GRACEMED HEALTH CLINIC INC: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization: GRACEMED HEALTH CLINIC INC (EIN 48-1159633)
Tax period: 2013-01-01 to 2013-12-31
Filed: 2014-08-15
IRS object ID: 201442279349301409
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
Form 990
Schedule A
Schedule B
Schedule D
Schedule G
Schedule J
Schedule L
Schedule O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2014-08-15T09:01:36-05:00	ReturnTs
Tax Period End	2013-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	481032601	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	ALLEN GIBBS & HOULIK LC	BusinessNameLine1

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	301 N MAIN SUITE 1700	AddressLine1
City	WICHITA	City
State	KS	State
ZIP Code	672024868	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	481159633	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	GRACEMED HEALTH CLINIC INC	BusinessNameLine1

Field	Value	IRS element (for citing)
Business Name Control	GRAC	BusinessNameControlTxt
Phone	3168662001	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1122 N TOPEKA	AddressLine1
City	WICHITA	City
State	KS	State
ZIP Code	67214	ZIPCode

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	DAVID SANFORD	PersonNm
Person Title	CEO	PersonTitleTxt
Phone	3168662011	PhoneNum
Signature	2014-08-14	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	JENNIFER A ALLEN	PreparerPersonNm
PTIN	P01338336	PTIN
Phone	3162677231	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	DAVID SANFORD	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1122 N TOPEKA	AddressLine1
City	WICHITA	City
State	KS	State
ZIP Code	67214	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	$12,426,764	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.GRACEMED.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1979	FormationYr
Legal Domicile State	KS	LegalDomicileStateCd
Activity Or Mission	TO PROVIDE PRIMARY HEALTH AND DENTAL CARE SERVICES TO KANSANS WITHOUT HEALTH INSURANCE OR ADEQUATE FINANCIAL RESOURCES TO SECURE TRADITIONAL HEALTH CARE SERVICES.	ActivityOrMissionDesc
Voting Members Governing Body	16	VotingMembersGoverningBodyCnt
Voting Members Independent	16	VotingMembersIndependentCnt
Total Employee	231	TotalEmployeeCnt
Total Volunteers	50	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$3,916,800	PYContributionsGrantsAmt
CY Contributions Grants	$3,163,301	CYContributionsGrantsAmt
PY Program Service Revenue	$6,885,367	PYProgramServiceRevenueAmt
CY Program Service Revenue	$8,646,990	CYProgramServiceRevenueAmt
PY Investment Income	$45,973	PYInvestmentIncomeAmt
CY Investment Income	-$58,447	CYInvestmentIncomeAmt
PY Other Revenue	$84,923	PYOtherRevenueAmt
CY Other Revenue	$31,562	CYOtherRevenueAmt
PY Total Revenue	$10,933,063	PYTotalRevenueAmt
CY Total Revenue	$11,783,406	CYTotalRevenueAmt
PY Grants And Similar Paid	$0	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$0	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$6,586,637	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$7,754,946	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$19,322	CYTotalFundraisingExpenseAmt
PY Other Expenses	$2,894,484	PYOtherExpensesAmt
CY Other Expenses	$3,056,963	CYOtherExpensesAmt
PY Total Expenses	$9,481,121	PYTotalExpensesAmt
CY Total Expenses	$10,811,909	CYTotalExpensesAmt
PY Revenues Less Expenses	$1,451,942	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$971,497	CYRevenuesLessExpensesAmt
Total Assets BOY	$6,712,014	TotalAssetsBOYAmt
Total Assets EOY	$7,535,112	TotalAssetsEOYAmt
Total Liabilities BOY	$1,146,641	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$899,515	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$5,565,373	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$6,635,597	NetAssetsOrFundBalancesEOYAmt
Mission	TO SHOW AND SHARE THE LOVE OF JESUS CHRIST BY PROVIDING COMPASSIONATE, ACCESSIBLE, HIGH-QUALITY HEALTH CARE FOR RESIDENTS OF SOUTH CENTRAL KANSAS.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$8,888,559	ExpenseAmt
Revenue	$8,568,034	RevenueAmt
Desc	PROVIDING PRIMARY HEALTH AND DENTAL CARE TO KANSANS WITHOUT HEALTH INSURANCE OR ADEQUATE FINANCIAL RESOURCES TO SECURE TRADITIONAL HEALTH CARE SERVICES	Desc
Total Program Service Expenses	$8,888,559	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	0	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	0	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	0	GrantsToIndividualsInd
Schedule J Required	Yes (1)	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	Yes (1)	BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri	0	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	9	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (1)	BackupWthldComplianceInd
Employee	231	EmployeeCnt
Employment Tax Returns Filed	0	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	0	QuidProQuoContributionsInd
Form8282 Property Disposed Of	Yes (1)	Form8282PropertyDisposedOfInd
Form8282 Filed	1	Form8282FiledCnt
Indoor Tanning Services	0	IndoorTanningServicesInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	16	GoverningBodyVotingMembersCnt
Independent Voting Member	16	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	0	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (1)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (1)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	0	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (1)	WhistleblowerPolicyInd
Document Retention Policy	Yes (1)	DocumentRetentionPolicyInd
Compensation Process CEO	0	CompensationProcessCEOInd
Compensation Process Other	0	CompensationProcessOtherInd
Investment In Joint Venture	0	InvestmentInJointVentureInd
States Where Copy Of Return Is Fld	KS	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	SHAROL SULLIVAN	BusinessNameLine1

Field	Value	IRS element (for citing)
Phone	3168662049	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1122 N TOPEKA	AddressLine1
City	WICHITA	City
State	KS	State
ZIP Code	67214	ZIPCode

Form990 Part VII Section A Form990PartVIISectionAGrp (26 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
FRED ERVIN
BOARD MEMBER	4.00	Yes (X)	$0	$0	$0
TOM BORREGO
BOARD MEMBER	4.00	Yes (X)	$0	$0	$0
TERRY BOURLARD
BOARD MEMBER	4.00	Yes (X)	$0	$0	$0
GARY BROOKS
BOARD MEMBER	4.00	Yes (X)	$0	$0	$0
SALLY CHESSER
BOARD MEMBER	4.00	Yes (X)	$0	$0	$0
LOU ANN EWERTT
BOARD MEMBER	4.00	Yes (X)	$0	$0	$0
MICHAEL GOOD
BOARD MEMBER	4.00	Yes (X)	$0	$0	$0
LAURIE LABARCA
BOARD MEMBER	4.00	Yes (X)	$0	$0	$0
GAROLD MINNS
BOARD MEMBER	4.00	Yes (X)	$0	$0	$0
MARC MINNIS
BOARD MEMBER	4.00	Yes (X)	$0	$0	$0
GAIL FINNEY
BOARD MEMBER	4.00	Yes (X)	$0	$0	$0
BARTON PRINCE
BOARD MEMBER	4.00	Yes (X)	$0	$0	$0
JON ROSELL
BOARD MEMBER	4.00	Yes (X)	$0	$0	$0
DENISE WREN
BOARD MEMBER	4.00	Yes (X)	$0	$0	$0
ABE RODRIGUEZ
BOARD MEMBER	4.00	Yes (X)	$0	$0	$0
SUSAN HOWEY
BOARD MEMBER	4.00	Yes (X)	$0	$0	$0
RUSSELL JOHNSON
CHIEF MEDICAL OFFICER	40.00		$180,003	$0	$4,875	Yes (X)
VENUS LEE
CHIEF OPERATING OFFICER	40.00		$95,055	$0	$1,660	Yes (X)
DR ROGER NOLTE
CHIEF DENTAL OFFICER	40.00		$139,029	$0	$4,429	Yes (X)
DAVID SANFORD
CHIEF EXECUTIVE OFFICER	40.00		$128,754	$0	$8,737	Yes (X)
SHAROL SULLIVAN
CHIEF FINANCIAL OFFICER	40.00		$91,249	$0	$2,753	Yes (X)
DR ANDREA BOOTHE
DENTIST	40.00		$110,574	$0	$6,533		Yes (X)
DR TERESA JOHNSON
DOCTOR	40.00		$120,265	$0	$8,483		Yes (X)
DR PHILLIP BROCKINGTON
DENTIST	40.00		$124,320	$0	$4,875		Yes (X)
DR JAMIE PAGE
DOCTOR	40.00		$104,179	$0	$8,000		Yes (X)
DR ELIZABETH WAWRZEWSKI
DOCTOR	40.00		$108,533	$0	$3,271		Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$1,201,961	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$53,616	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	16	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	0	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (1)	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
USD #259
201 N WATER	WICHITA	KS	67202	CLINIC CONSTRUCTION	$803,897
HENRY SCHEIN INC
DEPT CH 10241	PALATINE	IL	60055	DENTAL SUPPLIES	$312,421
USD #260
120 E WASHINGTON	DERBY	KS	67037	CLINIC CONSTRUCTION	$218,642
PEARCE TURK DENTAL LABORATORY
5775 WAYZATA BLVD SUITE 890	MINNEAPOLIS	MN	55416	DENTAL LAB	$213,255
MCKESSON DRUG
PO BOX 409521	ATLANTA	GA	30384	PHARMACY SUPPLIES	$212,882

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	9	CntrctRcvdGreaterThan100KCnt
Fundraising	$35,195	FundraisingAmt
Government Grants	$2,495,205	GovernmentGrantsAmt
All Other Contributions	$632,901	AllOtherContributionsAmt
Total Contributions	$3,163,301	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
MEDICAL & DENTAL SERVICES	621110	$8,340,990	$8,340,990
HIT CERT INCENTIVE	621110	$306,000	$306,000

Field	Value	IRS element (for citing)
Total Program Service Revenue	$8,646,990	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$32,863	TotalRevenueColumnAmt
Exclusion	$32,863	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$339,321	SecuritiesAmt
Other	$180,730	OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$336,676	SecuritiesAmt
Other	$274,685	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$2,645	SecuritiesAmt
Other	-$93,955	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$91,310	TotalRevenueColumnAmt
Related Or Exempt Func Income	-$93,955	RelatedOrExemptFuncIncomeAmt
Exclusion	$2,645	ExclusionAmt

Field	Value	IRS element (for citing)
Fundraising Gross Income	$48,560	FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event	$35,195	ContriRptFundraisingEventAmt
Fundraising Direct Expenses	$31,997	FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$16,563	TotalRevenueColumnAmt
Exclusion	$16,563	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

Field	Value	IRS element (for citing)
Desc	MISC REVENUE	Desc
Business	900099	BusinessCd
Total Revenue Column	$14,999	TotalRevenueColumnAmt
Related Or Exempt Func Income	$14,999	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$14,999	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$11,783,406	TotalRevenueColumnAmt
Related Or Exempt Func Income	$8,568,034	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$52,071	ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$634,090	TotalAmt
Program Services	$517,851	ProgramServicesAmt
Management And General	$116,239	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$6,523,364	TotalAmt
Program Services	$5,325,404	ProgramServicesAmt
Management And General	$1,196,036	ManagementAndGeneralAmt
Fundraising	$1,924	FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$58,148	TotalAmt
Program Services	$52,907	ProgramServicesAmt
Management And General	$5,142	ManagementAndGeneralAmt
Fundraising	$99	FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$539,344	TotalAmt
Program Services	$451,164	ProgramServicesAmt
Management And General	$86,937	ManagementAndGeneralAmt
Fundraising	$1,243	FundraisingAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$120,518	TotalAmt
Management And General	$120,518	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$258,167	TotalAmt
Program Services	$250,328	ProgramServicesAmt
Management And General	$7,839	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$51,440	TotalAmt
Management And General	$46,688	ManagementAndGeneralAmt
Fundraising	$4,752	FundraisingAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$121,216	TotalAmt
Program Services	$72,516	ProgramServicesAmt
Management And General	$48,700	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$345,606	TotalAmt
Program Services	$325,779	ProgramServicesAmt
Management And General	$19,827	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$13,871	TotalAmt
Management And General	$13,871	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$328,780	TotalAmt
Program Services	$308,900	ProgramServicesAmt
Management And General	$19,880	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$24,643	TotalAmt
Program Services	$2,612	ProgramServicesAmt
Management And General	$22,031	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt	FundraisingFundraisingAmt
MEDICAL SUPPLIES	$1,016,310	$1,014,438	$1,872
CONSULTING & COMPUTER E	$298,376	$203,738	$94,618	$20
UTILITIES	$175,121	$154,553	$20,568
REPAIRS	$120,429	$103,155	$17,274

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$182,486	TotalAmt
Program Services	$105,214	ProgramServicesAmt
Management And General	$65,988	ManagementAndGeneralAmt
Fundraising	$11,284	FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$10,811,909	TotalAmt
Program Services	$8,888,559	ProgramServicesAmt
Management And General	$1,904,028	ManagementAndGeneralAmt
Fundraising	$19,322	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$354,337	BOYAmt
EOY	$315,808	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$1,054,753	BOYAmt
EOY	$941,064	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$382,886	BOYAmt
EOY	$473,550	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
EOY	$125,000	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$4,599	BOYAmt
EOY	$4,915	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$41,884	BOYAmt
EOY	$28,784	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$5,703,683	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$1,426,517	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$3,767,574	BOYAmt
EOY	$4,277,166	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$1,103,890	BOYAmt
EOY	$1,242,330	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$2,091	BOYAmt
EOY	$126,495	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$6,712,014	BOYAmt
EOY	$7,535,112	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$979,690	BOYAmt
EOY	$835,083	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$166,951	BOYAmt
EOY	$64,432	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$1,146,641	BOYAmt
EOY	$899,515	EOYAmt

Field	Value	IRS element (for citing)
Organization Follows SFAS117	Yes (X)	OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$5,546,501	BOYAmt
EOY	$6,375,710	EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$18,872	BOYAmt
EOY	$259,887	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$5,565,373	BOYAmt
EOY	$6,635,597	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$6,712,014	BOYAmt
EOY	$7,535,112	EOYAmt

Field	Value	IRS element (for citing)
Reconcilation Revenue Expnss	$971,497	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	$98,727	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	$0	OtherChangesInNetAssetsAmt
Info In Schedule O Part XII	Yes (X)	InfoInScheduleOPartXIIInd
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	Yes (1)	FederalGrantAuditRequiredInd
Federal Grant Audit Performed	Yes (1)	FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Publicly Supported Org509a2	Yes (X)	PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$2,644,753	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$2,178,498	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$2,025,778	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$3,961,224	CurrentTaxYearMinus1YearAmt
Current Tax Year	$3,211,861	CurrentTaxYearAmt
Total	$14,022,114	TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$3,684,944	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$3,839,861	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$5,181,866	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$6,953,176	CurrentTaxYearMinus1YearAmt
Current Tax Year	$8,661,989	CurrentTaxYearAmt
Total	$28,321,836	TotalAmt

Total509 Total509Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$6,329,697	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$6,018,359	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$7,207,644	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$10,914,400	CurrentTaxYearMinus1YearAmt
Current Tax Year	$11,873,850	CurrentTaxYearAmt
Total	$42,343,950	TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Field	Value	IRS element (for citing)
Public Support Total509	$42,343,950	PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$12,237	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$16,939	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$31,644	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$45,973	CurrentTaxYearMinus1YearAmt
Current Tax Year	-$58,447	CurrentTaxYearAmt
Total	$48,346	TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$12,237	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$16,939	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$31,644	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$45,973	CurrentTaxYearMinus1YearAmt
Current Tax Year	-$58,447	CurrentTaxYearAmt
Total	$48,346	TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$6,341,934	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$6,035,298	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$7,239,288	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$10,960,373	CurrentTaxYearMinus1YearAmt
Current Tax Year	$11,815,403	CurrentTaxYearAmt
Total	$42,392,296	TotalAmt

Field	Value	IRS element (for citing)
Public Support CY509	0.99890	PublicSupportCY509Pct
Public Support PY509	0.99680	PublicSupportPY509Pct
Investment Income CY	0.00110	InvestmentIncomeCYPct
Investment Income PY	0.00320	InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509	Yes (X)	ThirtyThrPctSuprtTestsCY509Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

Field	Value	IRS element (for citing)
Contributor	RESTRICTED	ContributorNum

Contributor Business Name ContributorBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	RESTRICTED	BusinessNameLine1

Contributor US Address ContributorUSAddress

Field	Value	IRS element (for citing)
Address Line1	RESTRICTED	AddressLine1
Address Line2	RESTRICTED	AddressLine2
City	RESTRICTED	City
State	RESTRICTED	State
ZIP Code	RESTRICTED	ZIPCode

Field	Value	IRS element (for citing)
Total Contributions	RESTRICTED	TotalContributionsAmt

Schedule D IRS990ScheduleD

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$3,784,312	InvestmentCostOrOtherBasisAmt
Depreciation	$472,663	DepreciationAmt
Book Value	$3,311,649	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Investment Cost Or Other Basis	$1,919,371	InvestmentCostOrOtherBasisAmt
Depreciation	$953,854	DepreciationAmt
Book Value	$965,517	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$4,277,166	TotalBookValueLandBuildingsAmt
Total Rev Etc Audited Fincl Stmt	$12,371,076	TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst	$98,727	NetUnrealizedGainsInvstAmt
Donated Services And Use Fclts	$456,946	DonatedServicesAndUseFcltsAmt
Other Revenue	$31,997	OtherRevenueAmt
Revenue Not Reported	$587,670	RevenueNotReportedAmt
Revenue Subtotal	$11,783,406	RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt	$0	RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990	$11,783,406	TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt	$11,300,852	TotExpnsEtcAuditedFinclStmtAmt
Donated Services Use Fclts	$456,946	DonatedServicesUseFcltsAmt
Other Expenses Included	$31,997	OtherExpensesIncludedAmt
Expenses Not Reported	$488,943	ExpensesNotReportedAmt
Expenses Subtotal	$10,811,909	ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt	$0	ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990	$10,811,909	TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
PART XI, LINE 2D - OTHER ADJUSTMENTS:	EXPENSES REPORTED ON SCHEDULE G 31,997.
PART XII, LINE 2D - OTHER ADJUSTMENTS:	EXPENSES REPORTED ON SCHEDULE G 31,997.

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

Field	Value	IRS element (for citing)
Name Of Event1	5K RACE	NameOfEvent1Amt
Gross Receipts Event1	$83,755	GrossReceiptsEvent1Amt
Charitable Contri Event1	$35,195	CharitableContriEvent1Amt
Gross Revenue Event1	$48,560	GrossRevenueEvent1Amt
Cash Prizes Event1	$1,000	CashPrizesEvent1Amt
Non Cash Prizes Event1	$13,696	NonCashPrizesEvent1Amt
Rent Facility Costs Event1	$1,245	RentFacilityCostsEvent1Amt
Other Direct Expenses Event1	$16,056	OtherDirectExpensesEvent1Amt
Gross Receipts Total	$83,755	GrossReceiptsTotalAmt
Charitable Contributions Tot	$35,195	CharitableContributionsTotAmt
Gross Revenue Total Events	$48,560	GrossRevenueTotalEventsAmt
Cash Prizes Total Events	$1,000	CashPrizesTotalEventsAmt
Non Cash Prizes Total Events	$13,696	NonCashPrizesTotalEventsAmt
Rent Fclty Costs Total Events	$1,245	RentFcltyCostsTotalEventsAmt
Oth Direct Expnss Total Events	$16,056	OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events	$31,997	DirectExpenseSummaryEventsAmt
Net Income Summary	$16,563	NetIncomeSummaryAmt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Compensation Committee	Yes (X)	CompensationCommitteeInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	Yes (1)	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	0	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	0	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	0	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	0	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	0	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	0	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	0	AnyNonFixedPaymentsInd
Initial Contract Exception	0	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp

Field	Value	IRS element (for citing)
Person	RUSSELL JOHNSON	PersonNm
Title	CHIEF MEDICAL OFFICER	TitleTxt
Base Compensation Filing Org	$180,003	BaseCompensationFilingOrgAmt
Compensation Based On Rltd Orgs	$0	CompensationBasedOnRltdOrgsAmt
Bonus Filing Organization	$0	BonusFilingOrganizationAmount
Bonus Related Organizations	$0	BonusRelatedOrganizationsAmt
Other Compensation Filing Org	$0	OtherCompensationFilingOrgAmt
Other Compensation Rltd Orgs	$0	OtherCompensationRltdOrgsAmt
Deferred Compensation Flng Org	$0	DeferredCompensationFlngOrgAmt
Deferred Comp Rltd Orgs	$0	DeferredCompRltdOrgsAmt
Nontaxable Benefits Filing Org	$4,875	NontaxableBenefitsFilingOrgAmt
Nontaxable Benefits Rltd Orgs	$0	NontaxableBenefitsRltdOrgsAmt
Total Compensation Filing Org	$184,878	TotalCompensationFilingOrgAmt
Total Compensation Rltd Orgs	$0	TotalCompensationRltdOrgsAmt
Comp Report Prior990 Filing Org	$0	CompReportPrior990FilingOrgAmt
Comp Report Prior990 Rltd Orgs	$0	CompReportPrior990RltdOrgsAmt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART I, LINE 4A	FormAndLineReferenceDesc
Explanation	RUSSELL JOHNSON RECEIVED $31,154 OF SEVERANCE PAYMENT.	ExplanationTxt

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (4 entries)

Relationship DescriptionRelationshipDescriptionTxt	TransactionTransactionAmt	TransactionTransactionDesc	Sharing Of RevenuesSharingOfRevenuesInd
SALLY CHESSER
BOARD MEMBER	$0	GRACEMED HEALTH CLINIC, INC. HOLDS AN INVESTMENT ACCOUNT WITH SALLY CHESSER AT TD AMERITRADE. SALLY DOES NOT CHARGE A FEE FOR HER SERVICES.	0
CHAD SANFORD
SON OF CEO	$42,979	CHAD SANFORD IS THE SON OF DAVID SANFORD, CEO OF GRACEMED. CHAD IS AN EMPLOYEE OF GRACEMED.	0
JOHN BORREGO
SON OF BOARD MEMBER	$27,537	JOHN BORREGO IS THE SON OF TOM BORREGO, THE PRESIDENT OF THE BOARD OF DIRECTORS. JOHN BORREGO IS AN EMPLOYEE OF GRACEMED	0
SARA BAYLESS
DAUGHTER OF OFFICER	$52,939	SARA BAYLESS IS THE DAUGHTER OF ROGER NOLTE, GRACEMED'S CHIEF DENTAL OFFICER. SARA BAYLESS IS AN EMPLOYEE OF GRACEMED.	0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11	THE ORGANIZATION HIRES AN OUTSIDE CPA TO PREPARE THE FINANCIAL STATEMENT AUDIT AND THE FORM 990 EACH YEAR. AFTER THE CPA HAS COMPLETED BOTH THE AUDIT AND FORM 990, THE CFO FOR THE ORGANIZATION AND THE CPA REVIEW THE INITIAL DRAFT OF THE RETURN TO ENSURE ITS COMPLETENESS AND ACCURACY. FOLLOWING THE REVIEW, THE FORM 990 IS COMPLETED AND THE ORGANIZATION FILES THE RETURN.
FORM 990, PART VI, SECTION C, LINE 19	THE ORGANIZATION MAKES THE GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICIES, AND AUDITED FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART XII, LINE 2C	THIS POLICY HAS NOT CHANGED SINCE THE PRIOR YEAR.