HENRY J AUSTIN HEALTH CENTER INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- HENRY J AUSTIN HEALTH CENTER INC (EIN 22-2682708)
- Tax period
- 2021-04-01 to 2022-03-31
- Filed
- 2023-02-15
- IRS object ID
- 202320469349301527
- 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 | 2023-02-15T16:00:34-06:00 | ReturnTs |
| Tax Period End | 2022-03-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 390859910 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BAKER TILLY US LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1570 FRUITVILLE PIKE SUITE 400 | AddressLine1Txt |
| City | LANCASTER | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 17601 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-04-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 222682708 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HENRY J AUSTIN HEALTH CENTER INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | HENR | BusinessNameControlTxt |
| Phone | 6092785900 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 321 N WARREN STREET | AddressLine1Txt |
| City | TRENTON | CityNm |
| State Abbreviation | NJ | StateAbbreviationCd |
| ZIP | 08618 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DR KEMI ALLI | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 6092785900 | PhoneNum |
| Signature | 2023-02-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | DR | PersonFirstNm |
| Person Last | KEMI ALLI | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | XXX-XX-XXXX | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KERRI N BOGDA CPA | PreparerPersonNm |
| PTIN | P00760402 | PTIN |
| Phone | 7177404863 | PhoneNum |
| Preparation | 2023-02-15 | PreparationDt |
| Self Employed | Yes (X) | SelfEmployedInd |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| 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 | DR KEMI ALLI | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 321 N WARREN STREET | AddressLine1Txt |
| City | TRENTON | CityNm |
| State Abbreviation | NJ | StateAbbreviationCd |
| ZIP | 08618 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $35,393,524 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.HENRYJAUSTIN.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1986 | FormationYr |
| Legal Domicile State | NJ | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE QUALITY HEALTHCARE TO MERCER COUNTY'S UNINSURED AND UNDERINSURED. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 209 | TotalEmployeeCnt |
| Total Volunteers | 22 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $9,902,993 | PYContributionsGrantsAmt |
| CY Contributions Grants | $17,290,257 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $13,247,185 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $13,654,652 | CYProgramServiceRevenueAmt |
| PY Investment Income | $5,215 | PYInvestmentIncomeAmt |
| CY Investment Income | $6,342 | CYInvestmentIncomeAmt |
| PY Other Revenue | $989,555 | PYOtherRevenueAmt |
| CY Other Revenue | $21,775 | CYOtherRevenueAmt |
| PY Total Revenue | $24,144,948 | PYTotalRevenueAmt |
| CY Total Revenue | $30,973,026 | 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 | $13,552,716 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $16,702,807 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $8,598,650 | PYOtherExpensesAmt |
| CY Other Expenses | $9,733,449 | CYOtherExpensesAmt |
| PY Total Expenses | $22,151,366 | PYTotalExpensesAmt |
| CY Total Expenses | $26,436,256 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,993,582 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $4,536,770 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $15,564,364 | TotalAssetsBOYAmt |
| Total Assets EOY | $16,813,946 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $9,692,386 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $6,368,910 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $5,871,978 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $10,445,036 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE HENRY J. AUSTIN HEALTH CENTER, INC. PROVIDES PATIENT-CENTERED, COMPREHENSIVE, ACCESSIBLE, EFFICIENT, QUALITY PRIMARY CARE SERVICES TO THE CULTURALLY DIVERSE GREATER TRENTON COMMUNITY. OUR EXCEPTIONAL, DEDICATED, WELL-TRAINED TEAM DELIVERS BEST PRACTICE HEALTH CARE, WORKING WITH COMMUNITY PARTNERS TO PROVIDE EXTRAORDINARY CUSTOMER SERVICE AND QUALITY OUTCOMES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $16,076,868 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $11,579,002 | RevenueAmt |
| Desc | HENRY J. AUSTIN HEALTH CENTER PROVIDES MEDICAL, DENTAL, MENTAL AND OTHER HEALTH CARE SERVICES TO THE LARGELY MEDICALLY UNDERSERVED POPULATION OF THE SURROUNDING TRENTON AREA. DURING THE YEAR, THE ORGANIZATION SAW 17,800 PATIENTS AND HAD 67,429 PATIENT VISITS. THE AVERAGE NUMBER OF VISITS PER PATIENT WAS 3.79. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,246,402 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $1,197,354 | RevenueAmt |
| Desc | HENRY J. AUSTIN HEALTH CENTER PROVIDES MEDICAL, DENTAL, MENTAL AND OTHER HEALTH CARE SERVICES TO THE HOMELESS POPULATION IN THE SURROUNDING TRENTON AREA. DURING THE YEAR, THE ORGANIZATION SAW 1,039 PATIENTS AND HAD 6,157 PATIENT VISITS. THE AVERAGE NUMBER OF VISITS PER PATIENT WAS 5.93. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,095,176 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $867,844 | RevenueAmt |
| Desc | HENRY J. AUSTIN HEALTH CENTER PROVIDES MEDICAL, DENTAL, MENTAL AND OTHER HEALTH CARE AND RELATED SUPPORTING SOCIAL SERVICES TO THE AFFECTED HIV POPULATION OF THE SURROUNDING TRENTON AREA. THESE SERVICES ALSO INCLUDE HIV EDUCATION AND PREVENTION SERVICES. DURING THE YEAR,THE ORGANIZATION SAW 424 PATIENTS AND HAD 11,624 PATIENT VISITS. THE AVERAGE NUMBER OF VISITS PER PATIENT WAS 27.42. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $18,418,446 | 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 | 92 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 209 | 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 | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | NJ | 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 KEMI ALLI CEO | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6092785939 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 321 N WARREN STREET | AddressLine1Txt |
| City | TRENTON | CityNm |
| State Abbreviation | NJ | StateAbbreviationCd |
| ZIP | 08618 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (25 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 |
|---|---|---|---|---|---|---|---|---|
| CHARLES DAVIS II | ||||||||
| BOARD CHAIRPERSON | 1.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| BEVERLY ANN SMITH | ||||||||
| BOARD VICE CHAIRPERSON | 1.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| DANIEL BENSON | ||||||||
| BOARD TREASURER | 1.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| DETRAVIUS BETHEA | ||||||||
| BOARD SECRETARY | 1.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| TYRONE GASKINS | ||||||||
| BOARD MEMBER | 1.50 | Yes (X) | $0 | $0 | $0 | |||
| DEKIA SMITH | ||||||||
| BOARD MEMBER | 1.50 | Yes (X) | $0 | $0 | $0 | |||
| AVERY INCE | ||||||||
| BOARD MEMBER | 1.50 | Yes (X) | $0 | $0 | $0 | |||
| MARYANN CRAWLEY | ||||||||
| BOARD MEMBER | 1.50 | Yes (X) | $0 | $0 | $0 | |||
| PRESTON WILSON | ||||||||
| BOARD MEMBER | 1.50 | Yes (X) | $0 | $0 | $0 | |||
| MAYA CRUZ | ||||||||
| BOARD MEMBER | 1.50 | Yes (X) | $0 | $0 | $0 | |||
| LAURENCE GANGES | ||||||||
| BOARD MEMBER (UNTIL 02/2022) | 1.50 | Yes (X) | $0 | $0 | $0 | |||
| ALFONSO LLANO | ||||||||
| BOARD MEMBER (UNTIL 02/2022) | 1.50 | Yes (X) | $0 | $0 | $0 | |||
| CHINWEZE AHAGHOTU | ||||||||
| BOARD MEMBER (UNTIL 02/2022) | 1.50 | Yes (X) | $0 | $0 | $0 | |||
| KEMI ALLI MD | ||||||||
| CHIEF EXECUTIVE OFFICER | 35.00 | Yes (X) | $212,415 | $0 | $20,833 | |||
| MERKLE CHERRY | ||||||||
| CHIEF OPERATING OFFICER | 35.00 | Yes (X) | $139,051 | $0 | $3,270 | |||
| RACHAEL EVANS MD | ||||||||
| CHIEF MEDICAL OFFICER | 35.00 | Yes (X) | $173,842 | $0 | $23,598 | |||
| JAMES FOLEY | ||||||||
| CHIEF FINANCIAL OFFICER TO 11/21 | 35.00 | Yes (X) | $140,558 | $0 | $1,838 | |||
| GENE BOUIE | ||||||||
| DOO | 35.00 | Yes (X) | $84,371 | $0 | $18,276 | |||
| ELONA DEPREZ AS OF 122021 | ||||||||
| CHIEF DEVELOPMENT & COMM. OFFICER | 35.00 | Yes (X) | $6,065 | $0 | $0 | |||
| DEVIN GOODMAN DMD | ||||||||
| DIRECTOR OF DENTAL SERVICES | 40.00 | $178,695 | $0 | $8,945 | Yes (X) | |||
| MALA KAILASAM | ||||||||
| PHYSICIAN | 40.00 | $210,269 | $0 | $3,783 | Yes (X) | |||
| KHADIJAH ISMAEL | ||||||||
| DENTIST | 40.00 | $143,840 | $0 | $15,763 | Yes (X) | |||
| SHAUNON MOTEN | ||||||||
| DENTIST | 40.00 | $145,778 | $0 | $15,193 | Yes (X) | |||
| MAGALI SANTOS | ||||||||
| DENTIST | 40.00 | $120,266 | $0 | $19,624 | Yes (X) | |||
| SADAF FAROOQ | ||||||||
| PEDIATRICIAN | 40.00 | $110,973 | $0 | $27,091 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,666,123 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $158,214 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 32 | 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 |
|---|---|---|---|---|---|
| SCOZZARI BUILDERS INC | |||||
| 1891 NORTH OLDEN AVE | TRENTON | NJ | 08638 | BUILDING CONSTRUCTION | $604,347 |
| MEDIX STAFFING SOLUTIONS INC | |||||
| 7839 SOLUTION CENTER | CHICAGO | IL | 60677 | TEMPORARY MEDICAL STAFFING | $535,478 |
| ABW MEDICAL LLC | |||||
| PO BOX 882141 | PORT ST LUCIE | FL | 34988 | BILLING AND EMR SPECIALISTS | $334,779 |
| CALL 4 HEALTH | |||||
| 2855 S CONGRESS AVE STE A B | DELRAY BEACH | FL | 33445 | MEDICAL CALL & ANSWERING SVCS. | $330,970 |
| FORVIS LLC | |||||
| 910 E ST LOUIS ST STE 200 | SPRINGFIELD | MO | 65801 | FINANCIAL AND ACCOUNTING SVCS. | $257,965 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 14 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $15,064,901 | GovernmentGrantsAmt |
| All Other Contributions | $2,225,356 | AllOtherContributionsAmt |
| Noncash Contributions | $787,133 | NoncashContributionsAmt |
| Total Contributions | $17,290,257 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENUE | 621400 | $8,587,766 | $8,587,766 |
| 340B PROGRAM | 621400 | $4,455,906 | $4,455,906 |
| ADMINISTRATIVE FEE REVENUE | 900099 | $384,922 | $384,922 |
| THIRD PARTY INCENTIVES | 621400 | $177,944 | $177,944 |
| MEANINGFUL USE REVENUE | 900099 | $34,000 | $34,000 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $14,114 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $14,114 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $13,654,652 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $6,342 | TotalRevenueColumnAmt |
| Exclusion | $6,342 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $35,870 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $31,724 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $4,146 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,146 | TotalRevenueColumnAmt |
| Exclusion | $4,146 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $4,378,322 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $4,388,774 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$10,452 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | -$10,452 | RelatedOrExemptFuncIncomeAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| MEDICAL RECORDS FEES | 900099 | $9,951 | $9,951 |
| REFUNDS AND INCENTIVES | 900099 | $6,995 | $6,995 |
| QI PARTICIPATION FEES | 900099 | $2,600 | $2,600 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $8,535 | TotalRevenueColumnAmt |
| Exclusion | $8,535 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $28,081 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $30,973,026 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $13,644,200 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $38,569 | 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 | $1,033,515 | TotalAmt |
| Program Services | $713,321 | ProgramServicesAmt |
| Management And General | $320,194 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,165,615 | TotalAmt |
| Program Services | $8,396,572 | ProgramServicesAmt |
| Management And General | $3,769,043 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $152,357 | TotalAmt |
| Program Services | $105,155 | ProgramServicesAmt |
| Management And General | $47,202 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,344,907 | TotalAmt |
| Program Services | $1,618,429 | ProgramServicesAmt |
| Management And General | $726,478 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,006,413 | TotalAmt |
| Program Services | $694,615 | ProgramServicesAmt |
| Management And General | $311,798 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $638,080 | TotalAmt |
| Program Services | $638,080 | ProgramServicesAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,239 | TotalAmt |
| Program Services | $35,898 | ProgramServicesAmt |
| Management And General | $341 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $484,584 | TotalAmt |
| Program Services | $367,373 | ProgramServicesAmt |
| Management And General | $117,211 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,442,684 | TotalAmt |
| Program Services | $1,772,553 | ProgramServicesAmt |
| Management And General | $1,670,131 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $52,223 | TotalAmt |
| Program Services | $20,780 | ProgramServicesAmt |
| Management And General | $31,443 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $591,734 | TotalAmt |
| Program Services | $374,247 | ProgramServicesAmt |
| Management And General | $217,487 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $146,377 | TotalAmt |
| Program Services | $9,710 | ProgramServicesAmt |
| Management And General | $136,667 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18 | TotalAmt |
| Program Services | $18 | ProgramServicesAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $172,506 | TotalAmt |
| Program Services | $132,826 | ProgramServicesAmt |
| Management And General | $39,680 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $166,696 | TotalAmt |
| Program Services | $59,932 | ProgramServicesAmt |
| Management And General | $106,764 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $696,968 | TotalAmt |
| Program Services | $696,968 | ProgramServicesAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $99,984 | TotalAmt |
| Program Services | $99,984 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $939,168 | $939,168 | $0 |
| ARRA IN-KIND | $748,682 | $748,682 | |
| EQUIPMENT RENTALS & PUR | $347,692 | $333,520 | $14,172 |
| LICENSE AND FEES | $265,444 | $79,220 | $186,224 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $904,370 | TotalAmt |
| Program Services | $581,395 | ProgramServicesAmt |
| Management And General | $322,975 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,436,256 | TotalAmt |
| Program Services | $18,418,446 | ProgramServicesAmt |
| Management And General | $8,017,810 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,100 | BOYAmt |
| EOY | $893 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,583,882 | BOYAmt |
| EOY | $4,541,836 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,227,596 | BOYAmt |
| EOY | $3,081,676 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,236,556 | BOYAmt |
| EOY | $1,130,579 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $185,275 | BOYAmt |
| EOY | $330,506 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $47,867 | BOYAmt |
| EOY | $140,386 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $13,640,301 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $6,052,231 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,237,423 | BOYAmt |
| EOY | $7,588,070 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $43,665 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,564,364 | BOYAmt |
| EOY | $16,813,946 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,631,158 | BOYAmt |
| EOY | $2,842,031 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,406,020 | BOYAmt |
| EOY | $892,676 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,273,790 | BOYAmt |
| EOY | $2,554,777 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,067,000 | BOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $314,418 | BOYAmt |
| EOY | $79,426 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,692,386 | BOYAmt |
| EOY | $6,368,910 | 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 | $5,716,614 | BOYAmt |
| EOY | $10,289,672 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $155,364 | BOYAmt |
| EOY | $155,364 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,871,978 | BOYAmt |
| EOY | $10,445,036 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,564,364 | BOYAmt |
| EOY | $16,813,946 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $4,536,770 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $36,288 | 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 | 0 | FSAuditedInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
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 | $6,974,711 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $8,757,591 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $8,349,550 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $9,902,993 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $17,290,257 | CurrentTaxYearAmt |
| Total | $51,275,102 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $11,563,734 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $13,917,115 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $17,978,089 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $18,082,257 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $18,032,974 | CurrentTaxYearAmt |
| Total | $79,574,169 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $18,538,445 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $22,674,706 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $26,327,639 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $27,985,250 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $35,323,231 | CurrentTaxYearAmt |
| Total | $130,849,271 | 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 | $130,849,271 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $13,466 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $692 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,029 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $5,215 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $42,212 | CurrentTaxYearAmt |
| Total | $63,614 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $13,466 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $692 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,029 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $5,215 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $42,212 | CurrentTaxYearAmt |
| Total | $63,614 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $25,259 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $58,174 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $37,803 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $14,115 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $28,081 | CurrentTaxYearAmt |
| Total | $163,432 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $18,577,170 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $22,733,572 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $26,367,471 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $28,004,580 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $35,393,524 | CurrentTaxYearAmt |
| Total | $131,076,317 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99830 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99840 | PublicSupportPY509Pct |
| Investment Income CY | 0.00050 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00030 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: | FormAndLineReferenceDesc |
| Explanation | MEDICAL RECORDS FEES - 2017 AMOUNT: $ 20,738. 2018 AMOUNT: $ 25,900. 2019 AMOUNT: $ 22,786. 2020 AMOUNT: $ 13,632. 2021 AMOUNT: $ 9,951. QI PARTICIPATION FEES - 2017 AMOUNT: $ 4,022. 2018 AMOUNT: $ 1,497. 2021 AMOUNT: $ 2,600. REFUNDS AND INCENTIVES - 2017 AMOUNT: $ 499. 2018 AMOUNT: $ 30,777. 2019 AMOUNT: $ 503. 2021 AMOUNT: $ 6,995. VENDOR SALES DISCOUNTS - 2019 AMOUNT: $ 12,074. 2020 AMOUNT: $ 483. CONSESSION PROCEEDS - EVENT - 2019 AMOUNT: $ 2,440. MISCELLANEOUS INCOME - 2021 AMOUNT: $ 8,535. | ExplanationTxt |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $102,342 | OtherCostOrOtherBasisAmt |
| Book Value | $102,342 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,475,980 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,867,009 | DepreciationAmt |
| Book Value | $2,608,971 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,231,992 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,080,601 | DepreciationAmt |
| Book Value | $2,151,391 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,097,172 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,104,621 | DepreciationAmt |
| Book Value | $992,551 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,732,815 | OtherCostOrOtherBasisAmt |
| Book Value | $1,732,815 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $7,588,070 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OTHER LIABILITIES | Desc |
| Amt | $79,426 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $79,426 | TotalLiabilityAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| KEMI ALLI MD | ||||||||||||||
| CHIEF EXECUTIVE OFFICER | $212,415 | $0 | $0 | $0 | $0 | $0 | $3,795 | $0 | $17,038 | $0 | $233,248 | $0 | $0 | $0 |
| MALA KAILASAM | ||||||||||||||
| PHYSICIAN | $210,269 | $0 | $0 | $0 | $0 | $0 | $3,055 | $0 | $728 | $0 | $214,052 | $0 | $0 | $0 |
| RACHAEL EVANS MD | ||||||||||||||
| CHIEF MEDICAL OFFICER | $173,842 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $23,598 | $0 | $197,440 | $0 | $0 | $0 |
| DEVIN GOODMAN DMD | ||||||||||||||
| DIRECTOR OF DENTAL SERVICES | $178,695 | $0 | $0 | $0 | $0 | $0 | $2,856 | $0 | $6,089 | $0 | $187,640 | $0 | $0 | $0 |
| SHAUNON MOTEN | ||||||||||||||
| DENTIST | $145,778 | $0 | $0 | $0 | $0 | $0 | $2,620 | $0 | $12,573 | $0 | $160,971 | $0 | $0 | $0 |
| KHADIJAH ISMAEL | ||||||||||||||
| DENTIST | $143,840 | $0 | $0 | $0 | $0 | $0 | $2,451 | $0 | $13,312 | $0 | $159,603 | $0 | $0 | $0 |
Schedule M IRS990ScheduleM
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 12411 | ContributionCnt |
| Noncash Contributions Rpt F990 | $787,133 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | COST | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | Yes (1) | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, COLUMN (B): | FormAndLineReferenceDesc |
| Explanation | THE NUMBER ON PART I, COLUMN B REPRESENTS NUMBER OF ITEMS DONATED. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 1A | IN EMERGENCY SITUATIONS WHERE THE FULL BOARD IS UNAVAILABLE, THE EXECUTIVE COMMITTEE, MADE UP OF THE CHAIRPERSON OF EACH COMMITTEE, MAY ACT. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 IS REVIEWED IN DETAIL BY THE CFO OF THE ORGANIZATION. A COPY OF THE 990 IS GIVEN TO EACH MEMBER OF THE BOARD OF DIRECTORS FOR THEIR REVIEW PRIOR TO FILING. ONCE THIS PROCEDURE IS COMPLETED, THE FORM 990 IS SIGNED BY THE CEO AND WILL BE FILED WITH THE INTERNAL REVENUE SERVICE. |
| FORM 990, PART VI, SECTION B, LINE 12C | EACH YEAR, THE ORGANIZATION DISTRIBUTES A CONFLICT OF INTEREST POLICY STATEMENT TO EXECUTIVE MANAGEMENT AND THE BOARD OF DIRECTORS FOR THEIR REVIEW AND AFFIRMATIVE ACKNOWLEDGEMENT THAT THEY ARE AWARE OF THE POLICY. THE CEO'S EXECUTIVE ASSISTANT REVIEWS AND MONITORS COMPLIANCE WITH THE CONFLICT STATEMENTS. IN ADDITION, THE ORGANIZATION ASKS FOR INFORMATION REGARDING ANY ORGANIZATION(S) THAT SENIOR MANAGEMENT, MEDICAL STAFF OR BOARD OF DIRECTORS HAVE AN INTEREST IN TO ENSURE THAT REFERRALS OR OTHER VENDOR RELATIONSHIPS ARE NOT BEING CONSUMMATED WITH THOSE ENTITIES. ANY POTENTIAL CONFLICTS OF INTEREST ARE BROUGHT TO A SUBSET OF THE BOARD OF DIRECTORS FOR THEIR INITIAL REVIEW. ANY CONFLICTS DEEMED BY THIS SUBSET TO BE POTENTIALLY DETRIMENTAL TO THE ORGANIZATION ARE REFERRED TO LEGAL COUNSEL FOR THEIR REVIEW. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS (NACHC) ISSUES AN ANNUAL SALARY SURVEY, AS DOES THE NEW JERSEY PRIMARY CARE ASSOCIATION (NJPCA). SUCH INFORMATION HAS BEEN PROVIDED TO THE BOARD FOR USE IN DETERMINING THE SALARY FOR THE CURRENT CEO WHO WAS HIRED IN MAY 2015 AND OTHER TOP MANAGEMENT POSITIONS (COO, CDCO AND CFO) HIRED IN 2019, 2021 AND 2022 RESPECTIVELY. THE CEO, CFO AND COO ALSO USE THE INFORMATION FOR HIRING SENIOR STAFF MEMBERS. DISCUSSIONS BY THE BOARD REGARDING COMPENSATION DETERMINATION ARE DOCUMENTED IN THE BOARD MEETING MINUTES. |
| 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 IX, LINE 11G | TEMPS: PROGRAM SERVICE EXPENSES 613,089. MANAGEMENT AND GENERAL EXPENSES 200,664. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 813,753. CONSULTANTS FEES: PROGRAM SERVICE EXPENSES 245,974. MANAGEMENT AND GENERAL EXPENSES 120,626. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 366,600. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 26,285. MANAGEMENT AND GENERAL EXPENSES 330,770. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 357,055. CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 887,205. MANAGEMENT AND GENERAL EXPENSES 1,018,071. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,905,276. |
| FORM 990, PART XI, LINE 9: | OTHER CHANGES TO NET ASSETS 36,288. |
| FORM 990, PART XII, LINE 2B: | THE ORGANIZATION IS REQUIRED TO GO THROUGH AN ANNUAL AUDIT BUT AUDITED FINANCIALS WERE NOT ISSUED AT THE TIME OF FILING FORM 990 FOR THE YEAR ENDING 3-31-2022. |
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