MY COMMUNITY HEALTH CENTER: Form 990, tax year 2023
View the entire original 990 at ProPublica ↗
- Organization
- MY COMMUNITY HEALTH CENTER (EIN 81-2171085)
- Tax period
- 2023-01-01 to 2023-12-31
- Filed
- 2024-10-01
- IRS object ID
- 202402759349301755
- 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 | 2024-10-01T17:51:03+00:00 | ReturnTs |
| Tax Period End | 2023-12-31 | 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 | 312 Walnut Street Suite 3000 | AddressLine1Txt |
| City | Cincinnati | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 45202 | 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 | 812171085 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MY COMMUNITY HEALTH CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MYCO | BusinessNameControlTxt |
| Phone | 3303636242 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2600 7TH STREET SW | AddressLine1Txt |
| City | CANTON | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 44710 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Kelly | PersonNm |
| Person Title | Lorenz | PersonTitleTxt |
| Phone | 3303636242 | PhoneNum |
| Signature | 2024-10-01 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
| 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 | Aaron Hershberger | PreparerPersonNm |
| PTIN | P00961884 | PTIN |
| Phone | 5136218300 | PhoneNum |
| Preparation | 2024-10-01 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2023 | TaxYr |
| Build TS | 2024-10-15 13:58:12Z | BuildTS |
Form 990 IRS990
Principal Ofcr Business Name PrincipalOfcrBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JUAN-PAULO AFABLE | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2600 7TH STREET SW | AddressLine1Txt |
| City | CANTON | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 44710 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $10,238,775 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.MYCOMHC.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2016 | FormationYr |
| Legal Domicile State | OH | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE COMPASSIONATE CARE TO ALL; HEALING AND LEARNING TOGETHER. | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 13 | VotingMembersIndependentCnt |
| Total Employee | 104 | TotalEmployeeCnt |
| Total Volunteers | 15 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $3,815,506 | PYContributionsGrantsAmt |
| CY Contributions Grants | $3,527,264 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $5,405,360 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $6,440,447 | CYProgramServiceRevenueAmt |
| PY Investment Income | $11,976 | PYInvestmentIncomeAmt |
| CY Investment Income | $198,952 | CYInvestmentIncomeAmt |
| PY Other Revenue | $77,236 | PYOtherRevenueAmt |
| CY Other Revenue | $72,112 | CYOtherRevenueAmt |
| PY Total Revenue | $9,310,078 | PYTotalRevenueAmt |
| CY Total Revenue | $10,238,775 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $4,434,060 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $4,515,926 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $3,704,256 | PYOtherExpensesAmt |
| CY Other Expenses | $4,881,504 | CYOtherExpensesAmt |
| PY Total Expenses | $8,138,316 | PYTotalExpensesAmt |
| CY Total Expenses | $9,397,430 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,171,762 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $841,345 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $7,380,647 | TotalAssetsBOYAmt |
| Total Assets EOY | $9,111,387 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,571,111 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $3,460,506 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $4,809,536 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $5,650,881 | NetAssetsOrFundBalancesEOYAmt |
| Mission | MY COMMUNITY HEALTH CENTER (MCHC) IS A GRASSROOTS, COMMUNITY-BASED 501(C)(3) OHIO NONPROFIT ORGANIZATION WHOSE MISSION IS TO PROVIDE COMPASSIONATE CARE TO ALL, HEALING AND LEARNING TOGETHER. MCHC'S GOAL IS TO BE RESPONSIVE TO THE NEEDS OF THE COMMUNITIES IT SERVES, BUT WITH CONTINUED EMPHASIS ON THE UNDERSERVED AND THOSE WITHOUT ACCESS TO CARE, REGARDLESS OF RACE, ECONOMIC STATUS, AGE, SEX, SEXUAL ORIENTATION, OR DISABILITY. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $7,006,010 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $6,440,447 | RevenueAmt |
| Desc | MY COMMUNITY HEALTH CENTER (MCHC) IS A GRASSROOTS, COMMUNITY BASED 501(C)(3) OHIO NONPROFIT ORGANIZATION WHOSE MISSION IS TO PROVIDE COMPASSIONATE CARE TO ALL, HEALING AND LEARNING TOGETHER. MCHC'S GOAL IS TO BE RESPONSIVE TO THE NEEDS OF THE COMMUNITIES IT SERVES, BUT WITH CONTINUED EMPHASIS ON THE UNDERSERVED AND THOSE WITHOUT ACCESS TO CARE, REGARDLESS OF RACE, ECONOMIC STATUS, AGE, SEX, SEXUAL ORIENTATION, OR DISABILITY. MCHC ESTABLISHED ITSELF AS A COMMUNITY CLINIC SITE IN AUGUST 2017 AND HAS BEEN ACTIVE AS A COMMUNITY HEALTH CARE PROVIDER SINCE. THE ORGANIZATION BELIEVES IN TRAINING THE NEXT GENERATION OF HEALTH CARE PROVIDERS. AS SUCH, MCHC HAS ESTABLISHED A RELATIONSHIP WITH THREE RESIDENCY PROGRAMS FOR THEIR RESIDENTS TO PROVIDE OUTPATIENT, CONTINUITY OF CARE AT MCHC: INTERNAL MEDICINE, FAMILY MEDICINE AND OBSTETRICS AND GYNECOLOGY. THE INTERNAL MEDICINE ALSO PROVIDES A RICH LEARNING ENVIRONMENT FOR PHARMACY RESIDENTS. IN ADDITION TO PROVIDERS, MCHC IS A CLINICAL SITE FOR NURSING AND MEDICAL ASSISTANT STUDENTS. IN SEPTEMBER 2019, MCHC RECEIVED FULL DESIGNATION FROM THE FEDERAL HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA) TO BE FEDERALLY QUALIFIED HEALTH CENTER. MCHC EMPLOYS MORE THAN 70 EMPLOYEES, MANY FROM THE LOCAL COMMUNITY. STAFF ARE FLUENT IN ENGLISH, SPANISH, AND AMERICAN SIGN LANGUAGE (CONTRACTED TRANSLATION SERVICES FOR OTHER LANGUAGES) AND EFFECTIVE AT WORKING WITH PEOPLE AT ALL LEVELS OF LITERACY. SERVICES PROVIDED BY MCHC INCLUDE FAMILY PRACTICE, INTERNAL MEDICINE, PRENATAL SERVICES, POSTPARTUM CARE, WELL CHILD AND PEDIATRIC CARE, SCREENINGS, CHRONIC DISEASE MANAGEMENT, DENTAL CARE (BY REFERRAL), LABORATORY, BEHAVIORAL HEALTH (INCLUDING INDIVIDUALS/GROUPS), FAMILY PLANNING, OUTREACH, HEALTH EDUCATION (INCLUDING NUTRITION), ELIGIBILITY ASSISTANCE, AND CASE MANAGEMENT. THESE OUTPATIENT PRIMARY HEALTH SERVICES ARE PROVIDED TO THE MEDICALLY UNDERSERVED POPULATIONS IN STARK COUNTY, OHIO AND SURROUNDING COMMUNITIES. OUR OBSTETRICAL PROGRAM IS UNIQUE IN THE FACT THAT WE ARE THE LARGEST OB PROVIDER FOR MEDICAID PATIENTS IN STARK COUNTY. THE ORGANIZATION RECEIVED APPROVAL TO OPEN A SECOND SITE IN MAGNOLIA, OHIO, A HRSA DESIGNATED UNDERSERVED AREA IN SEPTEMBER 2019. THIS FULLY FUNCTIONING SATELLITE OFFICE BEGAN OPERATIONS IN JANUARY 2020 AND PROVIDES MOST OF THE SAME HEALTH CENTER SERVICES AS DESCRIBED ABOVE. IN MARCH OF 2020 TO MEET THE CHALLENGING ISSUES OF COVID-19 WITH OUR PATIENTS, MCHC ADDED TELEHEALTH SERVICES AND WE HAVE CONTINUED TO PROVIDE THIS SERVICE. IN 2023 WE PROVIDED OVER 1,100 TELEHEALTH VISITS AND SO MANY OF OUR PATIENTS CAN ACCESS OUR CARE. FURTHERMORE, MCHC PROVIDED CARE TO, YET AGAIN OVER 10,000 PATIENTS WITH OVER 36,500 MEDICAL VISITS AND OVER 750 MENTAL HEALTH VISITS IN 2023. ON MARCH 8, 2023, MCHC OPENED A 340B INHOUSE PHARMACY TO PROVIDE PRESCRIPTION MEDICATIONS TO MCHC PATIENTS. THIS WAS A SIGNIFICANT CHANGE IN OUR CARE DELIVERY AND TRULY ADDRESSED ADHERENCE IN TREATMENT, ESPECIALLY WITH MAT AND SUD. COMMUNITY COLLABORATION IS OF UTMOST IMPORTANCE TO MCHC. BELOW ARE SOME OF THE HIGHLIGHTS OF OUR MANY COLLABORATIONS WITH COMMUNITY PARTNERS. OUR OB-GYN DEPARTMENT CONTINUES TO COLLABORATE WITH STARK COUNTY AND CANTON CITY HEALTH DEPARTMENT FOR THE THRIVE INITIATIVE TO REDUCE INFANT MORTALITY. OUR INTERNAL MEDICINE DIVISION CONTINUES TO COLLABORATE WITH ACCESS HEALTH TO PROVIDE COMMUNITY HEALTH WORKERS FOR HIGH-RISK DIABETICS IN THE PRACTICE. THIS SAME DEPARTMENT STARTED COLLABORATING MORE WITH CANTON CITY HEALTH DEPARTMENT AND EQUITAS HEALTH IN 2023, TO PROVIDE INFECTIOUS DISEASE MEDICAL CARE TO TREAT PATIENTS WITH HIV, HEPATITIS C AND ALSO PATIENTS WITH SUBSTANCE USE DISORDER. OVER 4500 PATIENTS WERE TESTED WITH HIV AND A TOTAL OF 9 WERE DIAGNOSED IN 2023. WE HAVE OVER 80 PATIENTS WHO HAS THE HEP C DIAGNOSIS AND MANY HAVE BEEN TREATED AT OUR FACILITY. LASTLY, WE HAVE OVER 250 PATIENTS WITH AN SUD DIAGNOSIS AND WE CONTINUE TO ENGAGE PATIENTS TO BE TREATED. IN 2023, MCHC CONTINUED TO PARTICIPATE IN MANY COMMUNITY EVENTS, PLEASE SEE THEM OUTLINED BELOW. IN EARLY APRIL, MCHC HOSTED THE GRAND OPENING OF THE INHOUSE PHARMACY AND INVITED MANY COMMUNITY STAKEHOLDERS TO BE PRESENT FOR THE OPENING. WE GAVE MCHC TRINKETS TO MANY PARTNERS AND PATIENTS TO PROMOTE THE OPENING OF OUR PHARMACY. WE HAD BEEN FEATURED BY THE LOCAL NEWSPAPER, THE CANTON REPOSITORY, THROUGH OUR PARTNERSHIP FROM THE STARK COMMUNITY FOUNDATION. BY MAY, OUR PHARMACY STARTED DELIVERING PRESCRIPTIONS TO PATIENT HOMES. IN JULY, MCHC MADE A DONATION TO THE AKRON-CANTON REGIONAL FOOD BANK. THE FUNDS RAISED WERE BORN OUT THE DOLLAR DENIM PROGRAM WERE STAFF DONATED $2 EVERY FRIDAY. HALF OF THE FUNDS RAISED GOES TO A CHARITY WE HAVE CHOSEN AND HALF GOES TO A FUND FOR STAFF CULTURE. IN AUGUST, MCHC ONCE AGAIN PARTICIPATED AT THE SANDY VALLEY BACK TO SCHOOL BASH. WE GAVE AWAY STRING BAGS, WATER BOTTLES, SCREENING TOOL GUIDELINES AND EDUCATED MANY PARENTS ABOUT THE IMPORTANCE OF VACCINATIONS FOR CHILDREN. IN SEPTEMBER, MCHC JOINED THE MASSILLON HEALTH AND WELLNESS FAIR AT THE DUNCAN PLAZA TO PROMOTE WELLNESS AND IMPORTANCE OF SCREENINGS IN THE COMMUNITY. IN OCTOBER, MCHC MADE A DONATION TO THE YWCA OF CANTON OHIO. THE ONLY WOMEN AND CHILDREN'S EMERGENCY SHELTER AND LARGEST OF ITS KIND IN CANTON OHIO. THE FUNDS RAISED ALSO CAME OUT OF THE DOLLAR DENIM PROGRAM. STAFF ARE TRULY EXCITED TO BE ABLE TO CONTRIBUTE TO THE MANY CAUSES AROUND US. MANY OF OUR PATIENTS COME FROM THE YMCA SHELTER. IN DECEMBER, MCHC PARTICIPATED AGAIN AT THE COMMUNITY CHRISTMAS OF STARK COUNTY. WE ONCE AGAIN, ADOPTED MULTIPLE FAMILIES. MCHC RAISED OVER $1,000 TO PROVIDE GIFTS AND MUCH NEEDED SUPPORT TO DISADVANTAGED FAMILIES IN OUR COUNTY. OTHER HIGHLIGHTS OF THE YEAR 2023 ARE DESCRIBED BELOW. IN OCTOBER, BOTH OUR CANTON AND MAGNOLIA LOCATION RECEIVED RECOGNITION AGAIN AS A PATIENT CENTERED MEDICAL HOME, AN ACCREDITATION FROM THE NATIONAL COMMITTEE FOR QUALITY ASSURANCE (NCQA). THIS DESIGNATION CONTINUES TO DEMONSTRATE OUR COMMITMENT TO IMPROVING THE QUALITY OF HEALTH CARE FOR OUR PATIENTS. IN NOVEMBER, MCHC FORMALIZED A PARTNERSHIP WITH YUVO HEALTH, A VALUE BASED CARE ORGANIZATION THAT HELPS FQHCS TO BENEFIT FULLY FROM PAYOR BASED VALUE ARRANGEMENTS. THIS IS A UNIQUE OPPORTUNITY AS YUVO IS QUITE AN INNOVATIVE CONCEPT IN VALUE BASED CARE. THEY ARE FINANCIALLY BACKED AND CAN SUPPORT FQHCS HAVING BEEN ABLE TO SUPPORT MANY FQHCS IN NEW YORK CITY. MCHC IS THE FIRST ORGANIZATION TO JOIN THE YUVO IPA AND THIS OPENED UP MANY OPPORTUNITIES FOR MCHC TO CAPTURE MORE REVENUE TO SUPPORT OUR UNDER-RESOURCED PATIENTS. TOWARDS THE END OF 2023 MCHC WAS PUTTING THE FINAL PIECES TOWARDS THE OPENING OF OUR THIRD LOCATION AT GONDER PLACE. THIS CLINIC OF OURS IS THROUGH A COLLABORATION WITH THE CITY OF CANTON, CANTON FOR ALL PEOPLE AND SOMMERS MARKET. THIS PROJECT HAS GONE THROUGH MANY DELAYS BUT OUR GROUP HAS REMAINED RESOLUTE AND UNYIELDING AS IT HAS BEEN OUR DREAM TO OPEN A THE FIRST HEALTH CENTER AND GROCERY STORE COMBINATION IN THE SOUTHEAST OF CANTON WHICH IS A FOOD AND HEALTH CARE DESERT. MY COMMUNITY HEALTH CENTER CONTINUED TO THRIVE AND GROW IN 2023 MAKING IT EASIER TO ACCESS CRITICAL PREVENTATIVE CARE FOR ALL PATIENTS. | Desc |
| Total Program Service Expenses | $7,006,010 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| 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 | Yes (true) | 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 | 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 |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 9 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 104 | 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 | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 13 | 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 | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KELLY LORENZ | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3303631310 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2600 7TH STREET SW | AddressLine1Txt |
| City | CANTON | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 44710 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|
| CYRILIA PRATT | ||||||||
| SECRETARY | 1.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| KEVIN SMITH | ||||||||
| TREASURER | 1.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| SUSAN MERCER MD | ||||||||
| PRESIDENT | 1.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| CARL SCHLEICH MD | ||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| CAROL JOHNSON | ||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| JEFFREY ZELLERS | ||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| LINDA MUIR | ||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| MARIA HEEGE | ||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| MAUREEN ATER | ||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| PHILLIP MICKLEY | ||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| RICK SMITH | ||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| SATYNNE PYLES | ||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| TOM CASEY | ||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| JOHN SUTTON MD | ||||||||
| CMO (TERM ENDED 1/31/2023) | 40.0 | 0.0 | Yes (X) | $37,704 | $0 | $3,005 | ||
| JUAN-PAULO AFABLE | ||||||||
| CEO | 40.0 | 0.0 | Yes (X) | $197,424 | $0 | $13,686 | ||
| KELLY LORENZ | ||||||||
| CFO | 40.0 | 0.0 | Yes (X) | $119,697 | $0 | $11,713 | ||
| SARAH HOEHNEN DO | ||||||||
| CMO (TERM BEGAN 4/3/2023) | 40.0 | 0.0 | Yes (X) | $178,140 | $0 | $1,731 | ||
| Terry Regula | ||||||||
| FORMER CEO | 0.0 | 0.0 | $102,688 | $0 | $226 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $635,653 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $30,361 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 4 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | 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 |
|---|---|---|---|---|---|
| Aultman Hospital | |||||
| 2600 Sixth Street SW | Canton | OH | 44710 | Preceptors | $995,418 |
| Aultman Health Foundation | |||||
| 2600 Sixth Street SW | Canton | OH | 44710 | Master Service Agreement & Malpractice | $725,146 |
| Allscripts Healtcare LLC | |||||
| 24630 Network Place | Chicago | IL | 60673 | Billing Service, E H R hosting & Quality Software | $440,510 |
| Cardinal Health Pharmacy Serivces LLC | |||||
| 13651 Dubli Court | Stafford | TX | 77477 | Pharmacy Services | $366,301 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $1,470,887 | GovernmentGrantsAmt |
| All Other Contributions | $2,056,377 | AllOtherContributionsAmt |
| Total Contributions | $3,527,264 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENUE | 621400 | $4,897,820 | $4,897,820 |
| PHARMACY REVENUE | 621400 | $1,386,269 | $1,386,269 |
| QUALITY INCENTIVE REVENUE | 621400 | $156,358 | $156,358 |
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 | $6,440,447 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $198,952 | TotalRevenueColumnAmt |
| Exclusion | $198,952 | ExclusionAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OTHER REVENUE | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $72,112 | TotalRevenueColumnAmt |
| Exclusion | $72,112 | 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 | $72,112 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $10,238,775 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $6,440,447 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $271,064 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $666,014 | TotalAmt |
| Program Services | $530,842 | ProgramServicesAmt |
| Management And General | $135,172 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,008,845 | TotalAmt |
| Program Services | $2,390,926 | ProgramServicesAmt |
| Management And General | $617,919 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $72,100 | TotalAmt |
| Program Services | $61,107 | ProgramServicesAmt |
| Management And General | $10,993 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $487,389 | TotalAmt |
| Program Services | $413,080 | ProgramServicesAmt |
| Management And General | $74,309 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $281,578 | TotalAmt |
| Program Services | $238,648 | ProgramServicesAmt |
| Management And General | $42,930 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,000 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $9,000 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $61,025 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $61,025 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,537,066 | TotalAmt |
| Program Services | $1,950,304 | ProgramServicesAmt |
| Management And General | $586,762 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $157,525 | TotalAmt |
| Program Services | $72,485 | ProgramServicesAmt |
| Management And General | $85,040 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $152,426 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $152,426 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $449,815 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $449,815 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,039 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $3,039 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,914 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $3,914 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $129,362 | TotalAmt |
| Program Services | $95,728 | ProgramServicesAmt |
| Management And General | $33,634 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $69,769 | TotalAmt |
| Program Services | $22,645 | ProgramServicesAmt |
| Management And General | $47,124 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Expenses OtherExpensesGrp (2 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| MEDICAL SUPPLIES & EQUIPMENT | $1,163,488 | $1,163,488 | $0 | $0 |
| OTHER EXPENSES | $145,075 | $66,757 | $78,318 | $0 |
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 | $9,397,430 | TotalAmt |
| Program Services | $7,006,010 | ProgramServicesAmt |
| Management And General | $2,391,420 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,783,293 | BOYAmt |
| EOY | $4,588,189 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $242,736 | BOYAmt |
| EOY | $148,142 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $421,792 | BOYAmt |
| EOY | $688,709 | 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 |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,084 | BOYAmt |
| EOY | $26,737 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $41,959 | BOYAmt |
| EOY | $60,151 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $1,151,729 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $320,888 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $802,125 | BOYAmt |
| EOY | $830,841 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,056,658 | BOYAmt |
| EOY | $2,768,618 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,380,647 | BOYAmt |
| EOY | $9,111,387 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $521,665 | BOYAmt |
| EOY | $694,979 | 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 | $2,049,446 | BOYAmt |
| EOY | $2,765,527 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,571,111 | BOYAmt |
| EOY | $3,460,506 | 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 | $4,674,446 | BOYAmt |
| EOY | $5,517,888 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $135,090 | BOYAmt |
| EOY | $132,993 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,809,536 | BOYAmt |
| EOY | $5,650,881 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,380,647 | BOYAmt |
| EOY | $9,111,387 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $841,345 | ReconcilationRevenueExpnssAmt |
| 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) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Tax Rev Levied Orgnztnl Bnft170 TaxRevLeviedOrgnztnlBnft170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $0 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $0 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $0 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $0 | SubstantialContributorsTotAmt |
| Public Support Total170 | $0 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $0 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $0 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $0 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $0 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $0 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0 | PublicSupportCY170Pct |
| Public Support PY170 | 0.0 | PublicSupportPY170Pct |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Tax Rev Levied Orgnztnl Bnft509 TaxRevLeviedOrgnztnlBnft509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Govt Furn Srvc Fclts Vl509 GovtFurnSrvcFcltsVl509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $0 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $0 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $0 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $0 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $0 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $0 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $0 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $0 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $0 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $0 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $0 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $0 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $0 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $0 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Post1975 UBTI Post1975UBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $0 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $0 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $0 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $0 | TotalAmt |
Net Income From Other UBI NetIncomeFromOtherUBIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $0 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $0 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $0 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $0 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $0 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $0 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $0 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0 | PublicSupportCY509Pct |
| Public Support PY509 | 0.0 | PublicSupportPY509Pct |
| Investment Income CY | 0 | InvestmentIncomeCYPct |
| Investment Income PY | 0.0 | InvestmentIncomePYPct |
| Private Foundation509 | Yes (X) | PrivateFoundation509Ind |
Distributable Amount DistributableAmountGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| CY Adj Net Income Distributable | $0 | CYAdjNetIncomeDistributableAmt |
| CY Pct85 Adjusted Net Income | $0 | CYPct85AdjustedNetIncomeAmt |
| CY Total Min Ast Distributable | $0 | CYTotalMinAstDistributableAmt |
| CY Greater Adjusted Minimum | $0 | CYGreaterAdjustedMinimumAmt |
| CY Income Tax Imposed PY | $0 | CYIncomeTaxImposedPYAmt |
| CY Distributable As Adjusted | $0 | CYDistributableAsAdjustedAmt |
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) |
|---|---|---|
| Investment Cost Or Other Basis | $0 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $0 | OtherCostOrOtherBasisAmt |
| Book Value | $0 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $0 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $0 | OtherCostOrOtherBasisAmt |
| Depreciation | $0 | DepreciationAmt |
| Book Value | $0 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $0 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $1,024,511 | OtherCostOrOtherBasisAmt |
| Depreciation | $305,318 | DepreciationAmt |
| Book Value | $719,193 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $0 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $127,218 | OtherCostOrOtherBasisAmt |
| Depreciation | $15,570 | DepreciationAmt |
| Book Value | $111,648 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $0 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $0 | OtherCostOrOtherBasisAmt |
| Depreciation | $0 | DepreciationAmt |
| Book Value | $0 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $830,841 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Right of Use Assets | Desc |
| Book Value | $2,768,618 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $2,768,618 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Lease Liabilities | Desc |
| Amt | $2,765,527 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $2,765,527 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $10,238,775 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | $0 | OtherRevenueAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $10,238,775 | RevenueSubtotalAmt |
| Other Revenues Not Included | $0 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $10,238,775 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $9,397,430 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $0 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $9,397,430 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $0 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $9,397,430 | TotalExpensesPerForm990Amt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| 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 | Yes (true) | 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 (3 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JUAN-PAULO AFABLE | ||||||||||||||
| CEO | $197,124 | $0 | $0 | $0 | $300 | $0 | $3,692 | $0 | $9,994 | $0 | $211,110 | $0 | $0 | $0 |
| SARAH HOEHNEN DO | ||||||||||||||
| CMO (TERM BEGAN 4/3/2023) | $177,885 | $0 | $0 | $0 | $255 | $0 | $1,731 | $0 | $0 | $0 | $179,871 | $0 | $0 | $0 |
| Terry Regula | ||||||||||||||
| FORMER CEO | $6,530 | $0 | $0 | $0 | $96,158 | $0 | $226 | $0 | $0 | $0 | $102,914 | $0 | $96,084 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan | Terry Regula, former CEO $96,084 - Non Qualified Deferred Compansation Plan |
| Schedule J, Part I, Line 3 | COMPENSATION OF CEO THE BOARD OF DIRECTORS DECIDES AND APPROVES THE CEO'S COMPENSATION. THE COMPENSATION IS THEN REVIEWED BY THE HUMAN RESOURCES MANAGER. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Line 11b Review of form 990 by governing body | THE FORM 990 WAS PREPARED BY AN INDEPENDENT CPA FIRM BASED ON INFORMATION PROVIDED BY THE ORGANIZATION'S CFO. THE CEO AND CFO CAREFULLY REVIEWED AND ANALYZED THE TAX RETURN, RECONCILING THE GENERAL LEDGER AMOUNTS TO THE APPROPRIATE SCHEDULES ON THE FORM 990 AND COMPARING THOSE AMOUNTS TO THE AUDITED FINANCIAL STATEMENTS. A COMPLETE COPY OF THE 990 WAS THEN SENT VIA EMAIL TO THE BOARD OF DIRECTORS FOR THEIR REVIEW PRIOR TO FILING. |
| Form 990, Part VI, Line 12c Conflict of interest policy | THE ORGANIZATION'S CONFLICT OF INTEREST POLICY APPLIES TO CLINIC BOARD MEMBERS, EMPLOYEES, CONSULTANTS AND THOSE WHO FURNISH GOODS OR SERVICES TO THE ORGANIZATION. EACH BOARD MEMBER IS REQUIRED TO COMPLETE A CERTIFICATION OF AGREEMENT WITH THE CONFLICT OF INTEREST POLICY AND DISCLOSE ANY KNOWN CONFLICTS OF INTEREST UPON HIS OR HER ELECTION OR REELECTION TO THE BOARD AND ANNUALLY THEREAFTER. WHENEVER THE CHIEF EXECUTIVE OFFICER, KEY MANAGEMENT PERSONNEL OR ANY BOARD MEMBER HAS A CONFLICT OF INTEREST OR A PERCEIVED CONFLICT OF INTEREST WITH MCHC, HE OR SHE IS REQUIRED TO NOTIFY THE FULL BOARD OF SUCH CONFLICT IN WRITING USING THE ANNUAL CERTIFICATION FORM. WHEN ANY CONFLICT OF INTEREST IS RELEVANT TO A MATTER THAT COMES UNDER CONSIDERATION OR REQUIRES ACTION BY THE BOARD, OR A BOARD COMMITTEE, THE INTERESTED PERSON IS REQUIRED TO CALL IT TO THE ATTENTION OF THE BOARD CHAIR AND MUST LEAVE THE MEETING DURING BOARD OR COMMITTEE DISCUSSION OR DECISION ON THE MATTER. HOWEVER, THAT PERSON IS ALLOWED TO PROVIDE THE BOARD OR APPLICABLE COMMITTEE WITH ANY AND ALL RELEVANT INFORMATION ON THE PARTICULAR MATTER. BOARD MEMBERS WHO VIOLATE THE CONFLICT OF INTEREST POLICY MAY, DEPENDING ON THE SEVERITY OF THE VIOLATION, BE SUBJECT TO ORAL ADMONISHMENT OR REMOVAL FROM THEIR POSITION. |
| Form 990, Part VI, Line 15a Process to establish compensation of top management official | THE ANNUAL REVIEW FOR THE CEO WAS DONE IN November OF 2023. THE BOARD OF DIRECTORS DECIDES AND APPROVES THE CEO'S COMPENSATION. THE COMPENSATION IS THEN REVIEWED BY THE HUMAN RESOURCE MANAGER. |
| Form 990, Part VI, Line 19 Required documents available to the public | MY COMMUNITY HEALTH CENTER MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| Form 990, Part IX, Line 11g Other Fees | Other - Total Expense: 2537066, Program Service Expense: 1950304, Management and General Expenses: 586762, Fundraising Expenses: 0; |
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