SEATTLE ROOTS COMMUNITY HEALTH: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- SEATTLE ROOTS COMMUNITY HEALTH (EIN 23-7100868)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-11-11
- IRS object ID
- 201333169349301458
- 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 | 2013-11-11T15:53:25-06:00 | Timestamp |
| Tax Period End Date | 2012-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 410746749 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3000 NORTHUP WAY SUITE 200 | AddressLine1 |
| City | BELLEVUE | City |
| State | WA | State |
| ZIP Code | 98004 | 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 | 237100868 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COUNTRY DOCTOR COMMUNITY CLINIC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | COUN | NameControl |
| Phone | 2062991937 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2101 EAST YESLER WAY NO 210 | AddressLine1 |
| City | SEATTLE | City |
| State | WA | State |
| ZIP Code | 981225900 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | LINDA MCVEIGH | Name |
| Title | EXECUTIVE DIRECTOR | Title |
| Phone | 2062991937 | Phone |
| Date Signed | 2013-11-11 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | PAUL MBAILEY | Name |
| PTIN | P00292653 | PTIN |
| Phone | 4252506100 | Phone |
| Date Prepared | 2013-11-08 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | LINDA MCVEIGH | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 500 19TH AVENUE EAST | AddressLine1 |
| City | SEATTLE | City |
| State | WA | State |
| ZIP Code | 98112 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 11236450 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.COUNTRYDOCTOR.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1971 | YearFormation |
| State Legal Domicile | WA | StateLegalDomicile |
| Activity Or Mission Description | THE MISSION OF COUNTRY DOCTOR COMMUNITY CLINIC IS TO IMPROVE THE HEALTH OF OUR COMMUNITY BY PROVIDING HIGH QUALITY, CARING, CULTURALLY APPROPRIATE PRIMARY HEALTH CARE THAT ADDRESSESS THE NEEDS OF PEOPLE REGARDLESS OF THEIR ABILITY TO PAY. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 15 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 15 | NbrIndependentVotingMembers |
| Total Nbr Employees | 182 | TotalNbrEmployees |
| Total Nbr Volunteers | 16 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 4792780 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 4856236 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 5393367 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 5991341 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 14210 | InvestmentIncomePriorYear |
| Investment Income Current Year | 37684 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 646771 | OtherRevenuePriorYear |
| Other Revenue Current Year | 301808 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 10847128 | TotalRevenuePriorYear |
| Total Revenue Current Year | 11187069 | 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 | 8070734 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 8291100 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 127786 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 3098796 | OtherExpensePriorYear |
| Other Expenses Current Year | 3362624 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 11169530 | TotalExpensesPriorYear |
| Total Expenses Current Year | 11653724 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -322402 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -466655 | RevenuesLessExpensesCY |
| Total Assets BOY | 7032258 | TotalAssetsBOY |
| Total Assets EOY | 7923410 | TotalAssetsEOY |
| Total Liabilities BOY | 2898251 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 4265446 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 4134007 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 3657964 | NetAssetsOrFundBalancesEOY |
| Mission Description | THE MISSION OF COUNTRY DOCTOR COMMUNITY CLINIC IS TO IMPROVE THE HEALTH OF OUR COMMUNITY BY PROVIDING HIGH QUALITY, CARING, CULTURALLY APPROPRIATE PRIMARY HEALTH CARE THAT ADDRESSESS THE NEEDS OF PEOPLE REGARDLESS OF THEIR ABILITY TO PAY. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 8987514 | Expense |
| Revenue | 6181648 | Revenue |
| Description | IN 2012 COUNTRY DOCTOR COMMUNITY CLINIC PROVIDED 48,687 MEDICAL VISITS. 88% OF THE PATIENTS SEEN IN 2012 HAD INCOME LESS THAN 200% OF THE FEDERAL POVERTY (FPL). ALL UNINSURED PATIENTS (53% OF THE TOTAL PATIENTS SEEN) EARNING LESS THAN 200% OF FPL WERE SEEN ON A SLIDING SCALE DISCOUNT. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 60520 | Expense |
| Revenue | 30000 | Revenue |
| Description | DENTAL CARE IS PROVIDED TO COUNTRY DOCTOR COMMUNITY CLINC (CDCC) PATIENTS THROUGH A CONTRACTUAL ARRANGEMENT WITH A COMMUNITY DENTAL PROVIDER. IN 2012, 171 DENTAL VISITS WERE PROVIDED TO LOW INCOME, UNINSURED PATIENTS. | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 1140640 | Expense |
| Description | THE OTHER HEALTH SERVICES PROGRAM PROVIDED 14,876 ANCILLARY HEALTH VISITS (EG NUTRITION, MENTAL HEALTH, WIC, ELIGIBILITY) TO LOW INCOME PATIENTS. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 10188674 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 1 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 1 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 1 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 0 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 1 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 182 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 1 | QuidProQuoContributions |
| Quid Pro Quo Disclosure | 1 | QuidProQuoDisclosure |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Form8899 Filed | 0 | Form8899Filed |
| Form1098 C Filed | 0 | Form1098CFiled |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 15 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 15 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | WA | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SUSANA TANTICO | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 2062991937 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2101 EAST YESLER WAY SUITE 210 | AddressLine1 |
| City | SEATTLE | City |
| State | WA | State |
| ZIP Code | 98122 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (21 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| AUGUST PIPER | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| CHERYL ANDERSON | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| COLT DEWOLF | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| JERRET SALE | ||||||||
| TREASURER | 1.00 | X | 0 | 0 | 0 | |||
| JOAN KLEINBERG | ||||||||
| SECRETARY | 1.00 | X | 0 | 0 | 0 | X | ||
| LY SIENG NGO | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | X | ||
| PAMELA DUNN | ||||||||
| CHAIRPERSON | 1.00 | X | 0 | 0 | 0 | |||
| PATRICK FERGUSON | ||||||||
| VICE CHAIRPERSON | 1.00 | X | 0 | 0 | 0 | X | ||
| RIK WYMAN | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| SARA THOMPSON | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| WINNIE SPERRY | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| MORGAN DUTTON | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| MARY BYRD | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| CARLA KROEZE | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| ALLAN GUIDEN | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| LINDA MCVEIGH | ||||||||
| EXECUTIVE DIRECTOR | 35.00 | 148456 | 0 | 13374 | X | |||
| RICHARD KOVAR | ||||||||
| MEDICAL DIRECTOR | 31.00 | 158289 | 0 | 18334 | X | |||
| HAROLD MOORE | ||||||||
| CLINIC SITE DIRECTOR | 35.00 | 145496 | 0 | 14246 | X | |||
| CARRIE RUBENSTEIN | ||||||||
| PHYSICIAN/CLINICAL DIRECTO | 28.00 | 110291 | 0 | 11137 | X | |||
| MEGAN DEBELL | ||||||||
| PHYSICIAN/CLINICAL DIRECTO | 28.00 | 110290 | 0 | 10686 | X | |||
| JEFFERY WARNER | ||||||||
| MEDICAL DIRECTOR | 21.00 | 111368 | 0 | 10958 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 784190 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 78735 | TotalOtherCompensation |
| Number Individuals GT100 K | 9 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation
Name Of Contractor NameOfContractor
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PTSO OF WASHINGTON | BusinessNameLine1 |
Address Of Contractor AddressOfContractor
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3101 FOURTH AVE SUITE 320 | AddressLine1 |
| City | SEATTLE | City |
| State | WA | State |
| ZIP Code | 98101 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description Of Services | INFO TECH SUPPORT | DescriptionOfServices |
| Compensation | 304729 | Compensation |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 1 | NumberOfContractorsGT100K |
| Fundraising Events | 57000 | FundraisingEvents |
| Government Grants | 4196962 | GovernmentGrants |
| All Other Contributions | 602274 | AllOtherContributions |
| Noncash Contributions | 262995 | NoncashContributions |
| Total Contributions | 4856236 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| PATIENT FEES | 621400 | 2609587 | 2609587 |
| THIRD PARTY PAYMENTS | 900099 | 1832909 | 1832909 |
| MEDICARE/MEDICAID PAYMENTS | 900099 | 1548845 | 1548845 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 5991341 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 37684 | TotalRevenueColumn |
| Exclusion | $37,684 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 58463 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 58463 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 58463 | TotalRevenueColumn |
| Exclusion | $58,463 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 72419 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 57000 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 49381 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 23038 | TotalRevenueColumn |
| Exclusion | $23,038 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | OTHER REVENUE | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 220307 | TotalRevenueColumn |
| Related Or Exempt Function Income | 220307 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 220307 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 11187069 | TotalRevenueColumn |
| Related Or Exempt Function Income | 6211648 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $119,185 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 338452 | Total |
| Program Services | 133631 | ProgramServices |
| Management And General | 204821 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6254835 | Total |
| Program Services | 5825503 | ProgramServices |
| Management And General | 346301 | ManagementAndGeneral |
| Fundraising | 83031 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 264098 | Total |
| Program Services | 223309 | ProgramServices |
| Management And General | 37541 | ManagementAndGeneral |
| Fundraising | 3248 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 757256 | Total |
| Program Services | 654591 | ProgramServices |
| Management And General | 92961 | ManagementAndGeneral |
| Fundraising | 9704 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 676459 | Total |
| Program Services | 571981 | ProgramServices |
| Management And General | 96158 | ManagementAndGeneral |
| Fundraising | 8320 | Fundraising |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 82158 | Total |
| Management And General | 82158 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 71872 | Total |
| Management And General | 71872 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 726481 | Total |
| Program Services | 693665 | ProgramServices |
| Management And General | 32790 | ManagementAndGeneral |
| Fundraising | 26 | Fundraising |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 247325 | Total |
| Program Services | 175575 | ProgramServices |
| Management And General | 53639 | ManagementAndGeneral |
| Fundraising | 18111 | Fundraising |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 349892 | Total |
| Program Services | 233276 | ProgramServices |
| Management And General | 113554 | ManagementAndGeneral |
| Fundraising | 3062 | Fundraising |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 37536 | Total |
| Program Services | 27224 | ProgramServices |
| Management And General | 9985 | ManagementAndGeneral |
| Fundraising | 327 | Fundraising |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 414324 | Total |
| Program Services | 390096 | ProgramServices |
| Management And General | 24146 | ManagementAndGeneral |
| Fundraising | 82 | Fundraising |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 89133 | Total |
| Program Services | 8174 | ProgramServices |
| Management And General | 80959 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| BAD DEBT | 582298 | 582298 | ||
| PHARMACEUTICALS | 467670 | 467670 | ||
| OTHER HEALTHCARE SUPPLI | 148856 | 148817 | 39 | |
| MISCELLANEOUS | 145079 | 52864 | 90340 | 1875 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11653724 | Total |
| Program Services | 10188674 | ProgramServices |
| Management And General | 1337264 | ManagementAndGeneral |
| Fundraising | 127786 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 308879 | BOY |
| EOY | 284735 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 91367 | BOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 734297 | BOY |
| EOY | 597017 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 778079 | BOY |
| EOY | 923118 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 460170 | BOY |
| EOY | 469121 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 9194834 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 5027527 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2992864 | BOY |
| EOY | 4167307 | EOY |
Investments Pub Traded Securities InvestmentsPubTradedSecurities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1653174 | BOY |
| EOY | 1482112 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13428 | BOY |
| EOY | 0 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7032258 | BOY |
| EOY | 7923410 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 878509 | BOY |
| EOY | 1205977 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1697853 | BOY |
| EOY | 2756386 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 321889 | BOY |
| EOY | 303083 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2898251 | BOY |
| EOY | 4265446 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4050952 | BOY |
| EOY | 3574909 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 83055 | BOY |
| EOY | 83055 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4134007 | BOY |
| EOY | 3657964 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7032258 | BOY |
| EOY | 7923410 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | -466655 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | -9388 | ReconciliationUnrealizedInvest |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Separate | X | FinancialStatementSeparate |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 1 | FederalGrantAuditRequired |
| Federal Grant Audit Performed | 1 | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org170b1 Avi | X | PubliclySupportedOrg170b1Avi |
Gifts Grants Contrib Received170 GiftsGrantsContribReceived170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 4565967 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 4928394 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 5556179 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 4792780 | CurrentTaxYearMinus1Year |
| Current Tax Year | 4856236 | CurrentTaxYear |
| Total | 24699556 | Total |
Total170 Total170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 4565967 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 4928394 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 5556179 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 4792780 | CurrentTaxYearMinus1Year |
| Current Tax Year | 4856236 | CurrentTaxYear |
| Total | 24699556 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | 24699556 | PublicSupportTotal170 |
Gross Investment Income170 GrossInvestmentIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 134216 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 95365 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 84668 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 57372 | CurrentTaxYearMinus1Year |
| Current Tax Year | 96147 | CurrentTaxYear |
| Total | 467768 | Total |
Net UBI NetUBI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 94785 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 74227 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 30685 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 78158 | CurrentTaxYearMinus1Year |
| Current Tax Year | -49381 | CurrentTaxYear |
| Total | 228474 | Total |
Other Income170 OtherIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 1882 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 3841 | CurrentTaxYearMinus3Years |
| Total | 5723 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | 25401521 | TotalSupport |
| Public Support Pertcentage170 | 0.97240 | PublicSupportPertcentage170 |
| Public Support Pertcent Prior Year | 0.96080 | 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 D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 83055 | BeginningOfYearBalance |
| End Of Year Balance | 83055 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 83055 | BeginningOfYearBalance |
| End Of Year Balance | 83055 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 83055 | BeginningOfYearBalance |
| End Of Year Balance | 83055 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 83055 | BeginningOfYearBalance |
| End Of Year Balance | 83055 | EndOfYearBalance |
Current Year Minus4 Years CurrentYearMinus4Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 83055 | BeginningOfYearBalance |
| End Of Year Balance | 83055 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Endowments Held By Unrelated Orgs | 0 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 0 | EndowmentsHeldByRelatedOrgs |
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 184000 | OtherCostOrOtherBasis |
| Book Value | 184000 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 6780574 | OtherCostOrOtherBasis |
| Depreciation | 3283280 | Depreciation |
| Book Value | 3497294 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 182047 | OtherCostOrOtherBasis |
| Depreciation | 171633 | Depreciation |
| Book Value | 10414 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2048213 | OtherCostOrOtherBasis |
| Depreciation | 1572614 | Depreciation |
| Book Value | 475599 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 4167307 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| CAPITAL LEASE | $15,950 |
| FQHC ENHANCEMENT SETTLEMENT | $287,133 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 303083 | TotalOfAmounts |
| Footnote In Part XIII | X | FootnoteInPartXIII |
| Tot Revenue Etc Audited Fincl Stmt | 11308949 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | -9388 | NetUnrealizedGainsInvestments |
| Donated Srvc And Use Of Facilities | 81887 | DonatedSrvcAndUseOfFacilities |
| Other Revenues | 49381 | OtherRevenues |
| Revenue Not Rptd F990 | 121880 | RevenueNotRptdF990 |
| Revenue Subtotal | 11187069 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 11187069 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 11784992 | TotExpensesEtcAuditedFinclStmt |
| Donated Services Use Of Facilities | 81887 | DonatedServicesUseOfFacilities |
| Other Expenses Included | 49381 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 131268 | ExpensesNotRptdF990 |
| Expenses Subtotal | 11653724 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 11653724 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII (6 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: | PART V, LINE 4: | THE ENDOWMENT FUNDS ARE ASSETS SET ASIDE AND RESTRICTED BY DONORS. THE INCOME GENERATED FROM THESE ASSETS IS USED TO FUND OPERATIONS OF THE ORGANIZATION. |
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X, LINE 2: | CDCHC HAS RECEIVED A DETERMINATION LETTER FROM THE IRS THAT STATES IT IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. NO PROVISION FOR INCOME TAXES IS SHOWN IN THE FINANCIAL STATEMENTS BECAUSE CDCHC IS A NONPROFIT ORGANIZATION, EXEMPT FROM INCOME TAXES. MANAGEMENT EVALUATED CDCHC'S TAX POSITIONS AND CONCLUDED THAT CDCHC HAD TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENTS TO THE FINANCIAL STATEMENTS TO COMPLY WITH THE PROVISIONS OF TOPIC 740 OF THE ACCOUNTING STANDARDS CODIFICATION. CDCHC IS NO LONGER SUBJECT TO U.S. FEDERAL INCOME TAX EXAMINATIONS BY TAX AUTHORITIES FOR THE YEARS BEFORE 2009. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | DIRECT SPECIAL EVENT EXPENSE | |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | DIRECT SPECIAL EVENT EXPENSE | |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: DIRECT SPECIAL EVENT EXPENSES PART XIII, LINE 2D - OTHER ADJUSTMENTS: DIRECT SPECIAL EVENT EXPENSES | ||
| CDCHC HAS RECEIVED A DETERMINATION LETTER FROM THE IRS THAT STATES IT IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. NO PROVISION FOR INCOME TAXES IS SHOWN IN THE FINANCIAL STATEMENTS BECAUSE CDCHC IS A NOT-FOR-PROFIT ORGANIZATION, EXEMPT FROM INCOME TAXES. MANAGEMENT EVALUATED CDCHCS TAX POSITIONS AND CONCLUDED THAT CDCHC HAD TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENTS TO THE FINANCIAL STATEMENTS TO COMPLY WITH THE PROVISIONS OF TOPIC 740 OF THE ACCOUNTING STANDARDS CODIFICATION. CDCHC IS NO LONGER SUBJECT TO U.S. FEDERAL INCOME TAX EXAMINATIONS BY TAX AUTHORITIES FOR THE YEARS BEFORE 2008. |
Schedule G IRS990ScheduleG
Events Information EventsInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Event1 | FUND RAISING DINNER | NameOfEvent1 |
| Gross Receipts Event1 | 129419 | GrossReceiptsEvent1 |
| Charitable Contributions Event1 | 57000 | CharitableContributionsEvent1 |
| Gross Revenue Event1 | 72419 | GrossRevenueEvent1 |
| Rent Facility Costs Event1 | 13513 | RentFacilityCostsEvent1 |
| Entertainment Event1 | 1000 | EntertainmentEvent1 |
| Other Direct Expenses Event1 | 34868 | OtherDirectExpensesEvent1 |
| Gross Receipts Total | 129419 | GrossReceiptsTotal |
| Charitable Contributions Total | 57000 | CharitableContributionsTotal |
| Gross Revenue Total Events | 72419 | GrossRevenueTotalEvents |
| Rent Facility Costs Total Events | 13513 | RentFacilityCostsTotalEvents |
| Entertainment Total Events | 1000 | EntertainmentTotalEvents |
| Other Direct Expenses Total Events | 34868 | OtherDirectExpensesTotalEvents |
| Direct Expense Summary Events | 49381 | DirectExpenseSummaryEvents |
| Net Income Summary | 23038 | NetIncomeSummary |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Independent Consultant | X | IndependentConsultant |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (3 entries)
| TitleTitle | 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| LINDA MCVEIGH | ||||||||||||||
| EXECUTIVE DIRECTOR | 148348 | 0 | 108 | 0 | 0 | 0 | 0 | 0 | 13374 | 0 | 161830 | 0 | 0 | 0 |
| RICHARD KOVAR | ||||||||||||||
| MEDICAL DIRECTOR | 158192 | 0 | 97 | 0 | 0 | 0 | 0 | 0 | 18334 | 0 | 176623 | 0 | 0 | 0 |
| HAROLD MOORE | ||||||||||||||
| CLINIC SITE DIRECTOR | 145388 | 0 | 108 | 0 | 0 | 0 | 0 | 0 | 14246 | 0 | 159742 | 0 | 0 | 0 |
Schedule M IRS990ScheduleM
Drugs And Medical Supplies DrugsAndMedicalSupplies
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Number Of Contributions | 12 | NumberOfContributions |
| Noncash Contribs Rptd F990 | 262955 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | COST OR SELLING PRICE | MethodOfDeterminingRevenues |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeld |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGifts |
| Third Parties Used | 0 | ThirdPartiesUsed |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (5 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | THE EXECUTIVE DIRECTOR AND DIRECTOR OF FINANCE BOTH REVIEW A DRAFT OF THE RETURN BEFORE IT IS PRESENTED TO THE FINANCE COMMITTEE FOR FURTHER REVIEW. AFTER REVIEW BY THE FINANCE COMMITTEE AND DISTRIBUTION TO THE FULL BOARD THE FORM 990 IS FILED WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | COMPLIANCE AND NON-COMPLIANCE WERE REGULARLY AND CONSISTENTLY MONITORED AND ENFORCED DURING THE MONTHLY MEETINGS. BOARD MEMBERS SIGN A CONFLICT OF INTEREST FORM ANNUALLY. ANY MEMBER WITH A STATED CONFLICT OF INTEREST IS REVIEWED BY THE EXECUTIVE COMMITTEE. THE BOARD CHAIRPERSON DETERMINES THE EXTENT OF THE CONFLICT AND WHETHER THE CONFLICTED BOARD MEMBER SHOULD NOT VOTE ON AN ISSUE OR SHOULD RECUSE THEMSELF FROM THE DISCUSSION. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE EXECUTIVE DIRECTOR'S COMPENSATION IS REVIEWED ANNUALLY BY THE BOARD OF DIRECTORS. EVERY TWO YEARS THIS PROCESS IS ASSISTED BY AN INDEPENDENT COMPENSATION CONSULTANT. THE LAST REVIEW PROCESS OF THE EXECUTIVE DIRECTOR'S COMPENSATION WAS DONE IN AUGUST 2010. THE DIRECTOR OF FINANCE'S COMPENSATION IS DETERMINED ANNUALLY BY THE BOARD BASED ON A MILLIMAN SURVEY THAT ASSESSES MARKET COMPENSATION. THE REVIEW OF THE DIRECTOR OF FINANCE'S COMPENSATION WAS DONE IN JULY 2010. |
| FORM 990, PART VI, SECTION C, LINE 19 | NO DOCUMENTS AVAILABLE TO THE PUBLIC. |
| THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEARS. |
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