AFFINITY HEALTH CENTER: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- AFFINITY HEALTH CENTER (EIN 57-1092940)
- Tax period
- 2017-01-01 to 2017-12-31
- Filed
- 2018-10-01
- IRS object ID
- 201822749349301257
- Schema version
- 2017v2.3
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule G
- Schedule I
- Schedule J
- Schedule L
- Schedule M
- Schedule O
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-10-01T16:30:52-05:00 | ReturnTs |
| Tax Period End | 2017-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 410746749 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 227 WEST TRADE STREET SUITE 800 | AddressLine1Txt |
| City | CHARLOTTE | CityNm |
| State Abbreviation | NC | StateAbbreviationCd |
| ZIP | 28202 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 571092940 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AFFINITY HEALTH CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | AFFI | BusinessNameControlTxt |
| Phone | 8039096363 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 455 LAKESHORE PARKWAY | AddressLine1Txt |
| City | ROCK HILL | CityNm |
| State Abbreviation | SC | StateAbbreviationCd |
| ZIP | 29730 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ANITA CASE | PersonNm |
| Person Title | EXECUTIVE DIRECTOR | PersonTitleTxt |
| Phone | 8039096363 | PhoneNum |
| Signature | 2018-08-28 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JOHN NORMAN | PreparerPersonNm |
| PTIN | P01506766 | PTIN |
| Phone | 7049985200 | PhoneNum |
| Preparation | 2018-08-28 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Change | Yes (X) | AddressChangeInd |
| Principal Officer | ANITA CASE | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 455 LAKESHORE PARKWAY | AddressLine1Txt |
| City | ROCK HILL | CityNm |
| State Abbreviation | SC | StateAbbreviationCd |
| ZIP | 29730 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $11,293,939 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | AFFINITYHEALTHCENTER.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2000 | FormationYr |
| Legal Domicile State | SC | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE HIGH-QUALITY COMPREHENSIVE HEALTHCARE WITH COMPASSION, DIGNITY AND RESPECT. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 12 | VotingMembersIndependentCnt |
| Total Employee | 70 | TotalEmployeeCnt |
| Total Volunteers | 39 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $3,403,356 | PYContributionsGrantsAmt |
| CY Contributions Grants | $3,667,468 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $5,862,431 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $7,623,442 | CYProgramServiceRevenueAmt |
| PY Investment Income | $637 | PYInvestmentIncomeAmt |
| CY Investment Income | $697 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$1,764 | PYOtherRevenueAmt |
| CY Other Revenue | -$19,215 | CYOtherRevenueAmt |
| PY Total Revenue | $9,264,660 | PYTotalRevenueAmt |
| CY Total Revenue | $11,272,392 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $666,312 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $810,178 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $2,401,470 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $2,841,973 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $6,407 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $4,397,200 | PYOtherExpensesAmt |
| CY Other Expenses | $5,401,529 | CYOtherExpensesAmt |
| PY Total Expenses | $7,464,982 | PYTotalExpensesAmt |
| CY Total Expenses | $9,053,680 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,799,678 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $2,218,712 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $12,916,825 | TotalAssetsBOYAmt |
| Total Assets EOY | $18,223,000 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $794,270 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $3,533,950 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $12,122,555 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $14,689,050 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO SERVE THE HEALTHCARE NEEDS OF OUR COMMUNITY BY PROVIDING ACCESS TO HIGH-QUALITY, COMPREHENSIVE CARE WITH COMPASSION, DIGNITY AND RESPECT. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $7,135,982 | ExpenseAmt |
| Grant | $760,612 | GrantAmt |
| Revenue | $7,623,442 | RevenueAmt |
| Desc | MEDICAL CARE IS PROVIDED IN A DIGNIFIED, COMPASSIONATE MANNER. WITH THE ACCESS TO QUALITY CARE, PATIENTS CAN LIVE LONGER AND HEALTHIER LIVES. MEDICAL SERVICES AT AFFINITY HEALTH CENTER INCLUDE 1) PRIMARY CARE, 2) HIV SPECIALTY CARE, 3) ORAL HEALTH CARE, 4) BEHAVIORAL HEALTH SERVICES, 5) PHLEMOTOMY/LABORATORY SERVICES, 6) NUTRITIONAL COUNSELING, AND 7) SPECIALTY CARE REFERRALS. AHC MEDICAL SERVICES ARE PROVIDED WITHOUT REGARD FOR ABILITY TO PAY AND CHARGES ARE BASED ON A SLIDING FEE SCALE. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $863,589 | ExpenseAmt |
| Grant | $49,367 | GrantAmt |
| Desc | SUPPORT SERVICES ARE INTENDED TO HELP PATIENTS ENGAGE IN AND REMAIN ENGAGED IN MEDICAL TREATMENT AND TO ASSIST THEM WITH REDUCING ANY BARRIERS TO CARE. SERVICES INCLUDE 1) MEDICAL CASE MANAGEMENT, 2) HEALTH EDUCATION, 3) OUTREACH TO THOSE OUT OF CARE, 4) EDUCATIONAL AND THERAPEUTIC SUPPORT GROUPS, 5) REFERRAL SERVICES AND ASSISTANCE WITH ACCESSING PUBLIC BENEFITS, 6) HOUSING SERVICES, 7) TRANSPORTATION ASSISTANCE TO MEDICAL APPOINTMENTS, AND 8) INTERPRETING SERVICES. ALL SUPPORT SERVICES ARE PROVIDED AT NO COST TO THE PATIENT. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $391,826 | ExpenseAmt |
| Grant | $199 | GrantAmt |
| Desc | AFFINITY HEALTH CENTER PROVIDES HEALTH EDUCATION SERVICES TO THE COMMUNITY WHICH INCLUDE INFORMATION ABOUT HIV AND OTHER SEXUALLY TRANSMITTED DISEASES. AFFINITY HEALTH CENTER PROVIDES FREE, CONFIDENTIAL, RAPID (20 MINS) HIV AND HEPATITIS C SCREENING AND SCREENINGS FOR OTHER SEXUALLY TRANSMITTED DISEASES. ADDITIONALLY, AFFINITY HEALTH CENTER HAS A PEER PROGRAM THAT UTILIZES PEOPLE LIVING WITH HIV/AIDS TO PROVIDE SUPPORT TO OTHERS LIVING WITH THIS DISEASE AND A VOLUNTEER PROGRAM TO ENGAGE COMMUNITY MEMBERS IN SERVICES TO OTHERS. ALL PREVENTION SERVICES ARE PROVIDED AT NO COST TO THE RECIPIENT. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $8,391,397 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | Yes (1) | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (1) | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | Yes (1) | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 59 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 70 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 12 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | SC | StatesWhereCopyOfReturnIsFldCd |
| Own Website | Yes (X) | OwnWebsiteInd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BRYAN C MARTIN | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8039096363 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 455 LAKESHORE PARKWAY | AddressLine1Txt |
| City | ROCK HILL | CityNm |
| State Abbreviation | SC | StateAbbreviationCd |
| ZIP | 29730 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (15 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd |
|---|---|---|---|---|---|---|---|
| JENNIFER MCDANIEL | |||||||
| BOARD CHAIR | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| JANICE CHISIM | |||||||
| BOARD VICE-CHAIR | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| MELISSA CASSELL | |||||||
| TREASURER | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| NINA FEEMSTER | |||||||
| SECRETARY | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| LECLAIR BOONE | |||||||
| DIRECTOR | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| JOANN DEBOE-WILSON | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DWIGHT BURNS | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| BIANCA PRESCOTT | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| RONNIE DUNCAN | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| SUZANNE WRIGHT | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| TAMMY WELLS | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| KAREN WORTHY | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| ANITA CASE | |||||||
| EXECUTIVE DIRECTOR | 40.00 | Yes (X) | $111,983 | $0 | $6,973 | ||
| BRYAN MARTIN | |||||||
| FINANCE DIRECTOR | 40.00 | Yes (X) | $87,263 | $0 | $6,062 | ||
| J CRAIG CHARLES | |||||||
| MEDICAL DIRECTOR | 40.00 | $226,781 | $0 | $10,680 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $426,027 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $23,715 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 2 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (3 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| LABORATORY CORPORATION OF AMERICA | |||||
| PO BOX 2270 | BURLINGTON | NC | 27216 | MEDICAL LAB SERVICES | $328,474 |
| RPA DESIGN PC | |||||
| 5960 FAIRVIEW ROAD SUITE 500 | CHARLOTTE | NC | 28210 | ARCHITECTURE AND ENGINEERING SERVICES | $148,014 |
| SERVCOM USA LLC | |||||
| 3284 LAKE WYLIE DRIVE | ROCK HILL | SC | 29730 | INFORMATION TECHNOLOGY SERVICES | $113,612 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 3 | CntrctRcvdGreaterThan100KCnt |
| Federated Campaigns | $41,234 | FederatedCampaignsAmt |
| Fundraising | $48,413 | FundraisingAmt |
| Government Grants | $3,111,734 | GovernmentGrantsAmt |
| All Other Contributions | $466,087 | AllOtherContributionsAmt |
| Noncash Contributions | $23,084 | NoncashContributionsAmt |
| Total Contributions | $3,667,468 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| 340B PHARMACY REVENUE | 624100 | $6,947,229 | $6,947,229 |
| PATIENT SERVICE REVENUE | 624100 | $676,213 | $676,213 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $7,623,442 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $697 | TotalRevenueColumnAmt |
| Exclusion | $697 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $1,932 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $48,413 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $21,347 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$19,415 | TotalRevenueColumnAmt |
| Exclusion | -$19,415 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $400 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $200 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $200 | TotalRevenueColumnAmt |
| Exclusion | $200 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $11,272,392 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $7,623,442 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$18,518 | ExclusionAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $810,178 | TotalAmt |
| Program Services | $810,178 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $449,742 | TotalAmt |
| Program Services | $386,142 | ProgramServicesAmt |
| Management And General | $62,802 | ManagementAndGeneralAmt |
| Fundraising | $798 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,964,893 | TotalAmt |
| Program Services | $1,687,031 | ProgramServicesAmt |
| Management And General | $274,377 | ManagementAndGeneralAmt |
| Fundraising | $3,485 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $240,620 | TotalAmt |
| Program Services | $204,575 | ProgramServicesAmt |
| Management And General | $35,627 | ManagementAndGeneralAmt |
| Fundraising | $418 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $186,718 | TotalAmt |
| Program Services | $160,310 | ProgramServicesAmt |
| Management And General | $26,042 | ManagementAndGeneralAmt |
| Fundraising | $366 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,200 | TotalAmt |
| Program Services | $21,843 | ProgramServicesAmt |
| Management And General | $5,356 | ManagementAndGeneralAmt |
| Fundraising | $1 | FundraisingAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,486 | TotalAmt |
| Program Services | $15,735 | ProgramServicesAmt |
| Management And General | $5,747 | ManagementAndGeneralAmt |
| Fundraising | $4 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $174,828 | TotalAmt |
| Program Services | $140,397 | ProgramServicesAmt |
| Management And General | $34,426 | ManagementAndGeneralAmt |
| Fundraising | $5 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,411 | TotalAmt |
| Program Services | $5,642 | ProgramServicesAmt |
| Management And General | $16,769 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $88,964 | TotalAmt |
| Program Services | $75,690 | ProgramServicesAmt |
| Management And General | $12,966 | ManagementAndGeneralAmt |
| Fundraising | $308 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $219,831 | TotalAmt |
| Program Services | $201,158 | ProgramServicesAmt |
| Management And General | $18,083 | ManagementAndGeneralAmt |
| Fundraising | $590 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $66,370 | TotalAmt |
| Program Services | $57,744 | ProgramServicesAmt |
| Management And General | $8,532 | ManagementAndGeneralAmt |
| Fundraising | $94 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $80,613 | TotalAmt |
| Program Services | $58,494 | ProgramServicesAmt |
| Management And General | $22,068 | ManagementAndGeneralAmt |
| Fundraising | $51 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $61,319 | TotalAmt |
| Program Services | $42,253 | ProgramServicesAmt |
| Management And General | $19,011 | ManagementAndGeneralAmt |
| Fundraising | $55 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $573 | TotalAmt |
| Management And General | $573 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $70,792 | TotalAmt |
| Program Services | $61,795 | ProgramServicesAmt |
| Management And General | $8,898 | ManagementAndGeneralAmt |
| Fundraising | $99 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,852 | TotalAmt |
| Program Services | $28,633 | ProgramServicesAmt |
| Management And General | $8,146 | ManagementAndGeneralAmt |
| Fundraising | $73 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| PHARMACEUTICALS | $3,073,530 | $3,073,530 |
| LAB SERVICES | $700,704 | $700,704 |
| 340B PROGRAM SERVICES | $359,046 | $359,046 |
| PHYSICIAN ON SITE | $36,429 | $36,429 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $360,581 | TotalAmt |
| Program Services | $264,068 | ProgramServicesAmt |
| Management And General | $96,453 | ManagementAndGeneralAmt |
| Fundraising | $60 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,053,680 | TotalAmt |
| Program Services | $8,391,397 | ProgramServicesAmt |
| Management And General | $655,876 | ManagementAndGeneralAmt |
| Fundraising | $6,407 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,429,880 | BOYAmt |
| EOY | $7,927,227 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,437,349 | BOYAmt |
| EOY | $700,898 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $503,750 | BOYAmt |
| EOY | $623,534 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,908 | BOYAmt |
| EOY | $56,908 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $66,610 | BOYAmt |
| EOY | $79,176 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $5,285,229 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $421,013 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,812,583 | BOYAmt |
| EOY | $4,864,216 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,644,745 | BOYAmt |
| EOY | $3,971,041 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,916,825 | BOYAmt |
| EOY | $18,223,000 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $794,270 | BOYAmt |
| EOY | $2,329,956 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $1,203,994 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $794,270 | BOYAmt |
| EOY | $3,533,950 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,121,647 | BOYAmt |
| EOY | $14,506,459 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $908 | BOYAmt |
| EOY | $182,591 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,122,555 | BOYAmt |
| EOY | $14,689,050 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,916,825 | BOYAmt |
| EOY | $18,223,000 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $2,218,712 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $347,783 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,993,139 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,369,257 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,327,979 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,403,356 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,786,577 | CurrentTaxYearAmt |
| Total | $13,880,308 | TotalAmt |
Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | $9,000 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $20,550 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $18,738 | CurrentTaxYearAmt |
| Total | $48,288 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,993,139 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,369,257 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,336,979 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,423,906 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,805,315 | CurrentTaxYearAmt |
| Total | $13,928,596 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $13,928,596 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $491 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $612 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $743 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $637 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $697 | CurrentTaxYearAmt |
| Total | $3,180 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | $2,445 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,248 | CurrentTaxYearMinus1YearAmt |
| Total | $5,693 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $13,937,469 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $26,734,695 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.99940 | PublicSupportCY170Pct |
| Public Support PY170 | 0.99920 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
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
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $439,126 | OtherCostOrOtherBasisAmt |
| Book Value | $439,126 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,119,999 | OtherCostOrOtherBasisAmt |
| Depreciation | $227,014 | DepreciationAmt |
| Book Value | $892,985 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $65,772 | OtherCostOrOtherBasisAmt |
| Depreciation | $9,135 | DepreciationAmt |
| Book Value | $56,637 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $284,780 | OtherCostOrOtherBasisAmt |
| Depreciation | $184,864 | DepreciationAmt |
| Book Value | $99,916 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,375,552 | OtherCostOrOtherBasisAmt |
| Book Value | $3,375,552 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $4,864,216 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $11,339,002 | TotalRevEtcAuditedFinclStmtAmt |
| Donated Services And Use Fclts | $67,307 | DonatedServicesAndUseFcltsAmt |
| Revenue Not Reported | $67,307 | RevenueNotReportedAmt |
| Revenue Subtotal | $11,271,695 | RevenueSubtotalAmt |
| Other Revenues Not Included | $697 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $697 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $11,272,392 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $9,120,987 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $67,307 | DonatedServicesUseFcltsAmt |
| Expenses Not Reported | $67,307 | ExpensesNotReportedAmt |
| Expenses Subtotal | $9,053,680 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $9,053,680 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | AFFINITY HEALTH CENTER IS EXEMPT FROM INCOME TAX UNDER INTERNAL REVENUE CODE SECTION 501(C)(3), AND IS NOT CLASSIFIED AS A PRIVATE FOUNDATION. AFFINITY HEALTH CENTER'S INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. THE ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX-EXEMPT STATUS. THE ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME OR EXCISE OF OTHER TAXES. GENERALLY ACCEPTED ACCOUNTING PRINCIPLES REQUIRE AN ORGANIZATION TO RECOGNIZE A TAX BENEFIT OR EXPENSE FROM UNCERTAIN TAX POSITION IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY THE TAX AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. MANAGEMENT BELIEVES THE ORGANIZATION HAD NO UNCERTAIN TAX POSITIONS AS OF DECEMBER 31, 2017 OR 2016. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | INTEREST INCOME 697. |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | DAZZLE & DENIM | Event1Nm |
| Gross Receipts Event1 | $50,345 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $48,413 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $1,932 | GrossRevenueEvent1Amt |
| Rent Facility Costs Event1 | $1,975 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $8,590 | FoodAndBeverageEvent1Amt |
| Entertainment Event1 | $3,013 | EntertainmentEvent1Amt |
| Other Direct Expenses Event1 | $7,769 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $50,345 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $48,413 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $1,932 | GrossRevenueTotalEventsAmt |
| Rent Fclty Costs Total Events | $1,975 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $8,590 | FoodAndBeverageTotalEventsAmt |
| Entertainment Total Events | $3,013 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $7,769 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $21,347 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$19,415 | NetIncomeSummaryAmt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp (7 entries)
| Grant TypeGrantTypeTxt | RecipientRecipientCnt | Cash GrantCashGrantAmt | Valuation Method UsedValuationMethodUsedDesc |
|---|---|---|---|
| OFF-SITE SPECIALTY CARE VISITS | 272 | $69,567 | FMV |
| MEDICATIONS | 202 | $37,543 | FMV |
| INSURANCE PREMIUMS/COPAYS | 276 | $599,530 | FMV |
| MEDICAL SUPPLIES | 83 | $22,105 | FMV |
| HOUSING | 27 | $24,891 | FMV |
| TRANSPORTATION | 314 | $16,620 | FMV |
| FOOD ASSISTANCE, TRANSLATOR SERVICES, OTHER ASSISTANCE | 175 | $39,922 | FMV |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | AFFINITY HEALTH CENTER PROVIDES ASSISTANCE TO CLIENTS BASED ON NEED FOR EXPENSES SUCH AS SPECIALTY CARE, MEDICATIONS, HOUSING, INSURANCE PREMIUMS, EMERGENCY FOOD, AND TRANSPORTATION TO MEDICAL APPOINTMENTS. PAYMENTS ARE MADE DIRECTLY TO OUTSIDE SERVICE PROVIDERS RATHER THAN TO CLIENTS. AHC REQUIRES SUPERVISORY APPROVAL OF ALL PAYMENT REQUESTS. THE FINANCE DEPARTMENT VERIFIES APPROPRIATE DOCUMENTATION IS SUBMITTED FOR EXPENDITURES. PRIOR TO SIGNING CHECKS, THE EXECUTIVE DIRECTOR REVIEWS ALL DOCUMENTATION TO ENSURE APPROPRIATE USE OF FUNDS. AN OFFICER OF THE BOARD OF DIRECTORS SIGNS OFF ON ANY PAYMENTS OVER $5,000. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | J CRAIG CHARLES | PersonNm |
| Title | MEDICAL DIRECTOR | TitleTxt |
| Base Compensation Filing Org | $224,220 | BaseCompensationFilingOrgAmt |
| Compensation Based On Rltd Orgs | $0 | CompensationBasedOnRltdOrgsAmt |
| Bonus Filing Organization | $2,561 | BonusFilingOrganizationAmount |
| Bonus Related Organizations | $0 | BonusRelatedOrganizationsAmt |
| Other Compensation Filing Org | $0 | OtherCompensationFilingOrgAmt |
| Other Compensation Rltd Orgs | $0 | OtherCompensationRltdOrgsAmt |
| Deferred Compensation Flng Org | $0 | DeferredCompensationFlngOrgAmt |
| Deferred Comp Rltd Orgs | $0 | DeferredCompRltdOrgsAmt |
| Nontaxable Benefits Filing Org | $10,680 | NontaxableBenefitsFilingOrgAmt |
| Nontaxable Benefits Rltd Orgs | $0 | NontaxableBenefitsRltdOrgsAmt |
| Total Compensation Filing Org | $237,461 | TotalCompensationFilingOrgAmt |
| Total Compensation Rltd Orgs | $0 | TotalCompensationRltdOrgsAmt |
| Comp Report Prior990 Filing Org | $0 | CompReportPrior990FilingOrgAmt |
| Comp Report Prior990 Rltd Orgs | $0 | CompReportPrior990RltdOrgsAmt |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SERVCOM USA LLC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | ENTITY CO-OWNED BY SON OF DIRECTOR, JANICE CHISM | RelationshipDescriptionTxt |
| Transaction | $113,612 | TransactionAmt |
| Transaction | ENTITY PROVIDED INFORMATION TECHNOLOGY SERVICES AND EQUIPMENT | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Schedule M IRS990ScheduleM
Other Non Cash Contri Table OtherNonCashContriTableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Desc | PROGRAM SUPPLIES | Desc |
| Contribution | 7 | ContributionCnt |
| Noncash Contributions Rpt F990 | $23,084 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | COST | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | ORGANIZATION'S FORM 990 IS GIVEN ANNUALLY TO THE ENTIRE BOARD IN ITS ENTIRETY FOR REVIEW AND FORMAL APPROVAL. |
| FORM 990, PART VI, SECTION B, LINE 12C | AFFINITY HEALTH CENTER (AHC) HAS A CONFLICT OF INTEREST POLICY WHICH IS REVIEWED WITH NEW BOARD MEMBERS DURING BOARD ORIENTATION. AT THAT TIME BOARD MEMBERS INDICATE IN WRITING ANY CONFLICTS OF INTEREST WITH AHC. OFFICERS AND DIRECTORS ARE REQUIRED TO DISCLOSE ON AN ANNUAL BASIS ANY POTENTIAL CONFLICTS OF INTEREST. |
| FORM 990, PART VI, SECTION B, LINE 15 | AFFINITY HEALTH CENTER (AHC) HIRED AN INDEPENDENT HUMAN RESOURCES CONSULTANT IN 2017 TO CONDUCT A SALARY SURVEY AND RECOMMEND SALARY RANGES FOR ALL POSITIONS INCLUDING THE EXECUTIVE DIRECTOR. IN 2017 AHC'S BOARD OF DIRECTORS APPROVED THE REVISED RANGES. THE FULL BOARD IS RESPONSIBLE FOR THE ANNUAL PERFORMANCE REVIEW OF THE EXECUTIVE DIRECTOR, INCLUDING DETERMINATION OF ANNUAL COMPENSATION ADJUSTMENTS. THE ANNUAL PERFORMANCE REVIEWS FOR OTHER OFFICERS OR KEY EMPLOYEES IS CONDUCTED IN ACCORDANCE WITH AHC POLICY BY APPROPRIATE SUPERVISOR. DETERMINATION OF ANNUAL COMPENSATION ADJUSTMENTS WITHIN APPROVED RANGES IS DETERMINED BY THE EXECUTIVE DIRECTOR. |
| FORM 990, PART VI, SECTION C, LINE 19 | AFFINITY HEALTH CENTER PROVIDES THESE DOCUMENTS TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART XII, LINE 2C | THE PROCESS HAS NOT CHANGED FROM PRIOR YEAR. |
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