2019-10-31T15:07:38-05:00 2018-12-31 410746749 CLIFTONLARSONALLEN LLP 4505 STEPHEN CIRCLE NW STE 200 CANTON OH 44718 990 2018-01-01 812171085 MY COMMUNITY HEALTH CENTER MYCO 3305884796 2600 7TH STREET SW CANTON OH 44710 KELLY LORENZ CFO 3303631310 2019-10-29 1 JENNIFER COLEMAN P00743188 3304972000 67.137.57.251 2019-10-29 16:58:05 ED P 7BE7DF1651D6D8591F67A801A29A6D8D893E2ED2 7C573EA794E54661D093FC45AEACE25987ECA875 2018 2019-02-21 02:37:17Z TERRY REGULA 2600 7TH STREET SW CANTON OH 44710 5923590 0 X WWW.MYCOMHC.ORG X 2016 OH TO PROVIDE COMPASSIONATE CARE TO ALL; HEALING AND LEARNING TOGETHER. 9 9 1 9 0 0 1298286 2939544 1134592 2984046 0 0 0 0 2432878 5923590 100 350 0 0 1403395 2996462 0 0 0 936687 2674773 2340182 5671585 92696 252005 694319 1118199 601623 543173 92696 575026 X MY COMMUNITY HEALTH CENTER (MCHC) IS A GRASSROOTS, COMMUNITY-BASED 501(C)(3) OHIO NONPROFIT ORGANIZATION WHOSE MISSION IS TO PROVIDE COMPASSIONATE CARE TO ALL, HEALING AND LEARNING TOGETHER. MCHC'S GOAL IS TO BE RESPONSIVE TO THE NEEDS OF THE COMMUNITIES IT SERVES, BUT WITH CONTINUED EMPHASIS ON THE UNDERSERVED AND THOSE WITHOUT ACCESS TO CARE, REGARDLESS OF RACE, ECONOMIC STATUS, AGE, SEX, SEXUAL ORIENTATION, OR DISABILITY. 0 0 4678085 350 2984046 MY COMMUNITY HEALTH CENTER (MCHC) IS A GRASSROOTS, COMMUNITY-BASED 501(C)(3) OHIO NONPROFIT ORGANIZATION WHOSE MISSION IS TO PROVIDE COMPASSIONATE CARE TO ALL, HEALING AND LEARNING TOGETHER. MCHC'S GOAL IS TO BE RESPONSIVE TO THE NEEDS OF THE COMMUNITIES IT SERVES, BUT WITH CONTINUED EMPHASIS ON THE UNDERSERVED AND THOSE WITHOUT ACCESS TO CARE, REGARDLESS OF RACE, ECONOMIC STATUS, AGE, SEX, SEXUAL ORIENTATION, OR DISABILITY. MCHC ESTABLISHED ITSELF AS A COMMUNITY CLINIC SITE IN AUGUST 2017 AND HAS BEEN ACTIVE AS A COMMUNITY HEALTH CARE PROVIDER SINCE. THE ORGANIZATION BELIEVES IN TRAINING THE NEXT GENERATION OF HEALTH CARE PROVIDERS. AS SUCH MCHC HAS ESTABLISHED A RELATIONSHIP WITH THREE RESIDENCY PROGRAMS FOR THEIR RESIDENTS TO PROVIDE OUTPATIENT, CONTINUITY OF CARE AT MCHC; INTERNAL MEDICINE, FAMILY MEDICINE & OBSTETRICS AND GYNECOLOGY. IN SEPTEMBER 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 SEX 4678085 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 6 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 9 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 OH X KELLY LORENZ 3303631310 2600 SIXTH STREET SW CANTON OH 44710 MARIA HEEGE PRESIDENT 1.00 X X 0 0 0 SHARLA ELTON SECRETARY 1.00 X X 0 0 0 STEVE JACKSON TREASURER 1.00 X X 0 0 0 JAMES ANDERSON DIRECTOR 1.00 X 0 0 0 RENEE BACKIE DIRECTOR 1.00 X 0 0 0 SUSAN MERCER MD DIRECTOR 1.00 X 0 0 0 CYRILIA PRATT DIRECTOR 1.00 X 0 0 0 LINDA WOODLOCK DIRECTOR 1.00 X 0 0 0 JEFFREY ZELLERS DIRECTOR 1.00 X 0 0 0 JOHN SUTTON MD MEDICAL DIRECTOR 40.00 X 0 0 0 TERRY REGULA CEO 40.00 X 105358 0 9277 JORDAN WADE CFO 15.00 X 0 0 0 105358 0 9277 1 0 0 0 AULTMAN HOSPITAL 2600 SIXTH STREET SW CANTON OH 44710 ADMINISTRATIVE & MANAGEMENT 365416 1 253232 2686312 2939544 PATIENT SERVICE REVENUE 621400 2984046 2984046 2984046 5923590 2984046 0 0 X 350 350 114635 114635 2241105 2241105 75635 75635 405133 405133 159954 159954 26941 26941 28015 28015 807334 353711 453623 448 195 253 53015 23224 29791 279344 122388 156956 414192 181466 232726 5342 5342 5213 5213 19110 8372 10738 BAD DEBT EXPENSE 698269 698269 MEDICATIONS 251932 251932 SUPPLIES AND EQUIPMENT 76755 33625 43130 8863 8091 772 5671585 4678085 993500 0 449175 314915 245144 801405 0 1879 694319 1118199 601623 543173 601623 543173 X 92696 575026 92696 575026 694319 1118199 252005 230325 0 X 0 1 X 1 0 X 0 5225321 0 5225321 698269 698269 5923590 4973316 0 4973316 698269 698269 5671585 PART XI, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 698,269. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 698,269. FORM 990, PART VI, SECTION A, LINE 3 ALL 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 11B THE FORM 990 WAS PREPARED BY AN INDEPENDENT CPA FIRM BASED ON INFORMATION PROVIDED BY THE ORGANIZATION'S CFO. THE CEO AND CFO CAREFULLY REVIEWED AND ANALYZED THE TAX RETURN, RECONCILING THE GENERAL LEDGER AMOUNTS TO THE APPROPRIATE SCHEDULES ON THE FORM 990 AND COMPARING THOSE AMOUNTS TO THE AUDITED FINANCIAL STATEMENTS. A COMPLETE COPY OF THE 990 WAS THEN SENT VIA EMAIL TO THE BOARD OF DIRECTORS FOR THEIR REVIEW PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION'S CONFLICT OF INTEREST POLICY APPLIES TO CLINIC BOARD MEMBERS, EMPLOYEES, CONSULTANTS AND THOSE WHO FURNISH GOODS OR SERVICES TO THE ORGANIZATION. EACH BOARD MEMBER IS REQUIRED TO COMPLETE A CERTIFICATION OF AGREEMENT WITH THE CONFLICT OF INTEREST POLICY AND DISCLOSE ANY KNOWN CONFLICTS OF INTEREST UPON HIS OR HER ELECTION OR RE-ELECTION TO THE BOARD AND ANNUALLY THEREAFTER. WHENEVER THE CHIEF EXECUTIVE OFFICER, KEY MANAGEMENT PERSONNEL OR ANY BOARD MEMBER HAS A CONFLICT OF INTEREST OR A PERCEIVED CONFLICT OF INTEREST WITH MCHC, HE OR SHE IS REQUIRED TO NOTIFY THE FULL BOARD OF SUCH CONFLICT IN WRITING USING THE ANNUAL CERTIFICATION FORM. WHEN ANY CONFLICT OF INTEREST IS RELEVANT TO A MATTER THAT COMES UNDER CONSIDERATION OR REQUIRES ACTION BY THE BOARD, OR A BOARD COMMITTEE, THE INTERESTED PERSON IS REQUIRED TO CALL IT TO THE ATTENTION OF THE BOARD CHAIR AND MUST LEAVE THE MEETING DURING BOARD OR COMMITTEE DISCUSSION OR DECISION ON THE MATTER. HOWEVER, THAT PERSON IS ALLOWED TO PROVIDE THE BOARD OR APPLICABLE COMMITTEE WITH ANY AND ALL RELEVANT INFORMATION ON THE PARTICULAR MATTER. BOARD MEMBERS WHO VIOLATE THE CONFLICT OF INTEREST POLICY MAY, DEPENDING ON THE SEVERITY OF THE VIOLATION, BE SUBJECT TO ORAL ADMONISHMENT OR REMOVAL FROM THEIR POSITION. FORM 990, PART VI, SECTION C, LINE 19 MY COMMUNITY HEALTH CENTER MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 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.