COMMUNITY HEALTH CENTERS OF WESTERN KENTUCKY INC: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
COMMUNITY HEALTH CENTERS OF WESTERN KENTUCKY INC (EIN 61-1268014)
Tax period
2016-05-01 to 2017-04-30
Filed
2017-08-28
IRS object ID
201732409349300113
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

FieldValueIRS element (for citing)
Return2017-08-28T09:44:51-05:00ReturnTs
Tax Period End2017-04-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN610920132PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1RINEY HANCOCK CPAS PSCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line12900 VEACH ROAD SUITE 2AddressLine1Txt
CityOWENSBOROCityNm
State AbbreviationKYStateAbbreviationCd
ZIP42303ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2016-05-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN611268014EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1COMMUNITY HEALTH CENTERS OF WESTERNBusinessNameLine1Txt
Business Name Line2KENTUCKY INCBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlCOMMBusinessNameControlTxt
Phone2703385777PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1480 HOPKINSVILLE STREETAddressLine1Txt
CityGREENVILLECityNm
State AbbreviationKYStateAbbreviationCd
ZIP42345ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJOSEPH SWABPersonNm
Person TitleCFOPersonTitleTxt
Phone2703385777PhoneNum
Signature2017-08-08SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonCARLA J DOWELL CPAPreparerPersonNm
PTINP00104892PTIN
Phone2709264540PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address74.87.131.58IPv4AddressTxt
FieldValueIRS element (for citing)
IP2017-08-08IPDt
IP Tm13:51:15IPTm
IP TimezoneCDIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id8087D66AD7AA55E37CA98F42436ECB7DA213F963AtSubmissionCreationDeviceId
At Submission Filing Device Id8FB2D82C6C2B23CC7CBD317792CD018E240CA4C7AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerROGER ARBUCKLEPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1480 HOPKINSVILLE STAddressLine1Txt
CityGREENVILLECityNm
State AbbreviationKYStateAbbreviationCd
ZIP42345ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$8,542,460GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressN/AWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1994FormationYr
Legal Domicile StateKYLegalDomicileStateCd
Activity Or MissionTO PROVIDE AFFORDABLE PRIMARY HEALTHCARE SERVICESActivityOrMissionDesc
Voting Members Governing Body11VotingMembersGoverningBodyCnt
Voting Members Independent11VotingMembersIndependentCnt
Total Employee82TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$1,859,345PYContributionsGrantsAmt
CY Contributions Grants$2,918,975CYContributionsGrantsAmt
PY Program Service Revenue$4,435,106PYProgramServiceRevenueAmt
CY Program Service Revenue$5,595,883CYProgramServiceRevenueAmt
PY Investment Income$13,344PYInvestmentIncomeAmt
CY Investment Income$27,883CYInvestmentIncomeAmt
PY Other Revenue$100,105PYOtherRevenueAmt
CY Other Revenue-$281CYOtherRevenueAmt
PY Total Revenue$6,407,900PYTotalRevenueAmt
CY Total Revenue$8,542,460CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$3,632,035PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$4,232,721CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$1,803,061PYOtherExpensesAmt
CY Other Expenses$1,994,436CYOtherExpensesAmt
PY Total Expenses$5,435,096PYTotalExpensesAmt
CY Total Expenses$6,227,157CYTotalExpensesAmt
PY Revenues Less Expenses$972,804PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$2,315,303CYRevenuesLessExpensesAmt
Total Assets BOY$6,633,238TotalAssetsBOYAmt
Total Assets EOY$9,020,571TotalAssetsEOYAmt
Total Liabilities BOY$320,240TotalLiabilitiesBOYAmt
Total Liabilities EOY$392,270TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$6,312,998NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$8,628,301NetAssetsOrFundBalancesEOYAmt
MissionTO PROVIDE AFFORDABLE PRIMARY HEALTHCARE SERVICES IN MUHLENBERG AND LOGAN COUNTIES, KENTUCKY, AND IN MEDICALLY UNDER-SERVED URBAN, SUBURBAN, AND RURAL AREAS HAVING LIMITED AVAILABLE HEALTH RESOURCES.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$5,389,075ExpenseAmt
Revenue$5,595,883RevenueAmt
DescOPERATION OF COMMUNITY HEALTH CENTER AS AUTHORIZED BY SECTION 330 OF THE PUBLIC HEALTH SERVICES GRANTDesc
Total Program Service Expenses$5,389,075TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document18IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee82EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members11GoverningBodyVotingMembersCnt
Independent Voting Member11IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower Policy0WhistleblowerPolicyInd
Document Retention Policy0DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1JOSEPH SWABBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone2703385777PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1480 HOPKINSVILLE STAddressLine1Txt
CityGREENVILLECityNm
State AbbreviationKYStateAbbreviationCd
ZIP42345ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
CINDY BAIRD
BOARD MEMBER1.00Yes (X)$0$0$0
BILLY STEELE
BOARD MEMBER1.00Yes (X)$0$0$0
JULIE HANSEN
BOARD MEMBER1.00Yes (X)$0$0$0
ELIZABETH EAVES
BOARD MEMBER1.00Yes (X)$0$0$0
MOLLY ALWARD
BOARD MEMBER1.00Yes (X)$0$0$0
ELIZABETH GENTRY
BOARD MEMBER1.00Yes (X)$0$0$0
ANDREHIA HATFIELD
BOARD MEMBER1.00Yes (X)$0$0$0
CARY DAVIS
BOARD MEMBER1.00Yes (X)$0$0$0
RICHARD NEATHAMER
BOARD MEMBER1.00Yes (X)$0$0$0
BARBARA MILAM
BOARD MEMBER1.00Yes (X)$0$0$0
ROSEMARY BUCK
BOARD MEMBER1.00Yes (X)$0$0$0
ROGER ARBUCKLE
CEO40.00$157,500$0$12,141Yes (X)
JOSEPH SWAB
CFO40.00$100,001$0$9,383Yes (X)
SUSAN HAWKINS
PHYSICIAN40.00$200,500$0$10,025Yes (X)
BILLIE GALYEN
PHYSICIAN40.00$191,462$0$22,558Yes (X)
DAVID CONATSER
PHYSICIAN40.00$160,000$0$8,000Yes (X)
NATALIE HUTTON
PHYSICIAN40.00$165,000$0$18,665Yes (X)
SHANE NAPIER
PHYSICIAN40.00$105,385$0$2,312Yes (X)
JACKIE KIRBY
ARNP40.00$139,953$0$14,426Yes (X)
STEVEN ZELLER
PHYSICIAN40.00$192,135$0$15,766Yes (X)
RANDA BRUMFIELD
ARNP40.00$100,001$0$5,000Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,511,937TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$118,276TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K10IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Government Grants$2,918,975GovernmentGrantsAmt
Total Contributions$2,918,975TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescMEDICAL SERVICESDesc
Business621110BusinessCd
Total Revenue Column$5,595,883TotalRevenueColumnAmt
Related Or Exempt Func Income$5,595,883RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$5,595,883TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$27,883TotalRevenueColumnAmt
Exclusion$27,883ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescMISCELLANEOUSDesc
Business621110BusinessCd
Total Revenue Column-$281TotalRevenueColumnAmt
Exclusion-$281ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total-$281OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$8,542,460TotalRevenueColumnAmt
Related Or Exempt Func Income$5,595,883RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$27,602ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$979,008TotalAmt
Program Services$716,962ProgramServicesAmt
Management And General$262,046ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$2,599,725TotalAmt
Program Services$2,432,480ProgramServicesAmt
Management And General$167,245ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$123,768TotalAmt
Program Services$104,887ProgramServicesAmt
Management And General$18,881ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$275,499TotalAmt
Program Services$234,729ProgramServicesAmt
Management And General$40,770ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$254,721TotalAmt
Program Services$222,963ProgramServicesAmt
Management And General$31,758ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$6,262TotalAmt
Program Services$6,262ProgramServicesAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$55,864TotalAmt
Program Services$55,864ProgramServicesAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$768,296TotalAmt
Program Services$646,805ProgramServicesAmt
Management And General$121,491ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$35,385TotalAmt
Program Services$35,385ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$191,933TotalAmt
Program Services$116,013ProgramServicesAmt
Management And General$75,920ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$38,877TotalAmt
Program Services$38,877ProgramServicesAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$129,590TotalAmt
Program Services$77,358ProgramServicesAmt
Management And General$52,232ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$62,637TotalAmt
Program Services$27,054ProgramServicesAmt
Management And General$35,583ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$162,522TotalAmt
Program Services$162,522ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$36,871TotalAmt
Program Services$36,871ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
IMMUNIZATION EXPENSE$219,799$219,799
OPERATIONAL SUPPLIES$89,278$89,278
BAD DEBT EXPENSE$80,252$80,252
MEDICAL RECRUITMENT$55,045$55,045

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$61,825TotalAmt
Program Services$29,669ProgramServicesAmt
Management And General$32,156ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$6,227,157TotalAmt
Program Services$5,389,075ProgramServicesAmt
Management And General$838,082ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$71,579BOYAmt
EOY$38,525EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$3,465,891BOYAmt
EOY$3,806,381EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$560,321BOYAmt
EOY$742,113EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$44,163BOYAmt
EOY$61,177EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$51,469BOYAmt
EOY$32,447EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$5,676,883LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$1,336,955LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$2,439,815BOYAmt
EOY$4,339,928EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$6,633,238BOYAmt
EOY$9,020,571EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$320,240BOYAmt
EOY$392,270EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$320,240BOYAmt
EOY$392,270EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$6,117,719BOYAmt
EOY$8,439,036EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$195,279BOYAmt
EOY$189,265EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$6,312,998BOYAmt
EOY$8,628,301EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$6,633,238BOYAmt
EOY$9,020,571EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$2,315,303ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit RequiredYes (1)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (1)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,253,955CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,378,531CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,631,828CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,859,345CurrentTaxYearMinus1YearAmt
Current Tax Year$2,918,975CurrentTaxYearAmt
Total$9,042,634TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$3,811,042CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$3,108,863CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$3,803,134CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$4,435,106CurrentTaxYearMinus1YearAmt
Current Tax Year$5,595,883CurrentTaxYearAmt
Total$20,754,028TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$5,064,997CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$4,487,394CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$5,434,962CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$6,294,451CurrentTaxYearMinus1YearAmt
Current Tax Year$8,514,858CurrentTaxYearAmt
Total$29,796,662TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$29,796,662PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$403CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$2,688CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$3,511CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$13,344CurrentTaxYearMinus1YearAmt
Current Tax Year$27,883CurrentTaxYearAmt
Total$47,829TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$403CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$2,688CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$3,511CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$13,344CurrentTaxYearMinus1YearAmt
Current Tax Year$27,883CurrentTaxYearAmt
Total$47,829TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$5,065,400CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$4,490,082CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$5,438,473CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$6,307,795CurrentTaxYearMinus1YearAmt
Current Tax Year$8,542,741CurrentTaxYearAmt
Total$29,844,491TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.99840PublicSupportCY509Pct
Public Support PY5090.99900PublicSupportPY509Pct
Investment Income CY0.00160InvestmentIncomeCYPct
Investment Income PY0.00100InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$248,389OtherCostOrOtherBasisAmt
Book Value$248,389BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$4,292,355OtherCostOrOtherBasisAmt
Depreciation$586,158DepreciationAmt
Book Value$3,706,197BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$11,086OtherCostOrOtherBasisAmt
Depreciation$8,824DepreciationAmt
Book Value$2,262BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$921,032OtherCostOrOtherBasisAmt
Depreciation$632,205DepreciationAmt
Book Value$288,827BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$204,021OtherCostOrOtherBasisAmt
Depreciation$109,768DepreciationAmt
Book Value$94,253BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$4,339,928TotalBookValueLandBuildingsAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$8,542,460TotalRevEtcAuditedFinclStmtAmt
Revenue Not Reported$0RevenueNotReportedAmt
Revenue Subtotal$8,542,460RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$8,542,460TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$6,227,157TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$6,227,157ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$6,227,157TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationTHE CENTER IS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE, EXCEPT ON INCOME DERIVED FROM UNRELATED BUSINESS ACTIVITIES. THE CENTER BELIEVES THAT IT HAS SUPPORT FOR ANY TAX POSITIONS TAKEN, AND AS SUCH, DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS THAT ARE MATERIAL TO THE FINANCIAL STATEMENTS.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (1)AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
ROGER ARBUCKLE
CEO$157,500$0$0$0$0$0$7,875$0$4,266$0$169,641$0$0$0
SUSAN HAWKINS
PHYSICIAN$200,500$0$0$0$0$0$10,025$0$0$0$210,525$0$0$0
BILLIE GALYEN
PHYSICIAN$191,462$0$0$0$0$0$9,573$0$12,985$0$214,020$0$0$0
DAVID CONATSER
PHYSICIAN$160,000$0$0$0$0$0$8,000$0$0$0$168,000$0$0$0
NATALIE HUTTON
PHYSICIAN$165,000$0$0$0$0$0$8,250$0$10,415$0$183,665$0$0$0
JACKIE KIRBY
ARNP$102,308$0$37,645$0$0$0$5,115$0$9,311$0$154,379$0$0$0
STEVEN ZELLER
PHYSICIAN$192,135$0$0$0$0$0$4,073$0$11,693$0$207,901$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 7FormAndLineReferenceDesc
ExplanationPROVIDERS ARE ELIGIBLE TO RECEIVE A BONUS BASED ON A PRODUCTIVITY FORMULAExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11BMANAGEMENT PRESENTS THE FEDERAL FORM 990 TO THE BOARD AT THE REGULARLY SCHEDULED BOARD MEETING IMMEDIATELY PRECEDING THE RETURN'S DUE DATE. THE RETURN IS FILED AFTER BOARD REVIEW.
FORM 990, PART VI, SECTION B, LINE 12CBOARD MEMBERS AND OFFICERS SIGN ANNUAL CONFLICT OF INTEREST STATEMENTS.
FORM 990, PART VI, SECTION B, LINE 15THE BOARD DETERMINED THE CEO'S SALARY BASED ON SALARY SURVEY DATA FROM THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS AND CONDUCTS AN ANNUAL PERFORMANCE EVALUATION. THE CEO DETERMINED THE CFO'S SALARY BASED ON THE SAME INFORMATION WHICH IS EVALUATED ANNUALLY.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION MAKES GOVERNING DOCUMENTS, ITS CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST. ANNUAL FORMS 990 ARE AVAILABLE ON GUIDESTAR.ORG.
FORM 990, PART IX, LINE 11GCONTRACTED SERVICES : PROGRAM SERVICE EXPENSES 640,758. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 640,758. BANK FEES : PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 292. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 292. CONTRACTED SERVICES : PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 120,918. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 120,918. OTHER FEES-MNGMNT-990 : PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 281. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 281. OTHER FEES-PROGSERV-990 : PROGRAM SERVICE EXPENSES 6,047. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,047.
FORM 990, PART XII, LINE 2C:THE ORGANIZATION DID NOT CHANGE ITS OVERSIGHT OR SELECTION PROCESS FROM THE PRIOR YEAR.

Comments

Anonymous: no account or email. Up to 2,000 characters, at most one link. Comments are checked automatically; some wait for review.