SACRED HEART COMMUNITY CLINIC INC: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization
SACRED HEART COMMUNITY CLINIC INC (EIN 27-2901548)
Tax period
2018-01-01 to 2018-12-31
Filed
2019-09-23
IRS object ID
201942669349301064
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

FieldValueIRS element (for citing)
Return2019-09-23T16:50:00-06:00ReturnTs
Tax Period End2018-12-31TaxPeriodEndDt
Return Type990ReturnTypeCd
Tax Period Begin2018-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN272901548EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Sacred Heart Community ClinicBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% Jody PoslusznyInCareOfNm
Business Name ControlSACRBusinessNameControlTxt
Phone5127163929PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1620 Round Rock West Dr Ste Bldg 8AddressLine1Txt
CityRound RockCityNm
State AbbreviationTXStateAbbreviationCd
ZIP78681ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJODY POSLUSZNYPersonNm
Person TitleTreasurerPersonTitleTxt
Phone5127163929PhoneNum
Signature2019-09-20SignatureDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address70.114.179.85IPv4AddressTxt
FieldValueIRS element (for citing)
Federal Original Submission Id21010520192669983122FederalOriginalSubmissionId
Federal Original Submission Id2019-09-23FederalOriginalSubmissionIdDt
Filing License TypeOFilingLicenseTypeCd
At Submission Creation Device Id8241AD143A5D4B09DB17284636040425BDCA55DCAtSubmissionCreationDeviceId
At Submission Filing Device Id6FD366446D78B8C90FA8067AC64A8218A582B7FBAtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2018TaxYr
Build TS2019-02-21 02:37:17ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerDEBORAH HOPPSPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1620 Round Rock West Dr Ste Bldg 8AddressLine1Txt
CityRound RockCityNm
State AbbreviationTXStateAbbreviationCd
ZIP78681ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$766,645GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.sacredheartclinic.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2010FormationYr
Legal Domicile StateTXLegalDomicileStateCd
Activity Or MissionTo provide nocost outpatient health and dental services to the uninsured and underinsured residents of the Round Rock TX areaActivityOrMissionDesc
Voting Members Governing Body10VotingMembersGoverningBodyCnt
Voting Members Independent10VotingMembersIndependentCnt
Total Employee15TotalEmployeeCnt
Total Volunteers163TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$775,351PYContributionsGrantsAmt
CY Contributions Grants$610,097CYContributionsGrantsAmt
PY Program Service Revenue$417PYProgramServiceRevenueAmt
CY Program Service Revenue$505CYProgramServiceRevenueAmt
PY Investment Income$14,783PYInvestmentIncomeAmt
CY Investment Income$7,601CYInvestmentIncomeAmt
PY Other Revenue$105,932PYOtherRevenueAmt
CY Other Revenue$94,779CYOtherRevenueAmt
PY Total Revenue$896,483PYTotalRevenueAmt
CY Total Revenue$712,982CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$149,339PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$290,541CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$317,914PYOtherExpensesAmt
CY Other Expenses$358,402CYOtherExpensesAmt
PY Total Expenses$467,253PYTotalExpensesAmt
CY Total Expenses$648,943CYTotalExpensesAmt
PY Revenues Less Expenses$429,230PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$64,039CYRevenuesLessExpensesAmt
Total Assets BOY$945,022TotalAssetsBOYAmt
Total Assets EOY$1,037,476TotalAssetsEOYAmt
Total Liabilities BOY$7,331TotalLiabilitiesBOYAmt
Total Liabilities EOY$52,250TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$937,691NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$985,226NetAssetsOrFundBalancesEOYAmt
MissionTo provide no-cost outpatient basic health and dental services to the uninsured and under-insured residents of the Round Rock, TX area.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$392,210ExpenseAmt
DescBasic outpatient health care and dental sevices, diabetic and nutrition education to qualifiying uninsured and under- insured residents of the Round Rock , TX area.Desc
Total Program Service Expenses$392,210TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (true)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesYes (true)FundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredfalseScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContriYes (true)DeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document5IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld CompliancefalseBackupWthldComplianceInd
Employee15EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Form990 T FiledfalseForm990TFiledInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members10GoverningBodyVotingMembersCnt
Independent Voting Member10IndependentVotingMemberCnt
Family Or Business RlnYes (true)FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyfalseForm990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyfalseWhistleblowerPolicyInd
Document Retention PolicyfalseDocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Sacred Heart Community ClinicBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone5127163929PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1620 Round Rock West Dr Ste Bldg 8AddressLine1Txt
CityRound RockCityNm
State AbbreviationTXStateAbbreviationCd
ZIP78681ZIPCd
FieldValueIRS element (for citing)
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (11 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorInd
DEBORAH HOPPS
President3.000Yes (X)$0$0$0
RUDOLFO URIEGAS
Past Vice President1.000$0$0$0Yes (X)
NORMA R RODRIGUEZ
Secretary3.000Yes (X)$0$0$0
JODY POSLUSZNY
Treasurer4.000Yes (X)$0$0$0
FATHER DEAN WILHELM
Director$0$0$0Yes (X)
MICHAEL JACQUES
Director4.000$0$0$0Yes (X)
ISAAC KORENSTEIN
Vice President2.000Yes (X)$0$0$0
CYNTHIA FLORES
Director1.000$0$0$0Yes (X)
TINO HERNANDEZ
Past President2.000$0$0$0Yes (X)
REV DAVID KOPPEL
Director1.000$0$0$0Yes (X)
WILLIAM DROSTE
Past President3.000$0$0$0Yes (X)
FieldValueIRS element (for citing)
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KfalseTotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
Federated Campaigns$49,500FederatedCampaignsAmt
Fundraising$17,793FundraisingAmt
Government Grants$19,197GovernmentGrantsAmt
All Other Contributions$523,607AllOtherContributionsAmt
Noncash Contributions$65,618NoncashContributionsAmt
Total Contributions$610,097TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescRecord RequestsDesc
Total Revenue Column$505TotalRevenueColumnAmt
Related Or Exempt Func Income$505RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$505TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$7,610TotalRevenueColumnAmt
Exclusion$7,610ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$3,952SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$3,961SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities-$9SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$9TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$142,406FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$17,793ContriRptFundraisingEventAmt
Fundraising Direct Expenses$49,702FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$92,704TotalRevenueColumnAmt

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,075TotalRevenueColumnAmt
Exclusion$2,075ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$2,075OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$712,982TotalRevenueColumnAmt
Related Or Exempt Func Income$505RelatedOrExemptFuncIncomeAmt
Exclusion$9,685ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$269,889TotalAmt
Program Services$77,750ProgramServicesAmt
Management And General$192,139ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$20,652TotalAmt
Program Services$3,538ProgramServicesAmt
Management And General$17,114ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$7,833TotalAmt
Management And General$7,833ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$141,513TotalAmt
Program Services$141,513ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$14,882TotalAmt
Management And General$14,882ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$3,984TotalAmt
Management And General$3,984ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$3,012TotalAmt
Program Services$179ProgramServicesAmt
Management And General$2,833ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$688TotalAmt
Management And General$688ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$2,582TotalAmt
Management And General$2,582ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$25,292TotalAmt
Program Services$21,229ProgramServicesAmt
Management And General$4,063ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$6,839TotalAmt
Management And General$6,839ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Pharmaceuticals$96,637$96,637
Medical Services$26,621$26,621
Medical supplies$19,914$19,914
Fees & dues$2,442$2,442

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$6,163TotalAmt
Program Services$4,829ProgramServicesAmt
Management And General$1,334ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$648,943TotalAmt
Program Services$392,210ProgramServicesAmt
Management And General$256,733ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$181,085BOYAmt
EOY$227,242EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$36,708BOYAmt
EOY$55,894EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$9,913BOYAmt
EOY$8,067EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$668,349LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$83,084LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$601,000BOYAmt
EOY$585,265EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$116,316BOYAmt
EOY$161,008EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$945,022BOYAmt
EOY$1,037,476EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$3,695BOYAmt
EOY$6,000EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$3,636BOYAmt
EOY$46,250EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$7,331BOYAmt
EOY$52,250EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$937,691BOYAmt
EOY$958,976EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
EOY$26,250EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$937,691BOYAmt
EOY$985,226EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$945,022BOYAmt
EOY$1,037,476EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$64,039ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$16,504NetUnrlzdGainsLossesInvstAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind
Public Support Total170$0PublicSupportTotal170Amt

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$350,778CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$548,501CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$736,925CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$775,351CurrentTaxYearMinus1YearAmt
Current Tax Year$610,097CurrentTaxYearAmt
Total$3,021,652TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$350,778CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$548,501CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$736,925CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$775,351CurrentTaxYearMinus1YearAmt
Current Tax Year$610,097CurrentTaxYearAmt
Total$3,021,652TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$3,021,652PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$3,779CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,124CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,934CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$2,667CurrentTaxYearMinus1YearAmt
Current Tax Year$3,384CurrentTaxYearAmt
Total$12,888TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$3,779CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,124CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,934CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$2,667CurrentTaxYearMinus1YearAmt
Current Tax Year$3,384CurrentTaxYearAmt
Total$12,888TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$354,557CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$549,625CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$738,859CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$778,018CurrentTaxYearMinus1YearAmt
Current Tax Year$613,481CurrentTaxYearAmt
Total$3,034,540TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.99575PublicSupportCY509Pct
Investment Income CY0.00425InvestmentIncomeCYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule B IRS990ScheduleB

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Disclosed Org Leg CtrlfalseDisclosedOrgLegCtrlInd
Disclosed For Charitable PrpsfalseDisclosedForCharitablePrpsInd
Written Policy MonitoringfalseWrittenPolicyMonitoringInd
Section170h Rqr StsfdfalseSection170hRqrStsfdInd
Solicited Assets SalefalseSolicitedAssetsSaleInd
Agent Trustee EtcfalseAgentTrusteeEtcInd
Incl Escrow Custodial Acct LiabfalseInclEscrowCustodialAcctLiabInd

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$542,454InvestmentCostOrOtherBasisAmt
Depreciation$52,563DepreciationAmt
Book Value$489,891BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$125,895InvestmentCostOrOtherBasisAmt
Depreciation$30,521DepreciationAmt
Book Value$95,374BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$585,265TotalBookValueLandBuildingsAmt
Total Rev Etc Audited Fincl Stmt$948,489TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst-$16,504NetUnrealizedGainsInvstAmt
Donated Services And Use Fclts$202,309DonatedServicesAndUseFcltsAmt
Other Revenue$49,702OtherRevenueAmt
Revenue Not Reported$235,507RevenueNotReportedAmt
Revenue Subtotal$712,982RevenueSubtotalAmt
Total Revenue Per Form990$712,982TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$900,954TotExpnsEtcAuditedFinclStmtAmt
Donated Services Use Fclts$202,309DonatedServicesUseFcltsAmt
Other Expenses Included$49,702OtherExpensesIncludedAmt
Expenses Not Reported$252,011ExpensesNotReportedAmt
Expenses Subtotal$648,943ExpensesSubtotalAmt
Total Expenses Per Form990$648,943TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
P11, Ln 2dFund raising expense netted in 990 revenue. $49,702
P12, Ln 2dFund raising expense . $49,702

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1GalaEvent1Nm
Gross Receipts Event1$160,198GrossReceiptsEvent1Amt
Gross Revenue Event1$160,198GrossRevenueEvent1Amt
Non Cash Prizes Event1$3,314NonCashPrizesEvent1Amt
Rent Facility Costs Event1$4,839RentFacilityCostsEvent1Amt
Food And Beverage Event1$24,964FoodAndBeverageEvent1Amt
Entertainment Event1$8,899EntertainmentEvent1Amt
Other Direct Expenses Event1$1,777OtherDirectExpensesEvent1Amt
Gross Receipts Total$160,198GrossReceiptsTotalAmt
Gross Revenue Total Events$160,198GrossRevenueTotalEventsAmt
Non Cash Prizes Total Events$3,314NonCashPrizesTotalEventsAmt
Rent Fclty Costs Total Events$4,839RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events$24,964FoodAndBeverageTotalEventsAmt
Entertainment Total Events$8,899EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events$1,777OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$43,793DirectExpenseSummaryEventsAmt
Net Income Summary$116,405NetIncomeSummaryAmt

Schedule M IRS990ScheduleM

Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Noncash Contributions Rpt F990$65,618NoncashContributionsRptF990Amt
FieldValueIRS element (for citing)
Any Property That Must Be HeldfalseAnyPropertyThatMustBeHeldInd
Review Process Unusual NC GiftsfalseReviewProcessUnusualNCGiftsInd
Third Parties UsedfalseThirdPartiesUsedInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part VI Line 2Past VP is married clinical director(R & S Uriegas).
Part VI Line 2Past President is married to employee (Droste)
Part VI Line 11bTreasurer reviews form with Board if they meet at an appropriate time.
Part VI Line 11bOtherwise it is reviewed by President and Exec. director
Part VI Line 12cQuestioned and Reveiwed by board
Part VI Line 19All are made available upon request
Part IX Line 11gLicensed Professionals Total expenses - $141513.00 Program service expenses - $141513.00 Mgmt and general expenses - $0.00 Fundraising expenses - $0.00

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