GREATER PRINCE WILLIAM AREA COMMUNITY HEALTH CENTER INC: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- GREATER PRINCE WILLIAM AREA COMMUNITY HEALTH CENTER INC (EIN 83-0435138)
- Tax period
- 2016-07-01 to 2017-06-30
- Filed
- 2018-02-12
- IRS object ID
- 201810439349300331
- Schema version
- 2016v3.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-02-12T10:48:58-06:00 | ReturnTs |
| Tax Period End | 2017-06-30 | 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 | 901 N GLEBE ROAD SUITE 200 | AddressLine1Txt |
| City | ARLINGTON | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 22203 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 830435138 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GREATER PRINCE WILLIAM AREA COMMUNITY | BusinessNameLine1Txt |
| Business Name Line2 | HEALTH CENTER INC | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | GREA | BusinessNameControlTxt |
| Phone | 7036807950 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4379 RIDGEWOOD CENTER DRIVE NO 102 | AddressLine1Txt |
| City | WOODBRIDGE | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 22192 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MARK MEYE | PersonNm |
| Person Title | EXECUTIVE DIRECTOR | PersonTitleTxt |
| Phone | 7036807950 | PhoneNum |
| Signature | 2018-02-12 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | IVY BECKHAM | PreparerPersonNm |
| PTIN | P01316131 | PTIN |
| Phone | 5712279500 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 67.137.57.251 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2018-02-12 | IPDt |
| IP Tm | 09:40:46 | IPTm |
| IP Timezone | ES | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | A1F046B953991414D17544BCF233C1AB5D570FBA | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 42F564CBFE8260E3A927264CDE4494A8B488CDEA | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MARK MEYE | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4379 RIDGEWOOD CENTER DRIVE NO 102 | AddressLine1Txt |
| City | WOODBRIDGE | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 22192 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $10,386,413 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.GPWHEALTHCENTER.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2007 | FormationYr |
| Legal Domicile State | VA | LegalDomicileStateCd |
| Activity Or Mission | ACCESS TO AFFORDABLE HIGH QUALITY HEALTH CARE FOR THE WHOLE FAMILY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 13 | VotingMembersIndependentCnt |
| Total Employee | 96 | TotalEmployeeCnt |
| Total Volunteers | 50 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $3,632,529 | PYContributionsGrantsAmt |
| CY Contributions Grants | $4,271,475 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $4,049,412 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $6,090,223 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$38,496 | PYOtherRevenueAmt |
| CY Other Revenue | -$34,434 | CYOtherRevenueAmt |
| PY Total Revenue | $7,643,445 | PYTotalRevenueAmt |
| CY Total Revenue | $10,327,264 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $4,759,559 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $5,922,751 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $161,557 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $2,370,101 | PYOtherExpensesAmt |
| CY Other Expenses | $3,503,678 | CYOtherExpensesAmt |
| PY Total Expenses | $7,129,660 | PYTotalExpensesAmt |
| CY Total Expenses | $9,426,429 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $513,785 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $900,835 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $2,712,416 | TotalAssetsBOYAmt |
| Total Assets EOY | $4,187,933 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,122,011 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,692,118 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,590,405 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $2,495,815 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE CENTER'S MISSION IS TO INCREASE ACCESS TO HIGH QUALITY, COMPREHENSIVE AND PREVENTIVE HEALTH CARE THAT IS CULTURALLY SENSITIVE IN ORDER TO IMPROVE THE HEALTH STATUS OF THE UNDER SERVED AND VULNERABLE RESIDENTS OF PRINCE WILLIAM COUNTY AND THE CITIES OF MANASSAS AND MANASSAS PARK. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $3,980,057 | ExpenseAmt |
| Revenue | $3,052,760 | RevenueAmt |
| Desc | PRIMARY CARE: THE CENTER PROVIDES HEALTH AND MEDICAL CARE THAT IS CULTURALLY SENSITITVE IN ORDER TO IMPROVE THE HEALTH STATUS OF THE UNDERSERVED AND VULNERABLE RESIDENTS OF PRINCE WILLIAM COUNTY AND THE CITIES OF MANASSAS AND MANASSAS PARK. THE CENTER PROGRAMS ARE DESIGNED TO INCREASE ACCESS TO HIGH QUALITY, COMPREHENSIVE AND PREVENTIVE HEALTH CARE. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,455,691 | ExpenseAmt |
| Revenue | $1,751,564 | RevenueAmt |
| Desc | PRENATAL CARE: THE CENTER PROVIDES OB-GYN CARE THAT IS CULTURALLY SENSITIVE IN ORDER TO IMPROVE THE HEALTH STATUS OF THE UNDERSERVED AND VULNERABLE RESIDENTS OF PRINCE WILLIAM COUNTY AND THE CITIES OF MANASSAS AND MANASSAS PARK. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,407,414 | ExpenseAmt |
| Revenue | $929,424 | RevenueAmt |
| Desc | DENTAL CARE: THE CENTER PROVIDES DENTAL CARE THAT IS CULTURALLY SENSITIVE IN ORDER TO IMPROVE THE HEALTH STATUS OF THE UNDERSERVED AND VULNERABLE RESIDENTS OF PRINCE WILLIAM COUNTY AND THE CITIES OF MANASSAS AND MANASSAS PARK. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $736,261 | ExpenseAmt |
| Revenue | $356,475 | RevenueAmt |
| Desc | BEHAVIORAL HEALTH: THE CENTER PROVIDES BEHAVIORAL HEALTH AND OTHER HEALTH CARE THAT IS CULTURALLY SENSITIVE IN ORDER TO IMPROVE THE HEALTH STATUS OF THE UNDERSERVED AND VULNERABLE RESIDENTS OF PRINCE WILLIAM COUNTY AND THE CITIES OF MANASSAS AND MANASSAS PARK. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $736,261 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Revenue | $356,475 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $7,579,423 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 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 | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | Yes (1) | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 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 | 32 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 96 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 13 | 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 |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MARK MEYE | PersonNm |
| Phone | 7036807950 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4379 RIDGEWOOD CENTER DRIVE SUITE | AddressLine1Txt |
| City | WOODBRIDGE | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 22192 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| LUIS LOU FERRARO | ||||||||
| PRESIDENT | 3.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| DAVID B WILKS | ||||||||
| VICE PRESIDENT | 3.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| JOHN S GRAY | ||||||||
| TREASURER | 3.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| VALERIE E KEENE | ||||||||
| SECRETARY | 3.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| ABRA HOGARTH | ||||||||
| MEMBER | 1.50 | Yes (X) | $0 | $0 | $0 | |||
| ADDIE RAY WHITAKER | ||||||||
| MEMBER | 1.50 | Yes (X) | $0 | $0 | $0 | |||
| EVELYN MARR | ||||||||
| MEMBER | 1.50 | Yes (X) | $0 | $0 | $0 | |||
| JENNY PORTILLO | ||||||||
| MEMBER | 1.50 | Yes (X) | $0 | $0 | $0 | |||
| JULIO ALEX CORREA | ||||||||
| MEMBER | 1.50 | Yes (X) | $0 | $0 | $0 | |||
| LASHEECO GRAHAMAN | ||||||||
| MEMBER | 1.50 | Yes (X) | $0 | $0 | $0 | |||
| LAURA C POSEY | ||||||||
| MEMBER | 1.50 | Yes (X) | $0 | $0 | $0 | |||
| RICHARD GARON | ||||||||
| MEMBER | 1.50 | Yes (X) | $0 | $0 | $0 | |||
| ROSE GONZALEZ | ||||||||
| MEMBER | 3.00 | Yes (X) | $0 | $0 | $0 | |||
| GEORGE BARKER | ||||||||
| FORMER EXEC. DIR. (UNTIL 01/2017) | 40.00 | Yes (X) | $102,879 | $0 | $0 | |||
| MARK MEYE | ||||||||
| EXECUTIVE DIRECTOR | 40.00 | Yes (X) | $112,438 | $0 | $17,263 | |||
| RASHID MOHIUDDIN | ||||||||
| MEDICAL DIRECTOR | 40.00 | $200,793 | $0 | $13,171 | Yes (X) | |||
| SYED MAHBOOB | ||||||||
| PHYSICIAN | 40.00 | $165,632 | $0 | $12,799 | Yes (X) | |||
| AMBER HASAN | ||||||||
| DENTIST | 40.00 | $111,844 | $0 | $3,459 | Yes (X) | |||
| SHEETAL RAY | ||||||||
| DENTAL DIRECTOR (UNTIL 04/2017) | 40.00 | $117,267 | $0 | $3,625 | Yes (X) | |||
| LISA WIENER | ||||||||
| OB-GYN DIRECTOR | 40.00 | $109,836 | $0 | $10,746 | Yes (X) | |||
| MI-YON CHOI | ||||||||
| DENTIST (UNTIL 05/2017) | 40.00 | $107,338 | $0 | $9,416 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,028,027 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $70,479 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 9 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| COMMUNITY CARE NETWORK OF VIRGINIA | |||||
| 3831 WESTERRE PARKWAY | HENRICO | VA | 23233 | BILLING/CREDENTIALING | $205,473 |
| MCKESSON | |||||
| PO BOX 634404 | CINCINNATI | OH | 45263 | MEDICAL SUPPLIES | $171,290 |
| LABCORP | |||||
| PO BOX 12140 | BURLINGTON | NC | 27216 | LABORATORY | $159,019 |
| CA CONSTRUCTION | |||||
| 4078 DUNCAN LANE | GOLDVEIN | VA | 22720 | RENOVATION | $128,645 |
| ECLINICALWORKS | |||||
| PO BOX 847950 | BOSTON | MA | 02284 | ELECTRONIC HEALTH RECORDS | $110,849 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 6 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $61,273 | FundraisingAmt |
| Government Grants | $3,220,974 | GovernmentGrantsAmt |
| All Other Contributions | $989,228 | AllOtherContributionsAmt |
| Noncash Contributions | $395,532 | NoncashContributionsAmt |
| Total Contributions | $4,271,475 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT SERVICE REVENUES | Desc |
| Business | 624110 | BusinessCd |
| Total Revenue Column | $6,090,223 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $6,090,223 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $6,090,223 | TotalProgramServiceRevenueAmt |
| Fundraising Gross Income | $12,237 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $61,273 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $59,149 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$46,912 | TotalRevenueColumnAmt |
| Exclusion | -$46,912 | ExclusionAmt |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $12,478 | TotalRevenueColumnAmt |
| Exclusion | $12,478 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $12,478 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $10,327,264 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $6,090,223 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$34,434 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $457,639 | TotalAmt |
| Program Services | $27,458 | ProgramServicesAmt |
| Management And General | $411,875 | ManagementAndGeneralAmt |
| Fundraising | $18,306 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,670,478 | TotalAmt |
| Program Services | $4,441,370 | ProgramServicesAmt |
| Management And General | $220,987 | ManagementAndGeneralAmt |
| Fundraising | $8,121 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $106,272 | TotalAmt |
| Program Services | $101,740 | ProgramServicesAmt |
| Management And General | $4,376 | ManagementAndGeneralAmt |
| Fundraising | $156 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $306,568 | TotalAmt |
| Program Services | $278,181 | ProgramServicesAmt |
| Management And General | $27,281 | ManagementAndGeneralAmt |
| Fundraising | $1,106 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $381,794 | TotalAmt |
| Program Services | $334,098 | ProgramServicesAmt |
| Management And General | $45,788 | ManagementAndGeneralAmt |
| Fundraising | $1,908 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $34,333 | TotalAmt |
| Management And General | $34,333 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $62,484 | TotalAmt |
| Management And General | $62,484 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $617,271 | TotalAmt |
| Program Services | $527,794 | ProgramServicesAmt |
| Management And General | $7,557 | ManagementAndGeneralAmt |
| Fundraising | $81,920 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $706,666 | TotalAmt |
| Program Services | $631,103 | ProgramServicesAmt |
| Management And General | $69,035 | ManagementAndGeneralAmt |
| Fundraising | $6,528 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $74,175 | TotalAmt |
| Program Services | $46,482 | ProgramServicesAmt |
| Management And General | $24,735 | ManagementAndGeneralAmt |
| Fundraising | $2,958 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $944,893 | TotalAmt |
| Program Services | $591,024 | ProgramServicesAmt |
| Management And General | $316,073 | ManagementAndGeneralAmt |
| Fundraising | $37,796 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,068 | TotalAmt |
| Program Services | $6,598 | ProgramServicesAmt |
| Management And General | $7,470 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,190 | TotalAmt |
| Management And General | $10,190 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $274,211 | TotalAmt |
| Program Services | $84,710 | ProgramServicesAmt |
| Management And General | $189,501 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,994 | TotalAmt |
| Program Services | $13,986 | ProgramServicesAmt |
| Management And General | $8,008 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| CLINICAL SUPPLIES | $395,532 | $395,532 | ||
| BAD DEBT EXPENSE | $150,500 | $150,500 | ||
| OTHER PERSONNEL COSTS | $113,691 | $43,134 | $67,799 | $2,758 |
| AGENCY MEMBERSHIP FEES | $30,902 | $30,902 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $52,768 | TotalAmt |
| Program Services | $25,311 | ProgramServicesAmt |
| Management And General | $27,457 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,426,429 | TotalAmt |
| Program Services | $7,579,423 | ProgramServicesAmt |
| Management And General | $1,685,449 | ManagementAndGeneralAmt |
| Fundraising | $161,557 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $661,300 | BOYAmt |
| EOY | $796,792 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $173,789 | BOYAmt |
| EOY | $157,614 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $624,083 | BOYAmt |
| EOY | $1,666,435 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $36,916 | BOYAmt |
| EOY | $36,916 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $34,450 | BOYAmt |
| EOY | $40,240 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $2,279,517 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $943,109 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,042,518 | BOYAmt |
| EOY | $1,336,408 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,903 | BOYAmt |
| EOY | $14,559 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,081 | BOYAmt |
| EOY | $15,000 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $114,376 | BOYAmt |
| EOY | $123,969 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,712,416 | BOYAmt |
| EOY | $4,187,933 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $450,966 | BOYAmt |
| EOY | $644,517 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,351 | BOYAmt |
| EOY | $3,860 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $198,623 | BOYAmt |
| EOY | $136,331 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $470,071 | BOYAmt |
| EOY | $907,410 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,122,011 | BOYAmt |
| EOY | $1,692,118 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,450,405 | BOYAmt |
| EOY | $2,407,482 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $140,000 | BOYAmt |
| EOY | $88,333 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,590,405 | BOYAmt |
| EOY | $2,495,815 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,712,416 | BOYAmt |
| EOY | $4,187,933 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $900,835 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $4,575 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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) |
|---|---|---|
| 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
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,088,356 | OtherCostOrOtherBasisAmt |
| Depreciation | $430,954 | DepreciationAmt |
| Book Value | $657,402 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $790,416 | OtherCostOrOtherBasisAmt |
| Depreciation | $365,474 | DepreciationAmt |
| Book Value | $424,942 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $400,745 | OtherCostOrOtherBasisAmt |
| Depreciation | $146,681 | DepreciationAmt |
| Book Value | $254,064 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,336,408 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DEFERRED RENT LIABILITY | Desc |
| Amt | $907,410 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $907,410 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $10,357,389 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $4,575 | NetUnrealizedGainsInvstAmt |
| Donated Services And Use Fclts | $176,050 | DonatedServicesAndUseFcltsAmt |
| Other Revenue | -$150,500 | OtherRevenueAmt |
| Revenue Not Reported | $30,125 | RevenueNotReportedAmt |
| Revenue Subtotal | $10,327,264 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $10,327,264 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $9,451,979 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $176,050 | DonatedServicesUseFcltsAmt |
| Expenses Not Reported | $176,050 | ExpensesNotReportedAmt |
| Expenses Subtotal | $9,275,929 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $150,500 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $150,500 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $9,426,429 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | THE CENTER HAS BEEN RECOGNIZED AS EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. HOWEVER, THE CENTER IS SUBJECT TO FEDERAL INCOME TAX ON ANY UNRELATED BUSINESS TAXABLE INCOME. THE CENTER'S INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. THE CENTER IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX-EXEMPT STATUS. THE CENTER IS NOT AWARE OF ANY ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME OR EXCISE OR OTHER TAXES. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | BAD DEBT EXPENSE -150,500. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | BAD DEBT EXPENSE 150,500. |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | CHIPS 4 CHARITY | Event1Nm |
| Gross Receipts Event1 | $73,510 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $61,273 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $12,237 | GrossRevenueEvent1Amt |
| Cash Prizes Event1 | $1,842 | CashPrizesEvent1Amt |
| Rent Facility Costs Event1 | $8,600 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $17,568 | FoodAndBeverageEvent1Amt |
| Entertainment Event1 | $9,245 | EntertainmentEvent1Amt |
| Other Direct Expenses Event1 | $21,894 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $73,510 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $61,273 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $12,237 | GrossRevenueTotalEventsAmt |
| Cash Prizes Total Events | $1,842 | CashPrizesTotalEventsAmt |
| Rent Fclty Costs Total Events | $8,600 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $17,568 | FoodAndBeverageTotalEventsAmt |
| Entertainment Total Events | $9,245 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $21,894 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $59,149 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$46,912 | NetIncomeSummaryAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| 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 (2 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| RASHID MOHIUDDIN | ||||||||||||||
| MEDICAL DIRECTOR | $200,793 | $0 | $0 | $0 | $0 | $0 | $4,920 | $0 | $8,251 | $0 | $213,964 | $0 | $0 | $0 |
| SYED MAHBOOB | ||||||||||||||
| PHYSICIAN | $165,632 | $0 | $0 | $0 | $0 | $0 | $6,500 | $0 | $6,299 | $0 | $178,431 | $0 | $0 | $0 |
Schedule M IRS990ScheduleM
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $391,910 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FAIR MARKET VALUE | 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 A, LINE 1 | THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE OFFICERS OF THE BOARD AND THE CHAIRMAN OF STANDING COMMITTEES. THE COMMITTEE SHALL HAVE THE POWERS OF THE GOVERNING BOARD WHEN IT IS NOT IN SESSION. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE DRAFT 990 IS PROVIDED TO THE FINANCE COMMITTEE AND BOARD OF DIRECTORS FOR REVIEW PRIOR TO FILING WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | ANNUAL CONFLICT OF INTEREST POLICY REVIEW AND SIGNING BY EACH BOARD MEMBER; STAFF WHEN HIRED AND ANNUAL EDUCATION SESSIONS. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE BOARD SETS POSITION PAY RANGES. THE BOARD REVIEWS AND APPROVES EXECUTIVE DIRECTOR'S COMPENSATION AND BENEFITS. THE BOARD COMPENSATION RANGES ARE BASED ON SALARY SURVEY OF SIMILAR ORGANIZATIONS. THE SALARY SURVEY IS DOCUMENTED. THE BOARD DECISIONS ARE IN BOARD MINUTES. THE DECISION IS CONSISTENTLY APPLIED; NO FURTHER DOCUMENTATION SINCE APPLICATION IS CONSISTENT. THE BOARD REVIEWS THE COMPENSATION AND BENEFITS OF THE ORGANIZATION'S KEY EMPLOYEES BASED ON AN ANNUAL SALARY SURVEY FOR NORTHERN VIRGINIA. THE BOARD REVIEWED AND APPROVED SALARY SURVEY CONDUCTED DURING 2016 IN NOVEMBER 2016; APPROVED ADJUSTING KEY EMPLOYEE ANNUAL SALARY TO ALIGN WITH SURVEY. SALARY SURVEY BY NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS AND FOLLOW-UP SURVEY OF VIRGINIA HEALTH CENTERS WAS CONDUCTED BY EXECUTIVE DIRECTOR AND DIRECTOR OF HUMAN RESOURCES DURING MONTHS OF APRIL 2016 TO SEPTEMBER 2016; PRESENTED TO THE BOARD FOR REVIEW AND ADOPTION IN NOVEMBER 2016. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. |