SAMUEL U RODGERS HEALTH CENTER INC: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- SAMUEL U RODGERS HEALTH CENTER INC (EIN 43-0899356)
- Tax period
- 2016-10-01 to 2017-09-30
- Filed
- 2018-06-06
- IRS object ID
- 201811579349300311
- Schema version
- 2016v3.1
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule I
- Schedule J
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-06-06T09:36:21-05:00 | ReturnTs |
| Tax Period End | 2017-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BKD LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1201 Walnut Suite 1700 | AddressLine1Txt |
| City | Kansas City | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 641062246 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 430899356 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Samuel U Rodgers Health Center Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % CHRISTOPHER WALKER | InCareOfNm |
| Business Name Control | SAMU | BusinessNameControlTxt |
| Phone | 8164744920 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 825 Euclid Avenue | AddressLine1Txt |
| City | Kansas City | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 64124 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | BOB THEIS | PersonNm |
| Person Title | ACTING CEO | PersonTitleTxt |
| Phone | 8162216300 | PhoneNum |
| Signature | 2018-08-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Michael J Engle | PreparerPersonNm |
| PTIN | P00482834 | PTIN |
| Phone | 8162216300 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | BOB THEIS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 825 EUCLID AVENUE | AddressLine1Txt |
| City | KANSAS CITY | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 64124 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $21,923,470 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.RODGERSHEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1968 | FormationYr |
| Legal Domicile State | MO | LegalDomicileStateCd |
| Activity Or Mission | THE CENTER'S MISSION IS TO PROVIDE HIGH QUALITY, COMPASSIONATE AND AFFORDABLE HEALTHCARE FOR ALL. | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 13 | VotingMembersIndependentCnt |
| Total Employee | 292 | TotalEmployeeCnt |
| Total Volunteers | 83 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $10,340,160 | PYContributionsGrantsAmt |
| CY Contributions Grants | $9,921,866 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $10,186,841 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $10,073,170 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$8,837 | PYInvestmentIncomeAmt |
| CY Investment Income | $119,729 | CYInvestmentIncomeAmt |
| PY Other Revenue | $389,463 | PYOtherRevenueAmt |
| CY Other Revenue | $384,589 | CYOtherRevenueAmt |
| PY Total Revenue | $20,907,627 | PYTotalRevenueAmt |
| CY Total Revenue | $20,499,354 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $254,038 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $166,733 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $13,582,764 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $14,370,657 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $8,894,238 | PYOtherExpensesAmt |
| CY Other Expenses | $8,397,331 | CYOtherExpensesAmt |
| PY Total Expenses | $22,731,040 | PYTotalExpensesAmt |
| CY Total Expenses | $22,934,721 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$1,823,413 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$2,435,367 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $34,247,911 | TotalAssetsBOYAmt |
| Total Assets EOY | $32,756,500 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $4,708,868 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $5,546,286 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $29,539,043 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $27,210,214 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE CENTER'S MISSION IS TO PROVIDE HIGH QUALITY, COMPASSIONATE AND AFFORDABLE HEALTHCARE FOR ALL. | MissionDesc |
| Significant New Program Srvc | Yes (true) | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $19,580,911 | ExpenseAmt |
| Grant | $166,733 | GrantAmt |
| Revenue | $10,073,170 | RevenueAmt |
| Desc | SEE SCHEDULE O | Desc |
| Total Program Service Expenses | $19,580,911 | 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 | Yes (true) | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | Yes (true) | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | Yes (true) | 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 | 45 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 292 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 13 | 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 | MO | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CHRISTOPHER WALKER | PersonNm |
| Phone | 8168894801 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 825 EUCLID | AddressLine1Txt |
| City | KANSAS CITY | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 64124 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (21 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 |
|---|---|---|---|---|---|---|---|---|
| JOE VALENCIANO | ||||||||
| DIRECTOR/CHAIRPERSON TO DEC 16 | 1.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| DONNA WILSON PETERS | ||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| XIMENA ILABACA-SOMOZA | ||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| MELINA JOHNSON | ||||||||
| DIRECTOR/TREASURER | 1.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| JON TROZZOLO | ||||||||
| DIRECTOR/SECRETARY | 1.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| SIDNEY KING | ||||||||
| DIRECTOR/CHAIRPERSON | 1.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| THOMAS WRIGHT III | ||||||||
| DIRECTOR/VICE CHAIRPERSON | 1.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| ANNE VAN GARSSE | ||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| LEONARDO LOZADA | ||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| KATIE CASTRO GALICIA | ||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| GINA MACE | ||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| POORNIMA KUMAR | ||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| BENOIT BLONDEAU | ||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | ||
| BOB THEIS | ||||||||
| ACTING CEO/CFO/COO | 40.0 | 1.0 | Yes (X) | $179,554 | $0 | $20,415 | ||
| HILDA FUENTES | ||||||||
| PRESIDENT AND CEO | 40.0 | 1.0 | Yes (X) | $259,459 | $0 | $32,144 | ||
| CHRIS WALKER | ||||||||
| CHIEF FINANCIAL OFFICER | 40.0 | 0.0 | Yes (X) | $83,936 | $0 | $24,132 | ||
| SUDEEP ROSS | ||||||||
| CHIEF HEALTH OFFICER TO AUG 16 | 40.0 | 0.0 | $319,160 | $0 | $43,695 | Yes (X) | ||
| JOSE CRUZ | ||||||||
| PHYSICIAN | 40.0 | 0.0 | $177,267 | $0 | $18,333 | Yes (X) | ||
| ANTHONY GUTIERREZ | ||||||||
| PHYSICIAN | 40.0 | 0.0 | $147,364 | $0 | $17,748 | Yes (X) | ||
| CINDY RUTTAN | ||||||||
| PSYCHIATRIST TO NOV 16 | 40.0 | 0.0 | $172,702 | $0 | $15,437 | Yes (X) | ||
| DANIEL PURDOM | ||||||||
| CHIEF HEALTH OFFICER/PHYSICIAN | 40.0 | 0.0 | $181,903 | $0 | $14,067 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,521,345 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $185,971 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 17 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| PHARMACY SYSTEMS INC | |||||
| 5050 BRADENTON AVE | DUBLIN | OH | 43017 | PHARMACY MANAGEMENT | $532,925 |
| PRIORITY MANAGEMENT GROUP INC | |||||
| 700 SCHOOL ST | PAWTUCKET | RI | 02860 | BILLING MANAGMENT | $384,563 |
| ALEXANDER OPEN SYSTEMS INC | |||||
| 12980 FOSTER ST SUITE 300 | OVERLAND PARK | KS | 66213 | INFORMATION TECH | $225,138 |
| CYRACOM | |||||
| 5780 SWAN RD | TUSCON | AZ | 85718 | TRANSLATION SERVICES | $177,756 |
| BURTIN ASSOCIATES | |||||
| 5227 BLUE PARKWAY | KANSAS CITY | MO | 64130 | CUSTODIAL SVS | $133,640 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 6 | CntrctRcvdGreaterThan100KCnt |
| Federated Campaigns | $191,284 | FederatedCampaignsAmt |
| Fundraising | $0 | FundraisingAmt |
| Government Grants | $8,750,019 | GovernmentGrantsAmt |
| All Other Contributions | $980,563 | AllOtherContributionsAmt |
| Noncash Contributions | $82,381 | NoncashContributionsAmt |
| Total Contributions | $9,921,866 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Net Patient Service Revenue | Desc |
| Business | 621400 | BusinessCd |
| Total Revenue Column | $10,073,170 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $10,073,170 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $10,073,170 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $54,276 | TotalRevenueColumnAmt |
| Exclusion | $54,276 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $6,000 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $9,170 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$3,170 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$3,170 | TotalRevenueColumnAmt |
| Exclusion | -$3,170 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,467,335 | SecuritiesAmt |
| Other | $13,064 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,363,456 | SecuritiesAmt |
| Other | $51,490 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $103,879 | SecuritiesAmt |
| Other | -$38,426 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $65,453 | TotalRevenueColumnAmt |
| Exclusion | $65,453 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $0 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $0 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $0 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $0 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| 340B DRUG PROGRAM | 900099 | $71,843 | $71,843 |
| EHR Incentives | 900099 | $238,000 | $238,000 |
| All Other Misc Revenue | 900099 | $77,916 | $77,916 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $77,916 | TotalRevenueColumnAmt |
| Exclusion | $77,916 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $387,759 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $20,499,354 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $10,073,170 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $504,318 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $166,733 | TotalAmt |
| Program Services | $166,733 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $713,747 | TotalAmt |
| Program Services | $249,811 | ProgramServicesAmt |
| Management And General | $463,936 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,998,971 | TotalAmt |
| Program Services | $9,166,487 | ProgramServicesAmt |
| Management And General | $832,484 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $215,519 | TotalAmt |
| Program Services | $191,920 | ProgramServicesAmt |
| Management And General | $23,599 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,810,061 | TotalAmt |
| Program Services | $2,543,989 | ProgramServicesAmt |
| Management And General | $266,072 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $632,359 | TotalAmt |
| Program Services | $590,000 | ProgramServicesAmt |
| Management And General | $42,359 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $160,053 | TotalAmt |
| Management And General | $160,053 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $116,220 | TotalAmt |
| Management And General | $116,220 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,336 | TotalAmt |
| Management And General | $13,336 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,397,559 | TotalAmt |
| Program Services | $2,001,209 | ProgramServicesAmt |
| Management And General | $396,350 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $60,114 | TotalAmt |
| Program Services | $60,027 | ProgramServicesAmt |
| Management And General | $87 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $789,214 | TotalAmt |
| Program Services | $709,051 | ProgramServicesAmt |
| Management And General | $80,163 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $510,521 | TotalAmt |
| Program Services | $345,057 | ProgramServicesAmt |
| Management And General | $165,464 | ManagementAndGeneralAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $522,607 | TotalAmt |
| Program Services | $423,312 | ProgramServicesAmt |
| Management And General | $99,295 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $76,525 | TotalAmt |
| Program Services | $64,800 | ProgramServicesAmt |
| Management And General | $11,725 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,477 | TotalAmt |
| Program Services | $13,188 | ProgramServicesAmt |
| Management And General | $17,289 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,726,885 | TotalAmt |
| Program Services | $1,398,777 | ProgramServicesAmt |
| Management And General | $328,108 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $100,168 | TotalAmt |
| Management And General | $100,168 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Bad Debt Expense | $473,980 | $473,980 | |
| Repairs & Maintenance | $204,998 | $178,073 | $26,925 |
| Medical Supplies | $940,348 | $940,348 | |
| Dues & Subscriptions | $54,739 | $30,879 | $23,860 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $219,587 | TotalAmt |
| Program Services | $33,270 | ProgramServicesAmt |
| Management And General | $186,317 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,934,721 | TotalAmt |
| Program Services | $19,580,911 | ProgramServicesAmt |
| Management And General | $3,353,810 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $346,820 | BOYAmt |
| EOY | $753,508 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,566,208 | BOYAmt |
| EOY | $3,531,527 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $941,424 | BOYAmt |
| EOY | $414,439 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,922,189 | BOYAmt |
| EOY | $2,244,906 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $61,561 | BOYAmt |
| EOY | $32,801 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $158,901 | BOYAmt |
| EOY | $173,211 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $36,285,582 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $13,102,213 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,232,587 | BOYAmt |
| EOY | $23,183,369 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,581,887 | BOYAmt |
| EOY | $1,782,088 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $105,093 | BOYAmt |
| EOY | $120,050 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $331,241 | BOYAmt |
| EOY | $520,601 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $34,247,911 | BOYAmt |
| EOY | $32,756,500 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,644,581 | BOYAmt |
| EOY | $5,391,598 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $64,287 | BOYAmt |
| EOY | $154,688 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,708,868 | BOYAmt |
| EOY | $5,546,286 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,904,843 | BOYAmt |
| EOY | $22,853,233 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,634,200 | BOYAmt |
| EOY | $4,356,981 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,539,043 | BOYAmt |
| EOY | $27,210,214 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $34,247,911 | BOYAmt |
| EOY | $32,756,500 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$2,435,367 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $57,283 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $49,255 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| Coll Used Loan Or Exch Prog | Yes (X) | CollUsedLoanOrExchProgInd |
| Solicited Assets Sale | false | SolicitedAssetsSaleInd |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,815,173 | OtherCostOrOtherBasisAmt |
| Book Value | $1,815,173 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $26,971,639 | OtherCostOrOtherBasisAmt |
| Depreciation | $7,541,882 | DepreciationAmt |
| Book Value | $19,429,757 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $55,836 | OtherCostOrOtherBasisAmt |
| Depreciation | $37,867 | DepreciationAmt |
| Book Value | $17,969 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,393,186 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,522,464 | DepreciationAmt |
| Book Value | $1,870,722 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $49,748 | OtherCostOrOtherBasisAmt |
| Book Value | $49,748 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $23,183,369 | TotalBookValueLandBuildingsAmt |
| Total Rev Etc Audited Fincl Stmt | $19,911,758 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $57,283 | NetUnrealizedGainsInvstAmt |
| Other Revenue | $9,170 | OtherRevenueAmt |
| Revenue Not Reported | $66,453 | RevenueNotReportedAmt |
| Revenue Subtotal | $19,845,305 | RevenueSubtotalAmt |
| Investment Expenses Not Incld | $13,336 | InvestmentExpensesNotIncldAmt |
| Other Revenues Not Included | $640,713 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $654,049 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $20,499,354 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $22,289,842 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $9,170 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $9,170 | ExpensesNotReportedAmt |
| Expenses Subtotal | $22,280,672 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $13,336 | InvestmentExpensesNotIncld2Amt |
| Other Expenses Not Included | $640,713 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $654,049 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $22,934,721 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE D, PART III, LINE 4 | PAINTINGS BY RITA BLITT WERE INSTALLED AT THE HEALTH CENTER IN APRIL 2012. THESE PAINTINGS ARE PART OF THE RITA BLITT MUSEUM WITHOUT WALLS EXHIBITION. THE RITA BLITT MUSEUM WITHOUT WALLS WAS DEVELOPED IN 2012 TO LIST AND ILLUSTRATE EXHIBITIONS THAT ARE AVAILABLE FOR LOAN TO GALLERIES AND MUSEUMS, TO MAP THE NUMEROUS PUBLIC PLACES THROUGHOUT THE WORLD THAT ONE CAN VISIT TO VIEW BLITT'S ARTWORK, TO SHARE EDUCATIONAL CURRICULUM AND FILMS RELATING TO HER PRACTICE, AND TO SHOWCASE WORKS IN HER PORTFOLIO. THE EXHIBITION FEATURED IN THE ON VIEW SECTION WILL CHANGE ON A MONTHLY BASIS. BLITT HAS INDEFINITELY LOANED COLLECTIONS OF HER ART TO NON-PROFIT ORGANIZATIONS THROUGH THE RITA BLITT FOUNDATION, WHOSE MISSION IS TO SHARE, EDUCATE, AND INSPIRE THROUGH THE ARTWORKS OF BLITT. |
| SCHEDULE D, PART X, LINE 2 | MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. |
| SCHEDULE D, PART XI, LINE 2D | RENTAL EXPENSES $ 9,170 |
| SCHEDULE D, PART XI, LINE 4B | BAD DEBT EXPENSE $ 473,980 GRANT TO SURHC FOUNDATION 166,733 ----------- TOTAL $ 640,713 |
| SCHEDULE D, PART XII, LINE 2D | RENTAL EXPENSES $ 9,170 |
| SCHEDULE D, PART XII, LINE 4B | BAD DEBT EXPENSE $ 473,980 GRANT TO SURHC FOUNDATION 166,733 ----------- TOTAL $ 640,713 |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SAMUEL U RODGERS HEALTH CENTER FOUNDATION | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 825 EUCLID AVE | AddressLine1Txt |
| City | KANSAS CITY | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 64124 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 200751739 | RecipientEIN |
| IRC Section | 501(C)(3) | IRCSectionDesc |
| Cash Grant | $166,733 | CashGrantAmt |
| Purpose Of Grant | OPERATIONS | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE I, PART I, LINE 2 | FormAndLineReferenceDesc |
| Explanation | SAMUEL U. RODGERS HEALTH CENTER GRANTED SAMUEL U. RODGERS HEALTH CENTER FOUNDATION THE MONIES FOR ITS OPERATIONS. THE FOUNDATION IS A CONTROLLED ENTITY OF THE HEALTH CENTER, AND THEREFORE THE USE OF THE FUNDS IS KNOWN PRIOR TO TRANSFER. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| 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 (7 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BOB THEIS | ||||||||||||
| ACTING CEO/CFO/COO | $173,773 | $0 | $5,533 | $0 | $248 | $0 | $8,941 | $0 | $11,474 | $0 | $199,969 | $0 |
| HILDA FUENTES | ||||||||||||
| PRESIDENT AND CEO | $259,113 | $0 | $0 | $0 | $346 | $0 | $12,247 | $0 | $19,897 | $0 | $291,603 | $0 |
| SUDEEP ROSS | ||||||||||||
| CHIEF HEALTH OFFICER TO AUG 16 | $318,690 | $0 | $0 | $0 | $470 | $0 | $13,250 | $0 | $30,445 | $0 | $362,855 | $0 |
| JOSE CRUZ | ||||||||||||
| PHYSICIAN | $176,769 | $0 | $250 | $0 | $248 | $0 | $8,997 | $0 | $9,336 | $0 | $195,600 | $0 |
| ANTHONY GUTIERREZ | ||||||||||||
| PHYSICIAN | $147,116 | $0 | $0 | $0 | $248 | $0 | $0 | $0 | $17,748 | $0 | $165,112 | $0 |
| CINDY RUTTAN | ||||||||||||
| PSYCHIATRIST TO NOV 16 | $172,471 | $0 | $0 | $0 | $231 | $0 | $6,907 | $0 | $8,530 | $0 | $188,139 | $0 |
| DANIEL PURDOM | ||||||||||||
| CHIEF HEALTH OFFICER/PHYSICIAN | $181,903 | $0 | $0 | $0 | $0 | $0 | $8,476 | $0 | $5,591 | $0 | $195,970 | $0 |
Schedule M IRS990ScheduleM
| Field | Value | IRS element (for citing) |
|---|---|---|
| Works Of Art | WorksOfArtGrp | |
| Art Historical Treasures | ArtHistoricalTreasuresGrp | |
| Art Fractional Interest | ArtFractionalInterestGrp | |
| Books And Publications | BooksAndPublicationsGrp | |
| Clothing And Household Goods | ClothingAndHouseholdGoodsGrp | |
| Cars And Other Vehicles | CarsAndOtherVehiclesGrp | |
| Boats And Planes | BoatsAndPlanesGrp | |
| Intellectual Property | IntellectualPropertyGrp | |
| Securities Publicly Traded | SecuritiesPubliclyTradedGrp | |
| Securities Closely Held Stock | SecuritiesCloselyHeldStockGrp | |
| Secur Prtnrshp Trust Intrsts | SecurPrtnrshpTrustIntrstsGrp | |
| Securities Miscellaneous | SecuritiesMiscellaneousGrp | |
| Qualified Contrib Hist Struct | QualifiedContribHistStructGrp | |
| Qualified Contrib Other | QualifiedContribOtherGrp | |
| Real Estate Residential | RealEstateResidentialGrp | |
| Real Estate Commercial | RealEstateCommercialGrp | |
| Real Estate Other | RealEstateOtherGrp | |
| Collectibles | CollectiblesGrp | |
| Food Inventory | FoodInventoryGrp |
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 2 | ContributionCnt |
| Noncash Contributions Rpt F990 | $82,381 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Taxidermy | TaxidermyGrp | |
| Historical Artifacts | HistoricalArtifactsGrp | |
| Scientific Specimens | ScientificSpecimensGrp | |
| Archaeological Artifacts | ArchaeologicalArtifactsGrp | |
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | Yes (true) | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | false | ThirdPartiesUsedInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE M, PART I, COLUMN B | FormAndLineReferenceDesc |
| Explanation | THE AMOUNTS IN COLUMN B REPRESENT THE NUMBER OF CONTRIBUTIONS MADE. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (13 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART III, LINE 2 | SAMUEL U. RODGERS HEALTH CENTER ADDED A NEW LOCATION BASED IN THE NORTHERN PART OF KANSAS CITY, MISSOURI. THIS NEW LOCATION STARTED SEEING PATIENTS IN JANUARY 2017. |
| FORM 990, PART III, LINE 4A | AT THE SAMUEL U. RODGERS HEALTH CENTER, WE HAVE BELIEVED IN FAMILY SINCE THE BEGINNING. IN 1967 OUR FOUNDER, DR. SAMUEL U. RODGERS, OPENED THE FIRST FEDERALLY-RECOGNIZED COMMUNITY HEALTH CENTER IN MISSOURI AT THE WAYNE MINER HOUSING PROJECT, PROVIDING CARE FOR FAMILIES WHERE IT WAS NEEDED MOST, RIGHT IN THEIR OWN NEIGHBORHOOD. LOCATED IN NORTHEAST KANSAS CITY, THE HEALTH CENTER'S DOWNTOWN CAMPUS IS A VITAL PART OF THE COMMUNITY'S MULTICULTURAL FABRIC. WE STILL SERVE FAMILIES RESIDING IN NEARBY PUBLIC HOUSING COMMUNITIES, AS WELL AS IMMIGRANTS AND REFUGEES WHO DESPERATELY NEED HEALTH CARE. THE HEALTH CENTER'S GOAL IS THE SAME AS ITS MISSION: EACH DAY WE STRIVE TO PROVIDE HIGH QUALITY, COMPASSIONATE HEALTH CARE TO ALL. RODGERS HEALTH PROVIDES COMPREHENSIVE CARE TO PEOPLE THROUGHOUT THE KANSAS CITY METROPOLITAN AREA AS WELL AS RURAL LAFAYETTE COUNTY AND SURROUNDING AREAS IN MISSOURI. OUR OUTPATIENT PRIMARY CARE SERVICES INCLUDE: - ADULT & SENIOR SERVICES - BEHAVIORAL HEALTH - CHILDREN'S & ADOLESCENTS HEALTH - WOMEN'S HEALTH - DENTAL HEALTH - PODIATRY ON-SITE ANCILLARY AND SUPPORTIVE SERVICES INCLUDE: - LABORATORY - IMAGING - PHARMACY - INTERPRETERS - PATIENT TRANSPORTATION A FULL RANGE OF OUTREACH SERVICES COMPLETE THE ARRAY OF PRIMARY CARE SERVICES. THESE INCLUDE: - EDUCATION AND SCREENING FOR BREAST AND CERVICAL CANCER - COUNSELING AND TREATMENT FOR ALCOHOL, TOBACCO AND OTHER DRUG ABUSE - WIC AND NUTRITION EDUCATION SERVICES (SERVING MORE THAN 3,500 INDIVIDUALS MONTHLY) - MEDICAID AND ACA ENROLLMENT - COMMUNITY OUTREACH AND HEALTH EDUCATION TODAY'S CONSTANTLY CHANGING HEALTH CARE SYSTEM CREATES A SPECIAL CHALLENGE TO THE HEALTH CENTER'S ABILITY TO CARE FOR THE MEDICALLY UNDERSERVED PEOPLE IN OUR SERVICE AREA: - THE KANSAS CITY AREA IS HOME TO AN INCREASING NUMBER OF FINANCIALLY INDIGENT AND UNINSURED PATIENTS WHO ARE INELIGIBLE FOR PUBLIC SUPPORT PROGRAMS. - MANY OF THE HEALTH CENTER'S PATIENTS ARE MEDICALLY UNINSURED,WITH NO SOURCE OF PAYMENT. THE HEALTH CENTER'S PATIENT BASE IS EXTRAORDINARILY DIVERSE. BECAUSE WE ARE LOCATED NEAR TWO OF THE LARGEST REFUGEE RESETTLEMENT FACILITIES IN THE MIDWEST, OUR HEALTH CENTER IS A POINT OF ENTRY TO PRIMARY CARE SERVICES FOR IMMIGRANTS FROM WAR-TORN NATIONS. ABOUT 33 PERCENT OF OUR PATIENTS ARE BEST SERVED IN A LANGUAGE OTHER THAN ENGLISH. TO ENSURE OUR PATIENTS RECEIVE HIGH QUALITY CARE, THE HEALTH CENTER EMPLOYS A CADRE OF INTERPRETERS AND STAFF WHO SPEAK 10 LANGUAGES. AMONG PATIENTS SERVED, 42 PERCENT ARE HISPANIC/LATINO, 26 PERCENT CAUCASIAN, 19 PERCENT BLACK OR AFRICAN AMERICAN, 7 PERCENT REPRESENT OTHER ETHNICITIES/OR REFUSED TO REPORT, AND 6 PERCENT ARE ASIAN/PACIFIC ISLANDER. ADDITIONALLY, MORE THAN 20 PERCENT OF THE 1.9 MILLION RESIDENTS OF THE KANSAS CITY METROPOLITAN AREA ARE UNINSURED OR ARE ON MEDICAID. CHILDREN 17 YEARS OF AGE AND YOUNGER REPRESENT 41 PERCENT OF OUR PATIENT BASE. THUS, PROTECTING CHILDREN FROM CHILDHOOD DISEASES IS A VITAL PART OF OUR MISSION. UNCHECKED, THE RAVAGES OF CHILDHOOD ILLNESSES SUCH AS MEASLES, MUMPS, AND RUBELLA CAN CAUSE PERMANENT DISABILITY OR EVEN DEATH. 2011 - PROVIDED HEALTH CARE FOR 19,047 INDIVIDUALS THROUGH OVER 69,500 VISITS - LAUNCHED A DENTAL PRACTICE AT J.A. ROGERS ELEMENTARY SCHOOL TO PROVIDE ORAL HEALTH CARE SERVICES FOR LOW-INCOME CHILDREN - PROVIDED $2.9 MILLION IN INDIGENT CARE. 2012 - PROVIDED HEALTHCARE FOR 21,114 INDIVIDUALS THROUGH OVER 77,000 VISITS - LAUNCHED A DENTAL PRACTICE AT THE CLAY COUNTY LOCATION TO EXPAND THE HEALTH CENTER'S PRESENCE AT THAT LOCATION. - PROVIDED $4.4 MILLION IN INDIGENT CARE. 2013 - PROVIDED HEALTH CARE FOR 21,400 INDIVIDUALS THROUGH OVER 73,800 VISITS - PROVIDED $4.2 MILLION IN INDIGENT CARE. - PATIENT-CENTERED MEDICAL HOME RECOGNITION LEVEL 3 - ESTABLISHED A PATIENT PORTAL. 2014 - PROVIDED HEALTH CARE FOR 25,512 INDIVIDUALS THROUGH OVER 81,143 VISITS - PROVIDED $6.3 MILLION IN INDIGENT CARE. - ONE OF 10 SITES IN THE U.S. TO RECEIVE A SPECIAL GRANT FROM THE AMERICAN CANCER SOCIETY FOR AN HPV VACCINATION EFFORT FOR ADOLESCENTS. 2015 - PROVIDED HEALTH CARE FOR 24,611 INDIVIDUALS THROUGH OVER 77,804 VISITS - PROVIDED $7.3 MILLION IN INDIGENT CARE. - WIC SERVICES EARNED THE WIC LOVING SUPPORT AWARD OF EXCELLENCE FOR EXEMPLARY BREASTFEEDING SUPPORT AND PRACTICES FROM THE USDA. - HEALTH CENTER RECEIVED TWO QUALITY AWARDS, ONE FROM THE STATE OF MISSOURI AND ONE FROM THE FEDERAL GOVERNMENT FOR QUALITY CARE IMPROVEMENTS. 2016 - PROVIDED HEALTH CARE FOR 24,774 INDIVIDUALS THROUGHOVER 70,372 VISITS - PROVIDED $5.5 MILLION IN INDIGENT CARE. - HEALTH CENTER RECEIVED TWO QUALITY IMPROVEMENT AWARDS FOR MEETING OR EXCEEDING HEALTHY PEOPLE 2020 GOALS OR OTHER DEFINED CLINICAL OUTCOMES, ONE FROM THE STATE OF MISSOURI PRIMARY CARE ASSOCIATION AND ONE FROM THE FEDERAL GOVERNMENT FOR QUALITY CARE IMPROVEMENTS. 2017 - PROVIDED HEALTHCARE FOR 23,187 INDIVIDUALS THROUGH OVER 66,500 VISITS - PROVIDED $5.2 MILLION IN INDIGENT CARE. REDUCED A MAJOR BARRIER TO CARE BY OFFERING GREATER ACCESS TO TRANSPORTATION RESOURCES THROUGH AN INNOVATIVE PARTNERSHIP WITH CIRCULATION AND LYFT. |
| FORM 990, PART VI, SECTION B, LINE 11B | AN INDEPENDENT ACCOUNTING FIRM PREPARES AND REVIEWS THE 990. THE 990 IS THEN REVIEWED BY THE ORGANIZATION'S OFFICERS AND ACCOUNTING PERSONNEL. ANY QUESTIONS AND CONCERNS THE ORGANIZATION'S OFFICERS AND ACCOUNTING PERSONNEL HAVE ARE ADDRESSED AND ANY CORRECTIONS OR CLARIFICATIONS THAT NEED TO BE MADE ARE COMPLETED. THE 990 IS THEN PROVIDED TO THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS FOR THEIR REVIEW. ANY QUESTIONS AND CONCERNS THE FINANCE COMMITTEE HAS ARE ADDRESSED AND ANY CORRECTIONS OR CLARIFICATIONS THAT NEED TO BE MADE ARE COMPLETED. THE FINAL 990 WITH ALL REQUIRED SCHEDULES IS PROVIDED TO ALL VOTING MEMBERS OF THE BOARD PRIOR TO FILING THE 990. |
| FORM 990, PART VI, SECTION B, LINE 12C | DUTY TO DISCLOSE: IF AN INTERESTED PERSON HAS A POSITION OR FINANCIAL INTEREST IN ANY BUSINESS OR OTHER ENTITY WITH WHICH THE HEALTH CENTER IS CONSIDERING ENTERING INTO AN ARRANGEMENT OR TRANSACTION, THE INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF THE CONFLICT TO THE HEALTH CENTER'S BOARD OF DIRECTORS (BOARD) OR EXECUTIVE COMMITTEE AS SOON AS THE INTERESTED PERSON HAS KNOWLEDGE OF THE POTENTIAL ARRANGEMENT OR TRANSACTION, AND WHENEVER REQUESTED BY THE BOARD OR THE EXECUTIVE COMMITTEE. DETERMINING WHETHER A CONFLICT OF INTEREST EXISTS: THE BOARD OF DIRECTORS WILL MAKE THE DETERMINATION. PROCEDURES FOR ADDRESSING THE CONFLICT OF INTEREST: - PRIOR TO ANY DISCUSSION AND VOTE ON WHETHER A CONFLICT OF INTEREST EXISTS, AN INTERESTED PERSON MAY MAKE A PRESENTATION TO THE BOARD OR THE EXECUTIVE COMMITTEE REGARDING THE INTERESTED PERSON'S POSITION OR FINANCIAL INTEREST. AFTER SUCH PRESENTATION, THE INTERESTED PERSON WILL LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE PROPOSED TRANSACTION. - THE BOARD OR THE EXECUTIVE COMMITTEE WILL UNDERTAKE APPROPRIATE DUE DILIGENCE AND INFORM ITSELF OF ALL MATERIAL INFORMATION REASONABLY AVAILABLE TO IT AND EXPLORE ALL REASONABLE ALTERNATIVES TO THE PROPOSED TRANSACTION THAT WOULD NOT INVOLVE THE CONFLICT OF INTEREST. - IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY POSSIBLE UNDER CIRCUMSTANCES NOT PRODUCING A CONFLICT OF INTEREST, THE BOARD OR THE EXECUTIVE COMMITTEE WILL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED DIRECTORS WHETHER THE PROPOSED TRANSACTION IS (I) IN THE HEALTH CENTER'S BEST INTEREST, (II) FOR THE HEALTH CENTER'S OWN BENEFIT, AND (III) FAIR AND REASONABLE TO THE HEALTH CENTER. IN CONFORMITY WITH THIS DETERMINATION, THE BOARD OR THE EXECUTIVE COMMITTEE WILL MAKE ITS DECISION AS TO WHETHER THE HEALTH CENTER MAY ENTER INTO THE PROPOSED TRANSACTION. VIOLATIONS OF THE CONFLICTS OF INTEREST POLICY: IF THE BOARD OR THE EXECUTIVE COMMITTEE DETERMINES THAT THE COVERED PERSON HAS IN FACT FAILED TO DISCLOSE A POSITION OR A FINANCIAL INTEREST, THE BOARD OR THE EXECUTIVE COMMITTEE WILL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION. DOCUMENTATION IN MINUTES: WITH RESPECT TO THE DETERMINATION OF WHETHER A CONFLICT OF INTEREST EXISTS, THE NAME OF THE INTERESTED PERSON WHO DISCLOSED OR WAS OTHERWISE FOUND TO HAVE A POSITION OR FINANCIAL INTEREST IN CONNECTION WITH AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST; THE NATURE OF THE POSITION OR FINANCIAL INTEREST; ANY ACTION TAKEN TO DETERMINE WHETHER A CONFLICT OF INTEREST WAS PRESENT; AND THE BOARD OR THE EXECUTIVE COMMITTEE'S DECISION AS TO WHETHER A CONFLICT OF INTEREST IN FACT EXISTED. ANNUAL STATEMENTS: EACH COVERED PERSON WILL ANNUALLY SIGN A STATEMENT THAT AFFIRMS SUCH PERSON: - HAS RECEIVED A COPY OF THIS POLICY; - HAS READ AND UNDERSTANDS THE POLICY; - HAS AGREED TO COMPLY WITH THE POLICY; AND - UNDERSTANDS THE HEALTH CENTER IS EXEMPT FROM FEDERAL INCOME TAX AND TO MAINTAIN ITS FEDERAL TAX EXEMPTION THE HEALTH CENTER MUST ENGAGE PRIMARILY IN ACTIVITIES THAT ACCOMPLISH ONE OR MORE OF ITS TAX-EXEMPT PURPOSES. IN ADDITION, EACH COVERED PERSON WILL ANNUALLY COMPLETE, SIGN AND PROMPTLY RETURN TO THE BOARD OR THE EXECUTIVE COMMITTEE A QUESTIONNAIRE AND DISCLOSURE STATEMENT. A COVERED PERSON NEED NOT DISCLOSE COMPENSATION PAID TO THE COVERED PERSON BY HEALTH CENTER PURSUANT TO A RESOLUTION OF THE BOARD. PERIODIC REVIEWS: THE PERIODIC REVIEWS AS REQUIRED BY THE POLICY WILL, AT A MINIMUM, INCLUDE THE FOLLOWING SUBJECTS: - WHETHER THE HEALTH CENTER COMPENSATION ARRANGEMENTS ARE REASONABLE, BASED ON COMPETENT SURVEY INFORMATION, AND ARE THE RESULT OF ARM'S- LENGTH BARGAINING; AND - WHETHER TRANSACTIONS AND ARRANGEMENTS WITH OTHER ENTITIES AND INDIVIDUALS CONFORM TO THE HEALTH CENTER'S POLICIES, ARE PROPERLY RECORDED, REFLECT REASONABLE PAYMENTS FOR GOODS AND SERVICES, FURTHER THE HEALTH CENTER'S TAX-EXEMPT PURPOSES AND DO NOT RESULT IN PRIVATE INUREMENT, IMPERMISSIBLE PRIVATE BENEFIT, OR IN AN EXCESS BENEFIT TRANSACTION. |
| FORM 990, PART VI, SECTION B, LINE 15A | THE EVALUATION FOR THE CEO FOR THE YEAR ENDING SEPTEMBER 30, 2017 WAS IN JANUARY, 2017. THIS EVALUATION WAS PERFORMED BY THE HEALTH CENTER'S BOARD OF DIRECTORS. THE CHAIRPERSON OF THE BOARD WILL LEAD THE ASSESSMENT PROCESS. THE CHAIR SHALL SELECT A PERFORMANCE AND COMPENSATION COMMITTEE AND ITS CHAIR. THE CEO WILL COMPLETE A SELF-ASSESSMENT. THIS ALLOWS THE BOARD AND CEO TO COMPARE ONE ANOTHER'S PERCEPTION OF THE CEO'S PERFORMANCE. THE CHAIRPERSON OF THE PERFORMANCE AND COMPENSATION COMMITTEE WILL HAVE EACH BOARD MEMBER COMPLETE THE ASSESSMENT FORM INDIVIDUALLY AND COMPILE RESULTS. DISTRIBUTION OF THE ASSESSMENT FORM: THE COMMITTEE CHAIRPERSON WILL DISTRIBUTE THE CEO SELF-ASSESSMENT AND THE BOARD'S ASSESSMENT OF THE CEO WELL ENOUGH IN ADVANCE TO ALLOW AMPLE TIME FOR COMPLETION. THE COMMITTEE CHAIRPERSON WILL SET A DEADLINE FOR COMPLETING THE BOARD'S ASSESSMENT OF THE CEO. ANALYSIS OF THE RESULTS: THE RESPONSES FOR EACH QUESTION WILL BE ADDED TOGETHER AND THE AVERAGE RESPONSE COMPUTED. NEXT, THE AVERAGE RESPONSES FOR EACH QUESTION WILL BE ADDED TOGETHER AND THE AVERAGE RESPONSE FOR THE ASSESSMENT AS A WHOLE SHOULD BE CALCULATED. THE RESULTS WILL BE SHARED WITH THE BOARD FOR DISCUSSION AND ANALYSIS IN CLOSED SESSION. REVIEW OF THE RESULTS WITH THE CEO: THE CEO AND THE BOARD WILL MEET IN A CLOSED EXECUTIVE SESSION OR A SPECIAL MEETING TO REVIEW AND DISCUSS THE RESULTS. BASED ON THE RESULTS, THE BOARD AND CEO WILL DEVELOP A WRITTEN PERFORMANCE PLAN AND PERFORMANCE GOALS FOR THE CEO DESCRIBING AREAS OF FOCUS AND IMPROVEMENT FOR THE NEXT YEAR. THE PERFORMANCE ASSESSMENT WILL BE USED AS A BASIS FOR DETERMINING COMPENSATION. AN INDEPENDENT COMMITTEE, USING COMPARABILITY DATA WILL CONDUCT COMPENSATION ANALYSIS. SUCH DELIBERATIONS AND DECISIONS REGARDING COMPENSATION SHALL BE DOCUMENTED AND SUBSTANTIATED. THIS COMPENSATION REVIEW METHODOLOGY SHALL BE USED FOR ALL CHIEF OFFICER POSITIONS. SOLICIT THE CEO'S FEEDBACK: THE BOARD WILL OBTAIN THE CEO'S FEEDBACK REGARDING THE ASSESSMENT PROCESS. FEEDBACK WILL INCLUDE UNDERSTANDING THE CEO'S AGREEMENT OR DISAGREEMENT WITH THE BOARD'S ASSESSMENT; WHETHER THE FORMAT WAS APPROPRIATE, WHETHER THE BOARD AND THE CEO BELIEVED THAT THE FORM USED CAPTURED ALL OF THE NECESSARY ELEMENTS, AND WHICH AREAS COULD BE IMPROVED IN THE NEXT ASSESSMENT. |
| FORM 990, PART VI, SECTION B, LINE 15B | OTHER OFFICERS AND KEY EMPLOYEES: ON A REGULAR BASIS, HUMAN RESOURCES WILL CONDUCT SALARY SURVEYS TO ENSURE CURRENT JOB PAY RANGES AND MEDIAN PAY FOR CERTAIN BENCHMARKED POSITIONS REMAIN COMPETITIVE IN THE MARKETPLACE AND CONSISTENT WITH THE COMPANY'S COMPENSATION PHILOSOPHY. AN INDEPENDENT COMMITTEE USING COMPARABILITY DATA WILL CONDUCT A COMPENSATION ANALYSIS. SUCH DELIBERATIONS AND DECISIONS REGARDING COMPENSATION SHOULD BE DOCUMENTED AND SUBSTANTIATED. THIS REVIEW WAS PERFORMED IN NOVEMBER/DECEMBER OF 2016. ALL PROVIDER REVIEWS WERE DONE BY THE HEALTH CENTER'S CHIEF HEALTH OFFICER. ALL MEMBERS OF THE EXECUTIVE COMMITTEE WERE EVALUATED BY THE CHIEF EXECUTIVE OFFICER. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. |
| FORM 990, PART XI, LINE 9 | CHANGE OF THE INTEREST IN SAMUEL U RODGERS HEALTH CENTER FDN $ 49,255 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:CONTRACT PROFESSIONAL SERVICES TOTAL FEES:1451286 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:OUTSIDE LAB REFERRAL TOTAL FEES:269851 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:FACILITY MAINT & SECURITY TOTAL FEES:260294 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:CONSULTANTS - PHYSICIANS TOTAL FEES:94701 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:OTHER FEES FOR SERVICES TOTAL FEES:321427 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SAMUEL U RODGERS FOUNDATION INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 825 EUCLID | AddressLine1Txt |
| City | KANSAS CITY | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 64124 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 200751739 | EIN |
| Primary Activities | SUPPORT ORG | PrimaryActivitiesTxt |
| Legal Domicile State | MO | LegalDomicileStateCd |
| Exempt Code Section | 501(C)3) | ExemptCodeSectionTxt |
| Public Charity Status | 12A | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SURHC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | Yes (true) | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (true) | 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 | Yes (true) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | 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
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Samuel U Rodgers Health Center Foundation | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | B | TransactionTypeTxt |
| Involved | $166,733 | InvolvedAmt |
| Method Of Amount Determination | COST | MethodOfAmountDeterminationTxt |
Comments