SOUTHEAST COMMUNITY HEALTH SYSTEMS: Form 990, tax year 2023
View the entire original 990 at ProPublica ↗
- Organization
- SOUTHEAST COMMUNITY HEALTH SYSTEMS (EIN 72-1212880)
- Tax period
- 2023-01-01 to 2023-12-31
- Filed
- 2024-06-24
- IRS object ID
- 202411769349301176
- Schema version
- 2023v5.1
- 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 | 2024-06-24T14:26:21-04:00 | ReturnTs |
| Tax Period End | 2023-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 854373220 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Steven M DeRouen & Associates LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | P O Box 4265 | AddressLine1Txt |
| City | Lake Charles | CityNm |
| State Abbreviation | LA | StateAbbreviationCd |
| ZIP | 70606 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2023-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 721212880 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Southeast Community Health Systems | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | SOUT | BusinessNameControlTxt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | Post Office Box 770 | AddressLine1Txt |
| City | Zachary | CityNm |
| State Abbreviation | LA | StateAbbreviationCd |
| ZIP | 70791 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Alecia Cyprian PhD | PersonNm |
| Person Title | Executive Direc | PersonTitleTxt |
| Phone | 2253062015 | PhoneNum |
| Signature | 2024-06-24 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | Alecia | PersonFirstNm |
| Person Last | Cyprian | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | Yes (true) | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Steven M DeRouen | PreparerPersonNm |
| PTIN | P01050140 | PTIN |
| Phone | 3375134915 | PhoneNum |
| Preparation | 2024-06-24 | PreparationDt |
| Self Employed | Yes (X) | SelfEmployedInd |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 0 | TrustedCustomerCd |
| OOB Security Verification | 00 | OOBSecurityVerificationCd |
| Authentication Assurance Level | AAL2 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2023 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Alecia Cyprien PhD | PrincipalOfficerNm |
| Gross Receipts | $12,526,922 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.shchc.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1994 | FormationYr |
| Legal Domicile State | LA | LegalDomicileStateCd |
| Activity Or Mission | The mission of Southeast Community Health Systems is to provide quality, affordable healthcare to all patients in underserved areas and to improve the health and wellness of the communities we serve. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 154 | TotalEmployeeCnt |
| Total Volunteers | 10 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $5,986,926 | PYContributionsGrantsAmt |
| CY Contributions Grants | $6,876,658 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $5,979,148 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $5,533,072 | CYProgramServiceRevenueAmt |
| PY Investment Income | $105 | PYInvestmentIncomeAmt |
| CY Investment Income | $141,891 | CYInvestmentIncomeAmt |
| CY Other Revenue | -$24,699 | CYOtherRevenueAmt |
| PY Total Revenue | $11,966,179 | PYTotalRevenueAmt |
| CY Total Revenue | $12,526,922 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $8,086,861 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $7,886,582 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $5,050,507 | PYOtherExpensesAmt |
| CY Other Expenses | $4,654,426 | CYOtherExpensesAmt |
| PY Total Expenses | $13,137,368 | PYTotalExpensesAmt |
| CY Total Expenses | $12,541,008 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$1,171,189 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$14,086 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $12,725,001 | TotalAssetsBOYAmt |
| Total Assets EOY | $12,601,740 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $3,427,416 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $3,260,984 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $9,297,585 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $9,340,756 | NetAssetsOrFundBalancesEOYAmt |
| Mission | The mission of Southeast Community Health Systems is to provide quality, affordable healthcare to all patients in underserved areas and to improve the health and wellness of the communities we serve. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $10,115,829 | ExpenseAmt |
| Revenue | $5,533,072 | RevenueAmt |
| Desc | The promotion of health care by providing comprehensive outpatient medical services to persons residing with the vicinity of the clinic. | Desc |
| Total Program Service Expenses | $10,115,829 | 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 | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | 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 |
| 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 | Yes (true) | 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 |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 55 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 154 | 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 | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | 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 |
| Form990 Provided To Gvrn Body | Yes (true) | 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 | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Theresa Bankston | PersonNm |
| Phone | 2253062015 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6351 Main Street | AddressLine1Txt |
| City | Zachary | CityNm |
| State Abbreviation | LA | StateAbbreviationCd |
| ZIP | 70791 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Key EmployeeKeyEmployeeInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|---|---|
| Corey Hall | |||||||||
| Chief Clinical Officer | 40.00 | 0.00 | Yes (X) | $212,001 | $0 | $22,560 | |||
| Alecia Cyprien | |||||||||
| Chief Executive Officer | 40.00 | 0.00 | $181,424 | $0 | $30,947 | Yes (X) | |||
| Jeevan K Yenuganti | |||||||||
| Dental Director | 40.00 | 0.00 | Yes (X) | $173,370 | $0 | $11,874 | |||
| Marvin Trotter | |||||||||
| Podiatrist | 40.00 | 0.00 | $154,649 | $0 | $8,851 | Yes (X) | |||
| Tammy Smith | |||||||||
| Nurse Practitioner | 40.00 | 0.00 | $137,837 | $0 | $17,343 | Yes (X) | |||
| Theresa Bankston | |||||||||
| Chief Financial Officer | 40.00 | 0.00 | $119,531 | $0 | $17,103 | Yes (X) | |||
| Heather Muse | |||||||||
| Nurse Practitioner | 40.00 | 0.00 | $129,972 | $0 | $5,935 | Yes (X) | |||
| Denise Thomas | |||||||||
| Psychiatric Nurse Practitione | 40.00 | 0.00 | $111,625 | $0 | $16,562 | Yes (X) | |||
| Sean Gaffney | |||||||||
| Dentist | 40.00 | 0.00 | $104,193 | $0 | $18,141 | Yes (X) | |||
| Terry Addison | |||||||||
| Board Member | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| Linda Phillips | |||||||||
| Board Member | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| Renya Lopez | |||||||||
| Board Member | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| Major Coleman | |||||||||
| Board Member | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| Mira Robertson | |||||||||
| Board Member | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| Paula McNabb | |||||||||
| Board Member | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| Michael Martin | |||||||||
| Vice Chair | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | ||
| Dameon Jackson | |||||||||
| Chair | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | ||
| Joan Culberson | |||||||||
| Secretary | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | ||
| Sandy Tillery | |||||||||
| Finance Chair | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,324,602 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $149,316 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 10 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (4 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| JW Grand LLC | |||||
| 5940 Perkins Road Suite A | Baton Rouge | LA | 70808 | Construction | $982,876 |
| Universal Data Inc | |||||
| 1312 Distributors Row | New Orleans | LA | 70123 | Technical Data Svc | $283,046 |
| Synergy Billing LLC | |||||
| 1200 Synergy Way | Daytona Beach | FL | 32117 | Billing Services | $276,154 |
| eClinical Works | |||||
| 7011 Koll Center Pkwy | Pleasanton | CA | 94566 | Revenue Cycle Svcs | $272,322 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $6,165,464 | GovernmentGrantsAmt |
| All Other Contributions | $711,194 | AllOtherContributionsAmt |
| Noncash Contributions | $711,064 | NoncashContributionsAmt |
| Total Contributions | $6,876,658 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Patient Service Revenue | 621400 | $5,164,948 | $5,164,948 |
| Pharmacy Income | 621400 | $124,259 | $124,259 |
| Contract Revenue | 621400 | $185,236 | $185,236 |
| Managed Care Incentives | 621400 | $58,629 | $58,629 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $5,533,072 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $141,891 | TotalRevenueColumnAmt |
| Exclusion | $141,891 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Miscellaneous Revenue | 621400 | $106,751 | $106,751 |
| Goodwill Impairment | 621400 | -$131,450 | -$131,450 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | -$24,699 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $12,526,922 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $5,508,373 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $141,891 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $768,810 | TotalAmt |
| Program Services | $627,394 | ProgramServicesAmt |
| Management And General | $141,416 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,966,572 | TotalAmt |
| Program Services | $4,869,072 | ProgramServicesAmt |
| Management And General | $1,097,500 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $186,699 | TotalAmt |
| Program Services | $140,444 | ProgramServicesAmt |
| Management And General | $46,255 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $444,764 | TotalAmt |
| Program Services | $337,801 | ProgramServicesAmt |
| Management And General | $106,963 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $519,737 | TotalAmt |
| Program Services | $427,502 | ProgramServicesAmt |
| Management And General | $92,235 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,897 | TotalAmt |
| Program Services | $3,569 | ProgramServicesAmt |
| Management And General | $8,328 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $50,124 | TotalAmt |
| Program Services | $15,037 | ProgramServicesAmt |
| Management And General | $35,087 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $621,769 | TotalAmt |
| Program Services | $329,190 | ProgramServicesAmt |
| Management And General | $292,579 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $210,328 | TotalAmt |
| Program Services | $210,328 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $162,980 | TotalAmt |
| Program Services | $136,026 | ProgramServicesAmt |
| Management And General | $26,954 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $531,225 | TotalAmt |
| Program Services | $487,196 | ProgramServicesAmt |
| Management And General | $44,029 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $196,330 | TotalAmt |
| Program Services | $175,167 | ProgramServicesAmt |
| Management And General | $21,163 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $143,890 | TotalAmt |
| Program Services | $83,822 | ProgramServicesAmt |
| Management And General | $60,068 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $81,602 | TotalAmt |
| Program Services | $69,362 | ProgramServicesAmt |
| Management And General | $12,240 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $522,183 | TotalAmt |
| Program Services | $365,528 | ProgramServicesAmt |
| Management And General | $156,655 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $178,164 | TotalAmt |
| Program Services | $151,439 | ProgramServicesAmt |
| Management And General | $26,725 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Pharmacy and Medical Supply | $1,377,245 | $1,377,245 | |
| Supplies | $134,241 | $41,441 | $92,800 |
| Repairs and Maintenance | $274,441 | $233,275 | $41,166 |
| Professional Development | $82,452 | $22,032 | $60,420 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $75,555 | TotalAmt |
| Program Services | $12,959 | ProgramServicesAmt |
| Management And General | $62,596 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,541,008 | TotalAmt |
| Program Services | $10,115,829 | ProgramServicesAmt |
| Management And General | $2,425,179 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,894,897 | BOYAmt |
| EOY | $1,413,932 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $395,155 | BOYAmt |
| EOY | $421,956 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $665,007 | BOYAmt |
| EOY | $545,337 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $114,217 | BOYAmt |
| EOY | $93,443 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $132,125 | BOYAmt |
| EOY | $183,882 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $16,033,310 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $6,233,440 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,843,506 | BOYAmt |
| EOY | $9,799,870 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $128,041 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $131,450 | BOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $548,644 | BOYAmt |
| EOY | $15,279 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,725,001 | BOYAmt |
| EOY | $12,601,740 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $408,627 | BOYAmt |
| EOY | $780,837 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,797,710 | BOYAmt |
| EOY | $2,047,455 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,221,079 | BOYAmt |
| EOY | $432,692 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,427,416 | BOYAmt |
| EOY | $3,260,984 | 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 | $9,297,585 | BOYAmt |
| EOY | $9,340,756 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,297,585 | BOYAmt |
| EOY | $9,340,756 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,725,001 | BOYAmt |
| EOY | $12,601,740 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$14,086 | ReconcilationRevenueExpnssAmt |
| Prior Period Adjustments | $57,257 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,735,435 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $6,833,646 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $6,232,295 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $5,986,926 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $6,876,658 | CurrentTaxYearAmt |
| Total | $30,664,960 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,982,095 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,452,460 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $6,560,221 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $5,979,148 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $5,533,072 | CurrentTaxYearAmt |
| Total | $27,506,996 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $9,717,530 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $11,286,106 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $12,792,516 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $11,966,074 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $12,409,730 | CurrentTaxYearAmt |
| Total | $58,171,956 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $58,171,956 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $6,820 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $23,072 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $133 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $105 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $141,891 | CurrentTaxYearAmt |
| Total | $172,021 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $6,820 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $23,072 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $133 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $105 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $141,891 | CurrentTaxYearAmt |
| Total | $172,021 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | -$24,699 | CurrentTaxYearAmt |
| Total | -$24,699 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $9,724,350 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $11,309,178 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $12,792,649 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $11,966,179 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $12,526,922 | CurrentTaxYearAmt |
| Total | $58,319,278 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99750 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99900 | PublicSupportPY509Pct |
| Investment Income CY | 0.00000 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00000 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Other income Part II line 10 or Part III line 12 | FormAndLineReferenceDesc |
| Explanation | Other Income $73,045 | ExplanationTxt |
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
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $851,224 | OtherCostOrOtherBasisAmt |
| Book Value | $851,224 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $10,476,229 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,581,065 | DepreciationAmt |
| Book Value | $7,895,164 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $13,777 | OtherCostOrOtherBasisAmt |
| Book Value | $13,777 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,598,118 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,597,738 | DepreciationAmt |
| Book Value | $1,000,380 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $93,962 | OtherCostOrOtherBasisAmt |
| Depreciation | $54,637 | DepreciationAmt |
| Book Value | $39,325 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $9,799,870 | TotalBookValueLandBuildingsAmt |
Closely Held Equity Interests CloselyHeldEquityInterestsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Book Value | $128,041 | BookValueAmt |
| Method Valuation | C | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $128,041 | TotalBookValueSecuritiesAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| Right of Use Lease Liability | $39,321 |
| Due to IRS | $390,782 |
| Accrued Interest Payable | $1,266 |
| Other Liabilities | $1,323 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $432,692 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $12,526,922 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Subtotal | $12,526,922 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $12,526,922 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $12,541,008 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $12,541,008 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $12,541,008 | TotalExpensesPerForm990Amt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| 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 (5 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt |
|---|---|---|---|---|
| Alecia Cyprien PhD | ||||
| Chief Executive Officer | $181,424 | $10,524 | $20,423 | $212,371 |
| Corey Hall MD | ||||
| Chief Clinical Officer | $212,001 | $7,800 | $14,760 | $234,561 |
| Jeevan K Yenuganti DDS | ||||
| Dental Director | $173,370 | $11,874 | $185,244 | |
| Marvin Trotter DPM | ||||
| Podiatrist | $154,649 | $8,851 | $163,500 | |
| Tammy Smith NP | ||||
| Nurse Practitioner | $137,837 | $6,940 | $10,403 | $155,180 |
Schedule M IRS990ScheduleM
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 30774 | ContributionCnt |
| Noncash Contributions Rpt F990 | $711,064 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | Retail Value | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | Yes (true) | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | false | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990 governing body review Part VI line 11 | Board members will review an electronic copy of Form 990 prior to filing. |
| Conflict of interest policy compliance Part VI line 12c | Conflicts of interest are monitored and enforced on an ongoing basis by human resources and the CEO. Vendors are selected to provide a service for the health center and are chosen based on need, cost and quality of services, not by their relationship status to any employee, director, etc. Management strives to not only have no conflicts of interest in accordance with its policies, but to avoid any appearance of conflicts whatsoever. |
| CEO executive director top management comp Part VI line 15a | The board of directors reviews the qualifications of the Chief Executive Officer and decides on compensation based on experience and qualifications, along with salary scales developed by the National Association of Community Health Centers. |
| Other officer or key employee compensation Part VI line 15b | The board of directors reviews the qualifications of the key employees and decides on compensation based on experience and qualifications, along with salary scales developed by the National Association of Community Health Centers. |
| Governing documents etc available to public Part VI line 19 | The Organizations governing documents and various policies are made available to the public upon request. |