FAMILY CHRISTIAN HEALTH CENTER: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- FAMILY CHRISTIAN HEALTH CENTER (EIN 36-4346917)
- Tax period
- 2021-07-01 to 2022-06-30
- Filed
- 2024-08-21
- IRS object ID
- 202442349349301504
- Schema version
- 2021v4.2
- 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 | 2024-08-21T15:51:13-05:00 | ReturnTs |
| Tax Period End | 2022-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 390758449 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WIPFLI LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1502 LONDON ROAD SUITE 200 | AddressLine1Txt |
| City | DULUTH | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55812 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 364346917 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FAMILY CHRISTIAN HEALTH CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | FAMI | BusinessNameControlTxt |
| Phone | 7085965177 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 31 W 155TH STREET | AddressLine1Txt |
| City | HARVEY | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60426 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DR LISA GREEN | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 7085965177 | PhoneNum |
| Signature | 2024-07-31 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MICHAEL J PETERSON CPA | PreparerPersonNm |
| PTIN | P01833529 | PTIN |
| Phone | 2187224705 | PhoneNum |
| Preparation | 2024-07-31 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2024-08-08 14:25:15Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Amended Return | Yes (X) | AmendedReturnInd |
| Principal Officer | DR LISA GREEN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 31 W 155TH STREET | AddressLine1Txt |
| City | HARVEY | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60426 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $15,860,611 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.FAMILYCHC.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2000 | FormationYr |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE EXCELLENT HEALTHCARE TO THE COMMUNITY THAT COMMUNICATES IN WORD AND DEED THE LOVE AND GOSPEL OF JESUS CHRIST. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 195 | TotalEmployeeCnt |
| Total Volunteers | 10 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $8,488,981 | PYContributionsGrantsAmt |
| CY Contributions Grants | $7,370,606 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $8,366,244 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $8,466,214 | CYProgramServiceRevenueAmt |
| PY Investment Income | $303 | PYInvestmentIncomeAmt |
| CY Investment Income | $280 | CYInvestmentIncomeAmt |
| PY Other Revenue | $31,343 | PYOtherRevenueAmt |
| CY Other Revenue | $23,511 | CYOtherRevenueAmt |
| PY Total Revenue | $16,886,871 | PYTotalRevenueAmt |
| CY Total Revenue | $15,860,611 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $4,711 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $8,957 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $9,016,575 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $11,031,648 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $5,625,121 | PYOtherExpensesAmt |
| CY Other Expenses | $6,602,568 | CYOtherExpensesAmt |
| PY Total Expenses | $14,646,407 | PYTotalExpensesAmt |
| CY Total Expenses | $17,643,173 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $2,240,464 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$1,782,562 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $10,123,186 | TotalAssetsBOYAmt |
| Total Assets EOY | $8,241,075 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $5,607,732 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $5,508,183 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $4,515,454 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $2,732,892 | NetAssetsOrFundBalancesEOYAmt |
| Mission | FAMILY CHRISTIAN HEALTH CENTER WAS ORGANIZED TO PROVIDE PRIMARY HEALTH AND DENTAL CARE TO THE MEDICALLY UNDERSERVED IN THE GREATER HARVEY, ILLINOIS AREA. ALSO PROVIDE PRIMARY HEALTH CARE TO LYNWOOD AND DOLTON. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $15,422,846 | ExpenseAmt |
| Grant | $8,957 | GrantAmt |
| Revenue | $8,467,815 | RevenueAmt |
| Desc | FAMILY CHRISTIAN HEALTH CENTER, INC., PROVIDED MEDICALLY RELATED SERVICES TO OVER 26,500 RESIDENTS OF THE HARVEY AND DOLTON AREAS. ACCORDINGLY, APPROXIMATELY 61,000 PATIENT VISITS WERE PROVIDED. THE CENTER PROVIDED PRIMARY CARE, DENTAL CARE, BEHAVIORAL HEALTH AND OB/GYN SERVICES. THE PRIMARY PURPOSE OF THE CENTER IS TO ADDRESS THE GROWING NUMBER OF RESIDENTS WHO DO NOT HAVE ACCESS TO HEALTH CARE.DURING THE COVID-19 PANDEMIC FAMILY CHRISTIAN HEALTH CENTER, INC DISTRIBUTED 3,000 BOXES OF FOOD TO THE COMMUNITY DUE TO INCREASES IN UNEMPLOYMENT AND DELAYED UNEMPLOYMENT BENEFITS. THIS EFFORT INCREASED AFTER THE JUNE 30 FISCAL YEAR END. | Desc |
| Total Program Service Expenses | $15,422,846 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | Yes (1) | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 31 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 195 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | 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 | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | IL | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DR LISA GREEN CEO | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7083395526 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 31 W 155TH STREET | AddressLine1Txt |
| City | HARVEY | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60426 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| TOYA HARVEY | ||||||||
| PRESIDENT | 4.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| KAREN JACOBS | ||||||||
| VICE PRESIDENT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| KIMBERLY JONES SAUNDERS | ||||||||
| SECRETARY | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| KEN MCGHEE | ||||||||
| TREASURER | 3.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| VERNICE CLARK-DAVIS | ||||||||
| ASSISTANT SECRETARY | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| AYANNA GARNER | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| APRIL MOORE | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| AZUCENA G ROSAS | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| KATHRYN STEFO | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JEFFERY WADDY | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| DR LISA GREEN | ||||||||
| CHIEF EXECUTIVE OFFICER | 35.00 | Yes (X) | $286,783 | $0 | $20,493 | |||
| TIFFANY ROBERTSON | ||||||||
| CHIEF FINANCIAL OFFICER (THRU 04/22) | 40.00 | Yes (X) | $168,954 | $0 | $4,548 | |||
| DR LESTER HOCKENBERRY | ||||||||
| MEDICAL DIRECTOR | 35.00 | $196,028 | $0 | $29,052 | Yes (X) | |||
| DR LAVERNE BARNES | ||||||||
| PHYSICIAN OPERATIONS DIRECTOR | 35.00 | $198,178 | $0 | $25,604 | Yes (X) | |||
| FELICIA WILLIAMS | ||||||||
| FAMILY PRACTICE PHYSICIAN | 35.00 | $141,447 | $0 | $5,337 | Yes (X) | |||
| DR KAMILAH BANKS-WORD | ||||||||
| PEDIATRIC PHYSICIAN | 35.00 | $194,093 | $0 | $8,683 | Yes (X) | |||
| JEROME BUSTER | ||||||||
| FAMILY PRACTICE PHYSICIAN | 35.00 | $158,449 | $0 | $8,543 | Yes (X) | |||
| DR SHANDRA BUNDY-SMITH | ||||||||
| FAMILY PRACTICE PHYSICIAN | 35.00 | $128,419 | $0 | $10,857 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,472,351 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $113,117 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 24 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| VISUALUTIONS | |||||
| 7440 MINTWOOD LANE | SPRING | TX | 77379 | OUTSOURCE REVENUE CYCLE PROVIDER | $381,898 |
| SPENCE CONSULTING | |||||
| 6845 S EUCLID AVE | CHICAGO | IL | 60649 | IT CONSULTANT | $230,680 |
| DR EARNEST HAYES | |||||
| 400 E RANDOLPH UNIT 3730 | CHICAGO | IL | 60601 | OB/GYN PHYSICIAN | $154,096 |
| RESCUE 8 SPECIAL EVENTS AND TRAINING INC | |||||
| 12915 S MAY ST | CALUMET CITY | IL | 60409 | SECURITY | $141,053 |
| IRIS TELEHEALTH MEDICAL GROUP | |||||
| 114 W 7TH ST SUITE 900 | AUSTIN | TX | 78701 | TELEHEALTH SERVICES | $116,427 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $5,468,313 | GovernmentGrantsAmt |
| All Other Contributions | $1,902,293 | AllOtherContributionsAmt |
| Noncash Contributions | $1,319,817 | NoncashContributionsAmt |
| Total Contributions | $7,370,606 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 621110 | $6,876,852 | $6,876,852 |
| 340B PHARMACY REVENUE | 623990 | $1,414,365 | $1,414,365 |
| CAPITATION AND INCENTIVES REVENUE | 621300 | $174,997 | $174,997 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $8,466,214 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $280 | TotalRevenueColumnAmt |
| Exclusion | $280 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $18,724 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $18,724 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $18,724 | TotalRevenueColumnAmt |
| Exclusion | $18,724 | ExclusionAmt |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,787 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,601 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $3,186 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $4,787 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $15,860,611 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $8,467,815 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $22,190 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,957 | TotalAmt |
| Program Services | $8,957 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $688,186 | TotalAmt |
| Program Services | $598,722 | ProgramServicesAmt |
| Management And General | $89,464 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,809,186 | TotalAmt |
| Program Services | $7,663,992 | ProgramServicesAmt |
| Management And General | $1,145,194 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $68,166 | TotalAmt |
| Program Services | $59,304 | ProgramServicesAmt |
| Management And General | $8,862 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $819,975 | TotalAmt |
| Program Services | $713,378 | ProgramServicesAmt |
| Management And General | $106,597 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $646,135 | TotalAmt |
| Program Services | $562,137 | ProgramServicesAmt |
| Management And General | $83,998 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $43,095 | TotalAmt |
| Management And General | $43,095 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,670 | TotalAmt |
| Management And General | $17,670 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $989,640 | TotalAmt |
| Program Services | $913,852 | ProgramServicesAmt |
| Management And General | $75,788 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $86,144 | TotalAmt |
| Management And General | $86,144 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $301,498 | TotalAmt |
| Program Services | $262,303 | ProgramServicesAmt |
| Management And General | $39,195 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $997,968 | TotalAmt |
| Program Services | $868,232 | ProgramServicesAmt |
| Management And General | $129,736 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $823,630 | TotalAmt |
| Program Services | $716,558 | ProgramServicesAmt |
| Management And General | $107,072 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $69,493 | TotalAmt |
| Program Services | $60,459 | ProgramServicesAmt |
| Management And General | $9,034 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $112,002 | TotalAmt |
| Program Services | $97,442 | ProgramServicesAmt |
| Management And General | $14,560 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $227,355 | TotalAmt |
| Program Services | $197,799 | ProgramServicesAmt |
| Management And General | $29,556 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $636,133 | TotalAmt |
| Program Services | $438,932 | ProgramServicesAmt |
| Management And General | $197,201 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $44,049 | TotalAmt |
| Program Services | $38,323 | ProgramServicesAmt |
| Management And General | $5,726 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES AND PH | $1,642,225 | $1,642,225 | |
| 340B PHARMACY | $378,804 | $378,804 | |
| MEMBERSHIP DUES AND LIC | $119,098 | $103,615 | $15,483 |
| BAD DEBT EXPENSE | $29,900 | $26,013 | $3,887 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $83,864 | TotalAmt |
| Program Services | $71,799 | ProgramServicesAmt |
| Management And General | $12,065 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,643,173 | TotalAmt |
| Program Services | $15,422,846 | ProgramServicesAmt |
| Management And General | $2,220,327 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $563 | BOYAmt |
| EOY | $24 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,179,674 | BOYAmt |
| EOY | $259,442 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $50,000 | BOYAmt |
| EOY | $112,622 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,316,409 | BOYAmt |
| EOY | $1,923,236 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $332,146 | BOYAmt |
| EOY | $421,931 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $120,604 | BOYAmt |
| EOY | $126,864 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $11,622,688 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $6,225,732 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,123,790 | BOYAmt |
| EOY | $5,396,956 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,123,186 | BOYAmt |
| EOY | $8,241,075 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,020,772 | BOYAmt |
| EOY | $1,026,992 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $47,944 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,436,960 | BOYAmt |
| EOY | $4,283,247 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $150,000 | BOYAmt |
| EOY | $150,000 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,607,732 | BOYAmt |
| EOY | $5,508,183 | 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 | $4,117,785 | BOYAmt |
| EOY | $2,732,892 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $397,669 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,515,454 | BOYAmt |
| EOY | $2,732,892 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,123,186 | BOYAmt |
| EOY | $8,241,075 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$1,782,562 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | 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 (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | 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 | $3,199,639 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,006,743 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $5,690,985 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $8,488,981 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $7,370,606 | CurrentTaxYearAmt |
| Total | $28,756,954 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $7,364,929 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $7,200,047 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7,585,260 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $8,368,835 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $8,467,815 | CurrentTaxYearAmt |
| Total | $38,986,886 | TotalAmt |
Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $94,888 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $47,538 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $31,433 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,057 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,186 | CurrentTaxYearAmt |
| Total | $178,102 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $10,659,456 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $11,254,328 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $13,307,678 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $16,858,873 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $15,841,607 | CurrentTaxYearAmt |
| Total | $67,921,942 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $67,921,942 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $7,034 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $232 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $26,193 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $27,998 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $19,004 | CurrentTaxYearAmt |
| Total | $80,461 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $7,034 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $232 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $26,193 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $27,998 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $19,004 | CurrentTaxYearAmt |
| Total | $80,461 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $10,666,490 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $11,254,560 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $13,333,871 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $16,886,871 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $15,860,611 | CurrentTaxYearAmt |
| Total | $68,002,403 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99880 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99890 | PublicSupportPY509Pct |
| Investment Income CY | 0.00120 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00110 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
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 | $276,000 | OtherCostOrOtherBasisAmt |
| Book Value | $276,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,454,808 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,483,785 | DepreciationAmt |
| Book Value | $2,971,023 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,048,946 | OtherCostOrOtherBasisAmt |
| Depreciation | $381,343 | DepreciationAmt |
| Book Value | $667,603 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,699,023 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,281,334 | DepreciationAmt |
| Book Value | $1,417,689 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $143,911 | OtherCostOrOtherBasisAmt |
| Depreciation | $79,270 | DepreciationAmt |
| Book Value | $64,641 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $5,396,956 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | SBA LOANS PAYABLE | Desc |
| Amt | $150,000 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $150,000 | TotalLiabilityAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DR LISA GREEN | ||||||||||||||
| CHIEF EXECUTIVE OFFICER | $234,641 | $0 | $49,620 | $0 | $2,522 | $0 | $3,999 | $0 | $16,494 | $0 | $307,276 | $0 | $0 | $0 |
| DR LESTER HOCKENBERRY | ||||||||||||||
| MEDICAL DIRECTOR | $192,279 | $0 | $1,015 | $0 | $2,734 | $0 | $3,033 | $0 | $26,019 | $0 | $225,080 | $0 | $0 | $0 |
| DR LAVERNE BARNES | ||||||||||||||
| PHYSICIAN OPERATIONS DIRECTOR | $189,658 | $0 | $1,015 | $0 | $7,505 | $0 | $1,518 | $0 | $24,086 | $0 | $223,782 | $0 | $0 | $0 |
| DR KAMILAH BANKS-WORD | ||||||||||||||
| PEDIATRIC PHYSICIAN | $175,820 | $0 | $507 | $0 | $17,766 | $0 | $1,817 | $0 | $6,866 | $0 | $202,776 | $0 | $0 | $0 |
| TIFFANY ROBERTSON | ||||||||||||||
| CHIEF FINANCIAL OFFICER (THRU 04/22) | $144,685 | $0 | $21,173 | $0 | $3,096 | $0 | $910 | $0 | $3,638 | $0 | $173,502 | $0 | $0 | $0 |
| JEROME BUSTER | ||||||||||||||
| FAMILY PRACTICE PHYSICIAN | $153,066 | $0 | $1,015 | $0 | $4,368 | $0 | $1,233 | $0 | $7,310 | $0 | $166,992 | $0 | $0 | $0 |
Schedule M IRS990ScheduleM
Food Inventory FoodInventoryGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $5,000 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FAIR MARKET VALUE | MethodOfDeterminingRevenuesTxt |
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 2 | ContributionCnt |
| Noncash Contributions Rpt F990 | $1,314,817 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | ACQUISITION PRICE | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8283 Received | 0 | Form8283ReceivedCnt |
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | Yes (1) | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | THE CFO, CEO, AND TREASURER REVIEW THE FEDERAL FORM 990 AND STATE REGISTRATION FORMS. UPON COMPLETION OF THIS REVIEW AND APPROVAL THE FORMS ARE SUBMITTED TO THE FINANCE COMMITTEE FOR APPROVAL. UPON APPROVAL BY THE FINANCE COMMITTEE AND BEFORE FILING, THE RETURNS ARE PROVIDED TO THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION B, LINE 12C | IT IS THE POLICY OF FCHC THAT INTERESTS SHALL BE FULLY DISCLOSED BY ANY INDIVIDUAL REGARDLESS OF WHETHER A CONFLICT OF INTEREST IS DETERMINED TO EXIST. FHCH REQUIRES THAT ALL BOARD MEMBERS, OFFICERS, EMPLOYEES, CONTRACTORS OR AGENTS, AS WELL AS CANDIDATES FOR BOARD MEMBERSHIP, DISCLOSE IN WRITING AND UPDATE AT LEAST ANNUALLY. IN THE CASE OF A POTENTIALLY CONFLICTED PERSON WHO IS A BOARD MEMBER (INCLUDING THE CEO), THAT PERSON MAY MAKE A PRESENTATION, TO THE BOARD REGARDING WHETHER HE OR SHE HAS A CONFLICT AND MAY RESPOND TO RELATED QUESTIONS FROM THE BOARD. HOWEVER, AFTER SUCH PRESENTATION, HE OR SHE SHALL LEAVE THE MEETING DURING ANY DISCUSSION OF, OR VOTE ON, WHETHER A CONFLICT OF INTEREST EXISTS, AND IF SUCH CONFLICT IS DETERMINED BY THE BOARD TO EXIST, HE OR SHE SHALL LEAVE THE MEETING DURING ANY DISCUSSION OF, AND VOTING ON, THE TRANSACTION OR ARRANGEMENT THAT INVOLVES THE CONFLICT OF INTEREST. |
| FORM 990, PART VI, SECTION B, LINE 15A | THE PROCESS OF DETERMINING COMPENSATION OF THE ORGANIZATION'S CEO INCLUDES REVIEW OF COMPARABLE SALARY DATA, DETERMINING TOTAL COMPENSATION, AND DOCUMENTING MEETING MINUTES, FOLLOWED BY APPROVAL BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART XII, LINE 3B | THE ORGANIZATION IS REQUIRED TO BE INCLUDED IN A SINGLE AUDIT FO THE YEAR ENDED 06/30/2022. THE DEADLINE FOR THIS FILING FALLS AFTER THE DEADLINE FOR THE 990 FOR THE SAME FISCAL YEAR END. THE SINGLE AUDIT WILL NOT BE FINALIZED AT THE TIME OF THIS SUBMISSION. |
| FORM 990 - AMENDED RETURN | THE 2021 FORM 990 IS BEING AMENDED TO INCLUDE ISSUED FINANCIAL STATEMENT AMOUNTS FOR THE FISCAL YEAR 6/30/2022. THE RETURN IS AMENDING THE FOLLOWING: - FORM 990, PART I - FORM 990, PART III - FORM 990, PART IV - FORM 990, PART VIII - FORM 990, PART IX - FORM 990, PART X - FORM 990, PART XI - SCHEDULE A, PART III - SCHEDULE B, PART I - SCHEDULE D, PART VI - SCHEDULE D, PART X - SCHEDULE O |
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