FOOTHILLS COMMUNITY HEALTH CARE: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- FOOTHILLS COMMUNITY HEALTH CARE (EIN 26-2735317)
- Tax period
- 2021-05-01 to 2022-04-30
- Filed
- 2023-01-19
- IRS object ID
- 202300199349300915
- Schema version
- 2021v4.0
- 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 | 2023-01-19T11:59:12-05:00 | ReturnTs |
| Tax Period End | 2022-04-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 202102404 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PETWAY MILLS & PEARSON PA | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1036 | AddressLine1Txt |
| City | ZEBULON | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 275971036 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-05-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 262735317 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FOOTHILLS COMMUNITY HEALTH | BusinessNameLine1Txt |
| Business Name Line2 | CARE INC | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | FOOT | BusinessNameControlTxt |
| Phone | 8647220283 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 311 | AddressLine1Txt |
| City | CLEMSON | CityNm |
| State Abbreviation | SC | StateAbbreviationCd |
| ZIP | 29633 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MARK RAJKOWSKI | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 8647220283 | PhoneNum |
| Signature | 2022-12-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | MARK | PersonFirstNm |
| Person Last | RAJKOWSKI | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JAMES A RIDOUTT | PreparerPersonNm |
| PTIN | P00394550 | PTIN |
| Phone | 9192697405 | PhoneNum |
| Preparation | 2022-12-15 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2023-03-07 01:45:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MARK RAJKOWSKI | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 311 | AddressLine1Txt |
| City | CLEMSON | CityNm |
| State Abbreviation | SC | StateAbbreviationCd |
| ZIP | 29633 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $5,482,992 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.MYFCHC.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2008 | FormationYr |
| Legal Domicile State | SC | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE AFFORDABLE PRIMARY AND PREVENTATIVE HEALTHCARE SERVICES TO UNINSURED, AS WELL AS FULLY INSURED, CITIZENS OF PICKENS COUNTY SOUTH CAROLINA AND SURROUNDING AREAS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 14 | VotingMembersIndependentCnt |
| Total Employee | 51 | TotalEmployeeCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $3,532,508 | PYContributionsGrantsAmt |
| CY Contributions Grants | $2,739,587 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $1,259,963 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $2,743,362 | CYProgramServiceRevenueAmt |
| CY Investment Income | $43 | CYInvestmentIncomeAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $4,792,471 | PYTotalRevenueAmt |
| CY Total Revenue | $5,482,992 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $2,556,795 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $2,661,399 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,348,456 | PYOtherExpensesAmt |
| CY Other Expenses | $1,950,663 | CYOtherExpensesAmt |
| PY Total Expenses | $3,905,251 | PYTotalExpensesAmt |
| CY Total Expenses | $4,612,062 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $887,220 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $870,930 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $3,290,587 | TotalAssetsBOYAmt |
| Total Assets EOY | $4,140,707 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $582,784 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $561,974 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $2,707,803 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $3,578,733 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO PROVIDE AFFORDABLE PRIMARY AND PREVENTATIVE HEALTHCARE SERVICES TO UNINSURED, AS WELL AS FULLY INSURED, CITIZENS OF PICKENS COUNTY SOUTH CAROLINA AND SURROUNDING AREAS. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $3,359,128 | ExpenseAmt |
| Revenue | $2,743,362 | RevenueAmt |
| Desc | FOOTHILLS COMMUNITY HEALTHCARE PROVIDED HEALTHCARE SERVICES TO 5,487 PATIENTS DURING THE FISCAL YEAR ENDED 4/30/22. FCHC HAS A POLICY FOR PROVIDING CHARITY CARE TO PATIENTS WHO ARE FINANCIALLY UNABLE TO PAY FOR SERVICES. THE ESTIMATED COST OF CHARITY CARE TOTALED APPROXIMATELY 1,115,087 FOR THE FISCAL YEAR. | Desc |
| Total Program Service Expenses | $3,359,128 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| 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 | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 51 | 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 |
| Form8899 Filedind | false | Form8899Filedind |
| Form1098 C Filed | false | Form1098CFiledInd |
| 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 | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 14 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | THE ORGANIZATION | PersonNm |
| Phone | 8647220283 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 311 | AddressLine1Txt |
| City | CLEMSON | CityNm |
| State Abbreviation | SC | StateAbbreviationCd |
| ZIP | 29633 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| C WAYNE HELMS | |||||||
| PRESIDENT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| KEITH MOODY | |||||||
| VICE-PRESIDE | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| DR AMY ANDERSON | |||||||
| SECRETARY | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| WILLIAM WALKER | |||||||
| TREASURER | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| ELLIE TAYLOR | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| LEAH SANDERS | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| KENDRA JOHNSON | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DR JANET MARSH | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| CINDY TRIMMIER LEE | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| PETER SPARKS | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| LUCILIA BEATON | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| CHRIS BENSON | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| TRECA DESHIELDS | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| MARIA ROSA JUDEZ RIGUELME | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| MARK RAJKOWSKI | |||||||
| CEO | 40.00 | Yes (X) | $157,872 | $0 | $0 | ||
| MANJU LAKRA MD | |||||||
| CMO | 40.00 | Yes (X) | $176,002 | $0 | $0 | ||
| PAUL THOMPSON MD | |||||||
| PHYSICIAN | 40.00 | $108,542 | $0 | $0 | Yes (X) | ||
| TIMOTHY SANDERS MD | |||||||
| PHYSICIAN | 40.00 | $167,122 | $0 | $0 | Yes (X) | ||
| JEFFREY NATIONS MD | |||||||
| PHYSICIAN | 40.00 | $165,952 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $775,490 | TotalReportableCompFromOrgAmt |
| Indiv Rcvd Greater Than100 K | 5 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| Government Grants | $2,512,250 | GovernmentGrantsAmt |
| All Other Contributions | $227,337 | AllOtherContributionsAmt |
| Total Contributions | $2,739,587 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|
| PATIENT SERVICES REVENUE | $2,710,487 | $2,710,487 |
| OTHER OPERATING & FEE INCOME | $32,875 | $32,875 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $2,743,362 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $43 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $43 | RelatedOrExemptFuncIncomeAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,482,992 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $2,743,405 | RelatedOrExemptFuncIncomeAmt |
| 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 | $333,874 | TotalAmt |
| Program Services | $230,474 | ProgramServicesAmt |
| Management And General | $103,400 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,959,944 | TotalAmt |
| Program Services | $1,353,006 | ProgramServicesAmt |
| Management And General | $606,938 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,338 | TotalAmt |
| Program Services | $13,647 | ProgramServicesAmt |
| Management And General | $6,691 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $142,230 | TotalAmt |
| Program Services | $95,521 | ProgramServicesAmt |
| Management And General | $46,709 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $205,013 | TotalAmt |
| Program Services | $150,577 | ProgramServicesAmt |
| Management And General | $54,436 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $57,853 | TotalAmt |
| Program Services | $53,907 | ProgramServicesAmt |
| Management And General | $3,946 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $595,393 | TotalAmt |
| Program Services | $460,946 | ProgramServicesAmt |
| Management And General | $134,447 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,929 | TotalAmt |
| Program Services | $15,575 | ProgramServicesAmt |
| Management And General | $8,354 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $177,457 | TotalAmt |
| Program Services | $127,969 | ProgramServicesAmt |
| Management And General | $49,488 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $262,427 | TotalAmt |
| Program Services | $210,747 | ProgramServicesAmt |
| Management And General | $51,680 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,453 | TotalAmt |
| Program Services | $23,394 | ProgramServicesAmt |
| Management And General | $5,059 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,871 | TotalAmt |
| Management And General | $10,871 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $138,971 | TotalAmt |
| Program Services | $93,420 | ProgramServicesAmt |
| Management And General | $45,551 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,799 | TotalAmt |
| Program Services | $10,353 | ProgramServicesAmt |
| Management And General | $3,446 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $462,343 | $379,537 | $82,806 |
| PATIENT CARE | $77,487 | $77,487 | |
| DUES AND PUBLICATIONS | $33,910 | $17,075 | $16,835 |
| LEASE EXPENSE | $32,038 | $25,373 | $6,665 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $35,732 | TotalAmt |
| Program Services | $20,120 | ProgramServicesAmt |
| Management And General | $15,612 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,612,062 | TotalAmt |
| Program Services | $3,359,128 | ProgramServicesAmt |
| Management And General | $1,252,934 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $756,643 | BOYAmt |
| EOY | $2,191,589 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $604,338 | BOYAmt |
| EOY | $61,105 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $261,876 | BOYAmt |
| EOY | $228,696 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $68,057 | BOYAmt |
| EOY | $70,422 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $2,101,430 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $548,324 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,566,993 | BOYAmt |
| EOY | $1,553,106 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $1,000 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,680 | BOYAmt |
| EOY | $34,789 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,290,587 | BOYAmt |
| EOY | $4,140,707 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $199,019 | BOYAmt |
| EOY | $259,046 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $39,693 | BOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $344,072 | BOYAmt |
| EOY | $302,928 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $582,784 | BOYAmt |
| EOY | $561,974 | 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 | $2,707,803 | BOYAmt |
| EOY | $3,578,733 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,707,803 | BOYAmt |
| EOY | $3,578,733 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,290,587 | BOYAmt |
| EOY | $4,140,707 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $870,930 | ReconcilationRevenueExpnssAmt |
| 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) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,624,752 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,473,536 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,120,241 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,532,508 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,739,587 | CurrentTaxYearAmt |
| Total | $11,490,624 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,624,752 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,473,536 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,120,241 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,532,508 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,739,587 | CurrentTaxYearAmt |
| Total | $11,490,624 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $11,490,624 | PublicSupportTotal170Amt |
| Total Support | $11,490,624 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $6,943,548 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 1.00000 | PublicSupportCY170Pct |
| Public Support PY170 | 1.00000 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
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 | $43,061 | OtherCostOrOtherBasisAmt |
| Book Value | $43,061 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,069,540 | OtherCostOrOtherBasisAmt |
| Depreciation | $142,184 | DepreciationAmt |
| Book Value | $927,356 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $382,123 | OtherCostOrOtherBasisAmt |
| Depreciation | $119,329 | DepreciationAmt |
| Book Value | $262,794 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $606,706 | OtherCostOrOtherBasisAmt |
| Depreciation | $286,811 | DepreciationAmt |
| Book Value | $319,895 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,553,106 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $5,482,992 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Subtotal | $5,482,992 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $5,482,992 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $4,612,062 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $4,612,062 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $4,612,062 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE D, PAGE 3, PART X | FormAndLineReferenceDesc |
| Explanation | FCHC IMPLEMENTED THE NEW ACCOUNTING REQUIREMENTS ASSOCIATED WITH UNCERTAINTY IN INCOME TAXES USING THE PROVISIONS OF FASB ASC 740, INCOME TAXES. USING THAT GUIDANCE, TAX POSITIONS INITIALLY NEED TO BE RECOGNIZED IN THE FINANCIAL STATEMENTS WHEN IT IS MORE-LIKELY-THAN-NOT THE POSITIONS WILL BE SUSTAINED UPON EXAMINATION BY THE TAX AUTHORITIES. IT ALSO PROVIDES GUIDANCE FOR DE-RECOGNITION, CLASSIFICATION, INTEREST AND PENALTIES, ACCOUNTING IN INTERIM PERIODS, DISCLOSURE AND TRANSITION. AS OF THE DATE OF THE INDEPENDENT AUDITORS' REPORT, FCHC HAS NO UNCERTAIN TAX POSITIONS THAT QUALIFY FOR EITHER RECOGNITION OR DISCLOSURE IN THE FINANCIAL STATEMENTS. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt |
|---|---|---|
| MARK RAJKOWSKI | ||
| CEO | $157,872 | $157,872 |
| MANJU LAKRA MD | ||
| CMO | $176,002 | $176,002 |
| TIMOTHY SANDERS MD | ||
| PHYSICIAN | $167,122 | $167,122 |
| JEFFREY NATIONS MD | ||
| PHYSICIAN | $165,952 | $165,952 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 6, PART VI, LINE 11B | THE FORM 990 IS REVIEWED IN DETAIL WITH THE FINANCE COMMITTEE AND IS THEN PROVIDED TO ALL BOARD MEMBERS FOR DISCUSSION AND QUESTIONS. |
| FORM 990, PAGE 6, PART VI, LINE 12C | BOARD MEMBERS AND OFFICERS ARE REQUIRED TO DISCLOSE ANY POTENTIAL CONFLICTS OF INTEREST ANNUALLY. IF A CONFLICT ARISES IT IS PRESENTED TO THE BOARD OF DIRECTORS FOR DISCUSSION AND A VOTE ON AN APPROPRIATE ACTION TO BE TAKEN. CONFLICT OF INTEREST QUESTIONAIRES ARE COMPILED AND PRESENTED TO THE BOARD OF DIRECTORS FOR RESOLUTION. |
| FORM 990, PAGE 6, PART VI, LINE 15A | COMPENSATION FOR THE CEO IS DETERMINED AND VOTED ON BY THE EXECUTIVE COMMITTEE AFTER A THOROUGH REVIEW AND RESEARCH OF SIMILAR POSITIONS WITHIN THE INDUSTRY AND REGION. |
| FORM 990, PAGE 6, PART VI, LINE 15B | COMPENSATION FOR OTHER OFFICERS, KEY EMPLOYEES AND STAFF ARE DETERMINED BY HR AND THE CEO. |
| FORM 990, PAGE 6, PART VI, LINE 19 | GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE AT THE ORGANIZATION'S OFFICE UPON REQUEST |
| FORM 990, PART IX, LINE 11G | STAFFING CONTRACT 150,324 80,944 0 TELEMEDICINE 63,860 4,674 0 IT SERVICES 38,986 20,993 0 RECRUTING & RETENTION 85,489 6,257 0 OTHER SERVICES 3,604 263 0 CONTRACTED PHARMACY 4,245 1,853 0 PURCHASED SERVICES 114,438 19,463 0 TOTAL 460,946 134,447 0 |
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