HEALTH PARTNERS INC: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- HEALTH PARTNERS INC (EIN 52-1767044)
- Tax period
- 2019-01-01 to 2019-12-31
- Filed
- 2020-04-26
- IRS object ID
- 202011179349300001
- Schema version
- 2019v5.1
- 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 | 2020-04-26T03:41:30-04:00 | ReturnTs |
| Tax Period End | 2019-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 521224305 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Bechanan & Company LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 22226 Creekview Drive | AddressLine1Txt |
| City | Gaithersburg | CityNm |
| State Abbreviation | MD | StateAbbreviationCd |
| ZIP | 20882 | 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 | 521767044 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Health Partners Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | HEAL | BusinessNameControlTxt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | P O Box 1865 | AddressLine1Txt |
| City | Waldorf | CityNm |
| State Abbreviation | MD | StateAbbreviationCd |
| ZIP | 20604 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Dan Sansbury | PersonNm |
| Person Title | Treasurer | PersonTitleTxt |
| Phone | 3017521550 | PhoneNum |
| Signature | 2020-04-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Nancy Bechanan | PreparerPersonNm |
| PTIN | P00070812 | PTIN |
| Phone | 3018693747 | PhoneNum |
| Preparation | 2020-04-26 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 69.250.37.157 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2020-04-26 | IPDt |
| IP Tm | 10:01:04 | IPTm |
| Federal Original Submission Id | 2747132020117yrw0xqn | FederalOriginalSubmissionId |
| Federal Original Submission Id | 2020-04-26 | FederalOriginalSubmissionIdDt |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 0B5B33034A06E0D647E59228F5C8CCBE9FB7BDEE | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 0B5B33034A06E0D647E59228F5C8CCBE9FB7BDEE | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2020-11-19 02:30:22Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $1,312,508 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1992 | FormationYr |
| Legal Domicile State | MD | LegalDomicileStateCd |
| Activity Or Mission | To provide professional Medical and Dental services to the underserved residents of Southern Maryland and to create a medical and dental home for all persons seeking services under the Maryland State Medicaid programs. | ActivityOrMissionDesc |
| Voting Members Governing Body | 8 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 23 | TotalEmployeeCnt |
| Total Volunteers | 10 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $475,232 | PYContributionsGrantsAmt |
| CY Contributions Grants | $620,961 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $439,570 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $669,397 | CYProgramServiceRevenueAmt |
| PY Investment Income | $942 | PYInvestmentIncomeAmt |
| CY Investment Income | $920 | CYInvestmentIncomeAmt |
| PY Other Revenue | $65,676 | PYOtherRevenueAmt |
| CY Other Revenue | $14,035 | CYOtherRevenueAmt |
| PY Total Revenue | $981,420 | PYTotalRevenueAmt |
| CY Total Revenue | $1,305,313 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $788,088 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $984,708 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $12,309 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $289,371 | PYOtherExpensesAmt |
| CY Other Expenses | $355,494 | CYOtherExpensesAmt |
| PY Total Expenses | $1,077,459 | PYTotalExpensesAmt |
| CY Total Expenses | $1,340,202 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$96,039 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$34,889 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $608,651 | TotalAssetsBOYAmt |
| Total Assets EOY | $616,294 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $57,206 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $99,738 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $551,445 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $516,556 | NetAssetsOrFundBalancesEOYAmt |
| Mission | To provide professional Medical and Dental services to the underserved residents of Southern Maryland and to create a medical and dental home for all persons seeking services under the Maryland State Medicaid programs. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $1,288,947 | ExpenseAmt |
| Revenue | $669,397 | RevenueAmt |
| Desc | Health Partners is a charitable clinic providing primary medical care and dental services to theuninsured and underinsured citizens of Southern Maryland. In 2019, we provided 2,175 medical carevisits for 785 clients and 10,331 dental services for 1,868 patients. Our transportable dentalunit has expanded its reach in the community. We now provide dental services in various venuesincluding community centers, senior centers, and churches. With strong dedication from ourvolunteers and support through donations from our community, we have been able to continue togrow to meet the need for medical and dental care in our community. | Desc |
| Total Program Service Expenses | $1,288,947 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | 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 | Yes (true) | 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 | Yes (true) | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | 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 | Yes (true) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 23 | 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 |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Form8899 Filedind | false | Form8899Filedind |
| Form1098 C Filed | false | Form1098CFiledInd |
| 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 | 8 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 8 | 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 | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Dan Sansbury | PersonNm |
| Phone | 3016453556 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3070 Crain Highway | AddressLine1Txt |
| City | Waldorf | CityNm |
| State Abbreviation | MD | StateAbbreviationCd |
| ZIP | 20601 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (10 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| Dan Sansbury | ||||||||
| Treasurer | 8.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| William Leebel | ||||||||
| Vice-President | 8.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Sandy McGraw | ||||||||
| Director | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Meindert Smith | ||||||||
| Chief Medical Officer | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Evalyne Bryant-Ward | ||||||||
| Secretary | 8.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Chrisie Mulcahey | ||||||||
| Executive Director | 40.00 | 0.00 | Yes (X) | $81,934 | $0 | $0 | ||
| Jason Faherty | ||||||||
| Director | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| William Berry | ||||||||
| President | 8.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| P Michael Patterson | ||||||||
| Assistant Medical Officer | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Bernard Finch | ||||||||
| Dentist | 36.00 | 0.00 | $173,632 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $255,566 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $0 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 1 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| Government Grants | $392,091 | GovernmentGrantsAmt |
| All Other Contributions | $228,870 | AllOtherContributionsAmt |
| Total Contributions | $620,961 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Medical services | 621400 | $182,415 | $182,415 |
| Dental services | 621400 | $486,982 | $486,982 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $669,397 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $920 | TotalRevenueColumnAmt |
| Exclusion | $920 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $600 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $600 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $600 | TotalRevenueColumnAmt |
| Exclusion | $600 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $18,612 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $7,195 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $11,417 | TotalRevenueColumnAmt |
| Exclusion | $11,417 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Reimbursements | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $2,018 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $2,018 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $2,018 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,305,313 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $671,415 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $12,937 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $81,934 | TotalAmt |
| Program Services | $65,547 | ProgramServicesAmt |
| Management And General | $12,290 | ManagementAndGeneralAmt |
| Fundraising | $4,097 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $784,304 | TotalAmt |
| Program Services | $768,727 | ProgramServicesAmt |
| Management And General | $8,846 | ManagementAndGeneralAmt |
| Fundraising | $6,731 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $47,596 | TotalAmt |
| Program Services | $45,840 | ProgramServicesAmt |
| Management And General | $1,161 | ManagementAndGeneralAmt |
| Fundraising | $595 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $70,874 | TotalAmt |
| Program Services | $68,259 | ProgramServicesAmt |
| Management And General | $1,729 | ManagementAndGeneralAmt |
| Fundraising | $886 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,250 | TotalAmt |
| Program Services | $7,250 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,675 | TotalAmt |
| Program Services | $2,675 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,255 | TotalAmt |
| Program Services | $11,930 | ProgramServicesAmt |
| Management And General | $1,325 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $49,004 | TotalAmt |
| Program Services | $44,104 | ProgramServicesAmt |
| Management And General | $4,900 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $54,029 | TotalAmt |
| Program Services | $53,831 | ProgramServicesAmt |
| Management And General | $198 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,940 | TotalAmt |
| Program Services | $10,206 | ProgramServicesAmt |
| Management And General | $2,734 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Medical services | $30,405 | $30,405 | |
| Dental services | $125,662 | $125,662 | |
| Repairs and maintenance | $18,249 | $16,424 | $1,825 |
| Utilities | $14,015 | $12,614 | $1,401 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,010 | TotalAmt |
| Program Services | $25,473 | ProgramServicesAmt |
| Management And General | $2,537 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,340,202 | TotalAmt |
| Program Services | $1,288,947 | ProgramServicesAmt |
| Management And General | $38,946 | ManagementAndGeneralAmt |
| Fundraising | $12,309 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $161,632 | BOYAmt |
| EOY | $163,254 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,955 | BOYAmt |
| EOY | $26,575 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $65,044 | BOYAmt |
| EOY | $68,356 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $901,511 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $543,402 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $356,020 | BOYAmt |
| EOY | $358,109 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $608,651 | BOYAmt |
| EOY | $616,294 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $57,206 | BOYAmt |
| EOY | $99,738 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $57,206 | BOYAmt |
| EOY | $99,738 | 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 | $382,253 | BOYAmt |
| EOY | $392,035 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $169,192 | BOYAmt |
| EOY | $124,521 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $551,445 | BOYAmt |
| EOY | $516,556 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $608,651 | BOYAmt |
| EOY | $616,294 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$34,889 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | 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 | false | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
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 | $484,347 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $644,317 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,099,230 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $914,802 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,290,359 | CurrentTaxYearAmt |
| Total | $4,433,055 | TotalAmt |
Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $400,000 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $400,000 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $400,000 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $400,000 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $400,000 | CurrentTaxYearAmt |
| Total | $2,000,000 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $884,347 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,044,317 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,499,230 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,314,802 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,690,359 | CurrentTaxYearAmt |
| Total | $6,433,055 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $68,974 | SubstantialContributorsTotAmt |
| Public Support Total170 | $6,364,081 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $250 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $633 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $583 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $942 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $920 | CurrentTaxYearAmt |
| Total | $3,328 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $36,010 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $29,731 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $25,834 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $20,700 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,618 | CurrentTaxYearAmt |
| Total | $114,893 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $6,551,276 | TotalSupportAmt |
| Public Support CY170 | 0.97140 | PublicSupportCY170Pct |
| Public Support PY170 | 0.93550 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
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
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $598,335 | OtherCostOrOtherBasisAmt |
| Depreciation | $348,513 | DepreciationAmt |
| Book Value | $249,822 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $303,176 | OtherCostOrOtherBasisAmt |
| Depreciation | $194,889 | DepreciationAmt |
| Book Value | $108,287 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $358,109 | TotalBookValueLandBuildingsAmt |
| Total Rev Etc Audited Fincl Stmt | $1,810,491 | TotalRevEtcAuditedFinclStmtAmt |
| Donated Services And Use Fclts | $497,983 | DonatedServicesAndUseFcltsAmt |
| Other Revenue | $7,195 | OtherRevenueAmt |
| Revenue Not Reported | $505,178 | RevenueNotReportedAmt |
| Revenue Subtotal | $1,305,313 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $1,305,313 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $1,845,380 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $497,983 | DonatedServicesUseFcltsAmt |
| Other Expenses Included | $7,195 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $505,178 | ExpensesNotReportedAmt |
| Expenses Subtotal | $1,340,202 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $1,340,202 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Other revenues not included on Form 990 (Part XI, line 2d) | Fund raising expenses of 7,195 |
| Other expenses not included on Form 990 (Part XII, line 2d) | Fund raising expenses of 7,195 |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | Gala | Event1Nm |
| Gross Receipts Event1 | $12,675 | GrossReceiptsEvent1Amt |
| Gross Revenue Event1 | $12,675 | GrossRevenueEvent1Amt |
| Other Direct Expenses Event1 | $3,380 | OtherDirectExpensesEvent1Amt |
| Event2 | HOPE | Event2Nm |
| Gross Receipts Event2 | $5,925 | GrossReceiptsEvent2Amt |
| Gross Revenue Event2 | $5,925 | GrossRevenueEvent2Amt |
| Other Direct Expenses Event2 | $2,192 | OtherDirectExpensesEvent2Amt |
| Other Events Total | 1 | OtherEventsTotalCnt |
| Gross Receipts Other Events | $12 | GrossReceiptsOtherEventsAmt |
| Gross Revenue Other Events | $12 | GrossRevenueOtherEventsAmt |
| Oth Direct Expnss Other Events | $1,623 | OthDirectExpnssOtherEventsAmt |
| Gross Receipts Total | $18,612 | GrossReceiptsTotalAmt |
| Gross Revenue Total Events | $18,612 | GrossRevenueTotalEventsAmt |
| Oth Direct Expnss Total Events | $7,195 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $7,195 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $11,417 | NetIncomeSummaryAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Bernard Finch | PersonNm |
| Title | Dentist | TitleTxt |
| Base Compensation Filing Org | $173,632 | BaseCompensationFilingOrgAmt |
| Total Compensation Filing Org | $173,632 | TotalCompensationFilingOrgAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990 governing body review Part VI line 11 | Treasurer and board reviewed the 990 in draft form. |
| Conflict of interest policy compliance Part VI line 12c | Conflicts of interest are to be disclosed. |
| Governing documents etc available to public Part VI line 19 | Documents are available upon request. |
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