WellSource: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- WellSource (EIN 42-0763978)
- Tax period
- 2012-07-01 to 2013-06-30
- Filed
- 2014-02-14
- IRS object ID
- 201420499349301517
- Schema version
- 2012v2.0
- 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) |
|---|---|---|
| Timestamp | 2014-02-14T11:51:25-07:00 | Timestamp |
| Tax Period End Date | 2013-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | APC Accounting & Tax Service | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 455 First Street | AddressLine1 |
| City | Jesup | City |
| State | IA | State |
| ZIP Code | 50648 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 420763978 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Mental Health Center of North Iowa Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | MENT | NameControl |
| Phone | 6414242075 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 235 S Eisenhower Avenue | AddressLine1 |
| City | Mason City | City |
| State | IA | State |
| ZIP Code | 50401 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Andrew Eastwood | Name |
| Title | Executive Director | Title |
| Phone | 6414242075 | Phone |
| Date Signed | 2014-02-14 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Pamela Bergmann | Name |
| PTIN | P00891984 | PTIN |
| Phone | 3192400518 | Phone |
| Date Prepared | 2014-01-31 | DatePrepared |
| Self Employed | X | SelfEmployed |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Andrew Eastwood | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 235 S Eisenhower Avenue | AddressLine1 |
| City | Mason City | City |
| State | IA | State |
| ZIP Code | 50401 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 2589571 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.mhconi.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1955 | YearFormation |
| State Legal Domicile | IA | StateLegalDomicile |
| Activity Or Mission Description | Provides diagnosis and treatment of general psychiatric and psychological disorders in a six county area. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 8 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 8 | NbrIndependentVotingMembers |
| Total Nbr Employees | 42 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 51951 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 70662 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 2282359 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 2508769 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 10304 | InvestmentIncomePriorYear |
| Investment Income Current Year | 7522 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 5889 | OtherRevenuePriorYear |
| Other Revenue Current Year | 2618 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 2350503 | TotalRevenuePriorYear |
| Total Revenue Current Year | 2589571 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 1575140 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 1935997 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 1016319 | OtherExpensePriorYear |
| Other Expenses Current Year | 662872 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 2591459 | TotalExpensesPriorYear |
| Total Expenses Current Year | 2598869 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -240956 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -9298 | RevenuesLessExpensesCY |
| Total Assets BOY | 2025189 | TotalAssetsBOY |
| Total Assets EOY | 2020517 | TotalAssetsEOY |
| Total Liabilities BOY | 260797 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 257854 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 1764392 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 1762663 | NetAssetsOrFundBalancesEOY |
| Mission Description | Provides diagnosis and treatment of general psychiatric and psychological disorders in a six county area. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 1862022 | Expense |
| Grants | 0 | Grants |
| Revenue | 2518909 | Revenue |
| Description | Provided 5810 units of Psychiatric/Psychological Services 12801 units of Individual and Group Therapy Services and 1827 units of Diagnostic Services to patients in a six county area. | Description |
| Total Of Other Program Service Exp | 0 | TotalOfOtherProgramServiceExp |
| Total Of Other Program Service Grnt | 0 | TotalOfOtherProgramServiceGrnt |
| Total Of Other Program Service Rev | 0 | TotalOfOtherProgramServiceRev |
| Total Program Service Expense | 1862022 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 0 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 0 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 0 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 13 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 42 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 8 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 8 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Other Website | X | OtherWebsite |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | Andrew Eastwood | NamePerson |
| Telephone Number | 6414242075 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 235 S Eisenhower Avenue | AddressLine1 |
| City | Mason City | City |
| State | IA | State |
| ZIP Code | 50401 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (10 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Average Hours Per Week RelatedAverageHoursPerWeekRelated | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| Douglas Krull | ||||||||
| Director-President | 0 | 0 | X | 0 | 0 | 0 | ||
| Patricia Petersen | ||||||||
| Director | 0 | 0 | X | 0 | 0 | 0 | ||
| Ron Noah | ||||||||
| Director | 0 | 0 | X | 0 | 0 | 0 | ||
| James Hill | ||||||||
| Director | 0 | 0 | X | 0 | 0 | 0 | ||
| Penney Morse | ||||||||
| Director | 0 | 0 | X | 0 | 0 | 0 | ||
| Terri Tesch | ||||||||
| Director | 0 | 0 | X | 0 | 0 | 0 | ||
| Scott Helgeson | ||||||||
| Director-Treasurer | 0 | 0 | X | 0 | 0 | 0 | ||
| Andrew Hill | ||||||||
| Director | 0 | 0 | X | 0 | 0 | 0 | ||
| Andrew Eastwood | ||||||||
| Executive Director | 40 | 0 | 81553 | 0 | 14000 | X | ||
| Abbie White | ||||||||
| ARNP | 40 | 0 | 108056 | 0 | 13000 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 189609 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 27000 | TotalOtherCompensation |
| Number Individuals GT100 K | 1 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 0 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation
Name Of Contractor NameOfContractor
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FasPsych LLC | BusinessNameLine1 |
Address Of Contractor AddressOfContractor
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3260 N Hayden Road Suite 105 | AddressLine1 |
| City | Scottsdale | City |
| State | AZ | State |
| ZIP Code | 85251 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Of Services | Psychiatric Services | DescriptionOfServices |
| Compensation | 165393 | Compensation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 1 | NumberOfContractorsGT100K |
| Federated Campaigns | 0 | FederatedCampaigns |
| Membership Dues | 0 | MembershipDues |
| Fundraising Events | 0 | FundraisingEvents |
| Related Organizations | 0 | RelatedOrganizations |
| Government Grants | 70473 | GovernmentGrants |
| All Other Contributions | 189 | AllOtherContributions |
| Noncash Contributions | 0 | NoncashContributions |
| Total Contributions | 70662 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | Unrelated Business RevenueUnrelatedBusinessRevenue | ExclusionExclusionAmount |
|---|---|---|---|---|---|
| Patient Fees | 624100 | 2229395 | 2229395 | 0 | $0 |
| County Patient Fees Paid | 624100 | 279374 | 279374 | 0 | $0 |
Total Oth Program Service Revenue TotalOthProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 2508769 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 7522 | TotalRevenueColumn |
| Related Or Exempt Function Income | 7522 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
| Personal | 0 | Personal |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 0 | Securities |
| Other | 0 | Other |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrbtns Rprtd Fundraising Events | 0 | CntrbtnsRprtdFundraisingEvents |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 2618 | TotalRevenueColumn |
| Related Or Exempt Function Income | 2618 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 2618 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 2589571 | TotalRevenueColumn |
| Related Or Exempt Function Income | 2518909 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | X | InfoInScheduleOPartIX |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 95553 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 95553 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1492949 | Total |
| Program Services | 1140060 | ProgramServices |
| Management And General | 352889 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 69207 | Total |
| Program Services | 54689 | ProgramServices |
| Management And General | 14518 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 166225 | Total |
| Program Services | 105309 | ProgramServices |
| Management And General | 60916 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 112063 | Total |
| Program Services | 85788 | ProgramServices |
| Management And General | 26275 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11385 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 11385 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 20621 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 20621 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 31617 | Total |
| Program Services | 20546 | ProgramServices |
| Management And General | 11071 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 37582 | Total |
| Program Services | 2358 | ProgramServices |
| Management And General | 35224 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 29699 | Total |
| Program Services | 29699 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 15425 | Total |
| Program Services | 10669 | ProgramServices |
| Management And General | 4756 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3734 | Total |
| Program Services | 0 | ProgramServices |
| Management And General | 3734 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 59156 | Total |
| Program Services | 45567 | ProgramServices |
| Management And General | 13589 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 23417 | Total |
| Program Services | 15598 | ProgramServices |
| Management And General | 7819 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| Psychiatric Services | 186453 | 186453 | 0 | 0 |
| Repairs and Maintenance | 44481 | 38393 | 6088 | 0 |
| Continued Education | 38878 | 38136 | 742 | 0 |
| Program Supplies | 23163 | 23163 | 0 | 0 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 137261 | Total |
| Program Services | 65594 | ProgramServices |
| Management And General | 71667 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2598869 | Total |
| Program Services | 1862022 | ProgramServices |
| Management And General | 736847 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 372859 | BOY |
| EOY | 57914 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 445674 | BOY |
| EOY | 360196 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 21931 | BOY |
| EOY | 56618 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 916713 | BOY |
| EOY | 1316089 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 38801 | BOY |
| EOY | 37046 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 1522027 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 1329373 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 229211 | BOY |
| EOY | 192654 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2025189 | BOY |
| EOY | 2020517 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 260797 | BOY |
| EOY | 257854 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 260797 | BOY |
| EOY | 257854 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1748561 | BOY |
| EOY | 1746770 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14565 | BOY |
| EOY | 14625 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1266 | BOY |
| EOY | 1268 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1764392 | BOY |
| EOY | 1762663 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2025189 | BOY |
| EOY | 2020517 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | -9298 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | 7569 | ReconciliationUnrealizedInvest |
| Reconcilation Donated Services | 0 | ReconcilationDonatedServices |
| Reconcilation Invest Expenses | 0 | ReconcilationInvestExpenses |
| Reconcilation Prior Adjustment | 0 | ReconcilationPriorAdjustment |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Separate | X | FinancialStatementSeparate |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org170b1 Avi | X | PubliclySupportedOrg170b1Avi |
Gifts Grants Contrib Received170 GiftsGrantsContribReceived170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 219526 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 134958 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 152289 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 51951 | CurrentTaxYearMinus1Year |
| Current Tax Year | 70662 | CurrentTaxYear |
| Total | 629386 | Total |
Tax Rev Levied For Org Benefit170 TaxRevLeviedForOrgBenefit170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 575273 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 445566 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 415778 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 377227 | CurrentTaxYearMinus1Year |
| Current Tax Year | 379374 | CurrentTaxYear |
| Total | 2193218 | Total |
Value Srvc Fclts Furnished By Govt ValueSrvcFcltsFurnishedByGovt
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 0 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 0 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 0 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 0 | CurrentTaxYearMinus1Year |
| Current Tax Year | 0 | CurrentTaxYear |
| Total | 0 | Total |
Total170 Total170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 794799 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 580524 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 568067 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 429178 | CurrentTaxYearMinus1Year |
| Current Tax Year | 450036 | CurrentTaxYear |
| Total | 2822604 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Amounts Subst Contributors Total | 0 | AmountsSubstContributorsTotal |
| Public Support Total170 | 2822604 | PublicSupportTotal170 |
Gross Investment Income170 GrossInvestmentIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 48643 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 29790 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 19611 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 13267 | CurrentTaxYearMinus1Year |
| Current Tax Year | 15029 | CurrentTaxYear |
| Total | 126340 | Total |
Net UBI NetUBI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 0 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 0 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 0 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 0 | CurrentTaxYearMinus1Year |
| Current Tax Year | 0 | CurrentTaxYear |
| Total | 0 | Total |
Other Income170 OtherIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 11741 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 9459 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 13733 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 6173 | CurrentTaxYearMinus1Year |
| Current Tax Year | 2618 | CurrentTaxYear |
| Total | 43724 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | 2992668 | TotalSupport |
| Gross Receipts From Admissions Etc | 0 | GrossReceiptsFromAdmissionsEtc |
| Public Support Pertcentage170 | 0.94317 | PublicSupportPertcentage170 |
| Public Support Pertcent Prior Year | 0.9379 | PublicSupportPertcentPriorYear |
| Thirty Three Percnt Tests CY170 | X | ThirtyThreePercntTestsCY170 |
| General Explanation | Part II Section B Line 10 Miscellaneous Income | GeneralExplanation |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| 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) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 2000 | OtherCostOrOtherBasis |
| Book Value | 2000 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 818179 | OtherCostOrOtherBasis |
| Depreciation | 691134 | Depreciation |
| Book Value | 127045 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 0 | OtherCostOrOtherBasis |
| Depreciation | 0 | Depreciation |
| Book Value | 0 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 666687 | OtherCostOrOtherBasis |
| Depreciation | 608171 | Depreciation |
| Book Value | 58516 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 35161 | OtherCostOrOtherBasis |
| Depreciation | 30068 | Depreciation |
| Book Value | 5093 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 192654 | TotalOfBookValueLandBuildings |
| Tot Revenue Etc Audited Fincl Stmt | 2597140 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 7569 | NetUnrealizedGainsInvestments |
| Donated Srvc And Use Of Facilities | 0 | DonatedSrvcAndUseOfFacilities |
| Recoveries Of Prior Year Grants | 0 | RecoveriesOfPriorYearGrants |
| Other Revenues | 0 | OtherRevenues |
| Revenue Not Rptd F990 | 7569 | RevenueNotRptdF990 |
| Revenue Subtotal | 2589571 | RevenueSubtotal |
| Investment Expenses Not Included | 0 | InvestmentExpensesNotIncluded |
| Other Revenues Not Included | 0 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 2589571 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 2598869 | TotExpensesEtcAuditedFinclStmt |
| Donated Services Use Of Facilities | 0 | DonatedServicesUseOfFacilities |
| Prior Year Adjustments | 0 | PriorYearAdjustments |
| Losses Reported | 0 | LossesReported |
| Other Expenses Included | 0 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 2598869 | ExpensesSubtotal |
| Investment Expenses Not Included2 | 0 | InvestmentExpensesNotIncluded2 |
| Other Expenses Not Included | 0 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 2598869 | TotalExpensesPerForm990 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (5 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| F990_P06_S0B_L11b | Form 990, Part VI, Section B, Line 11b | Board Members and the Executive Director are given a copy of the 990 to review prior to filing. |
| F990_P06_S0B_L12c | Form 990, Part VI, Section B, Line 12c | The Centers Conflict of Interest policy requires each employee, student, independent contractor, volunteer and Board Member to advise the Executive Director immediately of any conflict of interest. Written disclosures are obtained and reviewed annually by the Executive Director. |
| F990_P06_S0B_L15 | Form 990, Part VI, Section B, Line 15 | Compensation for the Executive Director and Key Employees is determined using comparative data and is substantiated in the personnel files. The Board of Directors reviews and approves compensation. |
| F990_P06_S0C_L19 | Form 990, Part VI, Section C, Line 19 | Governing Documents, Conflict of Interest policy and Financial Statements are made available upon request to the public at the facility's central location, 235 S Eisenhower Avenue, Mason City, IA 50401. Financial Statements are also available at the Iowa State Auditors website at http://auditor.iowa.gov/reports/index.html |
| F990_P09_S00_L24a | Form 990, Part IX, Line 24a - 24e | Line 24e Telephone and Utilities 55957 Provision for Doubtful Accounts 54951 Staff Recruiting 12802 CHMC Association Dues 2273 Miscellaneous 11278 |
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