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MY COMMUNITY HEALTH CENTER: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization
MY COMMUNITY HEALTH CENTER (EIN 81-2171085)
Tax period
2020-01-01 to 2020-12-31
Filed
2021-10-11
IRS object ID
202112849349301566
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)
Return2021-10-11T17:00:23-05:00ReturnTs
Tax Period End2020-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN410746749PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line14334 MUNSON STREET SUITE 200AddressLine1Txt
CityCANTONCityNm
State AbbreviationOHStateAbbreviationCd
ZIP44718ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2020-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN812171085EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MY COMMUNITY HEALTH CENTERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlMYCOBusinessNameControlTxt
Phone3303636242PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12600 7TH STREET SWAddressLine1Txt
CityCANTONCityNm
State AbbreviationOHStateAbbreviationCd
ZIP44710ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonKELLY LORENZPersonNm
Person TitleCFOPersonTitleTxt
Phone3303631310PhoneNum
Signature2021-10-01SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstKELLYPersonFirstNm
Person LastLORENZPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJENNIFER COLEMANPreparerPersonNm
PTINP00743188PTIN
Phone3304972000PhoneNum

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 OfficerTERRY REGULAPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line12600 7TH STREET SWAddressLine1Txt
CityCANTONCityNm
State AbbreviationOHStateAbbreviationCd
ZIP44710ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$7,848,326GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.MYCOMHC.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2016FormationYr
Legal Domicile StateOHLegalDomicileStateCd
Activity Or MissionTO PROVIDE COMPASSIONATE CARE TO ALL; HEALING AND LEARNING TOGETHER.ActivityOrMissionDesc
Voting Members Governing Body9VotingMembersGoverningBodyCnt
Voting Members Independent9VotingMembersIndependentCnt
Total Employee96TotalEmployeeCnt
Total Volunteers9TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$2,868,174PYContributionsGrantsAmt
CY Contributions Grants$3,891,548CYContributionsGrantsAmt
PY Program Service Revenue$4,510,125PYProgramServiceRevenueAmt
CY Program Service Revenue$3,951,109CYProgramServiceRevenueAmt
PY Investment Income$15,791PYInvestmentIncomeAmt
CY Investment Income$5,650CYInvestmentIncomeAmt
PY Other Revenue$27PYOtherRevenueAmt
CY Other Revenue$19CYOtherRevenueAmt
PY Total Revenue$7,394,117PYTotalRevenueAmt
CY Total Revenue$7,848,326CYTotalRevenueAmt
PY Grants And Similar Paid$100PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$3,381,073PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$4,004,014CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$3,021,867PYOtherExpensesAmt
CY Other Expenses$2,819,382CYOtherExpensesAmt
PY Total Expenses$6,403,040PYTotalExpensesAmt
CY Total Expenses$6,823,396CYTotalExpensesAmt
PY Revenues Less Expenses$991,077PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$1,024,930CYRevenuesLessExpensesAmt
Total Assets BOY$2,065,525TotalAssetsBOYAmt
Total Assets EOY$3,081,082TotalAssetsEOYAmt
Total Liabilities BOY$499,422TotalLiabilitiesBOYAmt
Total Liabilities EOY$490,049TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$1,566,103NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$2,591,033NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionMY COMMUNITY HEALTH CENTER (MCHC) IS A GRASSROOTS, COMMUNITY-BASED 501(C)(3) OHIO NONPROFIT ORGANIZATION WHOSE MISSION IS TO PROVIDE COMPASSIONATE CARE TO ALL, HEALING AND LEARNING TOGETHER. MCHC'S GOAL IS TO BE RESPONSIVE TO THE NEEDS OF THE COMMUNITIES IT SERVES, BUT WITH CONTINUED EMPHASIS ON THE UNDERSERVED AND THOSE WITHOUT ACCESS TO CARE, REGARDLESS OF RACE, ECONOMIC STATUS, AGE, SEX, SEXUAL ORIENTATION, OR DISABILITY.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$5,314,088ExpenseAmt
Grant$0GrantAmt
Revenue$3,951,109RevenueAmt
DescMY COMMUNITY HEALTH CENTER (MCHC) IS A GRASSROOTS, COMMUNITY-BASED 501(C)(3) OHIO NONPROFIT ORGANIZATION WHOSE MISSION IS TO PROVIDE COMPASSIONATE CARE TO ALL, HEALING AND LEARNING TOGETHER. MCHC'S GOAL IS TO BE RESPONSIVE TO THE NEEDS OF THE COMMUNITIES IT SERVES, BUT WITH CONTINUED EMPHASIS ON THE UNDERSERVED AND THOSE WITHOUT ACCESS TO CARE, REGARDLESS OF RACE, ECONOMIC STATUS, AGE, SEX, SEXUAL ORIENTATION, OR DISABILITY.MCHC ESTABLISHED ITSELF AS A COMMUNITY CLINIC SITE IN AUGUST 2017 AND HAS BEEN ACTIVE AS A COMMUNITY HEALTH CARE PROVIDER SINCE. THE ORGANIZATION BELIEVES IN TRAINING THE NEXT GENERATION OF HEALTH CARE PROVIDERS. AS SUCH MCHC HAS ESTABLISHED A RELATIONSHIP WITH THREE RESIDENCY PROGRAMS FOR THEIR RESIDENTS TO PROVIDE OUTPATIENT, CONTINUITY OF CARE AT MCHC; INTERNAL MEDICINE, FAMILY MEDICINE & OBSTETRICS AND GYNECOLOGY. IN SEPTEMBER 2019, MCHC RECEIVED FULL DESIGNATION FROM THE FEDERAL HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA) TO BE FEDERALLY QUALIFIED HEALTH CENTER.SERVICES PROVIDED BY MCHC INCLUDE FAMILY PRACTICE, INTERNAL MEDICINE, PRENATAL SERVICES, POSTPARTUM CARE, WELL CHILD & PEDIATRIC CARE, SCREENINGS, CHRONIC DISEASE MANAGEMENT, DENTAL CARE (BY REFERRAL), LABORATORY, BEHAVIORAL HEALTH (INCLUDING INDIVIDUALS/GROUPS), FAMILY PLANNING, OUTREACH, HEALTH EDUCATION (INCLUDING NUTRITION), ELIGIBILITY ASSISTANCE, AND CASE MANAGEMENT. THESE OUTPATIENT PRIMARY HEALTH SERVICES ARE PROVIDED TO THE MEDICALLY UNDERSERVED POPULATIONS IN STARK COUNTY, OHIO AND SURROUNDING COMMUNITIES. THE ORGANIZATION RECEIVED APPROVAL TO OPEN A SECOND SITE IN MAGNOLIA, OHIO, A HRSA DESIGNATED UNDERSERVED AREA IN SEPTEMBER 2019. THIS FULLY FUNCTIONING SATELLITE OFFICE BEGAN OPERATIONS IN JANUARY 2020 AND PROVIDES MOST OF THE SAME HEALTH CENTER SERVICES AS DESCRIBED ABOVE. IN MARCH OF 2020 TO MEET THE CHALLENGING ISSUES OF COVID-19 WITH OUR PATIENTS, MCHC ADDED TELEHEALTH SERVICES AND PROVIDED OVER 6,700 TELEHEALTH VISITS. IN ADDITION, MCHC ALSO PROVIDED COVID TESTING TO APPROXIMATELY 860 PATIENTS. IN TOTAL FOR 2020, MCHC PROVIDED CARE TO APPROXIMATELY 9,200 PATIENTS WITH CLOSE TO 33,000 MEDICAL VISITS. MCHC EMPLOYS MORE THAN 70 EMPLOYEES, MANY FROM THE LOCAL COMMUNITY. STAFF ARE FLUENT IN ENGLISH AND AMERICAN SIGN LANGUAGE (CONTRACTED TRANSLATION SERVICES FOR OTHER LANGUAGES) AND EFFECTIVE AT WORKING WITH PEOPLE AT ALL LEVELS OF LITERACY.OUR OBSTETRICAL PROGRAM IS UNIQUE IN THE FACT THAT WE ARE THE LARGEST OB PROVIDER FOR MEDICAID PATIENTS IN STARK COUNTY. WE ALSO PROVIDE THE ONLY CERTIFIED CENTERING PROGRAM IN THE COUNTY.COMMUNITY COLLABORATION IS IMPORTANT TO MCHC. BELOW IS A BRIEF DESCRIPTION OF COLLABORATIONS WITH COMMUNITY PARTNERS: - OB DEPARTMENT COLLABORATES WITH STARK COUNTY AND CANTON CITY HEALTH DEPARTMENTS ON THE THRIVE INITIATIVE TO REDUCE INFANT MORTALITY. - THE INTERNAL MEDICINE DIVISION COLLABORATES WITH ACCESS HEALTH TO PROVIDE COMMUNITY HEALTH WORKERS FOR HIGH RISK DIABETICS IN THE PRACTICE. - MCHC COLLABORATES WITH BEACON PHARMACY TO PROVIDE PRESCRIPTION MEDICATIONS AT A REDUCED COST TO PATIENTS. THE STAFF TYPICALLY PARTICIPATE IN MANY COMMUNITY ACTIVITIES, BUT THEY WERE SUSPENDED IN 2020 DUE TO COVID. HOWEVER, THEY DID PARTICIPATE IN COVID TESTING WITH THE CANTON CITY HEALTH DEPARTMENT AND THE NATIONAL GUARD.Desc
Total Program Service Expenses$5,314,088TotalProgramServiceExpensesAmt
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 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 Document9IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee96EmployeeCnt
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 Members9GoverningBodyVotingMembersCnt
Independent Voting Member9IndependentVotingMemberCnt
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 CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldOHStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1KELLY LORENZBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone3303631310PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12600 7TH STREET SWAddressLine1Txt
CityCANTONCityNm
State AbbreviationOHStateAbbreviationCd
ZIP44710ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (12 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
MARIA HEEGE
PRESIDENT1.00Yes (X)Yes (X)$0$0$0
SHARLA ELTON
TREASURER1.00Yes (X)Yes (X)$0$0$0
CYRILIA PRATT
SECRETARY1.00Yes (X)Yes (X)$0$0$0
STEVE JACKSON
DIRECTOR1.00Yes (X)$0$0$0
JAMES ANDERSON
DIRECTOR1.00Yes (X)$0$0$0
RENEE BACKIE
DIRECTOR1.00Yes (X)$0$0$0
SUSAN MERCER MD
DIRECTOR1.00Yes (X)$0$0$0
LINDA WOODLOCK
DIRECTOR1.00Yes (X)$0$0$0
JEFFREY ZELLERS
DIRECTOR1.00Yes (X)$0$0$0
TERRY REGULA
CEO40.00Yes (X)$186,466$0$20,642
KELLY LORENZ
CFO40.00Yes (X)$109,325$0$6,505
JOHN SUTTON MD
MEDICAL DIRECTOR40.00$240,091$0$13,709Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$535,882TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$40,856TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K3IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (4 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
AULTMAN HEALTH FOUNDATION
2600 SIXTH STREET SWCANTONOH44710MSA AGREEMENT$953,541
AULTMAN HOSPITAL
2600 SIXTH STREET SWCANTONOH44710PRECEPTORING SERVICES$923,761
ALLSCRIPTS- ESCONDIDO CA
24630 NETWORK PLACECHICAGOIL60673BILLING SERVICE, EHR HOSTING & QUALITY S$263,492
CANTON MEDICAL EDUCATION FOUNDATION
2600 SIXTH STREET SWCANTONOH44710PRECEPTORING SERVICES$119,049
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K4CntrctRcvdGreaterThan100KCnt
Government Grants$1,906,324GovernmentGrantsAmt
All Other Contributions$1,985,224AllOtherContributionsAmt
Noncash Contributions$1,226NoncashContributionsAmt
Total Contributions$3,891,548TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PATIENT SERVICE REVENUE621400$3,800,241$3,800,241
QUALITY INCENTIVE REVENUE621400$104,095$104,095
STUDENT PRECEPT INCOME621400$46,773$46,773
FieldValueIRS element (for citing)
Total Program Service Revenue$3,951,109TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$5,650TotalRevenueColumnAmt
Exclusion$5,650ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescOTHER REVENUEDesc
Business900099BusinessCd
Total Revenue Column$19TotalRevenueColumnAmt
Exclusion$19ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$19OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$7,848,326TotalRevenueColumnAmt
Related Or Exempt Func Income$3,951,109RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$5,669ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$576,737TotalAmt
Program Services$308,627ProgramServicesAmt
Management And General$268,110ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$2,723,685TotalAmt
Program Services$2,376,087ProgramServicesAmt
Management And General$347,598ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$21,233TotalAmt
Program Services$10,815ProgramServicesAmt
Management And General$10,418ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$460,752TotalAmt
Program Services$384,327ProgramServicesAmt
Management And General$76,425ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$221,607TotalAmt
Program Services$178,555ProgramServicesAmt
Management And General$43,052ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$41,006TotalAmt
Management And General$41,006ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$1,703,153TotalAmt
Program Services$1,545,756ProgramServicesAmt
Management And General$157,397ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$18,815TotalAmt
Management And General$18,815ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$52,302TotalAmt
Program Services$587ProgramServicesAmt
Management And General$51,715ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$69,541TotalAmt
Program Services$69,541ProgramServicesAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$355,308TotalAmt
Management And General$355,308ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$986TotalAmt
Program Services$80ProgramServicesAmt
Management And General$906ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$538TotalAmt
Management And General$538ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$53,576TotalAmt
Management And General$53,576ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$36,414TotalAmt
Program Services$5,578ProgramServicesAmt
Management And General$30,836ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
COST OF GOODS SOLD$153,844$153,844
MEDICATIONS$133,561$133,561
SUPPLIES AND EQUIPMENT$102,845$99,818$3,027
OTHER EXPENSES$97,493$46,912$50,581

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$6,823,396TotalAmt
Program Services$5,314,088ProgramServicesAmt
Management And General$1,509,308ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,378,727BOYAmt
EOY$2,251,742EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$424,996BOYAmt
EOY$470,226EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$21,770BOYAmt
EOY$35,825EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$23,114BOYAmt
EOY$39,042EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$333,823LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$49,576LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$216,918BOYAmt
EOY$284,247EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$2,065,525BOYAmt
EOY$3,081,082EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$499,422BOYAmt
EOY$490,049EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$499,422BOYAmt
EOY$490,049EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,566,103BOYAmt
EOY$2,369,663EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
EOY$221,370EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,566,103BOYAmt
EOY$2,591,033EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,065,525BOYAmt
EOY$3,081,082EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$1,024,930ReconcilationRevenueExpnssAmt
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$333,823OtherCostOrOtherBasisAmt
Depreciation$49,576DepreciationAmt
Book Value$284,247BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$284,247TotalBookValueLandBuildingsAmt
Total Rev Etc Audited Fincl Stmt$7,848,326TotalRevEtcAuditedFinclStmtAmt
Revenue Not Reported$0RevenueNotReportedAmt
Revenue Subtotal$7,848,326RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$7,848,326TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$6,823,396TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$6,823,396ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$6,823,396TotalExpensesPerForm990Amt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Form990 Of Other OrganizationsYes (X)Form990OfOtherOrganizationsInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
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 (2 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
JOHN SUTTON MD
MEDICAL DIRECTOR$226,288$0$13,113$0$690$0$2,400$0$11,309$0$253,800$0$0$0
TERRY REGULA
CEO$179,974$0$5,000$0$1,492$0$20,642$0$0$0$207,108$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 3FormAndLineReferenceDesc
ExplanationTHE BOARD OF DIRECTORS DECIDES AND APPROVES THE CEO'S COMPENSATION. THE COMPENSATION IS THEN REVIEWED BY THE HUMAN RESOURCES MANAGER.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11BTHE FORM 990 WAS PREPARED BY AN INDEPENDENT CPA FIRM BASED ON INFORMATION PROVIDED BY THE ORGANIZATION'S CFO. THE CEO AND CFO CAREFULLY REVIEWED AND ANALYZED THE TAX RETURN, RECONCILING THE GENERAL LEDGER AMOUNTS TO THE APPROPRIATE SCHEDULES ON THE FORM 990 AND COMPARING THOSE AMOUNTS TO THE AUDITED FINANCIAL STATEMENTS. A COMPLETE COPY OF THE 990 WAS THEN SENT VIA EMAIL TO THE BOARD OF DIRECTORS FOR THEIR REVIEW PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12CTHE ORGANIZATION'S CONFLICT OF INTEREST POLICY APPLIES TO CLINIC BOARD MEMBERS, EMPLOYEES, CONSULTANTS AND THOSE WHO FURNISH GOODS OR SERVICES TO THE ORGANIZATION. EACH BOARD MEMBER IS REQUIRED TO COMPLETE A CERTIFICATION OF AGREEMENT WITH THE CONFLICT OF INTEREST POLICY AND DISCLOSE ANY KNOWN CONFLICTS OF INTEREST UPON HIS OR HER ELECTION OR RE-ELECTION TO THE BOARD AND ANNUALLY THEREAFTER. WHENEVER THE CHIEF EXECUTIVE OFFICER, KEY MANAGEMENT PERSONNEL OR ANY BOARD MEMBER HAS A CONFLICT OF INTEREST OR A PERCEIVED CONFLICT OF INTEREST WITH MCHC, HE OR SHE IS REQUIRED TO NOTIFY THE FULL BOARD OF SUCH CONFLICT IN WRITING USING THE ANNUAL CERTIFICATION FORM. WHEN ANY CONFLICT OF INTEREST IS RELEVANT TO A MATTER THAT COMES UNDER CONSIDERATION OR REQUIRES ACTION BY THE BOARD, OR A BOARD COMMITTEE, THE INTERESTED PERSON IS REQUIRED TO CALL IT TO THE ATTENTION OF THE BOARD CHAIR AND MUST LEAVE THE MEETING DURING BOARD OR COMMITTEE DISCUSSION OR DECISION ON THE MATTER. HOWEVER, THAT PERSON IS ALLOWED TO PROVIDE THE BOARD OR APPLICABLE COMMITTEE WITH ANY AND ALL RELEVANT INFORMATION ON THE PARTICULAR MATTER. BOARD MEMBERS WHO VIOLATE THE CONFLICT OF INTEREST POLICY MAY, DEPENDING ON THE SEVERITY OF THE VIOLATION, BE SUBJECT TO ORAL ADMONISHMENT OR REMOVAL FROM THEIR POSITION.
FORM 990, PART VI, SECTION C, LINE 19MY COMMUNITY HEALTH CENTER MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART IX, LINE 11GOTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 1,545,756. MANAGEMENT AND GENERAL EXPENSES 152,854. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,698,610. CONSULTING SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 4,543. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,543.

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