2016-08-23T06:05:07-05:00 2015-11-30 541967771 CAVANAUGH NELSON PLC 999 WATERSIDE DRIVE SUITE 2250 NORFOLK VA 23510 990 2014-12-01 541083954 PENINSULA INSTITUTE FOR COMMUNITY HEALTH DBA SOUTHEASTERN VIRGINIA HEALTH SYSTEM PENI 7573808709 1033 28TH STREET 2ND FLOOR NEWPORT NEWS VA 23607 ANGELA FUTRELL CEO 7573808709 2016-08-23 1 MARK A NELSON P00358004 7575784900 2014 2016-12-15 16:53:06Z ANGELA FUTRELL 1033 28TH STREET 2ND FLOOR NEWPORT NEWS VA 23607 12024122 0 X WWW.PICH.ORG X 1978 VA PROVIDE HIGH QUALITY, COMPREHENSIVE, PRIMARY HEALTH CARE SERVICES TO VIRGINIA RESIDENTS LIVING IN HAMPTON ROADS REGARDLESS OF THEIR ABILITY TO PAY. 13 13 197 0 0 0 7369024 6841791 4778935 5156423 2273 2625 8366 11427 12158598 12012266 0 0 0 0 8072263 7952892 0 0 0 4080233 3839448 12152496 11792340 6102 219926 5791312 9056102 1313058 4357922 4478254 4698180 PROVIDING MEDICAL AND DENTAL CARE TO INDIGENT PATIENTS 0 0 7511302 5156423 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 632344 HEALTHCARE FOR THE HOMELESS: PRIMARY MEDICAL CARE AND REFERRAL SERVICES FOR AREA HOMELESS: 6,012 VISITS 8143646 1 1 0 0 0 0 0 0 0 0 1 1 0 0 0 1 1 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 43 0 197 1 0 0 0 0 0 0 0 0 0 0 X 13 13 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X X THE ORGANIZATION 7573808709 1033 28TH STREET 2ND FLOOR NEWPORT NEWS VA 23607 ROBERT AYERS SECRETARY 2.00 X 0 0 0 EUGENE JOHNSON PARLIAMENTARIAN 8.00 X 0 0 0 WANDA ALLEN ESQUIRE CHAIR 6.00 X 0 0 0 BARBARA EASTER DIRECTOR 2.00 X 0 0 0 SHELIA HENDERSON DIRECTOR 2.00 X 0 0 0 JACQUELINE HUDGINS DIRECTOR 2.00 X 0 0 0 ALTON SKEETER DIRECTOR 2.00 X 0 0 0 SHIRLEY WILLS DIRECTOR 2.00 X 0 0 0 WENDELL BRAXTON DIRECTOR 2.00 X 0 0 0 DOROTHY MURRAY VICE-CHAIR 2.00 X 0 0 0 THOMAS E HARMON IV DIRECTOR 2.00 X 0 0 0 MELISSA COUNCE DIRECTOR 2.00 X 0 0 0 MELINDA WILLIAMS TREASURER 2.00 X 0 0 0 ANGELA FUTRELL CEO 40.00 X 196938 0 32435 VALDA BRANCH COO 40.00 X 131392 0 15524 ALADEE DELAHOUSSAYE MD CMO 40.00 X 153978 0 19530 NONA HILTON CFO 40.00 X 58383 0 0 CONCEPCION ASPILI PHYSICIAN 40.00 X 170151 0 25216 PAULINE REED PHYSICIAN 40.00 X 149139 0 2702 DAVID L LORENZO PHYSICIAN 40.00 X 183071 0 18465 ANDREI SAN MARINA PHYSICIAN 40.00 X 155617 0 2627 AURORA S BADAVI PHYSICIAN 40.00 X 162691 0 15512 1361360 0 132011 17 0 1 0 LABCORP 860 OMNI BLVD 302A NEWPORT NEWS VA 23606 LAB SERVICES 310229 PHYSICIAN SALES & SERVICES 600 GREEN TREE RD CHESAPEAKE VA 23320 MEDICAL SUPPLIES 295686 PENINSULA CLEANING SERVICE 12610 PATRICK HENRY DR NEWPORT NEWS VA 23602 CLEANING 233640 STERICYCLE INC 1330 BELLWOOD RD RICHMOND VA 23237 MEDICAL WASTE DISPOSAL 103782 4 6203360 638431 6841791 NET PATIENT SERVICE REVENUE 621110 5156423 5156423 5156423 2625 2625 23283 11856 11427 11427 12012266 5156423 0 14052 606208 167907 438301 6175936 4515759 1660177 661350 456720 204630 509398 351784 157614 30257 20895 9362 28387 19604 8783 915860 632482 283378 38960 26905 12055 1373959 948840 425119 175993 121539 54454 561909 388048 173861 11927 8237 3690 20842 14394 6448 262398 181209 81189 134360 92787 41573 DUES AND PUBLICATIONS 185387 128026 57361 RECRUITMENT 57134 39456 17678 TAXES AND LICENSES 22210 15338 6872 OTHER 19865 13716 6149 11792340 8143646 3648694 0 3297050 3260048 875711 3209325 343025 1074252 64873 73070 4766098 3817842 1210653 948256 491151 5791312 9056102 450032 548437 863026 3809485 1313058 4357922 X 4478254 4698180 4478254 4698180 5791312 9056102 219926 0 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 217200 217200 1608331 1606762 1569 1628431 1492709 135722 1312136 718371 593765 948256 WELLS FARGO 491151 C 491151 X 14449357 2437091 2437091 12012266 0 12012266 13421280 1628940 1628940 11792340 0 11792340 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. X 0 FALL FETE 23283 23283 11856 23283 23283 11856 11856 11427 X X 0 0 0 0 0 0 0 0 0 ANGELA FUTRELL CEO 196938 0 0 0 0 0 0 0 32435 0 229373 0 0 0 ALADEE DELAHOUSSAYE MD CMO 153978 0 0 0 0 0 0 0 19530 0 173508 0 0 0 CONCEPCION ASPILI PHYSICIAN 170151 0 0 0 0 0 0 0 25216 0 195367 0 0 0 PAULINE REED PHYSICIAN 149139 0 0 0 0 0 0 0 2702 0 151841 0 0 0 DAVID L LORENZO PHYSICIAN 183071 0 0 0 0 0 0 0 18465 0 201536 0 0 0 ANDREI SAN MARINA PHYSICIAN 155617 0 0 0 0 0 0 0 2627 0 158244 0 0 0 AURORA S BADAVI PHYSICIAN 162691 0 0 0 0 0 0 0 15512 0 178203 0 0 0 COMMUNITY HEALTHCARE ASSOCIATES INC PRINCIPAL OWNER IS FORMER CEO OF THE NONPROFIT 16310 COMPENSATION FOR GRANT WRITING;LIST TOTAL $16,310 0 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.