ST MARYS HEALTH WAGON: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- ST MARYS HEALTH WAGON (EIN 04-3739083)
- Tax period
- 2015-01-01 to 2015-12-31
- Filed
- 2016-09-27
- IRS object ID
- 201632719349300823
- Schema version
- 2015v2.0
- 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 | 2016-09-27T13:20:19-07:00 | ReturnTs |
| Tax Period End | 2015-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Larry D Sturgill CPA PC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 2080 | AddressLine1Txt |
| City | WISE | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 24293 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 043739083 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST MARYS HEALTH WAGON INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | STMA | BusinessNameControlTxt |
| Phone | 2763288550 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 7070 | AddressLine1Txt |
| City | WISE | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 24293 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TERESA GARDNER | PersonNm |
| Person Title | Director | PersonTitleTxt |
| Signature | 2016-05-23 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | LARRY D STURGILL | PreparerPersonNm |
| PTIN | P00381273 | PTIN |
| Phone | 2763289593 | PhoneNum |
| 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) |
|---|---|---|
| Gross Receipts | $1,661,856 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| All Affiliates Included | false | AllAffiliatesIncludedInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | THEHEALTHWAGON.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2004 | FormationYr |
| Legal Domicile State | VA | LegalDomicileStateCd |
| Activity Or Mission | THE HEALTH WAGON'S PURPOSE IS TO OVERSEE THE DELIVERY OF CHARITABLE HEALTH CARE THROUGH PREVENTATIVE AND PRIMARY SERVICES TO PEOPLE IN RURAL SOUTHWEST VIRGINIA. | ActivityOrMissionDesc |
| Voting Members Governing Body | 15 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 15 | VotingMembersIndependentCnt |
| Total Employee | 22 | TotalEmployeeCnt |
| Total Volunteers | 15 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $2,451,912 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,640,616 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $40,450 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $20,441 | CYProgramServiceRevenueAmt |
| PY Investment Income | $59,627 | PYInvestmentIncomeAmt |
| CY Investment Income | $799 | CYInvestmentIncomeAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $2,551,989 | PYTotalRevenueAmt |
| CY Total Revenue | $1,661,856 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $862,267 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $976,027 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $6,431 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $595,451 | PYOtherExpensesAmt |
| CY Other Expenses | $600,666 | CYOtherExpensesAmt |
| PY Total Expenses | $1,457,718 | PYTotalExpensesAmt |
| CY Total Expenses | $1,576,693 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,094,271 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $85,163 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $4,275,693 | TotalAssetsBOYAmt |
| Total Assets EOY | $4,352,000 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $81,355 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $72,499 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $4,194,338 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $4,279,501 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE HEALTH WAGON'S PURPOSE IS TO OVERSEE THE DELIVERY OF CHARITABLE HEALTH CARE THROUGH PREVENTATIVE AND PRIMARY SERVICES TO PEOPLE IN RURAL SOUTHWEST VIRGINIA. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $1,509,585 | ExpenseAmt |
| Desc | THE HEALTH WAGON PROVICES COMAPASSIONATE QUALITY CHARITABLE HEALTH CARE TO THE MEDICALLY UNDERSERVED PEOPLE IN THE VIRGINIA MOUNTAINS OF APPALACHIA. | Desc |
| Total Program Service Expenses | $1,509,585 | 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 | 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 | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBondsInd |
| Escrow Account | false | EscrowAccountInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| 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 |
| Transaction With Control Ent | false | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | false | BackupWthldComplianceInd |
| Employee | 22 | 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 |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Form8282 Filed | 0 | Form8282FiledCnt |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Form8899 Filedind | false | Form8899Filedind |
| Form1098 C Filed | false | Form1098CFiledInd |
| DAF Excess Business Holdings | false | DAFExcessBusinessHoldingsInd |
| Taxable Distributions | false | TaxableDistributionsInd |
| Distribution To Donor | false | DistributionToDonorInd |
| Org Filed In Lieu Of Form1041 | false | OrgFiledInLieuOfForm1041Ind |
| Licensed More Than One State | false | LicensedMoreThanOneStateInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 15 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 15 | 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 | 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 | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Own Website | Yes (X) | OwnWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TERESA GARDNER | PersonNm |
| Phone | 2763288550 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5626 PATRIOT DRIVE | AddressLine1Txt |
| City | WISE | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 24293 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | Yes (X) | NoListedPersonsCompensatedInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd |
|---|---|---|---|---|---|---|---|
| MARK LEONARD | |||||||
| Director | 0.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| ROGER RAMEY | |||||||
| Director | 0.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| THOMAS KENNEDY | |||||||
| Vice President | 0.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| VALARIE STEWART | |||||||
| Director | 0.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| MARK VANOVER | |||||||
| Director | 0.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| LOU BARNETTE | |||||||
| DIRECTORWISE | 0.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| CHARLES KISER | |||||||
| Director | 0.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| SHIRLEY WOODWARD | |||||||
| Director | 0.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| KERMIT ANDERSON | |||||||
| Director | 0.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| SR JEAN KORKISCH | |||||||
| President | 0.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| NANCY LAWSON | |||||||
| Director | 0.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| DR JOSEPH SMIDDY | |||||||
| Treasurer | 0.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| JENNIFER HAMMONS | |||||||
| Director | 0.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| MARY WHITE | |||||||
| Secretary | 0.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| GORDON SCOTT | |||||||
| Director | 0.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |
| TERESA GARDNER | |||||||
| EXECUTIVE DIRECTOR | 40.00 | 0.00 | $179,988 | $0 | $0 | Yes (X) | |
| PAULA MEADE | |||||||
| CLINICAL DIRECTOR | 40.00 | 0.00 | $158,756 | $0 | $0 | Yes (X) | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $338,744 | TotalReportableCompFromOrgAmt |
| Indiv Rcvd Greater Than100 K | 2 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $525,490 | GovernmentGrantsAmt |
| All Other Contributions | $1,115,126 | AllOtherContributionsAmt |
| Total Contributions | $1,640,616 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MEDICAL FEE'S | Desc |
| Total Revenue Column | $20,441 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $20,441 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $20,441 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $799 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $799 | RelatedOrExemptFuncIncomeAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,661,856 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $21,240 | RelatedOrExemptFuncIncomeAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $338,744 | TotalAmt |
| Program Services | $304,867 | ProgramServicesAmt |
| Management And General | $33,877 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $556,716 | TotalAmt |
| Program Services | $556,716 | ProgramServicesAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $80,567 | TotalAmt |
| Program Services | $76,539 | ProgramServicesAmt |
| Management And General | $4,028 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $48,500 | TotalAmt |
| Program Services | $46,075 | ProgramServicesAmt |
| Management And General | $2,425 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,951 | TotalAmt |
| Program Services | $21,803 | ProgramServicesAmt |
| Management And General | $1,148 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $31,785 | TotalAmt |
| Program Services | $30,196 | ProgramServicesAmt |
| Management And General | $1,589 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $39,689 | TotalAmt |
| Program Services | $37,705 | ProgramServicesAmt |
| Management And General | $1,984 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $114,179 | TotalAmt |
| Program Services | $108,470 | ProgramServicesAmt |
| Management And General | $5,709 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| RAM EXPENSE | $112,304 | $112,304 | |
| PATIENT SERVICE EXPENSE | $45,763 | $43,475 | $2,288 |
| UTILITIES | $37,578 | $35,699 | $1,879 |
| SMIDDY EXPENSES | $26,470 | $26,470 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $121,447 | TotalAmt |
| Program Services | $109,266 | ProgramServicesAmt |
| Management And General | $5,750 | ManagementAndGeneralAmt |
| Fundraising | $6,431 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,576,693 | TotalAmt |
| Program Services | $1,509,585 | ProgramServicesAmt |
| Management And General | $60,677 | ManagementAndGeneralAmt |
| Fundraising | $6,431 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,422,169 | BOYAmt |
| EOY | $1,474,405 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $56,157 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $938,240 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $221,879 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $732,369 | BOYAmt |
| EOY | $716,361 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,121,155 | BOYAmt |
| EOY | $2,105,077 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,275,693 | BOYAmt |
| EOY | $4,352,000 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $81,355 | BOYAmt |
| EOY | $72,499 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $81,355 | BOYAmt |
| EOY | $72,499 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,889,963 | BOYAmt |
| EOY | $3,985,162 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $304,375 | BOYAmt |
| EOY | $294,339 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,194,338 | BOYAmt |
| EOY | $4,279,501 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,275,693 | BOYAmt |
| EOY | $4,352,000 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $85,163 | ReconcilationRevenueExpnssAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | Yes (true) | AccountantCompileOrReviewInd |
Acct Compile Or Review Basis AcctCompileOrReviewBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,491,747 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,615,634 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,009,056 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,492,362 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,661,057 | CurrentTaxYearAmt |
| Total | $9,269,856 | TotalAmt |
Tax Rev Levied Orgnztnl Bnft170 TaxRevLeviedOrgnztnlBnft170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,491,747 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,615,634 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,009,056 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,492,362 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,661,057 | CurrentTaxYearAmt |
| Total | $9,269,856 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $0 | SubstantialContributorsTotAmt |
| Public Support Total170 | $9,269,856 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $7,688 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $107,717 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $178,613 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $59,627 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $799 | CurrentTaxYearAmt |
| Total | $354,444 | TotalAmt |
Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $9,624,300 | TotalSupportAmt |
| Public Support CY170 | 0.96320 | PublicSupportCY170Pct |
| Public Support PY170 | 0.95900 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $28,000 | InvestmentCostOrOtherBasisAmt |
| Book Value | $28,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $492,270 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $50,220 | DepreciationAmt |
| Book Value | $442,050 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $417,970 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $171,659 | DepreciationAmt |
| Book Value | $246,311 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $716,361 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)
| DescDesc | AmtAmt |
|---|---|
| ACCOUNTS PAYABLE | $7,797 |
| ACCRUED COMPENSATED ABSENCES | $60,595 |
| CREDIT CARD PAYABLE | $1,531 |
| PAYROLL WITHHOLDINGS | $543 |
| SALARIES PAYABLE | $2,033 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $72,499 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $1,661,856 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Subtotal | $1,661,856 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $1,661,856 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $1,576,693 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $1,576,693 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $1,576,693 | TotalExpensesPerForm990Amt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 |
| Rebuttable Presumption Proc | false | RebuttablePresumptionProcInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt |
|---|---|---|
| PAULA MEADE | ||
| CLINICAL DIRECTOR | $158,756 | $158,756 |
| TERESA GARDNER | ||
| EXECUTIVE DIRECTOR | $179,988 | $179,988 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Line 11b: Form 990 Review Process | BY THE BOARD OF DIRECTORS AND THE EXECUTIVE DIRECTOR |
| Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts | THE HEALTH WAGON HAS A CONFLICT OF INTEREST STATEMENT & MEMBERS ARE ASKED TO SIGN ANNUALLY. MEMBERS ARE ASKED TO ABSTAIN FROM VOTING IF A PERCEIVED CONFLICT OF INTEREST EXIST. |
| Form 990, Part VI, Line 15a: Compensation Review & Approval Process - CEO, Top Management | BOARD MEMBERS AND PERSONNEL COMMITTEE DO ANNUAL EVALUATIONS AND COMPENSATION REVIEW OF KEY EMPLOYEES |
| Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees | PERSONNEL COMMITTEE PERFORMS A ANNUAL EVALUATION & COMPENSATION REVIEW OF KEY EMPLOYEES |
| Form 990, Part VI, Line 19: Other Organization Documents Publicly Available | THE NON PROFIT WILL PROVIDE THE AUDIT ONLINE & BE MADE AVAILABLE TO ANY INDIVIDUAL UPON REQUEST. |
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