COMMUNITY HEALTH CENTER OF RICHMOND INC: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- COMMUNITY HEALTH CENTER OF RICHMOND INC (EIN 51-0567466)
- Tax period
- 2020-01-01 to 2020-12-31
- Filed
- 2021-12-22
- IRS object ID
- 202123569349301407
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-12-22T14:00:31-06:00 | ReturnTs |
| Tax Period End | 2020-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 390859910 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BAKER TILLY US LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1570 FRUITVILLE PIKE SUITE 400 | AddressLine1Txt |
| City | LANCASTER | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 17601 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 510567466 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY HEALTH CENTER OF RICHMOND INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | COMM | BusinessNameControlTxt |
| Phone | 7189242254 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 439 PORT RICHMOND AVENUE | AddressLine1Txt |
| City | STATEN ISLAND | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 10302 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | HENRY THOMPSON | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 7189242254 | PhoneNum |
| Signature | 2021-12-22 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | HENRY | PersonFirstNm |
| Person Last | THOMPSON | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KERRI N BOGDA CPA | PreparerPersonNm |
| PTIN | P00760402 | PTIN |
| Phone | 7177404863 | PhoneNum |
| Self Employed | Yes (X) | SelfEmployedInd |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | HENRY THOMPSON | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 439 PORT RICHMOND AVENUE | AddressLine1Txt |
| City | STATEN ISLAND | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 10302 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $16,734,726 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.CHCRICHMOND.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2006 | FormationYr |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE QUALITY HEALTH CARE AND SPECIALTY SERVICES THAT ARE AFFORDABLE AND ACCESSIBLE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 122 | TotalEmployeeCnt |
| Total Volunteers | 9 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $6,590,674 | PYContributionsGrantsAmt |
| CY Contributions Grants | $7,596,369 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $8,250,546 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $7,073,093 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,998 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,509 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,738,607 | PYOtherRevenueAmt |
| CY Other Revenue | $2,063,755 | CYOtherRevenueAmt |
| PY Total Revenue | $16,581,825 | PYTotalRevenueAmt |
| CY Total Revenue | $16,734,726 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $11,223,532 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $11,864,046 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $5,294,520 | PYOtherExpensesAmt |
| CY Other Expenses | $5,136,136 | CYOtherExpensesAmt |
| PY Total Expenses | $16,518,052 | PYTotalExpensesAmt |
| CY Total Expenses | $17,000,182 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $63,773 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$265,456 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $18,938,875 | TotalAssetsBOYAmt |
| Total Assets EOY | $19,691,599 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $6,930,735 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $7,948,915 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $12,008,140 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $11,742,684 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE MISSION OF THE COMMUNITY HEALTH CENTER OF RICHMOND, INC. (THE CENTER) IS TO PROVIDE AFFORDABLE, QUALITY PRIMARY HEALTH CARE AND COORDINATED ACCESS TO SPECIALTY SERVICES WITH RESPECT AND COMPASSION FOR ALL PEOPLE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $13,534,513 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $7,073,093 | RevenueAmt |
| Desc | PROVIDING PRIMARY CARE SERVICES TO RESIDENTS OF STATEN ISLAND, NEW YORK WITH PARTICULAR EMPHASIS PLACED ON SERVING THE POOR AND UNDER-INSURED WITHIN THE COMMUNITY. THERE WERE 34,944 VISITS FOR 2020. CHCR HAS PROVIDED SERVICES TO 9,721 PATIENTS OF WHICH 1,841 WERE UNINSURED AND 9,161 WERE AT 200% OR BELOW THE FEDERAL POVERTY GUIDELINE. THERE WERE 45 HEALTH CARE PROVIDER FTES WHO DELIVERED THE SERVICES DURING THE YEAR.THE CENTER PROVIDES CARE TO PATIENTS WHO MEET CERTAIN CRITERIA UNDER ITS CHARITY CARE POLICY WITHOUT CHARGE OR AT AMOUNTS LESS THAN ITS ESTABLISHED RATES. BECAUSE THE CENTER DOES NOT PURSUE COLLECTION OF AMOUNTS DETERMINED TO QUALIFY AS CHARITY CARE, THEY ARE NOT REPORTED AS REVENUES OR SHOWN AS GRANTS TO INDIVIDUALS.THE CENTER MAINTAINS RECORDS TO IDENTIFY AND MONITOR THE LEVEL OF CHARITY CARE THAT IT PROVIDES. THE COSTS ASSOCIATED WITH THE CHARITABLE CARE SERVICES PROVIDED ARE ESTIMATED BY APPLYING THE COST-TO-CHARGE RATIO FROM THE MOST RECENTLY FILED COST REPORT TO THE AMOUNT OF GROSS UNCOMPENSATED CHARGES FOR THE PATIENTS RECEIVING CHARITY CARE. TOTAL CHARITY CARE COSTS WERE $944,233 FOR THE YEAR ENDED DECEMBER 31, 2020. | Desc |
| Total Program Service Expenses | $13,534,513 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | Yes (1) | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 27 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 122 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | NY | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | BENITO LINDO CFO | PersonNm |
| Phone | 7189242254 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 439 PORT RICHMOND AVE | AddressLine1Txt |
| City | STATEN ISLAND | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 10302 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| JACK DE SANTIS JR CPA | |||||||
| PRESIDENT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| SHERIF FARAG MD | |||||||
| 1ST VICE PRESIDENT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| ARACELI ARIZMENDI | |||||||
| 2ND VICE PRESIDENT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| DEMETRIUS CAROLINA | |||||||
| TREASURER | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| BARBARA GRIFFITHS | |||||||
| SECRETARY | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| JOAN CARUSO | |||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| CAMELIA RANGEL | |||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| SHAMEEKA JOHNSON | |||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| MICHAEL PERRY | |||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| HENRY THOMPSON | |||||||
| CHIEF EXECUTIVE OFFICER | 40.00 | Yes (X) | $366,702 | $0 | $56,974 | ||
| BENITO LINDO | |||||||
| CHIEF FINANCIAL OFFICER | 40.00 | Yes (X) | $265,885 | $0 | $19,032 | ||
| ROSALINDA ROSARIO-LIPKA DO | |||||||
| CHIEF MEDICAL OFFICER | 30.00 | Yes (X) | $209,970 | $0 | $30,813 | ||
| MONIQUE WELBECK DNP | |||||||
| NURSE PRACTITIONER | 40.00 | $207,008 | $0 | $25,589 | Yes (X) | ||
| VLADIMIR BARAYEV | |||||||
| PHYSICIAN | 40.00 | $179,456 | $0 | $45,276 | Yes (X) | ||
| GERARD CASALE | |||||||
| PHYSICIAN | 40.00 | $227,157 | $0 | $35,580 | Yes (X) | ||
| PREETI SHETKAR | |||||||
| PHYSICIAN | 40.00 | $211,316 | $0 | $47,276 | Yes (X) | ||
| PATRICE FERGUSON | |||||||
| PHYSICIAN | 40.00 | $196,730 | $0 | $12,677 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,864,224 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $273,217 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 20 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| HENRICH GROUP LLC | |||||
| 125-28 QUEENS BLVD SUITE 617 | KEW GARDENS | NY | 11415 | CONSTRUCTION MGMT | $135,500 |
| SHORELINE HEALTH SOLUTIONS LLC | |||||
| 2 PARKMAN PLACE | OLD SAYBROOK | CT | 06475 | CONSULTING | $103,019 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $7,459,800 | GovernmentGrantsAmt |
| All Other Contributions | $136,569 | AllOtherContributionsAmt |
| Noncash Contributions | $313,394 | NoncashContributionsAmt |
| Total Contributions | $7,596,369 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NET PATIENT SVC REV | Desc |
| Business | 623000 | BusinessCd |
| Total Revenue Column | $7,073,093 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $7,073,093 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $7,073,093 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,509 | TotalRevenueColumnAmt |
| Exclusion | $1,509 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| PATIENT INCENTIVE REVENUE | 900099 | $1,086,909 | $1,086,909 |
| PHARMACY SALES AT COST | 446110 | $970,633 | $970,633 |
| MEDICAL RECORDS REVENUE | 900099 | $6,213 | $6,213 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $2,063,755 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $16,734,726 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $7,073,093 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $2,065,264 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $949,376 | TotalAmt |
| Program Services | $294,357 | ProgramServicesAmt |
| Management And General | $655,019 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,009,086 | TotalAmt |
| Program Services | $6,782,828 | ProgramServicesAmt |
| Management And General | $1,226,258 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $352,537 | TotalAmt |
| Program Services | $278,504 | ProgramServicesAmt |
| Management And General | $74,033 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,955,625 | TotalAmt |
| Program Services | $1,704,180 | ProgramServicesAmt |
| Management And General | $251,445 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $597,422 | TotalAmt |
| Program Services | $483,061 | ProgramServicesAmt |
| Management And General | $114,361 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $152,265 | TotalAmt |
| Management And General | $152,265 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $66,057 | TotalAmt |
| Management And General | $66,057 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $777,924 | TotalAmt |
| Program Services | $539,491 | ProgramServicesAmt |
| Management And General | $238,433 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,198 | TotalAmt |
| Management And General | $14,198 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,795,191 | TotalAmt |
| Program Services | $1,469,882 | ProgramServicesAmt |
| Management And General | $325,309 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $96,096 | TotalAmt |
| Program Services | $96,096 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $639,516 | TotalAmt |
| Program Services | $639,516 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $54,397 | TotalAmt |
| Program Services | $54,397 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $327,452 | TotalAmt |
| Program Services | $258,687 | ProgramServicesAmt |
| Management And General | $68,765 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $801,047 | TotalAmt |
| Program Services | $632,827 | ProgramServicesAmt |
| Management And General | $168,220 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $50,981 | TotalAmt |
| Program Services | $24,938 | ProgramServicesAmt |
| Management And General | $26,043 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| REPAIRS AND MAINTENANCE | $90,203 | $90,203 | |
| DUES AND SUBSCRIPTIONS | $77,648 | $57,452 | $20,196 |
| BDCC SURCHARGE | $50,712 | $50,712 | |
| LEASED EQUIPMENT | $49,394 | $49,394 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $93,055 | TotalAmt |
| Program Services | $78,700 | ProgramServicesAmt |
| Management And General | $14,355 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,000,182 | TotalAmt |
| Program Services | $13,534,513 | ProgramServicesAmt |
| Management And General | $3,465,669 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $350 | BOYAmt |
| EOY | $350 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $310,603 | BOYAmt |
| EOY | $1,596,815 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $357,346 | BOYAmt |
| EOY | $361,539 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,277,106 | BOYAmt |
| EOY | $1,292,314 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $384,876 | BOYAmt |
| EOY | $132,846 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $22,241,655 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $6,121,109 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,421,405 | BOYAmt |
| EOY | $16,120,546 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $68,027 | BOYAmt |
| EOY | $68,027 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $119,162 | BOYAmt |
| EOY | $119,162 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,938,875 | BOYAmt |
| EOY | $19,691,599 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,348,187 | BOYAmt |
| EOY | $766,571 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,777 | BOYAmt |
| EOY | $14,777 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,567,771 | BOYAmt |
| EOY | $5,167,567 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $2,000,000 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,930,735 | BOYAmt |
| EOY | $7,948,915 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,008,140 | BOYAmt |
| EOY | $11,742,684 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,008,140 | BOYAmt |
| EOY | $11,742,684 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,938,875 | BOYAmt |
| EOY | $19,691,599 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$265,456 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,988,432 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $5,664,656 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $6,099,115 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $6,941,794 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $7,596,369 | CurrentTaxYearAmt |
| Total | $31,290,366 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $6,815,170 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $9,559,504 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7,608,241 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $8,250,546 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $7,073,093 | CurrentTaxYearAmt |
| Total | $39,306,554 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $11,803,602 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $15,224,160 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $13,707,356 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $15,192,340 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $14,669,462 | CurrentTaxYearAmt |
| Total | $70,596,920 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $70,596,920 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,368 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,671 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,235 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,998 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,509 | CurrentTaxYearAmt |
| Total | $10,781 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,368 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,671 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,235 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,998 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,509 | CurrentTaxYearAmt |
| Total | $10,781 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $821,961 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $703,821 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,622,575 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,738,607 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,063,755 | CurrentTaxYearAmt |
| Total | $6,950,719 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $12,628,931 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $15,929,652 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $15,332,166 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $16,932,945 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $16,734,726 | CurrentTaxYearAmt |
| Total | $77,558,420 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.91020 | PublicSupportCY509Pct |
| Public Support PY509 | 0.92810 | PublicSupportPY509Pct |
| Investment Income CY | 0.00010 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00020 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: | FormAndLineReferenceDesc |
| Explanation | MISCELLANEOUS INCOME - 2016 AMOUNT: $ 278. 2017 AMOUNT: $ 8,806. 2018 AMOUNT: $ 57,196. 2019 AMOUNT: $ 3,500. 340B PHARMACY PROGRAM - 2016 AMOUNT: $ 124,146. 2017 AMOUNT: $ 132,845. 2018 AMOUNT: $ 352,615. 2019 AMOUNT: $ 795,650. 2020 AMOUNT: $ 970,633. MEDICAL RECORDS - 2016 AMOUNT: $ 3,062. 2017 AMOUNT: $ 3,098. 2018 AMOUNT: $ 3,589. 2019 AMOUNT: $ 15,573. 2020 AMOUNT: $ 6,213. INCENTIVE PROGRAM - 2016 AMOUNT: $ 324,190. 2017 AMOUNT: $ 109,934. 2018 AMOUNT: $ 479,248. 2019 AMOUNT: $ 254,151. 2020 AMOUNT: $ 510,144. DSRIP INCENTIVE - 2016 AMOUNT: $ 370,285. 2017 AMOUNT: $ 449,138. 2018 AMOUNT: $ 729,927. 2019 AMOUNT: $ 626,706. 2020 AMOUNT: $ 576,765. CHIPA PARTNERSHIP - 2019 AMOUNT: $ 43,027. | ExplanationTxt |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,290,364 | OtherCostOrOtherBasisAmt |
| Book Value | $5,290,364 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $13,935,377 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,832,165 | DepreciationAmt |
| Book Value | $9,103,212 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,572,549 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,288,944 | DepreciationAmt |
| Book Value | $283,605 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,443,365 | OtherCostOrOtherBasisAmt |
| Book Value | $1,443,365 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $16,120,546 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $16,709,232 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | -$25,494 | OtherRevenueAmt |
| Revenue Not Reported | -$25,494 | RevenueNotReportedAmt |
| Revenue Subtotal | $16,734,726 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $16,734,726 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $16,974,688 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $16,974,688 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $25,494 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $25,494 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $17,000,182 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | THE CENTER 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 HAS BEEN MET. MANAGEMENT DETERMINED THAT THERE WERE NO TAX UNCERTAINTIES THAT MET THE RECOGNITION THRESHOLD IN 2020 AND 2019. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | PROVISON FOR BAD DEBTS NETTED AGAINST REVENUE -25,494. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | PROVISON FOR BAD DEBTS NETTED AGAINST REVENUE 25,494. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| HENRY THOMPSON | ||||||||||||||
| CHIEF EXECUTIVE OFFICER | $366,702 | $0 | $0 | $0 | $0 | $0 | $25,698 | $0 | $31,276 | $0 | $423,676 | $0 | $0 | $0 |
| BENITO LINDO | ||||||||||||||
| CHIEF FINANCIAL OFFICER | $265,885 | $0 | $0 | $0 | $0 | $0 | $19,032 | $0 | $0 | $0 | $284,917 | $0 | $0 | $0 |
| GERARD CASALE | ||||||||||||||
| PHYSICIAN | $227,157 | $0 | $0 | $0 | $0 | $0 | $16,800 | $0 | $18,780 | $0 | $262,737 | $0 | $0 | $0 |
| PREETI SHETKAR | ||||||||||||||
| PHYSICIAN | $211,316 | $0 | $0 | $0 | $0 | $0 | $16,000 | $0 | $31,276 | $0 | $258,592 | $0 | $0 | $0 |
| ROSALINDA ROSARIO-LIPKA DO | ||||||||||||||
| CHIEF MEDICAL OFFICER | $209,970 | $0 | $0 | $0 | $0 | $0 | $14,850 | $0 | $15,963 | $0 | $240,783 | $0 | $0 | $0 |
| MONIQUE WELBECK DNP | ||||||||||||||
| NURSE PRACTITIONER | $207,008 | $0 | $0 | $0 | $0 | $0 | $14,615 | $0 | $10,974 | $0 | $232,597 | $0 | $0 | $0 |
| VLADIMIR BARAYEV | ||||||||||||||
| PHYSICIAN | $179,456 | $0 | $0 | $0 | $0 | $0 | $14,000 | $0 | $31,276 | $0 | $224,732 | $0 | $0 | $0 |
| PATRICE FERGUSON | ||||||||||||||
| PHYSICIAN | $196,730 | $0 | $0 | $0 | $0 | $0 | $12,677 | $0 | $0 | $0 | $209,407 | $0 | $0 | $0 |
Schedule M IRS990ScheduleM
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 2 | ContributionCnt |
| Noncash Contributions Rpt F990 | $313,394 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | COST | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8283 Received | 0 | Form8283ReceivedCnt |
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | Yes (1) | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, COLUMN (B): | FormAndLineReferenceDesc |
| Explanation | THE AMOUNT REPORTED IN COLUMN B OF SCHEDULE M REPRESENTS THE NUMBER OF CONTRIBUTORS. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | THE CEO AND CFO REVIEW THE FORM 990 BEFORE IT IS FILED. THE RETURN IS THEN PRESENTED TO THE FINANCE COMMITTEE FOR REVIEW AND THEN TO THE GENERAL BOARD FOR APPROVAL BEFORE THE RETURN IS FILED. |
| FORM 990, PART VI, SECTION B, LINE 12C | CHCR PROVIDES BOARD MEMBERS AND STAFF WITH A CONFLICT OF INTEREST STATEMENT WHICH SUMMARIZES THE KEY ELEMENTS OF THE ORGANIZATION'S CONFLICT OF INTEREST POLICY. THE STATEMENT IS PROVIDED TO AND SIGNED BY BOARD MEMBERS AND STAFF BOTH AT THE TIME OF THE INDIVIDUAL'S INITIAL AFFILIATION WITH THE ORGANIZATION AND ANNUALLY THEREAFTER. FAMILY AND BUSINESS RELATIONSHIPS ARE EXPRESSLY MENTIONED IN THE POLICY. THE CEO IS RESPONSIBLE FOR MONITORING THE CONFLICTS. THE BOARD OF DIRECTORS REVIEWS THE CEO'S ANNUAL CONFLICT OF INTEREST STATEMENT. IN THE CASE OF A CONFLICT OF INTEREST, THE BOARD MEMBER WILL REPORT THE CONFLICT TO THE FULL BOARD PRIOR TO ANY DISCUSSION OF THE MATTER AND RECUSE THEMSELVES FROM VOTING ON THE MATTER. |
| FORM 990, PART VI, SECTION B, LINE 15 | OFFICER COMPENSATION IS DETERMINED AND COMPARED BASED ON THE CURRENT MARKET, INDUSTRY STANDARDS AND SURVEYS TAKEN. THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS APPROVES THE CHIEF EXECUTIVE OFFICER'S SALARY. THE COMPENSATION SETTING PROCESS IS DOCUMENTED IN THE EXECUTIVE COMMITTEE MINUTES. THIS PROCESS IS THEN DONE WITH THE GOAL OF ENSURING A SALARY OF NO MORE THAN THE FAIR MARKET VALUE OF THE SERVICES RENDERED. SALARIES FOR THE OTHER OFFICERS AND STAFF ARE BASED UPON AN INDUSTRY SURVEY, E.G. NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS (NACHC), AND THE COMMUNITY HEALTH CENTER ASSOCIATION OF NEW YORK STATE (CHCANYS). THE ORGANIZATION HAS A BOARD PERSONNEL COMMITTEE THAT OVERSEES HIRING AND CREDENTIALING OF EMPLOYEES. THE CEO HAS THE PRIVILEGE AND SOLE AUTHORITY TO HIRE AND FIRE EMPLOYEES; TO ESTABLISH SALARIES BASED UPON THE SURVEY PARAMETERS, AND TO PROVIDE RECOMMENDATIONS TO THE BOARD FOR APPROVAL. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
Comments