2016-04-18T00:00:00-05:00 2015-12-31 231386942 CAMPBELL RAPPOLD & YURASITS LLP 1033 S CEDAR CREST BLVD ALLENTOWN PA 181035443 990 2015-01-01 233072363 THE CLINIC THEC 6109351134 143 CHURCH STREET PHOENIXVILLE PA 19460 JIM KOVALESKI PRESIDENT 6109351134 2016-04-06 1 TARA L BENDER CPA P00299403 6104357489 2015 2016-09-27 15:27:22Z JIM KOVALESKI 143 CHURCH STREET PHOENIXVILLE PA 19460 1201180 0 X WWW.THECLINICPA.ORG X 2001 PA TO PROVIDE QUALITY HEALTHCARE TO THE UNINSURED, IN AN ATMOSPHERE WHICH FOSTERS DIGNITY AND RESPECT FOR ITS PATIENTS. 13 13 21 156 0 0 828997 978506 136012 117264 13684 15826 -3204 -4170 975489 1107426 135538 104186 0 0 662186 672890 0 0 155377 248909 276440 1046633 1053516 -71144 53910 1608700 1638865 46952 44370 1561748 1594495 X THE CLINIC'S MISSION IS TO PROVIDE QUALITY HEALTHCARE TO THE UNINSURED, IN AN ATMOSPHERE WHICH FOSTERS DIGNITY AND RESPECT FOR ITS PATIENTS. IT IS OUR PRIVILEGE TO DO SO. 0 0 741046 104186 122923 THE CLINIC HAD THE PRIVILEGE OF PROVIDING THE FOLLOWING QUALITY HEALTH CARE SERVICES TO THE COMMUNITY, WHICH ENCOMPASSED APPROXIMATELY 34 TOWNSHIPS/MUNICIPALITIES IN CHESTER AND MONTGOMERY COUNTIES (APPROX. 220 SQUARE MILES), DURING FY 2015: A) MEDICAL SERVICES INCLUDED: FAMILY AND INTERNAL MEDICINE, GYNECOLOGY, PEDIATRICS, CARDIOLOGY, UROLOGY, ORTHOPEDICS, PSYCHIATRY, ALLERGY, DERMATOLOGY AND DERMATOLOGIC SURGERY.B) OTHER CLINICAL SERVICES INCLUDED: PSYCHOLOGICAL SERVICES, HOLISTIC HEALTH COUNSELING, ACUPUNCTURE, AND CERTIFIED ADDICTIONS COUNSELING. C) OVERALL PATIENT VISITS WERE 7,100, OF PRIMARY AND SPECIALTY MEDICAL CARE TO INDIVIDUALS AND FAMILIES WHO WERE WITHOUT MEDICAL INSURANCE AND UNDERSERVED. D) THERE WERE 2,400 UNIQUE, UNDUPLICATED PATIENTS DURING 2015.E) THE PHARMACY ASSISTANCE PROGRAM COORDINATED THE PROVISION OF 907 ANNUAL REFILLS OF FREE MEDICATIONS. THE TOTAL VALUE OF THESE MEDICATIONS (AVERAGE WHOLESALE PRICE) TOTALED APPROXIMATELY $875,000.F) THE CLINIC'S CLINICAL LABORATORY PERFORMED, OR OUTSOURCED, THE PROVISION OF APPROXIMATELY 3,595 LABORATORY TESTS WHICH WERE A CRUCIAL COMPONENT OF ASSESSING/DIAGNOSING OF MEDICAL PROBLEMS NEEDED TO DEVELOP AN ACCURATE TREATMENT PLAN.G) THE CLINIC, IN PARTNERSHIP WITH A LOCAL COMMUNITY HOSPITAL'S CHARITY CARE PROGRAM, COORDINATED THE PROVISION OF APPROXIMATELY 1,040 FREE DIAGNOSTIC TESTS, PROCEDURES AND CONSULTS TO OUR PATIENTS. THESE PROCEDURES INCLUDED SUCH SERVICES AS: X-RAYS, ULTRASOUNDS, MRI'S, CAT SCANS, MAMMOGRAMS, G.I. AND SURGICAL CONSULTS, AND BIOPSIES. WE PROVIDE ALL OF THESE CLINICAL SERVICES WITH DIGNITY AND RESPECT FOR OUR PATIENTS. 741046 1 1 0 0 0 0 0 0 0 1 1 1 0 0 0 1 1 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 6 0 1 21 1 0 0 0 0 0 1 1 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 PA X X LISA MATTHEWS 6109351134 143 CHURCH STREET PHOENIXVILLE PA 19460 JOHN ENYART VICE PRESIDENT 2.00 X X 0 0 0 GREG CARE TREASURER 2.00 X X 0 0 0 JAMES KOVALESKI PRESIDENT (CURRENT) 2.00 X X 0 0 0 ROBERT J DOLLFUS JR SECRETARY 2.00 X X 0 0 0 MARK BANFIELD BOARD MEMBER 2.00 X 0 0 0 LEWIS OSTERHOUDT BOARD MEMBER 2.00 X 0 0 0 DOUGLAS HUGHES BOARD MEMBER 2.00 X 0 0 0 ANA NEGRON MD BOARD MEMBER 2.00 X 0 0 0 SANDY CRABTREE BOARD MEMBER 2.00 X 0 0 0 THOMAS CARNEVALE BOARD MEMBER 2.00 X 0 0 0 DOUG DARLINGTON BOARD MEMBER 2.00 X 0 0 0 SARAH STRZELECKI EDD MBA RN PRESIDENT (FORMER) 2.00 X 0 0 0 THOMAS BURD EXECUTIVE DIRECTOR 50.00 X 0 97836 7958 LORNA STUART MD MEDICAL DIRECTOR 50.00 X 0 67704 2038 GEORGE SPYROPOULOS MD BEGAN 082015 MEDICAL DIRECTOR 50.00 X 0 50673 1520 0 216213 11516 0 0 0 0 0 26464 952042 26122 978506 LOW-COST MEDICAL SERVI 621400 117264 117264 117264 10167 10167 81298 75639 5659 5659 5659 13945 26464 18115 -4170 -4170 1107426 122923 0 5997 104186 104186 227729 174833 26448 26448 360158 248665 54898 56595 7854 5004 1624 1226 27257 10702 9135 7420 49892 35434 6978 7480 19065 898 18167 2932 2932 3422 2847 130 445 36178 18808 6646 10724 37279 27959 7456 1864 58183 43638 11635 2910 7408 4719 1532 1157 60 60 21027 15770 4206 1051 50256 45024 5090 142 FEASIBILITY 32250 32250 INDIRECT SPECIAL EVENTS 5660 5660 VOLUNTEER RECOGNITION 2290 2290 MISCELLANEOUS 430 269 156 5 1053516 741046 157093 155377 493724 549982 23000 67412 8639 6142 37973 17790 655003 327207 335717 327796 301480 286089 408167 383654 1608700 1638865 46952 44370 46952 44370 X 1190196 1176097 181510 228356 190042 190042 1561748 1594495 1608700 1638865 53910 -21163 0 X X 0 1 X 1 0 X 963638 832846 818945 790220 941532 4347181 146115 152434 155435 136012 117264 707260 1109753 985280 974380 926232 1058796 5054441 297500 175100 240525 266275 328200 1307600 0 297500 175100 240525 266275 328200 1307600 3746841 13351 8826 8541 11762 10167 52647 13351 8826 8541 11762 10167 52647 945 945 1124049 994106 982921 937994 1068963 5108033 0.73350 0.76250 0.01030 0.01050 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 269259 -11861 257398 255241 14018 269259 227861 1500 25880 255241 206513 21348 227861 209755 -420 -2822 206513 0.00000 0.73830 0.26170 0 0 455505 147307 308198 199498 179900 19598 327796 CERTIFICATE OF DEPOSIT 359196 F INVESTED WITH CHESTER COUNTY COMMUNITY FOUNDATION 24458 F 383654 X 1244340 -21163 166669 -2932 142574 1101766 5660 5660 1107426 1211593 166669 166669 1044924 8592 8592 1053516 PART V, LINE 4: TO PROVIDE FUTURE INCOME TO SUPPORT THE PROGRAMS OF THE CLINIC. PART X, LINE 2: THE CLINIC IS A NOT-FOR-PROFIT ORGANIZATION THAT IS EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND NONE OF ITS PRESENT OR ANTICIPATED FUTURE ACTIVITIES ARE SUBJECT TO TAXATION AS UNRELATED BUSINESS INCOME. THEREFORE, NO PROVISION FOR INCOME TAXES HAS BEEN MADE IN THE ACCOMPANYING FINANCIAL STATEMENTS. UNCERTAIN TAX POSITIONS ARE EVALUATED IN ACCORDANCE WITH FASB ASC 740-10. FASB ASC 740-10 CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN THE ORGANIZATION'S FINANCIAL STATEMENTS AND PRESCRIBES A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN-NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY. MEASUREMENT OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD HAS BEEN MET. FASB ASC 740-10 ALSO PROVIDES GUIDANCE ON DERECOGNITION, CLASSIFICATION, INTEREST AND PENALTIES, ACCOUNTING IN INTERIM PERIODS, AND DISCLOSURE. THE ORGANIZATION HAD NO MATERIAL UNRECOGNIZED TAX BENEFITS OR ACCRUED INTEREST OR PENALTIES. THE ORGANIZATION FILES INCOME TAX RETURNS IN THE UNITED STATES. THE ORGANIZATION IS NO LONGER SUBJECT TO U.S. TAX EXAMINATIONS BY TAXING AUTHORITIES FOR YEARS BEFORE 2012. PART XI, LINE 2D - OTHER ADJUSTMENTS: INVESTMENT FEES, NETTED AGAINST INCOME ON BOOKS -2,932. PART XI, LINE 4B - OTHER ADJUSTMENTS: DIRECT EXPENSES OF FUNDRAISING ACTIVITIES 5,660. PART XII, LINE 4B - OTHER ADJUSTMENTS: INVESTMENT FEES, NETTED AGAINST INCOME ON BOOKS 2,932. DIRECT EXPENSES OF FUNDRAISING ACTIVITIES 5,660. ANNIVERSARY DINNER 19570 13185 6385 6385 GOLF EVENT 20839 13279 7560 11730 40409 26464 13945 18115 18115 -4170 0 HEALTHCARE ASSISTANCE 7100 78065 26121 FMV PHARMECEUTICALS AND SUPPLIES GIVEN TO PATIENTS OF THE CLINIC X 26121 0 1 0 FORM 990, PART VI, SECTION B, LINE 11 A DRAFT OF THE FORM 990 AND ALL RELATED SCHEDULES IS PROVIDED TO THE AUDIT COMMITTEE FOR REVIEW AND ACCEPTANCE. ONCE THE COMMITTEE HAS APPROVED, IT IS PROVIDED TO THE BOARD OF DIRECTORS AND THE COMMITTEE RECOMMENDS APPROVAL FOR FILING. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REQUIRES THAT BOARD MEMBERS DISCLOSE ANY CONFLICTS OF INTEREST. IN CONNECTION WITH ANY TRANSACTION OR ARRANGEMENT PRESENTED TO THE BOARD OF DIRECTORS, EACH INTERESTED PERSON IS REQUIRED TO MAKE FULL DISCLOSURE OF THE MATERIAL FACTS RELATING TO THE CONFLICT OR POTENTIAL CONFLICT. THE BOARD OF DIRECTORS, WITHOUT THE PARTICIPATION OF THE INTERESTED PARTY, MAKES A DETERMINATION WHETHER A CONFLICT OF INTEREST EXISTS. IF A CONFLICT EXISTS, THE INTERESTED PARTY WILL EXCUSE HIMSELF FROM THE MEETING AND SHALL NOT VOTE ON THE ISSUE AT HAND. IF THE BOARD HAS REASONABLE CAUSE TO BELIEVE THAT A DIRECTOR, OFFICER, OR COMMITTEE MEMBER HAS FAILED TO DISCLOSE ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, IT SHALL INFORM SUCH PERSON OF THE BASIS FOR SUCH BELIEF AND AFFORD SUCH PERSON AN OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE. IF, AFTER HEARING THE RESPONSE OF SUCH PERSON AND MAKING SUCH FURTHER INVESTIGATION AS MAY BE WARRANTED IN THE CIRCUMSTANCES, THE BOARD DETERMINES THAT THE PERSON HAS FAILED TO DISCLOSE A CONFLICT OF INTEREST, IT SHALL TAKE APPROPRIATE DISCIPLINARY OR CORRECTIVE ACTIONS. EACH DIRECTOR ANNUALLY SIGNS A STATEMENT WHICH AFFIRMS THAT EACH PERSON HAS RECEIVED A COPY OF THE POLICY, HAS READ AND UNDERSTANDS THE POLICY, AND HAS AGREED TO COMPLY WITH THE POLICY. FORM 990, PART VI, SECTION B, LINE 15 THE ORGANIZATION HAS A PERSONNEL COMMITTEE. THE COMMITTEE DETERMINES SALARIES BY USING THE COMPENSATION AND BENEFITS SURVEY BY THE NONPROFIT TIMES. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE ON REQUEST. FORM 990; PART 12; LINE C2 THE PROCESS HAS NOT CHANGED FROM THAT OF PRIOR YEAR.