PORTLAND COMMUNITY HEALTH CENTER: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- PORTLAND COMMUNITY HEALTH CENTER (EIN 45-4960453)
- Tax period
- 2014-07-01 to 2015-06-30
- Filed
- 2016-03-28
- IRS object ID
- 201640889349300709
- 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 | 2016-03-28T10:33:42-05:00 | ReturnTs |
| Tax Period End | 2015-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 010511973 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NICHOLSON MICHAUD & COMPANY | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 76 SILVER STREET | AddressLine1Txt |
| City | WATERVILLE | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 04901 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 454960453 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PORTLAND COMMUNITY HEALTH CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PORT | BusinessNameControlTxt |
| Phone | 2078742141 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 180 PARK AVENUE | AddressLine1Txt |
| City | PORTLAND | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 04102 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | LESLIE CLARK | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 2078742141 | PhoneNum |
| Signature | 2016-03-24 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | ERIK NADEAU CPA | PreparerPersonNm |
| PTIN | P00959193 | PTIN |
| Phone | 2078727077 | PhoneNum |
| Preparation | 2016-03-24 | PreparationDt |
| 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 | LESLIE CLARK | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 180 PARK AVE | AddressLine1Txt |
| City | PORTLAND | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 041022957 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $4,058,829 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.PORTLANDCOMMUNITYHEALTHCENTER.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2013 | FormationYr |
| Legal Domicile State | ME | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE HIGH QUALITY, PATIENT-CENTERED HEALTHCARE THAT IS ACCESSIBLE, AFFORDABLE, AND CULTURALLY SENSITIVE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 13 | VotingMembersIndependentCnt |
| Total Employee | 71 | TotalEmployeeCnt |
| Total Volunteers | 21 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,640,079 | PYContributionsGrantsAmt |
| CY Contributions Grants | $2,246,513 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $1,218,878 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $1,783,470 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $5,548 | PYOtherRevenueAmt |
| CY Other Revenue | $28,846 | CYOtherRevenueAmt |
| PY Total Revenue | $2,864,505 | PYTotalRevenueAmt |
| CY Total Revenue | $4,058,829 | 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 | $2,060,085 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $2,720,510 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $971,196 | PYOtherExpensesAmt |
| CY Other Expenses | $1,148,016 | CYOtherExpensesAmt |
| PY Total Expenses | $3,031,281 | PYTotalExpensesAmt |
| CY Total Expenses | $3,868,526 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$166,776 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $190,303 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $578,270 | TotalAssetsBOYAmt |
| Total Assets EOY | $593,304 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $594,589 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $419,320 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$16,319 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $173,984 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO PROVIDE HIGH QUALITY, PATIENT-CENTERED HEALTHCARE THAT IS ACCESSIBLE, AFFORDABLE, AND CULTURALLY SENSITIVE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $2,948,865 | ExpenseAmt |
| Revenue | $1,304,868 | RevenueAmt |
| Desc | THE ORGANIZATION PROVIDES A COMPREHENSIVE ARRAY OF PRIMARY CARE SERVICES TO ITS TARGET POPULATIONS ACROSS THE FULL LIFECYCLE - PEDIATRIC, ADOLESCENT, ADULT, AND GERIATRIC CARE. OUTREACH AND ENROLLMENT WORKERS ASSISTED NEW AND PROSPECTIVE PATIENTS WITH ENROLLMENT IN THE AFFORDABLE CARE ACT MARKETPLACE FOR INSURANCE COVERAGE, AND ASSISTED WITH IDENTIFYING ELIGIBILITY AND ENROLLMENT FOR MEDICAID, MEDICARE, AND/OR OTHER ASSISTANCE PROGRAMS. THE ORGANIZATION PROVIDED ENABLING SERVICES INCLUDING CASE MANAGEMENT, TRANSLATION SERVICES, AND TRANSPORTATION VOUCHERS TO ENSURE ACCESS TO CARE AND CONNECTION WITH NEEDED SOCIAL SERVICES AND BASIC NEEDS.REFERRALS FOR SPECIALTY CARE ARE FACILITATED BY A REFERRALS COORDINATOR, AND THROUGH FORMAL ARRANGEMENTS WITH LOCAL HOSPITALS AND SPECIALISTS WHO ACCEPT PORTLAND COMMUNITY HEALTH CENTER'S SLIDING FEE SCALE AND PROVIDE CHARITY CARE FOR THOSE PATIENTS UNABLE TO PAY.LABORATORY AND RADIOLOGY SERVICES ARE PROVIDED THROUGH LOCAL HOSPITAL SYSTEMS ON A SLIDING FEE SCALE THAT ENSURES THE SAME OR LOWER CHARGES FOR THE HEALTH CENTER'S PATIENTS. HEALTH FAIRS AND SCREENING CLINICS ARE PROVIDED AT LOCAL SCHOOLS, HOUSING AUTHORITY COMMUNITIES, LIBRARY, AND SOCIAL SERVICE AGENCIES. PLEASE SEE SCHEDULE O FOR ADDITIONAL DESCRIPTION OF PROGRAM SERVICES UNDERTAKEN DURING THE YEAR. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $327,652 | ExpenseAmt |
| Revenue | $507,448 | RevenueAmt |
| Desc | THE ORGNIZATION PROVIDED COMPREHENSIVE MENTAL HEALTH AND SUBSTANCE ABUSE COUNSELING SERVICES IN A FULLY INTEGRATED MANNER ON-SITE AT ITS PORTLAND, MAINE LOCATION.LICENSED CLINICAL SOCIAL WORKERS ON EACH HEALTH CARE TEAM HELP PATIENTS MAKE NEEDED CHANGES THROUGH HEALTH COACHING AND PROVIDING BEHAVIORAL STRATEGIES THAT IMPROVE HEALTH AND REDUCE HARM. SOME OF THESE INCLUDE STRESS MANAGEMENT TECHNIQUES, SMOKING CESSATION, AND MOTIVATIONAL INTERVIEWING. SUPPORT GROUPS AND EDUCATIONAL SESSIONS ARE OFFERED ON SITE AT NOMINAL OR NO FEE. THESE INCLUDE NUTRITION CLASSES, SUPPORT GROUPS FOR NEW IMMIGRANTS, MEETINGS OF ALCOHOLICS ANONYMOUS, AND A VARIETY OF SPECIAL INTEREST TOPIC HEALTH SESSIONS, FOR EXAMPLE, DIABETES EDUCATION. PLEASE SEE SCHEDULE O FOR A COMPREHENSIVE DESCRIPTION OF PROGRAM SERVICES UNDERTAKEN DURING THE YEAR. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $3,276,517 | 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 | 0 | 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 | 0 | 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 | 18 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 71 | 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 |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BARBARA LANDRY CPFO | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2078742141 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 180 PARK AVENUE | AddressLine1Txt |
| City | PORTLAND | CityNm |
| State Abbreviation | ME | StateAbbreviationCd |
| ZIP | 04102 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (17 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 |
|---|---|---|---|---|---|---|---|
| KARIN ANDERSON | |||||||
| PRESIDENT | 3.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| GRETE ZEMANS | |||||||
| VICE PRESIDENT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| MICHAEL NELSON | |||||||
| TREASURER | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| BRUNO YOMOAH | |||||||
| SECRETARY | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| VICTORIA CHICON | |||||||
| DIRECTOR | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| VICTORIA FOLEY | |||||||
| DIRECTOR | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| NANCY KELLEHER | |||||||
| DIRECTOR | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| KATHLEEN STOKES | |||||||
| DIRECTOR | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| ERIC RUSTAD | |||||||
| DIRECTOR | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| ADRIA MOYNIHAN RUSK | |||||||
| DIRECTOR | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| JOYCE RACINE | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| NADINE TWAGIRAYEZU | |||||||
| DIRECTOR | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| MAURICE NAMWIRA | |||||||
| DIRECTOR | 0.50 | Yes (X) | $0 | $0 | $0 | ||
| LESLIE CLARK | |||||||
| CEO | 40.00 | Yes (X) | $98,272 | $0 | $6,928 | ||
| ANN TUCKER | |||||||
| CPFO | 40.00 | Yes (X) | $85,075 | $0 | $4,750 | ||
| RENEE FAY-LEBLANC | |||||||
| CMO | 40.00 | $111,340 | $0 | $7,916 | Yes (X) | ||
| CARRIE FROST | |||||||
| CMO | 40.00 | $116,700 | $0 | $7,589 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $411,387 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $27,183 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 2 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | 0 | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $2,066,877 | GovernmentGrantsAmt |
| All Other Contributions | $179,636 | AllOtherContributionsAmt |
| Total Contributions | $2,246,513 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENU | 621400 | $1,592,220 | $1,592,220 |
| MEANINGFUL USE | 621400 | $191,250 | $191,250 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $1,783,470 | TotalProgramServiceRevenueAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS | Desc |
| Business | 621400 | BusinessCd |
| Total Revenue Column | $28,846 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $28,846 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $28,846 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,058,829 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,812,316 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $222,371 | TotalAmt |
| Program Services | $189,015 | ProgramServicesAmt |
| Management And General | $33,356 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,082,463 | TotalAmt |
| Program Services | $1,842,992 | ProgramServicesAmt |
| Management And General | $239,471 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,625 | TotalAmt |
| Program Services | $1,425 | ProgramServicesAmt |
| Management And General | $200 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $220,995 | TotalAmt |
| Program Services | $192,887 | ProgramServicesAmt |
| Management And General | $28,108 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $193,056 | TotalAmt |
| Program Services | $170,235 | ProgramServicesAmt |
| Management And General | $22,821 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,234 | TotalAmt |
| Management And General | $1,234 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,552 | TotalAmt |
| Program Services | $4,558 | ProgramServicesAmt |
| Management And General | $16,994 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,972 | TotalAmt |
| Program Services | $2,675 | ProgramServicesAmt |
| Management And General | $297 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,394 | TotalAmt |
| Program Services | $16,805 | ProgramServicesAmt |
| Management And General | $3,589 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $171,138 | TotalAmt |
| Program Services | $162,643 | ProgramServicesAmt |
| Management And General | $8,495 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $193,686 | TotalAmt |
| Program Services | $174,317 | ProgramServicesAmt |
| Management And General | $19,369 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,191 | TotalAmt |
| Program Services | $14,191 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,195 | TotalAmt |
| Management And General | $5,195 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $78,650 | TotalAmt |
| Program Services | $70,172 | ProgramServicesAmt |
| Management And General | $8,478 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,213 | TotalAmt |
| Program Services | $30,756 | ProgramServicesAmt |
| Management And General | $7,457 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| CONTRACTUAL SERVICES | $257,453 | $123,453 | $134,000 |
| IMMUNIZATIONS | $88,837 | $88,837 | |
| SMALL EQUIPMENT PURCHAS | $46,362 | $39,681 | $6,681 |
| MEDICAL SUPPLIES | $40,922 | $40,922 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $167,217 | TotalAmt |
| Program Services | $110,953 | ProgramServicesAmt |
| Management And General | $56,264 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,868,526 | TotalAmt |
| Program Services | $3,276,517 | ProgramServicesAmt |
| Management And General | $592,009 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $145,851 | BOYAmt |
| EOY | $106,712 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $100,961 | BOYAmt |
| EOY | $170,380 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $33,980 | BOYAmt |
| EOY | $9,141 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $459,708 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $172,514 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $277,907 | BOYAmt |
| EOY | $287,194 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,571 | BOYAmt |
| EOY | $19,877 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $578,270 | BOYAmt |
| EOY | $593,304 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $368,757 | BOYAmt |
| EOY | $333,870 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $143,699 | BOYAmt |
| EOY | $23,137 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $82,133 | BOYAmt |
| EOY | $62,313 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $594,589 | BOYAmt |
| EOY | $419,320 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$51,817 | BOYAmt |
| EOY | $124,364 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $35,498 | BOYAmt |
| EOY | $49,620 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$16,319 | BOYAmt |
| EOY | $173,984 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $578,270 | BOYAmt |
| EOY | $593,304 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $190,303 | 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 | 0 | FederalGrantAuditRequiredInd |
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
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $274,300 | OtherCostOrOtherBasisAmt |
| Depreciation | $79,809 | DepreciationAmt |
| Book Value | $194,491 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $185,408 | OtherCostOrOtherBasisAmt |
| Depreciation | $92,705 | DepreciationAmt |
| Book Value | $92,703 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $287,194 | TotalBookValueLandBuildingsAmt |
| Total Rev Etc Audited Fincl Stmt | $4,058,829 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $4,058,829 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $4,058,829 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $3,868,526 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $3,868,526 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $3,868,526 | TotalExpensesPerForm990Amt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | THE FORM 990 WAS PROVIDED TO THE BOARD OF DIRECTORS FOR DISCUSSION, REVIEW AND APPROVAL BEFORE FILING |
| FORM 990, PART VI, SECTION B, LINE 12C | BOARD MEMBERS AND OTHER KEY EMPLOYEES ARE REQUIRED TO READ AND SIGN CONFLICT OF INTEREST STATEMENTS ON AN ANNUAL BASIS OR WHEN THERE IS A CHANGE IN BOARD MEMBER OR KEY OFFICER. |
| FORM 990, PART VI, SECTION B, LINE 15 | SENIOR MANAGEMENT SALARIES ARE BASED ON NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS SALARY SURVEY INFORMATION THAT IS PROVIDED AND REVIEWED ANNUALLY BY THE FINANCE COMMITTEE AND BOARD OF DIRECTORS. COMPENSATION IN THE RANGE IS BASED ON REQUISITE EXPERIENCE. |
| FORM 990, PART VI, SECTION C, LINE 19 | PRINT COPIES OF GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE AT ORGANIZATION HEADQUARTERS. FINANCIAL STATEMENTS ARE NOT AVAILABLE TO THE PUBLIC HOWEVER PERTINENT ANNUAL FINANCIAL RESULTS ARE AVAILABLE UPON REQUEST. |
| FORM 990, PART XII, LINE 2C: | THE ORGANIZATION HAS AN EXECUTIVE COMMITTEE AS A SUBCOMMITTEE OF THE BOARD, WHICH HAS OVERSIGHT OVER THE AUDIT AND SELECTION PROCESS. |
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