CHOTA COMMUNITY HEALTH SERVICES: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- CHOTA COMMUNITY HEALTH SERVICES (EIN 68-0560048)
- Tax period
- 2013-01-01 to 2013-12-31
- Filed
- 2014-06-03
- IRS object ID
- 201441549349300404
- 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 | 2014-06-03T06:37:21-07:00 | ReturnTs |
| Tax Period End | 2013-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Terry Horne CPA & Associates PC | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 732 West Main Street | AddressLine1 |
| City | Lebanon | City |
| State | TN | State |
| ZIP Code | 37087 | 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 | 680560048 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHOTA COMMUNITY HEALTH SERVICES | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CHOT | BusinessNameControlTxt |
| Phone | 4234427268 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1206 HWY 411 | AddressLine1 |
| City | VONORE | City |
| State | TN | State |
| ZIP Code | 37885 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | LAURA HARRIS | PersonNm |
| Person Title | CHIEF EXECUTIVE OFFICER | PersonTitleTxt |
| Phone | 4234427268 | PhoneNum |
| Signature | 2014-04-21 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | TERRY HORNE | PreparerPersonNm |
| Phone | 6154447293 | PhoneNum |
| Preparation | 2014-06-03 | PreparationDt |
| 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 | LAURA HARRIS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1206 HWY 411 | AddressLine1 |
| City | VONORE | City |
| State | TN | State |
| ZIP Code | 37885 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $4,904,360 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2003 | FormationYr |
| Legal Domicile State | TN | LegalDomicileStateCd |
| Activity Or Mission | THE ORGANIZATION PROVIDES HEALTH CARE TO INDIVIDUALS REGARDLESS OF THEIR ABILITY TO PAY. THIS IS A DIRECT FULFILLMENT OF THEIR TAX EXEMPT PURPOSE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 14 | VotingMembersIndependentCnt |
| Total Employee | 90 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $333,136 | PYContributionsGrantsAmt |
| CY Contributions Grants | $926,371 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $2,301,528 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $3,970,030 | CYProgramServiceRevenueAmt |
| CY Investment Income | $229 | CYInvestmentIncomeAmt |
| PY Other Revenue | $14,756 | PYOtherRevenueAmt |
| CY Other Revenue | $7,730 | CYOtherRevenueAmt |
| PY Total Revenue | $2,649,420 | PYTotalRevenueAmt |
| CY Total Revenue | $4,904,360 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $2,070,380 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $3,465,762 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $631,789 | PYOtherExpensesAmt |
| CY Other Expenses | $1,259,845 | CYOtherExpensesAmt |
| PY Total Expenses | $2,702,169 | PYTotalExpensesAmt |
| CY Total Expenses | $4,725,607 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$52,749 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $178,753 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $1,795,280 | TotalAssetsBOYAmt |
| Total Assets EOY | $1,551,457 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,222,857 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $799,961 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $572,423 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $751,496 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE ORGANIZATION PROVIDES HEALTH CARE | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $2,881,302 | ExpenseAmt |
| Revenue | $3,970,030 | RevenueAmt |
| Desc | THE ORGANIZATION PROVIDES HEALTH CARE REGARDLESS OF THE INDIVIDUALS ABILITY TO PAY. THESE MEDICAL SERVICES ARE PROVIDED IN AREAS THAT HAVE A SHORTAGE OF HEALTH CARE PROVIDERS. THIS IS A DIRECT FULFILLMENT OF THEIR TAX EXEMPT PURPOSE. OVER 35,900 VISITS WERE PROVIDED DURING THE YEAR. | Desc |
| Total Program Service Expenses | $2,881,302 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | false | 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 | Yes (true) | 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 | Yes (true) | 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 |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 7 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 90 | 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 |
| Excess Business Holdings | false | ExcessBusinessHoldingsInd |
| 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 | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 14 | 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 | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | 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 | MELISSA COFFELT | PersonNm |
| Phone | 4238847271 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1206 HIGHWAY 411 | AddressLine1 |
| City | VONORE | City |
| State | TN | State |
| ZIP Code | 37855 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| BRUCE CHRISTOPHER | |||||||
| BOARD PRESIDENT | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| RAY TALLENT | |||||||
| VICE PRESIDENT | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| PETER ALLIMAN | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| LAWRENCE H HARRIS II | |||||||
| TREASURER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| MICHAEL TALLENT | |||||||
| SECRETARY | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| EMILY JEFFCOAT | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JUDITH LEE | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| WILLIAM O'DONNELL | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| AUGUSTA T DAVIS | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| KAY TALLENT | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| WESLEY MCNEAL | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| MARTHA TURPIN | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| MICHAEL POULSEN | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DONALD WHITTAKER | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| LAURA HARRIS | |||||||
| CHIEF EXECUTIVE OFFICER | 40 | $67,878 | $5,277 | Yes (X) | |||
| JOEL BURROUGHS | |||||||
| MEDICAL DIRECTOR | 40 | $169,225 | $9,077 | Yes (X) | |||
| MELISSA COFFELT | |||||||
| CHIEF FINANCIAL OFFICER | 40 | $41,925 | $2,902 | Yes (X) | |||
| JANET HUNT | |||||||
| CHIEF OPERATIONAL OFFICER | 40 | $2,692 | Yes (X) | ||||
| THOMAS COX | |||||||
| PHYSICIAN | 40 | $150,128 | $8,333 | Yes (X) | |||
| WILLIAM THORNTON | |||||||
| FNP | 40 | $110,665 | $7,133 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $542,513 | TotalReportableCompFromOrgAmt |
| Total Other Compensation | $32,722 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 3 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NEXTGEN HEALTHCARE INFORM SYS | BusinessNameLine1 |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 809390 | AddressLine1 |
| City | CHICAGO | City |
| State | IL | State |
| ZIP Code | 60680 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | COMPUTER SUPPORT/MAINTENANCE | ServicesDesc |
| Compensation | $167,239 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $920,629 | GovernmentGrantsAmt |
| All Other Contributions | $5,742 | AllOtherContributionsAmt |
| Total Contributions | $926,371 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT FEES | Desc |
| Business | 621110 | BusinessCd |
| Total Revenue Column | $3,970,030 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $3,970,030 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $229 | TotalRevenueColumnAmt |
| Exclusion | $229 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $7,730 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $7,730 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $7,730 | TotalRevenueColumnAmt |
| Exclusion | $7,730 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,904,360 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,970,030 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $7,959 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $281,720 | TotalAmt |
| Program Services | $169,225 | ProgramServicesAmt |
| Management And General | $112,495 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,622,541 | TotalAmt |
| Program Services | $1,652,016 | ProgramServicesAmt |
| Management And General | $970,525 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $54,293 | TotalAmt |
| Program Services | $34,205 | ProgramServicesAmt |
| Management And General | $20,088 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $302,509 | TotalAmt |
| Program Services | $190,581 | ProgramServicesAmt |
| Management And General | $111,928 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $204,699 | TotalAmt |
| Program Services | $128,961 | ProgramServicesAmt |
| Management And General | $75,738 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,040 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $6,040 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,825 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $5,825 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $106,206 | TotalAmt |
| Program Services | $30,499 | ProgramServicesAmt |
| Management And General | $75,707 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $578,386 | TotalAmt |
| Program Services | $340,109 | ProgramServicesAmt |
| Management And General | $238,277 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $302,619 | TotalAmt |
| Program Services | $257,226 | ProgramServicesAmt |
| Management And General | $45,393 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,982 | TotalAmt |
| Program Services | $14,128 | ProgramServicesAmt |
| Management And General | $13,854 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,471 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $14,471 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $203,645 | TotalAmt |
| Program Services | $49,681 | ProgramServicesAmt |
| Management And General | $153,964 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,671 | TotalAmt |
| Program Services | $14,671 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,725,607 | TotalAmt |
| Program Services | $2,881,302 | ProgramServicesAmt |
| Management And General | $1,844,305 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $34,719 | BOYAmt |
| EOY | $47,213 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $119,089 | BOYAmt |
| EOY | $75,141 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $458,359 | BOYAmt |
| EOY | $434,019 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,400 | BOYAmt |
| EOY | $2,400 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $2,036,723 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,054,039 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,180,713 | BOYAmt |
| EOY | $982,684 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $10,000 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,795,280 | BOYAmt |
| EOY | $1,551,457 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $679,406 | BOYAmt |
| EOY | $324,814 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $543,451 | BOYAmt |
| EOY | $475,147 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,222,857 | BOYAmt |
| EOY | $799,961 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $572,423 | BOYAmt |
| EOY | $751,496 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $572,423 | BOYAmt |
| EOY | $751,496 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,795,280 | BOYAmt |
| EOY | $1,551,457 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $178,753 | ReconcilationRevenueExpnssAmt |
| Prior Period Adjustments | $320 | PriorPeriodAdjustmentsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | 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 (true) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
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 | $968,164 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,482,841 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,446,976 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $333,136 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $926,371 | CurrentTaxYearAmt |
| Total | $5,157,488 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $968,164 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,482,841 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,446,976 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $333,136 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $926,371 | CurrentTaxYearAmt |
| Total | $5,157,488 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $5,157,488 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,364 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $20,546 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7,891 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $14,756 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $7,959 | CurrentTaxYearAmt |
| Total | $53,516 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $5,211,004 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $20,795,507 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.98970 | PublicSupportCY170Pct |
| Public Support PY170 | 0.99050 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
| Public Support Total509 | $0 | PublicSupportTotal509Amt |
| Public Support CY509 | 0 | PublicSupportCY509Pct |
| Investment Income CY | 0 | InvestmentIncomeCYPct |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $140,192 | InvestmentCostOrOtherBasisAmt |
| Book Value | $140,192 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $542,135 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $78,995 | DepreciationAmt |
| Book Value | $463,140 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $1,354,396 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $975,044 | DepreciationAmt |
| Book Value | $379,352 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $982,684 | TotalBookValueLandBuildingsAmt |
| Total Rev Etc Audited Fincl Stmt | $4,904,360 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Subtotal | $4,904,360 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $4,904,360 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $4,725,607 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $4,725,607 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $4,725,607 | TotalExpensesPerForm990Amt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| 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 (2 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt |
|---|---|---|---|
| JOEL BURROUGHS | |||
| $169,225 | $6,800 | $2,277 | $178,302 |
| THOMAS COX | |||
| $150,128 | $1,200 | $7,133 | $158,461 |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BJ3 | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | FORMER CEO & MEDICAL DIRECTOR | RelationshipDescriptionTxt |
| Transaction | $209,500 | TransactionAmt |
| Transaction | ORGANIZATION RENTS BLDG | TransactionDesc |
| Sharing Of Revenues | false | SharingOfRevenuesInd |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART IV LINE 1 | THE ORGANIZATION IS CURRENTLY RENTING A BUILDING FROM BJ3,LLC FOR $18,500 |
| PART IV LINE 1 | PER MONTH. BJ3, LLC IS OWNED BY DR. BARBARA LEVIN & DR. JOSHUA GETTINGER |
| PART IV LINE 1 | WHO ARE FORMER DIRECTORS OF THE ORGANIZATION. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Pt VI, Line 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST |
| Pt VI, Line 19 | POLICY AND FORM 990 AVAILABLE UPON WRITTEN REQUEST. |
| Pt VI, Line 11b | THE CEO AND FINANCE COMMITTEE REVIEWS THE FORM 990 AND THEN PRESENTS TO FULL BOARD. |
| Pt VI, Line 15a | STATE AND NATIONAL SALARY COMPARISONS ARE USED TO ESTABLISH SALARY LIMITS |
| Pt VI, Line 15b | FOR TOP MANAGEMENT OFFICIALS. PERFORMANCE EVALUATION ARE PERFORMED ANNUALLY |
| Pt VI, Line 15b | AND SALARY INCREASES ARE BOARD APPROVED. |
| Pt XII, Line 2c | THE CEO OVERSEES FINANCIAL STATEMENT PREPARATION AND AUDIT ENGAGEMENT. |
| Pt VI, Line 12c | ANNUALLY THE CONFLICT OF INTEREST STATEMENT IS SIGNED BY BOARD MEMBERS AND |
| Pt VI, Line 12c | REVIEWED BY THE ENTIRE BOARD. BOARD MEMBERS SHALL EXCUSE THEMSELVES FROM |
| Pt VI, Line 12c | ISSUES THAT ENHANCE THE PROBABILITY OF THEIR OWN PERSONAL AND PRIVATE GAIN. |
| Pt XI | PT XI LINE 8-TO ADJUST PRIOR YEAR NET ASSET BALANCE ADJUSTED BY $320 TO ACTUAL. |
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