2021-05-17T09:39:04-05:00 2020-06-30 420714325 RSM US LLP 100 INTERNATIONAL DRIVE SUITE 1400 BALTIMORE MD 21202 990 2019-07-01 520988386 COMMUNITY CLINIC INC COMM 3013407525 8630 FENTON STREET NO 1204 SILVER SPRING MD 20910 DR SONYA BRUTON CEO & PRESIDENT 3013407525 2021-05-17 1 JULIA FLANNERY CPA P00928918 4102469300 2021-05-17 2019 2022-09-23 18:48:47Z CCI HEALTH & WELLNESS SERVICES DR SONYA BRUTON 8630 FENTON STREET NO 1204 SILVER SPRING MD 20910 30620042 0 X WWW.CCIWEB.ORG X 1972 MD EMPOWER PATIENTS TO PARTNER WITH STAFF FOR AN UNPARALLELED HEALTHCARE EXPERIENCE THROUGH INTEGRATED TEAMS IN A LEARNING ENVIRONMENT. WE DELIVER HIGH QUALITY, AFFORDABLE CARE TO EVERY PATIENT DURING ALL STAGES OF LIFE. 9 9 339 10 0 0 10305076 13328027 14189523 14454380 783 -44632 2401233 1981911 26896615 29719686 0 0 0 0 18748390 20097965 0 0 433837 9360814 11011607 28109204 31109572 -1212589 -1389886 18442923 20293117 4477127 7520258 13965796 12772859 X CCI HEALTH & WELLNESS SERVICES, A GROUP PRACTICE, EMPOWERS PATIENTS TO PARTNER WITH STAFF FOR AN UNPARALLELED HEALTHCARE EXPERIENCE. THROUGH INTEGRATED TEAMS IN A LEARNING ENVIRONMENT, WE DELIVER HIGH-QUALITY, AFFORDABLE CARE TO EVERY PATIENT DURING ALL STAGES OF LIFE. 0 0 21447917 13115366 HEALTH CENTERS; PROVIDED COMPREHENSIVE PRIMARY CARE SERVICES TO 76,802 INDIVIDUAL ENCOUNTERS MANY OF WHICH AREN'T COVERED BY HEALTH INSURANCE. CCI PROVIDES DIRECT CARE FOR PRE-NATAL SERVICES AS WELL AS ADOLESCENT SERVICES. 5132791 WOMEN, INFANTS AND CHILDREN (WIC): NUTRITION COUNSELING TO 30,507 INCOME-ELEGIBLE INFANTS AND CHILDREN AS WELL AS PREGNANT AND BREASTFEEDING WOMEN. 2289602 1339014 COMPREHENSIVE DENTAL SERVICE PROGRAM: PROVIDING 8,263 DENTAL ENCOUNTERS TO ALL PATIENTS IRRESPECTIVE OF THEIR ABILITY TO PAY. 1981911 OTHER 1981911 28870310 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 18 0 1 339 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 9 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 MD X SEKOU MURPHY 3013407525 8630 FENTON STREET SUITE 1204 SILVER SPRING MD 20910 KATHLEEN KNOLHOFF CEO & PRESIDENT (THRU 4/30/20) 40.00 X 429576 0 49844 SONYA BRUTON CEO & PRESIDENT (BEG 4/27/20) 40.00 X 341277 0 21343 PARVEJ MALIK PHYSICIAN 40.00 X 185872 0 34341 ROBERT MILES PHYSICIAN 40.00 X 213041 0 4388 DR MELISSA CLARK ASSOCIATE CMO 40.00 X 203214 0 11227 CECEILA HALL CARRINGTON PHYSICIAN 40.00 X 177136 0 32893 NNEOMA UGORJI PHYSICIAN 40.00 X 172308 0 33741 DR FELIPE DIAZ BEG 5619 CMO 40.00 X 183817 0 20841 ROBERT BAROR CHIEF LEGAL OFFICER & GENERAL COUNCEL 40.00 X 186210 0 8044 MEAZA BEKELE PHYSICIAN 40.00 X 166965 0 12845 SHELDON KRONZEK CFO (THRU 7/15/19) 40.00 X 146738 0 10792 JOSE LUIS DIAZ CAO (BEG 4/22/19) 40.00 X 112893 0 10321 ELIZABETH DURHAM CHAIR 1.00 X X 0 0 0 CARLA SATINSKY CHAIR-ELECT 1.00 X X 0 0 0 DELLA COX SECRETARY 1.00 X X 0 0 0 SHARON THAMES TREASURER 1.00 X X 0 0 0 LORIANN BEHM BOARD MEMBER 1.00 X 0 0 0 LOUISE BRADFORD BOARD MEMBER 1.00 X 0 0 0 MARIANA CORDIER BOARD MEMBER 1.00 X 0 0 0 DR ROBERT WISE BOARD MEMBER 1.00 X 0 0 0 DR JUDITH FALLON BOARD MEMBER 1.00 X 0 0 0 MICHELLE PRESTON COO (BEG 6/1/20) 40.00 X 0 0 0 SEKOU MURPHY CFO (BEG 2/10/20) 40.00 X 0 0 0 2519047 0 250620 29 0 1 0 BLUENOVO INC 8070 GEORGIA AVENUE SUITE 302 SILVER SPRING MD 20910 IT CONSULTING & SUPPORTING SERVICES 944969 LABORATORY CORPORATION OF AMERICA PO BOX 12140 BURLINGTON NC 272162140 MEDICAL LAB TEST SERVICES 466065 QUADRANT INCORPORATED 1881 CAMPUS COMMONS DRIVE RESTON VA 20191 CONTRACT LABOR - TEMPORARY AGENCY SERVIC 430809 GREG FACKTOR & ASSOCIATES 316 N ROSSMORE AVENUE SUITE 505 LOS ANGELES CA 900042595 INTERIM CFO & FINANCIAL PROJECT MANAGEME 241606 WOMEN BUILDERS GROUP LLC 8701 GEORGIA AVENUE SUITE 511 SILVER SPRING MD 20910 JANITORIAL SERVICES 142191 6 13041754 286273 121194 13328027 PATIENT SERVICE FEES 621400 14454380 14454380 14454380 231784 231784 623940 900356 -276416 -276416 -276416 OTHER HEALTH SERVICES 621400 1561779 1561779 QUALITY INCENTIVE 621400 420132 420132 1981911 29719686 16436291 0 -44632 1826807 1709021 86837 30949 15605057 14584600 747276 273181 494223 470603 20325 3295 1090751 1038623 44856 7272 1081127 992963 22446 65718 34435 34435 118803 118803 68011 68011 2451171 2255277 181929 13965 1330031 1203202 121756 5073 993296 832301 154555 6440 1952548 1882458 67286 2804 140556 112486 26947 1123 123359 113451 9512 396 1203518 1120748 62279 20491 73657 67411 5996 250 MEDICAL SUPPLIES 1987565 1987565 TRANSLATION SERVICES 342413 342413 MEMBERSHIPS 98776 80203 17830 743 LICENSE 23207 20787 2323 97 70261 56198 12023 2040 31109572 28870310 1805425 433837 1892075 438770 201994 2541609 2103332 1441976 1186212 2452982 60000 60000 176487 122949 16719711 9226535 6372070 7493176 6276055 5566930 100 100 174598 174625 18442923 20293117 2030296 2488240 242349 279037 1000000 3445185 1204482 1307796 4477127 7520258 X 13965796 12648331 124528 13965796 12772859 18442923 20293117 -1389886 196949 0 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 10644159 5184491 5459668 4937464 3648235 1289229 1138088 393809 744279 7493176 DEFERRED RENT 1307796 1307796 X 29948624 196949 100000 296949 29651675 68011 68011 29719686 31141561 100000 100000 31041561 68011 68011 31109572 PART X, LINE 2: CCI HAS BEEN RECOGNIZED BY THE IRS AS EXEMPT FROM FEDERAL INCOME TAXES UNDER IRC SECTION 501(C)(3), EXCEPT FOR TAXES ON INCOME GENERATED FROM UNRELATED BUSINESS ACTIVITIES. INCOME THAT IS NOT RELATED TO EXEMPT PURPOSES, LESS APPLICABLE DEDUCTIONS, IS SUBJECT TO FEDERAL AND STATE INCOME TAXES. CCI HAD NO UNRELATED BUSINESS INCOME FOR THE YEARS ENDED JUNE 30, 2020 AND 2019. ACCORDINGLY, NO PROVISION FOR INCOME TAXES IS REFLECTED IN THESE FINANCIAL STATEMENTS. CCI HAS ADOPTED ACCOUNTING GUIDANCE REGARDING THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES, WHICH ADDRESSES THE DETERMINATION OF WHETHER TAX BENEFITS CLAIMED OR EXPECTED TO BE CLAIMED ON A TAX RETURN SHOULD BE RECORDED IN THE FINANCIAL STATEMENTS. UNDER THIS POLICY, CCI MAY RECOGNIZE THE TAX BENEFIT FROM AN UNCERTAIN TAX POSITION ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WOULD BE SUSTAINED ON EXAMINATION BY TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. MANAGEMENT HAS EVALUATED CCI'S TAX POSITIONS AND HAS CONCLUDED THAT CCI HAS TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENT TO THE FINANCIAL STATEMENTS TO COMPLY WITH PROVISIONS OF THIS GUIDANCE. AS OF JUNE 30, 2020 AND 2019, THERE ARE NO MATERIAL UNRECOGNIZED/DERECOGNIZED TAX BENEFITS OR TAX PENALTIES OR INTEREST. CCI IS NO LONGER SUBJECT TO U.S. FEDERAL, STATE OR LOCAL TAX EXAMINATIONS BY TAX AUTHORITIES FOR YEARS ENDED BEFORE JUNE 30, 2017. X X 0 0 0 0 0 0 0 1 0 KATHLEEN KNOLHOFF CEO & PRESIDENT (THRU 4/30/20) 395976 0 33600 0 0 0 42455 0 7389 0 479420 0 0 0 SONYA BRUTON CEO & PRESIDENT (BEG 4/27/20) 283980 0 57000 0 297 0 12436 0 8907 0 362620 0 0 0 PARVEJ MALIK PHYSICIAN 185752 0 0 0 120 0 13613 0 20728 0 220213 0 0 0 ROBERT MILES PHYSICIAN 197188 0 15000 0 853 0 3949 0 439 0 217429 0 0 0 DR MELISSA CLARK ASSOCIATE CMO 198027 0 5000 0 187 0 8229 0 2998 0 214441 0 0 0 CECEILA HALL CARRINGTON PHYSICIAN 176620 0 0 0 516 0 7558 0 25335 0 210029 0 0 0 NNEOMA UGORJI PHYSICIAN 171516 0 0 0 792 0 5764 0 27977 0 206049 0 0 0 DR FELIPE DIAZ BEG 5619 CMO 178500 0 5000 0 317 0 7258 0 13583 0 204658 0 0 0 ROBERT BAROR CHIEF LEGAL OFFICER & GENERAL COUNCE 186090 0 0 0 120 0 7444 0 600 0 194254 0 0 0 MEAZA BEKELE PHYSICIAN 166173 0 0 0 792 0 5000 0 7845 0 179810 0 0 0 SHELDON KRONZEK CFO (THRU 7/15/19) 145800 0 0 0 938 0 5402 0 5390 0 157530 0 0 0 PART I, LINE 7 DISCRETIONARY BONUSES FOR EXEMPLARY PERFORMANCE AND EXCEEDING GOALS WERE AWARDED DURING THE CALENDAR YEAR. STAFF BONUSES ARE APPROVED BY THE CEO AND ONE ADDITIONAL EXECUTIVE STAFF MEMBER. THE CEO'S BONUS IS APPROVED BY THE BOARD OF DIRECTORS. X 3 121194 FMV 0 0 0 0 PART I, COLUMN (B): REPORTING THE NUMBER OF CONTRIBUTIONS. FORM 990, PART VI, SECTION A, LINE 3 CCI HEALTH & WELLNESS SERVICES, HIRED GREG FACKTOR & ASSOCIATES FOR FINANCIAL MANAGEMENT SERVICES. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED BY THE CEO AND CFO. BOARD MEMBERS RECEIVE AN ELECTRONIC COPY OF THE FORM 990 BEFORE IT IS FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ACTIVITIES OF THE CORPORATION SHALL BE CONDUCTED SO THAT NO PART OF ITS INCOME PROPERTY OR EARNINGS SHALL INURE TO THE BENEFIT OF ANY DIRECTOR, OFFICER, EMPLOYEE OR OTHER INDIVIDUAL, CORPORATION, INSTITUTION OR ASSOCIATION. ANY DIRECTOR HAVING AN OUTSIDE INTEREST IN A MATTER BEFORE THE BOARD SHALL DISCLOSE THE POTENTIAL CONFLICT TO THE BOARD BEFORE IT DELIBERATES AND ACTS ON THE MATTER AND IF THE BOARD DETERMINES A CONFLICT EXISTS, THE MEMBER SHALL ABSTAIN FROM ANY DELIBERATIONS OR VOTE ON THE MATTER. EACH DIRECTOR SHALL SIGN A CONFLICT OF INTEREST STATEMENT UPON JOINING THE BOARD AND SHALL SIGN AN UPDATED STATEMENT ANNUALLY THEREAFTER. FORM 990, PART VI, SECTION B, LINE 15 THE DETERMINATION OF COMPENSATION AMOUNTS FOR THE ORGANIZATION'S CEO OCCURS WHEN THE BOARD EVALUATES THE CEO'S PERFORMANCE AND MAKES THEIR RECOMMENDATION FOR THE SALARY INCREASE. THE DETERMINATION OF COMPENSATION AMOUNTS FOR THE CEO AND KEY EMPLOYEES INCLUDES A REVIEW OF LOCAL & NATIONAL COMPARABLES FOR PROFESSIONALS WITH REQUIRED SKILLS AND BACKGROUND, AS WELL AS A REVIEW OF ORGANIZATION FINANCIALS TO DETERMINE WHAT MAKES SENSE GIVING EXISTING BUDGET CONSTRAINTS. FORM 990, PART VI, SECTION C, LINE 19 COMMUNITY CLINIC, INC. MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST FOR THE SAME PERIOD OF DISCLOSURE AS SET FORTH IN SECTION 6104(D).