CHESPENN HEALTH SERVICES: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization
CHESPENN HEALTH SERVICES (EIN 23-7354899)
Tax period
2020-07-01 to 2021-06-30
Filed
2022-05-13
IRS object ID
202231339349303788
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)
Return2022-05-13T11:34:17-05:00ReturnTs
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)
EIN237354899EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1CHESPENN HEALTH SERVICES INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlCHESBusinessNameControlTxt
Phone6104853800PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11510 CHESTER PIKE NO 200AddressLine1Txt
CityEDDYSTONECityNm
State AbbreviationPAStateAbbreviationCd
ZIP19022ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDANIEL CAPLANPersonNm
Person TitleCHIEF FINANCIAL OFFICERPersonTitleTxt
Phone6104853800PhoneNum
Signature2022-05-13SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstDANIELPersonFirstNm
Person LastCAPLANPersonLastNm
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 OfficerDANIEL CAPLANPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11510 CHESTER PIKE NO 200AddressLine1Txt
CityEDDYSTONECityNm
State AbbreviationPAStateAbbreviationCd
ZIP19022ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$13,786,205GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.CHESPENN.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1972FormationYr
Legal Domicile StatePALegalDomicileStateCd
Activity Or MissionTO OPERATE THREE COMPREHENSIVE HEALTH CENTERS LOCATED IN CHESTER AND DELAWARE COUNTIES.ActivityOrMissionDesc
Voting Members Governing Body10VotingMembersGoverningBodyCnt
Voting Members Independent10VotingMembersIndependentCnt
Total Employee185TotalEmployeeCnt
Total Volunteers11TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$4,232,107PYContributionsGrantsAmt
CY Contributions Grants$5,764,797CYContributionsGrantsAmt
PY Program Service Revenue$7,874,235PYProgramServiceRevenueAmt
CY Program Service Revenue$7,939,474CYProgramServiceRevenueAmt
PY Investment Income$64,029PYInvestmentIncomeAmt
CY Investment Income$81,934CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$12,170,371PYTotalRevenueAmt
CY Total Revenue$13,786,205CYTotalRevenueAmt
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$7,088,971PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$6,710,324CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$5,742,392PYOtherExpensesAmt
CY Other Expenses$6,217,559CYOtherExpensesAmt
PY Total Expenses$12,831,363PYTotalExpensesAmt
CY Total Expenses$12,927,883CYTotalExpensesAmt
PY Revenues Less Expenses-$660,992PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$858,322CYRevenuesLessExpensesAmt
Total Assets BOY$7,912,700TotalAssetsBOYAmt
Total Assets EOY$8,301,423TotalAssetsEOYAmt
Total Liabilities BOY$2,960,142TotalLiabilitiesBOYAmt
Total Liabilities EOY$2,490,543TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$4,952,558NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$5,810,880NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionCHESPENN HEALTH SERVICES IS A NETWORK OF NON-PROFIT, FEDERALLY QUALIFIED HEALTH CENTERS THAT PROVIDES COMPREHENSIVE PRIMARY AND PREVENTIVE HEALTH CARE AND SOCIAL SERVICES TO MEDICALLY UNDERSERVED FAMILIES AND INDIVIDUALS ON A SLIDING SCALE. CHESPENN HEALTH SERVICES STRIVES TO MEET THE UNIQUE HEALTH NEEDS IN ITS COMMUNITIES IN LINGUISTICALLY AND CULTURALLY COMPETENT WAYS.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$9,430,502ExpenseAmt
Revenue$7,939,474RevenueAmt
DescSINCE 1973, CHESPENN HEALTH SERVICES HAS PROVIDED COMPREHENSIVE FAMILY MEDICAL AND DENTAL CARE TO THE RESIDENTS OF CHESTER, PA AND NEIGHBORING COMMUNITIES. IN 2005, CHESPENN EXPANDED THESE HEALTH CARE SERVICES TO THE COATESVILLE AREA, AND IN 2009, CHESPENN OPENED THE CENTER FOR FAMILY HEALTH IN UPPER DARBY, PA. ADDITIONAL SERVICES THAT ARE OFFERED INCLUDE HEALTH CARE, FAMILY PLANNING SERVICES, OB/GYN, HIV/AIDS CARE, BEHAVIORAL HEALTH AND AN IN-HOUSE PHYSICIAN DISPENSARY. CHESPENN IS PRINCIPALLY FUNDED BY GRANTS FROM THE DEPARTMENT OF HEALTH AND HUMAN SERVICES. DURING THE 2020 TAX YEAR, CHESPENN RECEIVED TOTAL GRANT REVENUE OF $4,091,159.DURING THE 2020 TAX YEAR, CHESPENN HAD TOTAL BILLABLE ENCOUNTERS OF 49,407. THE BILLABLE ENCOUNTERS CONSISTED OF THE FOLLOWING IN CHESTER, PA: 6,094 PEDIATRIC ENCOUNTERS, 14,698 ADULT ENCOUNTERS, AND 3,539 DENTAL ENCOUNTERS. IN ADDITION, THERE WERE 11,131 MEDICAL ENCOUNTERS AT THE UPPER DARBY CENTER FOR FAMILY HEALTH AND 13,945 MEDICAL AND DENTAL ENCOUNTERS IN THE COATESVILLE SERVICE AREA. CHESPENN PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. THE AMOUNTS DETERMINED TO BE CHARITY CARE ARE NOT REPORTED AS REVENUES. DURING THE 2020 TAX YEAR, CHESPENN PROVIDED CHARITY CARE OF APPROXIMATELY $1,238,000 TO PATIENTS.Desc
Total Program Service Expenses$9,430,502TotalProgramServiceExpensesAmt
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 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash 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 Document9IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee185EmployeeCnt
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 Members10GoverningBodyVotingMembersCnt
Independent Voting Member10IndependentVotingMemberCnt
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 FldPAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1DANIEL A CAPLANBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone6104853800PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11510 CHESTER PIKE STE 200AddressLine1Txt
CityEDDYSTONECityNm
State AbbreviationPAStateAbbreviationCd
ZIP19022ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
WILLIE MAE WELLS
PRESIDENT1.000.00Yes (X)Yes (X)$0$0$0
RAE ROEDER
SECRETARY1.000.00Yes (X)Yes (X)$0$0$0
KAREN VESELY
TREASURER1.000.00Yes (X)Yes (X)$0$0$0
CAROL ALLEN
BOARD MEMBER1.000.00Yes (X)$0$0$0
ANTHONY HALL
BOARD MEMBER1.000.00Yes (X)$0$0$0
DONNA LAWLER
BOARD MEMBER1.000.00Yes (X)$0$0$0
DAVID KEITH
BOARD MEMBER1.000.00Yes (X)$0$0$0
JEFFREY GREEN
BOARD MEMBER1.000.00Yes (X)$0$0$0
GWEN SMITH
BOARD MEMBER1.000.00Yes (X)$0$0$0
DINA CAPALONGO
BOARD MEMBER1.000.00Yes (X)$0$0$0
GARY DAVIS
PRESIDENT/CEO40.000.00Yes (X)$153,300$0$8,239
DANIEL A CAPLAN
CHIEF FINANCIAL OFFICER40.000.00Yes (X)$138,760$0$16,554
KEVIN MCCABE MD
PHYSICIAN40.000.00$193,086$0$10,947Yes (X)
NEERAJA PERI MD
PHYSICIAN40.000.00$180,174$0$13,159Yes (X)
RAQUIBUL ISLAM MD
PHYSICIAN40.000.00$172,576$0$18,417Yes (X)
TINA AHMADINEJAD MD
PHYSICIAN40.000.00$179,147$0$15,364Yes (X)
BRUCE AUDEN MD
PHYSICIAN40.000.00$167,929$0$20,717Yes (X)
MICHAEL G LUCAS
FORMER PRES/CEO TO 4/18/200.000.00$152,266$0$4,576Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,337,238TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$107,973TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K17IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (1)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
PROSPECT HEALTH ACCESS NETWORK
ONE MEDICAL CENTER BLVDUPLANDPA19013CONTRACTED PHYSICIAN SERVICES$1,526,019
CALL 4 HEALTH
2855 S CONGRESS AVENUEDELRAY BEACHFL33445CALL CENTER SERVICE$366,144
VIRTUAL OFFICEWARE HC SOLUTIONS
2000 CLIFF MINE RD STE 510PITTSBURGHPA15275INFORMATION TECHNOLOGY & SRVS$355,680
COORDINATED CARE NETWORK
300 PENN CENTER BLVDPITTSBURGHPA15235CONTRACTED PHARMACY SERVICES$348,288
PENN MEDICINE CHESTER COUNTY HOSPITAL
701 EAST MARSHALL STREETWEST CHESTERPA19380CONTRACTED PHYSICIAN SERVICES$173,777
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K8CntrctRcvdGreaterThan100KCnt
Federated Campaigns$26,540FederatedCampaignsAmt
Government Grants$4,889,834GovernmentGrantsAmt
All Other Contributions$848,423AllOtherContributionsAmt
Total Contributions$5,764,797TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescNET PATIENT SERVICE REVENUEDesc
Business621400BusinessCd
Total Revenue Column$7,939,474TotalRevenueColumnAmt
Related Or Exempt Func Income$7,939,474RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$7,939,474TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$81,934TotalRevenueColumnAmt
Exclusion$81,934ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$13,786,205TotalRevenueColumnAmt
Related Or Exempt Func Income$7,939,474RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$81,934ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$372,417TotalAmt
Management And General$372,417ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$5,352,803TotalAmt
Program Services$3,943,676ProgramServicesAmt
Management And General$1,409,127ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$219,704TotalAmt
Program Services$174,493ProgramServicesAmt
Management And General$45,211ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$330,361TotalAmt
Program Services$238,233ProgramServicesAmt
Management And General$92,128ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$435,039TotalAmt
Program Services$302,268ProgramServicesAmt
Management And General$132,771ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$4,185TotalAmt
Management And General$4,185ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$62,430TotalAmt
Program Services$13,244ProgramServicesAmt
Management And General$49,186ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$2,490,026TotalAmt
Program Services$2,247,008ProgramServicesAmt
Management And General$243,018ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$12,275TotalAmt
Management And General$12,275ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$629,895TotalAmt
Program Services$468,252ProgramServicesAmt
Management And General$161,643ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$580,254TotalAmt
Program Services$7,326ProgramServicesAmt
Management And General$572,928ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$939,550TotalAmt
Program Services$744,444ProgramServicesAmt
Management And General$195,106ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$68,837TotalAmt
Program Services$8,620ProgramServicesAmt
Management And General$60,217ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$27,867TotalAmt
Management And General$27,867ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$94,345TotalAmt
Program Services$94,345ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$50,666TotalAmt
Program Services$25,498ProgramServicesAmt
Management And General$25,168ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
PATIENT CARE$728,856$721,036$7,820
EQUIPMENT RENTAL$260,686$244,820$15,866
PROVISION FOR DOUBTFUL$182,472$182,472
DUES AND SUBSCRIPTIONS$48,887$7,976$40,911

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$36,328TotalAmt
Program Services$6,791ProgramServicesAmt
Management And General$29,537ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$12,927,883TotalAmt
Program Services$9,430,502ProgramServicesAmt
Management And General$3,497,381ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$302,505BOYAmt
EOY$317,890EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$5,732,499BOYAmt
EOY$6,222,414EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$198,430BOYAmt
EOY$67,992EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$458,404BOYAmt
EOY$423,521EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$12,532BOYAmt
EOY$7,881EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$84,445BOYAmt
EOY$54,698EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$5,171,212LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$3,964,185LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$1,123,885BOYAmt
EOY$1,207,027EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$7,912,700BOYAmt
EOY$8,301,423EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,374,877BOYAmt
EOY$1,492,089EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$83,333BOYAmt
EOY$359,910EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$1,292,391BOYAmt
EOY$465,885EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$209,541BOYAmt
EOY$172,659EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$2,960,142BOYAmt
EOY$2,490,543EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$4,952,558BOYAmt
EOY$5,810,880EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$4,952,558BOYAmt
EOY$5,810,880EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$7,912,700BOYAmt
EOY$8,301,423EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$858,322ReconcilationRevenueExpnssAmt
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 Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$3,990,080CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$3,721,480CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$3,554,740CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$4,232,107CurrentTaxYearMinus1YearAmt
Current Tax Year$5,764,797CurrentTaxYearAmt
Total$21,263,204TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$7,234,651CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$8,233,321CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$8,642,475CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$7,874,235CurrentTaxYearMinus1YearAmt
Current Tax Year$7,939,474CurrentTaxYearAmt
Total$39,924,156TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$11,224,731CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$11,954,801CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$12,197,215CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$12,106,342CurrentTaxYearMinus1YearAmt
Current Tax Year$13,704,271CurrentTaxYearAmt
Total$61,187,360TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$61,187,360PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$6,672CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$21,900CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$71,918CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$64,029CurrentTaxYearMinus1YearAmt
Current Tax Year$81,934CurrentTaxYearAmt
Total$246,453TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$6,672CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$21,900CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$71,918CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$64,029CurrentTaxYearMinus1YearAmt
Current Tax Year$81,934CurrentTaxYearAmt
Total$246,453TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$11,231,403CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$11,976,701CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$12,269,133CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$12,170,371CurrentTaxYearMinus1YearAmt
Current Tax Year$13,786,205CurrentTaxYearAmt
Total$61,433,813TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.99600PublicSupportCY509Pct
Public Support PY5090.99720PublicSupportPY509Pct
Investment Income CY0.00400InvestmentIncomeCYPct
Investment Income PY0.00280InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

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

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$100,838OtherCostOrOtherBasisAmt
Book Value$100,838BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$3,153,067OtherCostOrOtherBasisAmt
Depreciation$2,230,299DepreciationAmt
Book Value$922,768BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$349,794OtherCostOrOtherBasisAmt
Depreciation$349,794DepreciationAmt
Book Value$0BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,341,554OtherCostOrOtherBasisAmt
Depreciation$1,335,620DepreciationAmt
Book Value$5,934BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$225,959OtherCostOrOtherBasisAmt
Depreciation$48,472DepreciationAmt
Book Value$177,487BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$1,207,027TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescESTIMATED THIRD-PARTY PAYOR SETTLEMENTSDesc
Amt$172,659Amt
FieldValueIRS element (for citing)
Total Liability$172,659TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$13,786,205TotalRevEtcAuditedFinclStmtAmt
Revenue Not Reported$0RevenueNotReportedAmt
Revenue Subtotal$13,786,205RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$13,786,205TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$12,927,883TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$12,927,883ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$12,927,883TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationTHE CORPORATION ACCOUNTS FOR UNCERTAINTY IN INCOME TAXES USING A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN-NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY. MEASUREMENT OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD IS MET. MANAGEMENT DETERMINED THERE WERE NO TAX UNCERTAINTIES THAT MET THE RECOGNITION THRESHOLD IN 2021 AND 2020.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Form990 Of Other OrganizationsYes (X)Form990OfOtherOrganizationsInd
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 Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 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
KEVIN MCCABE MD
PHYSICIAN$192,786$0$300$0$0$0$9,654$0$1,293$0$204,033$0$0$0
TINA AHMADINEJAD MD
PHYSICIAN$178,847$0$300$0$0$0$9,059$0$6,305$0$194,511$0$0$0
NEERAJA PERI MD
PHYSICIAN$179,874$0$300$0$0$0$9,059$0$4,100$0$193,333$0$0$0
RAQUIBUL ISLAM MD
PHYSICIAN$172,276$0$300$0$0$0$9,043$0$9,374$0$190,993$0$0$0
BRUCE AUDEN MD
PHYSICIAN$167,629$0$300$0$0$0$9,015$0$11,702$0$188,646$0$0$0
GARY DAVIS
PRESIDENT/CEO$151,000$0$2,300$0$0$0$7,665$0$574$0$161,539$0$0$0
MICHAEL G LUCAS
FORMER PRES/CEO TO 4/18/20$152,266$0$0$0$0$0$3,830$0$746$0$156,842$0$0$0
DANIEL A CAPLAN
CHIEF FINANCIAL OFFICER$138,460$0$300$0$0$0$7,214$0$9,340$0$155,314$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE J PART II, COLUMN BIIIFormAndLineReferenceDesc
ExplanationBONUSES IN COLUMN BIII RELATE TO BONUSES APPROVED BY A FEDERAL COVID GRANT FOR ATTENDANCE DURING THE PANDEMIC.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 1KEY FINANCIAL DECISIONS AND REPORTS ARE APPROVED BY THE FINANCE COMMITTEE AND THEN PRESENTED TO THE BOARD OF DIRECTORS FOR APPROVAL. MEMBERS OF THE FINANCE COMMITTEE ARE ALSO MEMBERS OF THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION B, LINE 11BTHE FINAL 990 RETURN WAS REVIEWED AND APPROVED BY THE FINANCE COMMITTEE ALONG WITH THE BOARD OF DIRECTORS OF CHESPENN HEALTH SERVICES.
FORM 990, PART VI, SECTION B, LINE 12CBOARD MEMBERS MUST ANNUALLY SIGN THE CONFLICT OF INTEREST POLICY. BOARD MEMBERS ARE ALSO REQUIRED TO DISCLOSE ANY CONFLICT OF INTEREST THAT MAY ARISE DURING THE YEAR AND MUST REFRAIN FROM DISCUSSING, AS WELL AS VOTING ON, SUCH MATTERS THAT PERTAIN TO THE CONFLICT. EMPLOYEES OF THE ORGANIZATION ARE ALSO REQUIRED TO REPORT ANY POTENTIAL OR ACTUAL CONFLICT TO THE PRESIDENT/CEO. THE PRESIDENT/CEO IS RESPONSIBLE FOR MONITORING AND RESOLVING ANY CONFLICT OF INTEREST THAT MAY ARISE WITHIN THE ORGANIZATION.
FORM 990, PART VI, SECTION B, LINE 15TO DETERMINE THE SALARY OF THE PRESIDENT/CEO, CHESPENN HEALTH SERVICES RELIES ON SURVEY INFORMATION FROM TWO SOURCES. THE FIRST SOURCE IS AN ANNUAL SURVEY CONDUCTED BY THE HOSPITAL AND THE HEALTHCARE COMPENSATION SERVICE FOR THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS WHICH CATEGORIZES ALL COMMUNITY HEALTH CENTERS BY SERVICE LEVEL, GEOGRAPHY AND BUDGET. THE SECOND SOURCE IS THE IRS FORM 990 IN WHICH A COMPENSATION SURVEY OF REGIONAL COMMUNITY HEALTH CENTERS IS CONDUCTED. BOTH SOURCES OF INFORMATION ARE USED BY CHESPENN HEALTH SERVICES' BOARD OF DIRECTORS TO DETERMINE THE COMPENSATION LEVEL. THIS COMPENSATION REVIEW IS CONDUCTED ON AN ANNUAL BASIS TO ASSURE THAT COMPENSATION IS IN LINE WITH FAIR MARKET VALUE, AND THE PROCESS IS DOCUMENTED IN THE BOARD MINUTES.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATIONS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART IX, LINE 11GPHYSICIANS, DENTAL, INTERPRETING: PROGRAM SERVICE EXPENSES 2,247,008. MANAGEMENT AND GENERAL EXPENSES 243,018. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,490,026.

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