GIRDWOOD HEALTH CLINIC: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- GIRDWOOD HEALTH CLINIC (EIN 90-0622646)
- Tax period
- 2013-01-01 to 2013-12-31
- Filed
- 2014-11-16
- IRS object ID
- 201423209349300022
- Schema version
- 2013v3.1
- 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 | 2014-11-16T12:55:17-09:00 | ReturnTs |
| Tax Period End | 2013-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 920150055 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | White and Associates CPA | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 772165 | AddressLine1 |
| City | Eagle River | City |
| State | AK | State |
| ZIP Code | 99577 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 900622646 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Girdwood Health Clinic Inc | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | GIRD | BusinessNameControlTxt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 1130 | AddressLine1 |
| City | Girdwood | City |
| State | AK | State |
| ZIP Code | 99587 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Mary Jo Thill | PersonNm |
| Person Title | President | PersonTitleTxt |
| Phone | 9077831355 | PhoneNum |
| Signature | 2014-11-12 | SignatureDt |
| Discuss With Paid Preparer | false | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Sharon K White CPA | PreparerPersonNm |
| PTIN | P00100413 | PTIN |
| Phone | 9075619599 | PhoneNum |
| Self Employed | Yes (X) | SelfEmployedInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $768,484 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.girdwoodhealthclinic.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2011 | FormationYr |
| Legal Domicile State | AK | LegalDomicileStateCd |
| Activity Or Mission | provide expanded, quality health care to residents and visitors of the area without regard to ability to pay, through the operation of a sustainable, nonprofit community health clinic | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 13 | VotingMembersIndependentCnt |
| Total Employee | 9 | TotalEmployeeCnt |
| Total Volunteers | 20 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $67,855 | PYContributionsGrantsAmt |
| CY Contributions Grants | $383,509 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $425,980 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $384,403 | CYProgramServiceRevenueAmt |
| PY Investment Income | $24 | PYInvestmentIncomeAmt |
| CY Investment Income | $22 | CYInvestmentIncomeAmt |
| PY Other Revenue | $344 | PYOtherRevenueAmt |
| CY Other Revenue | $550 | CYOtherRevenueAmt |
| PY Total Revenue | $494,203 | PYTotalRevenueAmt |
| CY Total Revenue | $768,484 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $224,314 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $328,851 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $207,178 | PYOtherExpensesAmt |
| CY Other Expenses | $291,122 | CYOtherExpensesAmt |
| PY Total Expenses | $431,492 | PYTotalExpensesAmt |
| CY Total Expenses | $619,973 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $62,711 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $148,511 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $217,716 | TotalAssetsBOYAmt |
| Total Assets EOY | $353,942 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $139,951 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $127,666 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $77,765 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $226,276 | NetAssetsOrFundBalancesEOYAmt |
| Mission | provide expanded, quality health care to residents and visitors of the area without regard to ability to pay, through the operation of a sustainable, nonprofit community health clinic | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $31,200 | ExpenseAmt |
| Revenue | $12,000 | RevenueAmt |
| Desc | Opened and operated a satellite clinc in Hope in continuation of grant awarded in 2012 by the State of Alaska. Hope is an underserved area too small to support a full clinic on its own. GHC staffs a Hope telemedicine site with advanced Emergency Medical Technicians trained to connect paitients in Hope with clinicians in Girdwood. Using cloud based electronic health records (EHR) the trained staff in Hope can send and receive digital images and information to and from the Girdwood clinic creating a cost effective telemedicine system for Hope. Hope has a year round population of 197. Approximately 7 paitients per month receive services, with about 20 regular clients. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $586,688 | ExpenseAmt |
| Revenue | $372,403 | RevenueAmt |
| Desc | The Girdwood Health Clinic offers primary and urgent health care for permanent and seasonal residents of the Turnagain Arm area, as well as tourists visiting the resort town. The clinic offers x-ray services and is able to provide casting and splinting, wound care including stitches, medications and lab services. A discount fee schedule based on FPL is offered to those without insurance or who are underinsured. Medicare and Medicaid payments accepted as well as private insurance. GHC participates in the Breast and Cervical Health Check (BCHC) program which funds Pap tests and mammograms for low income women.The clinic also participates in the Alaska department of Health and Social Services epidemiology vaccine depot immunization program. Vaccines are received and provided to patients in need or who are underinsured.Fees for services in 2013 were discounted over $90,000 for low income, medicare/medicaid and underinsured paitients. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Equipment acquisitions and building upgrades for onsite medical laboratory.A $20,000 grant from the Rasmuson Foundation was received for onsite laboratory and equipment. Matching contributions of $5,000 raised as required in the terms of the grant. Funds provided for digital lab equipment for basic lab work including blood chemistries, blood counts and long term diabetes monitoring. Applied for and awarded a second grant from State of Alaska of $219,084 for medical equipement, records systems, planning and training. Implemented digital equipment including vitals monitor, EKG and Spirometer anddigital x-ray machine. A total of $128,135 expended on new equipment including XRay machine placed in service January 2014. Funds of $13,197 were expended on building renovations and improvements needed to support operation of the equipment. Cost and turnaround time on routine testing were reduced, patient care improved. Revenue from use and availablility of equipment not separately reported. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $617,888 | 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 | false | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | 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 | Yes (true) | 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 |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 9 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 9 | 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 |
| Form8899 Filedind | false | Form8899Filedind |
| Form1098 C Filed | false | Form1098CFiledInd |
| 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 | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 13 | 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 | false | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Steve Bartholomew | PersonNm |
| Phone | 9077831355 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 1053 | AddressLine1 |
| City | Girdwood | City |
| State | AK | State |
| ZIP Code | 99587 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | Yes (X) | NoListedPersonsCompensatedInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Key EmployeeKeyEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| Clinton Dow | ||||||||
| Director | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Kathy Trautner | ||||||||
| Director | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Eugene Bjornstad | ||||||||
| Director | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Karl Erickson | ||||||||
| Director | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Dorinda Carter | ||||||||
| Director | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Michelle Cosper | ||||||||
| Director | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Peter Preis | ||||||||
| Director | 4.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Robin Ingram | ||||||||
| Director | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Rochelle Morris | ||||||||
| Director | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Mary Jo Thill | ||||||||
| President | 6.00 | 0.00 | $0 | $0 | $0 | Yes (X) | ||
| Amanda Snitzer | ||||||||
| Sectretary | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | ||
| Steve Bartholomew | ||||||||
| Treasurer | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | ||
| Theresa Sherwood | ||||||||
| Vice President | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | ||
| Kerry Dorius | ||||||||
| Key Employee | 60.00 | 0.00 | $150,600 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $150,600 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $0 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 1 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| Government Grants | $321,749 | GovernmentGrantsAmt |
| All Other Contributions | $61,760 | AllOtherContributionsAmt |
| Total Contributions | $383,509 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Patient Health Care | Desc |
| Business | 621300 | BusinessCd |
| Total Revenue Column | $384,403 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $384,403 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $384,403 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $22 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $22 | RelatedOrExemptFuncIncomeAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Miscellaneous Revenue | Desc |
| Business | 323100 | BusinessCd |
| Total Revenue Column | $550 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $550 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $550 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $768,484 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $384,975 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $150,600 | TotalAmt |
| Program Services | $150,600 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $153,707 | TotalAmt |
| Program Services | $153,707 | ProgramServicesAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,544 | TotalAmt |
| Program Services | $24,544 | ProgramServicesAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $60 | TotalAmt |
| Management And General | $60 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $43,927 | TotalAmt |
| Program Services | $42,277 | ProgramServicesAmt |
| Management And General | $1,650 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $97,608 | TotalAmt |
| Program Services | $97,608 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,806 | TotalAmt |
| Program Services | $3,806 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,582 | TotalAmt |
| Program Services | $11,582 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $63,278 | TotalAmt |
| Program Services | $63,278 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,813 | TotalAmt |
| Program Services | $5,813 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,849 | TotalAmt |
| Program Services | $16,849 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,003 | TotalAmt |
| Program Services | $4,003 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Board and Staff Training | $65 | $65 | |
| Licenses and dues | $910 | $535 | $375 |
| Merchant fees | $3,298 | $3,298 | |
| Medical Supply | $39,923 | $39,923 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $619,973 | TotalAmt |
| Program Services | $617,888 | ProgramServicesAmt |
| Management And General | $2,085 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,587 | BOYAmt |
| EOY | $25,330 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $92,650 | BOYAmt |
| EOY | $78,378 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,013 | BOYAmt |
| EOY | $69,568 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $134,248 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $21,180 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $48,635 | BOYAmt |
| EOY | $113,068 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $72,831 | BOYAmt |
| EOY | $67,598 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $217,716 | BOYAmt |
| EOY | $353,942 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,589 | BOYAmt |
| EOY | $25,061 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,882 | BOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $127,480 | BOYAmt |
| EOY | $102,605 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $139,951 | BOYAmt |
| EOY | $127,666 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $69,883 | BOYAmt |
| EOY | $226,276 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,882 | BOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $77,765 | BOYAmt |
| EOY | $226,276 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $217,716 | BOYAmt |
| EOY | $353,942 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $148,511 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | false | FSAuditedInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | $7,793 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $67,855 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $383,509 | CurrentTaxYearAmt |
| Total | $459,157 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | $15,308 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $426,324 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $384,953 | CurrentTaxYearAmt |
| Total | $826,585 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | $23,101 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $494,179 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $768,462 | CurrentTaxYearAmt |
| Total | $1,285,742 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | $31,269 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $24,966 | CurrentTaxYearAmt |
| Total | $56,235 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | $31,269 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $24,966 | CurrentTaxYearAmt |
| Total | $56,235 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $1,229,507 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | $24 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $22 | CurrentTaxYearAmt |
| Total | $46 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | $24 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $22 | CurrentTaxYearAmt |
| Total | $46 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus2 Years | $23,101 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $494,203 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $768,484 | CurrentTaxYearAmt |
| Total | $1,285,788 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| First5 Years509 | Yes (X) | First5Years509Ind |
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
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $23,197 | OtherCostOrOtherBasisAmt |
| Depreciation | $537 | DepreciationAmt |
| Book Value | $22,660 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $111,051 | OtherCostOrOtherBasisAmt |
| Depreciation | $20,643 | DepreciationAmt |
| Book Value | $90,408 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $113,068 | TotalBookValueLandBuildingsAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Kerry Dorius | PersonNm |
| Title | Key Employee | TitleTxt |
| Base Compensation Filing Org | $150,600 | BaseCompensationFilingOrgAmt |
| Total Compensation Filing Org | $150,600 | TotalCompensationFilingOrgAmt |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Kerry Dorius | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | Key Employee | RelationshipDescriptionTxt |
| Transaction | $135,000 | TransactionAmt |
| Transaction | Sale of assets | TransactionDesc |
| Sharing Of Revenues | false | SharingOfRevenuesInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Supplemental Information for Schedule L | FormAndLineReferenceDesc |
| Explanation | Business TransactionsAsset Acquisition Statement under section 1060Purchaser: Girdwood Health Clinic, IncSeller: Kerry L DoriusDate of Sale: 12-22-2011 Total sales Price: 135,500Allocation of Sales Price:Class V assets: 57,000Class VI and VII assets:78,500A written agreement was signed by both parties which provided for an allocation of the sales price. This sale was done on an installment basis. Payments began in 2012. The remaining balance of the loan at 12-31-13 was $102,605 | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990 governing body review Part VI line 11 | The Board of Directors recieved a copy of the return, have reviewed and approved the Form 990 in their regular board meeting prior to filing. |
| Conflict of interest policy compliance Part VI line 12c | The conflict of interest policy is included in the by-laws of the organization. The policy is enforced thru self-monoritoring and is reviewed and discussed regularly at board meetings. |
| Governing documents etc available to public Part VI line 19 | The organization makes its governing documents, conflict of interest policy and financial statements available to the public by request. |
| List of other fees for services expenses Part IX line 11g | Outside service fees comprise of: IT services $ 7,908 Contracted Clinicians 65,085 Courier Services 4,180 Lab Services 11,647 Grant Writing 1,275 Snowplow services 4,065 Electrocardiam interpitation 504 Other Misc Services 2,944Total (part IX, line 11(g) $97,608 |
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