MUSKINGUM VALLEY HEALTH CENTERS: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- MUSKINGUM VALLEY HEALTH CENTERS (EIN 20-8814374)
- Tax period
- 2016-01-01 to 2016-12-31
- Filed
- 2017-05-25
- IRS object ID
- 201741459349300514
- 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 | 2017-05-25T10:13:20-05:00 | ReturnTs |
| Tax Period End | 2016-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 341310124 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | REA & ASSOCIATES INC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1166 MILITARY ROAD SUITE A | AddressLine1Txt |
| City | ZANESVILLE | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 43701 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 208814374 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MUSKINGUM VALLEY HEALTH CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MUSK | BusinessNameControlTxt |
| Phone | 7408919000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 716 ADAIR AVENUE | AddressLine1Txt |
| City | ZANESVILLE | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 437012836 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | REBECCA CARR | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 7408919000 | PhoneNum |
| Signature | 2017-05-24 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | CHAD A BICE CPA | PreparerPersonNm |
| PTIN | P00831863 | PTIN |
| Phone | 7404543198 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 98.102.154.154 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2017-05-24 | IPDt |
| IP Tm | 11:59:46 | IPTm |
| IP Timezone | ED | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | B4AAD542CBB7734BE66E80FA2A80CD8EAB44765E | 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 | REBECCA CARR | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 716 ADAIR AVENUE | AddressLine1Txt |
| City | ZANESVILLE | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 437012836 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $21,789,023 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.mvhccares.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2007 | FormationYr |
| Legal Domicile State | OH | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE AFFORDABLE, ACCESSIBLE AND QUALITY HEALTHCARE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 14 | VotingMembersIndependentCnt |
| Total Employee | 274 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $2,736,464 | PYContributionsGrantsAmt |
| CY Contributions Grants | $3,692,359 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $14,591,149 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $17,701,642 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$2,230 | PYInvestmentIncomeAmt |
| CY Investment Income | $16,722 | CYInvestmentIncomeAmt |
| PY Other Revenue | $343,353 | PYOtherRevenueAmt |
| CY Other Revenue | $337,898 | CYOtherRevenueAmt |
| PY Total Revenue | $17,668,736 | PYTotalRevenueAmt |
| CY Total Revenue | $21,748,621 | 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 | $10,772,028 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $12,133,005 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $46,151 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $5,414,987 | PYOtherExpensesAmt |
| CY Other Expenses | $6,195,842 | CYOtherExpensesAmt |
| PY Total Expenses | $16,187,015 | PYTotalExpensesAmt |
| CY Total Expenses | $18,328,847 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,481,721 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $3,419,774 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $15,116,698 | TotalAssetsBOYAmt |
| Total Assets EOY | $18,174,089 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $3,510,562 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $3,117,547 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $11,606,136 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $15,056,542 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO PROVIDE AFFORDABLE, ACCESSIBLE AND QUALITY HEALTHCARE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $12,625,329 | ExpenseAmt |
| Revenue | $14,029,347 | RevenueAmt |
| Desc | MUSKINGUM VALLEY HEALTH CENTER PROVIDES NUMEROUS SERVICES, INCLUDING ADULT PRIMARY CARE, PEDIATRICS, DENTAL, MENTAL HEALTH, OB/GYN AND PODIATRY SERVICES. THE THREE LARGEST SERVICE PROGRAMS ARE ADULT HEALTH, DENTAL AND PEDIATRICS. DURING THE YEAR, THE CENTER PROVIDED SERVICES FOR APPROXIMATELY 31,633 PATIENTS RESULTING IN 115,966 VISITS, AND PROVIDED A SLIDING FEE SCALE ADJUSTMENT IN THE AMOUNT OF $502,545. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,956,621 | ExpenseAmt |
| Revenue | $3,672,295 | RevenueAmt |
| Desc | MUSKINGUM VALLEY HEALTH CENTERS PARTICIPATES IN A 340B PRESCRIPTION DRUG PROGRAM WHICH PROVIDES PRESCRIPTIONS AT A DISCOUNT TO QUALIFYING PATIENTS OF THE ORGANIZATION. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Revenue | $378,300 | RevenueAmt |
| Desc | MUSKINGUM VALLEY HEALTH CENTERS PERFORMS CONTRACT SERVICES FOR OTHER ORGANIZATIONS AND PARTICPATES IN ACTIVITIES THAT GENERATE ADDITIONAL FUNDING SOURCES RELATED TO THEIR MISSION. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $14,581,950 | 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 | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | 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 | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 5 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 274 | 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 | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 14 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | 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 | OH | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RECECCA CARR | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7408919090 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 716 ADAIR AVENUE | AddressLine1Txt |
| City | ZANESVILLE | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 43701 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| CAROLYN JENKINS | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JAN SNOUFFER | ||||||||
| SECRETARY | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| JIM WILSON | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JASON T HEINS | ||||||||
| TREASURER | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| CAROL HOWDYSHELL | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| SUSAN SMALL | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| COREY HAMILTON | ||||||||
| VICE CHAIR | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| SCOTT SILVESTRI | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| DEAN WRIGHT | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| RHONDA SMITH | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| HEATHER COEN | ||||||||
| CHAIR | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| BRIAN DUNLAP | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| SLOAN ALBERT | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| SHELLEY MCPEEK | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| MARY GREEN | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| REBECCA CARR | ||||||||
| CFO | 40.00 | $108,361 | $0 | $5,099 | Yes (X) | |||
| DAN ATKINSON | ||||||||
| CEO | 40.00 | $158,154 | $0 | $6,308 | Yes (X) | |||
| DAVID KLEIN | ||||||||
| CMO | 40.00 | $218,752 | $0 | $5,136 | Yes (X) | |||
| COURTNEY FLANIGAN | ||||||||
| PHYSICIAN | 40.00 | $181,269 | $0 | $14,058 | Yes (X) | |||
| MICHAEL BOBB | ||||||||
| PHYSICIAN | 40.00 | $221,382 | $0 | $20,951 | Yes (X) | |||
| BIJAN GOODARZI | ||||||||
| PHYSICIAN | 40.00 | $275,121 | $0 | $12,748 | Yes (X) | |||
| BILLIMAGGA RANGASWAMY | ||||||||
| PHYSICIAN | 40.00 | $162,342 | $0 | $13,993 | Yes (X) | |||
| DONOVAN CAMPBELL | ||||||||
| PHYSICIAN | 40.00 | $159,740 | $0 | $11,501 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,485,121 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $89,794 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 8 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| SHRIVER'S PHARMACY | |||||
| 406 BRIGHTEN BLVD | ZANESVILLE | OH | 43701 | PHARMACY SERVICE FEES | $682,905 |
| NORTHSIDE PHARMACY | |||||
| 2899 BELL STREET | ZANESVILLE | OH | 43701 | PHARMACY SERVICE FEES | $373,644 |
| OHIO PSYCHIATRIC ASSOCIATES INC | |||||
| 975 BETHESDA DRIVE | ZANESVILLE | OH | 43701 | CONTRACT PHYSICIAN SERVICES | $289,390 |
| COSHOCTON COUNTY MEMORIAL HOSPITAL | |||||
| 1460 ORANGE STREET | COSHOCTON | OH | 43812 | CONTRACT PHYSICIAN SERVICES | $159,075 |
| WALGREENS PHARMACY | |||||
| 1415 LAKE COOK RD | DEERFIELD | IL | 60015 | PHARMACY SERVICE FEES | $142,442 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $63,685 | FundraisingAmt |
| Government Grants | $3,451,041 | GovernmentGrantsAmt |
| All Other Contributions | $177,633 | AllOtherContributionsAmt |
| Total Contributions | $3,692,359 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICES | 623000 | $14,029,347 | $14,029,347 |
| 340B PRESCRIPTION DRUG PROGRAM | 623000 | $3,672,295 | $3,672,295 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $17,701,642 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $16,722 | TotalRevenueColumnAmt |
| Exclusion | $16,722 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $17,720 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $7,916 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $9,804 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $9,804 | TotalRevenueColumnAmt |
| Exclusion | $9,804 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $31,125 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $63,685 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $32,486 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$1,361 | TotalRevenueColumnAmt |
| Exclusion | -$1,361 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| OTHER REVENUE | 623000 | $179,200 | $179,200 |
| CONTRACT SERVICES | 623000 | $150,255 | $150,255 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $329,455 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $21,748,621 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $18,031,097 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $25,165 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $501,810 | TotalAmt |
| Program Services | $401,448 | ProgramServicesAmt |
| Management And General | $100,362 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,586,221 | TotalAmt |
| Program Services | $7,668,977 | ProgramServicesAmt |
| Management And General | $1,917,244 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,270,399 | TotalAmt |
| Program Services | $1,016,319 | ProgramServicesAmt |
| Management And General | $254,080 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $774,575 | TotalAmt |
| Program Services | $619,660 | ProgramServicesAmt |
| Management And General | $154,915 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $79,506 | TotalAmt |
| Management And General | $79,506 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $50,167 | TotalAmt |
| Management And General | $50,167 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,042,770 | TotalAmt |
| Program Services | $1,916,376 | ProgramServicesAmt |
| Management And General | $125,632 | ManagementAndGeneralAmt |
| Fundraising | $762 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $105,371 | TotalAmt |
| Program Services | $16,345 | ProgramServicesAmt |
| Management And General | $82,396 | ManagementAndGeneralAmt |
| Fundraising | $6,630 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $106,366 | TotalAmt |
| Program Services | $40,539 | ProgramServicesAmt |
| Management And General | $65,702 | ManagementAndGeneralAmt |
| Fundraising | $125 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $242,144 | TotalAmt |
| Program Services | $194,141 | ProgramServicesAmt |
| Management And General | $48,003 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $368,494 | TotalAmt |
| Program Services | $332,265 | ProgramServicesAmt |
| Management And General | $35,958 | ManagementAndGeneralAmt |
| Fundraising | $271 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $79,528 | TotalAmt |
| Program Services | $35,405 | ProgramServicesAmt |
| Management And General | $43,873 | ManagementAndGeneralAmt |
| Fundraising | $250 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,937 | TotalAmt |
| Program Services | $6,285 | ProgramServicesAmt |
| Management And General | $20,652 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $95,813 | TotalAmt |
| Management And General | $95,813 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $548,399 | TotalAmt |
| Program Services | $359,605 | ProgramServicesAmt |
| Management And General | $188,794 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $67,175 | TotalAmt |
| Program Services | $41,798 | ProgramServicesAmt |
| Management And General | $25,377 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| SUPPLIES | $2,072,780 | $1,799,037 | $264,191 | $9,552 |
| RENT | $102,088 | $73,588 | $28,500 | |
| STAFF DEVELOPMENT | $57,503 | $40,847 | $16,656 | |
| DUES AND SUBSCRIPTIONS | $42,455 | $6,895 | $31,599 | $3,961 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $108,346 | TotalAmt |
| Program Services | $12,420 | ProgramServicesAmt |
| Management And General | $71,326 | ManagementAndGeneralAmt |
| Fundraising | $24,600 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,328,847 | TotalAmt |
| Program Services | $14,581,950 | ProgramServicesAmt |
| Management And General | $3,700,746 | ManagementAndGeneralAmt |
| Fundraising | $46,151 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,388,657 | BOYAmt |
| EOY | $1,006,079 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,555,716 | BOYAmt |
| EOY | $2,730,530 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,705 | BOYAmt |
| EOY | $342,718 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,469,768 | BOYAmt |
| EOY | $1,725,350 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $349,232 | BOYAmt |
| EOY | $446,450 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $103,958 | BOYAmt |
| EOY | $93,047 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $13,119,032 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $2,722,332 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,217,255 | BOYAmt |
| EOY | $10,396,700 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $1,433,215 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,407 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,116,698 | BOYAmt |
| EOY | $18,174,089 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $916,269 | BOYAmt |
| EOY | $806,923 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,594,293 | BOYAmt |
| EOY | $2,310,624 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,510,562 | BOYAmt |
| EOY | $3,117,547 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,517,952 | BOYAmt |
| EOY | $14,928,532 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $88,184 | BOYAmt |
| EOY | $128,010 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,606,136 | BOYAmt |
| EOY | $15,056,542 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,116,698 | BOYAmt |
| EOY | $18,174,089 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $3,419,774 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $30,632 | 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) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,261,875 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $353,754 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,034,518 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,736,464 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,692,359 | CurrentTaxYearAmt |
| Total | $10,078,970 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $9,830,519 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,249,290 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $11,911,580 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $14,591,149 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $17,701,642 | CurrentTaxYearAmt |
| Total | $57,284,180 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $11,092,394 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,603,044 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $13,946,098 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $17,327,613 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $21,394,001 | CurrentTaxYearAmt |
| Total | $67,363,150 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $67,363,150 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,065 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $376 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,144 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,550 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $25,165 | CurrentTaxYearAmt |
| Total | $30,300 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,065 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $376 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,144 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,550 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $25,165 | CurrentTaxYearAmt |
| Total | $30,300 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $94,400 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $41,009 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $175,692 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $343,353 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $329,455 | CurrentTaxYearAmt |
| Total | $983,909 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $11,187,859 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,644,429 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $14,122,934 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $17,673,516 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $21,748,621 | CurrentTaxYearAmt |
| Total | $68,377,359 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.98520 | PublicSupportCY509Pct |
| Public Support PY509 | 0.98680 | PublicSupportPY509Pct |
| Investment Income CY | 0.00040 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00010 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
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 | $974,902 | OtherCostOrOtherBasisAmt |
| Book Value | $974,902 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $9,352,260 | OtherCostOrOtherBasisAmt |
| Depreciation | $789,690 | DepreciationAmt |
| Book Value | $8,562,570 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $443,056 | OtherCostOrOtherBasisAmt |
| Depreciation | $237,517 | DepreciationAmt |
| Book Value | $205,539 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,348,814 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,695,125 | DepreciationAmt |
| Book Value | $653,689 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $10,396,700 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $21,819,655 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $30,632 | NetUnrealizedGainsInvstAmt |
| Other Revenue | $40,402 | OtherRevenueAmt |
| Revenue Not Reported | $71,034 | RevenueNotReportedAmt |
| Revenue Subtotal | $21,748,621 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $21,748,621 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $18,369,249 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $18,369,249 | ExpensesSubtotalAmt |
| Other Expenses Not Included | -$40,402 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | -$40,402 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $18,328,847 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part X, Line 2: | The Organization is exempt from federal, state, and city income taxes derived principally by it being classified as a 501(c)(3) organization in the Internal Revenue Code. However, the Organization may be subjected to tax on unrelated business income. For the years ended December 31, 2016 and 2015, the Organization earned no unrelated business income. Accordingly, no provision for income taxes has been recorded within the financial statements. Generally accepted accounting principles required the Organization to evaluate the level of uncertainty related to whether tax positions taken will be sustained upon examination. Any positions taken that do not meet the more-likely-than-not threshold must be quantified and recorded as a liability for unrecognized tax benefits in the accompanying statement of financial position along with any associated interest and penalties that would be payable to the taxing authorities upon examination. Management believes that none of the tax positions taken would materially impact the financial statements and no such liabilities have been recorded. |
| Part XI, Line 2d - Other Adjustments: | Rent expense and fundraising expense reported on page 9 |
| Part XII, Line 4b - Other Adjustments: | Rent expense and fundraising expense reported on page 9 |
| SCHEDULE D PAGE 4 PART XI LINES 2D AND 4 B | Rent expense and fundraising expense reported on page 9 |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | WILD NIGHT FOR WELLNESS EVENT | Event1Nm |
| Gross Receipts Event1 | $94,810 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $63,685 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $31,125 | GrossRevenueEvent1Amt |
| Rent Facility Costs Event1 | $6,664 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $9,188 | FoodAndBeverageEvent1Amt |
| Entertainment Event1 | $700 | EntertainmentEvent1Amt |
| Other Direct Expenses Event1 | $15,934 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $94,810 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $63,685 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $31,125 | GrossRevenueTotalEventsAmt |
| Rent Fclty Costs Total Events | $6,664 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $9,188 | FoodAndBeverageTotalEventsAmt |
| Entertainment Total Events | $700 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $15,934 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $32,486 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$1,361 | NetIncomeSummaryAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 (7 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DAN ATKINSON | ||||||||||||||
| CEO | $158,154 | $0 | $0 | $0 | $0 | $0 | $6,283 | $0 | $25 | $0 | $164,462 | $0 | $0 | $0 |
| DAVID KLEIN | ||||||||||||||
| CMO | $218,752 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $5,136 | $0 | $223,888 | $0 | $0 | $0 |
| COURTNEY FLANIGAN | ||||||||||||||
| PHYSICIAN | $181,269 | $0 | $0 | $0 | $0 | $0 | $7,427 | $0 | $6,631 | $0 | $195,327 | $0 | $0 | $0 |
| MICHAEL BOBB | ||||||||||||||
| PHYSICIAN | $221,382 | $0 | $0 | $0 | $0 | $0 | $7,224 | $0 | $13,727 | $0 | $242,333 | $0 | $0 | $0 |
| BIJAN GOODARZI | ||||||||||||||
| PHYSICIAN | $275,121 | $0 | $0 | $0 | $0 | $0 | $9,453 | $0 | $3,295 | $0 | $287,869 | $0 | $0 | $0 |
| BILLIMAGGA RANGASWAMY | ||||||||||||||
| PHYSICIAN | $162,342 | $0 | $0 | $0 | $0 | $0 | $6,598 | $0 | $7,395 | $0 | $176,335 | $0 | $0 | $0 |
| DONOVAN CAMPBELL | ||||||||||||||
| PHYSICIAN | $159,740 | $0 | $0 | $0 | $0 | $0 | $6,573 | $0 | $4,928 | $0 | $171,241 | $0 | $0 | $0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section B, line 11b | THE CFO REVIEWS FORM 990 AND AN ELECTRONIC COPY IS PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO FILING. |
| Form 990, Part VI, Section B, line 12c | BOARD MEMBERS SIGN CONFLICT OF INTEREST AND CONFIDENTIALITY STATEMENTS ANNUALLY. FORMS ARE MAINTAINED BY MANAGEMENT. BOARD MEMBERS DISCLOSE CONFLICTS OF INTEREST THAT MIGHT INFLUENCE JUDGEMENT IN THEIR DECISION MAKING PROCESS. FOLLOWING DISCLOSURE, THE BOARD'S EXECUTIVE COMMITTEE SHALL DETERMINE APPROPRIATE ACTION,RANGING FROM ABSTAINING FROM SPECIFIC BOARD DECISIONS, TO STEPPING DOWN FROM MEMBERSHIP. |
| Form 990, Part VI, Section B, line 15 | COMPENSATION FOR OFFICERS AND KEY EMPLOYEES IS MONITORED AND DETERMINED BY THE BOARD OF DIRECTORS. COMPENSATION PACKAGES ARE BENCHMARKED BASED ON THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS SURVEY INFORMATION. COMPENSATION RANGES ARE REVIEWED AND APPROVED ON AN ANNUAL BASIS AND DOCUMENTED IN THE BOARD MEETING MINUTES. |
| Form 990, Part VI, Section C, line 19 | THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND THE FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| Form 990, Part IX, line 11g | PROFESSIONAL CONTRACT SERVICES: Program service expenses 713,785. Management and general expenses 120,537. Fundraising expenses 512. Total expenses 834,834. SERVICE CONTRACT FEE: Program service expenses 1,198,991. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,198,991. TRANSPORTATION: Program service expenses 3,600. Management and general expenses 5,095. Fundraising expenses 250. Total expenses 8,945. |
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