PARTNERS IN EXCEPTIONAL CARE: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- PARTNERS IN EXCEPTIONAL CARE (EIN 39-1904074)
- Tax period
- 2011-07-01 to 2012-06-30
- Filed
- 2013-05-15
- IRS object ID
- 201341359349301529
- Schema version
- 2011v1.5
- 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 | 2013-05-15T10:59:06-05:00 | Timestamp |
| Tax Period End Date | 2012-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 420714325 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MCGLADREY LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 201 N HARRISON STREET SUITE 300 | AddressLine1 |
| City | DAVENPORT | City |
| State | IA | State |
| ZIP Code | 528011999 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-07-01 | 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 | 7155422176 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 17TH AND WELLS STREETS PO BOX 217 | AddressLine1 |
| City | CLARINDA | City |
| State | IA | State |
| ZIP Code | 51632 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JASON BRIDIE | Name |
| Title | STAFF DIRECTOR | Title |
| Phone | 7155422176 | Phone |
| Date Signed | 2013-05-14 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JOHN J ROMANO | Name |
| PTIN | P00227323 | PTIN |
| Phone | 5638884000 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | JASON BRIDIE | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 17TH AND WELLS STREETS PO BOX 217 | AddressLine1 |
| City | CLARINDA | City |
| State | IA | State |
| ZIP Code | 51632 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 431759 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.CLARINDAHEALTH.COM | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1996 | YearFormation |
| State Legal Domicile | IA | StateLegalDomicile |
| Activity Or Mission Description | 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. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 10 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 10 | NbrIndependentVotingMembers |
| Total Nbr Employees | 0 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 480981 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 293852 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 0 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 0 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 2989 | InvestmentIncomePriorYear |
| Investment Income Current Year | 11913 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 8461 | OtherRevenuePriorYear |
| Other Revenue Current Year | 950 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 492431 | TotalRevenuePriorYear |
| Total Revenue Current Year | 306715 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 675759 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 0 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 0 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 1309 | OtherExpensePriorYear |
| Other Expenses Current Year | 100 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 1309 | TotalExpensesPriorYear |
| Total Expenses Current Year | 675859 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 491122 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -369144 | RevenuesLessExpensesCY |
| Total Assets BOY | 736981 | TotalAssetsBOY |
| Total Assets EOY | 355962 | TotalAssetsEOY |
| Total Liabilities BOY | 0 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 0 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 736981 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 355962 | NetAssetsOrFundBalancesEOY |
| Mission Description | NONE | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 675859 | Expense |
| Grants | 675759 | Grants |
| Description | CLARINDA MEDICAL FOUNDATION MANAGES THE COLLECTION AND DISBURSEMENT OF CONTRIBUTIONS FOR CLARINDA REGIONAL HEALTH CENTER. | Description |
| Total Program Service Expense | 675859 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 0 | ReportLandBldgEquip |
| Report Invest Oth Securities | 1 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 0 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 1 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 0 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 1 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 0 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 0 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 0 | NumberOfEmployees |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 10 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 10 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 1 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 1 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 0 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 0 | ConflictOfInterestPolicy |
| Whistleblower Policy | 0 | WhistleblowerPolicy |
| Document Retention Policy | 0 | DocumentRetentionPolicy |
| Compensation Process CEO | 0 | CompensationProcessCEO |
| Compensation Process Other | 0 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JASON BRIDIE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 7125428339 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 823 SOUTH 17TH STREET | AddressLine1 |
| City | CLARINDA | City |
| State | IA | State |
| ZIP Code | 51632 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | X | NoListedPersonsCompensated |
Form990 Part VII Section A Form990PartVIISectionA (12 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation |
|---|---|---|---|---|---|---|
| MONTY BOSWELL | ||||||
| PRESIDENT | 0.30 | X | X | 0 | 0 | 0 |
| JEAN NEGLEY | ||||||
| VICE PRESIDENT | 0.30 | X | X | 0 | 0 | 0 |
| RANDY WALTERS | ||||||
| SECRETARY/TREASURER | 0.30 | X | X | 0 | 0 | 0 |
| RICHARD DAVIDSON | ||||||
| PAST VICE PRESIDENT | 0.30 | X | X | 0 | 0 | 0 |
| JOHN CLARK | ||||||
| PAST SECRETARY/TREASURER | 0.30 | X | X | 0 | 0 | 0 |
| CHRIS STIPE | ||||||
| BOARD MEMBER | 0.30 | X | 0 | 0 | 0 | |
| GLORIA KLINE | ||||||
| BOARD MEMBER | 0.30 | X | 0 | 0 | 0 | |
| MAGGIE BROWN | ||||||
| BOARD MEMBER | 0.30 | X | 0 | 0 | 0 | |
| RON RICHARDSON | ||||||
| BOARD MEMBER | 0.30 | X | 0 | 0 | 0 | |
| MIDGE STANLEY | ||||||
| BOARD MEMBER | 0.30 | X | 0 | 0 | 0 | |
| MARK KLINE | ||||||
| BOARD MEMBER | 0.30 | X | 0 | 0 | 0 | |
| JASON BRIDIE | ||||||
| STAFF DIRECTOR | 20.00 | X | 0 | 0 | 0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 0 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 0 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 0 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
| Number Of Contractors GT100 K | 0 | NumberOfContractorsGT100K |
| Fundraising Events | 9925 | FundraisingEvents |
| All Other Contributions | 283927 | AllOtherContributions |
| Noncash Contributions | 45458 | NoncashContributions |
| Total Contributions | 293852 | TotalContributions |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 3934 | TotalRevenueColumn |
| Exclusion | $3,934 | ExclusionAmount |
Gross Amount Sales Assets GrossAmountSalesAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 129538 | Securities |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 121559 | Securities |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 7979 | Securities |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 7979 | TotalRevenueColumn |
| Exclusion | $7,979 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 4369 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 9925 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 3485 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 884 | TotalRevenueColumn |
| Exclusion | $884 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | MISCELLANEOUS | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 66 | TotalRevenueColumn |
| Related Or Exempt Function Income | 66 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 66 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 306715 | TotalRevenueColumn |
| Related Or Exempt Function Income | 66 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $12,797 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 675759 | Total |
| Program Services | 675759 | ProgramServices |
Other Expenses OtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | MISCELLANEOUS EXPENSES | Description |
| Total | 100 | Total |
| Program Services | 100 | ProgramServices |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 675859 | Total |
| Program Services | 675859 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 324021 | BOY |
| EOY | 208796 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 39439 | BOY |
| EOY | 22217 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 373521 | BOY |
| EOY | 124949 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 736981 | BOY |
| EOY | 355962 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Do Not Follow SFAS117 | X | DoNotFollowSFAS117 |
Cap Stck Trst Prin Current Funds CapStckTrstPrinCurrentFunds
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Paid In Cap Srpls Land Bldg Eqp Fund PaidInCapSrplsLandBldgEqpFund
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 736981 | BOY |
| EOY | 355962 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 736981 | BOY |
| EOY | 355962 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 736981 | BOY |
| EOY | 355962 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | -369144 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -11875 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
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 | 30084 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 17482 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 14870 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 480981 | CurrentTaxYearMinus1Year |
| Current Tax Year | 293852 | CurrentTaxYear |
| Total | 837269 | Total |
Gross Receipts From Admissions GrossReceiptsFromAdmissions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 21902 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 20001 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 14312 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 14510 | CurrentTaxYearMinus1Year |
| Current Tax Year | 4369 | CurrentTaxYear |
| Total | 75094 | Total |
Total509 Total509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 51986 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 37483 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 29182 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 495491 | CurrentTaxYearMinus1Year |
| Current Tax Year | 298221 | CurrentTaxYear |
| Total | 912363 | Total |
Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 1000 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 775 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 1050 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 9800 | CurrentTaxYearMinus1Year |
| Current Tax Year | 4635 | CurrentTaxYear |
| Total | 17260 | 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 | 1000 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 775 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 1050 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 9800 | CurrentTaxYearMinus1Year |
| Current Tax Year | 4635 | CurrentTaxYear |
| Total | 17260 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | 895103 | PublicSupportTotal509 |
Gross Investment Income509 GrossInvestmentIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 40013 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 16438 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 2689 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 4800 | CurrentTaxYearMinus1Year |
| Current Tax Year | 11913 | CurrentTaxYear |
| Total | 75853 | Total |
Investment Income And UBTI InvestmentIncomeAndUBTI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 40013 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 16438 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 2689 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 4800 | CurrentTaxYearMinus1Year |
| Current Tax Year | 11913 | CurrentTaxYear |
| Total | 75853 | Total |
Other Income509 OtherIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 321 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus2 Years | 4163 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 181 | CurrentTaxYearMinus1Year |
| Current Tax Year | 66 | CurrentTaxYear |
| Total | 4731 | Total |
Total Support Total TotalSupportTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 92320 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 53921 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 36034 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 500472 | CurrentTaxYearMinus1Year |
| Current Tax Year | 310200 | CurrentTaxYear |
| Total | 992947 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Percentage509 | 0.90150 | PublicSupportPercentage509 |
| Prior Year Support Percentage | 0.89110 | PriorYearSupportPercentage |
| Investment Income Percentage | 0.07640 | InvestmentIncomePercentage |
| Prior Yr Invest Income Percentage | 0.08920 | 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 D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 0 | TotalOfBookValueLandBuildings |
Other Securities OtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | RAYMOND JAMES INVESTMENTS | Description |
| Book Value | 124949 | BookValue |
| Method Of Valuation | F | MethodOfValuation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Securities | 124949 | TotalOfBookValueSecurities |
| Total Revenue | 306715 | TotalRevenue |
| Total Expenses | 675859 | TotalExpenses |
| Excess Or Deficit For Year | -369144 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | -11875 | NetUnrealizedGLOnInvestments |
| Total Adjustments | -11875 | TotalAdjustments |
| Excess Or Deficit Per FS | -381019 | ExcessOrDeficitPerFS |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | Identifier |
| Return Reference | PART X: | ReturnReference |
| Explanation | FIN 48 IS NOT APPLICABLE. | Explanation |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | 0 | RecordsMaintained |
Recipient Table RecipientTable
Recipient Name Business RecipientNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLARINDA REGIONAL HEALTH CENTER | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 220 ESSIE DAVISON DR | AddressLine1 |
| City | CLARINDA | City |
| State | IA | State |
| ZIP Code | 51635 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN Of Recipient | 426005819 | EINOfRecipient |
| Amount Of Cash Grant | 630301 | AmountOfCashGrant |
| Amount Of Non Cash Assistance | 45458 | AmountOfNonCashAssistance |
| Method Of Valuation | FMV | MethodOfValuation |
| Description Of Non Cash Assistance | LIFT GATES | DescriptionOfNonCashAssistance |
| Purpose Of Grant | THE HOSPITAL PURCHASES NECESSARY MEDICAL EQUIPMENT WITH THE CASH DONATED. | PurposeOfGrant |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Nbr Of501 C3 And Govt Grants | 1 | TotalNbrOf501C3AndGovtGrants |
| Total Nbr Of Other Organizations | 0 | TotalNbrOfOtherOrganizations |
Schedule M IRS990ScheduleM
Other Non Cash Contributions Table OtherNonCashContributionsTable
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Description | EQUIPMENT | Description |
| Number Of Contributions | 1 | NumberOfContributions |
| Noncash Contribs Rptd F990 | 45458 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | FAIR MARKET VALUE | MethodOfDeterminingRevenues |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeld |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGifts |
| Third Parties Used | 0 | ThirdPartiesUsed |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (8 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | MARK KLINE AND GLORIA KLINE ARE SPOUSES. | |
| FORM 990, PART VI, SECTION A, LINE 6 | CLARINDA REGIONAL HEALTH CENTER IS THE SOLE MEMBER OF CLARINDA MEDICAL FOUNDATION. THE SOLE MEMBER DOES NOT HAVE ANY RIGHTS DESIGNATED BY THE BYLAWS. | |
| FORM 990, PART VI, SECTION A, LINE 8B | CLARINDA MEDICAL FOUNDATION DOES NOT HAVE ANY COMMITTEES WITH AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. | |
| FORM 990, PART VI, SECTION B, LINE 11 | NO REVIEW HAS OR WILL BE COMPLETED OF THE FORM 990. | |
| FORM 990, PART VI, SECTION B, LINE 12 | WHILE CLARINDA MEDICAL FOUNDATION HAS NOT FORMALLY ADOPTED THE CONFLICT OF INTEREST, WHISTLEBLOWER, AND DOCUMENT RETENTION AND DESTRUCTION POLICIES OF CLARINDA REGIONAL HEALTH CENTER, THE FOUNDATION DOES ADHERE TO THESE POLICIES. | |
| FORM 990, PART VI, SECTION C, LINE 19 | CLARINDA MEDICAL FOUNDATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. | |
| FORM 990, PART XI, LINE 5: | NET UNREALIZED LOSSES ON INVESTMENTS: -11,875. | CHANGES IN NET ASSETS OR FUND BALANCES: |
| FORM 990, PART XII, LINE 2C | CLARINDA MEDICAL FOUNDATION'S FINANCIAL INFORMATION IS INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS OF THE CLARINDA REGIONAL HEALTH CENTER, AN AFFILIATED ORGANIZATION. CLARINDA REGIONAL HEALTH CENTER'S GOVERNING BOARD MEETS WITH THE AUDITORS TO REVIEW THE AUDIT REPORT AND MANAGEMENT LETTER. |