OCRACOKE HEALTH CENTER INC: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- OCRACOKE HEALTH CENTER INC (EIN 56-1273237)
- Tax period
- 2015-02-01 to 2016-01-31
- Filed
- 2016-11-15
- IRS object ID
- 201603209349315535
- Schema version
- 2015v2.1
- 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 | 2016-11-15T16:21:15-06:00 | ReturnTs |
| Tax Period End | 2016-01-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SHERRI ROSE CPA PLLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 8732 UNION GROVE CHURCH RD | AddressLine1Txt |
| City | CHAPEL HILL | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27516 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-02-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 561273237 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OCRACOKE HEALTH CENTER INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | OCRA | BusinessNameControlTxt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 543 | AddressLine1Txt |
| City | OCRACOKE | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27960 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SUSAN PENTZ | PersonNm |
| Person Title | CHAIR | PersonTitleTxt |
| Phone | 2529288104 | PhoneNum |
| Signature | 2016-11-09 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | SHERRI ROSE | PreparerPersonNm |
| PTIN | P00695775 | PTIN |
| Phone | 9199498483 | PhoneNum |
| Preparation | 2016-11-09 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2017-02-10 21:41:12Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | SUSAN PENTZ | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 305 BACK ROAD | AddressLine1Txt |
| City | OCRACOKE | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27960 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $1,220,184 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1980 | FormationYr |
| Legal Domicile State | NC | LegalDomicileStateCd |
| Activity Or Mission | PROVIDE MEDICAL CARE AND OUTREACH TO UNDERUTILIZED COMMUNITY | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 14 | VotingMembersIndependentCnt |
| Total Employee | 12 | TotalEmployeeCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $507,373 | PYContributionsGrantsAmt |
| CY Contributions Grants | $808,644 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $160,682 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $411,540 | CYProgramServiceRevenueAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $668,055 | PYTotalRevenueAmt |
| CY Total Revenue | $1,220,184 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $313,202 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $622,600 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $231,570 | PYOtherExpensesAmt |
| CY Other Expenses | $379,991 | CYOtherExpensesAmt |
| PY Total Expenses | $544,772 | PYTotalExpensesAmt |
| CY Total Expenses | $1,002,591 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $123,283 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $217,593 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $884,653 | TotalAssetsBOYAmt |
| Total Assets EOY | $911,353 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $21,766 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $16,589 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $862,887 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $894,764 | NetAssetsOrFundBalancesEOYAmt |
| Mission | PROVIDE MEDICAL CARE AND OUTREACH TO UNDERUTILIZED COMMUNITY | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $748,661 | ExpenseAmt |
| Revenue | $411,540 | RevenueAmt |
| Desc | PROVIDE MEDICAL CARE AND OUTREACH | Desc |
| Total Program Service Expenses | $748,661 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | false | 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 | Yes (true) | 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 | 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 | Yes (true) | 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 | 1 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 12 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 14 | 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 | false | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | false | 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 |
| Other Website | Yes (X) | OtherWebsiteInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OCRACOKE MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2529281511 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 543 | AddressLine1Txt |
| City | OCRACOKE | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27960 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | Yes (X) | NoListedPersonsCompensatedInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|
| SUSAN PENTZ | |||||
| CHAIR | 1.00 | Yes (X) | $0 | $0 | $0 |
| MICHAEL ADAMS | |||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 |
| MICHAEL ADAMS | |||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 |
| MICHAEL ADAMS | |||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 |
| AMY HILTON | |||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 |
| AMY HILTON | |||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 |
| ALICE KEENEY | |||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 |
| R S SPENCER JR | |||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 |
| ART KEENEY | |||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 |
| ANN BORELAND | |||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 |
| JASON WELLS | |||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 |
| HOWARD BENNINK | |||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 |
| BENJI HART | |||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 |
| ALICE MCCABE | |||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 |
| EARL PUGH JR | |||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 |
| CLAUDIA LEWIS | |||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 |
| JULIO MORALES | |||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 |
| JUSTIN LEBLANC | |||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | false | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| Federated Campaigns | $49,159 | FederatedCampaignsAmt |
| Government Grants | $759,416 | GovernmentGrantsAmt |
| All Other Contributions | $69 | AllOtherContributionsAmt |
| Total Contributions | $808,644 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PROGRAM SERVICE REVENUE | Desc |
| Total Revenue Column | $411,540 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $411,540 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $411,540 | TotalProgramServiceRevenueAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,220,184 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $411,540 | RelatedOrExemptFuncIncomeAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $518,544 | TotalAmt |
| Program Services | $347,629 | ProgramServicesAmt |
| Management And General | $170,915 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $63,370 | TotalAmt |
| Program Services | $40,418 | ProgramServicesAmt |
| Management And General | $22,952 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $40,686 | TotalAmt |
| Program Services | $27,150 | ProgramServicesAmt |
| Management And General | $13,536 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $37,011 | TotalAmt |
| Program Services | $37,011 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,090 | TotalAmt |
| Management And General | $1,090 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,182 | TotalAmt |
| Program Services | $796 | ProgramServicesAmt |
| Management And General | $2,386 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,109 | TotalAmt |
| Program Services | $13,109 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,231 | TotalAmt |
| Program Services | $4,556 | ProgramServicesAmt |
| Management And General | $2,675 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,346 | TotalAmt |
| Program Services | $224 | ProgramServicesAmt |
| Management And General | $8,122 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,397 | TotalAmt |
| Program Services | $5,397 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $76,819 | TotalAmt |
| Program Services | $76,819 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,753 | TotalAmt |
| Program Services | $23,154 | ProgramServicesAmt |
| Management And General | $13,599 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| CHARITY CARE | $68,418 | $68,418 | |
| MAINTENANCE - BLDG | $18,576 | $11,703 | $6,873 |
| MEDICAL SUPPLIES | $18,245 | $18,245 | |
| PHARMACEUTICALS | $16,366 | $16,366 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $69,448 | TotalAmt |
| Program Services | $57,666 | ProgramServicesAmt |
| Management And General | $11,782 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,002,591 | TotalAmt |
| Program Services | $748,661 | ProgramServicesAmt |
| Management And General | $253,930 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $206,251 | BOYAmt |
| EOY | $290,774 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $46,599 | BOYAmt |
| EOY | $55,087 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,333 | BOYAmt |
| EOY | $12,112 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $1,072,697 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $519,317 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $622,470 | BOYAmt |
| EOY | $553,380 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $884,653 | BOYAmt |
| EOY | $911,353 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,789 | BOYAmt |
| EOY | $9,055 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,977 | BOYAmt |
| EOY | $7,534 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,766 | BOYAmt |
| EOY | $16,589 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $862,887 | BOYAmt |
| EOY | $894,764 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $862,887 | BOYAmt |
| EOY | $894,764 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $884,653 | BOYAmt |
| EOY | $911,353 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $217,593 | ReconcilationRevenueExpnssAmt |
| Prior Period Adjustments | -$185,716 | PriorPeriodAdjustmentsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | Yes (true) | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
| 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 Minus1 Year | $507,373 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $808,644 | CurrentTaxYearAmt |
| Total | $1,316,017 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | $507,373 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $808,644 | CurrentTaxYearAmt |
| Total | $1,316,017 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $1,316,017 | PublicSupportTotal170Amt |
| Total Support | $1,316,017 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $411,540 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 1.00000 | PublicSupportCY170Pct |
| Public Support PY170 | 1.00000 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $47,135 | OtherCostOrOtherBasisAmt |
| Book Value | $47,135 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $606,827 | OtherCostOrOtherBasisAmt |
| Depreciation | $269,047 | DepreciationAmt |
| Book Value | $337,780 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $376,248 | OtherCostOrOtherBasisAmt |
| Depreciation | $230,410 | DepreciationAmt |
| Book Value | $145,838 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $42,487 | OtherCostOrOtherBasisAmt |
| Depreciation | $19,860 | DepreciationAmt |
| Book Value | $22,627 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $553,380 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OTHER LIABILITIES | Desc |
| Amt | $7,534 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $7,534 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $1,220,184 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Subtotal | $1,220,184 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $1,220,184 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $1,002,591 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $1,002,591 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $1,002,591 | TotalExpensesPerForm990Amt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 6, PART VI, LINE 11B | THE COMPLETED 990 IS REVIEWED BY THE CFO AND DIRECTOR BEFORE IT IS FILED. THE RETURN IS PRESENTED TO THE BOARD OF DIRECTORS AS THE NEXT SCHEDULED MEETING. |
| FORM 990, PAGE 6, PART VI, LINE 15A | APPROVED BY THE BOARD |
| FORM 990, PAGE 6, PART VI, LINE 15B | REVIEWED AND APPROVED BY THE BOARD |
| FORM 990, PAGE 6, PART VI, LINE 19 | AVAILABLE UPON REQUEST |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ENGELHARD MEDICAL CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 277 | AddressLine1Txt |
| City | ENGELHARD | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27824 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 202271983 | EIN |
| Primary Activities | FQHC | PrimaryActivitiesTxt |
| Legal Domicile State | NC | LegalDomicileStateCd |
| Exempt Code Section | 501C3 | ExemptCodeSectionTxt |
| Public Charity Status | 7 | PublicCharityStatusTxt |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Controlled Organization | false | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE R | FormAndLineReferenceDesc |
| Explanation | COMMON BOARD OF DIRECTORS AND MANAGEMENT | ExplanationTxt |
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