CULPEPER WELLNESS FOUNDATION: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- CULPEPER WELLNESS FOUNDATION (EIN 52-1366700)
- Tax period
- 2018-01-01 to 2018-12-31
- Filed
- 2019-08-14
- IRS object ID
- 201902269349301345
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule G
- Schedule I
- Schedule J
- Schedule L
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2019-08-14T11:44:55-05:00 | ReturnTs |
| Tax Period End | 2018-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 540737372 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PBMARES LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 558 SOUTH MAIN STREET | AddressLine1Txt |
| City | HARRISONBURG | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 22801 | 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 | 521366700 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CULPEPER WELLNESS FOUNDATION INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CULP | BusinessNameControlTxt |
| Phone | 5404312397 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 311 S EAST ST NO 100 | AddressLine1Txt |
| City | CULPEPER | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 22701 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SHARI J LANDRY | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 5404312397 | PhoneNum |
| Signature | 2019-08-13 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KEVIN HUMPHRIES | PreparerPersonNm |
| PTIN | P00168667 | PTIN |
| Phone | 5404345975 | PhoneNum |
| Preparation | 2019-08-13 | PreparationDt |
| Self Employed | Yes (X) | SelfEmployedInd |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 209.10.80.132 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2019-08-13 | IPDt |
| IP Tm | 12:37:56 | IPTm |
| IP Timezone | ED | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 0CD500D61E63C9BEF9A26F14A66EA0E6F9C673DF | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 50C539A4451AFBFB1AFF376C49F51610FD3C4593 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | SHARI J LANDRY | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 311 S EAST ST NO 100 | AddressLine1Txt |
| City | CULPEPER | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 22701 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $4,855,188 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.CULPEPERWELLNESSFOUNDATION.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1985 | FormationYr |
| Legal Domicile State | VA | LegalDomicileStateCd |
| Activity Or Mission | THE MISSION OF CULPEPER WELLNESS FOUNDATION IS TO IMPROVE HEALTH AND PROMOTE WELLNESS IN CULPEPER, MADISON AND ORANGE COUNTIES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 13 | VotingMembersIndependentCnt |
| Total Employee | 133 | TotalEmployeeCnt |
| Total Volunteers | 34 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $560,571 | PYContributionsGrantsAmt |
| CY Contributions Grants | $840,169 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $1,910,296 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $2,265,391 | CYProgramServiceRevenueAmt |
| PY Investment Income | $780,781 | PYInvestmentIncomeAmt |
| CY Investment Income | $972,520 | CYInvestmentIncomeAmt |
| PY Other Revenue | $519,135 | PYOtherRevenueAmt |
| CY Other Revenue | $439,231 | CYOtherRevenueAmt |
| PY Total Revenue | $3,770,783 | PYTotalRevenueAmt |
| CY Total Revenue | $4,517,311 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $197,285 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $565,824 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $1,794,005 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $1,962,133 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,893,347 | PYOtherExpensesAmt |
| CY Other Expenses | $2,169,835 | CYOtherExpensesAmt |
| PY Total Expenses | $3,884,637 | PYTotalExpensesAmt |
| CY Total Expenses | $4,697,792 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$113,854 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$180,481 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $35,265,868 | TotalAssetsBOYAmt |
| Total Assets EOY | $33,541,124 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $238,354 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $216,005 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $35,027,514 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $33,325,119 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE MISSION OF CULPEPER WELLNESS FOUNDATION IS TO IMPROVE HEALTH AND PROMOTE WELLNESS IN CULPEPER, MADISON AND ORANGE COUNTIES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $2,728,528 | ExpenseAmt |
| Revenue | $2,272,127 | RevenueAmt |
| Desc | THE POWELL WELLNESS CENTER HELPS INDIVIDUALS ACHIEVE PHYSICAL AND EMOTIONAL WELL-BEING THROUGH EXERCISE, PHYSICAL ACTIVITY, AND MEDICALLY INTEGRATED SERVICES. CULPEPER SPORT AND FITNESS HELPS INDIVIDUALS - WITH AN EMPHASIS ON YOUTH - IMPROVE THEIR HEALTH AND WELLNESS THROUGH PARTICIPATION IN FITNESS PROGRAMS AND ACTIVITIES. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $902,219 | ExpenseAmt |
| Desc | THE FREE CLINIC OF CULPEPER DELIVERS HIGH-QUALITY MEDICAL CARE TO UNINSURED ADULTS IN CULPEPER COUNTY. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $565,823 | ExpenseAmt |
| Grant | $565,823 | GrantAmt |
| Desc | THE FOUNDATION SEEKS TO IMPROVE HEATH AND PROMOTE WELLNESS THROUGH LOCAL COLLABORATIONS AND HEALTH-RELATED INITIATIVES AS WELL AS THROUGH GRANTS TO LOCAL NONPROFITS WORKING IN SUPPORT OF ITS MISSION. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $4,196,570 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | Yes (1) | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | Yes (1) | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | Yes (1) | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 32 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 133 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 13 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DEBRA DODSON | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5404455412 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 311 S EAST STREET SUITE 100 | AddressLine1Txt |
| City | CULPEPER | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 22701 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd |
|---|---|---|---|---|---|---|
| CATHY DALRYMPLE | ||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |
| RICHARD HARRINGTON | ||||||
| CHAIR | 4.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| CHARLES BARRELL | ||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |
| TRIPP BUTLER | ||||||
| TREASURER | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| SHIRLEY ANN BAYNE | ||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |
| JAMIE CLANCEY | ||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |
| LAURA GRIGSBY | ||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |
| DEBBIE BENNETT | ||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |
| DAVID JONES | ||||||
| VICE CHAIR | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| DR THOMAS REYNOLDS MD | ||||||
| SECRETARY | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| MORT CHILDS MD | ||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |
| SPENCER DEJARNETTE | ||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |
| JEFF HETMANSKI | ||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |
| SHARI J LANDRY | ||||||
| PRESIDENT | 40.00 | $145,029 | $0 | $18,134 | Yes (X) | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $145,029 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $18,134 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 1 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Federated Campaigns | $15,643 | FederatedCampaignsAmt |
| Fundraising | $52,009 | FundraisingAmt |
| Government Grants | $12,000 | GovernmentGrantsAmt |
| All Other Contributions | $760,517 | AllOtherContributionsAmt |
| Noncash Contributions | $439,772 | NoncashContributionsAmt |
| Total Contributions | $840,169 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| MEMBERSHIP DUES | 713940 | $1,777,057 | $1,777,057 |
| OTHER FEE REVENUE | 713940 | $488,334 | $488,334 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $2,265,391 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $434,965 | TotalRevenueColumnAmt |
| Exclusion | $434,965 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $700,279 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $253,758 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $446,521 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $446,521 | TotalRevenueColumnAmt |
| Exclusion | $446,521 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $543,347 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $5,792 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $543,347 | SecuritiesAmt |
| Other | -$5,792 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $537,555 | TotalRevenueColumnAmt |
| Exclusion | $537,555 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $20,624 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $52,009 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $34,650 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$14,026 | TotalRevenueColumnAmt |
| Exclusion | -$14,026 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $50,413 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $43,677 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $6,736 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $6,736 | RelatedOrExemptFuncIncomeAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,517,311 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $2,272,127 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,405,015 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $565,824 | TotalAmt |
| Program Services | $565,824 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $145,029 | TotalAmt |
| Management And General | $145,029 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,525,740 | TotalAmt |
| Program Services | $1,525,740 | ProgramServicesAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $31,881 | TotalAmt |
| Program Services | $25,701 | ProgramServicesAmt |
| Management And General | $6,180 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $138,642 | TotalAmt |
| Program Services | $130,912 | ProgramServicesAmt |
| Management And General | $7,730 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $120,841 | TotalAmt |
| Program Services | $111,288 | ProgramServicesAmt |
| Management And General | $9,553 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,463 | TotalAmt |
| Program Services | $188 | ProgramServicesAmt |
| Management And General | $1,275 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $60,291 | TotalAmt |
| Program Services | $51,765 | ProgramServicesAmt |
| Management And General | $8,526 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $154,777 | TotalAmt |
| Management And General | $154,777 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $99,937 | TotalAmt |
| Program Services | $59,015 | ProgramServicesAmt |
| Management And General | $40,922 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $64,786 | TotalAmt |
| Program Services | $62,909 | ProgramServicesAmt |
| Management And General | $1,877 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $122,806 | TotalAmt |
| Program Services | $96,202 | ProgramServicesAmt |
| Management And General | $26,604 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $577,649 | TotalAmt |
| Program Services | $519,841 | ProgramServicesAmt |
| Management And General | $57,808 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,437 | TotalAmt |
| Program Services | $18,519 | ProgramServicesAmt |
| Management And General | $5,918 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $492,781 | TotalAmt |
| Program Services | $475,045 | ProgramServicesAmt |
| Management And General | $17,736 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $59,970 | TotalAmt |
| Program Services | $48,306 | ProgramServicesAmt |
| Management And General | $11,664 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES AND DR | $433,106 | $433,106 | |
| PROGRAM SUPPLIES | $63,538 | $60,296 | $3,242 |
| LAUNDRY | $9,007 | $9,007 | |
| DUES & SUBSCRIPTIONS | $5,287 | $2,906 | $2,381 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,697,792 | TotalAmt |
| Program Services | $4,196,570 | ProgramServicesAmt |
| Management And General | $501,222 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $550,779 | BOYAmt |
| EOY | $564,631 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,856,000 | BOYAmt |
| EOY | $2,371,000 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $63,357 | BOYAmt |
| EOY | $59,397 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,492 | BOYAmt |
| EOY | $26,284 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,267 | BOYAmt |
| EOY | $650 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $19,870,495 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $7,842,878 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,391,150 | BOYAmt |
| EOY | $12,027,617 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,311,179 | BOYAmt |
| EOY | $18,418,430 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $55,390 | BOYAmt |
| EOY | $49,660 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,254 | BOYAmt |
| EOY | $23,455 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $35,265,868 | BOYAmt |
| EOY | $33,541,124 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $193,783 | BOYAmt |
| EOY | $179,897 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,043 | BOYAmt |
| EOY | $10,089 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,528 | BOYAmt |
| EOY | $26,019 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $238,354 | BOYAmt |
| EOY | $216,005 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,171,514 | BOYAmt |
| EOY | $30,954,119 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,856,000 | BOYAmt |
| EOY | $2,371,000 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $35,027,514 | BOYAmt |
| EOY | $33,325,119 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $35,265,868 | BOYAmt |
| EOY | $33,541,124 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$180,481 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$1,509,873 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | -$12,041 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $861,426 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $218,962 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $398,274 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $541,751 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $808,782 | CurrentTaxYearAmt |
| Total | $2,829,195 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,808,690 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $456,652 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,880,888 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,971,947 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,315,804 | CurrentTaxYearAmt |
| Total | $8,433,981 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,670,116 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $675,614 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,279,162 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,513,698 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,124,586 | CurrentTaxYearAmt |
| Total | $11,263,176 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $11,263,176 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,077,263 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $752,913 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,032,751 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,140,300 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,135,244 | CurrentTaxYearAmt |
| Total | $5,138,471 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,077,263 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $752,913 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,032,751 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,140,300 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,135,244 | CurrentTaxYearAmt |
| Total | $5,138,471 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,747,379 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,428,527 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,311,913 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,653,998 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,259,830 | CurrentTaxYearAmt |
| Total | $16,401,647 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.68670 | PublicSupportCY509Pct |
| Public Support PY509 | 0.68570 | PublicSupportPY509Pct |
| Investment Income CY | 0.31330 | InvestmentIncomeCYPct |
| Investment Income PY | 0.31430 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule B IRS990ScheduleB
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,796,386 | BeginningYearBalanceAmt |
| Contributions | $37,500 | ContributionsAmt |
| Investment Earnings Or Losses | $145,658 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $90,717 | OtherExpendituresAmt |
| End Year Balance | $2,662,346 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,406,784 | BeginningYearBalanceAmt |
| Contributions | $127,500 | ContributionsAmt |
| Investment Earnings Or Losses | $390,095 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $125,993 | OtherExpendituresAmt |
| End Year Balance | $2,796,386 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,413,628 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $216,855 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $223,699 | OtherExpendituresAmt |
| End Year Balance | $2,406,784 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $2,399,295 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $28,018 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $13,685 | OtherExpendituresAmt |
| End Year Balance | $2,413,628 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $201,667 | BeginningYearBalanceAmt |
| Contributions | -$201,667 | ContributionsAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 1.00000 | BoardDesignatedBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,378,632 | OtherCostOrOtherBasisAmt |
| Book Value | $2,378,632 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $16,005,286 | OtherCostOrOtherBasisAmt |
| Depreciation | $6,842,602 | DepreciationAmt |
| Book Value | $9,162,684 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $141,059 | OtherCostOrOtherBasisAmt |
| Depreciation | $42,316 | DepreciationAmt |
| Book Value | $98,743 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,096,986 | OtherCostOrOtherBasisAmt |
| Depreciation | $857,551 | DepreciationAmt |
| Book Value | $239,435 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $248,532 | OtherCostOrOtherBasisAmt |
| Depreciation | $100,409 | DepreciationAmt |
| Book Value | $148,123 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $12,027,617 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | ANNUITY PAYABLE | Desc |
| Amt | $26,019 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $26,019 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $4,491,807 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$1,509,873 | NetUnrealizedGainsInvstAmt |
| Donated Services And Use Fclts | $1,307,013 | DonatedServicesAndUseFcltsAmt |
| Other Revenue | $332,133 | OtherRevenueAmt |
| Revenue Not Reported | $129,273 | RevenueNotReportedAmt |
| Revenue Subtotal | $4,362,534 | RevenueSubtotalAmt |
| Investment Expenses Not Incld | $154,777 | InvestmentExpensesNotIncldAmt |
| Revenue Not Reported Fincl Stmt | $154,777 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $4,517,311 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $6,194,203 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $1,307,013 | DonatedServicesUseFcltsAmt |
| Other Expenses Included | $344,175 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $1,651,188 | ExpensesNotReportedAmt |
| Expenses Subtotal | $4,543,015 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $154,777 | InvestmentExpensesNotIncld2Amt |
| Expenses Not Rpt Fincl Stmt | $154,777 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $4,697,792 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | THE ORGANIZATION IS EXEMPT FROM FEDERAL INCOME TAXES UNDER CODE SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE CODE). IN ADDITION, CWF QUALIFIES FOR THE CHARITABLE CONTRIBUTION DEDUCTION UNDER SECTION 170(B)(1)(A) OF THE CODE AND HAS BEEN CLASSIFIED AS AN ORGANIZATION THAT IS NOT A PRIVATE ORGANIZATION UNDER CODE SECTION 509(A)(2). PWC IS A LIMITED LIABILITY COMPANY THAT HAS NOT ELECTED TO BE TAXED AS A CORPORATION UNDER CURRENT INTERNAL REVENUE SERVICE REGULATIONS. AS SUCH, PWC IS A DISREGARDED ENTITY FOR FEDERAL INCOME TAX PURPOSES AND DOES NOT HAVE TO FILE AN ANNUAL FEDERAL RETURN. RATHER, ITS TAX RESULTS ARE REFLECTED ON THE ANNUAL TAX FILINGS OF ITS MEMBER AS IF THE ACTIVITIES OF PWC WERE ACTIVITIES OF THE MEMBER. PRIOR TO OCTOBER 1, 2014, THE ORGANIZATION WAS CLASSIFIED AS A FUNCTIONALLY RELATED SUPPORTING ORGANIZATION OF CULPEPER REGIONAL HOSPITAL. DURING 2014, THE ORGANIZATION'S INTEREST IN THE HOSPITAL WAS ACQUIRED BY ANOTHER HOSPITAL SYSTEM. THE ORGANIZATION HAS SINCE TRANSITIONED TO SERVE A GREATER PUBLIC INTEREST AND RECEIVED A CHANGE IN EXEMPT CLASSIFICATION WITH THE INTERNAL REVENUE SERVICE TO ACCOMMODATE ITS CHANGE IN MISSION. MANAGEMENT EVALUATED THE ORGANIZATION'S TAX POSITIONS AND DETERMINED THAT THE ORGANIZATION HAS NO UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENT TO THE FINANCIAL STATEMENTS AT DECEMBER 31, 2018. THE ORGANIZATION FILES FORM 990, RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX, ANNUALLY WITH THE UNITED STATES DEPARTMENT OF THE TREASURY. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | RENTAL EXPENSES 253,758. FUNDRAISING EVENT EXPENSES 34,650. COST OF GOODS SOLD 43,677. ROUNDING 48. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | RENTAL EXPENSE 253,758. FUNDRAISING EXPENSE 34,650. COST OF GOODS SOLD 43,677. LOSS ON UNCOLLECTIBLE PLEDGES 12,041. ROUNDING 49. |
| SCHEDULE D, PART V, LINE 4 | QUASI-ENDOWMENT FUNDS ARE INTENDED TO PROVIDE INCOME TO SUPPLEMENT GRANTS AWARDED AND OTHER GENERAL FOUNDATION OPERATIONS. |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | OYSTER FEST | Event1Nm |
| Gross Receipts Event1 | $65,698 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $48,896 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $16,802 | GrossRevenueEvent1Amt |
| Rent Facility Costs Event1 | $9,158 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $16,802 | FoodAndBeverageEvent1Amt |
| Entertainment Event1 | $400 | EntertainmentEvent1Amt |
| Other Direct Expenses Event1 | $1,944 | OtherDirectExpensesEvent1Amt |
| Event2 | TURKEY TROT | Event2Nm |
| Gross Receipts Event2 | $6,935 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $3,113 | CharitableContriEvent2Amt |
| Gross Revenue Event2 | $3,822 | GrossRevenueEvent2Amt |
| Food And Beverage Event2 | $182 | FoodAndBeverageEvent2Amt |
| Other Direct Expenses Event2 | $6,164 | OtherDirectExpensesEvent2Amt |
| Gross Receipts Total | $72,633 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $52,009 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $20,624 | GrossRevenueTotalEventsAmt |
| Rent Fclty Costs Total Events | $9,158 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $16,984 | FoodAndBeverageTotalEventsAmt |
| Entertainment Total Events | $400 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $8,108 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $34,650 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$14,026 | NetIncomeSummaryAmt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (20 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|
| BOYS AND GIRLS CLUB OF CENTRAL VIRGINIA | ||||||
| PO BOX 707 | CHARLOTTESVILLE | VA | 22902 | 541602004 | $10,000 | HEALTH/WELLNESS PROGRAMS IN MADISON AND ORANGE |
| COMMUNITY RESOURCES UNITED TO STOP HEROIN (CRUSH) | ||||||
| PO BOX 1355 | CULPEPER | VA | 22701 | 546001236 | $5,000 | SUPPORT FOR HEROIN ADDICTION |
| CULPEPER HOUSING AND SHELTER SERVICES | ||||||
| 602 MAIN STREET SUITE 3 | CULPEPER | VA | 22701 | 541704431 | $5,000 | 2018 YEAR END UNRESTRICTED GRANT |
| CULPEPER LITERACY COUNCIL | ||||||
| 415 S MAIN STREET SUITE 204 | CULPEPER | VA | 22701 | 541446838 | $6,150 | TRAINING TO IMPLEMENT A HEALTH LITERACY PROGRAM |
| CULPEPER MID-DAY LIONS CLUB | ||||||
| PO BOX 777 | CULPEPER | VA | 22701 | 823072719 | $10,000 | HEARING AIDE REPLACEMENT AND DISTRIBUTION |
| FRIENDS OF THE CULPEPER COUNTY LIBRARY | ||||||
| 271 SUOTHGRATE SHOPPING CENTER | CULPEPER | VA | 22701 | 541870477 | $8,101 | A COLLABORATIVE HEATH AND WELLNESS PROGRAM CALLED LET'S GET HEALTHY |
| GIRLS ON THE RUN | ||||||
| PO BOX 245 | WARRENTON | VA | 20186 | 463737841 | $5,000 | A ONE WEEK PRGRAM FOR ELEMENTARY SCHOOL GIRLS |
| LAKE OF THE WOODS FIRE AND RESCUE | ||||||
| 104 LAKEVIEW PARKWAY | LOCUST GROVE | VA | 22508 | 237222171 | $10,000 | ACQUISITION OF AUTOMATED CARIOPULMONARY RESUSCITATION DEVICE |
| MANNA MINISTRY | ||||||
| 215 S MAIN STREET | CULPEPER | VA | 22701 | 546044240 | $12,302 | KITCHEN UPGRADES AND FUNDS FOR FRESH FRUIT/VEGGIES |
| NORTHERN PIEDMONT COMM FOUNDATION | ||||||
| PO BOX 5 | CULPEPER | VA | 22701 | 311742955 | $25,000 | CWF H & W SCHOLARSHIP |
| ORANGE COUNTY FREE CLINIC | ||||||
| PO BOX 441 | ORANGE | VA | 22960 | 251922019 | $15,000 | DENTAL VOUCHERS |
| PARTNERSHIPS FOR STRATEGIC IMPACT | ||||||
| PO BOX 5211 | CHARLOTTESVILLE | VA | 22905 | 832802397 | $31,813 | ASSESSMENT OF NEEDS AND DESIRES OF YOUTH |
| PATH FOUNDATION | ||||||
| 321 WALKER DR SUITE 301 | WARRENTON | VA | 20186 | 300219424 | $5,000 | MENTAL HEALTH TRAINING |
| PAUL STEFAN FOUNDATION OLOG | ||||||
| PO BOX 754 | LOCUST GROVE | VA | 22508 | 205111635 | $6,200 | FIRE ESCAPE FOR THE REGIONAL HOUSING AND EDUCATIONAL CENTER |
| PIEDMONT REGIONAL DENTAL CARE | ||||||
| PO BOX 151 | ORANGE | VA | 22960 | 270625764 | $10,000 | DENTAL CARE FOR WINTER HEAT SHELTER PROGRAM PARTICIPANTS |
| RAPPU INC | ||||||
| PO BOX 181 | WASHINGTON | VA | 22747 | 474370354 | $7,500 | SCHOLARSHIPS FOR CULPEPER AND MADISON STUDENTS APPLYING FOR HEALTHCARE TRAINING COURSES |
| SERVICES TO ABUSED FAMILES | ||||||
| PO BOX 402 | CULPEPER | VA | 22701 | 521227834 | $5,000 | 2018 YEAR END UNRESTRICTED GRANT |
| SEX DRUGS AND GOD | ||||||
| 5409 RIXEYVILLE RD | RIXEYVILLE | VA | 22737 | 821988558 | $6,000 | MOBILE ADDICTION |
| TOWN OF CULPEPER | ||||||
| 400 S MAIN STREET SUITE 109 | CULPEPER | VA | 22701 | 546001234 | $260,000 | OBSTACLE COURSE/DASH/BOULDERING WALL |
| CENTER FOR NONPROFIT EXCELLENCE | ||||||
| 1701-A ALLIED STRET | CHARLOTTESVILLE | VA | 22903 | 203412827 | $8,600 | WORKSHOPS I AND II |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 20 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION MAINTAINS CLEAR CRITERIA FOR THE HEALTHY LIVING GRANT PROGRAM AND STRATEGIC GRANTS ARE MADE ONLY BY BOARD APPROVAL. THE ORGANIZATION MANDATES THAT FUNDS AWARDED MUST BE USED WITHIN 90 DAYS OF BEING GRANTED AND STAYS IN CLOSE COMMUNICATION WITH GRANTEES TO MONITOR THEIR USE. GRANTEES MUST PROVIDE A FINAL ACCOUNTING ON THE USE OF FUNDS, INCLUDING THE POPULATION SERVED AND HEALTH IMPACT. REPORTS MUST BE COMPLETED WITHIN 30 DAYS OF PROJECT COMPLETION. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | Yes (1) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | 0 | SubstantiationRequiredInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SHARI J LANDRY | PersonNm |
| Title | PRESIDENT | TitleTxt |
| Base Compensation Filing Org | $145,029 | BaseCompensationFilingOrgAmt |
| Compensation Based On Rltd Orgs | $0 | CompensationBasedOnRltdOrgsAmt |
| Bonus Filing Organization | $0 | BonusFilingOrganizationAmount |
| Bonus Related Organizations | $0 | BonusRelatedOrganizationsAmt |
| Other Compensation Filing Org | $0 | OtherCompensationFilingOrgAmt |
| Other Compensation Rltd Orgs | $0 | OtherCompensationRltdOrgsAmt |
| Deferred Compensation Flng Org | $6,180 | DeferredCompensationFlngOrgAmt |
| Deferred Comp Rltd Orgs | $0 | DeferredCompRltdOrgsAmt |
| Nontaxable Benefits Filing Org | $11,954 | NontaxableBenefitsFilingOrgAmt |
| Nontaxable Benefits Rltd Orgs | $0 | NontaxableBenefitsRltdOrgsAmt |
| Total Compensation Filing Org | $163,163 | TotalCompensationFilingOrgAmt |
| Total Compensation Rltd Orgs | $0 | TotalCompensationRltdOrgsAmt |
| Comp Report Prior990 Filing Org | $0 | CompReportPrior990FilingOrgAmt |
| Comp Report Prior990 Rltd Orgs | $0 | CompReportPrior990RltdOrgsAmt |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| JEFF HETMANSKI | |||
| DIRECTOR | $374,204 | 2018 OPPT RENT PAID BY NOVANT HEALTH UVA HEALTH SYSTEM CULPEPER MEDICAL CENTER TO POWELL WELLNESS CENTER | 0 |
| CHARLES BARRELL | |||
| DIRECTOR | $374,204 | 2018 OPPT RENT PAID BY NOVANT HEALTH UVA HEALTH SYSTEM CULPEPER MEDICAL CENTER TO POWELL WELLNESS CENTER | 0 |
Schedule M IRS990ScheduleM
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 40 | ContributionCnt |
| Noncash Contributions Rpt F990 | $439,772 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FREE CLINIC RECORDS | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | FORM 990 IS PREPARED BY AN OUTSIDE ACCOUNTING FIRM, REVIEWED BY THE CHIEF EXECUTIVE OFFICER AND MADE AVAILABLE TO THE BOARD MEMBERS PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | BOARD MEMBERS ARE REQUIRED TO AFFIRM THEIR COMMITMENT TO UPHOLD THE CONFLICT OF INTEREST POLICY ANNUALLY. |
| FORM 990, PART VI, SECTION B, LINE 15A | THE BOARD WILL REVIEW AND DETERMINE ANNUALLY COMPENSATION OF OFFICERS OR KEY EMPLOYEES. FOR THIS REPORTING PERIOD, COMPENSATION WAS DETERMINED BY BOARD APPROVAL. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART XI, LINE 9: | LOSS ON UNCOLLECTED PLEDGES -12,041. |
| FORM 990, PART XII, LINE 2C | THE ORGANIZATION HAS NOT CHANGED ITS PROCESS FOR THE SELECTION AND OVERSIGHT OF AN INDEPENDENT ACCOUNTANT. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | POWELL WELLNESS CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1005 GOLF DRIVE | AddressLine1Txt |
| City | CULPEPER | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 22701 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 204803079 | EIN |
| Primary Activities | WELLNESS CENTER | PrimaryActivitiesTxt |
| Legal Domicile State | VA | LegalDomicileStateCd |
| Total Income | -$119,544 | TotalIncomeAmt |
| End Of Year Assets | $7,855,385 | EndOfYearAssetsAmt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CWF | BusinessNameLine1Txt |
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