FAIR HAVEN COMMUNITY HEALTH CLINIC INC: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- FAIR HAVEN COMMUNITY HEALTH CLINIC INC (EIN 06-0883545)
- Tax period
- 2012-07-01 to 2013-06-30
- Filed
- 2014-05-12
- IRS object ID
- 201421329349302387
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2014-05-12T13:03:45-05:00 | Timestamp |
| Tax Period End Date | 2013-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 061354191 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | VISCONTI & ASSOCIATES PC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 41 MIDDLETOWN AVENUE | AddressLine1 |
| City | NORTH HAVEN | City |
| State | CT | State |
| ZIP Code | 064733926 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 060883545 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FAIR HAVEN COMMUNITY HEALTH CLINIC INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | FAIR | NameControl |
| Phone | 2037777411 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 374 GRAND AVENUE | AddressLine1 |
| City | NEW HAVEN | City |
| State | CT | State |
| ZIP Code | 06513 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | SUZANNE LAGARDE | Name |
| Title | CHIEF EXECUTIVE OFFICER | Title |
| Phone | 2037777411 | Phone |
| Date Signed | 2014-05-12 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JOHN J VISCONTI | Name |
| PTIN | P00027180 | PTIN |
| Phone | 2038652927 | Phone |
| Date Prepared | 2014-05-12 | 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 | SUZANNE LAGARDE MD | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 374 GRAND AVENUE | AddressLine1 |
| City | NEW HAVEN | City |
| State | CT | State |
| ZIP Code | 06513 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 14628897 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | FHCHC.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1971 | YearFormation |
| State Legal Domicile | CT | StateLegalDomicile |
| Activity Or Mission Description | TO PROVIDE HEALTH SERVICES TO THE MEDICALLY UNDERSERVED IN THE NEW HAVEN AREA. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 11 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 11 | NbrIndependentVotingMembers |
| Total Nbr Employees | 246 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 8161631 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 8672941 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 7331836 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 5954712 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 1255 | InvestmentIncomePriorYear |
| Investment Income Current Year | 1244 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 0 | OtherRevenuePriorYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 15494722 | TotalRevenuePriorYear |
| Total Revenue Current Year | 14628897 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 9610720 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 10423221 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 17589 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 4897006 | OtherExpensePriorYear |
| Other Expenses Current Year | 4768338 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 14507726 | TotalExpensesPriorYear |
| Total Expenses Current Year | 15191559 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 986996 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -562662 | RevenuesLessExpensesCY |
| Total Assets BOY | 7871045 | TotalAssetsBOY |
| Total Assets EOY | 7054440 | TotalAssetsEOY |
| Total Liabilities BOY | 4249387 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 3995444 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 3621658 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 3058996 | NetAssetsOrFundBalancesEOY |
| Mission Description | TO PROVIDE HEALTH SERVICES TO THE MEDICALLY UNDERSERVED IN THE NEW HAVEN AREA. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 10742516 | Expense |
| Revenue | 5954712 | Revenue |
| Description | THE GENERAL CLINIC SERVED APPROXIMATELY 15,000 PATIENTS AND HANDLED APPROXIMATELY 72,300 PATIENT VISITS FOR THE FISCAL YEAR ENDED JUNE 30, 2012. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 1061234 | Expense |
| Description | WIC PROGRAM PROVIDES NUTRITION EDUCATION AND FOOD BENEFITS FOR PREGNANT AND LACTATING WOMEN, INFANTS, AND CHILDREN UNDER THE AGE OF FIVE. APPROXIMATELY 2,500 PEOPLE BENEFIT FROM THIS PROGRAM. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 11803750 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 1 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 0 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 5 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 246 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 11 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 11 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 1 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Other Website | X | OtherWebsite |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SUZANNE LAGARDE MD EXECUTIVE DIRECTOR | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 2037777411 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 374 GRAND AVENUE | AddressLine1 |
| City | NEW HAVEN | City |
| State | CT | State |
| ZIP Code | 06513 | 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 | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| WILLIAM MORICO | ||||||||
| BOARD OF DIRECTORS MEMBER | 1.00 | X | 0 | 0 | 0 | |||
| GEORGINA LUCAS | ||||||||
| BOARD OF DIRECTORS MEMBER | 1.00 | X | 0 | 0 | 0 | |||
| NITZA DIAZ | ||||||||
| PRESIDENT | 1.00 | X | 0 | 0 | 0 | X | ||
| MAGDA ANA NATAL | ||||||||
| SECRETARY | 1.00 | X | 0 | 0 | 0 | X | ||
| JOE RODRIGUEZ | ||||||||
| BOARD OF DIRECTORS MEMBER | 1.00 | X | 0 | 0 | 0 | |||
| DORETTA BOWMAN | ||||||||
| BOARD OF DIRECTORS MEMBER | 1.00 | X | 0 | 0 | 0 | |||
| ENRIQUE JUNCADELLA | ||||||||
| BOARD OF DIRECTORS MEMBER | 1.00 | X | 0 | 0 | 0 | |||
| THOMAS THETFORD | ||||||||
| VICE PRESIDENT | 1.00 | X | 0 | 0 | 0 | X | ||
| TOM CANDRICK | ||||||||
| TREASURER | 1.00 | X | 0 | 0 | 0 | X | ||
| ELIZABETH CRUZ | ||||||||
| BOARD OF DIRECTORS MEMBER | 1.00 | X | 0 | 0 | 0 | |||
| DARCEY COBBS-LOMAX | ||||||||
| BOARD OF DIRECTORS MEMBER | 1.00 | X | 0 | 0 | 0 | |||
| LAURIE BRIDGER | ||||||||
| MEDICAL DIRECTOR | 35.00 | 163114 | 0 | 0 | X | |||
| LAUREL SHADER | ||||||||
| PHYSICIAN | 35.00 | 133434 | 0 | 0 | X | |||
| SHARON ANDERSON | ||||||||
| PHYSICIAN | 35.00 | 132595 | 0 | 0 | X | |||
| ELIZABETH MAGENHEIMER | ||||||||
| NURSE PRACTITIONER | 35.00 | 130122 | 0 | 0 | X | |||
| JAMES EDWARD SEELY | ||||||||
| PHYSICIAN | 35.00 | 126947 | 0 | 0 | X | |||
| ANNE CAMP | ||||||||
| PHYSICIAN | 35.00 | 125798 | 0 | 0 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 812010 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 0 | TotalOtherCompensation |
| Number Individuals GT100 K | 9 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (3 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| BURCHMAN TERRIO GEBHARDT & QUIST LLC | |||||
| 80 BROAD STREET 15TH FL | NEW YORK | NY | 10004 | MEDICAL BILLING | 307811 |
| A TO Z PROPERTY PRESERVATION INC | |||||
| PO BOX 1882 | WALLINGFORD | CT | 06492 | CLEANING SERVICES | 125783 |
| LEADERS FOR TODAY LLC | |||||
| 50 RESNICK ROAD | PLYMOUTH | MA | 02360 | BUSINESS CONSULTANTS | 113983 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 3 | NumberOfContractorsGT100K |
| Government Grants | 7785430 | GovernmentGrants |
| All Other Contributions | 887511 | AllOtherContributions |
| Noncash Contributions | 1858894 | NoncashContributions |
| Total Contributions | 8672941 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | PATIENT GENERATED FEES | Description |
| Business Code | 621400 | BusinessCode |
| Total Revenue Column | 5954712 | TotalRevenueColumn |
| Related Or Exempt Function Income | 5954712 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 5954712 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1244 | TotalRevenueColumn |
| Exclusion | $1,244 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 14628897 | TotalRevenueColumn |
| Related Or Exempt Function Income | 5954712 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $1,244 | ExclusionAmount |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8652922 | Total |
| Program Services | 6700016 | ProgramServices |
| Management And General | 1938562 | ManagementAndGeneral |
| Fundraising | 14344 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 988352 | Total |
| Program Services | 765288 | ProgramServices |
| Management And General | 221426 | ManagementAndGeneral |
| Fundraising | 1638 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 781947 | Total |
| Program Services | 599381 | ProgramServices |
| Management And General | 181225 | ManagementAndGeneral |
| Fundraising | 1341 | Fundraising |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 414179 | Total |
| Program Services | 321234 | ProgramServices |
| Management And General | 92945 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12103 | Total |
| Program Services | 9387 | ProgramServices |
| Management And General | 2716 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9745 | Total |
| Program Services | 7558 | ProgramServices |
| Management And General | 2187 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 52520 | Total |
| Program Services | 47668 | ProgramServices |
| Management And General | 4852 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 304255 | Total |
| Program Services | 235978 | ProgramServices |
| Management And General | 68277 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 32531 | Total |
| Program Services | 25231 | ProgramServices |
| Management And General | 7300 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| WIC FOOD BENEFITS | 1061234 | 1061234 | |
| VACCINES | 797660 | 797660 | |
| CONSULTANTS | 660790 | 32025 | 628765 |
| PROVISION FOR BAD DEBTS | 466841 | 466841 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 956480 | Total |
| Program Services | 734249 | ProgramServices |
| Management And General | 221965 | ManagementAndGeneral |
| Fundraising | 266 | Fundraising |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 15191559 | Total |
| Program Services | 11803750 | ProgramServices |
| Management And General | 3370220 | ManagementAndGeneral |
| Fundraising | 17589 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 986081 | BOY |
| EOY | 265854 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 630098 | BOY |
| EOY | 682082 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1041368 | BOY |
| EOY | 882709 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 74627 | BOY |
| EOY | 117346 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 7750041 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 2754333 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4917400 | BOY |
| EOY | 4995708 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 83333 | BOY |
| EOY | 83333 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 138138 | BOY |
| EOY | 27408 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7871045 | BOY |
| EOY | 7054440 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1386937 | BOY |
| EOY | 1733578 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1762034 | BOY |
| EOY | 1936221 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1100416 | BOY |
| EOY | 325645 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4249387 | BOY |
| EOY | 3995444 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3621658 | BOY |
| EOY | 3058996 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3621658 | BOY |
| EOY | 3058996 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7871045 | BOY |
| EOY | 7054440 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | -562662 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Separate | X | FinancialStatementSeparate |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 1 | FederalGrantAuditRequired |
| Federal Grant Audit Performed | 1 | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | X | PubliclySupportedOrg509a2 |
Gifts Grants Contrib Received509 GiftsGrantsContribReceived509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 7091651 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 7956359 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 7643151 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 8161631 | CurrentTaxYearMinus1Year |
| Current Tax Year | 8672941 | CurrentTaxYear |
| Total | 39525733 | Total |
Gross Receipts From Admissions GrossReceiptsFromAdmissions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 5728944 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 5371473 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 6095563 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 7331836 | CurrentTaxYearMinus1Year |
| Current Tax Year | 5954712 | CurrentTaxYear |
| Total | 30482528 | Total |
Total509 Total509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 12820595 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 13327832 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 13738714 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 15493467 | CurrentTaxYearMinus1Year |
| Current Tax Year | 14627653 | CurrentTaxYear |
| Total | 70008261 | Total |
Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Amts From Subst Contributors AmtsFromSubstContributors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Support From DQ Ps Etc SupportFromDQPsEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | 70008261 | PublicSupportTotal509 |
Gross Investment Income509 GrossInvestmentIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus3 Years | 4244 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus1 Year | 1255 | CurrentTaxYearMinus1Year |
| Current Tax Year | 1244 | CurrentTaxYear |
| Total | 6743 | Total |
Investment Income And UBTI InvestmentIncomeAndUBTI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus3 Years | 4244 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus1 Year | 1255 | CurrentTaxYearMinus1Year |
| Current Tax Year | 1244 | CurrentTaxYear |
| Total | 6743 | Total |
Total Support Total TotalSupportTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 12820595 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 13332076 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 13738714 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 15494722 | CurrentTaxYearMinus1Year |
| Current Tax Year | 14628897 | CurrentTaxYear |
| Total | 70015004 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Percentage509 | 0.99990 | PublicSupportPercentage509 |
| Prior Year Support Percentage | 0.99990 | PriorYearSupportPercentage |
| Investment Income Percentage | 0.00010 | InvestmentIncomePercentage |
| Prior Yr Invest Income Percentage | 0.00010 | PriorYrInvestIncomePercentage |
| Thirty Three Percnt Tests CY509 | X | ThirtyThreePercntTestsCY509 |
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 | 212000 | OtherCostOrOtherBasis |
| Book Value | 212000 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 5768347 | OtherCostOrOtherBasis |
| Depreciation | 1791319 | Depreciation |
| Book Value | 3977028 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1769694 | OtherCostOrOtherBasis |
| Depreciation | 963014 | Depreciation |
| Book Value | 806680 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 4995708 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | DEFERRED INCOME | Description |
| Amount | $325,645 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 325645 | TotalOfAmounts |
| Footnote In Part XIII | X | FootnoteInPartXIII |
| Tot Revenue Etc Audited Fincl Stmt | 14851569 | TotRevenueEtcAuditedFinclStmt |
| Donated Srvc And Use Of Facilities | 222672 | DonatedSrvcAndUseOfFacilities |
| Revenue Not Rptd F990 | 222672 | RevenueNotRptdF990 |
| Revenue Subtotal | 14628897 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 14628897 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 15414231 | TotExpensesEtcAuditedFinclStmt |
| Donated Services Use Of Facilities | 222672 | DonatedServicesUseOfFacilities |
| Expenses Not Rptd F990 | 222672 | ExpensesNotRptdF990 |
| Expenses Subtotal | 15191559 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 15191559 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | Identifier |
| Return Reference | PART X, LINE 2: | ReturnReference |
| Explanation | THE CLINIC ADOPTED ASC 740 INCOME TAXES. ASC 740 PROVIDES DETAILED GUIDANCE FOR THE FINANCIAL STATEMENT RECOGNITION, MEASUREMENT AND DISCLOSURE OF UNCERTAIN TAX POSITIONS RECOGNIZED IN AN ENTITY'S FINANCIAL STATEMENTS. INCOME TAX POSITIONS MUST MEET A MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD AT THE EFFECTIVE DATE TO BE RECOGNIZED UPON ADOPTION OF ASC 740 AND IN SUBSEQUENT PERIODS. MANAGEMENT IS NOT AWARE OF ANY UNCERTAIN TAX POSITIONS TAKEN BY THE CLINIC AS OF THAT DATE. TAX YEARS ENDED JUNE 30, 2009 THROUGH JUNE 30, 2012 REMAIN SUBJECT TO EXAMINATION BY MAJOR TAX JURISDICTIONS. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | LAURIE BRIDGER | NamePerson |
| Title | MEDICAL DIRECTOR | Title |
| Base Compensation Filing Org | 147425 | BaseCompensationFilingOrg |
| Comp Based On Related Orgs | 0 | CompBasedOnRelatedOrgs |
| Bonus Filing Org | 15689 | BonusFilingOrg |
| Bonus Related Orgs | 0 | BonusRelatedOrgs |
| Other Compensation Filing Org | 0 | OtherCompensationFilingOrg |
| Other Compensation Related Orgs | 0 | OtherCompensationRelatedOrgs |
| Deferred Comp Filing Org | 0 | DeferredCompFilingOrg |
| Deferred Comp Related Orgs | 0 | DeferredCompRelatedOrgs |
| Nontaxable Benefits Filing Org | 0 | NontaxableBenefitsFilingOrg |
| Nontaxable Benefits Related Orgs | 0 | NontaxableBenefitsRelatedOrgs |
| Total Compensation Filing Org | 163114 | TotalCompensationFilingOrg |
| Total Compensation Related Orgs | 0 | TotalCompensationRelatedOrgs |
| Comp Report Prior990 Filing Org | 0 | CompReportPrior990FilingOrg |
| Comp Report Prior990 Related Orgs | 0 | CompReportPrior990RelatedOrgs |
Schedule M IRS990ScheduleM
Other Non Cash Contributions Table OtherNonCashContributionsTable (2 entries)
| Non Cash CheckboxNonCashCheckbox | DescriptionDescription | Noncash Contribs Rptd F990NoncashContribsRptdF990 |
|---|---|---|
| X | WIC FOOD BENEFITS | 1061234 |
| X | VACCINES | 797660 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeld |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGifts |
| Third Parties Used | 0 | ThirdPartiesUsed |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (6 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | THE TAX RETURN IS REVIEWED BY MANAGEMENT AND THE BOARD OF DIRECTORS. | |
| FORM 990, PART VI, SECTION B, LINE 12C | ANY POTENTIAL CONFLICTS OF INTEREST ARE REVIEWED AND RESOLVED BY THE BOARD. | |
| FORM 990, PART VI, SECTION B, LINE 15 | THE EXECUTIVE DIRECTOR'S COMPENSATION IS REVIEWED AND APPROVED BY THE BOARD. OTHER OFFICER AND KEY EMPLOYEE COMPENSATION IS REVIEWED AND APPROVED BY THE EXECUTIVE DIRECTOR. | |
| FORM 990, PART VI, SECTION C, LINE 19 | THEY ARE MADE AVAILABLE UPON REQUEST. | |
| FORM 990, PART VII | WILLIAM MORICO - 176 BEAR PATH LANE, HAMDEN, CT 06514. GEORGINA LUCAS - 333 CEDAR STREET, NEW HAVEN, CT 06520. NITZA DIAZ - 112 PECK STREET, NEW HAVEN, CT 06513. MAGDA ANA NATAL - 195 CHURCH STREET, NEW HAVEN, CT 06510. JOE RODRIGUEZ - 221 NORTH HIGH STREET, EAST HAVEN, CT 06512. DORETTA BOWMAN - 202 CHATHAM STREET, NEW HAVEN, CT 06513. ENRIQUE JUNCADELLA - 62 CARDINAL DRIVE, GUILFORD, CT 06437. THOMAS THETFORD - 135 COLLEGE STREET, NEW HAVEN, CT 06510. TOM CANDRICK - 195 CHURCH STREET, NEW HAVEN, CT 06510. ELIZABETH CRUZ - 221 NORTH HIGH STREET, EAST HAVEN, CT 06512. | CONTACT ADDRESSES FOR OFFICERS, DIRECTORS, ETC |
| PART XI, LINE 2C EXPLANATION | THERE HAS BEEN NO CHANGE SINCE THE PRIOR YEAR. |
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