COMMUNITY HEALTH CENTERS OF WESTERN KENTUCKY INC: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization
COMMUNITY HEALTH CENTERS OF WESTERN KENTUCKY INC (EIN 61-1268014)
Tax period
2020-05-01 to 2021-04-30
Filed
2021-08-03
IRS object ID
202102159349300645
Schema version
2020v4.1
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)
Return2021-08-03T16:30:37-05:00ReturnTs
Tax Period End2021-04-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN610920132PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1RINEY HANCOCK CPAS PSCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line12900 VEACH ROAD SUITE 2AddressLine1Txt
CityOWENSBOROCityNm
State AbbreviationKYStateAbbreviationCd
ZIP42303ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2020-05-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN611268014EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1COMMUNITY HEALTH CENTERS OF WESTERNBusinessNameLine1Txt
Business Name Line2KENTUCKY INCBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlCOMMBusinessNameControlTxt
Phone2703385777PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1480 HOPKINSVILLE STREETAddressLine1Txt
CityGREENVILLECityNm
State AbbreviationKYStateAbbreviationCd
ZIP42345ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonLINDSAY DURALLPersonNm
Person TitleCFOPersonTitleTxt
Phone2703385777PhoneNum
Signature2021-07-27SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstLINDSAYPersonFirstNm
Person LastDURALLPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonSCOTT L CLAY CPAPreparerPersonNm
PTINP00114132PTIN
Phone2709264540PhoneNum

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer3TrustedCustomerCd
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 OfficerROGER ARBUCKLEPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1480 HOPKINSVILLE STAddressLine1Txt
CityGREENVILLECityNm
State AbbreviationKYStateAbbreviationCd
ZIP42345ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$11,826,290GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressN/AWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1994FormationYr
Legal Domicile StateKYLegalDomicileStateCd
Activity Or MissionTO PROVIDE AFFORDABLE PRIMARY HEALTHCARE SERVICESActivityOrMissionDesc
Voting Members Governing Body10VotingMembersGoverningBodyCnt
Voting Members Independent10VotingMembersIndependentCnt
Total Employee105TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$3,036,040PYContributionsGrantsAmt
CY Contributions Grants$4,267,083CYContributionsGrantsAmt
PY Program Service Revenue$7,200,084PYProgramServiceRevenueAmt
CY Program Service Revenue$7,422,700CYProgramServiceRevenueAmt
PY Investment Income$100,954PYInvestmentIncomeAmt
CY Investment Income$76,695CYInvestmentIncomeAmt
PY Other Revenue$804PYOtherRevenueAmt
CY Other Revenue$59,812CYOtherRevenueAmt
PY Total Revenue$10,337,882PYTotalRevenueAmt
CY Total Revenue$11,826,290CYTotalRevenueAmt
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$5,693,403PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$5,982,702CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$3,201,197PYOtherExpensesAmt
CY Other Expenses$3,148,394CYOtherExpensesAmt
PY Total Expenses$8,894,600PYTotalExpensesAmt
CY Total Expenses$9,131,096CYTotalExpensesAmt
PY Revenues Less Expenses$1,443,282PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$2,695,194CYRevenuesLessExpensesAmt
Total Assets BOY$13,027,538TotalAssetsBOYAmt
Total Assets EOY$15,506,105TotalAssetsEOYAmt
Total Liabilities BOY$1,286,697TotalLiabilitiesBOYAmt
Total Liabilities EOY$1,070,070TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$11,740,841NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$14,436,035NetAssetsOrFundBalancesEOYAmt
MissionTO PROVIDE AFFORDABLE PRIMARY HEALTHCARE SERVICES IN MUHLENBERG AND LOGAN COUNTIES, KENTUCKY, AND IN MEDICALLY UNDER-SERVED URBAN, SUBURBAN, AND RURAL AREAS HAVING LIMITED AVAILABLE HEALTH RESOURCES.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$8,076,857ExpenseAmt
Revenue$7,422,700RevenueAmt
DescOPERATION OF COMMUNITY HEALTH CENTER AS AUTHORIZED BY SECTION 330 OF THE PUBLIC HEALTH SERVICES GRANTDesc
Total Program Service Expenses$8,076,857TotalProgramServiceExpensesAmt
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 Liabilities0ReportOtherLiabilitiesInd
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 Document4IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee105EmployeeCnt
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
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 Policy0WhistleblowerPolicyInd
Document Retention Policy0DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1LINDSAY DURALLBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone2703385777PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1480 HOPKINSVILLE STAddressLine1Txt
CityGREENVILLECityNm
State AbbreviationKYStateAbbreviationCd
ZIP42345ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
JIMMY OWENS
BOARD MEMBER1.00Yes (X)$0$0$0
ELIZABETH GENTRY
BOARD MEMBER1.00Yes (X)$0$0$0
ELIZABETH EAVES
BOARD MEMBER1.00Yes (X)$0$0$0
CARY DAVIS
BOARD MEMBER1.00Yes (X)$0$0$0
ANDREHIA HATFIELD
BOARD MEMBER1.00Yes (X)$0$0$0
RICHARD NEATHAMER
BOARD MEMBER1.00Yes (X)$0$0$0
CINDY BAIRD
BOARD MEMBER1.00Yes (X)$0$0$0
AMANDA HENSON
BOARD MEMBER1.00Yes (X)$0$0$0
BILLY STEELE
BOARD MEMBER1.00Yes (X)$0$0$0
ROSEMARY BUCK
BOARD MEMBER1.00Yes (X)$0$0$0
LINDSAY DURALL CFO
CFO40.00$50,750$0$7,856Yes (X)
JOSEPH A SWAB CFO
CFO40.00$104,423$0$10,539Yes (X)
ROGER ARBUCKLE CEO
CEO40.00$165,000$0$16,843Yes (X)
DAVID CONATSER MD
PHYSICIAN40.00$160,000$0$8,000Yes (X)
DEANDRA DAVIS
PHYSICIAN40.00$186,162$0$8,189Yes (X)
STEVEN R ZELLER MD
PHYSICIAN40.00$210,000$0$25,833Yes (X)
ELIZA WHITTEN
PHYSICIAN40.00$179,265$0$23,265Yes (X)
BILLIE GALYEN
PHYSICIAN40.00$191,440$0$24,563Yes (X)
LEE B SPARKS
PHYSICIAN40.00$220,000$0$24,301Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,467,040TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$149,389TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K17IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

FieldValueIRS element (for citing)
PersonCHERYL BROTHERSPersonNm

Contractor Address ContractorAddress

US Address USAddress

FieldValueIRS element (for citing)
Address Line1420 KING ROADAddressLine1Txt
CityLEWISBURGCityNm
State AbbreviationKYStateAbbreviationCd
ZIP42256ZIPCd
FieldValueIRS element (for citing)
ServicesHOUSEKEEPING SERVICESServicesDesc
Compensation$123,000CompensationAmt
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K1CntrctRcvdGreaterThan100KCnt
Government Grants$4,267,083GovernmentGrantsAmt
Total Contributions$4,267,083TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescMEDICAL SERVICESDesc
Business621110BusinessCd
Total Revenue Column$7,422,700TotalRevenueColumnAmt
Related Or Exempt Func Income$7,422,700RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$7,422,700TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$76,695TotalRevenueColumnAmt
Exclusion$76,695ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescMISCELLANEOUSDesc
Business621110BusinessCd
Total Revenue Column$59,812TotalRevenueColumnAmt
Exclusion$59,812ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$59,812OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$11,826,290TotalRevenueColumnAmt
Related Or Exempt Func Income$7,422,700RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$136,507ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$523,219TotalAmt
Program Services$168,000ProgramServicesAmt
Management And General$355,219ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$4,447,753TotalAmt
Program Services$4,279,863ProgramServicesAmt
Management And General$167,890ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$175,598TotalAmt
Program Services$171,104ProgramServicesAmt
Management And General$4,494ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$472,591TotalAmt
Program Services$405,890ProgramServicesAmt
Management And General$66,701ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$363,541TotalAmt
Program Services$324,254ProgramServicesAmt
Management And General$39,287ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$8,442TotalAmt
Program Services$8,442ProgramServicesAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$90,465TotalAmt
Program Services$90,465ProgramServicesAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$1,580,620TotalAmt
Program Services$1,396,404ProgramServicesAmt
Management And General$184,216ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$44,692TotalAmt
Program Services$44,692ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$179,448TotalAmt
Program Services$90,360ProgramServicesAmt
Management And General$89,088ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$55,687TotalAmt
Program Services$55,687ProgramServicesAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$100,848TotalAmt
Program Services$28,261ProgramServicesAmt
Management And General$72,587ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$53,201TotalAmt
Program Services$26,037ProgramServicesAmt
Management And General$27,164ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$272,843TotalAmt
Program Services$272,843ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$34,851TotalAmt
Program Services$34,851ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
IMMUNIZATION EXPENSE$333,506$333,506
OPERATIONAL SUPPLIES$316,414$316,414
DUES & SUBSCRIPTIONS$72,719$29,202$43,517
OTHER EXPENSES$4,658$582$4,076

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$9,131,096TotalAmt
Program Services$8,076,857ProgramServicesAmt
Management And General$1,054,239ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$2,257,924BOYAmt
EOY$4,542,173EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$5,268,164BOYAmt
EOY$5,609,290EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$757,710BOYAmt
EOY$697,530EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$120,476BOYAmt
EOY$125,526EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$44,748BOYAmt
EOY$44,823EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$6,873,977LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$2,387,214LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$4,578,516BOYAmt
EOY$4,486,763EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$13,027,538BOYAmt
EOY$15,506,105EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$389,422BOYAmt
EOY$420,925EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$56,575BOYAmt
EOY$649,145EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$840,700BOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,286,697BOYAmt
EOY$1,070,070EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$11,567,541BOYAmt
EOY$14,268,116EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$173,300BOYAmt
EOY$167,919EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$11,740,841BOYAmt
EOY$14,436,035EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$13,027,538BOYAmt
EOY$15,506,105EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$2,695,194ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
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)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,918,975CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$2,350,109CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$2,470,221CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$3,036,040CurrentTaxYearMinus1YearAmt
Current Tax Year$4,267,083CurrentTaxYearAmt
Total$15,042,428TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$5,595,883CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$5,871,372CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$6,643,958CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$7,200,084CurrentTaxYearMinus1YearAmt
Current Tax Year$7,422,700CurrentTaxYearAmt
Total$32,733,997TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$8,514,858CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$8,221,481CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$9,114,179CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$10,236,124CurrentTaxYearMinus1YearAmt
Current Tax Year$11,689,783CurrentTaxYearAmt
Total$47,776,425TotalAmt

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$47,776,425PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$27,883CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$35,904CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$77,929CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$100,954CurrentTaxYearMinus1YearAmt
Current Tax Year$76,695CurrentTaxYearAmt
Total$319,365TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$27,883CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$35,904CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$77,929CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$100,954CurrentTaxYearMinus1YearAmt
Current Tax Year$76,695CurrentTaxYearAmt
Total$319,365TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years$510CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$367CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$804CurrentTaxYearMinus1YearAmt
Current Tax Year$59,812CurrentTaxYearAmt
Total$61,493TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$8,542,741CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$8,257,895CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$9,192,475CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$10,337,882CurrentTaxYearMinus1YearAmt
Current Tax Year$11,826,290CurrentTaxYearAmt
Total$48,157,283TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.99210PublicSupportCY509Pct
Public Support PY5090.99160PublicSupportPY509Pct
Investment Income CY0.00660InvestmentIncomeCYPct
Investment Income PY0.00600InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME:FormAndLineReferenceDesc
ExplanationMISCELLANEOUS INCOME - 2017 AMOUNT: $ 510. 2018 AMOUNT: $ 367. 2019 AMOUNT: $ 804. 2020 AMOUNT: $ 59,812.ExplanationTxt

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$248,389OtherCostOrOtherBasisAmt
Book Value$248,389BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$5,118,542OtherCostOrOtherBasisAmt
Depreciation$1,214,406DepreciationAmt
Book Value$3,904,136BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$15,825OtherCostOrOtherBasisAmt
Depreciation$15,078DepreciationAmt
Book Value$747BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,200,451OtherCostOrOtherBasisAmt
Depreciation$978,425DepreciationAmt
Book Value$222,026BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$290,770OtherCostOrOtherBasisAmt
Depreciation$179,305DepreciationAmt
Book Value$111,465BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$4,486,763TotalBookValueLandBuildingsAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$11,826,290TotalRevEtcAuditedFinclStmtAmt
Revenue Not Reported$0RevenueNotReportedAmt
Revenue Subtotal$11,826,290RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$11,826,290TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$9,131,096TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$9,131,096ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$9,131,096TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationTHE CENTER IS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, EXCEPT ON INCOME DERIVED FROM UNRELATED BUSINESS ACTIVITIES. THE CENTER BELIEVES THAT IT HAS SUPPORT FOR ANY TAX POSITIONS TAKEN, AND AS SUCH, DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE FINANCIAL STATEMENTS.ExplanationTxt

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 (7 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
LEE B SPARKS
PHYSICIAN$220,000$0$0$0$0$0$11,000$0$13,301$0$244,301$0$0$0
STEVEN R ZELLER MD
PHYSICIAN$210,000$0$0$0$0$0$10,500$0$15,333$0$235,833$0$0$0
BILLIE GALYEN
PHYSICIAN$191,440$0$0$0$0$0$9,500$0$15,063$0$216,003$0$0$0
ELIZA WHITTEN
PHYSICIAN$179,265$0$0$0$0$0$8,963$0$14,302$0$202,530$0$0$0
DEANDRA DAVIS
PHYSICIAN$186,162$0$0$0$0$0$8,189$0$0$0$194,351$0$0$0
ROGER ARBUCKLE CEO
CEO$165,000$0$0$0$0$0$8,250$0$8,593$0$181,843$0$0$0
DAVID CONATSER MD
PHYSICIAN$160,000$0$0$0$0$0$8,000$0$0$0$168,000$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 7FormAndLineReferenceDesc
ExplanationPROVIDERS ARE ELIGIBLE TO RECEIVE A BONUS BASED ON A PRODUCTIVITY FORMULA.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11BMANAGEMENT PRESENTS THE FEDERAL FORM 990 TO THE BOARD AT THE REGULARLY SCHEDULED BOARD MEETING IMMEDIATELY PRECEDING THE RETURN'S DUE DATE. THE RETURN IS FILED AFTER BOARD REVIEW.
FORM 990, PART VI, SECTION B, LINE 12CBOARD MEMBERS AND OFFICERS SIGN ANNUAL CONFLICT OF INTEREST STATEMENTS.
FORM 990, PART VI, SECTION B, LINE 15THE BOARD DETERMINED THE CEO'S SALARY BASED ON SALARY SURVEY DATA FROM THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS AND CONDUCTS AN ANNUAL PERFORMANCE EVALUATION. THE CEO DETERMINED THE CFO'S SALARY BASED ON THE SAME INFORMATION WHICH IS EVALUATED ANNUALLY.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION MAKES GOVERNING DOCUMENTS, ITS CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST. ANNUAL FORMS 990 ARE AVAILABLE ON GUIDESTAR.ORG.
FORM 990, PART IX, LINE 11GCONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 1,396,404. MANAGEMENT AND GENERAL EXPENSES 183,997. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,580,401. BANK FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 219. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 219.
FORM 990, PART XII, LINE 2C:THE ORGANIZATION DID NOT CHANGE ITS OVERSIGHT OR SELECTION PROCESS FROM THE PRIOR YEAR.

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