BETA

MY COMMUNITY HEALTH CENTER: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization
MY COMMUNITY HEALTH CENTER (EIN 81-2171085)
Tax period
2019-01-01 to 2019-12-31
Filed
2020-10-02
IRS object ID
202032769349300508
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)
Return2020-10-02T08:02:18-05:00ReturnTs
Tax Period End2019-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN410746749PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line14505 STEPHENS CIRCLE NWAddressLine1Txt
CityCANTONCityNm
State AbbreviationOHStateAbbreviationCd
ZIP44718ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2019-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN812171085EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MY COMMUNITY HEALTH CENTERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlMYCOBusinessNameControlTxt
Phone3303636242PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12600 7TH STREET SWAddressLine1Txt
CityCANTONCityNm
State AbbreviationOHStateAbbreviationCd
ZIP44710ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonKELLY LORENZPersonNm
Person TitleCFOPersonTitleTxt
Phone3303631310PhoneNum
Signature2020-09-29SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJENNIFER COLEMANPreparerPersonNm
PTINP00743188PTIN
Phone3304972000PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address67.137.57.251IPv4AddressTxt
FieldValueIRS element (for citing)
IP2020-09-29IPDt
IP Tm15:36:09IPTm
IP TimezoneEDIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdDA39A3EE5E6B4B0D3255BFEF95601890AFD80709AtSubmissionCreationDeviceId
At Submission Filing Device Id8AC9A41C6456F6B0E35BD43A98B74F92684A3D23AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2019TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerTERRY REGULAPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line12600 7TH STREET SWAddressLine1Txt
CityCANTONCityNm
State AbbreviationOHStateAbbreviationCd
ZIP44710ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$7,394,117GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.MYCOMHC.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2016FormationYr
Legal Domicile StateOHLegalDomicileStateCd
Activity Or MissionTO PROVIDE COMPASSIONATE CARE TO ALL; HEALING AND LEARNING TOGETHER.ActivityOrMissionDesc
Voting Members Governing Body9VotingMembersGoverningBodyCnt
Voting Members Independent9VotingMembersIndependentCnt
Total Employee76TotalEmployeeCnt
Total Volunteers9TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$2,939,544PYContributionsGrantsAmt
CY Contributions Grants$2,868,174CYContributionsGrantsAmt
PY Program Service Revenue$2,984,046PYProgramServiceRevenueAmt
CY Program Service Revenue$4,510,125CYProgramServiceRevenueAmt
PY Investment Income$0PYInvestmentIncomeAmt
CY Investment Income$15,791CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$27CYOtherRevenueAmt
PY Total Revenue$5,923,590PYTotalRevenueAmt
CY Total Revenue$7,394,117CYTotalRevenueAmt
PY Grants And Similar Paid$350PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$100CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$2,996,462PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$3,381,073CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$2,674,773PYOtherExpensesAmt
CY Other Expenses$3,021,867CYOtherExpensesAmt
PY Total Expenses$5,671,585PYTotalExpensesAmt
CY Total Expenses$6,403,040CYTotalExpensesAmt
PY Revenues Less Expenses$252,005PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$991,077CYRevenuesLessExpensesAmt
Total Assets BOY$1,118,199TotalAssetsBOYAmt
Total Assets EOY$2,065,525TotalAssetsEOYAmt
Total Liabilities BOY$543,173TotalLiabilitiesBOYAmt
Total Liabilities EOY$499,422TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$575,026NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$1,566,103NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionMY COMMUNITY HEALTH CENTER (MCHC) IS A GRASSROOTS, COMMUNITY-BASED 501(C)(3) OHIO NONPROFIT ORGANIZATION WHOSE MISSION IS TO PROVIDE COMPASSIONATE CARE TO ALL, HEALING AND LEARNING TOGETHER. MCHC'S GOAL IS TO BE RESPONSIVE TO THE NEEDS OF THE COMMUNITIES IT SERVES, BUT WITH CONTINUED EMPHASIS ON THE UNDERSERVED AND THOSE WITHOUT ACCESS TO CARE, REGARDLESS OF RACE, ECONOMIC STATUS, AGE, SEX, SEXUAL ORIENTATION, OR DISABILITY.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant ChangeYes (1)SignificantChangeInd
Expense$5,090,131ExpenseAmt
Grant$100GrantAmt
Revenue$4,510,125RevenueAmt
DescMY COMMUNITY HEALTH CENTER (MCHC) IS A GRASSROOTS, COMMUNITY-BASED 501(C)(3) OHIO NONPROFIT ORGANIZATION WHOSE MISSION IS TO PROVIDE COMPASSIONATE CARE TO ALL, HEALING AND LEARNING TOGETHER. MCHC'S GOAL IS TO BE RESPONSIVE TO THE NEEDS OF THE COMMUNITIES IT SERVES, BUT WITH CONTINUED EMPHASIS ON THE UNDERSERVED AND THOSE WITHOUT ACCESS TO CARE, REGARDLESS OF RACE, ECONOMIC STATUS, AGE, SEX, SEXUAL ORIENTATION, OR DISABILITY.MCHC ESTABLISHED ITSELF AS A COMMUNITY CLINIC SITE IN AUGUST 2017 AND HAS BEEN ACTIVE AS A COMMUNITY HEALTH CARE PROVIDER SINCE. THE ORGANIZATION BELIEVES IN TRAINING THE NEXT GENERATION OF HEALTH CARE PROVIDERS. AS SUCH MCHC HAS ESTABLISHED A RELATIONSHIP WITH THREE RESIDENCY PROGRAMS FOR THEIR RESIDENTS TO PROVIDE OUTPATIENT, CONTINUITY OF CARE AT MCHC; INTERNAL MEDICINE, FAMILY MEDICINE & OBSTETRICS AND GYNECOLOGY. IN SEPTEMBER 2019, MCHC RECEIVED FULL DESIGNATION FROM THE FEDERAL HEALTH RESOURCES AND SERVICES ADMINISTRATION (HRSA) TO BE FEDERALLY QUALIFIED HEALTH CENTER.SERVICES PROVIDED BY MCHC INCLUDE FAMILY PRACTICE, INTERNAL MEDICINE, PRENATAL SERVICES, POSTPARTUM CARE, WELL CHILD & PEDIATRIC CARE, SCREENINGS, CHRONIC DISEASE MANAGEMENT, DENTAL CARE (BY REFERRAL), LABORATORY, BEHAVIORAL HEALTH (INCLUDING INDIVIDUALS/GROUPS), FAMILY PLANNING, OUTREACH, HEALTH EDUCATION (INCLUDING NUTRITION), ELIGIBILITY ASSISTANCE, AND CASE MANAGEMENT. THESE OUTPATIENT PRIMARY HEALTH SERVICES ARE PROVIDED TO THE MEDICALLY UNDERSERVED POPULATIONS IN STARK COUNTY, OHIO AND SURROUNDING COMMUNITIES. THE ORGANIZATION ALSO BEGAN RENOVATION OF A SECOND HEALTH CENTER IN MAGNOLIA, OHIO, A HRSA DESIGNATED UNDERSERVED AREA IN SEPTEMBER 2019. THIS FULLY FUNCTIONING SATELLITE OFFICE BEGAN OPERATIONS IN JANUARY 2020 AND WILL PROVIDE MOST OF THE SAME HEALTH CENTER SERVICES AS DESCRIBED ABOVE. IN 2019, MCHC PROVIDED CARE TO APPROXIMATELY 8,900 PATIENTS WITH CLOSE TO 35,000 MEDICAL VISITS. IN MARCH 2019, MCHC ENDED ITS CO-EMPLOYMENT AGREEMENT WITH AULTMAN HOSPITAL. MCHC EMPLOYED ALL EMPLOYEES DIRECTLY AND OFFERED HEALTH CARE AND ANCILLARY BENEFITS. MCHC EMPLOYS MORE THAN 60 EMPLOYEES, MANY FROM THE LOCAL COMMUNITY. STAFF ARE FLUENT IN ENGLISH AND AMERICAN SIGN LANGUAGE (CONTRACTED TRANSLATION SERVICES FOR OTHER LANGUAGES) AND EFFECTIVE AT WORKING WITH PEOPLE AT ALL LEVELS OF LITERACY.OUR OBSTETRICAL PROGRAM IS UNIQUE IN THE FACT THAT WE ARE THE LARGEST OB PROVIDER FOR MEDICAID PATIENTS IN STARK COUNTY. WE ALSO PROVIDE THE ONLY CERTIFIED CENTERING PROGRAM IN THE COUNTY.TELEHEALTH SERVICES IN REFUGE OF HOPE WERE DISCONTINUED IN THE FALL OF 2019. LACK OF VOLUME WAS THE KEY DRIVER IN THIS DECISION. COMMUNITY COLLABORATION IS IMPORTANT TO MCHC. BELOW IS A BRIEF DESCRIPTION OF COLLABORATIONS WITH COMMUNITY PARTNERS: - OB DEPARTMENT COLLABORATES WITH STARK COUNTY AND CANTON CITY HEALTH DEPARTMENTS ON THE THRIVE INITIATIVE TO REDUCE INFANT MORTALITY. - THE INTERNAL MEDICINE DIVISION COLLABORATES WITH ACCESS HEALTH TO PROVIDE COMMUNITY HEALTH WORKERS FOR HIGH RISK DIABETICS IN THE PRACTICE. - FAMILY MEDICINE COLLABORATES WITH REFUGE OF HOPE, A LOCAL HOMELESS SHELTER, TO PROVIDE TELEMEDICINE SERVICES FREE OF CHARGE TO THE HOMELESS. - MCHC COLLABORATES WITH BEACON PHARMACY TO PROVIDE PRESCRIPTION MEDICATIONS AT A REDUCED COST TO PATIENTS. THE STAFF HAVE PARTICIPATED IN MANY COMMUNITY ACTIVITIES, INCLUDING THE FOLLOWING: - OUTREACH AT REFUGE OF HOPE - MEDICAID ELIGIBILITY; DESCRIBE OUR PRIMARY CARE SERVICES - CANTON CALVARY MISSION - PREPARED AND SERVED FOOD TO NEEDY - COMMUNITY SAFETY FAIR - PROVIDED EDUCATION ON SUN SAFETY, HYGIENE AND SAFE SEXDesc
Total Program Service Expenses$5,090,131TotalProgramServiceExpensesAmt
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 Footnote0IncludeFIN48FootnoteInd
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 Document5IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee76EmployeeCnt
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
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
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 Members9GoverningBodyVotingMembersCnt
Independent Voting Member9IndependentVotingMemberCnt
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 PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldOHStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1KELLY LORENZBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone3303631310PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12600 7TH STREET SWAddressLine1Txt
CityCANTONCityNm
State AbbreviationOHStateAbbreviationCd
ZIP44710ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (13 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
MARIA HEEGE
PRESIDENT1.00Yes (X)Yes (X)$0$0$0
SHARLA ELTON
SECRETARY1.00Yes (X)Yes (X)$0$0$0
STEVE JACKSON
TREASURER1.00Yes (X)Yes (X)$0$0$0
JAMES ANDERSON
DIRECTOR1.00Yes (X)$0$0$0
RENEE BACKIE
DIRECTOR1.00Yes (X)$0$0$0
SUSAN MERCER MD
DIRECTOR1.00Yes (X)$0$0$0
CYRILIA PRATT
DIRECTOR1.00Yes (X)$0$0$0
LINDA WOODLOCK
DIRECTOR1.00Yes (X)$0$0$0
JEFFREY ZELLERS
DIRECTOR1.00Yes (X)$0$0$0
TERRY REGULA
CEO40.00Yes (X)$174,863$0$24,520
JORDAN WADE
FORMER CFO15.00Yes (X)$0$0$0
KELLY LORENZ
CFO40.00Yes (X)$24,617$0$1,404
JOHN SUTTON MD
MEDICAL DIRECTOR40.00$190,144$0$14,657Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$389,624TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$40,581TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K2IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (3 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
AULTMAN HEALTH FOUNDATION
2600 SIXTH STREET SWCANTONOH44710MSA AGREEMENT$1,714,462
AULTMAN HOSPITAL
2600 SIXTH STREET SWCANTONOH44710PRECEPTORING SERVICES$874,377
CANTON MEDICAL EDUCATION FOUNDATION
2600 SIXTH STREET SWCANTONOH44710PRECEPTORING SERVICES$136,774
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K3CntrctRcvdGreaterThan100KCnt
Government Grants$137,307GovernmentGrantsAmt
All Other Contributions$2,730,867AllOtherContributionsAmt
Total Contributions$2,868,174TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPATIENT SERVICE REVENUEDesc
Business621400BusinessCd
Total Revenue Column$4,510,125TotalRevenueColumnAmt
Related Or Exempt Func Income$4,510,125RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$4,510,125TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$15,791TotalRevenueColumnAmt
Exclusion$15,791ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescOTHER REVENUEDesc
Business900099BusinessCd
Total Revenue Column$27TotalRevenueColumnAmt
Exclusion$27ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$27OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$7,394,117TotalRevenueColumnAmt
Related Or Exempt Func Income$4,510,125RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$15,818ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$100TotalAmt
Program Services$100ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$472,114TotalAmt
Program Services$298,067ProgramServicesAmt
Management And General$174,047ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$2,255,703TotalAmt
Program Services$1,907,377ProgramServicesAmt
Management And General$348,326ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$54,192TotalAmt
Program Services$37,874ProgramServicesAmt
Management And General$16,318ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$388,011TotalAmt
Program Services$322,640ProgramServicesAmt
Management And General$65,371ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$211,053TotalAmt
Program Services$170,211ProgramServicesAmt
Management And General$40,842ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$11,058TotalAmt
Management And General$11,058ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$37,444TotalAmt
Management And General$37,444ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$1,630,666TotalAmt
Program Services$1,493,621ProgramServicesAmt
Management And General$137,045ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$678TotalAmt
Program Services$654ProgramServicesAmt
Management And General$24ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$43,040TotalAmt
Program Services$9,412ProgramServicesAmt
Management And General$33,628ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$47,153TotalAmt
Program Services$47,153ProgramServicesAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$357,387TotalAmt
Management And General$357,387ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$9,833TotalAmt
Program Services$2,995ProgramServicesAmt
Management And General$6,838ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$10,239TotalAmt
Program Services$2,943ProgramServicesAmt
Management And General$7,296ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$28,783TotalAmt
Program Services$5,976ProgramServicesAmt
Management And General$22,807ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
BAD DEBT EXPENSE$435,895$435,895
COST OF GOODS SOLD$152,014$152,014
MEDICATIONS$117,480$117,480
SUPPLIES AND EQUIPMENT$90,263$80,565$9,698

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$49,934TotalAmt
Program Services$5,154ProgramServicesAmt
Management And General$44,780ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$6,403,040TotalAmt
Program Services$5,090,131ProgramServicesAmt
Management And General$1,312,909ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$314,915BOYAmt
EOY$1,378,727EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$801,405BOYAmt
EOY$424,996EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
EOY$21,770EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$1,879BOYAmt
EOY$23,114EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$216,918LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$0LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$216,918EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$1,118,199BOYAmt
EOY$2,065,525EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$543,173BOYAmt
EOY$499,422EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$543,173BOYAmt
EOY$499,422EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$575,026BOYAmt
EOY$1,566,103EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$575,026BOYAmt
EOY$1,566,103EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,118,199BOYAmt
EOY$2,065,525EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$991,077ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
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 Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

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

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$216,918OtherCostOrOtherBasisAmt
Book Value$216,918BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$216,918TotalBookValueLandBuildingsAmt
Total Rev Etc Audited Fincl Stmt$6,958,222TotalRevEtcAuditedFinclStmtAmt
Revenue Not Reported$0RevenueNotReportedAmt
Revenue Subtotal$6,958,222RevenueSubtotalAmt
Other Revenues Not Included$435,895OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$435,895RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$7,394,117TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$5,967,145TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$5,967,145ExpensesSubtotalAmt
Other Expenses Not Included$435,895OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$435,895ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$6,403,040TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART XI, LINE 4B - OTHER ADJUSTMENTS:BAD DEBT EXPENSE 435,895.
PART XII, LINE 4B - OTHER ADJUSTMENTS:BAD DEBT EXPENSE 435,895.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Form990 Of Other OrganizationsYes (X)Form990OfOtherOrganizationsInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
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 Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 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
TERRY REGULA
CEO$174,863$0$0$0$0$0$24,520$0$0$0$199,383$0$0$0
JOHN SUTTON MD
MEDICAL DIRECTOR$182,844$0$7,300$0$0$0$5,610$0$9,047$0$204,801$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 3FormAndLineReferenceDesc
ExplanationTHE CEO EXECUTIVE COMPENSATION METHOD WAS REVIEWED AND DISCUSSED WITH THE HR MANAGER.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART III, LINE 3TELEHEALTH SERVICES IN REFUGE OF HOPE WERE DISCONTINUED IN THE FALL OF 2019. LACK OF VOLUME WAS THE KEY DRIVER IN THIS DECISION.
FORM 990, PART VI, SECTION B, LINE 11BTHE FORM 990 WAS PREPARED BY AN INDEPENDENT CPA FIRM BASED ON INFORMATION PROVIDED BY THE ORGANIZATION'S CFO. THE CEO AND CFO CAREFULLY REVIEWED AND ANALYZED THE TAX RETURN, RECONCILING THE GENERAL LEDGER AMOUNTS TO THE APPROPRIATE SCHEDULES ON THE FORM 990 AND COMPARING THOSE AMOUNTS TO THE AUDITED FINANCIAL STATEMENTS. A COMPLETE COPY OF THE 990 WAS THEN SENT VIA EMAIL TO THE BOARD OF DIRECTORS FOR THEIR REVIEW PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12CTHE ORGANIZATION'S CONFLICT OF INTEREST POLICY APPLIES TO CLINIC BOARD MEMBERS, EMPLOYEES, CONSULTANTS AND THOSE WHO FURNISH GOODS OR SERVICES TO THE ORGANIZATION. EACH BOARD MEMBER IS REQUIRED TO COMPLETE A CERTIFICATION OF AGREEMENT WITH THE CONFLICT OF INTEREST POLICY AND DISCLOSE ANY KNOWN CONFLICTS OF INTEREST UPON HIS OR HER ELECTION OR RE-ELECTION TO THE BOARD AND ANNUALLY THEREAFTER. WHENEVER THE CHIEF EXECUTIVE OFFICER, KEY MANAGEMENT PERSONNEL OR ANY BOARD MEMBER HAS A CONFLICT OF INTEREST OR A PERCEIVED CONFLICT OF INTEREST WITH MCHC, HE OR SHE IS REQUIRED TO NOTIFY THE FULL BOARD OF SUCH CONFLICT IN WRITING USING THE ANNUAL CERTIFICATION FORM. WHEN ANY CONFLICT OF INTEREST IS RELEVANT TO A MATTER THAT COMES UNDER CONSIDERATION OR REQUIRES ACTION BY THE BOARD, OR A BOARD COMMITTEE, THE INTERESTED PERSON IS REQUIRED TO CALL IT TO THE ATTENTION OF THE BOARD CHAIR AND MUST LEAVE THE MEETING DURING BOARD OR COMMITTEE DISCUSSION OR DECISION ON THE MATTER. HOWEVER, THAT PERSON IS ALLOWED TO PROVIDE THE BOARD OR APPLICABLE COMMITTEE WITH ANY AND ALL RELEVANT INFORMATION ON THE PARTICULAR MATTER. BOARD MEMBERS WHO VIOLATE THE CONFLICT OF INTEREST POLICY MAY, DEPENDING ON THE SEVERITY OF THE VIOLATION, BE SUBJECT TO ORAL ADMONISHMENT OR REMOVAL FROM THEIR POSITION.
FORM 990, PART VI, SECTION C, LINE 19MY COMMUNITY HEALTH CENTER MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART IX, LINE 11GOTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 1,474,174. MANAGEMENT AND GENERAL EXPENSES 134,629. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,608,803. CONSULTING SERVICES: PROGRAM SERVICE EXPENSES 19,447. MANAGEMENT AND GENERAL EXPENSES 2,416. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 21,863.

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