SACRED HEART COMMUNITY CLINIC INC: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- SACRED HEART COMMUNITY CLINIC INC (EIN 27-2901548)
- Tax period
- 2016-01-01 to 2016-12-31
- Filed
- 2017-11-02
- IRS object ID
- 201733069349301558
- 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 | 2017-11-02T14:39:00-06:00 | ReturnTs |
| Tax Period End | 2016-12-31 | TaxPeriodEndDt |
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 272901548 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SACRED HEART COMMUNITY CLINIC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % Jody M Posluszny | InCareOfNm |
| Business Name Control | SACR | BusinessNameControlTxt |
| Phone | 5127163929 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 620 ROUND ROCK WEST DRIVE BLDG 8 | AddressLine1Txt |
| City | ROUND ROCK | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 78681 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JODY M POSLUSZNY | PersonNm |
| Person Title | Treasurer | PersonTitleTxt |
| Phone | 5127163929 | PhoneNum |
| Signature | 2017-11-02 | SignatureDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 70.114.179.85 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Federal Original Submission Id | 21010520173068874024 | FederalOriginalSubmissionId |
| Federal Original Submission Id | 2017-11-02 | FederalOriginalSubmissionIdDt |
| Filing License Type | O | FilingLicenseTypeCd |
| At Submission Creation Device Id | 99EDF268EEC8543503960FB1CD39BFA4922EA014 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 99EDF268EEC8543503960FB1CD39BFA4922EA014 | 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 | WILL DROSTE | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 620 Round Rock West Dr | AddressLine1Txt |
| City | Round Rock | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 78681 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $879,004 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | sacredheartclinic.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2010 | FormationYr |
| Legal Domicile State | TX | LegalDomicileStateCd |
| Activity Or Mission | To provide nocost outpatient health dental services to the uninsured and underinsured residents of the Round Rock TX area | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 4 | TotalEmployeeCnt |
| Total Volunteers | 75 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $548,501 | PYContributionsGrantsAmt |
| CY Contributions Grants | $736,925 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $81 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $519 | CYProgramServiceRevenueAmt |
| PY Investment Income | $3,000 | PYInvestmentIncomeAmt |
| CY Investment Income | $6,352 | CYInvestmentIncomeAmt |
| PY Other Revenue | $119,377 | PYOtherRevenueAmt |
| CY Other Revenue | $89,205 | CYOtherRevenueAmt |
| PY Total Revenue | $670,959 | PYTotalRevenueAmt |
| CY Total Revenue | $833,001 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $79,274 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $109,638 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $319,083 | PYOtherExpensesAmt |
| CY Other Expenses | $327,038 | CYOtherExpensesAmt |
| PY Total Expenses | $398,357 | PYTotalExpensesAmt |
| CY Total Expenses | $436,676 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $272,602 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $396,325 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $606,699 | TotalAssetsBOYAmt |
| Total Assets EOY | $769,893 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,081 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $42,856 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $604,618 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $727,037 | NetAssetsOrFundBalancesEOYAmt |
| Mission | To provide no-cost outpatient health and dental services to the uninsured and under-insured residents of the Round Rock, TX area | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $284,483 | ExpenseAmt |
| Desc | Providing free outpatient health care services to the qualifying uninsured and under-insured residents of the Round Rock, TX area | Desc |
| Total Program Service Expenses | $284,483 | 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 | 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 | 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 | 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 |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 15 | IRPDocumentCnt |
| IRP Document W2 G | 4 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 4 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | false | Form990TFiledInd |
| 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 | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (true) | 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 | false | 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 | JODY M POSLUSZNY | PersonNm |
| Phone | 5127163929 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 620 Round Rock West Dr Ste BLDG 8 | AddressLine1Txt |
| City | Round Rock | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 78681 | 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 |
|---|---|---|---|---|---|---|
| RUDOLFO URIEGAS MD | ||||||
| Vice President | 4.000 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| WILLIAM DROSTE | ||||||
| President | 4.000 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| JODY POSLUSZNY | ||||||
| Treasurer | 4.000 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| NORMA R RODRIGUEZ ESQ | ||||||
| Secretary | 2.000 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| ELIZABETH BURTON-GARCIA | ||||||
| Executive Director | 40.00 | Yes (X) | $40,000 | $0 | $0 | |
| WENDI BAIRD | ||||||
| Director | 3.000 | Yes (X) | $0 | $0 | $0 | |
| MICHELLE BURR RN | ||||||
| Clinical Director | 40.00 | Yes (X) | $40,000 | $0 | $0 | |
| SABRINA URIEGAS MD | ||||||
| Medical Director | 20.00 | Yes (X) | $50,000 | $0 | $0 | |
| MICHAEL JACQUES DDS | ||||||
| Dental Director | 4.000 | Yes (X) | $0 | $0 | $0 | |
| TINO HERNANDEZ | ||||||
| Past President | 3.000 | Yes (X) | $0 | $0 | $0 | |
| CRISTY WERNER | ||||||
| Dental Ops Director | 8.000 | Yes (X) | $7,448 | $0 | $0 | |
| FATHER DEAN WILHEIM | ||||||
| Pastor | 1.000 | Yes (X) | $0 | $0 | $0 | |
| REV DAVE KOPPELL | ||||||
| Pastor | 1.000 | Yes (X) | $0 | $0 | $0 | |
| KAREN L SOUTHMAYD MD | ||||||
| Director | 3.000 | Yes (X) | $0 | $0 | $0 | |
| DEBORAH HOPPS | ||||||
| Director | 1.000 | Yes (X) | $0 | $0 | $0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $137,448 | TotalReportableCompFromOrgAmt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | false | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| Fundraising | $19,800 | FundraisingAmt |
| All Other Contributions | $717,125 | AllOtherContributionsAmt |
| Noncash Contributions | $281,651 | NoncashContributionsAmt |
| Total Contributions | $736,925 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Record Requests | Desc |
| Business | 561000 | BusinessCd |
| Total Revenue Column | $519 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $519 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $519 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $6,351 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $6,351 | RelatedOrExemptFuncIncomeAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $41 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $40 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $135,168 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $19,800 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $45,963 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $89,205 | TotalRevenueColumnAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $833,001 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $6,870 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $101,847 | TotalAmt |
| Management And General | $101,847 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,791 | TotalAmt |
| Management And General | $7,791 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,871 | TotalAmt |
| Management And General | $7,871 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $743 | TotalAmt |
| Management And General | $743 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $199,027 | TotalAmt |
| Program Services | $199,027 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,135 | TotalAmt |
| Management And General | $10,135 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,603 | TotalAmt |
| Management And General | $3,603 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,965 | TotalAmt |
| Program Services | $91 | ProgramServicesAmt |
| Management And General | $8,874 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,745 | TotalAmt |
| Management And General | $1,745 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,197 | TotalAmt |
| Program Services | $1,227 | ProgramServicesAmt |
| Management And General | $4,970 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,603 | TotalAmt |
| Management And General | $3,603 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Pharmaceuticals | Desc |
| Total | $36,938 | TotalAmt |
| Program Services | $36,938 | ProgramServicesAmt |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $48,211 | TotalAmt |
| Program Services | $47,200 | ProgramServicesAmt |
| Management And General | $1,011 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $436,676 | TotalAmt |
| Program Services | $284,483 | ProgramServicesAmt |
| Management And General | $152,193 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $508,010 | BOYAmt |
| EOY | $219,954 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $14,175 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $477,330 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $32,836 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,318 | BOYAmt |
| EOY | $444,494 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $80,371 | BOYAmt |
| EOY | $91,270 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $606,699 | BOYAmt |
| EOY | $769,893 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,081 | BOYAmt |
| EOY | $20,656 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $4,200 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $18,000 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,081 | BOYAmt |
| EOY | $42,856 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $598,118 | BOYAmt |
| EOY | $713,814 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,500 | BOYAmt |
| EOY | $13,223 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $604,618 | BOYAmt |
| EOY | $727,037 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $606,699 | BOYAmt |
| EOY | $769,893 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $396,325 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $1,022 | NetUnrlzdGainsLossesInvstAmt |
| Donated Services And Use Fclts | -$281,651 | DonatedServicesAndUseFcltsAmt |
| Other Changes In Net Assets | $6,723 | OtherChangesInNetAssetsAmt |
| 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 |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $82,519 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $84,996 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $350,778 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $548,501 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $736,925 | CurrentTaxYearAmt |
| Total | $1,803,719 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $82,519 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $84,996 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $350,778 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $548,501 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $736,925 | CurrentTaxYearAmt |
| Total | $1,803,719 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $1,803,719 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $277 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $57 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,779 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,124 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,934 | CurrentTaxYearAmt |
| Total | $7,171 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $277 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $57 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,779 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,124 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,934 | CurrentTaxYearAmt |
| Total | $7,171 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $82,796 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $85,053 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $354,557 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $549,625 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $738,859 | CurrentTaxYearAmt |
| Total | $1,810,890 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99604 | PublicSupportCY509Pct |
| Investment Income CY | 0.00396 | InvestmentIncomeCYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Disclosed Org Leg Ctrl | false | DisclosedOrgLegCtrlInd |
| Disclosed For Charitable Prps | false | DisclosedForCharitablePrpsInd |
| Written Policy Monitoring | false | WrittenPolicyMonitoringInd |
| Section170h Rqr Stsfd | false | Section170hRqrStsfdInd |
| Solicited Assets Sale | false | SolicitedAssetsSaleInd |
| Agent Trustee Etc | false | AgentTrusteeEtcInd |
| Incl Escrow Custodial Acct Liab | false | InclEscrowCustodialAcctLiabInd |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $8,740 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $3,205 | DepreciationAmt |
| Book Value | $5,535 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $62,842 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $29,631 | DepreciationAmt |
| Book Value | $33,211 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $405,748 | InvestmentCostOrOtherBasisAmt |
| Book Value | $405,748 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $444,494 | TotalBookValueLandBuildingsAmt |
| Total Rev Etc Audited Fincl Stmt | $1,133,195 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $1,022 | NetUnrealizedGainsInvstAmt |
| Donated Services And Use Fclts | $253,209 | DonatedServicesAndUseFcltsAmt |
| Other Revenue | $45,963 | OtherRevenueAmt |
| Revenue Not Reported | $300,194 | RevenueNotReportedAmt |
| Revenue Subtotal | $833,001 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $833,001 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $1,017,499 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $253,209 | DonatedServicesUseFcltsAmt |
| Other Expenses Included | $327,614 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $580,823 | ExpensesNotReportedAmt |
| Expenses Subtotal | $436,676 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $436,676 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| P12, Ln 2d | Fund raising expense $45,963 |
| P12, Ln 2d | Donated pharmaceuticals $281,651 |
| P12, Ln 2d | Fund raising direct expense $45,963 |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | Gala | Event1Nm |
| Gross Receipts Event1 | $154,968 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $19,800 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $135,168 | GrossRevenueEvent1Amt |
| Cash Prizes Event1 | $15 | CashPrizesEvent1Amt |
| Rent Facility Costs Event1 | $6,997 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $24,832 | FoodAndBeverageEvent1Amt |
| Entertainment Event1 | $8,400 | EntertainmentEvent1Amt |
| Other Direct Expenses Event1 | $5,719 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $154,968 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $19,800 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $135,168 | GrossRevenueTotalEventsAmt |
| Cash Prizes Total Events | $15 | CashPrizesTotalEventsAmt |
| Rent Fclty Costs Total Events | $6,997 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $24,832 | FoodAndBeverageTotalEventsAmt |
| Entertainment Total Events | $8,400 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $5,719 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $45,963 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $89,205 | NetIncomeSummaryAmt |
Schedule M IRS990ScheduleM
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 2 | ContributionCnt |
| Noncash Contributions Rpt F990 | $281,651 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | Retail | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | false | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | false | ThirdPartiesUsedInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | P1, Col B | FormAndLineReferenceDesc |
| Explanation | Number of contributors | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part VI Line 1a | Executive Director, Medical Director, Dental Director and |
| Part VI Line 1a | Clinical Director are non-voting board members. |
| Part VI Line 2 | 2 members (R & S Uriegas) are married. |
| Part VI Line 11b | Form 990 reviewed with President, Treasurer and Executive Director prior. |
| Part VI Line 11b | Board will review after filing at December board meeting. |
| Part VI Line 19 | Upon request |
| Part IX Line 11g | Licensed professionals Total expenses - $199027.00 Program service expenses - $199027.00 Mgmt and general expenses - $0.00 Fundraising expenses - $0.00 |
| Part IX Line 24e | Medical Services Total expenses - $29760.00 Program service expenses - $29760.00 Mgmt and general expenses - $0.00 Fundraising expenses - $0.00 |
| Part IX Line 24e | Medical Supplies Total expenses - $11315.00 Program service expenses - $11315.00 Mgmt and general expenses - $0.00 Fundraising expenses - $0.00 |
| Part IX Line 24e | Dues & Fees Total expenses - $5326.00 Program service expenses - $5026.00 Mgmt and general expenses - $300.00 Fundraising expenses - $0.00 |
| Part IX Line 24e | Other Total expenses - $1810.00 Program service expenses - $1099.00 Mgmt and general expenses - $711.00 Fundraising expenses - $0.00 |
| Part XI Line 9 | Released from restriction (-16,682). Board restricted (23,405) |
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