COMMUNITY HEALTH CENTERS OF WESTERN KENTUCKY INC: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization
COMMUNITY HEALTH CENTERS OF WESTERN KENTUCKY INC (EIN 61-1268014)
Tax period
2019-05-01 to 2020-04-30
Filed
2020-08-31
IRS object ID
202022449349300512
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

FieldValueIRS element (for citing)
Return2020-08-31T14:39:17-05:00ReturnTs
Tax Period End2020-04-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN610920132PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1RINEY HANCOCK CPAS PSCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line12900 VEACH ROAD SUITE 2AddressLine1Txt
CityOWENSBOROCityNm
State AbbreviationKYStateAbbreviationCd
ZIP42303ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2019-05-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN611268014EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1COMMUNITY HEALTH CENTERS OF WESTERNBusinessNameLine1Txt
Business Name Line2KENTUCKY INCBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlCOMMBusinessNameControlTxt
Phone2703385777PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1480 HOPKINSVILLE STREETAddressLine1Txt
CityGREENVILLECityNm
State AbbreviationKYStateAbbreviationCd
ZIP42345ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJOSEPH SWABPersonNm
Person TitleCFOPersonTitleTxt
Phone2703385777PhoneNum
Signature2020-08-31SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonCARLA J DOWELL CPAPreparerPersonNm
PTINP00104892PTIN
Phone2709264540PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address74.87.131.58IPv4AddressTxt
FieldValueIRS element (for citing)
IP2020-08-31IPDt
IP Tm06:20:19IPTm
IP TimezoneCDIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdCE57507312F03E43F5A19A2BCE00F9006A1BC891AtSubmissionCreationDeviceId
At Submission Filing Device IdEFF8F207A4B6A27F98432D8E7E4325D7BA0DBED3AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2019TaxYr
Build TS2020-11-19 02:30:22ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerROGER ARBUCKLEPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1480 HOPKINSVILLE STAddressLine1Txt
CityGREENVILLECityNm
State AbbreviationKYStateAbbreviationCd
ZIP42345ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$10,337,882GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressN/AWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1994FormationYr
Legal Domicile StateKYLegalDomicileStateCd
Activity Or MissionTO PROVIDE AFFORDABLE PRIMARY HEALTHCARE SERVICESActivityOrMissionDesc
Voting Members Governing Body10VotingMembersGoverningBodyCnt
Voting Members Independent10VotingMembersIndependentCnt
Total Employee105TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$2,470,221PYContributionsGrantsAmt
CY Contributions Grants$3,036,040CYContributionsGrantsAmt
PY Program Service Revenue$6,643,958PYProgramServiceRevenueAmt
CY Program Service Revenue$7,200,084CYProgramServiceRevenueAmt
PY Investment Income$77,929PYInvestmentIncomeAmt
CY Investment Income$100,954CYInvestmentIncomeAmt
PY Other Revenue$367PYOtherRevenueAmt
CY Other Revenue$804CYOtherRevenueAmt
PY Total Revenue$9,192,475PYTotalRevenueAmt
CY Total Revenue$10,337,882CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$5,460,800PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$5,693,403CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$2,829,282PYOtherExpensesAmt
CY Other Expenses$3,201,197CYOtherExpensesAmt
PY Total Expenses$8,290,082PYTotalExpensesAmt
CY Total Expenses$8,894,600CYTotalExpensesAmt
PY Revenues Less Expenses$902,393PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$1,443,282CYRevenuesLessExpensesAmt
Total Assets BOY$10,784,953TotalAssetsBOYAmt
Total Assets EOY$13,027,538TotalAssetsEOYAmt
Total Liabilities BOY$487,394TotalLiabilitiesBOYAmt
Total Liabilities EOY$1,286,697TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$10,297,559NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$11,740,841NetAssetsOrFundBalancesEOYAmt
MissionTO PROVIDE AFFORDABLE PRIMARY HEALTHCARE SERVICES IN MUHLENBERG AND LOGAN COUNTIES, KENTUCKY, AND IN MEDICALLY UNDER-SERVED URBAN, SUBURBAN, AND RURAL AREAS HAVING LIMITED AVAILABLE HEALTH RESOURCES.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$7,778,819ExpenseAmt
Revenue$7,200,084RevenueAmt
DescOPERATION OF COMMUNITY HEALTH CENTER AS AUTHORIZED BY SECTION 330 OF THE PUBLIC HEALTH SERVICES GRANTDesc
Total Program Service Expenses$7,778,819TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document20IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee105EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members10GoverningBodyVotingMembersCnt
Independent Voting Member10IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower Policy0WhistleblowerPolicyInd
Document Retention Policy0DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1JOSEPH SWABBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone2703385777PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1480 HOPKINSVILLE STAddressLine1Txt
CityGREENVILLECityNm
State AbbreviationKYStateAbbreviationCd
ZIP42345ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
CINDY BAIRD
BOARD MEMBER1.00Yes (X)$0$0$0
BILLY STEELE
BOARD MEMBER1.00Yes (X)$0$0$0
AMANDA HENSON
BOARD MEMBER1.00Yes (X)$0$0$0
ELIZABETH EAVES
BOARD MEMBER1.00Yes (X)$0$0$0
ELIZABETH GENTRY
BOARD MEMBER1.00Yes (X)$0$0$0
ANDREHIA HATFIELD
BOARD MEMBER1.00Yes (X)$0$0$0
CARY DAVIS
BOARD MEMBER1.00Yes (X)$0$0$0
RICHARD NEATHAMER
BOARD MEMBER1.00Yes (X)$0$0$0
ROSEMARY BUCK
BOARD MEMBER1.00Yes (X)$0$0$0
JIMMY OWENS
BOARD MEMBER1.00Yes (X)$0$0$0
ROGER ARBUCKLE
CEO40.00$165,000$0$19,825Yes (X)
JOSEPH SWAB
CFO40.00$100,000$0$9,778Yes (X)
DAVID CONATSER
PHYSICIAN40.00$160,000$0$8,000Yes (X)
STEVEN ZELLER
PHYSICIAN40.00$210,000$0$23,311Yes (X)
BILLIE GALYEN
PHYSICIAN40.00$194,800$0$22,508Yes (X)
BRITNEY BERTSCH
PHYSICIAN40.00$161,575$0$16,960Yes (X)
LEE B SPARKS
PHYSICIAN40.00$220,000$0$20,883Yes (X)
ELIZA WHITTEN-HOSKINS
PHYSICIAN40.00$180,000$0$18,350Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,391,375TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$139,615TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K17IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (2 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
COMP HEALTH
PO BOX 972651DALLASTX753972651PHYSICIAN SERVICES$228,225
CHERYL BROTHERS
420 KING ROADLEWISBURGKY42256HOUSEKEEPING SERVICES$123,000
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K2CntrctRcvdGreaterThan100KCnt
Government Grants$3,036,040GovernmentGrantsAmt
Total Contributions$3,036,040TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescMEDICAL SERVICESDesc
Business621110BusinessCd
Total Revenue Column$7,200,084TotalRevenueColumnAmt
Related Or Exempt Func Income$7,200,084RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$7,200,084TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$100,954TotalRevenueColumnAmt
Exclusion$100,954ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescMISCELLANEOUSDesc
Business621110BusinessCd
Total Revenue Column$804TotalRevenueColumnAmt
Exclusion$804ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$804OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$10,337,882TotalRevenueColumnAmt
Related Or Exempt Func Income$7,200,084RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$101,758ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$480,412TotalAmt
Program Services$174,462ProgramServicesAmt
Management And General$305,950ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$4,355,167TotalAmt
Program Services$4,092,611ProgramServicesAmt
Management And General$262,556ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$179,134TotalAmt
Program Services$173,303ProgramServicesAmt
Management And General$5,831ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$315,581TotalAmt
Program Services$271,666ProgramServicesAmt
Management And General$43,915ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$363,109TotalAmt
Program Services$327,177ProgramServicesAmt
Management And General$35,932ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$7,866TotalAmt
Program Services$7,866ProgramServicesAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$80,478TotalAmt
Program Services$80,478ProgramServicesAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$1,485,546TotalAmt
Program Services$1,285,845ProgramServicesAmt
Management And General$199,701ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$80,633TotalAmt
Program Services$80,633ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$213,258TotalAmt
Program Services$97,112ProgramServicesAmt
Management And General$116,146ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$67,308TotalAmt
Program Services$67,308ProgramServicesAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$101,281TotalAmt
Program Services$22,063ProgramServicesAmt
Management And General$79,218ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$63,021TotalAmt
Program Services$30,049ProgramServicesAmt
Management And General$32,972ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$256,908TotalAmt
Program Services$256,908ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$33,699TotalAmt
Program Services$33,699ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
IMMUNIZATION EXPENSE$353,958$353,958
BAD DEBT EXPENSE$212,815$212,815
OPERATIONAL SUPPLIES$172,920$172,920
DUES & SUBSCRIPTIONS$58,145$35,007$23,138

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$13,361TotalAmt
Program Services$2,939ProgramServicesAmt
Management And General$10,422ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$8,894,600TotalAmt
Program Services$7,778,819ProgramServicesAmt
Management And General$1,115,781ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$273,957BOYAmt
EOY$2,257,924EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$5,049,659BOYAmt
EOY$5,268,164EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$664,876BOYAmt
EOY$757,710EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$86,260BOYAmt
EOY$120,476EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$34,991BOYAmt
EOY$44,748EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$6,692,887LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$2,114,371LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$4,675,210BOYAmt
EOY$4,578,516EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$10,784,953BOYAmt
EOY$13,027,538EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$487,394BOYAmt
EOY$389,422EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
EOY$56,575EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
EOY$840,700EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$487,394BOYAmt
EOY$1,286,697EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$10,118,864BOYAmt
EOY$11,567,541EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$178,695BOYAmt
EOY$173,300EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$10,297,559BOYAmt
EOY$11,740,841EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$10,784,953BOYAmt
EOY$13,027,538EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$1,443,282ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit RequiredYes (1)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (1)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,859,345CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$2,918,975CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$2,350,109CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$2,470,221CurrentTaxYearMinus1YearAmt
Current Tax Year$3,036,040CurrentTaxYearAmt
Total$12,634,690TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$4,435,106CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$5,595,883CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$5,871,372CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$6,643,958CurrentTaxYearMinus1YearAmt
Current Tax Year$7,200,084CurrentTaxYearAmt
Total$29,746,403TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$6,294,451CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$8,514,858CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$8,221,481CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$9,114,179CurrentTaxYearMinus1YearAmt
Current Tax Year$10,236,124CurrentTaxYearAmt
Total$42,381,093TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$42,381,093PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$13,344CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$27,883CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$35,904CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$77,929CurrentTaxYearMinus1YearAmt
Current Tax Year$100,954CurrentTaxYearAmt
Total$256,014TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$13,344CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$27,883CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$35,904CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$77,929CurrentTaxYearMinus1YearAmt
Current Tax Year$100,954CurrentTaxYearAmt
Total$256,014TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$100,105CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus2 Years$510CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$367CurrentTaxYearMinus1YearAmt
Current Tax Year$804CurrentTaxYearAmt
Total$101,786TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$6,407,900CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$8,542,741CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$8,257,895CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$9,192,475CurrentTaxYearMinus1YearAmt
Current Tax Year$10,337,882CurrentTaxYearAmt
Total$42,738,893TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.99160PublicSupportCY509Pct
Public Support PY5090.99310PublicSupportPY509Pct
Investment Income CY0.00600InvestmentIncomeCYPct
Investment Income PY0.00420InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME:FormAndLineReferenceDesc
ExplanationMISCELLANEOUS INCOME - 2015 AMOUNT: $ 100,105. 2017 AMOUNT: $ 510. 2018 AMOUNT: $ 367. 2019 AMOUNT: $ 804.ExplanationTxt

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$248,389OtherCostOrOtherBasisAmt
Book Value$248,389BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$5,040,651OtherCostOrOtherBasisAmt
Depreciation$1,051,671DepreciationAmt
Book Value$3,988,980BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$12,628OtherCostOrOtherBasisAmt
Depreciation$11,115DepreciationAmt
Book Value$1,513BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,152,005OtherCostOrOtherBasisAmt
Depreciation$892,814DepreciationAmt
Book Value$259,191BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$239,214OtherCostOrOtherBasisAmt
Depreciation$158,771DepreciationAmt
Book Value$80,443BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$4,578,516TotalBookValueLandBuildingsAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$10,337,882TotalRevEtcAuditedFinclStmtAmt
Revenue Not Reported$0RevenueNotReportedAmt
Revenue Subtotal$10,337,882RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$10,337,882TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$8,894,600TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$8,894,600ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$8,894,600TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationTHE CENTER IS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, EXCEPT ON INCOME DERIVED FROM UNRELATED BUSINESS ACTIVITIES. THE CENTER BELIEVES THAT IT HAS SUPPORT FOR ANY TAX POSITIONS TAKEN, AND AS SUCH, DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE FINANCIAL STATEMENTS.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (1)AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
ROGER ARBUCKLE
CEO$165,000$0$0$0$0$0$8,250$0$11,575$0$184,825$0$0$0
DAVID CONATSER
PHYSICIAN$160,000$0$0$0$0$0$8,000$0$0$0$168,000$0$0$0
STEVEN ZELLER
PHYSICIAN$210,000$0$0$0$0$0$10,500$0$12,811$0$233,311$0$0$0
BILLIE GALYEN
PHYSICIAN$194,800$0$0$0$0$0$9,500$0$13,008$0$217,308$0$0$0
BRITNEY BERTSCH
PHYSICIAN$161,575$0$0$0$0$0$5,385$0$11,575$0$178,535$0$0$0
LEE B SPARKS
PHYSICIAN$220,000$0$0$0$0$0$9,308$0$11,575$0$240,883$0$0$0
ELIZA WHITTEN-HOSKINS
PHYSICIAN$180,000$0$0$0$0$0$5,539$0$12,811$0$198,350$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 7FormAndLineReferenceDesc
ExplanationPROVIDERS ARE ELIGIBLE TO RECEIVE A BONUS BASED ON A PRODUCTIVITY FORMULA.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11BMANAGEMENT PRESENTS THE FEDERAL FORM 990 TO THE BOARD AT THE REGULARLY SCHEDULED BOARD MEETING IMMEDIATELY PRECEDING THE RETURN'S DUE DATE. THE RETURN IS FILED AFTER BOARD REVIEW.
FORM 990, PART VI, SECTION B, LINE 12CBOARD MEMBERS AND OFFICERS SIGN ANNUAL CONFLICT OF INTEREST STATEMENTS.
FORM 990, PART VI, SECTION B, LINE 15THE BOARD DETERMINED THE CEO'S SALARY BASED ON SALARY SURVEY DATA FROM THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS AND CONDUCTS AN ANNUAL PERFORMANCE EVALUATION. THE CEO DETERMINED THE CFO'S SALARY BASED ON THE SAME INFORMATION WHICH IS EVALUATED ANNUALLY.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION MAKES GOVERNING DOCUMENTS, ITS CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST. ANNUAL FORMS 990 ARE AVAILABLE ON GUIDESTAR.ORG.
FORM 990, PART IX, LINE 11GCONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 1,285,845. MANAGEMENT AND GENERAL EXPENSES 199,720. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,485,565. BANK FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES -19. FUNDRAISING EXPENSES 0. TOTAL EXPENSES -19.
FORM 990, PART XII, LINE 2C:THE ORGANIZATION DID NOT CHANGE ITS OVERSIGHT OR SELECTION PROCESS FROM THE PRIOR YEAR.

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