| (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 |
||||||
| Calendar year (or fiscal year beginning in) | (a) 2021 | (b) 2022 | (c) 2023 | (d) 2024 | (e) 2025 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | 8,734,168 | 9,340,417 | 10,117,109 | 10,032,036 | 11,627,360 | 49,851,090 |
| 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 | 8,734,168 | 9,340,417 | 10,117,109 | 10,032,036 | 11,627,360 | 49,851,090 |
| 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) .. | ||||||
| 6 | Public support. Subtract line 5 from line 4. | 49,851,090 | |||||
| Calendar year (or fiscal year beginning in) | (a) 2021 | (b) 2022 | (c) 2023 | (d) 2024 | (e) 2025 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 8,734,168 | 9,340,417 | 10,117,109 | 10,032,036 | 11,627,360 | 49,851,090 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | ||||||
| 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.).. | 409 | 2,709 | 4,204 | 625 | 148 | 8,095 |
| 11 | Total support. Add lines 7 through 10 | 49,859,185 | |||||
| Calendar year (or fiscal year beginning in) | (a) 2021 | (b) 2022 | (c) 2023 | (d) 2024 | (e) 2025 | (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) 2021 | (b) 2022 | (c) 2023 | (d) 2024 | (e) 2025 | (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.).. | ||||||
| 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 | |
| 6Total annual distributions. Add lines 1 through 5. | 6 | |
|
7
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
7 | |
| 8 Distributable amount for 2025 from Section C, line 6 | 8 | |
| 9 Line 7 amount divided by Line 8 amount | 9 | |
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2025 |
(iii) Distributable Amount for 2025 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2025 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2025 (reasonable cause required-- explain in Part VI).
See instructions. |
||||
| 3 Excess distributions carryover, if any, to 2025: | ||||
| a From 2020....... | ||||
| b From 2021....... | ||||
| c From 2022....... | ||||
| d From 2023....... | ||||
| e From 2024....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2025 distributable amount | ||||
|
i
Carryover from 2020 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2025 from Section D, line 6: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2025 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2025, 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 2025. 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 2026. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2021..... | ||||
| b Excess from 2022..... | ||||
| c Excess from 2023..... | ||||
| d Excess from 2024..... | ||||
| e Excess from 2025..... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|---|
| PART II, LINE 10 | 7,947 |
| Software ID: | |
| Software Version: |
| Return Reference | Explanation |
|---|---|
| FORM 990, PART III | (CONTINUED FROM 990 PAGE 2 PART III LINE 4A) TO FURTHER EXPAND ACCESS, LACKEY CLINIC OFFERS FREE VIRTUAL URGENT CARE TO RESIDENTS ACROSS VIRGINIA REGARDLESS OF INSURANCE STATUS. THIS SERVICE HELPS PATIENTS OVERCOME BARRIERS SUCH AS COST, TRANSPORTATION CHALLENGES, CHILDCARE RESPONSIBILITIES, AND WORK CONSTRAINTS WHILE PROVIDING AN ALTERNATIVE TO COSTLY EMERGENCY DEPARTMENT VISITS. OVER THE PAST SIX YEARS, LACKEY CLINIC HAS RESEARCHED, PILOTED, AND VALIDATED ITS HYBRID CARE MODEL, DEMONSTRATING THAT IT IS AN EFFECTIVE, SCALABLE, AND REPLICABLE SOLUTION FOR EXPANDING ACCESS TO CARE WHILE IMPROVING HEALTH OUTCOMES. THIS MODEL INTEGRATES IN-PERSON CARE, TELEHEALTH, CONNECTED CARE, ASYNCHRONOUS VIRTUAL CARE, AND BEHAVIORAL HEALTH SERVICES TO MEET PATIENTS WHERE THEY ARE PHYSICALLY, EMOTIONALLY, AND TECHNOLOGICALLY WHILE ADDRESSING KEY SOCIAL DETERMINANTS OF HEALTH. HYBRID CARE MODEL COMPONENTS IN-PERSON CARE: PATIENTS BEGIN WITH COMPREHENSIVE ASSESSMENTS, DIAGNOSTICS, TREATMENT PLANNING, AND RELATIONSHIP-BUILDING THAT FORM THE FOUNDATION FOR LONG-TERM HEALTH IMPROVEMENT. TELEHEALTH (DOXIMITY): SECURE, HIPAA-COMPLIANT VIDEO VISITS SUPPORT CHRONIC DISEASE MANAGEMENT, MEDICATION ADJUSTMENTS, AND FOLLOW-UP CARE BETWEEN IN- PERSON APPOINTMENTS. CONNECTED CARE (FLORENCE): PATIENTS RECEIVE ONGOING SUPPORT THROUGH AUTOMATED TEXT MESSAGING THAT COLLECTS HEALTH INFORMATION, PROVIDES PERSONALIZED EDUCATION, REINFORCES CARE PLANS, AND ENCOURAGES HEALTHY BEHAVIORS BETWEEN VISITS. ASYNCHRONOUS VIRTUAL CARE (FABRIC): PATIENTS THROUGHOUT VIRGINIA CAN ACCESS SYMPTOM-BASED ASSESSMENT AND TREATMENT WITHOUT REQUIRING A REAL-TIME APPOINTMENT, REDUCING SCHEDULING BARRIERS AND EXPANDING ACCESS TO CARE. BEHAVIORAL HEALTH (VIRGINIA TELEMENTAL HEALTH INITIATIVE): PATIENTS RECEIVE TELEHEALTH ACCESS TO LICENSED MENTAL HEALTH PROFESSIONALS FOR TREATMENT OF DEPRESSION, ANXIETY, TRAUMA, AND OTHER BEHAVIORAL HEALTH CONDITIONS. PROGRAM OUTCOMES IN FY'26, LACKEY CLINIC DELIVERED 11,618 MEDICAL AND DENTAL VISITS AND 2,544 VIRTUAL CARE VISITS, PROVIDING A TOTAL OF 14,162 PATIENT ENCOUNTERS. VIRTUAL CARE INCREASED OVERALL VISIT CAPACITY BY NEARLY 22%, ENABLING THE CLINIC TO SERVE SUBSTANTIALLY MORE PATIENTS WITHOUT THE FACILITY AND STAFFING COSTS ASSOCIATED WITH TRADITIONAL EXPANSION. OUR INTEGRATED CARE MODEL SERVED 2,859 UNIQUE PATIENTS ACROSS TRADITIONAL AND VIRTUAL CARE PLATFORMS, INCLUDING 1,104 PATIENTS WHO RECEIVED CARE EXCLUSIVELY THROUGH VIRTUAL SERVICES. THESE RESULTS DEMONSTRATE THE ABILITY OF VIRTUAL CARE TO REACH INDIVIDUALS WHO MIGHT OTHERWISE GO WITHOUT TREATMENT. AS MANY FREE AND CHARITABLE CLINICS FACE FINANCIAL PRESSURES AND REDUCED OPERATING HOURS, LACKEY VIRTUAL CARE OFFERS AN EFFECTIVE WAY TO MAINTAIN PATIENT ACCESS WHILE EXTENDING LIMITED HEALTHCARE RESOURCES. OUR PHARMACY PROGRAM SERVED 1,295 UNDUPLICATED PATIENTS, PROVIDED 7,259 PHARMACY VISITS, DISPENSED 27,949 PRESCRIPTIONS, AND DELIVERED MORE THAN 10.1 MILLION IN PRESCRIPTION VALUE, HELPING PATIENTS OBTAIN MEDICATIONS THEY OTHERWISE COULD NOT AFFORD. OUR CONNECTED CARE PROGRAM ENROLLED 746 PATIENTS DURING FY'26. THROUGH AUTOMATED OUTREACH AND MONITORING, PATIENTS RECEIVED SUPPORT FOR CHRONIC DISEASE MANAGEMENT, LIFESTYLE IMPROVEMENT, AND ORAL HEALTH EDUCATION. CONNECTED CARE DEMONSTRATED MEANINGFUL IMPROVEMENTS IN HEALTH OUTCOMES. AMONG PARTICIPANTS ENROLLED IN THE HYPERTENSION PROTOCOL, THE NUMBER OF PATIENTS CLASSIFIED WITH STAGE 2 HYPERTENSION DECREASED BY 44%. FOR DIABETIC PATIENTS THERE WAS A 56% INCREASE IN THE NUMBER OF PATIENTS IN TARGET RANGE. THE PROGRAM ALSO IMPROVED EFFICIENCY BY AUTOMATING ROUTINE PATIENT ENGAGEMENT ACTIVITIES, ALLOWING CLINICAL STAFF TO SPEND MORE TIME DELIVERING DIRECT PATIENT CARE. THROUGH THE VIRGINIA TELEMENTAL HEALTH INITIATIVE, LACKEY CLINIC PROVIDES PATIENTS WITH ACCESS TO LICENSED BEHAVIORAL HEALTH PROFESSIONALS AT NO COST TO THE ORGANIZATION. THIS PARTNERSHIP HAS EXPANDED ACCESS TO MENTAL HEALTH SERVICES WHILE INCREASING CAPACITY AND IMPROVING SUSTAINABILITY, ENABLING MORE PATIENTS TO RECEIVE TREATMENT FOR ANXIETY, DEPRESSION, TRAUMA, AND RELATED BEHAVIORAL HEALTH CONDITIONS. BY COMBINING COMPASSIONATE CARE WITH INNOVATIVE DELIVERY MODELS, LACKEY CLINIC CONTINUES TO DEMONSTRATE THAT HIGH-QUALITY HEALTHCARE CAN BE DELIVERED EFFECTIVELY AND EFFICIENTLY TO UNDERSERVED POPULATIONS WHILE HONORING ITS MISSION TO SERVE OTHERS IN THE NAME OF JESUS CHRIST. |
| FORM 990, PAGE 6, PART VI, LINE 11B | FORM 990 IS DISTRIBUTED ELECTRONICALLY TO THE MEMBERS OF THE GOVERNING BOARD IN ADVANCE TO BEING FILED. |
| FORM 990, PAGE 6, PART VI, LINE 12C | THE CONFLICT OF INTEREST POLICY IS SIGNED BY BOARD MEMBERS DURING ORIENTATION, AND THEN ON AN ANNUAL BASIS. KEY EMPLOYEES AND BOARD MEMBERS ARE REQUIRED TO BECOME FAMILIAR WITH THE POLICY AND DISCLOSE ANY CONFLICTS OF INTEREST. |
| FORM 990, PAGE 6, PART VI, LINE 15A | TO DETERMINE CEO AND TOP MANAGEMENT'S SALARIES, THE BOARD (EXECUTIVE COMMITTEE) REVIEWS THE SALARY COMPENSATION STUDIES PERFORMED BY THE VIRGINIA ASSOCIATION OF FREE AND CHARITABLE CLINICS (VAFCC) AND DETERMINES THE ANNUAL SALARY OR INCREASE. |
| FORM 990, PAGE 6, PART VI, LINE 15B | EXECUTIVE DIRECTOR AND MEDICAL DIRECTOR GIVE RECOMMENDATIONS TO THE BOARD AND THEY MAKE FINAL DECISIONS ON SALARY OR INCREASES. |
| FORM 990, PAGE 6, PART VI, LINE 19 | THE CLINIC'S GOVERNING DOCUMENTS ARE AVAILABLE IN THE ADMINISTRATIVE OFFICE FOR THE PUBLIC'S INSPECTION DURING NORMAL BUSINESS HOURS. |
| Software ID: | |
| Software Version: |