SANDHILLS MEDICAL FOUNDATION INC: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- SANDHILLS MEDICAL FOUNDATION INC (EIN 57-0672342)
- Tax period
- 2014-06-01 to 2015-05-31
- Filed
- 2015-09-09
- IRS object ID
- 201512529349300811
- 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 | 2015-09-09T10:53:00-07:00 | ReturnTs |
| Tax Period End | 2015-05-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Terry Horne CPA & Associates PC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 732 West Main Street | AddressLine1Txt |
| City | Lebanon | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 37087 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-06-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 570672342 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SANDHILLS MEDICAL FOUNDATION INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | SAND | BusinessNameControlTxt |
| Phone | 8436583006 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 366 | AddressLine1Txt |
| City | MCBEE | CityNm |
| State Abbreviation | SC | StateAbbreviationCd |
| ZIP | 29101 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CHRIS DIXON | PersonNm |
| Person Title | CHIEF EXECUTIVE OFFICER | PersonTitleTxt |
| Phone | 8436583006 | PhoneNum |
| Signature | 2015-09-09 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | TERRY HORNE CPA | PreparerPersonNm |
| Phone | 6154447293 | PhoneNum |
| Preparation | 2015-09-09 | 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 | CHRIS DIXON | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 366 | AddressLine1Txt |
| City | MCBEE | CityNm |
| State Abbreviation | SC | StateAbbreviationCd |
| ZIP | 29101 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $12,077,065 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1977 | FormationYr |
| Legal Domicile State | SC | LegalDomicileStateCd |
| Activity Or Mission | THE ORGANIZATION PROVIDES HEALTH CARE TO INDIVIDUALS REGARDLESS OF THEIR ABILITY TO PAY. THIS IS A DIRECT FULFILLMENT OF THEIR TAX EXEMPT PURPOSE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 101 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $1,981,256 | PYContributionsGrantsAmt |
| CY Contributions Grants | $2,084,967 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $7,576,907 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $9,977,375 | CYProgramServiceRevenueAmt |
| PY Investment Income | $644 | PYInvestmentIncomeAmt |
| CY Investment Income | $2,723 | CYInvestmentIncomeAmt |
| PY Other Revenue | $12,000 | PYOtherRevenueAmt |
| CY Other Revenue | $12,000 | CYOtherRevenueAmt |
| PY Total Revenue | $9,570,807 | PYTotalRevenueAmt |
| CY Total Revenue | $12,077,065 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $5,004,065 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $5,155,383 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $3,905,636 | PYOtherExpensesAmt |
| CY Other Expenses | $5,468,006 | CYOtherExpensesAmt |
| PY Total Expenses | $8,909,701 | PYTotalExpensesAmt |
| CY Total Expenses | $10,623,389 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $661,106 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,453,676 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $7,997,506 | TotalAssetsBOYAmt |
| Total Assets EOY | $9,467,823 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $3,778,939 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $3,795,580 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $4,218,567 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $5,672,243 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE ORGANIZATION PROVIDES HEALTH CARE | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $8,575,183 | ExpenseAmt |
| Revenue | $9,977,375 | RevenueAmt |
| Desc | THE ORGANIZATION PROVIDES HEALTH CARE REGARDLESS OF THE INDIVIDUALS ABILITY TO PAY. THESE MEDICAL SERVICES ARE PROVIDED IN AREAS THAT HAVE A SHORTAGE OF HEALTH CARE PROVIDERS. THIS IS A DIRECT FULFILLMENT OF THEIR TAX EXEMPT PURPOSE. OVER 29,700 VISITS WERE PROVIDED DURING THE YEAR. | Desc |
| Total Program Service Expenses | $8,575,183 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | false | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | false | TransactionWithControlEntInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 18 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 101 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| DAF Excess Business Holdings | false | DAFExcessBusinessHoldingsInd |
| Taxable Distributions | false | TaxableDistributionsInd |
| Distribution To Donor | false | DistributionToDonorInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (true) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | Yes (true) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (true) | WrittenPolicyOrProcedureInd |
| States Where Copy Of Return Is Fld | SC | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | WILLIAM MILES | PersonNm |
| Phone | 8433358291 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 645 S SEVENTH STREET | AddressLine1Txt |
| City | MCBEE | CityNm |
| State Abbreviation | SC | StateAbbreviationCd |
| ZIP | 29101 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| JANET DEFEE | |||||||
| SECRETARY | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| GLENN ODOM | |||||||
| TREASURER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| E WAYNE WALLACE | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| LAVILLA EVANS | |||||||
| VICE CHAIR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| STEPHEN BARRINEAU | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| WANDA GARDNER | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| REV DON ROBINSON | |||||||
| CHAIR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DORETHIA RUTLEDGE | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| MICHELE REEDER | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| SUZAN J MYERS | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| WARREN B HIX | |||||||
| CHIEF EXEC. OFFICER | 40.00 | $110,198 | $0 | $10,408 | Yes (X) | ||
| CRYSTAL MAXWELL | |||||||
| MEDICAL DIRECTOR | 40.00 | $179,284 | $0 | $12,346 | Yes (X) | ||
| CHRISTOPHER DIXON | |||||||
| CHIEF EXEC. OFFICER & CHIEF FINANCIAL OFFCER | 40.00 | $149,150 | $0 | $8,476 | Yes (X) | ||
| WILLIAM MILES | |||||||
| CHIEF FINANCIAL OFFICER | 40.00 | $81,685 | $0 | $5,462 | Yes (X) | ||
| EMANUIEL COOPER | |||||||
| PHYSICIAN | 40 | $176,159 | $9,976 | Yes (X) | |||
| UDAY DOPPALAPUDI | |||||||
| PHYSICIAN | 40 | $170,275 | Yes (X) | ||||
| MICHELLE BALMACEDA | |||||||
| PHYSICIAN | 40 | $155,692 | $10,549 | Yes (X) | |||
| ALYSSA NORWOOD | |||||||
| PHARMACIST | 40 | $131,982 | $4,783 | Yes (X) | |||
| DEBBIE BLACKWELL | |||||||
| PHARMACIST | 40 | $114,146 | $6,873 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,268,571 | TotalReportableCompFromOrgAmt |
| Total Other Compensation | $68,873 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 8 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (3 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| LABCORP | |||||
| PO BOX 12140 | BURLINGTON | NC | 272162140 | LAB SERVICES | $185,470 |
| AMICUS | |||||
| 313 MAIN STREET SUITE B | GREENWOOD | SC | 29646 | LAB SERVICES | $194,347 |
| LIFEFORTE ASSOCIATE | |||||
| PO BOX 492 | CAMDEN | SC | 29201 | PHYSICIAN CONTRACTUAL WORK | $138,248 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 3 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $1,772,563 | GovernmentGrantsAmt |
| All Other Contributions | $312,404 | AllOtherContributionsAmt |
| Total Contributions | $2,084,967 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT FEES | Desc |
| Business | 621111 | BusinessCd |
| Total Revenue Column | $9,977,375 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $9,977,375 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,723 | TotalRevenueColumnAmt |
| Exclusion | $2,723 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $12,000 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $12,000 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $12,000 | TotalRevenueColumnAmt |
| Exclusion | $12,000 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $12,077,065 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $9,977,375 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $14,723 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $520,317 | TotalAmt |
| Program Services | $179,284 | ProgramServicesAmt |
| Management And General | $341,033 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,821,099 | TotalAmt |
| Program Services | $3,302,749 | ProgramServicesAmt |
| Management And General | $518,350 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $70,968 | TotalAmt |
| Program Services | $45,420 | ProgramServicesAmt |
| Management And General | $25,548 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $444,113 | TotalAmt |
| Program Services | $286,509 | ProgramServicesAmt |
| Management And General | $157,604 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $298,886 | TotalAmt |
| Program Services | $191,274 | ProgramServicesAmt |
| Management And General | $107,612 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $46,738 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $46,738 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,690 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $13,690 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $911,151 | TotalAmt |
| Program Services | $703,878 | ProgramServicesAmt |
| Management And General | $207,273 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,794,497 | TotalAmt |
| Program Services | $3,366,793 | ProgramServicesAmt |
| Management And General | $427,704 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $406,372 | TotalAmt |
| Program Services | $365,761 | ProgramServicesAmt |
| Management And General | $40,611 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $220,452 | TotalAmt |
| Program Services | $63,106 | ProgramServicesAmt |
| Management And General | $157,346 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $35,335 | TotalAmt |
| Program Services | $34,615 | ProgramServicesAmt |
| Management And General | $720 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $39,771 | TotalAmt |
| Program Services | $35,794 | ProgramServicesAmt |
| Management And General | $3,977 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,623,389 | TotalAmt |
| Program Services | $8,575,183 | ProgramServicesAmt |
| Management And General | $2,048,206 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $573,570 | BOYAmt |
| EOY | $845,820 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,564,453 | BOYAmt |
| EOY | $2,596,723 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $919,774 | BOYAmt |
| EOY | $1,161,773 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $283,061 | BOYAmt |
| EOY | $283,961 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $60,731 | BOYAmt |
| EOY | $113,762 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $5,831,541 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,582,952 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,394,175 | BOYAmt |
| EOY | $4,248,589 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $201,742 | BOYAmt |
| EOY | $217,195 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,997,506 | BOYAmt |
| EOY | $9,467,823 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $544,007 | BOYAmt |
| EOY | $680,957 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $112,996 | BOYAmt |
| EOY | $53,467 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,121,936 | BOYAmt |
| EOY | $3,061,156 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,778,939 | BOYAmt |
| EOY | $3,795,580 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,144,325 | BOYAmt |
| EOY | $5,582,548 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $74,242 | BOYAmt |
| EOY | $89,695 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,218,567 | BOYAmt |
| EOY | $5,672,243 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,997,506 | BOYAmt |
| EOY | $9,467,823 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $1,453,676 | ReconcilationRevenueExpnssAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,982,851 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,946,182 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,831,713 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,981,256 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,084,967 | CurrentTaxYearAmt |
| Total | $9,826,969 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,982,851 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,946,182 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,831,713 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,981,256 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,084,967 | CurrentTaxYearAmt |
| Total | $9,826,969 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $9,826,969 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $12,871 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $14,736 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $14,290 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $14,322 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $14,723 | CurrentTaxYearAmt |
| Total | $70,942 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $9,897,911 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $35,881,123 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.99280 | PublicSupportCY170Pct |
| Public Support PY170 | 0.99300 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
| Public Support Total509 | $0 | PublicSupportTotal509Amt |
| Public Support CY509 | 0 | PublicSupportCY509Pct |
| Investment Income CY | 0 | InvestmentIncomeCYPct |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $145,095 | InvestmentCostOrOtherBasisAmt |
| Book Value | $145,095 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $4,692,671 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $939,683 | DepreciationAmt |
| Book Value | $3,752,988 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $156,865 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $31,659 | DepreciationAmt |
| Book Value | $125,206 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $836,910 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $611,610 | DepreciationAmt |
| Book Value | $225,300 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $4,248,589 | TotalBookValueLandBuildingsAmt |
| Total Rev Etc Audited Fincl Stmt | $12,077,065 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Subtotal | $12,077,065 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $12,077,065 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $10,623,389 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $10,623,389 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $10,623,389 | TotalExpensesPerForm990Amt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (5 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt |
|---|---|---|---|
| CRYSTAL MAXWELL | |||
| $179,284 | $5,421 | $6,925 | $191,630 |
| CHRISTOPHER DIXON | |||
| $149,150 | $3,740 | $4,736 | $157,626 |
| EMANUIEL COOPER | |||
| $176,159 | $5,178 | $4,798 | $186,135 |
| UDAY DOPPALAPUDI | |||
| $170,275 | $170,275 | ||
| MICHELLE BALMACEDA | |||
| $155,692 | $3,622 | $6,927 | $166,241 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Pt VI, Line 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST |
| Pt VI, Line 19 | POLICY AND FORM 990 AVAILABLE UPON WRITTEN REQUEST. |
| Pt VI, Line 11b | THE FORM 990 IS PRESENTED TO THE AUDIT COMMITTEE FOR REVIEW PRIOR TO FILING. |
| Pt VI, Line 15a | STATE AND NATIONAL SALARY COMPARISONS ARE USED TO ESTABLISH SALARY LIMITS |
| Pt VI, Line 15b | FOR TOP MANAGEMENT OFFICIALS. PERFORMANCE EVALUATION ARE PERFORMED ANNUALLY |
| Pt VI, Line 15b | AND SALARY INCREASES ARE BOARD APPROVED. |
| Pt VI, Line 12c | BOARD IS APPRISED ANNUALLY OF THE POLICY. DISCUSSIONS THAT MAY GIVE A MEMBER A |
| Pt VI, Line 12c | POSSIBLE CONFLICT, REQUIRE THE MEMBER TO STEP OUT OF THE BOARD MEETING. |
| Pt XII, Line 2c | THE CEO, CFO AND FINANCE COMMITTEE OVERSEE FINANCIAL STATEMENT PREPARATION |
| Pt XII, Line 2c | AND AUDIT ENGAGEMENT. |
| Pt VI, Line 2 | A BOARD MEMBER IS CO-OWNER IN THE PHARMACY WHICH ADMINISTERS THE |
| Pt VI, Line 2 | 340 (B) DRUG PROGRAM. THIS PHARMACY ALSO RENTS SPACE FROM THE ORGANIZATION |
| Pt VI, Line 2 | FOR $1000 PER MONTH. |