Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
|
Total |
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Calendar year (or fiscal year beginning in) ![]() |
(a) 2016 | (b) 2017 | (c) 2018 | (d) 2019 | (e) 2020 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | 450,605 | 362,749 | 653,661 | 407,771 | 451,815 | 2,326,601 |
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.... | 0 | |||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | 0 | |||||
| 4 | Total. Add lines 1 through 3 | 450,605 | 362,749 | 653,661 | 407,771 | 451,815 | 2,326,601 |
| 5 | The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f).. | 268,169 | |||||
| 6 | Public support. Subtract line 5 from line 4. | 2,058,432 | |||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2016 | (b) 2017 | (c) 2018 | (d) 2019 | (e) 2020 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 450,605 | 362,749 | 653,661 | 407,771 | 451,815 | 2,326,601 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | 0 | |||||
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | 0 | |||||
| 11 | Total support. Add lines 7 through 10 | 2,326,601 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2016 | (b) 2017 | (c) 2018 | (d) 2019 | (e) 2020 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | ||||||
| 2 | Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose | ||||||
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513 ..... | ||||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | ||||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge | ||||||
| 6 | Total. Add lines 1 through 5 | ||||||
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons | ||||||
| b | Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year. | ||||||
| c | Add lines 7a and 7b.. | ||||||
| 8 | Public support. (Subtract line 7c from line 6.) | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2016 | (b) 2017 | (c) 2018 | (d) 2019 | (e) 2020 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | ||||||
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | ||||||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | ||||||
| 11 | Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. | ||||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | ||||||
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e |
Discount claimed for blockage or other factors (explain in detail in Part VI): |
|||||
| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 0.015 of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by 0.035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | 1 | |
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
2 | |
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | 3 | |
| 4 Amounts paid to acquire exempt-use assets | 4 | |
| 5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) | 5 | |
| 6 Other distributions (describe in Part VI). See instructions | 6 | |
| 7Total annual distributions. Add lines 1 through 6. | 7 | |
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
8 | |
| 9 Distributable amount for 2020 from Section C, line 6 | 9 | |
| 10 Line 8 amount divided by Line 9 amount | 10 | |
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2020 |
(iii) Distributable Amount for 2020 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2020 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2019 (reasonable cause required-- explain in Part VI). See instructions. |
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| 3 Excess distributions carryover, if any, to 2020: | ||||
| a From 2015....... | ||||
| b From 2016....... | ||||
| c From 2017....... | ||||
| d From 2018....... | ||||
| e From 2019....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2020 distributable amount | ||||
|
i
Carryover from 2015 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2020 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2020 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2020, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
6
Remaining underdistributions for 2020. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
7 Excess distributions carryover to 2021. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2016..... | ||||
| b Excess from 2017..... | ||||
| c Excess from 2018..... | ||||
| d Excess from 2019..... | ||||
| e Excess from 2020..... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|
| Software ID: | 20011551 |
| Software Version: | 2020v4.0 |
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| Form 990, Part VI, Line 2: Description of Business or Family Relationship of Officers, Directors, Et | One director of GiveHear is also a director of Hearing the Call.Two directors of GiveHear are part owners in Breckenridge Village, LLC. |
| Form 990, Part VI, Line 11b: Form 990 Review Process | FORM 990 REVIEW POLICYI. Purpose of the Policy. The purpose of this policy is to create a process for preparation and review of the Form 990 and its distribution to all board members of HearCare Connection (the Organization) whether before or after filing with the Internal Revenue Service. This process will provide the board members the opportunity to review the Form 990 while also ensuring that annual filing deadlines may be met.II. Procedure for Preparation and Review of Form 990. The Organizations Executive Director is responsible for the timely preparation of the Form 990. The Organizations Executive Director may confer with accountants and legal counsel of the Organization with respect to drafts of the Form 990. Copies of the completed Form 990 (including required schedules) will also be reviewed by the Treasurer. Any questions or concerns will be noted and addressed, and the Treasurer shall ensure that any appropriate changes are incorporated into the Form 990, which then shall be signed by the Executive Director or other authorized officer of the Organization. III. Filing of Form 990 (with possible prior distribution to the governing body). The Form 990 shall then be filed with the IRS on a timely basis; provided, if management considers it feasible and appropriate under the circumstances, it may distribute the final version of the Form 990 (with required schedules) to every voting member of the organizations Board of Directors prior to filing with the Internal Revenue Service. The final form may be distributed either in paper or electronic form in any manner deemed appropriate by the Organizations Treasurer.IV. Distribution of Form 990 to All Members of Governing Body. A copy of the filed Form 990, if the final version was not circulated prior to filing, shall be circulated to the Board of Directors as promptly as reasonably practical after the filing, and in no case later than its next regular meeting following such filing. For the manner of distribution, see III. above. |
| Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts | Any Board member with an interest in the topic up for vote presents the information and then recuses himself / herself from the discussion and the vote. Due diligence is practiced by getting multiple quotes for services if a conflict of interest exists. |
| Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees | Not applicable. No other officers are compensated. |
| Form 990, Part VI, Line 19: Other Organization Documents Publicly Available | The Organization makes its governing documents and financial statements available at www.guidestar.org and upon request. The Organization makes its conflict of interest policy available upon request. |
| Part III, line 4a (continued) | Our main office in downtown Fort Wayne increased clinic operations to 5 days per week and added a second part-time staff audiologist to manage patient volume. Our Goshen satellite office increased hours to two days per month, and we launched a monthly satellite clinic in Garrett, IN. Hearing Assessment Program: Encompasses diagnostic assessment of hearing function using state-of-the-art equipment, which is appropriate for patients of any age and functional ability. GiveHear receives assessment referrals from other area health care professionals, Indianas early intervention program First Steps, organizations assisting veterans, other nonprofit agencies, and by self-referral. Hearing Aid Rehabilitation Program: Encompasses the selection, fitting, follow-up, and maintenance of new or donated hearing aids. Patients qualify for this program according to adjusted household income and pay for a portion of their device cost based on our reduced sliding fee scale. GiveHear fit 203 hearing aids in 2020 on 119 unique individuals - 119 lives improved through the gift of hearing! Circle of Giving: GiveHear hearing aid recipients on our sliding fee scale complete a set number of volunteer service hours at a nonprofit agency within their community to give back via volunteerism. Because GiveHear relies on community support to execute our mission, our patients give back to the community that supports us and makes their hearing health care possible. GiveHear patients and their families contributed 1,325 volunteer hours in 2020. Hearing Aid Donation Program: We collect gently used hearing aids that can be reconditioned and reprogrammed for our patients. This program serves many of our hearing aid recipients and gives an opportunity for the community to return used hearing aids to our clinic. Newborn Hearing Program: Provides affordable, price-capped follow-up diagnostic testing for babies who fail or do not receive a newborn hearing screening at birth. Using our highly specialized equipment, 157 babies were tested in 2020 through our partnerships with local hospitals, birthing centers, and midwives. School Screening Program: Provides on-site hearing screenings, primarily preschool-aged children attending early education programs for low-income families and/or children with special needs. In an effort to identify hearing loss as early as possible, grant funded follow-up testing in our clinic is also offered for children who do not pass the on-site screening. We partner with BrightPoint Head Start, Associated Churches, and Lions Club. We screened 307 children in 2020 (There were limited screening opportunities due to the pandemic.) Cancer Treatment and Hospice Loaner Programs: Partnerships with Cancer Services of Northeast Indiana, Heartland Hospice, and Visiting Nurse allow us to provide hearing aids for patients undergoing cancer treatment or in hospice care. The loaned hearing aids foster improved communication with family, caregivers, and community. Served 20 patients in 2020. Cochlear Implant and Auditory Processing Disorder (APD) Programs: Provision of sub-specialty audiology services to eliminate access deserts in northeast Indiana. GiveHear is the only regional provider for APD testing and diagnosis as well as the only regional center offering support for Med-El, one of the three implant systems used in the U.S. GiveHear is unique. There are no other similar programs to ours in the region. Only a handful of similar programs exist nationally, some of which GiveHear helped develop at the request of those communities. The effects of undiagnosed and/or untreated hearing loss are significant, detrimental, and can be mitigated or eliminated with appropriate, quality hearing health care. Hearing aids are a highly effective, yet costly tool to counteract the negative impact of most hearing losses. They are designed to improve sound localization, listening in noisy situations, speech understanding, and provide better overall hearing. In fact, 80% of hearing losses can be effectively rehabilitated using hearing aids. According to the American Speech Language Hearing Association (ASHA), less than 25% of people who could benefit from hearing aids actually have them. Oftentimes, cost is the limiting factor. These issues are at the heart of the services GiveHear provides to our community. Our clinics provide hearing screenings, hearing tests, hearing aids and related accessories, hearing aid maintenance and repairs, and follow up care to individuals who otherwise would not have access to these services. Fees for hearing aid services are based on a sliding fee scale according to family size and income, and we primarily serve individuals up to 250% of the Federal Poverty Level. In addition to our nominal fees, we require our financially qualified patients to complete a set number of volunteer service hours at a nonprofit agency within our community. This volunteerism helps reduce social isolation, ensures they are invested in their own hearing health care, promotes self-sufficiency, and builds feelings of self-worth. This is our Circle of Giving program. In addition to hearing aid services, GiveHear also connects with our community via outreach efforts, providing hearing screenings at schools and health fairs. We have identified access deserts for certain sub-specialty audiology services and offer those services locally, ensuring that the community has regional access to a more comprehensive roster of audiology services. |
| Part III, line 4a (continued) | Hearing Screening at Local Preschool and Day Care Facilities: Serving large percentages of low-income families.Loaner Program for Cancer & Hospice Patients: Partnership with Cancer Services and Heartland Home Healthcare to provide hearing aids for cancer patients and hospice patients who have lost their hearing.Satellite Program: In response to requests from audiology practices in other cities looking to begin their own not-for-profit programs in their community, we are providing administrative support and guidance to programs in Toledo, Ohio and Sarasota, Florida. Each satellite raises funds to support its work.Circle of Giving Program: We are not a free clinic. Fees for services are based on a sliding fee scale according to family size and income so that hearing aids are affordable for patients while also requiring them to make a personal investment in their own healthcare. Thus, we require patients to complete a set number of volunteer service hours at a not-for-profit agency within our community to earn sweat equity for their hearing aids. Because we rely on the communitys support to operate our program, our patients give back to the community that has made in possible for them to receive care. Many individuals with hearing loss experience social isolation, whether they realize it or not. It might begin with avoiding large parties or gatherings and trickle down to canceling smaller, more intimate affairs. For those with hearing loss, large groups, noisy venues and dark environments can make it even more difficult to hear, engage in conversation and contribute in social situations. In certain conditions, including age, illness and genetics may all contribute to hearing loss. Approximately 1 in 5 people have some degree of hearing loss. Hearing loss can also have a very real and negative impact on persons economic stability. In Indiana, only half of those struggling with hearing loss are in gainful employment (Disabilities Statistics Compendium, 2014). Among those who are employed, a higher percentage of people with hearing loss are in lower grades of employment, some up to 25% lower, compared to the general workforce (The Hearing Journal). In Allen County alone, it is estimated that over 10,000 individuals living in poverty have hearing loss. With ongoing changes in healthcare the number of individuals needing financial support to obtain individual hearing aids is growing. In summary, our clinics provide hearing screenings, hearing tests, hearing aids and related apparatus, hearing aid maintenance and repairs, and follow up care after initial treatment. We also provide newborn hearing screenings and Auditory Processing Disorder (APD) testing. We fit patients with gently used reprogrammable donated hearing aids collected through our community donation program and we purchase new hearing aids at greatly reduced costs from the manufacturer. We also take our services out into the greater Fort Wayne community with hearing clinics and hearing screenings for folks of all ages. Fees for services are based on a sliding fee scale based upon family size and income. In addition to our discounted fees, we require our patients to complete a set number of volunteer service hours at a local not-for-profit agency through our Circle of Giving program. This community service helps prevent social isolation, ensures investment in our community by our patient, and promotes self-sufficiency and self-worth. GiveHear is a unique program and the only one of its kind in our community and among the first of its kind in the nation. Our experienced audiologist is a licensed professional and follows all standard procedures and requirements in hearing testing and treatment. We verify all of our hearing aid fits with RealEar measurements making sure that the patient is getting a proper fit before leaving their first fitting appointment. |
| Software ID: | 20011551 |
| Software Version: | 2020v4.0 |