PENINSULA INSTITUTE FOR COMMUNITY HEALTH INC: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- PENINSULA INSTITUTE FOR COMMUNITY HEALTH INC (EIN 54-1083954)
- Tax period
- 2019-01-01 to 2019-12-31
- Filed
- 2020-06-03
- IRS object ID
- 202021559349300802
- 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 | 2020-06-03T09:54:13-05:00 | ReturnTs |
| Tax Period End | 2019-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 541896113 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ROBINSON FARMER COX ASSOCIATES | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 401 SOUTHLAKE BLVD | AddressLine1Txt |
| City | RICHMOND | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 23236 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2019-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 541083954 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PENINSULA INSTITUTE FOR COMMUNITY | BusinessNameLine1Txt |
| Business Name Line2 | HEALTH | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PENI | BusinessNameControlTxt |
| Phone | 7573808709 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1033 28TH STREET 2ND FLOOR | AddressLine1Txt |
| City | NEWPORT NEWS | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 23607 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ANGELA FUTRELL | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 7573808709 | PhoneNum |
| Signature | 2020-04-10 | SignatureDt |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | AARON B HAWKINS | PreparerPersonNm |
| PTIN | P01458736 | PTIN |
| Phone | 8043784200 | PhoneNum |
| Preparation | 2020-06-03 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 50.77.77.25 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2020-06-03 | IPDt |
| IP Tm | 09:54:13 | IPTm |
| IP Timezone | CD | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 9ABF4A4CD9073D44961EDDFBB9D4FC555C086CE7 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 9ABF4A4CD9073D44961EDDFBB9D4FC555C086CE7 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SOUTHEASTERN VIRGINIA HEALTH SYSTEM | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ANGELA FUTRELL | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1033 28TH STREET 2ND FLOOR | AddressLine1Txt |
| City | NEWPORT NEWS | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 23607 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $16,103,630 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.PICH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1978 | FormationYr |
| Legal Domicile State | VA | LegalDomicileStateCd |
| Activity Or Mission | PROVIDE HIGH QUALITY, COMPREHENSIVE, PRIMARY HEALTH CARE SERVICES TO VIRGINIA RESIDENTS LIVING IN HAMPTON ROADS REGARDLESS OF THEIR ABILITY TO PAY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 13 | VotingMembersIndependentCnt |
| Total Employee | 221 | TotalEmployeeCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $9,415,186 | PYContributionsGrantsAmt |
| CY Contributions Grants | $9,359,597 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $5,199,449 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $6,045,988 | CYProgramServiceRevenueAmt |
| PY Investment Income | $4,353 | PYInvestmentIncomeAmt |
| CY Investment Income | $54,656 | CYInvestmentIncomeAmt |
| CY Other Revenue | $29,646 | CYOtherRevenueAmt |
| PY Total Revenue | $14,618,988 | PYTotalRevenueAmt |
| CY Total Revenue | $15,489,887 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $9,293,419 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $9,020,700 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $4,800,536 | PYOtherExpensesAmt |
| CY Other Expenses | $5,833,806 | CYOtherExpensesAmt |
| PY Total Expenses | $14,093,955 | PYTotalExpensesAmt |
| CY Total Expenses | $14,854,506 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $525,033 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $635,381 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $11,056,552 | TotalAssetsBOYAmt |
| Total Assets EOY | $11,195,112 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,863,525 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,297,191 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $9,193,027 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $9,897,921 | NetAssetsOrFundBalancesEOYAmt |
| Mission | PROVIDING MEDICAL AND DENTAL CARE TO INDIGENT PATIENTS. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $10,255,225 | ExpenseAmt |
| Revenue | $6,045,988 | RevenueAmt |
| Desc | MEDICAL CARE: PRIMARY MEDICAL CARE, DENTAL SERVICES AND MENTAL HEALTH SERVICES FOR THE MEDICALLY UNDERSERVED AREAS OF NEWPORT NEWS, HAMPTON, SUFFOLK, VIRGINIA BEACH, CHESPEAKE, MATHEWS COUNTY, AND FRANKLIN, VIRGINIA. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,120,572 | ExpenseAmt |
| Desc | CASE MANAGEMENT: ASSISTANCE FOR PATIENTS MANAGING AND COORDINATING CARE FOR COMPLEX AND/OR CHRONIC CONDITIONS. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $236,352 | ExpenseAmt |
| Desc | OTHER PATIENT SERVICES: ENABLING SERVICES TO INCLUDE OUTREACH, PATIENT EDUCATION AND PHARMACY ASSISTANCE FOR MEDICALLY UNDERSERVED POPULATIONS SERVED BY THE HEALTH CENTER. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $11,612,149 | 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 | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | 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 | Yes (true) | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | 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 | 32 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | false | BackupWthldComplianceInd |
| Employee | 221 | 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 |
| 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 | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 13 | 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 | Yes (true) | LocalChaptersInd |
| Policies Reference Chapters | Yes (true) | PoliciesReferenceChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | 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 |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ANGELA FUTRELL | PersonNm |
| Phone | 7573808709 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1033 28TH STREET 2ND FLOOR | AddressLine1Txt |
| City | NEWPORT NEWS | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 23607 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | Yes (X) | NoListedPersonsCompensatedInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Key EmployeeKeyEmployeeInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd |
|---|---|---|---|---|---|---|---|---|
| ANGELA FUTRELL | ||||||||
| CEO | 40.00 | Yes (X) | $276,791 | $0 | $9,155 | |||
| DAVID LORENZO | ||||||||
| PHYSICIAN | 40.00 | $198,684 | $0 | $7,800 | Yes (X) | |||
| VALDA BRANCH | ||||||||
| COO | 40.00 | Yes (X) | $185,870 | $0 | $7,032 | |||
| CONCEPCION ASPILI | ||||||||
| PHYSICIAN | 40.00 | $177,593 | $0 | $7,000 | Yes (X) | |||
| PAULINE REED | ||||||||
| CMO | 40.00 | Yes (X) | $174,912 | $0 | $7,000 | |||
| ANDREI SAN-MARINA | ||||||||
| PHYSICIAN | 40.00 | $173,699 | $0 | $7,000 | Yes (X) | |||
| SUFIA B SHAHID | ||||||||
| PHYSICIAN | 40.00 | $164,717 | $0 | $6,454 | Yes (X) | |||
| NONA HILTON | ||||||||
| CFO | 40.00 | Yes (X) | $157,670 | $0 | $6,324 | |||
| ROBERT AYERS | ||||||||
| DIRECTOR | 2.00 | $0 | $0 | $0 | Yes (X) | |||
| TIFFANY BROWN-WILKINS | ||||||||
| SECRETARY | 2.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | ||
| M DENISE COUNCE | ||||||||
| TREASURER | 2.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | ||
| WANDA ALLEN ESQ | ||||||||
| CHAIR | 6.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | ||
| BARRETT FRANKLIN | ||||||||
| DIRECTOR | 2.00 | $0 | $0 | $0 | Yes (X) | |||
| KATHERINE GRANT-DAVIS | ||||||||
| DIRECTOR | 2.00 | $0 | $0 | $0 | Yes (X) | |||
| RUTH HOLMES | ||||||||
| DIRECTOR | 2.00 | $0 | $0 | $0 | Yes (X) | |||
| ARAVIA JOHNSON | ||||||||
| DIRECTOR | 2.00 | $0 | $0 | $0 | Yes (X) | |||
| ASA JENRETTE JR | ||||||||
| DIRECTOR | 2.00 | $0 | $0 | $0 | Yes (X) | |||
| ROZ MERDITAJ | ||||||||
| DIRECTOR | 2.00 | $0 | $0 | $0 | Yes (X) | |||
| DOROTHY MURRAY | ||||||||
| DIRECTOR | 2.00 | $0 | $0 | $0 | Yes (X) | |||
| STYLIE WILLIAMS | ||||||||
| PARLIAMENTAR | 2.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | ||
| SHIRLEY WILLS | ||||||||
| VICE CHAIR | 2.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,509,936 | TotalReportableCompFromOrgAmt |
| Total Other Compensation | $57,765 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 8 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| STAFFCARE INC | |||||
| 5001 STATESMAN DR | IRVING | TX | 75063 | STAFFING | $850,050 |
| INTEGRITY HEALTHCARE CORPORATION | |||||
| 243 MCLAWS CIRCLE SUITE 101 | WILLIAMSBURG | VA | 23185 | BEHAVIOR HEALTH | $272,635 |
| PENINSULA CLEANING SERVICE | |||||
| 12610 PATRICK HENRY DR SUITE A | NEWPORT NEWS | VA | 23602 | JANITORIAL | $262,831 |
| LABCORP | |||||
| PO BOX 2250 | BURLINGTON | NC | 272162240 | LAB WORK | $171,332 |
| MEDICAL TEMPORARIES | |||||
| 840 FIRST COLONIAL ROAD SUITE 102A | VIRGINIA BEACH | VA | 23451 | STAFFING | $152,032 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $8,421,709 | GovernmentGrantsAmt |
| All Other Contributions | $937,888 | AllOtherContributionsAmt |
| Total Contributions | $9,359,597 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|
| NET PATIENT SERVICE REVENUE | $5,658,486 | $5,658,486 |
| RX STRATEGIES | $306,150 | $306,150 |
| OTHER INCOME | $81,352 | $81,352 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $6,045,988 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $40,508 | TotalRevenueColumnAmt |
| Exclusion | $40,508 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $627,891 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $613,743 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $14,148 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $14,148 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $14,148 | RelatedOrExemptFuncIncomeAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | GAIN ON SALE OF ASSETS | Desc |
| Total Revenue Column | $29,646 | TotalRevenueColumnAmt |
| Exclusion | $29,646 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $29,646 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $15,489,887 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $6,060,136 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $70,154 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $806,740 | TotalAmt |
| Program Services | $120,847 | ProgramServicesAmt |
| Management And General | $685,893 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,662,682 | TotalAmt |
| Program Services | $5,923,435 | ProgramServicesAmt |
| Management And General | $739,247 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $950,087 | TotalAmt |
| Program Services | $643,325 | ProgramServicesAmt |
| Management And General | $306,762 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $601,191 | TotalAmt |
| Program Services | $449,911 | ProgramServicesAmt |
| Management And General | $151,280 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,812 | TotalAmt |
| Management And General | $21,812 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $44,858 | TotalAmt |
| Management And General | $44,858 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,207,073 | TotalAmt |
| Program Services | $2,160,056 | ProgramServicesAmt |
| Management And General | $47,017 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,355,481 | TotalAmt |
| Program Services | $1,004,413 | ProgramServicesAmt |
| Management And General | $351,068 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $116,534 | TotalAmt |
| Program Services | $13,984 | ProgramServicesAmt |
| Management And General | $102,550 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,396,056 | TotalAmt |
| Program Services | $1,155,050 | ProgramServicesAmt |
| Management And General | $241,006 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,351 | TotalAmt |
| Program Services | $508 | ProgramServicesAmt |
| Management And General | $5,843 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,485 | TotalAmt |
| Program Services | $2,789 | ProgramServicesAmt |
| Management And General | $15,696 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $303,463 | TotalAmt |
| Program Services | $53,427 | ProgramServicesAmt |
| Management And General | $250,036 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $74,319 | TotalAmt |
| Management And General | $74,319 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Management And GeneralManagementAndGeneralAmt | Program ServicesProgramServicesAmt |
|---|---|---|---|
| DUES & PUB - MGMT & GEN | $106,025 | $106,025 | |
| RECRUITING | $56,142 | $29,755 | $26,387 |
| MARKETING | $53,767 | $51,939 | $1,828 |
| TAXES AND LICENSES | $39,559 | $15,626 | $23,933 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,881 | TotalAmt |
| Program Services | $32,256 | ProgramServicesAmt |
| Management And General | $1,625 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,854,506 | TotalAmt |
| Program Services | $11,612,149 | ProgramServicesAmt |
| Management And General | $3,242,357 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,507,260 | BOYAmt |
| EOY | $2,882,956 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,648,255 | BOYAmt |
| EOY | $829,951 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $964,240 | BOYAmt |
| EOY | $1,455,699 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $124,054 | BOYAmt |
| EOY | $98,899 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $9,308,473 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $4,784,365 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,026,005 | BOYAmt |
| EOY | $4,524,108 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $786,738 | BOYAmt |
| EOY | $1,403,499 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,056,552 | BOYAmt |
| EOY | $11,195,112 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,253,537 | BOYAmt |
| EOY | $906,507 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $609,988 | BOYAmt |
| EOY | $390,684 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,863,525 | BOYAmt |
| EOY | $1,297,191 | 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 | $9,193,027 | BOYAmt |
| EOY | $9,897,921 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,193,027 | BOYAmt |
| EOY | $9,897,921 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,056,552 | BOYAmt |
| EOY | $11,195,112 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $635,381 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $69,513 | NetUnrlzdGainsLossesInvstAmt |
| 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 | $217,200 | OtherCostOrOtherBasisAmt |
| Book Value | $217,200 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,253,294 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,239,626 | DepreciationAmt |
| Book Value | $4,013,668 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,837,979 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,544,739 | DepreciationAmt |
| Book Value | $293,240 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $4,524,108 | TotalBookValueLandBuildingsAmt |
| Total Rev Etc Audited Fincl Stmt | $15,755,593 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $69,513 | NetUnrealizedGainsInvstAmt |
| Donated Services And Use Fclts | $196,193 | DonatedServicesAndUseFcltsAmt |
| Revenue Not Reported | $265,706 | RevenueNotReportedAmt |
| Revenue Subtotal | $15,489,887 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $15,489,887 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $15,050,699 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $196,193 | DonatedServicesUseFcltsAmt |
| Expenses Not Reported | $196,193 | ExpensesNotReportedAmt |
| Expenses Subtotal | $14,854,506 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $14,854,506 | TotalExpensesPerForm990Amt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| 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 (8 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt |
|---|---|---|---|---|
| ANGELA FUTRELL | ||||
| CEO | $276,791 | $9,155 | $23,197 | $285,946 |
| DAVID LORENZO | ||||
| PHYSICIAN | $198,684 | $7,800 | $23,032 | $206,484 |
| VALDA BRANCH | ||||
| COO | $185,870 | $7,032 | $17,375 | $192,902 |
| CONCEPCION ASPILI | ||||
| PHYSICIAN | $177,593 | $7,000 | $31,968 | $184,593 |
| PAULINE REED | ||||
| CMO | $174,912 | $7,000 | $11,847 | $181,912 |
| ANDREI SAN-MARINA | ||||
| PHYSICIAN | $173,699 | $7,000 | $2,585 | $180,699 |
| SUFIA B SHAHID | ||||
| PHYSICIAN | $164,717 | $6,454 | $19,327 | $171,171 |
| NONA HILTON | ||||
| CFO | $157,670 | $6,324 | $11,668 | $163,994 |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | COMMUNITY HEALTHCARE ASSOCIATES | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | PRINCIPAL OWNER | RelationshipDescriptionTxt |
| Transaction | $13,380 | TransactionAmt |
| Transaction | GRANT WRITING | TransactionDesc |
| Sharing Of Revenues | false | SharingOfRevenuesInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE L, PART V | FormAndLineReferenceDesc |
| Explanation | (A) NAME OF PERSON: COMMUNITY HEALTHCARE ASSOCIATES, INC. (B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: PRINCIPAL OWNER IS FORMER CEO OF THE NONPROFIT. (C) AMOUNT OF TRANSACTION: 13,380 (D) DESCRIPTION OF TRANSACTION: COMPENSATION FOR GRANT WRITING. (E) SHARING OF ORGANIZATION REVENUES?: NO | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 6, PART VI, LINE 11B | THE CFO AND CEO REVIEW THE FORM 990 BEFORE FILING. |
| FORM 990, PAGE 6, PART VI, LINE 12C | THE BOARD IS CHARGED WITH REVIEWING THE POLICIES ANNUALLY OR AS APPROPRIATE. |
| FORM 990, PAGE 6, PART VI, LINE 15A | COMPENSATION NEGOTIATIONS ARE BASED UPON EXPERIENCE AND SKILL SET IN KEEPING WITH FAIR MARKET VALUE AND FORMAL PAY SCALE. |
| FORM 990, PAGE 6, PART VI, LINE 15B | COMPENSATION NEGOTIATIONS ARE BASED UPON EXPERIENCE AND SKILL SET IN KEEPING WITH FAIR MARKET VALUE AND FORMAL PAY SCALE. |
| FORM 990, PAGE 6, PART VI, LINE 19 | GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | PROF. FEES - MEDICAL CARE 2,069,106 0 0 PROF. FEES - CASE MGMT 90,950 0 0 PROF. FEES - MGMT & GENERAL 0 47,017 0 TOTAL 2,160,056 47,017 0 |