TRI CITIES COMMUNITY HEALTH: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- TRI CITIES COMMUNITY HEALTH (EIN 91-1138675)
- Tax period
- 2014-06-01 to 2015-05-31
- Filed
- 2016-04-18
- IRS object ID
- 201601099349301300
- 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 | 2016-04-18T17:37:18-05:00 | ReturnTs |
| Tax Period End | 2015-05-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 410746749 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3000 NORTHUP WAY SUITE 200 | AddressLine1Txt |
| City | BELLEVUE | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98004 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-06-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 911138675 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TRI-CITIES COMMUNITY HEALTH | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | TRI- | BusinessNameControlTxt |
| Phone | 5055472204 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1452 | AddressLine1Txt |
| City | PASCO | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 99301 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JUAN CORDOVA | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 5092420874 | PhoneNum |
| Signature | 2016-04-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KYLA DELGADO CPA | PreparerPersonNm |
| PTIN | P01874220 | PTIN |
| Phone | 4252506100 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-08-17 19:52:53Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JUAN CORDOVA | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1452 | AddressLine1Txt |
| City | PASCO | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 99301 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $23,863,325 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.MYTCCH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1981 | FormationYr |
| Legal Domicile State | WA | LegalDomicileStateCd |
| Activity Or Mission | OUR MISSION IS IMPROVING OUR COMMUNITY'S HEALTH. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 289 | TotalEmployeeCnt |
| Total Volunteers | 10 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $8,999,685 | PYContributionsGrantsAmt |
| CY Contributions Grants | $9,092,398 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $11,743,372 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $14,403,840 | CYProgramServiceRevenueAmt |
| PY Investment Income | $29,941 | PYInvestmentIncomeAmt |
| CY Investment Income | $39,371 | CYInvestmentIncomeAmt |
| PY Other Revenue | $360,465 | PYOtherRevenueAmt |
| CY Other Revenue | $325,423 | CYOtherRevenueAmt |
| PY Total Revenue | $21,133,463 | PYTotalRevenueAmt |
| CY Total Revenue | $23,861,032 | 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 | $15,345,766 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $16,446,553 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $5,768,450 | PYOtherExpensesAmt |
| CY Other Expenses | $6,154,637 | CYOtherExpensesAmt |
| PY Total Expenses | $21,114,216 | PYTotalExpensesAmt |
| CY Total Expenses | $22,601,190 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $19,247 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,259,842 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $17,706,206 | TotalAssetsBOYAmt |
| Total Assets EOY | $21,915,864 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $4,882,052 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $7,829,091 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $12,824,154 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $14,086,773 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | OUR MISSION IS IMPROVING OUR COMMUNITY'S HEALTH. | MissionDesc |
| Significant New Program Srvc | Yes (1) | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $14,427,196 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $10,728,792 | RevenueAmt |
| Desc | THE CLINIC PROVIDES MEDICAL, DENTAL, VISION AND URGENT CARE TO MIGRANT AND LOW INCOME PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT BELOW COST AND TO INDIVIDUALS WHO ARE UNABLE TO PAY.THE UNREIMBURSED VALUE OF PROVIDING CARE TO THESE PATIENTS WAS $572,300 FOR CHARITY CARE, $62,954 FOR MEDICARE, $3,187,661 FOR MEDICAID, AND $2,678,770 FOR OTHER THIRD PARTY PAYORS FOR THE YEAR.THE CLINIC PROVIDED 55,223 MEDICAL ENCOUNTERS AND 20,333 DENTAL ENCOUNTERS FOR THE YEAR. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $3,665,961 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $2,726,194 | RevenueAmt |
| Desc | THE CLINIC PROVIDES MENTAL AND SUBSTANCE ABUSE COUNSELING, THERAPY AND PSYCHIATRIC SERVICES TO MIGRANT AND LOW INCOME PERSONS THROUGHOUT BENTON AND FRANKLIN COUNTIES. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,275,941 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $948,854 | RevenueAmt |
| Desc | THE CLINIC OFFERS MATERNITY SUPPORT SERVICES (MSS), INFANT CASE MANAGEMENT (ICM), SOCIAL SERVICES (OUTREACH) AND WIC NUTRITION EDUCATION APPOINTMENTS, AND CLASSES TO HIGH RISK MOMS DURING AND POST-DELIVERY. A LARGE PERCENTAGE OF THOSE TCH SERVES ARE MIGRANT AND SEASONAL FARMER WORKERS. TCCH SERVES WELL OVER 4,750 CLIENTS PER MONTH THROUGH THESE PROGRAMS. THESE PROGRAMS IMPROVE ACCESS TO CARE AND PROMOTE PROACTIVE HEALTH CARE MESSAGES TO IMPROVE HEALTHY DELIVERIES AND LIVING. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $19,369,098 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | 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 | Yes (1) | 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 | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | 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 | 0 | 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 | Yes (1) | 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 | 40 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 289 | 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 | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | 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 | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JIM MAIN | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5055472204 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 515 WEST COURT STREET PO BOX 1452 | AddressLine1Txt |
| City | PASCO | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 99301 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| JOHN INTRAVARTOLO | |||||||
| CHAIR | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| RON WEED | |||||||
| VICE CHAIR | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| RUDY MENDOZA | |||||||
| TREASURER | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| BEVERLY HERRIN | |||||||
| SECRETARY | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| LILLIAN PARRA | |||||||
| SERGEANT AT ARMS | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| DOROTEO CHAVEZ | |||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| ANA RUIZ PERALTA | |||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| MARK MORRISSETTE | |||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JOSE ROJAS | |||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| MICHAEL TUOHY | |||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JUAN CORDOVA | |||||||
| CEO | 40.00 | Yes (X) | $185,382 | $0 | $15,043 | ||
| ESLEEN FULTZ | |||||||
| CFO | 40.00 | Yes (X) | $145,254 | $0 | $6,111 | ||
| BRIAN SCHUR | |||||||
| CDO | 40.00 | Yes (X) | $155,058 | $0 | $15,043 | ||
| JENNIFER ROBINSON | |||||||
| COO | 40.00 | Yes (X) | $99,038 | $0 | $11,282 | ||
| RICHARD WILLIAMS | |||||||
| PHYSICIAN | 40.00 | $296,131 | $0 | $17,304 | Yes (X) | ||
| SERGIO FLORES | |||||||
| PHYSICIAN | 40.00 | $252,240 | $0 | $9,537 | Yes (X) | ||
| ANA MADARIYA | |||||||
| PHYSICIAN | 40.00 | $236,245 | $0 | $11,157 | Yes (X) | ||
| LEONEL ZOLESSI | |||||||
| PHYSICIAN | 40.00 | $220,955 | $0 | $10,437 | Yes (X) | ||
| CHERYL HIPOLITO | |||||||
| PHYSICIAN | 40.00 | $195,839 | $0 | $5,974 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,786,142 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $101,888 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 18 | 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 |
|---|---|---|---|---|---|
| LCR CONSTRUCTION | |||||
| 8382 GAGE BOULEVARD SUITE J | KENNEWICK | WA | 99336 | CONSTRUCTION SERVICES | $531,142 |
| I-CLEAN BUILDING SERVICES | |||||
| PO BOX 4836 | PASCO | WA | 99301 | JANITORIAL SERVICES | $256,393 |
| EXPRESS SERVICES INC | |||||
| 9701 BOARDWALK BOULEVARD | OKLAHOMA CITY | OK | 73162 | TEMPORARY LABOR | $114,559 |
| SMITH COVE PARTNERSHIP | |||||
| 552 NORTH COLORADO SUITE 101 | KENNEWICK | WA | 99336 | CONSTRUCTION SERVICES | $108,024 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $8,583,249 | GovernmentGrantsAmt |
| All Other Contributions | $509,149 | AllOtherContributionsAmt |
| Noncash Contributions | $508,649 | NoncashContributionsAmt |
| Total Contributions | $9,092,398 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENUE, NET | 624100 | $10,439,430 | $10,439,430 |
| CAPITATION REVENUE | 624100 | $3,847,254 | $3,847,254 |
| ELECTRONIC HEALTH RECORDS INCENTI | 624100 | $117,156 | $117,156 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $14,403,840 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $41,664 | TotalRevenueColumnAmt |
| Exclusion | $41,664 | ExclusionAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $2,293 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$2,293 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$2,293 | TotalRevenueColumnAmt |
| Exclusion | -$2,293 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| RISK POOL REVENUE | 900099 | $252,650 | $252,650 |
| OTHER REVENUE | 900099 | $72,773 | $72,773 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $325,423 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $23,861,032 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $14,403,840 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $364,794 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $631,156 | TotalAmt |
| Management And General | $631,156 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,606,213 | TotalAmt |
| Program Services | $11,798,946 | ProgramServicesAmt |
| Management And General | $807,267 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $113,972 | TotalAmt |
| Program Services | $100,387 | ProgramServicesAmt |
| Management And General | $13,585 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,095,212 | TotalAmt |
| Program Services | $2,726,272 | ProgramServicesAmt |
| Management And General | $368,940 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $87,726 | TotalAmt |
| Program Services | $52,144 | ProgramServicesAmt |
| Management And General | $35,582 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $53,016 | TotalAmt |
| Program Services | $31,513 | ProgramServicesAmt |
| Management And General | $21,503 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,353,387 | TotalAmt |
| Program Services | $855,215 | ProgramServicesAmt |
| Management And General | $498,172 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $143,160 | TotalAmt |
| Program Services | $54,515 | ProgramServicesAmt |
| Management And General | $88,645 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $109,128 | TotalAmt |
| Program Services | $70,931 | ProgramServicesAmt |
| Management And General | $38,197 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $244,204 | TotalAmt |
| Program Services | $92,993 | ProgramServicesAmt |
| Management And General | $151,211 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $532,891 | TotalAmt |
| Program Services | $351,294 | ProgramServicesAmt |
| Management And General | $181,597 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $45,046 | TotalAmt |
| Program Services | $17,154 | ProgramServicesAmt |
| Management And General | $27,892 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $35,864 | TotalAmt |
| Program Services | $13,657 | ProgramServicesAmt |
| Management And General | $22,207 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $894,541 | TotalAmt |
| Program Services | $773,695 | ProgramServicesAmt |
| Management And General | $120,846 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $113,482 | TotalAmt |
| Program Services | $22,086 | ProgramServicesAmt |
| Management And General | $91,396 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $2,006,813 | $1,957,160 | $49,653 |
| BAD DEBT | $357,945 | $357,945 | |
| EQUIPMENT LEASE, REPAIR | $96,484 | $62,342 | $34,142 |
| MISCELLANEOUS | $80,950 | $30,849 | $50,101 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,601,190 | TotalAmt |
| Program Services | $19,369,098 | ProgramServicesAmt |
| Management And General | $3,232,092 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $207,475 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,220,768 | BOYAmt |
| EOY | $7,820,395 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $388,931 | BOYAmt |
| EOY | $442,946 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $602,497 | BOYAmt |
| EOY | $559,578 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $895,558 | BOYAmt |
| EOY | $828,058 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $83,439 | BOYAmt |
| EOY | $150,485 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $89,429 | BOYAmt |
| EOY | $158,267 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $15,545,161 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $6,451,250 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,674,469 | BOYAmt |
| EOY | $9,093,911 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $903,656 | BOYAmt |
| EOY | $926,436 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,847,459 | BOYAmt |
| EOY | $1,728,313 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,706,206 | BOYAmt |
| EOY | $21,915,864 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,351,982 | BOYAmt |
| EOY | $3,296,135 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $211,705 | BOYAmt |
| EOY | $2,318,509 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,164,118 | BOYAmt |
| EOY | $2,181,302 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $154,247 | BOYAmt |
| EOY | $33,145 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,882,052 | BOYAmt |
| EOY | $7,829,091 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,824,154 | BOYAmt |
| EOY | $14,086,773 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,824,154 | BOYAmt |
| EOY | $14,086,773 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,706,206 | BOYAmt |
| EOY | $21,915,864 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $1,259,842 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $2,777 | 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) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Agent Trustee Etc | Yes (1) | AgentTrusteeEtcInd |
| Beginning Balance | $10,044 | BeginningBalanceAmt |
| Additions During Year | $116,281 | AdditionsDuringYearAmt |
| Distributions During Year | $118,300 | DistributionsDuringYearAmt |
| Ending Balance | $8,025 | EndingBalanceAmt |
| Incl Escrow Custodial Acct Liab | Yes (1) | InclEscrowCustodialAcctLiabInd |
| Explanation Provided | Yes (X) | ExplanationProvidedInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $219,289 | OtherCostOrOtherBasisAmt |
| Book Value | $219,289 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $10,842,564 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,320,966 | DepreciationAmt |
| Book Value | $7,521,598 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $54,797 | OtherCostOrOtherBasisAmt |
| Depreciation | $16,846 | DepreciationAmt |
| Book Value | $37,951 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,153,438 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,113,438 | DepreciationAmt |
| Book Value | $1,040,000 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $275,073 | OtherCostOrOtherBasisAmt |
| Book Value | $275,073 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $9,093,911 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (5 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| SELF-FUNDED INSURANCE ASSET | $73,844 |
| ESTIMATED RISK POOL SETTLEMENT RECEIVABLE | $169,000 |
| ENHANCEMENT RECEIVABLE | $120,955 |
| ASSETS LIMITED AS TO USE FOR HOUSING PROGRAM | $1,353,636 |
| SECURITY DEPOSITS | $10,878 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $1,728,313 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | ESTIMATED THIRD-PARTY SETTLEMENTS | Desc |
| Amt | $33,145 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $33,145 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $23,566,718 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $23,566,718 | RevenueSubtotalAmt |
| Other Revenues Not Included | $294,314 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $294,314 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $23,861,032 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $22,601,190 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $22,601,190 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $22,601,190 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART IV, LINE 1B: | CHECK BOOKS ARE HELD FOR A NUMBER OF PATIENTS. THE BANK ACCOUNT IS UNDER THE PATIENT'S NAME. TCCH MAKES SURE BILLS ARE PAID BUT THE MONEY IS NOT PROVIDED TO TCCH DIRECTLY. |
| PART IV, LINE 2B: | STATE DEPARTMENT OF COMMERCE- THESE FUNDS ARE AVAILABLE TO THE CLINIC FOR 50 YEARS. HOUSING ASSISTANCE COUNCIL- THESE FUNDS ARE FOR THE PURCHASE OF LOTS FOR SELF-HELP HOUSING PROGRAM. THE FUNDS ARE DRAWN DOWN AT THE TIME OF PURCHASE AND WHEN THE LOTS ARE SOLD, 75 PERCENT OF THE FUNDS ARE HELD IN A REVOLVING FUND FOR FUTURE LOT PURCHASES WITH THE REMAINING 25 PERCENT RETURNED TO THE HOUSING ASSISTANCE COUNCIL. HOUSING AND URBAN DEVELOPMENT- THESE FUNDS ARE ALLOCATED FOR USE AS SPECIFIED BY THE GRANT AGREEMENTS. FUNDS RECEIVED BY THE CLINIC ARE FOR THE PURCHASE OF LOTS TO BE SOLD TO FAMILIES IN THE SELF-HELP PROGRAM AND ARE INCLUDED IN A REVOLVING ACCOUNT UNTIL IT IS NO LONGER USED FOR LOT PURCHASES OR SUBSIDIES AT WHICH TIME IT IS TO BE RETURNED TO HOUSING AND URBAN DEVELOPMENT. COMMUNITY HOUSING DEVELOPMENT ORGANIZATION- THESE FUNDS ARE TO BE RETURNED SHOULD THE HOME BE SOLD OR FORECLOSED BEFORE THE MINIMUM AFFORDIBILITY PERIOD ENDS, WHICH VARIES BETWEEN 5 AND 15 YEARS BASED ON THE COST OF THE UNIT. AFTER THE MINIMUM AFFORDIBILITY PERIOD HAS BEEN ACHIEVED, THE ASSOCIATED DEBT IS FORGIVEN AND THE FUNDS ARE RECOGNIZED AS REVENUE BY THE CLINIC. |
| PART X, LINE 2: | THE CLINIC HAS RECEIVED A DETERMINATION LETTER FROM THE INTERNAL REVENUE SERVICE THAT STATES IT IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, NO PROVISION FOR INCOME TAXES IS SHOWN IN THE FINANCIAL STATEMENTS. MANAGEMENT EVALUATED THE CLINIC'S TAX POSITIONS AND CONCLUDED THAT THE CLINIC HAD TAKEN NO SIGNIFICANT UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENTS TO THE FINANCIAL STATEMENTS TO COMPLY WITH THE PROVISIONS OF TOPIC 740 OF THE ACCOUNTING STANDARDS CODIFICATION. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | RISK POOL SAVINGS 252,650. INTEREST INCOME 41,664. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| 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 (8 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JUAN CORDOVA | ||||||||||||||
| CEO | $162,382 | $0 | $0 | $0 | $23,000 | $0 | $0 | $0 | $15,043 | $0 | $200,425 | $0 | $0 | $0 |
| ESLEEN FULTZ | ||||||||||||||
| CFO | $145,254 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $6,111 | $0 | $151,365 | $0 | $0 | $0 |
| BRIAN SCHUR | ||||||||||||||
| CDO | $155,058 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $15,043 | $0 | $170,101 | $0 | $0 | $0 |
| RICHARD WILLIAMS | ||||||||||||||
| PHYSICIAN | $278,631 | $0 | $0 | $0 | $17,500 | $0 | $0 | $0 | $17,304 | $0 | $313,435 | $0 | $0 | $0 |
| SERGIO FLORES | ||||||||||||||
| PHYSICIAN | $252,240 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $9,537 | $0 | $261,777 | $0 | $0 | $0 |
| ANA MADARIYA | ||||||||||||||
| PHYSICIAN | $221,013 | $0 | $0 | $0 | $15,232 | $0 | $0 | $0 | $11,157 | $0 | $247,402 | $0 | $0 | $0 |
| LEONEL ZOLESSI | ||||||||||||||
| PHYSICIAN | $220,955 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $10,437 | $0 | $231,392 | $0 | $0 | $0 |
| CHERYL HIPOLITO | ||||||||||||||
| PHYSICIAN | $195,839 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $5,974 | $0 | $201,813 | $0 | $0 | $0 |
Schedule M IRS990ScheduleM
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 3 | ContributionCnt |
| Noncash Contributions Rpt F990 | $508,649 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | COST | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8283 Received | 0 | Form8283ReceivedCnt |
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | Yes (1) | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART I, LINE 6: | VOLUNTEERS FOR THE CLINIC PROVIDE SUPPORT IN ADMINISTRATION, FACILITY, AND SUPPORT SERVICE DEPARTMENTS. |
| FORM 990, PART III, LINE 2 | AN EYE CLINIC AND VISION PROGRAM WERE OPENED IN MARCH OF 2015. |
| FORM 990, PART VI, SECTION A, LINE 1 | THE EXECUTIVE COMMITTEE CONSISTS OF THE OFFICERS OF THE GOVERNING BOARD AND ONE OTHER BOARD MEMBER TO BE DESIGNATED BY THE BOARD. THE EXECUTIVE COMMITTEE IS AUTHORIZED TO REVIEW AND TAKE ANY NECESSARY ACTION, WHICH, IN THE OPINION OF A MAJORITY OF THE COMMITTEE UPON VOTE WHERE FOUR MEMBERS ARE PRESENT, CANNOT WAIT FOR THE NEXT REGULARLY SCHEDULED BOARD MEETING OR WHERE CALLING A SPECIAL BOARD MEETING IS NOT PRACTICAL. THE EXECUTIVE COMMITTEE CHAIRPERSON MUST REPORT TO THE BOARD AT THE NEXT REGULAR MEETING ALL ACTIONS TAKEN BY THE COMMITTEE. |
| FORM 990, PART VI, SECTION B, LINE 11 | A COPY OF THE 99O WAS PROVIDED TO THE CEO AND CONTROLLER, WHO REVIEWED THE FORM, SCHEDULES AND RELATED ATTACHMENTS. ANY COMMENTS OR QUESTIONS WERE ADDRESSED WITH THE PREPARER AND A FINAL DRAFT WAS PRESENTED TO THE CEO, WHO THEN APPROVED THE 990. ONCE MANAGEMENT WAS SATISFIED WITH THE 990, IT WAS DISTRIBUTED TO ALL BOARD MEMBERS FOR REVIEW. AFTER BOARD REVIEW, THE CEO SIGNED THE FORM 8879-EO AUTHORIZING THE PREPARER TO E-FILE THE RETURN. |
| FORM 990, PART VI, SECTION B, LINE 12C | ALL BOARD MEMBERS ARE REQUIRED TO DISCLOSE ANY POTENTIAL CONFLICTS OF INTEREST AT THE TIME OF APPOINTMENT TO THE BOARD OR THROUGH SELF-DISCLOSURE IN THE INTERIM. DISCLOSURES ARE REVIEWED BY THE FULL BOARD. IF A CONFLICT OF INTEREST EXISTS, THE BOARD MEMBER IS EXCUSED FROM ALL DISCUSSIONS AND ANY VOTING THAT RELATES TO THE MATTER IN QUESTION. IT IS UNDERSTOOD THAT ALL BOARD MEMBERS HAVE AN OBLIGATION TO REPORT ANY MATTERS OR ISSUES THAT MAY GIVE RISE TO A CONFLICT OF INTEREST. |
| FORM 990, PART VI, SECTION B, LINE 15A | THE HUMAN RESOURCE DEPARTMENT REGULARY CONDUCTS SALARY REVIEWS AND SURVEYS FOR ALL POSITIONS, INCLUDING KEY EMPLOYEES AND OFFICERS, AND ADVISES THE BOARD OF DIRECTORS OF THEIR FINDINGS UPON REQUEST. THE BOARD OF DIRECTORS REVIEWS AND APPROVES THE CEO'S COMPENSATION. THE BOARD OF DIRECTORS REVIEWS AND APPROVES THE COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES WHEN THEY ARE HIRED, BUT THE CEO REVIEWS AND APPROVES THEIR COMPENSATION IN SUBSEQUENT YEARS. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE CLINIC MAKES ITS GOVERINING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND AUDITED FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
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