PORTLAND COMMUNITY HEALTH CENTER: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- PORTLAND COMMUNITY HEALTH CENTER (EIN 45-4960453)
- Tax period
- 2020-07-01 to 2021-06-30
- Filed
- 2022-03-03
- IRS object ID
- 202200629349301500
- Schema version
- 2020v4.2
- 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 | 2022-03-03T13:09:21-06:00 | ReturnTs |
| Tax Period End | 2021-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 010523282 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Berry Dunn McNeil & Parker LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 1100 | AddressLine1Txt |
| City | Portland | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 041041100 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 454960453 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Portland Community Health Center | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PORT | BusinessNameControlTxt |
| Phone | 2078742141 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 180 Park Avenue | AddressLine1Txt |
| City | Portland | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 04102 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Ann Tucker | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 2078742141 | PhoneNum |
| Signature | 2022-02-28 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | Ann | PersonFirstNm |
| Person Last | Tucker | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Melissa Magoon CPA | PreparerPersonNm |
| PTIN | P01712842 | PTIN |
| Phone | 2077752387 | PhoneNum |
| Preparation | 2022-02-28 | 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 | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Greater Portland Health | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Ann Tucker | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 180 Park Avenue | AddressLine1Txt |
| City | Portland | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 04102 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $14,240,428 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.greaterportlandhealth.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2013 | FormationYr |
| Legal Domicile State | ME | LegalDomicileStateCd |
| Activity Or Mission | To provide high quality, patient-centered healthcare that is accessible, affordable, and culturally sensitive. | ActivityOrMissionDesc |
| Voting Members Governing Body | 15 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 15 | VotingMembersIndependentCnt |
| Total Employee | 177 | TotalEmployeeCnt |
| Total Volunteers | 16 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $6,156,192 | PYContributionsGrantsAmt |
| CY Contributions Grants | $7,336,780 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $5,985,758 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $6,894,851 | CYProgramServiceRevenueAmt |
| PY Investment Income | $7,980 | PYInvestmentIncomeAmt |
| CY Investment Income | $8,797 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $12,149,930 | PYTotalRevenueAmt |
| CY Total Revenue | $14,240,428 | 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 | $8,004,217 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $9,053,525 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $3,345,066 | PYOtherExpensesAmt |
| CY Other Expenses | $4,143,576 | CYOtherExpensesAmt |
| PY Total Expenses | $11,349,283 | PYTotalExpensesAmt |
| CY Total Expenses | $13,197,101 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $800,647 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,043,327 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $8,014,989 | TotalAssetsBOYAmt |
| Total Assets EOY | $6,097,385 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $4,527,823 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,408,420 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $3,487,166 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $4,688,965 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | To provide high quality, patient-centered healthcare that is accessible, affordable, and culturally sensitive. | MissionDesc |
| Significant New Program Srvc | Yes (1) | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $7,381,308 | ExpenseAmt |
| Revenue | $4,440,284 | RevenueAmt |
| Desc | The Organization is a community health center providing comprehensive primary care services to the greater Portland community across the full lifecycle (pediatric, adolescent, adult and geriatric care). The organization provides an array of enabling services: community health workers, peer support, and financial assistance counselors. The financial assistance counselors connect patients to insurances and an affordable sliding fee scale. The referrals team connects patients to specialty care that is offered in the community. Transportation and interpreting services are offered for patients that need these options. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $2,762,260 | ExpenseAmt |
| Revenue | $1,661,659 | RevenueAmt |
| Desc | The Organization provided comprehensive mental health and substance use counseling services in a fully integrated manner on-site at its Portland and South Portland, Maine locations. Licensed clinical social workers on each health care team help patients make needed changes through health coaching and providing behavioral strategies that improve health and reduce harm. Some of these include stress management techniques, smoking cessation and motivational interviewing. Support groups and educational sessions are offered as needed. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,318,091 | ExpenseAmt |
| Revenue | $792,907 | RevenueAmt |
| Desc | The Organization provides comprehensive dental services including preventative treatment, exams, follow up and oral health education for adults and children at its Portland sites and at the Portland public schools locations. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $11,461,659 | 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 | 0 | 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 | 0 | 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 | 21 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 177 | 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 | 15 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 15 | 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 | ME | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Robert Zager | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2078742141 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 180 Park Avenue | AddressLine1Txt |
| City | Portland | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 04102 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (24 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 |
|---|---|---|---|---|---|---|---|---|
| Grete Zemans | ||||||||
| President | 3.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| M Isabella Borrero | ||||||||
| Vice President | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Richard White | ||||||||
| Treasurer | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Paul Santomenna | ||||||||
| Secretary | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Amy Kustra Barksdale | ||||||||
| Director | 0.50 | Yes (X) | $0 | $0 | $0 | |||
| Rebecca Bass | ||||||||
| Director | 0.50 | Yes (X) | $0 | $0 | $0 | |||
| Chris Dana | ||||||||
| Director | 0.50 | Yes (X) | $0 | $0 | $0 | |||
| Gloria Herboldsheimer | ||||||||
| Director | 0.50 | Yes (X) | $0 | $0 | $0 | |||
| Jean Paul Mugiraneza | ||||||||
| Director | 0.50 | Yes (X) | $0 | $0 | $0 | |||
| Joyce Racine | ||||||||
| Director | 0.50 | Yes (X) | $0 | $0 | $0 | |||
| Joelle Rutembesa | ||||||||
| Director | 0.50 | Yes (X) | $0 | $0 | $0 | |||
| John Skeen | ||||||||
| Director | 0.50 | Yes (X) | $0 | $0 | $0 | |||
| Eileen Skillings | ||||||||
| Director | 0.50 | Yes (X) | $0 | $0 | $0 | |||
| Jeanne Uwimana | ||||||||
| Director | 0.50 | Yes (X) | $0 | $0 | $0 | |||
| Benjamin White | ||||||||
| Director | 0.50 | Yes (X) | $0 | $0 | $0 | |||
| Adria Moynihan Rusk | ||||||||
| Past Director | 0.50 | Yes (X) | $0 | $0 | $0 | |||
| Ann Tucker | ||||||||
| Chief Executive Officer | 40.00 | Yes (X) | $200,303 | $0 | $31,369 | |||
| Robert E Zager | ||||||||
| Chief Financial Officer | 40.00 | Yes (X) | $124,265 | $0 | $19,634 | |||
| Renee M Fay-LeBlanc | ||||||||
| Chief Medical Officer | 40.00 | $266,008 | $0 | $29,182 | Yes (X) | |||
| John P Fitzsimons | ||||||||
| Dental Director | 40.00 | $176,874 | $0 | $9,285 | Yes (X) | |||
| Diana Lapp | ||||||||
| Physician, Clinical Director | 34.00 | $161,622 | $0 | $14,617 | Yes (X) | |||
| Gita A Rao | ||||||||
| Physician, Pediatric Clinical Director | 40.00 | $151,798 | $0 | $3,250 | Yes (X) | |||
| Magan R Waterman | ||||||||
| Physician | 32.00 | $142,166 | $0 | $24,511 | Yes (X) | |||
| Gladys Estrada | ||||||||
| Physician, Clinical Director | 28.00 | $138,335 | $0 | $750 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,361,371 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $132,598 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 16 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Federated Campaigns | $37,252 | FederatedCampaignsAmt |
| Government Grants | $6,606,336 | GovernmentGrantsAmt |
| All Other Contributions | $693,192 | AllOtherContributionsAmt |
| Total Contributions | $7,336,780 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Patient Service Revenue | 621110 | $6,856,580 | $6,856,580 |
| Income from CCPM LLC | 621110 | $38,271 | $38,271 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $6,894,851 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $8,797 | TotalRevenueColumnAmt |
| Exclusion | $8,797 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $14,240,428 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $6,894,851 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $8,797 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $670,760 | TotalAmt |
| Management And General | $670,760 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,025,766 | TotalAmt |
| Program Services | $6,525,864 | ProgramServicesAmt |
| Management And General | $499,902 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $80,750 | TotalAmt |
| Program Services | $71,114 | ProgramServicesAmt |
| Management And General | $9,636 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $668,214 | TotalAmt |
| Program Services | $639,300 | ProgramServicesAmt |
| Management And General | $28,914 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $608,035 | TotalAmt |
| Program Services | $520,964 | ProgramServicesAmt |
| Management And General | $87,071 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $32,005 | TotalAmt |
| Management And General | $32,005 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $103,070 | TotalAmt |
| Management And General | $103,070 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $609,685 | TotalAmt |
| Program Services | $565,941 | ProgramServicesAmt |
| Management And General | $43,744 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,640 | TotalAmt |
| Program Services | $21,968 | ProgramServicesAmt |
| Management And General | $3,672 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $220,951 | TotalAmt |
| Program Services | $189,310 | ProgramServicesAmt |
| Management And General | $31,641 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $412,700 | TotalAmt |
| Program Services | $353,601 | ProgramServicesAmt |
| Management And General | $59,099 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $587,810 | TotalAmt |
| Program Services | $524,199 | ProgramServicesAmt |
| Management And General | $63,611 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $40,922 | TotalAmt |
| Program Services | $35,062 | ProgramServicesAmt |
| Management And General | $5,860 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,196 | TotalAmt |
| Program Services | $2,738 | ProgramServicesAmt |
| Management And General | $458 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $104,208 | TotalAmt |
| Program Services | $89,285 | ProgramServicesAmt |
| Management And General | $14,923 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $70,050 | TotalAmt |
| Program Services | $60,019 | ProgramServicesAmt |
| Management And General | $10,031 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Program Supplies | $1,437,222 | $1,437,222 | |
| Other expenses | $475,261 | $407,203 | $68,058 |
| Equipment Rental/Repair | $20,856 | $17,869 | $2,987 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,197,101 | TotalAmt |
| Program Services | $11,461,659 | ProgramServicesAmt |
| Management And General | $1,735,442 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part X | Yes (X) | InfoInScheduleOPartXInd |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,261,893 | BOYAmt |
| EOY | $3,892,738 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $300,366 | BOYAmt |
| EOY | $62 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,723,975 | BOYAmt |
| EOY | $450,385 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $912,070 | BOYAmt |
| EOY | $821,706 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,925 | BOYAmt |
| EOY | $105,393 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $1,507,537 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $954,912 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $552,487 | BOYAmt |
| EOY | $552,625 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $208,174 | BOYAmt |
| EOY | $246,445 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,196 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,903 | BOYAmt |
| EOY | $28,031 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,014,989 | BOYAmt |
| EOY | $6,097,385 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,052,321 | BOYAmt |
| EOY | $1,378,819 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,475,502 | BOYAmt |
| EOY | $29,601 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,527,823 | BOYAmt |
| EOY | $1,408,420 | 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 | $3,401,424 | BOYAmt |
| EOY | $4,523,051 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $85,742 | BOYAmt |
| EOY | $165,914 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,487,166 | BOYAmt |
| EOY | $4,688,965 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,014,989 | BOYAmt |
| EOY | $6,097,385 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $1,043,327 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $158,472 | 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) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Schedule A, Part I, Line 3: | FormAndLineReferenceDesc |
| Explanation | The Organization's tax exemption is based upon the classification as a hospital or cooperative hospital service organization described in Section 170(b)(1)(A)(iii). Since the Organization is not licensed in the State of Maine as a hospital, but rather as an FQHC, Schedule H is not required. | 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
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $461,011 | OtherCostOrOtherBasisAmt |
| Depreciation | $170,977 | DepreciationAmt |
| Book Value | $290,034 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,046,526 | OtherCostOrOtherBasisAmt |
| Depreciation | $783,935 | DepreciationAmt |
| Book Value | $262,591 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $552,625 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $14,264,428 | TotalRevEtcAuditedFinclStmtAmt |
| Donated Services And Use Fclts | $24,000 | DonatedServicesAndUseFcltsAmt |
| Revenue Not Reported | $24,000 | RevenueNotReportedAmt |
| Revenue Subtotal | $14,240,428 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $14,240,428 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $13,221,101 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $24,000 | DonatedServicesUseFcltsAmt |
| Expenses Not Reported | $24,000 | ExpensesNotReportedAmt |
| Expenses Subtotal | $13,197,101 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $13,197,101 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part X, Line 2: | FormAndLineReferenceDesc |
| Explanation | The Organization is a public charity under Section 501(c)(3) of the Internal Revenue Code. As a public charity, the Organization is exempt from state and federal income taxes on income earned in accordance with its tax-exempt purpose. Unrelated business income is subject to state and federal income tax. Management has evaluated the Organization's tax positions and concluded that the Organization has no uncertain tax positions that require adjustment to the financial statements. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | 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 | Yes (1) | 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Renee M Fay-LeBlanc | ||||||||||||||
| Chief Medical Officer | $234,210 | $0 | $12,298 | $0 | $19,500 | $0 | $750 | $0 | $28,432 | $0 | $295,190 | $0 | $0 | $0 |
| Ann Tucker | ||||||||||||||
| Chief Executive Officer | $158,782 | $0 | $15,521 | $0 | $26,000 | $0 | $750 | $0 | $30,619 | $0 | $231,672 | $0 | $0 | $0 |
| John P Fitzsimons | ||||||||||||||
| Dental Director | $152,519 | $0 | $4,855 | $0 | $19,500 | $0 | $750 | $0 | $8,535 | $0 | $186,159 | $0 | $0 | $0 |
| Diana Lapp | ||||||||||||||
| Physician, Clinical Director | $145,201 | $0 | $2,921 | $0 | $13,500 | $0 | $750 | $0 | $13,867 | $0 | $176,239 | $0 | $0 | $0 |
| Magan R Waterman | ||||||||||||||
| Physician | $119,600 | $0 | $5,046 | $0 | $17,520 | $0 | $750 | $0 | $23,761 | $0 | $166,677 | $0 | $0 | $0 |
| Gita A Rao | ||||||||||||||
| Physician, Pediatric Clinical Direct | $128,479 | $0 | $3,819 | $0 | $19,500 | $0 | $750 | $0 | $2,500 | $0 | $155,048 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Line 7 | FormAndLineReferenceDesc |
| Explanation | Bonuses amounts are approved and paid at the discretion of the board. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part III, line 2 | We opened a school-based health clinic at Westbrook High School and Sagamore Village, though those clinics provide similar services as existing clinics. |
| Form 990, Part VI, Section B, line 11b | The Form 990 was provided to the Board of Directors for discussion, review, and approval before filing. |
| Form 990, Part VI, Section B, line 12c | Board members and key employees are required to read and sign conflict of interest statements on an annual basis, or when there is a change in board member or key officer. |
| Form 990, Part VI, Section B, line 15 | Compensation process for top official senior management, officers, and key employee salaries are based on National Association of Community Health Centers salary survey information that is provided and reviewed annually by the finance committee and Board of Directors. Compensation in the range is based on requisite experience. |
| Form 990, Part VI, Section C, line 19 | Governing documents disclosure explanation, printed copies of governing documents, and the conflict of interest policy are available at the Organization's headquarters. Financial statements are not available to the public; however, pertinent annual financial results are available upon request. |
| Form 990, Part X, Line 10: Land, Buildings, and Equipment: | Section 1.263(a)-3(n) Election: Portland Community Health Center 180 Park Avenue Portland, ME 04102 EIN: 45-4960453 Section 1.263(a)-3(n) Election: Portland Community Health Center is electing to capitalize repair and maintenance costs under Regulation Section 1.263(a)-3(n). |
| Form 990, Part XI, line 9: | Restatement of Deferred Revenue - Donor Restricted Contributions 158,472. |
Comments