ERIE FAMILY HEALTH CENTER INC: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
ERIE FAMILY HEALTH CENTER INC (EIN 36-3088628)
Tax period
2009-07-01 to 2010-06-30
Filed
2011-03-21
IRS object ID
201120809349300117
Schema version
2009v1.7
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)
Timestamp2011-03-21T18:17:47-05:00Timestamp
Tax Period End Date2010-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1BLACKMAN KALLICK LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line110 S RIVERSIDE PLAZA 9TH FLOORAddressLine1
CityCHICAGOCity
StateILState
ZIP Code60606ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2009-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN363088628EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1ERIE FAMILY HEALTH CENTER INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlERIENameControl
Phone3126663494Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line11701 W SUPERIOR STREETAddressLine1
CityCHICAGOCity
StateILState
ZIP Code60622ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameLEE FRANCISName
TitlePRESIDENT AND CEOTitle
Phone3126663494Phone
Date Signed2011-02-22DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameKIMBERLY HAUMANNName
Phone3122071040Phone
Date Prepared2011-02-22DatePrepared
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonLEE FRANCISNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line11701 W SUPERIOR STREETAddressLine1
CityCHICAGOCity
StateILState
ZIP Code60622ZIPCode
FieldValueIRS element (for citing)
Gross Receipts27021316GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web SiteWWW.ERIEFAMILYHEALTH.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1970YearFormation
State Legal DomicileILStateLegalDomicile
Activity Or Mission Descriptionoperate a healthcare center to serve a largely medically underserved population in Chicago.ActivityOrMissionDescription
Nbr Voting Members Governing Body24NbrVotingMembersGoverningBody
Nbr Independent Voting Members24NbrIndependentVotingMembers
Total Nbr Employees396TotalNbrEmployees
Total Nbr Volunteers10TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year10716883ContributionsGrantsPriorYear
Contributions Grants Current Year11249810ContributionsGrantsCurrentYear
Program Service Revenue Prior Year13729086ProgramServiceRevenuePriorYear
Program Service Revenue CY15704428ProgramServiceRevenueCY
Investment Income Prior Year69532InvestmentIncomePriorYear
Investment Income Current Year20124InvestmentIncomeCurrentYear
Other Revenue Prior Year55861OtherRevenuePriorYear
Other Revenue Current Year-6942OtherRevenueCurrentYear
Total Revenue Prior Year24571362TotalRevenuePriorYear
Total Revenue Current Year26967420TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year16592243SalariesEtcPriorYear
Salaries Etc Current Year18489377SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year353312TotalFundrsngExpCurrentYear
Other Expense Prior Year5602887OtherExpensePriorYear
Other Expenses Current Year6918035OtherExpensesCurrentYear
Total Expenses Prior Year22195130TotalExpensesPriorYear
Total Expenses Current Year25407412TotalExpensesCurrentYear
Revenues Less Expenses Prior Year2376232RevenuesLessExpensesPriorYear
Revenues Less Expenses CY1560008RevenuesLessExpensesCY
Total Assets BOY15669791TotalAssetsBOY
Total Assets EOY16999850TotalAssetsEOY
Total Liabilities BOY4938228TotalLiabilitiesBOY
Total Liabilities EOY4708279TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY10731563NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY12291571NetAssetsOrFundBalancesEOY
Mission DescriptionERIE FAMILY HEALTH CENTER, INC OPERATES A HEALTHCARE CENTER LOCATED IN CHICAGO, ILLINOIS. THE CENTER PROVIDES A BROAD RANGE OF HEALTH SERVICES TO A LARGELY MEDICALLY UNDERSERVED POPULATION.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense18931589Expense
Revenue12770450Revenue
DescriptionErie Family Health Center (Erie) serves patients regardless of the ability to pay. Over 66% of adults served by Erie are uninsured. Erie provided comprehensive health services to 31,387 patients annually at nine health centers: three large primary health care centers, one adolescent-only health center,three school-based health centers, and 2 dental health centers as described in 4b. Erie provides primary care medical services including pediatrics, internal medicine, family medicine, women's health and podiatry. In addition, Erie provides HIV/AIDS care, behavioral health counseling, case management services, and health education (asthma, diabetes, nutrition, parenting and prenatal). Erie provides these services to low-income, minority individuals who predominantly reside in the Chicago community areas of Albany Park, Avondale, Belmont Cragin, Hermosa, Humboldt Park, Irving Park, Lincoln Square, Logan Square, North Lawndale and West Town. Erie's patient population is 84% Hispanic and 95% live below 200% of the Federal Poverty Level. Approximately 67% of Erie's patients identify themselves as best served in Spanish. Thirty-seven percent of patients are uninsured, 58% are low income and qualify for Medicaid coverage only 2% carry private insurance and 2% have Medicare coverage. Uninsured patients pay a minimal fee based on their income to receive comprehensive services.Erie's mission is to provide comprehensive affordable health care for those in need. Erie therefore focuses on primary care throughout the full range ages. Over 1,500 healthy babies were delivered by Erie practitioners in 2009 meeting the need of lack of prenatal care in the service area and focusing on high risk expectant moms. Children receive up to date immunizations via our pediatric program and comprehensive well child care such that Erie's immunization rates are better than local, state and national averages. Although Erie provides health care to approximately 30,000 individuals, this generated 149,345 patient visits in 2009 indicating that many patients visit the health center several times per year, a reflection of the level of chronic disease amongst adults in the service community. Chronic illness such as diabetes, obesity, asthma, hypertension and cardiovascular disease all receive special attention at Erie. In addition, there is a special focus on cancer screening in adults. One of Erie's major recent accomplishments has been the launch of an Electronic Health Record System (EHRS) which increases efficiencies in care and has proven to reduce medical errors, as well as providing prompts for improving Erie's quality of patient care overall. Erie also has improved its patient care by increasing access to low cost medications. Erie schedules patients efficiently using a centralized call center which improves access to care.Erie provides innovative services such as school-based health with clinic sites located in 3 high impact Chicago Public School sites. This allows Erie to address health issues which improves a child's ability to stay in school. Similarly, our adolescent health center works with challenging teenagers with a focus on prevention in a unique setting.As a response to community need Erie has almost doubled the volume of services provided between calendar year 2000 and calendar year 2009. The 52 years of Erie's existence have shown progressive accomplishments, commitment to the community and to making a difference amongst those most in need of health services.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense2472222Expense
Revenue2933978Revenue
DescriptionErie's Oral Health Program addresses the need for high quality oral health services in the community by linking dental and medical homes for its patients. Erie employs a tri-fold strategy to achieve program goals, which includes: 1) direct patient care; 2) anticipatory guidance at medical visits; and 3) oral health education in the medical and community settings. In the second half of 2009 and the first half of 2010, the Oral Health program served 6,470 patients and accommodated 21,725 visits. Direct Patient Care: Erie will expand the following direct patient care oral health services to the target population: basic community-based dentistry services such as comprehensive preventive services (including x-ray), restorative services (fillings, crowns and bridges), prosthontic services (restore missing teeth as well as partials, dentures, spacers, and crowns), endodontic services (root canals) and emergency, periodontal (gums) services and oral cancer screening services. These services will be provided to pregnant women, children and their parents and HIV/AIDS patients. Additional preventive care will be provided by the new Dental Hygienist and restorative care and other complex services (prosthontic and endodontic care) will be provided by a new dentist. In order to reduce barriers to care for working families, Erie has expanded the Dental Center's hours of operation to include one evening during the week and Saturday morning hours. Additionally, a new service provided as a result of the expansion is oral cancer screenings for patients that use tobacco. An oral health patient of any age that smokes will be screened for oral cancer and referred to community partner, Division Oral Surgery, if screening results are abnormal.Anticipatory Guidance at Medical Visits: One of the most innovative components of Erie's oral health program is anticipatory guidance. Anticipatory guidance (oral health preventive education in the medical setting) links the medical home with the oral health home. This is particularly important as more research is revealing a link between dental health and overall health. Erie's providers will educate their patients on the importance of oral health for their overall wellness as part of the medical visit. Through conversations with providers and informational brochures, patients will begin to understand the link between oral health and overall health. This approach has proven to improve the oral health status of children. Oral Health Prevention Education: Erie cannot possibly serve all community members in need of oral health care; therefore, Erie provides education to community members on how to take care of their oral health at home and how to receive care at Erie Dental Health Center or other community resources. This preventive health education and outreach will be provided by Erie's Oral Health Educator at a variety of community venues, such as elementary schools and community agencies. The Oral Health Educator will establish new relationships with community organizations, as well as maintain contact with existing community partners. At presentations, the Oral Health Educator will present on various topics such as why our teeth are important, how we take care of them, brushing and flossing, good foods versus bad foods and visiting the dentist. This unique and cost-effective component of Erie's oral health program will help Erie improve the oral health of the community beyond the walls of Erie Dental Health Center-Humboldt Park, reaching out to the greater low-income community through a culturally competent approach.Description
FieldValueIRS element (for citing)
Total Program Service Expense21403811TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Balance Sheet Amounts Reported1BalanceSheetAmountsReported
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 Activities1FundraisingActivities
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 With109638NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees396NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions1QuidProQuoContributions
Quid Pro Quo Disclosure1QuidProQuoDisclosure
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Nbr Voting Governing Body Members24NbrVotingGoverningBodyMembers
Number Independent Voting Members24NumberIndependentVotingMembers
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 FiledILStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1zizi atiaBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number3124327389TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11701 west superior streetAddressLine1
CitychicagoCity
StateILState
ZIP Code60622ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (33 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployee
William Kistner
Board Chair2.00XX000
Daniel J Tounsel III
Board Vice Chair1.50XX000
Eric Mayeda
Board Treasurer2.00XX000
Angelica Gomez
Board Secretary1.50XX000
Rosalie Alicea
DIRECTOR1.50X000
Celeste Castillo
DIRECTOR1.50X000
Michael Cole
DIRECTOR1.00X000
Linda Cushman
Director0.50X000
Pilar Gonzalez
Director0.50X000
Maria Hernandez
DIRECTOR0.50X000
Brian P Marsella
Director0.50X000
Michael J O'Connor
Director0.50X000
Reverand Ed Sarden
dirECTOR1.00X000
Ana Maria Soto
dirECTOR1.00X000
Daryl Tom
dirECTOR1.00X000
Humberto Uribe
Director1.00X000
Katherine Wilson
dirECTOR1.00X000
Deborah-B Wright-Powell
Director1.00X000
Julie Zerwic
Director1.00X000
Matt Aaronson
dirECTOR1.00X000
Luis Leon
Director1.00X000
Jill Simon Svoboda
Director1.50X000
Jacqueline Cervantes
dirECTOR1.00X000
Amelia Madrigal
Director1.00X000
Marcelo Jarmendia
DIRECTOR1.00X000
Lee Francis
President & CEO40.00X17137505826
David R Buchanan
Chief Medical Officer40.00X172254011909
Zakeya Atia
Chief Financial Officer40.00X12177301265
Katherine Thurer
OB/GYN Physician40.0020272004869X
Virgil C Reid III
Physician Medical Head40.0019028206165X
Javier Fajardo
OB/GYN Physician40.0017951205737X
Fred Rachman
Pediatrician40.0017747303106X
Frank Castillo
Family Practice Physician40.0017621707885X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1391606TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation46762TotalOtherCompensation
Number Individuals GT100 K25NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (4 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
LAB CORP
PO BOX 12140BURLINGTONNC27216LAB SERVICES447747
GHAFARI ASSOCIATES LLC
17101 MICHIGAN AVEDEARBORNMI48126Construction contractor110890
AIR COMFORT
2550 BRAGA DRIVEBROADVIEWIL60155HVAC CONTRACTOR110364
TFI RESOURCES
PO BOX 4346HOUSTONTX77210Employment agency102312
FieldValueIRS element (for citing)
Number Of Contractors GT100 K4NumberOfContractorsGT100K
Fundraising Events176935FundraisingEvents
Government Grants9327101GovernmentGrants
All Other Contributions1745774AllOtherContributions
Noncash Contributions217000NoncashContributions
Total Contributions11249810TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
MEDICARE/MEDICAID PAYM6241001351243813512438
self-pay62410015922611592261
KID CARE/HEALTHY MOM624100587730587730
MEDICAL RECORD FEES6241001199911999
FieldValueIRS element (for citing)
Total Program Service Revenue15704428TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column17624TotalRevenueColumn
Exclusion$17,624ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Other2500Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Other2500Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column2500TotalRevenueColumn
Exclusion$2,500ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events16070GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events176935CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses53896FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column-37826TotalRevenueColumn
Exclusion-$37,826ExclusionAmount

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionOTHERDescription
Business Code624100BusinessCode
Total Revenue Column30884TotalRevenueColumn
Exclusion$30,884ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue30884TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column26967420TotalRevenueColumn
Related Or Exempt Function Income15704428RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$13,182ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1838082Total
Program Services1583052ProgramServices
Management And General225089ManagementAndGeneral
Fundraising29941Fundraising

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total13881964Total
Program Services11959580ProgramServices
Management And General1696007ManagementAndGeneral
Fundraising226377Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total168942Total
Program Services132841ProgramServices
Management And General36101ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total1483079Total
Program Services1166162ProgramServices
Management And General300028ManagementAndGeneral
Fundraising16889Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1117310Total
Program Services878554ProgramServices
Management And General221281ManagementAndGeneral
Fundraising17475Fundraising

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total50523Total
Management And General50523ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total41038Total
Program Services25000ProgramServices
Management And General16038ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total285093Total
Program Services179304ProgramServices
Management And General94270ManagementAndGeneral
Fundraising11519Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total40728Total
Program Services26547ProgramServices
Management And General14181ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total402566Total
Program Services357951ProgramServices
Management And General40763ManagementAndGeneral
Fundraising3852Fundraising

Occupancy Occupancy

FieldValueIRS element (for citing)
Total1070678Total
Program Services953712ProgramServices
Management And General116966ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total39538Total
Program Services31008ProgramServices
Management And General8281ManagementAndGeneral
Fundraising249Fundraising

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total47998Total
Program Services37642ProgramServices
Management And General10058ManagementAndGeneral
Fundraising298Fundraising

Interest Interest

FieldValueIRS element (for citing)
Total106936Total
Management And General106936ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total1025438Total
Program Services835680ProgramServices
Management And General189384ManagementAndGeneral
Fundraising374Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total170020Total
Program Services121006ProgramServices
Management And General49014ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
contracted diagnostic s607780607780
pharmaceuticals4568804552011679
EQUIPMENT RENTAL & MAIN442665326887115778
bad debt428044428044
SHARE OF ALLIANCE LOSS400459400459

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total1301651Total
Program Services897401ProgramServices
Management And General357912ManagementAndGeneral
Fundraising46338Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total25407412Total
Program Services21403811ProgramServices
Management And General3650289ManagementAndGeneral
Fundraising353312Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY895676BOY
EOY1613798EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY5202526BOY
EOY4404989EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY1064906BOY
EOY1832327EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY1352263BOY
EOY1863269EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY239647BOY
EOY139476EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis13850104LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec7154424LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY6074624BOY
EOY6695680EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
BOY675438BOY
EOY294980EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY164711BOY
EOY155331EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY15669791BOY
EOY16999850EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY1962068BOY
EOY1981621EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY75000BOY
EOY75950EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY1881350BOY
EOY1818598EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY1019810BOY
EOY832110EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY4938228BOY
EOY4708279EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY10264568BOY
EOY11886243EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY466995BOY
EOY405328EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY10731563BOY
EOY12291571EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY15669791BOY
EOY16999850EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit Required1FederalGrantAuditRequired
Federal Grant Audit Performed1FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org170b1 AviXPubliclySupportedOrg170b1Avi

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years10444076CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years9827952CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years9769035CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year10716883CurrentTaxYearMinus1Year
Current Tax Year11249810CurrentTaxYear
Total52007756Total

Value Srvc Fclts Furnished By Govt ValueSrvcFcltsFurnishedByGovt

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years207762CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years31160CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years37597CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year40830CurrentTaxYearMinus1Year
Current Tax Year42883CurrentTaxYear
Total360232Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years10651838CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years9859112CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years9806632CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year10757713CurrentTaxYearMinus1Year
Current Tax Year11292693CurrentTaxYear
Total52367988Total
FieldValueIRS element (for citing)
Public Support Total17052367988PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years26597CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years25246CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years83204CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year74238CurrentTaxYearMinus1Year
Current Tax Year17624CurrentTaxYear
Total226909Total

Other Income170 OtherIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years37597CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year40830CurrentTaxYearMinus1Year
Current Tax Year42883CurrentTaxYear
Total121310Total
FieldValueIRS element (for citing)
Total Support52716207TotalSupport
Gross Receipts From Admissions Etc61581675GrossReceiptsFromAdmissionsEtc
Public Support Pertcentage1700.99340PublicSupportPertcentage170
Public Support Pertcent Prior Year0.97550PublicSupportPertcentPriorYear
Thirty Three Percnt Tests CY170XThirtyThreePercntTestsCY170

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

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis77800OtherCostOrOtherBasis
Book Value77800BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis4319002OtherCostOrOtherBasis
Depreciation1887343Depreciation
Book Value2431659BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis4060045OtherCostOrOtherBasis
Depreciation2015369Depreciation
Book Value2044676BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis2785389OtherCostOrOtherBasis
Depreciation1439388Depreciation
Book Value1346001BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis2607868OtherCostOrOtherBasis
Depreciation1812324Depreciation
Book Value795544BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings6695680TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionTHIRD-PARTY PAYOR LIABILITYDescription
Amount$832,110Amount
FieldValueIRS element (for citing)
Total Of Amounts832110TotalOfAmounts
Total Revenue26967420TotalRevenue
Total Expenses25407412TotalExpenses
Excess Or Deficit For Year1560008ExcessOrDeficitForYear
Total Adjustments0TotalAdjustments
Excess Or Deficit Per FS1560008ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt27007020TotRevenueEtcAuditedFinclStmt
Donated Srvc And Use Of Facilities39600DonatedSrvcAndUseOfFacilities
Revenue Not Rptd F99039600RevenueNotRptdF990
Revenue Subtotal26967420RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form99026967420TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt25447012TotExpensesEtcAuditedFinclStmt
Donated Services Use Of Facilities39600DonatedServicesUseOfFacilities
Expenses Not Rptd F99039600ExpensesNotRptdF990
Expenses Subtotal25407412ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form99025407412TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV

FieldValueIRS element (for citing)
IdentifierPart X:Identifier
Return ReferenceDescription of Uncertain Tax Positions Under FIN 48:ReturnReference
ExplanationThe Center's adoption of the Income Tax Topic regarding uncertain tax positions of GAAPUSA on July 1, 2009 had no effect on its financial position as management believes the Center has no material unrecognized income tax benefits, including any potential risk of loss of its not-for-profit tax status. The Center would account for any potential interest or penalties related to possible future liabilities for unrecognized income tax benefits as income tax expense. The Center is no longer subject to examination by federal, state or local tax authorities for periods before 2007. Prior to adoption of the Income Tax Topic, the Center accounted for tax positions under a contingent loss model, requiring recognition of a tax liability when it was both (1) probable that it had been incurred as of year-end and (2) the amount could be reasonably estimated.Explanation

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1GOLDEN TOOTHBRUSHNameOfEvent1
Gross Receipts Event1134057GrossReceiptsEvent1
Charitable Contributions Event1125247CharitableContributionsEvent1
Gross Revenue Event18810GrossRevenueEvent1
Other Direct Expenses Event135911OtherDirectExpensesEvent1
Name Of Event2PAINT THE TOWN REDNameOfEvent2
Gross Receipts Event258948GrossReceiptsEvent2
Charitable Contributions Event251688CharitableContributionsEvent2
Gross Revenue Event27260GrossRevenueEvent2
Other Direct Expenses Event217985OtherDirectExpensesEvent2
Gross Receipts Total193005GrossReceiptsTotal
Charitable Contributions Total176935CharitableContributionsTotal
Gross Revenue Total Events16070GrossRevenueTotalEvents
Other Direct Expenses Total Events53896OtherDirectExpensesTotalEvents
Direct Expense Summary Events53896DirectExpenseSummaryEvents
Net Income Summary-37826NetIncomeSummary

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Independent ConsultantXIndependentConsultant
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 (7 entries)

Base 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
Lee Francis
1598200115550003800020260177201000
David R Buchanan
1559700162840004035078740184163000
Katherine Thurer
1892950134250003310015590207589000
Virgil C Reid III
1773100129720003735024300196447000
Javier Fajardo
170347091650004266014710185249000
Fred Rachman
177473000000031060180579000
Frank Castillo
167648085690004130037550184102000

Schedule M IRS990ScheduleM

Drugs And Medical Supplies DrugsAndMedicalSupplies

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Number Of Contributions1NumberOfContributions
Noncash Contribs Rptd F990217000NoncashContribsRptdF990
Method Of Determining RevenuesCOMPARABLE SALESMethodOfDeterminingRevenues
FieldValueIRS element (for citing)
Any Property That Must Be Held0AnyPropertyThatMustBeHeld
Review Process Unusual NC Gifts1ReviewProcessUnusualNCGifts
Third Parties Used0ThirdPartiesUsed

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (4 entries)

IdentifierIdentifierExplanationExplanation
Form 990, Part VI, Section B, line 11ERIE FAMILY HEALTH CENTER (EFHC) USES A THIRD PARTY (INDEPENDENT CPA FIRM) TO PREPARE ITS 990 TAX FORM. UPON THE FORM'S COMPLETION, A COPY IS PROVIDED TO EFHC'S MANAGEMENT FOR REVIEW AND THE SUBSEQUENT REVIEW BY THE BOARD OF DIRECTORS. ANY NECESSARY CHANGES WILL BE COMMUNICATED BACK TO THE CPA FIRM AND A NEW DRAFT OF THE 990 WILL BE PRESENTED BACK TO EFHC MANAGEMENT AND BOARD OF DIRECTORS FOR REVIEW AND APPROVAL. ONCE THE 990 DRAFT IS APPROVED BY THE BOARD OF DIRECTORS THE THIRD PARTY WILL FILE ON EFHC'S BEHALF.
Form 990, Part VI, Section B, line 12cOFFICERS, DIRECTORS, KEY EMPLOYEES, AND MEMBERS OF THE BOARD ARE ANNUALLY REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE FORM AS A PRECURSOR TO THEIR SERVICE TO THE ORGANIZATION. POTENTIAL CONFLICTS ARE LOGGED WITH AND MONITORED BY EFHC MANAGEMENT.
Form 990, Part VI, Section B, line 15EFHC PERIODICALLY USES AN INDEPENDENT THIRD PARTY TO REVIEW THE CURRENT COMPENSATION FOR MEMBERS OF THE LEADERSHIP TEAM. BASED ON THIS REVIEW, COMPENSATION LEVELS ARE SET FOR EACH LEVEL OF EMPLOYMENT. COMPENSATION REVIEWS BY THIRD PARTIES ARE CONDUCTED EVERY 3 YEARS. THE LAST REVIEW WAS CONDUCTED IN 2008 AND EFHC IS CURRENTLY IN THE PROCESS OF CONDUCTING A NEW REVIEW FOR EXECUTIVE STAFF AND PROVIDER COMPENSATION.
Form 990, Part VI, Section C, line 19EFHC GOVERNING DOCUMENTS, FINANCIAL STATEMENTS, AND CONFLICT OF INTEREST POLICY ARE AVAILABLE FOR PUBLIC REVIEW UPON REQUEST. REQUESTS ARE REQUIRED TO BE IN WRITING AND AT THE ATTENTION OF ZIZI ATIA, CFO.

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