2018-02-12T10:48:58-06:00 2017-06-30 410746749 CLIFTONLARSONALLEN LLP 901 N GLEBE ROAD SUITE 200 ARLINGTON VA 22203 990 2016-07-01 830435138 GREATER PRINCE WILLIAM AREA COMMUNITY HEALTH CENTER INC GREA 7036807950 4379 RIDGEWOOD CENTER DRIVE NO 102 WOODBRIDGE VA 22192 MARK MEYE EXECUTIVE DIRECTOR 7036807950 2018-02-12 1 IVY BECKHAM P01316131 5712279500 67.137.57.251 2018-02-12 09:40:46 ES P A1F046B953991414D17544BCF233C1AB5D570FBA 42F564CBFE8260E3A927264CDE4494A8B488CDEA 2016 2021-01-29 14:40:06Z MARK MEYE 4379 RIDGEWOOD CENTER DRIVE NO 102 WOODBRIDGE VA 22192 10386413 0 X WWW.GPWHEALTHCENTER.ORG X 2007 VA ACCESS TO AFFORDABLE HIGH QUALITY HEALTH CARE FOR THE WHOLE FAMILY. 13 13 96 50 0 0 3632529 4271475 4049412 6090223 0 0 -38496 -34434 7643445 10327264 0 0 0 0 4759559 5922751 0 0 161557 2370101 3503678 7129660 9426429 513785 900835 2712416 4187933 1122011 1692118 1590405 2495815 X 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. 0 0 3980057 3052760 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. 1455691 1751564 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. 1407414 929424 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. 736261 356475 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. 736261 356475 7579423 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 32 0 96 1 0 0 0 0 0 0 0 0 0 0 X 13 13 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X MARK MEYE 7036807950 4379 RIDGEWOOD CENTER DRIVE SUITE WOODBRIDGE VA 22192 LUIS LOU FERRARO PRESIDENT 3.00 X X 0 0 0 DAVID B WILKS VICE PRESIDENT 3.00 X X 0 0 0 JOHN S GRAY TREASURER 3.00 X X 0 0 0 VALERIE E KEENE SECRETARY 3.00 X X 0 0 0 ABRA HOGARTH MEMBER 1.50 X 0 0 0 ADDIE RAY WHITAKER MEMBER 1.50 X 0 0 0 EVELYN MARR MEMBER 1.50 X 0 0 0 JENNY PORTILLO MEMBER 1.50 X 0 0 0 JULIO ALEX CORREA MEMBER 1.50 X 0 0 0 LASHEECO GRAHAMAN MEMBER 1.50 X 0 0 0 LAURA C POSEY MEMBER 1.50 X 0 0 0 RICHARD GARON MEMBER 1.50 X 0 0 0 ROSE GONZALEZ MEMBER 3.00 X 0 0 0 GEORGE BARKER FORMER EXEC. DIR. (UNTIL 01/2017) 40.00 X 102879 0 0 MARK MEYE EXECUTIVE DIRECTOR 40.00 X 112438 0 17263 RASHID MOHIUDDIN MEDICAL DIRECTOR 40.00 X 200793 0 13171 SYED MAHBOOB PHYSICIAN 40.00 X 165632 0 12799 AMBER HASAN DENTIST 40.00 X 111844 0 3459 SHEETAL RAY DENTAL DIRECTOR (UNTIL 04/2017) 40.00 X 117267 0 3625 LISA WIENER OB-GYN DIRECTOR 40.00 X 109836 0 10746 MI-YON CHOI DENTIST (UNTIL 05/2017) 40.00 X 107338 0 9416 1028027 0 70479 9 0 1 0 COMMUNITY CARE NETWORK OF VIRGINIA 3831 WESTERRE PARKWAY HENRICO VA 23233 BILLING/CREDENTIALING 205473 MCKESSON PO BOX 634404 CINCINNATI OH 45263 MEDICAL SUPPLIES 171290 LABCORP PO BOX 12140 BURLINGTON NC 27216 LABORATORY 159019 CA CONSTRUCTION 4078 DUNCAN LANE GOLDVEIN VA 22720 RENOVATION 128645 ECLINICALWORKS PO BOX 847950 BOSTON MA 02284 ELECTRONIC HEALTH RECORDS 110849 6 61273 3220974 989228 395532 4271475 PATIENT SERVICE REVENUES 624110 6090223 6090223 6090223 12237 61273 59149 -46912 -46912 12478 12478 12478 10327264 6090223 0 -34434 457639 27458 411875 18306 4670478 4441370 220987 8121 106272 101740 4376 156 306568 278181 27281 1106 381794 334098 45788 1908 34333 34333 62484 62484 617271 527794 7557 81920 706666 631103 69035 6528 74175 46482 24735 2958 944893 591024 316073 37796 14068 6598 7470 10190 10190 274211 84710 189501 21994 13986 8008 CLINICAL SUPPLIES 395532 395532 BAD DEBT EXPENSE 150500 150500 OTHER PERSONNEL COSTS 113691 43134 67799 2758 AGENCY MEMBERSHIP FEES 30902 30902 52768 25311 27457 9426429 7579423 1685449 161557 661300 796792 173789 157614 624083 1666435 36916 36916 34450 40240 2279517 943109 1042518 1336408 8903 14559 16081 15000 114376 123969 2712416 4187933 450966 644517 2351 3860 198623 136331 470071 907410 1122011 1692118 X 1450405 2407482 140000 88333 1590405 2495815 2712416 4187933 900835 4575 0 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1088356 430954 657402 790416 365474 424942 400745 146681 254064 1336408 DEFERRED RENT LIABILITY 907410 907410 X 10357389 4575 176050 -150500 30125 10327264 0 10327264 9451979 176050 176050 9275929 150500 150500 9426429 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. CHIPS 4 CHARITY 73510 61273 12237 1842 8600 17568 9245 21894 73510 61273 12237 1842 8600 17568 9245 21894 59149 -46912 X X X 0 0 0 0 0 0 0 0 0 RASHID MOHIUDDIN MEDICAL DIRECTOR 200793 0 0 0 0 0 4920 0 8251 0 213964 0 0 0 SYED MAHBOOB PHYSICIAN 165632 0 0 0 0 0 6500 0 6299 0 178431 0 0 0 X 1 391910 FAIR MARKET VALUE 0 0 0 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.