LONGVIEW WELLNESS CENTER INC: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- LONGVIEW WELLNESS CENTER INC (EIN 75-2723993)
- Tax period
- 2016-01-01 to 2016-12-31
- Filed
- 2017-11-15
- IRS object ID
- 201713199349304346
- 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 | 2017-11-15T10:02:20-06:00 | ReturnTs |
| Tax Period End | 2016-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 752570395 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DURBIN & COMPANY LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2950 50TH STREET | AddressLine1Txt |
| City | LUBBOCK | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 79413 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 752723993 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LONGVIEW WELLNESS CENTER INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | LONG | BusinessNameControlTxt |
| Phone | 9037582610 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 3647 | AddressLine1Txt |
| City | LONGVIEW | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 756063647 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TIMOTHY CHAD JONES | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 9037582610 | PhoneNum |
| Signature | 2017-11-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | GAYLE L DE HAAS | PreparerPersonNm |
| PTIN | P01774581 | PTIN |
| Phone | 8067911591 | PhoneNum |
| Preparation | 2017-11-02 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 12.44.95.50 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2017-11-15 | IPDt |
| IP Tm | 10:01:55 | IPTm |
| IP Timezone | CS | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 00DC5DC89968C6BE560901454C496131615A7D99 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 00DC5DC89968C6BE560901454C496131615A7D99 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2017-02-10 21:41:12Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WELLNESS POINTE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | TIMOTHY CHAD JONES | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1107 EAST MARSHALL AVE | AddressLine1Txt |
| City | LONGVIEW | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 75601 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $15,211,763 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.WELLNESSPOINTE.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1997 | FormationYr |
| Legal Domicile State | TX | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE ACCESS TO HIGH QUALITY MEDICAL, DENTAL AND SOCIAL SERVICES ACROSS THE PATIENT LIFECYCLE WITHOUT REGARD TO INSURANCE STATUS OR ABILITY TO PAY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 231 | TotalEmployeeCnt |
| Total Volunteers | 20 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $5,411,046 | PYContributionsGrantsAmt |
| CY Contributions Grants | $6,104,411 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $7,309,450 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $8,466,701 | CYProgramServiceRevenueAmt |
| PY Investment Income | $7,364 | PYInvestmentIncomeAmt |
| CY Investment Income | $5,281 | CYInvestmentIncomeAmt |
| PY Other Revenue | $216,093 | PYOtherRevenueAmt |
| CY Other Revenue | $635,370 | CYOtherRevenueAmt |
| PY Total Revenue | $12,943,953 | PYTotalRevenueAmt |
| CY Total Revenue | $15,211,763 | 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 | $9,825,944 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $8,486,755 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $3,796,593 | PYOtherExpensesAmt |
| CY Other Expenses | $7,326,163 | CYOtherExpensesAmt |
| PY Total Expenses | $13,622,537 | PYTotalExpensesAmt |
| CY Total Expenses | $15,812,918 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$678,584 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$601,155 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $5,214,383 | TotalAssetsBOYAmt |
| Total Assets EOY | $4,641,356 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,844,547 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,872,675 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $3,369,836 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $2,768,681 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO PROVIDE ACCESS TO HIGH QUALITY MEDICAL, DENTAL AND SOCIAL SERVICES ACROSS THE PATIENT LIFECYCLE WITHOUT REGARD TO INSURANCE STATUS OR ABILITY TO PAY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $12,102,066 | ExpenseAmt |
| Revenue | $9,102,071 | RevenueAmt |
| Desc | PROVIDE MEDICAL CARE, OBSTETRIC & PEDIATRIC CARE, DENTAL SERVICES, PRENATAL AND NEWBORN HEALTHCARE, PSYCHIATRIC AND BEHAVIOR COUNSELING AND OPTOMETRY TO INDIGENT, UNINSURED AND UNDER-INSURED PATIENTS. THE ORGANIZATION SERVED 17,340 PATIENTS DURING 2016. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $798,940 | ExpenseAmt |
| Desc | ADMINISTERED THE WOMEN'S, INFANTS AND CHILDREN'S ("WIC") PROGRAM TO PROVIDE NUTRITIONAL EDUCATION AND VOUCHERS FOR WIC APPROVED NUTRITIONAL FOODS. ALSO PROVIDED TRAINING AND SUPPORT FOR BREAST FEEDING FOR NEW MOTHERS. THE ORGANIZATION SERVED AN AVERAGE OF 4,767 PARTICIPANTS PER MONTH DURING 2016. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $299,323 | ExpenseAmt |
| Desc | PROVIDED HOME VISITING SERVICES DESIGNED TO SUPPORT AND STRENGTHEN THE PARENT-CHILD RELATIONSHIP TO IMPROVE THE HEALTH, DEVELOPMENT AND WELL-BEING FOR THE CHILD AND FAMILY TO 79 FAMILIES DURING 2016. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp (3 entries)
| ExpenseExpenseAmt | DescDesc |
|---|---|
| $95,894 | PROVIDED ALCOHOL, DRUG AND ANGER MANAGEMENT COUNSELING TO 1,816 PATIENTS IN 2016. |
| $279,354 | PROVIDED HIV PREVENTION AND TREATMENT RELATED SERVICES TO 8,751 PATIENTS IN 2016. |
| $432,619 | PROJECT REACH HELPED 80 TEXAS ADOLESCENTS IN 2016 IMPROVE OVERALL HEALTH AND WELL-BEING BY INCREASING PROTECTIVE FACTORS AND BUILD RESILIENCY IN ADOLESCENTS THROUGH A COMPREHENSIVE HEALTH ADOLESCENT INITIATIVE WITH IMPLENTATION OF EVIDENCE-BASED YOUTH DEVELOPMENT STRATEGIES BY A LOCAL COUNCIL BASED ON LOCAL NEED AND POPULATION TO SERVE. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $807,867 | TotalOtherProgSrvcExpenseAmt |
| Total Program Service Expenses | $14,008,196 | 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 | Yes (1) | 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 | 0 | 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 | Yes (1) | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | Yes (1) | 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 | 33 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 231 | 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 |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | 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 | 0 | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | 0 | 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
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHAD JONES AND TALIA PETERSON | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 9037582610 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1107 EAST MARSHALL AVE | AddressLine1Txt |
| City | LONGVIEW | CityNm |
| State Abbreviation | TX | StateAbbreviationCd |
| ZIP | 75601 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (22 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| MARY ANN MILLER | |||||||
| PRESIDENT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| DEENA SHELTON | |||||||
| VICE-PRESIDENT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| ALLEN LIZZA | |||||||
| TREASURER | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| RIC BRACK | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JOYCELYNE FADOJUTIMI | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JOHN GREEN | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| LANCE LARISON | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| CASEY ROBERTSON | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| BARBARA SMITH | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| GABRIELA SOLIZ | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| MATT TOOKER | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| TIMOTHY CHAD JONES | |||||||
| CEO | 40.00 | Yes (X) | $227,746 | $0 | $0 | ||
| TALIA PETERSON | |||||||
| CFO | 40.00 | Yes (X) | $117,687 | $0 | $0 | ||
| ANNETTE OKPEKI | |||||||
| CMO | 40.00 | Yes (X) | $233,610 | $0 | $0 | ||
| MELISSA BRITTAIN | |||||||
| COO | 40.00 | Yes (X) | $83,916 | $0 | $0 | ||
| JEFFREY BROWN | |||||||
| BUSINESS DEVELOPMENT | 40.00 | $101,869 | $0 | $0 | Yes (X) | ||
| MICHAEL ESEDEBE | |||||||
| PHYSICIAN | 40.00 | $301,031 | $0 | $0 | Yes (X) | ||
| JACLYN GILLIAM | |||||||
| CMN | 40.00 | $164,663 | $0 | $0 | Yes (X) | ||
| RANDY MOORE | |||||||
| PHYSICIAN ASSISTANT | 40.00 | $106,999 | $0 | $0 | Yes (X) | ||
| JENNIFER SMITH | |||||||
| DENTIST | 40.00 | $113,090 | $0 | $0 | Yes (X) | ||
| RAMON VILLAFRIA | |||||||
| PHYSICIAN | 40.00 | $213,638 | $0 | $0 | Yes (X) | ||
| KHOSHUNDA WILLIAMS | |||||||
| PHYSICIAN ASSISTANT | 40.00 | $100,046 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,764,295 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $0 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 10 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| DAMON W SPENCER | |||||
| 6320 MISTRY TRAIL | DALLAS | TX | 75248 | DENTAL SERVICES | $281,661 |
| FRANK J TIBILETTI | |||||
| 1300 LEDUKE BLVD | LONGVIEW | TX | 75601 | OB-GYN SERVICES | $121,233 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $5,206,917 | GovernmentGrantsAmt |
| All Other Contributions | $897,494 | AllOtherContributionsAmt |
| Noncash Contributions | $864,301 | NoncashContributionsAmt |
| Total Contributions | $6,104,411 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PROGRAM SERVICE | Desc |
| Business | 621110 | BusinessCd |
| Total Revenue Column | $8,466,701 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $8,466,701 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $8,466,701 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,281 | TotalRevenueColumnAmt |
| Exclusion | $5,281 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PHARMACY 340B | 624100 | $311,268 | $311,268 |
| INCENTIVE REVENUE | 624100 | $154,712 | $154,712 |
| COMMUNITY HEALTHCORE R | 624100 | $128,560 | $128,560 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $40,830 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $40,830 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $635,370 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $15,211,763 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $9,102,071 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $5,281 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $662,959 | TotalAmt |
| Program Services | $233,610 | ProgramServicesAmt |
| Management And General | $429,349 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,860,131 | TotalAmt |
| Program Services | $6,093,120 | ProgramServicesAmt |
| Management And General | $767,011 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $95,197 | TotalAmt |
| Program Services | $70,005 | ProgramServicesAmt |
| Management And General | $25,192 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $281,214 | TotalAmt |
| Program Services | $259,918 | ProgramServicesAmt |
| Management And General | $21,296 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $587,254 | TotalAmt |
| Program Services | $546,221 | ProgramServicesAmt |
| Management And General | $41,033 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $80,619 | TotalAmt |
| Program Services | $80,619 | ProgramServicesAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,884,896 | TotalAmt |
| Program Services | $1,875,207 | ProgramServicesAmt |
| Management And General | $9,689 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $190,048 | TotalAmt |
| Program Services | $188,135 | ProgramServicesAmt |
| Management And General | $1,913 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $258,911 | TotalAmt |
| Program Services | $204,325 | ProgramServicesAmt |
| Management And General | $54,586 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $35,348 | TotalAmt |
| Program Services | $31,141 | ProgramServicesAmt |
| Management And General | $4,207 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $836,803 | TotalAmt |
| Program Services | $831,720 | ProgramServicesAmt |
| Management And General | $5,083 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $160,390 | TotalAmt |
| Program Services | $141,096 | ProgramServicesAmt |
| Management And General | $19,294 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $62,396 | TotalAmt |
| Program Services | $54,861 | ProgramServicesAmt |
| Management And General | $7,535 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,083 | TotalAmt |
| Program Services | $21,083 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $358,551 | TotalAmt |
| Management And General | $358,551 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $43,506 | TotalAmt |
| Program Services | $43,506 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| BAD BEDT | $1,392,436 | $1,392,436 | |
| IN KIND EXPENSE | $863,832 | $863,832 | |
| MEDICAL SUPPLIES | $626,670 | $626,670 | |
| MEDICAL RECORDS | $172,634 | $172,444 | $190 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $338,040 | TotalAmt |
| Program Services | $278,247 | ProgramServicesAmt |
| Management And General | $59,793 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,812,918 | TotalAmt |
| Program Services | $14,008,196 | ProgramServicesAmt |
| Management And General | $1,804,722 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $533,634 | BOYAmt |
| EOY | $242,627 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,267,515 | BOYAmt |
| EOY | $1,011,900 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,027,985 | BOYAmt |
| EOY | $569,456 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $86,438 | BOYAmt |
| EOY | $99,644 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $43,382 | BOYAmt |
| EOY | $28,860 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $6,395,862 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $4,368,483 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,255,429 | BOYAmt |
| EOY | $2,027,379 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $661,490 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,214,383 | BOYAmt |
| EOY | $4,641,356 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,344,858 | BOYAmt |
| EOY | $1,292,389 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $174,592 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $499,689 | BOYAmt |
| EOY | $405,694 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,844,547 | BOYAmt |
| EOY | $1,872,675 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,369,836 | BOYAmt |
| EOY | $2,768,681 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,369,836 | BOYAmt |
| EOY | $2,768,681 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,214,383 | BOYAmt |
| EOY | $4,641,356 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$601,155 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | Yes (1) | AccountantCompileOrReviewInd |
Acct Compile Or Review Basis AcctCompileOrReviewBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | $4,285,269 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,894,035 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $5,146,794 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $5,411,046 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $6,104,411 | CurrentTaxYearAmt |
| Total | $25,841,555 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,285,269 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,894,035 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $5,146,794 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $5,411,046 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $6,104,411 | CurrentTaxYearAmt |
| Total | $25,841,555 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $25,841,555 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $14,353 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $9,086 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7,840 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $7,363 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $5,281 | CurrentTaxYearAmt |
| Total | $43,923 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $25,885,478 | TotalSupportAmt |
| Public Support CY170 | 0.99830 | PublicSupportCY170Pct |
| Public Support PY170 | 0.99750 | 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 | $121,225 | OtherCostOrOtherBasisAmt |
| Book Value | $121,225 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,861,710 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,649,942 | DepreciationAmt |
| Book Value | $1,211,768 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $78,906 | OtherCostOrOtherBasisAmt |
| Depreciation | $53,814 | DepreciationAmt |
| Book Value | $25,092 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,308,979 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,656,261 | DepreciationAmt |
| Book Value | $652,718 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $25,042 | OtherCostOrOtherBasisAmt |
| Depreciation | $8,466 | DepreciationAmt |
| Book Value | $16,576 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $2,027,379 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OTHER RECEIVABLES | Desc |
| Book Value | $661,490 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $661,490 | TotalBookValueOtherAssetsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $13,819,327 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | -$1,392,436 | OtherRevenueAmt |
| Revenue Not Reported | -$1,392,436 | RevenueNotReportedAmt |
| Revenue Subtotal | $15,211,763 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $15,211,763 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $14,420,482 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $14,420,482 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $1,392,436 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $1,392,436 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $15,812,918 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | THE ORGANIZATION IS A NOT-FOR-PROFIT ORGANIZATION EXEMPT FROM FEDERAL INCOME TAXES UNDER IRC SECTION 501(C)(3). IT EVALUATES AND ACCOUNTS FOR UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH FASB ACS 740, INCOME TAXES (FORMERLY FASB INTERPRETATIONS 48 (FIN 48)) ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES. THIS STANDARD REQUIRES CERTAIN DISCLOSURES ABOUT UNCERTAIN INCOME TAX POSITIONS. THE ORGANIZATION EVALUATES ANY UNCERTAIN TAX POSITIONS USING THE PROVISIONS OF ACS 450, CONTINGENCIES. AS A RESULT, MANAGMENT DOES NOT BELIEVE ANY UNCERTAIN TAX POSITIONS CURRENTLY EXIST AND NO LOSS CONTINGENCY HAS BEEN RECOGNIZED IN THE FINANCIAL STATEMENTS. THE ORGANIZATION HAS FILED ALL APPLICABLE TAX RETURNS. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | BAD DEBT EXPENSE -1,392,436. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | BAD DEBT 1,392,436. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 (5 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| TIMOTHY CHAD JONES | ||||||||||||||
| CEO | $227,746 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $227,746 | $0 | $0 | $0 |
| ANNETTE OKPEKI | ||||||||||||||
| CMO | $233,610 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $233,610 | $0 | $0 | $0 |
| MICHAEL ESEDEBE | ||||||||||||||
| PHYSICIAN | $301,031 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $301,031 | $0 | $0 | $0 |
| JACLYN GILLIAM | ||||||||||||||
| CMN | $164,663 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $164,663 | $0 | $0 | $0 |
| RAMON VILLAFRIA | ||||||||||||||
| PHYSICIAN | $213,638 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $213,638 | $0 | $0 | $0 |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| CASEY ROBERTSON | |||
| BOARD MEMBER | $79,125 | OPERATING LEASE | 0 |
| CASEY ROBERTSON | |||
| BOARD MEMBER | $136,073 | MEDICAL CLAIMS | 0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART IV | FormAndLineReferenceDesc |
| Explanation | CASEY ROBERTSON, A BOARD MEMBER, IS THE CHIEF EXECUTIVE OFFICER FOR A LOCAL HOSPITAL WHERE THE ORGANIZATION HAS CURRENT OPERATING LEASE AGREEMENTS. FURTHERMORE, THE ORGANIZATION HAS A CONTRACT WITH THIS LOCAL HOSPITAL FOR EMPLOYEE MEDICAL CLAIMS PAID RELATED TO THE ORGANIZATION'S SELF-FUNDED INSURANCE PLAN.IN ADDITION, THE ORGANIZATION ENTRED INTO A DONATION AGREEMENT IN 2015 WITH THE HOSPITAL FOR A ONE TIME IRREVOCABLE DONATION IN THE AMOUNT OF $45,000 TO BE DISBURSED IN FOUR EQUAL PAYMENTS DURING THE PERIOD FROM MARCH 1, 2015 TO FEBRUARY 29, 2016. THE DONATION WAS TO PROVIDE SUPPORT FOR THE ORGANIZATION'S CHARITABLE MISSION. AT THE END OF 2015, THE ORGANIZATION HAD RECEIVED $33,750 AND THE REMIAING $11,250 WAS RECORDED AS A RECIEVABLE. IN JANUARY 2017, THE ORGANIZATION AND THE HOSPITAL ENTERED INTO ANOTHER ONE TIME IRREVOCABLE DONATION AGREEMENT TO THE ORGANIZATION. BOTH THE HOSPITAL AND THE ORGANIZATION AGREED THAT THE 2015 AGREEMENT WAS TERMINATED AND THE FINAL PAYMENT OF $11,250 WOULD BE WAIVED UPON MAKING THE 2017 AGREEMENT. THE ORGANIZATION DISCHARGED AND RELEASED THE HOSPITAL FROM ANY LIABILITY ARISING FROM THE 2015 AGREEMENT. | ExplanationTxt |
Schedule M IRS990ScheduleM
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 1000 | ContributionCnt |
| Noncash Contributions Rpt F990 | $821,537 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FMV | 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 | AN OUTSIDE, INDEPENDENT ACCOUNTING FIRM PREPARES THE ORGANIZATION'S FORM 990. THE ORGANIZATION'S CEO, CFO AND BOARD CHAIR REVIEW THE RETURN BEFORE PROVIDING THE RETURN TO THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION REMINDS ALL SENIOR MANAGEMENT AND MANAGERS TO BE VIGILANT IN RECOGNIZING CONFLICTS OF INTEREST AS THEY ARISE. THE ORGANIZATION, ITS EMPLOYEES AND BOARD MEMBERS ARE LOCATED IN A RELATIVELY SMALL TOWN WHERE BUSINESS INTERESTS AND RELATIONS ARE WELL KNOWN TO THE PUBLIC. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE ORGANIZATION'S SENIOR MANAGEMENT AND BOARD UTILIZE COMPENSTION COMPARABILITY DATA PROVIDED ANNUALLY BY THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS TO ESTABLISH COMPENSATION FOR SENIOR OFFICIALS AND MANAGERS. |
| FORM 990, PART VI, SECTION C, LINE 19 | EXCEPT AS PROVIDED FOR IN THE ORGANIZATION'S FORM 1023 AND FORM 990S, THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY OR FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. |
| FORM 990, PART IX, LINE 11G | PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 1,875,207. MANAGEMENT AND GENERAL EXPENSES 9,689. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,884,896. |
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