MOSES LAKE COMMUNITY HEALTH CENTER: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- MOSES LAKE COMMUNITY HEALTH CENTER (EIN 91-1537371)
- Tax period
- 2015-04-01 to 2016-03-31
- Filed
- 2017-02-07
- IRS object ID
- 201730389349301198
- Schema version
- 2015v3.0
- 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 | 2017-02-07T16:41:22-06:00 | ReturnTs |
| Tax Period End | 2016-03-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 911194016 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLARK NUBER PS | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10900 NE 4TH STREET SUITE 1700 | AddressLine1Txt |
| City | BELLEVUE | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98004 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-04-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 911537371 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MOSES LAKE COMMUNITY HEALTH CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MOSE | BusinessNameControlTxt |
| Phone | 5097650674 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 605 SOUTH COOLIDGE STREET | AddressLine1Txt |
| City | MOSES LAKE | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98837 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | AMANDA DUZON | PersonNm |
| Person Title | CHIEF FINANCIAL OFFICER | PersonTitleTxt |
| Phone | 5097650674 | PhoneNum |
| Signature | 2017-01-17 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KATHRYN J ONG | PreparerPersonNm |
| PTIN | P00746598 | PTIN |
| Phone | 4254544919 | PhoneNum |
| Preparation | 2017-01-17 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | SHEILA CHILSON | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 605 SOUTH COOLIDGE STREET | AddressLine1Txt |
| City | MOSES LAKE | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98837 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $32,403,158 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.MLCHC.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1991 | FormationYr |
| Legal Domicile State | WA | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE HIGH QUALITY, COMPASSIONATE AND COMPREHENSIVE PRIMARY HEALTH SERVICES FOR THE ENTIRE FAMILY, WITH A SPECIAL FOCUS ON THE UNDERSERVED AND MIGRANT FARM-WORKERS IN THE COMMUNITY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 298 | TotalEmployeeCnt |
| Total Volunteers | 11 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $5,254,443 | PYContributionsGrantsAmt |
| CY Contributions Grants | $5,783,143 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $19,635,114 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $19,920,313 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$594,346 | PYInvestmentIncomeAmt |
| CY Investment Income | $214,407 | CYInvestmentIncomeAmt |
| PY Other Revenue | $9,663 | PYOtherRevenueAmt |
| CY Other Revenue | $6,509 | CYOtherRevenueAmt |
| PY Total Revenue | $24,304,874 | PYTotalRevenueAmt |
| CY Total Revenue | $25,924,372 | 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 | $15,928,145 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $18,498,730 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $6,587,593 | PYOtherExpensesAmt |
| CY Other Expenses | $7,235,801 | CYOtherExpensesAmt |
| PY Total Expenses | $22,515,738 | PYTotalExpensesAmt |
| CY Total Expenses | $25,734,531 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,789,136 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $189,841 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $29,135,578 | TotalAssetsBOYAmt |
| Total Assets EOY | $31,856,736 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $6,175,249 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $8,822,245 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $22,960,329 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $23,034,491 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO PROVIDE HIGH QUALITY, COMPASSIONATE AND COMPREHENSIVE PRIMARY HEALTH SERVICES FOR THE ENTIRE FAMILY, WITH A SPECIAL FOCUS ON THE UNDERSERVED AND MIGRANT FARM-WORKERS IN THE COMMUNITY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $12,050,463 | ExpenseAmt |
| Revenue | $14,204,376 | RevenueAmt |
| Desc | MEDICAL SERVICES - THIS PROGRAM INCLUDES MEDICAL, BEHAVIORAL HEALTH AND PHARMACY SERVICES PROVIDED TO PATIENTS OF THE HEALTH CENTER. MOSES LAKE COMMUNITY HEALTH CENTER (MLCHC) PROVIDES PRIMARY CARE SERVICES INCLUDING OBSTETRICS CARE WITH 9 PHYSICIANS AND 10 MID-LEVEL PHYSICIANS ON STAFF. IN 2015, 21,025 MEDICAL PATIENTS WERE SEEN WITH A TOTAL OF 72,413 VISITS. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $4,571,346 | ExpenseAmt |
| Revenue | $4,535,633 | RevenueAmt |
| Desc | DENTAL SERVICES - MLCHC HAS 8 DENTISTS AND 5 DENTAL HYGIENISTS ON STAFF TO PROVIDE PREVENTATIVE, RESTORATIVE AND EMERGENCY CARE TO THE HEALTH CENTER'S INSURED AND UNINSURED PATIENTS. IN 2015, 11,875 PATIENTS WERE SEEN IN THE DENTAL DEPARTMENT WITH A TOTAL OF 34,100 VISITS PROVIDED. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $2,169,392 | ExpenseAmt |
| Revenue | $1,180,304 | RevenueAmt |
| Desc | OTHER HEALTH PROGRAMS - MLCHC PROVIDES MATERNITY SUPPORT SERVICES, WIC, INFANT TODDLER EARLY INTERVENTION AND DEVELOPMENTAL DISABILITY PARENT TRAINING PROGRAMS. THE MATERNITY SUPPORT SERVICES DEPARTMENT PROVIDED 7,624 VISITS TO APPROXIMATELY 1,261 PATIENTS. THE WIC PROGRAM SERVICES ELIGIBLE CLIENTS THROUGHOUT GRANT COUNTY IN MULTIPLE LOCATIONS. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $18,791,201 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | 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 | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 37 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 298 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | Yes (1) | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | WA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AMANDA DUZON | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5097650674 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 605 SOUTH COOLIDGE STREET | AddressLine1Txt |
| City | MOSES LAKE | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98837 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (22 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| AMY RAYMOND | |||||||||
| BOARD CHAIR | 2.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| SCOTT CAMPBELL | |||||||||
| BOARD VICE CHAIR | 2.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| MATTHEW BENSON | |||||||||
| TREASURER | 2.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| JUAN CARLOS MAGALLANES | |||||||||
| SECRETARY | 1.00 | 0.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| SHERRY DELGADO | |||||||||
| DIRECTOR | 1.00 | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| SHARON LANGE | |||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| CAROL SCHIMKE | |||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| DANIEL CHAVEZ | |||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| AMELIA CAMPOS | |||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| EVA HIDALGO | |||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| DAYANA RUIZ | |||||||||
| DIRECTOR | 1.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| SHEILA A CHILSON | |||||||||
| CEO | 40.00 | 1.00 | Yes (X) | $212,308 | $0 | $20,415 | |||
| JULIE WEISENBURG | |||||||||
| HR DIRECTOR | 40.00 | 0.00 | Yes (X) | $129,028 | $0 | $12,071 | |||
| AMANDA DUZON | |||||||||
| CFO | 40.00 | 1.00 | Yes (X) | $122,111 | $0 | $15,048 | |||
| KIM FRICKE | |||||||||
| COO (AS OF 9/2015) | 40.00 | 0.00 | Yes (X) | $40,416 | $0 | $454 | |||
| LARRY W VERHAGE | |||||||||
| PHYSICIAN/MEDICAL DIRECTOR | 40.00 | 0.00 | $326,797 | $0 | $24,581 | Yes (X) | |||
| BRETT L PACK | |||||||||
| DENTIST/DENTAL DIRECTOR | 40.00 | 0.00 | $242,975 | $0 | $23,656 | Yes (X) | |||
| AUGUST KING | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $313,329 | $0 | $24,581 | Yes (X) | |||
| COLE HEMMERLING | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $307,331 | $0 | $24,581 | Yes (X) | |||
| MICHAEL TOLLEY | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $299,767 | $0 | $24,578 | Yes (X) | |||
| JILL SIMON | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $248,708 | $0 | $21,216 | Yes (X) | |||
| SIMRAT SARAN | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $231,965 | $0 | $16,579 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,474,735 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $207,760 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 37 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (4 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| NUVODIA LLC | |||||
| 801 SOUTH STEVENS STREET | SPOKANE | WA | 99204 | INFORMATION TECHNOLOGY SERVICE | $667,692 |
| CLEANPROS | |||||
| PO BOX 305 | MOSES LAKE | WA | 98837 | JANITORIAL SERVICE | $219,505 |
| EXPENSE REDUCTION ANALYSTS INC | |||||
| PO BOX 856251 | ST LOUIS | MO | 63195 | EXPENSE REDUCTION SERVICES | $151,753 |
| INTERPATH | |||||
| PO BOX 1208 | PENDLETON | OR | 97801 | OUTSIDE LAB SERVICE | $144,478 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $5,673,617 | GovernmentGrantsAmt |
| All Other Contributions | $109,526 | AllOtherContributionsAmt |
| Total Contributions | $5,783,143 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICES | 624100 | $14,607,758 | $14,607,758 |
| MANAGED CARE | 624100 | $4,876,901 | $4,876,901 |
| CONTRACT SERVICES | 624100 | $435,654 | $435,654 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $19,920,313 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $255,634 | TotalRevenueColumnAmt |
| Exclusion | $255,634 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $1,650 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $1,650 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,650 | TotalRevenueColumnAmt |
| Exclusion | $1,650 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $6,437,559 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $6,411,194 | SecuritiesAmt |
| Other | $67,592 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $26,365 | SecuritiesAmt |
| Other | -$67,592 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$41,227 | TotalRevenueColumnAmt |
| Exclusion | -$41,227 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | SURPLUS | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $4,859 | TotalRevenueColumnAmt |
| Exclusion | $4,859 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $4,859 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $25,924,372 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $19,920,313 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $220,916 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,080,189 | TotalAmt |
| Program Services | $364,182 | ProgramServicesAmt |
| Management And General | $716,007 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,199,995 | TotalAmt |
| Program Services | $11,543,086 | ProgramServicesAmt |
| Management And General | $2,656,909 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $354,777 | TotalAmt |
| Program Services | $298,764 | ProgramServicesAmt |
| Management And General | $56,013 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,727,614 | TotalAmt |
| Program Services | $1,299,148 | ProgramServicesAmt |
| Management And General | $428,466 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,136,155 | TotalAmt |
| Program Services | $863,403 | ProgramServicesAmt |
| Management And General | $272,752 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $70,209 | TotalAmt |
| Management And General | $70,209 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | -$394 | TotalAmt |
| Program Services | -$1,675 | ProgramServicesAmt |
| Management And General | $1,281 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $58,750 | TotalAmt |
| Management And General | $58,750 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $55,817 | TotalAmt |
| Management And General | $55,817 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $193,098 | TotalAmt |
| Program Services | $186,928 | ProgramServicesAmt |
| Management And General | $6,170 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $55,119 | TotalAmt |
| Program Services | $9,495 | ProgramServicesAmt |
| Management And General | $45,624 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $198,770 | TotalAmt |
| Program Services | $99,166 | ProgramServicesAmt |
| Management And General | $99,604 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $928,288 | TotalAmt |
| Program Services | $247,668 | ProgramServicesAmt |
| Management And General | $680,620 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $426,816 | TotalAmt |
| Program Services | $94,562 | ProgramServicesAmt |
| Management And General | $332,254 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $143,320 | TotalAmt |
| Program Services | $80,504 | ProgramServicesAmt |
| Management And General | $62,816 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $92,452 | TotalAmt |
| Program Services | $71,567 | ProgramServicesAmt |
| Management And General | $20,885 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $61,993 | TotalAmt |
| Program Services | $61,957 | ProgramServicesAmt |
| Management And General | $36 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $808,695 | TotalAmt |
| Program Services | $320,568 | ProgramServicesAmt |
| Management And General | $488,127 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $88,186 | TotalAmt |
| Program Services | $34,781 | ProgramServicesAmt |
| Management And General | $53,405 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MED & PHARM SUPPLIES | $1,874,782 | $1,858,192 | $16,590 |
| PURCHASED SERVICES | $846,442 | $469,047 | $377,395 |
| BAD DEBT EXPENSE | $497,323 | $497,323 | |
| REPAIRS AND MAINTENANCE | $317,463 | $36,212 | $281,251 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $518,672 | TotalAmt |
| Program Services | $356,323 | ProgramServicesAmt |
| Management And General | $162,349 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,734,531 | TotalAmt |
| Program Services | $18,791,201 | ProgramServicesAmt |
| Management And General | $6,943,330 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,077,358 | BOYAmt |
| EOY | $2,065,325 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,476,526 | BOYAmt |
| EOY | $1,280,716 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $260,532 | BOYAmt |
| EOY | $183,774 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,158,515 | BOYAmt |
| EOY | $1,809,468 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,314,900 | BOYAmt |
| EOY | $6,314,900 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $444,792 | BOYAmt |
| EOY | $332,332 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $352,181 | BOYAmt |
| EOY | $276,029 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $16,747,557 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $7,275,570 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,730,925 | BOYAmt |
| EOY | $9,471,987 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,291,683 | BOYAmt |
| EOY | $10,095,568 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,166 | BOYAmt |
| EOY | $26,637 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,135,578 | BOYAmt |
| EOY | $31,856,736 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,175,249 | BOYAmt |
| EOY | $6,658,373 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $2,163,872 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,175,249 | BOYAmt |
| EOY | $8,822,245 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,960,329 | BOYAmt |
| EOY | $23,034,491 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,960,329 | BOYAmt |
| EOY | $23,034,491 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,135,578 | BOYAmt |
| EOY | $31,856,736 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $189,841 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$115,679 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| 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 | $3,939,664 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,891,803 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $4,307,074 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $5,254,443 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $5,783,143 | CurrentTaxYearAmt |
| Total | $23,176,127 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,939,664 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,891,803 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $4,307,074 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $5,254,443 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $5,783,143 | CurrentTaxYearAmt |
| Total | $23,176,127 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $23,176,127 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $227,236 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $256,737 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $260,631 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $249,322 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $257,284 | CurrentTaxYearAmt |
| Total | $1,251,210 | TotalAmt |
Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,274 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $20,610 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,786 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $9,313 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,859 | CurrentTaxYearAmt |
| Total | $41,842 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $193,250 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $63,750 | CurrentTaxYearMinus3YearsAmt |
| Total | $257,000 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $24,726,179 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $89,974,131 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.93730 | PublicSupportCY170Pct |
| Public Support PY170 | 0.93340 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: | FormAndLineReferenceDesc |
| Explanation | INCENTIVE PAYMENTS - 2011 AMOUNT: $ 193,250. 2012 AMOUNT: $ 63,750. | ExplanationTxt |
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 | $1,821,855 | OtherCostOrOtherBasisAmt |
| Book Value | $1,821,855 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,679,863 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,041,576 | DepreciationAmt |
| Book Value | $4,638,287 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,821,420 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,636,550 | DepreciationAmt |
| Book Value | $1,184,870 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,401,799 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,597,444 | DepreciationAmt |
| Book Value | $1,804,355 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $22,620 | OtherCostOrOtherBasisAmt |
| Book Value | $22,620 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $9,471,987 | TotalBookValueLandBuildingsAmt |
| Total Rev Etc Audited Fincl Stmt | $25,808,693 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$115,679 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | -$115,679 | RevenueNotReportedAmt |
| Revenue Subtotal | $25,924,372 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $25,924,372 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $26,042,017 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $307,486 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $307,486 | ExpensesNotReportedAmt |
| Expenses Subtotal | $25,734,531 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $25,734,531 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART XII, LINE 2D - OTHER ADJUSTMENTS: | FormAndLineReferenceDesc |
| Explanation | NET INCOME OF SUBSIDIARY 307,486. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| 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 (8 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SHEILA A CHILSON | ||||||||||||||
| CEO | $212,108 | $0 | $200 | $0 | $0 | $0 | $8,110 | $0 | $12,305 | $0 | $232,723 | $0 | $0 | $0 |
| LARRY W VERHAGE | ||||||||||||||
| PHYSICIAN/MEDICAL DIRECTOR | $326,597 | $0 | $200 | $0 | $0 | $0 | $10,600 | $0 | $13,981 | $0 | $351,378 | $0 | $0 | $0 |
| BRETT L PACK | ||||||||||||||
| DENTIST/DENTAL DIRECTOR | $241,875 | $0 | $200 | $0 | $900 | $0 | $9,675 | $0 | $13,981 | $0 | $266,631 | $0 | $0 | $0 |
| AUGUST KING | ||||||||||||||
| PHYSICIAN | $312,229 | $0 | $200 | $0 | $900 | $0 | $10,600 | $0 | $13,981 | $0 | $337,910 | $0 | $0 | $0 |
| COLE HEMMERLING | ||||||||||||||
| PHYSICIAN | $290,254 | $0 | $16,177 | $0 | $900 | $0 | $10,600 | $0 | $13,981 | $0 | $331,912 | $0 | $0 | $0 |
| MICHAEL TOLLEY | ||||||||||||||
| PHYSICIAN | $299,567 | $0 | $200 | $0 | $0 | $0 | $10,597 | $0 | $13,981 | $0 | $324,345 | $0 | $0 | $0 |
| JILL SIMON | ||||||||||||||
| PHYSICIAN | $222,608 | $0 | $20,200 | $0 | $5,900 | $0 | $8,911 | $0 | $12,305 | $0 | $269,924 | $0 | $0 | $0 |
| SIMRAT SARAN | ||||||||||||||
| PHYSICIAN | $230,765 | $0 | $300 | $0 | $900 | $0 | $9,235 | $0 | $7,344 | $0 | $248,544 | $0 | $0 | $0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART I, LINE 6: | THE BOARD OF DIRECTORS PER MLCHC BYLAWS REQUIRES A BOARD COMPOSITION OF 9 TO 15 MEMBERS. ALL VOLUNTEER POSITIONS ARE RELATED TO INVOLVEMENT ON THE BOARD, EITHER AS AN ELECTED MEMBER OR ADVISORY MEMBER. THESE INDIVIDUALS CONTRIBUTE A MINIMUM OF 3 HOURS A MONTH IN THIS CAPACITY. |
| FORM 990, PART VI, SECTION A, LINE 4 | THE ORGANIZATION'S BYLAWS WERE UPDATED TO INCLUDE DETAILS OF THE CONFLICT OF INTEREST POLICY. ADDITIONALLY, THE UPDATED BYLAWS SPECIFY THAT OFFICERS AND BOARD MEMBERS WILL SERVE WITHOUT COMPENSATION, BUT ARE ELIGIBLE TO RECEIVE REIMBURSEMENT FOR APPROVED EXPENSES INCURRED. |
| FORM 990, PART VI, SECTION B, LINE 11 | UPON COMPLETION OF THE FORM 990, THE RETURN WILL BE REVIEWED IN DETAIL WITH THE BOARD FINANCE COMMITTEE AND THEN IN SUMMARY WITH THE BOARD OF DIRECTORS. UPON APPROVAL BY THE BOARD OF DIRECTORS, THE FINAL FORM 990 WILL BE SUBMITTED TO THE INTERNAL REVENUE SERVICE. |
| FORM 990, PART VI, SECTION B, LINE 12C | OFFICERS, DIRECTORS AND KEY EMPLOYEES ARE REQUIRED ON A CONTINUOUS BASIS TO COMPLY WITH THE CONFLICT OF INTEREST POLICY AND ARE REQUIRED TO DISCLOSE TO THE BOARD OF DIRECTORS OR COMPLIANCE OFFICER ANY ISSUES OR CONCERNS. THE COMPLIANCE OFFICER IS RESPONSIBLE FOR MONITORING AND REPORTING ANY CONFLICTS OF INTEREST BROUGHT TO THE ATTENTION OF THE ORGANIZATION. A BOARD MEMBER WHO HAS A CONFLICT OF INTEREST, IN ANY MATTER BROUGHT BEFORE THE BOARD, SHALL DECLARE SUCH CONFLICT AND MAY BE INCLUDED IN, OR OFFER INFORMATION TO THE DISCUSSION, BUT SHALL ABSTAIN FROM VOTING. |
| FORM 990, PART VI, SECTION B, LINE 15 | FOR THE CEO, THE BOARD OF DIRECTORS REVIEWS SALARY SURVEYS AND REGIONAL MARKET COMPARISONS TO DETERMINE APPROPRIATE COMPENSATION LEVELS. THE CONTRACT IS REVIEWED BY THE BOARD OF DIRECTORS EVERY THREE YEARS AND APPROVED BY THE ENTIRE BOARD. OTHER OFFICERS AND KEY EMPLOYEES ARE REVIEWED UTILIZING SALARY SURVEYS AND REGIONAL MARKET COMPARISONS AS WELL. THIS PROCESS IS LED BY THE CEO WITH THE ASSISTANCE OF THE HR DIRECTOR. COMPENSATION INFORMATION IS REVIEWED WITH THE BOARD CHAIR BY THE CEO. THE LAST COMPENSATION REVIEW WAS PERFORMED IN MARCH 2016. A NEW WRITTEN CONTRACT FOR THE CEO WAS APPROVED BY THE BOARD OF DIRECTORS IN JUNE 2015. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE FOR VIEWING UPON REQUEST AT THE ORGANIZATION'S MAIN BUSINESS OFFICE IN THE PRESENCE OF THE CFO OR CEO. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MLCHC COMMUNITY SERVICES | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 605 SOUTH COOLIDGE STREET | AddressLine1Txt |
| City | MOSES LAKE | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98837 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 463517778 | EIN |
| Primary Activities | CLINIC EXPANSION | PrimaryActivitiesTxt |
| Legal Domicile State | WA | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | LINE 11A, I | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MOSES LAKE COMMUNITY HEALTH CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | Yes (1) | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MLCHC COMMUNITY SERVICES | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | K | TransactionTypeTxt |
| Involved | $122,100 | InvolvedAmt |
| Method Of Amount Determination | COST | MethodOfAmountDeterminationTxt |
Comments