WESTERN WAYNE FAMILY HEALTH CENTERS: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- WESTERN WAYNE FAMILY HEALTH CENTERS (EIN 30-0281587)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-04-19
- IRS object ID
- 201341099349300509
- 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 | 2013-04-19T10:22:54-05:00 | 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 | QUAST JANKE & CO CPA'S PC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1010 N JOHNSON | AddressLine1 |
| City | BAY CITY | City |
| State | MI | State |
| ZIP Code | 48708 | 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 | 300281587 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WESTERN WAYNE FAMILY HEALTH CENTERS | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | WEST | NameControl |
| Phone | 3135615100 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2500 HAMLIN RD | AddressLine1 |
| City | INKSTER | City |
| State | MI | State |
| ZIP Code | 48141 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | LINDA ATKINS | Name |
| Title | EXECUTIVE DIRECTOR | Title |
| Phone | 3135615100 | Phone |
| Date Signed | 2013-04-18 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | DAVID G GWIZDALA CPA | Name |
| Phone | 9898924549 | Phone |
| Date Prepared | 2013-04-18 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 5844735 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWFHCINKSTER.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 2006 | YearFormation |
| State Legal Domicile | MI | StateLegalDomicile |
| Activity Or Mission Description | TO PROVIDE QUALITY,COMPREHENSIVE PRIMARY HEALTH CARE SERVICES THAT ARE ACCESSIBLE, AFFORDABLE AND RESPONSIVE TO THE COMMUNITIES THAT WE SERVE. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 12 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 12 | NbrIndependentVotingMembers |
| Total Nbr Employees | 71 | TotalNbrEmployees |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 1776193 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 2233689 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 3225113 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 3610327 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 327 | InvestmentIncomePriorYear |
| Investment Income Current Year | 719 | InvestmentIncomeCurrentYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 5001633 | TotalRevenuePriorYear |
| Total Revenue Current Year | 5844735 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 2747266 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 3327317 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 1373392 | OtherExpensePriorYear |
| Other Expenses Current Year | 1678024 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 4120658 | TotalExpensesPriorYear |
| Total Expenses Current Year | 5005341 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 880975 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 839394 | RevenuesLessExpensesCY |
| Total Assets BOY | 2659594 | TotalAssetsBOY |
| Total Assets EOY | 3993702 | TotalAssetsEOY |
| Total Liabilities BOY | 263700 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 758414 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 2395894 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 3235288 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | TO PROVIDE QUALITY,COMPREHENSIVE PRIMARY HEALTH CARE SERVICES THAT ARE ACCESSIBLE, AFFORDABLE AND RESPONSIVE TO THE COMMUNITIES THAT WE SERVE. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Description | CENTER IS A FEDERALLY QUALIFIED HEALTH CENTER AND IS SERVICING APPROXIMATELY 10,000 PATIENTS IN A MEDICALLY UNDERSERVED AREA. CLINIC ENCOUNTERS FOR THE YEAR TOTALED APPROXIMATELY 35,600. | Description |
Activity Other ActivityOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 3827354 | Expense |
| Description | CENTER IS A FEDERALLY QUALIFIED HEALTH CENTER AND IS SERVICING APPROXIMATELY 10,000 PATIENTS IN A MEDICALLY UNDERSERVED AREA CLINIC ENCOUNTERS FOR THE YEAR WERE APPROXIMATELY 35,600 | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Other Program Service Exp | 3827354 | TotalOfOtherProgramServiceExp |
| Total Program Service Expense | 3827354 | 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 | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | true | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | false | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 41 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 71 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 12 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 12 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | false | MembersOrStockholders |
| Election Of Board Members | false | ElectionOfBoardMembers |
| Decisions Subject To Approval | false | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | 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 | RAO KAKARALA | NamePerson |
| Telephone Number | 3135615100 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2500 HAMLIN | AddressLine1 |
| City | INKSTER | City |
| State | MI | State |
| ZIP Code | 48141 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (19 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| LINDA ATKINS | |||||||
| CEO | 40.00 | X | X | 93985 | 0 | 4927 | |
| CINDY MURDOCK | |||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||
| NOAH BERGERON | |||||||
| CHAIRMAN | 4.00 | X | 0 | 0 | 0 | ||
| TERREL LECESNE | |||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||
| BOBBIE WALLACE | |||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||
| EUGINA DILLARD | |||||||
| SECRETARY | 2.00 | X | 0 | 0 | 0 | ||
| ROY BIRMINGHAM | |||||||
| TREASURER | 2.00 | X | 0 | 0 | 0 | ||
| DAVID IPPEL | |||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||
| LISA RUTLEDGE | |||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||
| TROY TIPTON | |||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||
| CAROLYN KIMBROUGH | |||||||
| VICE CHAIR | 2.00 | X | 0 | 0 | 0 | ||
| MARK TUCKER | |||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||
| BISHOP WALTER STARGHILL | |||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||
| ERROL ELRINGTON | |||||||
| CMO | 40.00 | X | 180083 | 0 | 70 | ||
| RAO KAKARALA | |||||||
| CFO | 12.00 | X | 0 | 0 | 0 | ||
| RULA AL-AOUAR | |||||||
| PHYSCIAN | 40.00 | 250421 | 0 | 4380 | X | ||
| LUNA ALKHAFAJI | |||||||
| PHYSICIAN | 40.00 | 176000 | 0 | 4927 | X | ||
| JONATHAN LEVI | |||||||
| PHYSICIAN | 40.00 | 163840 | 0 | 4450 | X | ||
| ANN CANE | |||||||
| NURSE PRACTI | 40.00 | 124368 | 0 | 4927 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 988697 | TotalReportableCompFromOrg |
| Total Other Compensation | 23681 | TotalOtherCompensation |
| Number Individuals GT100 K | 5 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (2 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| EHS | |||||
| ONE METROPLEX DR STE 500 | BIRMINGHAM | AL | 35209 | BILLING SERVICE | 180989 |
| COMMUNITY CARE PROPERTIES | |||||
| 26184 WEST OUTER DRIVE | LINCOLN PARK | MI | 48146 | RENT | 102179 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 2 | NumberOfContractorsGT100K |
| Government Grants | 2070901 | GovernmentGrants |
| All Other Contributions | 162788 | AllOtherContributions |
| Total Contributions | 2233689 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (4 entries)
| DescriptionDescription | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|
| PATIENT FEES | 3455092 | 3455092 |
| PHARMACY | 141090 | 141090 |
| MEDICAL RECORDS | 10722 | 10722 |
| OTHER | 3423 | 3423 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 3610327 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 719 | TotalRevenueColumn |
| Related Or Exempt Function Income | 719 | RelatedOrExemptFunctionIncome |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 5844735 | TotalRevenueColumn |
| Related Or Exempt Function Income | 3611046 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | X | InfoInScheduleOPartIX |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 274068 | Total |
| Program Services | 180083 | ProgramServices |
| Management And General | 93985 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2617431 | Total |
| Program Services | 2002852 | ProgramServices |
| Management And General | 614579 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 213364 | Total |
| Program Services | 161079 | ProgramServices |
| Management And General | 52285 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 222454 | Total |
| Program Services | 167942 | ProgramServices |
| Management And General | 54512 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 549940 | Total |
| Program Services | 414193 | ProgramServices |
| Management And General | 135747 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 16840 | Total |
| Program Services | 7578 | ProgramServices |
| Management And General | 9262 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 36267 | Total |
| Program Services | 24014 | ProgramServices |
| Management And General | 12253 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 174875 | Total |
| Program Services | 148644 | ProgramServices |
| Management And General | 26231 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 46230 | Total |
| Program Services | 23115 | ProgramServices |
| Management And General | 23115 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 20064 | Total |
| Program Services | 16051 | ProgramServices |
| Management And General | 4013 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12636 | Total |
| Program Services | 6386 | ProgramServices |
| Management And General | 6250 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| DEPRECIATION | 187797 | 140848 | 46949 |
| SUPPLIES | 173229 | 173229 | |
| BAD DEBT | 95615 | 95615 | |
| PHARMACEUTICALS | 69067 | 69067 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 295464 | Total |
| Program Services | 196658 | ProgramServices |
| Management And General | 98806 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5005341 | Total |
| Program Services | 3827354 | ProgramServices |
| Management And General | 1177987 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1116684 | BOY |
| EOY | 2851937 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 70409 | BOY |
| EOY | 118382 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 832594 | BOY |
| EOY | 189823 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 20564 | BOY |
| EOY | 17740 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 34474 | BOY |
| EOY | 70869 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 1347783 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 602832 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 584869 | BOY |
| EOY | 744951 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2659594 | BOY |
| EOY | 3993702 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 242691 | BOY |
| EOY | 333316 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 414593 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 21009 | BOY |
| EOY | 10505 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 263700 | BOY |
| EOY | 758414 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2395894 | BOY |
| EOY | 3235288 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2395894 | BOY |
| EOY | 3235288 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2659594 | BOY |
| EOY | 3993702 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 839394 | 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) |
|---|---|---|
| Federal Grant Audit Required | true | FederalGrantAuditRequired |
| Federal Grant Audit Performed | true | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org170b1 Avi | X | PubliclySupportedOrg170b1Avi |
Gifts Grants Contrib Received170 GiftsGrantsContribReceived170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 747774 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 1846572 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 1830224 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 1776193 | CurrentTaxYearMinus1Year |
| Current Tax Year | 2233689 | CurrentTaxYear |
| Total | 8434452 | Total |
Total170 Total170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 747774 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 1846572 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 1830224 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 1776193 | CurrentTaxYearMinus1Year |
| Current Tax Year | 2233689 | CurrentTaxYear |
| Total | 8434452 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | 8434452 | PublicSupportTotal170 |
| Total Support | 8434452 | TotalSupport |
| Gross Receipts From Admissions Etc | 3611046 | GrossReceiptsFromAdmissionsEtc |
| Public Support Pertcentage170 | 1.00000 | PublicSupportPertcentage170 |
| Public Support Pertcent Prior Year | 1.00000 | 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
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 286513 | OtherCostOrOtherBasis |
| Depreciation | 155065 | Depreciation |
| Book Value | 131448 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1061270 | OtherCostOrOtherBasis |
| Depreciation | 447767 | Depreciation |
| Book Value | 613503 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 744951 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| CAPITAL LEASE | $10,505 |
| MEDICAID COST REPORT PAYABLE |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 10505 | TotalOfAmounts |
| Tot Revenue Etc Audited Fincl Stmt | 5844735 | TotRevenueEtcAuditedFinclStmt |
| Revenue Subtotal | 5844735 | RevenueSubtotal |
| Total Revenue Per Form990 | 5844735 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 5005341 | TotExpensesEtcAuditedFinclStmt |
| Expenses Subtotal | 5005341 | ExpensesSubtotal |
| Total Expenses Per Form990 | 5005341 | TotalExpensesPerForm990 |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Form990 Of Other Organizations | X | Form990OfOtherOrganizations |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | false | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (4 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Deferred Comp Filing OrgDeferredCompFilingOrg | Total Compensation Filing OrgTotalCompensationFilingOrg |
|---|---|---|---|
| ERROL ELRINGTON | |||
| CMO | 180083 | 70 | 180153 |
| RULA AL-AOUAR | |||
| PHYSCIAN | 250421 | 4380 | 254801 |
| LUNA ALKHAFAJI | |||
| PHYSICIAN | 176000 | 4927 | 180927 |
| JONATHAN LEVI | |||
| PHYSICIAN | 163840 | 4450 | 168290 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (8 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| EXPLANATION ON VOLUNTEERS AND TYPES OF SERVICES OR BENEFITS | FORM 990, PAGE 1, PART I, LINE 6 | VOLUNTEER BOARD OF DIRECTORS |
| ALL OTHER ACCOMPLISHMENT DESCRIPTION | FORM 990, PAGE 2, PART III, LINE 4D | CENTER IS A FEDERALLY QUALIFIED HEALTH CENTER AND IS SERVICING APPROXIMATELY 10,000 PATIENTS IN A MEDICALLY UNDERSERVED AREA CLINIC ENCOUNTERS FOR THE YEAR WERE APPROXIMATELY 35,600 |
| ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 | FORM 990, PAGE 6, PART VI, LINE 11B | BOARD OF DIRECTORS, CFO AND AUDITOR REVIEW 990 PRIOR TO SUBMISSION. GOVERANCE QUESTIONS AGREED UPON AND REVIEWED ANNUALLY. |
| ENFORCEMENT OF CONFLICTS POLICY | FORM 990, PAGE 6, PART VI, LINE 12C | BOARD MEMBERS ARE ASKED IF ANY ITEM ON THE AGENDA REPRESENTS A CONFLICT OF INTEREST AT EACH MEETING. CONFLICTS ARE DISCUSSED PRIOR TO BOARD ACTION |
| COMPENSATION PROCESS FOR TOP OFFICIAL | FORM 990, PAGE 6, PART VI, LINE 15A | CEO COMPENSATION WITHIN 75TH PERCENTILE OF CEO OF OTHER CENTERS FROM DATA SUPPLIED BY NATIONAL ASSOCIATION OF HEALTH CENTERS |
| COMPENSATION PROCESS FOR OFFICERS | FORM 990, PAGE 6, PART VI, LINE 15B | BOARD COMPENSATION REVIEW AND APPROVAL FOR KEY EMPLOYEES |
| GOVERNING DOCUMENTS DISCLOSURE EXPLANATION | FORM 990, PAGE 6, PART VI, LINE 19 | AVAILABLE UPON REQUEST |
| OTHER FEES FOR SERVICES | FORM 990, PART IX, LINE 11G | CONTRACT SERVICES 223,304 39,407 0 PURCHASED SERVICES 45,245 40,000 0 PAYROLL SERVICE 0 723 0 COMPUTER SERVICE 78,772 13,901 0 SECURITY 59,048 10,420 0 CONSULTING 7,824 31,296 0 |
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