MILWAUKEE HEALTH SERVICES INC: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- MILWAUKEE HEALTH SERVICES INC (EIN 39-1664109)
- Tax period
- 2013-02-01 to 2014-01-31
- Filed
- 2014-12-15
- IRS object ID
- 201423499349300612
- Schema version
- 2013v3.0
- 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) |
|---|---|---|
| Return | 2014-12-15T09:53:53-06:00 | ReturnTs |
| Tax Period End | 2014-01-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 390758449 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WIPFLI LLP | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10000 INNOVATION DRIVE SUITE 250 | AddressLine1 |
| City | MILWAUKEE | City |
| State | WI | State |
| ZIP Code | 532264837 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-02-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 391664109 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MILWAUKEE HEALTH SERVICES INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MILW | BusinessNameControlTxt |
| Phone | 4143728080 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2555 N MARTIN LUTHER KING DRIVE | AddressLine1 |
| City | MILWAUKEE | City |
| State | WI | State |
| ZIP Code | 53212 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TITO IZARD MD | PersonNm |
| Person Title | PRESIDENT & CEO | PersonTitleTxt |
| Phone | 4143728080 | PhoneNum |
| Signature | 2014-12-12 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DAVE GLOBIG | PreparerPersonNm |
| PTIN | P01356041 | PTIN |
| Phone | 4144319300 | PhoneNum |
| Preparation | 2014-12-12 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | TITO IZARD MD | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2555 N MARTIN LUTHER KING DRIVE | AddressLine1 |
| City | MILWAUKEE | City |
| State | WI | State |
| ZIP Code | 53212 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $17,538,440 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.MHSI.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1989 | FormationYr |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE MEDICAL AND DENTAL PRIMARY CARE SERVICES TO A MEDICALLY UNDERSERVED POPULATION. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 276 | TotalEmployeeCnt |
| Total Volunteers | 10 | TotalVolunteersCnt |
| Total Gross UBI | $19,400 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $16,150 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $4,760,329 | PYContributionsGrantsAmt |
| CY Contributions Grants | $4,736,197 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $15,458,793 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $12,607,826 | CYProgramServiceRevenueAmt |
| PY Investment Income | $30,867 | PYInvestmentIncomeAmt |
| CY Investment Income | $31,494 | CYInvestmentIncomeAmt |
| PY Other Revenue | $680,653 | PYOtherRevenueAmt |
| CY Other Revenue | $76,603 | CYOtherRevenueAmt |
| PY Total Revenue | $20,930,642 | PYTotalRevenueAmt |
| CY Total Revenue | $17,452,120 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $16,648,586 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $14,689,253 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $6,233,647 | PYOtherExpensesAmt |
| CY Other Expenses | $5,859,506 | CYOtherExpensesAmt |
| PY Total Expenses | $22,882,233 | PYTotalExpensesAmt |
| CY Total Expenses | $20,548,759 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$1,951,591 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$3,096,639 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $17,499,427 | TotalAssetsBOYAmt |
| Total Assets EOY | $15,339,189 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $9,996,853 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $10,944,565 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $7,502,574 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $4,394,624 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO PROVIDE ACCESSIBLE, QUALITY PRIMARY AND RELATED HEALTH CARE SERVICES TO MILWAUKEE RESIDENTS, WITH OUR CONTINUING EMPHASIS ON MEDICALLY-UNDERSERVED FAMILIES AND INDIVIDUALS. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $16,522,991 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $12,665,029 | RevenueAmt |
| Desc | TO PROVIDE MEDICAL AND DENTAL PRIMARY CARE SERVICES TO A MEDICALLY UNDERSERVED POPULATION. 26,000 PATIENTS WERE SERVED DURING THE YEAR | Desc |
| Total Program Service Expenses | $16,522,991 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 38 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 276 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | WI | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DONNA WOLAK | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 4143728080 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2555 N MARTIN LUTHER KING DRIVE | AddressLine1 |
| City | MILWAUKEE | City |
| State | WI | State |
| ZIP Code | 53212 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| DR RICHARD EVANS | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| BETTY RUSS-BANKS TERM END 12314 | |||||||
| PRIOR TREASURER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| GINA GREEN-HARRIS | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| EMERY HARLAN | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| CURTISS HARRIS | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| PAULA LUCEY | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| CASSANDRA MCSHEPARD | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| SENATOR SPENCER COGGS | |||||||
| CHAIRPERSON | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| THOMAS TERRY | |||||||
| VICE CHAIR | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| KAREN BAKER | |||||||
| SECRETARY | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| AUDREY SELLERS | |||||||
| INTERIM TREASURER | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| DR TITO IZARD | |||||||
| PRESIDENT & CEO | 40.00 | $268,078 | $0 | $6,309 | Yes (X) | ||
| DR JANICE A LITZA | |||||||
| CHIEF MEDICAL OFFICER | 40.00 | $185,979 | $0 | $6,329 | Yes (X) | ||
| CLOVER BARNES | |||||||
| CHIEF OPERATIONS OFFICER | 40.00 | $91,094 | $0 | $6,598 | Yes (X) | ||
| DONNA WOLAK | |||||||
| CHIEF FINANCE OFFICER | 40.00 | $53,157 | $0 | $1,636 | Yes (X) | ||
| LAKESHA LAWRENCE | |||||||
| PHYSICIAN | 40.00 | $192,654 | $0 | $8,151 | Yes (X) | ||
| ILVA VAN VALKENBURGH | |||||||
| PHYSICIAN | 40.00 | $175,110 | $0 | $0 | Yes (X) | ||
| ENID OKONKON | |||||||
| PHYSICIAN | 40.00 | $144,734 | $0 | $5,294 | Yes (X) | ||
| JASON FOIL | |||||||
| PHYSICIAN | 40.00 | $168,114 | $0 | $2,624 | Yes (X) | ||
| CHRISTOPHER WITHERS | |||||||
| PHYSICIAN | 40.00 | $142,676 | $0 | $10,434 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,421,596 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $47,375 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 7 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| WHYTE HIRSCHBOECK DUDEK SC | |||||
| 555 WELLS ST | MILWAUKEE | WI | 53202 | LEGAL SERVICES | $264,012 |
| JENNIFER KING MD | |||||
| N52W21717 TAYLORS WOODS DRIVE | MENOMONEE FALLS | WI | 53051 | PHYSICIAN-BEHAVIORAL HEALTH | $192,075 |
| GRANT THORTON LLP | |||||
| 175 W JACKSOIN ST | CHICAGO | IL | 60604 | CONSULTANTS | $160,000 |
| ABM JANITORIAL SERVICES LLC | |||||
| 411 E WISCONSIN AVE STE L115 | MILWAUKEE | WI | 53202 | JANITORIAL | $147,760 |
| PLANTINUM SECURITY | |||||
| 544 E OGDEN STE 700 | MILWAUKEE | WI | 53202 | SECURITY | $147,428 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $4,511,513 | GovernmentGrantsAmt |
| All Other Contributions | $224,684 | AllOtherContributionsAmt |
| Total Contributions | $4,736,197 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| MEDICARE MEDICADE PAYMENTS | 624100 | $11,541,473 | $11,541,473 |
| OTHER THIRD PARTY | 624100 | $470,242 | $470,242 |
| CONTRACT SERVICES AND OTHER GRANT | 624100 | $455,936 | $455,936 |
| SELF PAY | 624100 | $140,175 | $140,175 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $12,607,826 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $7,014 | TotalRevenueColumnAmt |
| Exclusion | $7,014 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $19,400 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $19,400 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $19,400 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $19,400 | UnrelatedBusinessRevenueAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $110,800 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $86,320 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $24,480 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $24,480 | TotalRevenueColumnAmt |
| Exclusion | $24,480 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MEDICAL RECORDS | Desc |
| Business | 624100 | BusinessCd |
| Total Revenue Column | $57,203 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $57,203 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $57,203 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $17,452,120 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $12,665,029 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $19,400 | UnrelatedBusinessRevenueAmt |
| Exclusion | $31,494 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $619,180 | TotalAmt |
| Program Services | $515,355 | ProgramServicesAmt |
| Management And General | $103,825 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,468,924 | TotalAmt |
| Program Services | $9,545,793 | ProgramServicesAmt |
| Management And General | $1,923,131 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,732,825 | TotalAmt |
| Program Services | $1,562,041 | ProgramServicesAmt |
| Management And General | $170,784 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $868,324 | TotalAmt |
| Program Services | $782,744 | ProgramServicesAmt |
| Management And General | $85,580 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $412,038 | TotalAmt |
| Management And General | $412,038 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $32,148 | TotalAmt |
| Management And General | $32,148 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $891,664 | TotalAmt |
| Program Services | $523,289 | ProgramServicesAmt |
| Management And General | $368,375 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $282,257 | TotalAmt |
| Program Services | $201,224 | ProgramServicesAmt |
| Management And General | $81,033 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,338,056 | TotalAmt |
| Program Services | $1,161,059 | ProgramServicesAmt |
| Management And General | $176,997 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,723 | TotalAmt |
| Program Services | $24,012 | ProgramServicesAmt |
| Management And General | $9,711 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $254,186 | TotalAmt |
| Program Services | $254,186 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,185,722 | TotalAmt |
| Program Services | $806,291 | ProgramServicesAmt |
| Management And General | $379,431 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $135,487 | TotalAmt |
| Management And General | $135,487 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| PHARMACEUTICALS | $435,160 | $435,160 | |
| LABORATORY FEES | $351,547 | $351,547 | |
| MEDICAL SUPPLIES | $188,355 | $188,355 | |
| HEALTH PROMOTIONS | $64,293 | $43,426 | $20,867 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $254,870 | TotalAmt |
| Program Services | $128,509 | ProgramServicesAmt |
| Management And General | $126,361 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,548,759 | TotalAmt |
| Program Services | $16,522,991 | ProgramServicesAmt |
| Management And General | $4,025,768 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,934,482 | BOYAmt |
| EOY | $182,937 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $317,549 | BOYAmt |
| EOY | $52,977 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $458,129 | BOYAmt |
| EOY | $514,503 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,741,795 | BOYAmt |
| EOY | $2,178,006 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $126,632 | BOYAmt |
| EOY | $110,091 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $121,925 | BOYAmt |
| EOY | $50,178 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $19,744,102 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $7,493,605 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,758,570 | BOYAmt |
| EOY | $12,250,497 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $86,320 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $954,025 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,499,427 | BOYAmt |
| EOY | $15,339,189 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,696,041 | BOYAmt |
| EOY | $3,579,961 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $875 | BOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,299,937 | BOYAmt |
| EOY | $7,364,604 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,996,853 | BOYAmt |
| EOY | $10,944,565 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,057,436 | BOYAmt |
| EOY | $3,960,800 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $445,138 | BOYAmt |
| EOY | $433,824 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,502,574 | BOYAmt |
| EOY | $4,394,624 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,499,427 | BOYAmt |
| EOY | $15,339,189 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$3,096,639 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$11,311 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| 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) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $599,599 | OtherCostOrOtherBasisAmt |
| Book Value | $599,599 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $13,393,550 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,877,298 | DepreciationAmt |
| Book Value | $9,516,252 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $416,893 | OtherCostOrOtherBasisAmt |
| Depreciation | $416,893 | DepreciationAmt |
| Book Value | $0 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,094,575 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,033,651 | DepreciationAmt |
| Book Value | $2,060,924 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $239,485 | OtherCostOrOtherBasisAmt |
| Depreciation | $165,763 | DepreciationAmt |
| Book Value | $73,722 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $12,250,497 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $17,452,120 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $17,452,120 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $17,452,120 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $20,548,759 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $20,548,759 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $20,548,759 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | IN ORDER TO ACCOUNT FOR ANY UNCERTAIN TAX POSITIONS, THE ORGANIZATION DETERMINES WHETHER IT IS MORE LIKELY THAN NOT THAT A TAX POSITION WILL BE SUSTAINED UPON EXAMINATION ON THE TECHNICAL MERITS OF THE POSITION, ASSUMING THE TAXING AUTHORITY HAS FULL KNOWLEDGE OF ALL INFORMATION. IF THE TAX POSITION DOES NOT MEET THE MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD, THE BENEFIT OF THAT POSITION IS NOT RECOGNIZED IN THE FINANCIAL STATEMENTS. THE ORGANIZATION HAS RECORDED NO ASSETS OR LIABILITIES RELATED TO UNCERTAIN TAX POSITIONS. TAX RETURNS FOR THE YEAR ENDED JANUARY 31, 2011 AND ALL SUBSEQUENT YEARS REMAIN SUBJECT TO EXAMINATION BY THE APPLICABLE TAXING AUTHORITIES. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DR TITO IZARD | ||||||||||||||
| PRESIDENT & CEO | $268,078 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $6,309 | $0 | $274,387 | $0 | $0 | $0 |
| DR JANICE A LITZA | ||||||||||||||
| CHIEF MEDICAL OFFICER | $185,979 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $6,329 | $0 | $192,308 | $0 | $0 | $0 |
| LAKESHA LAWRENCE | ||||||||||||||
| PHYSICIAN | $187,700 | $0 | $4,954 | $0 | $0 | $0 | $0 | $0 | $8,151 | $0 | $200,805 | $0 | $0 | $0 |
| ILVA VAN VALKENBURGH | ||||||||||||||
| PHYSICIAN | $175,110 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $175,110 | $0 | $0 | $0 |
| ENID OKONKON | ||||||||||||||
| PHYSICIAN | $139,859 | $0 | $4,875 | $0 | $0 | $0 | $0 | $0 | $5,294 | $0 | $150,028 | $0 | $0 | $0 |
| JASON FOIL | ||||||||||||||
| PHYSICIAN | $168,114 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $2,624 | $0 | $170,738 | $0 | $0 | $0 |
| CHRISTOPHER WITHERS | ||||||||||||||
| PHYSICIAN | $140,777 | $0 | $1,899 | $0 | $0 | $0 | $0 | $0 | $10,434 | $0 | $153,110 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 7 | FormAndLineReferenceDesc |
| Explanation | INCENTIVES ARE ACCRUED FOR PROVIDERS BASED UPON PRODUCTION. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | THE FORM 990 IS REVIEWED BY THE COMPTROLLER, CHIEF FINANCIAL OFFICER, AND PRESIDENT/CEO OF THE ORGANIZATION. AFTER SATISFACTORY REVIEW, IT IS PRESENTED TO THE FINANCE COMMITTEE FOR REVIEW. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION REQUIRES THAT ALL EMPLOYEES AND BOARD MEMBERS DISCLOSE IN WRITING AND UPDATE AT LEAST ANNUALLY, ALL BUSINESS AND IMMEDIATE FAMILY RELATIONSHIPS WHICH MIGHT POTENTIALLY CREATE A CONFLICT OF INTEREST. IN ADDITION, EMPLOYEES MUST DISCLOSE TO THE PRESIDENT/CEO, AND PRESIDENT/CEO MUST DISCLOSE TO THE BOARD CHAIRPERSON, IN WRITING THE SPECIFICS OF ANY PLAN TO ACCEPT OUTSIDE EMPLOYMENT SO THAT OUTSIDE EMPLOYMENT MAY BE DETERMINED IF POTENTIAL CONFLICT EXISTS. |
| FORM 990, PART VI, SECTION B, LINE 15A | THE BOARD OF DIRECTORS INTERVIEWS, HIRES, AND NEGOTIATES THE SALARY OF THE CEO. |
| FORM 990, PART VI, SECTION C, LINE 19 | FORM 990 IS MADE AVAILABLE UPON REQUEST. |
| FORM 990, PART XI, LINE 9: | OTHER CHANGE IN NET ASSETS -11,311. |
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