EAST GEORGIA HEALTHCARE CENTER INC: Form 990, tax year 2009

View the entire original 990 at ProPublica ↗

Organization
EAST GEORGIA HEALTHCARE CENTER INC (EIN 58-2001607)
Tax period
2009-07-01 to 2010-06-30
Filed
2011-02-11
IRS object ID
201140429349301334
Schema version
2009v1.3
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)
Timestamp2011-02-11T13:12:24-08:00Timestamp
Tax Period End Date2010-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1TERRY HORNE CPA & ASSOCIATESBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1732 WEST MAIN STREETAddressLine1
CityLEBANONCity
StateTNState
ZIP Code37087ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2009-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN582001607EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1EAST GEORGIA HEALTHCARE CENTER INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlEASTNameControl
Phone4782376262Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 807AddressLine1
CitySWAINSBOROCity
StateGAState
ZIP Code30401ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJENNIE WREN DENMARKName
TitleCHIEF EXECUTIVE OFFICERTitle
Phone4782376262Phone
Date Signed2010-09-16DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
NameTERRY HORNEName
Phone6154447293Phone
Date Prepared2011-02-11DatePrepared
FieldValueIRS element (for citing)
Tax Year2009TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonJENNIE WREN DENMARKNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1PO BOX 807AddressLine1
CitySWAINSBOROCity
StateGAState
ZIP Code30401ZIPCode
FieldValueIRS element (for citing)
Gross Receipts6572825GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501cXOrganization501c
Web SiteN/AWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1992YearFormation
State Legal DomicileGAStateLegalDomicile
Activity Or Mission DescriptionTHE ORGANIZATION PROVIDES HEALTH CARE TO INDIVIDUALS REGARDLESS OF THEIR ABILITY TO PAY. THIS IS A DIRECT FULFILLMENT OF THEIR TAX EXEMPT PURPOSE.ActivityOrMissionDescription
Nbr Voting Members Governing Body16NbrVotingMembersGoverningBody
Nbr Independent Voting Members16NbrIndependentVotingMembers
Total Nbr Employees97TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year3714205ContributionsGrantsPriorYear
Contributions Grants Current Year3620774ContributionsGrantsCurrentYear
Program Service Revenue Prior Year1669854ProgramServiceRevenuePriorYear
Program Service Revenue CY2950301ProgramServiceRevenueCY
Investment Income Current Year-213InvestmentIncomeCurrentYear
Other Revenue Current Year1750OtherRevenueCurrentYear
Total Revenue Prior Year5384059TotalRevenuePriorYear
Total Revenue Current Year6572612TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year3469016SalariesEtcPriorYear
Salaries Etc Current Year4783318SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year1743622OtherExpensePriorYear
Other Expenses Current Year1752980OtherExpensesCurrentYear
Total Expenses Prior Year5212638TotalExpensesPriorYear
Total Expenses Current Year6536298TotalExpensesCurrentYear
Revenues Less Expenses Prior Year171421RevenuesLessExpensesPriorYear
Revenues Less Expenses CY36314RevenuesLessExpensesCY
Total Assets BOY1647663TotalAssetsBOY
Total Assets EOY1643892TotalAssetsEOY
Total Liabilities BOY659104TotalLiabilitiesBOY
Total Liabilities EOY619019TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY988559NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY1024873NetAssetsOrFundBalancesEOY
Mission DescriptionTHE ORGANIZATION PROVIDES HEALTH CAREMissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense4494967Expense
Revenue2950301Revenue
DescriptionTHE ORGANIZATION PROVIDES HEALTH CARE REGARDLESS OF THE INDIVIDUALS ABILITY TO PAY. THESE MEDICAL SERVICES ARE PROVIDED IN AREAS THAT HAVE A SHORTAGE OF HEALTH CARE PROVIDERS. THIS IS A DIRECT FULFILLMENT OF THEIR TAX EXEMPT PURPOSE. OVER 49,100 VISITS WERE PROVIDED DURING THE YEAR.Description
Total Program Service Expense4494967TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredfalseScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Balance Sheet Amounts ReportedtrueBalanceSheetAmountsReported
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntityfalseRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109615NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees97NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Excess Business HoldingsfalseExcessBusinessHoldings
Taxable DistributionsfalseTaxableDistributions
Distribution To DonorfalseDistributionToDonor
Nbr Voting Governing Body Members16NbrVotingGoverningBodyMembers
Number Independent Voting Members16NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonJILL SORRELLSNamePerson
Telephone Number4782376262TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1128 NORTH MAIN STREETAddressLine1
CitySWAINSBOROCity
StateGAState
ZIP Code30401ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (25 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployeeIndividual Trustee Or DirectorIndividualTrusteeOrDirector
JENNIE WREN DENMARK
CHIEF EXECUTIVE OFFICER40.00X99962016521
MUHAMMAD I JAMAL MD
CHIEF MEDICAL OFFICER40.00X190461018221
JILL SORRELLS
CHIEF FINANCIAL OFFICER40.00X77030016297
HERMAN THOMPSON
CHIEF INFORMATION OFFICER40.00X76603014554
TRACEYAN MENDEZ
PHYSICIAN40.00163901017520X
JOHN MURIMI
PHYSICIAN40.0014732605263X
HIROMI MARUYAMA
PHYSICIAN40.0014114705632X
BYRON MURPHY
DENTIST40.0013799006722X
SUZANNE CLARKE
PHYSICIAN40.0010532603613X
LYNDA MORGAN
BOARD MEMBER1.00000X
BETH HENDRIX
BOARD MEMBER1.00000X
KEN MERCER
BOARD MEMBER1.00000X
CECIL STRONG
BOARD MEMBER1.00000X
MARGIE C HALL
BOARD MEMBER1.00000X
PAT W GUNN
BOARD MEMBER1.00000X
AMANDA R BROWN
BOARD MEMBER1.00000X
RONNY BOATRIGHT
BOARD MEMBER1.00000X
GWENDOLYN B LOVE
BOARD MEMBER1X
JUAN YEPE
BOARD MEMBER1X
LUIS A MACHADO
BOARD MEMBER1X
PERCY L HODGES
BOARD MEMBER1X
FAYE B BALKCOM
BOARD MEMBER1X
GARY P BRADDY
BOARD MEMBER1X
THERON D FAISON
BOARD MEMBER1X
CLEVE WHITE
BOARD MEMBER1X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1139746TotalReportableCompFromOrg
Total Other Compensation104343TotalOtherCompensation
Number Individuals GT100 K6NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation

Name Of Contractor NameOfContractor

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1MEDICAL DOCTOR ASSOCISTESBusinessNameLine1

Address Of Contractor AddressOfContractor

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO BOX 277185AddressLine1
CityATLANTACity
StateGAState
ZIP Code303847185ZIPCode
FieldValueIRS element (for citing)
Description Of ServicesCONTRACTUAL PHYSICIANSDescriptionOfServices
Compensation131421Compensation
FieldValueIRS element (for citing)
Number Of Contractors GT100 K1NumberOfContractorsGT100K
Government Grants2982896GovernmentGrants
All Other Contributions637878AllOtherContributions
Total Contributions3620774TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPATIENT FEESDescription
Business Code621110BusinessCode
Total Revenue Column2950301TotalRevenueColumn
Related Or Exempt Function Income2950301RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue2950301TotalProgramServiceRevenue

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real1750Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real1750Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column1750TotalRevenueColumn
Exclusion$1,750ExclusionAmount

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities213Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities-213Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-213TotalRevenueColumn
Exclusion-$213ExclusionAmount

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column6572612TotalRevenueColumn
Related Or Exempt Function Income2950301RelatedOrExemptFunctionIncome
Exclusion$1,537ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total444056Total
Program Services190461ProgramServices
Management And General253595ManagementAndGeneral
Fundraising0Fundraising

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total3473783Total
Program Services2578137ProgramServices
Management And General895646ManagementAndGeneral
Fundraising0Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total59624Total
Program Services41737ProgramServices
Management And General17887ManagementAndGeneral
Fundraising0Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total604972Total
Program Services308056ProgramServices
Management And General296916ManagementAndGeneral
Fundraising0Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total200883Total
Program Services140618ProgramServices
Management And General60265ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total21545Total
Program Services0ProgramServices
Management And General21545ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total16475Total
Program Services0ProgramServices
Management And General16475ManagementAndGeneral
Fundraising0Fundraising

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total416451Total
Program Services340028ProgramServices
Management And General76423ManagementAndGeneral
Fundraising0Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total649464Total
Program Services449808ProgramServices
Management And General199656ManagementAndGeneral
Fundraising0Fundraising

Occupancy Occupancy

FieldValueIRS element (for citing)
Total409113Total
Program Services323911ProgramServices
Management And General85202ManagementAndGeneral
Fundraising0Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total94726Total
Program Services57092ProgramServices
Management And General37634ManagementAndGeneral
Fundraising0Fundraising

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total134431Total
Program Services65119ProgramServices
Management And General69312ManagementAndGeneral
Fundraising0Fundraising

Insurance Insurance

FieldValueIRS element (for citing)
Total10775Total
Program Services0ProgramServices
Management And General10775ManagementAndGeneral
Fundraising0Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total6536298Total
Program Services4494967ProgramServices
Management And General2041331ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY40982BOY
EOY28173EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY214422BOY
EOY87617EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY295851BOY
EOY357565EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY12292BOY
EOY19318EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis1907977LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec770532LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY1070542BOY
EOY1137445EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY13574BOY
EOY13774EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY1647663BOY
EOY1643892EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY576282BOY
EOY606029EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY29305BOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY53517BOY
EOY12990EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY659104BOY
EOY619019EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY988559BOY
EOY1024873EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY988559BOY
EOY1024873EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1647663BOY
EOY1643892EOY
FieldValueIRS element (for citing)
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit RequiredtrueFederalGrantAuditRequired
Federal Grant Audit PerformedtrueFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org170b1 AviXPubliclySupportedOrg170b1Avi

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years1799765CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years2013636CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years2334679CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year3714205CurrentTaxYearMinus1Year
Current Tax Year3620774CurrentTaxYear
Total13483059Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years1799765CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years2013636CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years2334679CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year3714205CurrentTaxYearMinus1Year
Current Tax Year3620774CurrentTaxYear
Total13483059Total
FieldValueIRS element (for citing)
Public Support Total17013483059PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Total Support13483059TotalSupport
Gross Receipts From Admissions Etc8144560GrossReceiptsFromAdmissionsEtc
Public Support Pertcentage1701.00000PublicSupportPertcentage170
Public Support Pertcent Prior Year0.64800PublicSupportPertcentPriorYear
Thirty Three Percnt Tests CY170XThirtyThreePercntTestsCY170
Public Support Total5090PublicSupportTotal509
Public Support Percentage5090PublicSupportPercentage509
Investment Income Percentage0InvestmentIncomePercentage

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Investment Cost Or Other Basis35000InvestmentCostOrOtherBasis
Book Value35000BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis690192InvestmentCostOrOtherBasis
Depreciation29635Depreciation
Book Value660557BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Investment Cost Or Other Basis1182785InvestmentCostOrOtherBasis
Depreciation740897Depreciation
Book Value441888BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings1137445TotalOfBookValueLandBuildings

Other Assets OtherAssets (2 entries)

DescriptionDescriptionBook ValueBookValue
INVESTMENT-INTEGRATED DELIVERY SYSTEM12000
DEPOSITS1774
FieldValueIRS element (for citing)
Total Book Value Other Assets13774TotalBookValueOtherAssets
Total Revenue6572612TotalRevenue
Total Expenses6536298TotalExpenses
Excess Or Deficit For Year36314ExcessOrDeficitForYear
Excess Or Deficit Per FS36314ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt6507597TotRevenueEtcAuditedFinclStmt
Revenue Subtotal6507597RevenueSubtotal
Total Revenue Per Form9906507597TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt6591052TotExpensesEtcAuditedFinclStmt
Expenses Subtotal6591052ExpensesSubtotal
Total Expenses Per Form9906591052TotalExpensesPerForm990

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (3 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgDeferred Comp Filing OrgDeferredCompFilingOrgNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgTotal Compensation Filing OrgTotalCompensationFilingOrgComp Report Prior990 Filing OrgCompReportPrior990FilingOrg
MUHAMMAD I JAMAL MD
190461515413067208682200719
TRACEYAN MENDEZ
163901460112919181421165393
JOHN MURIMI
1473265263152589177421

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (14 entries)

IdentifierIdentifierExplanationExplanation
Pt VI-C, Line 19THE ORGANIZATION MAKES IT GOVERNING DOCUMENTS, CONFLICT OF INTEREST
POLICY AND FORM 990 AVAILABLE UPON WRITTEN REQUEST.
Pt XI, Line 2cTHE CEO, CFO AND FINANCE COMMITTEE OVERSEE FINANCIAL STATEMENT PREPARATION
AND AUDIT ENGAGEMENT.
Pt VI-B, Line 11ATHE CFO WILL REVIEW A COMPLETED FORM 990 AND RELATED SCHEDULES WITH THE
BOARD OF DIRECTORS FINANCE COMMITTEE.
Pt VI-B, Line 12cANNUALLY THE CONFLICT OF INTEREST STATEMENT IS SIGNED BY BOARD MEMBERS AND
REVIEWED BY THE ENTIRE BOARD. BOARD MEMBERS SHALL EXCUSE THEMSELVES FROM
ISSUES THAT ENHANCE THE PROBABILITY OF THEIR OWN PERSONAL AND PRIVATE GAIN.
Pt VI-B, Line 15STATE AND NATIONAL SALARY COMPARISONS ARE USED TO ESTABLISH SALARY LIMITS
FOR TOP MANAGEMENT OFFICIALS. PERFORMANCE EVALUATION ARE PERFORMED ANNUALLY
AND SALARY INCREASES ARE BOARD APPROVED.
Pt VI-C, Line 19THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST
POLICY AND FORM 990 AVAILABLE UPON WRITTEN REQUEST.

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