GIRDWOOD HEALTH CLINIC: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- GIRDWOOD HEALTH CLINIC (EIN 90-0622646)
- Tax period
- 2016-01-01 to 2016-12-31
- Filed
- 2017-06-19
- IRS object ID
- 201741709349300729
- Schema version
- 2016v3.0
- 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 | 2017-06-19T15:32:34-07:00 | ReturnTs |
| Tax Period End | 2016-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FOSTER AND COMPANY LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 872194 | AddressLine1Txt |
| City | WASILLA | CityNm |
| State Abbreviation | AK | StateAbbreviationCd |
| ZIP | 996872194 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 900622646 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Girdwood Health Clinic Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | GIRD | BusinessNameControlTxt |
| Phone | 9077831355 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 1130 | AddressLine1Txt |
| City | Girdwood | CityNm |
| State Abbreviation | AK | StateAbbreviationCd |
| ZIP | 99587 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | LOUIS THEISS | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 9077831355 | PhoneNum |
| Signature | 2017-06-19 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KAREN FOSTER | PreparerPersonNm |
| Phone | 9073766901 | PhoneNum |
| Preparation | 2017-06-19 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 64.4.232.50 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2017-06-19 | IPDt |
| IP Tm | 15:32:23 | IPTm |
| IP Timezone | PD | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 9CAE34220E061CD2CEBE5122E9C8042A99237A70 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 9CAE34220E061CD2CEBE5122E9C8042A99237A70 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2018-03-14 21:41:22Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | LOUIS THEISS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 1130 | AddressLine1Txt |
| City | Girdwood | CityNm |
| State Abbreviation | AK | StateAbbreviationCd |
| ZIP | 99587 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $1,119,345 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.girdwoodhealthclinic.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2011 | FormationYr |
| Legal Domicile State | AK | LegalDomicileStateCd |
| Activity Or Mission | Provide expanded, quality health care to residents and visitors of the area without regard to ability to pay, through the operation of a sustainable, nonprofit community health clinic. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 12 | VotingMembersIndependentCnt |
| Total Employee | 12 | TotalEmployeeCnt |
| Total Volunteers | 20 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $322,495 | PYContributionsGrantsAmt |
| CY Contributions Grants | $773,825 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $295,404 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $345,420 | CYProgramServiceRevenueAmt |
| PY Investment Income | $17 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $957 | PYOtherRevenueAmt |
| CY Other Revenue | $100 | CYOtherRevenueAmt |
| PY Total Revenue | $618,873 | PYTotalRevenueAmt |
| CY Total Revenue | $1,119,345 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $374,218 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $679,851 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $15,719 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $222,626 | PYOtherExpensesAmt |
| CY Other Expenses | $274,064 | CYOtherExpensesAmt |
| PY Total Expenses | $596,844 | PYTotalExpensesAmt |
| CY Total Expenses | $953,915 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $22,029 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $165,430 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $324,061 | TotalAssetsBOYAmt |
| Total Assets EOY | $475,917 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $130,664 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $117,090 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $193,397 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $358,827 | NetAssetsOrFundBalancesEOYAmt |
| Mission | Provide expanded, quality health care | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $800,888 | ExpenseAmt |
| Revenue | $345,520 | RevenueAmt |
| Desc | THE GIRDWOOD HEALTH CLINIC INC (GHCI) OFFERS PRIMARY AND URGENT HEALTH CARE FOR PERMANENT AND SEASONAL RESIDENTS OF THE TURNAGAIN ARM AREA, AS WELL AS TOURISTS VISITING THE RESORT TOWN. THE CLINIC OFFERS X-RAY SERVICES AND IS ABLE TO PROVIDE CASTING AND SPLINTING, WOUND CARE INCLUDING STITCHES, MEDICATIONS AND LAB SERVICES. THE CLINIC PARTICIPATES IN THE STATE OF ALASKA BREAST AND CERVICAL HEALTH CHECK PROGRAM WHICH FUNDS PAP TEST AND MAMMOGRAMS FOR LOW INCOME WOMEN. THE CLINIC ALSO PARTICIPATES IN THE ALASKA DEPARTMENT OF HEALTH AND SOCIAL SERVICES EPIDEMIOLOGY VACCINE DEPOT IMMUNIZATION PROGRAM WHICH OFFERS VACCINES TO PATIENTS IN NEED, UNDERINSURED OR INSURED. A DISCOUNT FEE SCHEDULE BASED ON FPL IS OFFERED TO ALL PATIENTS. MEDICARE AND MEDICAID PAYMENTS ACCEPTED AS WELL AS PRIVATE INSURANCE. ON AUGUST 1, 2015, THE GIRDWOOD HEALTH CLINIC WAS AWARDED A FEDERAL GRANT TO BECOME A FEDERALLY QUALIFIED COMMUNITY HEALTH CENTER. THIS GRANT WILL ALLOW THE CLINIC TO EXPAND ITS PRIMARY HEALTHCARE OPTIONS TO BECOME MORE COMPREHENSIVE AND TO PROVIDE OUTREACH AND ENROLLMENT FOR INDIVIDUALS. | Desc |
| Total Program Service Expenses | $800,888 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | false | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | Yes (true) | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | false | TransactionWithControlEntInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 1 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 12 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 12 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | false | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TERRY SHERWOOD | PersonNm |
| Phone | 9077831355 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 1130 | AddressLine1Txt |
| City | Girdwood | CityNm |
| State Abbreviation | AK | StateAbbreviationCd |
| ZIP | 99587 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (15 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|
| LOUIS THEISS | ||||||
| President | 3.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| CAMILLA SEIFERT | ||||||
| Vice President | 3.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| TERRY SHERWOOD | ||||||
| Treasurer | 3.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| LAUREL MCFADDEN | ||||||
| Secretary | 3.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| KATHY TRAUTNER | ||||||
| Director | 3.00 | Yes (X) | $0 | $0 | $0 | |
| CLEARY DONOVAN | ||||||
| Director | 3.00 | Yes (X) | $0 | $0 | $0 | |
| PAT PREIS | ||||||
| Director | 3.00 | Yes (X) | $0 | $0 | $0 | |
| KALIE HARRISON | ||||||
| Director | 3.00 | Yes (X) | $0 | $0 | $0 | |
| JERRY REICHLIN | ||||||
| Director | 3.00 | Yes (X) | $0 | $0 | $0 | |
| ROBIN INGRIM | ||||||
| Director | 3.00 | Yes (X) | $0 | $0 | $0 | |
| MARY JO THILL | ||||||
| Director | 3.00 | Yes (X) | $0 | $0 | $0 | |
| DEBRA CROGHAN | ||||||
| Director | 3.00 | Yes (X) | $0 | $0 | $0 | |
| ROCHELLE MORRIS | ||||||
| Director | 3.00 | Yes (X) | $0 | $0 | $0 | |
| DORINDA CARNER | ||||||
| Director | 3.00 | Yes (X) | $0 | $0 | $0 | |
| TAWNY BUCK | ||||||
| Executive Director | 40 | Yes (X) | $113,940 | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $113,940 | TotalReportableCompFromOrgAmt |
| Indiv Rcvd Greater Than100 K | 1 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | false | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| Government Grants | $732,269 | GovernmentGrantsAmt |
| All Other Contributions | $41,556 | AllOtherContributionsAmt |
| Noncash Contributions | $1,171 | NoncashContributionsAmt |
| Total Contributions | $773,825 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt |
|---|---|---|
| Program Fees | 900099 | $344,462 |
| Flu Vaccine Program | 900099 | $958 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $345,420 | TotalProgramServiceRevenueAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | BCHC enrollment fees, health fair | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $100 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $100 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $100 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,119,345 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $345,520 | RelatedOrExemptFuncIncomeAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $113,940 | TotalAmt |
| Program Services | $90,720 | ProgramServicesAmt |
| Management And General | $16,009 | ManagementAndGeneralAmt |
| Fundraising | $7,211 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $441,543 | TotalAmt |
| Program Services | $368,989 | ProgramServicesAmt |
| Management And General | $65,115 | ManagementAndGeneralAmt |
| Fundraising | $7,439 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $44,519 | TotalAmt |
| Program Services | $37,841 | ProgramServicesAmt |
| Management And General | $6,678 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $79,849 | TotalAmt |
| Program Services | $67,872 | ProgramServicesAmt |
| Management And General | $11,977 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $35,180 | TotalAmt |
| Program Services | $29,903 | ProgramServicesAmt |
| Management And General | $5,277 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $67,119 | TotalAmt |
| Program Services | $57,051 | ProgramServicesAmt |
| Management And General | $10,068 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,777 | TotalAmt |
| Program Services | $3,683 | ProgramServicesAmt |
| Management And General | $650 | ManagementAndGeneralAmt |
| Fundraising | $444 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $35,571 | TotalAmt |
| Program Services | $30,411 | ProgramServicesAmt |
| Management And General | $5,160 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $53,943 | TotalAmt |
| Program Services | $45,852 | ProgramServicesAmt |
| Management And General | $8,091 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,811 | TotalAmt |
| Program Services | $10,039 | ProgramServicesAmt |
| Management And General | $1,772 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,934 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $3,934 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $43,922 | TotalAmt |
| Program Services | $43,922 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,229 | TotalAmt |
| Program Services | $11,245 | ProgramServicesAmt |
| Management And General | $1,984 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| Memberships | $3,184 | $2,706 | $478 | $0 |
| Equipment Purchases | $769 | $654 | $115 | $0 |
| Fundraising Costs | $625 | $0 | $0 | $625 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $953,915 | TotalAmt |
| Program Services | $800,888 | ProgramServicesAmt |
| Management And General | $137,308 | ManagementAndGeneralAmt |
| Fundraising | $15,719 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,968 | BOYAmt |
| EOY | $66,335 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,860 | BOYAmt |
| EOY | $14,280 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $46,042 | BOYAmt |
| EOY | $56,344 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,975 | BOYAmt |
| EOY | $4,491 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $397,031 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $115,853 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $166,894 | BOYAmt |
| EOY | $281,178 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $57,132 | BOYAmt |
| EOY | $51,899 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,190 | BOYAmt |
| EOY | $1,390 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $324,061 | BOYAmt |
| EOY | $475,917 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $50,753 | BOYAmt |
| EOY | $38,190 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $79,911 | BOYAmt |
| EOY | $78,900 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $130,664 | BOYAmt |
| EOY | $117,090 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $193,397 | BOYAmt |
| EOY | $358,827 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $193,397 | BOYAmt |
| EOY | $358,827 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $324,061 | BOYAmt |
| EOY | $475,917 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $165,430 | ReconcilationRevenueExpnssAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
| Public Support Total170 | $0 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY170 | 0 | PublicSupportCY170Pct |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $67,855 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $383,509 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $242,109 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $322,495 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $773,825 | CurrentTaxYearAmt |
| Total | $1,789,793 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $426,324 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $384,953 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $357,619 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $295,404 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $345,420 | CurrentTaxYearAmt |
| Total | $1,809,720 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $494,179 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $768,462 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $599,728 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $617,899 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,119,245 | CurrentTaxYearAmt |
| Total | $3,599,513 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $31,269 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $24,966 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $15,000 | CurrentTaxYearMinus2YearsAmt |
| Total | $71,235 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $31,269 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $24,966 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $15,000 | CurrentTaxYearMinus2YearsAmt |
| Total | $71,235 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $3,528,278 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $24 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $22 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $23 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $17 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $9 | CurrentTaxYearAmt |
| Total | $95 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $24 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $22 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $23 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $17 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $9 | CurrentTaxYearAmt |
| Total | $95 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | $6,876 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $957 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $100 | CurrentTaxYearAmt |
| Total | $7,933 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,607,541 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.97800 | PublicSupportCY509Pct |
| Investment Income CY | 0 | InvestmentIncomeCYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Pt III Ln 12 | FormAndLineReferenceDesc |
| Explanation | Other Income Part III, Line 12 Description: Enrollment fees, health fair 2012: 0. 2013: 0. 2014: 6876. 2015: 957. 2016: 100. | ExplanationTxt |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $119,704 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,677 | DepreciationAmt |
| Book Value | $117,027 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $277,327 | OtherCostOrOtherBasisAmt |
| Depreciation | $113,176 | DepreciationAmt |
| Book Value | $164,151 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $281,178 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $1,126,088 | TotalRevEtcAuditedFinclStmtAmt |
| Donated Services And Use Fclts | $6,741 | DonatedServicesAndUseFcltsAmt |
| Revenue Not Reported | $6,741 | RevenueNotReportedAmt |
| Revenue Subtotal | $1,119,347 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $1,119,347 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $960,658 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $6,741 | DonatedServicesUseFcltsAmt |
| Expenses Not Reported | $6,741 | ExpensesNotReportedAmt |
| Expenses Subtotal | $953,917 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $953,917 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Pt X, Line 2 | FormAndLineReferenceDesc |
| Explanation | The Clinic is exempt from federal income taxes under Section 501(c)(3) of the Internal Revenue Code, and is exempt from State income taxes under the Alaska Nonprofit Corporation Act. Therefore, the accompanying statements do not reflect a provision for income taxes. Although the Organization is exempt from federal income taxes, any income derived from unrelated business activities is subject to the requirement of filing Federal Income Tax Form 990-T and a tax liability may be determined on these activities. The Organization believes that it has appropriate support for any tax positions taken, and as such does not have any uncertain tax positions that are material to the financial statements. | ExplanationTxt |
Schedule L IRS990ScheduleL
Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp (2 entries)
| Relationship With OrgRelationshipWithOrgTxt | Loan PurposeLoanPurposeTxt | Loan To OrganizationLoanToOrganizationInd | Original PrincipalOriginalPrincipalAmt | Balance DueBalanceDueAmt | DefaultDefaultInd | Board Or Committee ApprovalBoardOrCommitteeApprovalInd | Written AgreementWrittenAgreementInd |
|---|---|---|---|---|---|---|---|
| John Trautner | |||||||
| Owner, Alyeska Mgmt | Trailer Purchase | Yes (X) | $25,000 | $23,791 | false | Yes (true) | Yes (true) |
| KERRY DORIUS | |||||||
| Former Employee | Asset Purchase | Yes (X) | $135,500 | $59,109 | false | Yes (true) | Yes (true) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | $82,900 | TotalBalanceDueAmt |
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PartII, Ln 2 | Asset Acquisition Statement under Section 1060 |
| PartII, Ln 2 | Purchaser: Girdwood Health Clinic, Inc |
| PartII, Ln 2 | Seller: Kerry L Dorius |
| PartII, Ln 2 | Date of Sale: 12-22-2011 Total Sales Price: 135,500 |
| PartII, Ln 2 | Allocation of Sales Price: Class V Assets: 57,000 Class VI and VII Assets: 78,500 |
| PartII, Ln 2 | - |
| PartII, Ln 2 | A written agreement was signed by both parties which provided for an allocation of the sales price. This sale was done on an installment basis. Payments began in 2012. The remaining balance of the loan at 12-31-16 was 55,109. |
| PartII, Ln 1 | Purchase of Mobile Office Trailer from Alyeska Management Services |
| PartII, Ln 1 | for $25,000 on 10/01/16. Owner is husband of Kathy Trautner, Board |
| PartII, Ln 1 | Director. This sale was done on an installment basis. Payments began in 2016. The remaining balance of the loan at 12-31-16 was 23,791. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Pt VI, Line 11b | The Board recieves a copy of the return, reviews and approves the Form 990 in their regular meeting prior to filing. |
| Pt VI, Line 12c | The conflict of interest policy is included in the by-laws of the organization. The policy is enforced through self-monitoring and is reviewed and discussed regularly at Board meetings. |
| Pt VI, Line 19 | The Organization make its governing documents, conflict of interest policy and financial statements available to the public by request. |
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