EASTERN IOWA HEALTH CENTER: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- EASTERN IOWA HEALTH CENTER (EIN 20-2405575)
- Tax period
- 2017-07-01 to 2018-06-30
- Filed
- 2019-02-28
- IRS object ID
- 201930649349301108
- Schema version
- 2017v2.2
- 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 | 2019-02-28T09:02:30-05:00 | ReturnTs |
| Tax Period End | 2018-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 421343677 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KOCH & LIPKEA PC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2750 FIRST AVENUE NE SUITE 210 | AddressLine1Txt |
| City | CEDAR RAPIDS | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 52402 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 202405575 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EASTERN IOWA HEALTH CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | EAST | BusinessNameControlTxt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 2205 | AddressLine1Txt |
| City | Cedar Rapids | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 52406 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JOE LOCK | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 3197307300 | PhoneNum |
| Signature | 2019-02-26 | SignatureDt |
| Discuss With Paid Preparer | false | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | David L Koch | PreparerPersonNm |
| PTIN | P00453894 | PTIN |
| Phone | 3193623856 | PhoneNum |
| Preparation | 2019-02-28 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 207.191.212.46 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2019-03-05 | IPDt |
| IP Tm | 17:47:31 | IPTm |
| Federal Original Submission Id | 42011420190643yx5kke | FederalOriginalSubmissionId |
| Federal Original Submission Id | 2019-03-05 | FederalOriginalSubmissionIdDt |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | CEC318EFB5B74D73746AEFA942405DE28671E454 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | CEC318EFB5B74D73746AEFA942405DE28671E454 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JOE LOCK | PrincipalOfficerNm |
| Gross Receipts | $13,186,303 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | easterniowahealthcenter.com | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2005 | FormationYr |
| Legal Domicile State | IA | LegalDomicileStateCd |
| Activity Or Mission | Eastern Iowa Health Center (EIHC) is a Federally Qualified Health Center with a mission to provide a medical home by offering patient-focused, quality, comprehensive primary, oral and behavioral health care services to patients in our service area, regardless of ability to pay. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 119 | TotalEmployeeCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $3,055,916 | PYContributionsGrantsAmt |
| CY Contributions Grants | $2,051,861 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $8,489,133 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $11,055,238 | CYProgramServiceRevenueAmt |
| PY Investment Income | $742 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,593 | CYInvestmentIncomeAmt |
| PY Other Revenue | $28,455 | PYOtherRevenueAmt |
| CY Other Revenue | $77,611 | CYOtherRevenueAmt |
| PY Total Revenue | $11,574,246 | PYTotalRevenueAmt |
| CY Total Revenue | $13,186,303 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $6,872,844 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $8,063,092 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $26,059 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $28,959 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $3,867,133 | PYOtherExpensesAmt |
| CY Other Expenses | $4,084,758 | CYOtherExpensesAmt |
| PY Total Expenses | $10,766,036 | PYTotalExpensesAmt |
| CY Total Expenses | $12,147,850 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $808,210 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,038,453 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $6,904,261 | TotalAssetsBOYAmt |
| Total Assets EOY | $6,750,073 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $4,256,943 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $3,064,302 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $2,647,318 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $3,685,771 | NetAssetsOrFundBalancesEOYAmt |
| Mission | Eastern Iowa Health Center (EIHC) is a Federally Qualified Health Center with a mission to provide a medical home by offering patient-focused, quality, comprehensive primary, oral and behavioral health care services to patients in our service area, regardless of ability to pay. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $10,158,268 | ExpenseAmt |
| Desc | Eastern Iowa Health Center is a clinic committed to providing quality medical care to underserved and uninsured individuals and families living in Linn, Benton, Iowa, Johnson and Jones Counties. Healthcare services provided include: annual physical exams, chronic disease management, immunizations, OB/Gyn, acute care visits, behavioral health and preventive and urgent oral healthcare services. EIHC employs social workers who provide patients with referrals to partner agencies, depression and anxiety screenings, health insurance education, enrollment assistance and more. Total patient visits for the fiscal year ended 6/30/18 were 48,283. | Desc |
| Total Program Service Expenses | $10,158,268 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| 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 | Yes (true) | 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 | false | 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 |
| Transaction With Control Ent | false | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 14 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 119 | 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 |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | 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 | false | LocalChaptersInd |
| 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 |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DANIEL T WASHBURN | PersonNm |
| Phone | 3197307300 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 2205 | AddressLine1Txt |
| City | Cedar Rapids | CityNm |
| State Abbreviation | IA | StateAbbreviationCd |
| ZIP | 52406 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| ANN HEARN | ||||||||
| TREASURER | 2.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| SHARI ROSS | ||||||||
| SECRETARY | 2.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| MICHELLE BEISKER | ||||||||
| PRESIDENT | 2.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| AMY GRUNEWALDT | ||||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| JOHN BRANDT | ||||||||
| VICE PRESIDENT | 2.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| JOHN LIPCAMON | ||||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| AURORA ENRIQUEZ | ||||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| CARLA SCHULTZ | ||||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| RON MULLER | ||||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| JOHN ROOF | ||||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| DENNY GOETTEL | ||||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| DANIEL T WASHBURN | ||||||||
| CHIEF FINANCIAL OFFICER | 40.00 | 0.00 | Yes (X) | $106,080 | $0 | $11,901 | ||
| JOE LOCK | ||||||||
| CEO | 40.00 | 0.00 | Yes (X) | $157,413 | $0 | $28,059 | ||
| SIDNEY J SMITH | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $324,147 | $0 | $33,171 | Yes (X) | ||
| BASSELL EID | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $412,487 | $0 | $35,820 | Yes (X) | ||
| URSULA LIVERMORE | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $239,559 | $0 | $28,938 | Yes (X) | ||
| JEANNE CHAN | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $323,738 | $0 | $20,249 | Yes (X) | ||
| JACQUELINE L COOPER | ||||||||
| PHYSICIAN | 40.00 | 0.00 | $316,692 | $0 | $29,957 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,880,116 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $188,095 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 7 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| CEDAR RAPIDS MED EDUC FOUND | |||||
| 1260 2nd Ave | Cedar Rapids | IA | 52403 | PHYSICIAN SERVICES | $541,120 |
| BKD LLP | |||||
| 910 E St Louis St 200 | Springfield | MO | 65806 | ACCOUNTING | $123,185 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $1,797,445 | GovernmentGrantsAmt |
| All Other Contributions | $254,416 | AllOtherContributionsAmt |
| Total Contributions | $2,051,861 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT REVENUE | 621990 | $10,898,414 | $10,898,414 |
| MEANINGFUL USE | 621990 | $136,000 | $136,000 |
| INCENTIVES | 621990 | $20,824 | $20,824 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $11,055,238 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,593 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,593 | RelatedOrExemptFuncIncomeAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| MISC INCOME | 621990 | $32,924 | $32,924 |
| IA HLTH ACO JT VENT | 621990 | $44,687 | $44,687 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $77,611 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $13,186,303 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $11,134,442 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| 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 | $1,880,116 | TotalAmt |
| Program Services | $1,616,623 | ProgramServicesAmt |
| Management And General | $263,493 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,718,250 | TotalAmt |
| Program Services | $4,131,704 | ProgramServicesAmt |
| Management And General | $562,554 | ManagementAndGeneralAmt |
| Fundraising | $23,992 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $206,613 | TotalAmt |
| Program Services | $179,296 | ProgramServicesAmt |
| Management And General | $26,906 | ManagementAndGeneralAmt |
| Fundraising | $411 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $842,289 | TotalAmt |
| Program Services | $733,564 | ProgramServicesAmt |
| Management And General | $107,010 | ManagementAndGeneralAmt |
| Fundraising | $1,715 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $415,824 | TotalAmt |
| Program Services | $360,499 | ProgramServicesAmt |
| Management And General | $54,011 | ManagementAndGeneralAmt |
| Fundraising | $1,314 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $49,025 | TotalAmt |
| Management And General | $49,025 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $147,561 | TotalAmt |
| Management And General | $147,561 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,759,893 | TotalAmt |
| Program Services | $1,582,977 | ProgramServicesAmt |
| Management And General | $175,416 | ManagementAndGeneralAmt |
| Fundraising | $1,500 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $37,006 | TotalAmt |
| Program Services | $6,973 | ProgramServicesAmt |
| Management And General | $30,033 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $567,709 | TotalAmt |
| Program Services | $419,743 | ProgramServicesAmt |
| Management And General | $147,966 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $109,919 | TotalAmt |
| Program Services | $62,651 | ProgramServicesAmt |
| Management And General | $47,268 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $48,747 | TotalAmt |
| Program Services | $16,400 | ProgramServicesAmt |
| Management And General | $32,347 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $89,876 | TotalAmt |
| Program Services | $15,443 | ProgramServicesAmt |
| Management And General | $74,433 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $370,517 | TotalAmt |
| Program Services | $346,495 | ProgramServicesAmt |
| Management And General | $24,022 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,178 | TotalAmt |
| Management And General | $19,178 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| RECRUITMENT | $28,562 | $10,475 | $18,087 | |
| SUPPLIES | $636,177 | $581,327 | $54,823 | $27 |
| LOSS ON EQUIPMENT | $53,565 | $53,565 | ||
| DUESSUBSBOOKSLIC | $143,548 | $74,923 | $68,625 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,475 | TotalAmt |
| Program Services | $19,175 | ProgramServicesAmt |
| Management And General | $4,300 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,147,850 | TotalAmt |
| Program Services | $10,158,268 | ProgramServicesAmt |
| Management And General | $1,960,623 | ManagementAndGeneralAmt |
| Fundraising | $28,959 | FundraisingAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Joint Costs | Yes (X) | JointCostsInd |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $367,788 | BOYAmt |
| EOY | $805,990 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $395,294 | BOYAmt |
| EOY | $242,023 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,212,407 | BOYAmt |
| EOY | $1,889,640 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $47,311 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $83,323 | BOYAmt |
| EOY | $109,650 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $4,256,912 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $668,602 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,822,987 | BOYAmt |
| EOY | $3,588,310 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,462 | BOYAmt |
| EOY | $67,149 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,904,261 | BOYAmt |
| EOY | $6,750,073 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,152,817 | BOYAmt |
| EOY | $1,280,670 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,104,126 | BOYAmt |
| EOY | $1,783,632 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,256,943 | BOYAmt |
| EOY | $3,064,302 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,497,360 | BOYAmt |
| EOY | $3,526,249 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $149,958 | BOYAmt |
| EOY | $159,522 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,647,318 | BOYAmt |
| EOY | $3,685,771 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,904,261 | BOYAmt |
| EOY | $6,750,073 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $1,038,453 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| 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) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,066,586 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,194,987 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,026,589 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,055,916 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,051,861 | CurrentTaxYearAmt |
| Total | $9,395,939 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,662,826 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $5,551,851 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $6,508,852 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $8,488,261 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $11,055,238 | CurrentTaxYearAmt |
| Total | $36,267,028 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $5,729,412 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $6,746,838 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $8,535,441 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $11,544,177 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $13,107,099 | CurrentTaxYearAmt |
| Total | $45,662,967 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $45,662,967 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,719 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,565 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $977 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $6,742 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,593 | CurrentTaxYearAmt |
| Total | $13,596 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,719 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,565 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $977 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $6,742 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,593 | CurrentTaxYearAmt |
| Total | $13,596 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | -$6,603 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $29,327 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $77,611 | CurrentTaxYearAmt |
| Total | $100,335 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $5,732,131 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $6,748,403 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $8,529,815 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $11,580,246 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $13,186,303 | CurrentTaxYearAmt |
| Total | $45,776,898 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99750 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99900 | PublicSupportPY509Pct |
| Investment Income CY | 0.00000 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00000 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule B IRS990ScheduleB
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | false | OtherActivitiesInd |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $231,100 | OtherCostOrOtherBasisAmt |
| Book Value | $231,100 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,910,538 | OtherCostOrOtherBasisAmt |
| Depreciation | $346,257 | DepreciationAmt |
| Book Value | $2,564,281 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,115,274 | OtherCostOrOtherBasisAmt |
| Depreciation | $322,345 | DepreciationAmt |
| Book Value | $792,929 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $3,588,310 | TotalBookValueLandBuildingsAmt |
| Total Rev Etc Audited Fincl Stmt | $13,186,303 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Subtotal | $13,186,303 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $13,186,303 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $12,147,850 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $12,147,850 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $12,147,850 | TotalExpensesPerForm990Amt |
Schedule G IRS990ScheduleG
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 (6 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt |
|---|---|---|---|---|
| SIDNEY J SMITH | ||||
| PHYSICIAN | $324,147 | $10,417 | $22,754 | $357,318 |
| BASSELL EID | ||||
| PHYSICIAN | $412,487 | $16,499 | $19,321 | $448,307 |
| URSULA LIVERMORE | ||||
| PHYSICIAN | $239,559 | $9,582 | $19,356 | $268,497 |
| JOE LOCK | ||||
| CEO | $157,413 | $6,297 | $21,762 | $185,472 |
| JEANNE CHAN | ||||
| PHYSICIAN | $323,738 | $12,950 | $7,299 | $343,987 |
| JACQUELINE L COOPER | ||||
| PHYSICIAN | $316,692 | $12,668 | $17,289 | $346,649 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990 governing body review Part VI line 11 | Form 990 will be presented to board of directors |
| Conflict of interest policy compliance Part VI line 12c | Board would discuss any conflict of interest |
| CEO executive director top management comp Part VI line 15a | Executive committee and finance committee review and make recommendation to board for CEO salary |
| Other officer or key employee compensation Part VI line 15b | CEO makes recommendation for compensation, executive committee and finance committee review and make recommendation to board for overall organizations wage increases. |
| Governing documents etc available to public Part VI line 19 | The governing documents, conflict of interest policy, and financial statements are not available to the general public. Public officials serve on the board and would share documents with their governmental entities. |
| List of other fees for services expenses Part IX line 11g | Program Services - Interpretation Services $85,505 Contracted Physician $607,260 Recruitment $36,090 340B Fee $78,120Patient Claim Processing $585,470 Collections $9,746 Pass through Grant Expense $53,150 Other Purchased Services $127,636 Total $1,582,977 Administrative Services - Consultants $55,935 IT Contract Services $17,626 Accounting $10,919 Payroll Processing 29,331 IT Software $41,169 Other $20,436 Total $175,416Fund Raising - IT Software $1,500 |