HOSPICE OF THE HIGHLAND RIM FOUNDATION INC: Form 990, tax year 2019
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- Organization
- HOSPICE OF THE HIGHLAND RIM FOUNDATION INC (EIN 62-1874162)
- Tax period
- 2019-01-01 to 2019-12-31
- Filed
- 2020-05-07
- IRS object ID
- 202001289349301495
- Schema version
- 2019v5.0
- 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 | 2020-05-07T13:23:57-05:00 | ReturnTs |
| Tax Period End | 2019-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 208032022 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOUSHOLDER ARTMAN PLLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 115 N JACKSON ST | AddressLine1Txt |
| City | TULLAHOMA | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 373883523 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2019-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 621874162 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HOSPICE OF THE HIGHLAND RIM | BusinessNameLine1Txt |
| Business Name Line2 | FOUNDATION INC | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | HOSP | BusinessNameControlTxt |
| Phone | 9315637439 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 110 E LAUDERDALE STREET | AddressLine1Txt |
| City | TULLAHOMA | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37388 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | PAT HOWARD | PersonNm |
| Person Title | SECRETARY/TREASURER | PersonTitleTxt |
| Phone | 9315637439 | PhoneNum |
| Signature | 2020-05-05 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | ANGELA D ELDRIDGE | PreparerPersonNm |
| PTIN | P00001213 | PTIN |
| Phone | 9314554248 | PhoneNum |
| Preparation | 2020-04-29 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 199.59.173.163 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2020-05-07 | IPDt |
| IP Tm | 13:23:57 | IPTm |
| IP Timezone | CD | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | C44D8CA652B8D83DD166B2B292321819AC3CF1F9 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | A1BACEF197711E4626D0C79F2174DA82C54D4508 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | PAT HOWARD | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 110 E LAUDERDALE STREET | AddressLine1Txt |
| City | TULLAHOMA | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37388 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $194,339 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2006 | FormationYr |
| Legal Domicile State | TN | LegalDomicileStateCd |
| Activity Or Mission | THE HOSPICE FOUNDATION PROVIDES FOR MEDICAL EXPENSES FOR INDIVIDUALS WHO ARE IN THE LAST STAGES OF TERMINAL ILLNESSES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 5 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 5 | VotingMembersIndependentCnt |
| Total Employee | 1 | TotalEmployeeCnt |
| Total Volunteers | 7 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $25,313 | PYContributionsGrantsAmt |
| CY Contributions Grants | $29,720 | CYContributionsGrantsAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $89,687 | PYInvestmentIncomeAmt |
| CY Investment Income | $89,935 | CYInvestmentIncomeAmt |
| PY Other Revenue | $2,758 | PYOtherRevenueAmt |
| CY Other Revenue | $6,107 | CYOtherRevenueAmt |
| PY Total Revenue | $117,758 | PYTotalRevenueAmt |
| CY Total Revenue | $125,762 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $73,532 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $75,154 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $46,404 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $14,122 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $32,160 | PYOtherExpensesAmt |
| CY Other Expenses | $25,629 | CYOtherExpensesAmt |
| PY Total Expenses | $152,096 | PYTotalExpensesAmt |
| CY Total Expenses | $114,905 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$34,338 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $10,857 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $867,054 | TotalAssetsBOYAmt |
| Total Assets EOY | $870,987 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $5,018 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $530 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $862,036 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $870,457 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE HOSPICE FOUNDATION PROVIDES FOR MEDICAL EXPENSES FOR INDIVIDUALS WHO ARE IN THE LAST STAGES OF TERMINAL ILLNESSES. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $108,987 | ExpenseAmt |
| Grant | $75,154 | GrantAmt |
| Desc | THE HOSPICE FOUNDATION ASSISTED TERMINALLY ILL PATIENTS WITH FINANCIAL NEEDS AND MEDICAL ATTENTION. | Desc |
| Total Program Service Expenses | $108,987 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | false | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (true) | GrantsToIndividualsInd |
| Schedule J Required | false | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | false | ScheduleORequiredInd |
| IRP Document | 1 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 1 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 5 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 5 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | false | ConflictOfInterestPolicyInd |
| Whistleblower Policy | false | WhistleblowerPolicyInd |
| Document Retention Policy | false | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | TN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | PAT HOWARD | PersonNm |
| Phone | 9315637439 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 110 E LAUDERDALE STREET | AddressLine1Txt |
| City | TULLAHOMA | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37388 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (5 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd |
|---|---|---|---|---|---|---|
| PAT HOWARD | ||||||
| SECRETARY/TR | 30.00 | Yes (X) | $13,118 | $0 | $0 | |
| DR DAVID ELROD | ||||||
| PRESIDENT | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| TJAWANNA HAMMOND | ||||||
| BOARD MEMBER | 0.50 | Yes (X) | $0 | $0 | $0 | |
| TERRI MILAM | ||||||
| BOARD MEMBER | 0.50 | Yes (X) | $0 | $0 | $0 | |
| REV MARTY NUTTER | ||||||
| BOARD MEMBER | 0.50 | Yes (X) | $0 | $0 | $0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $13,118 | TotalReportableCompFromOrgAmt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | false | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| Fundraising | $2,670 | FundraisingAmt |
| All Other Contributions | $27,050 | AllOtherContributionsAmt |
| Total Contributions | $29,720 | TotalContributionsAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $14,142 | TotalRevenueColumnAmt |
| Exclusion | $14,142 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $143,486 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $67,693 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $75,793 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $75,793 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $75,793 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $5,810 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $2,670 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $884 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,926 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS | Desc |
| Total Revenue Column | $1,181 | TotalRevenueColumnAmt |
| Exclusion | $1,181 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $1,181 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $125,762 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $75,793 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $15,323 | ExclusionAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $75,154 | TotalAmt |
| Program Services | $75,154 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,118 | TotalAmt |
| Program Services | $9,838 | ProgramServicesAmt |
| Management And General | $3,280 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,004 | TotalAmt |
| Program Services | $753 | ProgramServicesAmt |
| Management And General | $251 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,525 | TotalAmt |
| Management And General | $1,525 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,462 | TotalAmt |
| Program Services | $6,462 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,101 | TotalAmt |
| Program Services | $469 | ProgramServicesAmt |
| Management And General | $632 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,193 | TotalAmt |
| Program Services | $4,193 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $177 | TotalAmt |
| Program Services | $177 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,687 | TotalAmt |
| Program Services | $7,687 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,602 | TotalAmt |
| Program Services | $1,602 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| TELEPHONE | $1,782 | $1,782 | |
| FOREIGN TAX PAID | $870 | $870 | |
| REGISTRATION FEES | $200 | $200 | |
| BANK CHARGES | $30 | $30 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $114,905 | TotalAmt |
| Program Services | $108,987 | ProgramServicesAmt |
| Management And General | $5,918 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,378 | BOYAmt |
| EOY | $5,830 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,308 | BOYAmt |
| EOY | $1,312 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $330,212 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $48,837 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $289,062 | BOYAmt |
| EOY | $281,375 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $559,306 | BOYAmt |
| EOY | $582,470 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $867,054 | BOYAmt |
| EOY | $870,987 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,018 | BOYAmt |
| EOY | $530 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,018 | BOYAmt |
| EOY | $530 | 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 | $862,036 | BOYAmt |
| EOY | $870,457 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $862,036 | BOYAmt |
| EOY | $870,457 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $867,054 | BOYAmt |
| EOY | $870,987 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $10,857 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$2,436 | NetUnrlzdGainsLossesInvstAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | false | FSAuditedInd |
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 | $21,871 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $19,208 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $32,525 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $23,537 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $29,720 | CurrentTaxYearAmt |
| Total | $126,861 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $21,871 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $19,208 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $32,525 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $23,537 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $29,720 | CurrentTaxYearAmt |
| Total | $126,861 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $126,861 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $8,710 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $10,322 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $29,549 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $14,981 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $14,142 | CurrentTaxYearAmt |
| Total | $77,704 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus3 Years | $2,262 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $300 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $10 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,181 | CurrentTaxYearAmt |
| Total | $3,753 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $208,318 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $16,403 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.60900 | PublicSupportCY170Pct |
| Public Support PY170 | 0.37510 | 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 | PART II, LINE 10 | FormAndLineReferenceDesc |
| Explanation | OTHER INCOME 2,572 | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $20,000 | OtherCostOrOtherBasisAmt |
| Book Value | $20,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $307,500 | OtherCostOrOtherBasisAmt |
| Depreciation | $46,125 | DepreciationAmt |
| Book Value | $261,375 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,712 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,712 | DepreciationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $281,375 | TotalBookValueLandBuildingsAmt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | false | GrantRecordsMaintainedInd |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | MEDICAL ASSISTANCE | GrantTypeTxt |
| Cash Grant | $75,154 | CashGrantAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 6, PART VI, LINE 11B | NO REVIEW WAS OR WILL BE CONDUCTED. |
| FORM 990, PAGE 6, PART VI, LINE 15A | ANNUAL SALARY APPROVED BY ENTIRE BOARD OF DIRECTORS |
| FORM 990, PAGE 6, PART VI, LINE 19 | COPIES PROVIDED UPON REQUEST |
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