COMPASSIONATE HEALTH CENTER INC: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- COMPASSIONATE HEALTH CENTER INC (EIN 32-0237943)
- Tax period
- 2016-01-01 to 2016-12-31
- Filed
- 2017-02-15
- IRS object ID
- 201730469349301043
- 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 | 2017-02-15T10:02:29-05:00 | ReturnTs |
| Tax Period End | 2016-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 261194602 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | REA LOGAN & CO LLC CPA'S | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 825 N BROADWAY | AddressLine1Txt |
| City | PERU | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 469701618 | 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 | 320237943 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMPASSIONATE HEALTH CENTER INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | COMP | BusinessNameControlTxt |
| Phone | 5742236080 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 740 ST RD 25 N | AddressLine1Txt |
| City | ROCHESTER | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46975 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MARY KAY | PersonNm |
| Person Title | EXECUTIVE DIRECTOR | PersonTitleTxt |
| Phone | 5742236080 | PhoneNum |
| Signature | 2017-02-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | ALAN SMITH CPA | PreparerPersonNm |
| PTIN | P01696030 | PTIN |
| Phone | 7654738840 | PhoneNum |
| Preparation | 2017-02-14 | PreparationDt |
Filing Security Information FilingSecurityInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| At Submission Creation Device Id | D58EB4BD66A24B8BD68F69C442D55D1C28FB7233 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | FF8070ADC3C4F006DB62AC82C8EAE614D62A4DC3 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMPASSIONATE HEALTH CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MARY KAY | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 740 N ST RD 25 | AddressLine1Txt |
| City | ROCHESTER | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46975 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $182,459 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.COMPASSIONATEHEALTHCENTER.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2008 | FormationYr |
| Legal Domicile State | IN | LegalDomicileStateCd |
| Activity Or Mission | THE MISSION OF THE FULTON COUNTY FREE CLINIC IS TO PROVIDE UNDER SERVED AND UNINSURED RESIDENTS OF FULTON COUNTY WITH HIGH-QUALITY HEALTH SCREENINGS AND PREVENTIVE HEALTH SERVICES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 8 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 5 | TotalEmployeeCnt |
| Total Volunteers | 10 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $141,401 | PYContributionsGrantsAmt |
| CY Contributions Grants | $146,091 | CYContributionsGrantsAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $18,187 | PYInvestmentIncomeAmt |
| CY Investment Income | $19,353 | CYInvestmentIncomeAmt |
| PY Other Revenue | $17,103 | PYOtherRevenueAmt |
| CY Other Revenue | $12,804 | CYOtherRevenueAmt |
| PY Total Revenue | $176,691 | PYTotalRevenueAmt |
| CY Total Revenue | $178,248 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $93,415 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $91,737 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $3,668 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $57,126 | PYOtherExpensesAmt |
| CY Other Expenses | $63,025 | CYOtherExpensesAmt |
| PY Total Expenses | $150,541 | PYTotalExpensesAmt |
| CY Total Expenses | $154,762 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $26,150 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $23,486 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $384,541 | TotalAssetsBOYAmt |
| Total Assets EOY | $394,915 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $3,503 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $3,961 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $381,038 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $390,954 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE MISSION OF THE FULTON COUNTY FREE CLINIC IS TO PROVIDE UNDER SERVED AND UNINSURED RESIDENTS OF FULTON COUNTY WITH HIGH-QUALITY HEALTH SCREENINGS AND PREVENTIVE HEALTH SERVICES. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $135,813 | ExpenseAmt |
| Desc | PROVIDE PRIMARY HEALTHCARE SERVICES AND MEDICATION ASSISTANCE FOR UNINSURED RESIDENTS OF FULTON COUNTY WHO LIVE BELOW 250% OF THE FEDERAL POVERTY LEVEL AND DO NOT QUALIFY FOR ANY STATE OR FEDERAL SPONSORED PROGRAMS. | Desc |
| Total Program Service Expenses | $135,813 | 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 | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | 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 | Yes (true) | 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 | false | 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 |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 3 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 5 | 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 |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 8 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 8 | 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 | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | false | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | IN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MARY KAY | PersonNm |
| Phone | 5742236080 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 740 N ST RD 25 | AddressLine1Txt |
| City | ROCHESTER | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46975 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (9 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd |
|---|---|---|---|---|---|---|
| MARY KAY | ||||||
| EXECUTIVE DI | 24.00 | Yes (X) | $42,256 | $0 | $0 | |
| JOHN ALLEY | ||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| NANCY GOHN | ||||||
| PRESIDENT | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| JULEEN HENDERSON | ||||||
| VICE PRESIDE | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| JUDITH SHOWLEY | ||||||
| TREASURER | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| ANGIE NILE | ||||||
| SECRETARY | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| TERRI JOHNSON | ||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| TERRY RANDALL | ||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| BARRY HAZEL | ||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $42,256 | TotalReportableCompFromOrgAmt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | false | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| All Other Contributions | $146,091 | AllOtherContributionsAmt |
| Noncash Contributions | $7,452 | NoncashContributionsAmt |
| Total Contributions | $146,091 | TotalContributionsAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $19,353 | TotalRevenueColumnAmt |
| Exclusion | $19,353 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $16,370 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $4,211 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $12,159 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS REVENUE | Desc |
| Total Revenue Column | $645 | TotalRevenueColumnAmt |
| Exclusion | $645 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $645 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $178,248 | TotalRevenueColumnAmt |
| Exclusion | $19,998 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $85,218 | TotalAmt |
| Program Services | $72,435 | ProgramServicesAmt |
| Management And General | $10,226 | ManagementAndGeneralAmt |
| Fundraising | $2,557 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,519 | TotalAmt |
| Program Services | $5,541 | ProgramServicesAmt |
| Management And General | $782 | ManagementAndGeneralAmt |
| Fundraising | $196 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $500 | TotalAmt |
| Program Services | $425 | ProgramServicesAmt |
| Management And General | $60 | ManagementAndGeneralAmt |
| Fundraising | $15 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,874 | TotalAmt |
| Program Services | $26,874 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $564 | TotalAmt |
| Program Services | $479 | ProgramServicesAmt |
| Management And General | $68 | ManagementAndGeneralAmt |
| Fundraising | $17 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,849 | TotalAmt |
| Program Services | $3,271 | ProgramServicesAmt |
| Management And General | $462 | ManagementAndGeneralAmt |
| Fundraising | $116 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,653 | TotalAmt |
| Program Services | $5,654 | ProgramServicesAmt |
| Management And General | $799 | ManagementAndGeneralAmt |
| Fundraising | $200 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,975 | TotalAmt |
| Program Services | $12,729 | ProgramServicesAmt |
| Management And General | $1,797 | ManagementAndGeneralAmt |
| Fundraising | $449 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,624 | TotalAmt |
| Program Services | $1,380 | ProgramServicesAmt |
| Management And General | $195 | ManagementAndGeneralAmt |
| Fundraising | $49 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $552 | TotalAmt |
| Program Services | $552 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,278 | TotalAmt |
| Program Services | $1,935 | ProgramServicesAmt |
| Management And General | $274 | ManagementAndGeneralAmt |
| Fundraising | $69 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $3,120 | $2,746 | $374 |
| BUSINESS REGISTRATION | $753 | $663 | $90 |
| STAFF DEVELOPMENT | $512 | $451 | $61 |
| MISCELLANEOUS | $471 | $414 | $57 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $300 | TotalAmt |
| Program Services | $264 | ProgramServicesAmt |
| Management And General | $36 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $154,762 | TotalAmt |
| Program Services | $135,813 | ProgramServicesAmt |
| Management And General | $15,281 | ManagementAndGeneralAmt |
| Fundraising | $3,668 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,810 | BOYAmt |
| EOY | $4,802 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $362,451 | BOYAmt |
| EOY | $383,393 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $33 | BOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $8,673 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $8,673 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,929 | BOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,318 | BOYAmt |
| EOY | $6,720 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $384,541 | BOYAmt |
| EOY | $394,915 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,503 | BOYAmt |
| EOY | $3,961 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,503 | BOYAmt |
| EOY | $3,961 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $372,218 | BOYAmt |
| EOY | $382,750 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,502 | BOYAmt |
| EOY | $1,484 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,318 | BOYAmt |
| EOY | $6,720 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $381,038 | BOYAmt |
| EOY | $390,954 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $384,541 | BOYAmt |
| EOY | $394,915 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $23,486 | ReconcilationRevenueExpnssAmt |
| Prior Period Adjustments | -$13,570 | PriorPeriodAdjustmentsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | false | FSAuditedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $141,473 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $154,742 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $159,011 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $141,401 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $146,091 | CurrentTaxYearAmt |
| Total | $742,718 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $141,473 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $154,742 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $159,011 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $141,401 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $146,091 | CurrentTaxYearAmt |
| Total | $742,718 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $742,718 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,559 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $9,075 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $16,365 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $18,187 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $19,353 | CurrentTaxYearAmt |
| Total | $64,539 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,400 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,816 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $762 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $882 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $645 | CurrentTaxYearAmt |
| Total | $8,505 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $815,762 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $16,370 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.91050 | PublicSupportCY170Pct |
| Public Support PY170 | 0.93570 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II, LINE 10 | FormAndLineReferenceDesc |
| Explanation | MISCELLANEOUS REVENUE 7,860 | 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
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $8,673 | OtherCostOrOtherBasisAmt |
| Depreciation | $8,673 | DepreciationAmt |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | FUNDRAISING | Event1Nm |
| Gross Receipts Event1 | $16,370 | GrossReceiptsEvent1Amt |
| Gross Revenue Event1 | $16,370 | GrossRevenueEvent1Amt |
| Other Direct Expenses Event1 | $4,211 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $16,370 | GrossReceiptsTotalAmt |
| Gross Revenue Total Events | $16,370 | GrossRevenueTotalEventsAmt |
| Oth Direct Expnss Total Events | $4,211 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $4,211 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $12,159 | NetIncomeSummaryAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 6, PART VI, LINE 11B | BOARD OF DIRECTORS ARE PROVIDED COPY OF 990 FOR REVIEW. UPON APPROVAL BY THE BOARD OF DIRECTORS, THE EXECUTIVE DIRECTOR IS GIVEN PERMISSION TO SIGN AND SUBMIT THE TAX RETURN TO THE IRS VIA E-FILE BY THE ORGANIZATION'S TAX PREPARER. |
| FORM 990, PAGE 6, PART VI, LINE 12C | CONFLICT OF INTEREST POLICY IS REQUIRED TO BE SIGNED ANNUALLY BY ALL BOARD MEMBERS, THE EXECUTIVE DIRECTOR, AND THE OFFICE MANAGER. |
| FORM 990, PAGE 6, PART VI, LINE 15A | BOARD OF DIRECTORS REVIEW THE COMPENSATION FOR THE EXECUTIVE DIRECTOR ON AN ANNUAL BASIS AND DETERMINE WHETHER CHANGES SHOULD BE MADE BASED ON THE EXECUTIVE DIRECTOR'S PERFORMANCE EVALUATION. |
| FORM 990, PAGE 6, PART VI, LINE 15B | BOARD OF DIRECTORS REVIEW THE COMPENSATION FOR THE NURSE PRACTITIONER AND OFFICE MANAGER ON AN ANNUAL BASIS AND DETERMINE WHETHER CHANGES SHOULD BE MADE BASED ON PERFORMANCE EVALUATIONS AND INPUT FROM THE EXECUTIVE DIRECTOR. |
| FORM 990, PAGE 6, PART VI, LINE 19 | DOCUMENTS AVAILABLE UPON REQUEST AT ENTITY'S OFFICE DURING REGULAR OFFICE HOURS. |
| FORM 990, PART IX, LINE 11G | MAMMOGRAM AND DENTAL SERVICE 26,874 0 0 |
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