ERIE FAMILY HEALTH CENTER INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
ERIE FAMILY HEALTH CENTER INC (EIN 36-3088628)
Tax period
2011-07-01 to 2012-06-30
Filed
2013-05-14
IRS object ID
201311349349308161
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

FieldValueIRS element (for citing)
Timestamp2013-05-14T20:52:18-05:00Timestamp
Tax Period End Date2012-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN381357951EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1PLANTE & MORAN PLLCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line110 S RIVERSIDE PLAZA 9TH FLOORAddressLine1
CityCHICAGOCity
StateILState
ZIP Code60606ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN363088628EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1ERIE FAMILY HEALTH CENTER INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlERIENameControl
Phone3126663494Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11701 W SUPERIOR STREETAddressLine1
CityCHICAGOCity
StateILState
ZIP Code60622ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameLEE FRANCISName
TitlePRESIDENT AND CEOTitle
Phone3126663494Phone
Date Signed2013-05-14DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameKIMBERLY A HAUMANNName
PTINP00546491PTIN
Phone3122071040Phone
Date Prepared2013-05-14DatePrepared
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonLEE FRANCISNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11701 W SUPERIOR STREETAddressLine1
CityCHICAGOCity
StateILState
ZIP Code60622ZIPCode
FieldValueIRS element (for citing)
Gross Receipts33591809GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.ERIEFAMILYHEALTH.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1970YearFormation
State Legal DomicileILStateLegalDomicile
Activity Or Mission DescriptionOPERATE A HEALTHCARE CENTER TO SERVE A LARGELY MEDICALLY UNDERSERVED POPULATION IN CHICAGO.ActivityOrMissionDescription
Nbr Voting Members Governing Body23NbrVotingMembersGoverningBody
Nbr Independent Voting Members23NbrIndependentVotingMembers
Total Nbr Employees457TotalNbrEmployees
Total Nbr Volunteers84TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year13455508ContributionsGrantsPriorYear
Contributions Grants Current Year15418861ContributionsGrantsCurrentYear
Program Service Revenue Prior Year16779866ProgramServiceRevenuePriorYear
Program Service Revenue CY18121102ProgramServiceRevenueCY
Investment Income Prior Year18134InvestmentIncomePriorYear
Investment Income Current Year24361InvestmentIncomeCurrentYear
Other Revenue Prior Year10683OtherRevenuePriorYear
Other Revenue Current Year-23415OtherRevenueCurrentYear
Total Revenue Prior Year30264191TotalRevenuePriorYear
Total Revenue Current Year33540909TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year19614327SalariesEtcPriorYear
Salaries Etc Current Year22641956SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY179443TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year201588TotalFundrsngExpCurrentYear
Other Expense Prior Year6235513OtherExpensePriorYear
Other Expenses Current Year7105852OtherExpensesCurrentYear
Total Expenses Prior Year25849840TotalExpensesPriorYear
Total Expenses Current Year29927251TotalExpensesCurrentYear
Revenues Less Expenses Prior Year4414351RevenuesLessExpensesPriorYear
Revenues Less Expenses CY3613658RevenuesLessExpensesCY
Total Assets BOY21802587TotalAssetsBOY
Total Assets EOY25644724TotalAssetsEOY
Total Liabilities BOY5096665TotalLiabilitiesBOY
Total Liabilities EOY5325144TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY16705922NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY20319580NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionERIE FAMILY MEDICAL CENTER'S (ERIE) MISSION IS TO PROVIDE AFFORDABLE, ACCESSIBLE HIGH-QUALITY CARE TO THOSE IN NEED. IT ACCOMPLISHES THIS OBJECTIVE BY SERVING AS A MEDICAL HOME FOR THE MORE THAN 43,000 PATIENTS EACH YEAR AND CONTINUOUSLY EVOLVING TO RESPOND TO THE NEEDS OF EACH COMMUNITY IT SERVES.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense21558574Expense
Revenue16267042Revenue
DescriptionERIE FAMILY HEALTH CENTER PROVIDES COMPREHENSIVE PRIMARY CARE SERVICES AT THIRTEEN SITES IN CHICAGO AND THE NORTHERN SUBURBS, INCLUDING: FIVE LARGE PRIMARY HEALTH CARE CENTERS, ONE ADOLESCENT-ONLY HEALTH CENTER, FIVE SCHOOL-BASED HEALTH CENTERS, AND TWO DENTAL HEALTH CENTERS. ERIE'S PRIMARY CARE MEDICAL SERVICES INCLUDE PEDIATRICS, INTERNAL MEDICINE, FAMILY MEDICINE, AND WOMEN'S HEALTH. IN ADDITION, ERIE PROVIDES ORAL HEALTH SERVICES, PODIATRY, HIV/AIDS CARE, EYE CARE, BEHAVIORAL HEALTH COUNSELING, CASE MANAGEMENT SERVICES AND HEALTH EDUCATION. NINETY-SEVEN PERCENT OF ERIE'S PATIENTS LIVE AT OR BELOW 200% OF THE FEDERAL POVERTY LEVEL AND 33% ARE UNINSURED. ERIE'S HIGHLY SKILLED PROVIDERS, INNOVATIVE PARTNERSHIPS AND FORWARD-THINKING APPROACH MAKE IT A NATIONAL LEADER FOR THE PROVISION OF COMMUNITY-BASED HEALTH CARE.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense2675534Expense
Revenue1854060Revenue
DescriptionERIE'S AWARD-WINNING ORAL HEALTH PROGRAM SERVES MORE THAN 7,000 LOW-INCOME CHICAGOANS PER YEAR, INCLUDING CHILDREN AND THEIR NUCLEAR FAMILY MEMBERS, DIABETICS, INDIVIDUALS WITH HIV/AIDS AND PREGNANT WOMEN. SERVICES PROVIDED INCLUDE ROUTINE CLEANINGS, X-RAYS, SEALANTS, FILLINGS, CROWNS, ROOT CANALS AND TOOTH EXTRACTIONS. ERIE FOCUSES NOT ONLY ON TREATING, BUT ALSO ON PREVENTING ORAL HEALTH PROBLEMS. ORAL CARE IS INTEGRATED INTO THE PRIMARY MEDICAL CARE OFFERED AT ALL ERIE LOCATIONS. IN ADDITION, ERIE PROVIDES ORAL HEALTH EDUCATION TO MORE THAN 2,500 COMMUNITY MEMBERS ANNUALLY. TO CONTINUE TO MEET THE GROWING COMMUNITY NEED FOR AFFORDABLE HIGH-QUALITY CARE, ERIE PLANS TO DOUBLE ITS DENTAL CARE CAPACITY WITHIN THE NEXT FIVE YEARS.Description
FieldValueIRS element (for citing)
Total Program Service Expense24234108TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising1ProfessionalFundraising
Fundraising Activities1FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity0RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109633NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees457NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions1QuidProQuoContributions
Quid Pro Quo Disclosure1QuidProQuoDisclosure
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members23NbrVotingGoverningBodyMembers
Number Independent Voting Members23NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledILStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1ANGELICA SANCHEZBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number3124327389TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11701 WEST SUPERIOR STREETAddressLine1
CityCHICAGOCity
StateILState
ZIP Code60622ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (34 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployee
BRIAN P MARSELLA
BOARD CHAIR2.00XX000
ANA MARIA SOTO
BOARD VICE CHAIR1.50XX000
ERIC MAYEDA
BOARD TREASURER2.00XX000
DEBORAH B WRIGHT-POWELL
BOARD SECRETARY1.50XX000
WILLIAM KISTNER
DIRECTOR2.00X000
DANIEL J TOUNSEL III
DIRECTOR1.00X000
ROSALIE ALICEA
DIRECTOR1.50X000
CELESTE CASTILLO
DIRECTOR1.50X000
MICHAEL COLE
DIRECTOR1.00X000
LINDA CUSHMAN
DIRECTOR0.50X000
PILAR GONZALEZ
DIRECTOR0.50X000
MARIA HERNANDEZ
DIRECTOR0.50X000
REVEREND ED SARDEN
DIRECTOR1.00X000
DARYL TOM
DIRECTOR1.00X000
HUMBERTO URIBE
DIRECTOR1.00X000
KATHERINE WILSON
DIRECTOR1.00X000
JULIE ZERWIC
DIRECTOR1.00X000
MATT AARONSON
DIRECTOR1.00X000
JILL SIMON SVOBODA
DIRECTOR1.50X000
JACQUELINE CERVANTES
DIRECTOR1.00X000
AMELIA MADRIGAL
DIRECTOR1.00X000
JUAN FERNANDO JAUREGI
DIRECTOR1.00X000
ANA LILIA VIVAR
DIRECTOR1.00X000
LEE FRANCIS
PRESIDENT & CEO40.00X22477805862
DAVID R BUCHANAN
CHIEF MEDICAL OFFICER40.00X189218012759
KEVIN GREENBERG
VP OF FINANCE40.00X8148701743
ZAKEYA ATIA
PRIOR CFO40.00X10809501434
LUZ JIMENEZ
VP OF CLINICAL OPERATIONS40.00X11017706494
ILIANA MORA
SENIOR VP OF STRATEGY & BUSINESS OPERATION40.00X15130203493
RAMON BARAJAS
OB/GYN PHYSICIAN40.0024723008317X
DEBORAH L EDBERG
FAMILY PRACTICE PHYSICIAN40.00197244010587X
MIRIAH D PLAWER-VOLMERDING
OB/GYN PHYSICIAN40.0021424504040X
GHASSAN SOURI
DIRECTOR OF DENTAL40.0018674708917X
DIANE Q ROZYCKI
PHYSICIAN40.0018589906285X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1896422TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation69931TotalOtherCompensation
Number Individuals GT100 K33NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
LAB CORP
PO BOX 12140BURLINGTONNC27216LAB SERVICES607331
BELCORE ELECTRIC
1600 MAIN STREETMELROSE PARKIL60160ELECTRICAL SERVICES277782
COMCAST PHONE LLC
16333 COLLECTION CENTER DRIVECHICAGOIL60693PHONE AND INTERNET SERVICES241014
TYMPANI INC
2001 BUTTERFIELD ROAD SUITE 250DOWNERS GROVEIL60515CONSULTING AND PHONE SERVICES235155
ALLIANCE OF CHICAGO
215 W OHIO ST 4TH FLOORCHICAGOIL60654SUPPORT SERVICES208039
FieldValueIRS element (for citing)
Number Of Contractors GT100 K11NumberOfContractorsGT100K
Fundraising Events163934FundraisingEvents
Government Grants13069997GovernmentGrants
All Other Contributions2184930AllOtherContributions
Total Contributions15418861TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
MEDICARE/MEDICAID PAYM6241001628722616287226
SELF-PAY62410013055551305555
KID CARE/HEALTHY MOM624100506083506083
MEDICAL RECORD FEES6241001358613586
RENTAL INCOME53112086528652
FieldValueIRS element (for citing)
Total Program Service Revenue18121102TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column24361TotalRevenueColumn
Exclusion$24,361ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events27485GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events163934CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses50900FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column-23415TotalRevenueColumn
Exclusion-$23,415ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column33540909TotalRevenueColumn
Related Or Exempt Function Income18121102RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$946ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total601107Total
Program Services368692ProgramServices
Management And General232415ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total18658313Total
Program Services15632087ProgramServices
Management And General3026226ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total203098Total
Program Services148870ProgramServices
Management And General54228ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total1854414Total
Program Services1292225ProgramServices
Management And General562189ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1325024Total
Program Services971239ProgramServices
Management And General353785ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total63513Total
Management And General63513ManagementAndGeneral

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total179443Total
Fundraising179443Fundraising

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total470793Total
Program Services232592ProgramServices
Management And General230075ManagementAndGeneral
Fundraising8126Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total30268Total
Program Services23691ProgramServices
Management And General6577ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total400592Total
Program Services312515ProgramServices
Management And General86480ManagementAndGeneral
Fundraising1597Fundraising

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1131665Total
Program Services1017134ProgramServices
Management And General114531ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total39371Total
Program Services26440ProgramServices
Management And General12703ManagementAndGeneral
Fundraising228Fundraising

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total92522Total
Program Services62134ProgramServices
Management And General29329ManagementAndGeneral
Fundraising1059Fundraising

Interest Interest

FieldValueIRS element (for citing)
Total82608Total
Management And General82608ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total1344191Total
Program Services961838ProgramServices
Management And General377651ManagementAndGeneral
Fundraising4702Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total156946Total
Program Services133683ProgramServices
Management And General23263ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
CONTRACTED DIAGNOSTIC S643623643623
EQUIPMENT RENTAL & MAIN591293446808144485
MEDICAL AND LAB SUPPLIE556156556156
BAD DEBT551110551110

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total951201Total
Program Services853271ProgramServices
Management And General91497ManagementAndGeneral
Fundraising6433Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total29927251Total
Program Services24234108ProgramServices
Management And General5491555ManagementAndGeneral
Fundraising201588Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY2368921BOY
EOY4287556EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY4420917BOY
EOY4444807EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY1993216BOY
EOY2246543EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY1708683BOY
EOY3274264EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY148928BOY
EOY357305EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis19072460LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec8651569LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY10465581BOY
EOY10420891EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY462216BOY
EOY466365EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY234125BOY
EOY146993EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY21802587BOY
EOY25644724EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY2533485BOY
EOY2661080EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY10717BOY
EOY220363EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY1720353BOY
EOY1611591EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY832110BOY
EOY832110EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY5096665BOY
EOY5325144EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY16072557BOY
EOY19919892EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY633365BOY
EOY399688EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY16705922BOY
EOY20319580EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY21802587BOY
EOY25644724EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses3613658ReconcilationRevenueExpenses
Reconcilation Other Changes0ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit Required1FederalGrantAuditRequired
Federal Grant Audit Performed1FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org170b1 AviXPubliclySupportedOrg170b1Avi

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years9769035CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years10716883CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years11249810CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year13455508CurrentTaxYearMinus1Year
Current Tax Year15418861CurrentTaxYear
Total60610097Total

Value Srvc Fclts Furnished By Govt ValueSrvcFcltsFurnishedByGovt

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years37597CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years40830CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years42883CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year40002CurrentTaxYearMinus1Year
Current Tax Year13586CurrentTaxYear
Total174898Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years9806632CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years10757713CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years11292693CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year13495510CurrentTaxYearMinus1Year
Current Tax Year15432447CurrentTaxYear
Total60784995Total
FieldValueIRS element (for citing)
Public Support Total17060784995PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years83204CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years74238CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years17624CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year18134CurrentTaxYearMinus1Year
Current Tax Year24361CurrentTaxYear
Total217561Total

Other Income170 OtherIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years37597CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years40830CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years42883CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year40002CurrentTaxYearMinus1Year
Current Tax Year13586CurrentTaxYear
Total174898Total
FieldValueIRS element (for citing)
Total Support61177454TotalSupport
Gross Receipts From Admissions Etc77029301GrossReceiptsFromAdmissionsEtc
Public Support Pertcentage1700.99360PublicSupportPertcentage170
Public Support Pertcent Prior Year0.99320PublicSupportPertcentPriorYear
Thirty Three Percnt Tests CY170XThirtyThreePercntTestsCY170

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

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

Schedule C IRS990ScheduleC

Total Grassroots Lobbying TotalGrassrootsLobbying

FieldValueIRS element (for citing)
Filing Organizations Totals0FilingOrganizationsTotals

Total Direct Lobbying TotalDirectLobbying

FieldValueIRS element (for citing)
Filing Organizations Totals0FilingOrganizationsTotals

Total Lobbying Expenditures TotalLobbyingExpenditures

FieldValueIRS element (for citing)
Filing Organizations Totals0FilingOrganizationsTotals

Other Exempt Purpose Expenditures OtherExemptPurposeExpenditures

FieldValueIRS element (for citing)
Filing Organizations Totals29927251FilingOrganizationsTotals

Total Exempt Purpose Expenditures TotalExemptPurposeExpenditures

FieldValueIRS element (for citing)
Filing Organizations Totals29927251FilingOrganizationsTotals

Lobbying Nontaxable LobbyingNontaxableAmount

FieldValueIRS element (for citing)
Filing Organizations Totals1000000FilingOrganizationsTotals

Grassroots Nontaxable GrassrootsNontaxableAmount

FieldValueIRS element (for citing)
Filing Organizations Totals250000FilingOrganizationsTotals

Tot Lobbying Grassroot Minus Non Tx TotLobbyingGrassrootMinusNonTx

FieldValueIRS element (for citing)
Filing Organizations Totals0FilingOrganizationsTotals

Tot Lobby Expend Mns Lobbying Nontx TotLobbyExpendMnsLobbyingNontx

FieldValueIRS element (for citing)
Filing Organizations Totals0FilingOrganizationsTotals

Lobbying Nontaxable Amount2 LobbyingNontaxableAmount2

FieldValueIRS element (for citing)
Current Year Minus11000000CurrentYearMinus1
Current Year1000000CurrentYear
Total2000000Total
FieldValueIRS element (for citing)
Lobbying Ceiling$3,000,000LobbyingCeilingAmount

Total Lobbying Expenditures2 TotalLobbyingExpenditures2

FieldValueIRS element (for citing)
Current Year Minus17500CurrentYearMinus1
Total7500Total

Grassroots Nontaxable Amount2 GrassrootsNontaxableAmount2

FieldValueIRS element (for citing)
Current Year Minus1250000CurrentYearMinus1
Current Year250000CurrentYear
Total500000Total
FieldValueIRS element (for citing)
Grassroots Ceiling$750,000GrassrootsCeilingAmount

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis77800OtherCostOrOtherBasis
Book Value77800BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis5093236OtherCostOrOtherBasis
Depreciation2229382Depreciation
Book Value2863854BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis7657084OtherCostOrOtherBasis
Depreciation2585694Depreciation
Book Value5071390BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis3231901OtherCostOrOtherBasis
Depreciation1995862Depreciation
Book Value1236039BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis3012439OtherCostOrOtherBasis
Depreciation1840631Depreciation
Book Value1171808BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings10420891TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionTHIRD-PARTY PAYOR LIABILITYDescription
Amount$832,110Amount
FieldValueIRS element (for citing)
Total Of Amounts832110TotalOfAmounts
Total Revenue33540909TotalRevenue
Total Expenses29927251TotalExpenses
Excess Or Deficit For Year3613658ExcessOrDeficitForYear
Excess Or Deficit Per FS3613658ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt33619369TotRevenueEtcAuditedFinclStmt
Donated Srvc And Use Of Facilities78460DonatedSrvcAndUseOfFacilities
Revenue Not Rptd F99078460RevenueNotRptdF990
Revenue Subtotal33540909RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form99033540909TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt30005711TotExpensesEtcAuditedFinclStmt
Donated Services Use Of Facilities78460DonatedServicesUseOfFacilities
Expenses Not Rptd F99078460ExpensesNotRptdF990
Expenses Subtotal29927251ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form99029927251TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierDESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:Identifier
Return ReferencePART X:ReturnReference
ExplanationTHE CENTER'S APPLICATION OF GAAPUSA REGARDING UNCERTAIN TAX POSITIONS HAD NO EFFECT ON ITS FINANCIAL POSITION AS MANAGEMENT BELIEVES THE CENTER HAS NO MATERIAL UNRECOGNIZED INCOME TAX BENEFITS, INCLUDING ANY POTENTIAL RISK OF LOSS OF ITS NOT-FOR-PROFIT TAX STATUS. THE CENTER WOULD ACCOUNT FOR ANY POTENTIAL INTEREST OR PENALTIES RELATED TO POSSIBLE FUTURE LIABILITIES FOR UNRECOGNIZED INCOME TAX BENEFITS AS INCOME TAX EXPENSE. THE CENTER IS NO LONGER SUBJECT TO EXAMINATION BY FEDERAL, STATE OR LOCAL TAX AUTHORITIES FOR PERIODS BEFORE 2009.Explanation

Schedule G IRS990ScheduleG

FieldValueIRS element (for citing)
Mail SolicitationsXMailSolicitations
Email SolicitationsXEmailSolicitations
Phone SolicitationsXPhoneSolicitations
In Person SolicitationsXInPersonSolicitations
Solicitation Of Non Govt GrantsXSolicitationOfNonGovtGrants
Solicitation Of Govt GrantsXSolicitationOfGovtGrants
Special Fundraising EventsXSpecialFundraisingEvents
Agreement Ref Fundraising1AgreementRefFundraising

Fundraiser Activity Information FundraiserActivityInformation (2 entries)

Name Of IndividualNameOfIndividualAddress Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeActivityActivityFundraiser Control Of FundsFundraiserControlOfFundsGross ReceiptsGrossReceiptsAmount Retained By ContractorAmountRetainedByContractorNet To OrganizationNetToOrganization
THE LOEVY CONSULTING GROUP SARA SE1321 EAST 50TH STREETCHICAGOIL60615INTERIM DIRECTOR OF DEVELOPMENT0626633150410476223
RACHEL KRAUSE1439 NORTH OAKLEYCHICAGOIL60622GRANT WRITING035809029033329057
FieldValueIRS element (for citing)
Total Gross Receipts984723TotalGrossReceipts
Total Retained By Contractors179443TotalRetainedByContractors
Total Net To Organization805280TotalNetToOrganization
Licensed StatesILLicensedStates

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1GOLDEN TOOTHBRUSHNameOfEvent1
Gross Receipts Event1132305GrossReceiptsEvent1
Charitable Contributions Event1129425CharitableContributionsEvent1
Gross Revenue Event12880GrossRevenueEvent1
Rent Facility Costs Event121757RentFacilityCostsEvent1
Other Direct Expenses Event111289OtherDirectExpensesEvent1
Name Of Event2ERIEDESCENCENameOfEvent2
Gross Receipts Event259114GrossReceiptsEvent2
Charitable Contributions Event234509CharitableContributionsEvent2
Gross Revenue Event224605GrossRevenueEvent2
Rent Facility Costs Event215027RentFacilityCostsEvent2
Other Direct Expenses Event22827OtherDirectExpensesEvent2
Gross Receipts Total191419GrossReceiptsTotal
Charitable Contributions Total163934CharitableContributionsTotal
Gross Revenue Total Events27485GrossRevenueTotalEvents
Rent Facility Costs Total Events36784RentFacilityCostsTotalEvents
Other Direct Expenses Total Events14116OtherDirectExpensesTotalEvents
Direct Expense Summary Events50900DirectExpenseSummaryEvents
Net Income Summary-23415NetIncomeSummary

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
Form990 Of Other OrganizationsXForm990OfOtherOrganizations
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (8 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
LEE FRANCIS
1820690427090004031018310230640000
DAVID R BUCHANAN
1699030193150004412083470201977000
ILIANA MORA
134421016881000335301400154795000
RAMON BARAJAS
2361080111220005925023920255547000
DEBORAH L EDBERG
188253089910004850057370207831000
MIRIAH D PLAWER-VOLMERDING
199611014634000390001400218285000
GHASSAN SOURI
1662660204810003510054070195664000
DIANE Q ROZYCKI
1701730157260004080022050192184000

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (4 entries)

Return ReferenceReturnReferenceExplanationExplanation
FORM 990, PART VI, SECTION B, LINE 11ERIE FAMILY HEALTH CENTER (EFHC) USES A THIRD PARTY (INDEPENDENT CPA FIRM) TO PREPARE ITS 990 TAX FORM. UPON THE FORM'S COMPLETION, A COPY IS PROVIDED TO EFHC'S MANAGEMENT FOR REVIEW AND THEN SUBSEQUENTLY REVIEWED BY THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS. ANY NECESSARY CHANGES ARE COMMUNICATED TO THE CPA FIRM AND INCORPORATED AS APPROPRIATE. ONCE THE 990 DRAFT IS FINALIZED A COPY IS MADE AVAILABLE TO THE BOARD OF DIRECTORS. THE THIRD PARTY WILL THEN FILE THE 990 ON EFHC'S BEHALF.
FORM 990, PART VI, SECTION B, LINE 12COFFICERS, DIRECTORS, KEY EMPLOYEES, AND MEMBERS OF THE BOARD ARE ANNUALLY REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE FORM AS A PRECURSOR TO THEIR SERVICE TO THE ORGANIZATION. POTENTIAL CONFLICTS ARE LOGGED WITH AND MONITORED BY EFHC MANAGEMENT.
FORM 990, PART VI, SECTION B, LINE 15EFHC PERIODICALLY USES AN INDEPENDENT THIRD PARTY TO REVIEW THE CURRENT COMPENSATION FOR MEMBERS OF THE LEADERSHIP TEAM. BASED ON THIS REVIEW, COMPENSATION LEVELS ARE SET FOR EACH LEVEL OF EMPLOYMENT. COMPENSATION REVIEWS BY THIRD PARTIES ARE CONDUCTED EVERY 3 YEARS. THE LAST REVIEW WAS IN 2011.
FORM 990, PART VI, SECTION C, LINE 19EFHC GOVERNING DOCUMENTS, FINANCIAL STATEMENTS, AND CONFLICT OF INTEREST POLICY ARE AVAILABLE FOR PUBLIC REVIEW UPON REQUEST. REQUESTS ARE REQUIRED TO BE IN WRITING.

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