CEDAR VALLEY HOSPICE INC: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- CEDAR VALLEY HOSPICE INC (EIN 42-1135294)
- Tax period
- 2013-01-01 to 2013-12-31
- Filed
- 2014-08-14
- IRS object ID
- 201432269349301133
- Schema version
- 2013v3.0
- 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 | 2014-08-14T09:32:19-05:00 | ReturnTs |
| Tax Period End | 2013-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 421243538 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BERGAN PAULSEN & COMPANY PC | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 2100 | AddressLine1 |
| City | WATERLOO | City |
| State | IA | State |
| ZIP Code | 507042100 | 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 | 421135294 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CEDAR VALLEY HOSPICE INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CEDA | BusinessNameControlTxt |
| Phone | 3192722002 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 2880 | AddressLine1 |
| City | WATERLOO | City |
| State | IA | State |
| ZIP Code | 507042880 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MARVIN FAGERLIND | PersonNm |
| Person Title | EXECUTIVE DIRECTOR | PersonTitleTxt |
| Phone | 3192722002 | PhoneNum |
| Signature | 2014-08-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DAVID A RICHTER | PreparerPersonNm |
| PTIN | P00168204 | PTIN |
| Phone | 3192346885 | PhoneNum |
| 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) |
|---|---|---|
| Principal Officer | MARVIN FAGERLIND | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 2880 | AddressLine1 |
| City | WATERLOO | City |
| State | IA | State |
| ZIP Code | 507042880 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $11,888,346 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.cvhospice.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1979 | FormationYr |
| Legal Domicile State | IA | LegalDomicileStateCd |
| Activity Or Mission | PROVIDE HOSPICE AND COUNSELING SERVICES TO TERMINALLY ILL PATIENTS AND THEIR FAMILIES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 15 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 15 | VotingMembersIndependentCnt |
| Total Employee | 155 | TotalEmployeeCnt |
| Total Volunteers | 400 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,085,004 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,682,703 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $8,946,423 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $8,484,501 | CYProgramServiceRevenueAmt |
| PY Investment Income | $214,552 | PYInvestmentIncomeAmt |
| CY Investment Income | $344,292 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$4,493 | PYOtherRevenueAmt |
| CY Other Revenue | -$20,205 | CYOtherRevenueAmt |
| PY Total Revenue | $10,241,486 | PYTotalRevenueAmt |
| CY Total Revenue | $10,491,291 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $104,196 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $61,819 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $6,163,311 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $6,333,132 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $23,134 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $186,267 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $4,596,365 | PYOtherExpensesAmt |
| CY Other Expenses | $4,273,809 | CYOtherExpensesAmt |
| PY Total Expenses | $10,887,006 | PYTotalExpensesAmt |
| CY Total Expenses | $10,668,760 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$645,520 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$177,469 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $10,365,349 | TotalAssetsBOYAmt |
| Total Assets EOY | $10,557,131 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,317,355 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,318,702 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $9,047,994 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $9,238,429 | NetAssetsOrFundBalancesEOYAmt |
| Mission | CEDAR VALLEY HOSPICE PROVIDES THE LEADERSHIP AND SETS THE STANDARD FOR EXCELLENCE IN DELIVERING COMPREHENSIVE PALLIATIVE AND END OF LIFE CARE TO PATIENTS AND SERVICES TO THOSE THAT GRIEVE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $8,269,394 | ExpenseAmt |
| Grant | $61,819 | GrantAmt |
| Revenue | $8,484,501 | RevenueAmt |
| Desc | CEDAR VALLEY HOSPICE IS DEDICATED TO PROVIDING HOSPICE SERVICES TO THOSE WITH A SIX MONTH PROGNOSIS OR LESS, SERVING 936 PATIENTS IN 2013. THE AVERAGE DAILY CENSUS WAS 138.92 WHICH ALLOWED US TO PROVIDE 50,705.80 DAYS OF CARE. THE AVERAGE LENGTH OF STAY FOR OUR HOSPICE PATIENTS WAS 61.2 DAYS. CEDAR VALLEY HOSPICE PROVIDES GRIEF SUPPORT SERVICES TO ANYONE STRUGGLING WITH THE DEATH OF A LOVED ONE, SERVING 3,771 GRIEF CLIENTS IN 2013. GRIEF CLIENTS WERE SERVED THROUGH INDIVIDUAL VISITS, SUPPORT GROUPS, SMALL AND LARGE GROUP SETTINGS (I.E. EMPLOYERS/SCHOOL) AND MAILINGS. CEDAR VALLEY HOSPICE PROVIDES HOME CARE SERVICES TO THOSE WITH A LIFE THREATENING ILLNESS, SERVING 55 CLIENTS IN 2013. | Desc |
| Total Program Service Expenses | $8,269,394 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (1) | GrantsToIndividualsInd |
| Schedule J Required | 0 | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | Yes (1) | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 41 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 155 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 15 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 15 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MICHAELA VANDERSEE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3192722002 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2101 KIMBALL AVENUE SUITE 401 | AddressLine1 |
| City | WATERLOO | City |
| State | IA | State |
| ZIP Code | 50701 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| SUE MORKEL | |||||||
| SECRETARY | 0.20 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| SHELLI PINT | |||||||
| DIRECTOR | 0.20 | Yes (X) | $0 | $0 | $0 | ||
| GENE SANDELL | |||||||
| DIRECTOR | 0.20 | Yes (X) | $0 | $0 | $0 | ||
| CHRIS SCHILDROTH | |||||||
| VICE PRESIDENT | 0.20 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| GIA SHANNON | |||||||
| PRESIDENT | 0.20 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| RENAE BOCKHOLT | |||||||
| DIRECTOR | 0.20 | Yes (X) | $0 | $0 | $0 | ||
| PAM DOWIE | |||||||
| DIRECTOR | 0.20 | Yes (X) | $0 | $0 | $0 | ||
| JUNEVER HEYING | |||||||
| DIRECTOR | 0.20 | Yes (X) | $0 | $0 | $0 | ||
| JOAN HEADINGTON | |||||||
| DIRECTOR | 0.20 | Yes (X) | $0 | $0 | $0 | ||
| CHRIS HYERS | |||||||
| DIRECTOR | 0.20 | Yes (X) | $0 | $0 | $0 | ||
| KRIS IREY | |||||||
| DIRECTOR | 0.20 | Yes (X) | $0 | $0 | $0 | ||
| ED LARSON | |||||||
| DIRECTOR | 0.20 | Yes (X) | $0 | $0 | $0 | ||
| SCOTT WIENANDS | |||||||
| DIRECTOR | 0.20 | Yes (X) | $0 | $0 | $0 | ||
| TRACY MUDD | |||||||
| DIRECTOR | 0.20 | Yes (X) | $0 | $0 | $0 | ||
| MICHAEL RUFFCOM | |||||||
| TREASURER | 0.20 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| JAMES O'CONNER | |||||||
| DIRECTOR | 0.20 | Yes (X) | $0 | $0 | $0 | ||
| MARVIN FAGERLIND | |||||||
| EXECUTIVE DIRECTOR | 65.00 | Yes (X) | $123,753 | $0 | $17,059 | ||
| MICHAELA VANDERSEE | |||||||
| FINANCE DIRECTOR | 65.00 | Yes (X) | $82,230 | $0 | $36,517 | ||
| MICHAEL DETERS | |||||||
| MEDICAL DIRECTOR | 30.00 | $148,809 | $0 | $26,595 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $354,792 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $80,171 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 2 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | 0 | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| HOSPISCRIPT SERVICES LLC | |||||
| 4525 EXECUTIVE PARK DR SUITE 100 | MONTGOMERY | AL | 36116 | PHARMACIST CONSULTS AND PRESCRIPTIONS | $541,076 |
| COVENANT MEDICAL CLINIC | |||||
| 3421 WEST NINTH STREET | WATERLOO | IA | 50702 | INPATIENT AND OUTPATIENT SERVICES | $203,832 |
| CERNER | |||||
| 2800 ROCKCREEK PARKWAY | NORTH KANSAS CITY | MO | 64117 | PROFESSIONAL SERVICES AND SOFTWARE | $159,680 |
| WAVERLY HEALTH CENTER | |||||
| 312 9TH ST SW | WAVERLY | IA | 50677 | INPATIENT AND OUTPATIENT SERVICES | $147,275 |
| MARTIN HEALTH CENTER | |||||
| 420 EAST 11TH STREET | CEDAR FALLS | IA | 50613 | MEDICAID ROOM AND BOARD PASS THROUGH | $135,397 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $80,746 | FundraisingAmt |
| Government Grants | $163,415 | GovernmentGrantsAmt |
| All Other Contributions | $1,438,542 | AllOtherContributionsAmt |
| Noncash Contributions | $39,841 | NoncashContributionsAmt |
| Total Contributions | $1,682,703 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT CARE FEES | Desc |
| Business | 623990 | BusinessCd |
| Total Revenue Column | $8,484,501 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $8,484,501 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $8,484,501 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $246,211 | TotalRevenueColumnAmt |
| Exclusion | $246,211 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,469,383 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,371,302 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $98,081 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $98,081 | TotalRevenueColumnAmt |
| Exclusion | $98,081 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $5,548 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $80,746 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $25,753 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$20,205 | TotalRevenueColumnAmt |
| Exclusion | -$20,205 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $10,491,291 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $8,484,501 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $324,087 | ExclusionAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $61,819 | TotalAmt |
| Program Services | $61,819 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $412,418 | TotalAmt |
| Program Services | $157,851 | ProgramServicesAmt |
| Management And General | $254,567 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,752,234 | TotalAmt |
| Program Services | $3,729,853 | ProgramServicesAmt |
| Management And General | $938,948 | ManagementAndGeneralAmt |
| Fundraising | $83,433 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $114,744 | TotalAmt |
| Program Services | $83,479 | ProgramServicesAmt |
| Management And General | $28,737 | ManagementAndGeneralAmt |
| Fundraising | $2,528 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $681,771 | TotalAmt |
| Program Services | $511,784 | ProgramServicesAmt |
| Management And General | $160,183 | ManagementAndGeneralAmt |
| Fundraising | $9,804 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $371,965 | TotalAmt |
| Program Services | $283,443 | ProgramServicesAmt |
| Management And General | $82,515 | ManagementAndGeneralAmt |
| Fundraising | $6,007 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $78,707 | TotalAmt |
| Management And General | $78,707 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,500 | TotalAmt |
| Management And General | $18,500 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,418 | TotalAmt |
| Management And General | $28,418 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $48,480 | TotalAmt |
| Program Services | $19,015 | ProgramServicesAmt |
| Management And General | $29,465 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $117,011 | TotalAmt |
| Program Services | $270 | ProgramServicesAmt |
| Management And General | $116,741 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $283,968 | TotalAmt |
| Program Services | $104,003 | ProgramServicesAmt |
| Management And General | $169,267 | ManagementAndGeneralAmt |
| Fundraising | $10,698 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $79,253 | TotalAmt |
| Management And General | $77,958 | ManagementAndGeneralAmt |
| Fundraising | $1,295 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $148,202 | TotalAmt |
| Program Services | $115,323 | ProgramServicesAmt |
| Management And General | $25,731 | ManagementAndGeneralAmt |
| Fundraising | $7,148 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $281,604 | TotalAmt |
| Program Services | $257,899 | ProgramServicesAmt |
| Management And General | $22,729 | ManagementAndGeneralAmt |
| Fundraising | $976 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $105,081 | TotalAmt |
| Program Services | $73,843 | ProgramServicesAmt |
| Management And General | $31,115 | ManagementAndGeneralAmt |
| Fundraising | $123 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $152,501 | TotalAmt |
| Program Services | $117,426 | ProgramServicesAmt |
| Management And General | $27,450 | ManagementAndGeneralAmt |
| Fundraising | $7,625 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $46,354 | TotalAmt |
| Program Services | $34,485 | ProgramServicesAmt |
| Management And General | $9,289 | ManagementAndGeneralAmt |
| Fundraising | $2,580 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| PATIENT EXPENSES | $1,734,651 | $1,734,651 | |
| MEDICAL SUPPLIES & DRUG | $931,102 | $931,102 | |
| EQUIPMENT RENTAL & MAIN | $89,769 | $89,769 | |
| CONSORTIUM EXPENSE | $23,605 | $23,605 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $106,603 | TotalAmt |
| Program Services | $29,543 | ProgramServicesAmt |
| Management And General | $23,010 | ManagementAndGeneralAmt |
| Fundraising | $54,050 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,668,760 | TotalAmt |
| Program Services | $8,269,394 | ProgramServicesAmt |
| Management And General | $2,213,099 | ManagementAndGeneralAmt |
| Fundraising | $186,267 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $882,754 | BOYAmt |
| EOY | $311,299 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $295,482 | BOYAmt |
| EOY | $455,129 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $60,620 | BOYAmt |
| EOY | $655,180 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,408,388 | BOYAmt |
| EOY | $1,580,210 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $99,827 | BOYAmt |
| EOY | $98,076 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $3,148,851 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $2,048,036 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,249,023 | BOYAmt |
| EOY | $1,100,815 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,354,872 | BOYAmt |
| EOY | $6,336,513 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,383 | BOYAmt |
| EOY | $19,909 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,365,349 | BOYAmt |
| EOY | $10,557,131 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,317,355 | BOYAmt |
| EOY | $1,318,702 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,317,355 | BOYAmt |
| EOY | $1,318,702 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,261,786 | BOYAmt |
| EOY | $7,773,722 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $58,534 | BOYAmt |
| EOY | $736,183 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $727,674 | BOYAmt |
| EOY | $728,524 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,047,994 | BOYAmt |
| EOY | $9,238,429 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,365,349 | BOYAmt |
| EOY | $10,557,131 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$177,469 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $367,904 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
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 | $996,711 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $936,024 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,125,441 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,085,004 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,195,203 | CurrentTaxYearAmt |
| Total | $5,338,383 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $996,711 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $936,024 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,125,441 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,085,004 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,195,203 | CurrentTaxYearAmt |
| Total | $5,338,383 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $224,585 | SubstantialContributorsTotAmt |
| Public Support Total170 | $5,113,798 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $147,483 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $164,926 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $188,290 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $199,804 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $246,211 | CurrentTaxYearAmt |
| Total | $946,714 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $6,285,097 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $44,845,838 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.81360 | PublicSupportCY170Pct |
| Public Support PY170 | 0.81750 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Form990 Schedule A Part IV Form990ScheduleAPartIVGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE A, LINE 1 | FormAndLineReferenceDesc |
| Explanation | BEQUEST IN THE AMOUNT OF $237,500 AND PLEDGE IN THE AMOUNT OF $250,000 WERE EXCLUDED FROM LINE 1 AS THEY WERE LARGE AND UNEXPECTED. | ExplanationTxt |
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
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,840,277 | BeginningYearBalanceAmt |
| Contributions | $35,241 | ContributionsAmt |
| Investment Earnings Or Losses | $78,171 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $78,171 | OtherExpendituresAmt |
| End Year Balance | $1,875,518 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,725,337 | BeginningYearBalanceAmt |
| Contributions | $114,940 | ContributionsAmt |
| Investment Earnings Or Losses | $47,436 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $47,436 | OtherExpendituresAmt |
| End Year Balance | $1,840,277 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,608,914 | BeginningYearBalanceAmt |
| Contributions | $116,423 | ContributionsAmt |
| Investment Earnings Or Losses | $11,860 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $11,860 | OtherExpendituresAmt |
| End Year Balance | $1,725,337 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,415,943 | BeginningYearBalanceAmt |
| Contributions | $158,598 | ContributionsAmt |
| Investment Earnings Or Losses | $55,344 | InvestmentEarningsOrLossesAmt |
| Other Expenditures | $20,971 | OtherExpendituresAmt |
| End Year Balance | $1,608,914 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,234,758 | BeginningYearBalanceAmt |
| Contributions | $98,391 | ContributionsAmt |
| Investment Earnings Or Losses | $82,794 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $1,415,943 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.61000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.39000 | PrmnntEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | Yes (1) | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,634,479 | OtherCostOrOtherBasisAmt |
| Depreciation | $945,190 | DepreciationAmt |
| Book Value | $689,289 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $359,033 | OtherCostOrOtherBasisAmt |
| Depreciation | $345,693 | DepreciationAmt |
| Book Value | $13,340 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,155,339 | OtherCostOrOtherBasisAmt |
| Depreciation | $757,153 | DepreciationAmt |
| Book Value | $398,186 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,100,815 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $10,223,830 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $367,904 | NetUnrealizedGainsInvstAmt |
| Donated Services And Use Fclts | $17,381 | DonatedServicesAndUseFcltsAmt |
| Other Revenue | $36,616 | OtherRevenueAmt |
| Revenue Not Reported | $421,901 | RevenueNotReportedAmt |
| Revenue Subtotal | $9,801,929 | RevenueSubtotalAmt |
| Other Revenues Not Included | $689,362 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $689,362 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $10,491,291 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $10,711,894 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $17,381 | DonatedServicesUseFcltsAmt |
| Other Expenses Included | $25,753 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $43,134 | ExpensesNotReportedAmt |
| Expenses Subtotal | $10,668,760 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $10,668,760 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part X, Line 2: | INCOME TAX RETURNS ARE SUBJECT TO UNCERTAIN TAX POSITIONS THAT MIGHT NOT BE SUSTAINED UPON EXAMINATION BY TAXING AUTHORITIES. MANAGEMENT ANNUALLY MAKES AN APPROPRIATE EVALUATION OF ANY UNCERTAIN TAX POSITIONS THAT MAY EXIST WITHIN THE ORGANIZATION'S TAX RETURN. AS OF DECEMBER 31, 2013, MANAGEMENT BELIEVES THAT THERE WERE NO MATERIAL UNCERTAIN TAX POSITIONS THAT ARE REQUIRED TO BE RECORDED OR DISCLOSED. WITH FEW EXCEPTIONS, THE ORGANIZATION IS NO LONGER SUBJECT TO TAX EXAMINATIONS FOR YEARS BEFORE 2010. |
| Part XI, Line 2d - Other Adjustments: | NET ASSETS RELEASED FROM RESTRICTIONS 10,863. SPECIAL EVENTS EXENSE 25,753. |
| Part XI, Line 4b - Other Adjustments: | TEMPORARILY RESTRICTED NET ASSET CONTRIBUTIONS 688,512. PERMANENTLY RESTRICTED NET ASSET CONTRIBUTIONS 850. |
| Part XII, Line 2d - Other Adjustments: | SPECIAL EVENTS EXPENSE 25,753. |
| PART V, LINE 4: | THE ORGANIZATION'S POLICY IS TO DISTRIBUTE ALL OR A PORTION OF THE ANNUAL NET INVESTMENT EARNINGS TO SUPPORT THE ORGANIZATION'S PROGRAMS WHICH ARE NOT SELF-SUFFICIENT WHILE MAINTAINING THE FAIR VALUE OF THE ORIGINAL ENDOWMENT GIFTS. |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | NAUTICAL NIGHTS | NameOfEvent1Amt |
| Gross Receipts Event1 | $74,714 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $74,566 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $148 | GrossRevenueEvent1Amt |
| Rent Facility Costs Event1 | $12,508 | RentFacilityCostsEvent1Amt |
| Other Direct Expenses Event1 | $10,297 | OtherDirectExpensesEvent1Amt |
| Name Of Event2 | GOLF OUTING | NameOfEvent2Amt |
| Gross Receipts Event2 | $11,580 | GrossReceiptsEvent2Amt |
| Charitable Contri Event2 | $6,180 | CharitableContriEvent2Amt |
| Gross Revenue Event2 | $5,400 | GrossRevenueEvent2Amt |
| Other Direct Expenses Event2 | $2,948 | OtherDirectExpensesEvent2Amt |
| Gross Receipts Total | $86,294 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $80,746 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $5,548 | GrossRevenueTotalEventsAmt |
| Rent Fclty Costs Total Events | $12,508 | RentFcltyCostsTotalEventsAmt |
| Oth Direct Expnss Total Events | $13,245 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $25,753 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$20,205 | NetIncomeSummaryAmt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (6 entries)
| Grant TypeGrantTypeTxt | RecipientRecipientCnt | Cash GrantCashGrantAmt |
|---|---|---|
| ORAL HEALTH CARE | 3 | $1,154 |
| EMERGENCY FINANCIAL ASSISTANCE | 35 | $5,173 |
| HOUSING SERVICES | 11 | $10,988 |
| MEDICAL TRANSPORTATION ASSISTANCE | 33 | $5,885 |
| HEALTH INSURANCE PROGRAM | 14 | $35,285 |
| MENTAL HEALTH SERVICES | 6 | $3,334 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE I, PART III: | FormAndLineReferenceDesc |
| Explanation | ALL OF THE RECORDS TO ESTABLISH ELIGIBILITY FOR THE GRANT OR ASSISTANCE ARE MAINTAINED IN THE CLIENT'S CASE MANAGEMENT CHART. CHART AUDITS ARE PERFORMED TO ENSURE THAT CLIENTS WHO ARE RECEIVING ASSISTANCE ARE ELIGIBLE TO RECEIVE ASSISTANCE. ALSO TWO OF THE GOVERNMENT AGENCIES THAT GIVE THE ORGANIZATION MONEY TO EXPEND FOR THE BENEFIT OF ITS CLIENTS MONITOR THE ORGANIZATION'S CHARTS AND PAPERWORK FOR COMPLIANCE WITH THE GRANT REQUIREMENTS. THE CASE MANAGER REQUESTING THE ASSISTANCE FILLS OUT A REQUEST FOR THE ASSISTANCE INDICATING WHY/HOW THE CLIENT MEETS ELIGIBILITY. THE SUPERVISOR APPROVES THE ASSISTANCE FOR PAYMENT AND THEN THE ACCOUNTING DEPARTMENT PROCESSES THE CHECK AND MONITORS THE OVERALL USAGE OF THE GRANT. | ExplanationTxt |
Schedule M IRS990ScheduleM
Books And Publications BooksAndPublicationsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Noncash Contributions Rpt F990 | $62 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | COST | MethodOfDeterminingRevenuesTxt |
Clothing And Household Goods ClothingAndHouseholdGoodsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Noncash Contributions Rpt F990 | $10,407 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | COST | MethodOfDeterminingRevenuesTxt |
Food Inventory FoodInventoryGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 7 | ContributionCnt |
| Noncash Contributions Rpt F990 | $668 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | COST | MethodOfDeterminingRevenuesTxt |
Other Non Cash Contri Table OtherNonCashContriTableGrp (3 entries)
| Non Cash CheckboxNonCashCheckboxInd | DescDesc | ContributionContributionCnt | Noncash Contributions Rpt F990NoncashContributionsRptF990Amt | Method Of Determining RevenuesMethodOfDeterminingRevenuesTxt |
|---|---|---|---|---|
| Yes (X) | AUCTION ITEMS | 110 | $15,947 | COST |
| Yes (X) | EVENT PRIZES | 147 | $7,516 | COST |
| Yes (X) | OTHER | 17 | $5,241 | COST |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8283 Received | 0 | Form8283ReceivedCnt |
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | Yes (1) | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Column (b): | FormAndLineReferenceDesc |
| Explanation | NUMBER OF CONTRIBUTORS IS BASED ON THE NUMBER OF ITEMS CONTRIBUTED. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section B, line 11 | THE EXECUTIVE DIRECTOR AND FINANCE DIRECTOR REVIEW THE FORM 990. ONCE THEY HAVE REVIEWED THE RETURN, IT IS HANDED OUT TO THE BOARD OF DIRECTORS FOR THEIR REVIEW BEFORE BEING FILED. |
| Form 990, Part VI, Section B, line 12c | THE MONTHLY BOARD MEETING AGENDA INCLUDES AN AGENDA ITEM THAT REQUIRES BOARD MEMBERS TO REVIEW THE APPROVED AGENDA AND DECLARE ANY CONFLICTS OF INTEREST. |
| Form 990, Part VI, Section B, line 15 | THE EXECUTIVE COMMITTEE DETERMINES AND APPROVES THE EXECUTIVE DIRECTOR'S WAGES BASED ON AN ANNUAL REVIEW, REVIEW OF FORM 990 COMPENSATION OF SIMILAR POSITIONS AND INFORMATION OBTAINED FROM INDEPENDENT SALARY SURVEYS. THE DIRECTOR OF FINANCE'S AND MEDICAL DIRECOR'S WAGES ARE DETERMINED BASED ON A REVIEW OF FORM 990 COMPENSATION OF SIMILAR POSITIONS, INFORMATION OBTAINED FROM INDEPENDENT SALARY SURVEYS AND THE COLA ADJUSTMENT. THE EXECUTIVE DIRECTOR AND HUMAN RESOURCE DIRECTOR DETERMINE THE DIRECTOR OF FINANCE'S AND MEDICAL DIRECTOR'S WAGES BASED ON THIS INFORMATION. BOARD APPROVES ALL WAGES THROUGH THE BUDGET PROCESS. |
| Form 990, Part VI, Section C, line 19 | GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON WRITTEN REQUEST. |
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