2015-05-14T17:15:12-05:00 2014-06-30 381357951 PLANTE & MORAN PLLC 10 S RIVERSIDE PLAZA 9TH FLOOR CHICAGO IL 60606 990 2013-07-01 363088628 ERIE FAMILY HEALTH CENTER INC ERIE 3126663494 1701 W SUPERIOR STREET CHICAGO IL 60622 LEE FRANCIS PRESIDENT AND CEO 3126663494 2015-04-20 1 KIMBERLY A HAUMANN P00546491 3122071040 2015-04-20 2013 2016-02-25 16:41:14Z LEE FRANCIS 1701 W SUPERIOR STREET CHICAGO IL 60622 48246790 0 X WWW.ERIEFAMILYHEALTH.ORG X 1970 IL OPERATE A HEALTHCARE CENTER TO SERVE A LARGELY MEDICALLY UNDERSERVED POPULATION IN CHICAGO. 23 23 553 297 0 0 18683641 23422243 20686871 24759140 27836 23639 -6546 -22440 39391802 48182582 0 0 0 0 25556088 30958172 111605 19401 188336 9735710 14419473 35403403 45397046 3988399 2785536 30745854 37711271 6437875 10617756 24307979 27093515 X ERIE FAMILY HEALTH CENTER'S (ERIE) MISSION IS TO PROVIDE AFFORDABLE, ACCESSIBLE HIGH-QUALITY CARE TO THOSE IN NEED. IT ACCOMPLISHES THIS OBJECTIVE BY SERVING AS A MEDICAL HOME FOR THE MORE THAN 50,000 PATIENTS EACH YEAR AND CONTINUOUSLY EVOLVING TO RESPOND TO THE NEEDS OF EACH COMMUNITY IT SERVES. 0 0 34341496 22854387 ERIE FAMILY HEALTH CENTER PROVIDES COMPREHENSIVE PRIMARY CARE SERVICES AT THIRTEEN SITES IN CHICAGO AND THE NORTHERN SUBURBS, INCLUDING: SEVEN LARGE PRIMARY HEALTH CARE CENTERS, ONE ADOLESCENT HEALTH CENTER, AND FIVE SCHOOL-BASED HEALTH CENTERS. ERIE'S PRIMARY CARE MEDICAL SERVICES INCLUDE PEDIATRICS, INTERNAL MEDICINE, FAMILY MEDICINE, AND WOMEN'S HEALTH. IN ADDITION, ERIE PROVIDES ORAL HEALTH DENTAL SERVICES, PODIATRY, HIV/AIDS CARE, EYE CARE, BEHAVIORAL HEALTH COUNSELING, CASE MANAGEMENT SERVICES AND HEALTH EDUCATION. EIGHTY-FIVE PERCENT OF ERIE'S PATIENTS LIVE AT OR BELOW ONE-HUNDRED PERCENT OF THE FEDERAL POVERTY LEVEL AND THIRTHY PERCENT ARE UNINSURED. ERIE'S HIGHLY SKILLED PROVIDERS, INNOVATIVE PARTNERSHIPS AND FORWARD-THINKING APPROACH MAKE IT A NATIONAL LEADER FOR THE PROVISION OF COMMUNITY-BASED HEALTH CARE. 3037949 1904753 ERIE'S AWARD-WINNING ORAL HEALTH PROGRAM SERVES MORE THAN 9,000 LOW-INCOME CHICAGOANS PER YEAR, INCLUDING CHILDREN AND THEIR NUCLEAR FAMILY MEMBERS, DIABETICS, INDIVIDUALS WITH HIV/AIDS AND PREGNANT WOMEN. SERVICES PROVIDED INCLUDE ROUTINE CLEANINGS, X-RAYS, SEALANTS, FILLINGS, CROWNS, ROOT CANALS AND TOOTH EXTRACTIONS. ERIE FOCUSES NOT ONLY ON TREATING, BUT ALSO ON PREVENTING ORAL HEALTH PROBLEMS. ORAL CARE IS INTEGRATED INTO THE PRIMARY MEDICAL CARE OFFERED AT ALL ERIE LOCATIONS. IN ADDITION, ERIE PROVIDES ORAL HEALTH EDUCATION TO MORE THAN 2,500 COMMUNITY MEMBERS ANNUALLY. 37379445 1 1 0 1 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 1 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 25 0 1 553 1 0 0 0 0 0 1 1 0 0 0 0 X 23 23 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 IL X STEPHANIE SMITH 3124322725 1701 WEST SUPERIOR STREET CHICAGO IL 60622 BRIAN P MARSELLA BOARD CHAIR 2.00 0.00 X X 0 0 0 ANA MARIA SOTO BOARD VICE CHAIR 1.50 1.00 X X 0 0 0 ERIC MAYEDA BOARD TREASURER 2.00 0.00 X X 0 0 0 DEBORAH B WRIGHT-POWELL BOARD SECRETARY 1.50 0.00 X X 0 0 0 WILLIAM KISTNER DIRECTOR 2.00 0.00 X 0 0 0 DANIEL J TOUNSEL III DIRECTOR 1.00 0.00 X 0 0 0 ROSALIE ALICEA DIRECTOR 1.50 0.00 X 0 0 0 CELESTE CASTILLO DIRECTOR 1.50 0.00 X 0 0 0 MICHAEL COLE DIRECTOR 1.00 0.00 X 0 0 0 LINDA CUSHMAN DIRECTOR 0.50 0.00 X 0 0 0 SHELLIE KARNO DIRECTOR 0.50 0.00 X 0 0 0 MARIA HERNANDEZ DIRECTOR 0.50 0.00 X 0 0 0 REVEREND ED SARDEN DIRECTOR 1.00 0.00 X 0 0 0 DARYL TOM DIRECTOR 1.00 1.00 X 0 0 0 HUMBERTO URIBE DIRECTOR 1.00 0.00 X 0 0 0 KATHERINE WILSON DIRECTOR 1.00 0.00 X 0 0 0 JULIE ZERWIC DIRECTOR 1.00 0.00 X 0 0 0 MATT AARONSON DIRECTOR 1.00 0.00 X 0 0 0 JILL SIMON SVOBODA DIRECTOR 1.50 0.00 X 0 0 0 JACQUELINE CERVANTES DIRECTOR 1.00 0.00 X 0 0 0 AMELIA MADRIGAL DIRECTOR 1.00 0.00 X 0 0 0 JUAN FERNANDO JAUREGI DIRECTOR 1.00 0.00 X 0 0 0 ANA LILIA VIVAR DIRECTOR 1.00 0.00 X 0 0 0 LEE FRANCIS PRESIDENT & CEO 40.00 1.00 X 265665 0 20464 DAVID R BUCHANAN CHIEF MEDICAL OFFICER 40.00 0.00 X 231701 0 16336 GARY RAJU CHIEF FINANCIAL OFFICER 40.00 1.00 X 24075 0 4474 LUZ JIMENEZ VP OF CLINICAL OPERATIONS 40.00 0.00 X 137040 0 12088 ILIANA MORA SENIOR VP OF STRATEGY & BU 40.00 0.00 X 204487 0 15250 RAMON BARAJAS OB/GYN PHYSICIAN 40.00 0.00 X 244708 0 5924 DEBORAH L EDBERG FAMILY PRACTICE PHYSICIAN 40.00 0.00 X 183814 0 4492 FRED RACHMAN PEDIATRICIAN 40.00 0.00 X 182671 0 0 FRANK CASTILLO FAMILY PRACTICE PHYSICIAN 40.00 0.00 X 179898 0 3661 GAIL PATRICK PHYSICIAN 40.00 0.00 X 166502 0 0 1820561 0 82689 46 0 1 0 SKENDER INTERIORS G 200 W MADISON - SUITE 1300 CHICAGO IL 60606 CONSTRUCTION 6571815 ALLIANCE OF CHICAGO 215 W OHIO ST 4TH FLOOR CHICAGO IL 60654 SUPPORT SERVICES 867281 LAB CORP PO BOX 12140 BURLINGTON NC 27216 LAB SERVICES 535676 LEGAT ARCHITECTS 651 W WASHINGTON BLVD CHICAGO IL 60661 ARCHITECTS 286519 CDW GOVERNMENT INC 200 N MILWAUKEE AVE VERNON HILLS IL 60061 IT SERVICES 281242 31 179634 14096264 9146345 23422243 MEDICARE/MEDICAID PAYMENTS 624100 21079894 21079894 SELF-PAY 624100 2718594 2718594 KID CARE/HEALTHY MOM 624100 776386 776386 RENTAL INCOME 531120 85671 85671 ALLIANCE EQUITY INCOME 624100 75454 75454 23141 23141 24759140 23639 23639 41768 179634 64208 -22440 -22440 48182582 24759140 0 1199 666432 415654 250778 25577540 22198604 3239586 139350 250890 200712 50178 2846825 2277460 569365 1616485 1293188 323297 125223 125223 104446 104446 19401 19401 2381091 1622306 758785 186516 130561 43404 12551 1404694 906931 493737 4026 1444539 1305139 139400 67236 47077 17878 2281 231392 144655 82310 4427 72787 72787 2137987 1539350 592337 6300 243432 209352 34080 BAD DEBT 1673304 1673304 EQUIPMENT RENTAL & MAIN 1230325 922744 307581 PHARMACEUTICALS 1070935 1070935 OTHER EXPENSES 1002790 378697 624093 1042776 1042776 45397046 37379445 7829265 188336 5576029 1528395 4463123 2170377 4619261 5157097 2473064 4890151 446434 792377 29580103 7803726 12365282 21776377 640198 783527 162463 612970 30745854 37711271 4087868 7426639 22259 122593 1493224 2234000 834524 834524 6437875 10617756 X 21285597 25238948 3022382 1854567 24307979 27093515 30745854 37711271 2785536 0 X 0 1 X 1 1 1 X 11249810 13455508 15418861 18546525 23422243 82092947 42883 40002 13586 17736 23141 137348 11292693 13495510 15432447 18564261 23445384 82230295 82230295 17624 18134 24361 27836 23639 111594 42883 40002 13586 17736 23141 137348 82479237 96750254 0.99700 0.99550 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 823 823 45396223 45397046 1000000 250000 0 0 1000000 1000000 1000000 1000000 4000000 6000000 7500 2184 823 10507 250000 250000 250000 250000 1000000 1500000 742344 742344 4487286 1883181 2604105 10884627 2982275 7902352 3338143 1580052 1758091 10127703 1358218 8769485 21776377 THIRD-PARTY PAYOR LIABILITY 834524 834524 X 46871446 297960 64208 362168 46509278 1673304 1673304 48182582 44085910 297960 64208 362168 43723742 1673304 1673304 45397046 PART X, LINE 2: ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY THE CENTER AND RECOGNIZE A TAX LIABILITY IF THE CENTER HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS OR OTHER APPLICABLE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITIONS TAKEN BY THE CENTER, AND HAS CONCLUDED THAT AS OF JUNE 30, 2014, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE CENTER IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. MANAGEMENT BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO 2011. PART XI, LINE 2D - OTHER ADJUSTMENTS: EXPENSES FOR FUNDRAISING EVENTS 64,208. PART XI, LINE 4B - OTHER ADJUSTMENTS: EXPENSES FOR BAD DEBT 1,673,304. PART XII, LINE 2D - OTHER ADJUSTMENTS: EXPENSES FOR FUNDRAISING EVENTS 64,208. PART XII, LINE 4B - OTHER ADJUSTMENTS: EXPENSES FOR BAD DEBT 1,673,304. X X X X X X X 1 HASKEL CONSULTING 3355 BLACKBURN ST DALLAS TX 75204 FUNDRAISING CONSULTANT 0 0 12000 -12000 12000 -12000 IL ANNUAL LUNCHEON 166037 148582 17455 27714 4631 17120 ERIEDESCENCE 55365 31052 24313 11466 3277 221402 179634 41768 39180 4631 20397 64208 -22440 X X X X X 0 0 0 0 0 0 0 0 0 LEE FRANCIS PRESIDENT & CEO 231910 0 33755 0 0 0 20464 0 0 0 286129 0 0 0 DAVID R BUCHANAN CHIEF MEDICAL OFFICER 206737 0 24964 0 0 0 16336 0 0 0 248037 0 0 0 ILIANA MORA SENIOR VP OF STRATEGY & BU 189237 0 15250 0 0 0 15250 0 0 0 219737 0 0 0 RAMON BARAJAS OB/GYN PHYSICIAN 234860 0 9848 0 0 0 5924 0 0 0 250632 0 0 0 DEBORAH L EDBERG FAMILY PRACTICE PHYSICIAN 171066 0 12748 0 0 0 4492 0 0 0 188306 0 0 0 FRED RACHMAN PEDIATRICIAN 182671 0 0 0 0 0 0 0 0 0 182671 0 0 0 FRANK CASTILLO FAMILY PRACTICE PHYSICIAN 158993 0 20905 0 0 0 3661 0 0 0 183559 0 0 0 GAIL PATRICK PHYSICIAN 145781 0 20721 0 0 0 0 0 0 0 166502 0 0 0 FORM 990, PART VI, SECTION B, LINE 11 ERIE FAMILY HEALTH CENTER (EFHC) USES A THIRD PARTY (INDEPENDENT CPA FIRM) TO PREPARE ITS 990 TAX FORM. UPON THE FORM'S COMPLETION, A COPY IS PROVIDED TO EFHC'S MANAGEMENT FOR REVIEW AND THEN SUBSEQUENTLY REVIEWED BY THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS. ANY NECESSARY CHANGES ARE COMMUNICATED TO THE CPA FIRM AND INCORPORATED AS APPROPRIATE. ONCE THE 990 DRAFT IS FINALIZED A COPY IS MADE AVAILABLE TO THE BOARD OF DIRECTORS. THE THIRD PARTY WILL THEN FILE THE 990 ON EFHC'S BEHALF. FORM 990, PART VI, SECTION B, LINE 12C OFFICERS, DIRECTORS, KEY EMPLOYEES, AND MEMBERS OF THE BOARD ARE ANNUALLY REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE FORM AS A PRECURSOR TO THEIR SERVICE TO THE ORGANIZATION. POTENTIAL CONFLICTS ARE LOGGED WITH AND MONITORED BY EFHC MANAGEMENT. FORM 990, PART VI, SECTION B, LINE 15 PERIODICALLY ERIE REQUESTS COMPENSATION RANGES FOR POSITIONS AT ERIE AS ERIE GROWS OR RESPONSIBILITIES CHANGE. OUR COMPENSATION CONSULTANT REVIEWS THE JOB DESCRIPTION, OFTEN SETS UP A TIME TO REVIEW THE JOB DESCRIPTION WITH THE MANAGER OR ERIE'S HR DIRECTOR. ONCE SHE IS COMFORTABLE THAT SHE UNDERSTANDS THE EXTENT OF THE RESPONSIBILITIES OF THE POSITION SHE COMPARES IT TO A FEW PUBLISHED COMPENSATION SURVEYS (CHICAGO METRO/ MCHC/TOWERS WATSON/ MERCER) AND CONTACTS PHYSICIAN GROUPS AND A FEW HOSPITALS TO GET MORE RECENT COMPENSATION DATA AND A CLEARER PICTURE OF THE RECRUITMENT AND RETENTION CLIMATE. HER RECOMMENDATIONS ARE REVIEWED BY THE EXECUTIVE LEADERSHIP TEAM, FINANCE AND HR. WHEN THE COMPENSATION DATA IS FOR OFFICERS OF THE ORGANIZATIONS (AKA EXECUTIVE LEADERSHIP TEAM) THE COMPENSATION DATA IS REVIEWED BY THE BOARD'S COMPENSATION COMMITTEE. ONCE APPROVED, ANY ADJUSTMENTS ARE PROCESSED BY THE PRESIDENT AND CEO FOR OFFICERS (OTHER THAN HIMSELF) AND APPROVED BY FINANCE AND HR. THE PRESIDENT'S ADJUSTMENTS ARE INITIATED AND APPROVED BY THE BOARD PRESIDENT. FORM 990, PART VI, SECTION C, LINE 19 EFHC GOVERNING DOCUMENTS, FINANCIAL STATEMENTS, AND CONFLICT OF INTEREST POLICY ARE AVAILABLE FOR PUBLIC REVIEW UPON REQUEST. REQUESTS ARE REQUIRED TO BE IN WRITING. ERIE TITLE HOLDING COMPANY 1701 W SUPERIOR ST CHICAGO IL 606225646 465259444 TITLE HOLDING ENTITY FOR ERIE FAMILY HEALTH CENTER IL 501(C)(2) ERIE FAMILY HEALTH CENTER 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0