WEST CALCASIEU CAMERON HOSPITAL FOUNDATION: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization
WEST CALCASIEU CAMERON HOSPITAL FOUNDATION (EIN 72-1341439)
Tax period
2013-01-01 to 2013-12-31
Filed
2014-11-04
IRS object ID
201433089349300403
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

FieldValueIRS element (for citing)
Return2014-11-04T07:20:11-06:00ReturnTs
Tax Period End2013-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN800488055PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1STEVEN M DEROUEN & ASSOCIATESBusinessNameLine1

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1P O BOX 4265AddressLine1
CityLake CharlesCity
StateLAState
ZIP Code70606ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2013-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN721341439EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1West Calcasieu Cameron Hospital FoundationBusinessNameLine1
FieldValueIRS element (for citing)
Business Name ControlWESTBusinessNameControlTxt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1701 Cypress StreetAddressLine1
CitySulphurCity
StateLAState
ZIP Code70663ZIPCode

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonAlesia ComptonPersonNm
Person TitleBoard MemberPersonTitleTxt
Phone3375274238PhoneNum
Signature2014-11-04SignatureDt
Discuss With Paid PreparerfalseDiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonSteven M DeRouenPreparerPersonNm
PTINP01050140PTIN
Phone3375134915PhoneNum
Preparation2014-11-04PreparationDt
Self EmployedYes (X)SelfEmployedInd
FieldValueIRS element (for citing)
Tax2013TaxYr
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerIra FontenotPrincipalOfficerNm
Gross Receipts$352,098GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.wcch.com/wcchfoundationWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1996FormationYr
Legal Domicile StateLALegalDomicileStateCd
Activity Or MissionIt is the mission of the West Calcasieu Cameron Hospital Foundation to raise charitable gifts to provide quality medical services, healthcare programs, and community betterment while fostering a long-term positive relationship between the hospital and community.ActivityOrMissionDesc
Voting Members Governing Body15VotingMembersGoverningBodyCnt
Voting Members Independent15VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers52TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$69,253PYContributionsGrantsAmt
CY Contributions Grants$91,527CYContributionsGrantsAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$123PYInvestmentIncomeAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue$72,860PYOtherRevenueAmt
CY Other Revenue$70,108CYOtherRevenueAmt
PY Total Revenue$142,236PYTotalRevenueAmt
CY Total Revenue$161,635CYTotalRevenueAmt
PY Grants And Similar Paid$24,792PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$44,679CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$36,550PYOtherExpensesAmt
CY Other Expenses$20,030CYOtherExpensesAmt
PY Total Expenses$61,342PYTotalExpensesAmt
CY Total Expenses$64,709CYTotalExpensesAmt
PY Revenues Less Expenses$80,894PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$96,926CYRevenuesLessExpensesAmt
Total Assets BOY$2,632,576TotalAssetsBOYAmt
Total Assets EOY$2,689,132TotalAssetsEOYAmt
Total Liabilities BOY$2,248,920TotalLiabilitiesBOYAmt
Total Liabilities EOY$2,208,550TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$383,656NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$480,582NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionIt is the mission of the West Calcasieu Cameron Hospital Foundation to raise charitable gifts to provide quality medical services, healthcare programs, and community betterment while fostering a long-term positive relationship between the hospital and community.MissionDesc
Significant New Program SrvcYes (true)SignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$14,075ExpenseAmt
DescGenesis Therapeutic Riding Center: Offers therapy programs for those with physical, mental, and/or developmental disabilities and works to improve mobility, posture, cognition and balance. Additionally, the Center focuses on improving sensorimotor integration of tactile, visual and auditory skills through specialized modalities.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$23,928ExpenseAmt
Grant$6,675GrantAmt
DescTo establish and perpetuate community wide health awareness and health status improvement programs.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$26,245ExpenseAmt
Grant$26,245GrantAmt
DescConduct and coordinate fundraising efforts for funds to be dedicated for the benefit of West Calcasieu Cameron Hospital.Desc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp

FieldValueIRS element (for citing)
Expense$461ExpenseAmt
Grant$11,759GrantAmt
Revenue$23,594RevenueAmt
DescManagement of a gift shop by volunteer labor. Funds derived from the gift shop sales will be utilized for purchases of capital equipment for West Calcasieu Cameron Hospital.Desc
FieldValueIRS element (for citing)
Total Other Prog Srvc Expense$461TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Grant$11,759TotalOtherProgSrvcGrantAmt
Total Other Prog Srvc Revenue$23,594TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses$64,709TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (true)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesYes (true)FundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsYes (true)GrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredfalseScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Transaction With Control EntfalseTransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document3IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee0EmployeeCnt
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members15GoverningBodyVotingMembersCnt
Independent Voting Member15IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnfalseAnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcfalseRegularMonitoringEnfrcInd
Whistleblower PolicyfalseWhistleblowerPolicyInd
Document Retention PolicyfalseDocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonAlesia ComptonPersonNm
Phone3375274238PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1701 Cypress StreetAddressLine1
CitySulphurCity
StateLAState
ZIP Code70663ZIPCode
FieldValueIRS element (for citing)
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (15 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
Terry Backhaus
Vice President2.000.00Yes (X)Yes (X)$0$0$0
George Clyde
Treasurer2.000.00Yes (X)Yes (X)$0$0$0
Marilyn Dawdy
Board Member2.000.00Yes (X)$0$0$0
Ira Fontenot
President and CEO2.000.00Yes (X)Yes (X)$0$0$0
Tom Henning
Board Member2.000.00Yes (X)$0$0$0
Janie Fruge
Board Member2.000.00Yes (X)$0$0$0
Sondra Moss
Board Member2.000.00Yes (X)$0$0$0
Suzanne Peveto
Secretary2.000.00Yes (X)Yes (X)$0$0$0
Dr Sallye Toniette
Board Member2.000.00Yes (X)$0$0$0
Nina Vincent
Board Member2.000.00Yes (X)$0$0$0
Bobby Letard
Board Member2.000.00Yes (X)$0$0$0
Rick Watson
Board Member2.000.00Yes (X)$0$0$0
Bill Hankins
Board Member2.000.00Yes (X)$0$0$0
Debby Nabours
Executive Director2.000.00Yes (X)Yes (X)$0$0$0
Alesia Compton
Board Member2.000.00Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$0TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KfalseTotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
All Other Contributions$91,527AllOtherContributionsAmt
Total Contributions$91,527TotalContributionsAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$200,957RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$162,716RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$38,241RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$38,241TotalRevenueColumnAmt
Related Or Exempt Func Income$38,241RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$35,879FundraisingGrossIncomeAmt
Fundraising Direct Expenses$17,083FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$18,796TotalRevenueColumnAmt
Exclusion$18,796ExclusionAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$23,696GrossSalesOfInventoryAmt
Cost Of Goods Sold$10,664CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$13,032TotalRevenueColumnAmt
Related Or Exempt Func Income$13,032RelatedOrExemptFuncIncomeAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescMiscellaneous RevenueDesc
Business900099BusinessCd
Total Revenue Column$39TotalRevenueColumnAmt
Related Or Exempt Func Income$39RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$39OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$161,635TotalRevenueColumnAmt
Related Or Exempt Func Income$51,312RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$18,796ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$44,679TotalAmt
Program Services$44,679ProgramServicesAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$4,000TotalAmt
Program Services$4,000ProgramServicesAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$346TotalAmt
Program Services$346ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$138TotalAmt
Program Services$138ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$3,160TotalAmt
Program Services$3,160ProgramServicesAmt

Other Expenses OtherExpensesGrp (2 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
Marketing$6,350$6,350
Miscellaneous$6,036$6,036

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$64,709TotalAmt
Program Services$64,709ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$164,995BOYAmt
EOY$260,935EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
EOY$18,516EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$2,534,500LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$124,819LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$2,467,581BOYAmt
EOY$2,409,681EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$2,632,576BOYAmt
EOY$2,689,132EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$14,650BOYAmt
EOY$50,654EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$133,789BOYAmt
EOY$156,316EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$2,100,481BOYAmt
EOY$2,001,580EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$2,248,920BOYAmt
EOY$2,208,550EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$373,665BOYAmt
EOY$449,684EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$9,991BOYAmt
EOY$30,898EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$383,656BOYAmt
EOY$480,582EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,632,576BOYAmt
EOY$2,689,132EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$96,926ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$73,924CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$158,748CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$172,790CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$69,253CurrentTaxYearMinus1YearAmt
Current Tax Year$91,527CurrentTaxYearAmt
Total$566,242TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$73,924CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$158,748CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$172,790CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$69,253CurrentTaxYearMinus1YearAmt
Current Tax Year$91,527CurrentTaxYearAmt
Total$566,242TotalAmt
FieldValueIRS element (for citing)
Public Support Total170$566,242PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,676CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,023CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$610CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$123CurrentTaxYearMinus1YearAmt
Total$3,432TotalAmt
FieldValueIRS element (for citing)
Total Support$569,674TotalSupportAmt
Gross Receipts Rltd Activities$726,815GrossReceiptsRltdActivitiesAmt
Public Support CY1700.99400PublicSupportCY170Pct
Public Support PY1700.93610PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$500,000OtherCostOrOtherBasisAmt
Book Value$500,000BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,034,500OtherCostOrOtherBasisAmt
Depreciation$124,819DepreciationAmt
Book Value$1,909,681BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$2,409,681TotalBookValueLandBuildingsAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$341,434TotalRevEtcAuditedFinclStmtAmt
Other Revenue$179,799OtherRevenueAmt
Revenue Not Reported$179,799RevenueNotReportedAmt
Revenue Subtotal$161,635RevenueSubtotalAmt
Total Revenue Per Form990$161,635TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$244,508TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$179,799OtherExpensesIncludedAmt
Expenses Not Reported$179,799ExpensesNotReportedAmt
Expenses Subtotal$64,709ExpensesSubtotalAmt
Total Expenses Per Form990$64,709TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Other revenues not included on Form 990 (Part XI, line 2d)Fundraising and rental expenses reported on Form 990, Part VIII, line 6b and 8b.
Other expenses not included on Form 990 (Part XII, line 2d)Fundraising and rental expenses included on Form 990, Part VIII, line 6b and 8b.
Footnote for uncertain tax position under FIN 48 (Part X)The Organization is exempt from federal income taxes under Section 501 (c) (3) of the Internal Revenue Code and applicable state codes. According, no provision for federal and state income taxes is included in the financial statements. The Foundation had no uncertain tax positions that qualify for recognition or disclosure in the financial statements.

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Name Of Event1Golf TournamNameOfEvent1Amt
Gross Receipts Event1$35,385GrossReceiptsEvent1Amt
Gross Revenue Event1$35,385GrossRevenueEvent1Amt
Non Cash Prizes Event1$359NonCashPrizesEvent1Amt
Rent Facility Costs Event1$4,440RentFacilityCostsEvent1Amt
Food And Beverage Event1$617FoodAndBeverageEvent1Amt
Other Direct Expenses Event1$11,173OtherDirectExpensesEvent1Amt
Gross Receipts Total$35,385GrossReceiptsTotalAmt
Gross Revenue Total Events$35,385GrossRevenueTotalEventsAmt
Non Cash Prizes Total Events$359NonCashPrizesTotalEventsAmt
Rent Fclty Costs Total Events$4,440RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events$617FoodAndBeverageTotalEventsAmt
Oth Direct Expnss Total Events$11,173OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$16,589DirectExpenseSummaryEventsAmt
Net Income Summary$18,796NetIncomeSummaryAmt

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (true)GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1West Cal-Cam HospitalBusinessNameLine1

US Address USAddress

FieldValueIRS element (for citing)
Address Line1701 Cypress StreetAddressLine1
CitySulphurCity
StateLAState
ZIP Code70663ZIPCode
FieldValueIRS element (for citing)
Recipient EIN726008355RecipientEIN
IRC SectionWest Cal-Cam HoIRCSectionDesc
Cash Grant$38,004CashGrantAmt
Purpose Of GrantSupport HospPurposeOfGrantTxt
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceMonitoring procedures (Part I, line 2)FormAndLineReferenceDesc
ExplanationThe Organization maintains grant and receipient eligibility review documentation. This information is utilized when evaluating and approving grantees.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990 governing body review Part VI line 11The Form 990 is reviewed by the board of directors prior to issuance.
Governing documents etc available to public Part VI line 19The Organization's governing documents, conflict of interest policy, and financial statements are made available to the public upon request.
Significant program services not listed on prior year return Part III line 2The Organization assumed management of a gift shop effective July 1, 2013. The gift shop is operated with volunteer labor and funds derived from the gift shop sales will be utilized for purchases of capital equipment or provide other support for West Calcasieu Cameron Hospital.

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