FURP.ORG / PUBLIC DATA EXPLORER

GREATER PRINCE WILLIAM AREA COMMUNITY HEALTH CENTER INC: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization
GREATER PRINCE WILLIAM AREA COMMUNITY HEALTH CENTER INC (EIN 83-0435138)
Tax period
2020-07-01 to 2021-06-30
Filed
2022-05-09
IRS object ID
202231299349301243
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

FieldValueIRS element (for citing)
Return2022-05-09T08:49:09-05:00ReturnTs
Tax Period End2021-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN390859910PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BAKER TILLY US LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line11570 FRUITVILLE PIKE SUITE 400AddressLine1Txt
CityLANCASTERCityNm
State AbbreviationPAStateAbbreviationCd
ZIP17601ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2020-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN830435138EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1GREATER PRINCE WILLIAM AREA COMMUNITYBusinessNameLine1Txt
Business Name Line2HEALTH CENTER INCBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlGREABusinessNameControlTxt
Phone7036807950PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line14379 RIDGEWOOD CENTER DRIVE NO 102AddressLine1Txt
CityWOODBRIDGECityNm
State AbbreviationVAStateAbbreviationCd
ZIP22192ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMARK MEYEPersonNm
Person TitleCHIEF EXECUTIVE OFFICERPersonTitleTxt
Phone7036807950PhoneNum
Signature2022-03-10SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstMARKPersonFirstNm
Person LastMEYEPersonLastNm
FieldValueIRS element (for citing)
SSNXXX-XX-XXXXSSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonKERRI N BOGDA CPAPreparerPersonNm
PTINP00760402PTIN
Phone7177404863PhoneNum
Self EmployedYes (X)SelfEmployedInd

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer2TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2020TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerMARK MEYEPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line14379 RIDGEWOOD CENTER DRIVE NO 102AddressLine1Txt
CityWOODBRIDGECityNm
State AbbreviationVAStateAbbreviationCd
ZIP22192ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$19,215,869GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.GPWHEALTHCENTER.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2007FormationYr
Legal Domicile StateVALegalDomicileStateCd
Activity Or MissionTO INCREASE ACCESS TO AFFORDABLE HIGH QUALITY HEALTH CARE FOR THE WHOLE FAMILY.ActivityOrMissionDesc
Voting Members Governing Body15VotingMembersGoverningBodyCnt
Voting Members Independent15VotingMembersIndependentCnt
Total Employee220TotalEmployeeCnt
Total Volunteers18TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$4,923,978PYContributionsGrantsAmt
CY Contributions Grants$8,367,662CYContributionsGrantsAmt
PY Program Service Revenue$9,260,676PYProgramServiceRevenueAmt
CY Program Service Revenue$10,762,740CYProgramServiceRevenueAmt
PY Investment Income$2,666PYInvestmentIncomeAmt
CY Investment Income$20,488CYInvestmentIncomeAmt
PY Other Revenue$54,763PYOtherRevenueAmt
CY Other Revenue$64,979CYOtherRevenueAmt
PY Total Revenue$14,242,083PYTotalRevenueAmt
CY Total Revenue$19,215,869CYTotalRevenueAmt
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$10,649,276PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$10,867,149CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$113,677CYTotalFundraisingExpenseAmt
PY Other Expenses$4,136,412PYOtherExpensesAmt
CY Other Expenses$4,288,520CYOtherExpensesAmt
PY Total Expenses$14,785,688PYTotalExpensesAmt
CY Total Expenses$15,155,669CYTotalExpensesAmt
PY Revenues Less Expenses-$543,605PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$4,060,200CYRevenuesLessExpensesAmt
Total Assets BOY$6,621,913TotalAssetsBOYAmt
Total Assets EOY$9,047,910TotalAssetsEOYAmt
Total Liabilities BOY$4,026,954TotalLiabilitiesBOYAmt
Total Liabilities EOY$2,194,441TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$2,594,959NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$6,853,469NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTHE CENTER'S MISSION IS TO INCREASE ACCESS TO HIGH QUALITY COMPREHENSIVE AND PREVENTATIVE HEALTH CARE SERVICES THAT ARE CULTURALLY SENSITIVE IN ORDER TO IMPROVE THE HEALTH STATUS OF THE UNDERSERVED AND VULNERABLE RESIDENTS OF THE COMMUNITY.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$6,680,472ExpenseAmt
Revenue$6,236,466RevenueAmt
DescMEDICAL CARE: THE CENTER MEDICAL CARE THAT IS CULTURALLY SENSITIVE (BEING AWARE THAT CULTURAL DIFFERENCES AND SIMILARITIES BETWEEN PEOPLE EXIST WITHOUT ASSIGNING THEM A VALUE: POSITIVE OR NEGATIVE, BETTER OR WORSE, RIGHT OR WRONG; SET OF SKILLS THAT ENABLES US TO LEARN ABOUT AND UNDERSTAND PEOPLE WHO ARE DIFFERENT FROM OURSELVES, THEREBY BECOMING BETTER ABLE TO SERVE WITHIN THEIR OWN COMMUNITIES) TO IMPROVE THE HEALTH STATUS OF THE UNDERSERVED AND VULNERABLE RESIDENTS OF PRINCE WILLIAM COUNTY AND THE CITIES OF MANASSAS AND MANASSAS PARK. THE CENTER PROGRAMS ARE DESIGNED TO INCREASE ACCESS TO HIGH QUALITY, COMPREHENSIVE AND PREVENTATIVE HEALTH CARE. THIS PROGRAM HAD 32,580 VISITS INVOLVING 11,890 PATIENTS DURING THE FISCAL YEAR, REFLECTING RELATIVELY CONSISTENT PATIENT UTILIZATION OF MEDICAL CARE SERVICES PER PATIENT AS COMPARED TO PRIOR FISCAL YEAR DURING A FULL YEAR OF COVID.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$2,305,448ExpenseAmt
Grant$0GrantAmt
Revenue$1,991,803RevenueAmt
DescOB-GYN CARE: THE CENTER PROVIDES OB-GYN CARE THAT IS CULTURALLY SENSITIVE (BEING AWARE THAT CULTURAL DIFFERENCES AND SIMILARITIES BETWEEN PEOPLE EXIST WITHOUT ASSIGNING THEM A VALUE: POSITIVE OR NEGATIVE, BETTER OR WORSE, RIGHT OR WRONG; SET OF SKILLS THAT ENABLES US TO LEARN ABOUT AND UNDERSTAND PEOPLE WHO ARE DIFFERENT FROM OURSELVES, THEREBY BECOMING BETTER ABLE TO SERVE WITHIN THEIR OWN COMMUNITIES) TO IMPROVE THE HEALTH STATUS OF THE UNDERSERVED AND VULNERABLE RESIDENTS OF PRINCE WILLIAM COUNTY AND THE CITIES OF MANASSAS AND MANASSAS PARK. THIS PROGRAM HAD 12,760 VISITS INVOLVING 1,850 PATIENTS DURING THE FISCAL YEAR, REFLECTING RELATIVELY CONSISTENT PATIENT UTILIZATION OF MEDICAL CARE SERVICES PER PATIENT AS COMPARED TO PRIOR FISCAL YEAR DURING A FULL YEAR OF COVID.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$2,001,777ExpenseAmt
Grant$0GrantAmt
Revenue$1,722,944RevenueAmt
DescDENTAL CARE: THE CENTER PROVIDES DENTAL CARE THAT IS CULTURALLY SENSITIVE (BEING AWARE THAT CULTURAL DIFFERENCES AND SIMILARITIES BETWEEN PEOPLE EXIST WITHOUT ASSIGNING THEM A VALUE: POSITIVE OR NEGATIVE, BETTER OR WORSE, RIGHT OR WRONG; SET OF SKILLS THAT ENABLES US TO LEARN ABOUT AND UNDERSTAND PEOPLE WHO ARE DIFFERENT FROM OURSELVES, THEREBY BECOMING BETTER ABLE TO SERVE WITHIN THEIR OWN COMMUNITIES) TO IMPROVE THE HEALTH STATUS OF THE UNDERSERVED AND VULNERABLE RESIDENTS OF PRINCE WILLIAM COUNTY AND THE CITIES OF MANASSAS AND MANASSAS PARK. THIS PROGRAM HAD 9,444 VISITS INVOLVING 3,800 PATIENTS DURING THE FISCAL YEAR, REFLECTING RELATIVELY CONSISTENT PATIENT UTILIZATION OF MEDICAL CARE SERVICES PER PATIENT AS COMPARED TO PRIOR FISCAL YEAR DURING A FULL YEAR OF COVID.Desc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp

FieldValueIRS element (for citing)
Expense$1,433,851ExpenseAmt
Grant$0GrantAmt
Revenue$811,527RevenueAmt
DescBEHAVIORAL HEALTH: THE CENTER PROVIDES BEHAVIORAL HEALTH CARE THAT IS CULTURALLY SENSITIVE IN ORDER TO IMPROVE THE HEALTH STATUS OF THE UNDERSERVED AND VULNERABLE RESIDENTS OF PRINCE WILLIAM COUNTY AND THE CITIES OF MANASSAS AND MANASSAS PARK. THIS PROGRAM HAD 9,392 VISITS INVOLVING 1,060 PATIENTS DURING THE FISCAL YEAR.Desc
FieldValueIRS element (for citing)
Total Other Prog Srvc Expense$1,433,851TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Grant$0TotalOtherProgSrvcGrantAmt
Total Other Prog Srvc Revenue$811,527TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses$12,421,548TotalProgramServiceExpensesAmt
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 LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
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 Contri0DeductibleNonCashContriInd
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 Document26IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee220EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
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 Members15GoverningBodyVotingMembersCnt
Independent Voting Member15IndependentVotingMemberCnt
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 FldVAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonMARK MEYE CHIEF EXECUTIVE OFFICERPersonNm
Phone7036807950PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line14379 RIDGEWOOD CENTER DRIVE SUITEAddressLine1Txt
CityWOODBRIDGECityNm
State AbbreviationVAStateAbbreviationCd
ZIP22192ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (22 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
LUIS LOU FERRARO
PRESIDENT6.00Yes (X)Yes (X)$0$0$0
EVELYN MARR
VICE PRESIDENT6.00Yes (X)Yes (X)$0$0$0
JOHN S GRAY
TREASURER6.00Yes (X)Yes (X)$0$0$0
VALERIE E KEANE
SECRETARY4.00Yes (X)Yes (X)$0$0$0
ABRA HOGARTH
MEMBER1.00Yes (X)$0$0$0
ADDIE RAY WHITAKER
MEMBER3.00Yes (X)$0$0$0
JENNY PORTILLO
MEMBER1.00Yes (X)$0$0$0
JULIO ALEX CORREA
MEMBER1.00Yes (X)$0$0$0
OLAUN SIMMONS
MEMBER1.00Yes (X)$0$0$0
LAURA C POSEY
MEMBER2.00Yes (X)$0$0$0
MARLON MARSHALL
MEMBER2.00Yes (X)$0$0$0
ROSE GONZALEZ
MEMBER3.00Yes (X)$0$0$0
JIMMY FUENTES
MEMBER1.00Yes (X)$0$0$0
LASHEECO GRAHAMAN
MEMBER1.00Yes (X)$0$0$0
RICHARD GARON
MEMBER1.00Yes (X)$0$0$0
MARK MEYE
CHIEF EXECUTIVE OFFICER40.00Yes (X)$176,009$0$12,209
RASHID MOHIUDDIN
MEDICAL DIRECTOR40.00$264,336$0$25,436Yes (X)
HUSSEIN AL-SHAMMAA
PHYSICIAN40.00$222,570$0$19,452Yes (X)
SYED MAHBOOB
PHYSICIAN40.00$217,691$0$25,441Yes (X)
RENATO DAING
PHYSICIAN40.00$220,958$0$20,757Yes (X)
LAYLA ABDAL HUSSAIN
PHYSICIAN40.00$130,939$0$8,869Yes (X)
MICHAEL SMITH
PHYSICIAN40.00$236,052$0$12,207Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,468,555TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$124,371TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K21IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (2 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
COMMUNITY CARE NETWORK OF VIRGINIA
3831 WESTERRE PARKWAYHENRICOVA23233HEALTH CARE BILLING$316,756
LABCORP
PO BOX 12140BURLINGTONNC27216LABORATORY SERVICES$129,231
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K2CntrctRcvdGreaterThan100KCnt
Government Grants$7,604,092GovernmentGrantsAmt
All Other Contributions$763,570AllOtherContributionsAmt
Noncash Contributions$8,114NoncashContributionsAmt
Total Contributions$8,367,662TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
MEDICAL CARE624110$6,236,466$6,236,466
OB-GYN CARE624110$1,991,803$1,991,803
DENTAL CARE624110$1,722,944$1,722,944
BEHAVIORAL HEALTH624110$811,527$811,527
FieldValueIRS element (for citing)
Total Program Service Revenue$10,762,740TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$20,488TotalRevenueColumnAmt
Exclusion$20,488ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescMED RECORDS/INSURANCE INCENTIVESDesc
Business900099BusinessCd
Total Revenue Column$64,979TotalRevenueColumnAmt
Exclusion$64,979ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$64,979OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$19,215,869TotalRevenueColumnAmt
Related Or Exempt Func Income$10,762,740RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$85,467ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$453,621TotalAmt
Program Services$264,688ProgramServicesAmt
Management And General$170,788ManagementAndGeneralAmt
Fundraising$18,145FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$8,679,721TotalAmt
Program Services$7,748,205ProgramServicesAmt
Management And General$904,128ManagementAndGeneralAmt
Fundraising$27,388FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$272,653TotalAmt
Program Services$241,714ProgramServicesAmt
Management And General$29,988ManagementAndGeneralAmt
Fundraising$951FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$826,289TotalAmt
Program Services$727,065ProgramServicesAmt
Management And General$95,684ManagementAndGeneralAmt
Fundraising$3,540FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$634,865TotalAmt
Program Services$554,536ProgramServicesAmt
Management And General$77,116ManagementAndGeneralAmt
Fundraising$3,213FundraisingAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$52,096TotalAmt
Management And General$52,096ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$919,149TotalAmt
Program Services$856,631ProgramServicesAmt
Management And General$61,066ManagementAndGeneralAmt
Fundraising$1,452FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$329,300TotalAmt
Program Services$188,785ProgramServicesAmt
Management And General$136,582ManagementAndGeneralAmt
Fundraising$3,933FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$222,864TotalAmt
Program Services$130,041ProgramServicesAmt
Management And General$83,909ManagementAndGeneralAmt
Fundraising$8,914FundraisingAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,130,559TotalAmt
Program Services$677,597ProgramServicesAmt
Management And General$409,459ManagementAndGeneralAmt
Fundraising$43,503FundraisingAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$3,350TotalAmt
Program Services$352ProgramServicesAmt
Management And General$2,998ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$22,518TotalAmt
Management And General$22,518ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$319,031TotalAmt
Program Services$103,493ProgramServicesAmt
Management And General$215,538ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$32,483TotalAmt
Program Services$19,837ProgramServicesAmt
Management And General$12,646ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
VACCINE SUPPLIES$401,835$401,835
PROGRAM SUPPLIES$351,597$351,597
BAD DEBT EXPENSE$282,595$282,595
COMMUNITY OUTREACH$57,604$57,604

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$163,539TotalAmt
Program Services$97,568ProgramServicesAmt
Management And General$63,333ManagementAndGeneralAmt
Fundraising$2,638FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$15,155,669TotalAmt
Program Services$12,421,548ProgramServicesAmt
Management And General$2,620,444ManagementAndGeneralAmt
Fundraising$113,677FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$2,911,618BOYAmt
EOY$1,125,534EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$245,289BOYAmt
EOY$169,368EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$2,159,569BOYAmt
EOY$3,853,500EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
EOY$5,178EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$100,868BOYAmt
EOY$65,484EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$3,133,256LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$2,171,070LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$1,059,840BOYAmt
EOY$962,186EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$7,735BOYAmt
EOY$2,729,666EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$15,000BOYAmt
EOY$15,000EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$121,994BOYAmt
EOY$121,994EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$6,621,913BOYAmt
EOY$9,047,910EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,010,100BOYAmt
EOY$1,174,207EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$7,731BOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$3,009,123BOYAmt
EOY$1,020,234EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$4,026,954BOYAmt
EOY$2,194,441EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$2,410,500BOYAmt
EOY$6,691,802EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$184,459BOYAmt
EOY$161,667EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,594,959BOYAmt
EOY$6,853,469EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$6,621,913BOYAmt
EOY$9,047,910EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$4,060,200ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$198,310NetUnrlzdGainsLossesInvstAmt
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

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,106,704OtherCostOrOtherBasisAmt
Depreciation$778,487DepreciationAmt
Book Value$328,217BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,417,712OtherCostOrOtherBasisAmt
Depreciation$926,418DepreciationAmt
Book Value$491,294BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$608,840OtherCostOrOtherBasisAmt
Depreciation$466,165DepreciationAmt
Book Value$142,675BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$962,186TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescDEFERRED RENTDesc
Amt$1,020,234Amt
FieldValueIRS element (for citing)
Total Liability$1,020,234TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$19,323,869TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$198,310NetUnrealizedGainsInvstAmt
Donated Services And Use Fclts$192,285DonatedServicesAndUseFcltsAmt
Other Revenue-$282,595OtherRevenueAmt
Revenue Not Reported$108,000RevenueNotReportedAmt
Revenue Subtotal$19,215,869RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$19,215,869TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$15,065,359TotExpnsEtcAuditedFinclStmtAmt
Donated Services Use Fclts$192,285DonatedServicesUseFcltsAmt
Expenses Not Reported$192,285ExpensesNotReportedAmt
Expenses Subtotal$14,873,074ExpensesSubtotalAmt
Other Expenses Not Included$282,595OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$282,595ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$15,155,669TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART XI, LINE 2D - OTHER ADJUSTMENTS:BAD DEBT EXPENSE -282,595.
PART XII, LINE 4B - OTHER ADJUSTMENTS:BAD DEBT EXPENSE 282,595.

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 (6 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
RASHID MOHIUDDIN
MEDICAL DIRECTOR$264,336$0$0$0$0$0$13,271$0$12,165$0$289,772$0$0$0
MICHAEL SMITH
PHYSICIAN$236,052$0$0$0$0$0$6,044$0$6,163$0$248,259$0$0$0
SYED MAHBOOB
PHYSICIAN$217,691$0$0$0$0$0$13,271$0$12,170$0$243,132$0$0$0
HUSSEIN AL-SHAMMAA
PHYSICIAN$222,570$0$0$0$0$0$9,987$0$9,465$0$242,022$0$0$0
RENATO DAING
PHYSICIAN$220,958$0$0$0$0$0$10,507$0$10,250$0$241,715$0$0$0
MARK MEYE
CHIEF EXECUTIVE OFFICER$162,237$0$13,772$0$0$0$6,011$0$6,198$0$188,218$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 7FormAndLineReferenceDesc
ExplanationTHE BOARD ISSUED A DISCRETIONARY BONUS TO THE CHIEF EXECUTIVE OFFICER; THE PROCESS IS A CONFIDENTIAL MEETING BY THE BOARD OF DIRECTORS WHERE THE MATTER IS RAISED FOR CONSIDERATION AND, IF DEEMED WARRANTED, AN AMOUNT IS CONSIDERED. IF APPROVED, THE BONUS IS ISSUED.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 1THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE OFFICERS OF THE BOARD AND THE CHAIRMAN OF STANDING COMMITTEES. THE COMMITTEE SHALL HAVE THE POWERS OF THE GOVERNING BOARD WHEN IT IS NOT IN SESSION.
FORM 990, PART VI, SECTION B, LINE 11BTHE CHIEF EXECUTIVE OFFICER, CHIEF FINANCIAL OFFICER, AND ACCOUNTING MANAGER PERFORM AN INITIAL REVIEW OF THE DRAFT 990. THE RETURN IS THEN PROVIDED TO THE FINANCE COMMITTEE AND BOARD OF DIRECTORS FOR REVIEW PRIOR TO FILING WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12CBOARD DIRECTORS, OFFICERS, AND KEY EMPLOYEES COMPLETE A DISCLOSURE FORM ANNUALLY. INDIVIDUALS WITH POTENTIAL OR ACTUAL CONFLICTS ARE EXPECTED TO REPORT ANY INFORMATION PERTINENT TO THE CONFLICT. FAMILY AND BUSINESS RELATIONSHIPS ARE EXPRESSLY STATED IN THE DISCLOSURES AS BEING SOURCES OF POTENTIAL CONFLICTS. BOARD DIRECTORS MAKE THEIR DISCLOSURES TO THE COMPLIANCE OFFICER, WHILE THE CHIEF EXECUTIVE OFFICER DISCLOSES ANY POTENTIAL CONFLICTS TO THE BOARD. DIRECTORS WITH A CONFLICT MAY SPEAK TO THE BOARD ON THE CONFLICT, BUT MUST LEAVE THE MEETING DURING ANY DISCUSSION OR VOTE ON WHETHER THE CONFLCT EXISTS. IF IT IS DETERMINED THAT A CONFLICT EXISTS, THE INTERESTED DIRECTOR MUST RECUSE HIMSELF OR HERSELF FROM ANY DISCUSSION OF, OR VOTING ON, THE ARRANGEMENT THAT INVOLVES THE CONFLICT.
FORM 990, PART VI, SECTION B, LINE 15THE BOARD SETS POSITION PAY RANGES AND REVIEWS AND APPROVES THE CHIEF EXECUTIVE OFFICER'S COMPENSATION AND BENEFITS. THE BOARD COMPENSATION RANGES ARE BASED ON A SALARY SURVEY OF SIMILAR ORGANIZATIONS. THE SALARY SURVEY AND BOARD DECISIONS ARE DOCUMENTED IN BOARD MINUTES. A COMPREHENSIVE REVIEW OF KEY EMPLOYEE COMPENSATION WAS LAST PERFORMED IN APRIL 2021. THE BOARD REVIEWED THE SALARY SURVEY COMPLETED BY THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS AND A FOLLOW-UP SURVEY OF VIRGINIA HEALTH CENTERS, WHICH WAS CONDUCTED BY THE CHIEF EXECUTIVE OFFICER AND DIRECTOR OF HUMAN RESOURCES. THIS SURVEY WAS PRESENTED TO THE BOARD FOR REVIEW IN APRIL 2021. AS A RESULT, THE BOARD APPROVED ADJUSTING KEY EMPLOYEE ANNUAL SALARIES TO ALIGN MORE FULLY WITH THE SURVEYS PRESENTED TO IT FOR CONSIDERATION.
FORM 990, PART VI, SECTION C, LINE 19THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST.