ACCESS FAMILY HEALTH SERVICES INC: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- ACCESS FAMILY HEALTH SERVICES INC (EIN 64-0612902)
- Tax period
- 2015-02-01 to 2016-01-31
- Filed
- 2016-11-01
- IRS object ID
- 201613069349301561
- 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 | 2016-11-01T14:31:09-06:00 | ReturnTs |
| Tax Period End | 2016-01-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 474682450 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BELLENFANT PLLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 9007 OVERLOOK BOULEVARD | AddressLine1Txt |
| City | BRENTWOOD | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37027 | 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 | 640612902 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ACCESS FAMILY HEALTH SERVICES INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | ACCE | BusinessNameControlTxt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 179 | AddressLine1Txt |
| City | SMITHVILLE | CityNm |
| State Abbreviation | MS | StateAbbreviationCd |
| ZIP | 38870 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MARILYN SUMERFORD | PersonNm |
| Person Title | EXECUTIVE DIREC | PersonTitleTxt |
| Phone | 6626514686 | PhoneNum |
| Signature | 2016-05-03 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | BOB BELLENFANT CPA | PreparerPersonNm |
| PTIN | P00285790 | PTIN |
| Phone | 6153708700 | PhoneNum |
| Preparation | 2016-11-01 | 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 | MARILYN SUMERFORD | PrincipalOfficerNm |
| Gross Receipts | $6,155,005 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.ACCESSFAMILYHEALTH.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1980 | FormationYr |
| Legal Domicile State | MS | LegalDomicileStateCd |
| Activity Or Mission | THE MISSION OF ACCESS FAMILY HEALTH SERVICES, INC. IS TO PROVIDE AFFORDABLE, COMPREHENSIVE HEALTH CARE AND EDUCATION TO OUR COMMUNITIES WITH SUPERIOR SERVICES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 12 | VotingMembersIndependentCnt |
| Total Employee | 76 | TotalEmployeeCnt |
| Total Volunteers | 80 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $2,533,488 | PYContributionsGrantsAmt |
| CY Contributions Grants | $2,253,051 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $4,256,025 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $3,896,913 | CYProgramServiceRevenueAmt |
| PY Investment Income | $4,724 | PYInvestmentIncomeAmt |
| CY Investment Income | $5,041 | CYInvestmentIncomeAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $6,794,237 | PYTotalRevenueAmt |
| CY Total Revenue | $6,155,005 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $4,098,764 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $3,922,162 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,733,936 | PYOtherExpensesAmt |
| CY Other Expenses | $1,622,168 | CYOtherExpensesAmt |
| PY Total Expenses | $5,832,700 | PYTotalExpensesAmt |
| CY Total Expenses | $5,544,330 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $961,537 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $610,675 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $6,156,504 | TotalAssetsBOYAmt |
| Total Assets EOY | $6,652,607 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $459,592 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $345,020 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $5,696,912 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $6,307,587 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE MISSION OF ACCESS FAMILY HEALTH SERVICES, INC. IS TO PROVIDE AFFORDABLE, COMPREHENSIVE HEALTH CARE AND EDUCATION TO OUR COMMUNITIES WITH SUPERIOR SERVICES. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $4,638,637 | ExpenseAmt |
| Desc | PROVIDES RURAL HEALTH CARE SERVICES (DOCTORS, NURSES, PHARMACY FOR SMALL COMMUNITIES IN MISSISSIPPI IN EXCESS OF 9,000 PATIENTS AND 28,000 ENCOUNTERS PER YEAR. | Desc |
| Total Program Service Expenses | $4,638,637 | 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 | 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 | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 20 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 76 | 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 |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 12 | 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 | false | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | 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 | DANA RAMEY | PersonNm |
| Phone | 6626514686 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 179 | AddressLine1Txt |
| City | SMITHVILLE | CityNm |
| State Abbreviation | MS | StateAbbreviationCd |
| ZIP | 38870 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | Yes (X) | NoListedPersonsCompensatedInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| INITA MCMULLAN | |||||||||
| CHAIRPERSON | 2.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| DON WHITEHEAD | |||||||||
| VICE CHAIR | 2.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| BRAD STEVENS | |||||||||
| SECRETARY | 2.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| JERRY HALL | |||||||||
| TREASURER | 2.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| WILLIAM SHACK | |||||||||
| MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| NORMA DERRING | |||||||||
| MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| ANN SEALES | |||||||||
| MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| MARLON SUMMERFORD | |||||||||
| MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| ROBERT WHITEHEAD | |||||||||
| MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| DARRELL HARP JR | |||||||||
| MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| RUBY HOLLIN | |||||||||
| MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| BETTY ATKINSON | |||||||||
| MEMBER | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| BRIAN K FRILOUX | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $159,900 | $0 | $20,209 | Yes (X) | |||
| KEVIN R KOEHLER | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $212,689 | $0 | $29,040 | Yes (X) | |||
| JAMES M MONROE | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $198,576 | $0 | $25,232 | Yes (X) | |||
| NEIL R WANEE | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $200,520 | $0 | $12,535 | Yes (X) | |||
| VIVIAN DRAPER | |||||||||
| DENTIST | 40.00 | 0.00 | $117,437 | $0 | $13,150 | Yes (X) | |||
| KATHY J EVANS | |||||||||
| NURSE PRACTITIONER | 40.00 | 0.00 | $119,955 | $0 | $8,760 | Yes (X) | |||
| CARRISA I SEARCY | |||||||||
| NURSE PRACTITIONER | 40.00 | 0.00 | $100,574 | $0 | $6,084 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,109,651 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $115,010 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 14 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| Government Grants | $2,018,576 | GovernmentGrantsAmt |
| All Other Contributions | $234,475 | AllOtherContributionsAmt |
| Total Contributions | $2,253,051 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT SERVICES | Desc |
| Business | 621110 | BusinessCd |
| Total Revenue Column | $3,896,913 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,896,913 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $3,896,913 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,041 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $5,041 | RelatedOrExemptFuncIncomeAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $6,155,005 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,901,954 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,190,874 | TotalAmt |
| Program Services | $2,696,932 | ProgramServicesAmt |
| Management And General | $493,942 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $731,288 | TotalAmt |
| Program Services | $610,623 | ProgramServicesAmt |
| Management And General | $120,665 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $111,689 | TotalAmt |
| Program Services | $99,530 | ProgramServicesAmt |
| Management And General | $12,159 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $39,709 | TotalAmt |
| Program Services | $15,358 | ProgramServicesAmt |
| Management And General | $24,351 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $947 | TotalAmt |
| Program Services | $947 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $211,236 | TotalAmt |
| Program Services | $196,403 | ProgramServicesAmt |
| Management And General | $14,833 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,981 | TotalAmt |
| Program Services | $21,684 | ProgramServicesAmt |
| Management And General | $4,297 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| CONTRACTUAL SERVICES | $410,728 | $333,446 | $77,282 |
| SUPPLIES | $186,421 | $159,441 | $26,980 |
| PHARMACEUTICALS | $179,257 | $179,257 | |
| TELEPHONE | $114,921 | $102,472 | $12,449 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $341,279 | TotalAmt |
| Program Services | $222,544 | ProgramServicesAmt |
| Management And General | $118,735 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,544,330 | TotalAmt |
| Program Services | $4,638,637 | ProgramServicesAmt |
| Management And General | $905,693 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $725,199 | BOYAmt |
| EOY | $609,872 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $652,268 | BOYAmt |
| EOY | $1,732,718 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $712,510 | BOYAmt |
| EOY | $28,718 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $181,207 | BOYAmt |
| EOY | $508,495 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $73,000 | BOYAmt |
| EOY | $71,500 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $15,090 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,280 | BOYAmt |
| EOY | $31,556 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $4,730,088 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,075,430 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,798,040 | BOYAmt |
| EOY | $3,654,658 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,156,504 | BOYAmt |
| EOY | $6,652,607 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $427,337 | BOYAmt |
| EOY | $345,020 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,255 | BOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $459,592 | BOYAmt |
| EOY | $345,020 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,372,181 | BOYAmt |
| EOY | $5,982,856 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $324,731 | BOYAmt |
| EOY | $324,731 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,696,912 | BOYAmt |
| EOY | $6,307,587 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,156,504 | BOYAmt |
| EOY | $6,652,607 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $610,675 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | 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 | false | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $175,084 | OtherCostOrOtherBasisAmt |
| Book Value | $175,084 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,386,555 | OtherCostOrOtherBasisAmt |
| Depreciation | $385,775 | DepreciationAmt |
| Book Value | $3,000,780 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $263,064 | OtherCostOrOtherBasisAmt |
| Depreciation | $99,950 | DepreciationAmt |
| Book Value | $163,114 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $905,385 | OtherCostOrOtherBasisAmt |
| Depreciation | $589,705 | DepreciationAmt |
| Book Value | $315,680 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $3,654,658 | TotalBookValueLandBuildingsAmt |
| Total Rev Etc Audited Fincl Stmt | $6,155,005 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Subtotal | $6,155,005 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $6,155,005 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $5,544,330 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $5,544,330 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $5,544,330 | TotalExpensesPerForm990Amt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 (4 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt |
|---|---|---|---|---|
| BRIAN K FRILOUX | ||||
| PHYSICIAN | $159,900 | $10,544 | $9,665 | $180,109 |
| KEVIN R KOEHLER | ||||
| PHYSICIAN | $212,689 | $12,109 | $16,931 | $241,729 |
| JAMES M MONROE | ||||
| PHYSICIAN | $198,576 | $12,156 | $13,076 | $223,808 |
| NEIL R WANEE | ||||
| PHYSICIAN | $200,520 | $2,539 | $9,996 | $213,055 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Officer directors etc family relationship Part VI line 2 | THE ORGANIZATION LEASES THEIR ADMINISTRATION OFFICES FROM AN ENTITY PARTLY OWNED BY THE EXECUTIVE DIRECTOR. |
| Committee meeting documentation Part VI line 8b | THERE ARE NO COMMITTEES WITH THE AUTHORITY TO MAKE DECISIONS FOR THE BOARD OF DIRECTORS. |
| Form 990 governing body review Part VI line 11 | COPIES OF THE 990 ARE MADE AVAILABLE FOR THE BOARD OF DIRECTORS FOR REVIEW AND DISCUSSION. |
| Conflict of interest policy compliance Part VI line 12c | BOARD MEMBERS COMPLETE A CONFLICT OF INTEREST STATEMENT ANNUALLY AT THE ANNUAL MEETING IN JUNE. WHEN A CONFLICT OF INTEREST IS DISCLOSED, THE BOARD MEMBER MUST RESIGN IF IT IS IN CONFLICT WITH THE BOARDS BYLAWS. THE ORGANIZATION ALSO HAS A COMPLIANCE OFFICER THAT MONITORS COMPLIANCE WITH VARIOUS PROGRAMS. |
| Governing documents etc available to public Part VI line 19 | THE PUBLIC DOCUMENTS OF THE ORGANIZATION ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. |
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