CHARITABLE HEALTHCARE NETWORK INC: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- CHARITABLE HEALTHCARE NETWORK INC (EIN 22-3769296)
- Tax period
- 2015-01-01 to 2015-12-31
- Filed
- 2016-09-29
- IRS object ID
- 201642739349300109
- 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 | 2016-09-29T07:58:13-05:00 | ReturnTs |
| Tax Period End | 2015-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 310800053 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLARK SCHAEFER HACKETT & CO | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 14 E MAIN STREET SUITE 500 | AddressLine1Txt |
| City | SPRINGFIELD | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45502 | 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 | 223769296 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OHIO ASSOCIATION OF FREE CLINICS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | OHIO | BusinessNameControlTxt |
| Phone | 6149146458 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 35 NORTH FOURTH STREET NO 350 | AddressLine1Txt |
| City | COLUMBUS | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 43215 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DEBORAH MILLER | PersonNm |
| Person Title | EXECUTIVE DIRECTOR | PersonTitleTxt |
| Phone | 6149146458 | PhoneNum |
| Signature | 2016-09-29 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JESSE YOUNG CPA | PreparerPersonNm |
| PTIN | P01236247 | PTIN |
| Phone | 9373992000 | PhoneNum |
| Preparation | 2016-09-29 | 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 | DEBORAH MILLER | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 35 NORTH FOURTH STREET NO 350 | AddressLine1Txt |
| City | COLUMBUS | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 43215 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $1,049,878 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.OHIOFREECLINICS.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2002 | FormationYr |
| Legal Domicile State | OH | LegalDomicileStateCd |
| Activity Or Mission | TO IMPROVE ACCESS TO HEALTH CARE FOR THE UNINSURED AND UNDERINSURED PEOPLE IN OHIO, TO STRENGTHEN THE CAPACITY OF OHIO'S FREE CLINCS, TO BUILD A NETWORK AMONG FREE CLINICS AND TO BE AN ADVOCATE FOR FREE CLINICS AND THE PEOPLE THEY SERVE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 14 | VotingMembersIndependentCnt |
| Total Employee | 51 | TotalEmployeeCnt |
| Total Volunteers | 14 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $850,561 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,031,044 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $2,150 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $6,935 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | $243 | CYInvestmentIncomeAmt |
| PY Other Revenue | $3,416 | PYOtherRevenueAmt |
| CY Other Revenue | $11,656 | CYOtherRevenueAmt |
| PY Total Revenue | $856,127 | PYTotalRevenueAmt |
| CY Total Revenue | $1,049,878 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $386,805 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $377,630 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $377,727 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $540,179 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $11,593 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $71,448 | PYOtherExpensesAmt |
| CY Other Expenses | $104,299 | CYOtherExpensesAmt |
| PY Total Expenses | $835,980 | PYTotalExpensesAmt |
| CY Total Expenses | $1,022,108 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $20,147 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $27,770 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $297,380 | TotalAssetsBOYAmt |
| Total Assets EOY | $304,839 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $131,403 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $111,092 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $165,977 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $193,747 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO IMPROVE ACCESS TO HEALTH CARE FOR THE UNINSURED AND UNDERINSURED PEOPLE IN OHIO, TO STRENGTHEN THE CAPACITY OF OHIO'S FREE CLINICS, TO BUILD A NETWORK AMONG FREE CLINICS AND TO BE AN ADVOCATE FOR FREE CLINICS AND THE PEOPLE THEY SERVE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $377,630 | ExpenseAmt |
| Grant | $377,630 | GrantAmt |
| Revenue | $10,191 | RevenueAmt |
| Desc | COLLECT AND DISTRIBUTE FUNDS TO FREE CLINICS. PROMOTE NETWORKING AND INFORMATION SHARING AMONG OHIO FREE CLINICS, TO ADVOCATE ON BEHALF OF FREE CLINICS AND THE PEOPLE THEY SERVE AND TO MANAGE THE FREE CLINIC DATA. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $426,110 | ExpenseAmt |
| Desc | NAVIGATOR PROGRAM: ASSISTING PATIENTS OF THE ASSOCIATION'S MEMBER CLINICS IN ISSUES RELATD TO OHIO'S HEALTH INSURANCE EXCHANGE. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $107,191 | ExpenseAmt |
| Revenue | $8,400 | RevenueAmt |
| Desc | VISTA PROGRAM: SERVICES TO STRENGTHEN AND SUPPLEMENT EFFORTS TO ELIMINATE POVERTY AND POVERTY-RELATED HUMAN, SOCIAL, AND ENVIRONMENTAL PROBLEMS. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $910,931 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | 0 | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 51 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Taxable Distributions | 0 | TaxableDistributionsInd |
| Distribution To Donor | 0 | DistributionToDonorInd |
| Indoor Tanning Services | 0 | 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 | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DEBORAH MILLER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6149146458 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 35 NORTH FOURTH STREET NO 350 | AddressLine1Txt |
| City | COLUMBUS | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 43215 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (15 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|
| KATHRYN CLARK RN | ||||||
| PRESIDENT | 5.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| ROBERT BAILY | ||||||
| VICE PRESIDENT | 5.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| PAUL BAUMGARTNER | ||||||
| PAST PRESIDENT | 5.00 | Yes (X) | $0 | $0 | $0 | |
| SUSAN LABUDA SCHROP PHD | ||||||
| SECRETARY | 5.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| ANDREW MERRILL | ||||||
| TREASURER | 5.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| STEPHANIE BAILY CPA | ||||||
| DIRECTOR | 5.00 | Yes (X) | $0 | $0 | $0 | |
| HEATHER BAIRD RN JD MPH | ||||||
| DIRECTOR | 5.00 | Yes (X) | $0 | $0 | $0 | |
| MELISSA CANNEY | ||||||
| DIRECTOR | 5.00 | Yes (X) | $0 | $0 | $0 | |
| LEE ELMORE | ||||||
| DIRECTOR | 5.00 | Yes (X) | $0 | $0 | $0 | |
| JUSTIN COBY | ||||||
| DIRECTOR | 5.00 | Yes (X) | $0 | $0 | $0 | |
| SUE MEYER MD | ||||||
| DIRECTOR | 5.00 | Yes (X) | $0 | $0 | $0 | |
| JOHANNA HENZ | ||||||
| DIRECTOR | 5.00 | Yes (X) | $0 | $0 | $0 | |
| DR ANNE KLOOS PT PHD NSC | ||||||
| DIRECTOR | 5.00 | Yes (X) | $0 | $0 | $0 | |
| ANN QUILLEN | ||||||
| DIRECTOR | 5.00 | Yes (X) | $0 | $0 | $0 | |
| DEBORAH MILLER | ||||||
| EXECUTIVE DIRECTOR | 40.00 | Yes (X) | $73,581 | $0 | $0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $73,581 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $0 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | 0 | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Membership Dues | $24,075 | MembershipDuesAmt |
| Government Grants | $996,317 | GovernmentGrantsAmt |
| All Other Contributions | $10,652 | AllOtherContributionsAmt |
| Total Contributions | $1,031,044 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | EDUCATION EVENT | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $6,935 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $6,935 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $6,935 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $243 | TotalRevenueColumnAmt |
| Exclusion | $243 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OTHER INCOME | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $11,656 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $11,656 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $11,656 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,049,878 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $18,591 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $243 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $377,630 | TotalAmt |
| Program Services | $377,630 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $73,581 | TotalAmt |
| Program Services | $44,149 | ProgramServicesAmt |
| Management And General | $25,753 | ManagementAndGeneralAmt |
| Fundraising | $3,679 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $427,318 | TotalAmt |
| Program Services | $410,231 | ProgramServicesAmt |
| Management And General | $14,951 | ManagementAndGeneralAmt |
| Fundraising | $2,136 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $39,280 | TotalAmt |
| Program Services | $35,632 | ProgramServicesAmt |
| Management And General | $3,192 | ManagementAndGeneralAmt |
| Fundraising | $456 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,750 | TotalAmt |
| Management And General | $6,750 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,215 | TotalAmt |
| Program Services | $3,921 | ProgramServicesAmt |
| Fundraising | $294 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,800 | TotalAmt |
| Program Services | $5,800 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,088 | TotalAmt |
| Management And General | $17,088 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,675 | TotalAmt |
| Program Services | $11,946 | ProgramServicesAmt |
| Management And General | $7,729 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,675 | TotalAmt |
| Program Services | $8,326 | ProgramServicesAmt |
| Management And General | $5,349 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,161 | TotalAmt |
| Program Services | $1,161 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,283 | TotalAmt |
| Management And General | $2,283 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| CONTRACT SERVICES | $13,029 | $5,028 | $2,973 | $5,028 |
| DUES AND SUBSCRIPTIONS | $9,800 | $9,800 | ||
| EQUIPMENT | $3,618 | $3,618 | ||
| MISCELLANEOUS | $3,123 | $3,123 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,082 | TotalAmt |
| Program Services | $3,489 | ProgramServicesAmt |
| Management And General | $593 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,022,108 | TotalAmt |
| Program Services | $910,931 | ProgramServicesAmt |
| Management And General | $99,584 | ManagementAndGeneralAmt |
| Fundraising | $11,593 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $44,654 | BOYAmt |
| EOY | $35,184 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $115,676 | BOYAmt |
| EOY | $115,919 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $131,902 | BOYAmt |
| EOY | $147,189 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $650 | BOYAmt |
| EOY | $1,830 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $10,835 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $6,118 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,498 | BOYAmt |
| EOY | $4,717 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $297,380 | BOYAmt |
| EOY | $304,839 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $118,810 | BOYAmt |
| EOY | $94,260 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,593 | BOYAmt |
| EOY | $16,832 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $131,403 | BOYAmt |
| EOY | $111,092 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $165,977 | BOYAmt |
| EOY | $193,747 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $165,977 | BOYAmt |
| EOY | $193,747 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $297,380 | BOYAmt |
| EOY | $304,839 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $27,770 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
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 | $461,259 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $471,660 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $512,079 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $857,062 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,031,044 | CurrentTaxYearAmt |
| Total | $3,333,104 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $43,181 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $18,158 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $20,383 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $17,285 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $99,007 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $504,440 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $489,818 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $532,462 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $874,347 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,031,044 | CurrentTaxYearAmt |
| Total | $3,432,111 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | 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) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $3,432,111 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $74 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $507 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $122 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year | $243 | CurrentTaxYearAmt |
| Total | $946 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $74 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $507 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $122 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year | $243 | CurrentTaxYearAmt |
| Total | $946 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $504,514 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $490,325 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $532,584 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $874,347 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,031,287 | CurrentTaxYearAmt |
| Total | $3,433,057 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99970 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99960 | PublicSupportPY509Pct |
| Investment Income CY | 0.00030 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00040 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | Yes (1) | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | Yes (1) | DirectContactLegislatorsInd |
| Rallies Demonstrations | Yes (1) | RalliesDemonstrationsInd |
| Other Activities | 0 | OtherActivitiesInd |
| Total Lobbying Expenditures | $0 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | SECURED FUNDING IN THE STATE BIENNIAL BUDGET THROUGH MEETINGS WITH KEY MEMBERS OF THE OHIO GENERAL ASSEMBLY. | ExplanationTxt |
Schedule D IRS990ScheduleD
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $10,445 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,728 | DepreciationAmt |
| Book Value | $4,717 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $390 | OtherCostOrOtherBasisAmt |
| Depreciation | $390 | DepreciationAmt |
| Book Value | $0 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $4,717 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PAYROLL RELATED LIABILITIES | Desc |
| Amt | $16,832 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $16,832 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $672,248 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $672,248 | RevenueSubtotalAmt |
| Other Revenues Not Included | $377,630 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $377,630 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $1,049,878 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $644,478 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $644,478 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $377,630 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $377,630 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $1,022,108 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | OHIO ASSOCIATION OF FREE CLINICS IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. HOWEVER, INCOME FROM CERTAIN ACTIVITIES NOT DIRECTLY RELATED TO THE ASSOCIAITON'S TAX-EXEMPT PURPOSE IS SUBJECT TO TAXATION AS UNRELATED BUSINESS INCOME. THE ASSOCIATION'S REPORTING RETURNS ARE SUBJECT TO AUDIT BY FEDERAL AND STATE TAXING AUTHORITIES. NO INCOME TAX PROVISION HAS BEEN INCLUDED IN THE FINANCIAL STATEMENTS AS THE ASSOCIATION HAS DETERMINED IT DOES NOT HAVE UNRELATED BUSINESS INCOME SUBJECT TO TAXATION. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | AMOUNTS DESIGNATED FOR MEMBER CLINICS 377,630. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | GRANTS DESIGNATED FOR MEMBER CLINICS 377,630. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (41 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt | Address Line2USAddress/AddressLine2Txt |
|---|---|---|---|---|---|---|---|---|
| ASHLAND CHRISTIAN HEALTH CENTER | ||||||||
| 380 E 4TH STREET | ASHLAND | OH | 44805 | 421595274 | 501(C)(3) | $7,775 | TO PROVIDE SERVICES TO UNINSURED PATIENTS | |
| ASIAN AMERICAN COMMUNITY SERVICES | ||||||||
| 2231 N HIGH STREET FIRST FLOOR | COLUMBUS | OH | 43201 | 310898833 | 501(C)(3) | $7,775 | TO PROVIDE SERVICES TO UNINSURED PATIENTS | |
| BY THE WAY INC | ||||||||
| 1029 S BROAD STREET | LANCASTER | OH | 43130 | 262934275 | 501(C)(3) | $6,751 | TO PROVIDE SERVICES TO UNINSURED PATIENTS | |
| COLUMBUS FREE CLINIC | ||||||||
| 2231 N HIGH STREET | COLUMBUS | OH | 43201 | 010575698 | 501(C)(3) | $8,078 | TO PROVIDE SERVICES TO UNINSURED PATIENTS | |
| LICKING COUNTY COMMUNITY HEALTH CLINIC | ||||||||
| 144 B W MAIN STREET | NEWARK | OH | 43055 | 311340169 | 501(C)(3) | $7,775 | TO PROVIDE SERVICES TO UNINSURED PATIENTS | |
| COMPASSION MEDICAL CLINIC OF WILLIAMS COUNTY | ||||||||
| 614 E EDGERTON ST | BRYAN | OH | 43506 | 204352598 | 501(C)(3) | $6,448 | TO PROVIDE SERVICES TO UNINSURED PATIENTS | |
| COMPASSIONATE CARE OF SHELBY COUNTY | ||||||||
| PO BOX 4835 | SIDNEY | OH | 45365 | 208479583 | 501(C)(3) | $12,516 | TO PROVIDE SERVICES TO UNINSURED PATIENTS | |
| GOOD NEIGHBOR HOUSE | ||||||||
| 627 E FIRST STREET | DAYTON | OH | 45402 | 311374154 | 501(C)(3) | $5,466 | TO PROVIDE SERVICES TO UNINSURED PATIENTS | |
| HEALTH PARTNERS OF MIAMI COUNTY | ||||||||
| 1300 N COUNTY ROAD 25A | TROY | OH | 45373 | 311596731 | 501(C)(3) | $12,516 | TO PROVIDE SERVICES TO UNINSURED PATIENTS | |
| HELPING HANDS HEALTH & WELLNESS CENTER | ||||||||
| 1420 MORSE ROAD | COLUMBUS | OH | 43229 | 205937457 | 501(C)(3) | $9,988 | TO PROVIDE SERVICES TO UNINSURED PATIENTS | |
| JEFFERSON COUNTY 4TH STREET HEALTH CENTER | ||||||||
| 701 N 4TH STREET | STEUBENVILLE | OH | 43952 | 203924355 | 501(C)(3) | $10,303 | TO PROVIDE SERVICES TO UNINSURED PATIENTS | |
| LAKE COUNTY FREE CLINIC | ||||||||
| 54 SOUTH STATE STREET SUITE 302 | PAINESVILLE | OH | 44077 | 341081191 | 501(C)(3) | $12,516 | TO PROVIDE SERVICES TO UNINSURED PATIENTS | |
| LORAIN COUNTY FREE CLINIC INC | ||||||||
| 3323 PEARL AVENUE | LORAIN | OH | 44055 | 341506180 | 501(C)(3) | $12,516 | TO PROVIDE SERVICES TO UNINSURED PATIENTS | |
| MIDLOTHIAN FREE HEALTH CLINIC INC | ||||||||
| 388 E MIDLOTHIAN BLVD | YOUNGSTOWN | OH | 44507 | 010887315 | 501(C)(3) | $6,448 | TO PROVIDE SERVICES TO UNINSURED PATIENTS | |
| NORTH COAST HEALTH MINISTRY | ||||||||
| 16110 DETROIT AVENUE | LAKEWOOD | OH | 44107 | 341536257 | 501(C)(3) | $12,516 | TO PROVIDE SERVICES TO UNINSURED PATIENTS | |
| OPPORTUNITY PARISH ECUMENICAL NEIGHBORHOOD MINISTRY FREE CLINIC | ||||||||
| 941 PRINCETON AVENUE | AKRON | OH | 44311 | 341046107 | 501(C)(3) | $10,303 | TO PROVIDE SERVICES TO UNINSURED PATIENTS | |
| OUCOM COMMUNITY HEALTH PROGRAMS - FREE CLINIC | ||||||||
| 105 RESEARCH AND TECHNOLOGY CENTER | ATHENS | OH | 45701 | 316402113 | 501(C)(3) | $10,303 | TO PROVIDE SERVICES TO UNINSURED PATIENTS | |
| OXFORD COLLEGE CORNER CLINIC (DBA OXFORD FREE CLINIC) | ||||||||
| PO BOX 390 | OXFORD | OH | 45056 | 204253386 | 501(C)(3) | $7,775 | TO PROVIDE SERVICES TO UNINSURED PATIENTS | |
| PARMA HEALTH MINISTRY | ||||||||
| 7000 RIDGE ROAD | PARMA | OH | 44129 | 341754340 | 501(C)(3) | $5,959 | TO PROVIDE SERVICES TO UNINSURED PATIENTS | |
| PHYSICIANS CARECONNECTION | ||||||||
| 1390 DUBLIN ROAD | COLUMBUS | OH | 43215 | 311373719 | 501(C)(3) | $12,516 | TO PROVIDE SERVICES TO UNINSURED PATIENTS | |
| REACH OUT OF MONTGOMERY COUNTY INC | ||||||||
| 25 E FORAKER STREET | DAYTON | OH | 45409 | 311434282 | 501(C)(3) | $12,516 | TO PROVIDE SERVICES TO UNINSURED PATIENTS | |
| THE BREATHING ASSOCIATION FREE LUNG HEALTH CLINIC | ||||||||
| 1520 OLD HENDERSON ROAD | COLUMBUS | OH | 432203639 | 314387540 | 501(C)(3) | $10,303 | TO PROVIDE SERVICES TO UNINSURED PATIENTS | |
| THE CLINIC AT FAITH MISSION | ||||||||
| 245 N GRANT | COLUMBUS | OH | 43215 | 314412586 | 501(C)(3) | $9,988 | TO PROVIDE SERVICES TO UNINSURED PATIENTS | |
| TOLEDOLUCAS COUNTY CARENET INC | ||||||||
| 3231 CENTRAL PARK WEST DRIVE SUITE | TOLEDO | OH | 43617 | 431986672 | 501(C)(3) | $6,320 | TO PROVIDE SERVICES TO UNINSURED PATIENTS | 200 |
| TUSCARAWAS CLINIC FOR THE WORKING UNINSURED | ||||||||
| 420 REEVES AVENUE SUITE D | DOVER | OH | 44622 | 208456793 | 501(C)(3) | $9,988 | TO PROVIDE SERVICES TO UNINSURED PATIENTS | |
| VINEYARD FREE HEALTH CLINICS | ||||||||
| 6000 COOPER ROAD | WESTERVILLE | OH | 43081 | 753210233 | 501(C)(3) | $7,775 | TO PROVIDE SERVICES TO UNINSURED PATIENTS | |
| VINEYARD COMMUNITY CENTER | ||||||||
| 15187 PALMER ROAD | ETNA | OH | 43068 | 310954398 | 501(C)(3) | $8,078 | TO PROVIDE SERVICES TO UNINSURED PATIENTS | |
| VIOLA STARTZMAN FREE CLINIC | ||||||||
| 1874 CLEVELAND ROAD | WOOSTER | OH | 44691 | 341758151 | 501(C)(3) | $12,516 | TO PROVIDE SERVICES TO UNINSURED PATIENTS | |
| WASHINGTON COUNTY FREE CLINIC | ||||||||
| PO BOX 804 | MARIETTA | OH | 45750 | 452512931 | 501(C)(3) | $7,575 | TO PROVIDE SERVICES TO UNINSURED PATIENTS | |
| XENOS FREE CLINICS | ||||||||
| 3434 STONEVISTA LANE | COLUMBUS | OH | 43221 | 310996318 | 501(C)(3) | $6,751 | TO PROVIDE SERVICES TO UNINSURED PATIENTS | |
| HARTVILLE MIGRANT COUNCIL | ||||||||
| PO BOX 682 | HARTVILLE | OH | 44632 | 340899100 | 501(C)(3) | $7,775 | TO PROVIDE SERVICES TO UNINSURED PATIENTS | |
| LIVING WELL CLINIC | ||||||||
| 215 S ALLISON AVE PO BOX 15 | XENIA | OH | 45385 | 274307745 | 501(C)(3) | $6,087 | TO PROVIDE SERVICES TO UNINSURED PATIENTS | |
| MEDINA HEALTH MINISTRY | ||||||||
| 970 E WASHINGTON STREET SUITE 104 | MEDINA | OH | 44256 | 300092944 | 501(C)(3) | $6,751 | TO PROVIDE SERVICES TO UNINSURED PATIENTS | |
| PREGNANCY SUPPORT CENTER OF STARK COUNTY | ||||||||
| 4500 22ND ST NW | CANTON | OH | 44706 | 341461765 | 501(C)(3) | $9,988 | TO PROVIDE SERVICES TO UNINSURED PATIENTS | |
| VICTORY MINISTRIES | ||||||||
| 4142 WESTERVILLE ROAD | COLUMBUS | OH | 43224 | 311117522 | 501(C)(3) | $6,751 | TO PROVIDE SERVICES TO UNINSURED PATIENTS | |
| TRIHEALTH | ||||||||
| 619 OAK STREET | CINCINNATI | OH | 45206 | 311438846 | 501(C)(3) | $6,320 | TO PROVIDE SERVICES TO UNINSURED PATIENTS | |
| FAITHFUL SERVANTS FREE CLINIC | ||||||||
| 65 COMMUNITY ROAD SUITE F | TALLMADGE | OH | 44278 | 454734159 | 501(C)(3) | $9,988 | TO PROVIDE SERVICES TO UNINSURED PATIENTS | |
| FREE CLINIC OF FULTON COUNTY | ||||||||
| PO BOX 173 | WAUSEON | OH | 43567 | 020792665 | 501(C)(3) | $5,415 | TO PROVIDE SERVICES TO UNINSURED PATIENTS | |
| GOOD SAMARITAN FREE HEALTH CENTER | ||||||||
| 619 OAK STREET -ACCOUNTING 3 WEST | CINCINNATI | OH | 45206 | 273893817 | 501(C)(3) | $6,195 | TO PROVIDE SERVICES TO UNINSURED PATIENTS | |
| GRACE CLINIC OF DELAWARE | ||||||||
| 40 S FRANKLIN ST | DELAWARE | OH | 43015 | 270415624 | 501(C)(3) | $9,988 | TO PROVIDE SERVICES TO UNINSURED PATIENTS | |
| LINWORTH ROAD CHURCH | ||||||||
| 5400 LINWORTH ROAD | COLUMBUS | OH | 43235 | 310881670 | 501(C)(3) | $9,262 | TO PROVIDE SERVICES TO UNINSURED PATIENTS | |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | THE ORGANIZATION'S BOARD PRESIDENT AND OUR BOARD TREASURER ARE HUSBAND AND WIFE. |
| FORM 990, PART VI, SECTION A, LINE 6 | THE MEMBERS ELECT THE MEMBERS OF THE GOVERNING BODY. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE MEMBERS ELECT THE MEMBERS OF THE GOVERNING BODY. |
| FORM 990, PART VI, SECTION B, LINE 11 | BOARD MEMBERS RECEIVE A COPY OF THE 990 AND APPROVE IT BEFORE FILING WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | ANNUALLY, THE BOARD OF DIRECTORS AND ITS OFFICERS, WILL COMPLETE A QUESTIONNAIRE TO ASSIST THE ORGANIZATION WITH DETERMINING THAT THEY ARE IN COMPLIANCE WITH THE POLICY. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE BOARD OFFICERS RESEARCH, DELIBERATE, AND APPROVE COMPENSATION FOR THE EXECUTIVE DIRECTOR. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE UPON REQUEST. |
| FORM 990, PART XII, LINE 2C | THIS PROCESS HAS NOT CHANGED. |
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