COMMUNITY HEALTH CENTER OF FRANKLIN COUNTY INCORPORATED: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization
COMMUNITY HEALTH CENTER OF FRANKLIN COUNTY INCORPORATED (EIN 04-3312968)
Tax period
2021-07-01 to 2022-06-30
Filed
2023-04-28
IRS object ID
202321189349301237
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

FieldValueIRS element (for citing)
Return2023-04-28T13:27:38-05:00ReturnTs
Tax Period End2022-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN221478099PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1COHNREZNICK LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1350 CHURCH STREET 12TH FLOORAddressLine1Txt
CityHARTFORDCityNm
State AbbreviationCTStateAbbreviationCd
ZIP06103ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2021-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN043312968EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1COMMUNITY HEALTH CENTER OF FRANKLINBusinessNameLine1Txt
Business Name Line2COUNTY INCORPORATEDBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlCOMMBusinessNameControlTxt
Phone4133258500PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1102 MAIN STREETAddressLine1Txt
CityGREENFIELDCityNm
State AbbreviationMAStateAbbreviationCd
ZIP01301ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonARLEY HOYNOSKIPersonNm
Person TitleCFOPersonTitleTxt
Phone4133258500PhoneNum
Signature2023-04-27SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstARLEYPersonFirstNm
Person LastHOYNOSKIPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonLORI ROTHE YOKOBOSKY CPAPreparerPersonNm
PTINP01273422PTIN
Phone9592007000PhoneNum
Preparation2023-04-19PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer3TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2021TaxYr
Build TS2023-04-26 12:10:37ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerALLISON VAN DER VELDENPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1102 MAIN STREETAddressLine1Txt
CityGREENFIELDCityNm
State AbbreviationMAStateAbbreviationCd
ZIP01301ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$12,681,518GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.CHCFC.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1995FormationYr
Legal Domicile StateMALegalDomicileStateCd
Activity Or MissionTO CARE FOR THE HEALTH OF OUR COMMUNITY.ActivityOrMissionDesc
Voting Members Governing Body12VotingMembersGoverningBodyCnt
Voting Members Independent12VotingMembersIndependentCnt
Total Employee140TotalEmployeeCnt
Total Volunteers6TotalVolunteersCnt
Total Gross UBI$104,852TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$6,452,548PYContributionsGrantsAmt
CY Contributions Grants$5,212,910CYContributionsGrantsAmt
PY Program Service Revenue$5,812,420PYProgramServiceRevenueAmt
CY Program Service Revenue$7,320,631CYProgramServiceRevenueAmt
PY Investment Income$10,094PYInvestmentIncomeAmt
CY Investment Income$6,370CYInvestmentIncomeAmt
PY Other Revenue-$28,281PYOtherRevenueAmt
CY Other Revenue$141,607CYOtherRevenueAmt
PY Total Revenue$12,246,781PYTotalRevenueAmt
CY Total Revenue$12,681,518CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$6,787,536PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$8,307,195CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$2,795,160PYOtherExpensesAmt
CY Other Expenses$3,524,461CYOtherExpensesAmt
PY Total Expenses$9,582,696PYTotalExpensesAmt
CY Total Expenses$11,831,656CYTotalExpensesAmt
PY Revenues Less Expenses$2,664,085PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$849,862CYRevenuesLessExpensesAmt
Total Assets BOY$11,724,719TotalAssetsBOYAmt
Total Assets EOY$12,644,096TotalAssetsEOYAmt
Total Liabilities BOY$4,023,195TotalLiabilitiesBOYAmt
Total Liabilities EOY$4,092,710TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$7,701,524NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$8,551,386NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTHE FULL MISSION OF THE COMMUNITY HEALTH CENTER OF FRANKLIN COUNTY, INC IS TO MAINTAIN A COMMUNITY OWNED, RESPONSIVE HEALTH CENTER WHICH PROMOTES PUBLIC HEALTH AND WELL-BEING, AND PROVIDES COMPREHENSIVE PREVENTATIVE AND PRIMARY CARE SERVICES TO ALL WHO NEED OR DESIRE SUCH SERVICES, WITHOUT REGARD TO INCOME, INSURANCE STATUS, ABILITY TO PAY, OR PAST MEDICAL HISTORY.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$6,081,860ExpenseAmt
Revenue$5,362,715RevenueAmt
DescTHE HEALTH CENTER OFFERS HIGH QUALITY PRIMARY CARE, WITH AN EMPHASIS ON PREVENTIVE CARE AND EDUCATION. OUR PATIENTS ARE OFFERED A FULL RANGE OF PRIMARY CARE SERVICES, INCLUDING PHYSICAL EXAMS, GYNECOLOGICAL EXAMS, URGENT CARE, DISEASE MANAGEMENT, DIAGNOSTIC SCREENINGS, AND LABORATORY SERVICES.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$3,314,528ExpenseAmt
Revenue$1,994,671RevenueAmt
DescTHE HEALTH CENTER PROVIDES PREVENTIVE, RESTORATIVE, AND EMERGENCY DENTAL CARE FOR CHILDREN AND ADULTS. SERVICES INCLUDE EXAMS, CLEANINGS, SEALANTS, FILLINGS, EXTRACTIONS, INCLUDING "WISDOM TEETH", IMPLANTS, ROOT CANAL TREATMENT AND CROWNS, DENTURES, AND OTHER GENERAL DENTAL PROCEDURES. PARTICULAR EMPHASIS IS PLACED ON PREVENTIVE SERVICES FOR CHILDREN.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$9,396,388TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash ContriYes (1)DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document9IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee140EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (1)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (1)Form990TFiledInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members12GoverningBodyVotingMembersCnt
Independent Voting Member12IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldMAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonARLEY HOYNOSKIPersonNm
Phone4133258500PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1102 MAIN STREETAddressLine1Txt
CityGREENFIELDCityNm
State AbbreviationMAStateAbbreviationCd
ZIP01301ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
BECCA CONNOR
DIRECTOR1.00Yes (X)$0$0$0
CASSAUNDRA GONZALEZ
DIRECTOR1.00Yes (X)$0$0$0
EDMOND HAYES
DIRECTOR1.00Yes (X)$0$0$0
GAIL SAWOSIK
DIRECTOR1.00Yes (X)$0$0$0
GARTH SHANEYFELT
PRESIDENT1.00Yes (X)$0$0$0Yes (X)
JERRY LUND
DIRECTOR1.00Yes (X)$0$0$0
JULIE DAVIS
DIRECTOR1.00Yes (X)$0$0$0
K LEV BEN-EZRA
TREASURER1.00Yes (X)$0$0$0Yes (X)
PHOEBE WALKER
CLERK1.00Yes (X)$0$0$0
SHAWNA FISHER
VICE PRESIDENT1.00Yes (X)$0$0$0Yes (X)
TERRANCE BLANCHARD
MEMBER-AT-LARGE1.00Yes (X)$0$0$0
VICKIE ROWE
DIRECTOR1.00Yes (X)$0$0$0
ALLISON VAN DER VELDEN
CEO40.00$147,080$0$16,822Yes (X)
ARLEY HOYNOSKI
CFO40.00$131,280$0$23,741Yes (X)
HEMANT BHASKAR
DENTIST40.00$120,794$0$6,063Yes (X)
CARL GIMBRONE
DENTIST40.00$121,378$0$10,145Yes (X)
MARWA ELLEBOUDY
DENTIST40.00$133,219$0$21,475Yes (X)
RICHARD SZAL
ORAL SURGEON40.00$253,257$0$13,725Yes (X)
STEPHEN SEGATORE
NURSE PRACTITIONER40.00$124,582$0$6,706Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,031,590TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$98,677TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K14IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1HUTTER CONSTRUCTION CORPORATIONBusinessNameLine1Txt

Contractor Address ContractorAddress

US Address USAddress

FieldValueIRS element (for citing)
Address Line1810 TURNPIKE ROAD PO BOX 257AddressLine1Txt
CityNEW IPSWICHCityNm
State AbbreviationNHStateAbbreviationCd
ZIP03071ZIPCd
FieldValueIRS element (for citing)
ServicesCONSTRUCTION SERVICESServicesDesc
Compensation$1,794,104CompensationAmt
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K1CntrctRcvdGreaterThan100KCnt
Government Grants$5,028,179GovernmentGrantsAmt
All Other Contributions$184,731AllOtherContributionsAmt
Noncash Contributions$48,693NoncashContributionsAmt
Total Contributions$5,212,910TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
MEDICAID621400$3,503,010$3,503,010
THIRD-PARTY PAYORS AND OTHER621400$1,429,946$1,429,946
PHARMACY REVENUE 304B621400$999,865$999,865
MEDICARE621400$782,023$782,023
HEALTH SAFETY NET AND SELF-PAY PA621400$605,787$605,787
FieldValueIRS element (for citing)
Total Program Service Revenue$7,320,631TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$6,370TotalRevenueColumnAmt
Exclusion$6,370ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$104,852RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$104,852RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$104,852TotalRevenueColumnAmt
Unrelated Business Revenue$104,852UnrelatedBusinessRevenueAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescINCENTIVE INCOMEDesc
Business900099BusinessCd
Total Revenue Column$32,428TotalRevenueColumnAmt
Related Or Exempt Func Income$32,428RelatedOrExemptFuncIncomeAmt

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$4,327TotalRevenueColumnAmt
Related Or Exempt Func Income$4,327RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$36,755OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$12,681,518TotalRevenueColumnAmt
Related Or Exempt Func Income$7,357,386RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$104,852UnrelatedBusinessRevenueAmt
Exclusion$6,370ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$457,504TotalAmt
Program Services$367,577ProgramServicesAmt
Management And General$89,927ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$6,494,952TotalAmt
Program Services$5,269,123ProgramServicesAmt
Management And General$1,225,829ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$49,156TotalAmt
Program Services$35,973ProgramServicesAmt
Management And General$13,183ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$805,131TotalAmt
Program Services$589,211ProgramServicesAmt
Management And General$215,920ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$500,452TotalAmt
Program Services$366,240ProgramServicesAmt
Management And General$134,212ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$6,734TotalAmt
Management And General$6,734ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$59,768TotalAmt
Management And General$59,768ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$898,437TotalAmt
Program Services$898,437ProgramServicesAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$22,774TotalAmt
Program Services$408ProgramServicesAmt
Management And General$22,366ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$170,144TotalAmt
Program Services$71,075ProgramServicesAmt
Management And General$99,069ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$177,812TotalAmt
Program Services$78,337ProgramServicesAmt
Management And General$99,475ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$293,066TotalAmt
Program Services$222,746ProgramServicesAmt
Management And General$70,320ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$8,612TotalAmt
Program Services$7,009ProgramServicesAmt
Management And General$1,603ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$29,876TotalAmt
Program Services$23,148ProgramServicesAmt
Management And General$6,728ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$102,704TotalAmt
Management And General$102,704ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$445,600TotalAmt
Program Services$402,425ProgramServicesAmt
Management And General$43,175ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$97,898TotalAmt
Management And General$97,898ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES & DRUG$763,315$763,315
REPAIRS & MAINTENANCE$201,866$117,295$84,571
DUES, SUBSCRIPTIONS, AN$32,027$28,145$3,882
STAFF TRAINING$26,000$26,000

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$187,828TotalAmt
Program Services$129,924ProgramServicesAmt
Management And General$57,904ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$11,831,656TotalAmt
Program Services$9,396,388ProgramServicesAmt
Management And General$2,435,268ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$852,600BOYAmt
EOY$1,585,852EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$4,341,082BOYAmt
EOY$3,447,576EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$260,012BOYAmt
EOY$127,938EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$721,908BOYAmt
EOY$1,154,686EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$110,694BOYAmt
EOY$107,672EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$7,980,619LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$1,760,247LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$5,438,423BOYAmt
EOY$6,220,372EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$11,724,719BOYAmt
EOY$12,644,096EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$740,588BOYAmt
EOY$877,515EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$102,607BOYAmt
EOY$54,647EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$3,180,000BOYAmt
EOY$3,160,548EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$4,023,195BOYAmt
EOY$4,092,710EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$7,701,524BOYAmt
EOY$8,551,386EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$7,701,524BOYAmt
EOY$8,551,386EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$11,724,719BOYAmt
EOY$12,644,096EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$849,862ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit RequiredYes (1)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (1)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,500,000OtherCostOrOtherBasisAmt
Depreciation$108,554DepreciationAmt
Book Value$1,391,446BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$3,367,771OtherCostOrOtherBasisAmt
Depreciation$135,714DepreciationAmt
Book Value$3,232,057BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,550,849OtherCostOrOtherBasisAmt
Depreciation$1,432,034DepreciationAmt
Book Value$1,118,815BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$561,999OtherCostOrOtherBasisAmt
Depreciation$83,945DepreciationAmt
Book Value$478,054BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$6,220,372TotalBookValueLandBuildingsAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$12,681,518TotalRevEtcAuditedFinclStmtAmt
Revenue Not Reported$0RevenueNotReportedAmt
Revenue Subtotal$12,681,518RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$12,681,518TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$11,831,656TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$11,831,656ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$11,831,656TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationMANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE CENTER AND HAS CONCLUDED THAT, AS OF JUNE 30, 2022, THERE ARE NO UNCERTAIN TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR ASSET) OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE CENTER'S FEDERAL AND STATE INFORMATION RETURNS PRIOR TO FISCAL YEAR 2019 ARE CLOSED AND MANAGEMENT CONTINUALLY EVALUATES EXPIRING STATUTES OF LIMITATIONS, AUDITS, PROPOSED SETTLEMENTS, CHANGES IN TAX LAW AND NEW AUTHORITATIVE RULINGS.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (1)AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
RICHARD SZAL
ORAL SURGEON$252,147$0$899$0$211$0$2,763$0$10,962$0$266,982$0$0$0
ALLISON VAN DER VELDEN
CEO$146,944$0$0$0$136$0$3,005$0$13,817$0$163,902$0$0$0
ARLEY HOYNOSKI
CFO$129,792$0$899$0$589$0$2,723$0$21,018$0$155,021$0$0$0
MARWA ELLEBOUDY
DENTIST$132,133$0$899$0$187$0$0$0$21,475$0$154,694$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 7FormAndLineReferenceDesc
ExplanationINCLUDED ON SCHEDULE J, PART II, COLUMN B(II) ARE AMOUNTS REPRESENTING PERFORMANCE INCENTIVES FOR HIGHLY COMPENSATED EMPLOYEES. THESE AMOUNTS WERE INCLUDED IN THE INDIVIDUALS 2021 W-2'S AND APPROVED BY CEO AND CFO.ExplanationTxt

Schedule M IRS990ScheduleM

Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Contribution1ContributionCnt
Noncash Contributions Rpt F990$48,693NoncashContributionsRptF990Amt
Method Of Determining RevenuesFAIR VALUEMethodOfDeterminingRevenuesTxt
FieldValueIRS element (for citing)
Any Property That Must Be Held0AnyPropertyThatMustBeHeldInd
Review Process Unusual NC Gifts0ReviewProcessUnusualNCGiftsInd
Third Parties Used0ThirdPartiesUsedInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, COLUMN (B):FormAndLineReferenceDesc
ExplanationCOLUMN B REPRESENT NUMBER OF CONTRIBUTORS.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11BTHE 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. PROCEDURES WILL INCLUDE A THOROUGH REVIEW, WITH THE BOARD, OF THE FORM 990 DETAILED QUESTIONS AND THE RESPONSES TO EACH PRIOR TO SUBMITTING THE RETURN. BOARD MEMBERS WILL BE ADVISED THAT THEY ARE EXPECTED TO UNDERSTAND AND AGREE WITH THE INFORMATION BEING REPORTED AND THE RESPONSES TO GOVERNANCE, MANAGEMENT, AND DISCLOSURE QUESTIONS.
FORM 990, PART VI, SECTION B, LINE 12CANNUALLY, OR UPON APPOINTMENT, BOARD MEMBERS AND KEY EMPLOYEES ARE REQUIRED TO RE-CERTIFY THEIR UNDERSTANDING OF AND DISCLOSE ALL EXISTING CONFLICTS. IF THE BOARD OF DIRECTORS DETERMINES THAT A CONFLICT OF INTEREST EXISTS, THE BOARD MEMBER WITH THE CONFLICT OF INTEREST MUST ABSTAIN FROM PARTICIPATING IN THE DISCUSSION OF AND FROM VOTING ON THE ISSUE OF WHICH HE OR SHE HAS A CONFLICT.
FORM 990, PART VI, SECTION B, LINE 15COMPENSATION FOR THE CEO AND OTHER KEY POSITIONS IS BASED ON QUALIFICATIONS/CREDENTIALS AND EXPERIENCE, IN ADDITION TO ANNUAL BENCHMARKING OF WAGES AND BENEFITS TO REMAIN COMPETITIVE WITH THE MARKET. KEY MANAGEMENT WAGES AND BENEFITS ARE BENCHMARKED AGAINST: (1) OTHER SMALL, RURAL HEALTH CENTERS NATIONWIDE USING THE ANNUAL NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS COMPENSATION STUDY, (2) OTHER MASSACHUSETTS COMMUNITY HEALTH CENTERS USING THE ANNUAL MASSACHUSETTS LEAGUE OF COMMUNITY HEALTH CENTERS COMPENSATION STUDY, AND (3) LOCAL COMPENSATION DATA (ALL SECTORS). THE BOARD OF DIRECTORS APPROVES THE ORGANIZATION'S WAGE SCALE FOR ALL POSITIONS.
FORM 990, PART VI, SECTION C, LINE 19ALL REPORTS AND INFORMATION IN THE PUBLIC DOMAIN, INCLUDING THE ORGANIZATION'S AUDITED FINANCIAL STATEMENTS AND TAX RETURNS, ARE AVAILABLE UPON WRITTEN REQUEST AT NO CHARGE.
FORM 990, PART IV, LINE 20A:THE ORGANIZATION IS NOT REQUIRED TO FILE A SCHEDULE H AND IS LICENSED IN THE STATE OF MASSACHUSETTS AS A CLINIC. SINCE IT DOES NOT MEET THE DEFINITION OF A HOSPITAL UNDER THE REQUIREMENTS OF SCHEDULE H, THE ORGANIZATION IS NOT REQUIRED TO FILE SUCH SCHEDULE.

Comments

Anonymous: no account or email. Up to 2,000 characters, at most one link. Comments are checked automatically; some wait for review.