COMMUNITY HEALTH CENTERS OF WESTERN KENTUCKY INC: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization
COMMUNITY HEALTH CENTERS OF WESTERN KENTUCKY INC (EIN 61-1268014)
Tax period
2018-05-01 to 2019-04-30
Filed
2019-07-29
IRS object ID
201942109349301154
Schema version
2018v3.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2019-07-29T13:42:14-05:00ReturnTs
Tax Period End2019-04-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN610920132PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1RINEY HANCOCK CPAS PSCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line12900 VEACH ROAD SUITE 2AddressLine1Txt
CityOWENSBOROCityNm
State AbbreviationKYStateAbbreviationCd
ZIP42303ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2018-05-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN611268014EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1COMMUNITY HEALTH CENTERS OF WESTERNBusinessNameLine1Txt
Business Name Line2KENTUCKY INCBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlCOMMBusinessNameControlTxt
Phone2703385777PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1480 HOPKINSVILLE STREETAddressLine1Txt
CityGREENVILLECityNm
State AbbreviationKYStateAbbreviationCd
ZIP42345ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJOSEPH SWABPersonNm
Person TitleCFOPersonTitleTxt
Phone2703385777PhoneNum
Signature2019-07-29SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonCARLA J DOWELL CPAPreparerPersonNm
PTINP00104892PTIN
Phone2709264540PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address74.87.131.58IPv4AddressTxt
FieldValueIRS element (for citing)
IP2019-07-29IPDt
IP Tm13:22:09IPTm
IP TimezoneCDIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdEFF8F207A4B6A27F98432D8E7E4325D7BA0DBED3AtSubmissionCreationDeviceId
At Submission Filing Device IdEFF8F207A4B6A27F98432D8E7E4325D7BA0DBED3AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2018TaxYr
Build TS2019-02-21 02:37:17ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerROGER ARBUCKLEPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1480 HOPKINSVILLE STAddressLine1Txt
CityGREENVILLECityNm
State AbbreviationKYStateAbbreviationCd
ZIP42345ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$9,192,475GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressN/AWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1994FormationYr
Legal Domicile StateKYLegalDomicileStateCd
Activity Or MissionTO PROVIDE AFFORDABLE PRIMARY HEALTHCARE SERVICESActivityOrMissionDesc
Voting Members Governing Body9VotingMembersGoverningBodyCnt
Voting Members Independent9VotingMembersIndependentCnt
Total Employee102TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$2,350,109PYContributionsGrantsAmt
CY Contributions Grants$2,470,221CYContributionsGrantsAmt
PY Program Service Revenue$5,871,372PYProgramServiceRevenueAmt
CY Program Service Revenue$6,643,958CYProgramServiceRevenueAmt
PY Investment Income$35,904PYInvestmentIncomeAmt
CY Investment Income$77,929CYInvestmentIncomeAmt
PY Other Revenue$510PYOtherRevenueAmt
CY Other Revenue$367CYOtherRevenueAmt
PY Total Revenue$8,257,895PYTotalRevenueAmt
CY Total Revenue$9,192,475CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$5,131,993PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$5,460,800CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$2,359,037PYOtherExpensesAmt
CY Other Expenses$2,829,282CYOtherExpensesAmt
PY Total Expenses$7,491,030PYTotalExpensesAmt
CY Total Expenses$8,290,082CYTotalExpensesAmt
PY Revenues Less Expenses$766,865PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$902,393CYRevenuesLessExpensesAmt
Total Assets BOY$9,818,842TotalAssetsBOYAmt
Total Assets EOY$10,784,953TotalAssetsEOYAmt
Total Liabilities BOY$423,676TotalLiabilitiesBOYAmt
Total Liabilities EOY$487,394TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$9,395,166NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$10,297,559NetAssetsOrFundBalancesEOYAmt
MissionTO PROVIDE AFFORDABLE PRIMARY HEALTHCARE SERVICES IN MUHLENBERG AND LOGAN COUNTIES, KENTUCKY, AND IN MEDICALLY UNDER-SERVED URBAN, SUBURBAN, AND RURAL AREAS HAVING LIMITED AVAILABLE HEALTH RESOURCES.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$7,335,991ExpenseAmt
Revenue$6,643,958RevenueAmt
DescOPERATION OF COMMUNITY HEALTH CENTER AS AUTHORIZED BY SECTION 330 OF THE PUBLIC HEALTH SERVICES GRANTDesc
Total Program Service Expenses$7,335,991TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document20IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee102EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members9GoverningBodyVotingMembersCnt
Independent Voting Member9IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower Policy0WhistleblowerPolicyInd
Document Retention Policy0DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1JOSEPH SWABBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone2703385777PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1480 HOPKINSVILLE STAddressLine1Txt
CityGREENVILLECityNm
State AbbreviationKYStateAbbreviationCd
ZIP42345ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
CINDY BAIRD
BOARD MEMBER1.00Yes (X)$0$0$0
BILLY STEELE
BOARD MEMBER1.00Yes (X)$0$0$0
AMANDA HENSON
BOARD MEMBER1.00Yes (X)$0$0$0
ELIZABETH EAVES
BOARD MEMBER1.00Yes (X)$0$0$0
ELIZABETH GENTRY
BOARD MEMBER1.00Yes (X)$0$0$0
ANDREHIA HATFIELD
BOARD MEMBER1.00Yes (X)$0$0$0
CARY DAVIS
BOARD MEMBER1.00Yes (X)$0$0$0
RICHARD NEATHAMER
BOARD MEMBER1.00Yes (X)$0$0$0
ROSEMARY BUCK
BOARD MEMBER1.00Yes (X)$0$0$0
ROGER ARBUCKLE
CEO40.00$165,000$0$19,641Yes (X)
JOSEPH SWAB
CFO40.00$100,000$0$9,828Yes (X)
DAVID CONATSER
PHYSICIAN40.00$160,000$0$8,000Yes (X)
SUSAN HAWKINS
PHYSICIAN40.00$163,269$0$8,164Yes (X)
STEVEN ZELLER
PHYSICIAN40.00$229,231$0$23,454Yes (X)
BILLIE GALYEN
PHYSICIAN40.00$193,625$0$22,747Yes (X)
DEANDRA DAVIS
PHYSICIAN40.00$186,671$0$9,243Yes (X)
NATALIE HUTTON
PHYSICIAN40.00$169,231$0$18,685Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,367,027TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$119,762TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K16IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (2 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
CHERYL BROTHERS
420 KING ROADLEWISBERGKY42256HOUSEKEEPING SERVICES$123,035
COMP HEALTH
PO BOX 972651DALLASTX753972651LOCUM PHYSICIAN AT GUTHRIE$117,689
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K2CntrctRcvdGreaterThan100KCnt
Government Grants$2,470,221GovernmentGrantsAmt
Total Contributions$2,470,221TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescMEDICAL SERVICESDesc
Business621110BusinessCd
Total Revenue Column$6,643,958TotalRevenueColumnAmt
Related Or Exempt Func Income$6,643,958RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$6,643,958TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$77,929TotalRevenueColumnAmt
Exclusion$77,929ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescMISCELLANEOUSDesc
Business621110BusinessCd
Total Revenue Column$367TotalRevenueColumnAmt
Exclusion$367ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$367OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$9,192,475TotalRevenueColumnAmt
Related Or Exempt Func Income$6,643,958RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$78,296ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$462,469TotalAmt
Program Services$168,000ProgramServicesAmt
Management And General$294,469ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$4,180,406TotalAmt
Program Services$3,967,975ProgramServicesAmt
Management And General$212,431ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$152,810TotalAmt
Program Services$146,190ProgramServicesAmt
Management And General$6,620ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$332,818TotalAmt
Program Services$309,954ProgramServicesAmt
Management And General$22,864ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$332,297TotalAmt
Program Services$295,861ProgramServicesAmt
Management And General$36,436ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$5,301TotalAmt
Program Services$5,301ProgramServicesAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$73,307TotalAmt
Program Services$73,307ProgramServicesAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$1,308,427TotalAmt
Program Services$1,164,469ProgramServicesAmt
Management And General$143,958ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$74,584TotalAmt
Program Services$74,584ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$237,013TotalAmt
Program Services$142,712ProgramServicesAmt
Management And General$94,301ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$43,676TotalAmt
Program Services$43,676ProgramServicesAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$94,645TotalAmt
Program Services$19,801ProgramServicesAmt
Management And General$74,844ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$904TotalAmt
Program Services$26ProgramServicesAmt
Management And General$878ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$68,365TotalAmt
Program Services$34,798ProgramServicesAmt
Management And General$33,567ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$242,261TotalAmt
Program Services$242,261ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$31,911TotalAmt
Program Services$31,911ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
IMMUNIZATION EXPENSE$350,355$350,355
OPERATIONAL SUPPLIES$111,439$111,439
BAD DEBT EXPENSE$93,000$93,000
MEDICAL RECRUITMENT$34,370$34,370

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$59,724TotalAmt
Program Services$26,001ProgramServicesAmt
Management And General$33,723ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$8,290,082TotalAmt
Program Services$7,335,991ProgramServicesAmt
Management And General$954,091ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$429,578BOYAmt
EOY$273,957EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$3,461,817BOYAmt
EOY$5,049,659EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$952,795BOYAmt
EOY$664,876EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$79,364BOYAmt
EOY$86,260EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$46,755BOYAmt
EOY$34,991EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$6,532,673LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$1,857,463LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$4,848,533BOYAmt
EOY$4,675,210EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$9,818,842BOYAmt
EOY$10,784,953EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$423,676BOYAmt
EOY$487,394EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$423,676BOYAmt
EOY$487,394EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$9,211,115BOYAmt
EOY$10,118,864EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$184,051BOYAmt
EOY$178,695EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$9,395,166BOYAmt
EOY$10,297,559EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$9,818,842BOYAmt
EOY$10,784,953EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$902,393ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit RequiredYes (1)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (1)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,631,828CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,859,345CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$2,918,975CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$2,350,109CurrentTaxYearMinus1YearAmt
Current Tax Year$2,470,221CurrentTaxYearAmt
Total$11,230,478TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$3,803,134CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$4,435,106CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$5,595,883CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$5,871,372CurrentTaxYearMinus1YearAmt
Current Tax Year$6,643,958CurrentTaxYearAmt
Total$26,349,453TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$5,434,962CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$6,294,451CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$8,514,858CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$8,221,481CurrentTaxYearMinus1YearAmt
Current Tax Year$9,114,179CurrentTaxYearAmt
Total$37,579,931TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$37,579,931PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$3,511CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$13,344CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$27,883CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$35,904CurrentTaxYearMinus1YearAmt
Current Tax Year$77,929CurrentTaxYearAmt
Total$158,571TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$3,511CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$13,344CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$27,883CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$35,904CurrentTaxYearMinus1YearAmt
Current Tax Year$77,929CurrentTaxYearAmt
Total$158,571TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,269CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$100,105CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus1 Year$510CurrentTaxYearMinus1YearAmt
Current Tax Year$367CurrentTaxYearAmt
Total$102,251TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$5,439,742CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$6,407,900CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$8,542,741CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$8,257,895CurrentTaxYearMinus1YearAmt
Current Tax Year$9,192,475CurrentTaxYearAmt
Total$37,840,753TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.99310PublicSupportCY509Pct
Public Support PY5090.99750PublicSupportPY509Pct
Investment Income CY0.00420InvestmentIncomeCYPct
Investment Income PY0.00250InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME:FormAndLineReferenceDesc
ExplanationMISCELLANEOUS INCOME - 2014 AMOUNT: $ 1,269. 2015 AMOUNT: $ 100,105. 2017 AMOUNT: $ 510. 2018 AMOUNT: $ 367.ExplanationTxt

Schedule B IRS990ScheduleB

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$248,389OtherCostOrOtherBasisAmt
Book Value$248,389BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$4,990,912OtherCostOrOtherBasisAmt
Depreciation$890,807DepreciationAmt
Book Value$4,100,105BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$12,628OtherCostOrOtherBasisAmt
Depreciation$10,347DepreciationAmt
Book Value$2,281BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,048,711OtherCostOrOtherBasisAmt
Depreciation$814,625DepreciationAmt
Book Value$234,086BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$232,033OtherCostOrOtherBasisAmt
Depreciation$141,684DepreciationAmt
Book Value$90,349BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$4,675,210TotalBookValueLandBuildingsAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$9,192,475TotalRevEtcAuditedFinclStmtAmt
Revenue Not Reported$0RevenueNotReportedAmt
Revenue Subtotal$9,192,475RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$9,192,475TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$8,290,082TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$8,290,082ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$8,290,082TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationTHE CENTER IS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, EXCEPT ON INCOME DERIVED FROM UNRELATED BUSINESS ACTIVITIES. THE CENTER BELIEVES THAT IT HAS SUPPORT FOR ANY TAX POSITIONS TAKEN, AND AS SUCH, DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE FINANCIAL STATEMENTS.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (1)AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
ROGER ARBUCKLE
CEO$165,000$0$0$0$0$0$8,250$0$11,391$0$184,641$0$0$0
DAVID CONATSER
PHYSICIAN$160,000$0$0$0$0$0$8,000$0$0$0$168,000$0$0$0
SUSAN HAWKINS
PHYSICIAN$163,269$0$0$0$0$0$8,164$0$0$0$171,433$0$0$0
STEVEN ZELLER
PHYSICIAN$229,231$0$0$0$0$0$10,212$0$13,242$0$252,685$0$0$0
BILLIE GALYEN
PHYSICIAN$193,625$0$0$0$0$0$9,510$0$13,237$0$216,372$0$0$0
DEANDRA DAVIS
PHYSICIAN$186,671$0$0$0$0$0$9,243$0$0$0$195,914$0$0$0
NATALIE HUTTON
PHYSICIAN$169,231$0$0$0$0$0$8,462$0$10,223$0$187,916$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 7FormAndLineReferenceDesc
ExplanationPROVIDERS ARE ELIGIBLE TO RECEIVE A BONUS BASED ON A PRODUCTIVITY FORMULA.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11BMANAGEMENT PRESENTS THE FEDERAL FORM 990 TO THE BOARD AT THE REGULARLY SCHEDULED BOARD MEETING IMMEDIATELY PRECEDING THE RETURN'S DUE DATE. THE RETURN IS FILED AFTER BOARD REVIEW.
FORM 990, PART VI, SECTION B, LINE 12CBOARD MEMBERS AND OFFICERS SIGN ANNUAL CONFLICT OF INTEREST STATEMENTS.
FORM 990, PART VI, SECTION B, LINE 15THE BOARD DETERMINED THE CEO'S SALARY BASED ON SALARY SURVEY DATA FROM THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS AND CONDUCTS AN ANNUAL PERFORMANCE EVALUATION. THE CEO DETERMINED THE CFO'S SALARY BASED ON THE SAME INFORMATION WHICH IS EVALUATED ANNUALLY.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION MAKES GOVERNING DOCUMENTS, ITS CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST. ANNUAL FORMS 990 ARE AVAILABLE ON GUIDESTAR.ORG.
FORM 990, PART IX, LINE 11GCONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 1,164,469. MANAGEMENT AND GENERAL EXPENSES 143,816. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,308,285. BANK FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 142. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 142.
FORM 990, PART XII, LINE 2C:THE ORGANIZATION DID NOT CHANGE ITS OVERSIGHT OR SELECTION PROCESS FROM THE PRIOR YEAR.

Comments

Anonymous: no account or email. Up to 2,000 characters, at most one link. Comments are checked automatically; some wait for review.