ACCESS FAMILY HEALTH SERVICES INC: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- ACCESS FAMILY HEALTH SERVICES INC (EIN 64-0612902)
- Tax period
- 2012-02-01 to 2013-01-31
- Filed
- 2013-06-14
- IRS object ID
- 201341669349300329
- 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 | 2013-06-14T09:01:40-05:00 | Timestamp |
| Tax Period End Date | 2013-01-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 640736635 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FRANKS FRANKS & JARRELL PA | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 731 | AddressLine1 |
| City | TUPELO | City |
| State | MS | State |
| ZIP Code | 38802 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-02-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 640612902 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ACCESS FAMILY HEALTH SERVICES INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | ACCE | NameControl |
| Phone | 6626514686 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 179 | AddressLine1 |
| City | SMITHVILLE | City |
| State | MS | State |
| ZIP Code | 38870 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | MARILYN SUMERFORD | Name |
| Title | EXECUTIVE DIRECTOR | Title |
| Phone | 6626514686 | Phone |
| Date Signed | 2013-06-14 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | BRYON WILEMON | Name |
| PTIN | P00479223 | PTIN |
| Phone | 6628445226 | Phone |
| Date Prepared | 2013-06-13 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | MARILYN SUMERFORD | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 179 | AddressLine1 |
| City | SMITHVILLE | City |
| State | MS | State |
| ZIP Code | 38870 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 5338087 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.ACCESSFAMILYHEALTH.COM | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1980 | YearFormation |
| State Legal Domicile | MS | StateLegalDomicile |
| Activity Or Mission Description | TO PROVIDE AFFORDABLE, COMPREHENSIVE HEALTH CARE AND EDUCATION TO COMMUNITIES IN NORTH MISSISSIPPI | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 12 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 12 | NbrIndependentVotingMembers |
| Total Nbr Employees | 62 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 1359456 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 1436654 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 3692673 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 3817806 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 484446 | InvestmentIncomePriorYear |
| Investment Income Current Year | 8562 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 75000 | OtherRevenuePriorYear |
| Other Revenue Current Year | 75000 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 5611575 | TotalRevenuePriorYear |
| Total Revenue Current Year | 5338022 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 3389587 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 3416391 | 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 | 1414896 | OtherExpensePriorYear |
| Other Expenses Current Year | 1441466 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 4804483 | TotalExpensesPriorYear |
| Total Expenses Current Year | 4857857 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 807092 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 480165 | RevenuesLessExpensesCY |
| Total Assets BOY | 3470799 | TotalAssetsBOY |
| Total Assets EOY | 3846031 | TotalAssetsEOY |
| Total Liabilities BOY | 470977 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 372640 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 2999822 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 3473391 | NetAssetsOrFundBalancesEOY |
| Mission Description | THE MISSION OF ACCESS FAMILY HEALTH SERVICES, INC. IS TO PROVIDE AFFORDABLE, COMPREHENSIVE HEALTH CARE AND EDUCATION TO OUR COMMUNITIES WITH SUPERIOR SERVICES. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 4045892 | Expense |
| Revenue | 3817806 | Revenue |
| Description | PROVIDES RURAL HEALTH CARE SERVICES (DOCTORS, NURSES, PHARMACY FOR SMALL COMMUNITIES IN MISSISSIPPI IN EXCESS OF 9,000 PATIENTS AND 28,000 ENCOUNTERS PER YEAR) | Description |
| Total Program Service Expense | 4045892 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 0 | 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 | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | 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 | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | 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 | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | 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 | 0 | 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 |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 29 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 62 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| 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 |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 12 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 12 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | 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 | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | 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 | DANA RAMEY | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 6626514686 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 179 | AddressLine1 |
| City | SMITHVILLE | City |
| State | MS | State |
| ZIP Code | 38870 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (21 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| NORMA DERRING | |||||||
| MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| WILLIAM SHACK | |||||||
| MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| INITA MCMULLAN | |||||||
| SECRETARY | 1.00 | X | 0 | 0 | 0 | ||
| BRAD STEVENS | |||||||
| MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| DON WHITEHEAD | |||||||
| MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| MARLON SUMMERFORD | |||||||
| BOARD CHAIRMAN | 1.00 | X | 0 | 0 | 0 | ||
| ROBERT WHITEHEAD | |||||||
| TREASURER | 1.00 | X | 0 | 0 | 0 | ||
| ANN SEALES | |||||||
| MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| DARRELL HARP JR | |||||||
| MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| RUBY HOLLIN | |||||||
| BOARD VICE CHAIRMAN | 1.00 | X | 0 | 0 | 0 | ||
| JERRY HALL | |||||||
| MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| LASHUNDA BUGGS | |||||||
| MEMBER | 1.00 | X | 0 | 0 | 0 | ||
| MARILYN SUMERFORD | |||||||
| EXECUTIVE DIRECTOR | 40.00 | 83977 | 0 | 20123 | X | ||
| PATSY LYLE | |||||||
| NURSING DIRECTOR | 40.00 | 62407 | 0 | 8661 | X | ||
| DANA RAMEY | |||||||
| FINANCIAL DIRECTOR | 40.00 | 73726 | 0 | 4948 | X | ||
| REBECCA CAGLE | |||||||
| DIRECTOR OF CLINICAL QUALI | 40.00 | 97679 | 0 | 10776 | X | ||
| STEPHEN HATHCOCK | |||||||
| PHYSICIAN | 40.00 | 114233 | 0 | 12141 | X | ||
| JAMES MONROE | |||||||
| PHYSICIAN | 40.00 | 195085 | 0 | 23064 | X | ||
| ANGELA FURR | |||||||
| PHYSICIAN | 40.00 | 104896 | 0 | 11210 | X | ||
| KEVIN KOEHLER | |||||||
| PHYSICIAN | 40.00 | 204398 | 0 | 26721 | X | ||
| BRIAN FRILLOUX | |||||||
| PHYSICIAN | 40.00 | 202406 | 0 | 12247 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1138807 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 129891 | TotalOtherCompensation |
| Number Individuals GT100 K | 5 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (2 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| ARCHITECTURE SOUTH | |||||
| 300 W JEFFERSON ST | TUPELO | MS | 38804 | ARCHITECTURE SERVICES | 103436 |
| IMAGING CENTER AT GLOSTER CREEK VILLAGE | |||||
| 499 GLOSTER CREEK VLG STE G1 | TUPELO | MS | 38801 | MEDICAL SERVICES | 101316 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 2 | NumberOfContractorsGT100K |
| Government Grants | 1412654 | GovernmentGrants |
| All Other Contributions | 24000 | AllOtherContributions |
| Total Contributions | 1436654 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | PATIENT SERVICES | Description |
| Business Code | 621110 | BusinessCode |
| Total Revenue Column | 3817806 | TotalRevenueColumn |
| Related Or Exempt Function Income | 3817806 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 3817806 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 8627 | TotalRevenueColumn |
| Related Or Exempt Function Income | 8627 | RelatedOrExemptFunctionIncome |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 65 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -65 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -65 | TotalRevenueColumn |
| Related Or Exempt Function Income | -65 | RelatedOrExemptFunctionIncome |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | INSURANCE PROCEEDS | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 75000 | TotalRevenueColumn |
| Related Or Exempt Function Income | 75000 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 75000 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 5338022 | TotalRevenueColumn |
| Related Or Exempt Function Income | 3901368 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 362297 | Total |
| Management And General | 362297 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2420385 | Total |
| Program Services | 2368385 | ProgramServices |
| Management And General | 52000 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 633709 | Total |
| Program Services | 524746 | ProgramServices |
| Management And General | 108963 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 140554 | Total |
| Program Services | 131680 | ProgramServices |
| Management And General | 8874 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 69436 | Total |
| Program Services | 26697 | ProgramServices |
| Management And General | 42739 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5853 | Total |
| Program Services | 5853 | ProgramServices |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 58102 | Total |
| Program Services | 57859 | ProgramServices |
| Management And General | 243 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13276 | Total |
| Program Services | 8715 | ProgramServices |
| Management And General | 4561 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| CONTRACTUAL SERVICES | 580925 | 492348 | 88577 |
| SUPPLIES | 186107 | 157802 | 28305 |
| TELEPHONE | 80225 | 71817 | 8408 |
| MISCELLANEOUS | 57492 | 19921 | 37571 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 249496 | Total |
| Program Services | 180069 | ProgramServices |
| Management And General | 69427 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4857857 | Total |
| Program Services | 4045892 | ProgramServices |
| Management And General | 811965 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 184387 | BOY |
| EOY | 205768 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1409365 | BOY |
| EOY | 1773782 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14027 | BOY |
| EOY | 18632 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 698391 | BOY |
| EOY | 471061 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 126000 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 109 | BOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 35040 | BOY |
| EOY | 16938 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 1968722 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 734872 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1129480 | BOY |
| EOY | 1233850 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3470799 | BOY |
| EOY | 3846031 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 351902 | BOY |
| EOY | 280927 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 119075 | BOY |
| EOY | 91713 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 470977 | BOY |
| EOY | 372640 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2522338 | BOY |
| EOY | 2597643 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 477484 | BOY |
| EOY | 875748 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2999822 | BOY |
| EOY | 3473391 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3470799 | BOY |
| EOY | 3846031 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 480165 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | -6596 | ReconciliationUnrealizedInvest |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Separate | X | FinancialStatementSeparate |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 0 | AuditCommittee |
| Federal Grant Audit Required | 1 | FederalGrantAuditRequired |
| Federal Grant Audit Performed | 1 | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 171784 | OtherCostOrOtherBasis |
| Book Value | 171784 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 937337 | OtherCostOrOtherBasis |
| Depreciation | 415084 | Depreciation |
| Book Value | 522253 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 103935 | OtherCostOrOtherBasis |
| Depreciation | 46026 | Depreciation |
| Book Value | 57909 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 618205 | OtherCostOrOtherBasis |
| Depreciation | 273762 | Depreciation |
| Book Value | 344443 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 137461 | OtherCostOrOtherBasis |
| Book Value | 137461 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 1233850 | TotalOfBookValueLandBuildings |
| Tot Revenue Etc Audited Fincl Stmt | 5331426 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | -6596 | NetUnrealizedGainsInvestments |
| Revenue Not Rptd F990 | -6596 | RevenueNotRptdF990 |
| Revenue Subtotal | 5338022 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 5338022 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 4857857 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 4857857 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 4857857 | TotalExpensesPerForm990 |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (3 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JAMES MONROE | ||||||||||||||
| PHYSICIAN | 195085 | 0 | 0 | 0 | 0 | 0 | 11675 | 0 | 11389 | 0 | 218149 | 0 | 0 | 0 |
| KEVIN KOEHLER | ||||||||||||||
| PHYSICIAN | 204398 | 0 | 0 | 0 | 0 | 0 | 11605 | 0 | 15116 | 0 | 231119 | 0 | 0 | 0 |
| BRIAN FRILLOUX | ||||||||||||||
| PHYSICIAN | 202406 | 0 | 0 | 0 | 0 | 0 | 11913 | 0 | 334 | 0 | 214653 | 0 | 0 | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (4 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 8B | THERE ARE NO AUXILLARY COMMITTEES |
| FORM 990, PART VI, SECTION B, LINE 11 | COPIES OF THE 990 ARE MADE AVAILABLE TO THE BOARD FOR REVIEW AND DISCUSSION |
| FORM 990, PART VI, SECTION B, LINE 12C | BOARD MEMBERS COMPLETE A CONFLICT OF INTERST STATEMENT ANNUALLY AT THE ANNUAL MEETING IN JUNE. WHEN A CONFLICT OF INTEREST IS DISCLOSED, THE BOARD MEMBER MUST RESIGN IF IT IS IN CONFLICT WITH THE BOARD'S BYLAWS. THE ORGANIZATION ALSO HAS A COMPLIANCE OFFICER THAT MONITORS COMPLIANCE WITH THE VARIOUS PROGRAMS. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE PUBLIC DOCUMENTS OF THE ORGANIZATION ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. |
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