EBENZER MEDICAL OUTREACH INC: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
EBENZER MEDICAL OUTREACH INC (EIN 55-0745033)
Tax period
2014-07-01 to 2015-06-30
Filed
2016-05-09
IRS object ID
201621309349301727
Schema version
2014v6.0
Note
A later return for the same period supersedes this one.
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

FieldValueIRS element (for citing)
Return2016-05-09T15:25:39-04:00ReturnTs
Tax Period End2015-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN204891915PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1SullivanWebb PLLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1422 Kinetic Drive Suite CAddressLine1Txt
CityHuntingtonCityNm
State AbbreviationWVStateAbbreviationCd
ZIP25701ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2014-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN550745033EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1EBENEZER MEDICAL OUTREACH INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlEBENBusinessNameControlTxt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11448 TENTH AVENUEAddressLine1Txt
CityHUNTINGTONCityNm
State AbbreviationWVStateAbbreviationCd
ZIP25701ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonCHRISTIE KINSEYPersonNm
Person TitleBOARD PRESIDENTPersonTitleTxt
Phone3045290753PhoneNum
Signature2016-04-28SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonBRUCE I SULLIVAN CPAPreparerPersonNm
PTINP00177743PTIN
Phone3046970565PhoneNum
Preparation2016-05-09PreparationDt
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-08-17 19:52:53ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Gross Receipts$1,300,356GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.EMOHEALTH.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1996FormationYr
Legal Domicile StateWVLegalDomicileStateCd
Activity Or MissionPROVIDE MEDICAL SERVICES TO THE UNINSUREDActivityOrMissionDesc
Voting Members Governing Body18VotingMembersGoverningBodyCnt
Voting Members Independent18VotingMembersIndependentCnt
Total Employee25TotalEmployeeCnt
Total Volunteers37TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$2,100,357PYContributionsGrantsAmt
CY Contributions Grants$1,271,826CYContributionsGrantsAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$5,754PYInvestmentIncomeAmt
CY Investment Income$3,191CYInvestmentIncomeAmt
PY Other Revenue$59,554PYOtherRevenueAmt
CY Other Revenue$21,089CYOtherRevenueAmt
PY Total Revenue$2,165,665PYTotalRevenueAmt
CY Total Revenue$1,296,106CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$665,435PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$397,107CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$710CYTotalFundraisingExpenseAmt
PY Other Expenses$1,524,968PYOtherExpensesAmt
CY Other Expenses$1,578,612CYOtherExpensesAmt
PY Total Expenses$2,190,403PYTotalExpensesAmt
CY Total Expenses$1,975,719CYTotalExpensesAmt
PY Revenues Less Expenses-$24,738PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$679,613CYRevenuesLessExpensesAmt
Total Assets BOY$1,009,933TotalAssetsBOYAmt
Total Assets EOY$322,184TotalAssetsEOYAmt
Total Liabilities BOY$142,688TotalLiabilitiesBOYAmt
Total Liabilities EOY$172,183TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$867,245NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$150,001NetAssetsOrFundBalancesEOYAmt
MissionPROVIDE MEDICAL SERVICES TO THE UNINSUREDMissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$1,146,169ExpenseAmt
DescPROVIDES FREE MEDICAL CARE TO THE UNEMPLOYED AND WORKING POOR WHO ARE WITHOUT HEALTH INSURANCE AND ARE AT OR BELOW THE FEDERAL INCOME POVERTY GUIDELINES. SERVICES PROVIDED INCLUDE GENERAL MEDICINE, BREAST/CERVICAL CANCER SCREENINGS, COUNSELING, LAB AND MEDICINES.Desc
Total Program Service Expenses$1,146,169TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsYes (true)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesYes (true)FundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredfalseScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntYes (true)BusinessRlnWithOfficerEntInd
Deductible Non Cash ContriYes (true)DeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (true)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee25EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Form8899 FiledindfalseForm8899Filedind
Form1098 C FiledfalseForm1098CFiledInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members18GoverningBodyVotingMembersCnt
Independent Voting Member18IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnfalseAnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcfalseRegularMonitoringEnfrcInd
Whistleblower PolicyfalseWhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Written Policy Or ProcedurefalseWrittenPolicyOrProcedureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonREBECCA GLASSPersonNm
Phone3045290753PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11448 TENTH AVENUEAddressLine1Txt
CityHUNTINGTONCityNm
State AbbreviationWVStateAbbreviationCd
ZIP25701ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
DERON RUNYON
PRESIDENT1.000.00Yes (X)Yes (X)$0$0$0
STEPHEN PETRANY
VICE PRESIDENT1.000.00Yes (X)Yes (X)$0$0$0
SUE MCCLELLAND
SECRETARY1.000.00Yes (X)Yes (X)$0$0$0
AARON BLEVINS
TREASURER1.000.00Yes (X)Yes (X)$0$0$0
JANE FOTOS
BOARD MEMBER1.000.00Yes (X)$0$0$0
ELLA DORSEY
BOARD MEMBER1.000.00Yes (X)$0$0$0
STEPHANIE HOLMAN
BOARD MEMBER1.000.00Yes (X)$0$0$0
ROBERT LEVY
BOARD MEMBER1.000.00Yes (X)$0$0$0
DR MONIKA SAWHNEY
BOARD MEMBER1.000.00Yes (X)$0$0$0
DOUG SHEILS
BOARD MEMBER1.000.00Yes (X)$0$0$0
LEO FLECKENSTEIN
BOARD MEMBER1.000.00Yes (X)$0$0$0
CHERYL HENDERSON
BOARD MEMBER1.000.00Yes (X)$0$0$0
FRAN DEGIDIO
BOARD MEMBER1.000.00Yes (X)$0$0$0
SARAH DENMAN
BOARD MEMBER1.000.00Yes (X)$0$0$0
CHRISTIE KINSEY
BOARD MEMBER1.000.00Yes (X)$0$0$0
DENISE LANDRY
BOARD MEMBER1.000.00Yes (X)$0$0$0
LEON WHITE
BOARD MEMBER1.000.00Yes (X)$0$0$0
ROBERT CRABTREE
BOARD MEMBER1.000.00Yes (X)$0$0$0
YVONNE JONES
EXECUTIVE DIRECTOR40.000.00Yes (X)$38,867$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$38,867TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$0TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KfalseTotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
Government Grants$470,034GovernmentGrantsAmt
All Other Contributions$801,792AllOtherContributionsAmt
Noncash Contributions$503,985NoncashContributionsAmt
Total Contributions$1,271,826TotalContributionsAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$3,191TotalRevenueColumnAmt
Related Or Exempt Func Income$3,191RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$16,166FundraisingGrossIncomeAmt
Fundraising Direct Expenses$4,250FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$11,916TotalRevenueColumnAmt
Exclusion$11,916ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescMISCELLANEOUS REVENUEDesc
Business900099BusinessCd
Total Revenue Column$9,173TotalRevenueColumnAmt
Related Or Exempt Func Income$9,173RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$9,173OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,296,106TotalRevenueColumnAmt
Related Or Exempt Func Income$12,364RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$11,916ExclusionAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$361,539TotalAmt
Program Services$361,539ProgramServicesAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$3,317TotalAmt
Program Services$3,317ProgramServicesAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$32,251TotalAmt
Program Services$32,251ProgramServicesAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$143TotalAmt
Program Services$143ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$12,170TotalAmt
Program Services$12,170ProgramServicesAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$155,140TotalAmt
Program Services$155,140ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$2,872TotalAmt
Program Services$2,872ProgramServicesAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$3,576TotalAmt
Program Services$3,576ProgramServicesAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$1,894TotalAmt
Management And General$1,894ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$6,440TotalAmt
Program Services$3,332ProgramServicesAmt
Management And General$3,108ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$8,116TotalAmt
Program Services$8,116ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtManagement And GeneralManagementAndGeneralAmtProgram ServicesProgramServicesAmt
UNCOLLECTIBLE RECEIVABLES$822,340$822,340
CONTRIBUTED SUPPLIES AND EQ$503,985$503,985
PROFESSIONAL SERVICES$31,385$31,385
EQUIPMENT RENTALPURCHASES$12,039$12,039

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$18,512TotalAmt
Program Services$16,304ProgramServicesAmt
Management And General$1,498ManagementAndGeneralAmt
Fundraising$710FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$1,975,719TotalAmt
Program Services$1,146,169ProgramServicesAmt
Management And General$828,840ManagementAndGeneralAmt
Fundraising$710FundraisingAmt
FieldValueIRS element (for citing)
Joint CostsYes (X)JointCostsInd

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$33,543BOYAmt
EOY$156,718EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$6,616BOYAmt
EOY$60,829EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$165,000BOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$657,340BOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$2,766BOYAmt
EOY$2,546EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$278,217LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$250,214LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$36,077BOYAmt
EOY$28,003EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$19,857BOYAmt
EOY$19,850EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$88,734BOYAmt
EOY$54,238EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$1,009,933BOYAmt
EOY$322,184EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$126,088BOYAmt
EOY$172,183EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$16,600BOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$142,688BOYAmt
EOY$172,183EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$800,493BOYAmt
EOY$95,788EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$17,566BOYAmt
EOY$5,239EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$49,186BOYAmt
EOY$48,974EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$867,245BOYAmt
EOY$150,001EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,009,933BOYAmt
EOY$322,184EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$679,613ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$2,495NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets-$35,136OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$10,614,828CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$12,516,113CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$13,102,042CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$2,100,357CurrentTaxYearMinus1YearAmt
Current Tax Year$1,271,826CurrentTaxYearAmt
Total$39,605,166TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$10,614,828CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$12,516,113CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$13,102,042CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$2,100,357CurrentTaxYearMinus1YearAmt
Current Tax Year$1,271,826CurrentTaxYearAmt
Total$39,605,166TotalAmt
FieldValueIRS element (for citing)
Public Support Total170$39,605,166PublicSupportTotal170Amt

Other Income170 OtherIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$31,950CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$17,309CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$26,836CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$33,387CurrentTaxYearMinus1YearAmt
Current Tax Year$11,916CurrentTaxYearAmt
Total$121,398TotalAmt
FieldValueIRS element (for citing)
Total Support$39,726,564TotalSupportAmt
Gross Receipts Rltd Activities$18,391GrossReceiptsRltdActivitiesAmt
Public Support CY1700.99690PublicSupportCY170Pct
Public Support PY1700.96000PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$53,709BeginningYearBalanceAmt
Investment Earnings Or Losses$504InvestmentEarningsOrLossesAmt
End Year Balance$54,213EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$47,207BeginningYearBalanceAmt
Investment Earnings Or Losses$6,502InvestmentEarningsOrLossesAmt
End Year Balance$53,709EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$43,124BeginningYearBalanceAmt
Investment Earnings Or Losses$4,083InvestmentEarningsOrLossesAmt
End Year Balance$47,207EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$45,329BeginningYearBalanceAmt
Investment Earnings Or Losses-$2,205InvestmentEarningsOrLossesAmt
End Year Balance$43,124EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$40,343BeginningYearBalanceAmt
Investment Earnings Or Losses$4,986InvestmentEarningsOrLossesAmt
End Year Balance$45,329EndYearBalanceAmt
FieldValueIRS element (for citing)
Endowments Held Unrelated OrgYes (true)EndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgfalseEndowmentsHeldRelatedOrgInd

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$278,217InvestmentCostOrOtherBasisAmt
Depreciation$250,214DepreciationAmt
Book Value$28,003BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$28,003TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (2 entries)

DescDescBook ValueBookValueAmt
BENEFICIAL INTEREST-DENTAL FUND$54,213
HEALTH CARE CREDIT RECEIVABLE$25
FieldValueIRS element (for citing)
Total Book Value Other Assets$54,238TotalBookValueOtherAssetsAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceEndowment funds intended uses (Part V, line 4)FormAndLineReferenceDesc
ExplanationTHE PRINCIPAL VALUE OF THE ENDOWMENT IS TO BE PERMANENTLY RESTRICTED, THE ANNUAL NET INCOME AND ACCUMULATED INCOME FROM PRIOR YEARS IS AVAILABLE FOR USE IN DENTISTRY WITH THE APPROPRIATE APPROVALS.ExplanationTxt

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1SWHRT DINNEREvent1Nm
Gross Receipts Event1$16,166GrossReceiptsEvent1Amt
Gross Revenue Event1$16,166GrossRevenueEvent1Amt
Food And Beverage Event1$3,850FoodAndBeverageEvent1Amt
Other Direct Expenses Event1$400OtherDirectExpensesEvent1Amt
Gross Receipts Total$16,166GrossReceiptsTotalAmt
Gross Revenue Total Events$16,166GrossRevenueTotalEventsAmt
Food And Beverage Total Events$3,850FoodAndBeverageTotalEventsAmt
Oth Direct Expnss Total Events$400OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$4,250DirectExpenseSummaryEventsAmt
Net Income Summary$11,916NetIncomeSummaryAmt

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

FieldValueIRS element (for citing)
PersonDOUGLASS CENTRE LTD PARTNERSHPPersonNm
FieldValueIRS element (for citing)
Relationship DescriptionCONTROLLED ENTITYRelationshipDescriptionTxt
Transaction$154,879TransactionAmt
TransactionLEASE OF FACILITIESTransactionDesc
Sharing Of RevenuesYes (true)SharingOfRevenuesInd

Schedule M IRS990ScheduleM

Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Noncash Contributions Rpt F990$503,985NoncashContributionsRptF990Amt
Method Of Determining RevenuesWHOLESALE VALUEMethodOfDeterminingRevenuesTxt
FieldValueIRS element (for citing)
Any Property That Must Be HeldfalseAnyPropertyThatMustBeHeldInd
Review Process Unusual NC GiftsfalseReviewProcessUnusualNCGiftsInd
Third Parties UsedfalseThirdPartiesUsedInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990 governing body review Part VI line 11FORM 990 IS DISTRIBUTED TO THE GOVERNING BOARD VIA EMAIL FOR REVIEW BEFORE FILING.
CEO executive director top management comp Part VI line 15aTHE GOVERNING BODY REVIEWS AND APPROVES EXECUTIVE DIRECTORS COMPENSATION.
Governing documents etc available to public Part VI line 19GOVERNING DOCUMENTS ARE KEPT AT ADMINISTRATIVE OFFICE OF EBENEZER MEDICAL OUTREACH, INC. AND ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
Explanation of other changes in net assets or fund balances Part XI line 9LOSS ON DISPOSAL OF ASSETS OF $136 AND WRITE-OFF OF INVESTMENT IN EMOS, INC. OF $35,000

Schedule R IRS990ScheduleR

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1DOUGLASS CENTRE LPBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11448 TENTH AVEAddressLine1Txt
CityHUNTINGTONCityNm
State AbbreviationWVStateAbbreviationCd
ZIP25701ZIPCd
FieldValueIRS element (for citing)
EIN550784814EIN
Primary ActivitiesREAL ESTATE HOLDINGPrimaryActivitiesTxt
Legal Domicile StateWVLegalDomicileStateCd
Direct Controlling NAN/ADirectControllingNACd
Predominant Income TypeRELATEDPredominantIncomeTypeTxt
Share Of Total Income-$19,852ShareOfTotalIncomeAmt
Share Of EOY Assets$3,017,830ShareOfEOYAssetsAmt
Disproportionate AllocationsfalseDisproportionateAllocationsInd
General Or Managing PartnerYes (true)GeneralOrManagingPartnerInd

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1EMOS INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11448 TENTH AVENUEAddressLine1Txt
CityHUNTINGTONCityNm
State AbbreviationWVStateAbbreviationCd
ZIP25701ZIPCd
FieldValueIRS element (for citing)
EIN562387395EIN
Primary ActivitiesLEASING OFFICE BUILDINGPrimaryActivitiesTxt
Legal Domicile StateWVLegalDomicileStateCd
Direct Controlling NAN/ADirectControllingNACd
Entity TypeC CorpEntityTypeTxt
Ownership1.00000OwnershipPct
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (true)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingfalsePaidEmployeesSharingInd
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgfalseTransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

FieldValueIRS element (for citing)
Business Name Line1DOUGLASS CENTRE LIMITED PARTNERSHIPBusinessNameLine1Txt
FieldValueIRS element (for citing)
Transaction TypeKTransactionTypeTxt
Involved$154,879InvolvedAmt
Method Of Amount DeterminationFMVMethodOfAmountDeterminationTxt

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