HARRISONBURG COMMUNITY HEALTH CENTER INC: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- HARRISONBURG COMMUNITY HEALTH CENTER INC (EIN 02-0813294)
- Tax period
- 2019-01-01 to 2019-12-31
- Filed
- 2020-11-05
- IRS object ID
- 202023109349302057
- Schema version
- 2019v5.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2020-11-05T12:59:58-06:00 | ReturnTs |
| Tax Period End | 2019-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 540737372 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PBMARES LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 558 SOUTH MAIN STREET | AddressLine1Txt |
| City | HARRISONBURG | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 22801 | 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 | 020813294 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HARRISONBURG COMMUNITY HEALTH CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | HARR | BusinessNameControlTxt |
| Phone | 5404334913 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | P O BOX 308 | AddressLine1Txt |
| City | HARRISONBURG | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 22803 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | BETH MOSELEY | PersonNm |
| Person Title | CHIEF FINANCIAL OFFICER | PersonTitleTxt |
| Phone | 5404334913 | PhoneNum |
| Signature | 2020-10-28 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | EDWARD T YODER | PreparerPersonNm |
| PTIN | P00239134 | PTIN |
| Phone | 5404345975 | PhoneNum |
| Preparation | 2020-10-28 | PreparationDt |
| Self Employed | Yes (X) | SelfEmployedInd |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 209.10.80.132 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2020-10-28 | IPDt |
| IP Tm | 16:26:14 | IPTm |
| IP Timezone | ED | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 6F557F001C3EBF277D08C7FBEC393035A01D58A9 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 2EA705BCA03576C06D432B3E03FC0F72F854B6E0 | 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 | BETH MOSELEY | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1380 LITTLE SORRELL DRIVE SUITE 100 | AddressLine1Txt |
| City | HARRISONBURG | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 22801 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $9,786,037 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.HBURGCHC.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2007 | FormationYr |
| Legal Domicile State | VA | LegalDomicileStateCd |
| Activity Or Mission | TO BE A LEADING PROVIDER OF QUALITY HEALTHCARE IN THE DIVERSE COMMUNITY OF HARRISONBURG AND ROCKINGHAM COUNTY, VIRGINIA. THE ORGANIZATION PROVIDES DISCOUNTED MEDICAL AND DENTAL SERVICES BASED ON INCOME ELIGIBILITY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 17 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 17 | VotingMembersIndependentCnt |
| Total Employee | 137 | TotalEmployeeCnt |
| Total Volunteers | 17 | TotalVolunteersCnt |
| Total Gross UBI | -$17,229 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | -$8,367 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $2,578,098 | PYContributionsGrantsAmt |
| CY Contributions Grants | $2,737,422 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $6,072,181 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $6,996,172 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,599 | PYInvestmentIncomeAmt |
| CY Investment Income | $507 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$15,059 | PYOtherRevenueAmt |
| CY Other Revenue | -$17,229 | CYOtherRevenueAmt |
| PY Total Revenue | $8,636,819 | PYTotalRevenueAmt |
| CY Total Revenue | $9,716,872 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $6,005,504 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $6,670,783 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $53 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $1,282 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $37,905 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $2,592,874 | PYOtherExpensesAmt |
| CY Other Expenses | $2,874,115 | CYOtherExpensesAmt |
| PY Total Expenses | $8,598,431 | PYTotalExpensesAmt |
| CY Total Expenses | $9,546,180 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $38,388 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $170,692 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $6,127,750 | TotalAssetsBOYAmt |
| Total Assets EOY | $6,206,790 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,045,824 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,954,172 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $4,081,926 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $4,252,618 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO BE A LEADING PROVIDER OF QUALITY HEALTHCARE IN THE DIVERSE COMMUNITY OF HARRISONBURG AND ROCKINGHAM COUNTY, VIRGINIA. THE ORGANIZATION PROVIDES DISCOUNTED MEDICAL AND DENTAL SERVICES BASED ON INCOME ELIGIBILITY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $6,293,542 | ExpenseAmt |
| Revenue | $6,251,715 | RevenueAmt |
| Desc | PROVIDED ACCESSIBLE AND AFFORDABLE PRIMARY HEALTH CARE SERVICES IN HARRISONBURG, VIRGINIA, AND THE SURROUNDING AREA. THERE WERE 44,387 PATIENT VISITS IN 2019. IN 2019, 11,879 UNINSURED VISITS WERE PROVIDED WITH HEALTHCARE INCLUDING DISCOUNTS UNDER A SLIDING FEE SCALE FOR LOW INCOME ELIGIBLE PERSONS. THE ORGANIZATION PROVIDES CULTURALLY SENSITIVE HEALTHCARE INCLUDING LANGUAGE TRANSLATION AS NEEDED. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,243,168 | ExpenseAmt |
| Revenue | $727,228 | RevenueAmt |
| Desc | PROVIDED ACCESSIBLE AND AFFORABLE DENTAL SERVICES IN HARRISONBURG, VIRGINIA, AND THE SURROUNDING AREA. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $427,855 | ExpenseAmt |
| Grant | $253,908 | GrantAmt |
| Desc | GRANTS TO VALLEY AIDS NETWORK FUNDED BY THE FEDERAL RYAN WHITE PROGRAM TO PROVIDE RAPID HIV TESTING SERVICES, COMPREHESIVE HEALTH EDUCATION, AND HOLISTIC SUPPORT TO INDIVIDUALS AFFECTED BY HIV/AIDS IN THE CENTRAL SHENANDOAH VALLEY. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $7,964,565 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 50 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 137 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 17 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 17 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | 0 | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BETH MOSELEY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5404334913 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1380 LITTLE SORRELL DRIVE SUITE 100 | AddressLine1Txt |
| City | HARRISONBURG | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 22801 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| REGINA SCHWEITZER | ||||||||
| BOARD CHAIR | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| JOHN WEIR MD | ||||||||
| VICE CHAIR | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| SHERRY MONGOLD | ||||||||
| TREASURER | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| ERIKA METZLER-SAWIN | ||||||||
| SECRETARY | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| DAVID COCKLEY PHD | ||||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| LISA BURKHOLDER | ||||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| OZLEM ERSIN | ||||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| SAM NICKELS | ||||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| SANDRA STUMP | ||||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| HEIDI HOOVER | ||||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| RICK HAUSHALTER | ||||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| SILVIA GARCIA ROMERO | ||||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JANE HUBBELL | ||||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JOHN TAYLOR | ||||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| WAYNE WOODSON | ||||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JESS HOSTETLER | ||||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| RONDA WOLFE | ||||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| LISA BRICKER | ||||||||
| EXECUTIVE DIRECTOR | 35.00 | Yes (X) | $135,551 | $0 | $10,704 | |||
| ELIZABETH MOSELEY | ||||||||
| CHIEF FINANCIAL OFFICER | 35.00 | Yes (X) | $88,353 | $0 | $9,836 | |||
| JEROME HOTCHKISS MD | ||||||||
| MEDICAL PROVIDER | 35.00 | $186,477 | $0 | $20,184 | Yes (X) | |||
| MEGAN WILLIAMS MD | ||||||||
| MEDICAL PROVIDER | 35.00 | $171,192 | $0 | $6,604 | Yes (X) | |||
| THERESA HAMEL MD | ||||||||
| MEDICAL PROVIDER | 35.00 | $184,293 | $0 | $14,967 | Yes (X) | |||
| JEFF DOMINGUS MD | ||||||||
| MEDICAL PROVIDER | 35.00 | $193,933 | $0 | $17,677 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $959,799 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $79,972 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 6 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $2,521,043 | GovernmentGrantsAmt |
| All Other Contributions | $216,379 | AllOtherContributionsAmt |
| Total Contributions | $2,737,422 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| MEDICAL/DENTAL SERVICE | 622110 | $5,508,469 | $5,508,469 |
| PHARMACEUTICAL SALES | 446110 | $1,435,728 | $1,435,728 |
| OTHER INCOME | 999999 | $51,975 | $51,975 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $6,996,172 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $507 | TotalRevenueColumnAmt |
| Exclusion | $507 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $51,936 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $69,165 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$17,229 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$17,229 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | -$17,229 | UnrelatedBusinessRevenueAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $9,716,872 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $6,996,172 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | -$17,229 | UnrelatedBusinessRevenueAmt |
| Exclusion | $507 | 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 | $244,444 | TotalAmt |
| Management And General | $244,444 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,494,379 | TotalAmt |
| Program Services | $4,686,178 | ProgramServicesAmt |
| Management And General | $776,103 | ManagementAndGeneralAmt |
| Fundraising | $32,098 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $518,584 | TotalAmt |
| Program Services | $454,959 | ProgramServicesAmt |
| Management And General | $63,625 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $413,376 | TotalAmt |
| Program Services | $339,568 | ProgramServicesAmt |
| Management And General | $71,303 | ManagementAndGeneralAmt |
| Fundraising | $2,505 | FundraisingAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,282 | TotalAmt |
| Fundraising | $1,282 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,107,808 | TotalAmt |
| Program Services | $840,615 | ProgramServicesAmt |
| Management And General | $267,193 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,957 | TotalAmt |
| Program Services | $14,280 | ProgramServicesAmt |
| Management And General | $1,587 | ManagementAndGeneralAmt |
| Fundraising | $90 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $194,362 | TotalAmt |
| Program Services | $151,494 | ProgramServicesAmt |
| Management And General | $40,938 | ManagementAndGeneralAmt |
| Fundraising | $1,930 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $303,592 | TotalAmt |
| Program Services | $290,225 | ProgramServicesAmt |
| Management And General | $13,367 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,325 | TotalAmt |
| Program Services | $11,138 | ProgramServicesAmt |
| Management And General | $4,187 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $52,912 | TotalAmt |
| Program Services | $39,522 | ProgramServicesAmt |
| Management And General | $13,390 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $140,232 | TotalAmt |
| Program Services | $136,025 | ProgramServicesAmt |
| Management And General | $4,207 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,439 | TotalAmt |
| Program Services | $19,105 | ProgramServicesAmt |
| Management And General | $7,334 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| PATIENT CARE COSTS | $857,624 | $857,624 | |
| DUES, FEES, AND LICENSE | $74,906 | $57,932 | $16,974 |
| STAFF DEVELOPMENT | $70,233 | $65,373 | $4,860 |
| BANK SERVICE CHARGES | $14,419 | $527 | $13,892 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $306 | TotalAmt |
| Management And General | $306 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,546,180 | TotalAmt |
| Program Services | $7,964,565 | ProgramServicesAmt |
| Management And General | $1,543,710 | ManagementAndGeneralAmt |
| Fundraising | $37,905 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $291,462 | BOYAmt |
| EOY | $477,246 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,827,544 | BOYAmt |
| EOY | $1,678,340 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,071 | BOYAmt |
| EOY | $30,009 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $5,208,888 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,187,693 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,990,673 | BOYAmt |
| EOY | $4,021,195 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,127,750 | BOYAmt |
| EOY | $6,206,790 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $475,787 | BOYAmt |
| EOY | $587,550 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,418,366 | BOYAmt |
| EOY | $1,343,224 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $151,671 | BOYAmt |
| EOY | $23,398 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,045,824 | BOYAmt |
| EOY | $1,954,172 | 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 | $4,081,926 | BOYAmt |
| EOY | $4,252,618 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,081,926 | BOYAmt |
| EOY | $4,252,618 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,127,750 | BOYAmt |
| EOY | $6,206,790 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $170,692 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,540,021 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,822,225 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,381,220 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,578,098 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,737,422 | CurrentTaxYearAmt |
| Total | $11,058,986 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,716,858 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,837,036 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $5,357,620 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $6,072,179 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $6,996,172 | CurrentTaxYearAmt |
| Total | $23,979,865 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,256,879 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,659,261 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7,738,840 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $8,650,277 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $9,733,594 | CurrentTaxYearAmt |
| Total | $35,038,851 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $35,038,851 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $54,294 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $51,091 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $52,028 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $52,380 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $52,443 | CurrentTaxYearAmt |
| Total | $262,236 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $54,294 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $51,091 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $52,028 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $52,380 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $52,443 | CurrentTaxYearAmt |
| Total | $262,236 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,311,173 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,710,352 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7,790,868 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $8,702,657 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $9,786,037 | CurrentTaxYearAmt |
| Total | $35,301,087 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99260 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99110 | PublicSupportPY509Pct |
| Investment Income CY | 0.00740 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00890 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $769,404 | OtherCostOrOtherBasisAmt |
| Book Value | $769,404 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,739,367 | OtherCostOrOtherBasisAmt |
| Depreciation | $678,494 | DepreciationAmt |
| Book Value | $3,060,873 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,820 | OtherCostOrOtherBasisAmt |
| Depreciation | $516 | DepreciationAmt |
| Book Value | $1,304 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $698,297 | OtherCostOrOtherBasisAmt |
| Depreciation | $508,683 | DepreciationAmt |
| Book Value | $189,614 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $4,021,195 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $9,786,037 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | $69,165 | OtherRevenueAmt |
| Revenue Not Reported | $69,165 | RevenueNotReportedAmt |
| Revenue Subtotal | $9,716,872 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $9,716,872 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $9,615,345 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $69,165 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $69,165 | ExpensesNotReportedAmt |
| Expenses Subtotal | $9,546,180 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $9,546,180 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | THE ORGANIZATION ADOPTED THE PROVISIONS OF ACCOUNTING FOR UNCERTAINTY IN INCOME TAX POSITIONS AS REQUIRED BY THE INCOME TAXES TOPIC OF THE FINANCIAL ACCOUNTING STANDARDS BOARD (FASB) ACCOUNTING STANDARDS CODIFICATION (ASC); HOWEVER, MANAGEMENT DOES NOT BELIEVE IT IS EXPOSED TO ANY SUCH POSITIONS AS THEY ARE DEFINED IN THIS GUIDANCE. THE ORGANIZATION FILES FORM 990, RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX, ANNUALLY WITH THE UNITED STATES DEPARTMENT OF THE TREASURY AND FORM 990T, EXEMPT ORGANIZATION BUSINESS INCOME TAX RETURN, WHEN REQUIRED. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | RENTAL EXPENSES 69,165. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | RENTAL EXPENSES 69,165. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JEROME HOTCHKISS MD | ||||||||||||||
| MEDICAL PROVIDER | $186,477 | $0 | $0 | $0 | $0 | $0 | $7,815 | $0 | $12,369 | $0 | $206,661 | $0 | $0 | $0 |
| MEGAN WILLIAMS MD | ||||||||||||||
| MEDICAL PROVIDER | $171,192 | $0 | $0 | $0 | $0 | $0 | $3,554 | $0 | $3,050 | $0 | $177,796 | $0 | $0 | $0 |
| THERESA HAMEL MD | ||||||||||||||
| MEDICAL PROVIDER | $184,293 | $0 | $0 | $0 | $0 | $0 | $7,664 | $0 | $7,303 | $0 | $199,260 | $0 | $0 | $0 |
| JEFF DOMINGUS MD | ||||||||||||||
| MEDICAL PROVIDER | $193,933 | $0 | $0 | $0 | $0 | $0 | $8,139 | $0 | $9,538 | $0 | $211,610 | $0 | $0 | $0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | THE BOARD OF DIRECTORS REVIEWED AN ELECTRONIC COPY OF THE 990 PRIOR TO FILING THE RETURN. |
| FORM 990, PART VI, SECTION B, LINE 15A | THE BOARD OF DIRECTORS SETS AND REVIEWS COMPENSATION ON AN ANNUAL BASIS. |
| FORM 990, PART VI, SECTION C, LINE 19 | INFORMATION IS AVAILABLE TO THE PUBLIC UPON REQUEST AT THE CORPORATE OFFICE. |
| FORM 990, PART IX, LINE 11G | OTHER CONTRACTUAL SERVICES: PROGRAM SERVICE EXPENSES 840,615. MANAGEMENT AND GENERAL EXPENSES 267,193. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,107,808. |
| FORM 990, PART XII, LINE 2C: | THERE WERE NO CHANGES TO THE PROCESS FROM LAST YEAR. THE FINANCE COMMITTEE OVERSEES THE AUDIT PROCESS, INCLUDING THE SELECTION OF THE INDEPENDENT AUDITOR. |
Comments