2017-09-26T15:24:15-05:00 2017-01-31 454084437 Warren Averett LLC 3815 Interstate Ct Montgomery AL 36109 990 2016-02-01 630568762 Health Services Inc HEAL 3344205001 PO Drawer 70365 Montgomery AL 361070365 GILBERT F DARRINGTON Chief Executive Officer 3344205001 2017-09-19 1 D Clynton Hart Jr CPA P00191509 3342712200 2017-09-19 209.136.244.2 2017-09-19 10:23:54 CD P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 1C4810B5319DD293F2DA90C2F34FBB007D307061 2016 2021-01-29 14:40:06Z GILBERT F DARRINGTON PO Drawer 70365 Montgomery AL 361070365 24555236 0 X WWW.HEALTHSERVICESINC.ORG X 1968 AL Patient Centered Healthcare System enhancing the lives of individuals and families by providing access to affordable comprehensive health and wellness services in Montgomery and the surrounding areas. 17 17 343 17 0 0 8398385 8619108 14999819 15762866 129822 94843 71539 35191 23599565 24512008 0 0 0 0 14803169 15080400 0 0 0 7685135 8051361 22488304 23131761 1111261 1380247 20521092 21505084 3032011 2715756 17489081 18789328 Health Services, Inc. (HSI) is a medical home providing access to affordable primary, preventive and wellness services distinguished by compassion, quality, integrity and respect in Montgomery and surrounding areas. 0 0 16447250 15798057 HSI SERVED APPROXIMATELY 30,000 PATIENTS ACCOUNTING FOR APPROXIMATELY 117,000 VISITS DURING THE YEAR. THE VISITS COVERED A BROAD RANGE OF SERVICES INCLUDING GENERAL WELLNESS AND PRIMARY CARE, PEDIATRICS, DENTISTRY, OPTOMETRY, OB/GYN AND FAMILY PLANNING AND FAMILY CARE; COUNSELING AND PSYCHIATRY FOR VARIOUS TREATMENT AND DISORDERS IN CHILDREN AND ADULTS; MILITARY AND VETERAN RESOURCES, SPECIALTY REFERRALS, ENROLLMENT SERVICES AND THE WOMEN, INFANTS & CHILDREN (WIC) PROGRAM. 16447250 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 73 0 1 343 1 0 0 0 0 0 0 0 0 0 0 X 17 17 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X X SUSIE JONES 3344205001 PO DRAWER 70365 Montgomery AL 36107 choona lang dIRECTOR 1.00 X 0 0 0 JANICE DURR treasurer 1.00 X X 0 0 0 JAMES BROWN DIRECTOR 1.00 X 0 0 0 JOSIE KNOTT DIRECTOR 1.00 X 0 0 0 david hughes DIRECTOR 1.00 X 0 0 0 MOLLY STONE DIRECTOR 1.00 X 0 0 0 jacqueline navidad DIRECTOR 1.00 X 0 0 0 DR WILLIAM ABERNATHY DIRECTOR 1.00 X 0 0 0 NICOLETTE RUSSELL DIRECTOR 1.00 X 0 0 0 CLAUDE DOUGLAS VICE CHAIR 1.00 X X 0 0 0 CLASSIE THOMAS PAST CHAIR 1.00 X 0 0 0 ANITA ARCHIE DIRECTOR 1.00 X 0 0 0 SANDRA BERRY SECRETARY 1.00 X X 0 0 0 JAUNITA OWES CHAIR 1.00 X X 0 0 0 JESSIE BINION DIRECTOR 1.00 X 0 0 0 WILLIAM LOVE DIRECTOR 1.00 X 0 0 0 donna rich dIRECTOR 1.00 X 0 0 0 SUSIE JONES CFO 40.00 X 23075 0 0 BIANCA GRANGER COO 40.00 X 138734 0 0 GILBERT DARRINGTON CEO 40.00 X 210225 0 0 MAHMOOD ZAIED DOCTOR/CHIEF OF PEDIATRICS 76.00 X 396225 0 0 GEORGE THOMAS CMO/DOCTOR 67.00 X 287048 0 0 ABDULSATTAR ZIDAN DOCTOR 71.00 X 408862 0 0 THEODORE SMITH JR DOCTOR/ASSISTANT MEDICAL D 40.00 X 375529 0 0 VILMA E PESSOA DOCTOR 40.00 X 320433 0 0 2160131 0 0 7 0 1 0 PRIORITY MANAGEMENT GROUP 700 SCHOOL STREET PAWTUCKET RI 02860 AR/BILLING CONTRACTOR 952357 LABORATORY CORPORATION OF AMERICA 3221 3RD AVENUE SOUTH BIRMINGHAM AL 35222 LAB CONTRACTOR 690929 JOB KONNECTIONS LLC 1316 S GILMER AVE LANETT AL 36863 STAFFING CONTRACTOR 370149 MONTGOMERY COUNTY HEALTH DEPARTMENT 3060 MOBILE HIGHWAY MONTGOMERY AL 36108 occupancy costs 300497 AMERISOURCEBERGEN-BIRMINGHAM PO BOX 905223 CHARLOTTE NC 28290 Pharmaceuticals 268012 5 19361 8591934 7813 8619108 MEDICARE/MEDICAID 524114 13070776 13070776 SELF PAY 900099 1122729 1122729 THIRD PARTY INSURANCE 524292 1006262 1006262 340 (b) PHARMACY PROGRAM 446110 344308 344308 health management report 900099 166089 166089 52702 52702 15762866 133267 133267 4804 43228 -38424 -38424 -38424 MEDICAL RECORDS 900099 29632 29632 MISCELLANEOUS 900099 5559 5559 35191 24512008 15798057 0 94843 X 13210279 10356739 2853540 1006337 499655 506682 863784 663414 200370 63089 63089 34995 34995 3642191 1937521 1704670 128376 64162 64214 79118 32995 46123 1610246 1233305 376941 117855 69146 48709 38421 25913 12508 75807 75807 310521 310521 183424 11828 171596 SUPPLIES AND PHARMACEUT 1180646 1079852 100794 EQUIPMENT RENTAL 446382 378491 67891 MISCELLANEOUS 80801 69788 11013 DUES AND SUBSCRIPTIONS 59489 24441 35048 23131761 16447250 6684511 0 599481 1104130 794414 2333429 1355579 343566 1004018 907179 86825 114345 375693 402360 5166317 2827791 2308058 2338526 171784 169850 585862 505862 13239378 13285837 20521092 21505084 1539079 1418906 1321148 1127000 171784 169850 3032011 2715756 X 17474842 18775089 14239 14239 17489081 18789328 20521092 21505084 X 1380247 -80000 X 0 1 X 1 1 1 X 6899354 7108625 7351600 8398385 8619108 38377072 6899354 7108625 7351600 8398385 8619108 38377072 38377072 3499 2795 329941 130630 133267 600132 41344 43700 48078 71539 35191 239852 39217056 0.97860 0.98570 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 289944 289944 1709489 662523 1046966 358005 298820 59185 2372359 1632091 740268 436520 234357 202163 2338526 Due from Health Services Holding Company, Inc. 248944 note receivable - montgomery hsi investment fund, llc 13036893 13285837 DEFERRED COMPENSATION 169850 169850 X Part X, Line 2: The Organization is exempt from income taxes under Section 501(c)(3) of the Internal Revenue Code (IRC) and similar provisions of Alabama law and is classified by the Internal Revenue Service as an organization other than a private foundation. As of and for the year ended January 31, 2017, the Organization had no uncertain tax positions that qualify for recognition or disclosure in the financial statements and no interest and penalties related to income taxes. X X 1 0 0 0 0 0 0 1 0 GILBERT DARRINGTON CEO 210225 0 0 0 0 0 0 0 0 0 210225 0 0 0 MAHMOOD ZAIED DOCTOR/CHIEF OF PEDIATRICS 312269 0 83956 0 0 0 0 0 0 0 396225 0 0 0 GEORGE THOMAS CMO/DOCTOR 275048 0 12000 0 0 0 0 0 0 0 287048 0 0 0 ABDULSATTAR ZIDAN DOCTOR 276366 0 132496 0 0 0 0 0 0 0 408862 0 0 0 THEODORE SMITH JR DOCTOR/ASSISTANT MEDICAL D 243866 0 131663 0 0 0 0 0 0 0 375529 0 0 0 VILMA E PESSOA DOCTOR 185437 0 134996 0 0 0 0 0 0 0 320433 0 0 0 Part I, Line 3 CEO has a written contract that was approved by the board. Part I, Line 7 EMPLOYED PROVIDERS (MEDICAL DOCTORS, PHYSICIAN ASSISTANTS, AND NURSE PRACTITIONERS) RECEIVED INCENTIVES BASED UPON TOTAL ENCOUNTERS. Form 990, Part VI, Section B, line 11b The Controller, CFO, and CEO review support documents and tax return. Form 990, Part VI, Section B, line 12c It is monitored by the corporate compliance officer. Form 990, Part VI, Section B, line 15 The board of directors utilize an independent national legal firm of the organization's association to determine appropriate CEO compensation. Other key employee compensation is determined by using published materials and local comparability data. Form 990, Part VI, Section C, line 19 Governing documents are made available to the public upon request. Form 990, Part IX, line 11g Contractual costs: Program service expenses 1,937,521. Management and general expenses 1,704,670. Fundraising expenses 0. Total expenses 3,642,191. Form 990, Part XI, line 9: impairment of goodwill -80,000. ALABAMA HEALTCARE CONSORTIUM LLC 2731 ML KING JR BLVD TUSCALOOSA AL 35401 201031600 TECHNOLOGICAL GRANTS AL 501(C)3 Line 7 0 HEALTH SERVICES HOLDING CO INC 1845 CHERRY STREET mONTGOMERY AL 36106 460790158 PROMOTE HEALTH SERVICES INC AL 501(C)2 HEALTH SERVICES INC 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 0 1 0 0 health services holding company inc K 308079 cash