KOINONIA PRIMARY CARE INC: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization
KOINONIA PRIMARY CARE INC (EIN 45-3448794)
Tax period
2017-01-01 to 2017-12-31
Filed
2018-07-30
IRS object ID
201832119349300503
Schema version
2017v2.2
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2018-07-30T05:36:43-07:00ReturnTs
Tax Period End2017-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN141815961PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1ROBERT J PALMERINO CPABusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line179 NORTH PEARL STAddressLine1Txt
CityALBANYCityNm
State AbbreviationNYStateAbbreviationCd
ZIP122072294ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2017-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN453448794EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1KOINONIA PRIMARY CARE INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlKOINBusinessNameControlTxt
Phone5186890282PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1553 CLINTON AVEAddressLine1Txt
CityALBANYCityNm
State AbbreviationNYStateAbbreviationCd
ZIP12206ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDR ROBERT PAEGLOWPersonNm
Person TitlePresidentPersonTitleTxt
Signature2018-07-30SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonROBERT J PALMERINO CPAPreparerPersonNm
PTINP01214589PTIN
Phone5184324930PhoneNum
Self EmployedYes (X)SelfEmployedInd
FieldValueIRS element (for citing)
Tax2017TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerHERBERT L SHULTZ JRPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1553 CLINTON AVEAddressLine1Txt
CityALBANYCityNm
State AbbreviationNYStateAbbreviationCd
ZIP12206ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$1,126,815GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
All Affiliates IncludedfalseAllAffiliatesIncludedInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresskoinoniahc.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2012FormationYr
Legal Domicile StateNYLegalDomicileStateCd
Activity Or MissionKoinonia Primary Care, Inc. (Koinonia) is a NYS Diagnostic and Treatment Center whose mission is to provide compassionate, high quality, patient-centered healthcare, in a faith-based environment, to the underserved in New Yorks Capital Region.ActivityOrMissionDesc
Voting Members Governing Body9VotingMembersGoverningBodyCnt
Voting Members Independent8VotingMembersIndependentCnt
Total Employee21TotalEmployeeCnt
Total Volunteers50TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$216,316PYContributionsGrantsAmt
CY Contributions Grants$288,568CYContributionsGrantsAmt
PY Program Service Revenue$815,427PYProgramServiceRevenueAmt
CY Program Service Revenue$838,247CYProgramServiceRevenueAmt
CY Investment Income$0CYInvestmentIncomeAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$1,031,743PYTotalRevenueAmt
CY Total Revenue$1,126,815CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$703,436PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$797,122CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$319,683PYOtherExpensesAmt
CY Other Expenses$351,670CYOtherExpensesAmt
PY Total Expenses$1,023,119PYTotalExpensesAmt
CY Total Expenses$1,148,792CYTotalExpensesAmt
PY Revenues Less Expenses$8,624PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$21,977CYRevenuesLessExpensesAmt
Total Assets BOY$334,799TotalAssetsBOYAmt
Total Assets EOY$328,074TotalAssetsEOYAmt
Total Liabilities BOY$32,137TotalLiabilitiesBOYAmt
Total Liabilities EOY$47,389TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$302,662NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$280,685NetAssetsOrFundBalancesEOYAmt
MissionKoinonia Primary Care, Inc. (Koinonia) is a NYS Diagnostic and Treatment Center that provides quality patient centered healthcare to the underserved in New Yorks Capital Region in an environment that includes the healing power of prayer. Koinonia also provides educational opportunities for patients, students, and healthcare professionals centered around Koinonias values and actively participates in transforming the community locally and globally and encouraging others to do so.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$931,033ExpenseAmt
DescKoinonia Primary Care, Inc. (Koinonia) is a NYS Diagnostic and Treatment Center that 1) provides quality patient centered healthcare to the underserved in New Yorks Capital Region in an environment that includes the healing power of prayer 2)provides educational opportunities for patients, students, and healthcare professionals centered around Koinonias values and 3) actively participate in transforming the community locally and globally and encouraging others to do so.Desc
Total Program Service Expenses$931,033TotalProgramServiceExpensesAmt
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 FootnoteYes (true)IncludeFIN48FootnoteInd
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 ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredfalseScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Invest Tax Exempt BondsfalseInvestTaxExemptBondsInd
Escrow AccountfalseEscrowAccountInd
On Behalf Of IssuerfalseOnBehalfOfIssuerInd
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 EntYes (true)BusinessRlnWithOfficerEntInd
Deductible Non Cash ContriYes (true)DeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document2IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee21EmployeeCnt
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
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Form8282 Filed0Form8282FiledCnt
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Form8899 FiledindfalseForm8899Filedind
Form1098 C FiledfalseForm1098CFiledInd
DAF Excess Business HoldingsfalseDAFExcessBusinessHoldingsInd
Taxable DistributionsfalseTaxableDistributionsInd
Distribution To DonorfalseDistributionToDonorInd
Org Filed In Lieu Of Form1041falseOrgFiledInLieuOfForm1041Ind
Licensed More Than One StatefalseLicensedMoreThanOneStateInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members9GoverningBodyVotingMembersCnt
Independent Voting Member8IndependentVotingMemberCnt
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 BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldNYStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonROBERT J PAEGLOW IIPersonNm
Phone5186890282PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1553 CLINTON AVEAddressLine1Txt
CityALBANYCityNm
State AbbreviationNYStateAbbreviationCd
ZIP12206ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (10 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerInd
DR WILLIAM CROMIE
Director1.000.00Yes (X)$0$0$0
DR FREDERICK EAMES
Director1.000.00Yes (X)$0$0$0
DR JAMES CRUCETTI
Director1.000.00Yes (X)$0$0$0
DR ROBERT PAEGLOW
President60.000.00Yes (X)$149,062$0$0Yes (X)
DAVID POLLITZER
Secretary1.000.00Yes (X)$0$0$0Yes (X)
THOMAS PUTNAM
Treasurer1.000.00Yes (X)$0$0$0Yes (X)
DEAN RUECKERT
VICE CHAIR1.000.00Yes (X)$0$0$0
HERBERT L SHULTZ JR
Chairman1.000.00Yes (X)$0$0$0Yes (X)
LISA FERRETTI
Director1.000.00Yes (X)$0$0$0
ROBERT J PAEGLOW II
COO50.000.00$69,351$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$218,413TotalReportableCompFromOrgAmt
Indiv Rcvd Greater Than100 K1IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KfalseTotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
All Other Contributions$288,568AllOtherContributionsAmt
Noncash Contributions$50,001NoncashContributionsAmt
Total Contributions$288,568TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescMEDICAL SERVICESDesc
Total Revenue Column$838,247TotalRevenueColumnAmt
Related Or Exempt Func Income$838,247RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$838,247TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Other Revenue Total$0OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,126,815TotalRevenueColumnAmt
Related Or Exempt Func Income$838,247RelatedOrExemptFuncIncomeAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$218,413TotalAmt
Program Services$141,091ProgramServicesAmt
Management And General$77,322ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$470,581TotalAmt
Program Services$402,555ProgramServicesAmt
Management And General$68,026ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$52,793TotalAmt
Program Services$41,656ProgramServicesAmt
Management And General$11,137ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$55,335TotalAmt
Program Services$43,662ProgramServicesAmt
Management And General$11,673ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$6,000TotalAmt
Management And General$6,000ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$4,400TotalAmt
Program Services$3,000ProgramServicesAmt
Management And General$1,400ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$7,692TotalAmt
Program Services$6,069ProgramServicesAmt
Management And General$1,623ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$55,000TotalAmt
Program Services$43,397ProgramServicesAmt
Management And General$11,603ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$3,431TotalAmt
Program Services$2,707ProgramServicesAmt
Management And General$724ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$26,453TotalAmt
Program Services$20,873ProgramServicesAmt
Management And General$5,580ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$18,041TotalAmt
Program Services$14,235ProgramServicesAmt
Management And General$3,806ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
BILLING SERVICE$53,753$53,753
MEDICAL SUPPLIES$44,809$44,809
EQUIPMENT MAINT AND REPAIRS$44,128$34,819$9,309
PROFESSIONAL LIABILITY INSURAN$25,163$25,163

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$62,800TotalAmt
Program Services$53,244ProgramServicesAmt
Management And General$9,556ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$1,148,792TotalAmt
Program Services$931,033ProgramServicesAmt
Management And General$217,759ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$92,487BOYAmt
EOY$135,640EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$92,188BOYAmt
EOY$51,856EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$6,938BOYAmt
EOY$19,170EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$247,761LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$126,353LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$143,186BOYAmt
EOY$121,408EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$334,799BOYAmt
EOY$328,074EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$32,137BOYAmt
EOY$47,389EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$32,137BOYAmt
EOY$47,389EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$277,119BOYAmt
EOY$280,685EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$25,543BOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$302,662BOYAmt
EOY$280,685EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$334,799BOYAmt
EOY$328,074EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$21,977ReconcilationRevenueExpnssAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$204,166CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$182,867CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$188,360CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$216,316CurrentTaxYearMinus1YearAmt
Current Tax Year$288,568CurrentTaxYearAmt
Total$1,080,277TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$449,853CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$593,572CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$704,517CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$815,427CurrentTaxYearMinus1YearAmt
Current Tax Year$838,247CurrentTaxYearAmt
Total$3,401,616TotalAmt

Tax Rev Levied Orgnztnl Bnft509 TaxRevLeviedOrgnztnlBnft509Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Govt Furn Srvc Fclts Vl509 GovtFurnSrvcFcltsVl509Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$654,019CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$776,439CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$892,877CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,031,743CurrentTaxYearMinus1YearAmt
Current Tax Year$1,126,815CurrentTaxYearAmt
Total$4,481,893TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years$30,000CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$37,458CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$28,500CurrentTaxYearMinus1YearAmt
Current Tax Year$80,001CurrentTaxYearAmt
Total$175,959TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years$39,472CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$52,142CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$49,366CurrentTaxYearMinus1YearAmt
Current Tax Year$124,758CurrentTaxYearAmt
Total$265,738TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years$69,472CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$89,600CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$77,866CurrentTaxYearMinus1YearAmt
Current Tax Year$204,759CurrentTaxYearAmt
Total$441,697TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$4,040,196PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Post1975 UBTI Post1975UBTIGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Net Income From Other UBI NetIncomeFromOtherUBIGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$654,019CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$776,439CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$892,877CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,031,743CurrentTaxYearMinus1YearAmt
Current Tax Year$1,126,815CurrentTaxYearAmt
Total$4,481,893TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.90140PublicSupportCY509Pct
Public Support PY5091.00000PublicSupportPY509Pct
Investment Income CY0.00000InvestmentIncomeCYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$153,390OtherCostOrOtherBasisAmt
Depreciation$53,687DepreciationAmt
Book Value$99,703BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$94,371OtherCostOrOtherBasisAmt
Depreciation$72,666DepreciationAmt
Book Value$21,705BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$121,408TotalBookValueLandBuildingsAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$1,266,014TotalRevEtcAuditedFinclStmtAmt
Donated Services And Use Fclts$113,656DonatedServicesAndUseFcltsAmt
Other Revenue$25,543OtherRevenueAmt
Revenue Not Reported$139,199RevenueNotReportedAmt
Revenue Subtotal$1,126,815RevenueSubtotalAmt
Total Revenue Per Form990$1,126,815TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$1,262,448TotExpnsEtcAuditedFinclStmtAmt
Donated Services Use Fclts$113,656DonatedServicesUseFcltsAmt
Expenses Not Reported$113,656ExpensesNotReportedAmt
Expenses Subtotal$1,148,792ExpensesSubtotalAmt
Total Expenses Per Form990$1,148,792TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Part X : FIN48 FootnoteKoinonia adopted the authoritative guidance on accounting for and disclosure of uncertainty in tax positions as required by generally accepted accounting principles with no cumulative adjustment required.Income tax benefits are recognized for income tax positions taken or expected to be taken on a tax return, only when it is deemed that the income tax position will be more likely than not sustained upon examination by taxing authorities. Koinonia believes that its income tax positions would be sustained under examination by taxing authorities. Generally, tax years prior to 2014 are no longer subject to examination.
Part XI, Line 2d: Other revenue amounts included in F/S but not included on form 990NET ASSETS RELEASED FROM RESTRICTIONS $25543

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

FieldValueIRS element (for citing)
PersonRESSURECTION MINISTRIESPersonNm
FieldValueIRS element (for citing)
Relationship DescriptionCOMMON BRD MEMBERSRelationshipDescriptionTxt
Transaction$55,000TransactionAmt
TransactionOFFICE RENT PAYMENTSTransactionDesc
Sharing Of RevenuesfalseSharingOfRevenuesInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule L, Part V Supplemental InformationFormAndLineReferenceDesc
ExplanationRESSURECTION MINISTRIES (A 501(C)(3)) AND KOINONIA PRIMARY CARE, INC. HAVE COMMON BOARD MEMBERS. KOINONIA PRIMARY CARE, INC. LEASES ITS OFFICE SPACE FROM RESSURECTION MINISTRIES. SEE ALSO SCHEDULE RExplanationTxt

Schedule M IRS990ScheduleM

Securities Publicly Traded SecuritiesPubliclyTradedGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Contribution1ContributionCnt
Noncash Contributions Rpt F990$50,001NoncashContributionsRptF990Amt
Method Of Determining RevenuesCOMPARABLE SALESMethodOfDeterminingRevenuesTxt
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 (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Line 2: Description of Business or Family Relationship of Officers, Directors, EtTHE COO IS THE SON OF THE PRESIDENT
Form 990, Part VI, Line 11b: Form 990 Review ProcessTHE FINANCE COMMITTEE REVIEWS THE 990 AND PRESENTS IT TO THE BOARD BEFORE FILING
Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of ConflictsANNUALLY, BOARD MEMBERS ARE PROVIDED WITH THE CONFLICT OF INTEREST POLICY AND CONFIRM THAT NO CONFLICTS EXIST OR PROVIDE DETAILS IF A CONFLICT OR POTENTIAL CONFLICT EXISTS
Form 990, Part VI, Line 15a: Compensation Review & Approval Process - CEO, Top ManagementAll compensation and review procedures are established by the finance committee based on the review of similar non-profit's compensation structure, current market rate and standard human resource guidelines. Compensation is reviewed during the annual budgeting process and submitted to the Board for final approval.
Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailablePROVIDED UPON REQUEST

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1RESURRECTION MINISTRIESBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1553 CLINTON AVEAddressLine1Txt
CityALBANYCityNm
State AbbreviationNYStateAbbreviationCd
ZIP12206ZIPCd
FieldValueIRS element (for citing)
EIN542110332EIN
Primary ActivitiesNOT FOR PROFITPrimaryActivitiesTxt
Legal Domicile StateNYLegalDomicileStateCd
Exempt Code Section501 (c) 3ExemptCodeSectionTxt
Public Charity StatusPUBLIC CHARITYPublicCharityStatusTxt
Direct Controlling NAN/ADirectControllingNACd
Controlled OrganizationfalseControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (true)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingfalsePaidEmployeesSharingInd
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

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