LIFECARE FAMILY HEALTH AND DENTAL CENTER INC: Form 990, tax year 2022

View the entire original 990 at ProPublica ↗

Organization: LIFECARE FAMILY HEALTH AND DENTAL CENTER INC (EIN 34-1708901)
Tax period: 2022-01-01 to 2022-12-31
Filed: 2023-10-03
IRS object ID: 202322769349300612
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
Form 990
Schedule A
Schedule B
Schedule D
Schedule J
Schedule M
Schedule O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2023-10-03T08:08:03-05:00	ReturnTs
Tax Period End	2022-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	340677006	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	MALONEY NOVOTNY LLC	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	4774 MUNSON STREET NW SUITE 402	AddressLine1Txt
City	CANTON	CityNm
State Abbreviation	OH	StateAbbreviationCd
ZIP	447183634	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2022-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	341708901	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	LIFECARE FAMILY HEALTH AND DENTAL CENTER	BusinessNameLine1Txt
Business Name Line2	INC	BusinessNameLine2Txt

Field	Value	IRS element (for citing)
Business Name Control	LIFE	BusinessNameControlTxt
Phone	3304542000	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2725 LINCOLN STREET EAST	AddressLine1Txt
City	CANTON	CityNm
State Abbreviation	OH	StateAbbreviationCd
ZIP	44707	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	ERIC NIEMEYER	PersonNm
Person Title	CEO	PersonTitleTxt
Phone	3304542000	PhoneNum
Signature	2023-09-27	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

Field	Value	IRS element (for citing)
Person First	ERIC	PersonFirstNm
Person Last	NIEMEYER	PersonLastNm

Field	Value	IRS element (for citing)
SSN	999009999	SSN

Field	Value	IRS element (for citing)
IRS Responsible Prty Info Curr	0	IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	MATTHEW J BANJO	PreparerPersonNm
PTIN	P01260593	PTIN
Phone	3309669400	PhoneNum

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

Field	Value	IRS element (for citing)
Trusted Customer	2	TrustedCustomerCd
Authentication Assurance Level	AAL1	AuthenticationAssuranceLevelCd
Identity Assurance Level	IAL1	IdentityAssuranceLevelCd

Field	Value	IRS element (for citing)
Tax	2022	TaxYr
Build TS	2023-04-26 12:10:37Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	ERIC NIEMEYER	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2725 LINCOLN STREET EAST	AddressLine1Txt
City	CANTON	CityNm
State Abbreviation	OH	StateAbbreviationCd
ZIP	44707	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$12,715,700	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.LIFECAREFHDC.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1992	FormationYr
Legal Domicile State	OH	LegalDomicileStateCd
Activity Or Mission	PROVIDE HIGH-QUALITY, COMPREHENSIVE AND AFFORDABLE HEALTH SERVICES	ActivityOrMissionDesc
Voting Members Governing Body	11	VotingMembersGoverningBodyCnt
Voting Members Independent	11	VotingMembersIndependentCnt
Total Employee	132	TotalEmployeeCnt
Total Volunteers	0	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$7,373,874	PYContributionsGrantsAmt
CY Contributions Grants	$5,807,222	CYContributionsGrantsAmt
PY Program Service Revenue	$5,761,786	PYProgramServiceRevenueAmt
CY Program Service Revenue	$6,698,402	CYProgramServiceRevenueAmt
PY Investment Income	$11,693	PYInvestmentIncomeAmt
CY Investment Income	$15,743	CYInvestmentIncomeAmt
PY Other Revenue	$106,866	PYOtherRevenueAmt
CY Other Revenue	$86,107	CYOtherRevenueAmt
PY Total Revenue	$13,254,219	PYTotalRevenueAmt
CY Total Revenue	$12,607,474	CYTotalRevenueAmt
PY Grants And Similar Paid	$23,112	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$0	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$6,620,990	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$7,312,039	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$3,834,304	PYOtherExpensesAmt
CY Other Expenses	$4,271,162	CYOtherExpensesAmt
PY Total Expenses	$10,478,406	PYTotalExpensesAmt
CY Total Expenses	$11,583,201	CYTotalExpensesAmt
PY Revenues Less Expenses	$2,775,813	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$1,024,273	CYRevenuesLessExpensesAmt
Total Assets BOY	$7,333,836	TotalAssetsBOYAmt
Total Assets EOY	$8,408,044	TotalAssetsEOYAmt
Total Liabilities BOY	$1,521,776	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$1,725,072	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$5,812,060	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$6,682,972	NetAssetsOrFundBalancesEOYAmt
Mission	PROVIDE HIGH-QUALITY, COMPREHENSIVE AND AFFORDABLE HEALTH SERVICES THAT IMPROVE OUR PATIENT'S OVERALL HEALTH.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$8,937,658	ExpenseAmt
Revenue	$6,784,509	RevenueAmt
Desc	AS A FEDERALLY QUALIFIED HEALTH CENTER (FQHC), LIFECARE FAMILY HEALTH AND DENTAL CENTER PROVIDES QUALITY PREVENTATIVE AND RESTORATIVE PRIMARY HEALTH CARE TO PATIENTS WITH PAYMENT OPTIONS BASED ON A PATIENT'S ABILITY TO PAY. LIFECARE CONTINUALLY IMPROVES ITS SERVICES AND FACILITIES TO DEVELOP A GROWING, FINANCIALLY-SOUND, PROGRESSIVE COMMUNITY HEALTH CENTER.	Desc
Total Program Service Expenses	$8,937,658	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	Yes (1)	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	0	LobbyingActivitiesInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	0	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	0	CreditCounselingInd
Donor Rstr Or Quasi Endowments	Yes (1)	DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	0	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	0	ReportOtherAssetsInd
Report Other Liabilities	Yes (1)	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (1)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	Yes (1)	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	0	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	0	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	0	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	0	OperateHospitalInd
Grants To Organizations	0	GrantsToOrganizationsInd
Grants To Individuals	0	GrantsToIndividualsInd
Schedule J Required	Yes (1)	ScheduleJRequiredInd
Tax Exempt Bonds	0	TaxExemptBondsInd
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	0	PYExcessBenefitTransInd
Loan Outstanding	0	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	0	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	0	BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent	0	BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri	Yes (1)	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	0	DisregardedEntityInd
Related Entity	0	RelatedEntityInd
Related Organization Ctrl Ent	0	RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
IRP Document	29	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (1)	BackupWthldComplianceInd
Employee	132	EmployeeCnt
Employment Tax Returns Filed	Yes (1)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	0	UnrelatedBusIncmOverLimitInd
Foreign Financial Account	0	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	0	QuidProQuoContributionsInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	0	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	0	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	0	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	0	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	11	GoverningBodyVotingMembersCnt
Independent Voting Member	11	IndependentVotingMemberCnt
Family Or Business Rln	0	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	0	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	0	MembersOrStockholdersInd
Election Of Board Members	0	ElectionOfBoardMembersInd
Decisions Subject To Approva	0	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (1)	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	0	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (1)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (1)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (1)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (1)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (1)	WhistleblowerPolicyInd
Document Retention Policy	Yes (1)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (1)	CompensationProcessCEOInd
Compensation Process Other	Yes (1)	CompensationProcessOtherInd
Investment In Joint Venture	0	InvestmentInJointVentureInd
States Where Copy Of Return Is Fld	OH	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	PATRICIA JOHNSON	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	3304542000	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2725 LINCOLN STREET EAST	AddressLine1Txt
City	CANTON	CityNm
State Abbreviation	OH	StateAbbreviationCd
ZIP	44707	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	OfficerOfficerInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Highest Compensated EmployeeHighestCompensatedEmployeeInd
BARBARA FRUSTACI BSN RN
CHAIR	1.00	Yes (X)	Yes (X)	$0	$0	$0
DEAN VARIAN MD
DIRECTOR	1.00	Yes (X)		$0	$0	$0
ALLANA HAUT
DIRECTOR	1.00	Yes (X)		$0	$0	$0
GEORGE CRUES
DIRECTOR	1.00	Yes (X)		$0	$0	$0
REBECCA JOHNSON
DIRECTOR	1.00	Yes (X)		$0	$0	$0
TERRANCE JONES
DIRECTOR	1.00	Yes (X)		$0	$0	$0
ZACH HOSTETLER
DIRECTOR	1.00	Yes (X)		$0	$0	$0
GAIL TARANTINO
DIRECTOR	1.00	Yes (X)		$0	$0	$0
KELLY HENLEY
TREASURER	1.00	Yes (X)	Yes (X)	$0	$0	$0
REBEKKA RUSSELL
DIRECTOR	1.00	Yes (X)		$0	$0	$0
LINDA DAHL
VICE CHAIR	1.00	Yes (X)	Yes (X)	$0	$0	$0
ERICA WILSON-DOMER
SECRETARY	1.00	Yes (X)	Yes (X)	$0	$0	$0
JUDGE STEPHEN BELDEN
DIRECTOR	1.00	Yes (X)		$0	$0	$0
PATRICIA JOHNSON
CFO	40.00		Yes (X)	$116,288	$0	$12,572
JANET MCPEEK
CEO	40.00		Yes (X)	$101,184	$0	$10,151
ERIC NIEMEYER
CEO	40.00		Yes (X)	$148,657	$0	$22,952
DAVID M COLA
MEDICAL DIRECTOR	40.00			$354,592	$0	$11,829	Yes (X)
HOUNEINE GASHASH
PHYSICIAN	40.00			$128,288	$0	$15,280	Yes (X)
THOMAS K MUN
DENTAL DIRECTOR	40.00			$184,779	$0	$35,248	Yes (X)
TIMOTHY HIRST
DENTIST	40.00			$151,048	$0	$6,930	Yes (X)
BYRON ROSSI
DENTIST	40.00			$191,596	$0	$39,195	Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$1,376,432	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$154,157	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	14	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	0	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (1)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

Field	Value	IRS element (for citing)
Person	ECLINICALWORKS LLC	PersonNm

Contractor Address ContractorAddress

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	PO BOX 847950	AddressLine1Txt
City	BOSTON	CityNm
State Abbreviation	MA	StateAbbreviationCd
ZIP	02284	ZIPCd

Field	Value	IRS element (for citing)
Services	BILLING SERVICES	ServicesDesc
Compensation	$235,589	CompensationAmt

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	2	CntrctRcvdGreaterThan100KCnt
Government Grants	$4,160,841	GovernmentGrantsAmt
All Other Contributions	$1,646,381	AllOtherContributionsAmt
Noncash Contributions	$1,646,059	NoncashContributionsAmt
Total Contributions	$5,807,222	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDesc	BusinessBusinessCd	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PATIENT & THIRD PARTY FEE	621400	$5,652,745	$5,652,745
340B PROGRAM	621400	$975,465	$975,465
INSURANCE INCENTIVES	621400	$70,192	$70,192

Field	Value	IRS element (for citing)
Total Program Service Revenue	$6,698,402	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$24,694	TotalRevenueColumnAmt
Exclusion	$24,694	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$99,275	SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$103,336	SecuritiesAmt
Other	$4,890	OtherAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	-$4,061	SecuritiesAmt
Other	-$4,890	OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$8,951	TotalRevenueColumnAmt
Exclusion	-$8,951	ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

Field	Value	IRS element (for citing)
Desc	MISCELLANEOUS INCOME	Desc
Business	900099	BusinessCd
Total Revenue Column	$86,107	TotalRevenueColumnAmt
Related Or Exempt Func Income	$86,107	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$86,107	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$12,607,474	TotalRevenueColumnAmt
Related Or Exempt Func Income	$6,784,509	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$15,743	ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$411,804	TotalAmt
Program Services	$310,223	ProgramServicesAmt
Management And General	$101,581	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$5,507,767	TotalAmt
Program Services	$4,139,345	ProgramServicesAmt
Management And General	$1,368,422	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$88,469	TotalAmt
Program Services	$69,006	ProgramServicesAmt
Management And General	$19,463	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$874,788	TotalAmt
Program Services	$678,139	ProgramServicesAmt
Management And General	$196,649	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$429,211	TotalAmt
Program Services	$323,026	ProgramServicesAmt
Management And General	$106,185	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$17,551	TotalAmt
Management And General	$17,551	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$18,700	TotalAmt
Management And General	$18,700	ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$13,349	TotalAmt
Management And General	$13,349	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$227,978	TotalAmt
Program Services	$66,229	ProgramServicesAmt
Management And General	$161,749	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$189,302	TotalAmt
Program Services	$120,867	ProgramServicesAmt
Management And General	$68,435	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$268,901	TotalAmt
Program Services	$156,815	ProgramServicesAmt
Management And General	$112,086	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$553,311	TotalAmt
Program Services	$352,548	ProgramServicesAmt
Management And General	$200,763	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$176,788	TotalAmt
Program Services	$176,392	ProgramServicesAmt
Management And General	$396	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$9,722	TotalAmt
Program Services	$6,288	ProgramServicesAmt
Management And General	$3,434	ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$30,282	TotalAmt
Program Services	$9,166	ProgramServicesAmt
Management And General	$21,116	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$42,869	TotalAmt
Program Services	$35,633	ProgramServicesAmt
Management And General	$7,236	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$241,195	TotalAmt
Program Services	$158,228	ProgramServicesAmt
Management And General	$82,967	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$44,330	TotalAmt
Program Services	$39,251	ProgramServicesAmt
Management And General	$5,079	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES	$1,561,673	$1,561,673
WHOLESALER EXP.-340B PR	$245,570	$245,570
PATIENT SUPPORT	$240,208	$240,208
REPAIRS AND MAINTENANCE	$180,403	$153,780	$26,623

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$209,030	TotalAmt
Program Services	$95,271	ProgramServicesAmt
Management And General	$113,759	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$11,583,201	TotalAmt
Program Services	$8,937,658	ProgramServicesAmt
Management And General	$2,645,543	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$45,263	BOYAmt
EOY	$55,339	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$2,420,413	BOYAmt
EOY	$2,344,049	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$1,823	BOYAmt
EOY	$0	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$808,184	BOYAmt
EOY	$1,694,941	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$337,427	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$193,203	BOYAmt
EOY	$175,208	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$4,448,685	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$1,987,596	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$2,378,449	BOYAmt
EOY	$2,461,089	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
BOY	$1,206,229	BOYAmt
EOY	$1,085,087	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$277,772	BOYAmt
EOY	$252,404	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$2,500	BOYAmt
EOY	$2,500	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$7,333,836	BOYAmt
EOY	$8,408,044	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$479,627	BOYAmt
EOY	$664,652	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$1,042,149	BOYAmt
EOY	$984,856	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$75,564	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$1,521,776	BOYAmt
EOY	$1,725,072	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	$5,812,060	BOYAmt
EOY	$6,682,972	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$5,812,060	BOYAmt
EOY	$6,682,972	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$7,333,836	BOYAmt
EOY	$8,408,044	EOYAmt

Field	Value	IRS element (for citing)
Reconcilation Revenue Expnss	$1,024,273	ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst	-$153,361	NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets	$0	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	Yes (1)	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 (1)	AuditCommitteeInd
Federal Grant Audit Required	Yes (1)	FederalGrantAuditRequiredInd
Federal Grant Audit Performed	Yes (1)	FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

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

CY Endwmt Fund CYEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$277,772	BeginningYearBalanceAmt
Investment Earnings Or Losses	-$23,475	InvestmentEarningsOrLossesAmt
Administrative Expenses	$1,893	AdministrativeExpensesAmt
End Year Balance	$252,404	EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$236,448	BeginningYearBalanceAmt
Investment Earnings Or Losses	$43,319	InvestmentEarningsOrLossesAmt
Administrative Expenses	$1,995	AdministrativeExpensesAmt
End Year Balance	$277,772	EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$324,409	BeginningYearBalanceAmt
Investment Earnings Or Losses	$12,820	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$99,115	GrantsOrScholarshipsAmt
Administrative Expenses	$1,666	AdministrativeExpensesAmt
End Year Balance	$236,448	EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$485,988	BeginningYearBalanceAmt
Investment Earnings Or Losses	$78,821	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$237,000	GrantsOrScholarshipsAmt
Administrative Expenses	$3,400	AdministrativeExpensesAmt
End Year Balance	$324,409	EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

Field	Value	IRS element (for citing)
Beginning Year Balance	$586,399	BeginningYearBalanceAmt
Investment Earnings Or Losses	-$46,546	InvestmentEarningsOrLossesAmt
Grants Or Scholarships	$49,738	GrantsOrScholarshipsAmt
Administrative Expenses	$4,127	AdministrativeExpensesAmt
End Year Balance	$485,988	EndYearBalanceAmt

Field	Value	IRS element (for citing)
Board Designated Balance EOY	1.00000	BoardDesignatedBalanceEOYPct
Endowments Held Unrelated Org	Yes (1)	EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org	0	EndowmentsHeldRelatedOrgInd

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$77,201	OtherCostOrOtherBasisAmt
Book Value	$77,201	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$2,684,767	OtherCostOrOtherBasisAmt
Depreciation	$844,956	DepreciationAmt
Book Value	$1,839,811	BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$15,054	OtherCostOrOtherBasisAmt
Depreciation	$11,256	DepreciationAmt
Book Value	$3,798	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$1,572,351	OtherCostOrOtherBasisAmt
Depreciation	$1,107,087	DepreciationAmt
Book Value	$465,264	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$99,312	OtherCostOrOtherBasisAmt
Depreciation	$24,297	DepreciationAmt
Book Value	$75,015	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$2,461,089	TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

Field	Value	IRS element (for citing)
Desc	LEASE LIABILITIES	Desc
Amt	$75,564	Amt

Field	Value	IRS element (for citing)
Total Liability	$75,564	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd
Total Rev Etc Audited Fincl Stmt	$12,440,764	TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst	-$153,361	NetUnrealizedGainsInvstAmt
Revenue Not Reported	-$153,361	RevenueNotReportedAmt
Revenue Subtotal	$12,594,125	RevenueSubtotalAmt
Investment Expenses Not Incld	$13,349	InvestmentExpensesNotIncldAmt
Revenue Not Reported Fincl Stmt	$13,349	RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990	$12,607,474	TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt	$11,569,852	TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported	$0	ExpensesNotReportedAmt
Expenses Subtotal	$11,569,852	ExpensesSubtotalAmt
Investment Expenses Not Incld2	$13,349	InvestmentExpensesNotIncld2Amt
Expenses Not Rpt Fincl Stmt	$13,349	ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990	$11,583,201	TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

PART V, LINE 4:

THE INTENDED USE OF THE ENDOWMENT IS TO BE USED FOR THE OPERATIONS OF THE ORGANIZATION.

PART X, LINE 2:

THE PREPARATION OF FINANCIAL STATEMENTS IN CONFORMITY WITH GAAP REQUIRES THE CENTER TO REPORT INFORMATION REGARDING ITS EXPOSURE TO VARIOUS TAX POSITIONS TAKEN BY THE CENTER. THE CENTER HAS DETERMINED WHETHER ANY TAX POSITIONS HAVE MET THE RECOGNITION THRESHOLD AND HAS MEASURED THE CENTER'S EXPOSURE TO THOSE TAX POSITIONS. MANAGEMENT BELIEVES THAT THE CENTER HAS ADEQUATELY ADDRESSED ALL RELEVANT TAX POSITIONS AND THAT THERE ARE NO UNRECORDED TAX LIABILITIES. FEDERAL AND STATE TAX AUTHORITIES GENERALLY HAVE THE RIGHT TO EXAMINE AND AUDIT THE PREVIOUS THREE YEARS OF TAX RETURNS FILED.

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Substantiation Required	Yes (1)	SubstantiationRequiredInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	0	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	0	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	0	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	0	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	0	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	0	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	0	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	0	AnyNonFixedPaymentsInd
Initial Contract Exception	0	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (5 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	Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt	Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
DAVID M COLA
MEDICAL DIRECTOR	$285,181	$0	$69,411	$0	$0	$0	$11,829	$0	$0	$0	$366,421	$0	$0	$0
BYRON ROSSI
DENTIST	$191,596	$0	$0	$0	$0	$0	$8,593	$0	$30,602	$0	$230,791	$0	$0	$0
THOMAS K MUN
DENTAL DIRECTOR	$184,779	$0	$0	$0	$0	$0	$5,685	$0	$29,563	$0	$220,027	$0	$0	$0
ERIC NIEMEYER
CEO	$147,807	$0	$850	$0	$0	$0	$0	$0	$22,952	$0	$171,609	$0	$0	$0
TIMOTHY HIRST
DENTIST	$151,048	$0	$0	$0	$0	$0	$6,660	$0	$270	$0	$157,978	$0	$0	$0

Schedule M IRS990ScheduleM

Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp

Field	Value	IRS element (for citing)
Non Cash Checkbox	Yes (X)	NonCashCheckboxInd
Noncash Contributions Rpt F990	$1,646,059	NoncashContributionsRptF990Amt
Method Of Determining Revenues	FAIR MARKET VALUE	MethodOfDeterminingRevenuesTxt

Field	Value	IRS element (for citing)
Any Property That Must Be Held	0	AnyPropertyThatMustBeHeldInd
Review Process Unusual NC Gifts	0	ReviewProcessUnusualNCGiftsInd
Third Parties Used	0	ThirdPartiesUsedInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11B	FORM 990 REVIEW - FORM 990 IS REVIEWED BY THE CFO AND A COPY OF THE 990 IS SHARED WITH THE FINANCE COMMITTEE AND BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION B, LINE 12C	MONITORING AND ENFORCEMENT OF CONFLICT POLICY - BOARD MEMBERS ANNUALLY REVIEW THEIR STATUS FOR POTENTIAL CONFLICTS OF INTEREST AND DECLARE IN WRITING ANY THAT MAY EXIST. BOARD MEMBERS ABSTAIN FROM VOTING ON ISSUES THAT MAY REPRESENT A CONFLICT OF INTEREST FOR THEM.
FORM 990, PART VI, SECTION B, LINE 15	COMPENSATION REVIEW AND APPROVAL - COMPENSATION OF THE CEO AND CFO IS COMPARED TO THE COMPENSATION SHOWN ON FORM 990 FOR SIMILAR ORGANIZATIONS. COMPENSATION FOR KEY EMPLOYEES IS DETERMINED BY A COMPARISON TO INDUSTRY AVERAGES FOR THAT POSITION.
FORM 990, PART VI, SECTION C, LINE 19	AVAILABILITY OF DOCUMENTS - GOVERNING DOCUMENTS, POLICIES, AND FINANCIAL STATEMENTS ARE AVAILABLE AT THE CENTER'S OFFICE AND ARE PRESENTED TO THE PUBLIC UPON REQUEST.
COMPLETION OF SCHEDULE H	ALTHOUGH THIS ORGANIZATION UTILIZES THE PROVISION OF SECTION 170(B)(1)(A)(III) FOR ITS PUBLIC CHARITY STATUS, IT IS NOT LICENSED IN THE STATE OF OHIO AS A "HOSPITAL". THEREFORE, WE HAVE NOT COMPLETED SCHEDULE H IN ACCORDANCE WITH THE INSTRUCTIONS FOR THAT SCHEDULE.