SCALPEL AT THE CROSS INC: Form 990EZ, tax year 2011

View the entire original 990 at ProPublica ↗

Organization: SCALPEL AT THE CROSS INC (EIN 20-1175847)
Tax period: 2011-01-01 to 2011-12-31
Filed: 2012-07-17
IRS object ID: 201231999349200163
Schema version: 2011v1.2
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-EZ
Schedule A
Schedule B
Schedule O
Compensation Explanation

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2012-07-17T13:16:39-05:00	Timestamp
Tax Period End Date	2011-12-31	TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	J L WIDMAN INC	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	1289 W 500 S	AddressLine1
City	ROCHESTER	City
State	IN	State
ZIP Code	469757564	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990EZ	ReturnType
Tax Period Begin Date	2011-01-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	201175847	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	SCALPEL AT THE CROSS INC	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	SCAL	NameControl
Phone	5748355174	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	146 W PLEASANT LAKE ROAD	AddressLine1
City	NORTH OAKS	City
State	MN	State
ZIP Code	55127	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	LISA SCHRODER	Name
Title	SECRETARY/TREASURER	Title
Phone	5748355174	Phone
Date Signed	2012-05-14	DateSigned
Authorize Third Party	true	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	JENNIFER A KOROUS CPA	Name
Phone	5748575215	Phone
Date Prepared	2012-07-17	DatePrepared

Field	Value	IRS element (for citing)
Tax Year	2011	TaxYear
Build TS	2016-02-24 21:20:13Z	BuildTS

Form 990-EZ IRS990EZ

Field	Value	IRS element (for citing)
Method Of Accounting Cash	X	MethodOfAccountingCash
Web Site	WWW.SCALPELATTHECROSS.ORG	WebSite
Organization501c3	X	Organization501c3
Gross Receipts	148276	GrossReceipts
Info In Schedule O Part I	X	InfoInScheduleOPartI
Contributions Gifts Grants Etc	148276	ContributionsGiftsGrantsEtc
Total Revenue	148276	TotalRevenue
Salaries Other Comp Empl Benefits	58233	SalariesOtherCompEmplBenefits
Fees And Oth Pymt To Ind Contractors	1304	FeesAndOthPymtToIndContractors
Printing Publications Postage	8939	PrintingPublicationsPostage
Other Expenses Total	116937	OtherExpensesTotal
Total Expenses	185413	TotalExpenses
Excess Or Deficit For Year	-37137	ExcessOrDeficitForYear
Net Assets Or Fund Balances BOY	258369	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	221232	NetAssetsOrFundBalancesEOY
Info In Schedule O Part II	X	InfoInScheduleOPartII

Cash Savings And Investments CashSavingsAndInvestments

Field	Value	IRS element (for citing)
BOY	58202	BOY
EOY	30154	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	200512	BOY
EOY	191078	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	258714	BOY
EOY	221232	EOY

Sum Of Total Liabilities SumOfTotalLiabilities

Field	Value	IRS element (for citing)
BOY	345	BOY

Net Assets Or Fund Balances NetAssetsOrFundBalances

Field	Value	IRS element (for citing)
BOY	258369	BOY
EOY	221232	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part III	X	InfoInScheduleOPartIII
Primary Exempt Purpose	PURPOSE IS TO BUILD A MEDICAL MISSION CAMP WHICH SERVES THE ORTHOPEDIC NEEDS OF PUCALLPAN PERUVIANS BY STAFFING CAMP WITH PART TIME HEALTH CARE PROFESSIONALS	PrimaryExemptPurpose

Program Service Accomplishment ProgramServiceAccomplishment (4 entries)

Description Program Service AccomDescriptionProgramServiceAccom	Program Service ExpensesProgramServiceExpenses
MEDICAL MISSION CAMPAIGNS: IN 2011, 24 VOLUNTEERS TRAVELED WITH SCALPEL AT THE CROSS ACCOMPLISHING TWO SHORT-TERM MEDICAL CAMPAIGN TRIPS. DURING THESE TRIPS, WE EVALUATED 433 PATIENTS IN CLINIC, AND PERFORMED 57 ORTHOPAEDIC SURGERIES FOR THE PROVISION OF AN ESTIMATED 445K IN MEDICAL CARE. THE MEDICAL PROFESSIONAL TIME DONATION (EQUALING 240 VOLUNTEER DAYS) IS CONSERVATIVELY ESTIMATED TO BE AN ADDITIONAL 55K OF VALUE CONTRIBUTED.	62280
PATIENT FOLLOW UP: IN 2011, OUR PERUVIAN MEDICAL DIRECTOR TRAVELED TO PUCALLPA, PERU ON 9 OCCASIONS TO EVALUATE SURGICAL PATIENTS AND CONTINUE THEIR POST-OPERATIVE CARE. NINETY-EIGHT PATIENTS RECEIVED FREE MEDICAL EVALUATIONS, WOUND CARE AND PHYSICAL THERAPY INSTRUCTION AS PART OF THIS FOLLOW-UP PATIENT CARE PROGRAM.	20665
MEDICAL SUPPLY DONATIONS & TRANSPORT: IN 2011, SCALPEL AT THE CROSS PERSONNEL AND VOLUNTEERS GATHERED AND DELIVERED NEEDED MEDICAL EQUIPMENT AND SUPPLIES VALUED AT 96K IN CONJUNCTION WITH OUR SHORT-TERM MEDICAL CAMPAIGNS.	13654
IN 2011, 24 VOLUNTEERS TRAVELED WITH SCALPEL AT THE CROSS ON 2 SHORT-TERM (10 DAY) MEDICAL CAMPAIGN TRIPS. DURING THESE TRIPS, WE EVALUATED 433 PATIENTS IN CLINIC, PERFORMED 57 ORTHOPAEDIC SURGERIES, AND COMPLETED 98 FOLLOW-UP VISITS. IN ADDITION, OUR ORTHOPAEDIC SURGEON VOLUNTEERS PROVIDED LONG DISTANCE CONSULTATIONS FOR 24 ADDITIONAL PATIENTS GLOBALLY. THESE "E-CONSULT" REQUESTS COME FROM PERU AS WELL AS OTHER COUNTRIES WHERE MISSIONS CONTACTS ARE LOCATED.	15489

Field	Value	IRS element (for citing)
Total Program Service Expenses	112088	TotalProgramServiceExpenses

Officer Director Trustee Key Empl OfficerDirectorTrusteeKeyEmpl (3 entries)

Address Line1AddressUS/AddressLine1	CityAddressUS/City	StateAddressUS/State	ZIP CodeAddressUS/ZIPCode	TitleTitle	Avg Hours Per Wk Devoted To PositionAvgHoursPerWkDevotedToPosition	CompensationCompensation
DR PETER COLE
146 W PLEASANT LAKE ROAD	NORTH OAKS	MN	55127	PRESIDENT	000.00	0
ROBERT R KORLJAN
2828 N CENTRAL AVE SUITE 114	PHOENIX	AZ	85004	VICE PRESIDE	000.00	0
LISA K SCHRODER
1920 MAPLE COURT	ROCHESTER	IN	46975	SEC/TREAS	000.00	35000

Field	Value	IRS element (for citing)
Activities Not Previously Rpt	false	ActivitiesNotPreviouslyRpt
Made Changes To Orgnzng Etc Doc	false	MadeChangesToOrgnzngEtcDoc
Organization Had UBI	false	OrganizationHadUBI
Subject To Proxy Tax	false	SubjectToProxyTax
Organization Dissolved Etc	false	OrganizationDissolvedEtc
Did Org File Form1120 POL This Year	false	DidOrgFileForm1120POLThisYear
Made Loans To From Officers	false	MadeLoansToFromOfficers
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTrans
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTrans
States Where Copy Of Return Is Filed	MN	StatesWhereCopyOfReturnIsFiled

The Books Are In Care Of TheBooksAreInCareOf

Field	Value	IRS element (for citing)
Name Person	SCALPEL AT THE CROSS INC	NamePerson

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	146 W PLEASANT LAKE ROAD	AddressLine1
City	NORTH OAKS	City
State	MN	State
ZIP Code	55127	ZIPCode

Field	Value	IRS element (for citing)
Telephone Number	5742237118	TelephoneNumber

Field	Value	IRS element (for citing)
Foreign Financial Account	false	ForeignFinancialAccount
Foreign Office	false	ForeignOffice
Maintain Any Donor Advised Funds	false	MaintainAnyDonorAdvisedFunds
Does Org Have Hospital	false	DoesOrgHaveHospital
Tanning Services Provided	false	TanningServicesProvided
Related Org Controlled Entity	false	RelatedOrgControlledEntity
Engage Political Cmpgn Activities	false	EngagePoliticalCmpgnActivities
Engage In Lobbying Activities	false	EngageInLobbyingActivities
Operating School	false	OperatingSchool
Trnsfrs Exempt Non Char Related Org	false	TrnsfrsExemptNonCharRelatedOrg
Part VI Of Comp Of Highest Paid Empl	NONE	PartVIOfCompOfHighestPaidEmpl
Part VIA Hghst Paid Cntrct Prof Ser	NONE	PartVIAHghstPaidCntrctProfSer
Filed Schedule A	true	FiledScheduleA

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	122853	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	200225	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	163774	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	196230	CurrentTaxYearMinus1Year
Current Tax Year	148276	CurrentTaxYear
Total	831358	Total

Total509 Total509

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	122853	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	200225	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	163774	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	196230	CurrentTaxYearMinus1Year
Current Tax Year	148276	CurrentTaxYear
Total	831358	Total

Field	Value	IRS element (for citing)
Public Support Total509	831358	PublicSupportTotal509

Total Support Total TotalSupportTotal

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	122853	CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years	200225	CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years	163774	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	196230	CurrentTaxYearMinus1Year
Current Tax Year	148276	CurrentTaxYear
Total	831358	Total

Field	Value	IRS element (for citing)
Public Support Percentage509	1.00000	PublicSupportPercentage509
Prior Year Support Percentage	1.00000	PriorYearSupportPercentage
Investment Income Percentage	0.00000	InvestmentIncomePercentage
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 O IRS990ScheduleO

General Explanation GeneralExplanation (8 entries)

IdentifierIdentifier	Return ReferenceReturnReference	ExplanationExplanation
OTHER EXPENSES	FORM 990-EZ, PART I, LINE 16	EXPENSES OFFICE EXPENSE 575 CONFERENCE & CONVENTION 4,274 JUNGLE BUNKS UTILITIES 363 JUNGLE BUNKS REPAIRS 3,203 SUPPORT FOR LOCAL PROGRAM 1,902 PERU MED DIRECTOR EXP 6,645 MEDICAL SUPPLIES, SHIPPIN 13,654 TEAM HOUSING, MEALS, SUPP 10,962 PATIENT CARE 1,316 MISSION TRAVEL 50,002 PERU MED DIRECTOR COMP 14,020 NON-INVESTMENT DEPRECIATION 10,021 TOTAL 116,937
OTHER ASSETS	FORM 990-EZ, PART II, LINE 24	249,803 250,390 LESS ACCUMULATED DEPRECIATION 49,291 59,312 TOTAL 200,512 191,078
OTHER LIABILITIES	FORM 990-EZ, PART II, LINE 26	PAYROLL TAXES PAYABLE 345 0
PRIMARY EXEMPT PURPOSE	FORM 990-EZ, PART III	PURPOSE IS TO BUILD A MEDICAL MISSION CAMP WHICH SERVES THE ORTHOPEDIC NEEDS OF PUCALLPAN PERUVIANS BY STAFFING CAMP WITH PART TIME HEALTH CARE PROFESSIONALS
FIRST ACCOMPLISHMENT	FORM 990-EZ, PART III, LINE 28	MEDICAL MISSION CAMPAIGNS: IN 2011, 24 VOLUNTEERS TRAVELED WITH SCALPEL AT THE CROSS ACCOMPLISHING TWO SHORT-TERM MEDICAL CAMPAIGN TRIPS. DURING THESE TRIPS, WE EVALUATED 433 PATIENTS IN CLINIC, AND PERFORMED 57 ORTHOPAEDIC SURGERIES FOR THE PROVISION OF AN ESTIMATED 445K IN MEDICAL CARE. THE MEDICAL PROFESSIONAL TIME DONATION (EQUALING 240 VOLUNTEER DAYS) IS CONSERVATIVELY ESTIMATED TO BE AN ADDITIONAL 55K OF VALUE CONTRIBUTED.
SECOND ACCOMPLISHMENT	FORM 990-EZ, PART III, LINE 29	PATIENT FOLLOW UP: IN 2011, OUR PERUVIAN MEDICAL DIRECTOR TRAVELED TO PUCALLPA, PERU ON 9 OCCASIONS TO EVALUATE SURGICAL PATIENTS AND CONTINUE THEIR POST-OPERATIVE CARE. NINETY-EIGHT PATIENTS RECEIVED FREE MEDICAL EVALUATIONS, WOUND CARE AND PHYSICAL THERAPY INSTRUCTION AS PART OF THIS FOLLOW-UP PATIENT CARE PROGRAM.
THIRD ACCOMPLISHMENT	FORM 990-EZ, PART III, LINE 30	MEDICAL SUPPLY DONATIONS & TRANSPORT: IN 2011, SCALPEL AT THE CROSS PERSONNEL AND VOLUNTEERS GATHERED AND DELIVERED NEEDED MEDICAL EQUIPMENT AND SUPPLIES VALUED AT 96K IN CONJUNCTION WITH OUR SHORT-TERM MEDICAL CAMPAIGNS.
ALL OTHER ACCOMPLISHMENT	FORM 990-EZ, PART III, LINE 31	IN 2011, 24 VOLUNTEERS TRAVELED WITH SCALPEL AT THE CROSS ON 2 SHORT-TERM (10 DAY) MEDICAL CAMPAIGN TRIPS. DURING THESE TRIPS, WE EVALUATED 433 PATIENTS IN CLINIC, PERFORMED 57 ORTHOPAEDIC SURGERIES, AND COMPLETED 98 FOLLOW-UP VISITS. IN ADDITION, OUR ORTHOPAEDIC SURGEON VOLUNTEERS PROVIDED LONG DISTANCE CONSULTATIONS FOR 24 ADDITIONAL PATIENTS GLOBALLY. THESE "E-CONSULT" REQUESTS COME FROM PERU AS WELL AS OTHER COUNTRIES WHERE MISSIONS CONTACTS ARE LOCATED.

Compensation Explanation CompensationExplanation

Compensation Compensation (3 entries)

DR PETER COLE
ROBERT R KORLJAN
LISA K SCHRODER

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