NEIGHBORHOOD HEALTH: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- NEIGHBORHOOD HEALTH (EIN 54-1849891)
- Tax period
- 2019-07-01 to 2020-06-30
- Filed
- 2021-01-25
- IRS object ID
- 202130259349300003
- Schema version
- 2019v5.1
- 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 | 2021-01-25T08:05:59-06:00 | ReturnTs |
| Tax Period End | 2020-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 455310918 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FRANK BARCALOW CPA PLLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 108 WESTCHESTER | AddressLine1Txt |
| City | WILLIAMSBURG | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 23188 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2019-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 541849891 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NEIGHBORHOOD HEALTH | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | NEIG | BusinessNameControlTxt |
| Phone | 7035355568 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6677 RICHMOND HIGHWAY | AddressLine1Txt |
| City | ALEXANDRIA | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 22306 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DR BASIM KHAN | PersonNm |
| Person Title | EXECUTIVE DIRECTOR | PersonTitleTxt |
| Phone | 7035355568 | PhoneNum |
| Signature | 2021-01-25 | SignatureDt |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| PTIN | P00446788 | PTIN |
| Phone | 7572206626 | PhoneNum |
| Preparation | 2021-01-11 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | DR BASIM KHAN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6677 RICHMOND HIGHWAY | AddressLine1Txt |
| City | ALEXANDRIA | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 22306 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $24,533,213 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.NEIGHBORHOODHEALTHVA.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1997 | FormationYr |
| Legal Domicile State | VA | LegalDomicileStateCd |
| Activity Or Mission | TO IMPROVE HEALTH AND ADVANCE HEALTH EQUITY IN ALEXANDRIA, ARLINGTON, AND FAIRFAX BY PROVIDING HIGH QUALITY PRIMARY CARE REGARDLESS OF ABILITY TO PAY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 271 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $8,205,579 | PYContributionsGrantsAmt |
| CY Contributions Grants | $14,652,120 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $7,718,451 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $9,412,989 | CYProgramServiceRevenueAmt |
| PY Investment Income | $26,142 | PYInvestmentIncomeAmt |
| CY Investment Income | $37,634 | CYInvestmentIncomeAmt |
| PY Other Revenue | $419,741 | PYOtherRevenueAmt |
| CY Other Revenue | $430,470 | CYOtherRevenueAmt |
| PY Total Revenue | $16,369,913 | PYTotalRevenueAmt |
| CY Total Revenue | $24,533,213 | 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 | $10,016,730 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $15,807,951 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $233,584 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $5,607,727 | PYOtherExpensesAmt |
| CY Other Expenses | $8,608,517 | CYOtherExpensesAmt |
| PY Total Expenses | $15,624,457 | PYTotalExpensesAmt |
| CY Total Expenses | $24,416,468 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $745,456 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $116,745 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $15,550,480 | TotalAssetsBOYAmt |
| Total Assets EOY | $18,553,290 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $8,087,230 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $10,973,295 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $7,463,250 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $7,579,995 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO IMPROVE HEALTH AND ADVANCE HEALTH EQUITY IN ALEXANDRIA, ARLINGTON, AND FAIRFAX BY PROVIDING HIGH QUALITY PRIMARY CARE REGARDLESS OF ABILITY TO PAY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $21,154,550 | ExpenseAmt |
| Revenue | $9,843,459 | RevenueAmt |
| Desc | NEIGHBORHOOD HEALTH PROVIDED PRIMARY MEDICAL, DENTAL, BEHAVIORAL HEALTH, PREVENTIVE CARE, PHARMACY ASSISTANCE, HIV SERVICES, AND LABORATORY SERVICES FOR 35,000 PATIENTS IN THE CITY OF ALEXANDRIA, ARLINGTON COUNTY, AND FAIRFAX COUNTY. | Desc |
| Total Program Service Expenses | $21,154,550 | 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 | 0 | 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 | 0 | 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 | 50 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 271 | 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 | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | VA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE ORGANIZATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7035355568 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6677 RICHMOND HIGHWAY | AddressLine1Txt |
| City | ALEXANDRIA | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 22306 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (15 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 |
|---|---|---|---|---|---|---|---|
| MICHAEL L MILLMAN | |||||||
| BOARD PRESIDENT | 4.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| RICHARD GUNDLING | |||||||
| BOARD TREASURER | 4.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| NORA PARTLOW | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| ALISA VALUDES WHYTE | |||||||
| BOARD VICE PRESIDENT | 4.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| CARTER FLEMMING | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| MIRIAM AGUILA | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| MUHAMMAD ARIF | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| PAOLA NAVARRO | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| ELHAFEDH TALEBIMIJINE | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| BASIM KHAN MD | |||||||
| EXECUTIVE DIRECTOR | 40.00 | Yes (X) | $222,822 | $0 | $0 | ||
| MARTHA WELLMAN MD | |||||||
| MEDICAL DIRECTOR | 40.00 | $193,449 | $0 | $0 | Yes (X) | ||
| PAULA HAYES MD | |||||||
| PHYSICAN | 40.00 | $189,490 | $0 | $0 | Yes (X) | ||
| ALI SHAHCHERAGHI MD | |||||||
| PHYSICAN | 40.00 | $171,231 | $0 | $0 | Yes (X) | ||
| DANIEL HOLTAN MD | |||||||
| PHYSICAN | 40.00 | $180,492 | $0 | $0 | Yes (X) | ||
| NATALIE HEAVILIN MD | |||||||
| PHYSICAN | 40.00 | $159,557 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,117,041 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $0 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 16 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (4 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| LABCORP | |||||
| PO BOX 12140 | BURLINGTON | NC | 27216 | LAB WORK | $763,656 |
| CEM SOLUTIONS | |||||
| 20130 LAKEVIEW CENTER PLAZA SUITE | ASHBURN | VA | 20147 | IT SOLUTIONS | $413,958 |
| ADP LLC | |||||
| PO BOX 842875 | BOSTON | MA | 02284 | PAYROLL SERVICES | $345,978 |
| CENEVIA HEALTH BUSINESS SERVICES | |||||
| 3831 WESTERRE PARKWAY SUITE 1 | HENRICO | VA | 23233 | BILLING SERVICES | $279,534 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $3,940,437 | GovernmentGrantsAmt |
| All Other Contributions | $10,711,683 | AllOtherContributionsAmt |
| Total Contributions | $14,652,120 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT SERVICE | Desc |
| Business | 621110 | BusinessCd |
| Total Revenue Column | $9,412,989 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $9,412,989 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $9,412,989 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $37,634 | TotalRevenueColumnAmt |
| Exclusion | $37,634 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Personal | $351,238 | PersonalAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Personal | $0 | PersonalAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Personal | $351,238 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $351,238 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $351,238 | RelatedOrExemptFuncIncomeAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OTHER INCOME | Desc |
| Business | 621110 | BusinessCd |
| Total Revenue Column | $79,232 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $79,232 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $79,232 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $24,533,213 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $9,843,459 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $37,634 | ExclusionAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,265,431 | TotalAmt |
| Program Services | $11,796,772 | ProgramServicesAmt |
| Management And General | $1,294,334 | ManagementAndGeneralAmt |
| Fundraising | $174,325 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $217,428 | TotalAmt |
| Program Services | $193,511 | ProgramServicesAmt |
| Management And General | $21,743 | ManagementAndGeneralAmt |
| Fundraising | $2,174 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,312,397 | TotalAmt |
| Program Services | $1,166,942 | ProgramServicesAmt |
| Management And General | $127,525 | ManagementAndGeneralAmt |
| Fundraising | $17,930 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,012,695 | TotalAmt |
| Program Services | $900,576 | ProgramServicesAmt |
| Management And General | $98,811 | ManagementAndGeneralAmt |
| Fundraising | $13,308 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,569 | TotalAmt |
| Program Services | $2,569 | ProgramServicesAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $283,781 | TotalAmt |
| Management And General | $283,781 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,184,628 | TotalAmt |
| Program Services | $566,347 | ProgramServicesAmt |
| Management And General | $618,281 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $322,914 | TotalAmt |
| Program Services | $232,995 | ProgramServicesAmt |
| Management And General | $85,341 | ManagementAndGeneralAmt |
| Fundraising | $4,578 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $709,219 | TotalAmt |
| Program Services | $556,943 | ProgramServicesAmt |
| Management And General | $152,276 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,974 | TotalAmt |
| Program Services | $7,676 | ProgramServicesAmt |
| Management And General | $5,298 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,201 | TotalAmt |
| Program Services | $14,457 | ProgramServicesAmt |
| Management And General | $14,144 | ManagementAndGeneralAmt |
| Fundraising | $600 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $246,632 | TotalAmt |
| Program Services | $246,632 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $409,333 | TotalAmt |
| Program Services | $386,410 | ProgramServicesAmt |
| Management And General | $22,923 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $69,536 | TotalAmt |
| Program Services | $59,248 | ProgramServicesAmt |
| Management And General | $10,288 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| PATIENT CARE AND CONSUL | $2,428,688 | $2,428,688 | ||
| MEDICAL SUPPLIES | $2,427,263 | $2,399,198 | $28,065 | |
| EQUIPMENT AND FACILITY | $212,282 | $78,946 | $123,341 | $9,995 |
| MISCELLANEOUS | $205,269 | $116,491 | $82,821 | $5,957 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $64,228 | TotalAmt |
| Program Services | $149 | ProgramServicesAmt |
| Management And General | $59,362 | ManagementAndGeneralAmt |
| Fundraising | $4,717 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,416,468 | TotalAmt |
| Program Services | $21,154,550 | ProgramServicesAmt |
| Management And General | $3,028,334 | ManagementAndGeneralAmt |
| Fundraising | $233,584 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $193,387 | BOYAmt |
| EOY | $207,979 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,565,077 | BOYAmt |
| EOY | $8,020,474 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $236,030 | BOYAmt |
| EOY | $747,554 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,350,406 | BOYAmt |
| EOY | $402,436 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,790 | BOYAmt |
| EOY | $14,230 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $43,504 | BOYAmt |
| EOY | $28,928 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $12,988,251 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $3,884,595 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,126,253 | BOYAmt |
| EOY | $9,103,656 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,033 | BOYAmt |
| EOY | $28,033 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,550,480 | BOYAmt |
| EOY | $18,553,290 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,392,322 | BOYAmt |
| EOY | $2,041,633 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $465,871 | BOYAmt |
| EOY | $697,484 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,229,037 | BOYAmt |
| EOY | $6,024,378 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $2,209,800 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,087,230 | BOYAmt |
| EOY | $10,973,295 | 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 | $7,463,250 | BOYAmt |
| EOY | $7,579,995 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,463,250 | BOYAmt |
| EOY | $7,579,995 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,550,480 | BOYAmt |
| EOY | $18,553,290 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $116,745 | 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) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $5,953,003 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $6,803,047 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7,464,187 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $8,205,579 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $14,652,120 | CurrentTaxYearAmt |
| Total | $43,077,936 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $5,953,003 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $6,803,047 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7,464,187 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $8,205,579 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $14,652,120 | CurrentTaxYearAmt |
| Total | $43,077,936 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $43,077,936 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $43 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $134 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $10,740 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $26,142 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $37,634 | CurrentTaxYearAmt |
| Total | $74,693 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $540,639 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $519,672 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $598,787 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $419,741 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $430,470 | CurrentTaxYearAmt |
| Total | $2,509,309 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $45,661,938 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $33,915,799 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.94340 | PublicSupportCY170Pct |
| Public Support PY170 | 0.93170 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
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 | $732,360 | OtherCostOrOtherBasisAmt |
| Book Value | $732,360 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,127,129 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,170,281 | DepreciationAmt |
| Book Value | $4,956,848 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,243,109 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,240,840 | DepreciationAmt |
| Book Value | $3,002,269 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,885,653 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,473,474 | DepreciationAmt |
| Book Value | $412,179 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $9,103,656 | TotalBookValueLandBuildingsAmt |
| Total Rev Etc Audited Fincl Stmt | $25,753,615 | TotalRevEtcAuditedFinclStmtAmt |
| Donated Services And Use Fclts | $1,220,402 | DonatedServicesAndUseFcltsAmt |
| Revenue Not Reported | $1,220,402 | RevenueNotReportedAmt |
| Revenue Subtotal | $24,533,213 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $24,533,213 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $25,636,870 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $1,220,402 | DonatedServicesUseFcltsAmt |
| Expenses Not Reported | $1,220,402 | ExpensesNotReportedAmt |
| Expenses Subtotal | $24,416,468 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $24,416,468 | TotalExpensesPerForm990Amt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 (6 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BASIM KHAN MD | ||||||||||||||
| EXECUTIVE DIRECTOR | $222,822 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $222,822 | $0 | $0 | $0 |
| MARTHA WELLMAN MD | ||||||||||||||
| MEDICAL DIRECTOR | $193,449 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $193,449 | $0 | $0 | $0 |
| PAULA HAYES MD | ||||||||||||||
| PHYSICAN | $189,490 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $189,490 | $0 | $0 | $0 |
| ALI SHAHCHERAGHI MD | ||||||||||||||
| PHYSICAN | $171,231 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $171,231 | $0 | $0 | $0 |
| DANIEL HOLTAN MD | ||||||||||||||
| PHYSICAN | $180,492 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $180,492 | $0 | $0 | $0 |
| NATALIE HEAVILIN MD | ||||||||||||||
| PHYSICAN | $159,557 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $159,557 | $0 | $0 | $0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | THE BOARD WAS PROVIDED A DRAFT OF THE 990 BEFORE FILING FOR REVIEW. FEEDBACK WAS PROVIDED AND INCORPORATED INTO THE SCHEDULE PRIOR TO FILING |
| FORM 990, PART VI, SECTION B, LINE 12C | THE CONFLICT OF INTEREST STATEMENTS ARE SIGNED ON AN ANNUAL BASIS. |
| FORM 990, PART VI, SECTION B, LINE 15A | SALARIES ARE COMPARED TO SIMILAR SIZED ORGANIZATIONS. |
| FORM 990, PART VI, SECTION C, LINE 19 | DOCUMENTS ARE MADE AVAILABLE UPON REQUEST |