HEART CITY HEALTH CENTER INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- HEART CITY HEALTH CENTER INC (EIN 35-1875364)
- Tax period
- 2021-10-01 to 2022-09-30
- Filed
- 2023-08-14
- IRS object ID
- 202322269349300937
- Schema version
- 2021v4.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-08-14T10:05:11-05:00 | ReturnTs |
| Tax Period End | 2022-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FORVIS LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 201 N Illinois Street | AddressLine1Txt |
| City | INDIANAPOLIS | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46204 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 351875364 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Heart City Health Center Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % DARIA SZTABA | InCareOfNm |
| Business Name Control | HEAR | BusinessNameControlTxt |
| Phone | 5742930052 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 236 Simpson Ave | AddressLine1Txt |
| City | Elkhart | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46516 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ESLEEN FULTZ | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 5742930052 | PhoneNum |
| Signature | 2023-08-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | ESLEEN | PersonFirstNm |
| Person Last | FULTZ | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | NICOLE B FISHBACK | PreparerPersonNm |
| PTIN | P01279475 | PTIN |
| Phone | 3173834000 | PhoneNum |
| Preparation | 2023-08-15 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ESLEEN E FULTZ | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 236 SIMPSON AVE | AddressLine1Txt |
| City | ELKHART | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46516 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $17,079,308 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.HEARTCITYHEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1993 | FormationYr |
| Legal Domicile State | IN | LegalDomicileStateCd |
| Activity Or Mission | HEART 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 Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 191 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $69,278 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $5,187,836 | PYContributionsGrantsAmt |
| CY Contributions Grants | $4,690,388 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $7,874,373 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $10,028,266 | CYProgramServiceRevenueAmt |
| PY Investment Income | $75,259 | PYInvestmentIncomeAmt |
| CY Investment Income | $106,542 | CYInvestmentIncomeAmt |
| PY Other Revenue | $782,656 | PYOtherRevenueAmt |
| CY Other Revenue | $635,205 | CYOtherRevenueAmt |
| PY Total Revenue | $13,920,124 | PYTotalRevenueAmt |
| CY Total Revenue | $15,460,401 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $1,500 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $8,997,889 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $10,499,782 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $4,901,067 | PYOtherExpensesAmt |
| CY Other Expenses | $5,428,919 | CYOtherExpensesAmt |
| PY Total Expenses | $13,898,956 | PYTotalExpensesAmt |
| CY Total Expenses | $15,930,201 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $21,168 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$469,800 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $13,371,391 | TotalAssetsBOYAmt |
| Total Assets EOY | $13,300,201 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,137,709 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $2,915,397 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $11,233,682 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $10,384,804 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | HEART 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. (SEE SCH O) | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $8,230,039 | ExpenseAmt |
| Grant | $1,500 | GrantAmt |
| Revenue | $8,529,231 | RevenueAmt |
| Desc | HEART 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, 2022, HEART CITY PROVIDED 46,500 MEDICAL VISITS AND 5,000 BEHAVIORAL HEALTH VISITS TO 15,208 PATIENTS. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,548,082 | ExpenseAmt |
| Revenue | $1,499,035 | RevenueAmt |
| Desc | HEART CITY HEALTH CENTER, INC.'S (HEART CITY) LICENSED DENTISTS AND HYGIENISTS PROVIDE A LOW-COST OPTION FOR QUALITY GENERAL DENTISTRY SERVICES TO PEOPLE OF ALL AGES, INCOMES AND BACKGROUNDS, BUT PRIMARILY SERVES MEDICAID AND UNINSURED PATIENTS. THE DENTISTS AND HYGIENISTS SERVED 10,544 PATIENTS PROVIDING 7,717 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,600,789 | ExpenseAmt |
| Revenue | $2,244,825 | RevenueAmt |
| Desc | HEART CITY HAS AN ONSITE PHARMACY AT OUR SIMPSON STREET LOCATION WHICH PROVIDES CONVENIENT PRESCRIPTION SERVICES TO OUR PATIENTS AND THE COMMUNITY. PHARMACY FILLED 32,971 PRESCRIPTIONS AND SERVED 3,065 INDIVIDUAL PATIENTS. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $11,378,910 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | Yes (true) | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 18 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 191 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (true) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (true) | Form990TFiledInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | false | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | IN | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DARIA SZTABA | PersonNm |
| Phone | 5749701448 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 236 SIMPSON AVE | AddressLine1Txt |
| City | ELKHART | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46516 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|---|
| ESLEEN E FULTZ | ||||||||
| CEO | 40.0 | 0.0 | Yes (X) | $237,180 | $0 | $12,153 | ||
| DR ESSAM MONTASIR | ||||||||
| MD/DO | 40.0 | 0.0 | $204,979 | $0 | $16,991 | Yes (X) | ||
| DR MARY P MCMANMON | ||||||||
| ASSOCIATE MEDICAL DIRECTOR | 40.0 | 0.0 | $204,445 | $0 | $9,035 | Yes (X) | ||
| DR DWAYNE E JOHNSON | ||||||||
| MD/DO | 40.0 | 0.0 | $177,760 | $0 | $16,872 | Yes (X) | ||
| DR SHANNA KAUTZMAN | ||||||||
| MD/DO | 40.0 | 0.0 | $179,625 | $0 | $14,969 | Yes (X) | ||
| DR CHRISTINE DANKWA | ||||||||
| MD/DO | 40.0 | 0.0 | $168,330 | $0 | $5,060 | Yes (X) | ||
| LALAESHA BLACK | ||||||||
| COO | 40.0 | 0.0 | Yes (X) | $154,851 | $0 | $7,149 | ||
| JEREN STEPP | ||||||||
| CFO | 40.0 | 0.0 | Yes (X) | $130,649 | $0 | $13,156 | ||
| DR MEENAKSHI GUPTA | ||||||||
| CMO (END 5/20/22) | 40.0 | 0.0 | Yes (X) | $112,352 | $0 | $4,257 | ||
| ANGELIA WASHINGTON | ||||||||
| TREASURER | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| ANTHONY ENGLAND | ||||||||
| BOARD MEMBER | 1.0 | 0.0 | $0 | $0 | $0 | Yes (X) | ||
| ARVIS DAWSON | ||||||||
| SECRETARY | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| DELIA GRAJEDA | ||||||||
| BOARD MEMBER | 1.0 | 0.0 | $0 | $0 | $0 | Yes (X) | ||
| ROBERT TAYLOR | ||||||||
| BOARD MEMBER | 1.0 | 0.0 | $0 | $0 | $0 | Yes (X) | ||
| NANCY POIKONEN | ||||||||
| BOARD MEMBER | 1.0 | 0.0 | $0 | $0 | $0 | Yes (X) | ||
| DANIEL WEDDINGTON | ||||||||
| BOARD MEMBER | 1.0 | 0.0 | $0 | $0 | $0 | Yes (X) | ||
| NICOLE WILLIAMS | ||||||||
| BOARD MEMBER | 1.0 | 0.0 | $0 | $0 | $0 | Yes (X) | ||
| BEATRICE PHILLIPS | ||||||||
| BOARD MEMBER | 1.0 | 0.0 | $0 | $0 | $0 | Yes (X) | ||
| TARA MORRIS | ||||||||
| BOARD CHAIR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,570,171 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $99,642 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 19 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| BACON MEDICAL GROUP | |||||
| 710 NNILES AVE | SOUTH BEND | IN | 46617 | MEDICAL SERVICES | $542,942 |
| ELKHART GENERAL HEALTH CARE SYSTEMS | |||||
| PO BOX 972651 | DALLAS | IN | 753972651 | CLINICAL/MEDICAL | $206,188 |
| BE SMITH LLC | |||||
| 8801 Renner Blvd | LENEXA | KS | 66219 | CONTRUCTION SERVICES | $313,758 |
| ATHENAHEALTH INC | |||||
| 311 Arsenal Street | WATERTOWN | MA | 02472 | EMR SERVICES | $591,502 |
| MAPLETRONICS COMPUTERS INC | |||||
| PO BOX 136 | GOSHEN | IN | 46527 | IT SERVICES | $220,757 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 10 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $4,372,204 | GovernmentGrantsAmt |
| All Other Contributions | $318,184 | AllOtherContributionsAmt |
| Noncash Contributions | $266,929 | NoncashContributionsAmt |
| Total Contributions | $4,690,388 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| MEDICAL SERVICES | 624100 | $8,491,199 | $8,491,199 |
| DENTAL SERVICES | 624100 | $1,499,035 | $1,499,035 |
| MEDICAL RECORDS | 624100 | $3,496 | $3,496 |
| MISCELLANEOUS REVENUE | 900099 | $34,536 | $34,536 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $10,028,266 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $73,514 | TotalRevenueColumnAmt |
| Exclusion | $73,514 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $42,065 | SecuritiesAmt |
| Other | $250 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $9,287 | SecuritiesAmt |
| Other | $0 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $32,778 | SecuritiesAmt |
| Other | $250 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $33,028 | TotalRevenueColumnAmt |
| Exclusion | $33,028 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $0 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $0 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $0 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $2,244,825 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $1,609,620 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $635,205 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $565,927 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $69,278 | UnrelatedBusinessRevenueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $15,460,401 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $10,594,193 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $69,278 | UnrelatedBusinessRevenueAmt |
| Exclusion | $106,542 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,500 | TotalAmt |
| Program Services | $1,500 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $635,032 | TotalAmt |
| Program Services | $635,032 | ProgramServicesAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,355,971 | TotalAmt |
| Program Services | $5,759,619 | ProgramServicesAmt |
| Management And General | $2,596,352 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $85,351 | TotalAmt |
| Program Services | $58,831 | ProgramServicesAmt |
| Management And General | $26,520 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $785,456 | TotalAmt |
| Program Services | $541,401 | ProgramServicesAmt |
| Management And General | $244,055 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $637,972 | TotalAmt |
| Program Services | $439,742 | ProgramServicesAmt |
| Management And General | $198,230 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $39,251 | TotalAmt |
| Management And General | $39,251 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $91,067 | TotalAmt |
| Management And General | $91,067 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,003 | TotalAmt |
| Management And General | $16,003 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,334,885 | TotalAmt |
| Program Services | $2,236,222 | ProgramServicesAmt |
| Management And General | $98,663 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $244,107 | TotalAmt |
| Program Services | $167,728 | ProgramServicesAmt |
| Management And General | $76,379 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $495,569 | TotalAmt |
| Program Services | $246,541 | ProgramServicesAmt |
| Management And General | $249,028 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $337,042 | TotalAmt |
| Program Services | $231,585 | ProgramServicesAmt |
| Management And General | $105,457 | ManagementAndGeneralAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $470,261 | TotalAmt |
| Program Services | $233,951 | ProgramServicesAmt |
| Management And General | $236,310 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $40,383 | TotalAmt |
| Program Services | $5,941 | ProgramServicesAmt |
| Management And General | $34,442 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $260,536 | TotalAmt |
| Program Services | $38,328 | ProgramServicesAmt |
| Management And General | $222,208 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $57,189 | TotalAmt |
| Program Services | $39,295 | ProgramServicesAmt |
| Management And General | $17,894 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $583,402 | TotalAmt |
| Program Services | $404,356 | ProgramServicesAmt |
| Management And General | $179,046 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $79,400 | TotalAmt |
| Management And General | $79,400 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | FundraisingFundraisingAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|---|
| BAD DEBT | $234,431 | $234,431 | $0 | |
| DUES & SUBSCRIPTIONS | $76,259 | $52,398 | $23,861 | |
| EMPLOYEE RELATIONS | $45,467 | $31,241 | $14,226 | |
| LICENSES | $15,730 | $15,314 | $416 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,937 | TotalAmt |
| Program Services | $5,454 | ProgramServicesAmt |
| Management And General | $2,483 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,930,201 | TotalAmt |
| Program Services | $11,378,910 | ProgramServicesAmt |
| Management And General | $4,551,291 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,300 | BOYAmt |
| EOY | $12,600 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,525,385 | BOYAmt |
| EOY | $2,675,474 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $783,154 | BOYAmt |
| EOY | $298,140 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,406,757 | BOYAmt |
| EOY | $2,408,648 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $463,794 | BOYAmt |
| EOY | $463,732 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,883 | BOYAmt |
| EOY | $44,326 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $8,886,160 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $3,614,877 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,761,800 | BOYAmt |
| EOY | $5,271,283 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,367,689 | BOYAmt |
| EOY | $2,097,369 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $28,629 | BOYAmt |
| EOY | $28,629 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,371,391 | BOYAmt |
| EOY | $13,300,201 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $858,445 | BOYAmt |
| EOY | $1,059,842 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,256,328 | BOYAmt |
| EOY | $1,835,805 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,936 | BOYAmt |
| EOY | $19,750 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,137,709 | BOYAmt |
| EOY | $2,915,397 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,233,682 | BOYAmt |
| EOY | $10,384,804 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,233,682 | BOYAmt |
| EOY | $10,384,804 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,371,391 | BOYAmt |
| EOY | $13,300,201 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$469,800 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$368,078 | NetUnrlzdGainsLossesInvstAmt |
| Prior Period Adjustments | -$11,000 | PriorPeriodAdjustmentsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,357,530 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,423,672 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $5,563,602 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $5,187,836 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,690,388 | CurrentTaxYearAmt |
| Total | $22,223,028 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $5,513,713 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $6,611,487 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $6,764,406 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $9,951,155 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $12,120,716 | CurrentTaxYearAmt |
| Total | $40,961,477 | TotalAmt |
Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Tax Rev Levied Orgnztnl Bnft509 TaxRevLeviedOrgnztnlBnft509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Govt Furn Srvc Fclts Vl509 GovtFurnSrvcFcltsVl509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $8,871,243 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $10,035,159 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $12,328,008 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $15,138,991 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $16,811,104 | CurrentTaxYearAmt |
| Total | $63,184,505 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $63,184,505 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $77,205 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $81,784 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $81,690 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $59,514 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $73,514 | CurrentTaxYearAmt |
| Total | $373,707 | TotalAmt |
Post1975 UBTI Post1975UBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | $60,781 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $77,191 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $41,551 | CurrentTaxYearAmt |
| Total | $179,523 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $77,205 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $81,784 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $142,471 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $136,705 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $115,065 | CurrentTaxYearAmt |
| Total | $553,230 | TotalAmt |
Net Income From Other UBI NetIncomeFromOtherUBIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $8,948,448 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $10,116,943 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $12,470,479 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $15,275,696 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $16,926,169 | CurrentTaxYearAmt |
| Total | $63,737,735 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99132 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99120 | PublicSupportPY509Pct |
| Investment Income CY | 0.00868 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00880 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $213,700 | OtherCostOrOtherBasisAmt |
| Book Value | $213,700 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,522,479 | OtherCostOrOtherBasisAmt |
| Depreciation | $571,475 | DepreciationAmt |
| Book Value | $1,951,004 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $480,217 | OtherCostOrOtherBasisAmt |
| Depreciation | $200,373 | DepreciationAmt |
| Book Value | $279,844 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,507,004 | OtherCostOrOtherBasisAmt |
| Depreciation | $915,799 | DepreciationAmt |
| Book Value | $591,205 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,162,760 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,927,230 | DepreciationAmt |
| Book Value | $2,235,530 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $5,271,283 | TotalBookValueLandBuildingsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DRUGS AND PHARMACEUTICALS HELD | Desc |
| Amt | $19,750 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $19,750 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $16,451,509 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$368,078 | NetUnrealizedGainsInvstAmt |
| Other Revenue | $1,609,620 | OtherRevenueAmt |
| Revenue Not Reported | $1,241,542 | RevenueNotReportedAmt |
| Revenue Subtotal | $15,209,967 | RevenueSubtotalAmt |
| Investment Expenses Not Incld | $16,003 | InvestmentExpensesNotIncldAmt |
| Other Revenues Not Included | $234,431 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $250,434 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $15,460,401 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $17,289,387 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $1,609,620 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $1,609,620 | ExpensesNotReportedAmt |
| Expenses Subtotal | $15,679,767 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $16,003 | InvestmentExpensesNotIncld2Amt |
| Other Expenses Not Included | $234,431 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $250,434 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $15,930,201 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE D, PART X, LINE 2 | ASC 740: MANAGEMENT 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 & XII, LINE 2(D) | OTHER RECONCILING ITEMS: COST OF GOODS SOLD-PHARMACY: $1,609,620 |
| SCHEDULE D,PART XI & XII, LINE 4(B) | OTHER RECONCILING ITEMS: BAD DEBT: $234,431 |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Idemnification Gross Up Pmts | Yes (X) | IdemnificationGrossUpPmtsInd |
| Written Policy Ref T And E Expnss | false | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (true) | SubstantiationRequiredInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (true) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ESLEEN E FULTZ | ||||||||||||
| CEO | $237,180 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $12,153 | $0 | $249,333 | $0 |
| LALAESHA BLACK | ||||||||||||
| COO | $150,858 | $0 | $3,993 | $0 | $0 | $0 | $0 | $0 | $7,149 | $0 | $162,000 | $0 |
| DR CHRISTINE DANKWA | ||||||||||||
| MD/DO | $166,470 | $0 | $1,860 | $0 | $0 | $0 | $0 | $0 | $5,060 | $0 | $173,390 | $0 |
| DR DWAYNE E JOHNSON | ||||||||||||
| MD/DO | $175,764 | $0 | $1,996 | $0 | $0 | $0 | $0 | $0 | $16,872 | $0 | $194,632 | $0 |
| DR ESSAM MONTASIR | ||||||||||||
| MD/DO | $203,130 | $0 | $1,849 | $0 | $0 | $0 | $0 | $0 | $16,991 | $0 | $221,970 | $0 |
| DR MARY P MCMANMON | ||||||||||||
| ASSOCIATE MEDICAL DIRECTOR | $202,631 | $0 | $1,814 | $0 | $0 | $0 | $0 | $0 | $9,035 | $0 | $213,480 | $0 |
| DR SHANNA KAUTZMAN | ||||||||||||
| MD/DO | $177,784 | $0 | $1,841 | $0 | $0 | $0 | $0 | $0 | $14,969 | $0 | $194,594 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE J, PART 1, LINE 1A | GROSS-UP PAYMENTS: THE 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/REIMBURSEMENT: THE 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 | NONFIXED PAYMENTS: THE 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Works Of Art | WorksOfArtGrp | |
| Art Historical Treasures | ArtHistoricalTreasuresGrp | |
| Art Fractional Interest | ArtFractionalInterestGrp | |
| Books And Publications | BooksAndPublicationsGrp | |
| Clothing And Household Goods | ClothingAndHouseholdGoodsGrp | |
| Cars And Other Vehicles | CarsAndOtherVehiclesGrp | |
| Boats And Planes | BoatsAndPlanesGrp | |
| Intellectual Property | IntellectualPropertyGrp | |
| Securities Publicly Traded | SecuritiesPubliclyTradedGrp | |
| Securities Closely Held Stock | SecuritiesCloselyHeldStockGrp | |
| Secur Prtnrshp Trust Intrsts | SecurPrtnrshpTrustIntrstsGrp | |
| Securities Miscellaneous | SecuritiesMiscellaneousGrp | |
| Qualified Contrib Hist Struct | QualifiedContribHistStructGrp | |
| Qualified Contrib Other | QualifiedContribOtherGrp | |
| Real Estate Residential | RealEstateResidentialGrp | |
| Real Estate Commercial | RealEstateCommercialGrp | |
| Real Estate Other | RealEstateOtherGrp | |
| Collectibles | CollectiblesGrp | |
| Food Inventory | FoodInventoryGrp |
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 25 | ContributionCnt |
| Noncash Contributions Rpt F990 | $266,929 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | MARKET VALUE | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Taxidermy | TaxidermyGrp | |
| Historical Artifacts | HistoricalArtifactsGrp | |
| Scientific Specimens | ScientificSpecimensGrp | |
| Archaeological Artifacts | ArchaeologicalArtifactsGrp | |
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | Yes (true) | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | false | ThirdPartiesUsedInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCH M, PART I | FormAndLineReferenceDesc |
| Explanation | EXPLANATIONS OF REPORTING METHOD FOR NUMBER OF CONTRIBUTIONS: DRUGS AND MEDICAL SUPPLIES ARE REPORTED BY THE NUMBER OF CONTRIBUTIONS | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (22 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART III, LINE 1 | ORGANIZATION'S MISSION: 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. |
| FORM 990, PART VI, LINE 1A | DELEGATE 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. |
| FORM 990, PART VI, SECTION B, LINE 11B | REVIEW OF FORM 990 BY GOVERNING BODY: THE ORGANIZATION'S FORM 990 IS REVIEWED IN DETAIL BY THE EXECUTIVE MANAGEMENT. |
| FORM 990, PART VI, SECTION B, LINE 12C | CONFLICT OF INTEREST POLICY: AN 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, SECTION B, LINE 15A | PROCESS TO ESTABLISH COMPENSATION OF TOP MANAGEMENT OFFICIAL: COMPENSATION 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 2022. 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, SECTION B, LINE 15B | PROCESS USED TO ESTABLISH COMPENSATION OF OTHER OFFICERS/KEY EMPLOYEES: THE ORGANIZATION'S CEO COMPLETES AN ANNUAL PERFORMANCE EVALUATION FOR THE CFO; BASED ON THE OUTCOME OF THE PERFORMANCE EVALUATION AND THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS (NACHC) SALARY SURVEYS, THE CFO'S COMPENSATION IS REVIEWED AND ADJUSTED AS NECESSARY. THE ORGANIZATION'S CEO ALSO COMPLETES AN ANNUAL PERFORMANCE EVALUATION FOR THE CMO; BASED ON THE OUTCOME OF THE PERFORMANCE EVALUATION AND GENERAL COMPENSATION GUIDELINES SET BY THE BOARD, THE CMO'S EMPLOYMENT CONTRACT IS UPDATED AS NECESSARY. THESE PERFORMANCE EVALUATIONS AND COMPENSATION/EMPLOYMENT CONTRACT UPDATES WERE LAST COMPLETED DURING THE FISCAL YEAR ENDED SEPTEMBER 2022. |
| FORM 990, PART VI, SECTION C, LINE 19 | REQUIRED DOCUMENTS AVAILABLE TO THE PUBLIC: GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICIES, AND FINANCIAL STATEMENTS ARE NOT REQUIRED DISCLOSURES PURSUANT TO INTERNAL REVENUE CODE (IRC) SECTION 6104. THESE DOCUMENTS ARE NOT AVAILABLE TO THE PUBLIC AT THIS TIME. |
| FORM 990 PART IX LINE 11G | DESCRIPTION:LAB SERVICES TOTAL FEES:10146 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:DENTAL LABS TOTAL FEES:24308 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:CONTRACTED SERVICES - BEHAVIOR TOTAL FEES:4800 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:CONTRACTED SERVICES - PHARMACY TOTAL FEES:33691 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:CONTRACTED SERVICES - MEDICAL TOTAL FEES:518928 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:CONTRACTED SERVICES - EHR / PM TOTAL FEES:263784 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:CONTRACTED SERVICES - SECURITY TOTAL FEES:9618 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:INTERPRETING SERVICES TOTAL FEES:158100 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:PROFESSIONAL FEES - CONSULTING TOTAL FEES:98663 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:PROFESSIONAL FEES - PAYROLL TOTAL FEES:25197 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:TELEPHONE SERVICE TOTAL FEES:134590 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:CLAIMS PROCESSING TOTAL FEES:11037 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:EMPLOYEE UNIFORMS TOTAL FEES:18772 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:CONTRACTED SERVICES TOTAL FEES:973473 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:CONTRACTED SERVICES- CHARTSPAN TOTAL FEES:49778 |