TY 2021 Form 990

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)
(1) SALLY FABIAN - ORESIC RN MSN...................................................................... EXECUTIVE DIRECTOR	40.00 .................		X	112,184	19,000
(2) PAUL EDGERTON...................................................................... BOARD CHAIR	2.24 .................	X	X	0	0
(3) CHERYL MCDONALD...................................................................... VICE CHAIR	0.83 .................	X	X	0	0
(4) WILLIAM F COYNE CPA...................................................................... TREASURER	0.96 .................	X	X	0	0
(5) ALLISON BRINK RN...................................................................... SECRETARY	0.96 .................	X	X	0	0
(6) JOAN BLOCK RN...................................................................... MEMBER	0.56 .................	X		0	0
(7) MARIELLEN BRICKLEY-RAAB RDH...................................................................... MEMBER	0.52 .................	X		0	0
(8) JAMES BREXLER FACHE...................................................................... MEMBER	0.00 .................	X		0	0
(9) ALBERTJOHN DEPALANTINO CPA...................................................................... MEMBER	0.66 .................	X		0	0
(10) JORGE FERNANDEZ...................................................................... MEMBER	0.44 .................	X		0	0
(11) HAROLD GEVER MD...................................................................... MEMBER	0.69 .................	X		0	0
(12) KELLY LANNING...................................................................... MEMBER	0.19 .................	X		0	0
(13) SCOTT S LEVY MD...................................................................... MEMBER	0.17 .................	X		0	0
(14) GEORGE J PODHOR...................................................................... MEMBER	0.33 .................	X		0	0
(15) BRIAN R PRICE ESQ...................................................................... MEMBER	0.30 .................	X		0	0
(16) RICHARD REIF...................................................................... MEMBER	0.29 .................	X		0	0
(17) ROBERT RODENBAUGH...................................................................... IMMEDIATE PAST CHAIR	1.64 .................	X	X	0	0

- TIN:

SCHEDULE A
(Form 990)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public
Inspection

Name of the organization

ANN SILVERMAN COMMUNITY HEALTH CLINIC

Employer identification number

23-2892823

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990).)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 33 1/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 33 1/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box on lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990) 2021

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization failed to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") ..	689,077	1,530,531	910,962	1,084,943	871,824	5,087,337
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3	689,077	1,530,531	910,962	1,084,943	871,824	5,087,337
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) ..						1,314,376
6	Public support. Subtract line 5 from line 4.						3,772,961

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(f) Total
7	Amounts from line 4..	689,077	1,530,531	910,962	1,084,943	871,824	5,087,337
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...	54,649	65,689	69,655	82,741	79,409	352,143
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.)..
11	Total support. Add lines 7 through 10						5,439,480

Gross receipts from related activities, etc. (see instructions) ..................

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here ........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2021 (line 6, column (f) divided by line 11, column (f)) .........

69.360 %

Public support percentage for 2020 Schedule A, Part II, line 14 ...............

68.770 %

16a

33 1/3% support test—2021. If the organization did not check the box on line 13, and line 14 is 33 1/3 % or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2020. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2021. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2020. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990) 2021

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(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.)

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(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 on 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.)..

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2021 (line 8, column (f) divided by line 13, column (f)) .........

Public support percentage from 2020 Schedule A, Part III, line 15 ...............

Section D. Computation of Investment Income Percentage

Investment income percentage for 2021 (line 10c, column (f) divided by line 13, column (f)) ......

Investment income percentage from 2020 Schedule A, Part III, line 17 .............

19a

331/3% support tests—2021. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2020. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990) 2021

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked box 12a or 12b in Part I, answer lines 4b and 4c below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer lines 5b and 5c below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described on line 7? If “Yes,” complete Part I of Schedule L (Form 990).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons, as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined on line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined on line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990) 2021

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described on lines 11b and 11c below, the governing body of a supported organization?

11a

A family member of a person described on 11a above?

11b

A 35% controlled entity of a person described on line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the officers, directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in line 2 above, did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer lines 2a and 2b below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described on line 2a, above constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer lines 3a and 3b below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations?If "Yes" or "No", provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990) 2021

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	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

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990) 2021

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations(continued)

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 2021 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-2021	(iii) Distributable Amount for 2021
1 Distributable amount for 2021 from Section C, line 6
2 Underdistributions, if any, for years prior to 2021 (reasonable cause required-- explain in Part VI). See instructions.
3 Excess distributions carryover, if any, to 2021:
a From 2016.......
b From 2017.......
c From 2018.......
d From 2019.......
e From 2020.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2021 distributable amount
i Carryover from 2016 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from line 3f.
4Distributions for 2021 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2021 distributable amount
c Remainder. Subtract lines 4a and 4b from line 4.
5 Remaining underdistributions for years prior to 2021, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions.
6 Remaining underdistributions for 2021. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions.
7 Excess distributions carryover to 2022. Add lines 3j and 4c.
8 Breakdown of line 7:
a Excess from 2017.....
b Excess from 2018.....
c Excess from 2019.....
d Excess from 2020.....
e Excess from 2021.....

Schedule A (Form 990) (2021)

Schedule A (Form 990) 2021

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2021

Name of the organization

ANN SILVERMAN COMMUNITY HEALTH CLINIC

Employer identification number

23-2892823

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ
or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990) (2021)

Schedule B (Form 990) (2021) Page 2

Name of organization ANN SILVERMAN COMMUNITY HEALTH CLINIC

Part I Contributors	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990) (2021)

Schedule B (Form 990) (2021)

Page 3

Name of organization ANN SILVERMAN COMMUNITY HEALTH CLINIC		Employer identification number 23-2892823

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
Schedule B (Form 990) (2021)

Schedule B (Form 990) (2021)

Page 4


Name of organization ANN SILVERMAN COMMUNITY HEALTH CLINIC			Employer identification number 23-2892823
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990) (2021)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet

Attach to Form 990.
SchDMd Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

ANN SILVERMAN COMMUNITY HEALTH CLINIC

Employer identification number

23-2892823

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................

Yes No

Part II

Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.

If the organization elected, as permitted under FASB ASC 958, not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under FASB ASC 958, to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenue included on Form 990, Part VIII, line 1 ......................... SchDMd Bullet

(ii)

Assets included in Form 990, Part X ............................... SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under FASB ASC 958 relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2021

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....

Part V

Endowment Funds.
Complete if the organization answered "Yes" on Form 990, Part IV, line 10.

		(a) Current year	(b) Prior year	(c) Two years back	(d) Three years back	(e) Four years back

1a	Beginning of year balance ....	4,150,813	3,285,860	2,900,208	2,322,375	2,336,780
b	Contributions ...			246,214	450,000
c	Net investment earnings, gains, and losses	-606,809	864,953	139,438	162,669	164,346
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...				34,836	178,751
f	Administrative expenses ....
g	End of year balance ......	3,544,004	4,150,813	3,285,860	2,900,208	2,322,375

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

80.500 %

Permanent endowment SchDMd Bullet

19.500 %

Term endowment SchDMd Bullet

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) Unrelated organizations .................

3a(i)

(ii) Related organizations .................

3a(ii)

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b) Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land .....
b	Buildings ....	875,414	421,493	453,921
c	Leasehold improvements
d	Equipment ....	123,493	59,111	64,382
e	Other .....
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				518,303

Schedule D (Form 990) 2021

Page 3

Part VII

Investments - Other Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1) Financial derivatives.........
(2) Closely-held equity interests........
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

Investments - Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

Part X

Other Liabilities.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes

(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2021

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......			1	852,313
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a	-2,037,161
b	Donated services and use of facilities .........	2b	569,294
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d	2,642
e	Add lines 2a through 2d .....................			2e	-1,465,225
3	Subtract line 2e from line 1..................			3	2,317,538
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a	21,124
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................			4c	21,124
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......			5	2,338,662

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........			1	1,553,217
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a	569,294
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d	2,642
e	Add lines 2a through 2d....................			2e	571,936
3	Subtract line 2e from line 1...................			3	981,281
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a	21,124
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.....................			4c	21,124
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......			5	1,002,405

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference	Explanation
PART V, LINE 4 - INTENDED USES FOR ENDOWMENT FUNDS	ENDOWMENT FUNDS ARE TO BE USED TO SUPPORT THE CLINIC'S MISSION.
PART XI, LINE 2D - REVENUE AMOUNTS INCLUDED IN FINANCIALS	SPECIAL EVENT EXPENSES RECLASSIFIED $2,642
PART XII, LINE 2D - EXPENSE AMOUNTS INCLUDED IN FINANCIALS	SPECIAL EVENT EXPENSES RECLASSIFIED $2,642

Schedule D (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE G (Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information Regarding
Fundraising or Gaming Activities

Complete if the organization answered "Yes" on Form 990, Part IV, lines 17, 18, or 19, or if the organization entered more than $15,000 on Form 990-EZ, line 6a. right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization
ANN SILVERMAN COMMUNITY HEALTH CLINIC

Employer identification number

23-2892823

Part I

Fundraising Activities.Complete if the organization answered "Yes" on Form 990, Part IV, line 17.

Form 990-EZ filers are not required to complete this part.

Indicate whether the organization raised funds through any of the following activities. Check all that apply.

a	Mail solicitations	e	Solicitation of non-government grants
b	Internet and email solicitations	f	Solicitation of government grants
c	Phone solicitations	g	Special fundraising events
d	In-person solicitations

Did the organization have a written or oral agreement with any individual (including officers, directors, trustees

or key employees listed in Form 990, Part VII) or entity in connection with professional fundraising services?

YesNo

If "Yes," list the 10 highest paid individuals or entities (fundraisers) pursuant to agreements under which the fundraiser is
to be compensated at least $5,000 by the organization.

(i) Name and address of individual or entity (fundraiser)	(iii) Did fundraiser have custody or control of contributions?
	Yes	No










Total . . . . . . . . . . . . . . . . . . . .

List all states in which the organization is registered or licensed to solicit contributions or has been notified it is exempt from registration or licensing.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 50083H

Schedule G (Form 990) 2021

Page 2

Part II

Fundraising Events. Complete if the organization answered "Yes" on Form 990, Part IV, line 18, or reported more than $15,000 of fundraising event contributions and gross income on Form 990-EZ, lines 1 and 6b. List events with gross receipts greater than $5,000.

		(a) Event #1 GOLF EVENT (event type)	(d) Total events (add col. (a) through col. (c))
1	Gross receipts . . . . .	123,965	123,965
2	Less: Contributions . . . .	101,874	101,874
3	Gross income (line 1 minus line 2) . . . . . .	22,091	22,091

4	Cash prizes . . . . .
5	Noncash prizes . . . .	850	850
6	Rent/facility costs . . . .
7	Food and beverages . . .	1,187	1,187
8	Entertainment . . . .	20,634	20,634
9	Other direct expenses . . .	1,165	1,165
10	Direct expense summary. Add lines 4 through 9 in column (d) . . . . . . . . . .		23,836
11	Net income summary. Subtract line 10 from line 3, column (d). . . . . . . . . .		-1,745

Part III

Gaming. Complete if the organization answered "Yes" on Form 990, Part IV, line 19, or reported more than $15,000 on Form 990-EZ, line 6a.

		(a) Bingo	(b) Pull tabs/Instant bingo/progressive bingo	(c) Other gaming	(d) Total gaming (add col.(a) through col.(c))
1	Gross revenue . . . . .	15,385			15,385

2	Cash prizes . . . . .
3	Noncash prizes . . . .	1,510	1,510
4	Rent/facility costs . . . .
5	Other direct expenses . . .	1,477	1,477

Volunteer labor . . . .

	Yes10.000 %
	No

	Yes %
	No

	Yes %
	No

Direct expense summary. Add lines 2 through 5 in column (d) . . . . . . . . . . right arrow

2,987

Net gaming income summary. Subtract line 7 from line 1, column (d). . . . . . . . . right arrow

12,398

Enter the state(s) in which the organization conducts gaming activities: PA

Is the organization licensed to conduct gaming activities in each of these states? . . . . . . . .

YesNo

If "No," explain:

10a

Were any of the organization's gaming licenses revoked, suspended or terminated during the tax year? . . .

YesNo

If "Yes," explain:

Schedule G (Form 990) 2021

Page 3

Does the organization conduct gaming activities with nonmembers? . . . . . . . . . . .

YesNo

Is the organization a grantor, beneficiary or trustee of a trust or a member of a partnership or other entity

formed to administer charitable gaming? . . . . . . . . . . . . . . . . .

YesNo

Indicate the percentage of gaming activity conducted in:

The organization's facility . . . . . . . . . . . . . . . . . .

13a

An outside facility . . . . . . . . . . . . . . . . . . . .

13b

100.000 %

Enter the name and address of the person who prepares the organization's gaming/special events books and records:

Name

LISA T KAPLAN SENIOR ACCOUNTANT

Address

595 W STATE STREET DOYLESTOWN, PA18901

15a

Does the organization have a contract with a third party from whom the organization receives gaming

revenue? . . . . . . . . . . . . . . . . . . . . . . . .

YesNo

If "Yes," enter the amount of gaming revenue received by the organization right arrow

$ and the

amount of gaming revenue retained by the third party right arrow

$ .

If "Yes," enter name and address of the third party:

Name

Address

Gaming manager information:

Name

Gaming manager compensation right arrow

Description of services provided right arrow

Director/officer Employee Independent contractor

Mandatory distributions:

Is the organization required under state law to make charitable distributions from the gaming proceeds to

retain the state gaming license? . . . . . . . . . . . . . . . . . . .

YesNo

Enter the amount of distributions required under state law distributed to other exempt organizations or spent

in the organization's own exempt activities during the tax year right arrow

Part IV

Supplemental Information. Provide the explanations required by Part I, line 2b, columns (iii) and (v); and Part III, lines 9, 9b, 10b, 15b, 15c, 16, and 17b, as applicable. Also provide any additional information. See instructions.

Return Reference	Explanation

Schedule G (Form 990) 2021

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE M
(Form 990)

Department of the Treasury

Internal Revenue Service

Noncash Contributions

Complete if the organizations answered "Yes" on Form 990, Part IV, lines 29 or 30.
Right pointing arrow large image

Attach to Form 990.
Right pointing arrow large image

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

ANN SILVERMAN COMMUNITY HEALTH CLINIC

Employer identification number

23-2892823

Part I

Types of Property

	(a) Check if applicable	(b) Number of contributions or items contributed	(c) Noncash contribution amounts reported on Form 990, Part VIII, line 1g	(d) Method of determining noncash contribution amounts
1 Art—Works of art ....
2 Art—Historical treasures .
3 Art—Fractional interests ..
4 Books and publications ..
5 Clothing and household goods .......
6 Cars and other vehicles ..
7 Boats and planes ....
8 Intellectual property ...
9 Securities—Publicly traded .	X	4	20,382	FAIR MARKET VALUE
10 Securities—Closely held stock .
11 Securities—Partnership, LLC, or trust interests ....
12 Securities—Miscellaneous ..
13 Qualified conservation contribution—Historic structures .....
14 Qualified conservation contribution—Other ...
15 Real estate—Residential .
16 Real estate—Commercial ..
17 Real estate—Other ...
18 Collectibles .....
19 Food inventory ...
20 Drugs and medical supplies .	X	2	27,688	MARKET VALUE
21 Taxidermy ......
22 Historical artifacts ....
23 Scientific specimens ..
24 Archeological artifacts ...
25 Other ( )
26 Other ( )
27 Other ( )
28 Other ( )

Number of Forms 8283 received by the organization during the tax year for contributions
for which the organization completed Form 8283, Part IV, Donee Acknowledgement

Yes

30a

During the year, did the organization receive by contribution any property reported in Part I, lines 1 through 28, that it must hold for at least three years from the date of the initial contribution, and which isn't required to be used for exempt purposes for the entire holding period? ...................

30a

If "Yes," describe the arrangement in Part II.

Does the organization have a gift acceptance policy that requires the review of any nonstandard contributions?

32a

Does the organization hire or use third parties or related organizations to solicit, process, or sell noncash

contributions? ..........................

32a

If "Yes," describe in Part II.

If the organization didn't report an amount in column (c) for a type of property for which column (a) is checked,

describe in Part II.

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 51227J

Schedule M (Form 990) (2021)

Page 2

Part IISupplemental Information. Provide the information required by Part I, lines 30b, 32b, and 33, and whether the organization is reporting in Part I, column (b), the number of contributions, the number of items received, or a combination of both. Also complete this part for any additional information.

Return Reference	Explanation

Schedule M (Form 990) (2021)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2021

Open to Public
Inspection

Name of the organization

ANN SILVERMAN COMMUNITY HEALTH CLINIC

Employer identification number

23-2892823

Return Reference	Explanation
FORM 990, PART I, LINE 6	AS A VOLUNTEER-SUPPORTED NON-PROFIT ORGANIZATION, 258 INDIVIDUALS VOLUNTEERED THEIR SERVICES TO THE ANN SILVERMAN COMMUNITY HEALTH CLINIC IN FY21-22. THERE WERE 5,891 HOURS OF VOLUNTEER SERVICES WITH AN ESTIMATED VALUE OF $531,355. THE HEALTHCARE PROFESSIONAL VOLUNTEERS INCLUDE 11 PHYSICIANS, 1 PSYCHIATRIC NURSE PRACTITIONER, 1 MASSAGE/PAIN RELIEF THERAPIST, AND 9 NURSES PROVIDING ONSITE CARE. THERE WERE 136 MEDICAL SPECIALISTS PROVIDING CARE OFFSITE; THIS INCLUDED 14 RADIOLOGISTS, 10 CARDIOLOGISTS, AND 3 PATHOLOGISTS. IN THE DENTAL PROGRAM, 27 VOLUNTEER DENTISTS PROVIDED CARE TO OUR PATIENTS EITHER IN THEIR OWN OFFICES OR IN OUR CLINIC. THROUGH THE GENEROUS PARTNERSHIP WITH VISION BENEFITS OF AMERICA, FOUNDATION'S VISION BENEFIT PROGRAM, COMMUNITY EYE DOCTORS PROVIDED 150 PATIENTS WITH AN EYE EXAM AND GLASSES, VALUED AT $13,028. THE CLINIC ALSO RECEIVED VOLUNTEER SUPPORT FROM 19 BOARD MEMBERS, 17 LANGUAGE INTERPRETERS, 25 ADVISORY COMMITTEE MEMBERS, 4 GOLF EVENT VOLUNTEERS, 2 ELIGIBILITY PROCESSOR, 2 PHARMACEUTICAL APPLICATION PROCESSOR AND 5 ADMINISTRATIVE ASSISTANTS.
FORM 990, PART III, LINE 4A - FIRST ACCOMPLISHMENT	MEDICAL PROGRAM- ANN SILVERMAN COMMUNITY HEALTH CLINIC (ASCHC), FIRST FORMED IN 1994 AND INCORPORATED IN 1997, HAS A UNIQUE HISTORY. IT WAS FOUNDED 28 YEARS AGO BY A LOCAL PHYSICIAN, DR. DAN NESI AND HIS COLLEAGUES, TO PROVIDE FREE HEALTHCARE TO COMMUNITY MEMBERS WHO HAD LIMITED INCOME AND WERE UNINSURED. DOYLESTOWN HOSPITAL SUPPORTED THEIR EFFORTS TO ADDRESS THIS COMMUNITY NEED. TODAY THE CLINIC'S MISSION REMAINS UNCHANGED. ASCHC REMAINS A VOLUNTEER-DRIVEN FREE CLINIC FOR UNINSURED, LOW-INCOME RESIDENTS OF BUCKS COUNTY. IT PROVIDES FREE MEDICAL CARE - ACUTE, CHRONIC AND PREVENTATIVE SERVICES-AS WELL AS DIAGNOSTIC TESTING AND MEDICATION ASSISTANCE TO UNINSURED ADULTS AND CHILDREN WHO HAVE A HOUSEHOLD INCOME LESS THAN 250% OF THE FEDERAL POVERTY GUIDELINES. SINCE INCEPTION IN 1994, THE CLINIC HAS CARED FOR MORE THAN 16,000 ADULTS AND CHILDREN IN THE MEDICAL PROGRAM. IN FY 21-22, WE PROVIDED MEDICAL SERVICES TO 1,300 UNDUPLICATED PATIENTS VIA 3,605 MEDICAL CLINIC VISITS. ASCHC CARED FOR 302 NEW PATIENTS AT OUR CLINIC LOCATED IN DONATED SPACE ON THE GROUND FLOOR OF DOYLESTOWN HOSPITAL. THAT IS A 74% INCREASE OVER LAST FISCAL YEAR'S FIGURES. IT IS WORTH NOTING THAT THESE MEDICAL SERVICES WERE PROVIDED DESPITE THE CONTINUED DISRUPTION OF CARE CAUSED BY THE COVID PANDEMIC, LIMITING THE NUMBER OF PATIENTS THAT COULD BE SEEN IN THE CLINIC AT ONE TIME. THE ASCHC STAFF AND VOLUNTEERS UTILIZED BOTH TELEHEALTH AND IN-PERSON CLINIC VISITS TO PROVIDE THE NECESSARY CARE NEEDED BY OUR PATIENTS. THERE WERE 150 VOLUNTEER MEDICAL PROVIDERS -- PHYSICIANS, PHYSICIAN SPECIALISTS, AND OTHERS -- WHO PROVIDED $336,908 IN MEDICAL SERVICES, BOTH IN THE CLINIC AND OFFSITE. IN ADDITION, THERE WERE 2,737 HOURS OF VOLUNTEER SERVICES PROVIDED BY NURSES, ELIGIBILITY PROCESSORS, INTERPRETERS, PHARMACY APPLICATION PREPARERS, CLERICAL AND OTHER VOLUNTEERS. THE CLINIC ALSO PROCESSED 583 PRESCRIPTIONS ASSISTANCE PROGRAM (PAP) APPLICATIONS FOR MEDICATIONS NEEDED BY 425 PATIENTS, VALUED AT $978,034. MANY OF THE NEWER MEDICATIONS USED TO TREAT DIABETES AND DONATED BY THE PHARMACEUTICAL COMPANIES WERE COSTLY IN VALUE, RESULTING IN AN INCREASE IN THE DONATED VALUE OF MEDICATIONS THIS YEAR. ASCHC WORKED VIGOROUSLY TO PROTECT OUR PATIENTS BY ADMINISTERING COVID -19 VACCINES AND BOOSTERS WITH OUR PARTNERS, DOYLESTOWN HOSPITAL AND CHRIST HOME. IN TOTAL, WE HELD 6 COVID VACCINATION CLINICS AND 2 FLU CLINICS AS WELL AS VACCINATED PATIENTS DURING THEIR REGULAR CLINIC VISITS. ASCHC DISTRIBUTED NEARLY $9,000 IN GIFT CARDS FOR GROCERIES TO ASSIST CLINIC FAMILIES WHO WERE FACING FOOD INSUFFICIENCY BECAUSE OF THE CONTINUED IMPACT OF THE PANDEMIC ON JOBS AND INCOME.
FORM 990, PART III, LINE 4B - SECOND ACCOMPLISHMENT	DENTAL PROGRAM- THERE IS A TREMENDOUS NEED IN OUR COMMUNITY FOR DENTAL SERVICES FOR THOSE WHO ARE POOR AND HAVE NO HEALTH INSURANCE. THE ANN SILVERMAN COMMUNITY HEALTH CLINIC'S DENTAL PROGRAM HAS HISTORICALLY USED A HYBRID MODEL, PROVIDING PREVENTIVE SERVICES ONSITE AT OUR CLINIC AND SECURING FREE RESTORATIVE DENTAL CARE THROUGH OUR NETWORK OF VOLUNTEER DENTISTS IN THEIR OWN OFFICES. THE PANDEMIC SIGNIFICANTLY AFFECTED OUR COMMUNITY DENTAL PARTNERS WHO COULD NOT ACCEPT AS MANY CLINIC PATIENTS AFTER BEING CLOSED FOR SEVERAL MONTHS IN 2020. THEREFORE, IN MARCH OF 2021, THE CLINIC INITIATED A PILOT DENTAL RESTORATIVE PROGRAM IN OUR OWN CLINIC SPACE, USING SIX VOLUNTEER DENTISTS. THIS PROGRAM PROVED QUITE SUCCESSFUL AND IS NOW A PERMANENT PART OF OUR DENTAL SERVICES. DURING FY21-22, THERE WERE 146 PATIENTS WHO RECEIVED RESTORATIVE DENTAL CARE VIA THIS IN-HOUSE PROGRAM. SINCE THE DENTAL PROGRAM BEGAN IN 2002, ASCHC HAS PROVIDED 17,515 TREATMENT VISITS TO 4,628 ADULTS AND CHILDREN. IN FY 21-22, THE DENTAL PROGRAM SAW 676 UNDUPLICATED ADULTS AND CHILDREN, AN 84% INCREASE OVER LAST YEAR. THERE WERE 977 DENTAL HYGIENE SERVICES PROVIDED IN OUR CLINIC BY PAID AND VOLUNTEER DENTAL HYGIENISTS. THERE WERE 166 NEW PATIENTS SEEN AND 1,122 RETURN VISITS TO OUR DENTAL CLINIC. THE TOTAL TREATMENT VISITS OF 1,443 INCLUDES 1,288 ONSITE VISITS AND 155 COMMUNITY DENTAL VISITS WITH SERVICES PROVIDED BY VOLUNTEER DENTISTS.
FORM 990, PART III, LINE 4C - THIRD ACCOMPLISHMENT	BEHAVIORAL HEALTH SERVICES AND SOCIAL SERVICES - THE ANN SILVERMAN COMMUNITY HEALTH CLINIC SEEKS TO PROVIDE COMPREHENSIVE, HOLISTIC AND COMPASSIONATE HEALTH CARE. NEW AND RETURNING PATIENTS ARE ASSESSED AND INTERVIEWED ANNUALLY TO DETERMINE THEIR ELIGIBILITY FOR CLINIC SERVICES AND TO ADDRESS THEIR CASE MANAGEMENT NEEDS SUCH AS FOOD, CLOTHING, AND HOUSING. THEY ARE SCREENED FOR DEPRESSION AND ANXIETY BY OUR BILINGUAL STAFF AND REFERRED AS NEEDED FOR SUPPORT AND COUNSELING TO OUR PATIENT NAVIGATOR, OUR CLINIC COUNSELOR OR OUR BEHAVIORAL HEALTH VOLUNTEERS. THERE WERE 845 COMBINED SOCIAL SERVICE AND BEHAVIORAL HEALTH VISITS PROVIDED BY STAFF AND VOLUNTEERS. THERE WERE 466 PEOPLE APPROVED VIA ELIGIBILITY DETERMINATION VISITS. THERE WERE 501 ELIGIBILITY AND CASE MANAGEMENT VISITS. IN ADDITION, THERE WERE 252 SOCIAL WORK AND TREATMENT SESSIONS CONDUCTED. OUR VOLUNTEER PSYCHIATRIC NURSE PRACTITIONER PROVIDED SERVICES THROUGH 92 BEHAVIORAL HEALTH SESSIONS WITH THE SUPPORT OF VOLUNTEER SPANISH-SPEAKING INTERPRETERS. OVERALL, 107 UNDUPLICATED PATIENTS WERE PROVIDED BEHAVIORAL HEALTH CARE IN THIS FISCAL YEAR.
FORM 990, PART VI, SECTION B, LINE 11B	THE 990 IS DISTRIBUTED TO ALL BOARD MEMBERS BY EMAIL FOR THEIR REVIEW AND CONSIDERATION. BOARD MEMBERS ARE GIVEN THE OPPORTUNITY TO ASK QUESTIONS. ONCE ALL QUESTIONS HAVE BEEN SATISFACTORILY ANSWERED, A FINAL VOTE OF APPROVAL IS CONDUCTED EITHER IN PERSON OR VIA EMAIL DEPENDING ON THE TIMING OF MEETINGS. THE APPROVED 990 IS SUBMITTED AS REQUIRED.
FORM 990, PART VI, SECTION B, LINE 12C	THE POLICY IS DISTRIBUTED VIA EMAIL EACH FISCAL YEAR TO CURRENT BOARD MEMBERS. THE ED MAINTAINS THE SIGNED ACKNOWLEDGEMENT FROM EACH BOARD MEMBER.
FORM 990, PART VI, SECTION B, LINE 15A	AN ANNUAL PERFORMANCE REVIEW IS CONDUCTED OF THE EXECUTIVE DIRECTOR (ED) INCLUDING A WRITTEN REVIEW. ALL BOARD MEMBERS ARE GIVEN THE OPPORTUNITY TO COMPLETE A PERFORMANCE REVIEW DOCUMENT. THE RESULTS ARE CONDENSED INTO ONE DOCUMENT AND REVIEWED IN PERSON WITH THE BOARD CHAIRPERSON & ED. COMPENSATION INCREASES ARE COMMUNICATED TO THE HUMAN RELATIONS & PAYROLL DEPARTMENTS OF DOYLESTOWN HOSPITAL. ASCHC REIMBURSES DOYLESTOWN HOSPITAL FOR THE SALARIES OF ASCHC EMPLOYEES.
FORM 990, PART VI, SECTION C, LINE 19	GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON REQUEST.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990) 2021

Additional Data

Software ID:
Software Version:

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	1,084,943	871,824
9	Program service revenue (Part VIII, line 2g) .........	0	0
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	207,384	1,456,185
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	31,006	10,653
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	1,323,333	2,338,662
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	0	0
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	672,509	680,988
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 122,906
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	339,143	321,417
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	1,011,652	1,002,405
19	Revenue less expenses. Subtract line 18 from line 12.......	311,681	1,336,257
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	5,269,655	4,576,913
21	Total liabilities (Part X, line 26).............	488,496	496,658
22	Net assets or fund balances. Subtract line 21 from line 20.....	4,781,159	4,080,255

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 484,291 including grants of $ ) (Revenue $ )
	MEDICAL SERVICES JULY 2021 - JUNE 2022:THERE WERE 302 NEW PATIENTSTHERE WERE 3,303 INITIAL FY & RETURN VISITSTOTAL VISITS OF 3,605THE NUMBER OF UNDUPLICATED MEDICAL PATIENTS = 1,300

4b	(Code: ) (Expenses $ 176,112 including grants of $ ) (Revenue $ )
	DENTAL SERVICES JULY 2021 - JUNE 2022:THERE WERE 166 NEW PATIENTS AND 1,122 INITIAL FISCAL YEAR AND RETURN DENTAL VISITSTOTAL ONSITE TREATMENT VISITS = 1,288 AND OFFSITE (COMMUNITY DENTISTS' OFFICES = 155)TOTAL TREATMENT VISITS = 1,443UNDUPLICATED PATIENTS = 676

4c	(Code: ) (Expenses $ 91,752 including grants of $ ) (Revenue $ )
	BEHAVIORAL HEALTH PROGRAM AND SOCIAL SERVICESELIGIBILITY & CASE MANAGEMENT VISITS = 501SOCIAL WORK/TREATMENT SESSIONS = 252BEHAVIORAL HEALTH - SESSIONS WITH CERTIFIED REGISTERED NURSE PRACTICIONER VOLUNTEER = 92TOTAL VISITS = 845UNDUPLICATED PATIENTS = 107

4d	Other program services (Describe in Schedule O.)
	(Expenses $ including grants of $ ) (Revenue $ )
4e	Total program service expenses752,155

(A) Name and business address	(B) Description of services	(C) Compensation





2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 0

		Business Code
2a
b
c
d
e
f	All other program service revenue.
g	Total. Add lines 2a–2f .....

1	Briefly describe the organization’s mission or most significant activities: FREE HEALTHCARE FOR LOW-INCOME UNINSURED
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	19
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	19
5	Total number of individuals employed in calendar year 2021 (Part V, line 2a) ......	5	0
6	Total number of volunteers (estimate if necessary) .............	6	258
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	0

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(D) Reportable compensation from the organization (W-2/1099-MISC/1099-NEC)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and title
(18) ROBERT SILBERG........................................................................ MEMBER	0.52 .......................	X	0	0	0
(19) BINNY SILVERMAN........................................................................ MEMBER	0.15 .......................	X	0	0	0
(20) ROBERT A WEINHOLD........................................................................ MEMBER	0.15 .......................	X	0	0	0

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	0	112,184	19,000

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c	101,874
d	Related organizations		1d
e	Government grants (contributions)		1e

f	All other contributions, gifts, grants, and similar amounts not included above		1f	769,950

g	Noncash contributions included in lines 1a - 1f:$		1g	48,070

h Total. Add lines 1a-1f.......		871,824

3 Investment income (including dividends, interest, and othersimilar amounts) ......			79,409			79,409
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents			6a
b	Less: rental expenses			6b
c	Rental income or (loss)			6c
d	Net rental income or (loss).......
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory		4,899,094	7a
b	Less: cost or other basis and sales expenses		3,522,318	7b
c	Gain or (loss)		1,376,776	7c
d	Net gain or (loss).........			1,376,776			1,376,776
8a	Gross income from fundraising events (not including $ 101,874of contributions reported on line 1c). See Part IV, line 18 ....
			8a	22,091
b	Less: direct expenses ...		8b	23,836
c	Net income or (loss) from fundraising events..			-1,745			-1,745
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a	15,385
b	Less: direct expenses ...		9b	2,987
c	Net income or (loss) from gaming activities..			12,398			12,398
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......
12	Total revenue. See instructions.....			2,338,662	0	0	1,466,838

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........	143,249	85,949	28,650	28,650
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........
7	Other salaries and wages........	537,739	447,209	51,265	39,265
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....
9	Other employee benefits .......
10	Payroll taxes ...........
11	Fees for services (non-employees):
a	Management ......
b	Legal .........
c	Accounting ...........	9,250		9,250
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......	21,124		21,124
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	15,173			15,173
12	Advertising and promotion ....	10,858			10,858
13	Office expenses .......	37,437	17,351	2,443	17,643
14	Information technology ......
15	Royalties ..
16	Occupancy ...........	1	1
17	Travel ............
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....
20	Interest ...........	15,249	11,939	1,789	1,521
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	81,188	63,563	9,528	8,097
23	Insurance ...	1,921	1,921
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	PHARMACEUTICALS	87,892	87,892
b	DENTAL SUPPLIES	13,286	13,286
c	PATIENT NEEDS	11,149	11,149
d	MEDICAL SURGICAL SUPPLI	6,620	6,620
e	All other expenses	10,269	5,275	3,295	1,699
25	Total functional expenses. Add lines 1 through 24e	1,002,405	752,155	127,344	122,906
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........			4,184	1	209
2	Savings and temporary cash investments .........			432,868	2	637,432
3	Pledges and grants receivable, net ......			13,991	3	19,375
4	Accounts receivable, net .............				4
5	Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
					5
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
					6
7	Notes and loans receivable, net ...........				7
8	Inventories for sale or use ............			75,961	8	15,738
9	Prepaid expenses and deferred charges ......			2,793	9	12,200
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	998,907
b	Less: accumulated depreciation	10b	480,604	589,045	10c	518,303
11	Investments—publicly traded securities .			4,150,813	11	3,373,656
12	Investments—other securities. See Part IV, line 11 .....				12
13	Investments—program-related. See Part IV, line 11 ..				13
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........				15
16	Total assets. Add lines 1 through 15 (must equal line 33)...			5,269,655	16	4,576,913

17	Accounts payable and accrued expenses .....	115,282	17	146,571
18	Grants payable ...		18
19	Deferred revenue .........	567	19
20	Tax-exempt bond liabilities .........		20
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
			22
23	Secured mortgages and notes payable to unrelated third parties ..		23
24	Unsecured notes and loans payable to unrelated third parties ..	372,647	24	350,087
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D		25
26	Total liabilities. Add lines 17 through 25..	488,496	26	496,658

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	3,839,651	27	3,350,966
28	Net assets with donor restrictions ...........	941,508	28	729,289
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	4,781,159	32	4,080,255
33	Total liabilities and net assets/fund balances ........	5,269,655	33	4,576,913