PENINSULA INSTITUTE FOR COMMUNITY HEALTH INC: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- PENINSULA INSTITUTE FOR COMMUNITY HEALTH INC (EIN 54-1083954)
- Tax period
- 2018-01-01 to 2018-12-31
- Filed
- 2019-05-02
- IRS object ID
- 201921229349301182
- Schema version
- 2018v3.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2019-05-02T14:27:26-05:00 | ReturnTs |
| Tax Period End | 2018-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 541896113 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ROBINSON FARMER COX ASSOCIATES | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 401 SOUTHLAKE BLVD | AddressLine1Txt |
| City | RICHMOND | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 23236 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2018-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 541083954 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PENINSULA INSTITUTE FOR COMMUNITY | BusinessNameLine1Txt |
| Business Name Line2 | HEALTH | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PENI | BusinessNameControlTxt |
| Phone | 7573808709 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1033 28TH STREET 2ND FLOOR | AddressLine1Txt |
| City | NEWPORT NEWS | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 23607 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ANGELA FUTRELL | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 7573808709 | PhoneNum |
| Signature | 2019-04-15 | SignatureDt |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | AARON B HAWKINS | PreparerPersonNm |
| PTIN | P01458736 | PTIN |
| Phone | 8043784200 | PhoneNum |
| Preparation | 2019-05-02 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 50.77.77.25 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2019-05-02 | IPDt |
| IP Tm | 14:27:26 | IPTm |
| IP Timezone | CD | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 9ABF4A4CD9073D44961EDDFBB9D4FC555C086CE7 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 9ABF4A4CD9073D44961EDDFBB9D4FC555C086CE7 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SOUTHEASTERN VIRGINIA HEALTH SYSTEM | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ANGELA FUTRELL | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1033 28TH STREET 2ND FLOOR | AddressLine1Txt |
| City | NEWPORT NEWS | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 23607 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $14,618,988 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.PICH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1978 | FormationYr |
| Legal Domicile State | VA | LegalDomicileStateCd |
| Activity Or Mission | PROVIDE HIGH QUALITY, COMPREHENSIVE, PRIMARY HEALTH CARE SERVICES TO VIRGINIA RESIDENTS LIVING IN HAMPTON ROADS REGARDLESS OF THEIR ABILITY TO PAY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 12 | VotingMembersIndependentCnt |
| Total Employee | 209 | TotalEmployeeCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $8,983,567 | PYContributionsGrantsAmt |
| CY Contributions Grants | $9,415,186 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $7,089,356 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $5,199,449 | CYProgramServiceRevenueAmt |
| PY Investment Income | $13,446 | PYInvestmentIncomeAmt |
| CY Investment Income | $4,353 | CYInvestmentIncomeAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $16,086,369 | PYTotalRevenueAmt |
| CY Total Revenue | $14,618,988 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $9,867,160 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $9,293,419 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $3,972,644 | PYOtherExpensesAmt |
| CY Other Expenses | $4,800,536 | CYOtherExpensesAmt |
| PY Total Expenses | $13,839,804 | PYTotalExpensesAmt |
| CY Total Expenses | $14,093,955 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $2,246,565 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $525,033 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $10,787,759 | TotalAssetsBOYAmt |
| Total Assets EOY | $11,056,552 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,074,225 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,863,525 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $8,713,534 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $9,193,027 | NetAssetsOrFundBalancesEOYAmt |
| Mission | PROVIDING MEDICAL AND DENTAL CARE TO INDIGENT PATIENTS. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $9,455,610 | ExpenseAmt |
| Desc | MEDICAL CARE: PRIMARY MEDICAL CARE, DENTAL SERVICES AND MENTAL HEALTH SERVICES FOR THE MEDICALLY UNDERSERVED AREAS OF NEWPORT NEWS, HAMPTON, SUFFOLK, VIRGINIA BEACH, CHESPEAKE, MATHEWS COUNTY, AND FRANKLIN, VIRGINIA. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,139,379 | ExpenseAmt |
| Desc | CASE MANAGEMENT: ASSISTANCE FOR PATIENTS MANAGING AND COORDINATING CARE FOR COMPLEX AND/OR CHRONIC CONDITIONS. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $235,457 | ExpenseAmt |
| Desc | OTHER PATIENT SERVICES: ENABLING SERVICES TO INCLUDE OUTREACH, PATIENT EDUCATION AND PHARMACY ASSISTANCE FOR MEDICALLY UNDERSERVED POPULATIONS SERVED BY THE HEALTH CENTER. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $10,830,446 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | Yes (true) | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 39 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | false | BackupWthldComplianceInd |
| Employee | 209 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 12 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | Yes (true) | LocalChaptersInd |
| Policies Reference Chapters | Yes (true) | PoliciesReferenceChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ANGELA FUTRELL | PersonNm |
| Phone | 7573808709 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1033 28TH STREET 2ND FLOOR | AddressLine1Txt |
| City | NEWPORT NEWS | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 23607 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | Yes (X) | NoListedPersonsCompensatedInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| WANDA ALLEN ESQ | ||||||||
| CHAIR | 6.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| SHIRLEY WILLS | ||||||||
| VICE CHAIR | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| M DENISE COUNCE | ||||||||
| TREASURER | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| TIFFANY BROWN | ||||||||
| SECRETARY | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| STYLIE WILLIAMS | ||||||||
| PARLIAMENTAR | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| ROBERT AYERS | ||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| KATHERINE GRANT-DAVIS | ||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| RUTH HOLMES | ||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| ASA JENRETTE JR | ||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| ARAVIA JOHNSON | ||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| CATHY WILLIAMS | ||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| DOROTHY MURRAY | ||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| ANGELA FUTRELL | ||||||||
| CEO | 40.00 | $295,591 | $0 | $26,793 | Yes (X) | |||
| VALDA BRANCH | ||||||||
| COO | 40.00 | $193,775 | $0 | $22,677 | Yes (X) | |||
| PAULINE REED | ||||||||
| CMO | 40.00 | $180,828 | $0 | $16,793 | Yes (X) | |||
| NONA HILTON | ||||||||
| CFO | 40.00 | $161,255 | $0 | $15,176 | Yes (X) | |||
| DAVID LORENZO | ||||||||
| PHYSICIAN | 40.00 | $203,438 | $0 | $27,196 | Yes (X) | |||
| CONCEPCION ASPILI | ||||||||
| PHYSICIAN | 40.00 | $181,744 | $0 | $34,404 | Yes (X) | |||
| ANDREI SAN-MARINA | ||||||||
| PHYSICIAN | 40.00 | $179,237 | $0 | $6,373 | Yes (X) | |||
| AURORA S BADAVI | ||||||||
| PHYSICIAN | 40.00 | $166,811 | $0 | $16,733 | Yes (X) | |||
| SUFIA B SHAHID | ||||||||
| PHYSICIAN | 40.00 | $166,152 | $0 | $23,642 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,728,831 | TotalReportableCompFromOrgAmt |
| Total Other Compensation | $189,787 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 9 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| STAFFCARE INC | |||||
| 5001 STATESMAN DR | IRVING | TX | 75063 | STAFFING | $350,440 |
| LABCORP | |||||
| PO BOX 2250 | BURLINGTON | NC | 272162240 | LAB WORK | $304,542 |
| PENINSULA CLEANING SERVICE | |||||
| 12610 PATRICK HENRY DR SUITE A | NEWPORT NEWS | VA | 23602 | JANITORIAL | $233,689 |
| INTEGRITY HEALTHCARE CORPORATION | |||||
| 243 MCLAWS CIRCLE SUITE 101 | WILLIAMSBURG | VA | 23185 | BEHAVIOR HEALTH | $207,821 |
| ECLINICALWORKS LLC | |||||
| 2 TECHNOLOGY DRIVE | WESTBROUGH | MA | 01581 | SOFTWARE | $116,734 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $8,373,194 | GovernmentGrantsAmt |
| All Other Contributions | $1,041,992 | AllOtherContributionsAmt |
| Total Contributions | $9,415,186 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NET PATIENT SERVICE REVENUE | Desc |
| Total Revenue Column | $5,199,449 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $5,199,449 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $5,199,449 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,353 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $4,353 | RelatedOrExemptFuncIncomeAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $14,618,988 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $5,203,802 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $842,284 | TotalAmt |
| Program Services | $156,738 | ProgramServicesAmt |
| Management And General | $685,546 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,796,468 | TotalAmt |
| Program Services | $6,024,566 | ProgramServicesAmt |
| Management And General | $771,902 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,042,325 | TotalAmt |
| Program Services | $705,781 | ProgramServicesAmt |
| Management And General | $336,544 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $612,342 | TotalAmt |
| Program Services | $458,256 | ProgramServicesAmt |
| Management And General | $154,086 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,098 | TotalAmt |
| Management And General | $22,098 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $52,173 | TotalAmt |
| Management And General | $52,173 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,718,595 | TotalAmt |
| Program Services | $1,699,637 | ProgramServicesAmt |
| Management And General | $18,958 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,105,878 | TotalAmt |
| Program Services | $814,120 | ProgramServicesAmt |
| Management And General | $291,758 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $307,573 | TotalAmt |
| Program Services | $36,929 | ProgramServicesAmt |
| Management And General | $270,644 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,024,177 | TotalAmt |
| Program Services | $828,568 | ProgramServicesAmt |
| Management And General | $195,609 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,639 | TotalAmt |
| Program Services | $976 | ProgramServicesAmt |
| Management And General | $10,663 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,704 | TotalAmt |
| Program Services | $1,311 | ProgramServicesAmt |
| Management And General | $22,393 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $217,243 | TotalAmt |
| Program Services | $38,453 | ProgramServicesAmt |
| Management And General | $178,790 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $56,983 | TotalAmt |
| Management And General | $56,983 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Management And GeneralManagementAndGeneralAmt | Program ServicesProgramServicesAmt |
|---|---|---|---|
| DUES & PUB - MGMT & GEN | $106,081 | $106,081 | |
| MARKETING | $69,641 | $67,238 | $2,403 |
| DUES & PUB - MEDICAL CARE | $35,847 | $35,847 | |
| TAXES AND LICENSES | $23,705 | $9,363 | $14,342 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,199 | TotalAmt |
| Program Services | $12,519 | ProgramServicesAmt |
| Management And General | $12,680 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,093,955 | TotalAmt |
| Program Services | $10,830,446 | ProgramServicesAmt |
| Management And General | $3,263,509 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,232,495 | BOYAmt |
| EOY | $4,507,260 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,087,361 | BOYAmt |
| EOY | $1,648,255 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,352,719 | BOYAmt |
| EOY | $964,240 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $212,906 | BOYAmt |
| EOY | $124,054 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $7,596,704 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $4,570,699 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,070,000 | BOYAmt |
| EOY | $3,026,005 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $832,278 | BOYAmt |
| EOY | $786,738 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,787,759 | BOYAmt |
| EOY | $11,056,552 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $734,679 | BOYAmt |
| EOY | $1,253,537 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,339,546 | BOYAmt |
| EOY | $609,988 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,074,225 | BOYAmt |
| EOY | $1,863,525 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,713,534 | BOYAmt |
| EOY | $9,193,027 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,713,534 | BOYAmt |
| EOY | $9,193,027 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,787,759 | BOYAmt |
| EOY | $11,056,552 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $525,033 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$45,540 | NetUnrlzdGainsLossesInvstAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $217,200 | OtherCostOrOtherBasisAmt |
| Book Value | $217,200 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,541,592 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,005,105 | DepreciationAmt |
| Book Value | $536,487 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,781,599 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,565,594 | DepreciationAmt |
| Book Value | $216,005 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,056,313 | OtherCostOrOtherBasisAmt |
| Book Value | $2,056,313 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $3,026,005 | TotalBookValueLandBuildingsAmt |
| Total Rev Etc Audited Fincl Stmt | $14,763,926 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$45,540 | NetUnrealizedGainsInvstAmt |
| Donated Services And Use Fclts | $190,478 | DonatedServicesAndUseFcltsAmt |
| Revenue Not Reported | $144,938 | RevenueNotReportedAmt |
| Revenue Subtotal | $14,618,988 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $14,618,988 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $14,284,433 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $190,478 | DonatedServicesUseFcltsAmt |
| Expenses Not Reported | $190,478 | ExpensesNotReportedAmt |
| Expenses Subtotal | $14,093,955 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $14,093,955 | TotalExpensesPerForm990Amt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt |
|---|---|---|---|---|
| ANGELA FUTRELL | ||||
| CEO | $295,591 | $6,913 | $23,024 | $322,384 |
| VALDA BRANCH | ||||
| COO | $193,775 | $5,969 | $17,260 | $216,452 |
| PAULINE REED | ||||
| CMO | $180,828 | $6,731 | $13,039 | $197,621 |
| NONA HILTON | ||||
| CFO | $161,255 | $5,708 | $10,020 | $176,431 |
| DAVID LORENZO | ||||
| PHYSICIAN | $203,438 | $7,316 | $23,024 | $230,634 |
| CONCEPCION ASPILI | ||||
| PHYSICIAN | $181,744 | $5,814 | $31,715 | $216,148 |
| ANDREI SAN-MARINA | ||||
| PHYSICIAN | $179,237 | $6,373 | $3,125 | $185,610 |
| AURORA S BADAVI | ||||
| PHYSICIAN | $166,811 | $6,135 | $13,708 | $183,544 |
| SUFIA B SHAHID | ||||
| PHYSICIAN | $166,152 | $7,359 | $19,419 | $189,794 |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | COMMUNITY HEALTHCARE ASSOCIATES | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | PRINCIPAL OWNER | RelationshipDescriptionTxt |
| Transaction | $14,640 | TransactionAmt |
| Transaction | GRANT WRITING | TransactionDesc |
| Sharing Of Revenues | false | SharingOfRevenuesInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE L, PART V | FormAndLineReferenceDesc |
| Explanation | (A) NAME OF PERSON: COMMUNITY HEALTHCARE ASSOCIATES, INC. (B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIZATION: PRINCIPAL OWNER IS FORMER CEO OF THE NONPROFIT. (C) AMOUNT OF TRANSACTION: 14,640 (D) DESCRIPTION OF TRANSACTION: COMPENSATION FOR GRANT WRITING. (E) SHARING OF ORGANIZATION REVENUES?: NO | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 6, PART VI, LINE 11B | THE CFO AND CEO REVIEW THE FORM 990 BEFORE FILING. |
| FORM 990, PAGE 6, PART VI, LINE 12C | THE BOARD IS CHARGED WITH REVIEWING THE POLICIES ANNUALLY OR AS APPROPRIATE. |
| FORM 990, PAGE 6, PART VI, LINE 15A | COMPENSATION NEGOTIATIONS ARE BASED UPON EXPERIENCE AND SKILL SET IN KEEPING WITH FAIR MARKET VALUE AND FORMAL PAY SCALE. |
| FORM 990, PAGE 6, PART VI, LINE 15B | COMPENSATION NEGOTIATIONS ARE BASED UPON EXPERIENCE AND SKILL SET IN KEEPING WITH FAIR MARKET VALUE AND FORMAL PAY SCALE. |
| FORM 990, PAGE 6, PART VI, LINE 19 | GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | PROF. FEES - MEDICAL CARE 1,631,652 0 0 PROF. FEES - CASE MGMT 67,985 0 0 PROF. FEES - MGMT & GENERAL 0 18,958 0 TOTAL 1,699,637 18,958 0 |