OPEN ARMS FREE CLINIC INC: Form 990, tax year 2024

View the entire original 990 at ProPublica ↗

Organization
OPEN ARMS FREE CLINIC INC (EIN 45-4475625)
Tax period
2024-01-01 to 2024-12-31
Filed
2025-10-03
IRS object ID
202502769349300245
Schema version
2024v5.2
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)
Return2025-10-03T13:49:10-05:00ReturnTs
Tax Period End2024-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN390747409PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1REILLY PENNER & BENTON LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line11233 NORTH MAYFAIR RD SUITE 302AddressLine1Txt
CityMILWAUKEECityNm
State AbbreviationWIStateAbbreviationCd
ZIP532263255ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2024-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN454475625EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1OPEN ARMS FREE CLINIC INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlOPENBusinessNameControlTxt
Phone2623791401PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 678AddressLine1Txt
CityELKHORNCityNm
State AbbreviationWIStateAbbreviationCd
ZIP53121ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonROSEMARY DOLATOWSKIPersonNm
Person TitleCURRENT PRESIDENTPersonTitleTxt
Phone2623791401PhoneNum
Signature2025-09-18SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd
FieldValueIRS element (for citing)
IRS Responsible Prty Info CurrYes (1)IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonBRANDON PANKAPreparerPersonNm
PTINP01596345PTIN
Phone4142717800PhoneNum
FieldValueIRS element (for citing)
Tax2024TaxYr
Build TS2025-03-06 01:10:19ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerROSEMARY DOLATOWSKIPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 678AddressLine1Txt
CityELKHORNCityNm
State AbbreviationWIStateAbbreviationCd
ZIP53121ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$4,221,285GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressOPENARMSFREECLINIC.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2012FormationYr
Legal Domicile StateWILegalDomicileStateCd
Activity Or MissionTO BETTER UNDERSTAND AND SERVE WITH COMPASSION THE HEALTH AND WELLNESS NEEDS OF LOW-INCOME, UNINSURED RESIDENTS OF WALWORTH COUNTY.ActivityOrMissionDesc
Voting Members Governing Body14VotingMembersGoverningBodyCnt
Voting Members Independent14VotingMembersIndependentCnt
Total Employee47TotalEmployeeCnt
Total Volunteers258TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$2,393,591PYContributionsGrantsAmt
CY Contributions Grants$3,777,201CYContributionsGrantsAmt
PY Program Service Revenue$0PYProgramServiceRevenueAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$54,026PYInvestmentIncomeAmt
CY Investment Income$75,669CYInvestmentIncomeAmt
PY Other Revenue-$78,400PYOtherRevenueAmt
CY Other Revenue-$75,168CYOtherRevenueAmt
PY Total Revenue$2,369,217PYTotalRevenueAmt
CY Total Revenue$3,777,702CYTotalRevenueAmt
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$1,256,068PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$1,551,618CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$169,050CYTotalFundraisingExpenseAmt
PY Other Expenses$994,249PYOtherExpensesAmt
CY Other Expenses$1,792,082CYOtherExpensesAmt
PY Total Expenses$2,250,317PYTotalExpensesAmt
CY Total Expenses$3,343,700CYTotalExpensesAmt
PY Revenues Less Expenses$118,900PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$434,002CYRevenuesLessExpensesAmt
Total Assets BOY$2,966,510TotalAssetsBOYAmt
Total Assets EOY$3,464,595TotalAssetsEOYAmt
Total Liabilities BOY$82,122TotalLiabilitiesBOYAmt
Total Liabilities EOY$113,545TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$2,884,388NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$3,351,050NetAssetsOrFundBalancesEOYAmt
MissionTO BETTER UNDERSTAND AND SERVE WITH COMPASSION THE HEALTH AND WELLNESS NEEDS OF LOW-INCOME, UNINSURED RESIDENTS OF WALWORTH COUNTY.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$2,274,327ExpenseAmt
Revenue$2,114RevenueAmt
DescMEDICAL SERVICES - CLINICIANS AND SUPPORT VOLUNTEERS PROVIDE DIRECT PRIMARY AND SPECIALTY MEDICAL CARE FOR QUALIFIED PATIENTS. MEDICAL SERVICES ARE OFFERED AN AVERAGE OF 4+ DAYS A WEEK, 40 HOURS A WEEK. SERVICES INCLUDE PRIMARY CARE, SPECIALTY CARE, LAB, AND MEDICATIONS. THERE WERE 9,871 PATIENT VISITS (A 46% INCREASE FROM 2023), THAT INCLUDED 11,149 MEDICATIONS DISPENSED (15% INCREASE YOY), 5,539 LAB TESTS FOR 1,333 UNIQUE INDIVIDUALS (1,231 NEW PATIENT INTERVIEWS COMPLETED). WHILE WE CARE FOR ALL AGES, THE MAJORITY (84%) ARE ADULTS (OVER AGE 18 YEARS) WITH CHRONIC DISEASES (DIABETES, HEART DISEASE, ASTHMA, MENTAL HEALTH). ALL SERVICES ARE PROVIDED AT NO COST TO THE PATIENT.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$648,948ExpenseAmt
Revenue$603RevenueAmt
DescDENTAL SERVICES - ORAL HEALTH CARE IS PROVIDED BY VOLUNTEER AND PAID DENTISTS, ASSISTANTS, AND HYGIENISTS. IN 2024, THERE WERE 6,027 DENTAL PROCEDURES COMPLETED, AND 2,820 DENTAL VISITS (23% INCREASE YOY) FOR 1,197 UNIQUE PATIENTS. 66% OF THE PATIENTS HAVE NO INSURANCE, AND 34% HAVE MEDICAID INSURANCE. OAFC IS THE ONLY MEDICAID GENERAL DENTIST IN WALWORTH COUNTY. EACH PATIENT IS GIVEN AN INITIAL EXAM, THAT INCLUDES X-RAY, BASIC RESTORATIVE TREATMENT, EXTRACTIONS WHEN NEEDED, AND CLEANING. ALL SERVICES WERE PROVIDED FREE AT NO COST TO PATIENTS, EXCEPT THOSE WHO HAD MINIMAL CO-PAY WITH THEIR MEDICAID. OAFC IS CONTINUING THE PARTNERSHIP WITH MARQUETTE UNIVERSITY DENTAL SCHOOL AND HOSTED 120 DENTAL STUDENTS IN 2024.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$120,281ExpenseAmt
Revenue$112RevenueAmt
DescBEHAVIORAL HEALTH SERVICES - PATIENTS CAN RECEIVE BOTH MEDICATION AND COUNSELING THERAPEUTIC CARE WITHIN THE CLINIC BY PAID MENTAL HEALTH THERAPISTS TO PROVIDE 1,231 COUNSELING VISITS FOR 323 INDIVIDUALS, COUPLES, AND FAMILIES. MEDICATIONS ARE PRESCRIBED BY THE OAFC MEDICAL PROVIDERS, AND A VOLUNTEER PSYCHIATRIST PROVIDED MEDICATION MANAGEMENT AND REVIEW. OAFC CONTINUED OFFERING A STATE-WIDE TELE-BEHAVIORAL HEALTH NETWORK (VIRTUAL THERAPY) TO AN ADDITIONAL 15 FREE CLINICS IN WISCONSIN. OAFC HAS BEEN ABLE TO TREAT GENERAL ANXIETY, DEPRESSION, AND MOOD DISORDERS WITH THE AVAILABLE MEDICATIONS IN THE OPEN ARMS DISPENSARY. ALL SERVICES ARE PROVIDED AT NO COST TO THE PATIENT.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$3,043,556TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising ActivitiesYes (1)FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J Required0ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam MemYes (1)BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash ContriYes (1)DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document8IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee47EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members14GoverningBodyVotingMembersCnt
Independent Voting Member14IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn0AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc0RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldWIStatesWhereCopyOfReturnIsFldCd
Other WebsiteYes (X)OtherWebsiteInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SARA NICHOLSBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone2623791401PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 678AddressLine1Txt
CityELKHORNCityNm
State AbbreviationWIStateAbbreviationCd
ZIP53121ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
DONNA NESHEK RN
PRESIDENT1.00Yes (X)Yes (X)$0$0$0
JAMES LOVELL
VICE CHAIR1.00Yes (X)Yes (X)$0$0$0
GERARD MAKOVEC
TREASURER1.00Yes (X)Yes (X)$0$0$0
ROSEMARY DOLATOWSKI
SECRETARY1.00Yes (X)Yes (X)$0$0$0
THOMAS HARTZ
DIRECTOR1.00Yes (X)$0$0$0
STEVEN JENSEN
DIRECTOR1.00Yes (X)$0$0$0
KAREN LITTIG
DIRECTOR1.00Yes (X)$0$0$0
JOSE CANO
DIRECTOR1.00Yes (X)$0$0$0
DANIEL MAUS
DIRECTOR1.00Yes (X)$0$0$0
REV DANIEL SANDERS
DIRECTOR1.00Yes (X)$0$0$0
JOHN MURPHY
DIRECTOR1.00Yes (X)$0$0$0
PASTOR LILLIANNET ROSARIO
DIRECTOR1.00Yes (X)$0$0$0
NICK VORPAGEL
DIRECTOR1.00Yes (X)$0$0$0
JEFFREY BAHR MD
PAST PRESIDENT1.00Yes (X)$0$0$0
SARA NICHOLS
EXECUTIVE DIRECTOR40.00Yes (X)$85,405$0$3,968
MEAGAN MARKOVICH
EMPLOYEE36.00$108,014$0$3,840Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$193,419TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$7,808TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K1IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K0TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Fundraising$258,680FundraisingAmt
Government Grants$729,383GovernmentGrantsAmt
All Other Contributions$2,789,138AllOtherContributionsAmt
Noncash Contributions$1,459,810NoncashContributionsAmt
Total Contributions$3,777,201TotalContributionsAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$70,700TotalRevenueColumnAmt
Exclusion$70,700ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$278,034SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$273,065SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$4,969SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$4,969TotalRevenueColumnAmt
Exclusion$4,969ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$92,521FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$258,680ContriRptFundraisingEventAmt
Fundraising Direct Expenses$170,518FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column-$77,997TotalRevenueColumnAmt
Exclusion-$77,997ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescOTHER INCOMEDesc
Business900099BusinessCd
Total Revenue Column$2,829TotalRevenueColumnAmt
Related Or Exempt Func Income$2,829RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$2,829OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$3,777,702TotalRevenueColumnAmt
Related Or Exempt Func Income$2,829RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion-$2,328ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$90,445TotalAmt
Program Services$77,053ProgramServicesAmt
Management And General$6,286ManagementAndGeneralAmt
Fundraising$7,106FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$1,273,932TotalAmt
Program Services$1,087,072ProgramServicesAmt
Management And General$88,394ManagementAndGeneralAmt
Fundraising$98,466FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$32,021TotalAmt
Program Services$26,743ProgramServicesAmt
Management And General$2,430ManagementAndGeneralAmt
Fundraising$2,848FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$52,212TotalAmt
Program Services$42,447ProgramServicesAmt
Management And General$3,651ManagementAndGeneralAmt
Fundraising$6,114FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$103,008TotalAmt
Program Services$87,942ProgramServicesAmt
Management And General$7,077ManagementAndGeneralAmt
Fundraising$7,989FundraisingAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$10,750TotalAmt
Management And General$10,750ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$2,877TotalAmt
Management And General$2,877ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$1,922TotalAmt
Program Services$1,922ProgramServicesAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$16,872TotalAmt
Program Services$2,003ProgramServicesAmt
Fundraising$14,869FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$44,239TotalAmt
Program Services$25,334ProgramServicesAmt
Management And General$2,157ManagementAndGeneralAmt
Fundraising$16,748FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$27,433TotalAmt
Program Services$16,291ProgramServicesAmt
Management And General$541ManagementAndGeneralAmt
Fundraising$10,601FundraisingAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$33,480TotalAmt
Program Services$33,480ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$2,687TotalAmt
Program Services$465ProgramServicesAmt
Management And General$2,129ManagementAndGeneralAmt
Fundraising$93FundraisingAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$40,929TotalAmt
Program Services$40,288ProgramServicesAmt
Management And General$427ManagementAndGeneralAmt
Fundraising$214FundraisingAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$20,959TotalAmt
Program Services$19,233ProgramServicesAmt
Management And General$1,149ManagementAndGeneralAmt
Fundraising$577FundraisingAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
DONATED MEDICATIONS$1,291,649$1,291,649
PATIENT CARE$170,095$170,095
MEDICAL AND DENTAL EQUI$56,406$56,406
REPAIRS AND MAINTENANCE$36,210$33,385$2,825

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$35,574TotalAmt
Program Services$31,748ProgramServicesAmt
Management And General$401ManagementAndGeneralAmt
Fundraising$3,425FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$3,343,700TotalAmt
Program Services$3,043,556ProgramServicesAmt
Management And General$131,094ManagementAndGeneralAmt
Fundraising$169,050FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$254,149BOYAmt
EOY$84,068EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$247,418BOYAmt
EOY$299,473EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$105,697BOYAmt
EOY$630,304EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$5,400BOYAmt
EOY$17,731EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$23,610BOYAmt
EOY$37,297EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$1,011,435LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$334,919LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$707,020BOYAmt
EOY$676,516EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$1,587,588BOYAmt
EOY$1,698,856EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$35,628BOYAmt
EOY$20,350EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$2,966,510BOYAmt
EOY$3,464,595EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$46,891BOYAmt
EOY$93,307EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$35,231BOYAmt
EOY$20,238EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$82,122BOYAmt
EOY$113,545EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$2,850,843BOYAmt
EOY$2,910,089EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$33,545BOYAmt
EOY$440,961EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,884,388BOYAmt
EOY$3,351,050EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,966,510BOYAmt
EOY$3,464,595EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$434,002ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$32,660NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit RequiredYes (1)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (1)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

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

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$124,828OtherCostOrOtherBasisAmt
Book Value$124,828BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$550,504OtherCostOrOtherBasisAmt
Depreciation$75,577DepreciationAmt
Book Value$474,927BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$305,130OtherCostOrOtherBasisAmt
Depreciation$252,075DepreciationAmt
Book Value$53,055BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$30,973OtherCostOrOtherBasisAmt
Depreciation$7,267DepreciationAmt
Book Value$23,706BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$676,516TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescOPERATING LEASE LIABILITYDesc
Amt$20,238Amt
FieldValueIRS element (for citing)
Total Liability$20,238TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$4,993,504TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$32,660NetUnrealizedGainsInvstAmt
Donated Services And Use Fclts$1,148,119DonatedServicesAndUseFcltsAmt
Revenue Not Reported$1,180,779RevenueNotReportedAmt
Revenue Subtotal$3,812,725RevenueSubtotalAmt
Investment Expenses Not Incld$2,877InvestmentExpensesNotIncldAmt
Other Revenues Not Included-$37,900OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt-$35,023RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$3,777,702TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$4,526,843TotExpnsEtcAuditedFinclStmtAmt
Donated Services Use Fclts$1,148,119DonatedServicesUseFcltsAmt
Other Expenses Included$37,901OtherExpensesIncludedAmt
Expenses Not Reported$1,186,020ExpensesNotReportedAmt
Expenses Subtotal$3,340,823ExpensesSubtotalAmt
Investment Expenses Not Incld2$2,877InvestmentExpensesNotIncld2Amt
Expenses Not Rpt Fincl Stmt$2,877ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$3,343,700TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART X, LINE 2:THE ORGANIZATION IS A NONPROFIT ORGANIZATION WHICH IS TAX-EXEMPT UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE ORGANIZATION HAS IMPLEMENTED ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES IN ACCORDANCE WITH U.S.GAAP. THIS STANDARD DESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTABLE FOR FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN AND ALSO PROVIDES GUIDANCE ON VARIOUS RELATED MATTERS SUCH AS DERECOGNIZING, INTEREST, PENALTIES AND DISCLOSURE REQUIRED. MANAGEMENT OF THE ORGANIZATION EVALUATES THE UNCERTAIN TAX POSITIONS TAKEN, IF ANY, AND CONSULTS WITH OUTSIDE COUNSEL AS DEEMED NECESSARY. THE ORGANIZATION RECOGNIZES INTEREST AND PENALTIES, IF ANY, RELATED TO UNRECOGNIZED TAX LIABILITIES IN INCOME TAX EXPENSE. IN MANAGEMENT'S OPINION, THE ORGANIZATION HAS NOT TAKEN ANY UNCERTAIN TAX POSITIONS AND, ACCORDINGLY, HAS NOT REPORTED A CORRESPONDING LIABILITY IN THE ORGANIZATION'S FINANCIAL STATEMENTS.
PART XI, LINE 4B - OTHER ADJUSTMENTS:FUNDRAISING EVENT EXPENSES -37,900.
PART XII, LINE 2D - OTHER ADJUSTMENTS:FUNDRAISING EVENT EXPENSES 37,900. MISC 1.

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1BIRTHDAY DINNER GALAEvent1Nm
Gross Receipts Event1$292,976GrossReceiptsEvent1Amt
Charitable Contri Event1$221,815CharitableContriEvent1Amt
Gross Revenue Event1$71,161GrossRevenueEvent1Amt
Cash Prizes Event1$2,850CashPrizesEvent1Amt
Non Cash Prizes Event1$52,079NonCashPrizesEvent1Amt
Rent Facility Costs Event1$7,846RentFacilityCostsEvent1Amt
Food And Beverage Event1$69,369FoodAndBeverageEvent1Amt
Entertainment Event1$7,200EntertainmentEvent1Amt
Other Direct Expenses Event1$13,626OtherDirectExpensesEvent1Amt
Event2GOLF OUTINGEvent2Nm
Gross Receipts Event2$58,225GrossReceiptsEvent2Amt
Charitable Contri Event2$36,865CharitableContriEvent2Amt
Gross Revenue Event2$21,360GrossRevenueEvent2Amt
Cash Prizes Event2$825CashPrizesEvent2Amt
Non Cash Prizes Event2$288NonCashPrizesEvent2Amt
Rent Facility Costs Event2$12,182RentFacilityCostsEvent2Amt
Food And Beverage Event2$1,439FoodAndBeverageEvent2Amt
Other Direct Expenses Event2$2,814OtherDirectExpensesEvent2Amt
Gross Receipts Total$351,201GrossReceiptsTotalAmt
Charitable Contributions Tot$258,680CharitableContributionsTotAmt
Gross Revenue Total Events$92,521GrossRevenueTotalEventsAmt
Cash Prizes Total Events$3,675CashPrizesTotalEventsAmt
Non Cash Prizes Total Events$52,367NonCashPrizesTotalEventsAmt
Rent Fclty Costs Total Events$20,028RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events$70,808FoodAndBeverageTotalEventsAmt
Entertainment Total Events$7,200EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events$16,440OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$170,518DirectExpenseSummaryEventsAmt
Net Income Summary-$77,997NetIncomeSummaryAmt
FieldValueIRS element (for citing)
States Where Gaming ConductedWIStatesWhereGamingConductedCd
LicensedYes (1)LicensedInd
License Suspended Etc0LicenseSuspendedEtcInd
Gaming With Nonmembers0GamingWithNonmembersInd
Member Of Other Entity0MemberOfOtherEntityInd
Gaming Other Facility1.00000GamingOtherFacilityPct
Cntrct With3rd Prty For Game Rev0CntrctWith3rdPrtyForGameRevInd
Charitable Distribution Rqr0CharitableDistributionRqrInd

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

FieldValueIRS element (for citing)
PersonLORI HARTZPersonNm
FieldValueIRS element (for citing)
Relationship DescriptionMARRIED TO A BOARD MEMBERRelationshipDescriptionTxt
Transaction$22,779TransactionAmt
TransactionCOMPENSATED AS AN EMPLOYEE OF THE ORGANIZATIONTransactionDesc
Sharing Of Revenues0SharingOfRevenuesInd

Schedule M IRS990ScheduleM

Securities Publicly Traded SecuritiesPubliclyTradedGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Contribution8ContributionCnt
Noncash Contributions Rpt F990$89,388NoncashContributionsRptF990Amt
Method Of Determining RevenuesFAIR MARKET VALUEMethodOfDeterminingRevenuesTxt

Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Noncash Contributions Rpt F990$1,320,793NoncashContributionsRptF990Amt
Method Of Determining RevenuesFAIR MARKET VALUEMethodOfDeterminingRevenuesTxt

Other Non Cash Contri Table OtherNonCashContriTableGrp (2 entries)

Non Cash CheckboxNonCashCheckboxIndDescDescContributionContributionCntNoncash Contributions Rpt F990NoncashContributionsRptF990AmtMethod Of Determining RevenuesMethodOfDeterminingRevenuesTxt
Yes (X)AUCTION PRIZES108$42,479FAIR MARKET VALUE
Yes (X)RAFFLE PRIZES77$7,150FAIR MARKET VALUE
FieldValueIRS element (for citing)
Any Property That Must Be Held0AnyPropertyThatMustBeHeldInd
Review Process Unusual NC Gifts0ReviewProcessUnusualNCGiftsInd
Third Parties Used0ThirdPartiesUsedInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11BFORM 990 IS REVIEWED, SIGNED, AND FILED BY THE PRESIDENT WHO THEN PRESENTS A COPY TO EACH MEMBER OF THE BOARD OF DIRECTORS. SHOULD ANY MATERIAL REASON BE FOUND, AMENDMENTS TO THE RETURN WOULD BE MADE UNDER BOARD DIRECTION AND APPROVAL.
FORM 990, PART VI, SECTION C, LINE 19GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART XII, LINE 2C:THE PROCESS HAS NOT CHANGED FROM PRIOR YEARS.

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