COMPASSION HEALTH TOLEDO: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- COMPASSION HEALTH TOLEDO (EIN 47-3197108)
- Tax period
- 2017-01-01 to 2017-12-31
- Filed
- 2018-11-02
- IRS object ID
- 201823069349300112
- Schema version
- 2017v2.3
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-11-02T07:56:52-05:00 | ReturnTs |
| Tax Period End | 2017-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 383635706 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | REHMANN ROBSON LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7124 W CENTRAL AVE | AddressLine1Txt |
| City | TOLEDO | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 43617 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 473197108 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMPASSION HEALTH TOLEDO | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | COMP | BusinessNameControlTxt |
| Phone | 5676610565 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1638 BROADWAY ST | AddressLine1Txt |
| City | TOLEDO | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 43609 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ANN RUCH MD | PersonNm |
| Person Title | CHAIR OF BOARD | PersonTitleTxt |
| Phone | 5676610565 | PhoneNum |
| Signature | 2018-11-01 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | CAROLYN SULEWSKI | PreparerPersonNm |
| PTIN | P00449650 | PTIN |
| Phone | 4198658118 | PhoneNum |
| Preparation | 2018-11-01 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 71.10.16.3 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2018-11-01 | IPDt |
| IP Tm | 09:36:02 | IPTm |
| IP Timezone | ED | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 2A88BA5471F0B33FEC130272114476014B8442CA | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ANN RUCH MD | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1638 BROADWAY ST | AddressLine1Txt |
| City | TOLEDO | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 43609 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $348,254 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | HTTP://WWW.COMPASSIONHEALTHTOLEDO.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2015 | FormationYr |
| Legal Domicile State | OH | LegalDomicileStateCd |
| Activity Or Mission | PROVIDE CHRIST-CENTERED, INTEGRATED, AFFORDABLE AND QUALITY HEALTH CARE TO THOSE WHO NEED IT MOST. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 2 | TotalEmployeeCnt |
| Total Volunteers | 12 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $318,758 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $29,496 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $0 | PYTotalRevenueAmt |
| CY Total Revenue | $348,254 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $1,000 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $0 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $31,459 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $568 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $0 | PYOtherExpensesAmt |
| CY Other Expenses | $36,361 | CYOtherExpensesAmt |
| PY Total Expenses | $0 | PYTotalExpensesAmt |
| CY Total Expenses | $68,820 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $0 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $279,434 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $22,020 | TotalAssetsBOYAmt |
| Total Assets EOY | $302,201 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $140 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $887 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $21,880 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $301,314 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | PROVIDE CHRIST-CENTERED, INTEGRATED, AFFORDABLE AND QUALITY HEALTH CARE TO THOSE WHO NEED IT MOST. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $62,039 | ExpenseAmt |
| Grant | $1,000 | GrantAmt |
| Revenue | $29,496 | RevenueAmt |
| Desc | COMPASSION HEALTH TOLEDO OPENED JULY 31, 2017. IN THAT YEAR, CHT PROVIDED CHRIST-CENTERED, HIGH QUALITY, COMPREHENSIVE AND INTEGRATED HEALTH CARE TO 861 PATIENTS. OF THESE, 566 WERE EITHER MEDICAID RECIPIENTS OR WERE UNINSURED. ALL PATIENTS WHO PRESENTED WERE SEEN REGARDLESS OF THEIR ABILITY TO PAY. WE PROVIDED ALL PATIENTS WITH FULL MEDICAL EXAMINATIONS INCLUDING SCREENING FOR CERVICAL AND BREAST CANCER. EXAMS WERE PROVIDED BY OUR BOARD CERTIFIED PHYSICIANS INCLUDING ONE OB/GYN, 2 FAMILY DOCTORS AND 1 CARDIOLOGIST. IF INDICATED, PATIENTS RECEIVED ALL APPROPRIATE SCREENING TESTS INCLUDING (BUT NOT LIMITED TO) EKG'S, PAP SMEARS, MAMMOGRAMS, CHOLESTEROL, DIABETES, URINE EXAMS. ALL RECEIVED ANY NECESSARY MEDICATIONS, LAB WORK AND DIAGNOSTIC IMAGING. WE HAVE A SOCIAL WORKER AND 2 COMMUNITY HEALTH WORKERS WHO HELP PATIENTS WITH TRANSPORTATION ASSISTANCE, ASSISTANCE APPLYING FOR GOVERNMENT FUNDING, FACILITATION OF IN-HOME SERVICES, MENTAL HEALTH COUNSELING, APPLYING FOR SOCIAL SERVICES. IN 2017, WE PROVIDED COMPREHENSIVE PRENATAL CARE (INCLUDING DELIVERIES) FOR 55 WOMEN AND WE HAVE AN EXTRAORDINARILY LOW INFANT MORTALITY RATE CONSIDERING OUR VERY HIGH-RISK POPULATION. WE HAVE BEEN ABLE TO MAKE SIGNIFICANT IMPROVEMENTS IN THE LIVES OF OUR PATIENTS WHO SUFFER FROM CHRONIC DISEASE SUCH AS DIABETES, HYPERTENSION, ARTHRITIS AND CHRONIC PAIN. WE HAVE DEVELOPED A STRONG NETWORK OF REFERRING PHYSICIANS SO THAT OUR PATIENTS ARE ABLE TO RECEIVE CARE OR SURGERIES FROM SPECIALTY PHYSICIANS WHEN NEEDED. | Desc |
| Total Program Service Expenses | $62,039 | 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 | 0 | 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 | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | 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 | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | 0 | 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 | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | 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 | 2 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 2 | 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 | 0 | QuidProQuoContributionsInd |
| 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 |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | 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 | 0 | 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 | ZACH K STEINMETZ | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 4192833460 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1638 BROADWAY ST | AddressLine1Txt |
| City | TOLEDO | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 43609 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | Yes (X) | NoListedPersonsCompensatedInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (10 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Institutional TrusteeInstitutionalTrusteeInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd |
|---|---|---|---|---|---|---|
| LAURI COOPER JD | ||||||
| LEGAL COUNSEL | 3.00 | Yes (X) | $0 | $0 | $0 | |
| REV ROBERT HOEY | ||||||
| SPIRITUAL DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| LORI JOHNSTON | ||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |
| WENDY MARIA AVINA | ||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |
| MONICA MORALES | ||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |
| LAURA RUDOLPH | ||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |
| RACHEL EASLEY | ||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |
| ANNE RUCH MD | ||||||
| CHAIR OF BOARD | 10.00 | $0 | $0 | $0 | Yes (X) | |
| JANET ROBINSON PHD | ||||||
| VICE CHAIR & SECRETARY | 1.00 | $0 | $0 | $0 | Yes (X) | |
| BILL RUDOLPH | ||||||
| TREASURER | 10.00 | $0 | $0 | $0 | Yes (X) | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $0 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | 0 | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $35,000 | GovernmentGrantsAmt |
| All Other Contributions | $283,758 | AllOtherContributionsAmt |
| Noncash Contributions | $18,738 | NoncashContributionsAmt |
| Total Contributions | $318,758 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MEDICAL SERVICES | Desc |
| Business | 621110 | BusinessCd |
| Total Revenue Column | $29,496 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $29,496 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $29,496 | TotalProgramServiceRevenueAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $348,254 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $29,496 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,000 | TotalAmt |
| Program Services | $1,000 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,400 | TotalAmt |
| Program Services | $26,400 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,079 | TotalAmt |
| Program Services | $3,079 | ProgramServicesAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,980 | TotalAmt |
| Program Services | $1,980 | ProgramServicesAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,309 | TotalAmt |
| Program Services | $3,953 | ProgramServicesAmt |
| Management And General | $1,150 | ManagementAndGeneralAmt |
| Fundraising | $206 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $724 | TotalAmt |
| Program Services | $362 | ProgramServicesAmt |
| Fundraising | $362 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,858 | TotalAmt |
| Program Services | $5,150 | ProgramServicesAmt |
| Management And General | $708 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $660 | TotalAmt |
| Management And General | $660 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $842 | TotalAmt |
| Management And General | $842 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $634 | TotalAmt |
| Program Services | $461 | ProgramServicesAmt |
| Management And General | $173 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $100 | TotalAmt |
| Management And General | $100 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,291 | TotalAmt |
| Program Services | $11,291 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,023 | TotalAmt |
| Program Services | $3,023 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $2,831 | $2,831 | |
| MISCELLANEOUS EXPENSE | $2,781 | $520 | $2,261 |
| DUES & SUBSCRIPTIONS | $1,060 | $1,060 | |
| BANK & CREDIT CARD FEES | $711 | $711 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $537 | TotalAmt |
| Program Services | $218 | ProgramServicesAmt |
| Management And General | $319 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $68,820 | TotalAmt |
| Program Services | $62,039 | ProgramServicesAmt |
| Management And General | $6,213 | ManagementAndGeneralAmt |
| Fundraising | $568 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,020 | BOYAmt |
| EOY | $184,417 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $5,108 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $2,059 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $121,908 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $11,291 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $110,617 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,020 | BOYAmt |
| EOY | $302,201 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $140 | BOYAmt |
| EOY | $887 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $140 | BOYAmt |
| EOY | $887 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Org Does Not Follow SFAS117 | Yes (X) | OrgDoesNotFollowSFAS117Ind |
Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,880 | BOYAmt |
| EOY | $301,314 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,880 | BOYAmt |
| EOY | $301,314 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,020 | BOYAmt |
| EOY | $302,201 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $279,434 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | 0 | FSAuditedInd |
| 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 Minus1 Year | $24,253 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $318,758 | CurrentTaxYearAmt |
| Total | $343,011 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | $29,496 | CurrentTaxYearAmt |
| Total | $29,496 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | $24,253 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $348,254 | CurrentTaxYearAmt |
| Total | $372,507 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | $12,000 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $6,681 | CurrentTaxYearAmt |
| Total | $18,681 | 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) |
|---|---|---|
| Current Tax Year Minus1 Year | $12,000 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $6,681 | CurrentTaxYearAmt |
| Total | $18,681 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $353,826 | PublicSupportTotal509Amt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | $24,253 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $348,254 | CurrentTaxYearAmt |
| Total | $372,507 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| First5 Years509 | Yes (X) | First5Years509Ind |
Schedule B IRS990ScheduleB
Schedule D IRS990ScheduleD
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $42,031 | OtherCostOrOtherBasisAmt |
| Depreciation | $8,406 | DepreciationAmt |
| Book Value | $33,625 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $79,877 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,885 | DepreciationAmt |
| Book Value | $76,992 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $110,617 | TotalBookValueLandBuildingsAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | BILL & LAURA RUDOLPH, BOTH BOARD MEMBERS, ARE HUSBAND AND WIFE. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FULL 990 IS PROVIDED TO EACH BOARD MEMBER, DISCUSSED AND APPROVED BEFORE FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | ANNUALLY, THE DIRECTORS, CHIEF EXECUTIVE OFFICER AND CHIEF OPERATING OFFICER COMPLETE A NEW CONFLICT OF INTEREST FORM AND SUBMIT IT TO THE DIRECTOR OF HUMAN RESOURCES FOR REVIEW AND INCLUSION IN THEIR PERSONNEL FILE. THE DIRECTOR OF ACCOUNTING REVIEWS CONFLICT OF INTEREST FORMS RECEIVED WHICH INDICATE POTENTIAL CONFLICTS, ADVISES EMPLOYEES WITH POTENTIAL CONFLICTS, AND MONITORS THOSE ACTIVITIES WITH POTENTIAL CONFLICTS AS NECESSARY. |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENTS, CONFLICT OF INTEREST AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. |
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