2020-10-02T08:02:18-05:00 2019-12-31 410746749 CLIFTONLARSONALLEN LLP 4505 STEPHENS CIRCLE NW CANTON OH 44718 990 2019-01-01 812171085 MY COMMUNITY HEALTH CENTER MYCO 3303636242 2600 7TH STREET SW CANTON OH 44710 KELLY LORENZ CFO 3303631310 2020-09-29 1 JENNIFER COLEMAN P00743188 3304972000 67.137.57.251 2020-09-29 15:36:09 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 8AC9A41C6456F6B0E35BD43A98B74F92684A3D23 2019 2021-01-29 14:40:06Z TERRY REGULA 2600 7TH STREET SW CANTON OH 44710 7394117 0 X WWW.MYCOMHC.ORG X 2016 OH TO PROVIDE COMPASSIONATE CARE TO ALL; HEALING AND LEARNING TOGETHER. 9 9 76 9 0 0 2939544 2868174 2984046 4510125 0 15791 0 27 5923590 7394117 350 100 0 0 2996462 3381073 0 0 0 2674773 3021867 5671585 6403040 252005 991077 1118199 2065525 543173 499422 575026 1566103 X MY 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. 0 1 5090131 100 4510125 MY 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 SEX 5090131 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 5 0 76 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 OH X KELLY LORENZ 3303631310 2600 7TH STREET SW CANTON OH 44710 MARIA HEEGE PRESIDENT 1.00 X X 0 0 0 SHARLA ELTON SECRETARY 1.00 X X 0 0 0 STEVE JACKSON TREASURER 1.00 X X 0 0 0 JAMES ANDERSON DIRECTOR 1.00 X 0 0 0 RENEE BACKIE DIRECTOR 1.00 X 0 0 0 SUSAN MERCER MD DIRECTOR 1.00 X 0 0 0 CYRILIA PRATT DIRECTOR 1.00 X 0 0 0 LINDA WOODLOCK DIRECTOR 1.00 X 0 0 0 JEFFREY ZELLERS DIRECTOR 1.00 X 0 0 0 TERRY REGULA CEO 40.00 X 174863 0 24520 JORDAN WADE FORMER CFO 15.00 X 0 0 0 KELLY LORENZ CFO 40.00 X 24617 0 1404 JOHN SUTTON MD MEDICAL DIRECTOR 40.00 X 190144 0 14657 389624 0 40581 2 0 1 0 AULTMAN HEALTH FOUNDATION 2600 SIXTH STREET SW CANTON OH 44710 MSA AGREEMENT 1714462 AULTMAN HOSPITAL 2600 SIXTH STREET SW CANTON OH 44710 PRECEPTORING SERVICES 874377 CANTON MEDICAL EDUCATION FOUNDATION 2600 SIXTH STREET SW CANTON OH 44710 PRECEPTORING SERVICES 136774 3 137307 2730867 2868174 PATIENT SERVICE REVENUE 621400 4510125 4510125 4510125 15791 15791 OTHER REVENUE 900099 27 27 27 7394117 4510125 0 15818 X 100 100 472114 298067 174047 2255703 1907377 348326 54192 37874 16318 388011 322640 65371 211053 170211 40842 11058 11058 37444 37444 1630666 1493621 137045 678 654 24 43040 9412 33628 47153 47153 357387 357387 9833 2995 6838 10239 2943 7296 28783 5976 22807 BAD DEBT EXPENSE 435895 435895 COST OF GOODS SOLD 152014 152014 MEDICATIONS 117480 117480 SUPPLIES AND EQUIPMENT 90263 80565 9698 49934 5154 44780 6403040 5090131 1312909 0 314915 1378727 801405 424996 21770 1879 23114 216918 0 0 216918 1118199 2065525 543173 499422 543173 499422 X 575026 1566103 575026 1566103 1118199 2065525 991077 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 216918 216918 216918 6958222 0 6958222 435895 435895 7394117 5967145 0 5967145 435895 435895 6403040 PART XI, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 435,895. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 435,895. X X X X 0 0 0 0 0 0 0 0 0 TERRY REGULA CEO 174863 0 0 0 0 0 24520 0 0 0 199383 0 0 0 JOHN SUTTON MD MEDICAL DIRECTOR 182844 0 7300 0 0 0 5610 0 9047 0 204801 0 0 0 PART I, LINE 3 THE CEO EXECUTIVE COMPENSATION METHOD WAS REVIEWED AND DISCUSSED WITH THE HR MANAGER. FORM 990, PART III, LINE 3 TELEHEALTH 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 11B THE 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 12C THE 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 19 MY 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 11G OTHER 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.