WESTERN WAYNE FAMILY HEALTH CENTERS: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- WESTERN WAYNE FAMILY HEALTH CENTERS (EIN 30-0281587)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-03-20
- IRS object ID
- 201230809349300438
- Schema version
- 2011v1.2
- 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 | 2012-03-20T16:54:46-05:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | 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 | 2011-01-01 | 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 | 2012-03-14 | 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 | 2012-03-16 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 5001633 | 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 | 14 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 14 | NbrIndependentVotingMembers |
| Total Nbr Employees | 62 | TotalNbrEmployees |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 1830224 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 1776193 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 2130347 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 3225113 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 607 | InvestmentIncomePriorYear |
| Investment Income Current Year | 327 | InvestmentIncomeCurrentYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 3961178 | TotalRevenuePriorYear |
| Total Revenue Current Year | 5001633 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 2269359 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 2747266 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 1330093 | OtherExpensePriorYear |
| Other Expenses Current Year | 1373392 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 3599452 | TotalExpensesPriorYear |
| Total Expenses Current Year | 4120658 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 361726 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 880975 | RevenuesLessExpensesCY |
| Total Assets BOY | 1870973 | TotalAssetsBOY |
| Total Assets EOY | 2659594 | TotalAssetsEOY |
| Total Liabilities BOY | 356054 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 263700 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 1514919 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 2395894 | 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 8,000 PATIENTS IN A MEDICALLY UNDERSERVED AREA. CLINIC ENCOUNTERS FOR THE YEAR TOTALED APPROXIMATELY 26,000. | Description |
Activity Other ActivityOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 3202926 | Expense |
| Description | CENTER IS A FEDERALLY QUALIFIED HEALTH CENTER AND IS SERVICING APPROXIMATELY 8,000 PATIENTS IN A MEDICALLY UNDERSERVED AREA CLINIC ENCOUNTERS FOR THE YEAR WERE APPROXIMATELY 26,000 | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Other Program Service Exp | 3202926 | TotalOfOtherProgramServiceExp |
| Total Program Service Expense | 3202926 | 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 |
| Transaction Related Entity | false | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 35 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 62 | 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 | 14 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 14 | 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 (20 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 | 82336 | 0 | 0 | |
| DONALD AUSTIN | |||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||
| NOAH BERGERON | |||||||
| CHAIRMAN | 2.00 | X | 0 | 0 | 0 | ||
| TERREL LECESNE | |||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||
| BOBBIE WALLACE | |||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||
| LORETTA DAVIS | |||||||
| VICE CHAIR | 2.00 | X | 0 | 0 | 0 | ||
| EUGINA DILLARD | |||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||
| ROY BIRMINGHAM | |||||||
| TREASURER | 2.00 | X | 0 | 0 | 0 | ||
| DAVID IPPEL | |||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||
| DEARTISS RICHARDSON | |||||||
| 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 | |||||||
| DIRECTOR | 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 | 168000 | 0 | 0 | ||
| RAO KAKARALA | |||||||
| CFO | 16.00 | X | 0 | 0 | 0 | ||
| RULA AL-AOUAR | |||||||
| PHYSCIAN | 40.00 | 189659 | 0 | 0 | X | ||
| LUNA ALKHAFAJI | |||||||
| PHYSICIAN | 40.00 | 171635 | 0 | 0 | X | ||
| ISSA BOTROS | |||||||
| PHYSICIAN | 40.00 | 121928 | 0 | 0 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 733558 | TotalReportableCompFromOrg |
| Number Individuals GT100 K | 4 | 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 | 113238 |
| 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 | 1616035 | GovernmentGrants |
| All Other Contributions | 160158 | AllOtherContributions |
| Total Contributions | 1776193 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (4 entries)
| DescriptionDescription | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|
| PATIENT FEES | 3080999 | 3080999 |
| PHARMACY | 132599 | 132599 |
| OTHER | 10277 | 10277 |
| RENTAL INCOME | 1238 | 1238 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 3225113 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 327 | TotalRevenueColumn |
| Related Or Exempt Function Income | 327 | RelatedOrExemptFunctionIncome |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 5001633 | TotalRevenueColumn |
| Related Or Exempt Function Income | 3225440 | RelatedOrExemptFunctionIncome |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2386523 | Total |
| Program Services | 1813919 | ProgramServices |
| Management And General | 572604 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 180211 | Total |
| Program Services | 136985 | ProgramServices |
| Management And General | 43226 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 180532 | Total |
| Program Services | 137204 | ProgramServices |
| Management And General | 43328 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 404199 | Total |
| Program Services | 287638 | ProgramServices |
| Management And General | 116561 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7664 | Total |
| Program Services | 2595 | ProgramServices |
| Management And General | 5069 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 21798 | Total |
| Program Services | 15912 | ProgramServices |
| Management And General | 5886 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 177747 | Total |
| Program Services | 160432 | ProgramServices |
| Management And General | 17315 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 24008 | Total |
| Program Services | 10275 | ProgramServices |
| Management And General | 13733 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11809 | Total |
| Program Services | 5559 | ProgramServices |
| Management And General | 6250 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| DEPRECIATION | 149993 | 128114 | 21879 |
| BAD DEBT | 146116 | 146116 | |
| SUPPLIES | 111066 | 111066 | |
| PHARMACEUTICALS | 65402 | 65402 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 253590 | Total |
| Program Services | 181709 | ProgramServices |
| Management And General | 71881 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4120658 | Total |
| Program Services | 3202926 | ProgramServices |
| Management And General | 917732 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 920642 | BOY |
| EOY | 1116684 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 29932 | BOY |
| EOY | 70409 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 148597 | BOY |
| EOY | 832594 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 16539 | BOY |
| EOY | 20564 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 36909 | BOY |
| EOY | 34474 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 1000021 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 415152 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 718354 | BOY |
| EOY | 584869 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1870973 | BOY |
| EOY | 2659594 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 161142 | BOY |
| EOY | 242691 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 194912 | BOY |
| EOY | 21009 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 356054 | BOY |
| EOY | 263700 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1514919 | BOY |
| EOY | 2395894 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1514919 | BOY |
| EOY | 2395894 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1870973 | BOY |
| EOY | 2659594 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 880975 | ReconcilationRevenueExpenses |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | false | FSAudited |
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 | 722293 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 747774 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 1846572 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 1830224 | CurrentTaxYearMinus1Year |
| Current Tax Year | 1776193 | CurrentTaxYear |
| Total | 6923056 | Total |
Total170 Total170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 722293 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 747774 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 1846572 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 1830224 | CurrentTaxYearMinus1Year |
| Current Tax Year | 1776193 | CurrentTaxYear |
| Total | 6923056 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | 6923056 | PublicSupportTotal170 |
| Total Support | 6923056 | TotalSupport |
| Gross Receipts From Admissions Etc | 3225440 | 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Disclosed Orgs Legal Control | false | DisclosedOrgsLegalControl |
| Disclosed For Charitable Purposes | false | DisclosedForCharitablePurposes |
| Written Policy Monitoring | false | WrittenPolicyMonitoring |
| Sect170h Requirements Satisfied | false | Sect170hRequirementsSatisfied |
| Solicited Assets For Sale | false | SolicitedAssetsForSale |
| Agent Trustee Etc | false | AgentTrusteeEtc |
| Included On FS | false | IncludedOnFS |
| Endowments Held By Unrelated Orgs | false | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | false | EndowmentsHeldByRelatedOrgs |
| Are Related Orgs Listed Schedule R | false | AreRelatedOrgsListedScheduleR |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 211939 | OtherCostOrOtherBasis |
| Depreciation | 83366 | Depreciation |
| Book Value | 128573 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 788082 | OtherCostOrOtherBasis |
| Depreciation | 331786 | Depreciation |
| Book Value | 456296 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 584869 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| CAPITAL LEASE | $21,009 |
| MEDICAID COST REPORT PAYABLE |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 21009 | TotalOfAmounts |
| Total Revenue | 5001633 | TotalRevenue |
| Total Expenses | 4120658 | TotalExpenses |
| Excess Or Deficit For Year | 880975 | ExcessOrDeficitForYear |
| Excess Or Deficit Per FS | 880975 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 5001633 | TotRevenueEtcAuditedFinclStmt |
| Revenue Subtotal | 5001633 | RevenueSubtotal |
| Total Revenue Per Form990 | 5001633 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 4120658 | TotExpensesEtcAuditedFinclStmt |
| Expenses Subtotal | 4120658 | ExpensesSubtotal |
| Total Expenses Per Form990 | 4120658 | 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 (3 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Total Compensation Filing OrgTotalCompensationFilingOrg |
|---|---|
| ERROL ELRINGTON | |
| 168000 | 168000 |
| RULA AL-AOUAR | |
| 189659 | 189659 |
| LUNA ALKHAFAJI | |
| 171635 | 171635 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (7 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 8,000 PATIENTS IN A MEDICALLY UNDERSERVED AREA CLINIC ENCOUNTERS FOR THE YEAR WERE APPROXIMATELY 26,000 |
| 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 |
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