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HEART CITY HEALTH CENTER INC: Form 990, tax year 2022

View the entire original 990 at ProPublica ↗

Organization
HEART CITY HEALTH CENTER INC (EIN 35-1875364)
Tax period
2022-10-01 to 2023-09-30
Filed
2024-08-15
IRS object ID
202422289349302052
Schema version
2022v5.0
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)
Return2024-08-15T12:11:57+00:00ReturnTs
Tax Period End2023-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN440160260PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Forvis Mazars LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1820 Massachusetts Ave Suite 1370AddressLine1Txt
CityIndianapolisCityNm
State AbbreviationINStateAbbreviationCd
ZIP46204ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2022-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN351875364EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Heart City Health Center IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlHEARBusinessNameControlTxt
Phone5742930052PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1236 SIMPSON AVEAddressLine1Txt
CityELKHARTCityNm
State AbbreviationINStateAbbreviationCd
ZIP46516ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonEsleen FultzPersonNm
Person TitleCEOPersonTitleTxt
Phone5742930052PhoneNum
Signature2024-08-15SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd
FieldValueIRS element (for citing)
IRS Responsible Prty Info CurrYes (true)IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonNicole FishbackPreparerPersonNm
PTINP01279475PTIN
Phone3173834000PhoneNum
Preparation2024-08-15PreparationDt
FieldValueIRS element (for citing)
Tax2022TaxYr
Build TS2024-08-08 14:25:15ZBuildTS

Form 990 IRS990

Principal Ofcr Business Name PrincipalOfcrBusinessName

FieldValueIRS element (for citing)
Business Name Line1ESLEEN E FULTZBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1236 SIMPSON AVEAddressLine1Txt
CityELKHARTCityNm
State AbbreviationINStateAbbreviationCd
ZIP46516ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$19,174,845GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.HEARTCITYHEALTH.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1993FormationYr
Legal Domicile StateINLegalDomicileStateCd
Activity Or MissionHEART CITY HEALTH CENTER, INC. IS A FEDERALLY QUALIFIED HEALTH CENTER (FQHC) PROVIDING COMPREHENSIVE PRIMARY HEALTHCARE AND EDUCATION FOR THE ELKHART COMMUNITY.ActivityOrMissionDesc
Voting Members Governing Body10VotingMembersGoverningBodyCnt
Voting Members Independent10VotingMembersIndependentCnt
Total Employee273TotalEmployeeCnt
Total Gross UBI$43,996TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$4,690,388PYContributionsGrantsAmt
CY Contributions Grants$5,148,199CYContributionsGrantsAmt
PY Program Service Revenue$10,028,266PYProgramServiceRevenueAmt
CY Program Service Revenue$10,986,748CYProgramServiceRevenueAmt
PY Investment Income$106,542PYInvestmentIncomeAmt
CY Investment Income$106,422CYInvestmentIncomeAmt
PY Other Revenue$635,205PYOtherRevenueAmt
CY Other Revenue$325,366CYOtherRevenueAmt
PY Total Revenue$15,460,401PYTotalRevenueAmt
CY Total Revenue$16,566,735CYTotalRevenueAmt
PY Grants And Similar Paid$1,500PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$500CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$10,499,782PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$10,372,350CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$5,428,919PYOtherExpensesAmt
CY Other Expenses$6,845,112CYOtherExpensesAmt
PY Total Expenses$15,930,201PYTotalExpensesAmt
CY Total Expenses$17,217,962CYTotalExpensesAmt
PY Revenues Less Expenses-$469,800PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$651,227CYRevenuesLessExpensesAmt
Total Assets BOY$13,300,201TotalAssetsBOYAmt
Total Assets EOY$13,148,151TotalAssetsEOYAmt
Total Liabilities BOY$2,915,397TotalLiabilitiesBOYAmt
Total Liabilities EOY$3,276,253TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$10,384,804NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$9,871,898NetAssetsOrFundBalancesEOYAmt
MissionHEART CITY HEALTH CENTER, INC. (HEART CITY) IS A NON-PROFIT, FEDERALLY QUALIFIED HEALTH CENTER (FQHC) PROVIDING AFFORDABLE, HIGH QUALITY, PRIMARY HEALTH, BEHAVIORAL HEALTH, DENTAL AND PHARMACEUTICAL CARE TO RESIDENTS OF ELKHART AND SURROUNDING COUNTIES. HEART CITY HEALTH CENTER OFFERS A SLIDING FEE SCALE BASED ON INCOME AND FAMILY SIZE FOR THE UNINSURED, UNDER-INSURED 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 ELKHART AND SURROUNDING COUNTIES 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 ALMOST 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.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$8,870,049ExpenseAmt
Grant$500GrantAmt
Revenue$9,638,072RevenueAmt
DescHEART CITY HEALTH CENTER, INC. (HEART CITY) PROVIDES MEDICAL AND BEHAVIORAL HEALTHCARE IN THE AREA OF ADULTS AND PEDIATRICS TO THE PRIMARILY MEDICARE, MEDICAID, AND UNINSURED POPULATION OF ELKHART COUNTY. DURING THE YEAR ENDED SEPTEMEBER 30, 2023, HEART CITY PROVIDED 43,189 MEDICAL VISITS AND 4,429 BEHAVIORAL HEALTH VISITS TO 12,431 PATIENTS.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$1,991,798ExpenseAmt
Revenue$1,348,676RevenueAmt
DescHEART 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. THE DENTISTS AND HYGIENISTS SERVED 8,023 PATIENTS PROVIDING 6,598 VISITS. VARIOUS DENTAL SERVICES PROVIDED INCLUDE: EXAMINATIONS; TREATMENT PLANNING; CHILDREN'S DENTISTRY; CLEANING/DENTAL HYGIENE; EXTRACTIONS; FILLINGS; RADIOGRAPHS; AND PATIENT EDUCATION.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$1,307,577ExpenseAmt
Revenue$2,298,401RevenueAmt
DescHEART CITY HAS AN ONSITE PHARMACY AT OUR SIMPSON STREET LOCATION WHICH PROVIDES CONVENIENT PRESCRIPTION SERVICES TO OUR PATIENTS AND THE COMMUNITY. PHARMACY FILLED 33,356 PRESCRIPTIONS AND SERVED 3,047 INDIVIDUAL PATIENTS.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$12,169,424TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsfalseDonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (true)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContriYes (true)DeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document74IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee273EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitYes (true)UnrelatedBusIncmOverLimitInd
Form990 T FiledYes (true)Form990TFiledInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members10GoverningBodyVotingMembersCnt
Independent Voting Member10IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyfalseForm990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldINStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Esleen FultzBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone5749701448PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1236 SIMPSON AVEAddressLine1Txt
CityELKHARTCityNm
State AbbreviationINStateAbbreviationCd
ZIP46516ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
Angelia Washington
Treasurer1.00.0Yes (X)Yes (X)$0$0$0
Arvis Dawson
Secretary1.00.0Yes (X)Yes (X)$0$0$0
Tara Morris
Board Chair1.00.0Yes (X)Yes (X)$0$0$0
Anthony England
Board Member1.00.0Yes (X)$0$0$0
Beatrice Phillips
Board Member1.00.0Yes (X)$0$0$0
Daniel Weddington
Board Member1.00.0Yes (X)$0$0$0
Delia Grajeda
Board Member1.00.0Yes (X)$0$0$0
Nancy Poikonen
Board Member1.00.0Yes (X)$0$0$0
Nicole Williams
Board Member1.00.0Yes (X)$0$0$0
Robert Taylor
Board Member1.00.0Yes (X)$0$0$0
Daria Sztaba
CFO (BEG 03/27/23)1.00.0Yes (X)$0$0$0
Esleen Fultz
CEO40.00.0Yes (X)$249,796$0$2,537
Jeren Stepp (END 110922)
CFO40.00.0Yes (X)$137,247$0$4,990
Lalaesha Black
COO40.00.0Yes (X)$154,851$0$2,826
Dwayne Johnson
Physician MD/DO40.00.0$177,453$0$8,781Yes (X)
Erin Farrell
Physician MD/DO40.00.0$159,550$0$0Yes (X)
Essam Montasir
Physician MD/DO40.00.0$220,579$0$6,008Yes (X)
Mary P McManmon
Associate Medical Director40.00.0$204,445$0$2,537Yes (X)
Shanna Kautzmann
Physician MD/DO40.00.0$179,653$0$8,044Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,483,574TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$35,723TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K19IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
Cardinal Health
3740 Collections Center DriveChicagoIL606930037Pharmacy Supplies$1,212,995
Beacon Medical Group Inc
710 N Niles AveSouth BendIN46617Contracted Services - Baby Deliveries$703,110
Athena Health Inc
PO Box 415615BostonMA022415615Healthcare Patient Records$684,914
Valic Financial Advisors Inc
PO Box 301104DallasTX753031104Manage Pensions$431,821
BE Smith LLC
8801 Renner BlvdLenexaKS66219Construction Services$429,264
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K19CntrctRcvdGreaterThan100KCnt
Federated Campaigns$0FederatedCampaignsAmt
Membership Dues$0MembershipDuesAmt
Fundraising$0FundraisingAmt
Related Organizations$0RelatedOrganizationsAmt
Government Grants$4,848,260GovernmentGrantsAmt
All Other Contributions$299,939AllOtherContributionsAmt
Noncash Contributions$270,868NoncashContributionsAmt
Total Contributions$5,148,199TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
MEDICAL SERVICES624100$9,580,546$9,580,546
DENTAL SERVICES624100$1,348,676$1,348,676
MEDICAL RECORDS624100$15,434$15,434
MISCELLANEOUS REVENUE900099$42,092$42,092

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$10,986,748TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$76,222TotalRevenueColumnAmt
Exclusion$76,222ExclusionAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$0RealAmt
Personal$0PersonalAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$665,275SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$635,075SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$30,200SecuritiesAmt
Other$0OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$30,200TotalRevenueColumnAmt
Exclusion$30,200ExclusionAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$2,298,401GrossSalesOfInventoryAmt
Cost Of Goods Sold$1,973,035CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$325,366TotalRevenueColumnAmt
Related Or Exempt Func Income$281,370RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$43,996UnrelatedBusinessRevenueAmt

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$0OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$16,566,735TotalRevenueColumnAmt
Related Or Exempt Func Income$11,268,118RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$43,996UnrelatedBusinessRevenueAmt
Exclusion$106,422ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$500TotalAmt
Program Services$500ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$533,033TotalAmt
Program Services$533,033ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$8,300,510TotalAmt
Program Services$5,586,602ProgramServicesAmt
Management And General$2,713,908ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$116,926TotalAmt
Program Services$78,696ProgramServicesAmt
Management And General$38,230ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$778,510TotalAmt
Program Services$523,971ProgramServicesAmt
Management And General$254,539ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$643,371TotalAmt
Program Services$433,017ProgramServicesAmt
Management And General$210,354ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$41,728TotalAmt
Management And General$41,728ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$162,311TotalAmt
Management And General$162,311ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$17,214TotalAmt
Management And General$17,214ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$3,461,341TotalAmt
Program Services$3,401,290ProgramServicesAmt
Management And General$60,051ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$263,969TotalAmt
Program Services$144,310ProgramServicesAmt
Management And General$119,659ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$428,761TotalAmt
Program Services$172,098ProgramServicesAmt
Management And General$256,663ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$324,274TotalAmt
Program Services$177,278ProgramServicesAmt
Management And General$146,996ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$442,911TotalAmt
Program Services$177,778ProgramServicesAmt
Management And General$265,133ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$52,002TotalAmt
Program Services$4,589ProgramServicesAmt
Management And General$47,413ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$352,599TotalAmt
Program Services$31,113ProgramServicesAmt
Management And General$321,486ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$84,376TotalAmt
Program Services$46,128ProgramServicesAmt
Management And General$38,248ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$597,734TotalAmt
Program Services$414,290ProgramServicesAmt
Management And General$183,444ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$81,861TotalAmt
Management And General$81,861ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
BAD DEBT$310,944$310,944
DUES & SUBSCRIPTIONS$106,205$58,061$48,144
EMPLOYEE RELATIONS$79,715$43,579$36,136
LICENSES$28,513$27,416$1,097

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$8,654TotalAmt
Program Services$4,731ProgramServicesAmt
Management And General$3,923ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$17,217,962TotalAmt
Program Services$12,169,424ProgramServicesAmt
Management And General$5,048,538ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$12,600BOYAmt
EOY$12,600EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$2,675,474BOYAmt
EOY$2,046,851EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$298,140BOYAmt
EOY$421,049EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$2,408,648BOYAmt
EOY$2,879,913EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$463,732BOYAmt
EOY$411,216EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$44,326BOYAmt
EOY$62,078EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$9,179,662LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$4,212,611LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$5,271,283BOYAmt
EOY$4,967,051EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$2,097,369BOYAmt
EOY$2,318,764EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$28,629BOYAmt
EOY$28,629EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$13,300,201BOYAmt
EOY$13,148,151EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,059,842BOYAmt
EOY$1,364,106EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$1,835,805BOYAmt
EOY$1,876,709EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$19,750BOYAmt
EOY$35,438EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$2,915,397BOYAmt
EOY$3,276,253EOYAmt

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$10,384,804BOYAmt
EOY$9,871,898EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$10,384,804BOYAmt
EOY$9,871,898EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$13,300,201BOYAmt
EOY$13,148,151EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$651,227ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$138,321NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredYes (true)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (true)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Tax Rev Levied Orgnztnl Bnft170 TaxRevLeviedOrgnztnlBnft170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$0CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$0CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$0CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$0CurrentTaxYearMinus1YearAmt
Current Tax Year$0CurrentTaxYearAmt
Total$0TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$0SubstantialContributorsTotAmt
Public Support Total170$0PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Income170 OtherIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$0CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$0CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$0CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$0CurrentTaxYearMinus1YearAmt
Current Tax Year$0CurrentTaxYearAmt
Total$0TotalAmt
FieldValueIRS element (for citing)
Total Support$0TotalSupportAmt
Gross Receipts Rltd Activities$0GrossReceiptsRltdActivitiesAmt
Public Support CY1700PublicSupportCY170Pct
Public Support PY1700.0PublicSupportPY170Pct

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$3,423,672CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$5,563,602CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$5,187,836CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$4,690,388CurrentTaxYearMinus1YearAmt
Current Tax Year$5,148,199CurrentTaxYearAmt
Total$24,013,697TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$6,611,487CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$6,764,406CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$9,951,155CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$12,120,716CurrentTaxYearMinus1YearAmt
Current Tax Year$13,137,855CurrentTaxYearAmt
Total$48,585,619TotalAmt

Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Tax Rev Levied Orgnztnl Bnft509 TaxRevLeviedOrgnztnlBnft509Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Govt Furn Srvc Fclts Vl509 GovtFurnSrvcFcltsVl509Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$10,035,159CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$12,328,008CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$15,138,991CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$16,811,104CurrentTaxYearMinus1YearAmt
Current Tax Year$18,286,054CurrentTaxYearAmt
Total$72,599,316TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$0CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$0CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$0CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$0CurrentTaxYearMinus1YearAmt
Current Tax Year$0CurrentTaxYearAmt
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$0CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$0CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$0CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$0CurrentTaxYearMinus1YearAmt
Current Tax Year$0CurrentTaxYearAmt
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$0CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$0CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$0CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$0CurrentTaxYearMinus1YearAmt
Current Tax Year$0CurrentTaxYearAmt
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$72,599,316PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$81,784CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$81,690CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$59,514CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$73,514CurrentTaxYearMinus1YearAmt
Current Tax Year$76,222CurrentTaxYearAmt
Total$372,724TotalAmt

Post1975 UBTI Post1975UBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years$60,781CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$77,191CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$41,551CurrentTaxYearMinus1YearAmt
Current Tax Year$17,357CurrentTaxYearAmt
Total$196,880TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$81,784CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$142,471CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$136,705CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$115,065CurrentTaxYearMinus1YearAmt
Current Tax Year$93,579CurrentTaxYearAmt
Total$569,604TotalAmt

Net Income From Other UBI NetIncomeFromOtherUBIGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$0CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$0CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$0CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$0CurrentTaxYearMinus1YearAmt
Current Tax Year$0CurrentTaxYearAmt
Total$0TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$10,116,943CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$12,470,479CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$15,275,696CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$16,926,169CurrentTaxYearMinus1YearAmt
Current Tax Year$18,379,633CurrentTaxYearAmt
Total$73,168,920TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.9922PublicSupportCY509Pct
Public Support PY5090.9913PublicSupportPY509Pct
Investment Income CY0.01InvestmentIncomeCYPct
Investment Income PY0.01InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Distributable Amount DistributableAmountGrp

FieldValueIRS element (for citing)
CY Adj Net Income Distributable$0CYAdjNetIncomeDistributableAmt
CY Pct85 Adjusted Net Income$0CYPct85AdjustedNetIncomeAmt
CY Total Min Ast Distributable$0CYTotalMinAstDistributableAmt
CY Greater Adjusted Minimum$0CYGreaterAdjustedMinimumAmt
CY Income Tax Imposed PY$0CYIncomeTaxImposedPYAmt
CY Distributable As Adjusted$0CYDistributableAsAdjustedAmt

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$213,700OtherCostOrOtherBasisAmt
Book Value$213,700BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,522,479OtherCostOrOtherBasisAmt
Depreciation$680,459DepreciationAmt
Book Value$1,842,020BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$480,217OtherCostOrOtherBasisAmt
Depreciation$224,675DepreciationAmt
Book Value$255,542BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,648,947OtherCostOrOtherBasisAmt
Depreciation$1,160,834DepreciationAmt
Book Value$488,113BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$4,314,319OtherCostOrOtherBasisAmt
Depreciation$2,146,643DepreciationAmt
Book Value$2,167,676BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$4,967,051TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescDrugs and Pharmaceuticals HeldDesc
Amt$35,438Amt
FieldValueIRS element (for citing)
Total Liability$35,438TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$18,349,933TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$138,321NetUnrealizedGainsInvstAmt
Other Revenue$1,973,035OtherRevenueAmt
Revenue Not Reported$2,111,356RevenueNotReportedAmt
Revenue Subtotal$16,238,577RevenueSubtotalAmt
Investment Expenses Not Incld$17,214InvestmentExpensesNotIncldAmt
Other Revenues Not Included$310,944OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$328,158RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$16,566,735TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$18,862,839TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$1,973,035OtherExpensesIncludedAmt
Expenses Not Reported$1,973,035ExpensesNotReportedAmt
Expenses Subtotal$16,889,804ExpensesSubtotalAmt
Investment Expenses Not Incld2$17,214InvestmentExpensesNotIncld2Amt
Other Expenses Not Included$310,944OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$328,158ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$17,217,962TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnoteMANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS.
Schedule D, Part XI, Line 2(d) Other revenues in audited financial statements not in form 990COST OF GOODS SOLD - PHARMACY - 1973035
Schedule D, Part XI, Line 4(b) Other revenues in form 990 not in audited financial statementsBAD DEBT - 310944
Schedule D, Part XII, Line 2(d) Other expenses in audited financial statements not in form 990COST OF GOODS SOLD - PHARMACY - 1973035
Schedule D, Part XII, Line 4(b) Other expenses in form 990 not in audited financial statementsBAD DEBT - 310944

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Idemnification Gross Up PmtsYes (X)IdemnificationGrossUpPmtsInd
Written Policy Ref T And E ExpnssfalseWrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (true)SubstantiationRequiredInd
Independent ConsultantYes (X)IndependentConsultantInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (true)AnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Esleen Fultz
CEO$249,796$0$0$0$0$0$0$0$2,537$0$252,333$0$0$0
Lalaesha Black
COO$151,289$0$3,562$0$0$0$0$0$2,826$0$157,677$0$0$0
Mary P McManmon
Associate Medical Director$203,292$0$1,153$0$0$0$0$0$2,537$0$206,982$0$0$0
Essam Montasir
Physician MD/DO$220,579$0$0$0$0$0$0$0$6,008$0$226,587$0$0$0
Shanna Kautzmann
Physician MD/DO$178,586$0$1,067$0$0$0$0$0$8,044$0$187,697$0$0$0
Dwayne Johnson
Physician MD/DO$176,372$0$1,081$0$0$0$0$0$8,781$0$186,234$0$0$0
Erin Farrell
Physician MD/DO$159,550$0$0$0$0$0$0$0$0$0$159,550$0$0$0

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Schedule J, Part I, Line 1a Tax indemnification and gross-up paymentsTHE ORGANIZATION PROVIDED FOR THE GROSS UP OF BONUS PAYMENTS TO OFFICERS AND HIGHEST COMPENSATED EMPLOYEES, WHICH WAS INCLUDED IN THE INDIVIDUALS' TAXABLE COMPENSATION.
Schedule J, Part I, Line 1b Written policy regarding payment or reimbursement of expensesTHE ORGANIZATION DOES NOT FOLLOW A WRITTEN POLICY REGARDING THE GROSS-UP PAYMENTS PROVIDED TO OFFICERS AND HIGHEST COMPENSATED EMPLOYEES, HOWEVER THESE PAYMENTS ARE APPROVED BY THE ORGANIZATION'S BOARD OF DIRECTORS.
Schedule J, Part I, Line 7 Non-fixed paymentsTHE BONUS PAYMENTS ARE BASED ON LENGTH OF SERVICE FOR THE YEAR TO WHICH THE BONUS RELATES AND POSITION HELD. BONUS IS PAID ONLY IF PAYMENT RECEIVED FROM MANAGED CARE ENTITY FOR MEETING TARGETS. THE BOARD OF DIRECTORS DETERMINES WHETHER IT IS TO BE SHARED WITH EMPLOYEES EACH YEAR. THE EXECUTIVE BOARD MEMBERS ALSO DECIDE THE ANNUAL BONUS FOR THE CEO AS PART OF THE PERFORMANCE EVALUATION. THE BONUS IS A PERCENTAGE OF THE EXISTING COMPENSATION, NOT BASED ON THE COMPENSATION WITH RAISE. THE BONUS IS BASED ON NATIONAL COMPENSATION PACKAGE REPORTS AND PERFORMANCE OF THE CEO. OPTIONS FOR THE BONUS ARE LISTED ON THE EVALUATION AS WELL AS AN OPTION FOR NO BONUS. THE EXECUTIVE COMMITTEE AGREE ON THE AMOUNT AND FILE THEIR DECISION WITH EVALUATION AND RAISE INFORMATION WITH HEART CITY HEALTH'S ATTORNEY, BARNES & THORNBURG.

Schedule M IRS990ScheduleM

Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Contribution22ContributionCnt
Noncash Contributions Rpt F990$270,868NoncashContributionsRptF990Amt
Method Of Determining RevenuesMarket valueMethodOfDeterminingRevenuesTxt
FieldValueIRS element (for citing)
Any Property That Must Be HeldfalseAnyPropertyThatMustBeHeldInd
Review Process Unusual NC GiftsYes (true)ReviewProcessUnusualNCGiftsInd
Third Parties UsedfalseThirdPartiesUsedInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule M, Part I Explanations of reporting method for number of contributionsFormAndLineReferenceDesc
ExplanationDrugs and medical supplies - Heart City Health Center reported the number of ContributionsExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Line 11b Review of form 990 by governing bodyTHE ORGANIZATION'S FORM 990 IS REVIEWED IN DETAIL BY THE EXECUTIVE MANAGEMENT.
Form 990, Part VI, Line 12c Conflict of interest policyAN ANNUAL CONFLICT OF INTEREST FORM IS FILLED OUT BY EACH BOARD MEMBER. ALL OTHER EMPLOYEES SIGN THE CODE OF CONDUCT POLICY AT THE TIME OF HIRE WHICH COVERS CONFLICTS OF INTEREST. THE CEO AND THE BOARD LIAISON REVIEW THE CONFLICT OF INTEREST FORMS TO DETERMINE IF ANY POTENTIAL CONFLICT OF INTEREST EXISTS. IF A POTENTIAL CONFLICT OF INTEREST IS DETERMINED TO EXIST, THE CEO AND EXECUTIVE COMMITTEE OF THE BOARD, CONSISTING OF THE CHAIR, VICE CHAIR, 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.
Form 990, Part VI, Line 15a Process to establish compensation of top management officialCOMPENSATION FOR THE ORGANIZATION'S CEO IS DETERMINED BY THE BOARD OF DIRECTORS EXECUTIVE COMMITTEE BASED ON A PERFORMANCE EVALUATION AND INTERVIEW WITH THE CEO. EACH EXECUTIVE BOARD MEMBER COMPLETES AN EVALUATION, AND THEN THE EXECUTIVE COMMITTEE REPORTS THE FINDINGS AND ANY CHANGES IN COMPENSATION TO THE CEO AND IT IS SENT TO THE HEART CITY HEALTH'S ATTORNEY. ANY CHANGES IN COMPENSATION ARE BASED ON COMPILED NATIONAL BENCHMARKING SALARY REPORTS. THIS PROCESS HAS BEEN PERFORMED ANNUALLY IN THE PAST. HOWEVER A REVIEW AND COMPENSATION CHANGE HAS NOT OCCURRED SINCE THE LAST ONE ON SEPTEMBER OF 2023. THE EVALUATION AND REVIEW PROCESS IS SIGNED BY THE EXECUTIVE BOARD COMMITTEE AND IS DOCUMENTED AND ON FILE WITH HEART CITY HEALTH'S ATTORNEY, BARNES AND THORNBURG.
Form 990, Part VI, Line 15b Process to establish compensation of other employeesTHE 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 DURING THE FISCAL YEAR ENDED SEPTEMBER 2023.
Form 990, Part VI, Line 19 Required documents available to the publicGOVERNING 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.
Form 990, Part IX, Line 11g Other FeesLab Services - Total Expense: 11446, Program Service Expense: 11446, Management and General Expenses: , Fundraising Expenses: ; Dental Labs - Total Expense: 13426, Program Service Expense: 13426, Management and General Expenses: , Fundraising Expenses: ; Contracted Services- Labor - Total Expense: 908941, Program Service Expense: 908941, Management and General Expenses: , Fundraising Expenses: ; EHR/PM Fees - Total Expense: 786600, Program Service Expense: 786600, Management and General Expenses: , Fundraising Expenses: ; Contracted Services - Total Expense: 1157875, Program Service Expense: 1157875, Management and General Expenses: , Fundraising Expenses: ; Interpreting Services - Total Expense: 144672, Program Service Expense: 144672, Management and General Expenses: , Fundraising Expenses: ; Contracted Service- Chartspan - Total Expense: 221230, Program Service Expense: 221230, Management and General Expenses: , Fundraising Expenses: ; Claims Processing - Total Expense: 15035, Program Service Expense: 15035, Management and General Expenses: , Fundraising Expenses: ; Professional Fees- Consulting Services - Total Expense: 60051, Program Service Expense: , Management and General Expenses: 60051, Fundraising Expenses: ; Professional Fees- Payroll Services - Total Expense: 25716, Program Service Expense: 25716, Management and General Expenses: , Fundraising Expenses: ; Telephone Service - Total Expense: 106242, Program Service Expense: 106242, Management and General Expenses: , Fundraising Expenses: ; Employee Uniforms - Total Expense: 10107, Program Service Expense: 10107, Management and General Expenses: , Fundraising Expenses: ;
FORM 990, PART VI, LINE 1ADELEGATE BROAD AUTHORITY TO A COMMITTEE: THE EXECUTIVE COMMITTEE SHALL CONSIST OF THE FOLLOWING OFFICERS OF THE CORPORATION, ALL OF WHOM SHALL HAVE THE RIGHT TO VOTE: CHAIRPERSON, VICE CHAIR, SECRETARY AND TREASURER. THE CHIEF EXECUTIVE OFFICER SHALL BE A NON-VOTING MEMBER OF THE EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE SHALL HAVE THE FOLLOWING GENERAL AUTHORITY; THE EXECUTIVE COMMITTEE SHALL BE COMPROMISED EXCLUSIVELY OF BOARD MEMBERS AND SHALL ACT FOR THE CORPORATION IN THE INTERIM PERIODS BETWEEN MEETINGS OF THE BOARD OF DIRECTORS ONLY WITH RESPECT TO MATTERS OF AN URGENT NATURE AND THEN TO THE MAXIMUM EXTENT FEASIBLE, IN COMPLIANCE WITH THE ESTABLISHED POLICIES AND EXPRESSED POSITIONS OF THE BOARD. ANY SUCH ACTIONS BY THE EXECUTIVE COMMITTEE ON BEHALF OF THE CORPORATION SHALL REQUIRE RATIFICATION AT THE FOLLOWING REGULAR OR SPECIAL MEETING WHERE A QUORUM IS PRESENT. THE CHAIRPERSON OF THE BOARD OF DIRECTORS OR ANY THREE (3) EXECUTIVE COMMITTEE MEMBERS CONVENES. SAID WRITTEN NOTICE SHALL BE DELIVERED TO THE REMAINING MEMBERS OF THE EXECUTIVE COMMITTEE. A MAJORITY OF THE OFFICERS PRESENT AND IN PERSON, SHALL CONSTITUTE A QUORUM FOR THE TRANSACTION OF EXECUTIVE COMMITTEE BUSINESS.