PARTNERS IN EXCEPTIONAL CARE: Form 990EZ, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- PARTNERS IN EXCEPTIONAL CARE (EIN 39-1904074)
- Tax period
- 2015-07-01 to 2016-06-30
- Filed
- 2017-05-15
- IRS object ID
- 201741359349202459
- Schema version
- 2015v3.0
- 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 | 2017-05-15T10:04:26-05:00 | ReturnTs |
| Tax Period End | 2016-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 476097913 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SEIM JOHNSON LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 18081 BURT STREET SUITE 200 | AddressLine1Txt |
| City | OMAHA | CityNm |
| State Abbreviation | NE | StateAbbreviationCd |
| ZIP | 680224722 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990EZ | ReturnTypeCd |
| Tax Period Begin | 2015-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 391904074 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLARINDA MEDICAL FOUNDATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CLAR | BusinessNameControlTxt |
| Phone | 7125422176 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 220 ESSIE DAVISON DRIVE PO BOX 217 | AddressLine1Txt |
| City | CLARINDA | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 51632 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CHUCK MORRIS | PersonNm |
| Person Title | DIRECTOR | PersonTitleTxt |
| Phone | 7125422176 | PhoneNum |
| Signature | 2017-05-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | BARBARA J FAJEN | PreparerPersonNm |
| PTIN | P00400874 | PTIN |
| Phone | 4023302660 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990-EZ IRS990EZ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Schedule B Not Required | Yes (X) | ScheduleBNotRequiredInd |
| Website Address | WWW.CLARINDAHEALTH.COM | WebsiteAddressTxt |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Gross Receipts | $73,381 | GrossReceiptsAmt |
| Info In Schedule O Part I | Yes (X) | InfoInScheduleOPartIInd |
| Contributions Gifts Grants Etc | $30,149 | ContributionsGiftsGrantsEtcAmt |
| Investment Income | $1,389 | InvestmentIncomeAmt |
| Sale Of Assets Gross | $39,713 | SaleOfAssetsGrossAmt |
| Cost Or Other Basis Expense Sale | $40,606 | CostOrOtherBasisExpenseSaleAmt |
| Gain Or Loss From Sale Of Assets | -$893 | GainOrLossFromSaleOfAssetsAmt |
| Fundraising Gross Income | $1,870 | FundraisingGrossIncomeAmt |
| Special Events Direct Expenses | $4,224 | SpecialEventsDirectExpensesAmt |
| Special Events Net Income Loss | -$2,354 | SpecialEventsNetIncomeLossAmt |
| Other Revenue Total | $260 | OtherRevenueTotalAmt |
| Total Revenue | $28,551 | TotalRevenueAmt |
| Grants And Similar Amounts Paid | $6,549 | GrantsAndSimilarAmountsPaidAmt |
| Other Expenses Total | $980 | OtherExpensesTotalAmt |
| Total Expenses | $7,529 | TotalExpensesAmt |
| Excess Or Deficit For Year | $21,022 | ExcessOrDeficitForYearAmt |
| Net Assets Or Fund Balances BOY | $253,936 | NetAssetsOrFundBalancesBOYAmt |
| Other Changes In Net Assets | -$6,250 | OtherChangesInNetAssetsAmt |
| Net Assets Or Fund Balances EOY | $268,708 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part II | Yes (X) | InfoInScheduleOPartIIInd |
Cash Savings And Investments CashSavingsAndInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $251,489 | BOYAmt |
| EOY | $266,261 | EOYAmt |
Other Assets Total Detail OtherAssetsTotalDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,447 | BOYAmt |
| EOY | $2,447 | EOYAmt |
Form990 Total Assets Form990TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $253,936 | BOYAmt |
| EOY | $268,708 | EOYAmt |
Sum Of Total Liabilities SumOfTotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Net Assets Or Fund Balances NetAssetsOrFundBalancesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $253,936 | BOYAmt |
| EOY | $268,708 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Primary Exempt Purpose | THE FOUNDATION'S PURPOSE IS TO SOLICIT FUNDS TO ENHANCE HEALTH CARE SERVICES FOR RESIDENTS OF SOUTHWEST IOWA AND SURROUNDING COMMUNITIES AND SUPPORT THE CHARITABLE HEALTH CARE MISSION OF CLARINDA REGIONAL HEALTH CENTER. | PrimaryExemptPurposeTxt |
Program Srvc Accomplishment ProgramSrvcAccomplishmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Program Srvc Accom | CLARINDA MEDICAL FOUNDATION MANAGES THE COLLECTION AND DISBURSEMENT OF CONTRIBUTIONS FOR CLARINDA REGIONAL HEALTH CENTER. | DescriptionProgramSrvcAccomTxt |
| Grants And Allocations | $6,549 | GrantsAndAllocationsAmt |
| Program Service Expenses | $6,549 | ProgramServiceExpensesAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $6,549 | TotalProgramServiceExpensesAmt |
| Info In Schedule O Part IV | Yes (X) | InfoInScheduleOPartIVInd |
Officer Director Trustee Empl OfficerDirectorTrusteeEmplGrp (12 entries)
| TitleTitleTxt | Average Hrs Per Wk Devoted To PosAverageHrsPerWkDevotedToPosRt | CompensationCompensationAmt | Employee Benefit ProgramEmployeeBenefitProgramAmt | Expense Account Other AllwncExpenseAccountOtherAllwncAmt |
|---|---|---|---|---|
| RANDY WALTERS | ||||
| PRESIDENT | 0.30 | $0 | $0 | $0 |
| MAGGIE BROWN | ||||
| VICE PRESIDENT | 0.30 | $0 | $0 | $0 |
| WAYNE GOECKER | ||||
| SECRETARY/TREASURER | 0.30 | $0 | $0 | $0 |
| MONTY BOSWELL | ||||
| DIRECTOR | 0.30 | $0 | $0 | $0 |
| ELISSA BROCKMAN | ||||
| DIRECTOR | 0.30 | $0 | $0 | $0 |
| JOHN CLARK | ||||
| DIRECTOR | 0.30 | $0 | $0 | $0 |
| MARCY CRAIN | ||||
| DIRECTOR | 0.30 | $0 | $0 | $0 |
| DICK DAVIDSON | ||||
| DIRECTOR | 0.30 | $0 | $0 | $0 |
| TONJA DOWNEY | ||||
| DIRECTOR | 0.30 | $0 | $0 | $0 |
| MELISSA GARNER | ||||
| DIRECTOR | 0.30 | $0 | $0 | $0 |
| JEAN NEGLEY | ||||
| DIRECTOR | 0.30 | $0 | $0 | $0 |
| RON RICHARDSON | ||||
| DIRECTOR | 0.30 | $0 | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| Activities Not Previously Rpt | 0 | ActivitiesNotPreviouslyRptInd |
| Chg Made To Orgnzng Doc Not Rpt | 0 | ChgMadeToOrgnzngDocNotRptInd |
| Organization Had UBI | 0 | OrganizationHadUBIInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Organization Dissolved Etc | 0 | OrganizationDissolvedEtcInd |
| Direct Indirect Pltcl Expend | $0 | DirectIndirectPltclExpendAmt |
| Made Loans To From Officers | 0 | MadeLoansToFromOfficersInd |
| Tax Imposed Under IRC4911 | $0 | TaxImposedUnderIRC4911Amt |
| Tax Imposed Under IRC4912 | $0 | TaxImposedUnderIRC4912Amt |
| Tax Imposed Under IRC4955 | $0 | TaxImposedUnderIRC4955Amt |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| Tax Imposed On Organization Mgr | $0 | TaxImposedOnOrganizationMgrAmt |
| Tax Reimbursed By Organization | $0 | TaxReimbursedByOrganizationAmt |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | REBECCA FINCH | PersonNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 220 ESSIE DAVISON DRIVE | AddressLine1Txt |
| City | CLARINDA | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 51632 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7125422176 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Donor Advised Fnds | 0 | DonorAdvisedFndsInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Tanning Services Provided | 0 | TanningServicesProvidedInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| School Operating | 0 | SchoolOperatingInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Part VI Of Comp Of Hghst Pd Empl | NONE | PartVIOfCompOfHghstPdEmplTxt |
| Part VI Hghst Pd Cntrct Prof Srvc | NONE | PartVIHghstPdCntrctProfSrvcTxt |
| Filed Schedule A | Yes (1) | FiledScheduleAInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $293,852 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $65,493 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $17,789 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $16,548 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $30,149 | CurrentTaxYearAmt |
| Total | $423,831 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $293,852 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $65,493 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $17,789 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $16,548 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $30,149 | CurrentTaxYearAmt |
| Total | $423,831 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,635 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,452 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,770 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $868 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $960 | CurrentTaxYearAmt |
| Total | $11,685 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,635 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,452 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,770 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $868 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $960 | CurrentTaxYearAmt |
| Total | $11,685 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $412,146 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $11,913 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,234 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,210 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,363 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,389 | CurrentTaxYearAmt |
| Total | $19,109 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $11,913 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,234 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,210 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,363 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,389 | CurrentTaxYearAmt |
| Total | $19,109 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,435 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,800 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $18,939 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $18,216 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,130 | CurrentTaxYearAmt |
| Total | $48,520 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $310,200 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $72,527 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $38,938 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $36,127 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $33,668 | CurrentTaxYearAmt |
| Total | $491,460 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.83860 | PublicSupportCY509Pct |
| Public Support PY509 | 0.89130 | PublicSupportPY509Pct |
| Investment Income CY | 0.03890 | InvestmentIncomeCYPct |
| Investment Income PY | 0.02350 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | ANNUAL GOLF FUNDRAISER | Event1Nm |
| Gross Receipts Event1 | $16,987 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $15,117 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $1,870 | GrossRevenueEvent1Amt |
| Rent Facility Costs Event1 | $2,806 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $829 | FoodAndBeverageEvent1Amt |
| Other Direct Expenses Event1 | $589 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $16,987 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $15,117 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $1,870 | GrossRevenueTotalEventsAmt |
| Rent Fclty Costs Total Events | $2,806 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $829 | FoodAndBeverageTotalEventsAmt |
| Oth Direct Expnss Total Events | $589 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $4,224 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$2,354 | NetIncomeSummaryAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990-EZ, PART I, LINE 4 - OTHER INVESTMENT INCOME | DESCRIPTION: INTEREST INCOME. AMOUNT: 1,389. |
| FORM 990-EZ, PART I, LINE 8 - OTHER REVENUE | DESCRIPTION: MISCELLANEOUS. AMOUNT: 260. |
| FORM 990-EZ, PART I, LINE 10 - GRANTS AND SIMILAR AMOUNTS PAID | ACTIVITY CLASSIFICATION: GENERAL SUPPORT. GRANTEE NAME: CLARINDA REGIONAL HEALTH CENTER. GRANTEE ADDRESS: 220 ESSIE DAVISON DR CLARINDA, IA 51632. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH GRANT. AMOUNT GIVEN: 6,549. |
| FORM 990-EZ, PART I, LINE 16 - OTHER EXPENSES | DESCRIPTION: MISCELLANEOUS. AMOUNT: 620. DESCRIPTION: DUES AND SUBSCRIPTIONS. AMOUNT: 360. TOTAL TO FORM 990-EZ, LINE 16: 980. |
| FORM 990-EZ, PART I, LINE 20 - OTHER CHANGES IN NET ASSETS | DESCRIPTION: UNREALIZED GAIN/LOSS ON INVESTMENTS. AMOUNT: -6,250. |
| FORM 990-EZ, PART II, LINE 24 - OTHER ASSETS | DESCRIPTION: ACCOUNTS RECEIVABLE. BEG. OF YEAR AMOUNT: 2,447. END OF YEAR AMOUNT: 2,447. |
Transfer Prsnl Bnft Contracts Decl TransferPrsnlBnftContractsDecl
| Field | Value | IRS element (for citing) |
|---|---|---|
| Declaration | THE ORGANIZATION DID NOT, DURING THE YEAR, RECEIVE ANY FUNDS, DIRECTLY,OR INDIRECTLY, TO PAY PREMIUMS ON A PERSONAL BENEFIT CONTRACT.THE ORGANIZATION, DID NOT, DURING THE YEAR, PAY ANY PREMIUMS, DIRECTLY,OR INDIRECTLY, ON A PERSONAL BENEFIT CONTRACT. | DeclarationDesc |