ACCESS FAMILY HEALTH SERVICES INC: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- ACCESS FAMILY HEALTH SERVICES INC (EIN 64-0612902)
- Tax period
- 2014-02-01 to 2015-01-31
- Filed
- 2015-09-15
- IRS object ID
- 201502589349301450
- Schema version
- 2014v5.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-09-15T17:35:39-05:00 | ReturnTs |
| Tax Period End | 2015-01-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 640736635 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FRANKS FRANKS JARRELL & WILEMON PA | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 731 | AddressLine1Txt |
| City | TUPELO | CityNm |
| State Abbreviation | MS | StateAbbreviationCd |
| ZIP | 38802 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-02-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 640612902 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ACCESS FAMILY HEALTH SERVICES INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | ACCE | BusinessNameControlTxt |
| Phone | 6626514686 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 179 | AddressLine1Txt |
| City | SMITHVILLE | CityNm |
| State Abbreviation | MS | StateAbbreviationCd |
| ZIP | 38870 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MARILYN SUMERFORD | PersonNm |
| Person Title | EXECUTIVE DIRECTOR | PersonTitleTxt |
| Phone | 6626514686 | PhoneNum |
| Signature | 2015-09-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | BRYON WILEMON | PreparerPersonNm |
| PTIN | P00479223 | PTIN |
| Phone | 6628445226 | PhoneNum |
| Preparation | 2015-09-14 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MARILYN SUMERFORD | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 179 | AddressLine1Txt |
| City | SMITHVILLE | CityNm |
| State Abbreviation | MS | StateAbbreviationCd |
| ZIP | 38870 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $6,874,807 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.ACCESSFAMILYHEALTH.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1980 | FormationYr |
| Legal Domicile State | MS | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE AFFORDABLE, COMPREHENSIVE HEALTH CARE AND EDUCATION TO COMMUNITIES IN NORTH MISSISSIPPI | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 12 | VotingMembersIndependentCnt |
| Total Employee | 67 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $2,430,153 | PYContributionsGrantsAmt |
| CY Contributions Grants | $2,533,488 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $3,888,967 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $4,256,025 | CYProgramServiceRevenueAmt |
| PY Investment Income | $4,475 | PYInvestmentIncomeAmt |
| CY Investment Income | $4,724 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $6,323,595 | PYTotalRevenueAmt |
| CY Total Revenue | $6,794,237 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $3,631,992 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $4,098,764 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,429,619 | PYOtherExpensesAmt |
| CY Other Expenses | $1,733,936 | CYOtherExpensesAmt |
| PY Total Expenses | $5,061,611 | PYTotalExpensesAmt |
| CY Total Expenses | $5,832,700 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,261,984 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $961,537 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $5,139,907 | TotalAssetsBOYAmt |
| Total Assets EOY | $6,156,504 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $404,532 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $459,592 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $4,735,375 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $5,696,912 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE MISSION OF ACCESS FAMILY HEALTH SERVICES, INC. IS TO PROVIDE AFFORDABLE, COMPREHENSIVE HEALTH CARE AND EDUCATION TO OUR COMMUNITIES WITH SUPERIOR SERVICES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $4,886,098 | ExpenseAmt |
| Revenue | $4,260,749 | RevenueAmt |
| Desc | PROVIDES RURAL HEALTH CARE SERVICES (DOCTORS, NURSES, PHARMACY FOR SMALL COMMUNITIES IN MISSISSIPPI IN EXCESS OF 9,000 PATIENTS AND 28,000 ENCOUNTERS PER YEAR) | Desc |
| Total Program Service Expenses | $4,886,098 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | 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 | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | 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 | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | 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 | 38 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 67 | 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 |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 12 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | 0 | 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 | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | 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 | DANA RAMEY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6626514686 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 179 | AddressLine1Txt |
| City | SMITHVILLE | CityNm |
| State Abbreviation | MS | StateAbbreviationCd |
| ZIP | 38870 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| NORMA DERRING | ||||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| WILLIAM SHACK | ||||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| DON WHITEHEAD | ||||||||
| SECRETARY | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| BRAD STEVENS | ||||||||
| TREASURER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| MARLON SUMMERFORD | ||||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| ROBERT WHITEHEAD | ||||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| ANN SEALES | ||||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| DARRELL HARP JR | ||||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| RUBY HOLLIN | ||||||||
| EXEC COMMITTEE CHAIRMAN | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JERRY HALL | ||||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| LASHUNDA BUGGS | ||||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| INITA MCMULLAN | ||||||||
| EXEC COMMITTEE VICE CHAIR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| MARILYN SUMERFORD | ||||||||
| EXECUTIVE DIRECTOR | 40.00 | $103,324 | $0 | $23,272 | Yes (X) | |||
| PATSY LYLE | ||||||||
| NURSING DIRECTOR | 40.00 | $0 | $0 | $0 | Yes (X) | |||
| DANA RAMEY | ||||||||
| FINANCIAL DIRECTOR | 40.00 | $0 | $0 | $11,463 | Yes (X) | |||
| REBECCA CAGLE | ||||||||
| DIRECTOR OF CLINICAL QUALI | 40.00 | $0 | $0 | $0 | Yes (X) | |||
| JAMES MONROE | ||||||||
| PHYSICIAN | 40.00 | $182,551 | $0 | $25,531 | Yes (X) | |||
| KEVIN KOEHLER | ||||||||
| PHYSICIAN | 40.00 | $214,997 | $0 | $30,244 | Yes (X) | |||
| BRIAN FRILOUX | ||||||||
| PHYSICIAN | 40.00 | $202,730 | $0 | $22,311 | Yes (X) | |||
| VIVIAN DRAPER | ||||||||
| PHYSICIAN | 40.00 | $100,705 | $0 | $13,154 | Yes (X) | |||
| RACHEL RISH | ||||||||
| PHYSICIAN | 40.00 | $101,236 | $0 | $0 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $905,543 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $125,975 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 6 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | IMAGING CENTER AT GLOSTER CREEK VILLAGE | BusinessNameLine1Txt |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1937 | AddressLine1Txt |
| City | NEW ALBANY | CityNm |
| State Abbreviation | MS | StateAbbreviationCd |
| ZIP | 38652 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | MEDICAL SERVICES | ServicesDesc |
| Compensation | $113,484 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $2,533,488 | GovernmentGrantsAmt |
| Total Contributions | $2,533,488 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT SERVICES | Desc |
| Business | 621110 | BusinessCd |
| Total Revenue Column | $4,250,207 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $4,250,207 | RelatedOrExemptFuncIncomeAmt |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,818 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $5,818 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $4,256,025 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,136 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,136 | RelatedOrExemptFuncIncomeAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $82,158 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $80,570 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $1,588 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,588 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,588 | RelatedOrExemptFuncIncomeAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $6,794,237 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $4,260,749 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,338,349 | TotalAmt |
| Program Services | $2,840,910 | ProgramServicesAmt |
| Management And General | $497,439 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $760,415 | TotalAmt |
| Program Services | $624,497 | ProgramServicesAmt |
| Management And General | $135,918 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $204,104 | TotalAmt |
| Program Services | $191,958 | ProgramServicesAmt |
| Management And General | $12,146 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $47,821 | TotalAmt |
| Program Services | $25,365 | ProgramServicesAmt |
| Management And General | $22,456 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,675 | TotalAmt |
| Program Services | $2,675 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $159,520 | TotalAmt |
| Program Services | $149,445 | ProgramServicesAmt |
| Management And General | $10,075 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,884 | TotalAmt |
| Program Services | $15,543 | ProgramServicesAmt |
| Management And General | $4,341 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| CONTRACTUAL SERVICES | $493,398 | $391,650 | $101,748 |
| SUPPLIES | $229,010 | $194,127 | $34,883 |
| PHARMACEUTICALS | $146,709 | $146,709 | |
| TELEPHONE | $121,982 | $106,427 | $15,555 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $308,833 | TotalAmt |
| Program Services | $196,792 | ProgramServicesAmt |
| Management And General | $112,041 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,832,700 | TotalAmt |
| Program Services | $4,886,098 | ProgramServicesAmt |
| Management And General | $946,602 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $862,424 | BOYAmt |
| EOY | $725,199 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $744,524 | BOYAmt |
| EOY | $652,268 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,356 | BOYAmt |
| EOY | $712,510 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $650,942 | BOYAmt |
| EOY | $181,207 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $91,000 | BOYAmt |
| EOY | $73,000 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,454 | BOYAmt |
| EOY | $14,280 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $4,665,930 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $867,890 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,757,207 | BOYAmt |
| EOY | $3,798,040 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,139,907 | BOYAmt |
| EOY | $6,156,504 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $341,736 | BOYAmt |
| EOY | $427,337 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $62,796 | BOYAmt |
| EOY | $32,255 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $404,532 | BOYAmt |
| EOY | $459,592 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,291,852 | BOYAmt |
| EOY | $5,372,181 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $443,523 | BOYAmt |
| EOY | $324,731 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,735,375 | BOYAmt |
| EOY | $5,696,912 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,139,907 | BOYAmt |
| EOY | $6,156,504 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $961,537 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| 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 | 0 | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $175,084 | OtherCostOrOtherBasisAmt |
| Book Value | $175,084 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,386,556 | OtherCostOrOtherBasisAmt |
| Depreciation | $256,055 | DepreciationAmt |
| Book Value | $3,130,501 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $228,516 | OtherCostOrOtherBasisAmt |
| Depreciation | $85,971 | DepreciationAmt |
| Book Value | $142,545 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $875,774 | OtherCostOrOtherBasisAmt |
| Depreciation | $525,864 | DepreciationAmt |
| Book Value | $349,910 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $3,798,040 | TotalBookValueLandBuildingsAmt |
| Total Rev Etc Audited Fincl Stmt | $6,794,237 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $6,794,237 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $6,794,237 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $5,832,700 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $5,832,700 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $5,832,700 | TotalExpensesPerForm990Amt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (3 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JAMES MONROE | ||||||||||||||
| PHYSICIAN | $182,551 | $0 | $0 | $0 | $0 | $0 | $12,347 | $0 | $13,184 | $0 | $208,082 | $0 | $0 | $0 |
| KEVIN KOEHLER | ||||||||||||||
| PHYSICIAN | $214,997 | $0 | $0 | $0 | $0 | $0 | $12,338 | $0 | $17,906 | $0 | $245,241 | $0 | $0 | $0 |
| BRIAN FRILOUX | ||||||||||||||
| PHYSICIAN | $202,730 | $0 | $0 | $0 | $0 | $0 | $12,088 | $0 | $10,223 | $0 | $225,041 | $0 | $0 | $0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 8B | THERE ARE NO AUXILLARY COMMITTEES |
| FORM 990, PART VI, SECTION B, LINE 11 | COPIES OF THE 990 ARE MADE AVAILABLE TO THE BOARD FOR REVIEW AND DISCUSSION |
| FORM 990, PART VI, SECTION B, LINE 12C | BOARD MEMBERS COMPLETE A CONFLICT OF INTEREST STATEMENT ANNUALLY AT THE ANNUAL MEETING IN JUNE. WHEN A CONFLICT OF INTEREST IS DISCLOSED, THE BOARD MEMBER MUST RESIGN IF IT IS IN CONFLICT WITH THE BOARD'S BYLAWS. THE ORGANIZATION ALSO HAS A COMPLIANCE OFFICER THAT MONITORS COMPLIANCE WITH THE VARIOUS PROGRAMS. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE PUBLIC DOCUMENTS OF THE ORGANIZATION ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. |
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