LIFECARE FAMILY HEALTH AND DENTAL CENTER INC: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- LIFECARE FAMILY HEALTH AND DENTAL CENTER INC (EIN 34-1708901)
- Tax period
- 2017-01-01 to 2017-12-31
- Filed
- 2018-11-06
- IRS object ID
- 201823109349301457
- Schema version
- 2017v2.2
- 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 | 2018-11-06T09:40:20-08:00 | ReturnTs |
| Tax Period End | 2017-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 340677006 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Maloney Novotny LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1111 Superior Avenue Suite 700 | AddressLine1Txt |
| City | Cleveland | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 44114 | 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 | 341708901 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Lifecare Family Health and Dental Center | BusinessNameLine1Txt |
| Business Name Line2 | Inc | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | LIFE | BusinessNameControlTxt |
| Phone | 3304542000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2725 Lincoln Street East | AddressLine1Txt |
| City | Canton | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 44707 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Kay Scarp-Seeberger | PersonNm |
| Person Title | Executive Dir. | PersonTitleTxt |
| Signature | 2018-11-06 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Doreen M Smith CPA | PreparerPersonNm |
| PTIN | P00089068 | PTIN |
| Phone | 3304771075 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2018-06-14 16:35:46Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Kay Scarp-Seeberger | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2725 Lincoln Street East | AddressLine1Txt |
| City | Canton | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 44707 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $5,752,981 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| All Affiliates Included | false | AllAffiliatesIncludedInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.lifecarefhdc.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1992 | FormationYr |
| Legal Domicile State | OH | LegalDomicileStateCd |
| Activity Or Mission | Provide healthcare as an FQHC to the community, including underserved populations. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 95 | TotalEmployeeCnt |
| Total Volunteers | 10 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $2,607,559 | PYContributionsGrantsAmt |
| CY Contributions Grants | $2,862,568 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $2,968,886 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $2,877,907 | CYProgramServiceRevenueAmt |
| PY Investment Income | $743 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,060 | CYInvestmentIncomeAmt |
| PY Other Revenue | $7,718 | PYOtherRevenueAmt |
| CY Other Revenue | $11,446 | CYOtherRevenueAmt |
| PY Total Revenue | $5,584,906 | PYTotalRevenueAmt |
| CY Total Revenue | $5,752,981 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $3,016,084 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $4,111,496 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,342,279 | PYOtherExpensesAmt |
| CY Other Expenses | $1,983,422 | CYOtherExpensesAmt |
| PY Total Expenses | $4,358,363 | PYTotalExpensesAmt |
| CY Total Expenses | $6,094,918 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,226,543 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$341,937 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $5,171,556 | TotalAssetsBOYAmt |
| Total Assets EOY | $4,962,351 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,490,841 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,547,349 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $3,680,715 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $3,415,002 | NetAssetsOrFundBalancesEOYAmt |
| Mission | Provide healthcare as an FQHC to the community, including underserved populations. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $4,644,909 | ExpenseAmt |
| Revenue | $2,877,907 | RevenueAmt |
| Desc | As a Federally Qualified Health Center (FQHC), we provide quality preventative and restorative primary health care to our patients, with payment options based on a patient's ability to pay. We continually improve our services and facilities to develop a growing, financially sound, progressive community health clinic. | Desc |
| Total Program Service Expenses | $4,644,909 | 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 | false | 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 | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | 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 | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | false | InvestTaxExemptBondsInd |
| Escrow Account | false | EscrowAccountInd |
| On Behalf Of Issuer | false | OnBehalfOfIssuerInd |
| 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 | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | false | ScheduleORequiredInd |
| IRP Document | 16 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 95 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | false | Form990TFiledInd |
| 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 |
| Form8282 Filed | 0 | Form8282FiledCnt |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Form8899 Filedind | false | Form8899Filedind |
| Form1098 C Filed | false | Form1098CFiledInd |
| DAF Excess Business Holdings | false | DAFExcessBusinessHoldingsInd |
| Taxable Distributions | false | TaxableDistributionsInd |
| Distribution To Donor | false | DistributionToDonorInd |
| Org Filed In Lieu Of Form1041 | false | OrgFiledInLieuOfForm1041Ind |
| Licensed More Than One State | false | LicensedMoreThanOneStateInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | 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 | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | OH | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Kay Scarp-Seeberger | PersonNm |
| Phone | 3304542000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2725 Lincoln Street East | AddressLine1Txt |
| City | Canton | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 44707 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| Anthony Delis | |||||||||
| Trustee | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Judge Stephen Belden | |||||||||
| Trustee | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Viola Fisher | |||||||||
| Trustee | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| William Foreman | |||||||||
| Trustee | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| George Shaheen | |||||||||
| Chairman | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| Allana Haut | |||||||||
| Treasurer | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| Craig Smith | |||||||||
| Trustee | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Dean Varian | |||||||||
| Trustee | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Tom Ferrero | |||||||||
| Vice Chairman | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| David Maley | |||||||||
| Secretary | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| Janet McPeek | |||||||||
| CFO | 40.00 | 0.00 | $66,093 | $0 | $10,514 | Yes (X) | |||
| Kay Scarp-Seeberger | |||||||||
| CEO | 40.00 | 0.00 | $96,936 | $0 | $0 | Yes (X) | |||
| David M Cola | |||||||||
| Physician | 40.00 | 0.00 | $200,065 | $0 | $6,624 | Yes (X) | |||
| Houneine Gashash | |||||||||
| Medical Director | 40.00 | 0.00 | $195,009 | $0 | $21,804 | Yes (X) | |||
| Thomas K Mun | |||||||||
| Dentist | 0.00 | 0.00 | $162,266 | $0 | $22,319 | Yes (X) | |||
| Terri McNatt | |||||||||
| Nurse Practitioner | 40.00 | 0.00 | $112,074 | $0 | $7,202 | Yes (X) | |||
| Emily Kay Reusser | |||||||||
| Dentist | 0.00 | 0.00 | $129,546 | $0 | $17,754 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $961,989 | TotalReportableCompFromOrgAmt |
| Total Other Compensation | $86,217 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 5 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Allscripts | |||||
| 8700 W Bryn Mawr Ave 700N | Chicago | IL | 60631 | Billing Services | $114,788 |
| Ford & Associates | |||||
| 2725 Lincoln Street East | Canton | OH | 44707 | IT Services | $169,184 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $2,860,068 | GovernmentGrantsAmt |
| All Other Contributions | $2,500 | AllOtherContributionsAmt |
| Total Contributions | $2,862,568 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Insurance Incentives | 621400 | $45,230 | $45,230 |
| Patient & Third Party Fee | 621400 | $2,832,677 | $2,832,677 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $2,877,907 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,060 | TotalRevenueColumnAmt |
| Exclusion | $1,060 | 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 |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Miscellaneous Income | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $11,446 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $11,446 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $11,446 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,752,981 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $2,889,353 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $1,060 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
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 | $781,630 | TotalAmt |
| Program Services | $608,087 | ProgramServicesAmt |
| Management And General | $173,543 | 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 | $2,619,145 | TotalAmt |
| Program Services | $1,987,581 | ProgramServicesAmt |
| Management And General | $631,564 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,127 | TotalAmt |
| Program Services | $28,113 | ProgramServicesAmt |
| Management And General | $8,014 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $454,626 | TotalAmt |
| Program Services | $340,345 | ProgramServicesAmt |
| Management And General | $114,281 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $219,968 | TotalAmt |
| Program Services | $170,248 | ProgramServicesAmt |
| Management And General | $49,720 | 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 | $12,592 | TotalAmt |
| Management And General | $12,592 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,615 | TotalAmt |
| Management And General | $14,615 | 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 | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $60,060 | TotalAmt |
| Program Services | $56,388 | ProgramServicesAmt |
| Management And General | $3,672 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $32,522 | TotalAmt |
| Management And General | $32,522 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $46,036 | TotalAmt |
| Program Services | $33,182 | ProgramServicesAmt |
| Management And General | $12,854 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $165,195 | TotalAmt |
| Program Services | $161,531 | ProgramServicesAmt |
| Management And General | $3,664 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,405 | TotalAmt |
| Program Services | $3,366 | ProgramServicesAmt |
| Management And General | $2,039 | 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 | $0 | TotalAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $51,787 | TotalAmt |
| Program Services | $24,629 | ProgramServicesAmt |
| Management And General | $27,158 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $144,291 | TotalAmt |
| Program Services | $94,047 | ProgramServicesAmt |
| Management And General | $50,244 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,328 | TotalAmt |
| Management And General | $21,328 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Bad Debts | $277,145 | $277,145 | |
| Billing Expense | $215,876 | $215,876 | |
| Contractual Expense | $151,404 | $91,900 | $59,504 |
| Public Relations | $112,577 | $44,742 | $67,835 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $672,589 | TotalAmt |
| Program Services | $507,729 | ProgramServicesAmt |
| Management And General | $164,860 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,094,918 | TotalAmt |
| Program Services | $4,644,909 | ProgramServicesAmt |
| Management And General | $1,450,009 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,008,514 | BOYAmt |
| EOY | $1,416,875 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $623,126 | BOYAmt |
| EOY | $387,463 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $169,459 | BOYAmt |
| EOY | $47,880 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,113,944 | BOYAmt |
| EOY | $767,219 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $61,470 | BOYAmt |
| EOY | $91,225 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $2,746,758 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,083,968 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,682,368 | BOYAmt |
| EOY | $1,662,790 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $512,675 | BOYAmt |
| EOY | $588,899 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,171,556 | BOYAmt |
| EOY | $4,962,351 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $196,379 | BOYAmt |
| EOY | $299,140 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,294,462 | BOYAmt |
| EOY | $1,248,209 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,490,841 | BOYAmt |
| EOY | $1,547,349 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,680,715 | BOYAmt |
| EOY | $3,415,002 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,680,715 | BOYAmt |
| EOY | $3,415,002 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,171,556 | BOYAmt |
| EOY | $4,962,351 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$341,937 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $76,224 | NetUnrlzdGainsLossesInvstAmt |
| 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
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $29,174 | OtherCostOrOtherBasisAmt |
| Book Value | $29,174 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,102,403 | OtherCostOrOtherBasisAmt |
| Depreciation | $415,874 | DepreciationAmt |
| Book Value | $686,529 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,615,181 | OtherCostOrOtherBasisAmt |
| Depreciation | $668,094 | DepreciationAmt |
| Book Value | $947,087 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,662,790 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Deposits | Desc |
| Book Value | $2,500 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $588,899 | TotalBookValueOtherAssetsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $5,829,205 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $76,224 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | $76,224 | RevenueNotReportedAmt |
| Revenue Subtotal | $5,752,981 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $5,752,981 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $6,094,918 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $6,094,918 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $6,094,918 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part X : FIN48 Footnote | FormAndLineReferenceDesc |
| Explanation | Effective January 1, 2009, generally accepted accounting principles require the organization to evaluate the level of uncertainty related to whether tax positions taken will be sustained upon examination. Any positions taken that do not meet the more-likely-than-not threshold must be quantified and recorded as a liability for unrecognized tax benefits in the accompanying balance sheet along with any associated interest and penalties that would be payable to the taxing authorities upon examination. Interest and penalties associated with unrecognized tax benefits would be classified as additional income taxes in the statement of income. The organization believes that none of the tax positions taken would materially impact the financial statements and no such liabilities have been recorded. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantiation Required | Yes (true) | SubstantiationRequiredInd |
| 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 |
| Rebuttable Presumption Proc | false | RebuttablePresumptionProcInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (3 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt |
|---|---|---|---|---|
| David M Cola | ||||
| Physician | $200,065 | $6,000 | $624 | $206,689 |
| Houneine Gashash | ||||
| Medical Director | $195,009 | $6,993 | $14,811 | $216,813 |
| Thomas K Mun | ||||
| Dentist | $162,266 | $22,319 | $184,585 | |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (23 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Line 11b: Form 990 Review Process | No review was or will be conducted. |
| Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts | Board members annually review status for potential conflicts of interest and declare in writing any that may exist. board members abstain from voting on issues that may represent a conflict of interest for them. |
| Form 990, Part VI, Line 15a: Compensation Review & Approval Process - CEO, Top Management | Compensation set according to organization's pay scale. |
| Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees | Compensation set according to organization's pay scale. |
| Form 990, Part VI, Line 19: Other Organization Documents Publicly Available | Governing documents, policies, and financial statements are available at the organization's office and are presented to the public upon request. |
| Form 990, Part IX, Line 24e: Other Expenses | Bank Charges and Fees: Column (A) - Total = $4563; Column (B) - Program Services = $0; Column (C) - Management & General = $4563; Column (D) - Fundraising = $0 |
| Form 990, Part IX, Line 24e: Other Expenses | Dues and Subscriptions: Column (A) - Total = $16925; Column (B) - Program Services = $7627; Column (C) - Management & General = $9298; Column (D) - Fundraising = $0 |
| Form 990, Part IX, Line 24e: Other Expenses | Education and Training: Column (A) - Total = $34994; Column (B) - Program Services = $23239; Column (C) - Management & General = $11755; Column (D) - Fundraising = $0 |
| Form 990, Part IX, Line 24e: Other Expenses | Employee Relations: Column (A) - Total = $10220; Column (B) - Program Services = $8690; Column (C) - Management & General = $1530; Column (D) - Fundraising = $0 |
| Form 990, Part IX, Line 24e: Other Expenses | Hazardous Waste Removal: Column (A) - Total = $16151; Column (B) - Program Services = $16151; Column (C) - Management & General = $0; Column (D) - Fundraising = $0 |
| Form 990, Part IX, Line 24e: Other Expenses | Licenses and Permits: Column (A) - Total = $1250; Column (B) - Program Services = $1050; Column (C) - Management & General = $200; Column (D) - Fundraising = $0 |
| Form 990, Part IX, Line 24e: Other Expenses | Medications: Column (A) - Total = $16831; Column (B) - Program Services = $16831; Column (C) - Management & General = $0; Column (D) - Fundraising = $0 |
| Form 990, Part IX, Line 24e: Other Expenses | Miscellaneous Expenses: Column (A) - Total = $10408; Column (B) - Program Services = $7842; Column (C) - Management & General = $2566; Column (D) - Fundraising = $0 |
| Form 990, Part IX, Line 24e: Other Expenses | Patient Support: Column (A) - Total = $73683; Column (B) - Program Services = $73683; Column (C) - Management & General = $0; Column (D) - Fundraising = $0 |
| Form 990, Part IX, Line 24e: Other Expenses | Postage and Shipping: Column (A) - Total = $15080; Column (B) - Program Services = $11600; Column (C) - Management & General = $3480; Column (D) - Fundraising = $0 |
| Form 990, Part IX, Line 24e: Other Expenses | Printing and Publications: Column (A) - Total = $14531; Column (B) - Program Services = $8483; Column (C) - Management & General = $6048; Column (D) - Fundraising = $0 |
| Form 990, Part IX, Line 24e: Other Expenses | Real Estate Taxes: Column (A) - Total = $13434; Column (B) - Program Services = $0; Column (C) - Management & General = $13434; Column (D) - Fundraising = $0 |
| Form 990, Part IX, Line 24e: Other Expenses | Repairs and Maintenance: Column (A) - Total = $100652; Column (B) - Program Services = $68867; Column (C) - Management & General = $31785; Column (D) - Fundraising = $0 |
| Form 990, Part IX, Line 24e: Other Expenses | Small Equipment: Column (A) - Total = $4395; Column (B) - Program Services = $4395; Column (C) - Management & General = $0; Column (D) - Fundraising = $0 |
| Form 990, Part IX, Line 24e: Other Expenses | Supplies: Column (A) - Total = $95861; Column (B) - Program Services = $78224; Column (C) - Management & General = $17637; Column (D) - Fundraising = $0 |
| Form 990, Part IX, Line 24e: Other Expenses | Technology Support: Column (A) - Total = $91569; Column (B) - Program Services = $67433; Column (C) - Management & General = $24136; Column (D) - Fundraising = $0 |
| Form 990, Part IX, Line 24e: Other Expenses | Telephone: Column (A) - Total = $110367; Column (B) - Program Services = $85956; Column (C) - Management & General = $24411; Column (D) - Fundraising = $0 |
| Form 990, Part IX, Line 24e: Other Expenses | Utilities: Column (A) - Total = $41675; Column (B) - Program Services = $27658; Column (C) - Management & General = $14017; Column (D) - Fundraising = $0 |