RURAL HEALTH SERVICES INC: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- RURAL HEALTH SERVICES INC (EIN 23-7085643)
- Tax period
- 2014-06-01 to 2015-05-31
- Filed
- 2015-07-20
- IRS object ID
- 201532019349300618
- 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 | 2015-07-20T08:15:27-07:00 | 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 | 237085643 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RURAL HEALTH SERVICES INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | RURA | BusinessNameControlTxt |
| Phone | 8035939283 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 277 | AddressLine1Txt |
| City | CLEARWATER | CityNm |
| State Abbreviation | SC | StateAbbreviationCd |
| ZIP | 29822 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ROBERT T REEL JR | PersonNm |
| Person Title | CHIEF FINANCIAL OFFICER | PersonTitleTxt |
| Phone | 8035939283 | PhoneNum |
| Signature | 2015-07-20 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | TERRY HORNE | PreparerPersonNm |
| Phone | 6154447293 | PhoneNum |
| Preparation | 2015-07-20 | 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 | ROBERT T REEL JR | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 277 | AddressLine1Txt |
| City | CLEARWATER | CityNm |
| State Abbreviation | SC | StateAbbreviationCd |
| ZIP | 298220277 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $9,749,845 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.MJWCHC.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1970 | FormationYr |
| Legal Domicile State | SC | LegalDomicileStateCd |
| Activity Or Mission | THIS 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 | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 88 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $2,803,912 | PYContributionsGrantsAmt |
| CY Contributions Grants | $5,723,079 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $3,276,636 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $4,004,966 | CYProgramServiceRevenueAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $3,300 | PYOtherRevenueAmt |
| CY Other Revenue | $21,800 | CYOtherRevenueAmt |
| PY Total Revenue | $6,083,848 | PYTotalRevenueAmt |
| CY Total Revenue | $9,749,845 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $3,369,685 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $4,039,066 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,402,510 | PYOtherExpensesAmt |
| CY Other Expenses | $2,312,832 | CYOtherExpensesAmt |
| PY Total Expenses | $4,772,195 | PYTotalExpensesAmt |
| CY Total Expenses | $6,351,898 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,311,653 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $3,397,947 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $3,934,470 | TotalAssetsBOYAmt |
| Total Assets EOY | $7,202,840 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,887,037 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $2,757,460 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,047,433 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $4,445,380 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THIS ORGANIZATION PROVIDES HEALTH CARE | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $4,879,007 | ExpenseAmt |
| Revenue | $4,000,966 | RevenueAmt |
| Desc | THE ORGANIZATION PROVIDES HEALTH CARE SERVICES TO RESIDENTS OF CLEARWATER, SOUTH CAROLINA AND SURROUNDING AREAS REGARDLESS OF THEIR ABILITY TO PAY. THESE MEDICAL SERVICES ARE PROVIDED IN AREAS THAT HAVE A SHORTAGE OF HEALTH CARE PROVIDERS. THIS IS A DIRECT FULFILLMENT OF THIER TAX EXEMPT PURPOSE. OVER 36,300 VISITS WERE PROVIDED DURING THE YEAR. | Desc |
| Total Program Service Expenses | $4,879,007 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | 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 | Yes (true) | 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 | 17 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 88 | 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 | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | 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 | false | InvestmentInJointVentureInd |
| 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 | ROBERT T REEL JR CFO | PersonNm |
| Phone | 8035939283 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 277 | AddressLine1Txt |
| City | CLEARWATER | CityNm |
| State Abbreviation | SC | StateAbbreviationCd |
| ZIP | 29822 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (17 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 |
|---|---|---|---|---|---|---|---|
| KENNETH BALDWIN | |||||||
| BOARD CHAIR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JASON PRICE | |||||||
| VICE CHAIR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| SHEVONIE MEALER | |||||||
| TREASURER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| ANTOINETTE C NOBLE-WEBB | |||||||
| SECRETARY | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| ROSA ISHMAL | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| SHIRLEY VIVAS | |||||||
| TREASURER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| BENJAMIN BROUSSARD | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| SHIRLEY EDWARDS | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| HARVEY TOLLISON | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| CAROLYN EMANUEL-MCCLAIN | |||||||
| CHIEF EXECUTIVE OFFICER | 40.00 | $152,845 | $0 | $4,120 | Yes (X) | ||
| ROBERT T REEL JR | |||||||
| CHIEF FINANCIAL OFFICER | 40.00 | $78,527 | $0 | $4,120 | Yes (X) | ||
| JAMIE ULMER | |||||||
| CHIEF OPERATIONAL OFFICER | 40.00 | $1,635 | $0 | $0 | Yes (X) | ||
| TIFFANY K GOLDSMITH | |||||||
| MEDICAL DIRECTOR | 40.00 | $214,789 | $0 | $4,120 | Yes (X) | ||
| CHERISSE EDWARDS | |||||||
| DIRECTOR OF PHARMACY | 40.00 | $95,076 | $0 | $10,011 | Yes (X) | ||
| LLYOD DANIELS | |||||||
| PHYSICIAN | 40 | $216,071 | $8,024 | Yes (X) | |||
| GARY T FISCHBACH | |||||||
| PHYSICIAN | 40 | $165,697 | $10,011 | Yes (X) | |||
| JAMES L BLAND | |||||||
| PHYSICIAN | 40 | $140,070 | $8,024 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,064,710 | TotalReportableCompFromOrgAmt |
| Total Other Compensation | $48,430 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 5 | 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 |
|---|---|---|---|---|---|
| AUGUSTA BUSINESS INTERIORS INC | |||||
| 3127-G DAMASCUS RD | AUGUSTA | GA | 30909 | FURNITURE | $175,580 |
| EDTS LLC | |||||
| PO BOX 1926 | AUGUSTA | GA | 309031926 | IT SUPPORT | $199,331 |
| MB KAHN CONSTRUCTION CO INC | |||||
| PO BOX 1179 | COLUMBIA | SC | 29202 | CONSTRUCTION | $3,761,600 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 3 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $4,581,676 | GovernmentGrantsAmt |
| All Other Contributions | $1,141,403 | AllOtherContributionsAmt |
| Noncash Contributions | $22,196 | NoncashContributionsAmt |
| Total Contributions | $5,723,079 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT FEES | Desc |
| Business | 621111 | BusinessCd |
| Total Revenue Column | $4,004,966 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $4,004,966 | TotalProgramServiceRevenueAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $21,800 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $21,800 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $21,800 | TotalRevenueColumnAmt |
| Exclusion | $21,800 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $9,749,845 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $4,004,966 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $21,800 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $542,872 | TotalAmt |
| Program Services | $309,865 | ProgramServicesAmt |
| Management And General | $233,007 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,977,756 | TotalAmt |
| Program Services | $2,835,788 | ProgramServicesAmt |
| Management And General | $141,968 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $374,694 | TotalAmt |
| Program Services | $339,001 | ProgramServicesAmt |
| Management And General | $35,693 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $143,744 | TotalAmt |
| Program Services | $129,370 | ProgramServicesAmt |
| Management And General | $14,374 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,149 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $8,149 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,800 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $21,800 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $355,695 | TotalAmt |
| Program Services | $214,898 | ProgramServicesAmt |
| Management And General | $140,797 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,216,187 | TotalAmt |
| Program Services | $749,319 | ProgramServicesAmt |
| Management And General | $466,868 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $130,547 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $130,547 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $272,693 | TotalAmt |
| Program Services | $218,154 | ProgramServicesAmt |
| Management And General | $54,539 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $49,764 | TotalAmt |
| Program Services | $15,613 | ProgramServicesAmt |
| Management And General | $34,151 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,883 | TotalAmt |
| Program Services | $13,506 | ProgramServicesAmt |
| Management And General | $3,377 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $213,432 | TotalAmt |
| Program Services | $31,347 | ProgramServicesAmt |
| Management And General | $182,085 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,682 | TotalAmt |
| Program Services | $22,146 | ProgramServicesAmt |
| Management And General | $5,536 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,351,898 | TotalAmt |
| Program Services | $4,879,007 | ProgramServicesAmt |
| Management And General | $1,472,891 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part X | Yes (X) | InfoInScheduleOPartXInd |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $296,389 | BOYAmt |
| EOY | $148,784 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $338,914 | BOYAmt |
| EOY | $413,247 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $51,053 | BOYAmt |
| EOY | $67,198 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $8,258,729 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,735,772 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,205,040 | BOYAmt |
| EOY | $6,522,957 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $43,074 | BOYAmt |
| EOY | $50,654 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,934,470 | BOYAmt |
| EOY | $7,202,840 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $549,241 | BOYAmt |
| EOY | $847,006 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $400,000 | BOYAmt |
| EOY | $44,543 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,937,796 | BOYAmt |
| EOY | $1,865,911 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,887,037 | BOYAmt |
| EOY | $2,757,460 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,042,421 | BOYAmt |
| EOY | $4,432,070 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,012 | BOYAmt |
| EOY | $13,310 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,047,433 | BOYAmt |
| EOY | $4,445,380 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,934,470 | BOYAmt |
| EOY | $7,202,840 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $3,397,947 | ReconcilationRevenueExpnssAmt |
| 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 | $1,387,600 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,099,020 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,294,125 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,803,912 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $5,723,079 | CurrentTaxYearAmt |
| Total | $12,307,736 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,387,600 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,099,020 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,294,125 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,803,912 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $5,723,079 | CurrentTaxYearAmt |
| Total | $12,307,736 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $12,307,736 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $52 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,100 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,600 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,300 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $21,800 | CurrentTaxYearAmt |
| Total | $30,852 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $12,338,588 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $15,273,552 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.99750 | PublicSupportCY170Pct |
| Public Support PY170 | 0.99880 | 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 B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $184,543 | InvestmentCostOrOtherBasisAmt |
| Book Value | $184,543 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $6,757,048 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $1,058,821 | DepreciationAmt |
| Book Value | $5,698,227 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $1,317,138 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $676,951 | DepreciationAmt |
| Book Value | $640,187 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $6,522,957 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (4 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| CAPITALIZED LOAN COSTS | $26,794 |
| DEPOSITS | $10,550 |
| CASH RESTRICTED-USDA ESCROW | $11,983 |
| DONATED PHARMACY INVENTORY | $1,327 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $50,654 | TotalBookValueOtherAssetsAmt |
| Total Rev Etc Audited Fincl Stmt | $9,749,845 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Subtotal | $9,749,845 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $9,749,845 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $6,351,898 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $6,351,898 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $6,351,898 | 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 (4 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt |
|---|---|---|
| CAROLYN EMANUEL-MCCLAIN | ||
| $152,845 | $4,120 | $156,965 |
| TIFFANY K GOLDSMITH | ||
| $214,789 | $214,789 | |
| LLYOD DANIELS | ||
| $216,071 | $8,024 | $224,095 |
| GARY T FISCHBACH | ||
| $165,697 | $10,011 | $175,708 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (17 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Pt VI, Line 11b | MANAGEMENT AND THE BOARD REVIEW AND APPROVE THE FORM 990 BEFORE |
| Pt VI, Line 11b | IT IS FILED WITH THE IRS. |
| Pt VI, Line 12c | ANNUALLY, THE BOARD IS REQUIRED TO COMPLETE A CONFLICT OF INTEREST |
| Pt VI, Line 12c | STATEMENT THAT COMPLIES WIH THE CONFLICT OF INTEREST POLICY. |
| Pt VI, Line 15a | THE ORGANIZATION IS A MEMBER OF THE NATIONAL ASSOCIATION OF COMMUNITY |
| Pt VI, Line 15b | HEALTH CENTERS, AND WITH THIS MEMBERSHIP IS ABLE TO RECEIVE COMPLETED |
| Pt VI, Line 15b | COMPENSATION SURVEYS THAT LIST COMPENSATION BY FUNCTION AND REGION |
| Pt VI, Line 15b | OF EMPLOYMENT. USING THIS SURVEY IS THE INITIAL STATE OF COMPENSATION |
| Pt VI, Line 15b | EVAULATION. THE ORGANIZATION ALSO WILL REVIEW THE APPLICANT'S REQUESTED |
| Pt VI, Line 15b | COMPENSATION RANGE AND DETERMINE IF THIS MEETS PREVIOUSLY |
| Pt VI, Line 15b | COMPENSATION RANGE AND DETERMINE IF THIS MEETS PREVIOUSLY |
| Pt VI, Line 15b | AVAILABLE IN COMPLIANCE WITH THE FREEDOM OF INFORMATION ACT |
| Pt VI, Line 15b | THROUGH HRSA. |
| Pt VI, Line 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT |
| Pt VI, Line 19 | OF INTEREST POLICY AND FORM 990 AVAILABLE UPON WRITTEN REQUEST. |
| Pt XI | THE USE OF TEMPORARILY RESTRICTED NET ASSETS (DONATED SERVICES) FOR |
| Pt X | THEIR INTENDED PURPOSE. |
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