2012-05-08T15:00:12-05:00 2011-09-30 CROWE HORWATH LLP 70 West Madison Street Suite 700 Chicago IL 606024903 990 2010-10-01 351875364 HEART CITY HEALTH CENTER INC HEAR 5742930052 236 Simpson Avenue Elkhart IN 46516 VERNITA L TODD 2012-05-08 true 3128997000 2010 2016-02-24 21:20:13Z VERNITA TODD 236 Simpson Avenue Elkhart IN 46516 6907939 false X WWW.HEARTCITYHEALTH.ORG X 1993 IN HEART CITY HEALTH CENTER, INC. IS A FEDERALLY QUALIFIED HEALTH CENTER (FQHC) PROVIDING COMPREHENSIVE PRIMARY HEALTHCARE AND EDUCATION FOR THE ELKHART COMMUNITY. 9 9 118 17 -21512 -21512 2410015 1867200 3089840 4224475 9988 18975 -162406 -235057 5347437 5875593 524 0 0 0 2904926 3586654 0 0 0 1426309 1444938 4331759 5031592 1015678 844001 5999499 6321788 1592029 1070269 4407470 5251519 X HEART CITY HEALTH CENTER, INC. (HEART CITY) IS A NON-PROFIT, FEDERALLY QUALIFIED HEALTH CENTER (FQHC) PROVIDING AFFORDABLE, HIGH QUALITY, PRIMARY HEALTH AND DENTAL CARE TO ELKHART COUNTY RESIDENTS. (CONTINUED IN SCHEDULE O) false false 2636627 3523248 HEART CITY HEALTH CENTER, INC. (HEART CITY) PROVIDES PRIMARY HEALTHCARE IN THE AREA OF ADULTS AND PEDIATRICS TO THE PRIMARILY MEDICARE, MEDICAID, AND UNINSURED POPULATION OF ELKHART COUNTY. DURING THE YEAR ENDED SEPTEMBER 30, 2011, HEART CITY PROVIDED 29,853 PATIENT VISITS TO 10,150 UNDUPLICATED PATIENTS. (CONTINUED IN SCHEDULE O) 526948 465895 HEART CITY HEALTH CENTER, INC.'S (HEART CITY) LICENSED DENTISTS AND HYGIENISTS PROVIDE A LOW-COST OPTION FOR QUALITY GENERAL DENTISTRY SERVICES TO PEOPLE OF ALL AGES, INCOMES AND BACKGROUNDS, BUT PRIMARILY SERVES MEDICAID AND UNINSURED PATIENTS. DURING THE YEAR ENDED SEPTEMBER 30, 2011, HEART CITY SERVED 1,830 UNDUPLICATED PATIENTS IN 4,325 VISITS. VARIOUS DENTAL SERVICES PROVIDED INCLUDE: EXAMINATIONS; TREATMENT PLANNING; CHILDREN'S DENTISTRY; CLEANING/DENTAL HYGIENE; EXTRACTIONS; FILLINGS, CROWNS, AND BRIDGES; RADIOGRAPHS; FULL AND PARTIAL DENTURES; ROOT CANALS; AND PATIENT EDUCATION. 3163575 true true false false false false false false false true false false false true true true false false false false false false false false false false false false true false false false false false false false false true false false false false false false false false false true 9 0 true 118 true true true false false false false false false false false false X 9 9 false false false false false false false true true false false true true true true true true true false false IN X DIANA NITA 5742930052 236 SIMPSON AVENUE ELKHART IN 46516 DR DOUGLAS DEVENS 40 X 164759 0 9520 DR ERIN FARRELL 40 X 138478 0 8175 JAMES F JACKA 1 X X 0 0 0 NICOLE WILLIAMS-GOODWIN 1 X X 343 0 0 LAKEISHA POPE 1 X 539 0 0 TEDDY BROWN 1 X 441 0 0 R SUE ICKES 1 X 343 0 0 WAYNE SPINNER 1 X 147 0 0 DR OMOBOLA OLANIYAN 40 X 186509 0 9499 DIANA NITA 40 X 62833 0 1879 VERNITA L TODD 40 X 108370 0 12509 ILEANA MARTIN 1 X 147 0 0 BRUCE BEYLER 1 X 0 0 0 ROD ROBERSON 1 X 98 0 0 663007 0 41582 4 false true false BARNES & THORNBURG LLP 121 WEST FRANKLIN STREET SUITE 200 ELKHART IN 465163200 LEGAL FEES 115651 1 23733 1536482 306985 235738 1867200 MEDICAL SERVICES 3758580 3758580 DENTAL SERVICES 465895 465895 0 0 0 0 4224475 19405 19405 0 0 0 0 0 0 430 0 -430 -430 -430 0 0 775072 1031916 -256844 -235332 -21512 VENDING INCOME 5565 5565 MEDICAL RECORDS 6967 6967 MISCELLANEOUS REVENUE 9255 9255 0 0 0 0 21787 5875593 3989143 -21512 40762 0 0 0 0 383117 235894 147223 0 2748111 1700079 1048032 22620 12999 9621 201275 114555 86720 231531 133007 98524 0 49548 17134 32414 56451 43759 12692 0 0 0 279139 241092 38047 94924 73234 21690 461509 301149 160360 4526 2591 1935 0 52876 29750 23126 33199 5994 27205 0 35808 14484 21324 35451 19760 15691 0 187257 113527 73730 37253 27834 9419 BAD DEBT EXPENSE 46973 46973 DUES & SUBSCRIPTIONS 37406 9512 27894 EMPLOYEE RELATIONS 24548 14102 10446 LICENSES 3727 3727 4343 2419 1924 0 5031592 3163575 1868017 0 0 1000 1100 2316770 2438668 168672 188152 324183 392316 371178 369819 91215 58548 3880222 1011466 2722100 2868756 4381 4429 0 0 0 0 5999499 6321788 394049 371681 682136 528588 515844 170000 1592029 1070269 X 4396628 5243839 10842 7680 4407470 5251519 5999499 6321788 X 844001 48 X false true true X true true X 763597 1683994 1527070 2410015 1867200 8251876 2904157 3056821 3927086 3878440 4759275 18525779 14671 16121 17534 18927 21787 89040 0 0 3682425 4756936 5471690 6307382 6648262 26866695 0 0 0 0 0 0 0 0 26866695 8 2777 16352 25488 19405 64030 0 8 2777 16352 25488 19405 64030 0 2488 2488 3684921 4759713 5488042 6332870 6667667 26933213 0.99750 0.99720 0.00240 0.00190 X OTHER INCOME, SCHEDULE A, PART III, SECTION B, LINE 12, MISCELLANEOUS INCOME RECEIVED IN FURTHERANCE OF THE ORGANIZATION'S TAX-EXEMPT PURPOSE: 2006 - $2,488 2007 - $0 2008 - $0 2009 - $0 2010 - $0, RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 213700 213700 936300 81926 854374 2076331 567363 1508968 653891 362177 291714 0 2868756 0 DRUGS AND PHARMACEUTICALS HELD FOR OTHERS 170000 170000 5875593 5031592 844001 48 48 844049 6986646 79089 1031964 1111053 5875593 0 0 5875593 6142597 79089 1031916 1111005 5031592 0 0 5031592 FIN 48 (ASC 740) footnote Schedule D, Part X, Line 2 THE ORGANIZATION IS EXEMPT FROM INCOME TAXES ON INCOME FROM RELATED ACTIVITIES UNDER SECTION 501(C)(3) OF THE U.S. INTERNAL REVENUE CODE AND CORRESPONDING STATE TAX LAW. ACCORDINGLY, NO PROVISION HAS BEEN MADE FOR FEDERAL OR STATE INCOME TAXES. A TAX POSITION IS RECOGNIZED AS A BENEFIT ONLY IF IT IS "MORE LIKELY THAN NOT" THAT THE TAX POSITION WOULD BE SUSTAINED IN A TAX EXAMINATION, WITH A TAX EXAMINATION BEING PRESUMED TO OCCUR. THE AMOUNT RECOGNIZED IS THE LARGEST AMOUNT OF TAX BENEFIT THAT IS GREATER THAN 50% LIKELY OF BEING REALIZED ON EXAMINATION. FOR TAX POSITIONS NOT MEETING THE "MORE LIKELY THAN NOT" TEST, NO TAX BENEFIT IS RECORDED. DUE TO ITS TAX-EXEMPT STATUS, THE ORGANIZATION IS NOT GENERALLY SUBJECT TO U.S. FEDERAL INCOME TAX OR STATE INCOME TAX. THE ORGANIZATION'S FORM 990 HAS NOT BEEN SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE OR THE STATE OF INDIANA FOR THE LAST THREE YEARS. THE ORGANIZATION DOES NOT EXPECT THE TOTAL AMOUNT OF UNRECOGNIZED TAX BENEFITS TO SIGNIFICANTLY CHANGE IN THE NEXT 12 MONTHS. THE ORGANIZATION RECOGNIZES INTEREST AND/OR PENALTIES RELATED TO INCOME TAX MATTERS IN INCOME TAX EXPENSE. THE ORGANIZATION DID NOT HAVE ANY AMOUNTS ACCRUED FOR INTEREST AND PENALTIES AT SEPTEMBER 30, 2011 AND 2010. X X X false false false false false false false false false DR DOUGLAS DEVENS 161356 0 3403 0 0 0 4052 0 5468 0 174279 0 0 0 DR OMOBOLA OLANIYAN 183103 0 3406 0 0 0 4637 0 4862 0 196008 0 0 0 X 1010 235738 MARKET VALUE 0 false true false ORGANIZATION'S MISSION (CONTINUED FROM PART III) FORM 990, PART III, LINE 1 WE OFFER A SLIDING FEE SCALE BASED ON INCOME AND FAMILY SIZE FOR THE UNINSURED AND ALSO ACCEPT MEDICAID, MEDICARE AND SOME PRIVATE INSURANCES. HEART CITY IS COMMITTED TO REDUCING HEALTH DISPARITIES AMONG RESIDENTS BY PROVIDING PROFESSIONAL AND RESPECTFUL SERVICE TO THE ELKHART COMMUNITY THROUGH EDUCATION AND HIGH QUALITY PRIMARY MEDICAL CARE FOR THOSE IN NEED AND EXPERIENCING BARRIERS TO TRADITIONAL HEALTH CARE. THE MAJORITY OF HEART CITY'S PATIENTS ARE AT 100% OR BELOW THE FEDERAL POVERTY GUIDELINES, AND OVER 50% OF PATIENTS ARE UNDER THE AGE OF 18. HEART CITY IS ONE OF THE FEW SITES IN THE ELKHART AREA THAT PROVIDES SERVICES TO MEDICAID PATIENTS AND THE UNINSURED POPULATION. PROGRAM SERVICE ACCOMPLISHMENTS (CONTINUED FROM PART III) FORM 990, PART III, LINE 4A VARIOUS MEDICAL SERVICES PROVIDED INCLUDE: PRIMARY AND PREVENTIVE CARE; PHYSICAL EXAMINATIONS; EMPLOYMENT/SPORTS/SCHOOL PHYSICALS; WELL CHILD CHECKS; IMMUNIZATION; WOMEN'S HEALTH; CHRONIC DISEASES MANAGEMENT; BREAST AND CERVICAL CANCER SCREENINGS; LABORATORY WORK ; HEALTH AND WELLNESS EDUCATION; AND DIABETES SCREENING AND TREATMENT. HEART CITY ALSO DISPENSES PRESCRIPTIONS TO THE PRIMARILY MEDICARE, MEDICAID, AND UNINSURED POPULATION IN ELKHART COUNTY. HEART CITY'S PATIENT MEDICINE ASSISTANCE PROGRAM (MAP) WORKS WITH SEVERAL DRUG COMPANIES TO PROVIDE ASSISTANCE FOR PEOPLE HAVING TROUBLE AFFORDING NAME BRAND MEDICATIONS. HEART CITY'S MAP COORDINATOR HELPS PATIENTS SEE IF THEY ARE ELIGIBLE FOR THE PROGRAM, AND ALSO ASSISTS IN THE COMPLETION OF MAP APPLICATIONS. IN ADDITION, TO HELP ENSURE THAT PATIENTS HAVE ACCESS TO THE CARE THEY NEED, PRESCRIPTIONS WRITTEN BY HEART CITY PRACTITIONERS CAN BE FILLED AT REDUCED PRICES AT THE ONSITE PHARMACY. HEART CITY PARTICIPATES IN A FEDERAL GOVERNMENT PROGRAM TO PROVIDE LOW COST PRESCRIPTION DRUGS TO PATIENTS WITHOUT INSURANCE. DURING THE YEAR ENDED SEPTEMBER 30, 2011, HEART CITY'S PHARMACY FILLED 39,050 PRESCRIPTIONS AND SERVED 3,731 PATIENTS. Review of form 990 by governing body Form 990, Part VI, Section B, Line 11a THE ORGANIZATION'S FORM 990 IS REVIEWED IN DETAIL BY MANAGEMENT. A BOARD MEETING IS THEN HELD WITH OUR TAX ADVISORS TO PRESENT AND REVIEW A FINAL DRAFT OF THE FULL FORM 990, INCLUDING ALL APPLICABLE SCHEDULES; EACH BOARD MEMBER IS PROVIDED A COPY OF THE RETURN AT THE BOARD MEETING AND IS ALLOWED TO ASK ANY QUESTIONS THEY MAY HAVE. ONCE ALL QUESTIONS ARE ANSWERED, THE RETURN IS THEN FILED WITH THE IRS. Conflict of interest policy Form 990, Part VI, Section B, Line 12c AN ANNUAL CONFLICT OF INTEREST FORM IS FILLED OUT BY EACH BOARD MEMBER, WHICH IS VERIFIED BY OUR INDEPENDENT AUDITORS. ALL OTHER EMPLOYEES SIGN THE CODE OF CONDUCT POLICY AT TIME OF HIRE WHICH COVERS CONFLICTS OF INTEREST. THE CEO AND THE BOARD LIASON REVIEW THE CONFLICT OF INTEREST FORMS TO DETERMINE IF ANY POTENTIAL CONFLICTS OF INTEREST EXIST. IF A POTENTIAL CONFLICT OF INTEREST IS DETERMINED TO EXIST, THE CEO AND EXECUTIVE COMMITTEE OF THE BOARD, CONSISTING OF THE PRESIDENT, SECRETARY, AND TREASURER, MEET TO DISCUSS WHETHER ANY ACTUAL CONFLICTS OF INTEREST EXIST. ALTHOUGH NO CONFLICTS HAVE BEEN NOTED IN THE PAST, IF A CONFLICT OF INTEREST WAS TO ARISE, RESTRICTIONS WOULD BE IMPOSED AND THE BOARD MEMBER WOULD BE REQUIRED TO EXCUSE THEMSELVES FROM ANY DISCUSSIONS AND/OR VOTES RELATED TO THE CONFLICTING ISSUE. Process used to establish compensation of top management official Form 990, Part VI, Section B, Line 15a COMPENSATION FOR THE ORGANIZATION'S CEO IS DETERMINED BY THE BOARD OF DIRECTORS BASED UPON A PERFORMANCE EVALUATION. EACH BOARD MEMBER COMPLETES AN EVALUATION, AND THEN THE EXECUTIVE COMMITTEE REPORTS THE FINDINGS AND ANY CHANGES IN COMPENSATION TO THE CEO. ANY CHANGES IN COMPENSATION ARE BASED ON THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS (NACHC) SALARY SURVEYS. THIS PROCESS IS PERFORMED ANNUALLY, AND WAS LAST DONE DURING THE ORGANIZATION'S FISCAL YEAR ENDED SEPTEMBER 30, 2011. THE EVALUATION AND REVIEW PROCESS IS DOCUMENTED IN THE BOARD MEETING MINUTES. Public Disclosure Form 990, Part VI, Section C, Line 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICIES, AND FINANCIAL STATEMENTS ARE NOT REQUIRED DISCLOSURES PURSUANT TO INTERNAL REVENUE CODE (IRC) SECTION 6104. THESE DOCUMENTS ARE NOT AVAILABLE TO THE PUBLIC AT THIS TIME. PROCESS USED TO ESTABLISH COMPENSATION OF OTHER OFFICERS/KEY EMPLOYEES FORM 990, PART VI, SECTION B, LINE 15B THE ORGANIZATION'S CEO COMPLETES AN ANNUAL PERFORMANCE EVALUATION FOR THE CFO; BASED ON THE OUTCOME OF THE PERFORMANCE EVALUATION AND THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS (NACHC) SALARY SURVEYS, THE CFO'S COMPENSATION IS REVIEWED AND ADJUSTED AS NECESSARY. THE ORGANIZATION'S CEO ALSO COMPLETES AN ANNUAL PERFORMANCE EVALUATION FOR THE CMO; BASED ON THE OUTCOME OF THE PERFORMANCE EVALUATION AND GENERAL COMPENSATION GUIDELINES SET BY THE BOARD, THE CMO'S EMPLOYMENT CONTRACT IS UPDATED AS NECESSARY. THESE PERFORMANCE EVALUATIONS AND COMPENSATION/EMPLOYMENT CONTRACT UPDATES WERE LAST COMPLETED IN SEPTEMBER/OCTOBER OF 2011. Other changes in net assets or fund balances Form 990, Part XI, Line 5 CHANGE IN BENEFICIAL INTEREST IN ASSETS HELD BY COMMUNITY FOUNDATION - 48;