HEART CITY HEALTH CENTER INC: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization
HEART CITY HEALTH CENTER INC (EIN 35-1875364)
Tax period
2018-10-01 to 2019-09-30
Filed
2020-04-13
IRS object ID
202041049349300509
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

FieldValueIRS element (for citing)
Return2020-04-13T11:12:57-05:00ReturnTs
Tax Period End2019-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BKD LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1201 N Illinois StreetAddressLine1Txt
CityIndianapolisCityNm
State AbbreviationINStateAbbreviationCd
ZIP46204ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2018-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN351875364EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Heart City Health Center IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% ERNEST SMITHInCareOfNm
Business Name ControlHEARBusinessNameControlTxt
Phone5742930052PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1236 SIMPSON AVENUEAddressLine1Txt
CityELKHARTCityNm
State AbbreviationINStateAbbreviationCd
ZIP46516ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonESLEEN FULTZPersonNm
Person TitleCEOPersonTitleTxt
Phone5742930052PhoneNum
Signature2020-08-15SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonNICOLE B FISHBACKPreparerPersonNm
PTINP01279475PTIN
Phone3173834000PhoneNum
Preparation2020-08-15PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address167.68.126.162IPv4AddressTxt
FieldValueIRS element (for citing)
Federal Original Submission Id43033020201045000035FederalOriginalSubmissionId
Federal Original Submission Id2020-04-13FederalOriginalSubmissionIdDt
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id0E5A66BCFA8A901678C95AB5123EFFCB93BC0432AtSubmissionCreationDeviceId
At Submission Filing Device Id9B5ABA5A5A3316C8FEF8FB4057D6A7929F00F476AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2018TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerESLEEN FULTZPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1236 SIMPSON AVENUEAddressLine1Txt
CityELKHARTCityNm
State AbbreviationINStateAbbreviationCd
ZIP46516ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$11,410,340GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.HEARTCITYHEALTH.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1993FormationYr
Legal Domicile StateINLegalDomicileStateCd
Activity Or MissionHEART CITY HEALTH CENTER, INC. IS A FEDERALLY QUALIFIED HEALTH CENTER (FQHC) PROVIDING COMPREHENSIVE PRIMARY HEALTHCARE AND EDUCATION FOR THE ELKHART COMMUNITY.ActivityOrMissionDesc
Voting Members Governing Body10VotingMembersGoverningBodyCnt
Voting Members Independent10VotingMembersIndependentCnt
Total Employee138TotalEmployeeCnt
Total Volunteers11TotalVolunteersCnt
Total Gross UBI$41,732TotalGrossUBIAmt
PY Contributions Grants$3,357,530PYContributionsGrantsAmt
CY Contributions Grants$3,423,672CYContributionsGrantsAmt
PY Program Service Revenue$5,204,846PYProgramServiceRevenueAmt
CY Program Service Revenue$6,256,877CYProgramServiceRevenueAmt
PY Investment Income$101,419PYInvestmentIncomeAmt
CY Investment Income$93,271CYInvestmentIncomeAmt
PY Other Revenue$337,872PYOtherRevenueAmt
CY Other Revenue$396,342CYOtherRevenueAmt
PY Total Revenue$9,001,667PYTotalRevenueAmt
CY Total Revenue$10,170,162CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$6,105,416PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$6,707,957CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$3,751CYTotalFundraisingExpenseAmt
PY Other Expenses$2,893,676PYOtherExpensesAmt
CY Other Expenses$3,305,516CYOtherExpensesAmt
PY Total Expenses$8,999,092PYTotalExpensesAmt
CY Total Expenses$10,013,473CYTotalExpensesAmt
PY Revenues Less Expenses$2,575PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$156,689CYRevenuesLessExpensesAmt
Total Assets BOY$10,476,339TotalAssetsBOYAmt
Total Assets EOY$11,279,116TotalAssetsEOYAmt
Total Liabilities BOY$659,899TotalLiabilitiesBOYAmt
Total Liabilities EOY$1,319,410TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$9,816,440NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$9,959,706NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionHEART CITY HEALTH CENTER, INC. (HEART CITY) IS A NON-PROFIT, FEDERALLY QUALIFIED HEALTH CENTER (FQHC) PROVIDING AFFORDABLE, HIGH QUALITY, PRIMARY HEALTH, BEHAVIORAL HEALTH, DENTAL AND PHARMACEUTICAL CARE TO RESIDENTS OF ELKHART AND SURROUNDING COUNTIES. (SEE SCH O)MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$6,412,081ExpenseAmt
Revenue$5,760,936RevenueAmt
DescHEART CITY HEALTH CENTER, INC. (HEART CITY) PROVIDES MEDICAL AND BEHAVIORAL HEALTHCARE IN THE AREA OF ADULTS AND PEDIATRICS TO THE PRIMARILY MEDICARE, MEDICAID, AND UNINSURED POPULATION OF ELKHART COUNTY. DURING THE YEAR ENDED SEPTEMEBER 30, 2019, HEART CITY PROVIDED 33,216 MEDICAL VISITS AND 2,272 BEHAVIORAL HEALTH VISITS TO 11,758 UNDUPLICATED PATIENTS.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$835,650ExpenseAmt
Revenue$495,941RevenueAmt
DescHEART CITY HEALTH CENTER, INC.'S (HEART CITY) LICENSED DENTISTS AND HYGIENISTS PROVIDE A LOW-COST OPTION FOR QUALITY GENERAL DENTISTRY SERVICES TO PEOPLE OF ALL AGES, INCOMES AND BACKGROUNDS, BUT PRIMARILY SERVES MEDICAID AND UNINSURED PATIENTS. DURING THE YEAR ENDED SEPTEMBER 30, 2019, HEART CITY SERVED 1,614 UNDUPLICATED PATIENTS PROVIDING 3,785 VISITS. VARIOUS DENTAL SERVICES PROVIDED INCLUDE: EXAMINATIONS; TREATMENT PLANNING; CHILDREN'S DENTISTRY; CLEANING/DENTAL HYGIENE; EXTRACTIONS; FILLINGS; RADIOGRAPHS; AND PATIENT EDUCATION.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Revenue$396,342RevenueAmt
DescHEART CITY HAS AN ONSITE PHARMACY AT OUR SIMPSON STREET LOCATION WHICH PROVIDES CONVENIENT PRESCRIPTION SERVICES TO OUR PATIENTS AND THE COMMUNITY. DURING THE YEAR ENDED SEPTEMBER 30, 2019 THE PHARMACY FILLED 30,316 PRESCRIPTIONS FOR 2,755 PATIENTS.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$7,247,731TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (true)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContriYes (true)DeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document18IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee138EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (true)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (true)Form990TFiledInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members10GoverningBodyVotingMembersCnt
Independent Voting Member10IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldINStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonERNEST SMITHPersonNm
Phone5749701448PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1236 SIMPSON AVENUEAddressLine1Txt
CityELKHARTCityNm
State AbbreviationINStateAbbreviationCd
ZIP46516ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
DELIA VAZQUEZ
BOARD MEMBER1.00.0Yes (X)$0$0$0
ANGELIA WASHINGTON
TREASURER1.00.0Yes (X)$0$0$0Yes (X)
ROBERT TAYLOR
BOARD MEMBER1.00.0Yes (X)$0$0$0
MILLIE HERNANDEZ
BOARD MEMBER1.00.0Yes (X)$0$0$0
ROD ROBERSON
BOARD MEMBER (Ended 9/19)1.00.0Yes (X)$0$0$0
ANTHONY HUNT
VICE-CHAIR1.00.0Yes (X)$0$0$0Yes (X)
TARA MORRIS
CHAIRMAN1.00.0Yes (X)$0$0$0Yes (X)
ANA ROSA GARCIA
BOARD MEMBER (Ended 10/18)1.00.0Yes (X)$0$0$0
ARVIS DAWSON
SECRETARY1.00.0Yes (X)$0$0$0Yes (X)
ANTHONY ENGLAND
BOARD MEMBER1.00.0Yes (X)$0$0$0
ESLEEN FULTZ
CHIEF EXECUTIVE OFFICER40.00.0$241,557$0$13,113Yes (X)
PATRICIA KLINGER
CFO (Ended 5/19)40.00.0$105,836$0$17,264Yes (X)
DR MARTINA MCGOWAN
COO / CMO (Ended 8/19)40.00.0$139,721$0$9,883Yes (X)
DR OMOBOLA OLANIYAN
CHIEF MEDICAL OFF.(ENDED 9/18)40.00.0$224,148$0$11,824Yes (X)
ERNEST SMITH
CFO (Began 6/19)40.00.0$0$0$0Yes (X)
DR MEENAKSHI GUPTA
PEDIATRICIAN40.00.0$170,058$0$4,938Yes (X)
DR CHRISTINE DANKWA
PEDIATRICIAN40.00.0$170,357$0$4,938Yes (X)
DR DWAYNE JOHNSON
PEDIATRICIAN40.00.0$158,298$0$24,906Yes (X)
DR MARY P MCMANMON
FAMILY DOCTOR32.00.0$165,351$0$11,942Yes (X)
ESSAM MONTASIR
INTERNIST40.00.0$202,754$0$20,397Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,578,080TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$119,205TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K14IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (3 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
ELKHART GENERAL HOSPITAL
PO BOX 1329ELKHARTIN46515PHARMACIST CHARGES$167,330
TODD ALLEN DESIGN
2812 WARREN STREETELKHARTIN46516MARKETING/ADVERTISIN$140,437
INDEMAND INTERPRETING
PO BOX 675248DETROITMI482675248INTERPRETING SERVICE$116,604
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K3CntrctRcvdGreaterThan100KCnt
Federated Campaigns$63,333FederatedCampaignsAmt
Government Grants$2,996,574GovernmentGrantsAmt
All Other Contributions$363,765AllOtherContributionsAmt
Noncash Contributions$241,011NoncashContributionsAmt
Total Contributions$3,423,672TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
MEDICAL SERVICES624100$5,750,343$5,750,343
DENTAL SERVICES624100$495,941$495,941
MEDICAL RECORDS900099$5,068$5,068
MISCELLANEOUS REVENUE900099$5,525$5,525
FieldValueIRS element (for citing)
Total Program Service Revenue$6,256,877TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$81,784TotalRevenueColumnAmt
Exclusion$81,784ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$0RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$211,005SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$199,518SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$11,487SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$11,487TotalRevenueColumnAmt
Exclusion$11,487ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$0FundraisingGrossIncomeAmt
Fundraising Direct Expenses$0FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gaming Gross Income$0GamingGrossIncomeAmt
Gaming Direct Expenses$0GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$1,437,002GrossSalesOfInventoryAmt
Cost Of Goods Sold$1,040,660CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$396,342TotalRevenueColumnAmt
Related Or Exempt Func Income$354,610RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$41,732UnrelatedBusinessRevenueAmt
FieldValueIRS element (for citing)
Other Revenue Total$0OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$10,170,162TotalRevenueColumnAmt
Related Or Exempt Func Income$6,611,487RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$41,732UnrelatedBusinessRevenueAmt
Exclusion$93,271ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$672,615TotalAmt
Program Services$489,699ProgramServicesAmt
Management And General$182,916ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$5,021,842TotalAmt
Program Services$3,673,471ProgramServicesAmt
Management And General$1,348,371ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$83,801TotalAmt
Program Services$55,237ProgramServicesAmt
Management And General$28,564ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$526,073TotalAmt
Program Services$374,016ProgramServicesAmt
Management And General$152,057ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$403,626TotalAmt
Program Services$272,596ProgramServicesAmt
Management And General$131,030ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$31,019TotalAmt
Management And General$31,019ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$10,130TotalAmt
Management And General$10,130ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$14,794TotalAmt
Management And General$14,794ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$1,079,704TotalAmt
Program Services$981,692ProgramServicesAmt
Management And General$98,012ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$266,078TotalAmt
Program Services$139,433ProgramServicesAmt
Management And General$125,869ManagementAndGeneralAmt
Fundraising$776FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$612,551TotalAmt
Program Services$544,247ProgramServicesAmt
Management And General$68,304ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$378,757TotalAmt
Program Services$105,819ProgramServicesAmt
Management And General$272,938ManagementAndGeneralAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$297,168TotalAmt
Program Services$214,757ProgramServicesAmt
Management And General$82,411ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$48,238TotalAmt
Program Services$16,882ProgramServicesAmt
Management And General$31,356ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$55,714TotalAmt
Program Services$32,608ProgramServicesAmt
Management And General$23,106ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$7,081TotalAmt
Program Services$7,081ProgramServicesAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$217,443TotalAmt
Program Services$151,242ProgramServicesAmt
Management And General$66,201ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$51,568TotalAmt
Program Services$36,273ProgramServicesAmt
Management And General$15,295ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
DUES & SUBSCRIPTIONS$64,750$16,200$45,575$2,975
EMPLOYEE RELATIONS$54,578$39,946$14,632
UNIFORMS$9,617$8,607$1,010
BAD DEBTS$61,179$61,179$0

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$45,147TotalAmt
Program Services$26,746ProgramServicesAmt
Management And General$18,401ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$10,013,473TotalAmt
Program Services$7,247,731ProgramServicesAmt
Management And General$2,761,991ManagementAndGeneralAmt
Fundraising$3,751FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,100BOYAmt
EOY$1,150EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$4,057,917BOYAmt
EOY$2,957,930EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$53,523BOYAmt
EOY$53,524EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$748,269BOYAmt
EOY$848,658EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

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

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

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

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

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

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$260,566BOYAmt
EOY$314,948EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$76,136BOYAmt
EOY$43,793EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$6,968,046LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$1,991,687LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$3,246,607BOYAmt
EOY$4,976,359EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$2,007,609BOYAmt
EOY$1,989,337EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$24,612BOYAmt
EOY$93,417EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

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

Intangible Assets IntangibleAssetsGrp

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

Other Assets Total OtherAssetsTotalGrp

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

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$10,476,339BOYAmt
EOY$11,279,116EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$602,507BOYAmt
EOY$889,359EOYAmt

Grants Payable GrantsPayableGrp

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

Deferred Revenue DeferredRevenueGrp

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

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

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

Escrow Account Liability EscrowAccountLiabilityGrp

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

Loans From Officers Directors LoansFromOfficersDirectorsGrp

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

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$371,296EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

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

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$57,392BOYAmt
EOY$58,755EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$659,899BOYAmt
EOY$1,319,410EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$9,791,899BOYAmt
EOY$9,959,706EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$24,541BOYAmt
EOY$0EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

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

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$9,816,440BOYAmt
EOY$9,959,706EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$10,476,339BOYAmt
EOY$11,279,116EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$156,689ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$14,556NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$1,133OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

Schedule A IRS990ScheduleA

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

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,823,114CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$3,222,231CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$3,181,102CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$3,357,530CurrentTaxYearMinus1YearAmt
Current Tax Year$3,466,172CurrentTaxYearAmt
Total$16,050,149TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$6,301,527CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$5,509,601CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$5,794,883CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$5,513,713CurrentTaxYearMinus1YearAmt
Current Tax Year$6,568,987CurrentTaxYearAmt
Total$29,688,711TotalAmt

Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$8,299CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$10,095CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$5,284CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$0CurrentTaxYearMinus1YearAmt
Current Tax Year$0CurrentTaxYearAmt
Total$23,678TotalAmt

Tax Rev Levied Orgnztnl Bnft509 TaxRevLeviedOrgnztnlBnft509Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Govt Furn Srvc Fclts Vl509 GovtFurnSrvcFcltsVl509Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$9,132,940CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$8,741,927CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$8,981,269CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$8,871,243CurrentTaxYearMinus1YearAmt
Current Tax Year$10,035,159CurrentTaxYearAmt
Total$45,762,538TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$45,762,538PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$37,765CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$50,695CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$52,958CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$77,205CurrentTaxYearMinus1YearAmt
Current Tax Year$81,784CurrentTaxYearAmt
Total$300,407TotalAmt

Post1975 UBTI Post1975UBTIGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$37,765CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$50,695CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$52,958CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$77,205CurrentTaxYearMinus1YearAmt
Current Tax Year$81,784CurrentTaxYearAmt
Total$300,407TotalAmt

Net Income From Other UBI NetIncomeFromOtherUBIGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$9,170,705CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$8,792,622CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$9,034,227CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$8,948,448CurrentTaxYearMinus1YearAmt
Current Tax Year$10,116,943CurrentTaxYearAmt
Total$46,062,945TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.99348PublicSupportCY509Pct
Public Support PY5090.99430PublicSupportPY509Pct
Investment Income CY0.00652InvestmentIncomeCYPct
Investment Income PY0.00570InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

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

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp
CY Minus3 Yr Endwmt FundCYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt FundCYMinus4YrEndwmtFundGrp

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$213,700OtherCostOrOtherBasisAmt
Book Value$213,700BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,490,772OtherCostOrOtherBasisAmt
Depreciation$277,904DepreciationAmt
Book Value$1,212,868BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$4,248,670OtherCostOrOtherBasisAmt
Depreciation$1,426,925DepreciationAmt
Book Value$2,821,745BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$638,181OtherCostOrOtherBasisAmt
Depreciation$286,859DepreciationAmt
Book Value$351,322BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$376,724OtherCostOrOtherBasisAmt
Book Value$376,724BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$4,976,359TotalBookValueLandBuildingsAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescDRUGS AND PHARMACEUTICALS HELDDesc
Amt$58,755Amt
FieldValueIRS element (for citing)
Total Liability$58,755TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$11,135,363TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst-$14,556NetUnrealizedGainsInvstAmt
Donated Services And Use Fclts$13,937DonatedServicesAndUseFcltsAmt
Other Revenue$1,041,793OtherRevenueAmt
Revenue Not Reported$1,041,174RevenueNotReportedAmt
Revenue Subtotal$10,094,189RevenueSubtotalAmt
Investment Expenses Not Incld$14,794InvestmentExpensesNotIncldAmt
Other Revenues Not Included$61,179OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$75,973RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$10,170,162TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$10,992,097TotExpnsEtcAuditedFinclStmtAmt
Donated Services Use Fclts$13,937DonatedServicesUseFcltsAmt
Other Expenses Included$1,040,660OtherExpensesIncludedAmt
Expenses Not Reported$1,054,597ExpensesNotReportedAmt
Expenses Subtotal$9,937,500ExpensesSubtotalAmt
Investment Expenses Not Incld2$14,794InvestmentExpensesNotIncld2Amt
Other Expenses Not Included$61,179OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$75,973ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$10,013,473TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE D, PART X, LINE 2FIN 48: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS.
SCHEDULE D,PART XI, LINE 2DOTHER RECONCILING ITEMS: COST OF GOODS SOLD-PHARMACY: $1,040,660 CHANGE IN BENEFICIAL INTEREST AT COMMUNITY FOUNDATION: 1,133 TOTAL: $1,041,793 SCHEDULE D, PART XI & XII, LINE 4B OTHER RECONCILING ITEMS: BAD DEBT: $61,179
SCHEDULE D, PART XII, LINE 2DOTHER RECONCILING ITEMS: COST OF GOODS SOLD-PHARMACY: $1,040,660

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Idemnification Gross Up PmtsYes (X)IdemnificationGrossUpPmtsInd
Written Policy Ref T And E ExpnssfalseWrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (true)SubstantiationRequiredInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentYes (true)SeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (true)AnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt
ESLEEN FULTZ
CHIEF EXECUTIVE OFFICER$211,107$0$30,450$0$0$0$5,202$0$7,911$0$254,670$0$0
DR OMOBOLA OLANIYAN
CHIEF MEDICAL OFF.(ENDED 9/18)$132,219$0$0$0$91,929$0$5,540$0$6,284$0$235,972$0$0
DR MEENAKSHI GUPTA
PEDIATRICIAN$168,742$0$1,283$0$33$0$4,219$0$719$0$174,996$0$0
DR CHRISTINE DANKWA
PEDIATRICIAN$169,041$0$1,283$0$33$0$4,232$0$706$0$175,295$0$0
DR DWAYNE JOHNSON
PEDIATRICIAN$156,840$0$1,354$0$104$0$0$0$24,906$0$183,204$0$0
DR MARY P MCMANMON
FAMILY DOCTOR$164,035$0$1,283$0$33$0$4,165$0$7,777$0$177,293$0$0$0
ESSAM MONTASIR
INTERNIST$201,296$0$1,354$0$104$0$5,175$0$15,222$0$223,151$0$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE J, PART I, LINE 1AGROSS-UP PAYMENTS: ESSAM MONTASIR, MEENAKSHI GUPTA, CHRISTINE DANKWA, DWAYNE JOHNSON, MARTINA MCGOWAN, MARY P. MCMANMON, AND PATRICIA KLINGER EACH RECEIVED A TAX GROSS UP ON THE BONUS PAYMENT THEY RECEIVED. THIS WAS INCLUDED ON THEIR W-2.
SCHEDULE J, PART I, LINE 4CDR. OLANIYAN SIGNED A SEPARATION AGREEMENT THAT INCLUDED CONTINUATION OF SALARY THROUGH 12/31/18 AND A ONE TIME $5,000 PAYMENT AS SEVERANCE.
SCHEDULE J, PART I, LINE 7NONFIXED PAYMENTS: THE BONUS PAYMENTS ARE BASED ON LENGTH OF SERVICE FOR THE YEAR TO WHICH THE BONUS RELATES AND POSITION HELD. BONUS IS PAID ONLY IF PAYMENT RECEIVED FROM MANAGED CARE ENTITY FOR MEETING TARGETS. THE BOARD OF DIRECTORS DETERMINES WHETHER IT IS TO BE SHARED WITH EMPLOYEES EACH YEAR. THE EXECUTIVE BOARD MEMBERS ALSO DECIDE THE ANNUAL BONUS FOR THE CEO AS PART OF THE PERFORMANCE EVALUATION. THE BONUS IS A PERCENTAGE OF THE EXISTING COMPENSATION, NOT BASED ON THE COMPENSATION WITH RAISE. THE BONUS IS BASED ON NATIONAL COMPENSATION PACKAGE REPORTS AND PERFORMANCE OF THE CEO. OPTIONS FOR THE BONUS ARE LISTED ON THE EVALUATION AS WELL AS AN OPTION FOR NO BONUS. THE EXECUTIVE COMMITTEE AGREE ON THE AMOUNT AND FILE THEIR DECISION WITH EVALUATION AND RAISE INFORMATION WITH HEART CITY HEALTHS ATTORNEY, BARNES & THORNBURG.

Schedule M IRS990ScheduleM

FieldValueIRS element (for citing)
Works Of ArtWorksOfArtGrp
Art Historical TreasuresArtHistoricalTreasuresGrp
Art Fractional InterestArtFractionalInterestGrp
Books And PublicationsBooksAndPublicationsGrp
Clothing And Household GoodsClothingAndHouseholdGoodsGrp
Cars And Other VehiclesCarsAndOtherVehiclesGrp
Boats And PlanesBoatsAndPlanesGrp
Intellectual PropertyIntellectualPropertyGrp
Securities Publicly TradedSecuritiesPubliclyTradedGrp
Securities Closely Held StockSecuritiesCloselyHeldStockGrp
Secur Prtnrshp Trust IntrstsSecurPrtnrshpTrustIntrstsGrp
Securities MiscellaneousSecuritiesMiscellaneousGrp
Qualified Contrib Hist StructQualifiedContribHistStructGrp
Qualified Contrib OtherQualifiedContribOtherGrp
Real Estate ResidentialRealEstateResidentialGrp
Real Estate CommercialRealEstateCommercialGrp
Real Estate OtherRealEstateOtherGrp
CollectiblesCollectiblesGrp
Food InventoryFoodInventoryGrp

Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Contribution102ContributionCnt
Noncash Contributions Rpt F990$248,483NoncashContributionsRptF990Amt
Method Of Determining RevenuesMARKET VALUEMethodOfDeterminingRevenuesTxt
FieldValueIRS element (for citing)
TaxidermyTaxidermyGrp
Historical ArtifactsHistoricalArtifactsGrp
Scientific SpecimensScientificSpecimensGrp
Archaeological ArtifactsArchaeologicalArtifactsGrp
Any Property That Must Be HeldfalseAnyPropertyThatMustBeHeldInd
Review Process Unusual NC GiftsYes (true)ReviewProcessUnusualNCGiftsInd
Third Parties UsedfalseThirdPartiesUsedInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCH M, PART IFormAndLineReferenceDesc
ExplanationEXPLANATIONS OF REPORTING METHOD FOR NUMBER OF CONTRIBUTIONS: DRUGS AND MEDICAL SUPPLIES ARE REPORTED BY THE NUMBER OF CONTRIBUTIONSExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (20 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART III, LINE 1ORGANIZATION'S MISSION: HEART CITY HEALTH CENTER OFFERS A SLIDING FEE SCALE BASED ON INCOME AND FAMILY SIZE FOR THE UNINSURED, UNDER-INSURED AND ALSO ACCEPT MEDICAID, MEDICARE AND SOME PRIVATE INSURANCES. HEART CITY IS COMMITTED TO REDUCING HEALTH DISPARITIES AMONG RESIDENTS BY PROVIDING PROFESSIONAL AND RESPECTFUL SERVICE TO ELKHART AND SURROUNDING COUNTIES THROUGH EDUCATION AND HIGH QUALITY PRIMARY MEDICAL CARE FOR THOSE IN NEED AND EXPERIENCING BARRIERS TO TRADITIONAL HEALTH CARE. THE MAJORITY OF HEART CITY'S PATIENTS ARE AT 100% OR BELOW THE FEDERAL POVERTY GUIDELINES, AND ALMOST 50% OF PATIENTS ARE UNDER THE AGE OF 18. HEART CITY IS ONE OF THE FEW SITES IN THE ELKHART AREA THAT PROVIDES SERVICES TO MEDICAID PATIENTS AND THE UNINSURED POPULATION. FORM 990, PART VI, LINE 1A DELEGATE BROAD AUTHORITY TO A COMMITTEE: THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE FOLLOWING OFFICERS OF THE CORPORATION, ALL OF WHOM SHALL HAVE THE RIGHT TO VOTE: CHAIRPERSON, VICE CHAIR, SECRETARY AND TREASURER. THE CHIEF EXECUTIVE OFFICER SHALL BE A NON-VOTING MEMBER OF THE EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE SHALL HAVE THE FOLLOWING GENERAL AUTHORITY; THE EXECUTIVE COMMITTEE SHALL BE COMPROMISED EXCLUSIVELY OF BOARD MEMBERS AND SHALL ACT FOR THE CORPORATION IN THE INTERIM PERIODS BETWEEN MEETINGS OF THE BOARD OF DIRECTORS ONLY WITH RESPECT TO MATTERS OF AN URGENT NATURE AND THEN TO THE MAXIMUM EXTENT FEASIBLE, IN COMPLIANCE WITH THE ESTABLISHED POLICIES AND EXPRESSED POSITIONS OF THE BOARD. ANY SUCH ACTIONS BY THE EXECUTIVE COMMITTEE ON BEHALF OF THE CORPORATION SHALL REQUIRE RATIFICATION AT THE FOLLOWING REGULAR OR SPECIAL MEETING WHERE A QUORUM IS PRESENT. THE CHAIRPERSON OF THE BOARD OF DIRECTORS OR ANY THREE (3) EXECUTIVE COMMITTEE MEMBERS CONVENES. SAID WRITTEN NOTICE SHALL BE DELIVERED TO THE REMAINING MEMBERS OF THE EXECUTIVE COMMITTEE. A MAJORITY OF THE OFFICERS PRESENT AND IN PERSON, SHALL CONSTITUTE A QUORUM FOR THE TRANSACTION OF EXECUTIVE COMMITTEE BUSINESS.
FORM 990, PART VI, SECTION B, LINE 11BREVIEW OF FORM 990 BY GOVERNING BODY: THE ORGANIZATION'S FORM 990 IS REVIEWED IN DETAIL BY THE EXECUTIVE MANAGEMENT. A BOARD MEETING IS THEN HELD TO PRESENT AND REVIEW A FINAL DRAFT OF THE FULL FORM 990, INCLUDING ALL APPLICABLE SCHEDULES; EACH BOARD MEMBER IS PROVIDED A COPY OF THE RETURN AT THE BOARD MEETING AND IS ALLOWED TO ASK ANY QUESTIONS THEY MAY HAVE. ONCE ALL QUESTIONS ARE ANSWERED, THE BOARD VOTES TO APPROVE SUBMISSION BEFORE THE RETURN IS FILED WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12CCONFLICT OF INTEREST POLICY: AN ANNUAL CONFLICT OF INTEREST FORM IS FILLED OUT BY EACH BOARD MEMBER. ALL OTHER EMPLOYEES SIGN THE CODE OF CONDUCT POLICY AT THE TIME OF HIRE WHICH COVERS CONFLICTS OF INTEREST. THE CEO AND THE BOARD LIAISON REVIEW THE CONFLICT OF INTEREST FORMS TO DETERMINE IF ANY POTENTIAL CONFLICT OF INTEREST EXISTS. IF A POTENTIAL CONFLICT OF INTEREST IS DETERMINED TO EXIST, THE CEO AND EXECUTIVE COMMITTEE OF THE BOARD, CONSISTING OF THE CHAIR, VICE CHAIR, SECRETARY AND TREASURER, MEET TO DISCUSS WHETHER ANY ACTUAL CONFLICTS OF INTEREST EXIST. ALTHOUGH NO CONFLICTS HAVE BEEN NOTED IN THE PAST, IF A CONFLICT OF INTEREST WAS TO ARISE, RESTRICTIONS WOULD BE IMPOSED AND THE BOARD MEMBER WOULD BE REQUIRED TO EXCUSE THEMSELVES FROM ANY DISCUSSIONS AND/OR VOTES RELATED TO THE CONFLICTING ISSUE.
FORM 990, PART VI, SECTION B, LINE 15APROCESS TO ESTABLISH COMPENSATION OF TOP MANAGEMENT OFFICIAL: COMPENSATION FOR THE ORGANIZATION'S CEO IS DETERMINED BY THE BOARD OF DIRECTORS EXECUTIVE COMMITTEE BASED ON A PERFORMANCE EVALUATION AND INTERVIEW WITH THE CEO. EACH EXECUTIVE BOARD MEMBER COMPLETES AN EVALUATION, AND THEN THE EXECUTIVE COMMITTEE REPORTS THE FINDINGS AND ANY CHANGES IN COMPENSATION TO THE CEO AND IT IS SENT TO THE HEART CITY HEALTH'S ATTORNEY. ANY CHANGES IN COMPENSATION ARE BASED ON COMPILED NATIONAL BENCHMARKING SALARY REPORTS. THIS PROCESS HAS BEEN PERFORMED ANNUALLY IN THE PAST. HOWEVER A REVIEW AND COMPENSATION CHANGE HAS NOT OCCURRED SINCE THE LAST ONE ON SEPTEMBER OF 2018. THE EVALUATION AND REVIEW PROCESS IS SIGNED BY THE EXECUTIVE BOARD COMMITTEE AND IS DOCUMENTED AND ON FILE WITH HEART CITY HEALTH'S ATTORNEY, BARNES & THORNBURG
FORM 990, PART VI, LINE 15BPROCESS USED TO ESTABLISH COMPENSATION OF OTHER OFFICERS/KEY EMPLOYEES: THE ORGANIZATION'S CEO COMPLETES AN ANNUAL PERFORMANCE EVALUATION FOR THE CFO; BASED ON THE OUTCOME OF THE PERFORMANCE EVALUATION AND THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS (NACHC) SALARY SURVEYS, THE CFO'S COMPENSATION IS REVIEWED AND ADJUSTED AS NECESSARY. THE ORGANIZATION'S CEO ALSO COMPLETES AN ANNUAL PERFORMANCE EVALUATION FOR THE CMO; BASED ON THE OUTCOME OF THE PERFORMANCE EVALUATION AND GENERAL COMPENSATION GUIDELINES SET BY THE BOARD, THE CMO'S EMPLOYMENT CONTRACT IS UPDATED AS NECESSARY. THESE PERFORMANCE EVALUATIONS AND COMPENSATION/EMPLOYMENT CONTRACT UPDATES WERE LAST COMPLETED DURING THE FISCAL YEAR ENDED 10/01/2018.
FORM 990, PART VI, SECTION C, LINE 19REQUIRED DOCUMENTS AVAILABLE TO THE PUBLIC: GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICIES AND FINANCIAL STATEMENTS ARE NOT REQUIRED DISCLOSURES PURSUANT TO INTERNAL REVENUE CODE (IRC) SECTION 6104. THESE DOCUMENTS ARE NOT AVAILABLE TO THE PUBLIC AT THIS TIME.
FORM 990, PART XI, LINE 9OTHER CHANGES IN NET ASSETS OR FUND BALANCES: CHANGE IN BENEFICIAL INTEREST AT COMMUNITY FOUNDATION - $1,133
FORM 990 PART IX LINE 11GDESCRIPTION:LAB SERVICES TOTAL FEES:11410
FORM 990 PART IX LINE 11GDESCRIPTION:DENTAL LABS TOTAL FEES:3430
FORM 990 PART IX LINE 11GDESCRIPTION:CONTRACTED SERVICES - BEHAVIOR TOTAL FEES:133360
FORM 990 PART IX LINE 11GDESCRIPTION:CONTRACTED SERVICES - MEDICAL TOTAL FEES:80200
FORM 990 PART IX LINE 11GDESCRIPTION:CONTRACTED SERVICES - EHR / PM TOTAL FEES:520583
FORM 990 PART IX LINE 11GDESCRIPTION:CONTRACTED SERVICES - SECURITY TOTAL FEES:60391
FORM 990 PART IX LINE 11GDESCRIPTION:INTERPRETING SERVICES TOTAL FEES:89348
FORM 990 PART IX LINE 11GDESCRIPTION:PROFESSIONAL FEES - CONSULTING TOTAL FEES:43105
FORM 990 PART IX LINE 11GDESCRIPTION:PROFESSIONAL FEES - PAYROLL TOTAL FEES:21987
FORM 990 PART IX LINE 11GDESCRIPTION:TELEPHONE SERVICE TOTAL FEES:95011
FORM 990 PART IX LINE 11GDESCRIPTION:ANSWERING SERVICE TOTAL FEES:7850
FORM 990 PART IX LINE 11GDESCRIPTION:CLAIMS PROCESSING TOTAL FEES:3860
FORM 990 PART IX LINE 11GDESCRIPTION:INTERNET SERVICE TOTAL FEES:9169

Comments

Anonymous: no account or email. Up to 2,000 characters, at most one link. Comments are checked automatically; some wait for review.