SOUTHEAST MISSISSIPPI RURAL HEALTH INITIATIVE INC: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- SOUTHEAST MISSISSIPPI RURAL HEALTH INITIATIVE INC (EIN 64-0625076)
- Tax period
- 2016-02-01 to 2017-01-31
- Filed
- 2017-06-23
- IRS object ID
- 201731749349300508
- 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 | 2017-06-23T08:21:48-07:00 | ReturnTs |
| Tax Period End | 2017-01-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Terry Horne CPA & Associates PC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 732 West Main Street | AddressLine1Txt |
| City | Lebanon | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37087 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-02-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 640625076 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SOUTHEAST MISSISSIPPI RURAL HEALTH INITIATIVE INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | SOUT | BusinessNameControlTxt |
| Phone | 6015458700 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5488 US HWY 49/PO BOX 1729 | AddressLine1Txt |
| City | HATTIESBURG | CityNm |
| State Abbreviation | MS | StateAbbreviationCd |
| ZIP | 394031729 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | GEROLDEAN DYSE | PersonNm |
| Person Title | CHIEF EXECUTIVE OFFICER | PersonTitleTxt |
| Phone | 6015458700 | PhoneNum |
| Signature | 2017-06-22 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | TERRY HORNE CPA | PreparerPersonNm |
| Phone | 6154447293 | PhoneNum |
| Preparation | 2017-06-23 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 96.38.81.69 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2017-06-23 | IPDt |
| IP Tm | 08:21:31 | IPTm |
| IP Timezone | PD | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 813132FE58F5EFCDB3B149FDFD2D8B5486E0F4AC | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 813132FE58F5EFCDB3B149FDFD2D8B5486E0F4AC | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | GEROLDEAN DYSE | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5488 US HWY 49 | AddressLine1Txt |
| City | HATTIESBURG | CityNm |
| State Abbreviation | MS | StateAbbreviationCd |
| ZIP | 39403 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $20,148,480 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1979 | FormationYr |
| Legal Domicile State | MS | LegalDomicileStateCd |
| Activity Or Mission | THE ORGANIZATION PROVIDES HEALTH CARE TO INDIVIDUALS REGARDLESS OF THEIR ABILITY TO PAY. THIS IS A DIRECT FULFILLMENT OF THEIR TAX EXEMPT PURPOSE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 13 | VotingMembersIndependentCnt |
| Total Employee | 270 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $7,308,639 | PYContributionsGrantsAmt |
| CY Contributions Grants | $7,453,496 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $12,607,622 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $12,564,464 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$17,512 | PYInvestmentIncomeAmt |
| CY Investment Income | $130,520 | CYInvestmentIncomeAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $19,898,749 | PYTotalRevenueAmt |
| CY Total Revenue | $20,148,480 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $12,370,526 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $11,532,710 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $7,073,678 | PYOtherExpensesAmt |
| CY Other Expenses | $7,062,352 | CYOtherExpensesAmt |
| PY Total Expenses | $19,444,204 | PYTotalExpensesAmt |
| CY Total Expenses | $18,595,062 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $454,545 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,553,418 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $14,378,879 | TotalAssetsBOYAmt |
| Total Assets EOY | $16,097,205 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $5,500,682 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $5,635,207 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $8,878,197 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $10,461,998 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE ORGANIZATION PROVIDES HEALTH CARE | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $14,535,994 | ExpenseAmt |
| Revenue | $12,564,464 | RevenueAmt |
| Desc | THE ORGANIZATION PROVIDES HEALTH CARE REGARDLESS OF THE INDIVIDUALS ABILITY TO PAY. THESE MEDICAL SERVICES ARE PROVIDED IN AREAS THAT HAVE A SHORTAGE OF HEALTH CARE PROVIDERS. THIS IS A DIRECT FULFILLMENT OF THEIR TAX EXEMPT PURPOSE. OVER 89,500 VISITS WERE PROVIDED DURING THE YEAR. | Desc |
| Total Program Service Expenses | $14,535,994 | 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 | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | 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 | Yes (true) | 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 | Yes (true) | 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 | 22 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 270 | 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 |
| DAF Excess Business Holdings | false | DAFExcessBusinessHoldingsInd |
| Taxable Distributions | false | TaxableDistributionsInd |
| Distribution To Donor | false | DistributionToDonorInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 13 | 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 | false | 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 | Yes (true) | 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 | MS | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | POLLY EUBANKS | PersonNm |
| Phone | 6015458700 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5488 US HWY 49 | AddressLine1Txt |
| City | HATTIESBURG | CityNm |
| State Abbreviation | MS | StateAbbreviationCd |
| ZIP | 39403 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| DERRICK AUTMON | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| BILL FOLKES | ||||||||
| PRESIDENT | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| KAREN SPEED | ||||||||
| VICE PRESIDENT | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JOYCE WOULLARD | ||||||||
| TREASURER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| GINGER BURKS | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| NANNI T FREEMAN | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| SHARENE CONERLY | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| MAXINE BOLTON | ||||||||
| SECRETARY | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| HULDAH INGRAM | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| FRANKIE THOMAS | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| KATHRYN GARNER | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| KERMIT RAYBORN | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| STEVEN G MILLER | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| GEROLDEAN DYSE | ||||||||
| CHIEF EXECUTIVE OFFICER | 40.00 | $116,151 | $0 | $19,025 | Yes (X) | |||
| JAMES GRIFFIN | ||||||||
| MEDICAL DIRECTOR | 40 | $205,272 | $14,101 | Yes (X) | Yes (X) | |||
| POLLY EUBANKS | ||||||||
| CHIEF FINANCIAL OFFICER | 40 | $78,043 | $14,247 | Yes (X) | ||||
| NATHANIEL SONES | ||||||||
| CHIEF INFORMATION OFFICER | 40 | $132,908 | $8,745 | Yes (X) | ||||
| JANICE ROBINSON | ||||||||
| CHIEF HUMAN RESOURCE OFFICER | 40 | $72,312 | $11,143 | Yes (X) | ||||
| KEITH KERSTEN | ||||||||
| PHYSICIAN | 40 | $206,490 | $18,193 | Yes (X) | ||||
| QUENYATTA ECHOLS-WILLIAMS | ||||||||
| PHYSICIAN | 40 | $186,782 | $17,535 | Yes (X) | ||||
| GINGER PACE-HERNDON | ||||||||
| PHYSICIAN | 40 | $196,555 | $14,489 | Yes (X) | ||||
| CIERRA COLBERT | ||||||||
| PHYSICIAN | 40 | $175,844 | $7,150 | Yes (X) | ||||
| WILLIAM MCARTHUR | ||||||||
| PHYSICIAN | 40 | $177,171 | $11,103 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,547,528 | TotalReportableCompFromOrgAmt |
| Total Other Compensation | $135,731 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 8 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| LABCORP OF AMERICA | |||||
| 231 MAPLE AVENUE | BURLINGTON | NC | 27215 | LAB SERVICES | $277,956 |
| ALLSCRIPTS | |||||
| 24630 NETWORK PLACE | CHICAGO | IL | 606731246 | COMPUTER SERVICES | $264,383 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $6,781,290 | GovernmentGrantsAmt |
| All Other Contributions | $672,206 | AllOtherContributionsAmt |
| Total Contributions | $7,453,496 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT FEES | Desc |
| Business | 621111 | BusinessCd |
| Total Revenue Column | $12,564,464 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $12,564,464 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $130,520 | TotalRevenueColumnAmt |
| Exclusion | $130,520 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $20,148,480 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $12,564,464 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $130,520 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $604,686 | TotalAmt |
| Program Services | $205,272 | ProgramServicesAmt |
| Management And General | $399,414 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,147,148 | TotalAmt |
| Program Services | $8,158,504 | ProgramServicesAmt |
| Management And General | $988,644 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $504,342 | TotalAmt |
| Program Services | $433,734 | ProgramServicesAmt |
| Management And General | $70,608 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $588,218 | TotalAmt |
| Program Services | $501,695 | ProgramServicesAmt |
| Management And General | $86,523 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $688,316 | TotalAmt |
| Program Services | $591,960 | ProgramServicesAmt |
| Management And General | $96,356 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,965 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $1,965 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $58,720 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $58,720 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,983,977 | TotalAmt |
| Program Services | $884,936 | ProgramServicesAmt |
| Management And General | $1,099,041 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,158,800 | TotalAmt |
| Program Services | $2,373,351 | ProgramServicesAmt |
| Management And General | $785,449 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,492,984 | TotalAmt |
| Program Services | $1,194,387 | ProgramServicesAmt |
| Management And General | $298,597 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $173,166 | TotalAmt |
| Program Services | $37,963 | ProgramServicesAmt |
| Management And General | $135,203 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $135,047 | TotalAmt |
| Program Services | $108,038 | ProgramServicesAmt |
| Management And General | $27,009 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $57,693 | TotalAmt |
| Program Services | $46,154 | ProgramServicesAmt |
| Management And General | $11,539 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,595,062 | TotalAmt |
| Program Services | $14,535,994 | ProgramServicesAmt |
| Management And General | $4,059,068 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,591,216 | BOYAmt |
| EOY | $3,186,749 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $120,460 | BOYAmt |
| EOY | $374,640 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,353,646 | BOYAmt |
| EOY | $2,215,147 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $412,800 | BOYAmt |
| EOY | $376,993 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $47,243 | BOYAmt |
| EOY | $49,503 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $14,121,555 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $7,345,946 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,341,856 | BOYAmt |
| EOY | $6,775,609 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,511,658 | BOYAmt |
| EOY | $3,118,564 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,378,879 | BOYAmt |
| EOY | $16,097,205 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,563,781 | BOYAmt |
| EOY | $1,917,376 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,936,901 | BOYAmt |
| EOY | $3,717,831 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,500,682 | BOYAmt |
| EOY | $5,635,207 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,380,682 | BOYAmt |
| EOY | $10,182,302 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $497,515 | BOYAmt |
| EOY | $279,696 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,878,197 | BOYAmt |
| EOY | $10,461,998 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,378,879 | BOYAmt |
| EOY | $16,097,205 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $1,553,418 | ReconcilationRevenueExpnssAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| 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) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
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 | $7,780,469 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $7,983,319 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7,286,426 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $7,308,639 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $7,453,496 | CurrentTaxYearAmt |
| Total | $37,812,349 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $7,780,469 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $7,983,319 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7,286,426 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $7,308,639 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $7,453,496 | CurrentTaxYearAmt |
| Total | $37,812,349 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $37,812,349 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $31,179 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $18,030 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $18,356 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | -$17,512 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $130,520 | CurrentTaxYearAmt |
| Total | $180,573 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $37,992,922 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $56,122,884 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.99520 | PublicSupportCY170Pct |
| Public Support PY170 | 0.99760 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
| Public Support Total509 | $0 | PublicSupportTotal509Amt |
| Public Support CY509 | 0 | PublicSupportCY509Pct |
| Investment Income CY | 0 | InvestmentIncomeCYPct |
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
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $360,525 | InvestmentCostOrOtherBasisAmt |
| Book Value | $360,525 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $11,594,266 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $5,421,681 | DepreciationAmt |
| Book Value | $6,172,585 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $2,166,764 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $1,924,265 | DepreciationAmt |
| Book Value | $242,499 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $6,775,609 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (3 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| INVESTMENT | $1,181,682 |
| DEPOSITS | $4,381 |
| DEFERRED COMPENSATION | $1,932,501 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $3,118,564 | TotalBookValueOtherAssetsAmt |
| Total Rev Etc Audited Fincl Stmt | $20,148,480 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Subtotal | $20,148,480 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $20,148,480 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $18,595,062 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $18,595,062 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $18,595,062 | TotalExpensesPerForm990Amt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt |
|---|---|---|---|
| JAMES GRIFFIN | |||
| $205,272 | $8,001 | $6,099 | $219,372 |
| KEITH KERSTEN | |||
| $206,490 | $7,887 | $10,306 | $224,683 |
| QUENYATTA ECHOLS-WILLIAMS | |||
| $186,782 | $7,442 | $10,093 | $204,317 |
| GINGER PACE-HERNDON | |||
| $196,555 | $14,489 | $211,044 | |
| CIERRA COLBERT | |||
| $175,844 | $1,602 | $5,547 | $182,993 |
| WILLIAM MCARTHUR | |||
| $177,171 | $5,556 | $5,547 | $188,274 |
Schedule M IRS990ScheduleM
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 5510 | ContributionCnt |
| Noncash Contributions Rpt F990 | $275,476 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FAIR MARKET VALUE | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | Yes (true) | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | false | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Pt VI, Line 12c | CONFLICT OF INTEREST IS MONITORED THROUGH VARIOUS COMPANIES SUCH AS: ACCOUNTING POLICIES, EMPLOYMENT POLICIES AND COMPLIANCE POLICIES. WE CONSTANTLY MONITOR TO IDENTIFY CONFLICTS OF INTEREST AND ADDRESS THOSE ISSUES AS THEY RISE. |
| Pt VI, Line 15a | SALARY SURVEYS SUCH AS NACHC's ANNUAL SALARY SURVEY, HORNE LLP SALARY SURVEY |
| Pt VI, Line 15b | AND OTHER FQHC's HAVE BEEN CONTACTED FOR COMPARABLE SALARY INFORMATION. |
| Pt VI, Line 11b | EACH BOARD MEMBER IS PROVIDED A COPY OF THE FINAL AUDIT REPORT AND THE REPORT IS DISCUSSED DURING THE BOARD MEETING. THE CEO AND CFO PROVIDE THE INFORMATION FOR THE 990 TO BE COMPLETED AND REVIEW THE 990. |
| Pt VI, Line 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FORM 990 AVAILABLE UPON WRITTEN REQUEST. |
| Pt XII, Line 2c | THE CEO AND CFO OVERSEE FINANCIAL STATEMENT PREPARATION AND AUDIT ENGAGEMENT. |