COMPASSIONATE HEALTH CENTER INC: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- COMPASSIONATE HEALTH CENTER INC (EIN 32-0237943)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-06-25
- IRS object ID
- 201301769349300435
- 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 | 2013-06-25T16:11:08-05:00 | Timestamp |
| Tax Period End Date | 2012-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | VIRGA A SMITH CPA | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 986 S PRAIRIEWOOD DR | AddressLine1 |
| City | ROCHESTER | City |
| State | IN | State |
| ZIP Code | 469757141 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 320237943 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FULTON CNTY FREE MEDICAL CLINIC INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | FULT | NameControl |
| Phone | 5742236080 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 740 ST RD 25 N | AddressLine1 |
| City | ROCHESTER | City |
| State | IN | State |
| ZIP Code | 46975 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | MARY KAY | Name |
| Title | EXECUTIVE DIRECTOR | Title |
| Phone | 5742236080 | Phone |
| Date Signed | 2013-06-25 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | VIRGA A SMITH | Name |
| Phone | 5742235159 | Phone |
| Date Prepared | 2013-06-25 | DatePrepared |
| Self Employed | X | SelfEmployed |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
Doing Business As DoingBusinessAs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMPASSIONATE HEALTH CENTER | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | RICHARD A ENYART | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2420 COUNTRY CLUB DR S | AddressLine1 |
| City | ROCHESTER | City |
| State | IN | State |
| ZIP Code | 46975 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 162540 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | INFO@COMPASSIONATEHEALTHCENTER.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 2008 | YearFormation |
| State Legal Domicile | IN | StateLegalDomicile |
| Activity Or Mission Description | THE MISSION OF THE FULTON COUNTY FREE CLINIC IS TO PROVIDE UNDER SERVED AND UNINSURED RESIDENTS OF FULTON COUNTY WITH HIGH-QUALITY HEALTH SCREENINGS AND PREVENTIVE HEALTH SERVICES. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 7 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 0 | NbrIndependentVotingMembers |
| Total Nbr Employees | 5 | TotalNbrEmployees |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 189970 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 141473 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 408 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 1214 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 1445 | InvestmentIncomePriorYear |
| Investment Income Current Year | 1559 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 7679 | OtherRevenuePriorYear |
| Other Revenue Current Year | 13270 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 199502 | TotalRevenuePriorYear |
| Total Revenue Current Year | 157516 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 7709 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 7876 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 70478 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 89521 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 38637 | OtherExpensePriorYear |
| Other Expenses Current Year | 44595 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 116824 | TotalExpensesPriorYear |
| Total Expenses Current Year | 141992 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 82678 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 15524 | RevenuesLessExpensesCY |
| Total Assets BOY | 266151 | TotalAssetsBOY |
| Total Assets EOY | 282870 | TotalAssetsEOY |
| Total Liabilities BOY | 1479 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 2674 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 264672 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 280196 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | THE MISSION OF THE FULTON COUNTY FREE CLINIC IS TO PROVIDE UNDER SERVED AND UNINSURED RESIDENTS OF FULTON COUNTY WITH HIGH-QUALITY HEALTH SCREENINGS AND PREVENTIVE HEALTH SERVICES. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Description | PRIMARY HEALTHCARE SERVICES FOR 473 PATIENTS DURING 2101 TOTAL PATIENT VISITS. MEDICATION ASSISTANCE FOR PATIENTS WITH PRESCRIPTION ASSISTED VALUE OF 158,133.53 AND MEDICAL ASSISTED VALUE OF 178,585.00. | Description |
Activity Other ActivityOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 141992 | Expense |
| Description | PRIMARY HEALTHCARE SERVICES FOR 473 PATIENTS DURING 2101 TOTAL PATIENT VISITS. MEDICATION ASSISTANCE FOR PATIENTS WITH PRESCRIPTION ASSISTED VALUE OF 158,133.53 AND MEDICAL ASSISTED VALUE OF 178,585.00. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Other Program Service Exp | 141992 | TotalOfOtherProgramServiceExp |
| Total Program Service Expense | 141992 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | false | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | false | ReportOtherLiabilities |
| Report Fin48 Footnote | false | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | false | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | true | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | false | Hospital |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | false | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | false | ScheduleORequired |
| Number Forms Transmitted With1096 | 1 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 5 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 7 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 0 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | false | MembersOrStockholders |
| Election Of Board Members | false | ElectionOfBoardMembers |
| Decisions Subject To Approval | false | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | false | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | false | ConflictOfInterestPolicy |
| Whistleblower Policy | false | WhistleblowerPolicy |
| Document Retention Policy | false | DocumentRetentionPolicy |
| Compensation Process CEO | false | CompensationProcessCEO |
| Compensation Process Other | false | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | IN | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | MARY KAY | NamePerson |
| Telephone Number | 5742236080 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 740 STATE ROAD 25 N | AddressLine1 |
| City | ROCHESTER | City |
| State | IN | State |
| ZIP Code | 46975 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (9 entries)
| TitleTitle | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Average Hours Per WeekAverageHoursPerWeek | OfficerOfficer | FormerFormer |
|---|---|---|---|---|---|---|---|
| JOHN ALLEY | |||||||
| BOARD MEMBER | X | 0 | 0 | 0 | |||
| NANCY GOHN | |||||||
| BOARD MEMBER | X | 0 | 0 | 0 | |||
| PAT NICKOLSON | |||||||
| BOARD MEMBER | X | 0 | 0 | 0 | |||
| JAY ALBRIGHT | |||||||
| EXECUTIVE DI | 35481 | 0 | 0 | 40.00 | X | ||
| RICHARD A ENYART | |||||||
| PRESIDENT | 0 | 0 | 0 | X | |||
| PAT RATHBUN | |||||||
| VICE-PRESIDE | 0 | 0 | 0 | X | |||
| MARY KAY | |||||||
| SECRETARY | 0 | 0 | 0 | X | |||
| MELINDA STRAETER | |||||||
| TREASURER | 0 | 0 | 0 | X | |||
| LEANNE SCHALLER | |||||||
| 11308 | 0 | 0 | X | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 46789 | TotalReportableCompFromOrg |
| Formers Listed | true | FormersListed |
| Total Comp GT150 K | false | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
| All Other Contributions | 141473 | AllOtherContributions |
| Total Contributions | 141473 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | PROGRAM SERVICE REVENUE | Description |
| Total Revenue Column | 1214 | TotalRevenueColumn |
| Related Or Exempt Function Income | 1214 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 1214 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1559 | TotalRevenueColumn |
| Related Or Exempt Function Income | 1559 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 16893 | GrossIncomeFundraisingEvents |
| Fundraising Direct Expenses | 5024 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 11869 | TotalRevenueColumn |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | MISCELLANEOUS REVENUE | Description |
| Total Revenue Column | 1401 | TotalRevenueColumn |
| Related Or Exempt Function Income | 1401 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 1401 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 157516 | TotalRevenueColumn |
| Related Or Exempt Function Income | 4174 | RelatedOrExemptFunctionIncome |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7876 | Total |
| Program Services | 7876 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 35481 | Total |
| Program Services | 35481 | ProgramServices |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11308 | Total |
| Program Services | 11308 | ProgramServices |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 36370 | Total |
| Program Services | 36370 | ProgramServices |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6362 | Total |
| Program Services | 6362 | ProgramServices |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2683 | Total |
| Program Services | 2683 | ProgramServices |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 436 | Total |
| Program Services | 436 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12106 | Total |
| Program Services | 12106 | ProgramServices |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2357 | Total |
| Program Services | 2357 | ProgramServices |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 14400 | Total |
| Program Services | 14400 | ProgramServices |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1560 | Total |
| Program Services | 1560 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11053 | Total |
| Program Services | 11053 | ProgramServices |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 141992 | Total |
| Program Services | 141992 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 254935 | BOY |
| EOY | 268050 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 14820 | LandBuildingsEquipmentBasis |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11216 | BOY |
| EOY | 14820 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 266151 | BOY |
| EOY | 282870 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1479 | BOY |
| EOY | 2674 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1479 | BOY |
| EOY | 2674 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 264672 | BOY |
| EOY | 280196 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 264672 | BOY |
| EOY | 280196 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 266151 | BOY |
| EOY | 282870 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 15524 | ReconcilationRevenueExpenses |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | false | FSAudited |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org170b1 Avi | X | PubliclySupportedOrg170b1Avi |
Gifts Grants Contrib Received170 GiftsGrantsContribReceived170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus3 Years | 263887 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 101757 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 189970 | CurrentTaxYearMinus1Year |
| Current Tax Year | 141473 | CurrentTaxYear |
| Total | 697087 | Total |
Total170 Total170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus3 Years | 263887 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 101757 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 189970 | CurrentTaxYearMinus1Year |
| Current Tax Year | 141473 | CurrentTaxYear |
| Total | 697087 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | 697087 | PublicSupportTotal170 |
Gross Investment Income170 GrossInvestmentIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | 1559 | CurrentTaxYear |
| Total | 1559 | Total |
Other Income170 OtherIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | 1050 | CurrentTaxYearMinus1Year |
| Current Tax Year | 1400 | CurrentTaxYear |
| Total | 2450 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | 701096 | TotalSupport |
| Gross Receipts From Admissions Etc | 21067 | GrossReceiptsFromAdmissionsEtc |
| First5 Years170 | X | First5Years170 |
Schedule D IRS990ScheduleD
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 14820 | InvestmentCostOrOtherBasis |
| Book Value | 14820 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 14820 | TotalOfBookValueLandBuildings |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts Event1 | 16893 | GrossReceiptsEvent1 |
| Gross Revenue Event1 | 16893 | GrossRevenueEvent1 |
| Other Direct Expenses Event1 | 5024 | OtherDirectExpensesEvent1 |
| Gross Receipts Total | 16893 | GrossReceiptsTotal |
| Gross Revenue Total Events | 16893 | GrossRevenueTotalEvents |
| Other Direct Expenses Total Events | 5024 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 5024 | DirectExpenseSummaryEvents |
| Net Income Summary | 11869 | NetIncomeSummary |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | false | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | LEANNE SCHALLER | NamePerson |
| Base Compensation Filing Org | 11308 | BaseCompensationFilingOrg |
| Total Compensation Filing Org | 11308 | TotalCompensationFilingOrg |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (3 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| ALL OTHER ACCOMPLISHMENT DESCRIPTION | FORM 990, PAGE 2, PART III, LINE 4D | PRIMARY HEALTHCARE SERVICES FOR 473 PATIENTS DURING 2101 TOTAL PATIENT VISITS. MEDICATION ASSISTANCE FOR PATIENTS WITH PRESCRIPTION ASSISTED VALUE OF 158,133.53 AND MEDICAL ASSISTED VALUE OF 178,585.00. |
| ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 | FORM 990, PAGE 6, PART VI, LINE 11B | NO REVIEW WAS OR WILL BE CONDUCTED. |
| GOVERNING DOCUMENTS DISCLOSURE EXPLANATION | FORM 990, PAGE 6, PART VI, LINE 19 | DOCUMENTS AVAILABLE UPON REQUEST AT ENTITY'S OFFICE DURING REGULAR OFFICE HOURS. |
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