2015-01-21T07:59:41-06:00 2014-06-30 410746749 CLIFTONLARSONALLEN LLP 1301 W 22ND ST STE 1100 OAK BROOK IL 60523 990 2013-07-01 363317058 ACCESS COMMUNITY HEALTH NETWORK ACCE 3125262100 600 WEST FULTON 2ND FLOOR CHICAGO IL 60661 MAHOMED OUEDRAOGO CHIEF FINANCIAL OFFICER 3125262088 2015-01-13 1 GREGORY S ADAMS P00095597 6305738600 2013 2016-02-25 16:41:14Z MAHOMED OUEDRAOGO 600 WEST FULTON 2ND FLOOR CHICAGO IL 60661 118595644 0 X WWW.ACCESSCOMMUNITYHEALTH.NET X 1985 IL TO PROVIDE OUTSTANDING PREVENTIVE AND PRIMARY HEALTH CARE, ACCESSIBLE TO ALL IN THEIR OWN COMMUNITIES. 19 19 1093 0 0 0 21292159 22104915 82157620 82990295 0 0 10217193 13500434 113666972 118595644 0 0 0 0 60616218 62539115 0 0 0 50817614 53812931 111433832 116352046 2233140 2243598 39993106 42627026 31258788 31649110 8734318 10977916 X OUR MISSION IS TO PROVIDE OUTSTANDING PREVENTIVE AND PRIMARY HEALTH CARE, ACCESSIBLE TO ALL IN THEIR OWN COMMUNITIES. 0 0 84779732 96490729 COMMUNITY HEALTH CENTERS - ACCESS OFFERS A FULL RANGE OF COMPREHENSIVE, QUALITY HEALTH CARE SERVICES CONVENIENTLY LOCATED RIGHT IN YOUR COMMUNITY. OUR PRIMARY CARE SERVICES INCLUDE: FAMILY PRACTICE, INTERNAL MEDICINE, PEDIATRICS, SCHOOL AND SPORTS PHYSICALS, OBSTETRIC/GYNECOLOGICAL AND MIDWIFERY SERVICES, AND MANAGEMENT OF CHRONIC DISEASES, SUCH AS DIABETES, ASTHMA, AND HIGH BLOOD PRESSURE. OTHER SERVICES AVAILABLE AT SELECT SITES INCLUDE: LOW-COST BREAST AND CERVICAL CANCER SCREENINGS, BEHAVIORAL HEALTH SERVICES, HIV/AIDS COUNSELING, TESTING AND PRIMARY CARE, SUBSTANCE ABUSE TREATMENT PROGRAM, CASE MANAGEMENT, AND SPECIALTY CARE SERVICES.THIS YEAR ACCESS SERVED MORE THAN 175,000 LOW-INCOME INDIVIDUALS AND FAMILIES, INCLUDING 45,000 UNINSURED PATIENTS. 84779732 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 188 0 1 1093 1 0 0 0 0 0 0 0 0 0 0 X 19 19 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 IL X X MAHOMED QUEDRAOGO 3125262100 600 WEST FULTON STREET SUITE 200 CHICAGO IL 60661 BENA SULLIVAN CHAIRWOMAN EMERITUS 1.00 X X 0 0 0 DONNA SIMMONS VICE CHAIRWOMAN 1.00 X X 0 0 0 TERRY BROWN TREASURER 1.00 X X 0 0 0 DENISE KITCHEN CHAIRWOMAN 1.00 X X 0 0 0 OLIVIA BANKS BOARD MEMBER 1.00 X 0 0 0 PATRICIA BOBB BOARD MEMBER 1.00 X 0 0 0 ADRIENNE WATSON BOARD MEMBER 1.00 X 0 0 0 VIRGINIA OVIEDO BOARD MEMBER 1.00 X 0 0 0 ERIN STARKEY SECRETARY 1.00 X X 0 0 0 LEOLA TOWNES BOARD MEMBER 1.00 X 0 0 0 DERRICK TUNG BOARD MEMBER 1.00 X 0 0 0 DANIELLA LEVITT BOARD MEMBER 1.00 X 0 0 0 TOMMY FITZGIBBON BOARD MEMBER 1.00 X 0 0 0 RYAN HART BOARD MEMBER 1.00 X 0 0 0 MARILYN SCOTT BOARD MEMBER 1.00 X 0 0 0 DR CHARLES DESHAZER BOARD MEMBER 1.00 X 0 0 0 EVE SALAZAR BOARD MEMBER 1.00 X 0 0 0 ROBERT SHEESLEY BOARD MEMBER 1.00 X 0 0 0 PERLA HERRERA BOARD MEMBER 1.00 X 0 0 0 DONNA THOMPSON CHIEF EXECUTIVE OFFICER 40.00 X 733048 0 32738 JOAN BOOMSMA CHIEF MEDICAL OFFICER 40.00 X 286352 0 22338 TARIQ BUTT DEPUTY MEDICAL OFFICER 40.00 X 260426 0 29995 JULIE BONELLO CHIEF INFORMATION OFFICER 40.00 X 130777 0 42675 MAHOMED OUEDRAOGO CHIEF FINANCIAL OFFICER 40.00 X 169422 0 36909 LINDA SHAPIRO VP EXTERNAL AFFAIRS 40.00 X 243853 0 10517 ELEVA RILEY VP HUMAN RESOURCES 40.00 X 296591 0 22335 STEVEN GLASS VP QUALITY AND INNOVATION 40.00 X 197510 0 19879 JANIE GAWRYS VP OPERATIONS 40.00 X 208839 0 15045 EDWARD LAMPLEY PHYSICIAN 40.00 X 443760 0 14156 PAULA CAVENS PHYSICIAN 40.00 X 386589 0 42765 CARLOS SANDOVAL-HERRERA PHYSICIAN 40.00 X 426944 0 19200 LEMUEL SHAFFER PHYSICIAN 40.00 X 331791 0 30538 SARIKA ARORA PHYSICIAN 40.00 X 270145 0 36718 4386047 0 375808 120 0 1 0 EPIC 1979 MILKY WAY VERONA WI 53593 EHR PROVIDER 2770122 FULTON ASSOCIATES LLC 120 WEST 22ND STREET SUITE 100 OAK BROOK IL 60523 SPACE RENTAL 1366472 CARDINAL BUILDING MAINTENANCE 4952 WEST 128TH PLACE ALSIP IL 60803 CLEANING SERVICES 1074078 SPRINGFIELD SERVICE CORP 8151 183RD STREET TINLEY PARK IL 60487 PROFESSIONAL SERVICES 776719 SAGACIOUS CONSULTANTS 8207 MELROSE DRIVE SUITE 160 LENEXA KS 66214 PROFESSIONAL SERVICES 638876 61 146727 21133930 824258 22104915 NET PATIENT SERVICE REVENUE 621498 50508146 50508146 CAPITATION REVENUE 621498 30419862 30419862 AFFILIATE CONTRACTS 621498 2062287 2062287 82990295 OTHER 621498 13500434 13500434 13500434 118595644 96490729 0 0 2973263 2047570 925693 50652038 34882078 15769960 226467 30000 196467 5323311 3179802 2143509 3364036 2223417 1140619 410907 17766 393141 6475277 4622076 1853201 3509563 2322534 1187029 2110583 1475545 635038 11797949 9424319 2373630 1047081 725638 321443 5896713 3930245 1966468 589256 387852 201404 REFERRED MEDICAL SERVIC 7642738 7642738 0 BAD DEBT EXPENSE 4829151 4829151 340B PHARMACY AND FEES 3944308 3944308 0 OTHER 2579529 924172 1655357 2979876 2170521 809355 116352046 84779732 31572314 0 3859460 7159290 2714544 3637852 7285052 6912314 1279864 1292330 52149952 28524712 24854186 23625240 39993106 42627026 11800612 12136421 19458176 19512689 31258788 31649110 X 8346549 10583577 387769 394339 8734318 10977916 39993106 42627026 2243598 0 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 342415 342415 12725872 5955326 6770546 12896735 9732470 3164265 26184930 12836916 13348014 23625240 X 113766493 -4829151 -4829151 118595644 0 118595644 111522895 0 111522895 4829151 4829151 116352046 PART X, LINE 2: ACCESS IS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE IRC. IN ADDITION, ACCESS QUALIFIES FOR THE CHARITABLE CONTRIBUTION DEDUCTION UNDER SECTION 170(B)(1)(A) AND HAS BEEN CLASSIFIED AS AN ORGANIZATION THAT IS NOT A PRIVATE FOUNDATION WITHIN THE MEANING OF SECTION 509(A) OF THE IRC. ACCESS HAD NO UNRELATED BUSINESS INCOME DURING FISCAL YEARS 2013 AND 2012, AND THEREFORE, NO PROVISION FOR FEDERAL OR STATE INCOME TAXES HAS BEEN MADE IN THE ACCOMPANYING FINANCIAL STATEMENTS. ACCESS DETERMINED THAT IT WAS NOT REQUIRED TO RECORD A LIABILITY RELATED TO UNCERTAIN TAX POSITIONS. THE FEDERAL AND STATE TAX RETURNS FOR ACCESS' 2010, 2011 AND 2012 FISCAL YEARS ARE SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE (IRS) AND STATE TAXING AUTHORITIES, GENERALLY FOR THREE YEARS AFTER THEY WERE FILED. PART XI, LINE 2D - OTHER ADJUSTMENTS: BAD DEBT EXPENSE -4,829,151. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 4,829,151. X X 0 0 0 0 0 0 0 0 0 DONNA THOMPSON CHIEF EXECUTIVE OFFICER 417848 0 140200 0 175000 0 11335 0 21403 0 765786 0 0 0 JOAN BOOMSMA CHIEF MEDICAL OFFICER 286352 0 0 0 0 0 15171 0 7167 0 308690 0 0 0 TARIQ BUTT DEPUTY MEDICAL OFFICER 260426 0 0 0 0 0 12500 0 17495 0 290421 0 0 0 JULIE BONELLO CHIEF INFORMATION OFFICER 115777 0 15000 0 0 0 22000 0 20675 0 173452 0 0 0 MAHOMED OUEDRAOGO CHIEF FINANCIAL OFFICER 154422 0 15000 0 0 0 17498 0 19411 0 206331 0 0 0 LINDA SHAPIRO VP EXTERNAL AFFAIRS 118853 0 0 0 125000 0 0 0 10517 0 254370 0 0 0 ELEVA RILEY VP HUMAN RESOURCES 156591 0 15000 0 125000 0 15000 0 7335 0 318926 0 0 0 STEVEN GLASS VP QUALITY AND INNOVATION 72510 0 0 0 125000 0 10533 0 9346 0 217389 0 0 0 JANIE GAWRYS VP OPERATIONS 193839 0 15000 0 0 0 0 0 15045 0 223884 0 0 0 EDWARD LAMPLEY PHYSICIAN 443760 0 0 0 0 0 13742 0 414 0 457916 0 0 0 PAULA CAVENS PHYSICIAN 386589 0 0 0 0 0 23000 0 19765 0 429354 0 0 0 CARLOS SANDOVAL-HERRERA PHYSICIAN 426944 0 0 0 0 0 0 0 19200 0 446144 0 0 0 LEMUEL SHAFFER PHYSICIAN 331791 0 0 0 0 0 23000 0 7538 0 362329 0 0 0 SARIKA ARORA PHYSICIAN 270145 0 0 0 0 0 17500 0 19218 0 306863 0 0 0 FORM 990, PART VI, SECTION B, LINE 11 THE RETURN WAS E-MAILED TO ALL BOARD MEMBERS FOR REVIEW AND APPROVAL. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD IS REQUIRED TO COMPLETE CONFLICT OF INTEREST STATEMENTS ON AN ANNUAL BASIS AND SUBMIT TO THE CORPORATE COMPLIANCE OFFICER. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION COMMITTEE REVIEWS THE SALARIES OF THE SENIOR LEADERSHIP TEAM ON AN ANNUAL BASIS. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS ARE MADE PUBLIC UPON WRITTEN REQUEST. FORM 990, PART XII, LINE 2C THE ORGANIZATION'S BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. HEALTHCURA LLC 600 W FULTON CHICAGO IL 60661 462285138 COORDINATE & PROVIDE OVERSIGHT TO HEALTHCURA,INC. AND HEALTHCURA NETWORK,LLC DE 0 -184451 ACCESS COMMUNITY HEALTH NETWORK HEALTHCURA NETWORK LLC 600 W FULTON CHICAGO IL 60661 472300870 ESTABLISH A CLINICALLY INTEGRATED SYSTEM OF CARE DE 0 0 HEALTHCURA LLC HEALTHCURA INC 600 W FULTON CHICAGO IL 60661 465498098 ACCOUNTABLE CARE ENTITY IL HEALTHCURA LLC C -184451 216562 1.00000 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 HEALTHCURA LLC B CASH PROVIDED HEALTHCURA INC D 250000 CASH PROVIDED