GLOUCESTER MATHEWS CARE CLINIC: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- GLOUCESTER MATHEWS CARE CLINIC (EIN 54-1875619)
- Tax period
- 2020-01-01 to 2020-12-31
- Filed
- 2021-07-02
- IRS object ID
- 202141839349300029
- Schema version
- 2020v4.1
- 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 | 2021-07-02T11:59:51-05:00 | ReturnTs |
| Tax Period End | 2020-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 453936274 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BETH MOORE & ASSOCIATES CPAS | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 120547 | AddressLine1Txt |
| City | NEWPORT NEWS | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 23612 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 541875619 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GLOUCESTER MATHEWS CARE CLINIC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | GLOU | BusinessNameControlTxt |
| Phone | 8042101368 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6031 INDUSTRIAL DRIVE | AddressLine1Txt |
| City | GLOUCESTER | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 23061 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ARLENE ARMENTOR | PersonNm |
| Person Title | EXECUTIVE DIRECTOR | PersonTitleTxt |
| Phone | 8042101368 | PhoneNum |
| Signature | 2021-06-29 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | ARLENE | PersonFirstNm |
| Person Last | ARMENTOR | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | LISA CANDELLA CPA | PreparerPersonNm |
| PTIN | P01695830 | PTIN |
| Phone | 7572241174 | PhoneNum |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ARLENE ARMENTOR | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6031 INDUSTRIAL DRIVE | AddressLine1Txt |
| City | GLOUCESTER | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 23061 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $2,407,968 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.GMCARECLINIC.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1997 | FormationYr |
| Legal Domicile State | VA | LegalDomicileStateCd |
| Activity Or Mission | THE MISSION OF THE GLOUCESTER MATHEWS CARE CLINIC IS TO PROVIDE COMMUNITY-BASED HEALTHCARE FOR THE RESIDENTS OF GLOUCESTER AND MATHEWS COUNTIES, AND SELECT SURROUNDING AREAS, WHO LACK HEALTH INSURANCE, OR ARE COVERED BY MEDICAID. WE ACHIEVE THIS THROUGH THE EFFORTS OF VOLUNTEERS, PAID PROFESSIONALS AND SUPPORT STAFF, AND CONTRIBUTIONS FROM MEMBERS OF THE COMMUNITY WHO SHARE OUR VALUES AND CONCERN. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 12 | VotingMembersIndependentCnt |
| Total Employee | 27 | TotalEmployeeCnt |
| Total Volunteers | 90 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $2,410,618 | PYContributionsGrantsAmt |
| CY Contributions Grants | $2,350,277 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $50,560 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $39,479 | CYProgramServiceRevenueAmt |
| PY Investment Income | $320 | PYInvestmentIncomeAmt |
| CY Investment Income | $619 | CYInvestmentIncomeAmt |
| PY Other Revenue | $51,512 | PYOtherRevenueAmt |
| CY Other Revenue | $3,382 | CYOtherRevenueAmt |
| PY Total Revenue | $2,513,010 | PYTotalRevenueAmt |
| CY Total Revenue | $2,393,757 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | 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 | $754,929 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $688,150 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $54,341 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,523,227 | PYOtherExpensesAmt |
| CY Other Expenses | $1,713,845 | CYOtherExpensesAmt |
| PY Total Expenses | $2,278,156 | PYTotalExpensesAmt |
| CY Total Expenses | $2,401,995 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $234,854 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$8,238 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $2,163,311 | TotalAssetsBOYAmt |
| Total Assets EOY | $2,216,079 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $873,996 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $935,002 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,289,315 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $1,281,077 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE MISSION OF THE GLOUCESTER-MATHEWS CARE CLINIC IS TO PROVIDE COMMUNITY-BASED HEALTHCARE FOR RESIDENTS OF GLOUCESTER AND MATHEWS COUNTIES WHO LACK HEALTH INSURANCE. WE ACHIEVE THIS THROUGH THE EFFORTS OF VOLUNTEERS, PAID PROFESSIONALS AND SUPPORT STAFF, AND CONTRIBUTIONS FROM MEMBERS OF THE COMMUNITY WHO SHARE OUR VALUES AND CONCERN. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $2,182,605 | ExpenseAmt |
| Revenue | $39,479 | RevenueAmt |
| Desc | GLOUCESTER MATHEWS CARE CLINIC'S THREE MAJOR PROGRAMS ARE OUR MEDICAL CLINIC, DENTAL CLINIC AND PHARMACY, AND THESE SERVICES ARE PROVIDED TO UNINSURED PATIENTS AS WELL AS THOSE WITH MEDICAID THROUGH THE 2019 MEDICAID EXPANSION. OUR OVERARCHING GOAL IS TO PROVIDE EXCELLENT, COMPASSIONATE CARE, ENGAGING PATIENTS AS ACTIVE PARTICIPANTS WITH US IN MANAGING THEIR HEALTH CONDITIONS, ULTIMATELY IMPROVING THEIR QUALITY OF LIFE. DURING THE YEAR, WE SERVED 384 PATIENTS WITH 1,620 MEDICAL CARE VISITS, AND 42 DENTAL CARE VISITS. GMCC WAS ABLE TO PROVIDE 7,690 PRESCRIPTIONS FOR ITS CLIENTS. ALSO, OUR VOLUNTEERS PROVIDED 448 DONATED PHYSICIAN, NURSING, DENTIST AND PHARMACY AND OTHER HOURS TO OUR CLIENTS. GMCC CONTINUES TO REFER PATIENTS FOR ADDITIONAL CARE NEEDED TO RIVERSIDE HEALTHCARE SYSTEM AS WELL AS OTHER MEDICAL PROVIDERS. | Desc |
| Total Program Service Expenses | $2,182,605 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | 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 | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | 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 | Yes (1) | 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 | 6 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 27 | 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 |
| 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 | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 12 | 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 | 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 | 0 | 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 | 0 | 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 | ARLENE ARMENTOR | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8042101368 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6031 INDUSTRIAL DRIVE | AddressLine1Txt |
| City | GLOUCESTER | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 23061 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (13 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|
| LOUISE THEBERGE | ||||||
| PRESIDENT | 4.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| VICKY GUNN | ||||||
| VICE PRESIDENT | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| KATIE THOMPSON | ||||||
| SECRETARY | 3.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| REV JAMES R LARSEN | ||||||
| TREASURER | 3.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| REV SVEN L VANBAARS | ||||||
| VICE PRESIDENT | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| DIANNE LUCY | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| STEVEN GRISWOLD | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| CARL 'WOODY' HOBBS | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| FELICIA STOVALL | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| ASHLEY MILLER | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| MELANIE RAPP BEALE | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| WILLIAM HOUTZ | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| ARLENE ARMENTOR | ||||||
| EXECUTIVE | 40.00 | Yes (X) | $70,699 | $0 | $0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $70,699 | 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 |
| Federated Campaigns | $21,900 | FederatedCampaignsAmt |
| Fundraising | $154,305 | FundraisingAmt |
| Government Grants | $73,000 | GovernmentGrantsAmt |
| All Other Contributions | $2,101,072 | AllOtherContributionsAmt |
| Noncash Contributions | $1,373,513 | NoncashContributionsAmt |
| Total Contributions | $2,350,277 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | FEES AND OTHER INCOME | Desc |
| Business | 624100 | BusinessCd |
| Total Revenue Column | $39,479 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $39,479 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $39,479 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $619 | TotalRevenueColumnAmt |
| Exclusion | $619 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $17,593 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $154,305 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $14,211 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,382 | TotalRevenueColumnAmt |
| Exclusion | $3,382 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,393,757 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $39,479 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $4,001 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $70,699 | TotalAmt |
| Program Services | $53,732 | ProgramServicesAmt |
| Management And General | $12,018 | ManagementAndGeneralAmt |
| Fundraising | $4,949 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $517,896 | TotalAmt |
| Program Services | $393,600 | ProgramServicesAmt |
| Management And General | $88,043 | ManagementAndGeneralAmt |
| Fundraising | $36,253 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $52,245 | TotalAmt |
| Program Services | $39,706 | ProgramServicesAmt |
| Management And General | $8,882 | ManagementAndGeneralAmt |
| Fundraising | $3,657 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $47,310 | TotalAmt |
| Program Services | $36,503 | ProgramServicesAmt |
| Management And General | $7,655 | ManagementAndGeneralAmt |
| Fundraising | $3,152 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,649 | TotalAmt |
| Program Services | $4,649 | ProgramServicesAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,525 | TotalAmt |
| Management And General | $12,525 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,018 | TotalAmt |
| Program Services | $7,018 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,957 | TotalAmt |
| Management And General | $1,957 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,202 | TotalAmt |
| Management And General | $9,202 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $32,241 | TotalAmt |
| Program Services | $32,241 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,387 | TotalAmt |
| Program Services | $23,279 | ProgramServicesAmt |
| Management And General | $2,739 | ManagementAndGeneralAmt |
| Fundraising | $1,369 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,681 | TotalAmt |
| Program Services | $2,681 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,113 | TotalAmt |
| Program Services | $22,196 | ProgramServicesAmt |
| Management And General | $2,611 | ManagementAndGeneralAmt |
| Fundraising | $1,306 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $64,815 | TotalAmt |
| Program Services | $55,093 | ProgramServicesAmt |
| Management And General | $6,482 | ManagementAndGeneralAmt |
| Fundraising | $3,240 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,031 | TotalAmt |
| Program Services | $14,052 | ProgramServicesAmt |
| Management And General | $2,979 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| DONATED PHARMACEUTICALS | $1,373,513 | $1,373,513 |
| MEDICAL AND DENTAL SUPP | $59,302 | $59,302 |
| PATIENT OUTREACH | $35,663 | $35,663 |
| CONTRACTORS | $11,440 | $11,440 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,308 | TotalAmt |
| Program Services | $17,937 | ProgramServicesAmt |
| Management And General | $9,956 | ManagementAndGeneralAmt |
| Fundraising | $415 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,401,995 | TotalAmt |
| Program Services | $2,182,605 | ProgramServicesAmt |
| Management And General | $165,049 | ManagementAndGeneralAmt |
| Fundraising | $54,341 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $310,409 | BOYAmt |
| EOY | $423,855 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $231,318 | BOYAmt |
| EOY | $299,440 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $204,843 | BOYAmt |
| EOY | $138,963 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,875 | BOYAmt |
| EOY | $17,770 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $1,804,005 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $467,954 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,400,866 | BOYAmt |
| EOY | $1,336,051 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,163,311 | BOYAmt |
| EOY | $2,216,079 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $43,722 | BOYAmt |
| EOY | $53,602 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $830,274 | BOYAmt |
| EOY | $881,400 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $873,996 | BOYAmt |
| EOY | $935,002 | 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 | $781,674 | BOYAmt |
| EOY | $873,968 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $507,641 | BOYAmt |
| EOY | $407,109 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,289,315 | BOYAmt |
| EOY | $1,281,077 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,163,311 | BOYAmt |
| EOY | $2,216,079 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$8,238 | 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 | $1,092,331 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $865,041 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $916,930 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,410,618 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,350,277 | CurrentTaxYearAmt |
| Total | $7,635,197 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $274,182 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $250,145 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $222,426 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year | $39,479 | CurrentTaxYearAmt |
| Total | $786,232 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,366,513 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,115,186 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,139,356 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,410,618 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,389,756 | CurrentTaxYearAmt |
| Total | $8,421,429 | 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 | $8,421,429 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $6,064 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $476 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,813 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $320 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $619 | CurrentTaxYearAmt |
| Total | $9,292 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $6,064 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $476 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,813 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $320 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $619 | CurrentTaxYearAmt |
| Total | $9,292 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,372,577 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,115,662 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,141,169 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,410,938 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,390,375 | CurrentTaxYearAmt |
| Total | $8,430,721 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99890 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99790 | PublicSupportPY509Pct |
| Investment Income CY | 0.00110 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00210 | 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 D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $68,500 | OtherCostOrOtherBasisAmt |
| Book Value | $68,500 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,457,471 | OtherCostOrOtherBasisAmt |
| Depreciation | $256,810 | DepreciationAmt |
| Book Value | $1,200,661 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $278,034 | OtherCostOrOtherBasisAmt |
| Depreciation | $211,144 | DepreciationAmt |
| Book Value | $66,890 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,336,051 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $2,436,740 | TotalRevEtcAuditedFinclStmtAmt |
| Donated Services And Use Fclts | $42,983 | DonatedServicesAndUseFcltsAmt |
| Revenue Not Reported | $42,983 | RevenueNotReportedAmt |
| Revenue Subtotal | $2,393,757 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $2,393,757 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $2,444,978 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $42,983 | DonatedServicesUseFcltsAmt |
| Expenses Not Reported | $42,983 | ExpensesNotReportedAmt |
| Expenses Subtotal | $2,401,995 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $2,401,995 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE CLINIC HAS BEEN RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE U.S. INTERNAL REVENUE CODE. THE CLINIC DOES NOT HAVE ANY UNRELATED BUSINESS TAXABLE INCOME AND MANAGEMENT BELIEVES IT HAS SUPPORT FOR ANY TAX POSITIONS TAKEN, AND AS SUCH DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE FINANCIAL STATEMENTS. MANAGEMENT HAS DETERMINED THE CLINIC DOES NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF DECEMBER 31, 2020. FISCAL YEARS ENDING ON OR AFTER DECEMBER 31, 2017, REMAIN SUBJECT TO EXAMINATION BY FEDERAL AND STATE AUTHORITIES. | ExplanationTxt |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | CASINO NIGHT | Event1Nm |
| Gross Receipts Event1 | $104,160 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $92,610 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $11,550 | GrossRevenueEvent1Amt |
| Other Direct Expenses Event1 | $5,432 | OtherDirectExpensesEvent1Amt |
| Event2 | OKTOBERFEST | Event2Nm |
| Gross Receipts Event2 | $34,424 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $30,026 | CharitableContriEvent2Amt |
| Gross Revenue Event2 | $4,398 | GrossRevenueEvent2Amt |
| Other Events Total | 1 | OtherEventsTotalCnt |
| Gross Receipts Other Events | $33,314 | GrossReceiptsOtherEventsAmt |
| Charitable Contri Other Events | $31,669 | CharitableContriOtherEventsAmt |
| Gross Revenue Other Events | $1,645 | GrossRevenueOtherEventsAmt |
| Oth Direct Expnss Other Events | $8,779 | OthDirectExpnssOtherEventsAmt |
| Gross Receipts Total | $171,898 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $154,305 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $17,593 | GrossRevenueTotalEventsAmt |
| Oth Direct Expnss Total Events | $14,211 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $14,211 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $3,382 | NetIncomeSummaryAmt |
Schedule M IRS990ScheduleM
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 2938 | ContributionCnt |
| Noncash Contributions Rpt F990 | $1,373,513 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | RETAIL VALUE | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | 990 IS REVIEWED BY THE EXECUTIVE DIRECTOR, THE BOOKKEEPER, AND MEMBERS OF THE FINANCE COMMITTEE. GENERAL DISCUSSION OF THE 990 IS PERFORMED AT A BOARD MEETING, WITH AUTHORIZATION TO FILE APPROVED BY THE BOARD. |
| FORM 990, PART VI, SECTION B, LINE 12C | ANNUAL WRITTEN CONFIRMATION OF ANY CONFLICTS BY BOARD MEMBERS. |
| FORM 990, PART VI, SECTION C, LINE 19 | REQUESTS FOR GOVERNING DOCUMENTS ARE MADE AVAILABLE UPON WRITTEN REQUEST. |
| FORM 990, PART XII, LINE 2C: | THERE WERE NO CHANGES FROM THE PRIOR YEAR |
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