GREENVILLE FREE MEDICAL CLINIC: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
GREENVILLE FREE MEDICAL CLINIC (EIN 57-0855205)
Tax period
2014-07-01 to 2015-06-30
Filed
2016-02-08
IRS object ID
201640399349300209
Schema version
2014v6.0
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

FieldValueIRS element (for citing)
Return2016-02-08T08:29:32-06:00ReturnTs
Tax Period End2015-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN570661343PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1JENNINGS COOK & CO CPA'S PABusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 25937AddressLine1Txt
CityGREENVILLECityNm
State AbbreviationSCStateAbbreviationCd
ZIP29616ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2014-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN570855205EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1GREENVILLE FREE MEDICAL CLINIC INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlGREEBusinessNameControlTxt
Phone8642321470PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1600 ARLINGTON AVENUEAddressLine1Txt
CityGREENVILLECityNm
State AbbreviationSCStateAbbreviationCd
ZIP29601ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonSUZIE J FOLEYPersonNm
Person TitleEXECUTIVE DIRECTORPersonTitleTxt
Phone8642321470PhoneNum
Signature2016-01-06SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonDOUGLAS P SCHMIEDINGPreparerPersonNm
PTINP00101637PTIN
Phone8642974700PhoneNum
Preparation2016-02-08PreparationDt
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-08-17 19:52:53ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerSUZIE J FOLEY EXECUTIVE DIRECTORPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 8993AddressLine1Txt
CityGREENVILLECityNm
State AbbreviationSCStateAbbreviationCd
ZIP29604ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$8,066,483GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressGREENVILLEFREECLINIC.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1987FormationYr
Legal Domicile StateSCLegalDomicileStateCd
Activity Or MissionTO PROMOTE WELLNESS AND TO PROVIDE CARING, QUALITY PRIMARY MEDICAL CARE AND DENTAL SERVICES, HEALTH EDUCATION AND PRESCRIPTION MEDICATIONS WITHOUT CHARGE TO ELIGIBLE GREENVILLE COUNTY RESIDENTS.ActivityOrMissionDesc
Voting Members Governing Body16VotingMembersGoverningBodyCnt
Voting Members Independent16VotingMembersIndependentCnt
Total Employee25TotalEmployeeCnt
Total Volunteers600TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$8,041,407PYContributionsGrantsAmt
CY Contributions Grants$7,612,432CYContributionsGrantsAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$73,547PYInvestmentIncomeAmt
CY Investment Income$60,927CYInvestmentIncomeAmt
PY Other Revenue$94,192PYOtherRevenueAmt
CY Other Revenue$78,776CYOtherRevenueAmt
PY Total Revenue$8,209,146PYTotalRevenueAmt
CY Total Revenue$7,752,135CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$758,851PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$827,552CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$110,103CYTotalFundraisingExpenseAmt
PY Other Expenses$7,363,075PYOtherExpensesAmt
CY Other Expenses$6,994,330CYOtherExpensesAmt
PY Total Expenses$8,121,926PYTotalExpensesAmt
CY Total Expenses$7,821,882CYTotalExpensesAmt
PY Revenues Less Expenses$87,220PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$69,747CYRevenuesLessExpensesAmt
Total Assets BOY$1,855,103TotalAssetsBOYAmt
Total Assets EOY$1,750,501TotalAssetsEOYAmt
Total Liabilities BOY$1,373TotalLiabilitiesBOYAmt
Total Liabilities EOY$0TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$1,853,730NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$1,750,501NetAssetsOrFundBalancesEOYAmt
MissionTO PROMOTE WELLNESS AND TO PROVIDE CARING, QUALITY PRIMARY MEDICAL CARE AND DENTAL SERVICES, HEALTH EDUCATION AND PRESCRIPTION MEDICATIONS WITHOUT CHARGE TO ELIGIBLE GREENVILLE COUNTY RESIDENTS.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$7,413,330ExpenseAmt
Revenue$1,355,095RevenueAmt
DescSEE MISSION STATEMENT 7/1/14 - 6/30/15 ACCOMPLISHMENTS: 9,429 MEDICAL CARE VISITS 2,451 DENTAL CLINIC VISITS OVER 41,000 PRECRIPTIONS/REFILLS DISPENSED 1,644 NURSE CONSULTS,HEALTH PRESENTATIONS, AND OUTSIDE REFERRALS 5,665 DIAGNOSTICSDesc
Total Program Service Expenses$7,413,330TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
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 AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (true)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
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 EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContriYes (true)DeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document10IRPDocumentCnt
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
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members16GoverningBodyVotingMembersCnt
Independent Voting Member16IndependentVotingMemberCnt
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 ChaptersYes (true)LocalChaptersInd
Policies Reference ChaptersYes (true)PoliciesReferenceChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonSUZIE J FOLEYPersonNm
Phone8642321470PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1600 ARLINGTON AVEAddressLine1Txt
CityGREENVILLECityNm
State AbbreviationSCStateAbbreviationCd
ZIP29601ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerInd
BRYANT BROWN
BOD2.00Yes (X)$0$0$0
SCOTT CHRISTOPHER
BOD2.00Yes (X)$0$0$0
SAMUEL ERWIN
CHAIR2.00Yes (X)$0$0$0
PHIL FEISAL
BOD2.00Yes (X)$0$0$0
TERI FICICCHY
BOD2.00Yes (X)$0$0$0
LAUREL FOWLER
BOD2.00Yes (X)$0$0$0
CATHERINE GARNER
SECRETARY2.00Yes (X)$0$0$0
DR STEPHEN GEARY
BOD2.00Yes (X)$0$0$0
CHRIS JAMES
BOD2.00Yes (X)$0$0$0
MIKE KELLY
BOD2.00Yes (X)$0$0$0
DR PETER MAURIDES
BOD2.00Yes (X)$0$0$0
ROBERTO MARTINEZ
BOD2.00Yes (X)$0$0$0
DR DONALD RIDGELL
BOD2.00Yes (X)$0$0$0
DAVID SLADE
PAST CHAIR2.00Yes (X)$0$0$0
DAVID SUDDUTH
BOD2.00Yes (X)$0$0$0
MATTHEW UTECHT
VICE CHAIR2.00Yes (X)$0$0$0
SUZIE J FOLEY
EXECUTIVE DI40.00$91,344$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$91,344TotalReportableCompFromOrgAmt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KfalseTotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
Government Grants$340,172GovernmentGrantsAmt
All Other Contributions$7,272,260AllOtherContributionsAmt
Noncash Contributions$6,409,638NoncashContributionsAmt
Total Contributions$7,612,432TotalContributionsAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$22,921TotalRevenueColumnAmt
Exclusion$22,921ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$339,756SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$301,750SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$38,006SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$38,006TotalRevenueColumnAmt
Related Or Exempt Func Income$38,006RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$91,374FundraisingGrossIncomeAmt
Fundraising Direct Expenses$12,598FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$78,776TotalRevenueColumnAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$7,752,135TotalRevenueColumnAmt
Related Or Exempt Func Income$38,006RelatedOrExemptFuncIncomeAmt
Exclusion$22,921ExclusionAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$690,165TotalAmt
Program Services$472,309ProgramServicesAmt
Management And General$133,152ManagementAndGeneralAmt
Fundraising$84,704FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$83,998TotalAmt
Program Services$57,958ProgramServicesAmt
Management And General$15,960ManagementAndGeneralAmt
Fundraising$10,080FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$53,389TotalAmt
Program Services$36,838ProgramServicesAmt
Management And General$10,144ManagementAndGeneralAmt
Fundraising$6,407FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$8,518TotalAmt
Management And General$8,518ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$52,431TotalAmt
Program Services$27,268ProgramServicesAmt
Management And General$20,538ManagementAndGeneralAmt
Fundraising$4,625FundraisingAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$63,561TotalAmt
Program Services$50,849ProgramServicesAmt
Management And General$12,712ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$21,845TotalAmt
Management And General$21,845ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
DONATED MATERIALS$6,409,638$6,409,638
PRESCRIPTIONS$218,582$218,582
CONTRACTED SERVICES$74,310$46,463$27,847
MEDICAL & DENTAL SUPPLIES$44,930$44,930

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$100,515TotalAmt
Program Services$48,495ProgramServicesAmt
Management And General$47,733ManagementAndGeneralAmt
Fundraising$4,287FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$7,821,882TotalAmt
Program Services$7,413,330ProgramServicesAmt
Management And General$298,449ManagementAndGeneralAmt
Fundraising$110,103FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$239,492BOYAmt
EOY$136,476EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$2,037,466LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$1,367,980LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$685,547BOYAmt
EOY$669,486EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$880,031BOYAmt
EOY$894,497EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$50,033BOYAmt
EOY$50,042EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$1,855,103BOYAmt
EOY$1,750,501EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,373BOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,373BOYAmt
EOY$0EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,489,416BOYAmt
EOY$1,473,144EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$214,314BOYAmt
EOY$127,357EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$150,000BOYAmt
EOY$150,000EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,853,730BOYAmt
EOY$1,750,501EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,855,103BOYAmt
EOY$1,750,501EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$69,747ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$33,482NetUnrlzdGainsLossesInvstAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd

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$5,149,995CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$2,895,630CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$5,643,281CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$8,041,407CurrentTaxYearMinus1YearAmt
Current Tax Year$7,612,432CurrentTaxYearAmt
Total$29,342,745TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$5,149,995CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$2,895,630CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$5,643,281CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$8,041,407CurrentTaxYearMinus1YearAmt
Current Tax Year$7,612,432CurrentTaxYearAmt
Total$29,342,745TotalAmt
FieldValueIRS element (for citing)
Public Support Total170$29,342,745PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$25,476CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$12,602CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$22,736CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$20,851CurrentTaxYearMinus1YearAmt
Current Tax Year$22,921CurrentTaxYearAmt
Total$104,586TotalAmt
FieldValueIRS element (for citing)
Total Support$29,447,331TotalSupportAmt
Gross Receipts Rltd Activities$442,803GrossReceiptsRltdActivitiesAmt
Public Support CY1700.99640PublicSupportCY170Pct
Public Support PY1700.99580PublicSupportPY170Pct
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$895,047BeginningYearBalanceAmt
Investment Earnings Or Losses$27,489InvestmentEarningsOrLossesAmt
Administrative Expenses$9,574AdministrativeExpensesAmt
End Year Balance$912,962EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$787,503BeginningYearBalanceAmt
Investment Earnings Or Losses$116,565InvestmentEarningsOrLossesAmt
Administrative Expenses$9,021AdministrativeExpensesAmt
End Year Balance$895,047EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$740,406BeginningYearBalanceAmt
Investment Earnings Or Losses$80,293InvestmentEarningsOrLossesAmt
Other Expenditures$25,000OtherExpendituresAmt
Administrative Expenses$8,196AdministrativeExpensesAmt
End Year Balance$787,503EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$702,485BeginningYearBalanceAmt
Investment Earnings Or Losses$41,871InvestmentEarningsOrLossesAmt
Administrative Expenses$3,950AdministrativeExpensesAmt
End Year Balance$740,406EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$706,935BeginningYearBalanceAmt
Investment Earnings Or Losses$3,079InvestmentEarningsOrLossesAmt
Administrative Expenses$7,529AdministrativeExpensesAmt
End Year Balance$702,485EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.83570BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.16430PrmnntEndowmentBalanceEOYPct
Endowments Held Unrelated OrgYes (true)EndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgfalseEndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$20,000OtherCostOrOtherBasisAmt
Book Value$20,000BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,226,167OtherCostOrOtherBasisAmt
Depreciation$640,011DepreciationAmt
Book Value$586,156BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$706,602OtherCostOrOtherBasisAmt
Depreciation$644,507DepreciationAmt
Book Value$62,095BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$84,697OtherCostOrOtherBasisAmt
Depreciation$83,462DepreciationAmt
Book Value$1,235BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$669,486TotalBookValueLandBuildingsAmt
Total Rev Etc Audited Fincl Stmt$13,562,557TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst-$33,482NetUnrealizedGainsInvstAmt
Donated Services And Use Fclts$5,843,904DonatedServicesAndUseFcltsAmt
Revenue Not Reported$5,810,422RevenueNotReportedAmt
Revenue Subtotal$7,752,135RevenueSubtotalAmt
Total Revenue Per Form990$7,752,135TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$13,665,786TotExpnsEtcAuditedFinclStmtAmt
Donated Services Use Fclts$5,843,904DonatedServicesUseFcltsAmt
Expenses Not Reported$5,843,904ExpensesNotReportedAmt
Expenses Subtotal$7,821,882ExpensesSubtotalAmt
Total Expenses Per Form990$7,821,882TotalExpensesPerForm990Amt

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1BUBBLE-QEvent1Nm
Gross Receipts Event1$82,327GrossReceiptsEvent1Amt
Gross Revenue Event1$82,327GrossRevenueEvent1Amt
Other Direct Expenses Event1$10,659OtherDirectExpensesEvent1Amt
Event2WALK WITH THE DEvent2Nm
Gross Receipts Event2$9,047GrossReceiptsEvent2Amt
Gross Revenue Event2$9,047GrossRevenueEvent2Amt
Other Direct Expenses Event2$1,939OtherDirectExpensesEvent2Amt
Gross Receipts Total$91,374GrossReceiptsTotalAmt
Gross Revenue Total Events$91,374GrossRevenueTotalEventsAmt
Oth Direct Expnss Total Events$12,598OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$12,598DirectExpenseSummaryEventsAmt
Net Income Summary$78,776NetIncomeSummaryAmt

Schedule M IRS990ScheduleM

Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Contribution2ContributionCnt
Noncash Contributions Rpt F990$6,409,638NoncashContributionsRptF990Amt
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, PAGE 6, PART VI, LINE 11BTHE AUDIT COMMITTEE REVIEWS FORM 990. AFTER THE COMMITTEE'S REVIEW THE FORM 990 IS SUBMITTED TO THE ENTIRE BOARD OF DIRECTORS FOR FINAL APPROVAL.
FORM 990, PAGE 6, PART VI, LINE 12CPOLICY: 4.5 POLICY TITLE: BOARD MEMBER'S CODE OF CONDUCT PROCEDURES FOR ADDRESSING THE CONFLICT OF INTEREST: THE CHAIR OF THE BOARD OR COMMITTEE SHALL, IF APPROPRIATE, APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT. AFTER EXERCISING DUE DILIGENCE, THE BOARD OR COMMITTEE SHALL DETERMINE WHETHER THE CLINIC CAN OBTAIN A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST.
FORM 990, PAGE 6, PART VI, LINE 15ATHE CEO COMMITTEE REVIEWS THE EXECUTIVE DIRECTOR'S PERFORMANCE ANNUALLY TO DETERMINE IF THE EXECUTIVE DIRECTOR IS IN COMPLIANCE WITH THE CLINIC'S STATED POLICIES. THE COMMITTEE MAKES RECOMMENDATIONS OF COMPENSATION TO THE BOARD BASED ON THE RESULTS OF THE THEIR PERFORMANCE REVIEW. THE BOARD OF DIRECTORS GIVES FINAL APPROVAL OF THE EXECUTIVE DIRECTOR'S COMPENSATION. THE CEO EVALUATION COMMITTEE CONSISTS OF THREE BOARD MEMBERS.
FORM 990, PAGE 6, PART VI, LINE 19THE PUBLIC IS INVITED TO ALL BOARD MEETINGS AND MAY REVIEW ALL DOCUMENTS. ALL DOCUMENTS ARE ALSO AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST.

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