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MY COMMUNITY HEALTH CENTER: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization
MY COMMUNITY HEALTH CENTER (EIN 81-2171085)
Tax period
2018-01-01 to 2018-12-31
Filed
2019-10-31
IRS object ID
201923049349301142
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)
Return2019-10-31T15:07:38-05:00ReturnTs
Tax Period End2018-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN410746749PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line14505 STEPHEN CIRCLE NW STE 200AddressLine1Txt
CityCANTONCityNm
State AbbreviationOHStateAbbreviationCd
ZIP44718ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2018-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN812171085EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MY COMMUNITY HEALTH CENTERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlMYCOBusinessNameControlTxt
Phone3305884796PhoneNum

US Address USAddress

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

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonKELLY LORENZPersonNm
Person TitleCFOPersonTitleTxt
Phone3303631310PhoneNum
Signature2019-10-29SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJENNIFER COLEMANPreparerPersonNm
PTINP00743188PTIN
Phone3304972000PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address67.137.57.251IPv4AddressTxt
FieldValueIRS element (for citing)
IP2019-10-29IPDt
IP Tm16:58:05IPTm
IP TimezoneEDIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id7BE7DF1651D6D8591F67A801A29A6D8D893E2ED2AtSubmissionCreationDeviceId
At Submission Filing Device Id7C573EA794E54661D093FC45AEACE25987ECA875AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2018TaxYr
Build TS2019-02-21 02:37:17ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerTERRY REGULAPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line12600 7TH STREET SWAddressLine1Txt
CityCANTONCityNm
State AbbreviationOHStateAbbreviationCd
ZIP44710ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$5,923,590GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.MYCOMHC.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2016FormationYr
Legal Domicile StateOHLegalDomicileStateCd
Activity Or MissionTO PROVIDE COMPASSIONATE CARE TO ALL; HEALING AND LEARNING TOGETHER.ActivityOrMissionDesc
Voting Members Governing Body9VotingMembersGoverningBodyCnt
Voting Members Independent9VotingMembersIndependentCnt
Total Employee1TotalEmployeeCnt
Total Volunteers9TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$1,298,286PYContributionsGrantsAmt
CY Contributions Grants$2,939,544CYContributionsGrantsAmt
PY Program Service Revenue$1,134,592PYProgramServiceRevenueAmt
CY Program Service Revenue$2,984,046CYProgramServiceRevenueAmt
PY Investment Income$0PYInvestmentIncomeAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$2,432,878PYTotalRevenueAmt
CY Total Revenue$5,923,590CYTotalRevenueAmt
PY Grants And Similar Paid$100PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$350CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$1,403,395PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$2,996,462CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$936,687PYOtherExpensesAmt
CY Other Expenses$2,674,773CYOtherExpensesAmt
PY Total Expenses$2,340,182PYTotalExpensesAmt
CY Total Expenses$5,671,585CYTotalExpensesAmt
PY Revenues Less Expenses$92,696PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$252,005CYRevenuesLessExpensesAmt
Total Assets BOY$694,319TotalAssetsBOYAmt
Total Assets EOY$1,118,199TotalAssetsEOYAmt
Total Liabilities BOY$601,623TotalLiabilitiesBOYAmt
Total Liabilities EOY$543,173TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$92,696NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$575,026NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionMY COMMUNITY HEALTH CENTER (MCHC) IS A GRASSROOTS, COMMUNITY-BASED 501(C)(3) OHIO NONPROFIT ORGANIZATION WHOSE MISSION IS TO PROVIDE COMPASSIONATE CARE TO ALL, HEALING AND LEARNING TOGETHER. MCHC'S GOAL IS TO BE RESPONSIVE TO THE NEEDS OF THE COMMUNITIES IT SERVES, BUT WITH CONTINUED EMPHASIS ON THE UNDERSERVED AND THOSE WITHOUT ACCESS TO CARE, REGARDLESS OF RACE, ECONOMIC STATUS, AGE, SEX, SEXUAL ORIENTATION, OR DISABILITY.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$4,678,085ExpenseAmt
Grant$350GrantAmt
Revenue$2,984,046RevenueAmt
DescMY COMMUNITY HEALTH CENTER (MCHC) IS A GRASSROOTS, COMMUNITY-BASED 501(C)(3) OHIO NONPROFIT ORGANIZATION WHOSE MISSION IS TO PROVIDE COMPASSIONATE CARE TO ALL, HEALING AND LEARNING TOGETHER. MCHC'S GOAL IS TO BE RESPONSIVE TO THE NEEDS OF THE COMMUNITIES IT SERVES, BUT WITH CONTINUED EMPHASIS ON THE UNDERSERVED AND THOSE WITHOUT ACCESS TO CARE, REGARDLESS OF RACE, ECONOMIC STATUS, AGE, SEX, SEXUAL ORIENTATION, OR DISABILITY. MCHC ESTABLISHED ITSELF AS A COMMUNITY CLINIC SITE IN AUGUST 2017 AND HAS BEEN ACTIVE AS A COMMUNITY HEALTH CARE PROVIDER SINCE. THE ORGANIZATION BELIEVES IN TRAINING THE NEXT GENERATION OF HEALTH CARE PROVIDERS. AS SUCH MCHC HAS ESTABLISHED A RELATIONSHIP WITH THREE RESIDENCY PROGRAMS FOR THEIR RESIDENTS TO PROVIDE OUTPATIENT, CONTINUITY OF CARE AT MCHC; INTERNAL MEDICINE, FAMILY MEDICINE & OBSTETRICS AND GYNECOLOGY. IN SEPTEMBER 2018, MCHC RECEIVED DESIGNATION FROM THE FEDERAL HEALTH RESOURCES AND SERVICES ADMINISTRATION AS A FEDERALLY QUALIFIED HEALTH CENTER LOOK-ALIKE. SERVICES PROVIDED BY MCHC INCLUDE FAMILY PRACTICE, INTERNAL MEDICINE, PRENATAL SERVICES, POSTPARTUM CARE, WELL CHILD & PEDIATRIC CARE, SCREENINGS, CHRONIC DISEASE MANAGEMENT, DENTAL CARE (BY REFERRAL), LABORATORY, BEHAVIORAL HEALTH (INCLUDING INDIVIDUALS/GROUPS), FAMILY PLANNING, OUTREACH, HEALTH EDUCATION (INCLUDING NUTRITION), ELIGIBILITY ASSISTANCE, AND CASE MANAGEMENT.IN 2018, MCHC PROVIDED CARE TO MORE THAN 8,000 PATIENTS WITH MORE THAN 30,000 MEDICAL VISITS. MCHC EMPLOYS MORE THAN 50 EMPLOYEES, MANY FROM THE LOCAL COMMUNITY. STAFF ARE FLUENT IN ENGLISH AND AMERICAN SIGN LANGUAGE (CONTRACTED TRANSLATION SERVICES FOR OTHER LANGUAGES) AND EFFECTIVE AT WORKING WITH PEOPLE AT ALL LEVELS OF LITERACY.OUR OBSTETRICAL PROGRAM IS UNIQUE IN THE FACT THAT WE ARE THE LARGEST OB PROVIDER FOR MEDICAID PATIENTS IN STARK COUNTY. WE ALSO PROVIDE THE ONLY CERTIFIED CENTERING PROGRAM IN THE COUNTY.COMMUNITY COLLABORATION IS IMPORTANT TO MCHC. BELOW IS A BRIEF DESCRIPTION OF COLLABORATIONS WITH COMMUNITY PARTNERS: - OB DEPARTMENT COLLABORATES WITH STARK COUNTY AND CANTON CITY HEALTH DEPARTMENTS ON THE THRIVE INITIATIVE TO REDUCE INFANT MORTALITY. - THE INTERNAL MEDICINE DIVISION COLLABORATES WITH ACCESS HEALTH TO PROVIDE COMMUNITY HEALTH WORKERS FOR HIGH RISK DIABETICS IN THE PRACTICE. - FAMILY MEDICINE COLLABORATES WITH REFUGE OF HOPE, A LOCAL HOMELESS SHELTER, TO PROVIDE TELEMEDICINE SERVICES FREE OF CHARGE TO THE HOMELESS. - MCHC COLLABORATES WITH BEACON PHARMACY TO PROVIDE PRESCRIPTION MEDICATIONS AT A REDUCED COST TO PATIENTS. THE STAFF HAVE PARTICIPATED IN MANY COMMUNITY ACTIVITIES, INCLUDING THE FOLLOWING: - OUTREACH AT REFUGE OF HOPE - MEDICAID ELIGIBILITY; DESCRIBE OUR PRIMARY CARE SERVICES - CANTON CALVARY MISSION - PREPARED AND SERVED FOOD TO NEEDY - COMMUNITY SAFETY FAIR - PROVIDED EDUCATION ON SUN SAFETY, HYGIENE AND SAFE SEXDesc
Total Program Service Expenses$4,678,085TotalProgramServiceExpensesAmt
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 Equipment0ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J Required0ScheduleJRequiredInd
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 Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document6IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee1EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members9GoverningBodyVotingMembersCnt
Independent Voting Member9IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (1)DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldOHStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

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

US Address USAddress

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

Form990 Part VII Section A Form990PartVIISectionAGrp (12 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
MARIA HEEGE
PRESIDENT1.00Yes (X)Yes (X)$0$0$0
SHARLA ELTON
SECRETARY1.00Yes (X)Yes (X)$0$0$0
STEVE JACKSON
TREASURER1.00Yes (X)Yes (X)$0$0$0
JAMES ANDERSON
DIRECTOR1.00Yes (X)$0$0$0
RENEE BACKIE
DIRECTOR1.00Yes (X)$0$0$0
SUSAN MERCER MD
DIRECTOR1.00Yes (X)$0$0$0
CYRILIA PRATT
DIRECTOR1.00Yes (X)$0$0$0
LINDA WOODLOCK
DIRECTOR1.00Yes (X)$0$0$0
JEFFREY ZELLERS
DIRECTOR1.00Yes (X)$0$0$0
JOHN SUTTON MD
MEDICAL DIRECTOR40.00Yes (X)$0$0$0
TERRY REGULA
CEO40.00Yes (X)$105,358$0$9,277
JORDAN WADE
CFO15.00Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$105,358TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$9,277TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K1IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K0TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1AULTMAN HOSPITALBusinessNameLine1Txt

Contractor Address ContractorAddress

US Address USAddress

FieldValueIRS element (for citing)
Address Line12600 SIXTH STREET SWAddressLine1Txt
CityCANTONCityNm
State AbbreviationOHStateAbbreviationCd
ZIP44710ZIPCd
FieldValueIRS element (for citing)
ServicesADMINISTRATIVE & MANAGEMENTServicesDesc
Compensation$365,416CompensationAmt
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K1CntrctRcvdGreaterThan100KCnt
Government Grants$253,232GovernmentGrantsAmt
All Other Contributions$2,686,312AllOtherContributionsAmt
Total Contributions$2,939,544TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPATIENT SERVICE REVENUEDesc
Business621400BusinessCd
Total Revenue Column$2,984,046TotalRevenueColumnAmt
Related Or Exempt Func Income$2,984,046RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$2,984,046TotalProgramServiceRevenueAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$5,923,590TotalRevenueColumnAmt
Related Or Exempt Func Income$2,984,046RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$350TotalAmt
Program Services$350ProgramServicesAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$114,635TotalAmt
Program Services$114,635ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$2,241,105TotalAmt
Program Services$2,241,105ProgramServicesAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$75,635TotalAmt
Program Services$75,635ProgramServicesAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$405,133TotalAmt
Program Services$405,133ProgramServicesAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$159,954TotalAmt
Program Services$159,954ProgramServicesAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$26,941TotalAmt
Management And General$26,941ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$28,015TotalAmt
Management And General$28,015ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$807,334TotalAmt
Program Services$353,711ProgramServicesAmt
Management And General$453,623ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$448TotalAmt
Program Services$195ProgramServicesAmt
Management And General$253ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$53,015TotalAmt
Program Services$23,224ProgramServicesAmt
Management And General$29,791ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$279,344TotalAmt
Program Services$122,388ProgramServicesAmt
Management And General$156,956ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$414,192TotalAmt
Program Services$181,466ProgramServicesAmt
Management And General$232,726ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$5,342TotalAmt
Management And General$5,342ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$5,213TotalAmt
Management And General$5,213ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$19,110TotalAmt
Program Services$8,372ProgramServicesAmt
Management And General$10,738ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
BAD DEBT EXPENSE$698,269$698,269
MEDICATIONS$251,932$251,932
SUPPLIES AND EQUIPMENT$76,755$33,625$43,130

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$8,863TotalAmt
Program Services$8,091ProgramServicesAmt
Management And General$772ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$5,671,585TotalAmt
Program Services$4,678,085ProgramServicesAmt
Management And General$993,500ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$449,175BOYAmt
EOY$314,915EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$245,144BOYAmt
EOY$801,405EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$1,879EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$694,319BOYAmt
EOY$1,118,199EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$601,623BOYAmt
EOY$543,173EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$601,623BOYAmt
EOY$543,173EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$92,696BOYAmt
EOY$575,026EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$92,696BOYAmt
EOY$575,026EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$694,319BOYAmt
EOY$1,118,199EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$252,005ReconcilationRevenueExpnssAmt
Prior Period Adjustments$230,325PriorPeriodAdjustmentsAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Total Book Value Land Buildings$0TotalBookValueLandBuildingsAmt
Total Rev Etc Audited Fincl Stmt$5,225,321TotalRevEtcAuditedFinclStmtAmt
Revenue Not Reported$0RevenueNotReportedAmt
Revenue Subtotal$5,225,321RevenueSubtotalAmt
Other Revenues Not Included$698,269OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$698,269RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$5,923,590TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$4,973,316TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$4,973,316ExpensesSubtotalAmt
Other Expenses Not Included$698,269OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$698,269ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$5,671,585TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART XI, LINE 4B - OTHER ADJUSTMENTS:BAD DEBT EXPENSE 698,269.
PART XII, LINE 4B - OTHER ADJUSTMENTS:BAD DEBT EXPENSE 698,269.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 3ALL MANAGEMENT AND ADMINISTRATIVE SERVICES EXCEPT FOR TERRY REGULA'S FOR MY COMMUNITY HEALTH CENTER ARE PROVIDED BY AULTMAN HEALTH FOUNDATION (EIN 34-1445390). THE FOLLOWING DIRECTORS AND OFFICERS RECEIVED THE FOLLOWING COMPENSATION FROM AULTMAN HEALTH FOUNDATION DURING 2018: SUSAN MERCER, M.D.: $9,412 JOHN SUTTON, M.D.: $282,611 JORDAN WADE, CFO: $40,665
FORM 990, PART VI, SECTION B, LINE 11BTHE FORM 990 WAS PREPARED BY AN INDEPENDENT CPA FIRM BASED ON INFORMATION PROVIDED BY THE ORGANIZATION'S CFO. THE CEO AND CFO CAREFULLY REVIEWED AND ANALYZED THE TAX RETURN, RECONCILING THE GENERAL LEDGER AMOUNTS TO THE APPROPRIATE SCHEDULES ON THE FORM 990 AND COMPARING THOSE AMOUNTS TO THE AUDITED FINANCIAL STATEMENTS. A COMPLETE COPY OF THE 990 WAS THEN SENT VIA EMAIL TO THE BOARD OF DIRECTORS FOR THEIR REVIEW PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12CTHE ORGANIZATION'S CONFLICT OF INTEREST POLICY APPLIES TO CLINIC BOARD MEMBERS, EMPLOYEES, CONSULTANTS AND THOSE WHO FURNISH GOODS OR SERVICES TO THE ORGANIZATION. EACH BOARD MEMBER IS REQUIRED TO COMPLETE A CERTIFICATION OF AGREEMENT WITH THE CONFLICT OF INTEREST POLICY AND DISCLOSE ANY KNOWN CONFLICTS OF INTEREST UPON HIS OR HER ELECTION OR RE-ELECTION TO THE BOARD AND ANNUALLY THEREAFTER. WHENEVER THE CHIEF EXECUTIVE OFFICER, KEY MANAGEMENT PERSONNEL OR ANY BOARD MEMBER HAS A CONFLICT OF INTEREST OR A PERCEIVED CONFLICT OF INTEREST WITH MCHC, HE OR SHE IS REQUIRED TO NOTIFY THE FULL BOARD OF SUCH CONFLICT IN WRITING USING THE ANNUAL CERTIFICATION FORM. WHEN ANY CONFLICT OF INTEREST IS RELEVANT TO A MATTER THAT COMES UNDER CONSIDERATION OR REQUIRES ACTION BY THE BOARD, OR A BOARD COMMITTEE, THE INTERESTED PERSON IS REQUIRED TO CALL IT TO THE ATTENTION OF THE BOARD CHAIR AND MUST LEAVE THE MEETING DURING BOARD OR COMMITTEE DISCUSSION OR DECISION ON THE MATTER. HOWEVER, THAT PERSON IS ALLOWED TO PROVIDE THE BOARD OR APPLICABLE COMMITTEE WITH ANY AND ALL RELEVANT INFORMATION ON THE PARTICULAR MATTER. BOARD MEMBERS WHO VIOLATE THE CONFLICT OF INTEREST POLICY MAY, DEPENDING ON THE SEVERITY OF THE VIOLATION, BE SUBJECT TO ORAL ADMONISHMENT OR REMOVAL FROM THEIR POSITION.
FORM 990, PART VI, SECTION C, LINE 19MY COMMUNITY HEALTH CENTER MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART IX, LINE 11GOTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 337,487. MANAGEMENT AND GENERAL EXPENSES 432,817. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 770,304. CONSULTING SERVICES: PROGRAM SERVICE EXPENSES 16,224. MANAGEMENT AND GENERAL EXPENSES 20,806. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 37,030.

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