THUNDER BAY COMMUNITY HEALTH SERVICE INC: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- THUNDER BAY COMMUNITY HEALTH SERVICE INC (EIN 38-2290337)
- Tax period
- 2016-03-01 to 2017-02-28
- Filed
- 2017-09-13
- IRS object ID
- 201732569349300638
- 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 | 2017-09-13T12:32:02-04:00 | ReturnTs |
| Tax Period End | 2017-02-28 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 382963463 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | QUAST JANKE & CO CPA'S PC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1010 N JOHNSON | AddressLine1Txt |
| City | BAY CITY | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48708 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-03-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 382290337 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THUNDER BAY COMMUNITY HEALTH SERVIC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | THUN | BusinessNameControlTxt |
| Phone | 9897424583 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 15774 STATE ST PO BOX 427 | AddressLine1Txt |
| City | HILLMAN | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49746 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MICHELLE STYMA | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 9893542197 | PhoneNum |
| Signature | 2017-08-30 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DAVID G GWIZDALA CPA | PreparerPersonNm |
| PTIN | P00234130 | PTIN |
| Phone | 9898924549 | PhoneNum |
| Preparation | 2017-09-13 | PreparationDt |
Filing Security Information FilingSecurityInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| At Submission Creation Device Id | 982859116B0574F7CA29A53D21DB9135AC6AF44E | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | ADA3E992AFAE6BEACB1BAACB8F3BDDE5950F50C3 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MICHELLE STYMA | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 8855 M-65 SOUTH | AddressLine1Txt |
| City | POSEN | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49776 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $18,566,987 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.TBCHS.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1981 | FormationYr |
| Legal Domicile State | MI | LegalDomicileStateCd |
| Activity Or Mission | THUNDER BAY COMMUNITY HEALTH SERVICE COMMITS IT'S RESOURCES TO BUILDING HEALTHIER COMMUNITIES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 12 | VotingMembersIndependentCnt |
| Total Employee | 207 | TotalEmployeeCnt |
| Total Volunteers | 15 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $4,795,622 | PYContributionsGrantsAmt |
| CY Contributions Grants | $4,757,008 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $12,610,031 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $13,801,833 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,500 | PYInvestmentIncomeAmt |
| CY Investment Income | $2,548 | CYInvestmentIncomeAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $17,407,153 | PYTotalRevenueAmt |
| CY Total Revenue | $18,561,389 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $9,339,624 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $10,885,872 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $7,306,077 | PYOtherExpensesAmt |
| CY Other Expenses | $7,376,493 | CYOtherExpensesAmt |
| PY Total Expenses | $16,645,701 | PYTotalExpensesAmt |
| CY Total Expenses | $18,262,365 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $761,452 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $299,024 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $10,082,571 | TotalAssetsBOYAmt |
| Total Assets EOY | $11,386,437 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $3,863,179 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $4,868,021 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $6,219,392 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $6,518,416 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THUNDER BAY COMMUNITY HEALTH SERVICES COMMITS IT'S RESOURCES TO BUILDING HEALTHIER COMMUNITIES. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $14,202,083 | ExpenseAmt |
| Revenue | $13,801,833 | RevenueAmt |
| Desc | THIS FEDEERALLY QUALIFIED COMMUNITY HEALTH CENTER HAS APPROXIMATELY 14,000 PATIENTS AND PROVIDED MORE THAN 60,000 CLINICAL VISITS INCLUDING MEDICAL, DENTAL AND MENTAL HEALTH SERVICES. | Desc |
| Total Program Service Expenses | $14,202,083 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | Yes (true) | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 26 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 207 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Form8899 Filedind | false | Form8899Filedind |
| Form1098 C Filed | false | Form1098CFiledInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 12 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | LEIGHANN VIERS | PersonNm |
| Phone | 9893542197 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 N RIPLEY SUITE E | AddressLine1Txt |
| City | ALPENA | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 49707 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (24 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| MIKE WURTSMITH | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| NANCY DEXTROM | |||||||
| CHAIR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| TARRY DEO | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| AL MOE | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| SHANNA JOHNSON | |||||||
| TREASURER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| ROD FULLERTON | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| NINA KENNARD | |||||||
| SECRETARY | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| BEACH HALL | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| BEN BOLSER | |||||||
| VICE CHAIR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| ELEANOR LUTZE | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| MARY FITZGERALD | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| MICHEAL FAIRBANKS | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| CARRIE LOHMAN | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| MARK OBERMAN | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| JACQUELYN MCINTIRE | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| AMY LOU KREFT | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| MARION HAUTEA | |||||||
| CMO | 40.00 | $259,673 | $0 | $32,798 | Yes (X) | ||
| MICHELLE STYMA | |||||||
| CEO | 40.00 | $208,220 | $0 | $29,116 | Yes (X) | ||
| SHARRON GALLOP | |||||||
| CFO | 40.00 | $112,318 | $0 | $8,906 | Yes (X) | ||
| JEMELLEE JACALA-TADIAN | |||||||
| PHYSICIAN | 40.00 | $210,500 | $0 | $29,867 | Yes (X) | ||
| MARANA PERINOT | |||||||
| PHYSICAIN | 40.00 | $198,000 | $0 | $17,448 | Yes (X) | ||
| WAYNE MCEWEN | |||||||
| PHSICIAN ASS | 40.00 | $168,038 | $0 | $26,957 | Yes (X) | ||
| DONALD HILLMAN | |||||||
| PHYSICIAN | 40.00 | $167,115 | $0 | $18,473 | Yes (X) | ||
| ELAINE SMITH | |||||||
| PHYSICIAN | 40.00 | $140,226 | $0 | $15,358 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,464,090 | TotalReportableCompFromOrgAmt |
| Total Other Compensation | $178,923 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 16 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| MATT LISKE | |||||
| 6875 WINTERS | HUBBARD LAKE | MI | 49747 | MEDICAL | $134,071 |
| DENNIS ACOUSTICAL | |||||
| 3169 EMILS LANDING | HILLMAN | MI | 49746 | CONSULTING | $100,305 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $3,300,633 | GovernmentGrantsAmt |
| All Other Contributions | $1,456,375 | AllOtherContributionsAmt |
| Noncash Contributions | $1,402,626 | NoncashContributionsAmt |
| Total Contributions | $4,757,008 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|
| PATIENT FEES | $7,893,084 | $7,893,084 |
| PHARMACY SALES | $5,270,520 | $5,270,520 |
| MEDICAID MEANINGFUL USE | $212,500 | $212,500 |
| OTHER PROGRAM REVENUE | $160,621 | $160,621 |
| INCENTIVES | $141,877 | $141,877 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $123,231 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $123,231 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $13,801,833 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $8,146 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $8,146 | RelatedOrExemptFuncIncomeAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $5,598 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -$5,598 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$5,598 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | -$5,598 | RelatedOrExemptFuncIncomeAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $18,561,389 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $13,804,381 | RelatedOrExemptFuncIncomeAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $580,211 | TotalAmt |
| Program Services | $259,673 | ProgramServicesAmt |
| Management And General | $320,538 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,873,811 | TotalAmt |
| Program Services | $6,199,096 | ProgramServicesAmt |
| Management And General | $1,674,715 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,839,577 | TotalAmt |
| Program Services | $1,339,167 | ProgramServicesAmt |
| Management And General | $500,410 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $592,273 | TotalAmt |
| Program Services | $448,643 | ProgramServicesAmt |
| Management And General | $143,630 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,011,523 | TotalAmt |
| Program Services | $739,755 | ProgramServicesAmt |
| Management And General | $271,768 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $171,114 | TotalAmt |
| Program Services | $138,379 | ProgramServicesAmt |
| Management And General | $32,735 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $354,716 | TotalAmt |
| Program Services | $158,993 | ProgramServicesAmt |
| Management And General | $195,723 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $331,083 | TotalAmt |
| Program Services | $216,500 | ProgramServicesAmt |
| Management And General | $114,583 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $286,617 | TotalAmt |
| Program Services | $136,662 | ProgramServicesAmt |
| Management And General | $149,955 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $145,927 | TotalAmt |
| Management And General | $145,927 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $395,468 | TotalAmt |
| Program Services | $53,054 | ProgramServicesAmt |
| Management And General | $342,414 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $35,966 | TotalAmt |
| Program Services | $6,666 | ProgramServicesAmt |
| Management And General | $29,300 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $4,272,455 | $4,272,455 | |
| REPAIR AND MAINT | $196,492 | $187,195 | $9,297 |
| DUES AND LICENSES | $127,098 | $37,592 | $89,506 |
| OTHER | $48,034 | $8,253 | $39,781 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,262,365 | TotalAmt |
| Program Services | $14,202,083 | ProgramServicesAmt |
| Management And General | $4,060,282 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,624,039 | BOYAmt |
| EOY | $1,395,919 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,477,905 | BOYAmt |
| EOY | $1,604,968 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $336,128 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $917,288 | BOYAmt |
| EOY | $776,607 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $148,184 | BOYAmt |
| EOY | $143,805 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $202,819 | BOYAmt |
| EOY | $219,795 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $10,017,248 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $3,157,457 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,605,690 | BOYAmt |
| EOY | $6,859,791 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $106,646 | BOYAmt |
| EOY | $49,424 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,082,571 | BOYAmt |
| EOY | $11,386,437 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,050,747 | BOYAmt |
| EOY | $986,427 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,812,432 | BOYAmt |
| EOY | $3,881,594 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,863,179 | BOYAmt |
| EOY | $4,868,021 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,219,392 | BOYAmt |
| EOY | $6,518,416 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,219,392 | BOYAmt |
| EOY | $6,518,416 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,082,571 | BOYAmt |
| EOY | $11,386,437 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $299,024 | ReconcilationRevenueExpnssAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
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 | $445,021 | OtherCostOrOtherBasisAmt |
| Book Value | $445,021 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,424,825 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,217,132 | DepreciationAmt |
| Book Value | $5,207,693 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $232,617 | OtherCostOrOtherBasisAmt |
| Depreciation | $27,330 | DepreciationAmt |
| Book Value | $205,287 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,914,785 | OtherCostOrOtherBasisAmt |
| Depreciation | $912,995 | DepreciationAmt |
| Book Value | $1,001,790 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $6,859,791 | TotalBookValueLandBuildingsAmt |
| Total Rev Etc Audited Fincl Stmt | $18,663,354 | TotalRevEtcAuditedFinclStmtAmt |
| Donated Services And Use Fclts | $101,965 | DonatedServicesAndUseFcltsAmt |
| Revenue Not Reported | $101,965 | RevenueNotReportedAmt |
| Revenue Subtotal | $18,561,389 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $18,561,389 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $18,364,330 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $101,965 | DonatedServicesUseFcltsAmt |
| Expenses Not Reported | $101,965 | ExpensesNotReportedAmt |
| Expenses Subtotal | $18,262,365 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $18,262,365 | TotalExpensesPerForm990Amt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt |
|---|---|---|---|---|
| MARION HAUTEA | ||||
| CMO | $259,673 | $15,534 | $17,264 | $292,471 |
| MICHELLE STYMA | ||||
| CEO | $208,220 | $11,929 | $17,187 | $237,336 |
| JEMELLEE JACALA-TADIAN | ||||
| PHYSICIAN | $210,500 | $12,630 | $17,237 | $240,367 |
| MARANA PERINOT | ||||
| PHYSICAIN | $198,000 | $11,880 | $5,568 | $215,448 |
| WAYNE MCEWEN | ||||
| PHSICIAN ASSISTANT | $168,038 | $10,082 | $16,875 | $194,995 |
| DONALD HILLMAN | ||||
| PHYSICIAN | $167,115 | $5,013 | $13,460 | $185,588 |
| ELAINE SMITH | ||||
| PHYSICIAN | $140,226 | $8,414 | $6,944 | $155,584 |
Schedule M IRS990ScheduleM
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $1,402,626 | NoncashContributionsRptF990Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | false | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | false | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 1, PART I, LINE 6 | BOARD MEMBERS ARE ALL VOLUNTEERS IN ADDITION TO COMMUNITY MEMBERS WHO DONATE TIME FOR VARIOUS CENTER ACTIVITIES |
| FORM 990, PAGE 6, PART VI, LINE 11B | AUDITOR REVIEWS RETURN WITH FINANCE COMMITTEE AND PRESENTS REVIEW TO ENTIRE BOARD PRIOR TO SUBMISSION |
| FORM 990, PAGE 6, PART VI, LINE 12C | BOARD MEMBERS SUBMIT WRITTEN STATEMENTS TO EXECUTIVE TEAM FOR REVIEW ON ANY CONFLICT OF INTEREST ISSUES |
| FORM 990, PAGE 6, PART VI, LINE 15A | CEO COMPENSATION IS DETERMINED BY EXECUTIVE COMMITTEE BASED UPON COMPARABILITY DATA FOR SIMILIAR POSTION. ENTIRE BOARD MAKES FINAL APPROVAL OF WAGE DETERMINATION |
| FORM 990, PAGE 6, PART VI, LINE 15B | BOARD APPROVES WAGES OF CEO AND KEY EMPLOYEES BASED UPON BOARD APPROVED WAGE SCALE |
| FORM 990, PAGE 6, PART VI, LINE 19 | GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST, PREFERABLY IN WRITING. THE ORGANIZATION MAKES COPIES OF THE REQUESTED DOCUMENTS AND MAKES THEM AVAILABLE FOR PICK UP OR MAIL TO THE REQUESTEE. |