MCCLOUD HEALTHCARE CLINIC INC: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- MCCLOUD HEALTHCARE CLINIC INC (EIN 68-0427383)
- Tax period
- 2018-01-01 to 2018-12-31
- Filed
- 2019-11-15
- IRS object ID
- 201923199349311447
- Schema version
- 2018v3.1
- 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 | 2019-11-15T13:49:42-06:00 | ReturnTs |
| Tax Period End | 2018-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BKD LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 910 E ST LOUIS 200/PO BOX 1190 | AddressLine1Txt |
| City | SPRINGFIELD | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 658062523 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2018-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 680427383 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MCCLOUD HEALTHCARE CLINIC INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % JAMES PROFFITT | InCareOfNm |
| Business Name Control | MCCL | BusinessNameControlTxt |
| Phone | 5309642389 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1143 | AddressLine1Txt |
| City | MCCLOUD | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 96057 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JAMES SUMNER PROFFITT | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Signature | 2019-11-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Krystal K Creach | PreparerPersonNm |
| PTIN | P01248198 | PTIN |
| Phone | 4178658701 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 167.68.126.162 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Federal Original Submission Id | 43032920193195000020 | FederalOriginalSubmissionId |
| Federal Original Submission Id | 2019-11-15 | FederalOriginalSubmissionIdDt |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 8705656393E68C4A592E0CEA227AF158EB1E06AC | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | EADA8263F67F30EEC173F90D1C5FD4FB3EC213FF | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2020-03-31 21:24:44Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SHASTA CASCADE HEALTH CENTERS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JAMES SUMNER PROFFITT | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1143 | AddressLine1Txt |
| City | MCCLOUD | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 96057 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $4,786,443 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.SHASTACASCADEHEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1999 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | WE OFFER ACCESS TO A FULL SCOPE OF HIGH QUALITY, EFFICIENT HEALTH CARE FOR EVERYONE WITHOUT REGARD TO THEIR ABILITY TO PAY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 65 | TotalEmployeeCnt |
| Total Volunteers | 14 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,132,848 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,378,777 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $2,363,520 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $3,407,133 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$2,555 | PYInvestmentIncomeAmt |
| CY Investment Income | $233 | CYInvestmentIncomeAmt |
| PY Other Revenue | $300 | PYOtherRevenueAmt |
| CY Other Revenue | $300 | CYOtherRevenueAmt |
| PY Total Revenue | $3,494,113 | PYTotalRevenueAmt |
| CY Total Revenue | $4,786,443 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $2,397,015 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $3,210,053 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,657,348 | PYOtherExpensesAmt |
| CY Other Expenses | $2,273,771 | CYOtherExpensesAmt |
| PY Total Expenses | $4,054,363 | PYTotalExpensesAmt |
| CY Total Expenses | $5,483,824 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$560,250 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$697,381 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $1,751,554 | TotalAssetsBOYAmt |
| Total Assets EOY | $2,221,984 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $873,927 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $2,041,738 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $877,627 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $180,246 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | WE ARE A COMPREHENSIVE PRIMARY HEALTHCARE PRACTICE DEDICATED TO BUILDING A HEALTHY COMMUNITY AND IMPROVING THE INDIVIDUAL HEALTH, WELL-BEING, AND QUALITY OF LIFE FOR EVERYONE. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $2,908,719 | ExpenseAmt |
| Revenue | $3,407,133 | RevenueAmt |
| Desc | WE SERVED OVER 3000 UNIQUE PATIENTS IN 2018 AND PROVIDED HEALTH CARE SERVICES TO THE COMMUNITY REGARDLESS OF ABILITY TO PAY. SEE SCHEDULE O FOR MORE INFORMATION. | Desc |
| Total Program Service Expenses | $2,908,719 | 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 |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| 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 | Yes (true) | 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 | false | 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 With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | Yes (true) | 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 | 29 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 65 | 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 |
| 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 | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (true) | 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 |
| States Where Copy Of Return Is Fld | CA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JAMES PROFFITT | PersonNm |
| Phone | 5309642389 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 116 W MINNESOTA AVE | AddressLine1Txt |
| City | MCCLOUD | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 96057 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| ADRIENNE WEIDER | ||||||||
| BOARD MENTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| ANITA MCFALL | ||||||||
| SECRETARY | 3.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| ANTHONY KYDD | ||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| CHARLENE FAIRCHILD | ||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| CHRISTINE RICHEY | ||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| DIANE TOLOSANO | ||||||||
| VICE PRESIDENT | 3.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| MILTON SHRADER | ||||||||
| TREASURER | 3.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| DIANE BRICKELL | ||||||||
| PRESIDENT | 3.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| MARLENE HINES | ||||||||
| DIRECTOR BEGIN 12/2018 | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| RODGER PAGE | ||||||||
| DIRECTOR BEGIN 08/2018 | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| JAMES PROFFITT | ||||||||
| CEO | 40.0 | 0.0 | $168,960 | $0 | $8,448 | Yes (X) | ||
| CALEB OTT | ||||||||
| COO | 40.0 | 0.0 | $92,297 | $0 | $4,615 | Yes (X) | ||
| LISA PROFFITT | ||||||||
| CHIEF QUALITY OFFICER | 40.0 | 0.0 | $117,398 | $0 | $5,870 | Yes (X) | ||
| GABRIEL SMITH | ||||||||
| DENTIST | 40.0 | 0.0 | $226,156 | $0 | $22,163 | Yes (X) | ||
| GRADY R FORT | ||||||||
| DOCTOR | 40.0 | 0.0 | $183,370 | $0 | $9,169 | Yes (X) | ||
| JULIE FADNESS | ||||||||
| NURSE PRACTITIONER | 40.0 | 0.0 | $130,000 | $0 | $6,500 | Yes (X) | ||
| CECILY SHAW-SCALA | ||||||||
| NURSE PRACTITIONER | 40.0 | 0.0 | $102,563 | $0 | $5,128 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,020,744 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $61,893 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 6 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| BKD LLP | |||||
| 910 E SAINT LOUIS STREET SUITE 20 | SPRINGFIELD | MO | 658011190 | ACCOUNTING/AUDIT/TAX | $190,039 |
| HEALTH INFORMATION TECHNOLOGY CARE | |||||
| 1310 REDWOOD WAY STE 125 | PETALUMA | CA | 94954 | IT | $110,468 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $1,298,697 | GovernmentGrantsAmt |
| All Other Contributions | $80,080 | AllOtherContributionsAmt |
| Noncash Contributions | $26,649 | NoncashContributionsAmt |
| Total Contributions | $1,378,777 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENUE | 624100 | $3,254,790 | $3,254,790 |
| PCP QUALITY IMPROVEMENT PROGRAM REVENUE | 624100 | $110,866 | $110,866 |
| OTHER INCOME | 624100 | $41,477 | $41,477 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $3,407,133 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $233 | TotalRevenueColumnAmt |
| Exclusion | $233 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $300 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $300 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $300 | TotalRevenueColumnAmt |
| Exclusion | $300 | ExclusionAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $0 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $0 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $0 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $0 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,786,443 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,407,133 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $533 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $397,588 | TotalAmt |
| Management And General | $397,588 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,271,907 | TotalAmt |
| Program Services | $1,658,089 | ProgramServicesAmt |
| Management And General | $613,818 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,413 | TotalAmt |
| Program Services | $20,902 | ProgramServicesAmt |
| Management And General | $12,511 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $295,206 | TotalAmt |
| Program Services | $196,513 | ProgramServicesAmt |
| Management And General | $98,693 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $211,939 | TotalAmt |
| Program Services | $132,581 | ProgramServicesAmt |
| Management And General | $79,358 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $182,689 | TotalAmt |
| Management And General | $182,689 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,403 | TotalAmt |
| Management And General | $4,403 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $222,746 | TotalAmt |
| Management And General | $222,746 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $335,393 | TotalAmt |
| Program Services | $314,393 | ProgramServicesAmt |
| Management And General | $21,000 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,078 | TotalAmt |
| Management And General | $21,078 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $397,844 | TotalAmt |
| Management And General | $397,844 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $210,221 | TotalAmt |
| Management And General | $210,221 | ManagementAndGeneralAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $129,810 | TotalAmt |
| Program Services | $62,577 | ProgramServicesAmt |
| Management And General | $67,233 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $39,490 | TotalAmt |
| Management And General | $39,490 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,580 | TotalAmt |
| Management And General | $23,580 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $47,365 | TotalAmt |
| Program Services | $24,684 | ProgramServicesAmt |
| Management And General | $22,681 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $94,133 | TotalAmt |
| Program Services | $47,459 | ProgramServicesAmt |
| Management And General | $46,674 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $39,182 | TotalAmt |
| Program Services | $13,865 | ProgramServicesAmt |
| Management And General | $25,317 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES & DRUGS | $329,481 | $329,481 | |
| BAD DEBT | $106,147 | $106,147 | |
| LICENCES, DUES, SUBSCRIPTIONS | $62,688 | $62,688 | |
| RECRUITING & RETENTION | $21,391 | $21,391 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,130 | TotalAmt |
| Program Services | $2,028 | ProgramServicesAmt |
| Management And General | $4,102 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,483,824 | TotalAmt |
| Program Services | $2,908,719 | ProgramServicesAmt |
| Management And General | $2,575,105 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $120,928 | BOYAmt |
| EOY | $37,378 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $250,260 | BOYAmt |
| EOY | $110,190 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,897 | BOYAmt |
| EOY | $80,033 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $264,870 | BOYAmt |
| EOY | $349,379 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,100 | BOYAmt |
| EOY | $21,153 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $53,351 | BOYAmt |
| EOY | $73,902 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $1,806,239 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $310,823 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $858,468 | BOYAmt |
| EOY | $1,495,416 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $24,533 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $171,680 | BOYAmt |
| EOY | $30,000 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,751,554 | BOYAmt |
| EOY | $2,221,984 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $224,698 | BOYAmt |
| EOY | $553,244 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $314,229 | BOYAmt |
| EOY | $921,047 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $335,000 | BOYAmt |
| EOY | $567,447 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $873,927 | BOYAmt |
| EOY | $2,041,738 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $848,777 | BOYAmt |
| EOY | $157,478 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,850 | BOYAmt |
| EOY | $22,768 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $877,627 | BOYAmt |
| EOY | $180,246 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,751,554 | BOYAmt |
| EOY | $2,221,984 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$697,381 | ReconcilationRevenueExpnssAmt |
| 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 | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
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 | $982,270 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,108,802 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,114,665 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,132,848 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,378,777 | CurrentTaxYearAmt |
| Total | $5,717,362 | TotalAmt |
Tax Rev Levied Orgnztnl Bnft170 TaxRevLeviedOrgnztnlBnft170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $982,270 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,108,802 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,114,665 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,132,848 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,378,777 | CurrentTaxYearAmt |
| Total | $5,717,362 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $20,596 | SubstantialContributorsTotAmt |
| Public Support Total170 | $5,696,766 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $286 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $540 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $882 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $575 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $533 | CurrentTaxYearAmt |
| Total | $2,816 | TotalAmt |
Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $5,720,178 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $12,996,741 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.99591 | PublicSupportCY170Pct |
| Public Support PY170 | 0.99952 | 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $151,904 | OtherCostOrOtherBasisAmt |
| Book Value | $151,904 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,219,630 | OtherCostOrOtherBasisAmt |
| Depreciation | $83,985 | DepreciationAmt |
| Book Value | $1,135,645 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $129,369 | OtherCostOrOtherBasisAmt |
| Depreciation | $41,608 | DepreciationAmt |
| Book Value | $87,761 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $305,336 | OtherCostOrOtherBasisAmt |
| Depreciation | $185,230 | DepreciationAmt |
| Book Value | $120,106 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Land Buildings | OtherLandBuildingsGrp | |
| Total Book Value Land Buildings | $1,495,416 | TotalBookValueLandBuildingsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DUE TO THIRD PARTY | Desc |
| Amt | $567,447 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $567,447 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $4,686,378 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | -$77,297 | OtherRevenueAmt |
| Revenue Not Reported | -$77,297 | RevenueNotReportedAmt |
| Revenue Subtotal | $4,763,675 | RevenueSubtotalAmt |
| Other Revenues Not Included | $22,768 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $22,768 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $4,786,443 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $5,377,677 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $5,377,677 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $106,147 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $106,147 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $5,483,824 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE D, PART X, LINE 2 | UNCERTAIN TAX POSITIONS: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. |
| SCHEDULE D, PART XI, LINE 2D | AMOUNTS INCLUDED ON LINE 1, BUT NOT ON FORM 990, PART VIII, LINE 12: $(106,147) BAD DEBT EXPENSE 28,850 NET ASSETS RELEASED FROM RESTRICTION ---------- $(77,297) |
| SCHEDULE D, PART XI, LINE 4B | AMOUNTS INCLUDED ON FORM 990, PART VIII, LINE 12, BUT NOT ON LINE 1: $ 22,768 TEMPORARILY RESTRICTED CONTRIBUTIONS |
| SCHEDULE D, PART XII, LINE 4B | AMOUNTS INCLUDED ON FORM 990, PART IX, LINE 25, BUT NOT LINE 1: $ 106,147 BAD DEBT EXPENSE |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| 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 | Yes (true) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (3 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JAMES PROFFITT | ||||||||||||||
| CEO | $153,960 | $0 | $15,000 | $0 | $0 | $0 | $0 | $0 | $8,448 | $0 | $177,408 | $0 | $0 | $0 |
| GABRIEL SMITH | ||||||||||||||
| DENTIST | $226,156 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $22,163 | $0 | $248,319 | $0 | $0 | |
| GRADY R FORT | ||||||||||||||
| DOCTOR | $183,370 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $9,169 | $0 | $192,539 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE J, PART I, LINE 7 | FormAndLineReferenceDesc |
| Explanation | NON-FIXED PAYMENTS: PER BOARD OF DIRECTORS APPROVAL AND DISCRETION, ALL FULL-TIME EMPLOYEES AND MANAGEMENT EMPLOYEES RECEIVED A YEAR-END CHRISTMAS BONUS. THE BOARD ALSO HAS DISCRETION TO AWARD ADDITIONAL BONUSES TO TOP MANAGEMENT BASED UPON CERTAIN NON-FINANCIAL METRICS AND ANNUAL REVIEWS. | ExplanationTxt |
Schedule M IRS990ScheduleM
| Field | Value | IRS element (for citing) |
|---|---|---|
| Works Of Art | WorksOfArtGrp | |
| Art Historical Treasures | ArtHistoricalTreasuresGrp | |
| Art Fractional Interest | ArtFractionalInterestGrp | |
| Books And Publications | BooksAndPublicationsGrp | |
| Clothing And Household Goods | ClothingAndHouseholdGoodsGrp | |
| Cars And Other Vehicles | CarsAndOtherVehiclesGrp | |
| Boats And Planes | BoatsAndPlanesGrp | |
| Intellectual Property | IntellectualPropertyGrp | |
| Securities Publicly Traded | SecuritiesPubliclyTradedGrp | |
| Securities Closely Held Stock | SecuritiesCloselyHeldStockGrp | |
| Secur Prtnrshp Trust Intrsts | SecurPrtnrshpTrustIntrstsGrp | |
| Securities Miscellaneous | SecuritiesMiscellaneousGrp | |
| Qualified Contrib Hist Struct | QualifiedContribHistStructGrp | |
| Qualified Contrib Other | QualifiedContribOtherGrp | |
| Real Estate Residential | RealEstateResidentialGrp | |
| Real Estate Commercial | RealEstateCommercialGrp | |
| Real Estate Other | RealEstateOtherGrp | |
| Collectibles | CollectiblesGrp | |
| Food Inventory | FoodInventoryGrp |
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 323 | ContributionCnt |
| Noncash Contributions Rpt F990 | $26,649 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Taxidermy | TaxidermyGrp | |
| Historical Artifacts | HistoricalArtifactsGrp | |
| Scientific Specimens | ScientificSpecimensGrp | |
| Archaeological Artifacts | ArchaeologicalArtifactsGrp | |
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | false | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | false | ThirdPartiesUsedInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE M, PART I, COLUMN B | FormAndLineReferenceDesc |
| Explanation | NUMBER OF ITEMS RECEIVED: THE NUMBER IN COLUMN B REPRESENTS THE NUMBER OF VACCINES RECEIVED. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART III, LINE 4A | PROGRAM SERVICE ACCOMPLISHMENTS: THE MCCLOUD CLINIC SERVES A COMMUNITY POPULATION OF 1,850 AND IS CLASSIFIED AS A FRONTIER MEDICAL PROVIDER. WE PROVIDE HIGH QUALITY HEALTHCARE TO EVERYONE WITHOUT REGARD TO THEIR ABILITY TO PAY. WE PROVIDE BOTH SCHEDULED VISITS AND WALK IN CARE. WE ARE A PREFERRED PROVIDER FOR MEDICAL, MEDICARE AND BLUE CROSS. WE ACCEPT ALL INSURANCE AND PRIVATE PAY PATIENTS. WE OFFER A SLIDING SCALE FOR INDIVIDUALS WHO ARE UNINSURED OR UNDER-INSURED. ON JUNE 6, 2012, THE CLINIC WAS AWARDED THE NEW ACCESS POINT GRANT AND BECAME A 330 FUNDED FEDERALLY QUALIFIED HEALTH CENTER. WE WERE GRANTED FEDERALLY QUALIFIED HEALTH CENTER LOOK ALIKE STATUS IN OCTOBER 2008. IN 2014, WE OPENED THE MCCLOUD DENTAL CENTER (MDC), WHICH PROVIDES A WIDE RANGE OF DENTAL SERVICES VIA SCHEDULED AND WALK IN VISITS. THE MDC PROVIDES SLIDING SCALE DENTAL SERVICES FOR INDIVIDUALS WHO ARE UNINSURED OR UNDER-INSURED, AND ACCEPTS DENTI-CAL, AMONG OTHER INSURANCES, AND PRIVATE PAY PATIENTS. |
| FORM 990, PART VI, SECTION A, LINE 2 | FAMILY RELATIONSHIP: OFFICERS OF THE ORGANIZATION JAMES PROFFITT AND LISA PROFFITT HAVE A FAMILY RELATIONSHIP. |
| FORM 990, PART VI, SECTION B, LINE 11B | FORM 990 REVIEW PROCESS: THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. FORM 990 IS REVIEWED BY FINANCE DEPT STAFF AND CEO PRIOR TO BOARD PRESENTATION. THE FORM 990 IS FURNISHED TO THE BOARD PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY: ANNUAL CONFLICT OF INTEREST DISCLOSURE DOCUMENTS ARE REVIEWED BY THE CEO AND COO. TRANSACTIONS WITH RELATED PARTIES WHERE A POTENTIAL CONFLICT OF INTEREST EXISTS OR MAY APPEAR TO EXIST MUST BE CAREFULLY HANDLED. SUCH TRANSACTIONS REQUIRE ANNUAL SELF-DISCLOSURE, AND ARE CONSTANTLY MONITORED BY THE STAFF AND BOARD OF DIRECTORS. ANY DIRECTOR HAVING A CONFLICT OF INTEREST IS NOT ENTITLED TO VOTE ON THE DECISION TO ENTER INTO SUCH TRANSACTIONS AS MIGHT PRESENT A CONFLICT OF INTEREST OR RISK TO THE ORGANIZATION. |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENT AVAILABILITY: THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. |