COMMUNITY HEALTH CENTER OF RICHMOND INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
COMMUNITY HEALTH CENTER OF RICHMOND INC (EIN 51-0567466)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-11-04
IRS object ID
201343089349300674
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

FieldValueIRS element (for citing)
Timestamp2013-11-04T10:04:47-06:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN232932984EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1PARENTEBEARD LLCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line11650 MARKET STREET SUITE 4500AddressLine1
CityPHILADELPHIACity
StatePAState
ZIP Code19103ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN510567466EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1COMMUNITY HEALTH CENTER OF RICHMOND INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlCOMMNameControl
Phone7189242254Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1235 PORT RICHMOND AVENUEAddressLine1
CitySTATEN ISLANDCity
StateNYState
ZIP Code10302ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameHENRY THOMPSONName
TitleCEOTitle
Phone7189242254Phone
Date Signed2013-11-01DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameJULIUS GREEN CPAName
PTINP00350393PTIN
Phone2159720701Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonHENRY THOMPSONNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1235 PORT RICHMOND AVENUEAddressLine1
CitySTATEN ISLANDCity
StateNYState
ZIP Code10302ZIPCode
FieldValueIRS element (for citing)
Gross Receipts6388336GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteCHCRICHMOND.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2006YearFormation
State Legal DomicileNYStateLegalDomicile
Activity Or Mission DescriptionPROVIDE PRIMARY CARE SERVICES WITH AN EMPHASIS ON SERVING THE POOR AND UNDERINSURED.ActivityOrMissionDescription
Nbr Voting Members Governing Body14NbrVotingMembersGoverningBody
Nbr Independent Voting Members14NbrIndependentVotingMembers
Total Nbr Employees44TotalNbrEmployees
Total Nbr Volunteers14TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year4095323ContributionsGrantsPriorYear
Contributions Grants Current Year2678498ContributionsGrantsCurrentYear
Program Service Revenue Prior Year2769815ProgramServiceRevenuePriorYear
Program Service Revenue CY3515979ProgramServiceRevenueCY
Investment Income Prior Year2830InvestmentIncomePriorYear
Investment Income Current Year6211InvestmentIncomeCurrentYear
Other Revenue Prior Year175825OtherRevenuePriorYear
Other Revenue Current Year187648OtherRevenueCurrentYear
Total Revenue Prior Year7043793TotalRevenuePriorYear
Total Revenue Current Year6388336TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year2997470SalariesEtcPriorYear
Salaries Etc Current Year3175214SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year2410104OtherExpensePriorYear
Other Expenses Current Year2248548OtherExpensesCurrentYear
Total Expenses Prior Year5407574TotalExpensesPriorYear
Total Expenses Current Year5423762TotalExpensesCurrentYear
Revenues Less Expenses Prior Year1636219RevenuesLessExpensesPriorYear
Revenues Less Expenses CY964574RevenuesLessExpensesCY
Total Assets BOY6576276TotalAssetsBOY
Total Assets EOY8058524TotalAssetsEOY
Total Liabilities BOY2315519TotalLiabilitiesBOY
Total Liabilities EOY2833193TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY4260757NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY5225331NetAssetsOrFundBalancesEOY
Mission DescriptionTHE MISSION OF THE COMMUNITY HEALTH CENTER OF RICHMOND IS TO PROVIDE QUALITY PRIMARY CARE THAT IS ACCESSIBLE, AFFORDABLE AND RESPECTFUL TO ALL OF THE COMMUNITIES IT SERVES.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense3313917Expense
Revenue3515979Revenue
DescriptionPROVIDING PRIMARY CARE SERVICES TO RESIDENTS OF STATEN ISLAND, NEW YORK WITH PARTICULAR EMPHASIS PLACED ON SERVING THE POOR AND UNDER-INSURED WITHIN THE COMMUNITY. THERE WERE 23,693 VISITS FOR 2012. CHCR HAS PROVIDED SERVICES TO 6,750 PATIENTS OF WHICH 2,192 WERE UNINSURED AND 5,360 WERE AT 200% OR BELOW THE FEDERAL POVERTY GUIDELINE. THERE WERE 18.93 MEDICAL PROVIDER FTES WHO DELIVERED THE SERVICES DURING THE YEAR.Description
Total Program Service Expense3313917TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities0ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions1DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity0RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109620NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees44NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Excess Business Holdings0ExcessBusinessHoldings
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members14NbrVotingGoverningBodyMembers
Number Independent Voting Members14NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledNYStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonBENNY LINDO CFONamePerson
Telephone Number7189242254TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1242 PORT RICHMOND AVEAddressLine1
CitySTATEN ISLANDCity
StateNYState
ZIP Code10302ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (19 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployee
MARIBEL SANSONE
PRESIDENT1.00XX000
GONZALO MERCADO
VICE-PRESIDENT1.00XX000
JACK DE SANTIS
TREASURER1.00XX000
CHRISTINE HOLLIE
SECRETARY1.00XX000
TERRY TROIA
MEMBER1.00X000
PATRICIA KARNATSKI
MEMBER1.00X000
RICHARD YOUNGE MD
MEMBER1.00X000
FERN ZAGOR
MEMBER1.00X000
URSZULA CZYSZKIEWICZ
MEMBER1.00X000
ELIZABETH LOPEZ
MEMBER1.00X000
ESMERALDA RAMOS EFF 82012
MEMBER1.00X000
CAMILIA RANGEL
MEMBER1.00X000
RONALD SPEIGHT JREND 42012
MEMBER1.00X000
INES BRATCHER
MEMBER1.00X000
HENRY THOMPSON
CHIEF EXECUTIVE OFFICER40.00X172441016350
ROSALINDA ROSARIO-LIPKA DO
CHIEF MEDICAL OFFICER40.00X13470708080
KUDUVALLI OMPRAKASH MD
PHYSICIAN40.00150115015010X
JESSIE PITA MD
PHYSICIAN40.0014323808590X
ELAINE CLARKE MD
PHYSICIAN40.00138759014330X
FieldValueIRS element (for citing)
Total Reportable Comp From Org739260TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation62360TotalOtherCompensation
Number Individuals GT100 K5NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation

Name Of Contractor NameOfContractor

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1HENRICH GROUP LLCBusinessNameLine1

Address Of Contractor AddressOfContractor

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1125-28 QUEENS BLVD SUITE 617AddressLine1
CityKEW GARDENSCity
StateNYState
ZIP Code11415ZIPCode
FieldValueIRS element (for citing)
Description Of ServicesPROJECT MANAGEMENTDescriptionOfServices
Compensation127515Compensation
FieldValueIRS element (for citing)
Number Of Contractors GT100 K1NumberOfContractorsGT100K
Government Grants2678493GovernmentGrants
All Other Contributions5AllOtherContributions
Noncash Contributions237918NoncashContributions
Total Contributions2678498TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionNET PATIENT SVC REVDescription
Business Code623000BusinessCode
Total Revenue Column3515979TotalRevenueColumn
Related Or Exempt Function Income3515979RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue3515979TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column6211TotalRevenueColumn
Exclusion$6,211ExclusionAmount

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionPHARMACY SALES AT COSTDescription
Business Code446110BusinessCode
Total Revenue Column187648TotalRevenueColumn
Exclusion$187,648ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue187648TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column6388336TotalRevenueColumn
Related Or Exempt Function Income3515979RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$193,859ExclusionAmount
FieldValueIRS element (for citing)
Info In Schedule O Part IXXInfoInScheduleOPartIX

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total331578Total
Program Services207021ProgramServices
Management And General124557ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total2161347Total
Program Services1349438ProgramServices
Management And General811909ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total68470Total
Program Services42749ProgramServices
Management And General25721ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total418747Total
Program Services240089ProgramServices
Management And General178658ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total195072Total
Program Services121793ProgramServices
Management And General73279ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total23927Total
Management And General23927ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total17000Total
Management And General17000ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total783403Total
Program Services206730ProgramServices
Management And General576673ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total23699Total
Management And General23699ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total729450Total
Program Services508844ProgramServices
Management And General220606ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total4457Total
Program Services4457ProgramServices

Occupancy Occupancy

FieldValueIRS element (for citing)
Total274573Total
Program Services274573ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total44400Total
Program Services37931ProgramServices
Management And General6469ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total315Total
Program Services315ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total160953Total
Program Services160953ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total1573Total
Program Services40ProgramServices
Management And General1533ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
REPAIRS AND MAINTENANCE5224252242
DUES AND SUBSCRIPTIONS415752768013895
BAD DEBT EXPENSE3189131891
MEALS AND ENTERTAINMENT2635626356

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total32734Total
Program Services20815ProgramServices
Management And General11919ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total5423762Total
Program Services3313917ProgramServices
Management And General2109845ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY250BOY
EOY250EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY418770BOY
EOY377252EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY55580BOY
EOY97116EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY845797BOY
EOY735761EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY35281BOY
EOY44739EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis5462482LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec468898LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY3827128BOY
EOY4993584EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY1393470BOY
EOY1809822EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY6576276BOY
EOY8058524EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY741158BOY
EOY1042957EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY1574361BOY
EOY1790236EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY2315519BOY
EOY2833193EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY4260757BOY
EOY5225331EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY4260757BOY
EOY5225331EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY6576276BOY
EOY8058524EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses964574ReconcilationRevenueExpenses
Reconcilation Other Changes0ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement SeparateXFinancialStatementSeparate
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required1FederalGrantAuditRequired
Federal Grant Audit Performed1FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years4256220CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years2929979CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years2803070CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year3808430CurrentTaxYearMinus1Year
Current Tax Year2678498CurrentTaxYear
Total16476197Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years1896766CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years2655394CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years3181478CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year2769816CurrentTaxYearMinus1Year
Current Tax Year3515979CurrentTaxYear
Total14019433Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years6152986CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years5585373CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years5984548CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year6578246CurrentTaxYearMinus1Year
Current Tax Year6194477CurrentTaxYear
Total30495630Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Public Support Total50930495630PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years12708CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years3990CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years3881CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year2830CurrentTaxYearMinus1Year
Current Tax Year6211CurrentTaxYear
Total29620Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years12708CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years3990CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years3881CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year2830CurrentTaxYearMinus1Year
Current Tax Year6211CurrentTaxYear
Total29620Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years1006CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years102239CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years26CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year165122CurrentTaxYearMinus1Year
Current Tax Year187648CurrentTaxYear
Total456041Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years6166700CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years5691602CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years5988455CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year6746198CurrentTaxYearMinus1Year
Current Tax Year6388336CurrentTaxYear
Total30981291Total
FieldValueIRS element (for citing)
Public Support Percentage5090.98430PublicSupportPercentage509
Prior Year Support Percentage0.98830PriorYearSupportPercentage
Investment Income Percentage0.00100InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.00130PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

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

Schedule D IRS990ScheduleD

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis193078OtherCostOrOtherBasis
Depreciation88057Depreciation
Book Value105021BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis232431OtherCostOrOtherBasis
Depreciation112631Depreciation
Book Value119800BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis308495OtherCostOrOtherBasis
Depreciation135824Depreciation
Book Value172671BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis4728478OtherCostOrOtherBasis
Depreciation132386Depreciation
Book Value4596092BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings4993584TotalOfBookValueLandBuildings

Other Assets OtherAssets (2 entries)

DescriptionDescriptionBook ValueBookValue
SECURITY DEPOSITS19586
ASSETS WHOSE USE IS LIMITED1790236
FieldValueIRS element (for citing)
Total Book Value Other Assets1809822TotalBookValueOtherAssets

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionLOAN PAYABLE- PCDCDescription
Amount$1,790,236Amount
FieldValueIRS element (for citing)
Total Of Amounts1790236TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt6388207TotRevenueEtcAuditedFinclStmt
Other Revenues-129OtherRevenues
Revenue Not Rptd F990-129RevenueNotRptdF990
Revenue Subtotal6388336RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form9906388336TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt5423633TotExpensesEtcAuditedFinclStmt
Other Expenses Included-129OtherExpensesIncluded
Expenses Not Rptd F990-129ExpensesNotRptdF990
Expenses Subtotal5423762ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form9905423762TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X, LINE 2:THE CENTER ACCOUNTS FOR UNCERTAINTY IN INCOME TAXES USING A RECOGNITION THRESHOLD OF MORE-LIKELY-THAN-NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPROPRIATE TAXING AUTHORITY. MEASUREMENT OF THE TAX UNCERTAINTY OCCURS IF THE RECOGNITION THRESHOLD HAS BEEN MET. MANAGEMENT DETERMINED THAT THERE WERE NO TAX UNCERTAINTIES THAT MET THE RECOGNITION THRESHOLD IN 2012 AND 2011. THE FEDERAL EXEMPT ORGANIZATION TAX RETURNS FOR THE ORGANIZATION FOR THE YEARS ENDED DECEMBER 31, 2009, 2010 AND 2011 REMAIN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE.
PART XI, LINE 2D - OTHER ADJUSTMENTS:OTHER EXPENSE NETTED AGAINST MISCELLANEOUS INCOME -129.
PART XII, LINE 2D - OTHER ADJUSTMENTS:OTHER EXPENSE INCLUDED IN MISCELLANEOUS INCOME -129.

Schedule J IRS990ScheduleJ

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

Form990 Schedule J Part II Form990ScheduleJPartII (4 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
HENRY THOMPSON
CHIEF EXECUTIVE OFFICER1724410000010350060000188791000
KUDUVALLI OMPRAKASH MD
PHYSICIAN150115000009010060000165125000
JESSIE PITA MD
PHYSICIAN143238000008590000151828000
ELAINE CLARKE MD
PHYSICIAN138759000008330060000153089000

Schedule M IRS990ScheduleM

Drugs And Medical Supplies DrugsAndMedicalSupplies

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Number Of Contributions1NumberOfContributions
Noncash Contribs Rptd F990237918NoncashContribsRptdF990
Method Of Determining RevenuesCOST PAID BY DONORMethodOfDeterminingRevenues
FieldValueIRS element (for citing)
Any Property That Must Be Held0AnyPropertyThatMustBeHeld
Review Process Unusual NC Gifts1ReviewProcessUnusualNCGifts
Third Parties Used0ThirdPartiesUsed

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART VI, SECTION B, LINE 11THE CEO AND CFO REVIEW THE FORM 990 BEFORE IT IS FILED. THE RETURN IS THEN PRESENTED TO THE FINANCE COMMITTEE FOR REVIEW AND THEN TO THE GENERAL BOARD FOR APPROVAL OF FILING.
FORM 990, PART VI, SECTION B, LINE 12CCHCR PROVIDES BOARD MEMBERS AND STAFF WITH A CONFLICT OF INTEREST STATEMENT WHICH SUMMARIZES THE KEY ELEMENTS OF THE ORGANIZATION'S CONFLICT OF INTEREST POLICY. THE STATEMENT IS PROVIDED TO AND SIGNED BY BOARD MEMBERS AND STAFF BOTH AT THE TIME OF THE INDIVIDUAL'S INITIAL AFFILIATION WITH THE ORGANIZATION AND ANNUALLY THEREAFTER. THE CEO IS RESPONSIBLE FOR MONITORING THE CONFLICTS. THE BOARD OF DIRECTORS REVIEWS THE CEO'S ANNUAL CONFLICT OF INTEREST STATEMENT. IN THE CASE OF CONFLICT OF INTEREST, THE BOARD MEMBER WILL REPORT THE CONFLICT TO THE FULL BOARD PRIOR TO ANY DISCUSSION OF THE MATTER AND POTENTIALLY RECUSE THEMSELVES FROM VOTING ON THE MATTER.
FORM 990, PART VI, SECTION B, LINE 15OFFICER COMPENSATION IS DETERMINED AND COMPARED BASED ON THE CURRENT MARKET, INDUSTRY STANDARDS AND SURVEYS TAKEN. THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS APPROVES THE CHIEF EXECUTIVE OFFICER'S SALARY. THERE IS A WRITTEN CONTRACT BETWEEN THE CHIEF EXECUTIVE OFFICER AND THE CENTER, AND IS NEGOTIABLE AT A CERTAIN TIME PERIOD. THE COMPENSATION SETTING PROCESS IS DOCUMENTED IN THE EXECUTIVE COMMITTEE MINUTES.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART IX, LINE 11GCONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 206,730. MANAGEMENT AND GENERAL EXPENSES 500,447. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 707,177. CLEANING SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 76,226. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 76,226.OTHER FEES
THE PROCESSES USED BY COMMITTEE THAT ASSUMES RESPONSIBLITY FOR THE OVERSIGHT OF THE AUDIT OF THE ORGANIZATION'S FINANCIAL STATEMENTS AND THE SELECTION OF AN INDEPENDENT ACCOUNTANT HAVE NOT CHANGED FROM THE PRIOR YEAR.

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