DIRNE HEALTH CENTERS INC: Form 990, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- DIRNE HEALTH CENTERS INC (EIN 94-3036820)
- Tax period
- 2022-01-01 to 2022-12-31
- Filed
- 2023-11-03
- IRS object ID
- 202333079349301548
- Schema version
- 2022v5.0
- 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 | 2023-11-03T11:11:28-05:00 | ReturnTs |
| Tax Period End | 2022-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 410746749 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10700 NORTHUP WAY SUITE 200 | AddressLine1Txt |
| City | BELLEVUE | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98004 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2022-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 943036820 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DIRNE HEALTH CENTERS INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | DIRN | BusinessNameControlTxt |
| Phone | 2082920292 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1090 WEST PARK PLACE | AddressLine1Txt |
| City | COEUR DALENE | CityNm |
| State Abbreviation | ID | StateAbbreviationCd |
| ZIP | 83814 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MICHAEL BAKER | PersonNm |
| Person Title | CHIEF EXECUTIVE OFFICER | PersonTitleTxt |
| Phone | 2082920292 | PhoneNum |
| Signature | 2023-10-31 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | MICHAEL | PersonFirstNm |
| Person Last | BAKER | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | 0 | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KURT BENNION CPA | PreparerPersonNm |
| PTIN | P01469618 | PTIN |
| Phone | 4252506100 | PhoneNum |
| Preparation | 2023-10-31 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2022 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HERITAGE HEALTH | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | PAM THOMPSON | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1090 WEST PARK PLACE | AddressLine1Txt |
| City | COEUR DALENE | CityNm |
| State Abbreviation | ID | StateAbbreviationCd |
| ZIP | 83814 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $40,414,764 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.MYHERITAGEHEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1986 | FormationYr |
| Legal Domicile State | ID | LegalDomicileStateCd |
| Activity Or Mission | PROVIDE QUALITY HEALTH CARE TO LOW-INCOME AND UNINSURED INDIVIDUALS REGARDLESS OF ABILITY TO PAY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 14 | VotingMembersIndependentCnt |
| Total Employee | 410 | TotalEmployeeCnt |
| Total Volunteers | 35 | TotalVolunteersCnt |
| Total Gross UBI | $14,042 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $12,199 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $14,923,032 | PYContributionsGrantsAmt |
| CY Contributions Grants | $10,188,579 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $27,044,464 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $24,608,080 | CYProgramServiceRevenueAmt |
| PY Investment Income | $44,572 | PYInvestmentIncomeAmt |
| CY Investment Income | $6,310 | CYInvestmentIncomeAmt |
| PY Other Revenue | $5,390,051 | PYOtherRevenueAmt |
| CY Other Revenue | $4,216,002 | CYOtherRevenueAmt |
| PY Total Revenue | $47,402,119 | PYTotalRevenueAmt |
| CY Total Revenue | $39,018,971 | 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 | $23,448,931 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $26,139,134 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $457,317 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $13,675,047 | PYOtherExpensesAmt |
| CY Other Expenses | $12,641,911 | CYOtherExpensesAmt |
| PY Total Expenses | $37,123,978 | PYTotalExpensesAmt |
| CY Total Expenses | $38,781,045 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $10,278,141 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $237,926 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $28,010,711 | TotalAssetsBOYAmt |
| Total Assets EOY | $29,254,295 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $7,410,819 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $8,416,477 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $20,599,892 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $20,837,818 | NetAssetsOrFundBalancesEOYAmt |
| Mission | PROVIDE QUALITY HEALTH CARE TO LOW-INCOME AND UNINSURED INDIVIDUALS REGARDLESS OF ABILITY TO PAY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $26,537,127 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $28,451,838 | RevenueAmt |
| Desc | TO PROVIDE CARE TO ALL, REGARDLESS OF ABILITY TO PAY, AND TO SPECIALIZE IN PROVIDING CARE FOR THE MEDICALLY UNDERSERVED, LOW INCOME, AND OTHER DISADVANTAGED POPULATIONS IN KOOTENAI AND SHOSHONE COUNTIES. THE CLINIC PROVIDES COMPREHENSIVE AND COORDINATED SERVICES, INCLUDING PRIMARY MEDICAL CARE, DENTAL CARE, AND MENTAL HEALTH COUNSELING. THE CLINIC STRIVES TO IMPROVE THE OVERALL HEALTH OF THE GENERAL POPULATION THROUGH HEALTH EDUCATION AND PROMOTION ACTIVITIES. THE CLINIC'S PHILOSOPHY IS TO PROVIDE ACCESSIBLE, AFFORDABLE, COMPASSIONATE, QUALITY HEALTH CARE SERVICES FOR THE COMMUNITY. | Desc |
| Total Program Service Expenses | $26,537,127 | 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 | Yes (1) | 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 | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | 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 | 9 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 410 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| 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 | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 14 | 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 | Yes (1) | LocalChaptersInd |
| Policies Reference Chapters | Yes (1) | PoliciesReferenceChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | ID | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MICHAEL BAKER | PersonNm |
| Phone | 2082920256 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7830 N MEADOWLARK WAY | AddressLine1Txt |
| City | COEUR DALENE | CityNm |
| State Abbreviation | ID | StateAbbreviationCd |
| ZIP | 83815 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (24 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|
| ANTHONY REHIL-CREST | |||||||
| CMO | 40.00 | Yes (X) | $320,385 | $0 | $30,826 | ||
| MICHAEL BAKER | |||||||
| CEO | 40.00 | Yes (X) | $301,574 | $0 | $29,305 | ||
| HOLLI HANSEN | |||||||
| CLINIC MEDICAL DIRECTOR | 32.00 | $297,258 | $0 | $5,222 | Yes (X) | ||
| DANIEL HENBEST | |||||||
| CLINIC MEDICAL DIRECTOR | 40.00 | $266,390 | $0 | $26,204 | Yes (X) | ||
| GRAHAM RACHAL | |||||||
| CLINIC MEDICAL DIRECTOR | 40.00 | $257,131 | $0 | $26,117 | Yes (X) | ||
| TIFFANY KUGLER | |||||||
| NURSE PRACTITIONER | 32.00 | $267,796 | $0 | $3,788 | Yes (X) | ||
| MARK SMYLY | |||||||
| PHYSICIAN ASSISTANT | 40.00 | $237,330 | $0 | $10,725 | Yes (X) | ||
| MARK HAMPE | |||||||
| CFO | 40.00 | Yes (X) | $218,685 | $0 | $26,628 | ||
| DAVID ATKINS | |||||||
| CBHO | 40.00 | Yes (X) | $221,449 | $0 | $20,427 | ||
| EDWARD LARSEN | |||||||
| COO & CIO | 40.00 | Yes (X) | $193,811 | $0 | $27,749 | ||
| JADE EAST | |||||||
| CAO | 40.00 | Yes (X) | $100,173 | $0 | $11,951 | ||
| PAM THOMPSON | |||||||
| PRESIDENT | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| CHRISTOPHER WAY | |||||||
| VICE PRESIDENT | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| ELIZABETH MONTGOMERY | |||||||
| SECRETARY | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| GEORGE ROHLINGER | |||||||
| TREASURER | 2.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| PAUL AMADOR | |||||||
| DIRECTOR | 2.00 | $0 | $0 | $0 | Yes (X) | ||
| DONNA AUSTIN | |||||||
| DIRECTOR | 2.00 | $0 | $0 | $0 | Yes (X) | ||
| RON BEECHER | |||||||
| DIRECTOR | 2.00 | $0 | $0 | $0 | Yes (X) | ||
| ANN DARE | |||||||
| DIRECTOR | 2.00 | $0 | $0 | $0 | Yes (X) | ||
| DR JANA HULL | |||||||
| DIRECTOR | 2.00 | $0 | $0 | $0 | Yes (X) | ||
| LINDA JOHANN | |||||||
| DIRECTOR | 2.00 | $0 | $0 | $0 | Yes (X) | ||
| CARL MCMINIMY | |||||||
| DIRECTOR | 2.00 | $0 | $0 | $0 | Yes (X) | ||
| MICHAEL SCHMIDT | |||||||
| DIRECTOR | 2.00 | $0 | $0 | $0 | Yes (X) | ||
| CHERI ZAO | |||||||
| DIRECTOR | 2.00 | $0 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,681,982 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $218,942 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 43 | 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 |
|---|---|---|---|---|---|
| ATHENA HEALTH | |||||
| PO BOX 415615 | BOSTON | MA | 02241 | BILLING SERVICES | $1,197,836 |
| SMITH & MALEK | |||||
| 601 E FRONT AVENUE | COEUR DALENE | ID | 83814 | LEGAL SERVICES | $462,984 |
| FAMILY SUPPORT SERVICES | |||||
| 2201 IRONWOOD PLACE | COEUR DALENE | ID | 83814 | PROGRAM MANAGEMENT | $431,632 |
| TIMEDOC HEALTH | |||||
| 815 W WEED STREET | CHICAGO | IL | 60642 | CHRONIC CARE MANAGEMENT | $303,350 |
| PHREESIA INC | |||||
| 434 FAYETTEVILLE STREET SUITE 1400 | RALEIGH | NC | 27601 | POPULATION HEALTH MANAGEMENT | $278,146 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 9 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $9,741,918 | GovernmentGrantsAmt |
| All Other Contributions | $446,661 | AllOtherContributionsAmt |
| Noncash Contributions | $3,044,438 | NoncashContributionsAmt |
| Total Contributions | $10,188,579 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT REVENUE | 624100 | $24,539,261 | $24,539,261 |
| OTHER MEDICAL REVENUE | 624100 | $68,819 | $68,819 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $24,608,080 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $6,310 | TotalRevenueColumnAmt |
| Exclusion | $6,310 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $414,802 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $400,760 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $14,042 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $14,042 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $14,042 | UnrelatedBusinessRevenueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $4,838,791 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $995,033 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,843,758 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,843,758 | RelatedOrExemptFuncIncomeAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS INCOME | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $358,202 | TotalRevenueColumnAmt |
| Exclusion | $358,202 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $358,202 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $39,018,971 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $28,451,838 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $14,042 | UnrelatedBusinessRevenueAmt |
| Exclusion | $364,512 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,502,965 | TotalAmt |
| Program Services | $148,273 | ProgramServicesAmt |
| Management And General | $1,354,692 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,283,205 | TotalAmt |
| Program Services | $14,661,888 | ProgramServicesAmt |
| Management And General | $5,346,067 | ManagementAndGeneralAmt |
| Fundraising | $275,250 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $247,805 | TotalAmt |
| Program Services | $174,609 | ProgramServicesAmt |
| Management And General | $71,718 | ManagementAndGeneralAmt |
| Fundraising | $1,478 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,527,761 | TotalAmt |
| Program Services | $1,701,744 | ProgramServicesAmt |
| Management And General | $811,733 | ManagementAndGeneralAmt |
| Fundraising | $14,284 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,577,398 | TotalAmt |
| Program Services | $1,044,867 | ProgramServicesAmt |
| Management And General | $511,606 | ManagementAndGeneralAmt |
| Fundraising | $20,925 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $462,984 | TotalAmt |
| Management And General | $462,984 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $115,242 | TotalAmt |
| Management And General | $115,242 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,634,903 | TotalAmt |
| Program Services | $2,679,040 | ProgramServicesAmt |
| Management And General | $950,997 | ManagementAndGeneralAmt |
| Fundraising | $4,866 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $88,965 | TotalAmt |
| Program Services | $18,832 | ProgramServicesAmt |
| Management And General | $62,434 | ManagementAndGeneralAmt |
| Fundraising | $7,699 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $763,914 | TotalAmt |
| Program Services | $461,040 | ProgramServicesAmt |
| Management And General | $238,950 | ManagementAndGeneralAmt |
| Fundraising | $63,924 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,535,683 | TotalAmt |
| Program Services | $1,179,799 | ProgramServicesAmt |
| Management And General | $338,461 | ManagementAndGeneralAmt |
| Fundraising | $17,423 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $248,022 | TotalAmt |
| Program Services | $114,273 | ProgramServicesAmt |
| Management And General | $133,455 | ManagementAndGeneralAmt |
| Fundraising | $294 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $44,768 | TotalAmt |
| Program Services | $9,476 | ProgramServicesAmt |
| Management And General | $31,418 | ManagementAndGeneralAmt |
| Fundraising | $3,874 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $195,217 | TotalAmt |
| Program Services | $15,077 | ProgramServicesAmt |
| Management And General | $180,006 | ManagementAndGeneralAmt |
| Fundraising | $134 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $752,317 | TotalAmt |
| Program Services | $487,954 | ProgramServicesAmt |
| Management And General | $242,218 | ManagementAndGeneralAmt |
| Fundraising | $22,145 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $83,555 | TotalAmt |
| Program Services | $18,993 | ProgramServicesAmt |
| Management And General | $64,562 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Management And GeneralManagementAndGeneralAmt | Program ServicesProgramServicesAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| UBI TAXES | $3,405 | $3,405 | ||
| MEDICAL SUPPLIES | $3,418,403 | $3,418,403 | ||
| CONTINUING EDUCATION | $711,675 | $590,646 | $118,988 | $2,041 |
| EQUIPMENT | $251,393 | $97,707 | $147,664 | $6,022 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $331,465 | TotalAmt |
| Program Services | $136,207 | ProgramServicesAmt |
| Management And General | $178,300 | ManagementAndGeneralAmt |
| Fundraising | $16,958 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,781,045 | TotalAmt |
| Program Services | $26,537,127 | ProgramServicesAmt |
| Management And General | $11,786,601 | ManagementAndGeneralAmt |
| Fundraising | $457,317 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,232,411 | BOYAmt |
| EOY | $16,195,179 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,983 | BOYAmt |
| EOY | $39,983 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,689,760 | BOYAmt |
| EOY | $3,073,618 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $398,826 | BOYAmt |
| EOY | $863,699 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $151,489 | BOYAmt |
| EOY | $365,362 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $8,150,786 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $2,445,560 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,742,146 | BOYAmt |
| EOY | $5,705,226 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,763,096 | BOYAmt |
| EOY | $1,563,835 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $1,447,393 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,010,711 | BOYAmt |
| EOY | $29,254,295 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,682,461 | BOYAmt |
| EOY | $2,969,700 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $459,687 | BOYAmt |
| EOY | $409,687 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,960 | BOYAmt |
| EOY | $4,960 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,487,352 | BOYAmt |
| EOY | $3,155,704 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $776,359 | BOYAmt |
| EOY | $420,640 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $1,455,786 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,410,819 | BOYAmt |
| EOY | $8,416,477 | 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 | $20,599,892 | BOYAmt |
| EOY | $20,717,818 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $120,000 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,599,892 | BOYAmt |
| EOY | $20,837,818 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,010,711 | BOYAmt |
| EOY | $29,254,295 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $237,926 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $6,830,694 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $9,516,157 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $9,729,012 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $14,923,032 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $10,188,579 | CurrentTaxYearAmt |
| Total | $51,187,474 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $6,830,694 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $9,516,157 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $9,729,012 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $14,923,032 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $10,188,579 | CurrentTaxYearAmt |
| Total | $51,187,474 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $51,187,474 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $553 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,464 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,098 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $44,572 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $6,310 | CurrentTaxYearAmt |
| Total | $53,997 | TotalAmt |
Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | $38,392 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $14,042 | CurrentTaxYearAmt |
| Total | $52,434 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $470,823 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $604,814 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $412,544 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $980,882 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $358,202 | CurrentTaxYearAmt |
| Total | $2,827,265 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $54,121,170 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $144,242,259 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.94580 | PublicSupportCY170Pct |
| Public Support PY170 | 0.93900 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: | FormAndLineReferenceDesc |
| Explanation | OTHER INCOME SPECIAL FUNDRAISING EVENTS | 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | 0 | AgentTrusteeEtcInd |
| Incl Escrow Custodial Acct Liab | Yes (1) | InclEscrowCustodialAcctLiabInd |
| Explanation Provided | Yes (X) | ExplanationProvidedInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,051,198 | OtherCostOrOtherBasisAmt |
| Book Value | $1,051,198 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,855,605 | OtherCostOrOtherBasisAmt |
| Depreciation | $103,714 | DepreciationAmt |
| Book Value | $2,751,891 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,614,192 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,011,283 | DepreciationAmt |
| Book Value | $602,909 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,629,791 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,330,563 | DepreciationAmt |
| Book Value | $1,299,228 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $5,705,226 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | RIGHT-OF-USE LEASE LIABILITIES | Desc |
| Amt | $1,455,786 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,455,786 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $39,577,469 | TotalRevEtcAuditedFinclStmtAmt |
| Donated Services And Use Fclts | $75,307 | DonatedServicesAndUseFcltsAmt |
| Other Revenue | $1,395,793 | OtherRevenueAmt |
| Revenue Not Reported | $1,471,100 | RevenueNotReportedAmt |
| Revenue Subtotal | $38,106,369 | RevenueSubtotalAmt |
| Other Revenues Not Included | $912,602 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $912,602 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $39,018,971 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $40,247,303 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $75,307 | DonatedServicesUseFcltsAmt |
| Other Expenses Included | $1,395,793 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $1,471,100 | ExpensesNotReportedAmt |
| Expenses Subtotal | $38,776,203 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $4,842 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $4,842 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $38,781,045 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART IV, LINE 2B: | THE ORGANIZATION HOLDS TENANT SECURITY DEPOSITS FOR RENTAL SPACES. THE DEPOSIT, LESS REPAIRS FOR DAMAGES, WILL BE RETURNED TO THE TENANT WHEN THE LEASE IS TERMINATED. |
| PART X, LINE 2: | THE CLINIC HAS RECEIVED A DETERMINATION LETTER FROM THE INTERNAL REVENUE SERVICE THAT STATES IT IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC). ACCORDINGLY, NO PROVISION FOR INCOME TAXES IS SHOWN IN THE FINANCIAL STATEMENTS. MANAGEMENT EVALUATED THE CLINIC'S TAX POSITIONS AND CONCLUDED THAT THE CLINIC HAD TAKEN NO SIGNIFICANT UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENTS TO THE FINANCIAL STATEMENTS TO COMPLY WITH THE PROVISIONS OF TOPIC 740 OF THE ACCOUNTING STANDARDS CODIFICATION. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | RENTAL EXPENSES 400,760. COST OF GOODS SOLD 995,033. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | BAD DEBT EXPENSE 4,842. GRANTS AND CONTRIBUTIONS FOR ACQUISITION OF PROPERTY AND EQUIPMENT 787,760. GRANTS AND CONTRIBUTIONS WITH DONOR RESTRICTIONS 120,000. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | RENTAL EXPENSES 400,760. COST OF GOODS SOLD 995,033. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | BAD DEBT EXPENSE 4,842. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | Yes (1) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| 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 | Yes (1) | 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 (10 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ANTHONY REHIL-CREST | ||||||||||||||
| CMO | $307,946 | $0 | $12,439 | $0 | $0 | $0 | $5,761 | $0 | $25,065 | $0 | $351,211 | $0 | $0 | $0 |
| MICHAEL BAKER | ||||||||||||||
| CEO | $283,916 | $0 | $17,658 | $0 | $0 | $0 | $5,577 | $0 | $23,728 | $0 | $330,879 | $0 | $0 | $0 |
| HOLLI HANSEN | ||||||||||||||
| CLINIC MEDICAL DIRECTOR | $253,080 | $0 | $44,178 | $0 | $0 | $0 | $5,222 | $0 | $0 | $0 | $302,480 | $0 | $0 | $0 |
| DANIEL HENBEST | ||||||||||||||
| CLINIC MEDICAL DIRECTOR | $252,674 | $0 | $13,716 | $0 | $0 | $0 | $5,522 | $0 | $20,682 | $0 | $292,594 | $0 | $0 | $0 |
| GRAHAM RACHAL | ||||||||||||||
| CLINIC MEDICAL DIRECTOR | $249,946 | $0 | $7,185 | $0 | $0 | $0 | $3,669 | $0 | $22,448 | $0 | $283,248 | $0 | $0 | $0 |
| TIFFANY KUGLER | ||||||||||||||
| NURSE PRACTITIONER | $227,950 | $0 | $39,846 | $0 | $0 | $0 | $3,788 | $0 | $0 | $0 | $271,584 | $0 | $0 | $0 |
| MARK SMYLY | ||||||||||||||
| PHYSICIAN ASSISTANT | $232,448 | $0 | $4,882 | $0 | $0 | $0 | $2,777 | $0 | $7,948 | $0 | $248,055 | $0 | $0 | $0 |
| MARK HAMPE | ||||||||||||||
| CFO | $216,027 | $0 | $2,658 | $0 | $0 | $0 | $4,482 | $0 | $22,146 | $0 | $245,313 | $0 | $0 | $0 |
| DAVID ATKINS | ||||||||||||||
| CBHO | $212,389 | $0 | $9,060 | $0 | $0 | $0 | $4,289 | $0 | $16,138 | $0 | $241,876 | $0 | $0 | $0 |
| EDWARD LARSEN | ||||||||||||||
| COO & CIO | $191,737 | $0 | $2,074 | $0 | $0 | $0 | $4,021 | $0 | $23,728 | $0 | $221,560 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 1A | THE ORGANIZATION PROVIDES ALL EMPLOYEES WITH A DISCOUNT AT TWO LOCAL HEALTH CLUBS. DURING 2022, A PORTION OF MIKE BAKER'S PAID TIME OFF (PTO) WAS CASHED IN TO PAY FOR HIS GOLF CLUB MEMBERSHIP. THIS WAS INCLUDED IN HIS TAXABLE COMPENSATION. |
| PART I, LINE 5 | SOME PHYSICIANS ARE COMPENSATED BASED ON INDIVIDUALS SERVED AND AMOUNTS COLLECTED. |
Schedule M IRS990ScheduleM
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 12 | ContributionCnt |
| Noncash Contributions Rpt F990 | $3,044,438 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | COST | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8283 Received | 0 | Form8283ReceivedCnt |
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | Yes (1) | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 1A | THE BOARD OF DIRECTORS HAS AN EXECUTIVE COMMITTEE COMPRISED OF THE OFFICERS OF THE BOARD AND THE CHAIRS OF EACH COMMITTEE OF THE BOARD. THE EXECUTIVE COMMITTEE HAS THE POWERS OF THE BOARD WHEN THE BOARD IS NOT IN SESSION. THE EXECUTIVE COMMITTEE IS EMPOWERED TO ACT FOR THE FULL BOARD IN MATTERS THAT REQUIRE IMMEDIATE ACTION OR DO NOT INVOLVE MAJOR QUESTIONS OF POLICY OR FUNDING. IT IS ALSO THE COORDINATING COMMITTEE THAT ORGANIZES THE BOARD'S WORK AND THE ACTIVITIES OF THE OTHER COMMITTEES. |
| FORM 990, PART VI, SECTION B, LINE 11B | PRIOR TO FILING, THE FORM 990 WAS REVIEWED BY THE CEO, THEN IT WAS PRESENTED TO THE FINANCE COMMITTEE AND THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION B, LINE 12C | ALL POTENTIAL DIRECTOR CONFLICTS OF INTEREST ARE DISCLOSED TO THE BOARD. WHEN ANY SUCH INTEREST BECOMES A MATTER OF BOARD ACTION, THE DIRECTOR DOES NOT VOTE OR USE PERSONAL INFLUENCE ON THE MATTER AND ISN'T COUNTED IN DETERMINING WHETHER A QUORUM EXISTS. THE DIRECTOR MAY, HOWEVER, BRIEFLY STATE A POSITION ON THE MATTER AND ANSWER PERTINENT QUESTIONS. FOR EMPLOYEES, THE CEO OR THEIR DESIGNEE(S) REVIEWS ALL REPORTS OF CONFLICTS OF INTEREST AND CONDUCTS WHATEVER INVESTIGATION AND/OR TAKES WHATEVER ACTION HE OR SHE, IN THEIR JUDGEMENT, DETERMINES TO BE APPROPRIATE UNDER THE CIRCUMSTANCES. |
| FORM 990, PART VI, SECTION B, LINE 15A | THE CEO'S COMPENSATION IS DETERMINED BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS. SEVERAL MARKET RATE STUDIES ARE REVIEWED INCLUDING NWRPCA AND NACHC DATA. THIS INFORMATION IS GIVEN TO THE BOARD EXECUTIVE COMMITTEE TO DECIDE ANNUAL COMPENSATION FOR THE UPCOMING YEAR ALONG WITH MERIT CONSIDERATIONS. THE CEO'S COMPENSATION WAS LAST REVIEWED BY THE EXECUTIVE COMMITTEE IN 2022, ALTHOUGH AN ANALYSIS INCLUDING MARKET STUDIES WAS LAST COMPLETED IN 2016. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. |
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