FURP.ORG / PUBLIC DATA EXPLORER

CHARLES RIVER COMMUNITY HEALTH INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
CHARLES RIVER COMMUNITY HEALTH INC (EIN 23-7221597)
Tax period
2012-07-01 to 2013-06-30
Filed
2014-05-13
IRS object ID
201401339349305350
Schema version
2012v2.1
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)
Timestamp2014-05-13T16:24:01-05:00Timestamp
Tax Period End Date2013-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN042571780EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1ALEXANDER ARONSON FINNING & CO PCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line121 EAST MAIN STREETAddressLine1
CityWESTBOROCity
StateMAState
ZIP Code01581ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN237221597EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1JOSEPH M SMITH COMMUNITY HEALTH CENTER INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlJOSENameControl
Phone6177830500Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1287 WESTERN AVENUEAddressLine1
CityALLSTONCity
StateMAState
ZIP Code02134ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameELIZABETH BROWNEName
TitleEXECUTIVE DIRECTORTitle
Phone6175222766Phone
Date Signed2014-05-13DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameDAVID P MCMANUS CPAName
PTINP00533266PTIN
Phone5083669100Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonELIZABETH BROWNENameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1287 WESTERN AVENUEAddressLine1
CityALLSTONCity
StateMAState
ZIP Code02134ZIPCode
FieldValueIRS element (for citing)
Gross Receipts12865635GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.JMSCHC.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1970YearFormation
State Legal DomicileMAStateLegalDomicile
Activity Or Mission DescriptionHIGH-QUALITY, COMPREHENSIVE, CULTURALLY COMPETENT, AND AFFORDABLE COMMUNITY-BASED HEALTH CARE SERVICES FOR ALL RESIDENTS OF ALLSTON/BRIGHTON, WALTHAM AND SURROUNDING COMMUNITIES, INCLUDING UNINSURED, UNDER-INSURED, LOW INCOME, AND UNDERSERVED POPULATIONS.ActivityOrMissionDescription
Nbr Voting Members Governing Body19NbrVotingMembersGoverningBody
Nbr Independent Voting Members19NbrIndependentVotingMembers
Total Nbr Employees220TotalNbrEmployees
Total Nbr Volunteers2TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year3719775ContributionsGrantsPriorYear
Contributions Grants Current Year3757035ContributionsGrantsCurrentYear
Program Service Revenue Prior Year8020939ProgramServiceRevenuePriorYear
Program Service Revenue CY8680874ProgramServiceRevenueCY
Investment Income Prior Year6970InvestmentIncomePriorYear
Investment Income Current Year11300InvestmentIncomeCurrentYear
Other Revenue Prior Year2904OtherRevenuePriorYear
Other Revenue Current Year1187OtherRevenueCurrentYear
Total Revenue Prior Year11750588TotalRevenuePriorYear
Total Revenue Current Year12450396TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year23333GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY30000GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year8126634SalariesEtcPriorYear
Salaries Etc Current Year8816959SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year159578TotalFundrsngExpCurrentYear
Other Expense Prior Year3023391OtherExpensePriorYear
Other Expenses Current Year3143558OtherExpensesCurrentYear
Total Expenses Prior Year11173358TotalExpensesPriorYear
Total Expenses Current Year11990517TotalExpensesCurrentYear
Revenues Less Expenses Prior Year577230RevenuesLessExpensesPriorYear
Revenues Less Expenses CY459879RevenuesLessExpensesCY
Total Assets BOY8442052TotalAssetsBOY
Total Assets EOY9163236TotalAssetsEOY
Total Liabilities BOY1342799TotalLiabilitiesBOY
Total Liabilities EOY1562033TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY7099253NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY7601203NetAssetsOrFundBalancesEOY
Mission DescriptionHIGH-QUALITY, COMPREHENSIVE, CULTURALLY COMPETENT, AND AFFORDABLE COMMUNITY-BASED HEALTH CARE SERVICES FOR ALL RESIDENTS OF ALLSTON/BRIGHTON, WALTHAM, AND SURROUNDING COMMUNITIES, INCLUDING UNINSURED, UNDER-INSURED, LOW INCOME, AND UNDERSERVED POPULATIONS.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense7380536Expense
Grants30000Grants
Revenue6338173Revenue
DescriptionFAMILY PRACTICE - MEDICAL AND SPECIALTY SERVICES FOR RESIDENTS OF ALLSTON-BRIGHTON AND WALTHAM, MA, AND SURROUNDING COMMUNITIES. SPECIALTY SERVICES INCLUDE OB/GYN, ENDOCRINOLOGY, PODIATRY, CASE MANAGEMENT, CANCER SCREENING, FAMILY PLANNING, VISION, NUTRITION, HEALTH EDUCATION, HEALTH BENEFITS, AND PHARMACY.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense2209857Expense
Revenue1969211Revenue
DescriptionDENTAL - DENTAL SERVICES TO RESIDENTS OF THE ALLSTON-BRIGHTON AND WALTHAM, MA COMMUNITIES.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense896164Expense
Revenue374677Revenue
DescriptionCOUNSELING AND FAMILY SUPPORT - BEHAVIORAL HEALTH COUNSELING AND OUTREACH SERVICES TO RESIDENTS OF ALLSTON-BRIGHTON AND WALTHAM, MA, AND SURROUNDING COMMUNITIES.Description
FieldValueIRS element (for citing)
Total Program Service Expense10486557TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments1TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets1ReportOtherAssets
Report Other Liabilities0ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt1ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations1GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109622NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees220NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members19NbrVotingGoverningBodyMembers
Number Independent Voting Members19NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters1LocalChapters
Policies Reference Chapters1PoliciesReferenceChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledMAStatesWhereCopyOfReturnIsFiled
Other WebsiteXOtherWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1JAMES SOUZA CFOBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number6177830500TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1287 WESTERN AVENUEAddressLine1
CityALLSTONCity
StateMAState
ZIP Code02134ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (27 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
TRACEY MANGHAM
BOARD OF DIRECTORS MEMBER1.00X000
RAYMOND SLEEPER
BOARD OF DIRECTORS MEMBER1.00X000
PATRICE MCGREGOR
VICE CLERK1.00X000X
DAVID NORTON
CHAIRPERSON1.00X000X
PETER KOUTOUJIAN SR
TREASURER1.00X000X
CAROLINE GROSSMAN
BOARD OF DIRECTORS MEMBER1.00X000
ANGELA GONZALEZ
CLERK1.00X000X
SAGRARIO ORTIZ
BOARD OF DIRECTORS MEMBER1.00X000
GABRIELA CANEPA
BOARD OF DIRECTORS MEMBER1.00X000
HIEU DO
VICE CHAIRPERSON1.00X000X
JULIE MORAN
BOARD OF DIRECTORS MEMBER1.00X000
ADDISON POWERS
BOARD OF DIRECTORS MEMBER1.00X000
SUSAN KEARNS
BOARD OF DIRECTORS MEMBER1.00X000
PRAMILA VIVEK
BOARD OF DIRECTORS MEMBER1.00X000
ANTHONY RUFO
BOARD OF DIRECTORS MEMBER1.00X000
MEL SCOVELL
BOARD OF DIRECTORS MEMBER1.00X000
AMIT SONI
BOARD OF DIRECTORS MEMBER1.00X000
GISSELLE COLLINS
BOARD OF DIRECTORS MEMBER1.00X000
AMY ATWOOD
BOARD OF DIRECTORS MEMBER1.00X000
ELIZABETH BROWNE
EXECUTIVE DIRECTOR40.00133763014691X
JAMES SOUZA
CHIEF FINANCIAL OFFICER40.00118934013087X
KAMAU KARANJA
MEDICAL DIRECTOR40.0018162801584X
GLENN DIAZ
PHYSICIAN40.0016782705995X
NICOLE BADIE
PHYSICIAN40.0012119206751X
STEPHENSON TOBIERRE
PHYSICIAN40.00128098020022X
MARIA BOLIVAR
PHARMACIST40.0012393006044X
JULIA DEJOSEPH
PHYSICIAN40.0010086504554X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1076237TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation72728TotalOtherCompensation
Number Individuals GT100 K8NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (3 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
ISGENUITY LLC
321 SUMMER STREETBOSTONMA02210ARCHITECTURAL SERVICES530804
QUALITY SYSTEMS INC
18111 VON KARMAN AVE SUITE 700IRVINECA92612IS SUPPORT146860
NEW ENGLAND EYE INSTITUTE
940 COMMONWEALTH AVEBOSTONMA02115OPTOMETRIST112029
FieldValueIRS element (for citing)
Number Of Contractors GT100 K3NumberOfContractorsGT100K
Government Grants3198925GovernmentGrants
All Other Contributions558110AllOtherContributions
Total Contributions3757035TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
PATIENT SERVICE REVENUE62410056368895636889
MEDICARE/MEDICAID90009930439853043985
FieldValueIRS element (for citing)
Total Program Service Revenue8680874TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column16602TotalRevenueColumn
Exclusion$16,602ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities409937Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities405677Securities
Other9562Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities4260Securities
Other-9562Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-5302TotalRevenueColumn
Exclusion-$5,302ExclusionAmount

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionMISCELLANEOUS INCOMEDescription
Business Code900001BusinessCode
Total Revenue Column1187TotalRevenueColumn
Related Or Exempt Function Income1187RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue1187TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column12450396TotalRevenueColumn
Related Or Exempt Function Income8682061RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$11,300ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total30000Total
Program Services30000ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total476800Total
Program Services190708ProgramServices
Management And General286092ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total7000603Total
Program Services6387626ProgramServices
Management And General492656ManagementAndGeneral
Fundraising120321Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total140995Total
Program Services121743ProgramServices
Management And General16783ManagementAndGeneral
Fundraising2469Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total652502Total
Program Services599895ProgramServices
Management And General41257ManagementAndGeneral
Fundraising11350Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total546059Total
Program Services481574ProgramServices
Management And General55717ManagementAndGeneral
Fundraising8768Fundraising

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total21926Total
Management And General21926ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total50645Total
Management And General50645ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total532931Total
Program Services496837ProgramServices
Management And General28324ManagementAndGeneral
Fundraising7770Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total1123551Total
Program Services1058232ProgramServices
Management And General64880ManagementAndGeneral
Fundraising439Fundraising

Occupancy Occupancy

FieldValueIRS element (for citing)
Total815122Total
Program Services683092ProgramServices
Management And General132030ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total19853Total
Program Services13950ProgramServices
Management And General4226ManagementAndGeneral
Fundraising1677Fundraising

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total342860Total
Program Services278031ProgramServices
Management And General64829ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total34689Total
Management And General34689ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
BAD DEBT110943110943
MISCELLANEOUS367519320206476784
TEMPORARY HELP30100246065494
NON OPERATING EXPENSES-2418724187

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total11990517Total
Program Services10486557ProgramServices
Management And General1344382ManagementAndGeneral
Fundraising159578Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY15084BOY
EOY25264EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY4915145BOY
EOY4637374EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY356866BOY
EOY397532EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY956563BOY
EOY1186767EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY82022BOY
EOY90586EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis4117663LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec3396959LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY949273BOY
EOY720704EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY641343BOY
EOY724400EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
BOY6133BOY
EOY3302EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY519623BOY
EOY1377307EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY8442052BOY
EOY9163236EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY1194645BOY
EOY1479973EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY148154BOY
EOY82060EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY1342799BOY
EOY1562033EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY6004819BOY
EOY6533323EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY546458BOY
EOY519904EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY547976BOY
EOY547976EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY7099253BOY
EOY7601203EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY8442052BOY
EOY9163236EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses459879ReconcilationRevenueExpenses
Reconciliation Unrealized Invest42071ReconciliationUnrealizedInvest
Reconcilation Other Changes0ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement ConsolidatedXFinancialStatementConsolidated
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required1FederalGrantAuditRequired
Federal Grant Audit Performed1FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Hospital170b1 AiiiXHospital170b1Aiii

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management1PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members1MailingsMembers
Mailings Members$47MailingsMembersAmount
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators1DirectContactLegislators
Direct Contact Legislators$1,977DirectContactLegislatorsAmount
Rallies Demonstrations1RalliesDemonstrations
Rallies Demonstrations$2,007RalliesDemonstrationsAmount
Other Activities0OtherActivities
Total Lobbying Expenditures IIB4031TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Schedule D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance709276BeginningOfYearBalance
Investment Earnings Or Losses40343InvestmentEarningsOrLosses
End Of Year Balance749619EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance692376BeginningOfYearBalance
Investment Earnings Or Losses16900InvestmentEarningsOrLosses
End Of Year Balance709276EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance640002BeginningOfYearBalance
Investment Earnings Or Losses52374InvestmentEarningsOrLosses
End Of Year Balance692376EndOfYearBalance

Current Year Minus3 Years CurrentYearMinus3Years

FieldValueIRS element (for citing)
Beginning Of Year Balance601453BeginningOfYearBalance
Investment Earnings Or Losses38549InvestmentEarningsOrLosses
End Of Year Balance640002EndOfYearBalance

Current Year Minus4 Years CurrentYearMinus4Years

FieldValueIRS element (for citing)
Beginning Of Year Balance575586BeginningOfYearBalance
Contributions22558Contributions
Investment Earnings Or Losses3309InvestmentEarningsOrLosses
End Of Year Balance601453EndOfYearBalance
FieldValueIRS element (for citing)
Permanent Endowment EOY Balance0.73100PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.26900TermEndowmentEOYBalance
Endowments Held By Unrelated Orgs0EndowmentsHeldByUnrelatedOrgs
Endowments Held By Related Orgs0EndowmentsHeldByRelatedOrgs

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis2163431OtherCostOrOtherBasis
Depreciation1862889Depreciation
Book Value300542BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis1717850OtherCostOrOtherBasis
Depreciation1343439Depreciation
Book Value374411BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis236382OtherCostOrOtherBasis
Depreciation190631Depreciation
Book Value45751BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings720704TotalOfBookValueLandBuildings

Other Assets OtherAssets (2 entries)

DescriptionDescriptionBook ValueBookValue
INVESTMENT IN J.M.S. JR. INC.490218
CONSTRUCTION IN PROGRESS887089
FieldValueIRS element (for citing)
Total Book Value Other Assets1377307TotalBookValueOtherAssets
Footnote In Part XIIIXFootnoteInPartXIII

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS:PART V, LINE 4:PERMANENTLY RESTRICTED NET ASSETS CONSIST OF FUNDS THAT ARE RESTRICTED BY DONORS AGAINST ANY EXPENDITURE OF PRINCIPAL. INCOME GENERATED BY THE PERMANENTLY RESTRICTED ASSETS IS AVAILABLE FOR USE IN OPERATIONS, BUT MAY ALSO BE SUBJECT TO TEMPORARY RESTRICTIONS. ALL INCOME IS RECORDED AS EITHER UNRESTRICTED OR TEMPORARILY RESTRICTED NET ASSETS BASED UPON THE EXISTENCE OR LACK OF DONOR RESTRICTIONS.
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X, LINE 2:THE HEALTH CENTER FOLLOWS THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES STANDARD UNDER U.S. GAAP WHICH REQUIRES THE HEALTH CENTER TO REPORT UNCERTAIN TAX POSITIONS, RELATED INTEREST AND PENALTIES, AND TO ADJUST ITS ASSETS AND LIABILITIES RELATED TO UNRECOGNIZED TAX BENEFITS AND ACCRUED INTEREST AND PENALTIES ACCORDINGLY. AS OF JUNE 30, 2013, THE HEALTH CENTER DETERMINED THAT THERE ARE NO MATERIAL UNRECOGNIZED TAX BENEFITS TO REPORT. INFORMATIONAL RETURNS FILED FOR THE YEARS ENDED JUNE 30, 2012, 2011 AND 2010 REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE AND THE COMMONWEALTH OF MASSACHUSETTS. THE HEALTH CENTER DOES NOT EXPECT THAT THE AMOUNTS OF UNRECOGNIZED TAX BENEFITS WILL CHANGE SIGNIFICANTLY WITHIN THE NEXT TWELVE MONTHS.

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records Maintained1RecordsMaintained

Recipient Table RecipientTable

Recipient Name Business RecipientNameBusiness

FieldValueIRS element (for citing)
Business Name Line1BOSTON PUBLIC SCHOOLSBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line126 COURT STREETAddressLine1
CityBOSTONCity
StateMAState
ZIP Code02108ZIPCode
FieldValueIRS element (for citing)
EIN Of Recipient046001138EINOfRecipient
IRC SectionN/AIRCSection
Amount Of Cash Grant30000AmountOfCashGrant
Purpose Of GrantSCHOOL BASED GRANTPurposeOfGrant
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants1TotalNbrOf501C3AndGovtGrants

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierPROCEDURE FOR MONITORING GRANTS IN THE U.S.:Identifier
Return ReferencePART I, LINE 2:ReturnReference
ExplanationSCHEDULE I, PART I, LINE 2: GRANTS PROVIDED TO NON-PROFIT/CHARITABLE ORGANIZATIONS ARE DOCUMENTED AND GOVERNED BY WRITTEN CONTRACTUAL AGREEMENTS AND NOTICES OF GRANT AWARDS SUBJECT TO THE APPROVAL OF THE OFFICERS OF THE JOSEPH M SMITH COMMUNITY HEALTH CENTER, INC. ALL GRANT PROCEEDS AND DISBURSEMENTS ARE RECORDED AND TRACKED WITHIN THE HEALTH CENTER'S ACCOUNTING SYSTEMS AND RECORDS IN ORDER TO ASSESS AND DOCUMENT COMPLIANCE WITH GRANTOR RESTRICTIONS, TERMS, AND CONDITIONS.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Form990 Of Other OrganizationsXForm990OfOtherOrganizations
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments1AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (2 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
KAMAU KARANJA
MEDICAL DIRECTOR180378012500000015840183212000
GLENN DIAZ
PHYSICIAN167827000000059950173822000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
Return ReferencePART I, LINE 7ReturnReference
ExplanationKAMAU KARANJA RECEIVED $1,250 AND STEPHENSON TOBIERRE RECEIVED $345 OF INCENTIVE PAY FOR EXCEEDING THE TARGETED NUMBER OF VISITS.Explanation

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

Return ReferenceReturnReferenceExplanationExplanation
FORM 990, PART VI, SECTION B, LINE 11THE 990 IS REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION B, LINE 12CJOSEPH M SMITH COMMUNITY HEALTH CENTER CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY BY REQUIRING SENIOR MANAGEMENT AND BOARD MEMBERS TO SIGN ANNUALLY A CONFLICT OF INTEREST FORM ACKNOWLEDGING THAT THEY HAVE RECEIVED AND UNDERSTAND THE POLICY.
FORM 990, PART VI, SECTION B, LINE 15THE PROCESS FOR DETERMINING COMPENSATION FOR THE HEALTH CENTERS TOP MANAGEMENT OFFICIALS AND KEY EMPLOYEES IS BASED ON A DOCUMENTED EVALUATION PROCESS AND THE REVIEW OF AN INDEPENDENT COMPENSATION SURVEY OF OTHER MASSACHUSETTS COMMUNITY HEALTH CENTERS.
FORM 990, PART VI, SECTION C, LINE 19THE HEALTH CENTER'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART XII, LINE 2C: JOSEPH M. SMITH COMMUNITY HEALTH CENTER UTILIZES THEIR FINANCE COMMITTEE TO OVERSEE THE AUDIT AND SELECT THE INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED SINCE THE PRIOR YEAR.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1JMS JR INCBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1287 WESTERN AVENUEAddressLine1
CityALLSTONCity
StateMAState
ZIP Code02134ZIPCode
FieldValueIRS element (for citing)
EIN040519984EIN
Primary ActivitiesRELATED THROUGH COMMON BOARD OF DIRECTORSPrimaryActivities
Legal Domicile StateMALegalDomicileState
Exempt Code Section501(C)(3)ExemptCodeSection
Public Charity Status170(B)(1)(A)(III)PublicCharityStatus
Direct Controlling Entity NAN/ADirectControllingEntityNA
Controlled Org0ControlledOrg
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org1OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg

Transactions Related Orgs Table TransactionsRelatedOrgsTable

Name Of Other Organization NameOfOtherOrganization

FieldValueIRS element (for citing)
Business Name Line1JMS JR INCBusinessNameLine1
FieldValueIRS element (for citing)
Transaction TypeRTransactionType
Amount Involved490218AmountInvolved
Method Of Amt DeterminationAMOUNT OF INVESTMENT IN AFFILIATEMethodOfAmtDetermination