FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA INC: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- FAMILY HEALTH CENTERS OF SOUTHWEST FLORIDA INC (EIN 59-1741273)
- Tax period
- 2018-01-01 to 2018-12-31
- Filed
- 2019-06-27
- IRS object ID
- 201941799349300609
- Schema version
- 2018v3.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2019-06-27T09:37:39-04:00 | ReturnTs |
| Tax Period End | 2018-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 260254161 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Tuscan & Company PA | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 12621 World Plaza Lane Bldg 55 | AddressLine1Txt |
| City | Fort Myers | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 33907 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2018-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 591741273 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Family Health Centers of Southwest Florida Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | FAMI | BusinessNameControlTxt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2256 Heitman Street | AddressLine1Txt |
| City | Fort Myers | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 33901 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Dr Frank Mazzeo JR | PersonNm |
| Person Title | President and C | PersonTitleTxt |
| Phone | 2392783600 | PhoneNum |
| Signature | 2019-06-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Jeffrey M Tuscan CPA | PreparerPersonNm |
| PTIN | P00184439 | PTIN |
| Phone | 2393332090 | PhoneNum |
| Preparation | 2019-06-14 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 50.192.23.189 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2019-06-28 | IPDt |
| IP Tm | 10:13:10 | IPTm |
| Federal Original Submission Id | 6573472019179kvzwz5h | FederalOriginalSubmissionId |
| Federal Original Submission Id | 2019-06-28 | FederalOriginalSubmissionIdDt |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | BA58B87AC5F491E7F862D51EA5E7319EBB23C533 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | BA58B87AC5F491E7F862D51EA5E7319EBB23C533 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $59,935,065 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.fhcswf.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1977 | FormationYr |
| Legal Domicile State | FL | LegalDomicileStateCd |
| Activity Or Mission | The mission of Family Health Centers of Southwest Florida, Inc is to provide high quality health care services accessible to all people, but significantly servicing lower income patients. Family Health Centers is a medicaid provider and a FQHC. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 634 | TotalEmployeeCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $11,282,344 | PYContributionsGrantsAmt |
| CY Contributions Grants | $11,165,332 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $46,644,373 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $47,702,609 | CYProgramServiceRevenueAmt |
| PY Investment Income | $346,144 | PYInvestmentIncomeAmt |
| CY Investment Income | $478,528 | CYInvestmentIncomeAmt |
| PY Other Revenue | $242,550 | PYOtherRevenueAmt |
| CY Other Revenue | $451,679 | CYOtherRevenueAmt |
| PY Total Revenue | $58,515,411 | PYTotalRevenueAmt |
| CY Total Revenue | $59,798,148 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $32,728,887 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $37,612,866 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $13,953,426 | PYOtherExpensesAmt |
| CY Other Expenses | $15,252,707 | CYOtherExpensesAmt |
| PY Total Expenses | $46,682,313 | PYTotalExpensesAmt |
| CY Total Expenses | $52,865,573 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $11,833,098 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $6,932,575 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $80,485,539 | TotalAssetsBOYAmt |
| Total Assets EOY | $96,117,832 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $7,057,533 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $18,520,419 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $73,428,006 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $77,597,413 | NetAssetsOrFundBalancesEOYAmt |
| Mission | The mission of Family Health Centers of Southwest Florida, Inc is to provide high quality health care services accessible to all people, but significantly servicing lower income patients. Family Health Centers is a medicaid provider and a FQHC. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $42,095,641 | ExpenseAmt |
| Revenue | $47,702,609 | RevenueAmt |
| Desc | The Organization provided quality medical, dental, and ancillary services to patients as follows: Medical Services were provided to 64,701 patients with total of 173,626 patient visits. Dental Services were provided to 31,561 patients with a total of 105,184 patient visits. Optometry Services were provided to 2456 patients with a total of 2,585 patient visits. Patients were seen regardless of their ability to pay. A discounted fee schedule is used, based on the Federal Poverty Guidelines, to determine the amount due from qualifying patients. | Desc |
| Total Program Service Expenses | $42,095,641 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | Yes (true) | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | 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 | Yes (true) | 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 | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (true) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 23 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 634 | 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 |
| Form8899 Filedind | false | Form8899Filedind |
| Form1098 C Filed | false | Form1098CFiledInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | 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 | Yes (true) | InvestmentInJointVentureInd |
| Written Policy Or Procedure | Yes (true) | WrittenPolicyOrProcedureInd |
| States Where Copy Of Return Is Fld | FL | StatesWhereCopyOfReturnIsFldCd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Daniel Griffith | PersonNm |
| Phone | 2392783600 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2256 Heitman Street | AddressLine1Txt |
| City | Fort Myers | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 33901 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (25 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 |
|---|---|---|---|---|---|---|---|---|
| Steve Davis | ||||||||
| Immediate Past Chair | 2.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| James McGregor | ||||||||
| DirectorChairman | 2.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Loreen Downes | ||||||||
| Director | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Leah McCann | ||||||||
| DirectorTreasurer | 2.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Tomy Laufer | ||||||||
| Director | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Veronica Culbertson | ||||||||
| DirectorSecretary | 2.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Jose Fernandez | ||||||||
| Director | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Lee Golden | ||||||||
| Director | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Beth Mortimer | ||||||||
| Director | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Patricia Epifanio | ||||||||
| Director | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Mike Munzert | ||||||||
| Director | 0.50 | 0.00 | Yes (X) | $0 | $0 | $0 | ||
| Dr Frank Mazzeo | ||||||||
| PresCEOChief Dental Officer | 55.00 | 0.00 | Yes (X) | $804,544 | $0 | $112,070 | ||
| Dr Jorge Quinonez | ||||||||
| Chief Medical Officer | 45.00 | 0.00 | Yes (X) | $550,194 | $0 | $71,111 | ||
| Marie Andress | ||||||||
| Chief Financial Officer | 45.00 | 0.00 | Yes (X) | $250,473 | $0 | $33,992 | ||
| Theresa Buchanan | ||||||||
| Chief Admin Officer | 45.00 | 0.00 | Yes (X) | $127,780 | $0 | $42,607 | ||
| Robert Palussek | ||||||||
| VPChief Operating Officer | 45.00 | 0.00 | Yes (X) | $171,984 | $0 | $37,626 | ||
| Daniel Griffith | ||||||||
| Chief Financial Officer | 45.00 | 0.00 | Yes (X) | $193,806 | $0 | $36,337 | ||
| David Koester | ||||||||
| Chief HR Officer | 45.00 | 0.00 | Yes (X) | $133,816 | $0 | $31,874 | ||
| Nick Roller | ||||||||
| Chief Information Officer | 45.00 | 0.00 | Yes (X) | $147,558 | $0 | $9,502 | ||
| Dr Carrie Poulsom | ||||||||
| Chief Pharmacy Officer | 45.00 | 0.00 | Yes (X) | $181,436 | $0 | $42,121 | ||
| Dr Jeffry Garner | ||||||||
| VPDirector WHS | 40.00 | 0.00 | $400,338 | $0 | $48,937 | Yes (X) | ||
| Dr Alexander Gumiroff | ||||||||
| Physician | 40.00 | 0.00 | $358,220 | $0 | $59,751 | Yes (X) | ||
| Dr Carlos Alvarado | ||||||||
| Dentist | 40.00 | 0.00 | $314,060 | $0 | $47,707 | Yes (X) | ||
| Dr Juan Pablo Richiusa | ||||||||
| Physician | 40.00 | 0.00 | $341,449 | $0 | $34,453 | Yes (X) | ||
| Luis Cardenty | ||||||||
| Physician | 40.00 | 0.00 | $318,908 | $0 | $36,469 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $4,294,566 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $644,557 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 14 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (3 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Burks Plaza LLC | |||||
| 11751-2 Metro Parkway | Fort Myers | FL | 33966 | Property Lease | $142,500 |
| School House of Port Charlotte LLC | |||||
| 696 NE 125th Street | Miami | FL | 33161 | Property Lease | $126,069 |
| Sunshine Professional Suites LLC | |||||
| 8890 Salrose Lane Ste 200 | Fort Myers | FL | 33912 | Property Lease | $180,127 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 3 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $10,623,721 | GovernmentGrantsAmt |
| All Other Contributions | $541,611 | AllOtherContributionsAmt |
| Noncash Contributions | $16,560 | NoncashContributionsAmt |
| Total Contributions | $11,165,332 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Medicaid Net | 621110 | $33,503,486 | $33,503,486 |
| Patient Fees Net | 621110 | $11,485,278 | $11,485,278 |
| Medicaid EHR Incentive | 621110 | $161,500 | $161,500 |
| Medicare Net | 621110 | $2,371,008 | $2,371,008 |
| Clinical Incentive | 621110 | $181,337 | $181,337 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $47,702,609 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $615,395 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $210,419 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $404,976 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $50 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $136,917 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$136,867 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$136,867 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | -$136,867 | RelatedOrExemptFuncIncomeAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Other Revenue | Desc |
| Business | 621110 | BusinessCd |
| Total Revenue Column | $451,679 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $451,679 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $451,679 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $59,798,148 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $48,227,840 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $404,976 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,186,348 | TotalAmt |
| Program Services | $1,686,149 | ProgramServicesAmt |
| Management And General | $500,199 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,082,492 | TotalAmt |
| Program Services | $22,428,918 | ProgramServicesAmt |
| Management And General | $6,653,574 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,503,957 | TotalAmt |
| Program Services | $1,186,190 | ProgramServicesAmt |
| Management And General | $317,767 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,820,516 | TotalAmt |
| Program Services | $2,224,577 | ProgramServicesAmt |
| Management And General | $595,939 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,019,553 | TotalAmt |
| Program Services | $1,592,847 | ProgramServicesAmt |
| Management And General | $426,706 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $131,915 | TotalAmt |
| Management And General | $131,915 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $56,500 | TotalAmt |
| Management And General | $56,500 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,216,956 | TotalAmt |
| Program Services | $4,053,034 | ProgramServicesAmt |
| Management And General | $163,922 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $432,058 | TotalAmt |
| Program Services | $432,058 | ProgramServicesAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $971,350 | TotalAmt |
| Program Services | $902,026 | ProgramServicesAmt |
| Management And General | $69,324 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $150,172 | TotalAmt |
| Program Services | $101,197 | ProgramServicesAmt |
| Management And General | $48,975 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $223,357 | TotalAmt |
| Program Services | $137,654 | ProgramServicesAmt |
| Management And General | $85,703 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $430,776 | TotalAmt |
| Management And General | $430,776 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,384,603 | TotalAmt |
| Program Services | $1,180,776 | ProgramServicesAmt |
| Management And General | $203,827 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $227,848 | TotalAmt |
| Program Services | $175,781 | ProgramServicesAmt |
| Management And General | $52,067 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Supplies | $3,346,854 | $3,301,754 | $45,100 |
| Repairs and Maintenance | $1,163,426 | $1,111,758 | $51,668 |
| Capital Items less than 5k | $160,134 | $123,311 | $36,823 |
| Telecommunications | $731,136 | $436,477 | $294,659 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,625,622 | TotalAmt |
| Program Services | $1,021,134 | ProgramServicesAmt |
| Management And General | $604,488 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $52,865,573 | TotalAmt |
| Program Services | $42,095,641 | ProgramServicesAmt |
| Management And General | $10,769,932 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,934,705 | BOYAmt |
| EOY | $29,795,294 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,482,222 | BOYAmt |
| EOY | $20,343,041 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $90,299 | BOYAmt |
| EOY | $99,282 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,881,620 | BOYAmt |
| EOY | $7,556,066 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $66,068 | BOYAmt |
| EOY | $69,110 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $380,935 | BOYAmt |
| EOY | $177,835 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $36,745,973 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $11,353,185 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,661,413 | BOYAmt |
| EOY | $25,392,788 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $325,000 | BOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $12,023,750 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $663,277 | BOYAmt |
| EOY | $660,666 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $80,485,539 | BOYAmt |
| EOY | $96,117,832 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,833,252 | BOYAmt |
| EOY | $6,525,780 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $271,296 | BOYAmt |
| EOY | $459,426 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $10,445,311 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $952,985 | BOYAmt |
| EOY | $1,089,902 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,057,533 | BOYAmt |
| EOY | $18,520,419 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $73,428,006 | BOYAmt |
| EOY | $77,597,413 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $73,428,006 | BOYAmt |
| EOY | $77,597,413 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $80,485,539 | BOYAmt |
| EOY | $96,117,832 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $6,932,575 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$2,763,168 | 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) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| 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) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $11,030,259 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $9,651,435 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $12,519,460 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $11,282,344 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $11,165,332 | CurrentTaxYearAmt |
| Total | $55,648,830 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $11,030,259 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $9,651,435 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $12,519,460 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $11,282,344 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $11,165,332 | CurrentTaxYearAmt |
| Total | $55,648,830 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $55,648,830 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $51,535 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $80,235 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $50,901 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $120,068 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $404,976 | CurrentTaxYearAmt |
| Total | $707,715 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $56,356,545 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $214,843,665 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.98740 | PublicSupportCY170Pct |
| Public Support PY170 | 0.99810 | 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 | $5,570,811 | OtherCostOrOtherBasisAmt |
| Book Value | $5,570,811 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $25,967,874 | OtherCostOrOtherBasisAmt |
| Depreciation | $7,568,424 | DepreciationAmt |
| Book Value | $18,399,450 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,716,810 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,656,515 | DepreciationAmt |
| Book Value | $60,295 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,464,209 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,128,246 | DepreciationAmt |
| Book Value | $1,335,963 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $26,269 | OtherCostOrOtherBasisAmt |
| Book Value | $26,269 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $25,392,788 | TotalBookValueLandBuildingsAmt |
Invst Program Related Org InvstProgramRelatedOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt | Method ValuationMethodValuationCd |
|---|---|---|
| Health Choice Care LLC | $325,000 | C |
| Lehigh QalicB Inc | $11,698,750 | C |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Program Rltd | $12,023,750 | TotalBookValueProgramRltdAmt |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | 457b 457f Deferred Comp Plans | Desc |
| Book Value | $660,666 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $660,666 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| Commitments and Contingencies | $952,985 |
| Swap Agreement | $136,917 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,089,902 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $59,834,148 | TotalRevEtcAuditedFinclStmtAmt |
| Donated Services And Use Fclts | $36,000 | DonatedServicesAndUseFcltsAmt |
| Revenue Not Reported | $36,000 | RevenueNotReportedAmt |
| Revenue Subtotal | $59,798,148 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $59,798,148 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $52,901,573 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $36,000 | DonatedServicesUseFcltsAmt |
| Expenses Not Reported | $36,000 | ExpensesNotReportedAmt |
| Expenses Subtotal | $52,865,573 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $52,865,573 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Footnote for uncertain tax position under FIN 48 (Part X) | FormAndLineReferenceDesc |
| Explanation | Family Health Centers is exempt from federal income taxes under Section 501(c)(3) of the Internal Revenue Code. Family Health Centers is not classified as a private foundation within the meaning of Section 509(a) of the Internal Revenue Code.The Internal Revenue Code provides for taxation of unrelated business income under certain circumstances. Family Health Centers report no unrelated business taxable income; however, such status is subject to final determination upon examination of the related tax returns by the appropriate taxing authorities. The informational tax returns (Form 990) for the prior three (3) fiscal years remain open for examination. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | false | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (true) | SubstantiationRequiredInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| 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 (14 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt |
|---|---|---|---|---|---|---|
| Dr Frank Mazzeo | ||||||
| PresCEOChief Dental Officer | $652,072 | $150,000 | $2,472 | $84,244 | $27,826 | $916,614 |
| Dr Jorge Quinonez | ||||||
| Chief Medical Officer | $481,504 | $68,000 | $690 | $37,654 | $33,457 | $621,305 |
| Marie Andress | ||||||
| Chief Financial Officer | $182,032 | $68,000 | $441 | $27,549 | $6,443 | $284,465 |
| Theresa Buchanan | ||||||
| Chief Admin Officer | $127,527 | $253 | $28,591 | $14,016 | $170,387 | |
| Dr Jeffry Garner | ||||||
| VPDirector WHS | $308,050 | $90,383 | $1,905 | $19,150 | $29,787 | $449,275 |
| Dr Alexander Gumiroff | ||||||
| Physician | $282,681 | $75,333 | $206 | $19,150 | $40,601 | $417,971 |
| Robert Palussek | ||||||
| VPChief Operating Officer | $146,900 | $25,000 | $84 | $11,763 | $25,863 | $209,610 |
| Dr Carlos Alvarado | ||||||
| Dentist | $314,005 | $55 | $19,150 | $28,557 | $361,767 | |
| Daniel Griffith | ||||||
| Chief Financial Officer | $164,994 | $28,792 | $20 | $10,842 | $25,495 | $230,143 |
| David Koester | ||||||
| Chief HR Officer | $108,816 | $25,000 | $8,853 | $23,021 | $165,690 | |
| Nick Roller | ||||||
| Chief Information Officer | $122,442 | $25,000 | $116 | $9,502 | $157,060 | |
| Dr Juan Pablo Richiusa | ||||||
| Physician | $285,425 | $55,783 | $241 | $19,150 | $15,303 | $375,902 |
| Luis Cardenty | ||||||
| Physician | $225,250 | $93,365 | $293 | $18,340 | $18,129 | $355,377 |
| Dr Carrie Poulsom | ||||||
| Chief Pharmacy Officer | $165,310 | $16,000 | $126 | $13,554 | $28,567 | $223,557 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Benefit information (Part I, line 1a) | FormAndLineReferenceDesc |
| Explanation | The executive team is reimbursed for gym memberships. There is not a specific written policy regarding this reimbursement, however, the arrangement is outlined in the executive employment contracts. The reimbusement is processed through accounts payable and is included on the executives W2 as taxable income. | ExplanationTxt |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | See Supplemental Information Below | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Sharing Of Revenues | false | SharingOfRevenuesInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Supplemental Information for Schedule L | FormAndLineReferenceDesc |
| Explanation | Lehigh QALICB, Inc (Lehigh) is a Type 1 Supporting Organization and controlled by Family Health Centers of Southwest Florida (FHC). Steve Davis is a Board Member of both organizations. Dr. Frank Mazzeo, Jr. and Marie Andress were officers of FHC and Board Members of Lehigh. Marie Andress resigned in May 2018 and Daniel Griffith replaced her as Chief Financial Officer for FHC and in her Board position with Lehigh. During the year, there was an equity transfer from FHC to Lehigh in the amount of $2,763,168. At the end of the year, there was a receivable due from Lehigh totaling $2,537,098 which included $1,000,000 in cash and $1,537,098 in land and construction in progress transferred to Lehigh. It is intended that Lehigh will construct and own a facility that will be leased by FHC to operate a health center. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990 governing body review Part VI line 11 | The Finance Committee reviews the tax return. The tax return is then reviewed and approved by the full Board of Directors. |
| Conflict of interest policy compliance Part VI line 12c | The Organization annually reaffirms the written conflict of interest policy. |
| CEO executive director top management comp Part VI line 15a | The Board of Directors gather data from similar organizations and salary surveys to determine comparable executive compensation for the CEO. |
| Other officer or key employee compensation Part VI line 15b | Management gathers data from similar organizations and salary surveys to determine comparable executive compensation. |
| Governing documents etc available to public Part VI line 19 | The governing documents, conflict of interest policy and financial statements are available upon request. The financial statements are also available to the public (via Form 990) on a third-party website. |
| Explanation of other changes in net assets or fund balances Part XI line 9 | During the fiscal year, Family Health Centers of Southwest Florida, Inc made an equity transfer out to fund their supporting organization, Lehigh QALICB, Inc, to further their exempt purpose to be operated exclusively for the benefit of, to perform the functions of, and to carry out the purposes of the Family Health Centers of Southwest Florida, Inc. |
| General explanation attachment | Part VII Section ADaniel Griffith replaced Marie Andress as Chief Financial Officer when she resigned in May 2018.Veronica Culbertson resigned in June 2018, therefore, there were only 10 voting members at the end of the year. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Lehigh QalicB Inc | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2256 Heilman Street | AddressLine1Txt |
| City | Fort Myers | CityNm |
| State Abbreviation | FL | StateAbbreviationCd |
| ZIP | 33901 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 824042727 | EIN |
| Primary Activities | Medical facility | PrimaryActivitiesTxt |
| Legal Domicile State | FL | LegalDomicileStateCd |
| Exempt Code Section | 501c | ExemptCodeSectionTxt |
| Public Charity Status | 3 | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Family Health Centers of Southwest FL | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | false | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | Yes (true) | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (3 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| Lehigh QALICB Inc | ||
| r | $2,763,168 | Cost |
| Lehigh QALICB Inc | ||
| i | $1,537,098 | Cost |
| Lehigh QALICB Inc | ||
| i | $1,000,000 | Cost |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Explanation of information on Schedule R | FormAndLineReferenceDesc |
| Explanation | The amounts reported on Schedule R are as follows: Transfer of equity $2,763,168, transfer of land and related construction in progress $1,537,098, and transfer of cash $1,000,000. | ExplanationTxt |
Comments