THUNDER BAY COMMUNITY HEALTH SERVICE INC: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- THUNDER BAY COMMUNITY HEALTH SERVICE INC (EIN 38-2290337)
- Tax period
- 2019-03-01 to 2020-02-29
- Filed
- 2020-10-10
- IRS object ID
- 202012849349300301
- Schema version
- 2019v5.0
- 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 | 2020-10-10T08:47:16-05:00 | ReturnTs |
| Tax Period End | 2020-02-29 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 382963463 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | QUAST JANKE & CO CPA'S PC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1010 N JOHNSON | AddressLine1Txt |
| City | BAY CITY | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48708 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2019-03-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 382290337 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THUNDER BAY COMMUNITY HEALTH SERVIC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | THUN | BusinessNameControlTxt |
| Phone | 9897424583 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 15774 STATE ST PO BOX 427 | AddressLine1Txt |
| City | HILLMAN | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49746 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MICHELLE STYMA | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 9893542197 | PhoneNum |
| Signature | 2020-09-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DAVID G GWIZDALA CPA | PreparerPersonNm |
| PTIN | P00234130 | PTIN |
| Phone | 9898924549 | PhoneNum |
| Preparation | 2020-09-21 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 68.188.255.226 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2020-10-10 | IPDt |
| IP Tm | 08:47:16 | IPTm |
| IP Timezone | CD | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | D8BCDA6FAEE05FCE2D0413F04D2286D4FC501897 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 8C5457C659111890134E7037C06BD7E3EB37A991 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MICHELLE STYMA | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 8855 N M 65 | AddressLine1Txt |
| City | POSEN | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49776 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $21,794,741 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.TBCHS.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1981 | FormationYr |
| Legal Domicile State | MI | LegalDomicileStateCd |
| Activity Or Mission | THUNDER BAY COMMUNITY HEALTH SERVICE COMMITS ITS RESOURCES TO BUILDING HEALTHIER COMMUNITIES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 15 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 15 | VotingMembersIndependentCnt |
| Total Employee | 199 | TotalEmployeeCnt |
| Total Volunteers | 15 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $5,898,158 | PYContributionsGrantsAmt |
| CY Contributions Grants | $6,087,101 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $13,891,978 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $15,687,116 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$2,963 | PYInvestmentIncomeAmt |
| CY Investment Income | -$787 | CYInvestmentIncomeAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $19,787,173 | PYTotalRevenueAmt |
| CY Total Revenue | $21,773,430 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $11,643,870 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $12,335,838 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $7,914,052 | PYOtherExpensesAmt |
| CY Other Expenses | $9,149,679 | CYOtherExpensesAmt |
| PY Total Expenses | $19,557,922 | PYTotalExpensesAmt |
| CY Total Expenses | $21,485,517 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $229,251 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $287,913 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $11,592,313 | TotalAssetsBOYAmt |
| Total Assets EOY | $11,535,699 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $5,131,746 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $4,787,219 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $6,460,567 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $6,748,480 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THUNDER BAY COMMUNITY HEALTH SERVICE COMMITS ITS RESOURCES TO BUILDING HEALTHIER COMMUNITIES. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $17,175,563 | ExpenseAmt |
| Revenue | $15,687,116 | RevenueAmt |
| Desc | THIS FEDERALLY QUALIFIED COMMUNITY HEALTH CENTER HAD 15,833 PATIENTS AND PROVIDED 69,565 CLINICAL VISITS INCLUDING MEDICAL, DENTAL,OPTOMETRY AND BEHAVIORAL HEALTH SERVICES. | Desc |
| Total Program Service Expenses | $17,175,563 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | Yes (true) | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 40 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 199 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Form8899 Filedind | false | Form8899Filedind |
| Form1098 C Filed | false | Form1098CFiledInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 15 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 15 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | false | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | LEIGHANN VIERS | PersonNm |
| Phone | 9893542197 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 N RIPLEY SUITE E | AddressLine1Txt |
| City | ALPENA | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49707 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|
| MARION HAUTEA | |||||||
| CMO | 40.00 | Yes (X) | $293,750 | $0 | $35,588 | ||
| JEMELLEE JACALA-TADIAN | |||||||
| PHYSICIAN | 40.00 | $259,308 | $0 | $33,454 | Yes (X) | ||
| MICHELLE STYMA | |||||||
| CEO | 40.00 | Yes (X) | $257,747 | $0 | $33,446 | ||
| MANUEL HERNANDEZ | |||||||
| PHYSICIAN | 40.00 | $245,500 | $0 | $30,154 | Yes (X) | ||
| JEFFREY TAYLOR | |||||||
| DENTIST | 40.00 | $230,210 | $0 | $29,197 | Yes (X) | ||
| WAYNE MCEWEN | |||||||
| PHSICIAN ASS | 40.00 | $180,500 | $0 | $28,729 | Yes (X) | ||
| CAROL WEISE | |||||||
| DENTIST | 40.00 | $176,957 | $0 | $12,343 | Yes (X) | ||
| KAYLA BERRY | |||||||
| COO | 40.00 | Yes (X) | $93,162 | $0 | $20,659 | ||
| LEIGHANN VIERS | |||||||
| CFO | 40.00 | Yes (X) | $89,949 | $0 | $23,229 | ||
| BEN BOLSER | |||||||
| VICE CHAIR | 2.00 | $0 | $0 | $0 | Yes (X) | ||
| NANCY DEXTROM | |||||||
| CHAIR | 2.00 | $0 | $0 | $0 | Yes (X) | ||
| MICHAEL FAIRBANKS | |||||||
| DIRECTOR | 2.00 | $0 | $0 | $0 | Yes (X) | ||
| MARY FITZGERALD | |||||||
| DIRECTOR | 2.00 | $0 | $0 | $0 | Yes (X) | ||
| ROD FULLERTON | |||||||
| DIRECTOR | 2.00 | $0 | $0 | $0 | Yes (X) | ||
| BEACH HALL | |||||||
| DIRECTOR | 2.00 | $0 | $0 | $0 | Yes (X) | ||
| SHANNA JOHNSON | |||||||
| TREASURER | 2.00 | $0 | $0 | $0 | Yes (X) | ||
| NINA KENNARD | |||||||
| SECRETARY | 2.00 | $0 | $0 | $0 | Yes (X) | ||
| CARRIE LOHMAN | |||||||
| DIRECTOR | 2.00 | $0 | $0 | $0 | Yes (X) | ||
| JACQUELYN MCINTIRE | |||||||
| DIRECTOR | 2.00 | $0 | $0 | $0 | Yes (X) | ||
| AL MOE | |||||||
| DIRECTOR | 2.00 | $0 | $0 | $0 | Yes (X) | ||
| MIKE WURTSMITH | |||||||
| DIRECTOR | 2.00 | $0 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,827,083 | TotalReportableCompFromOrgAmt |
| Total Other Compensation | $246,799 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 19 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| COMMERICIAL CONTRACTING NORTH | |||||
| 181 N INDUSTRIAL HWY | ALPENA | MI | 49707 | CONSTRUCTION | $386,852 |
| BRUCE DIETZ | |||||
| 430 S STATE AVE | ALPENA | MI | 49707 | RENT | $145,590 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $4,270,388 | GovernmentGrantsAmt |
| All Other Contributions | $1,816,713 | AllOtherContributionsAmt |
| Noncash Contributions | $1,812,481 | NoncashContributionsAmt |
| Total Contributions | $6,087,101 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|
| PATIENT FEES | $9,023,762 | $9,023,762 |
| PHARMACY SALES | $6,231,394 | $6,231,394 |
| INCENTIVES | $156,221 | $156,221 |
| OTHER PROGRAM REVENUE | $124,563 | $124,563 |
| MI CARE TEAM | $116,376 | $116,376 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $34,800 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $34,800 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $15,687,116 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $20,524 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $20,524 | RelatedOrExemptFuncIncomeAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $21,311 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -$21,311 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$21,311 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | -$21,311 | RelatedOrExemptFuncIncomeAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $21,773,430 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $15,686,329 | RelatedOrExemptFuncIncomeAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $734,608 | TotalAmt |
| Program Services | $386,912 | ProgramServicesAmt |
| Management And General | $347,696 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,865,171 | TotalAmt |
| Program Services | $6,671,562 | ProgramServicesAmt |
| Management And General | $2,193,609 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,002,381 | TotalAmt |
| Program Services | $1,325,556 | ProgramServicesAmt |
| Management And General | $676,825 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $733,678 | TotalAmt |
| Program Services | $534,551 | ProgramServicesAmt |
| Management And General | $199,127 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $185,286 | TotalAmt |
| Management And General | $185,286 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,340,804 | TotalAmt |
| Program Services | $1,340,804 | ProgramServicesAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $133,370 | TotalAmt |
| Program Services | $119,087 | ProgramServicesAmt |
| Management And General | $14,283 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $269,813 | TotalAmt |
| Program Services | $117,207 | ProgramServicesAmt |
| Management And General | $152,606 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $453,389 | TotalAmt |
| Program Services | $280,736 | ProgramServicesAmt |
| Management And General | $172,653 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $176,052 | TotalAmt |
| Program Services | $88,542 | ProgramServicesAmt |
| Management And General | $87,510 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $163,001 | TotalAmt |
| Program Services | $152,981 | ProgramServicesAmt |
| Management And General | $10,020 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $513,786 | TotalAmt |
| Program Services | $413,221 | ProgramServicesAmt |
| Management And General | $100,565 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $37,894 | TotalAmt |
| Program Services | $22,699 | ProgramServicesAmt |
| Management And General | $15,195 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $5,410,581 | $5,410,581 | |
| REPAIR AND MAINT | $279,122 | $256,975 | $22,147 |
| DUES AND LICENSES | $121,419 | $54,009 | $67,410 |
| OTHER | $65,162 | $140 | $65,022 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,485,517 | TotalAmt |
| Program Services | $17,175,563 | ProgramServicesAmt |
| Management And General | $4,309,954 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $973,436 | BOYAmt |
| EOY | $104,024 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,696,113 | BOYAmt |
| EOY | $1,591,649 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $97,500 | BOYAmt |
| EOY | $207,881 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $777,781 | BOYAmt |
| EOY | $1,173,527 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $138,552 | BOYAmt |
| EOY | $169,798 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $188,259 | BOYAmt |
| EOY | $231,781 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $12,369,316 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $4,442,807 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,613,322 | BOYAmt |
| EOY | $7,926,509 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,500 | BOYAmt |
| EOY | $11,500 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $97,850 | BOYAmt |
| EOY | $119,030 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,592,313 | BOYAmt |
| EOY | $11,535,699 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,070,451 | BOYAmt |
| EOY | $1,034,437 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,061,295 | BOYAmt |
| EOY | $3,752,782 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,131,746 | BOYAmt |
| EOY | $4,787,219 | 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 | $6,460,567 | BOYAmt |
| EOY | $6,748,480 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,460,567 | BOYAmt |
| EOY | $6,748,480 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,592,313 | BOYAmt |
| EOY | $11,535,699 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $287,913 | ReconcilationRevenueExpnssAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | 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 (true) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
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 | $445,021 | OtherCostOrOtherBasisAmt |
| Book Value | $445,021 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $9,200,811 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,057,628 | DepreciationAmt |
| Book Value | $6,143,183 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $255,149 | OtherCostOrOtherBasisAmt |
| Depreciation | $64,057 | DepreciationAmt |
| Book Value | $191,092 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,468,335 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,321,122 | DepreciationAmt |
| Book Value | $1,147,213 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $7,926,509 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $22,041,333 | TotalRevEtcAuditedFinclStmtAmt |
| Donated Services And Use Fclts | $267,903 | DonatedServicesAndUseFcltsAmt |
| Revenue Not Reported | $267,903 | RevenueNotReportedAmt |
| Revenue Subtotal | $21,773,430 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $21,773,430 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $21,753,420 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $267,903 | DonatedServicesUseFcltsAmt |
| Expenses Not Reported | $267,903 | ExpensesNotReportedAmt |
| Expenses Subtotal | $21,485,517 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $21,485,517 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE D, PAGE 3, PART X | FormAndLineReferenceDesc |
| Explanation | MANAGEMENT HAS EVALUTED TAX POSITIONS TAKEN BY THE CENTER AND HAS CONCLUDED THAT AS OF FEBRUARY 29, 2020 THERE ARE NO UNCERTAIN TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt |
|---|---|---|---|---|
| MARION HAUTEA | ||||
| CMO | $293,750 | $16,726 | $18,862 | $329,338 |
| JEMELLEE JACALA-TADIAN | ||||
| PHYSICIAN | $259,308 | $14,608 | $18,846 | $292,762 |
| MICHELLE STYMA | ||||
| CEO | $257,747 | $14,134 | $19,312 | $291,193 |
| MANUEL HERNANDEZ | ||||
| PHYSICIAN | $245,500 | $11,292 | $18,862 | $275,654 |
| JEFFREY TAYLOR | ||||
| DENTIST | $230,210 | $13,812 | $15,385 | $259,407 |
| WAYNE MCEWEN | ||||
| PHSICIAN ASSISTANT | $180,500 | $10,830 | $17,899 | $209,229 |
| CAROL WEISE | ||||
| DENTIST | $176,957 | $10,617 | $1,726 | $189,300 |
Schedule M IRS990ScheduleM
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $1,812,481 | NoncashContributionsRptF990Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | false | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | false | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 1, PART I, LINE 6 | BOARD MEMBERS ARE ALL VOLUNTEERS IN ADDITION TO COMMUNITY MEMBERS WHO DONATE TIME FOR VARIOUS CENTER ACTIVITIES |
| FORM 990, PAGE 6, PART VI, LINE 11B | AUDITOR REVIEWS RETURN WITH FINANCE COMMITTEE AND PRESENTS REVIEW TO ENTIRE BOARD PRIOR TO SUBMISSION |
| FORM 990, PAGE 6, PART VI, LINE 12C | BOARD MEMBERS SUBMIT WRITTEN STATEMENTS TO EXECUTIVE TEAM FOR REVIEW ON ANY CONFLICT OF INTEREST ISSUES |
| FORM 990, PAGE 6, PART VI, LINE 15A | CEO COMPENSATION IS DETERMINED BY EXECUTIVE COMMITTEE BASED UPON COMPARABILITY DATA FOR SIMILIAR POSTION. ENTIRE BOARD MAKES FINAL APPROVAL OF WAGE DETERMINATION |
| FORM 990, PAGE 6, PART VI, LINE 15B | BOARD APPROVES WAGES OF CEO AND KEY EMPLOYEES BASED UPON BOARD APPROVED WAGE SCALE |
| FORM 990, PAGE 6, PART VI, LINE 19 | GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST, PREFERABLY IN WRITING. THE ORGANIZATION MAKES COPIES OF THE REQUESTED DOCUMENTS AND MAKES THEM AVAILABLE FOR PICK UP OR MAIL TO THE REQUESTEE. |