WESTERN WAYNE FAMILY HEALTH CENTERS: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- WESTERN WAYNE FAMILY HEALTH CENTERS (EIN 30-0281587)
- Tax period
- 2014-01-01 to 2014-12-31
- Filed
- 2015-05-16
- IRS object ID
- 201501369349300855
- Schema version
- 2014v5.0
- 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 | 2015-05-16T14:37:37-05:00 | ReturnTs |
| Tax Period End | 2014-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 382963463 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | QUAST JANKE & CO CPA'S PC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1010 N JOHNSON | AddressLine1Txt |
| City | BAY CITY | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48708 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 300281587 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WESTERN WAYNE FAMILY HEALTH CENTERS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | WEST | BusinessNameControlTxt |
| Phone | 3135615100 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2500 HAMLIN RD | AddressLine1Txt |
| City | INKSTER | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48141 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | LINDA ATKINS | PersonNm |
| Person Title | EXECUTIVE DIRECTOR | PersonTitleTxt |
| Phone | 3135615100 | PhoneNum |
| Signature | 2015-04-26 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DAVID G GWIZDALA CPA | PreparerPersonNm |
| PTIN | P00234130 | PTIN |
| Phone | 9898924549 | PhoneNum |
| Preparation | 2015-04-26 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | LINDA ATKINS | PrincipalOfficerNm |
| Gross Receipts | $7,383,370 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWFHCINKSTER.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2006 | FormationYr |
| Legal Domicile State | MI | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE QUALITY,COMPREHENSIVE PRIMARY HEALTH CARE SERVICES THAT ARE ACCESSIBLE, AFFORDABLE AND RESPONSIVE TO THE COMMUNITIES THAT WE SERVE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 12 | VotingMembersIndependentCnt |
| Total Employee | 89 | TotalEmployeeCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $1,752,043 | PYContributionsGrantsAmt |
| CY Contributions Grants | $3,003,270 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $3,815,993 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $4,379,120 | CYProgramServiceRevenueAmt |
| PY Investment Income | $700 | PYInvestmentIncomeAmt |
| CY Investment Income | $980 | CYInvestmentIncomeAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $5,568,736 | PYTotalRevenueAmt |
| CY Total Revenue | $7,383,370 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $4,007,377 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $4,335,836 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $2,128,646 | PYOtherExpensesAmt |
| CY Other Expenses | $2,432,520 | CYOtherExpensesAmt |
| PY Total Expenses | $6,136,023 | PYTotalExpensesAmt |
| CY Total Expenses | $6,768,356 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$567,287 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $615,014 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $3,703,140 | TotalAssetsBOYAmt |
| Total Assets EOY | $4,113,171 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,035,139 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $830,156 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $2,668,001 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $3,283,015 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO PROVIDE QUALITY,COMPREHENSIVE PRIMARY HEALTH CARE SERVICES THAT ARE ACCESSIBLE, AFFORDABLE AND RESPONSIVE TO THE COMMUNITIES THAT WE SERVE. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Desc | CENTER IS A FEDERALLY QUALIFIED HEALTH CENTER AND IS SERVICING APPROXIMATELY 10,000 PATIENTS IN A MEDICALLY UNDERSERVED AREA. CLINIC ENCOUNTERS FOR THE YEAR TOTALED APPROXIMATELY 32,600. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $4,744,421 | ExpenseAmt |
| Desc | CENTER IS A FEDERALLY QUALIFIED HEALTH CENTER AND IS SERVICING APPROXIMATELY 11,000 PATIENTS IN A MEDICALLY UNDERSERVED AREA CLINIC ENCOUNTERS FOR THE YEAR WERE APPROXIMATELY 35,700 | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $4,744,421 | TotalOtherProgSrvcExpenseAmt |
| Total Program Service Expenses | $4,744,421 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | false | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 18 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 89 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 12 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DONNA RUSSELL | PersonNm |
| Phone | 3135615100 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2500 HAMLIN | AddressLine1Txt |
| City | INKSTER | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48141 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (19 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 |
|---|---|---|---|---|---|---|---|
| NOAH BERGERON | |||||||
| CHAIRMAN | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| BISHOP WALTER STARGHILL | |||||||
| VICE CHAIRMA | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| DAVID IPPEL | |||||||
| TREASURER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| CAROLYN KIMBROUGH | |||||||
| SECRETARY | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| BOBBIE WALLACE | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| CHRISTINA ARNOLD | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| JEAN OVERMAN | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| JOHN FLYNN | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| KARL LAUB | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| MARSHA BEY | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| PATTY CAMPBELL | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| WILLIAM MILLER | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| LINDA ATKINS | |||||||
| CEO | 40.00 | $102,736 | $0 | $10,733 | Yes (X) | ||
| DONNA RUSSELL | |||||||
| CFO | 40.00 | $86,000 | $0 | $803 | Yes (X) | ||
| TANYA WYNN | |||||||
| PHYSICIAN | 40.00 | $236,412 | $0 | $803 | Yes (X) | ||
| JONATHAN LEVI | |||||||
| PHYSICIAN | 40.00 | $185,560 | $0 | $19,374 | Yes (X) | ||
| LUNA ALKHAFAJ | |||||||
| PHYSICIAN | 40.00 | $182,402 | $0 | $19,374 | Yes (X) | ||
| HARJIT KOHLI | |||||||
| PHYSICIAN | 40.00 | $167,960 | $0 | $803 | Yes (X) | ||
| GEORGE SAWABINI | |||||||
| PHYSICIAN | 40.00 | $114,040 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,075,110 | TotalReportableCompFromOrgAmt |
| Total Other Compensation | $51,890 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 6 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| STARFISH FAMILY SERVICES | |||||
| 30000 HIVELY RD | INKSTER | MI | 48141 | OTHER HEALTH SE | $170,494 |
| MICHIGAN PRIMARY CARE ASSOC | |||||
| 7215 WESTSHIRE DR | LANSING | MI | 48917 | CONSULTING | $115,611 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $2,976,770 | GovernmentGrantsAmt |
| All Other Contributions | $26,500 | AllOtherContributionsAmt |
| Total Contributions | $3,003,270 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|
| PATIENT FEES | $4,228,329 | $4,228,329 |
| PHARMACY | $134,219 | $134,219 |
| MEDICAL RECORDS | $15,624 | $15,624 |
| OTHER | $948 | $948 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $4,379,120 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $980 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $980 | RelatedOrExemptFuncIncomeAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $7,383,370 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $4,380,100 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $188,736 | TotalAmt |
| Management And General | $188,736 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,519,973 | TotalAmt |
| Program Services | $2,584,707 | ProgramServicesAmt |
| Management And General | $935,266 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $365,973 | TotalAmt |
| Program Services | $255,057 | ProgramServicesAmt |
| Management And General | $110,916 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $261,154 | TotalAmt |
| Program Services | $175,168 | ProgramServicesAmt |
| Management And General | $85,986 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $48,278 | TotalAmt |
| Management And General | $48,278 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,250 | TotalAmt |
| Management And General | $10,250 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $700,913 | TotalAmt |
| Program Services | $452,700 | ProgramServicesAmt |
| Management And General | $248,213 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,413 | TotalAmt |
| Program Services | $16,413 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $63,453 | TotalAmt |
| Program Services | $6,289 | ProgramServicesAmt |
| Management And General | $57,164 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $199,411 | TotalAmt |
| Program Services | $159,529 | ProgramServicesAmt |
| Management And General | $39,882 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $60,159 | TotalAmt |
| Program Services | $18,382 | ProgramServicesAmt |
| Management And General | $41,777 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $35,458 | TotalAmt |
| Program Services | $10,230 | ProgramServicesAmt |
| Management And General | $25,228 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,929 | TotalAmt |
| Management And General | $29,929 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $35,467 | TotalAmt |
| Management And General | $35,467 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| SUPPLIES | $283,934 | $283,934 | |
| DEPRECIATION | $197,265 | $157,812 | $39,453 |
| BAD DEBT | $152,685 | $152,685 | |
| PROPERTY TAXES | $92,789 | $74,231 | $18,558 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $506,116 | TotalAmt |
| Program Services | $397,284 | ProgramServicesAmt |
| Management And General | $108,832 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,768,356 | TotalAmt |
| Program Services | $4,744,421 | ProgramServicesAmt |
| Management And General | $2,023,935 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,046,105 | BOYAmt |
| EOY | $1,599,228 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $40,769 | BOYAmt |
| EOY | $39,148 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $188,172 | BOYAmt |
| EOY | $363,812 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,740 | BOYAmt |
| EOY | $31,103 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $51,200 | BOYAmt |
| EOY | $36,771 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $3,019,583 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $976,474 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,359,154 | BOYAmt |
| EOY | $2,043,109 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,703,140 | BOYAmt |
| EOY | $4,113,171 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $363,734 | BOYAmt |
| EOY | $312,156 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $140,047 | BOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $531,358 | BOYAmt |
| EOY | $518,000 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,035,139 | BOYAmt |
| EOY | $830,156 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,668,001 | BOYAmt |
| EOY | $3,033,015 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $250,000 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,668,001 | BOYAmt |
| EOY | $3,283,015 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,703,140 | BOYAmt |
| EOY | $4,113,171 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $615,014 | ReconcilationRevenueExpnssAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | false | FSAuditedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,830,224 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,776,193 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,233,689 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,752,043 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,003,270 | CurrentTaxYearAmt |
| Total | $10,595,419 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,830,224 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,776,193 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,233,689 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,752,043 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,003,270 | CurrentTaxYearAmt |
| Total | $10,595,419 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $10,595,419 | PublicSupportTotal170Amt |
| Total Support | $10,595,419 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $4,380,100 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 1.00000 | PublicSupportCY170Pct |
| Public Support PY170 | 1.00000 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Schedule D IRS990ScheduleD
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,010,000 | OtherCostOrOtherBasisAmt |
| Book Value | $1,010,000 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $463,537 | OtherCostOrOtherBasisAmt |
| Depreciation | $224,822 | DepreciationAmt |
| Book Value | $238,715 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,546,046 | OtherCostOrOtherBasisAmt |
| Depreciation | $751,652 | DepreciationAmt |
| Book Value | $794,394 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $2,043,109 | TotalBookValueLandBuildingsAmt |
| Total Rev Etc Audited Fincl Stmt | $7,383,370 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Subtotal | $7,383,370 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $7,383,370 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $6,768,356 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $6,768,356 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $6,768,356 | TotalExpensesPerForm990Amt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt |
|---|---|---|---|
| TANYA WYNN | |||
| PHYSICIAN | $236,412 | $803 | $237,215 |
| JONATHAN LEVI | |||
| PHYSICIAN | $185,560 | $19,374 | $204,934 |
| LUNA ALKHAFAJ | |||
| PHYSICIAN | $182,402 | $19,374 | $201,776 |
| HARJIT KOHLI | |||
| PHYSICIAN | $167,960 | $803 | $168,763 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 1, PART I, LINE 6 | VOLUNTEER BOARD OF DIRECTORS |
| FORM 990, PAGE 2, PART III, LINE 4D | CENTER IS A FEDERALLY QUALIFIED HEALTH CENTER AND IS SERVICING APPROXIMATELY 11,000 PATIENTS IN A MEDICALLY UNDERSERVED AREA CLINIC ENCOUNTERS FOR THE YEAR WERE APPROXIMATELY 35,700 |
| FORM 990, PAGE 6, PART VI, LINE 11B | BOARD OF DIRECTORS, CFO AND AUDITOR REVIEW 990 PRIOR TO SUBMISSION. GOVERANCE QUESTIONS AGREED UPON AND REVIEWED ANNUALLY. |
| FORM 990, PAGE 6, PART VI, LINE 12C | BOARD MEMBERS ARE ASKED IF ANY ITEM ON THE AGENDA REPRESENTS A CONFLICT OF INTEREST AT EACH MEETING. CONFLICTS ARE DISCUSSED PRIOR TO BOARD ACTION |
| FORM 990, PAGE 6, PART VI, LINE 15A | CEO COMPENSATION WITHIN 75TH PERCENTILE OF CEO OF OTHER CENTERS FROM DATA SUPPLIED BY NATIONAL ASSOCIATION OF HEALTH CENTERS |
| FORM 990, PAGE 6, PART VI, LINE 15B | BOARD COMPENSATION REVIEW AND APPROVAL FOR KEY EMPLOYEES |
| FORM 990, PAGE 6, PART VI, LINE 19 | AVAILABLE UPON REQUEST |
| FORM 990, PART IX, LINE 11G | CONTRACT SERVICES 81,782 0 0 PURCHASED SERVICES 192,792 31,387 0 PAYROLL SERVICE 0 12,584 0 COMPUTER SERVICE 105,769 90,099 0 SECURITY 72,357 61,637 0 CONSULTING 0 52,506 0 |
Comments