COMMUNITY HEALTH FOUNDATION OF FAIRFIELD: Form 990EZ, tax year 2023
View the entire original 990 at ProPublica ↗
- Organization
- COMMUNITY HEALTH FOUNDATION OF FAIRFIELD (EIN 57-0930442)
- Tax period
- 2023-07-01 to 2024-06-30
- Filed
- 2025-02-12
- IRS object ID
- 202510439349200246
- Schema version
- 2023v6.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2025-02-12T13:29:58-06:00 | ReturnTs |
| Tax Period End | 2024-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 620713250 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KRAFTCPAS PLLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6136 SHALLOWFORD ROAD 101 | AddressLine1Txt |
| City | CHATTANOOGA | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 374217214 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990EZ | ReturnTypeCd |
| Tax Period Begin | 2023-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 570930442 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY HEALTH FOUNDATION OF FAIRFIELD | BusinessNameLine1Txt |
| Business Name Line2 | JOHN A MARTIN PRIMARY HEALTH CARE | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | COMM | BusinessNameControlTxt |
| Phone | 8036356099 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 56 US HWY 321 BYPASS NORTH | AddressLine1Txt |
| City | WINNSBORO | CityNm |
| State Abbreviation | SC | StateAbbreviationCd |
| ZIP | 29180 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MARK SHAFFER | PersonNm |
| Person Title | MEDICAL DIRECTOR | PersonTitleTxt |
| Phone | 8036356099 | PhoneNum |
| Signature | 2025-02-12 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | Yes (1) | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | FRANCES E LEAHY | PreparerPersonNm |
| PTIN | P00713593 | PTIN |
| Phone | 4238947400 | PhoneNum |
| Preparation | 2025-02-11 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2023 | TaxYr |
| Build TS | 2025-03-06 01:10:19Z | BuildTS |
Form 990-EZ IRS990EZ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Final Return | Yes (X) | FinalReturnInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Schedule B Not Required | Yes (X) | ScheduleBNotRequiredInd |
| Website Address | N/A | WebsiteAddressTxt |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Gross Receipts | $8,706 | GrossReceiptsAmt |
| Info In Schedule O Part I | Yes (X) | InfoInScheduleOPartIInd |
| Program Service Revenue | $8,706 | ProgramServiceRevenueAmt |
| Total Revenue | $8,706 | TotalRevenueAmt |
| Grants And Similar Amounts Paid | $114,700 | GrantsAndSimilarAmountsPaidAmt |
| Salaries Other Comp Empl Bnft | $10,000 | SalariesOtherCompEmplBnftAmt |
| Fees And Other Pymt To Ind Cntrct | $31,099 | FeesAndOtherPymtToIndCntrctAmt |
| Occupancy Rent Utlts And Maint | $703 | OccupancyRentUtltsAndMaintAmt |
| Other Expenses Total | $108,570 | OtherExpensesTotalAmt |
| Total Expenses | $265,072 | TotalExpensesAmt |
| Excess Or Deficit For Year | -$256,366 | ExcessOrDeficitForYearAmt |
| Net Assets Or Fund Balances BOY | $256,366 | NetAssetsOrFundBalancesBOYAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Net Assets Or Fund Balances EOY | $0 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part II | Yes (X) | InfoInScheduleOPartIIInd |
Cash Savings And Investments CashSavingsAndInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $187,448 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total Detail OtherAssetsTotalDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $68,918 | BOYAmt |
| EOY | $0 | EOYAmt |
Form990 Total Assets Form990TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $256,366 | BOYAmt |
| EOY | $0 | EOYAmt |
Sum Of Total Liabilities SumOfTotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Net Assets Or Fund Balances NetAssetsOrFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $256,366 | BOYAmt |
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Primary Exempt Purpose | OPERATION OF A MEDICAL CLINIC IN A RURAL AREA. | PrimaryExemptPurposeTxt |
Program Srvc Accomplishment ProgramSrvcAccomplishmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Program Srvc Accom | THE ORGANIZATION PREVIOUSLY OPERATED AN ACADEMIC CLINICAL CENTER IN A RURAL AREA TO DELIVER HEALTH CARE TO A DEFINED POPULATION. OPERATIONS CEASED IN JANUARY 2022 WHEN PRISMA HEALTH ASSUMED OPERATIONS, HOWEVER, ONGOING COLLECTIONS CONTINUED THROUGH 2024. | DescriptionProgramSrvcAccomTxt |
| Grants And Allocations | $0 | GrantsAndAllocationsAmt |
| Program Service Expenses | $173,846 | ProgramServiceExpensesAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $173,846 | TotalProgramServiceExpensesAmt |
Officer Director Trustee Empl OfficerDirectorTrusteeEmplGrp (7 entries)
| TitleTitleTxt | Average Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRt | CompensationCompensationAmt | Employee Benefit ProgramEmployeeBenefitProgramAmt | Expense Account Other AllwncExpenseAccountOtherAllwncAmt |
|---|---|---|---|---|
| MARK SHAFFER | ||||
| MEDICAL DIRECTOR | 1.00 | $10,000 | $0 | $0 |
| KIMBERLY SEIBLES | ||||
| CHAIR | 1.00 | $0 | $0 | $0 |
| LESS HALL MD | ||||
| DIRECTOR | 1.00 | $0 | $0 | $0 |
| DORIS LEITNER | ||||
| DIRECTOR | 1.00 | $0 | $0 | $0 |
| THOMAS CHANDLER PHD | ||||
| DIRECTOR | 1.00 | $0 | $0 | $0 |
| BERTHA GOINS | ||||
| DIRECTOR | 1.00 | $0 | $0 | $0 |
| SHERYL MITCHELL | ||||
| DIRECTOR | 1.00 | $0 | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| Activities Not Previously Rpt | 0 | ActivitiesNotPreviouslyRptInd |
| Chg Made To Orgnzng Doc Not Rpt | 0 | ChgMadeToOrgnzngDocNotRptInd |
| Organization Had UBI | 0 | OrganizationHadUBIInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Organization Dissolved Etc | Yes (1) | OrganizationDissolvedEtcInd |
| Direct Indirect Pltcl Expend | $0 | DirectIndirectPltclExpendAmt |
| Made Loans To From Officers | 0 | MadeLoansToFromOfficersInd |
| Tax Imposed Under IRC4911 | $0 | TaxImposedUnderIRC4911Amt |
| Tax Imposed Under IRC4912 | $0 | TaxImposedUnderIRC4912Amt |
| Tax Imposed Under IRC4955 | $0 | TaxImposedUnderIRC4955Amt |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| Tax Imposed On Organization Mgr | $0 | TaxImposedOnOrganizationMgrAmt |
| Tax Reimbursed By Organization | $0 | TaxReimbursedByOrganizationAmt |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| States Where Copy Of Return Is Fld | SC | StatesWhereCopyOfReturnIsFldCd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MARK SHAFFER MD | PersonNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 56 US HWY 321 BYPASS NORTH | AddressLine1Txt |
| City | WINNSBORO | CityNm |
| State Abbreviation | SC | StateAbbreviationCd |
| ZIP | 29180 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8036356099 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Donor Advised Fnds | 0 | DonorAdvisedFndsInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Tanning Services Provided | 0 | TanningServicesProvidedInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| School Operating | 0 | SchoolOperatingInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Part VI Of Comp Of Hghst Pd Empl | NONE | PartVIOfCompOfHghstPdEmplTxt |
| Part VI Hghst Pd Cntrct Prof Srvc | NONE | PartVIHghstPdCntrctProfSrvcTxt |
| Filed Schedule A | Yes (1) | FiledScheduleAInd |
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 Minus3 Years | $190,700 | CurrentTaxYearMinus3YearsAmt |
| Total | $190,700 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $893,402 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $727,906 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $612,693 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $63,869 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $8,706 | CurrentTaxYearAmt |
| Total | $2,306,576 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $893,402 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $918,606 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $612,693 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $63,869 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $8,706 | CurrentTaxYearAmt |
| Total | $2,497,276 | 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 | $2,497,276 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $81 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $6 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2 | CurrentTaxYearMinus2YearsAmt |
| Total | $89 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $81 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $6 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2 | CurrentTaxYearMinus2YearsAmt |
| Total | $89 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $893,483 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $918,612 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $612,695 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $63,869 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $8,706 | CurrentTaxYearAmt |
| Total | $2,497,365 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 1.00000 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99990 | PublicSupportPY509Pct |
| Investment Income CY | 0.00000 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00010 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule N IRS990ScheduleN
Liquidation Of Assets Table LiquidationOfAssetsTableGrp
Liquidation Of Assets Detail LiquidationOfAssetsDetail (2 entries)
| Assets Distri Or Expnss PaidAssetsDistriOrExpnssPaidDesc | DistributionDistributionDt | Fair Market Value Of AssetFairMarketValueOfAssetAmt | Method Of FMV DeterminationMethodOfFMVDeterminationTxt | EINEIN | Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | IRC SectionIRCSectionTxt |
|---|---|---|---|---|---|---|---|---|---|
| UMRHN | |||||||||
| HEALTH SCHOLARSHIPS | 2024-06-11 | $100,000 | CASH VALUE | 203381102 | PO BOX 1537 | CHESTER | SC | 29706 | 501(C)(3) |
| USC UPSTATE FOUNDATION | |||||||||
| CHARITABLE CONTRIBUTION | 2024-05-16 | $14,700 | CASH VALUE | 570555699 | 800 UNIVERITY WAY | SPARTANBURG | SC | 29303 | 501(C)(3) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Director Of Successor | 0 | DirectorOfSuccessorInd |
| Employee Of Successor | 0 | EmployeeOfSuccessorInd |
| Owner Of Successor | 0 | OwnerOfSuccessorInd |
| Receive Compensation | 0 | ReceiveCompensationInd |
| Assets Distributed | Yes (1) | AssetsDistributedInd |
| Required To Notify AG | Yes (1) | RequiredToNotifyAGInd |
| Attorney General Notified | Yes (1) | AttorneyGeneralNotifiedInd |
| Liabilities Paid | Yes (1) | LiabilitiesPaidInd |
| Bonds Outstanding | 0 | BondsOutstandingInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID | ACTIVITY CLASSIFICATION: 501(C)(3). GRANTEE NAME: USC FOUNDATION. DATE OF GIFT: 05/16/24. AMOUNT GIVEN: 14,700. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID | ACTIVITY CLASSIFICATION: 501(C)(3). GRANTEE NAME: UMRHN. DATE OF GIFT: 06/11/24. AMOUNT GIVEN: 100,000. TOTAL INCLUDED ON FORM 990-EZ, LINE 10: 114,700. |
| FORM 990-EZ, PART I, LINE 16 - OTHER EXPENSES | DESCRIPTION: DEPRECIATION. AMOUNT: 68,918. DESCRIPTION: BANK CHARGES. AMOUNT: 385. DESCRIPTION: INSURANCE. AMOUNT: 455. DESCRIPTION: EMPLOYEE APPRECIATION. AMOUNT: 30,000. DESCRIPTION: GENERAL OFFICE SUPPLIES. AMOUNT: 984. DESCRIPTION: COMPUTER EXPENSE. AMOUNT: 7,073. DESCRIPTION: TAXES. AMOUNT: 666. DESCRIPTION: DUES AND SUBSCRIPTIONS. AMOUNT: 50. DESCRIPTION: OTHER EXPENSES. AMOUNT: 39. TOTAL TO FORM 990-EZ, LINE 16: 108,570. |
| FORM 990-EZ, PART II, LINE 24 - OTHER ASSETS | DESCRIPTION: OTHER DEPRECIABLE ASSETS. BEG. OF YEAR AMOUNT: 68,918. END OF YEAR AMOUNT: 0. |
Transfer Prsnl Bnft Contracts Decl TransferPrsnlBnftContractsDecl
| Field | Value | IRS element (for citing) |
|---|---|---|
| Declaration | THE ORGANIZATION DID NOT, DURING THE YEAR, RECEIVE ANY FUNDS, DIRECTLY,OR INDIRECTLY, TO PAY PREMIUMS ON A PERSONAL BENEFIT CONTRACT.THE ORGANIZATION, DID NOT, DURING THE YEAR, PAY ANY PREMIUMS, DIRECTLY,OR INDIRECTLY, ON A PERSONAL BENEFIT CONTRACT. | DeclarationDesc |
Comments