICS. PROMOTE NETWORKING AND INFORMATION SHARING AMONG OHIO FREE CLINICS, TO ADVOCATE ON BEHALF OF FREE CLINICS AND THE PEOPLE THEY SERVE AND TO MANAGE THE FREE CLINIC DATA. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $0 | ExpenseAmt |
| Revenue | $0 | RevenueAmt |
| Desc | VISTA PROGRAM: SERVICES TO STRENGTHEN AND SUPPLEMENT EFFORTS TO ELIMINATE POVERTY AND POVERTY-RELATED HUMAN, SOCIAL, AND ENVIRONMENTAL PROBLEMS. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $1,182,534 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | 0 | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 9 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 14 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JASON KOMA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6149146458 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 88 EAST BROAD STREET 1475 | AddressLine1Txt |
| City | COLUMBUS | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 43215 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (15 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|
| ISI GREEN | ||||||
| PRESIDENT | 5.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| JIM BENNEDICT | ||||||
| VICE PRESIDENT | 5.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| SUMMIT SHAH | ||||||
| TREASURER | 5.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| JUSTIN COBY | ||||||
| SECRETARY | 5.00 | Yes (X) | $0 | $0 | $0 | |
| CAPRI CAFARO | ||||||
| DIRECTOR | 5.00 | Yes (X) | $0 | $0 | $0 | |
| ROB COOPER | ||||||
| DIRECTOR | 5.00 | Yes (X) | $0 | $0 | $0 | |
| PAUL BAUMGARTNER | ||||||
| DIRECTOR | 5.00 | Yes (X) | $0 | $0 | $0 | |
| JAIME PARSONS | ||||||
| DIRECTOR | 5.00 | Yes (X) | $0 | $0 | $0 | |
| BRANDON CHAPMAN | ||||||
| DIRECTOR | 5.00 | Yes (X) | $0 | $0 | $0 | |
| JOEL KESSEL | ||||||
| DIRECTOR | 5.00 | Yes (X) | $0 | $0 | $0 | |
| SUE MEYER | ||||||
| DIRECTOR | 5.00 | Yes (X) | $0 | $0 | $0 | |
| LINDA SMITH BERRY | ||||||
| DIRECTOR | 5.00 | Yes (X) | $0 | $0 | $0 | |
| CAROLE MERKLE | ||||||
| DIRECTOR | 5.00 | Yes (X) | $0 | $0 | $0 | |
| DENISE LUCAS | ||||||
| DIRECTOR | 5.00 | Yes (X) | $0 | $0 | $0 | |
| DEBORAH MILLER | ||||||
| EXECUTIVE DIRECTOR - EXITED IN 2022 | 40.00 | Yes (X) | $86,286 | $0 | $0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $86,286 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $0 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | 0 | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Membership Dues | $28,916 | MembershipDuesAmt |
| Government Grants | $1,161,742 | GovernmentGrantsAmt |
| All Other Contributions | $4,840 | AllOtherContributionsAmt |
| Total Contributions | $1,195,498 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | EDUCATION EVENT | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $22,855 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $22,855 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $22,855 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $48 | TotalRevenueColumnAmt |
| Exclusion | $48 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS INCOME | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $418 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $418 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $418 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,218,819 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $23,273 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $48 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $935,199 | TotalAmt |
| Program Services | $935,199 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $86,286 | TotalAmt |
| Program Services | $43,143 | ProgramServicesAmt |
| Management And General | $38,829 | ManagementAndGeneralAmt |
| Fundraising | $4,314 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $131,608 | TotalAmt |
| Program Services | $129,410 | ProgramServicesAmt |
| Management And General | $1,978 | ManagementAndGeneralAmt |
| Fundraising | $220 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,482 | TotalAmt |
| Program Services | $20,034 | ProgramServicesAmt |
| Management And General | $2,203 | ManagementAndGeneralAmt |
| Fundraising | $245 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $465 | TotalAmt |
| Management And General | $465 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,028 | TotalAmt |
| Management And General | $12,028 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,226 | TotalAmt |
| Program Services | $3,257 | ProgramServicesAmt |
| Management And General | $3,630 | ManagementAndGeneralAmt |
| Fundraising | $339 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,432 | TotalAmt |
| Program Services | $12,432 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,659 | TotalAmt |
| Program Services | $5,915 | ProgramServicesAmt |
| Management And General | $17,744 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,768 | TotalAmt |
| Management And General | $4,768 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,309 | TotalAmt |
| Program Services | $22,309 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,609 | TotalAmt |
| Program Services | $1,304 | ProgramServicesAmt |
| Management And General | $1,305 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,031 | TotalAmt |
| Program Services | $4,031 | ProgramServicesAmt |
| Management And General | $875 | ManagementAndGeneralAmt |
| Fundraising | $125 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Management And GeneralManagementAndGeneralAmt | Program ServicesProgramServicesAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| DUES AND SUBSCRIPTIONS | $10,324 | $10,324 | ||
| CONTRACT SERVICES | $5,665 | $1,133 | $2,266 | $2,266 |
| MISCELLANEOUS | $3,853 | $3,853 | ||
| EQUIPMENT | $2,979 | $2,979 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,505 | TotalAmt |
| Program Services | $255 | ProgramServicesAmt |
| Management And General | $1,250 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,290,428 | TotalAmt |
| Program Services | $1,182,534 | ProgramServicesAmt |
| Management And General | $100,385 | ManagementAndGeneralAmt |
| Fundraising | $7,509 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $382,712 | BOYAmt |
| EOY | $56,581 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $150,023 | BOYAmt |
| EOY | $150,071 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $243,125 | BOYAmt |
| EOY | $187,000 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,397 | BOYAmt |
| EOY | $16,929 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $23,365 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $14,271 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,103 | BOYAmt |
| EOY | $9,094 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $790,360 | BOYAmt |
| EOY | $419,675 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $465,296 | BOYAmt |
| EOY | $167,027 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $1,031 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,838 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $467,134 | BOYAmt |
| EOY | $168,058 | 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 | $323,226 | BOYAmt |
| EOY | $251,617 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $323,226 | BOYAmt |
| EOY | $251,617 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $790,360 | BOYAmt |
| EOY | $419,675 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$71,609 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $989,046 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $627,863 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $798,766 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,898,054 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,195,498 | CurrentTaxYearAmt |
| Total | $5,509,227 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $7,833 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $22,976 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $28,200 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $18,333 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $22,855 | CurrentTaxYearAmt |
| Total | $100,197 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $996,879 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $650,839 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $826,966 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,916,387 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,218,353 | CurrentTaxYearAmt |
| Total | $5,609,424 | 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 | $5,609,424 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $151 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $226 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $250 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $93 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $48 | CurrentTaxYearAmt |
| Total | $768 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $151 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $226 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $250 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $93 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $48 | CurrentTaxYearAmt |
| Total | $768 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $9,474 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $7,400 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $6,815 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year | $418 | CurrentTaxYearAmt |
| Total | $24,107 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,006,504 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $658,465 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $834,031 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,916,480 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,218,819 | CurrentTaxYearAmt |
| Total | $5,634,299 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99560 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99390 | PublicSupportPY509Pct |
| Investment Income CY | 0.00010 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00020 | 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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | Yes (1) | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | Yes (1) | DirectContactLegislatorsInd |
| Rallies Demonstrations | Yes (1) | RalliesDemonstrationsInd |
| Other Activities | 0 | OtherActivitiesInd |
| Total Lobbying Expenditures | $0 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | SECURED FUNDING IN THE STATE BIENNIAL BUDGET THROUGH MEETINGS WITH KEY MEMBERS OF THE OHIO GENERAL ASSEMBLY. | ExplanationTxt |
Schedule D IRS990ScheduleD
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $22,975 | OtherCostOrOtherBasisAmt |
| Depreciation | $13,881 | DepreciationAmt |
| Book Value | $9,094 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $390 | OtherCostOrOtherBasisAmt |
| Depreciation | $390 | DepreciationAmt |
| Book Value | $0 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $9,094 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $1,218,819 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $1,218,819 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $1,218,819 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $1,290,428 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $1,290,428 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $1,290,428 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | OHIO ASSOCIATION OF FREE CLINICS IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. HOWEVER, INCOME FROM CERTAIN ACTIVITIES NOT DIRECTLY RELATED TO THE ASSOCIAITON'S TAX-EXEMPT PURPOSE IS SUBJECT TO TAXATION AS UNRELATED BUSINESS INCOME. THE ASSOCIATION'S REPORTING RETURNS ARE SUBJECT TO AUDIT BY FEDERAL AND STATE TAXING AUTHORITIES. NO INCOME TAX PROVISION HAS BEEN INCLUDED IN THE FINANCIAL STATEMENTS AS THE ASSOCIATION HAS DETERMINED IT DOES NOT HAVE UNRELATED BUSINESS INCOME SUBJECT TO TAXATION. | ExplanationTxt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (53 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Non Cash AssistanceNonCashAssistanceAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|---|
| ASHLAND CHRISTIAN HEALTH CENTER | ||||||||
| 380 E 4TH STREET | ASHLAND | OH | 44805 | 421595274 | 501(C)(3) | $26,519 | $0 | TO PROVIDE SERVICES TO UNINSURED PATIENTS |
| ASIAN AMERICAN COMMUNITY SERVICES | ||||||||
| 2231 N HIGH STREET FIRST FLOOR | COLUMBUS | OH | 43201 | 310898833 | 501(C)(3) | $17,196 | $0 | TO PROVIDE SERVICES TO UNINSURED PATIENTS |
| BEACON CHARITABLE PHARMACY | ||||||||
| 408 9TH STREET SW 1450 | CANTON | OH | 44707 | 200797475 | 501(C)(3) | $17,196 | $0 | TO PROVIDE SERVICES TO UNINSURED PATIENTS |
| BELLBROOK OPEN ARMS FREE CLINIC | ||||||||
| 4403 OH-725 E | BELLBROOK | OH | 45305 | 454475625 | 501(C)(3) | $6,292 | $0 | TO PROVIDE SERVICES TO UNINSURED PATIENTS |
| BREATHING ASSOCIATION FREE LUNG HEALTH CLINIC | ||||||||
| 1520 OLD HENDERSON ROAD | COLUMBUS | OH | 432203639 | 314387540 | 501(C)(3) | $11,202 | $0 | TO PROVIDE SERVICES TO UNINSURED PATIENTS |
| BY THE WAY INC | ||||||||
| 1029 S BROAD STREET | LANCASTER | OH | 43130 | 262934275 | 501(C)(3) | $11,202 | $0 | TO PROVIDE SERVICES TO UNINSURED PATIENTS |
| CHARITABLE PHARMACY OF CENTRAL OHIO | ||||||||
| 200 E LIVINGSTON AVE | COLUMBUS | OH | 43215 | 270147099 | 501(C)(3) | $6,292 | $0 | TO PROVIDE SERVICES TO UNINSURED PATIENTS |
| CLEVELAND IBN SINA CLINIC | ||||||||
| 6055 W 130TH STREET | PARMA | OH | 44130 | 834347692 | 501(C)(3) | $23,337 | $0 | TO PROVIDE SERVICES TO UNINSURED PATIENTS |
| COLUMBUS CANCER CLINIC | ||||||||
| 1699 W MOUND ST | COLUMBUS | OH | 43223 | 314379494 | 501(C)(3) | $17,196 | $0 | TO PROVIDE SERVICES TO UNINSURED PATIENTS |
| COLUMBUS FREE CLINIC | ||||||||
| 2231 N HIGH STREET | COLUMBUS | OH | 43201 | 010575698 | 501(C)(3) | $26,518 | $0 | TO PROVIDE SERVICES TO UNINSURED PATIENTS |
| COMMUNITY CARE FREE MEDICAL CLINIC | ||||||||
| 2150 S BYRNE RD | TOLEDO | OH | 43614 | 274077912 | 501(C)(3) | $17,196 | $0 | TO PROVIDE SERVICES TO UNINSURED PATIENTS |
| COMPASSION MEDICAL CLINIC OF WILLIAMS COUNTY | ||||||||
| 614 E EDGERTON ST | BRYAN | OH | 43506 | 204352598 | 501(C)(3) | $11,202 | $0 | TO PROVIDE SERVICES TO UNINSURED PATIENTS |
| COMPASSIONATE CARE OF SHELBY COUNTY | ||||||||
| 124 N OHIO AVENUE | SIDNEY | OH | 45365 | 208479583 | 501(C)(3) | $6,292 | $0 | TO PROVIDE SERVICES TO UNINSURED PATIENTS |
| DWELL COMMUNITY CHURCH FREE CLINIC | ||||||||
| 1390 COMMUNITY PARK DR | COLUMBUS | OH | 43229 | 501(C)(3) | $5,988 | $0 | TO PROVIDE SERVICES TO UNINSURED PATIENTS | |
| FAITHFUL SERVANTS FREE CLINIC | ||||||||
| 65 COMMUNITY ROAD SUITE F | TALLMADGE | OH | 44278 | 454734159 | 501(C)(3) | $29,331 | $0 | TO PROVIDE SERVICES TO UNINSURED PATIENTS |
| FREE CLINIC OF FULTON COUNTY | ||||||||
| PO BOX 173 | WAUSEON | OH | 43567 | 020792665 | 501(C)(3) | $5,528 | $0 | TO PROVIDE SERVICES TO UNINSURED PATIENTS |
| FREE CLINIC OF MEDINA COUNTY | ||||||||
| 970 E WASHINGTON STREET SUITE 104 | MEDINA | OH | 44256 | 300092944 | 501(C)(3) | $8,187 | $0 | TO PROVIDE SERVICES TO UNINSURED PATIENTS |
| GOOD NEIGHBOR HOUSE | ||||||||
| 627 E FIRST STREET | DAYTON | OH | 45402 | 311374154 | 501(C)(3) | $26,519 | $0 | TO PROVIDE SERVICES TO UNINSURED PATIENTS |
| GOOD SAMARITAN FREE HEALTH CENTER | ||||||||
| 619 OAK STREET -ACCOUNTING 3 WEST | CINCINNATI | OH | 45206 | 273893817 | 501(C)(3) | $29,331 | $0 | TO PROVIDE SERVICES TO UNINSURED PATIENTS |
| GRACE CLINIC OF DELAWARE | ||||||||
| 40 S FRANKLIN ST | DELAWARE | OH | 43015 | 270415624 | 501(C)(3) | $26,519 | $0 | TO PROVIDE SERVICES TO UNINSURED PATIENTS |
| HALIM CLINIC | ||||||||
| 6855 SPRING VALLEY DR | HOLLAND | OH | 43528 | 831212020 | 501(C)(3) | $23,337 | $0 | TO PROVIDE SERVICES TO UNINSURED PATIENTS |
| HARTVILLE MIGRANT COUNCIL | ||||||||
| PO BOX 682 | HARTVILLE | OH | 44632 | 340899100 | 501(C)(3) | $14,384 | $0 | TO PROVIDE SERVICES TO UNINSURED PATIENTS |
| HEALTH PARTNERS FREE CLINIC | ||||||||
| 1300 N COUNTY RD 25A | TROY | OH | 45373 | 311596731 | 501(C)(3) | $17,196 | $0 | TO PROVIDE SERVICES TO UNINSURED PATIENTS |
| HELPING HANDS HEALTH & WELLNESS CENTER | ||||||||
| 1420 MORSE ROAD | COLUMBUS | OH | 43229 | 205937457 | 501(C)(3) | $17,196 | $0 | TO PROVIDE SERVICES TO UNINSURED PATIENTS |
| HOPE CLINIC OF ROSS COUNTY | ||||||||
| 610 CENTRAL CENTER | CHILLICOTHE | OH | 45601 | 452390821 | 501(C)(3) | $26,519 | $0 | TO PROVIDE SERVICES TO UNINSURED PATIENTS |
| KIDSMILE PEDIATRIC DENTAL CLINIC | ||||||||
| 770 BETHEL ROAD | COLUMBUS | OH | 43214 | 263706958 | 501(C)(3) | $8,663 | $0 | TO PROVIDE SERVICES TO UNINSURED PATIENTS |
| LA CLINICA LATINA | ||||||||
| 2231 N HIGH STREET | COLUMBUS | OH | 43201 | 860893491 | 501(C)(3) | $21,350 | $0 | TO PROVIDE SERVICES TO UNINSURED PATIENTS |
| LAKE COUNTY FREE CLINIC | ||||||||
| 54 SOUTH STATE STREET SUITE 302 | PAINESVILLE | OH | 44077 | 341081191 | 501(C)(3) | $29,331 | $0 | TO PROVIDE SERVICES TO UNINSURED PATIENTS |
| LICKING COUNTY COMMUNITY HEALTH CLINIC | ||||||||
| 144 B W MAIN STREET | NEWARK | OH | 43055 | 311340169 | 501(C)(3) | $26,519 | $0 | TO PROVIDE SERVICES TO UNINSURED PATIENTS |
| LIFECARE ALLIANCE | ||||||||
| 1699 W MOUND ST | COLUMBUS | OH | 43223 | 314379494 | 501(C)(3) | $12,135 | $0 | TO PROVIDE SERVICES TO UNINSURED PATIENTS |
| LIVING WELL CLINIC | ||||||||
| 215 S ALLISON AVE PO BOX 15 | XENIA | OH | 45385 | 274307745 | 501(C)(3) | $26,518 | $0 | TO PROVIDE SERVICES TO UNINSURED PATIENTS |
| LORAIN COUNTY FREE CLINIC INC | ||||||||
| 3323 PEARL AVENUE | LORAIN | OH | 44055 | 341506180 | 501(C)(3) | $29,331 | $0 | TO PROVIDE SERVICES TO UNINSURED PATIENTS |
| MIDLOTHIAN FREE HEALTH CLINIC INC | ||||||||
| 388 E MIDLOTHIAN BLVD | YOUNGSTOWN | OH | 44507 | 010887315 | 501(C)(3) | $11,202 | $0 | TO PROVIDE SERVICES TO UNINSURED PATIENTS |
| NEW LIFE COMMUNITY OUTREACH | ||||||||
| 25 WEST 5TH AVENUE | COLUMBUS | OH | 43201 | 352386294 | 501(C)(3) | $12,267 | $0 | TO PROVIDE SERVICES TO UNINSURED PATIENTS |
| OHIO UNIVERSITY HERITAGE COMMUNITY CLINIC | ||||||||
| 16 W GREEN DR | ATHENS | OH | 45701 | 954814550 | 501(C)(3) | $17,196 | $0 | TO PROVIDE SERVICES TO UNINSURED PATIENTS |
| OHIO VALLEY HEALTH CENTER | ||||||||
| 1 ROSS PARK BLVD STE 202 | STUEBENVILLE | OH | 43952 | 203924355 | 501(C)(3) | $26,518 | $0 | TO PROVIDE SERVICES TO UNINSURED PATIENTS |
| OPPORTUNITY PARISH ECUMENICAL NEIGHBORHOOD MINISTRY FREE CLINIC | ||||||||
| 941 PRINCETON AVENUE | AKRON | OH | 44311 | 341046107 | 501(C)(3) | $28,398 | $0 | TO PROVIDE SERVICES TO UNINSURED PATIENTS |
| OXFORD COLLEGE CORNER CLINIC (DBA OXFORD FREE CLINIC) | ||||||||
| PO BOX 390 | OXFORD | OH | 45056 | 204253386 | 501(C)(3) | $11,202 | $0 | TO PROVIDE SERVICES TO UNINSURED PATIENTS |
| PHYSICIANS CARE CONNECTION | ||||||||
| 1390 DUBLIN ROAD | COLUMBUS | OH | 43215 | 311373719 | 501(C)(3) | $17,196 | $0 | TO PROVIDE SERVICES TO UNINSURED PATIENTS |
| PREGNANCY SUPPORT CENTER OF STARK COUNTY | ||||||||
| 4500 22ND ST NW | CANTON | OH | 44706 | 341461765 | 501(C)(3) | $17,196 | $0 | TO PROVIDE SERVICES TO UNINSURED PATIENTS |
| RISING SUNS NON-PROFIT PHARMACY | ||||||||
| 86 COLUMBUS CIRCLE STE 104G | ATHENS | OH | 45701 | 501(C)(3) | $11,202 | $0 | TO PROVIDE SERVICES TO UNINSURED PATIENTS | |
| SALAAM CLINIC | ||||||||
| 1925 ST CLAIR AVE NE | CLEVELAND | OH | 44114 | 261368320 | 501(C)(3) | $6,292 | $0 | TO PROVIDE SERVICES TO UNINSURED PATIENTS |
| SOAR STUDENT RUN FREE CLINIC | ||||||||
| 4209 ST RT 44 | ROOTSTOWN | OH | 44272 | 464173762 | 501(C)(3) | $11,202 | $0 | TO PROVIDE SERVICES TO UNINSURED PATIENTS |
| ST MARY'S CONNECT | ||||||||
| 501(C)(3) | $17,196 | $0 | TO PROVIDE SERVICES TO UNINSURED PATIENTS | |||||
| ST VINCENT DE PAUL CHARITABLE PHARMACY | ||||||||
| 1125 BANK ST | CINCINNATI | OH | 45214 | 310537510 | 501(C)(3) | $12,135 | $0 | TO PROVIDE SERVICES TO UNINSURED PATIENTS |
| STOWE MISSION DENTAL AND VISION CLINIC | ||||||||
| 888 PARSONS AVE | COLUMBUS | OH | 43206 | 320326645 | 501(C)(3) | $17,196 | $0 | TO PROVIDE SERVICES TO UNINSURED PATIENTS |
| THE NEIGHBORHOOD FREE CLINIC | ||||||||
| 306 N BUSH STREET | TOLEDO | OH | 43604 | 271052744 | 501(C)(3) | $13,215 | $0 | TO PROVIDE SERVICES TO UNINSURED PATIENTS |
| TOLDEOLUCAS COUNTY CARENET | ||||||||
| 3231 CENTRAL PARK WEST SUITE 200 | TOLEDO | OH | 43617 | 431986672 | 501(C)(3) | $26,518 | $0 | TO PROVIDE SERVICES TO UNINSURED PATIENTS |
| TUSCARAWAS CLINIC FOR THE WORKING UNINSURED | ||||||||
| 420 REEVES AVENUE SUITE D | DOVER | OH | 44622 | 208456793 | 501(C)(3) | $26,518 | $0 | TO PROVIDE SERVICES TO UNINSURED PATIENTS |
| VICTORY MINISTRIES | ||||||||
| 4142 WESTERVILLE ROAD | COLUMBUS | OH | 43224 | 311117522 | 501(C)(3) | $11,202 | $0 | TO PROVIDE SERVICES TO UNINSURED PATIENTS |
| VINEYARD COMMUNITY CENTER | ||||||||
| 15187 PALMER ROAD | ETNA | OH | 43068 | 310954398 | 501(C)(3) | $11,202 | $0 | TO PROVIDE SERVICES TO UNINSURED PATIENTS |
| VINEYARD FREE HEALTH CLINICS | ||||||||
| 6000 COOPER ROAD | WESTERVILLE | OH | 43081 | 753210233 | 501(C)(3) | $14,383 | $0 | TO PROVIDE SERVICES TO UNINSURED PATIENTS |
| VIOLA STARTZMAN FREE CLINIC | ||||||||
| 1874 CLEVELAND ROAD | WOOSTER | OH | 44691 | 341758151 | 501(C)(3) | $29,331 | $0 | TO PROVIDE SERVICES TO UNINSURED PATIENTS |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THE MEMBERS ELECT THE MEMBERS OF THE GOVERNING BODY. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE MEMBERS ELECT THE MEMBERS OF THE GOVERNING BODY. |
| FORM 990, PART VI, SECTION B, LINE 11B | BOARD MEMBERS RECEIVE A COPY OF THE 990 AND APPROVE IT BEFORE FILING WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | ANNUALLY, THE BOARD OF DIRECTORS AND ITS OFFICERS, WILL COMPLETE A QUESTIONNAIRE TO ASSIST THE ORGANIZATION WITH DETERMINING THAT THEY ARE IN COMPLIANCE WITH THE POLICY. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE BOARD OFFICERS RESEARCH, DELIBERATE, AND APPROVE COMPENSATION FOR THE EXECUTIVE DIRECTOR. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE UPON REQUEST. |
| FORM 990, PART XII, LINE 2C: | THE PROCESS HAS NOT CHANGED. |
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