COMMUNITY HEALTH CENTERS ALLIANCE INC: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- COMMUNITY HEALTH CENTERS ALLIANCE INC (EIN 59-3631620)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-08-13
- IRS object ID
- 201312259349301441
- Schema version
- 2012v2.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-08-13T10:51:42-05:00 | Timestamp |
| Tax Period End Date | 2012-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MYERS BRETTHOLTZ & COMPANY PA | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 12671 WHITEHALL DR | AddressLine1 |
| City | FORT MYERS | City |
| State | FL | State |
| ZIP Code | 339073626 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 593631620 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY HEALTH CENTERS ALLIANCE | BusinessNameLine1 |
| Business Name Line2 | INC | BusinessNameLine2 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | COMM | NameControl |
| Phone | 7275732422 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 140 FOUNTAIN PARKWAY | AddressLine1 |
| Address Line2 | ROOM/SUITE 210 | AddressLine2 |
| City | ST PETERSBURG | City |
| State | FL | State |
| ZIP Code | 33716 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JEANETTE LUGO CPA | Name |
| Title | VP, FINANCE DIRECTOR | Title |
| Phone | 7275732422 | Phone |
| Date Signed | 2013-08-13 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | ANGELINE K CHOO CPA | Name |
| Phone | 2399395775 | Phone |
| Date Prepared | 2013-08-13 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | DIANE GADDIS CEO | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 140 FOUNTAIN PARKWAY | AddressLine1 |
| City | ST PETERSBURG | City |
| State | FL | State |
| ZIP Code | 33716 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 5856963 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.CHCALLIANCE.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1999 | YearFormation |
| State Legal Domicile | FL | StateLegalDomicile |
| Activity Or Mission Description | THE ORGANIZATION ("CHCA") FACILITATES THE SELECTION, IMPLEMENTATION, AND SUPPORT OF SERVICES AND TECHNOLOGIES THROUGH A CENTRALIZED ORGANIZATION, ALLOWING ITS MEMBERS TO EXPAND AND IMPROVE HEALTH-RELATED SERVICES FOR ALL. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 4 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 0 | NbrIndependentVotingMembers |
| Total Nbr Employees | 0 | TotalNbrEmployees |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 2427835 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 3957075 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 2579908 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 1778863 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 11717 | InvestmentIncomePriorYear |
| Investment Income Current Year | 12638 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 45595 | OtherRevenuePriorYear |
| Other Revenue Current Year | 108387 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 5065055 | TotalRevenuePriorYear |
| Total Revenue Current Year | 5856963 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 399836 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 224700 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 2225051 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 2923232 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 1595633 | OtherExpensePriorYear |
| Other Expenses Current Year | 2075840 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 4220520 | TotalExpensesPriorYear |
| Total Expenses Current Year | 5223772 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 844535 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 633191 | RevenuesLessExpensesCY |
| Total Assets BOY | 4635365 | TotalAssetsBOY |
| Total Assets EOY | 5478508 | TotalAssetsEOY |
| Total Liabilities BOY | 572929 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 782881 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 4062436 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 4695627 | NetAssetsOrFundBalancesEOY |
| Mission Description | THE ORGANIZATION ("CHCA") FACILITATES THE SELECTION, IMPLEMENTATION, AND SUPPORT OF SERVICES AND TECHNOLOGIES THROUGH A CENTRALIZED ORGANIZATION, ALLOWING ITS MEMBERS TO EXPAND AND IMPROVE HEALTH-RELATED SERVICES FOR ALL. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 4752286 | Expense |
| Grants | 224700 | Grants |
| Description | COMMUNITY HEALTH CENTERS ALLIANCE, INC. ("CHCA") IS A 501(C)(3) FEDERALLY QUALIFIED HEALTH CENTER CONTROLLED NETWORK SERVICING SAFETY-NET, RURAL, AND PRIMARY CARE PROVIDERS THROUGH ITS ORIGINAL SERVICES AS A TECHNOLOGY PARTNER TO ITS FQHC MEMBERS AND THROUGH ITS DESIGNATION AS A FEDERALLY FUNDED AND RECOGNIZED REGIONAL EXTENSION CENTER (REC). WITH A PRIMARY FOCUS ON THE IMPROVEMENT OF HEALTH OUTCOMES AND PATIENT ENGAGEMENT VIA THE ADVANCEMENT OF HEALTH INFORMATION TECHNOLOGY, CHCA ENROLLED OVER 2,000 PROVIDERS IN ITS REC PROGRAM AND IS PROVIDING A VARIETY OF ASSISTANCE RELATED TO BEST PRACTICES IN ELECTRONIC HEALTH RECORDS ADOPTION, ATTAINMENT OF MEANINGFUL USE, AND PREPARATION FOR PATIENT CENTERED MEDICAL HOMES. | Description |
| Total Program Service Expense | 4752286 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | true | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | 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 | true | 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 | true | 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 | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | true | 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 |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 10 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Number Of Employees | 0 | NumberOfEmployees |
| 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 |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 4 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 0 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | true | MembersOrStockholders |
| Election Of Board Members | true | 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 | false | LocalChapters |
| 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 | JEANETTE LUGO | NamePerson |
| Telephone Number | 7275732422 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 140 FOUNTAIN PARKWAY | AddressLine1 |
| Address Line2 | SUITE 201 | AddressLine2 |
| City | ST PETERSBURG | City |
| State | FL | State |
| ZIP Code | 33716 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (5 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation |
|---|---|---|---|---|---|---|
| RICHARD AKIN | ||||||
| CHAIR | 1.00 | X | X | 0 | 0 | 0 |
| J R RICHARDS | ||||||
| DIRECTOR | 1.00 | X | X | 0 | 0 | 0 |
| MICKEY PRESHA | ||||||
| VICE CHAIR | 1.00 | X | X | 0 | 0 | 0 |
| EVERETT KELLY | ||||||
| SEC/TRES | 1.00 | X | 0 | 0 | 0 | |
| DIANE GADDIS | ||||||
| CEO | 55.00 | X | 239602 | 0 | 44864 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 239602 | TotalReportableCompFromOrg |
| Total Other Compensation | 44864 | TotalOtherCompensation |
| Number Individuals GT100 K | 1 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (5 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation | Address Line2AddressOfContractor/AddressUS/AddressLine2 |
|---|---|---|---|---|---|---|
| GE HEALTHCARE IITS USA CORP | ||||||
| 15724 COLLECTIONS CENTER DRIVE | CHICAGO | IL | 60693 | IT SERVICES | 924850 | |
| QUEST SOFTWARE INC | ||||||
| PO BOX 731381 | DALLAS | TX | 75373 | IT SERVICES | 189959 | |
| CDW GOVERNMENT INC | ||||||
| 75 REMITTANCE DRIVE | CHICAGO | IL | 60675 | IT SUPPLIES | 167620 | SUITE 1515 |
| CENTURYLINK | ||||||
| PO BOX 52187 | PHOENIX | AZ | 85072 | NETWORKING SERV | 137179 | |
| AMERISURE MUTUAL INSURANCE | ||||||
| 26777 HALSTED ROAD | FAMINGTON HILLS | MI | 48331 | RENT | 113517 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 5 | NumberOfContractorsGT100K |
| Government Grants | 3957075 | GovernmentGrants |
| Total Contributions | 3957075 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (4 entries)
| DescriptionDescription | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|
| IT SERVICES | 1449463 | 1449463 |
| REIMBURSABLE SERVICES | 140038 | 140038 |
| SOFTWARE SUPPORT | 129862 | 129862 |
| MEMBERSHIP DUES | 59500 | 59500 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 1778863 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 12638 | TotalRevenueColumn |
| Exclusion | $12,638 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | OTHER | Description |
| Total Revenue Column | 108387 | TotalRevenueColumn |
| Exclusion | $108,387 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 108387 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 5856963 | TotalRevenueColumn |
| Related Or Exempt Function Income | 1778863 | RelatedOrExemptFunctionIncome |
| Exclusion | $121,025 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | X | InfoInScheduleOPartIX |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 224700 | Total |
| Program Services | 224700 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 239602 | Total |
| Program Services | 107821 | ProgramServices |
| Management And General | 131781 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2111469 | Total |
| Program Services | 2004813 | ProgramServices |
| Management And General | 106656 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 572161 | Total |
| Program Services | 534755 | ProgramServices |
| Management And General | 37406 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 28578 | Total |
| Program Services | 11395 | ProgramServices |
| Management And General | 17183 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 776921 | Total |
| Program Services | 752478 | ProgramServices |
| Management And General | 24443 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12325 | Total |
| Program Services | 11864 | ProgramServices |
| Management And General | 461 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 315498 | Total |
| Program Services | 315498 | ProgramServices |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 113240 | Total |
| Program Services | 90592 | ProgramServices |
| Management And General | 22648 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 185210 | Total |
| Program Services | 168695 | ProgramServices |
| Management And General | 16515 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 372740 | Total |
| Program Services | 372740 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 15759 | Total |
| Program Services | 5309 | ProgramServices |
| Management And General | 10450 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| EQUIP. MAINT. & REPAIRS | 63484 | 63484 | |
| RECRUITMENT & RETENTION | 60821 | 5893 | 54928 |
| TELEPHONE | 49626 | 49235 | 391 |
| PROCESSING FEES | 39355 | 39355 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 42283 | Total |
| Program Services | 33014 | ProgramServices |
| Management And General | 9269 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5223772 | Total |
| Program Services | 4752286 | ProgramServices |
| Management And General | 471486 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 29417 | BOY |
| EOY | 97881 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3349012 | BOY |
| EOY | 3337548 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 336992 | BOY |
| EOY | 408537 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 253383 | BOY |
| EOY | 277659 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 91206 | BOY |
| EOY | 498364 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 2893854 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 2048254 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 562436 | BOY |
| EOY | 845600 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 12919 | BOY |
| EOY | 12919 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4635365 | BOY |
| EOY | 5478508 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 156469 | BOY |
| EOY | 205439 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 416460 | BOY |
| EOY | 577442 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 572929 | BOY |
| EOY | 782881 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4062436 | BOY |
| EOY | 4695627 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4062436 | BOY |
| EOY | 4695627 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4635365 | BOY |
| EOY | 5478508 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 633191 | ReconcilationRevenueExpenses |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Separate | X | FinancialStatementSeparate |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | true | AuditCommittee |
| Federal Grant Audit Required | true | FederalGrantAuditRequired |
| Federal Grant Audit Performed | true | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | X | PubliclySupportedOrg509a2 |
Gifts Grants Contrib Received509 GiftsGrantsContribReceived509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 1292138 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 1025242 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 873823 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 2427835 | CurrentTaxYearMinus1Year |
| Current Tax Year | 3957075 | CurrentTaxYear |
| Total | 9576113 | Total |
Gross Receipts From Admissions GrossReceiptsFromAdmissions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 1444129 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 2115940 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 2352150 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 2579908 | CurrentTaxYearMinus1Year |
| Current Tax Year | 1778863 | CurrentTaxYear |
| Total | 10270990 | Total |
Gross Receipts From Non UBI GrossReceiptsFromNonUBI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | 11675 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 45595 | CurrentTaxYearMinus1Year |
| Current Tax Year | 108387 | CurrentTaxYear |
| Total | 165657 | Total |
Total509 Total509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 2736267 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 3141182 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 3237648 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 5053338 | CurrentTaxYearMinus1Year |
| Current Tax Year | 5844325 | CurrentTaxYear |
| Total | 20012760 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | 20012760 | PublicSupportTotal509 |
Gross Investment Income509 GrossInvestmentIncome509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 26115 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 21610 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 8069 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 11717 | CurrentTaxYearMinus1Year |
| Current Tax Year | 12638 | CurrentTaxYear |
| Total | 80149 | Total |
Investment Income And UBTI InvestmentIncomeAndUBTI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 26115 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 21610 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 8069 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 11717 | CurrentTaxYearMinus1Year |
| Current Tax Year | 12638 | CurrentTaxYear |
| Total | 80149 | Total |
Total Support Total TotalSupportTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 2762382 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 3162792 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 3245717 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 5065055 | CurrentTaxYearMinus1Year |
| Current Tax Year | 5856963 | CurrentTaxYear |
| Total | 20092909 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Percentage509 | 0.99600 | PublicSupportPercentage509 |
| Prior Year Support Percentage | 0.99160 | PriorYearSupportPercentage |
| Investment Income Percentage | 0.00000 | InvestmentIncomePercentage |
| Prior Yr Invest Income Percentage | 0.01000 | PriorYrInvestIncomePercentage |
| Thirty Three Percnt Tests CY509 | X | ThirtyThreePercntTestsCY509 |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2893854 | OtherCostOrOtherBasis |
| Depreciation | 2048254 | Depreciation |
| Book Value | 845600 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 845600 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| DUE TO MEMBER (LEASED EMPL/BENEFITS) | $570,593 |
| ACCRUED EXPENSES | $6,849 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 577442 | TotalOfAmounts |
| Tot Revenue Etc Audited Fincl Stmt | 5856963 | TotRevenueEtcAuditedFinclStmt |
| Revenue Subtotal | 5856963 | RevenueSubtotal |
| Total Revenue Per Form990 | 5856963 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 5223772 | TotExpensesEtcAuditedFinclStmt |
| Expenses Subtotal | 5223772 | ExpensesSubtotal |
| Total Expenses Per Form990 | 5223772 | TotalExpensesPerForm990 |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Records Maintained | true | RecordsMaintained |
Recipient Table RecipientTable (2 entries)
| Address Line1AddressUS/AddressLine1 | CityAddressUS/City | StateAddressUS/State | ZIP CodeAddressUS/ZIPCode | EIN Of RecipientEINOfRecipient | IRC SectionIRCSection | Amount Of Cash GrantAmountOfCashGrant | Purpose Of GrantPurposeOfGrant |
|---|---|---|---|---|---|---|---|
| LMH | |||||||
| 2776 CLEVELAND AVENUE | FORT MYERS | FL | 33901 | 592559835 | 3 | 193500 | REC PROGRAM |
| PMG | |||||||
| 911 SOUTH MAIN STREET | TRENTON | FL | 32693 | 592871302 | 3 | 31200 | REC PROGRAM |
Form990 Schedule I Part IV Form990ScheduleIPartIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | PROCEDURES FOR MONITORING THE USE OF GRANT FUNDS INSIDE THE UNITED STATES | Identifier |
| Return Reference | SCHEDULE I, PAGE 1, PART I, LINE 2 | ReturnReference |
| Explanation | FOR ALL SUB-RECIPIENTS, THERE ARE SIGNED AGREEMENTS. ALL EXPENDITURES ARE REVIEWED FOR COMPLIANCE WITH AGREEMENTS ON HAND. ALL EXPENDITURES MUST HAVE SUPPORTING/BACK UP DOCUMENTATION. MONTHLY, ALL SUB-RECIPIENTS SEND ACTIVITY REPORTS OF PRACTICE/SITE VISITS ALONG WITH MONTHLY EXPENDITURES WHICH ARE REVIEWED BY FINANCE DIRECTOR AFTER WHICH CHECK IS ISSUED BY CEO. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Independent Consultant | X | IndependentConsultant |
| Written Employment Contract | X | WrittenEmploymentContract |
| 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 | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | DIANE GADDIS | NamePerson |
| Title | CEO | Title |
| Base Compensation Filing Org | 212715 | BaseCompensationFilingOrg |
| Other Compensation Filing Org | 26887 | OtherCompensationFilingOrg |
| Deferred Comp Filing Org | 30865 | DeferredCompFilingOrg |
| Nontaxable Benefits Filing Org | 13999 | NontaxableBenefitsFilingOrg |
| Total Compensation Filing Org | 284466 | TotalCompensationFilingOrg |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | OTHER ADDITIONAL INFORMATION | Identifier |
| Return Reference | SCHEDULE J, PART III | ReturnReference |
| Explanation | OTHER REPORTABLE COMPENSATION OF 26,887 CONSISTED OF RETRO PAYMENT. CEO HAD NOT RECEIVED A RETRO PAYMENT OR SALARY INCREASE SINCE 2008. | Explanation |
Schedule L IRS990ScheduleL
Form990 Schedule L Part IV Form990ScheduleLPartIV (4 entries)
| RelationshipRelationship | Amount Of TransactionAmountOfTransaction | Description Of TransactionDescriptionOfTransaction | Sharing Of RevenuesSharingOfRevenues |
|---|---|---|---|
| RICHARD AKIN | |||
| CEO OF MEMBER | 604930 | DUES/MEMBER SERVICES | false |
| MICKEY PRESHA | |||
| CEO OF MEMBER | 608340 | DUES/MEMBER SERVICES | false |
| JR RICHARDS | |||
| CEO OF MEMBER | 118701 | DUES/MEMBER SERVICES | false |
| EVERETT KELLY | |||
| CEO OF MEMBER | 215670 | DUES/MEMBER SERVICES | false |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (8 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| CLASSES OF MEMBERS OR STOCKHOLDERS | FORM 990, PAGE 6, PART VI, LINE 6 | THE ORGANIZATION CURRENTLY WORKS WITH OVER 3,000 HEALTHCARE PROVIDERS THROUGH THE STATE OF FLORIDA WHO COLLECTIVELY USE OVER 50 DIFFERENT EHR SYSTEMS. THESE MEMBERS INCLUDE BOTH PRIMARY CARE AND SPECIALTY CLINICIANS FROM PRIVATE PRACTICES, FEDERALLY QUALIFIED HEALTH CENTERS, PRATICE CONSORTIA, RURAL HOSPITALS AND CRITICAL ACCESS HOSPITALS. |
| ELECTION OF MEMBERS AND THEIR RIGHTS | FORM 990, PAGE 6, PART VI, LINE 7A | MEMBERS OF THE ORGANIZATION SELECT THE GOVERNING BODY. |
| ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 | FORM 990, PAGE 6, PART VI, LINE 11B | THE CEO AND FINANCE DIRECTOR REVIEW FORM 990 FOR ACCURACY AND COMPLETENESS PRIOR TO FORWARDING TO THE BOARD FOR APPROVAL. THE BOARD ALSO RECEIVES A COPY OF THE FORM 990 FOR REVIEW BEFORE FILING. |
| ENFORCEMENT OF CONFLICTS POLICY | FORM 990, PAGE 6, PART VI, LINE 12C | ARTICLE VI OF THE CONFLICT OF INTEREST POLICY REQUIRES THAT EACH DIRECTOR, PRINCIPAL OFFICER AND MEMBER OF THE BOARD OF DIRECTORS ANNUALLY SIGN A STATEMENT AFFIRMING THAT THEY HAVE RECEIVED, READ, UNDERSTAND AND AGREE TO COMPLY WITH THE POLICY. |
| COMPENSATION PROCESS FOR TOP OFFICIAL | FORM 990, PAGE 6, PART VI, LINE 15A | COMPENSATION FOR CEO IS ESTABLISHED BY AN APPROVAL PROCESS BY THE BOARD, WHICH INCLUDES AN INDEPENDENT COMPENSATION CONSULTANT AND A FINAL WRITTEN EMPLOYMENT CONTRACT. THE DECISION IS DOCUMENTED IN THE BOARD MEETING MINUTES. |
| COMPENSATION PROCESS FOR OFFICERS | FORM 990, PAGE 6, PART VI, LINE 15B | COMPENSATION FOR KEY EMPLOYEES IS DETERMINED AFTER COMPARING AND EVALUATING MARKET VALUE FOR SIMILAR POSITIONS USING AN INDEPENDENT CONSULTANT EVERY TWO YEARS. |
| GOVERNING DOCUMENTS DISCLOSURE EXPLANATION | FORM 990, PAGE 6, PART VI, LINE 19 | THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE ALL AVAILABLE TO PUBLIC UPON REQUEST. |
| OTHER FEES FOR SERVICES | FORM 990, PART IX, LINE 11G | CONTRACTED PERSONNEL 418,000 0 0 CONSULTANTS 137,327 24,443 0 CONTRACTED HOSTING SERVICES 197,151 0 0 |
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