PENINSULA INSTITUTE FOR COMMUNITY HEALTH INC: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- PENINSULA INSTITUTE FOR COMMUNITY HEALTH INC (EIN 54-1083954)
- Tax period
- 2014-12-01 to 2015-11-30
- Filed
- 2016-08-23
- IRS object ID
- 201602369349300500
- Schema version
- 2014v6.0
- 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 | 2016-08-23T06:05:07-05:00 | ReturnTs |
| Tax Period End | 2015-11-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 541967771 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CAVANAUGH NELSON PLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 999 WATERSIDE DRIVE SUITE 2250 | AddressLine1Txt |
| City | NORFOLK | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 23510 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-12-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 541083954 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PENINSULA INSTITUTE FOR COMMUNITY HEALTH | BusinessNameLine1Txt |
| Business Name Line2 | DBA SOUTHEASTERN VIRGINIA HEALTH SYSTEM | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PENI | BusinessNameControlTxt |
| Phone | 7573808709 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1033 28TH STREET 2ND FLOOR | AddressLine1Txt |
| City | NEWPORT NEWS | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 23607 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ANGELA FUTRELL | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 7573808709 | PhoneNum |
| Signature | 2016-08-23 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MARK A NELSON | PreparerPersonNm |
| PTIN | P00358004 | PTIN |
| Phone | 7575784900 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-12-15 16:53:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ANGELA FUTRELL | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1033 28TH STREET 2ND FLOOR | AddressLine1Txt |
| City | NEWPORT NEWS | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 23607 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $12,024,122 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.PICH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1978 | FormationYr |
| Legal Domicile State | VA | LegalDomicileStateCd |
| Activity Or Mission | PROVIDE HIGH QUALITY, COMPREHENSIVE, PRIMARY HEALTH CARE SERVICES TO VIRGINIA RESIDENTS LIVING IN HAMPTON ROADS REGARDLESS OF THEIR ABILITY TO PAY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 13 | VotingMembersIndependentCnt |
| Total Employee | 197 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $7,369,024 | PYContributionsGrantsAmt |
| CY Contributions Grants | $6,841,791 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $4,778,935 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $5,156,423 | CYProgramServiceRevenueAmt |
| PY Investment Income | $2,273 | PYInvestmentIncomeAmt |
| CY Investment Income | $2,625 | CYInvestmentIncomeAmt |
| PY Other Revenue | $8,366 | PYOtherRevenueAmt |
| CY Other Revenue | $11,427 | CYOtherRevenueAmt |
| PY Total Revenue | $12,158,598 | PYTotalRevenueAmt |
| CY Total Revenue | $12,012,266 | 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 | $8,072,263 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $7,952,892 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $4,080,233 | PYOtherExpensesAmt |
| CY Other Expenses | $3,839,448 | CYOtherExpensesAmt |
| PY Total Expenses | $12,152,496 | PYTotalExpensesAmt |
| CY Total Expenses | $11,792,340 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $6,102 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $219,926 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $5,791,312 | TotalAssetsBOYAmt |
| Total Assets EOY | $9,056,102 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,313,058 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $4,357,922 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $4,478,254 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $4,698,180 | NetAssetsOrFundBalancesEOYAmt |
| Mission | PROVIDING MEDICAL AND DENTAL CARE TO INDIGENT PATIENTS | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $7,511,302 | ExpenseAmt |
| Revenue | $5,156,423 | RevenueAmt |
| Desc | COMMUNITY HEALTH CENTER: PRIMARY MEDICAL, DENTAL AND HEALTHCARE ENABLING SERVICES FOR THE MEDICALLY UNDERSERVED AREAS OF NEWPORT NEWS, HAMPTON, SUFFOLK, VIRGINIA BEACH, CHESAPEAKE, AND MATHEWS COUNTY, VA.: 68,914 VISITS | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $632,344 | ExpenseAmt |
| Desc | HEALTHCARE FOR THE HOMELESS: PRIMARY MEDICAL CARE AND REFERRAL SERVICES FOR AREA HOMELESS: 6,012 VISITS | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $8,143,646 | 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 | Yes (1) | 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 | Yes (1) | 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 | 43 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 197 | 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 | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 13 | 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 |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE ORGANIZATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7573808709 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1033 28TH STREET 2ND FLOOR | AddressLine1Txt |
| City | NEWPORT NEWS | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 23607 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (22 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 |
|---|---|---|---|---|---|---|---|
| ROBERT AYERS | |||||||
| SECRETARY | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| EUGENE JOHNSON | |||||||
| PARLIAMENTARIAN | 8.00 | Yes (X) | $0 | $0 | $0 | ||
| WANDA ALLEN ESQUIRE | |||||||
| CHAIR | 6.00 | Yes (X) | $0 | $0 | $0 | ||
| BARBARA EASTER | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| SHELIA HENDERSON | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| JACQUELINE HUDGINS | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| ALTON SKEETER | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| SHIRLEY WILLS | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| WENDELL BRAXTON | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| DOROTHY MURRAY | |||||||
| VICE-CHAIR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| THOMAS E HARMON IV | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| MELISSA COUNCE | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| MELINDA WILLIAMS | |||||||
| TREASURER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| ANGELA FUTRELL | |||||||
| CEO | 40.00 | $196,938 | $0 | $32,435 | Yes (X) | ||
| VALDA BRANCH | |||||||
| COO | 40.00 | $131,392 | $0 | $15,524 | Yes (X) | ||
| ALADEE DELAHOUSSAYE MD | |||||||
| CMO | 40.00 | $153,978 | $0 | $19,530 | Yes (X) | ||
| NONA HILTON | |||||||
| CFO | 40.00 | $58,383 | $0 | $0 | Yes (X) | ||
| CONCEPCION ASPILI | |||||||
| PHYSICIAN | 40.00 | $170,151 | $0 | $25,216 | Yes (X) | ||
| PAULINE REED | |||||||
| PHYSICIAN | 40.00 | $149,139 | $0 | $2,702 | Yes (X) | ||
| DAVID L LORENZO | |||||||
| PHYSICIAN | 40.00 | $183,071 | $0 | $18,465 | Yes (X) | ||
| ANDREI SAN MARINA | |||||||
| PHYSICIAN | 40.00 | $155,617 | $0 | $2,627 | Yes (X) | ||
| AURORA S BADAVI | |||||||
| PHYSICIAN | 40.00 | $162,691 | $0 | $15,512 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,361,360 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $132,011 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 17 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (4 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| LABCORP | |||||
| 860 OMNI BLVD 302A | NEWPORT NEWS | VA | 23606 | LAB SERVICES | $310,229 |
| PHYSICIAN SALES & SERVICES | |||||
| 600 GREEN TREE RD | CHESAPEAKE | VA | 23320 | MEDICAL SUPPLIES | $295,686 |
| PENINSULA CLEANING SERVICE | |||||
| 12610 PATRICK HENRY DR | NEWPORT NEWS | VA | 23602 | CLEANING | $233,640 |
| STERICYCLE INC | |||||
| 1330 BELLWOOD RD | RICHMOND | VA | 23237 | MEDICAL WASTE DISPOSAL | $103,782 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $6,203,360 | GovernmentGrantsAmt |
| All Other Contributions | $638,431 | AllOtherContributionsAmt |
| Total Contributions | $6,841,791 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NET PATIENT SERVICE REVENUE | Desc |
| Business | 621110 | BusinessCd |
| Total Revenue Column | $5,156,423 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $5,156,423 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $5,156,423 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,625 | TotalRevenueColumnAmt |
| Exclusion | $2,625 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $23,283 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $11,856 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $11,427 | TotalRevenueColumnAmt |
| Exclusion | $11,427 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $12,012,266 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $5,156,423 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $14,052 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $606,208 | TotalAmt |
| Program Services | $167,907 | ProgramServicesAmt |
| Management And General | $438,301 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,175,936 | TotalAmt |
| Program Services | $4,515,759 | ProgramServicesAmt |
| Management And General | $1,660,177 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $661,350 | TotalAmt |
| Program Services | $456,720 | ProgramServicesAmt |
| Management And General | $204,630 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $509,398 | TotalAmt |
| Program Services | $351,784 | ProgramServicesAmt |
| Management And General | $157,614 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,257 | TotalAmt |
| Program Services | $20,895 | ProgramServicesAmt |
| Management And General | $9,362 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,387 | TotalAmt |
| Program Services | $19,604 | ProgramServicesAmt |
| Management And General | $8,783 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $915,860 | TotalAmt |
| Program Services | $632,482 | ProgramServicesAmt |
| Management And General | $283,378 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,960 | TotalAmt |
| Program Services | $26,905 | ProgramServicesAmt |
| Management And General | $12,055 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,373,959 | TotalAmt |
| Program Services | $948,840 | ProgramServicesAmt |
| Management And General | $425,119 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $175,993 | TotalAmt |
| Program Services | $121,539 | ProgramServicesAmt |
| Management And General | $54,454 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $561,909 | TotalAmt |
| Program Services | $388,048 | ProgramServicesAmt |
| Management And General | $173,861 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,927 | TotalAmt |
| Program Services | $8,237 | ProgramServicesAmt |
| Management And General | $3,690 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,842 | TotalAmt |
| Program Services | $14,394 | ProgramServicesAmt |
| Management And General | $6,448 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $262,398 | TotalAmt |
| Program Services | $181,209 | ProgramServicesAmt |
| Management And General | $81,189 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $134,360 | TotalAmt |
| Program Services | $92,787 | ProgramServicesAmt |
| Management And General | $41,573 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| DUES AND PUBLICATIONS | $185,387 | $128,026 | $57,361 |
| RECRUITMENT | $57,134 | $39,456 | $17,678 |
| TAXES AND LICENSES | $22,210 | $15,338 | $6,872 |
| OTHER | $19,865 | $13,716 | $6,149 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,792,340 | TotalAmt |
| Program Services | $8,143,646 | ProgramServicesAmt |
| Management And General | $3,648,694 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,297,050 | BOYAmt |
| EOY | $3,260,048 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $875,711 | BOYAmt |
| EOY | $3,209,325 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $343,025 | BOYAmt |
| EOY | $1,074,252 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $64,873 | BOYAmt |
| EOY | $73,070 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $4,766,098 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $3,817,842 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,210,653 | BOYAmt |
| EOY | $948,256 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $491,151 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,791,312 | BOYAmt |
| EOY | $9,056,102 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $450,032 | BOYAmt |
| EOY | $548,437 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $863,026 | BOYAmt |
| EOY | $3,809,485 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,313,058 | BOYAmt |
| EOY | $4,357,922 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,478,254 | BOYAmt |
| EOY | $4,698,180 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,478,254 | BOYAmt |
| EOY | $4,698,180 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,791,312 | BOYAmt |
| EOY | $9,056,102 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $219,926 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| 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) |
|---|---|---|
| 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 | $217,200 | OtherCostOrOtherBasisAmt |
| Book Value | $217,200 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,608,331 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,606,762 | DepreciationAmt |
| Book Value | $1,569 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,628,431 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,492,709 | DepreciationAmt |
| Book Value | $135,722 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,312,136 | OtherCostOrOtherBasisAmt |
| Depreciation | $718,371 | DepreciationAmt |
| Book Value | $593,765 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $948,256 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | WELLS FARGO | Desc |
| Book Value | $491,151 | BookValueAmt |
| Method Valuation | C | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $491,151 | TotalBookValueSecuritiesAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $14,449,357 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | $2,437,091 | OtherRevenueAmt |
| Revenue Not Reported | $2,437,091 | RevenueNotReportedAmt |
| Revenue Subtotal | $12,012,266 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $12,012,266 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $13,421,280 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $1,628,940 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $1,628,940 | ExpensesNotReportedAmt |
| Expenses Subtotal | $11,792,340 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $11,792,340 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | SEVHS HAS BEEN RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS EXEMPT FOR FEDERAL INCOME TAX PURPOSES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. SEVHS ANNUALLY FILES AN INFORMATIONAL RETURN FOR EXEMPT ORGANIZATIONS WITH THE IRS AND SUCH RETURNS ARE GENERALLY SUBJECT TO IRS EXAMINATION FOR A PERIOD OF THREE YEARS FROM THE TIME THEY WERE FILED. ACCORDINGLY, RETURNS FOR THE YEARS ENDED NOVEMBER 30, 2014, 2013, AND 2012 REMAIN OPEN FOR EXAMINATION. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | SHORT YEAR DECEMBER 2015 REVENUE 2,437,091. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | SHORT YEAR DECEMBER 2015 EXPENSES 1,628,940. |
Schedule G IRS990ScheduleG
| Field | Value | IRS element (for citing) |
|---|---|---|
| Special Fundraising Events | Yes (X) | SpecialFundraisingEventsInd |
| Agrmt Prof Fundraising Acty | 0 | AgrmtProfFundraisingActyInd |
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | FALL FETE | Event1Nm |
| Gross Receipts Event1 | $23,283 | GrossReceiptsEvent1Amt |
| Gross Revenue Event1 | $23,283 | GrossRevenueEvent1Amt |
| Other Direct Expenses Event1 | $11,856 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $23,283 | GrossReceiptsTotalAmt |
| Gross Revenue Total Events | $23,283 | GrossRevenueTotalEventsAmt |
| Oth Direct Expnss Total Events | $11,856 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $11,856 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $11,427 | NetIncomeSummaryAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ANGELA FUTRELL | ||||||||||||||
| CEO | $196,938 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $32,435 | $0 | $229,373 | $0 | $0 | $0 |
| ALADEE DELAHOUSSAYE MD | ||||||||||||||
| CMO | $153,978 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $19,530 | $0 | $173,508 | $0 | $0 | $0 |
| CONCEPCION ASPILI | ||||||||||||||
| PHYSICIAN | $170,151 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $25,216 | $0 | $195,367 | $0 | $0 | $0 |
| PAULINE REED | ||||||||||||||
| PHYSICIAN | $149,139 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $2,702 | $0 | $151,841 | $0 | $0 | $0 |
| DAVID L LORENZO | ||||||||||||||
| PHYSICIAN | $183,071 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $18,465 | $0 | $201,536 | $0 | $0 | $0 |
| ANDREI SAN MARINA | ||||||||||||||
| PHYSICIAN | $155,617 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $2,627 | $0 | $158,244 | $0 | $0 | $0 |
| AURORA S BADAVI | ||||||||||||||
| PHYSICIAN | $162,691 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $15,512 | $0 | $178,203 | $0 | $0 | $0 |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY HEALTHCARE ASSOCIATES INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | PRINCIPAL OWNER IS FORMER CEO OF THE NONPROFIT | RelationshipDescriptionTxt |
| Transaction | $16,310 | TransactionAmt |
| Transaction | COMPENSATION FOR GRANT WRITING;LIST TOTAL $16,310 | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | THE CFO AND CEO REVIEW FORM 990 BEFORE FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE BOARD IS CHARGED WITH REVIEWING THE POLICIES ANNUALLY OR AS APPROPRIATE. |
| FORM 990, PART VI, SECTION B, LINE 15 | COMPENSATION NEGOTIATIONS ARE BASED UPON EXPERIENCE AND SKILL SET IN KEEPING WITH FAIR MARKET VALUE AND FORMAL PAY SCALE |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. |
| FORM 990, PART XII, LINE 2C: | THE PROCESSES FOR AUDIT AND SELECTION OF THE INDEPENDENT ACCOUNTANT HAVE NOT CHANGED. |