GREATER PRINCE WILLIAM AREA COMMUNITY HEALTH CENTER INC: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- GREATER PRINCE WILLIAM AREA COMMUNITY HEALTH CENTER INC (EIN 83-0435138)
- Tax period
- 2018-07-01 to 2019-06-30
- Filed
- 2020-04-30
- IRS object ID
- 202031219349300528
- Schema version
- 2018v3.1
- 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 | 2020-04-30T12:27:49-05:00 | ReturnTs |
| Tax Period End | 2019-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 390859910 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BAKER TILLY VIRCHOW KRAUSE LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1570 FRUITVILLE PIKE SUITE 400 | AddressLine1Txt |
| City | LANCASTER | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 17601 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2018-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 830435138 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GREATER PRINCE WILLIAM AREA COMMUNITY | BusinessNameLine1Txt |
| Business Name Line2 | HEALTH CENTER INC | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | GREA | BusinessNameControlTxt |
| Phone | 7036807950 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4379 RIDGEWOOD CENTER DRIVE NO 102 | AddressLine1Txt |
| City | WOODBRIDGE | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 22192 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MARK MEYE | PersonNm |
| Person Title | CHIEF EXECUTIVE OFFICER | PersonTitleTxt |
| Phone | 7036807950 | PhoneNum |
| Signature | 2020-04-30 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KERRI N BOGDA CPA | PreparerPersonNm |
| PTIN | P00760402 | PTIN |
| Phone | 7177404863 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 73.187.220.225 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2020-04-30 | IPDt |
| IP Tm | 10:33:21 | IPTm |
| IP Timezone | ED | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | BF90B4BE16E9AE312C0D8383967EBAED4A365E8B | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MARK MEYE | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4379 RIDGEWOOD CENTER DRIVE NO 102 | AddressLine1Txt |
| City | WOODBRIDGE | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 22192 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $13,911,235 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.GPWHEALTHCENTER.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2007 | FormationYr |
| Legal Domicile State | VA | LegalDomicileStateCd |
| Activity Or Mission | TO INCREASE ACCESS TO AFFORDABLE HIGH QUALITY HEALTH CARE FOR THE WHOLE FAMILY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 13 | VotingMembersIndependentCnt |
| Total Employee | 155 | TotalEmployeeCnt |
| Total Volunteers | 25 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $3,975,369 | PYContributionsGrantsAmt |
| CY Contributions Grants | $4,435,470 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $7,779,103 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $9,365,779 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | $21 | CYInvestmentIncomeAmt |
| PY Other Revenue | $44,862 | PYOtherRevenueAmt |
| CY Other Revenue | $78,709 | CYOtherRevenueAmt |
| PY Total Revenue | $11,799,334 | PYTotalRevenueAmt |
| CY Total Revenue | $13,879,979 | 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 | $8,399,477 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $8,931,281 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $97,786 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $3,683,947 | PYOtherExpensesAmt |
| CY Other Expenses | $4,015,035 | CYOtherExpensesAmt |
| PY Total Expenses | $12,083,424 | PYTotalExpensesAmt |
| CY Total Expenses | $12,946,316 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$284,090 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $933,663 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $4,101,568 | TotalAssetsBOYAmt |
| Total Assets EOY | $5,273,915 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,890,303 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $2,130,636 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $2,211,265 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $3,143,279 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE CENTER'S MISSION IS TO INCREASE ACCESS TO HIGH QUALITY COMPREHENSIVE AND PREVENTATIVE HEALTH CARE SERVICES THAT ARE CULTURALLY SENSITIVE IN ORDER TO IMPROVE THE HEALTH STATUS OF THE UNDERSERVED AND VULNERABLE RESIDENTS OF THE COMMUNITY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $4,928,849 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $4,499,016 | RevenueAmt |
| Desc | MEDICAL CARE: THE CENTER MEDICAL CARE THAT IS CULTURALLY SENSITIVE(BEING AWARE THAT CULTURAL DIFFERENCES AND SIMILARITIES BETWEEN PEOPLE EXIST WITHOUT ASSIGNING THEM A VALUE POSITIVE OR NEGATIVE, BETTER OR WORSE, RIGHT OR WRONG; SET OF SKILLS THAT ENABLES US TO LEARN ABOUT AND UNDERSTAND PEOPLE WHO ARE DIFFERENT FROM OURSELVES, THEREBY BECOMING BETTER ABLE TO SERVE WITHIN THEIR OWN COMMUNITIES)IN ORDER TO IMPROVE THE HEALTH STATUS OF THE UNDERSERVED AND VULNERABLE RESIDENTS OF PRINCE WILLIAM COUNTY AND THE CITIES OF MANASSAS AND MANASSAS PARK. THE CENTER PROGRAMS ARE DESIGNED TO INCREASE ACCESS TO HIGH QUALITY, COMPREHENSIVE AND PREVENTIVE HEALTH CARE. THIS PROGRAM HAD 31,560 VISITS INVOLVING 11,000 PATIENTS DURING THE FISCAL YEAR. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $2,286,014 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $1,645,294 | RevenueAmt |
| Desc | OB-GYN CARE: THE CENTER PROVIDES OB-GYN CARE THAT IS CULTURALLY SENSITIVE(BEING AWARE THAT CULTURAL DIFFERENCES AND SIMILARITIES BETWEEN PEOPLE EXIST WITHOUT ASSIGNING THEM A VALUE POSITIVE OR NEGATIVE, BETTER OR WORSE, RIGHT OR WRONG; SET OF SKILLS THAT ENABLES US TO LEARN ABOUT AND UNDERSTAND PEOPLE WHO ARE DIFFERENT FROM OURSELVES, THEREBY BECOMING BETTER ABLE TO SERVE WITHIN THEIR OWN COMMUNITIES)IN ORDER TO IMPROVE THE HEALTH STATUS OF THE UNDERSERVED AND VULNERABLE RESIDENTS OF PRINCE WILLIAM COUNTY AND THE CITIES OF MANASSAS AND MANASSAS PARK. THIS PROGRAM HAD 13,010 VISITS INVOLVING 1,890 PATIENTS DURING THE FISCAL YEAR. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,997,851 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $2,520,171 | RevenueAmt |
| Desc | DENTAL CARE: THE CENTER PROVIDES DENTAL CARE THAT IS CULTURALLY SENSITIVE(BEING AWARE THAT CULTURAL DIFFERENCES AND SIMILARITIES BETWEEN PEOPLE EXIST WITHOUT ASSIGNING THEM A VALUE POSITIVE OR NEGATIVE, BETTER OR WORSE, RIGHT OR WRONG; SET OF SKILLS THAT ENABLES US TO LEARN ABOUT AND UNDERSTAND PEOPLE WHO ARE DIFFERENT FROM OURSELVES, THEREBY BECOMING BETTER ABLE TO SERVE WITHIN THEIR OWN COMMUNITIES)IN ORDER TO IMPROVE THE HEALTH STATUS OF THE UNDERSERVED AND VULNERABLE RESIDENTS OF PRINCE WILLIAM COUNTY AND THE CITIES OF MANASSAS AND MANASSAS PARK. THIS PROGRAM HAD 10,700 VISITS INVOLVING 4,120 PATIENTS DURING THE FISCAL YEAR. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,310,030 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $701,298 | RevenueAmt |
| Desc | BEHAVIORAL HEALTH - THE CENTER PROVIDES BEHAVIORAL HEALTH CARE THAT IS CULTURALLY SENSITIVE(BEING AWARE THAT CULTURAL DIFFERENCES AND SIMILARITIES BETWEEN PEOPLE EXIST WITHOUT ASSIGNING THEM A VALUE POSITIVE OR NEGATIVE, BETTER OR WORSE, RIGHT OR WRONG; SET OF SKILLS THAT ENABLES US TO LEARN ABOUT AND UNDERSTAND PEOPLE WHO ARE DIFFERENT FROM OURSELVES, THEREBY BECOMING BETTER ABLE TO SERVE WITHIN THEIR OWN COMMUNITIES)IN ORDER TO IMPROVE THE HEALTH STATUS OF THE UNDERSERVED AND VULNERABLE RESIDENTS OF PRINCE WILLIAM COUNTY AND THE CITIES OF MANASSAS AND MANASSAS PARK. THIS PROGRAM HAD 9,010 VISITS INVOLVING 1,670 PATIENTS DURING THE FISCAL YEAR. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $1,310,030 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Grant | $0 | TotalOtherProgSrvcGrantAmt |
| Total Other Prog Srvc Revenue | $701,298 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $10,522,744 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| 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 | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | 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 With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| 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 | 24 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 155 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 13 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | VA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MARK MEYE CHIEF EXECUTIVE OFFICER | PersonNm |
| Phone | 7036807950 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4379 RIDGEWOOD CENTER DRIVE SUITE | AddressLine1Txt |
| City | WOODBRIDGE | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 22192 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (20 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 |
|---|---|---|---|---|---|---|---|---|
| LUIS LOU FERRARO | ||||||||
| PRESIDENT | 6.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| DAVID B WILKS | ||||||||
| VICE PRESIDENT | 4.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| JOHN S GRAY | ||||||||
| TREASURER | 4.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| VALERIE E KEENE | ||||||||
| SECRETARY | 4.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| ABRA HOGARTH | ||||||||
| MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| ADDIE RAY WHITAKER | ||||||||
| MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| EVELYN MARR | ||||||||
| MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| JENNY PORTILLO | ||||||||
| MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| JULIO ALEX CORREA | ||||||||
| MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| LASHEECO GRAHAMAN | ||||||||
| MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| LAURA C POSEY | ||||||||
| MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| RICHARD GARON | ||||||||
| MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| ROSE GONZALEZ | ||||||||
| MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| MARK MEYE | ||||||||
| CHIEF EXECUTIVE OFFICER | 40.00 | Yes (X) | $157,525 | $0 | $10,457 | |||
| RASHID MOHIUDDIN | ||||||||
| MEDICAL DIRECTOR | 40.00 | $230,856 | $0 | $18,217 | Yes (X) | |||
| SYED MAHBOOB | ||||||||
| PHYSICIAN | 40.00 | $192,749 | $0 | $17,073 | Yes (X) | |||
| LISA WIENER | ||||||||
| OB-GYN DIRECTOR | 40.00 | $127,550 | $0 | $14,036 | Yes (X) | |||
| RENATO DAING | ||||||||
| PHYSICIAN | 40.00 | $193,492 | $0 | $13,696 | Yes (X) | |||
| HUSSEIN AL-SHAMMAA | ||||||||
| PHYSICIAN | 40.00 | $195,000 | $0 | $15,049 | Yes (X) | |||
| CAMILLE HORTON-THOMPSON | ||||||||
| PHYSICIAN | 40.00 | $181,868 | $0 | $12,698 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,279,040 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $101,226 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 16 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (3 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| COMMUNITY CARE NETWORK OF VIRGINIA | |||||
| 3831 WESTERRE PARKWAY | HENRICO | VA | 23233 | HEALTH CARE BILLING | $271,006 |
| LABCORP | |||||
| PO BOX 12140 | BURLINGTON | NC | 27216 | LABORATORY SERVICES | $236,806 |
| ECLINICALWORKS | |||||
| PO BOX 847950 | BOSTON | MA | 02284 | ELECT. HEALTH RECORDS | $108,911 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 3 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $6,216 | FundraisingAmt |
| Government Grants | $3,628,436 | GovernmentGrantsAmt |
| All Other Contributions | $800,818 | AllOtherContributionsAmt |
| Noncash Contributions | $650 | NoncashContributionsAmt |
| Total Contributions | $4,435,470 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| MEDICAL CARE | 624110 | $4,499,016 | $4,499,016 |
| DENTAL CARE | 624110 | $2,520,171 | $2,520,171 |
| OB-GYN CARE | 624110 | $1,645,294 | $1,645,294 |
| BEHAVIORAL HEALTH | 624110 | $701,298 | $701,298 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $9,365,779 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $21 | TotalRevenueColumnAmt |
| Exclusion | $21 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $42,389 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $6,216 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $31,256 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $11,133 | TotalRevenueColumnAmt |
| Exclusion | $11,133 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| MEANINGFUL USE REVENUE | 900099 | $34,000 | $34,000 |
| WORKERS COMPENSATION | 900099 | $17,527 | $17,527 |
| MANAGED CARE INCENTIVES | 900099 | $8,639 | $8,639 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $7,410 | TotalRevenueColumnAmt |
| Exclusion | $7,410 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $67,576 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $13,879,979 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $9,365,779 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $78,730 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $422,446 | TotalAmt |
| Program Services | $248,990 | ProgramServicesAmt |
| Management And General | $156,558 | ManagementAndGeneralAmt |
| Fundraising | $16,898 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,195,665 | TotalAmt |
| Program Services | $6,533,087 | ProgramServicesAmt |
| Management And General | $645,376 | ManagementAndGeneralAmt |
| Fundraising | $17,202 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $214,798 | TotalAmt |
| Program Services | $192,255 | ProgramServicesAmt |
| Management And General | $21,911 | ManagementAndGeneralAmt |
| Fundraising | $632 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $548,177 | TotalAmt |
| Program Services | $486,948 | ProgramServicesAmt |
| Management And General | $59,169 | ManagementAndGeneralAmt |
| Fundraising | $2,060 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $550,195 | TotalAmt |
| Program Services | $483,945 | ProgramServicesAmt |
| Management And General | $63,600 | ManagementAndGeneralAmt |
| Fundraising | $2,650 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,274 | TotalAmt |
| Management And General | $1,274 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,891 | TotalAmt |
| Management And General | $38,891 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $825,235 | TotalAmt |
| Program Services | $737,235 | ProgramServicesAmt |
| Management And General | $87,198 | ManagementAndGeneralAmt |
| Fundraising | $802 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $207,103 | TotalAmt |
| Program Services | $132,205 | ProgramServicesAmt |
| Management And General | $70,026 | ManagementAndGeneralAmt |
| Fundraising | $4,872 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $187,359 | TotalAmt |
| Program Services | $112,082 | ProgramServicesAmt |
| Management And General | $68,039 | ManagementAndGeneralAmt |
| Fundraising | $7,238 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,071,890 | TotalAmt |
| Program Services | $634,154 | ProgramServicesAmt |
| Management And General | $395,647 | ManagementAndGeneralAmt |
| Fundraising | $42,089 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,730 | TotalAmt |
| Program Services | $1,751 | ProgramServicesAmt |
| Management And General | $4,979 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,209 | TotalAmt |
| Management And General | $2,209 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $301,006 | TotalAmt |
| Program Services | $85,701 | ProgramServicesAmt |
| Management And General | $215,305 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $37,842 | TotalAmt |
| Program Services | $23,541 | ProgramServicesAmt |
| Management And General | $14,301 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Management And GeneralManagementAndGeneralAmt | Program ServicesProgramServicesAmt |
|---|---|---|---|
| BAD DEBT EXPENSE | $400,753 | $400,753 | |
| PROGRAM SUPPLIES | $346,225 | $346,225 | |
| VACCINE SUPPLIES | $326,142 | $326,142 | |
| COMMUNITY OUTREACH | $65,860 | $65,860 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $196,516 | TotalAmt |
| Program Services | $112,623 | ProgramServicesAmt |
| Management And General | $80,550 | ManagementAndGeneralAmt |
| Fundraising | $3,343 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,946,316 | TotalAmt |
| Program Services | $10,522,744 | ProgramServicesAmt |
| Management And General | $2,325,786 | ManagementAndGeneralAmt |
| Fundraising | $97,786 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $871,362 | BOYAmt |
| EOY | $1,076,977 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $155,081 | BOYAmt |
| EOY | $260,960 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,689,990 | BOYAmt |
| EOY | $2,572,908 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,622 | BOYAmt |
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $69,502 | BOYAmt |
| EOY | $63,398 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $2,681,005 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,530,777 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,149,943 | BOYAmt |
| EOY | $1,150,228 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,099 | BOYAmt |
| EOY | $12,450 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,000 | BOYAmt |
| EOY | $15,000 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $123,969 | BOYAmt |
| EOY | $121,994 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,101,568 | BOYAmt |
| EOY | $5,273,915 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $923,947 | BOYAmt |
| EOY | $1,161,052 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,860 | BOYAmt |
| EOY | $28,019 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $70,273 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $888,223 | BOYAmt |
| EOY | $941,565 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,890,303 | BOYAmt |
| EOY | $2,130,636 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,028,598 | BOYAmt |
| EOY | $2,959,579 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $182,667 | BOYAmt |
| EOY | $183,700 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,211,265 | BOYAmt |
| EOY | $3,143,279 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,101,568 | BOYAmt |
| EOY | $5,273,915 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $933,663 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$1,649 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,088,356 | OtherCostOrOtherBasisAmt |
| Depreciation | $623,129 | DepreciationAmt |
| Book Value | $465,227 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,044,662 | OtherCostOrOtherBasisAmt |
| Depreciation | $613,266 | DepreciationAmt |
| Book Value | $431,396 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $547,987 | OtherCostOrOtherBasisAmt |
| Depreciation | $294,382 | DepreciationAmt |
| Book Value | $253,605 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,150,228 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DEFERRED RENT | Desc |
| Amt | $941,565 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $941,565 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $13,632,452 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$1,649 | NetUnrealizedGainsInvstAmt |
| Donated Services And Use Fclts | $154,875 | DonatedServicesAndUseFcltsAmt |
| Other Revenue | -$400,753 | OtherRevenueAmt |
| Revenue Not Reported | -$247,527 | RevenueNotReportedAmt |
| Revenue Subtotal | $13,879,979 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $13,879,979 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $12,700,438 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $154,875 | DonatedServicesUseFcltsAmt |
| Expenses Not Reported | $154,875 | ExpensesNotReportedAmt |
| Expenses Subtotal | $12,545,563 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $400,753 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $400,753 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $12,946,316 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | BAD DEBT EXPENSE -400,753. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | BAD DEBT EXPENSE 400,753. |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | CHIPS4CHARITY | Event1Nm |
| Gross Receipts Event1 | $48,605 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $6,216 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $42,389 | GrossRevenueEvent1Amt |
| Food And Beverage Event1 | $12,148 | FoodAndBeverageEvent1Amt |
| Entertainment Event1 | $11,427 | EntertainmentEvent1Amt |
| Other Direct Expenses Event1 | $7,681 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $48,605 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $6,216 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $42,389 | GrossRevenueTotalEventsAmt |
| Food And Beverage Total Events | $12,148 | FoodAndBeverageTotalEventsAmt |
| Entertainment Total Events | $11,427 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $7,681 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $31,256 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $11,133 | NetIncomeSummaryAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| 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 | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MARK MEYE | ||||||||||||||
| CHIEF EXECUTIVE OFFICER | $143,655 | $0 | $13,870 | $0 | $0 | $0 | $4,310 | $0 | $6,147 | $0 | $167,982 | $0 | $0 | $0 |
| RASHID MOHIUDDIN | ||||||||||||||
| MEDICAL DIRECTOR | $230,856 | $0 | $0 | $0 | $0 | $0 | $6,926 | $0 | $11,291 | $0 | $249,073 | $0 | $0 | $0 |
| SYED MAHBOOB | ||||||||||||||
| PHYSICIAN | $192,749 | $0 | $0 | $0 | $0 | $0 | $5,782 | $0 | $11,291 | $0 | $209,822 | $0 | $0 | $0 |
| RENATO DAING | ||||||||||||||
| PHYSICIAN | $193,492 | $0 | $0 | $0 | $0 | $0 | $5,805 | $0 | $7,891 | $0 | $207,188 | $0 | $0 | $0 |
| HUSSEIN AL-SHAMMAA | ||||||||||||||
| PHYSICIAN | $195,000 | $0 | $0 | $0 | $0 | $0 | $5,850 | $0 | $9,199 | $0 | $210,049 | $0 | $0 | $0 |
| CAMILLE HORTON-THOMPSON | ||||||||||||||
| PHYSICIAN | $181,868 | $0 | $0 | $0 | $0 | $0 | $5,456 | $0 | $7,242 | $0 | $194,566 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 7 | FormAndLineReferenceDesc |
| Explanation | THE BOARD ISSUED A DISCRETIONARY BONUS TO THE CHIEF EXECUTIVE OFFICER; THE PROCESS IS A CONFIDENTIAL MEETING BY THE BOARD OF DIRECTORS WHERE THE MATTER IS RAISED FOR CONSIDERATION AND, IF DEEMED WARRANTED, AN AMOUNT IS CONSIDERED. IF APPROVED, THE BONUS IS ISSUED. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 1 | THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE OFFICERS OF THE BOARD AND THE CHAIRMAN OF STANDING COMMITTEES. THE COMMITTEE SHALL HAVE THE POWERS OF THE GOVERNING BOARD WHEN IT IS NOT IN SESSION. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE CHIEF EXECUTIVE OFFICER, CHIEF FINANCIAL OFFICER, AND ACCOUNTING MANAGER PERFORM AN INITIAL REVIEW OF THE DRAFT 990. THE RETURN IS THEN PROVIDED TO THE FINANCE COMMITTEE AND BOARD OF DIRECTORS FOR REVIEW PRIOR TO FILING WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | BOARD DIRECTORS, OFFICERS, AND KEY EMPLOYEES COMPLETE A DISCLOSURE FORM ANNUALLY. INDIVIDUALS WITH POTENTIAL OR ACTUAL CONFLICTS ARE EXPECTED TO REPORT ANY INFORMATION PERTINENT TO THE CONFLICT. FAMILY AND BUSINESS RELATIONSHIPS ARE EXPRESSLY STATED IN THE DISCLOSURES AS BEING SOURCES OF POTENTIAL CONFLICTS. BOARD DIRECTORS MAKE THEIR DISCLOSURES TO THE COMPLIANCE OFFICER, WHILE THE CHIEF EXECUTIVE OFFICER DISCLOSES ANY POTENTIAL CONFLICTS TO THE BOARD. DIRECTORS WITH A CONFLICT MAY SPEAK TO THE BOARD ON THE CONFLICT, BUT MUST LEAVE THE MEETING DURING ANY DISCUSSION OR VOTE ON WHETHER THE CONFLCT EXISTS. IF IT IS DETERMINED THAT A CONFLICT EXISTS, THE INTERESTED DIRECTOR MUST RECUSE HIMSELF OR HERSELF FROM ANY DISCUSSION OF, OR VOTING ON, THE ARRANGEMENT THAT INVOLVES THE CONFLICT. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE BOARD SETS POSITION PAY RANGES AND REVIEWS AND APPROVES THE CHIEF EXECUTIVE OFFICER'S COMPENSATION AND BENEFITS. THE BOARD COMPENSATION RANGES ARE BASED ON A SALARY SURVEY OF SIMILAR ORGANIZATIONS. THE SALARY SURVEY AND BOARD DECISIONS ARE DOCUMENTED IN BOARD MINUTES. A COMPREHENSIVE REVIEW OF KEY EMPLOYEE COMPENSATION WAS LAST PERFORMED IN 2019. THE BOARD REVIEWED THE SALARY SURVEY COMPLETED BY THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS AND A FOLLOW-UP SURVEY OF VIRGINIA HEALTH CENTERS, WHICH WAS CONDUCTED BY THE CHIEF EXECUTIVE OFFICER AND DIRECTOR OF HUMAN RESOURCES. THIS SURVEY WAS PRESENTED TO THE BOARD FOR REVIEW IN 2019. AS A RESULT, THE BOARD APPROVED ADJUSTING KEY EMPLOYEE ANNUAL SALARIES TO ALIGN MORE FULLY WITH THE SURVEYS PRESENTED TO IT FOR CONSIDERATION. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. |