2015-08-24T14:15:58-05:00 2014-11-30 541967771 CAVANAUGH NELSON PLC 999 WATERSIDE DRIVE SUITE 2250 NORFOLK VA 23510 990 2013-12-01 541083954 PENINSULA INSTITUTE FOR COMMUNITY HEALTH DBA SOUTHEASTERN VIRGINIA HEALTH SYSTEM PENI 7573808709 1033 28TH STREET 2ND FLOOR NEWPORT NEWS VA 23607 ANGELA FUTRELL CEO 7573808709 2015-08-24 1 MARK A NELSON P00358004 7575784900 2013 2016-02-25 16:41:14Z ANGELA FUTRELL 1033 28TH STREET 2ND FLOOR NEWPORT NEWS VA 23607 12186624 0 X WWW.PICH.ORG X 1978 VA PROVIDE HIGH QUALITY, COMPREHENSIVE, PRIMARY HEALTH CARE SERVICES TO VIRGINIA RESIDENTS LIVING IN HAMPTON ROADS REGARDLESS OF THEIR ABILITY TO PAY. 13 13 192 0 0 0 6922238 7369024 5168479 4778935 5855 2273 13262 8366 12109834 12158598 0 0 0 0 7904844 8072263 0 0 0 3692488 4080233 11597332 12152496 512502 6102 5754107 5791312 1281955 1313058 4472152 4478254 PROVIDING MEDICAL AND DENTAL CARE TO INDIGENT PATIENTS 0 0 7597137 4778935 COMMUNITY HEALTH CENTER: PRIMARY MEDICAL, DENTAL AND HEALTHCARE ENABLING SERVICES FOR THE MEDICALLY UNDERSERVED AREAS OF NEWPORT NEWS, HAMPTON, SUFFOLK, VIRGINIA BEACH, CHESAPEAKE, AND MATHEWS COUNTY, VA.: 74,446 VISITS 729027 HEALTHCARE FOR THE HOMELESS: PRIMARY MEDICAL CARE AND REFERRAL SERVICES FOR AREA HOMELESS: 8,702 VISITS 8326164 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 1 0 0 1 0 0 0 0 0 0 0 0 1 50 0 192 1 0 0 0 0 0 0 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 X X THE ORGANIZATION 7573808709 1033 28TH STREET 2ND FLOOR NEWPORT NEWS VA 23607 ROBERT AYERS SECRETARY 2.00 X 0 0 0 EUGENE JOHNSON PARLIAMENTARIAN 8.00 X 0 0 0 WANDA ALLEN ESQUIRE CHAIR 6.00 X 0 0 0 BARBARA EASTER DIRECTOR 2.00 X 0 0 0 SHELIA HENDERSON DIRECTOR 2.00 X 0 0 0 JACQUELINE HUDGINS DIRECTOR 2.00 X 0 0 0 ALTON SKEETER DIRECTOR 2.00 X 0 0 0 SHIRLEY WILLS DIRECTOR 2.00 X 0 0 0 WENDELL BRAXTON DIRECTOR 2.00 X 0 0 0 DOROTHY MURRAY VICE-CHAIR 2.00 X 0 0 0 THOMAS E HARMON IV DIRECTOR 2.00 X 0 0 0 MELISSA COUNCE DIRECTOR 2.00 X 0 0 0 MELINDA WILLIAMS TREASURER 2.00 X 0 0 0 ANGELA FUTRELL CEO 40.00 X 171915 0 29587 VALDA BRANCH COO 40.00 X 108291 0 14266 DENISE NEWLON CFO 40.00 X 117894 0 6794 ALADEE DELAHOUSSAYE MD CMO 40.00 X 140380 0 18000 CONCEPCION ASPILI PHYSICIAN 40.00 X 162440 0 23407 CHARLIE M FAULK PHYSICIAN 40.00 X 220450 0 16666 DAVID L LORENZO PHYSICIAN 40.00 X 178094 0 18208 SUFIA B SHAHID PHYSICIAN 40.00 X 159103 0 14482 AURORA S BADAVI PHYSICIAN 40.00 X 155071 0 14482 1413638 0 155892 18 0 1 0 LABCORP 860 OMNI BLVD 302A NEWPORT NEWS VA 23606 LAB SERVICES 573048 PENINSULA CLEANING SERVICE 12610 PATRICK HENRY DR NEWPORT NEWS VA 23602 CLEANING 222501 2 6522463 846561 7369024 NET PATIENT SERVICE REVENUE 621110 4778935 4778935 4778935 2273 2273 36392 28026 8366 8366 12158598 4778935 0 10639 X 607127 158380 448747 6327098 4674974 1652124 617572 521785 95787 520466 352632 167834 78262 57165 21097 32616 23824 8792 1217218 889088 328130 127313 103296 24017 1356725 885177 471548 106257 106257 551344 285758 265586 22322 2305 20017 20221 6346 13875 302911 207411 95500 107780 25250 82530 DUES AND PUBLICATIONS 133506 19668 113838 TAXES AND LICENSES 19776 6848 12928 RECRUITMENT 3982 3982 12152496 8326164 3826332 0 3397313 3297050 533068 875711 169018 343025 172246 64873 4766098 3555445 1482462 1210653 5754107 5791312 774502 450032 507453 863026 1281955 1313058 X 4472152 4478254 4472152 4478254 5754107 5791312 6102 0 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 217200 217200 1608331 1376670 231661 1628431 1422777 205654 1312136 755998 556138 1210653 X 12372198 213600 213600 12158598 0 12158598 12366096 213600 213600 12152496 0 12152496 PART X, LINE 2: SEVHS HAS BEEN RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS EXEMPT FOR FEDERAL INCOME TAX PURPOSES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. SEVHS ANNUALLY FILES AN INFORMATIONAL RETURN FOR EXEMPT ORGANIZATIONS WITH THE IRS AND SUCH RETURNS ARE GENERALLY SUBJECT TO IRS EXAMINATION FOR A PERIOD OF THREE YEARS FROM THE TIME THEY WERE FILED. ACCORDINGLY, RETURNS FOR THE YEARS ENDED NOVEMBER 30, 2013, 2012, AND 2011 REMAIN OPEN FOR EXAMINATION. X 0 FALL FETE 36392 36392 22577 5449 36392 36392 22577 5449 28026 8366 X X 0 0 0 0 0 0 0 0 0 ANGELA FUTRELL CEO 171915 0 0 0 0 0 0 0 29587 0 201502 0 0 0 ALADEE DELAHOUSSAYE MD CMO 140380 0 0 0 0 0 0 0 18000 0 158380 0 0 0 CONCEPCION ASPILI PHYSICIAN 162440 0 0 0 0 0 0 0 23407 0 185847 0 0 0 CHARLIE M FAULK PHYSICIAN 220450 0 0 0 0 0 0 0 16666 0 237116 0 0 0 DAVID L LORENZO PHYSICIAN 178094 0 0 0 0 0 0 0 18208 0 196302 0 0 0 SUFIA B SHAHID PHYSICIAN 159103 0 0 0 0 0 0 0 14482 0 173585 0 0 0 AURORA S BADAVI PHYSICIAN 155071 0 0 0 0 0 0 0 14482 0 169553 0 0 0 EDWINA GARY FORMER CEO 16310 COMPENSATION FOR GRANT WRITING;LIST TOTAL $16,310 0 X YEARLY LEASES 3 213600 FMV 0 0 0 FORM 990, PART VI, SECTION B, LINE 11 THE CFO AND CEO REVIEW FORM 990 BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD IS CHARGED WITH REVIEWING THE POLICIES ANNUALLY OR AS APPROPRIATE. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION NEGOTIATIONS ARE BASED UPON EXPERIENCE AND SKILL SET IN KEEPING WITH FAIR MARKET VALUE AND FORMAL PAY SCALE FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G PATIENT CARE CONSULTING: PROGRAM SERVICE EXPENSES 777,466. MANAGEMENT AND GENERAL EXPENSES 286,934. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,064,400. CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 111,622. MANAGEMENT AND GENERAL EXPENSES 41,196. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 152,818. FORM 990, PART XII, LINE 2C: THE PROCESSES FOR AUDIT AND SELECTION OF THE INDEPENDENT ACCOUNTANT HAVE NOT CHANGED.