KENOSHA COMMUNITY HEALTH CENTER INC: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- KENOSHA COMMUNITY HEALTH CENTER INC (EIN 39-1789874)
- Tax period
- 2017-03-01 to 2018-02-28
- Filed
- 2019-01-15
- IRS object ID
- 201940159349300444
- Schema version
- 2017v2.3
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule I
- Schedule J
- Schedule M
- Schedule O
- Schedule R
- Reasonable Cause Explanation
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2019-01-15T13:09:01-06:00 | ReturnTs |
| Tax Period End | 2018-02-28 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 390758449 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WIPFLI LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10000 INNOVATION DRIVE SUITE 250 | AddressLine1Txt |
| City | MILWAUKEE | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 532264837 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-03-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 391789874 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KENOSHA COMMUNITY HEALTH CENTER INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | KENO | BusinessNameControlTxt |
| Phone | 2627643608 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 625 57TH STREET NO 700 | AddressLine1Txt |
| City | KENOSHA | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53140 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JEFFERY GRANT | PersonNm |
| Person Title | CHIEF FINANCIAL OFFICER | PersonTitleTxt |
| Phone | 2627643608 | PhoneNum |
| Signature | 2019-01-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DAVE GLOBIG | PreparerPersonNm |
| PTIN | P01356041 | PTIN |
| Phone | 4144319300 | PhoneNum |
| Preparation | 2019-01-15 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 207.250.78.130 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2019-01-15 | IPDt |
| IP Tm | 10:05:05 | IPTm |
| IP Timezone | CS | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | CC322FB1B7FC8ED290785ACCB7D2994D8745AEAD | 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 | ALAN MARSHALL | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 625 57TH STREET NO 700 | AddressLine1Txt |
| City | KENOSHA | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53140 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $11,230,546 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.KENOSHACHC.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1994 | FormationYr |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Activity Or Mission | TO ESTABLISH, MAINTAIN AND OPERATE A HEALTH CENTER IN ORDER TO PROVIDE PRIMARY CARE & REFERRAL HEALTH SERVICES TO DISADVANTAGED & UNDERSERVED POPULATIONS IN KENOSHA, WISCONSIN; AND TO PROMOTE, FOSTER AND ENSURE THAT BASIC PRIMARY HEALTH SERVICES ARE AVAILABLE & ACCESSIBLE TO UNINSURED AND/OR UNDERINSURED RESIDENTS OF KENOSHA, WISCONSIN IN COORDINATION WITH OTHER LEVELS OF HEALTH CARE AND SUPPORT SERVICES IN THE COMMUNITY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 143 | TotalEmployeeCnt |
| Total Volunteers | 11 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $2,846,771 | PYContributionsGrantsAmt |
| CY Contributions Grants | $3,129,166 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $7,079,574 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $8,055,578 | CYProgramServiceRevenueAmt |
| PY Investment Income | $154 | PYInvestmentIncomeAmt |
| CY Investment Income | $119 | CYInvestmentIncomeAmt |
| PY Other Revenue | $170,937 | PYOtherRevenueAmt |
| CY Other Revenue | $45,683 | CYOtherRevenueAmt |
| PY Total Revenue | $10,097,436 | PYTotalRevenueAmt |
| CY Total Revenue | $11,230,546 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $335,602 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $330,070 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $7,128,297 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $7,135,622 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $4,247,093 | PYOtherExpensesAmt |
| CY Other Expenses | $3,729,917 | CYOtherExpensesAmt |
| PY Total Expenses | $11,710,992 | PYTotalExpensesAmt |
| CY Total Expenses | $11,195,609 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$1,613,556 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $34,937 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $8,643,868 | TotalAssetsBOYAmt |
| Total Assets EOY | $8,727,598 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $3,855,053 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $3,903,846 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $4,788,815 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $4,823,752 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO PROMOTE AND IMPROVE THE HEALTH OF THE MEDICALLY UNDERSERVED POPULATION IN AND AROUND THE CITY OF KENOSHA AND OTHER AREAS OF KENOSHA COUNTY BY PRIMARILY PROVIDING PREVENTIVE, PRIMARY AND SUPPLEMENTAL HEALTH CARE SERVICES (INCLUDING, BUT NOT LIMITED TO, DENTAL, PSYCHIATRIC, GYNECOLOGICAL, ADULT MEDICINE, AND RELATED SERVICES) AND HEALTH EDUCATION SERVICES TO SUCH POPULATION IN A MANNER WHICH WILL BEST MEET THEIR NEEDS AND REGARDLESS OF A PATIENT'S ABILITY TO PAY; TO ENGAGE IN ANY LAWFUL ACT IN WHICH A CORPORATION INCORPORATED UNDER THE WISCONSIN NONPROFIT CORPORATION ACT MAY ENGAGE; TO ESTABLISH AND MAINTAIN COLLABORATIVE RELATIONSHIPS WITH OTHER HEALTH CARE PROVIDERS IN THE SERVICE AREA. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $5,082,499 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $4,788,872 | RevenueAmt |
| Desc | INCREASE ACCESS TO COMPREHENSIVE DENTAL CARE FOR MEDICAID ENROLLEES AND THE UNINSURED. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $4,191,604 | ExpenseAmt |
| Grant | $330,070 | GrantAmt |
| Revenue | $3,065,690 | RevenueAmt |
| Desc | INCREASE ACCESS TO COMPREHENSIVE MEDICAL HEALTH CARE FOR MEDICAID ENROLLEES AND THE UNINSURED. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $516,386 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $201,016 | RevenueAmt |
| Desc | INCREASE ACCESS TO COMPREHENSIVE BEHAVIORAL HEALTH CARE FOR MEDICAID ENROLLEES AND THE UNINSURED. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $9,790,489 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (1) | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | Yes (1) | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | Yes (1) | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 13 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 143 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | 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 | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | WI | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JEFFERY GRANT | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2627643608 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 625 57TH STREET SUITE 700 | AddressLine1Txt |
| City | KENOSHA | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53140 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| SUE GERBER | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JOSEPH MICHAELIS | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| COVETRUS O'NEAL | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| NANCY PHILLIPS | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| WILLIAM ROBERTS | |||||||
| PRESIDENT | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| DOUG KOCH | |||||||
| VICE PRESIDENT (THRU 03/17)/BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| LAVETTA ARRINGTON | |||||||
| BOARD MEMBER/VICE PRESIDENT (BEG 4/17) | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| MARILYN MASI | |||||||
| SECRETARY (THRU 3/17)/BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| HEIDI GOTTFRIED-ARVOLD | |||||||
| BOARD MEMBER/SECRETARY (BEG 4/17) | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| DANIEL HEYDEN | |||||||
| TREASURER (THRU 3/17)/BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| JOSEPH CLARK | |||||||
| BOARD MEMBER/TREASURER (BEG 4/17) | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| MARY COFFEY | |||||||
| CHIEF EXECUTIVE OFFICER (THRU 7/17) | 40.00 | $120,441 | $0 | $0 | Yes (X) | ||
| BRENT RAFFERTY | |||||||
| CHIEF EXECUTIVE OFFICER (THRU 4/18) | 40.00 | $59,108 | $0 | $0 | Yes (X) | ||
| SHEILA MORAN | |||||||
| INTERIM CHIEF FINANCIAL OFFICER (THRU 6/17) | 40.00 | $96,250 | $0 | $0 | Yes (X) | ||
| JEFFERY GRANT | |||||||
| CHIEF FINANCIAL OFFICER (BEG 3/17) | 40.00 | $90,926 | $0 | $0 | Yes (X) | ||
| JOSEPH BARTA | |||||||
| DENTIST | 40.00 | $147,589 | $0 | $0 | Yes (X) | ||
| DAVID CONNELL | |||||||
| DENTIST | 40.00 | $156,511 | $0 | $0 | Yes (X) | ||
| THOMAS JAZWIECKI | |||||||
| DENTIST | 40.00 | $169,264 | $0 | $0 | Yes (X) | ||
| SAPNA PATEL | |||||||
| PHYSICIAN | 40.00 | $149,549 | $0 | $0 | Yes (X) | ||
| MIHAELA POPA | |||||||
| DENTAL DIRECTOR | 40.00 | $170,000 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,159,638 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $0 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 9 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| OFFICE TEAM | |||||
| 12400 COLLECTIONS CENTER DRIVE | CHICAGO | IL | 60693 | STAFFING AGENCY | $384,854 |
| GREENWAY HEALTH | |||||
| PO BOX 204485 | DALLAS | TX | 75320 | ELECTRONIC HEALTHCARE SYSTEM | $334,122 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $2,618,229 | GovernmentGrantsAmt |
| All Other Contributions | $510,937 | AllOtherContributionsAmt |
| Noncash Contributions | $330,070 | NoncashContributionsAmt |
| Total Contributions | $3,129,166 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT SERVICE FEES | Desc |
| Business | 621110 | BusinessCd |
| Total Revenue Column | $8,055,578 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $8,055,578 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $8,055,578 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $119 | TotalRevenueColumnAmt |
| Exclusion | $119 | ExclusionAmt |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $45,683 | TotalRevenueColumnAmt |
| Exclusion | $45,683 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $45,683 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $11,230,546 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $8,055,578 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $45,802 | ExclusionAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $330,070 | TotalAmt |
| Program Services | $330,070 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $481,868 | TotalAmt |
| Program Services | $481,868 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,209,958 | TotalAmt |
| Program Services | $4,980,511 | ProgramServicesAmt |
| Management And General | $229,447 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $149,587 | TotalAmt |
| Program Services | $149,587 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $755,081 | TotalAmt |
| Program Services | $747,765 | ProgramServicesAmt |
| Management And General | $7,316 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $539,128 | TotalAmt |
| Program Services | $452,872 | ProgramServicesAmt |
| Management And General | $86,256 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $106,083 | TotalAmt |
| Program Services | $38,640 | ProgramServicesAmt |
| Management And General | $67,443 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $77,073 | TotalAmt |
| Program Services | $25,559 | ProgramServicesAmt |
| Management And General | $51,514 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $815,317 | TotalAmt |
| Program Services | $520,927 | ProgramServicesAmt |
| Management And General | $294,390 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,984 | TotalAmt |
| Program Services | $15,294 | ProgramServicesAmt |
| Management And General | $18,690 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $813,224 | TotalAmt |
| Program Services | $481,326 | ProgramServicesAmt |
| Management And General | $331,898 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $137,466 | TotalAmt |
| Program Services | $137,466 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $628,144 | TotalAmt |
| Program Services | $510,646 | ProgramServicesAmt |
| Management And General | $117,498 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,762 | TotalAmt |
| Program Services | $5,460 | ProgramServicesAmt |
| Management And General | $4,302 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $64,723 | TotalAmt |
| Program Services | $32,258 | ProgramServicesAmt |
| Management And General | $32,465 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $115,064 | TotalAmt |
| Management And General | $115,064 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $330,084 | TotalAmt |
| Program Services | $311,706 | ProgramServicesAmt |
| Management And General | $18,378 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,974 | TotalAmt |
| Program Services | $17,262 | ProgramServicesAmt |
| Management And General | $8,712 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (2 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL & LAB SUPPLIES | $531,999 | $528,715 | $3,284 |
| DUES & SUBSCRIPTIONS | $18,585 | $2,600 | $15,985 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,435 | TotalAmt |
| Program Services | $19,957 | ProgramServicesAmt |
| Management And General | $2,478 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,195,609 | TotalAmt |
| Program Services | $9,790,489 | ProgramServicesAmt |
| Management And General | $1,405,120 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $103 | BOYAmt |
| EOY | $100 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $715,617 | BOYAmt |
| EOY | $860,019 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $395,429 | BOYAmt |
| EOY | $203,215 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,436,973 | BOYAmt |
| EOY | $2,896,115 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $194,317 | BOYAmt |
| EOY | $169,116 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $9,661,076 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $5,062,043 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,901,429 | BOYAmt |
| EOY | $4,599,033 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,643,868 | BOYAmt |
| EOY | $8,727,598 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,197,149 | BOYAmt |
| EOY | $1,425,158 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $147,998 | BOYAmt |
| EOY | $68,806 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,489,273 | BOYAmt |
| EOY | $2,398,432 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,633 | BOYAmt |
| EOY | $11,450 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,855,053 | BOYAmt |
| EOY | $3,903,846 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,788,815 | BOYAmt |
| EOY | $4,823,752 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,788,815 | BOYAmt |
| EOY | $4,823,752 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,643,868 | BOYAmt |
| EOY | $8,727,598 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $34,937 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,455,056 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,770,345 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,367,140 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,846,771 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,129,166 | CurrentTaxYearAmt |
| Total | $11,568,478 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,455,056 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,770,345 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,367,140 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,846,771 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,129,166 | CurrentTaxYearAmt |
| Total | $11,568,478 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $11,568,478 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $576 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $735 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $458 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $154 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $119 | CurrentTaxYearAmt |
| Total | $2,042 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $11,570,520 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $46,619,017 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.99980 | PublicSupportCY170Pct |
| Public Support PY170 | 0.99980 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Schedule B IRS990ScheduleB
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $159,200 | OtherCostOrOtherBasisAmt |
| Book Value | $159,200 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,690,002 | OtherCostOrOtherBasisAmt |
| Depreciation | $942,733 | DepreciationAmt |
| Book Value | $2,747,269 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,229,483 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,032,641 | DepreciationAmt |
| Book Value | $1,196,842 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,555,742 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,086,669 | DepreciationAmt |
| Book Value | $469,073 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $26,649 | OtherCostOrOtherBasisAmt |
| Book Value | $26,649 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $4,599,033 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | CAPITAL LEASE OBLIGATION | Desc |
| Amt | $11,450 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $11,450 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $10,900,476 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $10,900,476 | RevenueSubtotalAmt |
| Other Revenues Not Included | $330,070 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $330,070 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $11,230,546 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $10,865,539 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $10,865,539 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $330,070 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $330,070 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $11,195,609 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | THE ORGANIZATION RECOGNIZES THE BENEFITS OF A TAX POSITION ONLY AFTER DETERMINING WHETHER IT IS MORE LIKELY THAN NOT THAT THE TAXING AUTHORITY WOULD SUSTAIN THE TAX POSITION UPON EXAMINATION OF THE TECHNICAL MERITS OF THE TAX POSITION, ASSUMING THE TAXING AUTHORITY HAS FULL KNOWLEDGE OF ALL INFORMATION. THE ORGANIZATION RECORDED NO ASSETS OR LIABILITIES RELATED TO UNCERTAIN TAX POSITIONS. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | NONCASH CONTRIBUTIONS 330,070. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | NONCASH CONTRIBUTIONS 330,070. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | PRESCRIPTION DRUG ASSISTANCE | GrantTypeTxt |
| Recipient | 2442 | RecipientCnt |
| Cash Grant | $0 | CashGrantAmt |
| Non Cash Assistance | $330,070 | NonCashAssistanceAmt |
| Valuation Method Used | FMV | ValuationMethodUsedDesc |
| Non Cash Assistance | PRESCRIPTIONS AND VACCINES PROVIDED TO CLINIC PATIENTS | NonCashAssistanceDesc |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION DOCUMENTS ALL RELEVANT INFORMATION PERTAINING TO THE MEDICAL ASSISTANCE GIVEN IN THE PATIENT'S CHART AS PART OF THEIR PERMANENT RECORD. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (3 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DAVID CONNELL | ||||||||||||||
| DENTIST | $154,442 | $0 | $2,069 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $156,511 | $0 | $0 | $0 |
| THOMAS JAZWIECKI | ||||||||||||||
| DENTIST | $169,264 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $169,264 | $0 | $0 | $0 |
| MIHAELA POPA | ||||||||||||||
| DENTAL DIRECTOR | $167,589 | $0 | $2,411 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $170,000 | $0 | $0 | $0 |
Schedule M IRS990ScheduleM
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 24 | ContributionCnt |
| Noncash Contributions Rpt F990 | $330,070 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | COST OF DONATED PROPERTY | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8283 Received | 0 | Form8283ReceivedCnt |
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | Yes (1) | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, COLUMN (B): | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION TRACKS AND REPORTS THE ACTUAL NUMBER OF CONTRIBUTIONS THAT IT RECEIVES. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 IS REVIEWED BY THE BOARD OF DIRECTORS AND THE FINANCE COMMITTEE BEFORE IT IS FILED WITH THE INTERNAL REVENUE SERVICE. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION REQUIRES ALL NEW BOARD MEMBERS TO SIGN A CONFLICT OF INTEREST STATEMENT. BOARD MEMBERS ARE REQUIRED TO UPDATE THESE STATEMENTS ANNUALLY. SHOULD A CONFLICT ARISE, THE PERSON AFFECTED IS ASKED TO EXCUSE THEMSELVES FROM VOTING. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE ORGANIZATION USES A VARIETY OF REGIONAL AND EXECUTIVE RECRUITING FIRMS FOR KEY EMPLOYEES WHO RECOMMEND COMPENSATION PACKAGES BASED ON MARKET DATA. THE ORGANIZATION ALSO PARTICIPATES IN A VARIETY OF COMPENSATION SURVEYS THROUGH NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS, WISCONSIN PRIMARY HEALTH CARE ASSOCIATION, AND GENERALIST HUMAN RESOURCES ORGANIZATIONS AND RECEIVE THOSE REPORTS. THERE ARE ALSO PERIODIC SPOT CHECKS LOCALLY FOR SPECIFIC POSITIONS. COMPENSATION FOR TOP MANAGEMENT IS APROVED BY THE BOARD. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KCHC REAL ESTATE LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4536 22ND AVENUE | AddressLine1Txt |
| City | KENOSHA | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53140 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 391789874 | EIN |
| Primary Activities | REAL ESTATE HOLDING | PrimaryActivitiesTxt |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Total Income | $232,727 | TotalIncomeAmt |
| End Of Year Assets | $3,000,555 | EndOfYearAssetsAmt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KENOSHA COMMUNITY HEALTH CENTER INC | BusinessNameLine1Txt |
Reasonable Cause Explanation ReasonableCauseExplanation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Explanation | THE ORGANIZATION RELIED UPON THE SYSTEMS ENLISTED FROM THEIR CERTIFIED PUBLIC ACCOUNTANT TO TRACK THE PREPARATION AND FILING OF THE EXTENSION TO FILE FOR THE FORM 990. DURING THE YEAR, THE ORGANIZATION WAS IN THE PROCESS OF AMENDING THE 2016 FORM 990 AND FILING OF THE 2017 EXTENSION TO FILE WAS INADVERTENTLY MISSED. THE ORGANIZATION WORKED WITH THEIR CERTIFIED PUBLIC ACCOUNTANT TO FILE THE 990 AS SOON AS POSSIBLE AND WOULD HAVE BEEN TIMELY FILED HAD AN EXTENSION BEEN FILED. THE ORGANIZATION HAS ALWAYS FILED THEIR FORM 990 TIMELY. THE ORGANIZATION RESPECTFULLY REQUESTS THAT THE INTERNAL REVENUE SERVICE ACCEPT THIS EXPLANATION AS REASONABLE CAUSE FOR LATE FILING. | ExplanationTxt |