ANDEAN HEALTH AND DEVELOPMENT INC: Form 990, tax year 2014

View the entire original 990 at ProPublica ↗

Organization
ANDEAN HEALTH AND DEVELOPMENT INC (EIN 39-1809174)
Tax period
2014-01-01 to 2014-12-31
Filed
2015-11-10
IRS object ID
201503149349302265
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

FieldValueIRS element (for citing)
Return2015-11-10T11:44:09-06:00ReturnTs
Tax Period End2014-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN392043144PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1LULLOFF & TAYLOR LLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line13333 N MAYFAIR RD STE 203AddressLine1Txt
CityWAUWATOSACityNm
State AbbreviationWIStateAbbreviationCd
ZIP53222ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2014-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN391809174EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ANDEAN HEALTH AND DEVELOPMENT INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlANDEBusinessNameControlTxt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11100 DELAPLAINE COURTAddressLine1Txt
CityMADISONCityNm
State AbbreviationWIStateAbbreviationCd
ZIP53715ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDAVID GAUSPersonNm
Person TitleEXECUTIVE DIRECTORPersonTitleTxt
Signature2015-04-15SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonDAVID A TAYLORPreparerPersonNm
PTINP00003270PTIN
Phone4147770700PhoneNum
Preparation2015-10-20PreparationDt
FieldValueIRS element (for citing)
Tax2014TaxYr
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Gross Receipts$1,561,085GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.ANDEANHEALTH.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1997FormationYr
Legal Domicile StateWILegalDomicileStateCd
Activity Or MissionPROVIDING FUNDING FOR PRIMARY HEALTH CAREActivityOrMissionDesc
Voting Members Governing Body17VotingMembersGoverningBodyCnt
Voting Members Independent0VotingMembersIndependentCnt
Total Employee2TotalEmployeeCnt
Total Volunteers30TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$1,360,058PYContributionsGrantsAmt
CY Contributions Grants$1,501,487CYContributionsGrantsAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$28,379PYInvestmentIncomeAmt
CY Investment Income$56,748CYInvestmentIncomeAmt
CY Other Revenue$2,850CYOtherRevenueAmt
PY Total Revenue$1,388,437PYTotalRevenueAmt
CY Total Revenue$1,561,085CYTotalRevenueAmt
PY Grants And Similar Paid$1,463,039PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$2,390,479CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$224,150PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$227,802CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$39,685CYTotalFundraisingExpenseAmt
PY Other Expenses$131,411PYOtherExpensesAmt
CY Other Expenses$239,239CYOtherExpensesAmt
PY Total Expenses$1,818,600PYTotalExpensesAmt
CY Total Expenses$2,857,520CYTotalExpensesAmt
PY Revenues Less Expenses-$430,163PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$1,296,435CYRevenuesLessExpensesAmt
Total Assets BOY$1,538,119TotalAssetsBOYAmt
Total Assets EOY$914,170TotalAssetsEOYAmt
Total Liabilities BOY$672,840TotalLiabilitiesBOYAmt
Total Liabilities EOY$1,345,483TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$865,279NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY-$431,313NetAssetsOrFundBalancesEOYAmt
MissionPROVIDING FUNDING FOR PRIMARY HEALTH CAREMissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$2,785,619ExpenseAmt
Grant$2,390,479GrantAmt
DescIMPLEMENTATION OF PRIMARY HEALTH CARE SERVICES IN RURAL ECUADOR BENEFITING OVER 50,000 PEOPLE SINCE MARCH 2001Desc
Total Program Service Expenses$2,785,619TotalProgramServiceExpensesAmt
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 EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (true)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficeYes (true)ForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgYes (true)MoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
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 Document2IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee2EmployeeCnt
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 Members17GoverningBodyVotingMembersCnt
Independent Voting Member0IndependentVotingMemberCnt
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 PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyfalseWhistleblowerPolicyInd
Document Retention PolicyfalseDocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldWIStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ANDEAN HEALTH & DEVELOPMENT INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone6197886833PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11100 DELAPLANE COURTAddressLine1Txt
CityMADISONCityNm
State AbbreviationWIStateAbbreviationCd
ZIP53715ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (3 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerInd
THEODORE M HESBURGH CSC
PRESIDENT2.00Yes (X)$0$0$0
MICHAEL HEISLER MD
VICE PRESIDE2.00Yes (X)$0$0$0
DAVID P GAUS MD
EXEC DIRECTO30.00$133,008$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$133,008TotalReportableCompFromOrgAmt
Indiv Rcvd Greater Than100 K1IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KfalseTotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
All Other Contributions$1,501,487AllOtherContributionsAmt
Noncash Contributions$31,819NoncashContributionsAmt
Total Contributions$1,501,487TotalContributionsAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$56,748TotalRevenueColumnAmt
Exclusion$56,748ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescMISCELLANEOUSDesc
Total Revenue Column$2,850TotalRevenueColumnAmt
Exclusion$2,850ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$2,850OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,561,085TotalRevenueColumnAmt
Exclusion$59,598ExclusionAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$2,390,479TotalAmt
Program Services$2,390,479ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$163,650TotalAmt
Program Services$143,650ProgramServicesAmt
Management And General$10,000ManagementAndGeneralAmt
Fundraising$10,000FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$49,163TotalAmt
Program Services$49,163ProgramServicesAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$14,989TotalAmt
Program Services$13,157ProgramServicesAmt
Management And General$916ManagementAndGeneralAmt
Fundraising$916FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$5,631TotalAmt
Management And General$5,631ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$20,197TotalAmt
Program Services$20,197ProgramServicesAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$20,878TotalAmt
Program Services$20,878ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$114TotalAmt
Program Services$114ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$15,669TotalAmt
Management And General$15,669ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtFundraisingFundraisingAmt
BAD DEBT-ACCRUED INTEREST$55,880$55,880
OUTSIDE SERVICES$52,333$23,564$28,769
VOLUNTEERS$32,168$32,168
CONTRACT LABOR$20,605$20,605

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$15,764TotalAmt
Program Services$15,764ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$2,857,520TotalAmt
Program Services$2,785,619ProgramServicesAmt
Management And General$32,216ManagementAndGeneralAmt
Fundraising$39,685FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$444,369BOYAmt
EOY$57,402EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$99,346BOYAmt
EOY$284,673EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$980,235BOYAmt
EOY$557,699EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$9,712BOYAmt
EOY$13,806EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$9,153LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$8,563LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$861BOYAmt
EOY$590EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$3,596BOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$1,538,119BOYAmt
EOY$914,170EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$3,864BOYAmt
EOY$15,570EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$625,000BOYAmt
EOY$1,275,000EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$43,976BOYAmt
EOY$54,913EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$672,840BOYAmt
EOY$1,345,483EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$690,279BOYAmt
EOY-$431,313EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$175,000BOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$865,279BOYAmt
EOY-$431,313EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,538,119BOYAmt
EOY$914,170EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$1,296,435ReconcilationRevenueExpnssAmt
Other Changes In Net Assets-$157OtherChangesInNetAssetsAmt
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
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$405,450CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,539,859CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$2,021,699CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,360,058CurrentTaxYearMinus1YearAmt
Current Tax Year$1,501,487CurrentTaxYearAmt
Total$6,828,553TotalAmt

Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$5,566CurrentTaxYearMinus4YearsAmt
Current Tax Year$2,850CurrentTaxYearAmt
Total$8,416TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$411,016CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,539,859CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$2,021,699CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,360,058CurrentTaxYearMinus1YearAmt
Current Tax Year$1,504,337CurrentTaxYearAmt
Total$6,836,969TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$6,836,969PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,658CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$694CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$550CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$28,379CurrentTaxYearMinus1YearAmt
Current Tax Year$56,748CurrentTaxYearAmt
Total$88,029TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,658CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$694CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$550CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$28,379CurrentTaxYearMinus1YearAmt
Current Tax Year$56,748CurrentTaxYearAmt
Total$88,029TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$412,674CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,540,553CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$2,022,249CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,388,437CurrentTaxYearMinus1YearAmt
Current Tax Year$1,561,085CurrentTaxYearAmt
Total$6,924,998TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.98730PublicSupportCY509Pct
Public Support PY5090.99420PublicSupportPY509Pct
Investment Income CY0.01000InvestmentIncomeCYPct
Investment Income PY0.01000InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

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

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$9,153OtherCostOrOtherBasisAmt
Book Value$9,153BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Depreciation$8,563DepreciationAmt
Book Value-$8,563BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$590TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDescAmtAmt
ACCRUED PENSION PAYABLE$49,163
ACCRUED PAYROLL LIABILITIES$3,920
ACCRUED INTEREST$1,830
ACCRUED PAYROLL
FieldValueIRS element (for citing)
Total Liability$54,913TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$1,561,085TotalRevEtcAuditedFinclStmtAmt
Revenue Subtotal$1,561,085RevenueSubtotalAmt
Total Revenue Per Form990$1,561,085TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$2,857,677TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$157OtherExpensesIncludedAmt
Expenses Not Reported$157ExpensesNotReportedAmt
Expenses Subtotal$2,857,520ExpensesSubtotalAmt
Total Expenses Per Form990$2,857,520TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE D, PAGE 4, PART XII, LINE 2DFormAndLineReferenceDesc
ExplanationBOOK / TAX DEPRECIATION DIFFERENCE 157ExplanationTxt

Schedule F IRS990ScheduleF

Grants To Org Outside US GrantsToOrgOutsideUSGrp

FieldValueIRS element (for citing)
Purpose Of GrantHOSPITAL OPERATIONSPurposeOfGrantTxt
Cash Grant$2,390,479CashGrantAmt
Manner Of Cash DisbursementBANK TRANSFERSMannerOfCashDisbursementTxt
Valuation Method UsedFMVValuationMethodUsedDesc
FieldValueIRS element (for citing)
Transfer To Foreign CorpfalseTransferToForeignCorpInd
Interest In Foreign TrustfalseInterestInForeignTrustInd
Foreign Corp OwnershipfalseForeignCorpOwnershipInd
Passive Foreign Investmest CofalsePassiveForeignInvestmestCoInd
Foreign PartnershipfalseForeignPartnershipInd
Boycott CountriesfalseBoycottCountriesInd

Schedule M IRS990ScheduleM

Other Non Cash Contri Table OtherNonCashContriTableGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Contribution6ContributionCnt
Noncash Contributions Rpt F990$31,819NoncashContributionsRptF990Amt
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 (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PAGE 6, PART VI, LINE 11BBOARD MEMBERS RECEIVE A COPY OF THE FORM 990 FOR REVIEW PRIOR TO MAILING.
FORM 990, PAGE 6, PART VI, LINE 12CALL OFFICERS, DIRECTORS AND EMPLOYEES ARE INFORMED OF THE ORGANZATIONS CONFLICT OF INTEREST POLICY AND ARE INSTRUCTED TO NOTIFY THE BOARD OF DIRECTORS IF THEY HAVE ANY CONCERNS. THE BOARD OF DIRECTORS REVIEWS AND MONITORS ANY CONCERNS RELATED TO CONFLICT OR INTERESTS.
FORM 990, PAGE 6, PART VI, LINE 15AMEMBERS OF THE BOARD OF DIRECTORS ANNUALLY REVIEW THE COMPENSATION FOR THE EXECUTIVE DIRECTOR AND BASED UPON PRIOR SALARIES AND ANTICIPATED REVENUE THE BOARD MEMBERS OFFER THE EXECUTIVE DIRECTOR A COMPENSATION PACKAGE.
FORM 990, PAGE 6, PART VI, LINE 19ALL FINANCIAL RECORDS ARE MAINTAINED BY THE TREASURER AND ARE AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST.
FORM 990, PART XI, LINE 9BOOK / TAX DEPRECIATION DIFFERENCE -157

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