FURP.ORG / PUBLIC DATA EXPLORER

GREATER PRINCE WILLIAM AREA COMMUNITY HEALTH CENTER INC: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization
GREATER PRINCE WILLIAM AREA COMMUNITY HEALTH CENTER INC (EIN 83-0435138)
Tax period
2017-07-01 to 2018-06-30
Filed
2019-02-11
IRS object ID
201900429349300110
Schema version
2017v2.3
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)
Return2019-02-11T07:52:16-06:00ReturnTs
Tax Period End2018-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN390859910PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BAKER TILLY VIRCHOW KRAUSE LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line11650 MARKET STREET SUITE 4500AddressLine1Txt
CityPHILADELPHIACityNm
State AbbreviationPAStateAbbreviationCd
ZIP191037341ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2017-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN830435138EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1GREATER PRINCE WILLIAM AREA COMMUNITYBusinessNameLine1Txt
Business Name Line2HEALTH CENTER INCBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlGREABusinessNameControlTxt
Phone7036807950PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line14379 RIDGEWOOD CENTER DRIVE NO 102AddressLine1Txt
CityWOODBRIDGECityNm
State AbbreviationVAStateAbbreviationCd
ZIP22192ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMARK MEYEPersonNm
Person TitleEXECUTIVE DIRECTORPersonTitleTxt
Phone7036807950PhoneNum
Signature2019-02-09SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonKERRI N BOGDAPreparerPersonNm
PTINP00760402PTIN
Phone2159720701PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address96.80.2.34IPv4AddressTxt
FieldValueIRS element (for citing)
IP2019-02-09IPDt
IP Tm07:09:33IPTm
IP TimezoneESIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id310B0B985092CD611011E244C6BDB4CEA288B0D0AtSubmissionCreationDeviceId
At Submission Filing Device IdF58787FA80410BAE38B710EAF9FCC5760AD3BCDFAtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2017TaxYr
Build TS2019-02-21 02:37:17ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerMARK MEYEPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line14379 RIDGEWOOD CENTER DRIVE NO 102AddressLine1Txt
CityWOODBRIDGECityNm
State AbbreviationVAStateAbbreviationCd
ZIP22192ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$11,838,571GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.GPWHEALTHCENTER.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2007FormationYr
Legal Domicile StateVALegalDomicileStateCd
Activity Or MissionTO INCREASE ACCESS TO AFFORDABLE HIGH QUALITY HEALTH CARE FOR THE WHOLE FAMILY.ActivityOrMissionDesc
Voting Members Governing Body13VotingMembersGoverningBodyCnt
Voting Members Independent13VotingMembersIndependentCnt
Total Employee145TotalEmployeeCnt
Total Volunteers50TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$4,271,475PYContributionsGrantsAmt
CY Contributions Grants$3,975,369CYContributionsGrantsAmt
PY Program Service Revenue$6,090,223PYProgramServiceRevenueAmt
CY Program Service Revenue$7,779,103CYProgramServiceRevenueAmt
PY Investment Income$0PYInvestmentIncomeAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue-$34,434PYOtherRevenueAmt
CY Other Revenue$44,862CYOtherRevenueAmt
PY Total Revenue$10,327,264PYTotalRevenueAmt
CY Total Revenue$11,799,334CYTotalRevenueAmt
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$5,922,751PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$8,399,477CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$134,328CYTotalFundraisingExpenseAmt
PY Other Expenses$3,503,678PYOtherExpensesAmt
CY Other Expenses$3,683,947CYOtherExpensesAmt
PY Total Expenses$9,426,429PYTotalExpensesAmt
CY Total Expenses$12,083,424CYTotalExpensesAmt
PY Revenues Less Expenses$900,835PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$284,090CYRevenuesLessExpensesAmt
Total Assets BOY$4,187,933TotalAssetsBOYAmt
Total Assets EOY$4,101,568TotalAssetsEOYAmt
Total Liabilities BOY$1,692,118TotalLiabilitiesBOYAmt
Total Liabilities EOY$1,890,303TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$2,495,815NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$2,211,265NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTHE 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 Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$4,690,164ExpenseAmt
Grant$0GrantAmt
Revenue$3,598,915RevenueAmt
DescMEDICAL CARE: THE CENTER MEDICAL CARE THAT IS CULTURALLY SENSITIVE 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 26,760 VISITS INVOLVING 9,320 PATIENTS DURING THE FISCAL YEAR.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$2,309,295ExpenseAmt
Grant$0GrantAmt
Revenue$1,930,417RevenueAmt
DescOB-GYN CARE: THE CENTER PROVIDES OB-GYN CARE THAT IS CULTURALLY SENSITIVE 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 14,220 VISITS INVOLVING 2,070 PATIENTS DURING THE FISCAL YEAR.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$1,999,642ExpenseAmt
Grant$0GrantAmt
Revenue$1,735,722RevenueAmt
DescDENTAL CARE: THE CENTER PROVIDES DENTAL CARE THAT IS CULTURALLY SENSITIVE 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 8,210 VISITS INVOLVING 3,200 PATIENTS DURING THE FISCAL YEAR.Desc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp

FieldValueIRS element (for citing)
Expense$1,074,687ExpenseAmt
Grant$0GrantAmt
Revenue$514,049RevenueAmt
DescBEHAVIORAL HEALTH - THE CENTER PROVIDES BEHAVIORAL HEALTH CARE THAT IS CULTURALLY SENSITIVE 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 6,760 VISITS INVOLVING 1,260 PATIENTS DURING THE FISCAL YEAR.Desc
FieldValueIRS element (for citing)
Total Other Prog Srvc Expense$1,074,687TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Grant$0TotalOtherProgSrvcGrantAmt
Total Other Prog Srvc Revenue$514,049TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses$10,073,788TotalProgramServiceExpensesAmt
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
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
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 ActivitiesYes (1)FundraisingActivitiesInd
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 With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash ContriYes (1)DeductibleNonCashContriInd
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 Document30IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee145EmployeeCnt
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
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members13GoverningBodyVotingMembersCnt
Independent Voting Member13IndependentVotingMemberCnt
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 CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldVAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonMARK MEYE EXECUTIVE DIRECTORPersonNm
Phone7036807950PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line14379 RIDGEWOOD CENTER DRIVE SUITEAddressLine1Txt
CityWOODBRIDGECityNm
State AbbreviationVAStateAbbreviationCd
ZIP22192ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
LUIS LOU FERRARO
PRESIDENT6.00Yes (X)Yes (X)$0$0$0
DAVID B WILKS
VICE PRESIDENT4.00Yes (X)Yes (X)$0$0$0
JOHN S GRAY
TREASURER4.00Yes (X)Yes (X)$0$0$0
VALERIE E KEENE
SECRETARY4.00Yes (X)Yes (X)$0$0$0
ABRA HOGARTH
MEMBER2.00Yes (X)$0$0$0
ADDIE RAY WHITAKER
MEMBER2.00Yes (X)$0$0$0
EVELYN MARR
MEMBER2.00Yes (X)$0$0$0
JENNY PORTILLO
MEMBER2.00Yes (X)$0$0$0
JULIO ALEX CORREA
MEMBER2.00Yes (X)$0$0$0
LASHEECO GRAHAMAN
MEMBER2.00Yes (X)$0$0$0
LAURA C POSEY
MEMBER2.00Yes (X)$0$0$0
RICHARD GARON
MEMBER2.00Yes (X)$0$0$0
ROSE GONZALEZ
MEMBER2.00Yes (X)$0$0$0
MARK MEYE
EXECUTIVE DIRECTOR40.00Yes (X)$147,710$0$8,551
RASHID MOHIUDDIN
MEDICAL DIRECTOR40.00$213,799$0$16,278Yes (X)
SYED MAHBOOB
PHYSICIAN40.00$182,887$0$15,351Yes (X)
LISA WIENER
OB-GYN DIRECTOR40.00$121,601$0$13,458Yes (X)
RENATO DAING
PHYSICIAN40.00$168,435$0$12,064Yes (X)
LINNEA LINDERMAN
PHYSICIAN40.00$191,672$0$5,902Yes (X)
CHRISTINE BAKER
DENTIST40.00$115,183$0$5,854Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,141,287TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$77,458TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K11IndivRcvdGreaterThan100KCnt
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
COMMUNITY CARE NETWORK OF VIRGINIA
3831 WESTERRE PARKWAYHENRICOVA23233HEALTH CARE BILLING$205,313
LABCORP
PO BOX 12140BURLINGTONNC27216LABORATORY SERVICES$175,945
ECLINICALWORKS
PO BOX 847950BOSTONMA02284ELECTRONIC HEALTH RECORDS$120,553
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K3CntrctRcvdGreaterThan100KCnt
Fundraising$50,981FundraisingAmt
Government Grants$3,807,424GovernmentGrantsAmt
All Other Contributions$116,964AllOtherContributionsAmt
Noncash Contributions$114,375NoncashContributionsAmt
Total Contributions$3,975,369TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
MEDICAL CARE624110$3,598,915$3,598,915
OB-GYN CARE624110$1,930,417$1,930,417
DENTAL CARE624110$1,735,722$1,735,722
BEHAVIORAL HEALTH624110$514,049$514,049
FieldValueIRS element (for citing)
Total Program Service Revenue$7,779,103TotalProgramServiceRevenueAmt
Fundraising Gross Income$5,907FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$50,981ContriRptFundraisingEventAmt
Fundraising Direct Expenses$39,237FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column-$33,330TotalRevenueColumnAmt
Exclusion-$33,330ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmt
MEANINGFUL USE REVENUE900099$68,000$68,000
CREDIT CARD REWARDS900099$4,201$4,201
REBATES900099$2,853$2,853

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$3,138TotalRevenueColumnAmt
Exclusion$3,138ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$78,192OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$11,799,334TotalRevenueColumnAmt
Related Or Exempt Func Income$7,779,103RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$44,862ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$406,864TotalAmt
Program Services$252,011ProgramServicesAmt
Management And General$138,578ManagementAndGeneralAmt
Fundraising$16,275FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$6,761,601TotalAmt
Program Services$6,142,633ProgramServicesAmt
Management And General$603,610ManagementAndGeneralAmt
Fundraising$15,358FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$201,080TotalAmt
Program Services$177,305ProgramServicesAmt
Management And General$23,097ManagementAndGeneralAmt
Fundraising$678FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$509,140TotalAmt
Program Services$446,089ProgramServicesAmt
Management And General$60,937ManagementAndGeneralAmt
Fundraising$2,114FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$520,792TotalAmt
Program Services$452,130ProgramServicesAmt
Management And General$65,915ManagementAndGeneralAmt
Fundraising$2,747FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$3,846TotalAmt
Management And General$3,846ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$25,840TotalAmt
Management And General$25,840ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$768,927TotalAmt
Program Services$693,147ProgramServicesAmt
Management And General$32,710ManagementAndGeneralAmt
Fundraising$43,070FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$241,446TotalAmt
Program Services$159,022ProgramServicesAmt
Management And General$76,792ManagementAndGeneralAmt
Fundraising$5,632FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$176,576TotalAmt
Program Services$109,611ProgramServicesAmt
Management And General$59,927ManagementAndGeneralAmt
Fundraising$7,038FundraisingAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$939,122TotalAmt
Program Services$596,652ProgramServicesAmt
Management And General$303,950ManagementAndGeneralAmt
Fundraising$38,520FundraisingAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$13,484TotalAmt
Program Services$6,636ProgramServicesAmt
Management And General$6,848ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$6,424TotalAmt
Management And General$6,424ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$294,187TotalAmt
Program Services$82,273ProgramServicesAmt
Management And General$211,914ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$23,414TotalAmt
Program Services$16,776ProgramServicesAmt
Management And General$6,638ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
PROGRAM SUPPLIES$672,089$672,089
BAD DEBT EXPENSE$178,445$178,445
CLINICAL SUPPLIES$113,038$113,038
RECRUITMENT & RETENTION$92,383$54,889$35,994$1,500

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$134,726TotalAmt
Program Services$99,487ProgramServicesAmt
Management And General$33,843ManagementAndGeneralAmt
Fundraising$1,396FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$12,083,424TotalAmt
Program Services$10,073,788ProgramServicesAmt
Management And General$1,875,308ManagementAndGeneralAmt
Fundraising$134,328FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$796,792BOYAmt
EOY$871,362EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$157,614BOYAmt
EOY$155,081EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,666,435BOYAmt
EOY$1,689,990EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$36,916BOYAmt
EOY$12,622EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$40,240BOYAmt
EOY$69,502EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$2,387,240LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$1,237,297LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$1,336,408BOYAmt
EOY$1,149,943EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$14,559BOYAmt
EOY$14,099EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$15,000BOYAmt
EOY$15,000EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$123,969BOYAmt
EOY$123,969EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$4,187,933BOYAmt
EOY$4,101,568EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$644,517BOYAmt
EOY$923,947EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$3,860BOYAmt
EOY$7,860EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$136,331BOYAmt
EOY$70,273EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$907,410BOYAmt
EOY$888,223EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,692,118BOYAmt
EOY$1,890,303EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$2,407,482BOYAmt
EOY$2,028,598EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$88,333BOYAmt
EOY$182,667EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,495,815BOYAmt
EOY$2,211,265EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$4,187,933BOYAmt
EOY$4,101,568EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$284,090ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$460NetUnrlzdGainsLossesInvstAmt
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 RequiredYes (1)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (1)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Schedule D IRS990ScheduleD

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,088,356OtherCostOrOtherBasisAmt
Depreciation$529,065DepreciationAmt
Book Value$559,291BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$820,302OtherCostOrOtherBasisAmt
Depreciation$480,381DepreciationAmt
Book Value$339,921BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$478,582OtherCostOrOtherBasisAmt
Depreciation$227,851DepreciationAmt
Book Value$250,731BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$1,149,943TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescDEFERRED RENTDesc
Amt$888,223Amt
FieldValueIRS element (for citing)
Total Liability$888,223TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$11,953,329TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst-$460NetUnrealizedGainsInvstAmt
Donated Services And Use Fclts$332,900DonatedServicesAndUseFcltsAmt
Other Revenue-$178,445OtherRevenueAmt
Revenue Not Reported$153,995RevenueNotReportedAmt
Revenue Subtotal$11,799,334RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$11,799,334TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$12,237,879TotExpnsEtcAuditedFinclStmtAmt
Donated Services Use Fclts$332,900DonatedServicesUseFcltsAmt
Expenses Not Reported$332,900ExpensesNotReportedAmt
Expenses Subtotal$11,904,979ExpensesSubtotalAmt
Other Expenses Not Included$178,445OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$178,445ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$12,083,424TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART XI, LINE 2D - OTHER ADJUSTMENTS:BAD DEBT EXPENSE -178,445.
PART XII, LINE 4B - OTHER ADJUSTMENTS:BAD DEBT EXPENSE 178,445.

Schedule G IRS990ScheduleG

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1CHIPS4CHARITYEvent1Nm
Gross Receipts Event1$56,888GrossReceiptsEvent1Amt
Charitable Contri Event1$50,981CharitableContriEvent1Amt
Gross Revenue Event1$5,907GrossRevenueEvent1Amt
Food And Beverage Event1$11,998FoodAndBeverageEvent1Amt
Entertainment Event1$10,007EntertainmentEvent1Amt
Other Direct Expenses Event1$17,232OtherDirectExpensesEvent1Amt
Gross Receipts Total$56,888GrossReceiptsTotalAmt
Charitable Contributions Tot$50,981CharitableContributionsTotAmt
Gross Revenue Total Events$5,907GrossRevenueTotalEventsAmt
Food And Beverage Total Events$11,998FoodAndBeverageTotalEventsAmt
Entertainment Total Events$10,007EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events$17,232OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$39,237DirectExpenseSummaryEventsAmt
Net Income Summary-$33,330NetIncomeSummaryAmt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
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 PaymentsYes (1)AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (5 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
MARK MEYE
EXECUTIVE DIRECTOR$136,973$0$10,737$0$0$0$4,109$0$4,442$0$156,261$0$0$0
RASHID MOHIUDDIN
MEDICAL DIRECTOR$213,799$0$0$0$0$0$6,414$0$9,864$0$230,077$0$0$0
SYED MAHBOOB
PHYSICIAN$182,887$0$0$0$0$0$5,487$0$9,864$0$198,238$0$0$0
RENATO DAING
PHYSICIAN$168,435$0$0$0$0$0$5,053$0$7,011$0$180,499$0$0$0
LINNEA LINDERMAN
PHYSICIAN$191,672$0$0$0$0$0$5,750$0$152$0$197,574$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 7FormAndLineReferenceDesc
ExplanationTHE BOARD ISSUED A DISCRETIONARY BONUS TO THE EXECUTIVE DIRECTOR; 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, THEN THE BONUS IS ISSUED.ExplanationTxt

Schedule M IRS990ScheduleM

Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Contribution3ContributionCnt
Noncash Contributions Rpt F990$114,375NoncashContributionsRptF990Amt
Method Of Determining RevenuesPURCHASE PRICEMethodOfDeterminingRevenuesTxt
FieldValueIRS element (for citing)
Form8283 Received0Form8283ReceivedCnt
Any Property That Must Be Held0AnyPropertyThatMustBeHeldInd
Review Process Unusual NC GiftsYes (1)ReviewProcessUnusualNCGiftsInd
Third Parties Used0ThirdPartiesUsedInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, COLUMN (B):FormAndLineReferenceDesc
ExplanationTHE NUMBER IN COLUMN B REPRESENTS THE NUMBER OF CONTRIBUTORS.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 1THE 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 11BTHE EXECUTIVE DIRECTOR, DIRECTOR OF FINANCE, 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 12CBOARD DIRECTORS, OFFICERS, AND KEY EMPLOYEES COMPLETE A DISCLOSURES FORM ANNUALLY. INDIVIDUALS WITH POTENTIAL OR ACTUAL CONFLICTS ARE EXPECTED TO REPORT ANY INFORMATION PERTINENT TO THE CONFLICT. FAMILY AND BUSINESS RELATIONSHIPS RE EXPRESSLY STATED IN THE DISCLOSURES AS BEING SOURCES OF POTENTIAL CONFLICTS. BOARD DIRECTORS MAKE THEIR DISCLOSURES TO THE COMPLIANCE OFFICER, WHILE THE EXECUTIVE DIRECTOR 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 15THE BOARD SETS POSITION PAY RANGES AND REVIEWS AND APPROVES THE EXECUTIVE DIRECTOR'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 2016. 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 EXECUTIVE DIRECTOR AND DIRECTOR OF HUMAN RESOURCES FROM APRIL 2016 TO SEPTEMBER 2016, THIS SURVEY WAS PRESENTED TO THE BOARD FOR REVIEW IN NOVEMBER 2016. 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 19THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST.