CHIRICAHUA COMMUNITY HEALTH CENTERS INC: Form 990, tax year 2012
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- Organization
- CHIRICAHUA COMMUNITY HEALTH CENTERS INC (EIN 86-0814898)
- Tax period
- 2012-05-01 to 2013-04-30
- Filed
- 2014-01-09
- IRS object ID
- 201400139349302400
- Schema version
- 2012v2.3
- 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) |
|---|---|---|
| Timestamp | 2014-01-09T15:26:57-06:00 | Timestamp |
| Tax Period End Date | 2013-04-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FESTER & CHAPMAN PC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 8283 N HAYDEN RD STE 200 | AddressLine1 |
| City | SCOTTSDALE | City |
| State | AZ | State |
| ZIP Code | 852582456 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-05-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 860814898 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHIRICAHUA COMMUNITY HEALTH CENTERS | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | CHIR | NameControl |
| Phone | 5203646851 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1205 F AVENUE | AddressLine1 |
| City | DOUGLAS | City |
| State | AZ | State |
| ZIP Code | 85607 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | VICTORIA BRAND | Name |
| Title | PRESIDENT | Title |
| Phone | 5203646851 | Phone |
| Date Signed | 2014-01-08 | DateSigned |
| Authorize Third Party | false | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | RACHEL R LOCKE CPA | Name |
| Phone | 6022643077 | Phone |
| Date Prepared | 2014-01-09 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | GARY MCPHERRAN | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1205 F AVENUE | AddressLine1 |
| City | DOUGLAS | City |
| State | AZ | State |
| ZIP Code | 85607 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 12778537 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.CCHCI.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1995 | YearFormation |
| State Legal Domicile | AZ | StateLegalDomicile |
| Activity Or Mission Description | TO PROVIDE QUALITY, EFFICIENT PRIMARY HEALTH CARE TO ALL IN COCHISE COUNTY, REGARDLESS OF ABILITY TO PAY. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 9 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 9 | NbrIndependentVotingMembers |
| Total Nbr Employees | 218 | TotalNbrEmployees |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 5083126 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 5120245 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 6758658 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 7635952 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 1 | InvestmentIncomePriorYear |
| Investment Income Current Year | 1 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 54316 | OtherRevenuePriorYear |
| Other Revenue Current Year | 22339 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 11896101 | TotalRevenuePriorYear |
| Total Revenue Current Year | 12778537 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 7907656 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 8766407 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 3873616 | OtherExpensePriorYear |
| Other Expenses Current Year | 4009818 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 11781272 | TotalExpensesPriorYear |
| Total Expenses Current Year | 12776225 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 114829 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 2312 | RevenuesLessExpensesCY |
| Total Assets BOY | 8471509 | TotalAssetsBOY |
| Total Assets EOY | 8621595 | TotalAssetsEOY |
| Total Liabilities BOY | 2268056 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 2415830 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 6203453 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 6205765 | NetAssetsOrFundBalancesEOY |
| Mission Description | TO PROVIDE QUALITY, EFFICIENT PRIMARY HEALTH CARE TO ALL IN COCHISE COUNTY, REGARDLESS OF ABILITY TO PAY. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 9439310 | Expense |
| Description | CCHC PROVIDES PRIMARY HEALTH CARE SERVICES TO SPECIALIZED GROUPS IN SOUTHEASTERN ARIZONA. THE SERVICE AREA IS DESIGNATED AS AN UNDERSERVED AND HEALTH PROVIDER SHORTAGE AREA. | Description |
| Total Program Service Expense | 9439310 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | false | ReportFin48Footnote |
| Independent Audit Financial Stmt | true | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | false | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | false | Hospital |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | true | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | false | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 10 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 218 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 9 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 9 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | false | MembersOrStockholders |
| Election Of Board Members | false | ElectionOfBoardMembers |
| Decisions Subject To Approval | false | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | AZ | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | JEANNE BUTLER | NamePerson |
| Telephone Number | 5203646851 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10566 HIGHWAY 191 | AddressLine1 |
| Address Line2 | PO BOX 263 | AddressLine2 |
| City | EL FRIDA | City |
| State | AZ | State |
| ZIP Code | 85610 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (17 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| MANNY ALVAREZ | |||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||
| VICKIE BRAND | |||||||
| PRESIDENT | 2.00 | X | 0 | 0 | 0 | ||
| ELIZABETH STONER | |||||||
| VICE-PRESIDE | 2.00 | X | 0 | 0 | 0 | ||
| ELISA DE LA CRUZ | |||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||
| CARRIE GUSTAVSON | |||||||
| TREASURER | 2.00 | X | 0 | 0 | 0 | ||
| IRENE CORNEJO | |||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||
| LOURDEZ FERNANDEZ | |||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||
| AIDA LA FORGE | |||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||
| TALIA RETANA | |||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||
| JONATHAN LEE-MELK MD | |||||||
| CMO | 40.00 | 169015 | 0 | 0 | X | ||
| JENNIFER RYAN | |||||||
| CEO | 40.00 | 156383 | 0 | 0 | X | ||
| GARY MCPHERRAN | |||||||
| CFO | 40.00 | 82057 | 0 | 0 | X | ||
| STEPHEN LINDSTROM MD | |||||||
| MEDICAL DIRE | 40.00 | 175482 | 0 | 0 | X | ||
| SHAHEDUL ISLAM MD | |||||||
| PHYSICIAN | 40.00 | 161915 | 0 | 0 | X | ||
| APRIL ALVAREZ-CORONA MD | |||||||
| PHYSICIAN | 40.00 | 146274 | 0 | 0 | X | ||
| MARIO FRAGOSO DO | |||||||
| PHYSICIAN | 40.00 | 141714 | 0 | 0 | X | ||
| KAREN CROCKETT MD | |||||||
| PHYSICIAN | 40.00 | 134204 | 0 | 0 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1167044 | TotalReportableCompFromOrg |
| Number Individuals GT100 K | 7 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
| Government Grants | 4287744 | GovernmentGrants |
| All Other Contributions | 832501 | AllOtherContributions |
| Noncash Contributions | 830123 | NoncashContributions |
| Total Contributions | 5120245 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | PATIENT REVENUE | Description |
| Total Revenue Column | 7635952 | TotalRevenueColumn |
| Related Or Exempt Function Income | 7635952 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 7635952 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1 | TotalRevenueColumn |
| Exclusion | $1 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | OTHER | Description |
| Total Revenue Column | 22339 | TotalRevenueColumn |
| Related Or Exempt Function Income | 22339 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 22339 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 12778537 | TotalRevenueColumn |
| Related Or Exempt Function Income | 7658291 | RelatedOrExemptFunctionIncome |
| Exclusion | $1 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 407455 | Total |
| Program Services | 301516 | ProgramServices |
| Management And General | 105939 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7123560 | Total |
| Program Services | 5271434 | ProgramServices |
| Management And General | 1852126 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1235392 | Total |
| Program Services | 926544 | ProgramServices |
| Management And General | 308848 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2752 | Total |
| Management And General | 2752 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 100998 | Total |
| Management And General | 100998 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 118645 | Total |
| Program Services | 118645 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 135299 | Total |
| Management And General | 135299 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 282633 | Total |
| Program Services | 251543 | ProgramServices |
| Management And General | 31090 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 231740 | Total |
| Program Services | 129774 | ProgramServices |
| Management And General | 101966 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 49983 | Total |
| Management And General | 49983 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 396564 | Total |
| Program Services | 198282 | ProgramServices |
| Management And General | 198282 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 67707 | Total |
| Program Services | 33854 | ProgramServices |
| Management And General | 33853 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| SUPPLIES | 1445445 | 1427403 | 18042 |
| CONTRACTUAL SERVICES | 701192 | 483822 | 217370 |
| TELEPHONE | 163026 | 138572 | 24454 |
| REPAIR & MAINTENANCE | 81443 | 67598 | 13845 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 232391 | Total |
| Program Services | 90323 | ProgramServices |
| Management And General | 142068 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12776225 | Total |
| Program Services | 9439310 | ProgramServices |
| Management And General | 3336915 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 637278 | BOY |
| EOY | 358228 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1848184 | BOY |
| EOY | 2280195 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 422693 | BOY |
| EOY | 588077 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 66974 | BOY |
| EOY | 53063 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 122629 | BOY |
| EOY | 140392 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 8152493 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 2950853 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5294397 | BOY |
| EOY | 5201640 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 79354 | BOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8471509 | BOY |
| EOY | 8621595 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 746962 | BOY |
| EOY | 964939 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 920904 | BOY |
| EOY | 787713 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 600190 | BOY |
| EOY | 663178 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2268056 | BOY |
| EOY | 2415830 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6203453 | BOY |
| EOY | 6205765 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6203453 | BOY |
| EOY | 6205765 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8471509 | BOY |
| EOY | 8621595 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 2312 | ReconcilationRevenueExpenses |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Separate | X | FinancialStatementSeparate |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | true | AuditCommittee |
| Federal Grant Audit Required | true | FederalGrantAuditRequired |
| Federal Grant Audit Performed | true | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org170b1 Avi | X | PubliclySupportedOrg170b1Avi |
Gifts Grants Contrib Received170 GiftsGrantsContribReceived170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 3552621 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 4553925 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 6187248 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 5083126 | CurrentTaxYearMinus1Year |
| Current Tax Year | 5120245 | CurrentTaxYear |
| Total | 24497165 | Total |
Total170 Total170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 3552621 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 4553925 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 6187248 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 5083126 | CurrentTaxYearMinus1Year |
| Current Tax Year | 5120245 | CurrentTaxYear |
| Total | 24497165 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | 24497165 | PublicSupportTotal170 |
Gross Investment Income170 GrossInvestmentIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus3 Years | 135 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 146 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 3301 | CurrentTaxYearMinus1Year |
| Current Tax Year | 1 | CurrentTaxYear |
| Total | 3583 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | 24500748 | TotalSupport |
| Gross Receipts From Admissions Etc | 7658291 | GrossReceiptsFromAdmissionsEtc |
| Public Support Pertcentage170 | 0.99990 | PublicSupportPertcentage170 |
| Public Support Pertcent Prior Year | 0.99980 | PublicSupportPertcentPriorYear |
| Thirty Three Percnt Tests CY170 | X | ThirtyThreePercntTestsCY170 |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 35323 | OtherCostOrOtherBasis |
| Book Value | 35323 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 4983193 | OtherCostOrOtherBasis |
| Depreciation | 1811551 | Depreciation |
| Book Value | 3171642 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2254176 | OtherCostOrOtherBasis |
| Depreciation | 819466 | Depreciation |
| Book Value | 1434710 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 879801 | OtherCostOrOtherBasis |
| Depreciation | 319836 | Depreciation |
| Book Value | 559965 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 5201640 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities (3 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| LINE OF CREDIT | $500,000 |
| OTHER NONCURRENT LIABILITY | $163,178 |
| CAPITAL LEASES |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 663178 | TotalOfAmounts |
| Tot Revenue Etc Audited Fincl Stmt | 12778537 | TotRevenueEtcAuditedFinclStmt |
| Revenue Subtotal | 12778537 | RevenueSubtotal |
| Total Revenue Per Form990 | 12778537 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 12776225 | TotExpensesEtcAuditedFinclStmt |
| Expenses Subtotal | 12776225 | ExpensesSubtotal |
| Total Expenses Per Form990 | 12776225 | TotalExpensesPerForm990 |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | false | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (4 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Bonus Filing OrgBonusFilingOrg | Total Compensation Filing OrgTotalCompensationFilingOrg |
|---|---|---|---|
| JONATHAN LEE-MELK MD | |||
| CMO | 164514 | 4501 | 169015 |
| JENNIFER RYAN | |||
| CEO | 156383 | 156383 | |
| STEPHEN LINDSTROM MD | |||
| MEDICAL DIRECTOR | 173982 | 1500 | 175482 |
| SHAHEDUL ISLAM MD | |||
| PHYSICIAN | 158273 | 3642 | 161915 |
Schedule M IRS990ScheduleM
Drugs And Medical Supplies DrugsAndMedicalSupplies
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Number Of Contributions | 1 | NumberOfContributions |
| Noncash Contribs Rptd F990 | 830123 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenues |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeld |
| Review Process Unusual NC Gifts | false | ReviewProcessUnusualNCGifts |
| Third Parties Used | false | ThirdPartiesUsed |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (5 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 | FORM 990, PAGE 6, PART VI, LINE 11B | THE CFO REVIEWS THE 990 AND THEN PRESENTS TO THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS FOR REVIEW. THE FINANCE COMMITTEE PRESENTS TO THE BOARD OF DIRECTORS FOR REVIEW. |
| ENFORCEMENT OF CONFLICTS POLICY | FORM 990, PAGE 6, PART VI, LINE 12C | THE CONFLICT OF INTEREST POLICY IS REVIEWED, APPROVED AND SIGNED ANNUALLY. |
| COMPENSATION PROCESS FOR TOP OFFICIAL | FORM 990, PAGE 6, PART VI, LINE 15A | COMPENSATION FOR KEY EMPLOYEES IS REVIEWED AND APPROVED BY BOTH HR AND FINANCE. RATES OF COMPARABLE HEALTH CENTERS IS REVIEWED AND RANGES ARE APPROVED BY THE BOD. |
| COMPENSATION PROCESS FOR OFFICERS | FORM 990, PAGE 6, PART VI, LINE 15B | COMPENSATION FOR KEY EMPLOYEES IS REVIEWED AND APPROVED BY BOTH HR AND FINANCE. RATES OF COMPARABLE HEALTH CENTERS IS REVIEWED AND RANGES ARE APPROVED BY THE BOD. OFFICERS AND BOD MEMBERS ARE NOT COMPENSATED. |
| GOVERNING DOCUMENTS DISCLOSURE EXPLANATION | FORM 990, PAGE 6, PART VI, LINE 19 | GOVERNING DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC MONTHLY AT EACH BOARD OF DIRECTORS MEETING AND UPON REQUEST. |
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