COMMUNITY HEALTH CENTER OF CENTRAL WYOMING INC: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- COMMUNITY HEALTH CENTER OF CENTRAL WYOMING INC (EIN 83-0326307)
- Tax period
- 2011-04-01 to 2012-03-31
- Filed
- 2013-02-15
- IRS object ID
- 201300469349302395
- Schema version
- 2011v1.5
- 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 | 2013-02-15T16:16:21-06:00 | Timestamp |
| Tax Period End Date | 2012-03-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BKD LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 910 E ST LOUIS 200/PO BOX 1190 | AddressLine1 |
| City | SPRINGFIELD | City |
| State | MO | State |
| ZIP Code | 658062523 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-04-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 830326307 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY HEALTH CENTER OF CENTRAL WYOMING | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of Name | % DIAHANN BARRERA | InCareOfName |
| Name Control | COMM | NameControl |
| Phone | 3072336000 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2546 EAST 2ND STREET | AddressLine1 |
| City | CASPER | City |
| State | WY | State |
| ZIP Code | 82609 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | MARTY THONE | Name |
| Title | CEO | Title |
| Date Signed | 2013-02-08 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 4178658701 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | MARTY THONE | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2546 EAST 2ND STREET STE 600 | AddressLine1 |
| City | CASPER | City |
| State | WY | State |
| ZIP Code | 82609 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 16295077 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.chccw.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1999 | YearFormation |
| State Legal Domicile | WY | StateLegalDomicile |
| Activity Or Mission Description | TO MAINTAIN A HIGH QUALITY PATIENT CARE DELIVERY SYSTEM THAT PROVIDES ACCESS TO COMPREHENSIVE HEALTH CARE SERVICES, REGARDLESS OF ABILITY TO PAY. SEE SCHEDULE O FOR ADDITIONAL INFORMATION. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 12 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 12 | NbrIndependentVotingMembers |
| Total Nbr Employees | 183 | TotalNbrEmployees |
| Total Nbr Volunteers | 13 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 1974381 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 9240080 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 8923821 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 7048848 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 21439 | InvestmentIncomePriorYear |
| Investment Income Current Year | -599383 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 0 | OtherRevenuePriorYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 10919641 | TotalRevenuePriorYear |
| Total Revenue Current Year | 15689545 | 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 | 7328856 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 6662255 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 3393514 | OtherExpensePriorYear |
| Other Expenses Current Year | 4284519 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 10722370 | TotalExpensesPriorYear |
| Total Expenses Current Year | 10946774 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 197271 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 4742771 | RevenuesLessExpensesCY |
| Total Assets BOY | 6021861 | TotalAssetsBOY |
| Total Assets EOY | 11222828 | TotalAssetsEOY |
| Total Liabilities BOY | 931314 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 1392743 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 5090547 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 9830085 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | TO PROVIDE COMPASSIONATE, AFFORDABLE AND HIGH QUALITY PATIENT CARE WITH A COMPREHENSIVE RANGE OF HEALTH CARE SERVICES FOR RESIDENTS OF CENTRAL WYOMING, REGARDLESS OF THEIR INCOME. SEE SCHEDULE O FOR ADDITIONAL INFORMATION. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 6960793 | Expense |
| Revenue | 6005384 | Revenue |
| Description | MEDICAL FACILITY - THE ORGANIZATION PROVIDES LAB, MULTIPHASIC, PHARMACY, AND MEDICAL SERVICES TO PATIENTS. APPROXIMATELY 31,088 PATIENT VISITS WERE SEEN AT THE MEDICAL FACILITY DURING THE FISCAL YEAR. SERVICES INCLUDE: FAMILY MEDICINE, GERIATRIC CARE, PEDIATRICS, INTERNAL MEDICINE AND OBSTETRICS; INPATIENT SERVICES AT WYOMING MEDICAL CENTER AND LONG-TERM CARE FACILITIES; FULL PHARMACY FOR PATIENTS; LABORATORY, X-RAYS, ULTRASOUNDS, AND OTHER SCREENING AND DIAGNOSTIC TESTS, SUCH AS VISION AND HEARING; PATIENT HEALTH EDUCATION, PATIENT ASSISTANCE, PREVENTATIVE CARE, AND SPANISH TRANSLATION SERVICES. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 1081348 | Expense |
| Revenue | 895613 | Revenue |
| Description | DENTAL - THE ORGANIZATION'S DENTAL CLINIC OPERATES WITHIN SCOPE AND PROVIDED APPROXIMATELY 6,935 PATIENT VISITS DURING THE FISCAL YEAR. SERVICES INCLUDE: DENTAL HYGIENE, GENERAL RESTORATIVE ORAL CARE (FILLINGS), CROWNS, BRIDGES, ENDODONTIC (ROOT CANALS), EXODONTIA (EXTRACTIONS), PERIODONTAL SURGERY, PROSTHODONTICS (DENTURES, PARTIALS), MINI IMPLANTS FOR DENTURES, EMERGENCY DENTAL APPOINTMENTS, ORAL CANCER SCREENING, AND ELECTRONIC PATIENT RECORDS. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 174716 | Expense |
| Revenue | 147851 | Revenue |
| Description | BEHAVIORAL HEALTH - THE ORGANIZATION'S BEHAVIORAL HEALTH DEPARTMENT OPERATES WITHIN SCOPE AND PROVIDED APPROXIMATELY 1,146 PATIENT VISITS DURING THE FISCAL YEAR. SERVICES INCLUDE: PSYCHOLOGICAL EVALUATIONS & TESTING, PERSONAL SKILLS TRAINING, MEDICATION MGMT, PSYCHOTHERAPY, SOCIAL INTERACTION GROUP THERAPY, BEHAVIORAL MODIFICATION TREATMENT FOR ATTENTION DEFICIT DISORDER, SPECIALIZED TREATMENT (POST TRAUMATIC STRESS DISORDER, PSYCHOLOGICAL TRAUMA & ABUSE, AUTISM & ASPERGER'S SYNDROME, HEAD INJURIES), AND PSYCHOLOGICAL EVALUATIONS FOR CHRONIC PAIN MANAGEMENT. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 8216857 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | true | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | false | ReportOtherLiabilities |
| Report Fin48 Footnote | false | ReportFin48Footnote |
| Independent Audit Financial Stmt | true | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | false | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | false | Hospital |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | true | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | false | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transaction Related Entity | false | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 44 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 183 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 12 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 12 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | true | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | false | MembersOrStockholders |
| Election Of Board Members | false | ElectionOfBoardMembers |
| Decisions Subject To Approval | false | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | true | LocalChapters |
| Policies Reference Chapters | true | PoliciesReferenceChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | DIAHANN BARRERA | NamePerson |
| Telephone Number | 3072336000 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5000 BLACKMORE RD | AddressLine1 |
| City | CASPER | City |
| State | WY | State |
| ZIP Code | 82609 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (21 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| DOUG FOLLICK | |||||||
| CHAIRMAN, BEGINNING 11/11 | 1.0 | X | X | 0 | |||
| SEAN ELLIS DDS | |||||||
| SECRETARY/TREASURER | 1.0 | X | X | 0 | |||
| DEB JOHNSON | |||||||
| DIRECTOR | 1.0 | X | 0 | ||||
| SUSAN KARAVITIS | |||||||
| DIRECTOR | 1.0 | X | 0 | ||||
| RORY FRANKLIN | |||||||
| DIRECTOR | 1.0 | X | 0 | ||||
| MARTY THONE MS PHD | |||||||
| VICE CHAIRMAN, ENDING 5/11 | 1.0 | X | X | 300 | |||
| JEFF MURATORE | |||||||
| DIRECTOR, BEGINNING 11/11 | 1.0 | X | 0 | ||||
| MELISSA CONNELY | |||||||
| DIRECTOR | 1.0 | X | 0 | ||||
| RANDY STUTHEIT | |||||||
| DIRECTOR | 1.0 | X | 0 | ||||
| MIKE GILMORE | |||||||
| CHAIRMAN - 10/11, DIRECTOR | 1.0 | X | X | 0 | |||
| CRAIG ABEL | |||||||
| DIRECTOR, BEGINNING 11/11 | 1.0 | X | 0 | ||||
| CATHY CARSEN | |||||||
| DIRECTOR, ENDING 12/11 | 1.0 | X | 0 | ||||
| JANICE LYNCH | |||||||
| DIRECTOR, BEGINNING 1/12 | 1.0 | X | 0 | ||||
| LESLI WRIGHT | |||||||
| DIRECTOR | 1.0 | X | 0 | 0 | 0 | ||
| CONNIE LONGWELL | |||||||
| CFO, ENDING 2/12 | 40.0 | X | 107563 | 0 | 16666 | ||
| DANIEL J REINER | |||||||
| CEO | 40.0 | X | 152096 | 0 | 20552 | ||
| DR STEEN GODDIK | |||||||
| PHYSICIAN | 40.0 | 111467 | 0 | 11925 | X | ||
| DR LARISSA TOLLEY | |||||||
| DENTIST | 40.0 | 126557 | 0 | 17482 | X | ||
| DR JASON WILLIS | |||||||
| PHYSICIAN | 40.0 | 126859 | 0 | 2343 | X | ||
| DR KARL RADKE | |||||||
| PHYSICIAN | 40.0 | 191268 | 0 | 16444 | X | ||
| DR RUMA SAHA | |||||||
| DENTIST | 40.0 | 108122 | 6750 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 924232 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 92162 | TotalOtherCompensation |
| Number Individuals GT100 K | 7 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|
| FCI CONSTRUCTION INC | |
| CONSTRUCTION | 5316385 |
| BOULDER ASSOCIATES | |
| ARCHITECT FIRM | 491998 |
| EMISSARY | |
| PHARMACY MANAGEMENT | 132324 |
| BKD LLP | |
| AUDIT/TAX/CONSULTING | 109562 |
| ADBAY | |
| ADVERTISING FIRM | 105795 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 5 | NumberOfContractorsGT100K |
| Federated Campaigns | 45030 | FederatedCampaigns |
| Government Grants | 9194400 | GovernmentGrants |
| All Other Contributions | 650 | AllOtherContributions |
| Total Contributions | 9240080 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| PATIENT SERVICE REVENUE | 624100 | 6957325 | 6957325 |
| OTHER | 624100 | 91523 | 91523 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 7048848 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 6149 | TotalRevenueColumn |
| Exclusion | $6,149 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | 605532 | Other |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -605532 | Other |
Net Gain Or Loss Investments NetGainOrLossInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -605532 | TotalRevenueColumn |
| Exclusion | -$605,532 | ExclusionAmount |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income From Gaming NetIncomeFromGaming
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
Net Income Or Loss NetIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 0 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 15689545 | TotalRevenueColumn |
| Related Or Exempt Function Income | 7048848 | RelatedOrExemptFunctionIncome |
| Exclusion | -$599,383 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Grants To Domestic Individuals GrantsToDomesticIndividuals
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Foreign Grants ForeignGrants
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Benefits To Members BenefitsToMembers
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 309875 | Total |
| Management And General | 309875 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Comp Disqual Persons CompDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 113995 | Total |
| Management And General | 113995 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5072171 | Total |
| Program Services | 3962069 | ProgramServices |
| Management And General | 1110102 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 44960 | Total |
| Program Services | 42816 | ProgramServices |
| Management And General | 2144 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 728823 | Total |
| Program Services | 545341 | ProgramServices |
| Management And General | 183482 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 392431 | Total |
| Program Services | 284801 | ProgramServices |
| Management And General | 107630 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 98507 | Total |
| Management And General | 98507 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 103701 | Total |
| Management And General | 103701 | ManagementAndGeneral |
Fees For Services Lobbying FeesForServicesLobbying
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 548451 | Total |
| Program Services | 426800 | ProgramServices |
| Management And General | 121651 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 136451 | Total |
| Program Services | 136451 | ProgramServices |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 322661 | Total |
| Program Services | 8323 | ProgramServices |
| Management And General | 314338 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 204504 | Total |
| Program Services | 183716 | ProgramServices |
| Management And General | 20788 | ManagementAndGeneral |
Royalties Royalties
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 617595 | Total |
| Program Services | 600311 | ProgramServices |
| Management And General | 17284 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 90601 | Total |
| Program Services | 41362 | ProgramServices |
| Management And General | 49239 | ManagementAndGeneral |
Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 32001 | Total |
| Program Services | 23310 | ProgramServices |
| Management And General | 8691 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Payments To Affiliates PaymentsToAffiliates
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 317950 | Total |
| Program Services | 250962 | ProgramServices |
| Management And General | 66988 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 15872 | Total |
| Program Services | 1141 | ProgramServices |
| Management And General | 14731 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| MEDICAL SUPPLIES & DRUGS | 1104479 | 1104479 | |
| BAD DEBT | 588580 | 588580 | |
| RECRUITING & RETENTION | 74301 | 74301 | |
| LICENSES, DUES, SUBSCRIPTIONS | 24549 | 16395 | 8154 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4316 | Total |
| Management And General | 4316 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10946774 | Total |
| Program Services | 8216857 | ProgramServices |
| Management And General | 2729917 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4061 | BOY |
| EOY | 28315 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2055347 | BOY |
| EOY | 1102300 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 171296 | BOY |
| EOY | 577888 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 805362 | BOY |
| EOY | 627392 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Receivables From Disqual Persons ReceivablesFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Notes Loans Receivable Net OtherNotesLoansReceivableNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 120638 | BOY |
| EOY | 94685 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 104610 | BOY |
| EOY | 128221 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 10542556 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 1888907 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2760547 | BOY |
| EOY | 8653649 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Investments Other Securities InvestmentsOtherSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Investments Program Related InvestmentsProgramRelated
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Intangible Assets IntangibleAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 10378 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6021861 | BOY |
| EOY | 11222828 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 884318 | BOY |
| EOY | 1380827 | EOY |
Grants Payable GrantsPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 11916 | BOY |
| EOY | 11916 | EOY |
Tax Exempt Bond Liabilities TaxExemptBondLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Escrow Account Liability EscrowAccountLiability
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Loans From Officers Directors LoansFromOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 35080 | BOY |
| EOY | 0 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 931314 | BOY |
| EOY | 1392743 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5010206 | BOY |
| EOY | 9781195 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 80341 | BOY |
| EOY | 48890 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5090547 | BOY |
| EOY | 9830085 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6021861 | BOY |
| EOY | 11222828 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 4742771 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -3233 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| Audit Committee | true | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | true | FederalGrantAuditRequired |
| Federal Grant Audit Performed | true | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org170b1 Avi | X | PubliclySupportedOrg170b1Avi |
Gifts Grants Contrib Received170 GiftsGrantsContribReceived170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 2477659 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 2021448 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 2126591 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 1974381 | CurrentTaxYearMinus1Year |
| Current Tax Year | 9240080 | CurrentTaxYear |
| Total | 17840159 | Total |
Total170 Total170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 2477659 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 2021448 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 2126591 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 1974381 | CurrentTaxYearMinus1Year |
| Current Tax Year | 9240080 | CurrentTaxYear |
| Total | 17840159 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | 17840159 | PublicSupportTotal170 |
Gross Investment Income170 GrossInvestmentIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 85730 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 25055 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 10092 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 21439 | CurrentTaxYearMinus1Year |
| Current Tax Year | 6149 | CurrentTaxYear |
| Total | 148465 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | 17988624 | TotalSupport |
| Gross Receipts From Admissions Etc | 39680938 | GrossReceiptsFromAdmissionsEtc |
| Public Support Pertcentage170 | 0.99175 | PublicSupportPertcentage170 |
| Public Support Pertcent Prior Year | 0.98237 | PublicSupportPertcentPriorYear |
| Thirty Three Percnt Tests CY170 | X | ThirtyThreePercntTestsCY170 |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbying | |
| Total Direct Lobbying | TotalDirectLobbying | |
| Total Lobbying Expenditures | TotalLobbyingExpenditures | |
| Other Exempt Purpose Expenditures | OtherExemptPurposeExpenditures | |
| Total Exempt Purpose Expenditures | TotalExemptPurposeExpenditures | |
| Lobbying Nontaxable | LobbyingNontaxableAmount | |
| Grassroots Nontaxable | GrassrootsNontaxableAmount | |
| Tot Lobbying Grassroot Minus Non Tx | TotLobbyingGrassrootMinusNonTx | |
| Tot Lobby Expend Mns Lobbying Nontx | TotLobbyExpendMnsLobbyingNontx | |
| Volunteers | false | Volunteers |
| Paid Staff Or Management | false | PaidStaffOrManagement |
| Media Advertisements | false | MediaAdvertisements |
| Mailings Members | false | MailingsMembers |
| Publications Or Broadcast | false | PublicationsOrBroadcast |
| Grants Other Organizations | false | GrantsOtherOrganizations |
| Direct Contact Legislators | false | DirectContactLegislators |
| Rallies Demonstrations | false | RalliesDemonstrations |
| Other Activities | true | OtherActivities |
| Not Described In501c3 | false | NotDescribedIn501c3 |
Form990 Schedule C Part IV Form990ScheduleCPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | OTHER LOBBYING ACTIVITIES | Identifier |
| Return Reference | SCHEDULE C, PART II-B, LINE 1(I) | ReturnReference |
| Explanation | THE ORGANIZATION PAYS DUES TO THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS (NACHC). A PORTION OF THESE DUES MAY BE USED FOR LOBBYING PURPOSES. | Explanation |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amts | ArtPublicExhibitionAmts | |
| Held Works Of Art Amts | HeldWorksOfArtAmts | |
| Current Year Minus3 Years | CurrentYearMinus3Years |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1260084 | OtherCostOrOtherBasis |
| Book Value | 1260084 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 5343 | OtherCostOrOtherBasis |
| Depreciation | 201 | Depreciation |
| Book Value | 5142 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 18302 | OtherCostOrOtherBasis |
| Depreciation | 13222 | Depreciation |
| Book Value | 5080 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2477351 | OtherCostOrOtherBasis |
| Depreciation | 1875484 | Depreciation |
| Book Value | 601867 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 6781476 | OtherCostOrOtherBasis |
| Depreciation | 0 | Depreciation |
| Book Value | 6781476 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 8653649 | TotalOfBookValueLandBuildings |
| Total Revenue | 15689545 | TotalRevenue |
| Total Expenses | 10946774 | TotalExpenses |
| Excess Or Deficit For Year | 4742771 | ExcessOrDeficitForYear |
| Other | -$3,233 | OtherAmount |
| Total Adjustments | -3233 | TotalAdjustments |
| Excess Or Deficit Per FS | 4739538 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 16385960 | TotRevenueEtcAuditedFinclStmt |
| Donated Srvc And Use Of Facilities | 94116 | DonatedSrvcAndUseOfFacilities |
| Recoveries Of Prior Year Grants | -3233 | RecoveriesOfPriorYearGrants |
| Revenue Not Rptd F990 | 90883 | RevenueNotRptdF990 |
| Revenue Subtotal | 16295077 | RevenueSubtotal |
| Other Revenues Not Included | -605532 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | -605532 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 15689545 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 11646422 | TotExpensesEtcAuditedFinclStmt |
| Donated Services Use Of Facilities | 94116 | DonatedServicesUseOfFacilities |
| Other Expenses Included | 605532 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 699648 | ExpensesNotRptdF990 |
| Expenses Subtotal | 10946774 | ExpensesSubtotal |
| Total Expenses Per Form990 | 10946774 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (4 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| UNCERTAIN TAX POSITIONS | SCHEDULE D, PART X, LINE 2 | MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. |
| OTHER RECONCILING CHANGE IN NET ASSETS | SCHEDULE D, PART XI, LINE 8 | ($3,233) RECOVERIES OF PRIOR YEAR GRANT |
| OTHER REVENUE INCLUDED ON FORM 990, PART VIII, LINE 12, BUT NOT ON LINE 1 | SCHEDULE D, PART XII, LINE 4B | ($605,532) LOSS ON DISPOSAL OF ASSETS |
| OTHER EXPENSE INCLUDED ON LINE 1, BUT NOT ON FORM 990, PART IX, LINE 25 | SCHEDULE D, PART XIII, LINE 2D | $605,532 LOSS ON DISPOSAL OF ASSETS |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Form990 Of Other Organizations | X | Form990OfOtherOrganizations |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | false | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | true | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (2 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DR KARL RADKE | |||||||||||||
| 172107 | 0 | 19161 | 0 | 0 | 0 | 5063 | 0 | 11381 | 0 | 207712 | 0 | 0 | 0 |
| DANIEL J REINER | |||||||||||||
| 134379 | 0 | 17717 | 0 | 0 | 0 | 8770 | 0 | 11782 | 0 | 172648 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII (2 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| NON-FIXED PAYMENTS | SCHEDULE J, PART I, LINE 7 | DAN REINER AND CONNIE LONGWELL RECEIVED KEY EMPLOYEE INCENTIVES, WHICH WERE BONUSES GIVEN TO CERTAIN EMPLOYEES FOR PURPOSES OF RETENTION. THESE BONUSES WERE CALCULATED AS 10% OF EMPLOYEE'S ANNUAL SALARY, WITH 7% PAID IN JUNE 2011 AND 3% PAID IN DECEMBER 2012. |
| OTHER BONUS COMPENSATION | SCHEDULE J, PART II, COLUMN (B)(II) | DR. RUMA SAHA, DR. LARISSA TOLLEY, AND DR. KARL RADKE RECEIVED PRODUCTIVITY BONUSES, WHICH WERE BONUSES GIVEN TO PROVIDERS BASED ON PRODUCTION GOALS (ENCOUNTERS AND CHARGES) STIPULATED IN THEIR EMPLOYMENT CONTRACTS. |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV (2 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| GOLDIE OLSON | |||
| SISTER OF C. LONGWELL | 68081 | EMPLOYEE COMPENSATION | false |
| TONYA WILLIAMS | |||
| COUSIN OF C. LONGWELL | 45914 | EMPLOYEE COMPENSATION | false |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (9 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| ORGANIZATION'S MISSION | FORM 990, PART I, LINE 1 | IT IS THE MISSION OF THE COMMUNITY HEALTH CENTER OF CENTRAL WYOMING (CHCCW) TO MAINTAIN A HIGH QUALITY PATIENT CARE DELIVERY SYSTEM THAT PROVIDES 100% ACCESS TO COMPREHENSIVE HEALTH CARE SERVICES FOR ALL RESIDENTS OF CASPER AND NATRONA COUNTIES AND THROUGHOUT WYOMING, REGARDLESS OF ABILITY TO PAY. IT IS ALSO THE DESIRE OF CHCCW TO SUPPORT THE EDUCATION AND TRAINING OF MULTIPLE DISCIPLINES OF HEALTH CARE PROFESSIONALS. FROM PRENATAL CARE TO GERIATRIC CARE, COMPREHENSIVE SERVICES COVER ALL LIFE SPANS, MAKING THE CHCCW A TRUE HEALTHCARE HOME. AS STEWARDS OF THE COMMUNITY, THE ORGANIZATION SEEKS TO UNDERSTAND, RESPOND TO, AND SERVE COMMUNITY NEEDS, OFFERING ASSISTANCE TO THOSE WITH LIMITED OPTIONS AND REMOVING BARRIERS THAT PREVENT PEOPLE FROM ACCESSING CARE. THE VISION OF CHCCW IS FOR CENTRAL WYOMING TO BECOME THE HEALTHIEST REGION IN THE STATE. |
| VOLUNTEERS | FORM 990, PART I, LINE 6 | THE ORGANIZATION'S BOARD OF DIRECTORS IS A VOLUNTEER BOARD. |
| BOARD-APPROVED MISSION STATEMENT | FORM 990, PART III, LINE 1 | THE BOARD-APPROVED MISSION STATEMENT IS AS FOLLOWS: IT IS THE MISSION OF CHCCW TO PROVIDE COMPASSIONATE, AFFORDABLE AND HIGH QUALITY PATIENT CARE WITH A COMPREHENSIVE RANGE OF HEALTH CARE SERVICES FOR RESIDENTS OF CENTRAL WYOMING, REGARDLESS OF THEIR INCOME. IT IS THE DESIRE OF CHCCW TO TREAT ALL PATIENTS WITH THE DIGNITY AND RESPECT THEY DESERVE. |
| SIGNIFICANT CHANGES TO GOVERNING DOCUMENTS | FORM 990, PART VI, SECTION A, LINE 4 | THE FOLLOWING SIGNIFICANT CHANGES WERE MADE TO THE BYLAWS OF THE ORGANIZATION: IF A BOARD MEMBER VACANCY OCCURS DURING THE YEAR, THE NEWLY APPOINTED INDIVIDUAL WILL COMPLETE THE REMAINING TERM OF THE DEPARTING MEMBER OR, IN THE CASE OF A NEWLY OPENED SEAT, THE REMAINING MONTHS PRIOR TO THE ANNUAL MEETING. TERMS OF OFFICE WERE MODIFIED TO STATE THAT A TERM IS FOUR (4) YEARS AND THAT MEMBERS ARE ELIGIBLE TO SERVE FOR A MAXIMUM OF FOUR (4) FULL FOUR-YEAR TERMS. SPECIFIC RESPONSIBILITIES OF THE BOARD OFFICERS THAT WERE NOT PREVIOUSLY LISTED IN THE BYLAWS WERE ADDED. THE CHAIRPERSON IS RESPONSIBLE FOR ORGANIZATION, INTERNAL DISCIPLINE, TEAM BUILDING, SERVING AS A LIAISON BETWEEN THE BOARD AND CEO, ENSURING AGENDA ITEMS ARE DISCUSSED AND TASK DELEGATION. THE VICE CHAIRPERSON IS RESPONSIBLE TO STAY ABREAST OF CURRENT BOARD ISSUES AND OPERATIONS. THE SECRETARY IS RESPONSIBLE FOR THE ACCURACY AND COMPLETENESS OF THE NOTES/MINUTES AND FOR THE CENTER'S HISTORICAL AND LEGAL DOCUMENTS. THE TREASURER IS RESPONSIBLE FOR ADEQUATE RETENTION OF FINANCIAL RECORDS, TIMELY FINANCIAL REPORTS AND ENSURING THAT THE CENTER'S FINANCES ARE AUDITED ANNUALLY. THE BOARD OF DIRECTORS SELF EVALUATION FORM WILL BE COMPLETED AT LEAST ONCE A YEAR BY EACH BOARD MEMBER. |
| REVIEW OF FORM 990 | FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. THE CEO AND CFO REVIEW THE RETURN IN DETAIL WITH THE INDEPENDENT ACCOUNTING FIRM PREPARING THE FORM. UPON COMPLETION OF TOP MANAGEMENT'S REVIEW, A TENTATIVE FINAL DRAFT IS EMAILED/MAILED TO ALL BOARD MEMBERS FOR THEIR REVIEW. ANY QUESTIONS OR RECOMMENDED CHANGES ARE DIRECTED TO THE CFO AND CHANGED IF NECESSARY PRIOR TO FILING. |
| CONFLICT OF INTEREST POLICY | FORM 990, PART VI, SECTION B, LINE 12C | THE BOARD OF DIRECTORS, THROUGH THE SENIOR MANAGEMENT, IS ACCOUNTABLE FOR IMPLEMENTATION, ENFORCEMENT, MONITORING, OVERSIGHT, AND COMMUNICATION OF THE ORGANIZATION'S CONFLICT OF INTEREST POLICY. DEPARTMENTAL DIRECTORS AND SUPERVISORS ARE ACCOUNTABLE FOR IMPLEMENTATION, ENFORCEMENT, MONITORING, OVERSIGHT, AND COMMUNICATION OF THE CONFLICT OF INTEREST POLICY IN THEIR DEPARTMENTS. MEMBERS OF THE BOARD MUST NOT ENGAGE IN ANY ACTIVITIES OR RELATIONSHIPS WHICH MIGHT DIRECTLY OR INDIRECTLY RESULT IN A CONFLICT OF INTEREST, OR IMPAIR THEIR INDEPENDENCE OF JUDGMENT. THEY MUST NOT ACCEPT GIFTS, FAVORS, OR BENEFITS THAT MIGHT TEND IN ANY WAY TO INFLUENCE THEM IN PERFORMANCE OF THEIR DUTIES AS TRUSTEES. CONFLICT OF INTEREST IS IDENTIFIED BY A MEMBER OF THE BOARD OF DIRECTORS OR SENIOR MANAGEMENT WHO CAN OBJECTIVELY ASSESS THE SITUATION AND IMPOSE THE NECESSARY RESTRICTIONS TO PROTECT THE INTERESTS OF THE ORGANIZATION. IF A CONFLICT WAS TO ARISE, THE INTERESTED PERSON WOULD NOT PARTICIPATE IN DECISION MAKING RELATED TO THE CONFLICT. CORPORATE OFFICERS AND KEY EMPLOYEES ARE ALSO REQUIRED TO ANNUALLY REVIEW POTENTIAL CONFLICTS OF INTEREST. WHEN A CONFLICT OF INTEREST IS IDENTIFIED, DISCLOSURE WOULD BE MADE TO A MEMBER OF THE SENIOR MANAGEMENT WHO CAN OBJECTIVELY ASSES THE SITUATION. IF THE CONFLICT INVOLVES A SENIOR MANAGER, DISCLOSURE SHOULD BE MADE TO THE MEDICAL DIRECTOR OF COMPLIANCE AND EXCELLENCE OR A MEMBER OF THE BOARD. IF THE CONFLICT WARRANTS ACTION, SUCH ACTION WILL BE TAKEN TO PROTECT THE INTEREST OF THE ORGANIZATION SUCH AS THE TERMINATION IN THEIR PARTICIPATION OF THE DECISION MAKING RELATED TO THE CONFLICT. |
| COMPENSATION REVIEW | FORM 990, PART VI, SECTION B, LINES 15A & 15B | EACH YEAR AS PART OF THE BUDGET PROCESS, IN EXECUTIVE SESSION THE BOARD OF DIRECTORS CONDUCTS A COMPENSATION REVIEW. TO OBTAIN THE APPROPRIATE COMPENSATION PACKAGE FOR THE CEO, THE BOARD OF DIRECTORS REVIEWS COMPARABLE DATA FOR THE ORGANIZATION'S LOCATION, INCLUDING ANY COMPENSATION DATA PROVIDED BY THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS(NACHC) AND THE CHAMPS SALARY GUIDE. THIS DATA IS SPECIFIC TO REGION, SIZE OF ORGANIZATION, AND NUMBER OF ENCOUNTERS GENERATED. THE REVIEW PROCESS IS MENTIONED IN THE BOARD MINUTES. EACH YEAR, THE CEO REVIEWS THE COMPENSATION OF OTHER OFFICERS AND KEY EMPLOYEES OF THE ORGANIZATION. THE CEO REVIEWS ALL ANNUAL SALARY INCREASES USING COMPARABILITY DATA FROM THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS (NACHC). HOWEVER, IF A SALARY CHANGES BY $10,000 OR 10%, THE BOARD IS REQUIRED TO REVIEW AND APPROVE THE SALARY CHANGE. THIS REVIEW PROCESS IS MENTIONED IN THE BOARD MINUTES. |
| DOCUMENT DISCLOSURE | FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENTS ARE MADE AVAILABLE UPON REQUEST AND WILL BE MAILED OR EMAILED TO THE REQUESTING PERSON. THE ORGANIZATION'S CONFLICT OF INTEREST POLICY IS CURRENTLY AVAILABLE ON THE ORGANIZATION'S WEBSITE OR UPON REQUEST. A COPY CAN ALSO BE OBTAINED VIA MAIL OR EMAIL. FINANCIAL STATEMENTS ARE ONLY MADE AVAILABLE FOR BONA FIDE BUSINESS PURPOSES, SUCH AS REQUESTS FROM FINANCIAL INSTITUTIONS, VENDORS, AND THIRD PARTY AGENCIES. |
| RECONCILIATION OF NET ASSETS | FORM 990, PART XI, LINE 5 | ($3,233) RECOVERIES OF PRIOR YEAR GRANTS |