PARTNERS IN EXCEPTIONAL CARE: Form 990EZ, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- PARTNERS IN EXCEPTIONAL CARE (EIN 39-1904074)
- Tax period
- 2012-07-01 to 2013-06-30
- Filed
- 2014-05-14
- IRS object ID
- 201441349349204034
- Schema version
- 2012v2.1
- 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) |
|---|---|---|
| Timestamp | 2014-05-14T16:48:12-05:00 | Timestamp |
| Tax Period End Date | 2013-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 476097913 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SEIM JOHNSON LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 18081 BURT STREET SUITE 200 | AddressLine1 |
| City | OMAHA | City |
| State | NE | State |
| ZIP Code | 680224722 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990EZ | ReturnType |
| Tax Period Begin Date | 2012-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 391904074 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLARINDA MEDICAL FOUNDATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | CLAR | NameControl |
| Phone | 7125422176 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 220 ESSIE DAVISON DRIVE | AddressLine1 |
| City | CLARINDA | City |
| State | IA | State |
| ZIP Code | 51632 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | REBECCA FINCH | Name |
| Title | DIRECTOR | Title |
| Phone | 7125422176 | Phone |
| Date Signed | 2014-05-14 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | WENDY R COOLEY | Name |
| PTIN | P01523804 | PTIN |
| Phone | 4023302660 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990-EZ IRS990EZ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Change | X | AddressChange |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Web Site | WWW.CLARINDAHEALTH.COM | WebSite |
| Organization501c3 | X | Organization501c3 |
| Gross Receipts | 95200 | GrossReceipts |
| Info In Schedule O Part I | X | InfoInScheduleOPartI |
| Contributions Gifts Grants Etc | 65493 | ContributionsGiftsGrantsEtc |
| Investment Income | 2234 | InvestmentIncome |
| Gross Amount From Sale Of Assets | 22673 | GrossAmountFromSaleOfAssets |
| Cost Other Basis And Sales Expenses | 23460 | CostOtherBasisAndSalesExpenses |
| Gain Or Loss From Sale Of Assets | -787 | GainOrLossFromSaleOfAssets |
| Fundraising Gross Income | 4800 | FundraisingGrossIncome |
| Special Events Direct Expenses | 3548 | SpecialEventsDirectExpenses |
| Special Events Net Income Loss | 1252 | SpecialEventsNetIncomeLoss |
| Total Revenue | 68192 | TotalRevenue |
| Grants And Similar Amounts Paid | 90026 | GrantsAndSimilarAmountsPaid |
| Other Expenses Total | 2034 | OtherExpensesTotal |
| Total Expenses | 92060 | TotalExpenses |
| Excess Or Deficit For Year | -23868 | ExcessOrDeficitForYear |
| Net Assets Or Fund Balances BOY | 355962 | NetAssetsOrFundBalancesBOY |
| Other Changes In Net Assets | 15716 | OtherChangesInNetAssets |
| Net Assets Or Fund Balances EOY | 347810 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part II | X | InfoInScheduleOPartII |
Cash Savings And Investments CashSavingsAndInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 333745 | BOY |
| EOY | 339897 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 22217 | BOY |
| EOY | 7913 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 355962 | BOY |
| EOY | 347810 | EOY |
Sum Of Total Liabilities SumOfTotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Net Assets Or Fund Balances NetAssetsOrFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 355962 | BOY |
| EOY | 347810 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Primary Exempt Purpose | THE FOUNDATION'S PURPOSE IS TO SOLICIT FUNDS TO ENHANCE HEALTH CARE SERVICES FOR RESIDENTS OF SOUTHWEST IOWA AND SURROUNDING COMMUNITIES AND SUPPORT THE CHARITABLE HEALTH CARE MISSION OF CLARINDA REGIONAL HEALTH CENTER. | PrimaryExemptPurpose |
Program Service Accomplishment ProgramServiceAccomplishment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Program Service Accom | CLARINDA MEDICAL FOUNDATION MANAGES THE COLLECTION AND DISBURSEMENT OF CONTRIBUTIONS FOR CLARINDA REGIONAL HEALTH CENTER. | DescriptionProgramServiceAccom |
| Grants And Allocations | 90026 | GrantsAndAllocations |
| Program Service Expenses | 92060 | ProgramServiceExpenses |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | 92060 | TotalProgramServiceExpenses |
Officer Director Trustee Key Empl OfficerDirectorTrusteeKeyEmpl (11 entries)
| TitleTitle | Avg Hours Per Wk Devoted To PositionAvgHoursPerWkDevotedToPosition | CompensationCompensation | Contri To Empl Benefit Plans EtcContriToEmplBenefitPlansEtc | Expense Account Other AllowancesExpenseAccountOtherAllowances |
|---|---|---|---|---|
| JEAN NEGLEY | ||||
| PRESIDENT | 0.30 | 0 | 0 | 0 |
| MARK KLINE | ||||
| VICE PRESIDENT | 0.30 | 0 | 0 | 0 |
| RANDY WALTERS | ||||
| SECRETARY/TREASURER | 0.30 | 0 | 0 | 0 |
| MONTY BOSWELL | ||||
| DIRECTOR | 0.30 | 0 | 0 | 0 |
| MAGGIE BROWN | ||||
| DIRECTOR | 0.30 | 0 | 0 | 0 |
| JOHN CLARK | ||||
| DIRECTOR | 0.30 | 0 | 0 | 0 |
| DICK DAVIDSON | ||||
| DIRECTOR | 0.30 | 0 | 0 | 0 |
| RON RICHARDSON | ||||
| DIRECTOR | 0.30 | 0 | 0 | 0 |
| MIDGE STANLEY | ||||
| DIRECTOR | 0.30 | 0 | 0 | 0 |
| CHRIS STIPE | ||||
| DIRECTOR | 0.30 | 0 | 0 | 0 |
| JASON BRIDIE | ||||
| STAFF DIRECTOR | 20.00 | 0 | 0 | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part V | X | InfoInScheduleOPartV |
| Activities Not Previously Rpt | 0 | ActivitiesNotPreviouslyRpt |
| Made Changes To Orgnzng Etc Doc | 0 | MadeChangesToOrgnzngEtcDoc |
| Organization Had UBI | 0 | OrganizationHadUBI |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Organization Dissolved Etc | 0 | OrganizationDissolvedEtc |
| Direct Indirect Political Expend | 0 | DirectIndirectPoliticalExpend |
| Made Loans To From Officers | 0 | MadeLoansToFromOfficers |
| Tax Imposed Under IRC4911 | 0 | TaxImposedUnderIRC4911 |
| Tax Imposed Under IRC4912 | 0 | TaxImposedUnderIRC4912 |
| Tax Imposed Under IRC4955 | 0 | TaxImposedUnderIRC4955 |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTrans |
| Amount Of Tax Imposed On Org Mgr | 0 | AmountOfTaxImposedOnOrgMgr |
| Amount Of Tax Reimbursed By Org | 0 | AmountOfTaxReimbursedByOrg |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | REBECCA FINCH | NamePerson |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 220 ESSIE DAVISON DRIVE | AddressLine1 |
| City | CLARINDA | City |
| State | IA | State |
| ZIP Code | 51632 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 7125422176 | TelephoneNumber |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Foreign Office | 0 | ForeignOffice |
| Maintain Any Donor Advised Funds | 0 | MaintainAnyDonorAdvisedFunds |
| Does Org Have Hospital | 0 | DoesOrgHaveHospital |
| Tanning Services Provided | 0 | TanningServicesProvided |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Engage Political Cmpgn Activities | 0 | EngagePoliticalCmpgnActivities |
| Engage In Lobbying Activities | 0 | EngageInLobbyingActivities |
| Operating School | 0 | OperatingSchool |
| Trnsfrs Exempt Non Char Related Org | 0 | TrnsfrsExemptNonCharRelatedOrg |
| Part VI Of Comp Of Highest Paid Empl | NONE | PartVIOfCompOfHighestPaidEmpl |
| Part VIA Hghst Paid Cntrct Prof Ser | NONE | PartVIAHghstPaidCntrctProfSer |
| Filed Schedule A | 1 | FiledScheduleA |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | X | PubliclySupportedOrg509a2 |
Gifts Grants Contrib Received509 GiftsGrantsContribReceived509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 17482 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 14870 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 480981 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 293852 | CurrentTaxYearMinus1Year |
| Current Tax Year | 65493 | CurrentTaxYear |
| Total | 872678 | Total |
Total509 Total509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 17482 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 14870 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 480981 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 293852 | CurrentTaxYearMinus1Year |
| Current Tax Year | 65493 | CurrentTaxYear |
| Total | 872678 | Total |
Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 775 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 1050 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 9800 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 4635 | CurrentTaxYearMinus1Year |
| Current Tax Year | 3452 | CurrentTaxYear |
| Total | 19712 | Total |
Amts From Subst Contributors AmtsFromSubstContributors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Support From DQ Ps Etc SupportFromDQPsEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 775 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 1050 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 9800 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 4635 | CurrentTaxYearMinus1Year |
| Current Tax Year | 3452 | CurrentTaxYear |
| Total | 19712 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | 852966 | PublicSupportTotal509 |
Gross Investment Income509 GrossInvestmentIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 16438 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 2689 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 4800 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 11913 | CurrentTaxYearMinus1Year |
| Current Tax Year | 2234 | CurrentTaxYear |
| Total | 38074 | Total |
Investment Income And UBTI InvestmentIncomeAndUBTI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 16438 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 2689 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 4800 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 11913 | CurrentTaxYearMinus1Year |
| Current Tax Year | 2234 | CurrentTaxYear |
| Total | 38074 | Total |
Other Income509 OtherIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 20001 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 18475 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 14691 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 4435 | CurrentTaxYearMinus1Year |
| Current Tax Year | 4800 | CurrentTaxYear |
| Total | 62402 | Total |
Total Support Total TotalSupportTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 53921 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 36034 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 500472 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 310200 | CurrentTaxYearMinus1Year |
| Current Tax Year | 72527 | CurrentTaxYear |
| Total | 973154 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Percentage509 | 0.87650 | PublicSupportPercentage509 |
| Prior Year Support Percentage | 0.90150 | PriorYearSupportPercentage |
| Investment Income Percentage | 0.03910 | InvestmentIncomePercentage |
| Prior Yr Invest Income Percentage | 0.07640 | PriorYrInvestIncomePercentage |
| Thirty Three Percnt Tests CY509 | X | ThirtyThreePercntTestsCY509 |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (5 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| OTHER INVESTMENT INCOME | FORM 990-EZ, PART I, LINE 4 | INTEREST INCOME 2,234.. |
| GRANTS AND SIMILAR AMOUNTS PAID | FORM 990-EZ, PART I, LINE 10 | ACTIVITY CLASSIFICATION: GENERAL SUPPORT. GRANTEE NAME: CLARINDA REGIONAL HEALTH CENTER. GRANTEE ADDRESS: 220 ESSIE DAVISON DR CLARINDA, IA 51635. GRANTEE RELATIONSHIP: NONE. PROPERTY DESCRIPTION: CASH GRANT. DATE OF GIFT: 01/01/13. AMOUNT GIVEN: 90,026. |
| OTHER EXPENSES | FORM 990-EZ, PART I, LINE 16 | DESCRIPTION: MISCELLANEOUS. AMOUNT: 2,034. |
| OTHER CHANGES IN NET ASSETS | FORM 990-EZ, PART I, LINE 20 | DESCRIPTION: UNREALIZED GAIN/LOSS ON INVESTMENTS. AMOUNT: 15,491. DESCRIPTION: PRIOR PERIOD ADJUSTMENT. AMOUNT: 225. TOTAL TO FORM 990-EZ, LINE 20: 15,716. |
| OTHER ASSETS | FORM 990-EZ, PART II, LINE 24 | DESCRIPTION: ACCOUNTS RECEIVABLE. BEG. OF YEAR AMOUNT: 22,217. END OF YEAR AMOUNT: 7,913. |
Transfer Prsnl Bnft Contracts Decl TransferPrsnlBnftContractsDecl
| Field | Value | IRS element (for citing) |
|---|---|---|
| Declaration | THE ORGANIZATION DID NOT, DURING THE YEAR, RECEIVE ANY FUNDS, DIRECTLY,OR INDIRECTLY, TO PAY PREMIUMS ON A PERSONAL BENEFIT CONTRACT.THE ORGANIZATION, DID NOT, DURING THE YEAR, PAY ANY PREMIUMS, DIRECTLY,OR INDIRECTLY, ON A PERSONAL BENEFIT CONTRACT. | Declaration |