TRIAD ADULT AND PEDIATRIC MEDICINE INC: Form 990, tax year 2024
View the entire original 990 at ProPublica ↗
- Organization
- TRIAD ADULT AND PEDIATRIC MEDICINE INC (EIN 56-1991438)
- Tax period
- 2024-07-01 to 2025-06-30
- Filed
- 2026-05-04
- IRS object ID
- 202641249349300909
- Schema version
- 2024v5.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2026-05-04T08:34:39+00:00 | ReturnTs |
| Tax Period End | 2025-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 440160260 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Forvis Mazars LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 910 E St Louis 200 PO Box 1190 | AddressLine1Txt |
| City | Springfield | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 658062523 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2024-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 561991438 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Triad Adult & Pediatric Medicine Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | TRIA | BusinessNameControlTxt |
| Phone | 3363559696 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1002 S EUGENE STREET | AddressLine1Txt |
| City | GREENSBORO | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27406 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MICHELLE LEWIS | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 3363559696 | PhoneNum |
| Signature | 2026-05-04 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Krystal Creach | PreparerPersonNm |
| PTIN | P01248198 | PTIN |
| Phone | 4178658701 | PhoneNum |
| Preparation | 2026-05-04 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2024 | TaxYr |
| Build TS | 2025-03-06 01:10:19Z | BuildTS |
Form 990 IRS990
Principal Ofcr Business Name PrincipalOfcrBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MICHELLE LEWIS | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1002 S EUGENE STREET | AddressLine1Txt |
| City | GREENSBORO | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27406 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $16,440,046 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.TAPMEDICINE.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1997 | FormationYr |
| Legal Domicile State | NC | LegalDomicileStateCd |
| Activity Or Mission | TRIAD ADULT AND PEDIATRIC MEDICINE PROVIDES THE RESIDENTS OF GUILFORD COUNTY, NC WITH EXCEPTIONAL HEALTHCARE THAT IS COMPREHENSIVE AND DELIVERED WITH COMPASSION AND RESPECT. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 141 | TotalEmployeeCnt |
| Total Volunteers | 14 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $3,120,981 | PYContributionsGrantsAmt |
| CY Contributions Grants | $2,865,475 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $10,521,935 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $11,956,123 | CYProgramServiceRevenueAmt |
| PY Investment Income | $309,539 | PYInvestmentIncomeAmt |
| CY Investment Income | $355,260 | CYInvestmentIncomeAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $13,952,455 | PYTotalRevenueAmt |
| CY Total Revenue | $15,176,858 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $3,329 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $12,750 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $8,253,112 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $8,814,130 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $5,225,127 | PYOtherExpensesAmt |
| CY Other Expenses | $4,934,455 | CYOtherExpensesAmt |
| PY Total Expenses | $13,481,568 | PYTotalExpensesAmt |
| CY Total Expenses | $13,761,335 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $470,887 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,415,523 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $23,750,920 | TotalAssetsBOYAmt |
| Total Assets EOY | $25,589,927 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,119,971 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,236,002 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $22,630,949 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $24,353,925 | NetAssetsOrFundBalancesEOYAmt |
| Mission | Triad Adult and Pediatric Medicine provides the residents of Guilford County, NC with exceptional healthcare that is comprehensive and delivered with compassion and respect. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $7,407,120 | ExpenseAmt |
| Grant | $12,750 | GrantAmt |
| Revenue | $11,956,123 | RevenueAmt |
| Desc | THE ORGANIZATION IS A FEDERALLY QUALIFIED HEALTH CENTER (FQHC) AND ITS PURPOSE IS TO PROVIDE OUTPATIENT PRIMARY HEALTH CARE SERVICES TO UNINSURED OR UNDERINSURED RESIDENTS, PRIMARILY OF GUILFORD COUNTY, NC. THE ORGANIZATION, WHICH HAS 5 LOCATIONS IN THE TRIAD AREA, SERVED APPROXIMATELY 13,673 PATIENTS DURING THE FISCAL YEAR ENDED 6/30/25. | Desc |
| Total Program Service Expenses | $7,407,120 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | Yes (true) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Escrow Account | false | EscrowAccountInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | false | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 16 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 141 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Policies Reference Chapters | false | PoliciesReferenceChaptersInd |
| Form990 Provided To Gvrn Body | false | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Written Policy Or Procedure | false | WrittenPolicyOrProcedureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MICHELLE LEWIS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3363559715 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 300 W NORTHWOOD ST | AddressLine1Txt |
| City | GREENSBORO | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 27401 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| Felicia Reid | |||||||
| Chair End 10/24 | 1.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Jasmine Beard | |||||||
| Vice Chair/Chair Beg 10/24 | 1.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Milagros Amaro | |||||||
| Board Member/Vice Chair Beg 10/24 | 1.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Sofia Crisp | |||||||
| Treasurer | 1.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Tiffany Grant | |||||||
| Treasurer End 08/24 | 1.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Tiffany Pilson | |||||||
| Board Member/Secretary Beg 08/24 | 1.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Dr Dontae Roberts | |||||||
| Board Member Beg 08/24 | 1.0 | Yes (X) | $0 | $0 | $0 | ||
| Dr Doug Hall | |||||||
| Board Member Beg 08/24 | 1.0 | Yes (X) | $0 | $0 | $0 | ||
| Dr Tammy Artis | |||||||
| Board Member Beg 11/24 | 1.0 | Yes (X) | $0 | $0 | $0 | ||
| Fred Henry | |||||||
| Board Member Beg 08/24 | 1.0 | Yes (X) | $0 | $0 | $0 | ||
| Kristen Moore | |||||||
| Board Member End 08/24 | 1.0 | Yes (X) | $0 | $0 | $0 | ||
| Marcus Thomas | |||||||
| BOARD MEMBER | 1.0 | Yes (X) | $0 | $0 | $0 | ||
| Danielle Cole | |||||||
| CFO | 40.0 | Yes (X) | $112,449 | $0 | $10,165 | ||
| Katina Marshall-Dawson | |||||||
| COO | 40.0 | Yes (X) | $98,102 | $0 | $10,260 | ||
| Michelle Lewis | |||||||
| CEO | 40.0 | Yes (X) | $179,355 | $0 | $36,766 | ||
| Subhankar Samal MD | |||||||
| CMO BEG 11/23 | 40.0 | Yes (X) | $228,323 | $0 | $27,955 | ||
| Daniellee Artis | |||||||
| Physician | 40.0 | $174,085 | $0 | $16,013 | Yes (X) | ||
| David Roper | |||||||
| Physician | 40.0 | $152,578 | $0 | $16,286 | Yes (X) | ||
| Faith Gardner | |||||||
| Pediatrician | 32.0 | $136,796 | $0 | $22,180 | Yes (X) | ||
| Maurice McGhee | |||||||
| IT Director | 40.0 | $107,853 | $0 | $7,406 | Yes (X) | ||
| Peter Coccaro | |||||||
| Physician | 40.0 | $171,215 | $0 | $17,717 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,360,756 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $164,748 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 17 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | Address Line2ContractorAddress/USAddress/AddressLine2Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|---|
| Right Touch Hygencis | ||||||
| 415 Pisgah Church Rd | Box 311 | Greensboro | NC | 27455 | FACILITIES MAINTENANCE | $253,529 |
| Zing Life | ||||||
| 212 Aston Glen | Durham | NC | 27703 | NURSE TRIAGE SERVICES | $205,834 | |
| Coporate Transcendence | ||||||
| 1010 Fairground Rd | Dunn | NC | 28334 | consulting | $46,346 | |
| Huron Consulting Services LLC | ||||||
| 3005 Momentum Pl | Chicago | IL | 60689 | consulting | $31,132 | |
| Teresa Bratton | ||||||
| 1110 Sunset Dr | Greensboro | NC | 27408 | contract provider | $24,510 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 17 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $2,766,142 | GovernmentGrantsAmt |
| All Other Contributions | $99,333 | AllOtherContributionsAmt |
| Total Contributions | $2,865,475 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 621110 | $11,121,441 | $11,121,441 |
| MANAGEMENT FEES | 541611 | $760,208 | $760,208 |
| OTHER REVENUE | 900099 | $74,474 | $74,474 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $11,956,123 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $242,453 | TotalRevenueColumnAmt |
| Exclusion | $242,453 | ExclusionAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,375,995 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,263,188 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $112,807 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $112,807 | TotalRevenueColumnAmt |
| Exclusion | $112,807 | ExclusionAmt |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $15,176,858 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $11,956,123 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $355,260 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,750 | TotalAmt |
| Program Services | $12,750 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $703,375 | TotalAmt |
| Program Services | $256,278 | ProgramServicesAmt |
| Management And General | $447,097 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,738,708 | TotalAmt |
| Program Services | $3,594,905 | ProgramServicesAmt |
| Management And General | $3,143,803 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $134,763 | TotalAmt |
| Program Services | $75,215 | ProgramServicesAmt |
| Management And General | $59,548 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $685,210 | TotalAmt |
| Program Services | $367,199 | ProgramServicesAmt |
| Management And General | $318,011 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $552,074 | TotalAmt |
| Program Services | $286,900 | ProgramServicesAmt |
| Management And General | $265,174 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,355 | TotalAmt |
| Management And General | $14,355 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $190,280 | TotalAmt |
| Management And General | $190,280 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $41,316 | TotalAmt |
| Management And General | $41,316 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,473,925 | TotalAmt |
| Program Services | $1,021,407 | ProgramServicesAmt |
| Management And General | $452,518 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $35,933 | TotalAmt |
| Management And General | $35,933 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $453,313 | TotalAmt |
| Program Services | $123,496 | ProgramServicesAmt |
| Management And General | $329,817 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $768,990 | TotalAmt |
| Program Services | $368,744 | ProgramServicesAmt |
| Management And General | $400,246 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $498,151 | TotalAmt |
| Program Services | $320,363 | ProgramServicesAmt |
| Management And General | $177,788 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $72,741 | TotalAmt |
| Program Services | $1,246 | ProgramServicesAmt |
| Management And General | $71,495 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,225 | TotalAmt |
| Program Services | $10,710 | ProgramServicesAmt |
| Management And General | $15,515 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $634 | TotalAmt |
| Management And General | $634 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $499,310 | TotalAmt |
| Program Services | $279,609 | ProgramServicesAmt |
| Management And General | $219,701 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $108,709 | TotalAmt |
| Management And General | $108,709 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $540,104 | $540,104 | |
| PHARMACY EXPENSES | $148,194 | $148,194 | |
| LICENSES, DUES, & SUBSCRIPTIONS | $62,275 | $62,275 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,761,335 | TotalAmt |
| Program Services | $7,407,120 | ProgramServicesAmt |
| Management And General | $6,354,215 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,459,246 | BOYAmt |
| EOY | $2,232,191 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $329,051 | BOYAmt |
| EOY | $418,063 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,000 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $383,645 | BOYAmt |
| EOY | $521,913 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $162,089 | BOYAmt |
| EOY | $241,053 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $15,524,128 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $3,506,293 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,578,483 | BOYAmt |
| EOY | $12,017,835 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,846,564 | BOYAmt |
| EOY | $6,293,802 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,750 | BOYAmt |
| EOY | $18,750 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,963,092 | BOYAmt |
| EOY | $3,846,320 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,750,920 | BOYAmt |
| EOY | $25,589,927 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $617,985 | BOYAmt |
| EOY | $860,234 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $501,986 | BOYAmt |
| EOY | $375,768 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,119,971 | BOYAmt |
| EOY | $1,236,002 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,555,304 | BOYAmt |
| EOY | $23,952,024 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $75,645 | BOYAmt |
| EOY | $401,901 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,630,949 | BOYAmt |
| EOY | $24,353,925 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,750,920 | BOYAmt |
| EOY | $25,589,927 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $1,415,523 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $282,808 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $24,645 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $687,175 | BeginningYearBalanceAmt |
| Contributions | $2,299 | ContributionsAmt |
| Investment Earnings Or Losses | $69,702 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $9,200 | AdministrativeExpensesAmt |
| End Year Balance | $749,976 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $619,387 | BeginningYearBalanceAmt |
| Contributions | $130 | ContributionsAmt |
| Investment Earnings Or Losses | $77,376 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $9,718 | AdministrativeExpensesAmt |
| End Year Balance | $687,175 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $437,565 | BeginningYearBalanceAmt |
| Contributions | $185,000 | ContributionsAmt |
| Investment Earnings Or Losses | $5,287 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $8,465 | AdministrativeExpensesAmt |
| End Year Balance | $619,387 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $430,822 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $6,743 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $437,565 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $338,266 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $98,874 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $6,318 | AdministrativeExpensesAmt |
| End Year Balance | $430,822 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 1.0 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.0 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.0 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | Yes (true) | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | false | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,219,084 | OtherCostOrOtherBasisAmt |
| Book Value | $1,219,084 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $8,619,718 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,399,054 | DepreciationAmt |
| Book Value | $7,220,664 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,608,979 | OtherCostOrOtherBasisAmt |
| Book Value | $1,608,979 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,678,015 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,107,239 | DepreciationAmt |
| Book Value | $570,776 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,398,332 | OtherCostOrOtherBasisAmt |
| Book Value | $1,398,332 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $12,017,835 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (5 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| DUE FROM THIRD PARTIES - PARTY PAYORS | $1,780,000 |
| OTHER RECEIVABLES | $820,486 |
| OTHER ASSETS | $123,534 |
| ROU ASSETS | $372,324 |
| BENEFICIAL INTEREST IN PERPETUAL TRUST | $749,976 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $3,846,320 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| Federal Income Taxes | |
| ROU LIABILITIES | $375,768 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $375,768 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $15,190,674 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $282,808 | NetUnrealizedGainsInvstAmt |
| Donated Services And Use Fclts | $73,935 | DonatedServicesAndUseFcltsAmt |
| Other Revenue | $44,645 | OtherRevenueAmt |
| Revenue Not Reported | $401,388 | RevenueNotReportedAmt |
| Revenue Subtotal | $14,789,286 | RevenueSubtotalAmt |
| Investment Expenses Not Incld | $41,316 | InvestmentExpensesNotIncldAmt |
| Other Revenues Not Included | $346,256 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $387,572 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $15,176,858 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $13,793,954 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $73,935 | DonatedServicesUseFcltsAmt |
| Other Expenses Included | $0 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $73,935 | ExpensesNotReportedAmt |
| Expenses Subtotal | $13,720,019 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $41,316 | InvestmentExpensesNotIncld2Amt |
| Other Expenses Not Included | $0 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $41,316 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $13,761,335 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule D, Part X, Line 2 UNCERTAIN TAX POSITIONS | MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. |
| Schedule D, Part V, Line 4 Intended uses of endowment funds | ENDOWMENT FUNDS HELD BY THE ORGANIZATION ARE INTENDED TO SUPPORT THE ORGANIZATION'S TAX EXEMPT PURPOSE. |
| Schedule D, Part XI, Line 2(d) Other revenues in audited financial statements not in form 990 | Net assets released from restriction - 44645 |
| Schedule D, Part XI, Line 4(b) Other revenues in form 990 not in audited financial statements | Temporarily Restricted Contributions - 346256 |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Subhankar Samal MD | ||||||||||||||
| CMO BEG 11/23 | $228,323 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $27,955 | $0 | $256,278 | $0 | $0 | $0 |
| Michelle Lewis | ||||||||||||||
| CEO | $169,355 | $0 | $10,000 | $0 | $0 | $0 | $5,200 | $0 | $31,566 | $0 | $216,121 | $0 | $0 | $0 |
| Daniellee Artis | ||||||||||||||
| Physician | $174,085 | $0 | $0 | $0 | $0 | $0 | $6,000 | $0 | $10,013 | $0 | $190,098 | $0 | $0 | $0 |
| David Roper | ||||||||||||||
| Physician | $152,578 | $0 | $0 | $0 | $0 | $0 | $5,485 | $0 | $10,801 | $0 | $168,864 | $0 | $0 | $0 |
| Peter Coccaro | ||||||||||||||
| Physician | $171,215 | $0 | $0 | $0 | $0 | $0 | $6,024 | $0 | $11,693 | $0 | $188,932 | $0 | $0 | $0 |
| Faith Gardner | ||||||||||||||
| Pediatrician | $136,796 | $0 | $0 | $0 | $0 | $0 | $1,488 | $0 | $20,692 | $0 | $158,976 | $0 | $0 | $0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Line 11b Review of form 990 by governing body | THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. PRIOR TO FILING, THE FORM 990 IS REVIEWED BY THE CEO AND CFO. THE FORM 990 IS REVIEWED WITH THE BOARD OF DIRECTORS BY THE AUDIT FIRM AFTER IT IS FILED. |
| Form 990, Part VI, Line 12c Conflict of interest policy | THERE IS ANNUAL REVIEW OF THE CONFLICTS OF INTEREST POLICY WITH STAFF AND BOARD MEMBERS. THE STAFF AND BOARD MEMBERS SIGN AN ANNUAL STATEMENT REFLECTING THEIR UNDERSTANDING OF THE POLICY AND PROCESSES. |
| Form 990, Part VI, Line 15a Process to establish compensation of top management official | MARKET DATA FROM OTHER FEDERALLY QUALIFIED HEALTH CENTERS AND SIMILAR ORGANIZATIONS IS REVIEWED. THE BOARD COMPLETES AN ANNUAL EVALUATION AND DETERMINES THE CEO COMPENSATION BASED ON THE MARKET AND PERFORMANCE. |
| Form 990, Part VI, Line 19 Required documents available to the public | THE ORGANIZATION MAKES THESE DOCUMENTS AVAILABLE FOR INSPECTIONS UPON WRITTEN REQUEST. |
| Form 990, Part IX, Line 11g Other Fees | CONTRACTED SERVICES - Total Expense: 753829, Program Service Expense: 621364, Management and General Expenses: 132465, Fundraising Expenses: ; TRANSLATION SERVICES - Total Expense: 224140, Program Service Expense: 224140, Management and General Expenses: , Fundraising Expenses: ; PAYROLL PROCESSING FEES - Total Expense: 190314, Program Service Expense: , Management and General Expenses: 190314, Fundraising Expenses: ; ON CALL SERVICES - Total Expense: 66344, Program Service Expense: 66344, Management and General Expenses: , Fundraising Expenses: ; PHARMACY FEES - Total Expense: 76065, Program Service Expense: 76065, Management and General Expenses: , Fundraising Expenses: ; COLLECTIONS FEES - Total Expense: 11372, Program Service Expense: , Management and General Expenses: 11372, Fundraising Expenses: ; SECURITY SERVICES - Total Expense: 24069, Program Service Expense: 13478, Management and General Expenses: 10591, Fundraising Expenses: ; LAB SERVICES - Total Expense: 1326, Program Service Expense: 1326, Management and General Expenses: , Fundraising Expenses: ; SPECIALTY CLINIC - Total Expense: 15735, Program Service Expense: 15735, Management and General Expenses: , Fundraising Expenses: ; OTHER SERVICES - Total Expense: 10529, Program Service Expense: 2955, Management and General Expenses: 7574, Fundraising Expenses: ; CONSULTING SERVICES - Total Expense: 95880, Program Service Expense: , Management and General Expenses: 95880, Fundraising Expenses: ; GRANT WRITING FEES - Total Expense: 4322, Program Service Expense: , Management and General Expenses: 4322, Fundraising Expenses: ; |
| Form 990, Part XI, Line 9 Other changes in net assets or fund balances | Restricted Donated Rent - 24645; Total - 24645; |