FREE MEDICAL CLINIC OF OAK RIDGE INC: Form 990, tax year 2024

View the entire original 990 at ProPublica ↗

Organization
FREE MEDICAL CLINIC OF OAK RIDGE INC (EIN 90-0715369)
Tax period
2024-01-01 to 2024-12-31
Filed
2025-09-02
IRS object ID
202512459349301131
Schema version
2024v5.1
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

FieldValueIRS element (for citing)
Return2025-09-02T13:03:45+00:00ReturnTs
Tax Period End2024-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN332621854PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CRI Capin Crouse Advisors LLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1345 Massachusetts Ave Suite 300AddressLine1Txt
CityIndianapolisCityNm
State AbbreviationINStateAbbreviationCd
ZIP46204ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2024-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN900715369EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Free Medical Clinic of Oak RidgeBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlFREEBusinessNameControlTxt
Phone8654833904PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1116 East Division RdAddressLine1Txt
CityOak RidgeCityNm
State AbbreviationTNStateAbbreviationCd
ZIP37830ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonBilly J Edmonds JrPersonNm
Person TitleExecutive DirectorPersonTitleTxt
Phone8654833904PhoneNum
Signature2025-09-02SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonSara TibbottPreparerPersonNm
PTINP01486965PTIN
Phone5055022746PhoneNum
Preparation2025-09-02PreparationDt
FieldValueIRS element (for citing)
Tax2024TaxYr
Build TS2025-03-06 01:10:19ZBuildTS

Form 990 IRS990

Principal Ofcr Business Name PrincipalOfcrBusinessName

FieldValueIRS element (for citing)
Business Name Line1Billy J Edmonds JrBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1116 East Division RdAddressLine1Txt
CityOak RidgeCityNm
State AbbreviationTNStateAbbreviationCd
ZIP37830ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$3,406,799GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.fmcor.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2011FormationYr
Legal Domicile StateTNLegalDomicileStateCd
Activity Or MissionTo provide no charge primary care to the low-income and uninsured residents of Anderson, Morgan, and Roane Counites of Tennessee and any partnership related to our medical programs.ActivityOrMissionDesc
Voting Members Governing Body9VotingMembersGoverningBodyCnt
Voting Members Independent9VotingMembersIndependentCnt
Total Employee36TotalEmployeeCnt
Total Volunteers86TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$2,511,096PYContributionsGrantsAmt
CY Contributions Grants$2,685,041CYContributionsGrantsAmt
PY Program Service Revenue$22,383PYProgramServiceRevenueAmt
CY Program Service Revenue$22,738CYProgramServiceRevenueAmt
PY Investment Income$22,028PYInvestmentIncomeAmt
CY Investment Income$42,278CYInvestmentIncomeAmt
PY Other Revenue-$37,201PYOtherRevenueAmt
CY Other Revenue-$164,209CYOtherRevenueAmt
PY Total Revenue$2,518,306PYTotalRevenueAmt
CY Total Revenue$2,585,848CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$1,253,493PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$1,592,761CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$79,001CYTotalFundraisingExpenseAmt
PY Other Expenses$668,465PYOtherExpensesAmt
CY Other Expenses$961,613CYOtherExpensesAmt
PY Total Expenses$1,921,958PYTotalExpensesAmt
CY Total Expenses$2,554,374CYTotalExpensesAmt
PY Revenues Less Expenses$596,348PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$31,474CYRevenuesLessExpensesAmt
Total Assets BOY$2,273,863TotalAssetsBOYAmt
Total Assets EOY$2,328,871TotalAssetsEOYAmt
Total Liabilities BOY$139,438TotalLiabilitiesBOYAmt
Total Liabilities EOY$169,784TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$2,134,425NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$2,159,087NetAssetsOrFundBalancesEOYAmt
MissionTo provide no charge primary care to the low-income and uninsured residents of Anderson, Morgan, and Roane counties of Tennessee and any partnership related to our medical programs.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$2,156,707ExpenseAmt
Grant$0GrantAmt
Revenue$40,099RevenueAmt
DescIn 2024, FMC provided care to over 3,800 patients. Primary, preventative, and specialty care services including diagnostics, vaccinations, immunizations, and medical events for community outreach led to over 15,000 patient encounters for the low-income, uninsured, rural, and minority populations in our service. The overall value of care in 2024 was over 9 million dollars.Desc
Total Program Service Expenses$2,156,707TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsfalseDonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecYes (true)ReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (true)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesYes (true)FundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredfalseScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Escrow AccountfalseEscrowAccountInd
On Behalf Of IssuerfalseOnBehalfOfIssuerInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContriYes (true)DeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Transaction With Control EntfalseTransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document25IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee36EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsYes (true)QuidProQuoContributionsInd
Quid Pro Quo Contri DisclYes (true)QuidProQuoContriDisclInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members9GoverningBodyVotingMembersCnt
Independent Voting Member9IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Policies Reference ChaptersfalsePoliciesReferenceChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Written Policy Or ProcedurefalseWrittenPolicyOrProcedureInd
States Where Copy Of Return Is FldTNStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Billy EdmondsBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone8654833904PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1116 East Division RdAddressLine1Txt
CityOak RidgeCityNm
State AbbreviationTNStateAbbreviationCd
ZIP37830ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (10 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
Angela Richardson
Secretary/Treasurer3.0Yes (X)Yes (X)$0$0$0
Ashley Golden
Vice-President3.0Yes (X)Yes (X)$0$0$0
Ben Stephens
President3.0Yes (X)Yes (X)$0$0$0
David Seay
Member1.0Yes (X)$0$0$0
Evaristo Figueroa
Member1.0Yes (X)$0$0$0
Mae Mosley
Member1.0Yes (X)$0$0$0
Ron Gregory
Member1.0Yes (X)$0$0$0
Ronnie Baggett
Member/Medical Lead2.0Yes (X)$0$0$0
Scott Branham
Member/Funding Development2.0Yes (X)$0$0$0
Billy J Edmonds Jr
Executive Director40.0Yes (X)$119,885$0$17,759
FieldValueIRS element (for citing)
Total Reportable Comp From Org$119,885TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$17,759TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K1IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KfalseTotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Federated Campaigns$27,125FederatedCampaignsAmt
Fundraising$170,269FundraisingAmt
Government Grants$1,577,720GovernmentGrantsAmt
All Other Contributions$909,927AllOtherContributionsAmt
Noncash Contributions$137,250NoncashContributionsAmt
Total Contributions$2,685,041TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescMedical record feesDesc
Business900099BusinessCd
Total Revenue Column$22,738TotalRevenueColumnAmt
Related Or Exempt Func Income$22,738RelatedOrExemptFuncIncomeAmt

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$22,738TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$42,278TotalRevenueColumnAmt
Exclusion$42,278ExclusionAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$0RealAmt
Personal$0PersonalAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$599,000SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$599,000SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt
Other$0OtherAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$40,381FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$170,269ContriRptFundraisingEventAmt
Fundraising Direct Expenses$221,951FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column-$181,570TotalRevenueColumnAmt
Exclusion-$181,570ExclusionAmt

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$17,361TotalRevenueColumnAmt
Related Or Exempt Func Income$17,361RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$17,361OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,585,848TotalRevenueColumnAmt
Related Or Exempt Func Income$40,099RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion-$139,292ExclusionAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$137,644TotalAmt
Program Services$130,762ProgramServicesAmt
Management And General$6,882ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$1,223,094TotalAmt
Program Services$1,113,985ProgramServicesAmt
Management And General$67,149ManagementAndGeneralAmt
Fundraising$41,960FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$17,962TotalAmt
Program Services$17,064ProgramServicesAmt
Management And General$898ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$115,112TotalAmt
Program Services$107,265ProgramServicesAmt
Management And General$6,017ManagementAndGeneralAmt
Fundraising$1,830FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$98,949TotalAmt
Program Services$94,002ProgramServicesAmt
Management And General$4,947ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$39,044TotalAmt
Management And General$39,044ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$7,547TotalAmt
Management And General$7,547ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$218,244TotalAmt
Program Services$175,226ProgramServicesAmt
Management And General$43,018ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$31,213TotalAmt
Management And General$23,410ManagementAndGeneralAmt
Fundraising$7,803FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$252,462TotalAmt
Program Services$171,571ProgramServicesAmt
Management And General$72,375ManagementAndGeneralAmt
Fundraising$8,516FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$29,670TotalAmt
Program Services$26,703ProgramServicesAmt
Management And General$2,967ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$156,795TotalAmt
Program Services$148,127ProgramServicesAmt
Management And General$8,668ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$33,440TotalAmt
Program Services$31,184ProgramServicesAmt
Management And General$2,256ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$13,304TotalAmt
Program Services$11,974ProgramServicesAmt
Management And General$1,330ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$33,730TotalAmt
Program Services$32,044ProgramServicesAmt
Management And General$1,686ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$30,472TotalAmt
Management And General$30,472ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtFundraisingFundraisingAmt
Primary care medical$81,742$81,742
Other Event expenses$18,892$18,892
Volunteer Support$15,058$15,058

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$2,554,374TotalAmt
Program Services$2,156,707ProgramServicesAmt
Management And General$318,666ManagementAndGeneralAmt
Fundraising$79,001FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$442,436BOYAmt
EOY$322,794EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$650,051BOYAmt
EOY$249,208EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$309,482BOYAmt
EOY$403,410EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$172BOYAmt
EOY$2,562EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$649,544LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$125,716LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$376,722BOYAmt
EOY$523,828EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$495,000BOYAmt
EOY$554,979EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$272,090EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$2,273,863BOYAmt
EOY$2,328,871EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$139,438BOYAmt
EOY$169,784EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$139,438BOYAmt
EOY$169,784EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,824,943BOYAmt
EOY$1,755,677EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$309,482BOYAmt
EOY$403,410EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,134,425BOYAmt
EOY$2,159,087EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,273,863BOYAmt
EOY$2,328,871EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$31,474ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$6,812NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$773,018CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$958,002CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,987,263CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$2,511,096CurrentTaxYearMinus1YearAmt
Current Tax Year$2,685,041CurrentTaxYearAmt
Total$8,914,420TotalAmt

Tax Rev Levied Orgnztnl Bnft170 TaxRevLeviedOrgnztnlBnft170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$773,018CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$958,002CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,987,263CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$2,511,096CurrentTaxYearMinus1YearAmt
Current Tax Year$2,685,041CurrentTaxYearAmt
Total$8,914,420TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$0SubstantialContributorsTotAmt
Public Support Total170$8,914,420PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,253CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$543CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$4,696CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$22,028CurrentTaxYearMinus1YearAmt
Current Tax Year$42,278CurrentTaxYearAmt
Total$70,798TotalAmt

Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Income170 OtherIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$3,595CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$7,403CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$3,607CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$21,211CurrentTaxYearMinus1YearAmt
Current Tax Year$17,361CurrentTaxYearAmt
Total$53,177TotalAmt
FieldValueIRS element (for citing)
Total Support$9,038,395TotalSupportAmt
Gross Receipts Rltd Activities$45,121GrossReceiptsRltdActivitiesAmt
Public Support CY1700.98628PublicSupportCY170Pct
Public Support PY1700.97739PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule A, Part II, Line 10 Other IncomeFormAndLineReferenceDesc
ExplanationDESCRIPTION - MISC INCOME, COLUMN A - 3595.0, COLUMN B - 7403.0, COLUMN C - 3607.0, COLUMN D - 11704.0, COLUMN E - 17361.0, COLUMN F - 43670.0; DESCRIPTION - INSURANCE PROCEEDS, COLUMN A - 0.0, COLUMN B - 0.0, COLUMN C - 0.0, COLUMN D - 9507.0, COLUMN E - 0.0, COLUMN F - 9507.0;ExplanationTxt

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$14,977OtherCostOrOtherBasisAmt
Depreciation$2,621DepreciationAmt
Book Value$12,356BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$223,499OtherCostOrOtherBasisAmt
Depreciation$48,014DepreciationAmt
Book Value$175,485BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$411,068OtherCostOrOtherBasisAmt
Depreciation$75,081DepreciationAmt
Book Value$335,987BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$523,828TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp (3 entries)

DescDescBook ValueBookValueAmtMethod ValuationMethodValuationCd
Closely-held equity interests
Financial derivatives
Certificates of Deposit$272,090F
FieldValueIRS element (for citing)
Total Book Value Securities$272,090TotalBookValueSecuritiesAmt
Total Rev Etc Audited Fincl Stmt$3,463,685TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst-$6,812NetUnrealizedGainsInvstAmt
Donated Services And Use Fclts$892,196DonatedServicesAndUseFcltsAmt
Other Revenue$0OtherRevenueAmt
Revenue Not Reported$885,384RevenueNotReportedAmt
Revenue Subtotal$2,578,301RevenueSubtotalAmt
Investment Expenses Not Incld$7,547InvestmentExpensesNotIncldAmt
Other Revenues Not Included$0OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$7,547RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$2,585,848TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$3,439,023TotExpnsEtcAuditedFinclStmtAmt
Donated Services Use Fclts$892,196DonatedServicesUseFcltsAmt
Other Expenses Included$0OtherExpensesIncludedAmt
Expenses Not Reported$892,196ExpensesNotReportedAmt
Expenses Subtotal$2,546,827ExpensesSubtotalAmt
Investment Expenses Not Incld2$7,547InvestmentExpensesNotIncld2Amt
Other Expenses Not Included$0OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$7,547ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$2,554,374TotalExpensesPerForm990Amt

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1BashEvent1Nm
Gross Receipts Event1$210,650GrossReceiptsEvent1Amt
Charitable Contri Event1$170,269CharitableContriEvent1Amt
Gross Revenue Event1$40,381GrossRevenueEvent1Amt
Non Cash Prizes Event1$475NonCashPrizesEvent1Amt
Rent Facility Costs Event1$375RentFacilityCostsEvent1Amt
Food And Beverage Event1$10,200FoodAndBeverageEvent1Amt
Entertainment Event1$26,987EntertainmentEvent1Amt
Other Direct Expenses Event1$183,914OtherDirectExpensesEvent1Amt
Gross Revenue Event2$0GrossRevenueEvent2Amt
Gross Revenue Other Events$0GrossRevenueOtherEventsAmt
Gross Receipts Total$210,650GrossReceiptsTotalAmt
Charitable Contributions Tot$170,269CharitableContributionsTotAmt
Gross Revenue Total Events$40,381GrossRevenueTotalEventsAmt
Non Cash Prizes Total Events$475NonCashPrizesTotalEventsAmt
Rent Fclty Costs Total Events$375RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events$10,200FoodAndBeverageTotalEventsAmt
Entertainment Total Events$26,987EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events$183,914OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$221,951DirectExpenseSummaryEventsAmt
Net Income Summary-$181,570NetIncomeSummaryAmt

Schedule M IRS990ScheduleM

Other Non Cash Contri Table OtherNonCashContriTableGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
DescEquipmentDesc
Contribution2ContributionCnt
Noncash Contributions Rpt F990$137,250NoncashContributionsRptF990Amt
Method Of Determining RevenuesMarket valueMethodOfDeterminingRevenuesTxt
FieldValueIRS element (for citing)
Form8283 Received0Form8283ReceivedCnt
Any Property That Must Be HeldfalseAnyPropertyThatMustBeHeldInd
Review Process Unusual NC GiftsfalseReviewProcessUnusualNCGiftsInd
Third Parties UsedfalseThirdPartiesUsedInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Line 15bThe organization does not compensate any other officers or key employees. Therefore, this line was answered no in accordance with the instructions.
Form 990, Part VI, Line 1a Delegate broad authority to a committeeThe organization has an executive committee that consists of the President, Vice President, Treasurer, Secretary, and Medical Committee Lead. This committee's authority includes but is not limited to: Bylaws, policy review, board selection, and governing processes.
Form 990, Part VI, Line 11b Review of form 990 by governing bodyForm 990 is prepared by an independent CPA firm and reviewed in detail by the organization's top management. The reviewed Form 990 is then provided to the board of directors prior to filing with the IRS.
Form 990, Part VI, Line 12c Conflict of interest policyBoard members and officers sign annual conflict of interest statements which are reviewed by the Board Chair and President. Should any potential conflicts of interest be disclosed, the board member or officer would be asked to refrain from participation in any deliberation or decision with regard to matters affected by the relationship.
Form 990, Part VI, Line 15a Process to establish compensation of top management officialThe Executive Committee conducts an annual performance review. The Committee gathers information as from a variety of sources, self-evaluations, board evaluations, staff input, goals met, industry standards, compensation surveys, etc.) and prepares the evaluation report and compensation recommendation. The full board votes on the salary recommendation of the Executive Committee. A formal report is prepared for signature by the President and Board Chair. Contemporaneous substantiation of the deliberation and decision is documented in the board minutes.
Form 990, Part VI, Line 19 Required documents available to the publicThe organization makes its governing documents, conflict of interest policy, and financial statements available to the public upon request.
Form 990, Part VIII, Line 11d Other Miscellaneous RevenueOther Income - Total Revenue: 17361, Related or Exempt Function Revenue: 17361, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ;

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