BETA

PORTLAND COMMUNITY HEALTH CENTER: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization
PORTLAND COMMUNITY HEALTH CENTER (EIN 45-4960453)
Tax period
2013-07-01 to 2014-06-30
Filed
2015-03-09
IRS object ID
201520689349300202
Schema version
2013v4.0
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

FieldValueIRS element (for citing)
Return2015-03-09T07:38:35-05:00ReturnTs
Tax Period End2014-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN010511973PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1NICHOLSON MICHAUD & COMPANYBusinessNameLine1

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line176 SILVER STREETAddressLine1
CityWATERVILLECity
StateMEState
ZIP Code04901ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2013-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN454960453EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1PORTLAND COMMUNITY HEALTH CENTERBusinessNameLine1
FieldValueIRS element (for citing)
Business Name ControlPORTBusinessNameControlTxt
Phone2078742141PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1180 PARK AVENUEAddressLine1
CityPORTLANDCity
StateMEState
ZIP Code04102ZIPCode

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonLESLIE CLARKPersonNm
Person TitleCEOPersonTitleTxt
Phone2078742141PhoneNum
Signature2015-02-21SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonP JAMES NICHOLSON CPAPreparerPersonNm
PTINP00482325PTIN
Phone2078727077PhoneNum
Preparation2015-02-21PreparationDt
FieldValueIRS element (for citing)
Tax2013TaxYr
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerLESLIE CLARKPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1180 PARK AVEAddressLine1
CityPORTLANDCity
StateMEState
ZIP Code041022957ZIPCode
FieldValueIRS element (for citing)
Gross Receipts$2,864,505GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.PORTLANDCOMMUNITYHEALTHCENTER.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2013FormationYr
Legal Domicile StateMELegalDomicileStateCd
Activity Or MissionTO PROVIDE HIGH QUALITY, PATIENT-CENTERED HEALTHCARE THAT IS ACCESSIBLE, AFFORDABLE, AND CULTURALLY SENSITIVE.ActivityOrMissionDesc
Voting Members Governing Body13VotingMembersGoverningBodyCnt
Voting Members Independent13VotingMembersIndependentCnt
Total Employee54TotalEmployeeCnt
Total Volunteers20TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$538,355PYContributionsGrantsAmt
CY Contributions Grants$1,640,079CYContributionsGrantsAmt
PY Program Service Revenue$553,787PYProgramServiceRevenueAmt
CY Program Service Revenue$1,218,878CYProgramServiceRevenueAmt
PY Investment Income$0PYInvestmentIncomeAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue$303PYOtherRevenueAmt
CY Other Revenue$5,548CYOtherRevenueAmt
PY Total Revenue$1,092,445PYTotalRevenueAmt
CY Total Revenue$2,864,505CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$890,610PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$2,060,085CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$464,820PYOtherExpensesAmt
CY Other Expenses$971,196CYOtherExpensesAmt
PY Total Expenses$1,355,430PYTotalExpensesAmt
CY Total Expenses$3,031,281CYTotalExpensesAmt
PY Revenues Less Expenses-$262,985PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$166,776CYRevenuesLessExpensesAmt
Total Assets BOY$565,806TotalAssetsBOYAmt
Total Assets EOY$578,270TotalAssetsEOYAmt
Total Liabilities BOY$415,349TotalLiabilitiesBOYAmt
Total Liabilities EOY$594,589TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$150,457NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY-$16,319NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTO PROVIDE HIGH QUALITY, PATIENT-CENTERED HEALTHCARE THAT IS ACCESSIBLE, AFFORDABLE, AND CULTURALLY SENSITIVE.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$2,142,746ExpenseAmt
Revenue$881,587RevenueAmt
DescTHE 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

FieldValueIRS element (for citing)
Expense$238,083ExpenseAmt
Revenue$342,839RevenueAmt
DescTHE ORGNIZATION PROVIDED COMPREHENSIVE MENTAL HEALTH AND SUBSTANCE ABUSE COUNCELING 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
FieldValueIRS element (for citing)
Total Program Service Expenses$2,380,829TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J Required0ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document14IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee54EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members13GoverningBodyVotingMembersCnt
Independent Voting Member13IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ANN TUCKER CPFOBusinessNameLine1
FieldValueIRS element (for citing)
Phone2078742141PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1180 PARK AVENUEAddressLine1
CityPORTLANDCity
StateMEState
ZIP Code04102ZIPCode

Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
KATHLEEN STOKES
PRESIDENT3.00Yes (X)Yes (X)$0$0$0
KARIN ANDERSON
VICE PRESIDENT1.00Yes (X)Yes (X)$0$0$0
ERIC RUSTAD
TREASURER1.00Yes (X)Yes (X)$0$0$0
BRUNO YOMOAH
SECRETARY1.00Yes (X)Yes (X)$0$0$0
VICTORIA CHICON
DIRECTOR0.50Yes (X)$0$0$0
VICTORIA FOLEY
DIRECTOR0.50Yes (X)$0$0$0
NANCY KELLEHER
DIRECTOR0.50Yes (X)$0$0$0
MAURICE NAMWIRA
DIRECTOR0.50Yes (X)$0$0$0
MICHAEL NELSON
DIRECTOR0.50Yes (X)$0$0$0
ADRIA MOYNIHAN RUSK
DIRECTOR0.50Yes (X)$0$0$0
JOYCE RACINE
DIRECTOR2.00Yes (X)$0$0$0
NADINE TWAGIRAYEZU
DIRECTOR0.50Yes (X)$0$0$0
GRETE ZEMANS
DIRECTOR0.50Yes (X)$0$0$0
LESLIE CLARK
CEO40.00Yes (X)$96,604$0$16,702
ANN TUCKER
CPFO40.00Yes (X)$78,309$0$1,175
RENEE FAY-LEBLANC
CMO40.00Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$174,913TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$17,877TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K0TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Government Grants$1,395,003GovernmentGrantsAmt
All Other Contributions$245,076AllOtherContributionsAmt
Total Contributions$1,640,079TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PATIENT SERVICE REVENU621400$1,176,378$1,176,378
MEANINGFUL USE621400$42,500$42,500
FieldValueIRS element (for citing)
Total Program Service Revenue$1,218,878TotalProgramServiceRevenueAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescMISCELLANEOUSDesc
Business621400BusinessCd
Total Revenue Column$5,548TotalRevenueColumnAmt
Related Or Exempt Func Income$5,548RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$5,548OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,864,505TotalRevenueColumnAmt
Related Or Exempt Func Income$1,224,426RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$210,503TotalAmt
Program Services$178,928ProgramServicesAmt
Management And General$31,575ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$1,519,414TotalAmt
Program Services$1,259,404ProgramServicesAmt
Management And General$260,010ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$2,422TotalAmt
Program Services$2,011ProgramServicesAmt
Management And General$411ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$175,920TotalAmt
Program Services$145,890ProgramServicesAmt
Management And General$30,030ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$151,826TotalAmt
Program Services$126,205ProgramServicesAmt
Management And General$25,621ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$26,762TotalAmt
Program Services$3,216ProgramServicesAmt
Management And General$23,546ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$17,776TotalAmt
Program Services$2,136ProgramServicesAmt
Management And General$15,640ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$4,121TotalAmt
Program Services$4,121ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$18,133TotalAmt
Program Services$14,942ProgramServicesAmt
Management And General$3,191ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$136,947TotalAmt
Program Services$131,641ProgramServicesAmt
Management And General$5,306ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$158,352TotalAmt
Program Services$142,517ProgramServicesAmt
Management And General$15,835ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$7,520TotalAmt
Program Services$7,520ProgramServicesAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$7,678TotalAmt
Management And General$7,678ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$64,449TotalAmt
Program Services$57,391ProgramServicesAmt
Management And General$7,058ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$31,521TotalAmt
Program Services$28,369ProgramServicesAmt
Management And General$3,152ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
CONTRACTUAL SERVICES$224,801$77,620$147,181
CONSULTING$64,726$9,709$55,017
IMMUNIZATIONS$63,176$63,176
REPAIRS AND MAINTENANCE$39,822$35,840$3,982

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$105,412TotalAmt
Program Services$90,193ProgramServicesAmt
Management And General$15,219ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$3,031,281TotalAmt
Program Services$2,380,829ProgramServicesAmt
Management And General$650,452ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$123,818BOYAmt
EOY$145,851EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$89,086BOYAmt
EOY$100,961EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$27,613BOYAmt
EOY$33,980EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$372,452LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$94,545LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$292,566BOYAmt
EOY$277,907EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$32,723BOYAmt
EOY$19,571EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$565,806BOYAmt
EOY$578,270EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$290,233BOYAmt
EOY$368,757EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$4,240BOYAmt
EOY$143,699EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$100,888BOYAmt
EOY$82,133EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$19,988BOYAmt
EOY$0EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$415,349BOYAmt
EOY$594,589EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$114,242BOYAmt
EOY-$51,817EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$36,215BOYAmt
EOY$35,498EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$150,457BOYAmt
EOY-$16,319EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$565,806BOYAmt
EOY$578,270EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$166,776ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$187,044OtherCostOrOtherBasisAmt
Depreciation$38,923DepreciationAmt
Book Value$148,121BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$185,408OtherCostOrOtherBasisAmt
Depreciation$55,622DepreciationAmt
Book Value$129,786BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$277,907TotalBookValueLandBuildingsAmt
Total Rev Etc Audited Fincl Stmt$2,864,505TotalRevEtcAuditedFinclStmtAmt
Revenue Not Reported$0RevenueNotReportedAmt
Revenue Subtotal$2,864,505RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$2,864,505TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$3,031,281TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$3,031,281ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$3,031,281TotalExpensesPerForm990Amt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11THE FORM 990 WAS PROVIDED TO THE BOARD OF DIRECTORS FOR DISCUSSION, REVIEW AND APPROVAL BEFORE FILING
FORM 990, PART VI, SECTION B, LINE 12CBOARD 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 15SENIOR 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 19PRINT 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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