LA CLINICA TEPEYAC INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- LA CLINICA TEPEYAC INC (EIN 84-1285505)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-11-14
- IRS object ID
- 202233189349308423
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule G
- Schedule J
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-11-14T12:26:58-06:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 410746749 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 8390 EAST CRESCENT PARKWAY SUITE | AddressLine1Txt |
| Address Line2 | 300 | AddressLine2Txt |
| City | GREENWOOD VILLAGE | CityNm |
| State Abbreviation | CO | StateAbbreviationCd |
| ZIP | 80111 | 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 | 841285505 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LA CLINICA TEPEYAC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | LACL | BusinessNameControlTxt |
| Phone | 7202742923 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4725 HIGH STREET | AddressLine1Txt |
| City | DENVER | CityNm |
| State Abbreviation | CO | StateAbbreviationCd |
| ZIP | 80216 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JIM GARCIA | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 7202742923 | PhoneNum |
| Signature | 2022-11-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | JIM | PersonFirstNm |
| Person Last | GARCIA | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | XXX-XX-XXXX | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | SARAH HINTZ | PreparerPersonNm |
| PTIN | P00492291 | PTIN |
| Phone | 3037795710 | PhoneNum |
| Preparation | 2022-11-07 | 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
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TEPEYAC COMMUNITY HEALTH CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JIM GARCIA | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4725 HIGH STREET | AddressLine1Txt |
| City | DENVER | CityNm |
| State Abbreviation | CO | StateAbbreviationCd |
| ZIP | 80216 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $7,464,165 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.TEPEYACHEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1994 | FormationYr |
| Legal Domicile State | CO | LegalDomicileStateCd |
| Activity Or Mission | INSPIRE HEALTH, WELLBEING, AND HUMANITY IN OUR COMMUNITY, THROUGH ALL OF LIFE'S STAGES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 14 | VotingMembersIndependentCnt |
| Total Employee | 84 | TotalEmployeeCnt |
| Total Volunteers | 14 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $5,170,843 | PYContributionsGrantsAmt |
| CY Contributions Grants | $5,889,761 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $966,451 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $1,399,528 | CYProgramServiceRevenueAmt |
| PY Investment Income | $8,396 | PYInvestmentIncomeAmt |
| CY Investment Income | $97,306 | CYInvestmentIncomeAmt |
| PY Other Revenue | $128,052 | PYOtherRevenueAmt |
| CY Other Revenue | $3,160 | CYOtherRevenueAmt |
| PY Total Revenue | $6,273,742 | PYTotalRevenueAmt |
| CY Total Revenue | $7,389,755 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $599,845 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $3,410,180 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $3,969,706 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $88,366 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $49,076 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $265,989 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $2,354,713 | PYOtherExpensesAmt |
| CY Other Expenses | $2,531,823 | CYOtherExpensesAmt |
| PY Total Expenses | $6,453,104 | PYTotalExpensesAmt |
| CY Total Expenses | $6,550,605 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$179,362 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $839,150 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $15,588,630 | TotalAssetsBOYAmt |
| Total Assets EOY | $16,516,064 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $8,915,948 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $8,999,395 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $6,672,682 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $7,516,669 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | INSPIRE HEALTH, WELLBEING, AND HUMANITY IN OUR COMMUNITY, THROUGH ALL OF LIFE'S STAGES. WE ENVISION A HEALTHY COMMUNITY WITH ACCESS TO REGULAR AND ONGOING HEALTH CARE. AS WE EXPAND OUR REACH AND BRING CULTURAL RESPONSIVENESS INTO THE COMMUNITY WE STRIVE FOR EXCEPTIONAL, TRUSTWORTHY CARE THAT EMPOWERS OUR PATIENTS, DECREASES ROUTINE VISITS TO EMERGENCY ROOMS, AND CREATES HEALTHIER FAMILIES OVERALL. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $3,857,373 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $1,399,528 | RevenueAmt |
| Desc | CLINIC: PROVIDE BASIC PRIMARY CARE SERVICES, BASIC WELLNESS, PHYSICAL EXAMS, BEHAVIORAL HEALTH AND HEALTH EDUCATION. THIS INCLUDES WOMEN'S HEALTH EXAMS, MAMMOGRAPHY, PRENATAL CARE, IMMUNIZATIONS, SCHOOL PHYSICALS, DIABETES MANAGEMENT, COLPOSCOPIES, PREVENTIVE HEALTH EDUCATION, WELLNESS CLASSES, AND ORAL HEALTH CARE.HEALTH PROMOTION: PROVIDES EDUCATION FOR THE LATINX COMMUNITY AND THEIR FAMILIES TO REDUCE THE RISK OF CHRONIC DISEASE THROUGH COMMUNITY OUTREACH AND PREVENTIVE HEALTH EDUCATION CONDUCTED BY THE PROMOTORAS DE SALUD (HEALTH PROMOTERS). | Desc |
| Total Program Service Expenses | $3,857,373 | 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 | Yes (1) | 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 | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | 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 | Yes (1) | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | 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 | Yes (1) | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 25 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 84 | 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 | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| 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 | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | 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 | 0 | 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 | JOHANNA HELLER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7202742923 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4725 HIGH STREET | AddressLine1Txt |
| City | DENVER | CityNm |
| State Abbreviation | CO | StateAbbreviationCd |
| ZIP | 80216 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (22 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| DR LINDA OSTERLUND PHD | ||||||||
| PRESIDENT | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| DR HARVEY BOGRAD | ||||||||
| BOARD MEMBER & CO-VICE PRESIDENT | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| JESSE OGAS | ||||||||
| BOARD MEMBER & CO-VICE PRESIDENT | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| CANDY HERNANDEZ | ||||||||
| TREASURER | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| LUDY ESPERANZA CHACON | ||||||||
| SECRETARY | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| JACQUELINE MORALES-LOZANO | ||||||||
| ASSISTANT SECRETARY | 0.50 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| CAROLINE ACHA | ||||||||
| CONSUMER BOARD MEMBER | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| JOHN BAUER-MARTINEZ | ||||||||
| BOARD MEMBER | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| STEVE CHAVEZ | ||||||||
| BOARD MEMBER | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| YUVICELA GARCIA-DIAZ | ||||||||
| BOARD MEMBER (THRU 06/21) | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| JUANA MALDONADO | ||||||||
| CONSUMER BOARD MEMBER | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| GEORGINA MILLAN | ||||||||
| CONSUMER BOARD MEMBER | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| DR SAMIT SHAH | ||||||||
| BOARD MEMBER | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| RITA TORO | ||||||||
| CONSUMER BOARD MEMBER | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| DR GILBERT VIGIL DDS | ||||||||
| BOARD MEMBER | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| DR PAMELA VALENZA MD | ||||||||
| CHO | 50.00 | 0.00 | Yes (X) | $232,016 | $0 | $16,887 | ||
| JIM GARCIA | ||||||||
| CEO | 60.00 | 1.00 | Yes (X) | $140,400 | $0 | $15,702 | ||
| AMANDA SILK | ||||||||
| CFO | 50.00 | 0.00 | Yes (X) | $80,538 | $0 | $2,377 | ||
| OLGA WEBBER | ||||||||
| COO (THRU 02/2021) | 50.00 | 0.00 | Yes (X) | $16,417 | $0 | $3,505 | ||
| JOHANNA HELLER | ||||||||
| INTERIM CFO | 40.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| SHANA MOTROSE | ||||||||
| CAO | 40.00 | 0.00 | Yes (X) | $8,484 | $0 | $1,648 | ||
| DR PATRICK HUFFER MD | ||||||||
| FAMILY PHYSICIAN | 40.00 | 0.00 | $173,744 | $0 | $19,185 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $651,599 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $59,304 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 3 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (4 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| COMMUNITY LINK CONSULTING | |||||
| PO BOX 276 | NEWMAN LAKE | WA | 99025 | MANAGEMENT SERVICES | $203,131 |
| CREA RESULTS | |||||
| 3702 QUIVAS ST | DENVER | CO | 80211 | COMMUNITY OUTREACH | $133,695 |
| VIRSAGE SOLUTIONS | |||||
| PO BOX 29650 | PHOENIX | AZ | 85038 | CONTRACTED IT DEPARTMENT | $131,655 |
| ECLINICAL WORKS | |||||
| PO BOX 847950 | BOSTON | MA | 02284 | EHR SYSTEM | $106,056 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
| Federated Campaigns | $80,000 | FederatedCampaignsAmt |
| Fundraising | $68,696 | FundraisingAmt |
| Government Grants | $3,239,780 | GovernmentGrantsAmt |
| All Other Contributions | $2,501,285 | AllOtherContributionsAmt |
| Noncash Contributions | $172,618 | NoncashContributionsAmt |
| Total Contributions | $5,889,761 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT FEES | Desc |
| Business | 621110 | BusinessCd |
| Total Revenue Column | $1,399,528 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,399,528 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $1,399,528 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $96,090 | TotalRevenueColumnAmt |
| Exclusion | $96,090 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,216 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,216 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,216 | TotalRevenueColumnAmt |
| Exclusion | $1,216 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $41,767 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $68,696 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $74,410 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$32,643 | TotalRevenueColumnAmt |
| Exclusion | -$32,643 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS INCOME | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $35,803 | TotalRevenueColumnAmt |
| Exclusion | $35,803 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $35,803 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $7,389,755 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,399,528 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $100,466 | 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 | $517,975 | TotalAmt |
| Program Services | $221,717 | ProgramServicesAmt |
| Management And General | $228,169 | ManagementAndGeneralAmt |
| Fundraising | $68,089 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,920,432 | TotalAmt |
| Program Services | $2,000,773 | ProgramServicesAmt |
| Management And General | $851,064 | ManagementAndGeneralAmt |
| Fundraising | $68,595 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $34,832 | TotalAmt |
| Program Services | $18,021 | ProgramServicesAmt |
| Management And General | $16,811 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $236,400 | TotalAmt |
| Program Services | $121,018 | ProgramServicesAmt |
| Management And General | $110,461 | ManagementAndGeneralAmt |
| Fundraising | $4,921 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $260,067 | TotalAmt |
| Program Services | $130,757 | ProgramServicesAmt |
| Management And General | $120,944 | ManagementAndGeneralAmt |
| Fundraising | $8,366 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $55,039 | TotalAmt |
| Management And General | $55,039 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,455 | TotalAmt |
| Management And General | $36,455 | ManagementAndGeneralAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $49,076 | TotalAmt |
| Fundraising | $49,076 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $765,290 | TotalAmt |
| Program Services | $184,722 | ProgramServicesAmt |
| Management And General | $534,057 | ManagementAndGeneralAmt |
| Fundraising | $46,511 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,851 | TotalAmt |
| Program Services | $9,982 | ProgramServicesAmt |
| Management And General | $600 | ManagementAndGeneralAmt |
| Fundraising | $17,269 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $126,385 | TotalAmt |
| Program Services | $68,737 | ProgramServicesAmt |
| Management And General | $56,821 | ManagementAndGeneralAmt |
| Fundraising | $827 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $279,767 | TotalAmt |
| Program Services | $159,332 | ProgramServicesAmt |
| Management And General | $119,584 | ManagementAndGeneralAmt |
| Fundraising | $851 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $164,891 | TotalAmt |
| Program Services | $95,502 | ProgramServicesAmt |
| Management And General | $68,674 | ManagementAndGeneralAmt |
| Fundraising | $715 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,882 | TotalAmt |
| Program Services | $5,126 | ProgramServicesAmt |
| Management And General | $2,756 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,971 | TotalAmt |
| Program Services | $9,045 | ProgramServicesAmt |
| Management And General | $10,911 | ManagementAndGeneralAmt |
| Fundraising | $15 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $354,070 | TotalAmt |
| Program Services | $317,705 | ProgramServicesAmt |
| Management And General | $36,365 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $88,955 | TotalAmt |
| Program Services | $54,489 | ProgramServicesAmt |
| Management And General | $34,466 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $65,833 | TotalAmt |
| Program Services | $14,542 | ProgramServicesAmt |
| Management And General | $51,162 | ManagementAndGeneralAmt |
| Fundraising | $129 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| MEDICAL SUPPLIES | $233,437 | $230,734 | $2,703 | |
| CLINIC | $106,621 | $105,917 | $704 | |
| EQUIPMENT | $84,857 | $64,178 | $20,669 | $10 |
| DUES & MEMBERSHIPS | $67,172 | $15,136 | $51,951 | $85 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $47,347 | TotalAmt |
| Program Services | $29,940 | ProgramServicesAmt |
| Management And General | $16,877 | ManagementAndGeneralAmt |
| Fundraising | $530 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,550,605 | TotalAmt |
| Program Services | $3,857,373 | ProgramServicesAmt |
| Management And General | $2,427,243 | ManagementAndGeneralAmt |
| Fundraising | $265,989 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $144,697 | BOYAmt |
| EOY | $239,571 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,949,573 | BOYAmt |
| EOY | $2,435,265 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,795,989 | BOYAmt |
| EOY | $2,115,982 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $119,449 | BOYAmt |
| EOY | $233,127 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,496,937 | BOYAmt |
| EOY | $9,496,937 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $61,159 | BOYAmt |
| EOY | $28,646 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $2,718,188 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $825,004 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,952,311 | BOYAmt |
| EOY | $1,893,184 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $54,195 | BOYAmt |
| EOY | $59,032 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,320 | BOYAmt |
| EOY | $14,320 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,588,630 | BOYAmt |
| EOY | $16,516,064 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $356,461 | BOYAmt |
| EOY | $482,272 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $500,000 | BOYAmt |
| EOY | $471,966 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,059,487 | BOYAmt |
| EOY | $8,045,157 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,915,948 | BOYAmt |
| EOY | $8,999,395 | 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 | $2,048,881 | BOYAmt |
| EOY | $4,887,989 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,623,801 | BOYAmt |
| EOY | $2,628,680 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,672,682 | BOYAmt |
| EOY | $7,516,669 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,588,630 | BOYAmt |
| EOY | $16,516,064 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $839,150 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $4,837 | 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) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
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 | $4,331,157 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $6,264,586 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $4,270,179 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $5,170,843 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $5,889,761 | CurrentTaxYearAmt |
| Total | $25,926,526 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,331,157 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $6,264,586 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $4,270,179 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $5,170,843 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $5,889,761 | CurrentTaxYearAmt |
| Total | $25,926,526 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $247,993 | SubstantialContributorsTotAmt |
| Public Support Total170 | $25,678,533 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,704 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $8,730 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $15,186 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $8,375 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $96,090 | CurrentTaxYearAmt |
| Total | $132,085 | TotalAmt |
Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | $70,274 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $41,564 | CurrentTaxYearMinus1YearAmt |
| Total | $111,838 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $28,084 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $31,258 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $56,297 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $86,488 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $35,803 | CurrentTaxYearAmt |
| Total | $237,930 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $26,408,379 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $5,219,054 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.97240 | PublicSupportCY170Pct |
| Public Support PY170 | 0.96290 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: | FormAndLineReferenceDesc |
| Explanation | OTHER INCOME - 2017 AMOUNT: $ 28,084. 2018 AMOUNT: $ 31,258. 2019 AMOUNT: $ 56,297. 2020 AMOUNT: $ 86,488. 2021 AMOUNT: $ 35,803. | 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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Political Expenditures | $0 | PoliticalExpendituresAmt |
| Volunteer Hours | 0 | VolunteerHoursCnt |
| Section4955 Organization Tax | $0 | Section4955OrganizationTaxAmt |
| Section4955 Managers Tax | $0 | Section4955ManagersTaxAmt |
| 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 | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $367 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $367 | 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 | A PORTION OF THE ORGANIZATIONS MEMBERSHIP DUES TO CERTAIN ASSOCIATIONS ARE USED BY THOSE ASSOCIATIONS TO LOBBY ON BEHALF OF THEIR MEMBERS. | ExplanationTxt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $54,195 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $5,404 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $567 | AdministrativeExpensesAmt |
| End Year Balance | $59,032 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $48,268 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $6,406 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $479 | AdministrativeExpensesAmt |
| End Year Balance | $54,195 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $41,663 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $7,057 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $452 | AdministrativeExpensesAmt |
| End Year Balance | $48,268 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $44,285 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | -$2,180 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $442 | AdministrativeExpensesAmt |
| End Year Balance | $41,663 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $38,788 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $5,497 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $44,285 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.00000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 1.00000 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.00000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | Yes (1) | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $22,500 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $274,000 | OtherCostOrOtherBasisAmt |
| Book Value | $296,500 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,905,509 | OtherCostOrOtherBasisAmt |
| Depreciation | $471,796 | DepreciationAmt |
| Book Value | $1,433,713 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $516,179 | OtherCostOrOtherBasisAmt |
| Depreciation | $353,208 | DepreciationAmt |
| Book Value | $162,971 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,893,184 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $7,394,592 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | $4,837 | OtherRevenueAmt |
| Revenue Not Reported | $4,837 | RevenueNotReportedAmt |
| Revenue Subtotal | $7,389,755 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $7,389,755 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $6,798,883 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $248,278 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $248,278 | ExpensesNotReportedAmt |
| Expenses Subtotal | $6,550,605 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $6,550,605 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | THE PURPOSE OF THE ENDOWMENT FUND IS TO PAY FOR MEDICAL SERVICES FOR THE UNINSURED. |
| PART X, LINE 2: | THE ORGANIZATION QUALIFIES AS A TAX-EXEMPT CORPORATION DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE ORGANIZATION IS NOT A PRIVATE FOUNDATION, AND CONTRIBUTIONS TO THE ORGANIZATION QUALIFY AS CHARITABLE TAX DEDUCTIONS BY THE CONTRIBUTOR. THE ORGANIZATION FOLLOWS GUIDANCE IN THE INCOME TAX STANDARD REGARDING THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX PROVISIONS. THE APPLICATION OF THIS STANDARD HAS NO EFFECT ON THE ORGANIZATIONS CONSOLIDATED FINANCIAL STATEMENTS. THE ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX-EXEMPT STATUS OR AWARE OF ANY ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME OR EXCISE OR OTHER TAXES. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | CHANGE IN BENEFICIAL INTEREST IN ASSETS HELD BY OTHERS 4,837. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | CONSOLIDATED EXPENSES - TEPEYAC QALICB 248,278. |
Schedule G IRS990ScheduleG
| Field | Value | IRS element (for citing) |
|---|---|---|
| Mail Solicitations | Yes (X) | MailSolicitationsInd |
| Email Solicitations | Yes (X) | EmailSolicitationsInd |
| Phone Solicitations | Yes (X) | PhoneSolicitationsInd |
| In Person Solicitations | Yes (X) | InPersonSolicitationsInd |
| Solicitation Of Non Govt Grants | Yes (X) | SolicitationOfNonGovtGrantsInd |
| Solicitation Of Govt Grants | Yes (X) | SolicitationOfGovtGrantsInd |
| Special Fundraising Events | Yes (X) | SpecialFundraisingEventsInd |
| Agrmt Prof Fundraising Acty | Yes (1) | AgrmtProfFundraisingActyInd |
Fundraiser Activity Info FundraiserActivityInfoGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | ActivityActivityTxt | Fundraiser Control Of FundsFundraiserControlOfFundsInd | Gross ReceiptsGrossReceiptsAmt | Retained By ContractorRetainedByContractorAmt | Net To OrganizationNetToOrganizationAmt |
|---|---|---|---|---|---|---|---|---|
| RIPPLE AFFECT LLC | ||||||||
| 4000 LIPAN STREET | DENVER | CO | 80211 | CAPITAL CAMPAIGN CONSULTING | 0 | $0 | $26,031 | $0 |
| EVENTFUL PRODUCTION | ||||||||
| 1427 LARIMER STREET | DENVER | CO | 80202 | EVENT MANAGEMENT | 0 | $0 | $23,045 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Retained By Contractors | $49,076 | TotalRetainedByContractorsAmt |
| Licensed States | CO | LicensedStatesCd |
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | FIESTA ON THE PLAZA | Event1Nm |
| Gross Receipts Event1 | $66,618 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $45,618 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $21,000 | GrossRevenueEvent1Amt |
| Food And Beverage Event1 | $10,730 | FoodAndBeverageEvent1Amt |
| Other Direct Expenses Event1 | $21,659 | OtherDirectExpensesEvent1Amt |
| Event2 | TORTILLAS FOR TEPEYAC | Event2Nm |
| Gross Receipts Event2 | $23,078 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $23,078 | CharitableContriEvent2Amt |
| Other Direct Expenses Event2 | $33,356 | OtherDirectExpensesEvent2Amt |
| Gross Receipts Total | $89,696 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $68,696 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $21,000 | GrossRevenueTotalEventsAmt |
| Food And Beverage Total Events | $10,730 | FoodAndBeverageTotalEventsAmt |
| Oth Direct Expnss Total Events | $55,015 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $65,745 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$44,745 | NetIncomeSummaryAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (3 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DR PAMELA VALENZA MD | ||||||||||||||
| CHO | $232,016 | $0 | $0 | $0 | $0 | $0 | $7,876 | $0 | $9,011 | $0 | $248,903 | $0 | $0 | $0 |
| DR PATRICK HUFFER MD | ||||||||||||||
| FAMILY PHYSICIAN | $173,744 | $0 | $0 | $0 | $0 | $0 | $6,550 | $0 | $12,635 | $0 | $192,929 | $0 | $0 | $0 |
| JIM GARCIA | ||||||||||||||
| CEO | $140,400 | $0 | $0 | $0 | $0 | $0 | $5,147 | $0 | $10,555 | $0 | $156,102 | $0 | $0 | $0 |
Schedule M IRS990ScheduleM
Securities Publicly Traded SecuritiesPubliclyTradedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 2 | ContributionCnt |
| Noncash Contributions Rpt F990 | $172,618 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FAIR MARKET VALUE | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8283 Received | 0 | Form8283ReceivedCnt |
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, COLUMN (B): | FormAndLineReferenceDesc |
| Explanation | THE NUMBER OF CONTRIBUTIONS WAS USED IN PART I. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 1A | THE EXECUTIVE COMMITTEE IS COMPOSED OF THE PRESIDENT, VICE-PRESIDENT, SECRETARY, TREASURER, AND IMMEDIATE PAST-PRESIDENT OF THE BOARD OF DIRECTORS. WHEN THE BOARD IS NOT IN SESSION, THE EXECUTIVE COMMITTEE HAS THE POWER AND AUTHORITY OF THE BOARD TO TRANSACT ALL REGULAR BUSINESS OF THE CORPORATION, SUBJECT TO THE LIMITATIONS IMPOSED BY THE COLORADO NONPROFIT CORPORATION ACT AND TO ANY LIMITATIONS IMPOSED BY THE BOARD, INCLUDING, THAT SUCH COMMITTEE SHALL NOT: (1) ELECT, APPOINT, OR REMOVE ANY DIRECTOR; (2) AMEND ARTICLES OF INCORPORATION; (3) ADOPT, AMEND, OR REPEAL BYLAWS; (4) APPROVE A PLAN OF CONVERSION OR PLAN OF MERGER WITH ANOTHER ENTITY; OR (5) APPROVE A SALE, LEASE, EXCHANGE, OR OTHER DISPOSITION OF ALL, OR SUBSTANTIALLY ALL, OF ITS PROPERTY. THE EXECUTIVE COMMITTEE MUST REPORT ALL ACTIONS TAKEN INDEPENDENTLY AND ON BEHALF OF THE BOARD TO THE FULL GOVERNING BOARD, AND THE FULL GOVERNING BOARD MUST VOTE ON THESE ACTIONS AND REORD THEM IN THE BOARD MINUTES. |
| FORM 990, PART VI, SECTION A, LINE 3 | DURING 2021, THE ORGANIZATION PAID COMMUNITY LINK CONSULTING $203,131 FOR INTERIM FINANCIAL MANAGEMENT SERVICES, WHICH INCLUDED THE SERVICES PERFORMED BY JOHANNA HELLER, INTERIM CFO. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 WAS PREPARED BY THE ORGANIZATION'S INDEPENDENT CPA WITH INFORMATION PROVIDED BY MANAGEMENT. A COPY OF THE FORM 990 WAS REVIEWED BY THE CFO AND THE CEO, THEN BY THE FINANCE COMMITTEE. THE 990 IS THEN DISTRIBUTED TO THE BOARD OF DIRECTORS PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | ON AN ANNUAL BASIS, EACH BOARD MEMBER COMPLETES A CONFLICT OF INTEREST DISCLOSURE. IF A POTENTIAL CONFLICT OF INTEREST ARISES WITH A BOARD MEMBER, THE INDIVIDUAL PROVIDES WRITTEN NOTICE OF THE POTENTIAL CONFLICT OF INTEREST TO THE BOARD OF DIRECTORS AND REFRAINS FROM PARTICIPATION IN ANY DISCUSSION OR VOTING ON ANY MATTERS PERTAINING TO THE CONFLICT OF INTEREST. ANY DISCUSSION OF POTENTIAL CONFLICTS OF INTEREST ARE DOCUMENTED IN THE BOARD MINUTES. |
| FORM 990, PART VI, SECTION B, LINE 15A | THE BOARD OF DIRECTORS ANNUALLY REVIEWS THE CEO'S PERFORMANCE TO DETERMINE COMPENSATION. SALARY SURVEYS FROM THE COLORADO COMMUNITY HEALTH NETWORK AND THE COLORADO NONPROFIT ASSOCIATION ARE USED AS GUIDELINES. DISCUSSION RELATED TO THE DELIBERATION AND THE DECISION IS DOCUMENTED IN THE BOARD MINUTES. BASED ON COMPARABLE SALARY INFORMATION, THE CEO, CONTROLLER AND HR MANAGER REVIEW AND APPROVE THE COMPENSATION FOR THE OTHER OFFICERS OF THE ORGANIZATION. THE MOST RECENT COMPENSATION REVIEW WAS CONDUCTED IN 2021. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, AUDITED FINANCIAL STATEMENTS, AND CONFLICT OF INTEREST POLICY AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | OTHER SERVICES: PROGRAM SERVICE EXPENSES 184,722. MANAGEMENT AND GENERAL EXPENSES 534,057. FUNDRAISING EXPENSES 46,511. TOTAL EXPENSES 765,290. |
| FORM 990, PART XI, LINE 9: | CHANGE IN BENEFICIAL INTEREST IN ASSETS HELD BY OTHERS 4,837. |
| PART XII, LINE 2C | THE PROCESS AND OVERSIGHT FOR SELECTION OF AN INDEPENDENT ACCOUNTANT HAS NOT CHANGED SINCE THE PRIOR YEAR. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TEPEYAC QALICB INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4725 HIGH STREET | AddressLine1Txt |
| City | DENVER | CityNm |
| State Abbreviation | CO | StateAbbreviationCd |
| ZIP | 80216 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 851563851 | EIN |
| Primary Activities | SUPPORT LA CLINICA TEPEYAC | PrimaryActivitiesTxt |
| Legal Domicile State | CO | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | LINE 12C, III-FI | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LA CLINICA TEPEYAC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | Yes (1) | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |