MILWAUKEE HEALTH SERVICES INC: Form 990, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- MILWAUKEE HEALTH SERVICES INC (EIN 39-1664109)
- Tax period
- 2022-02-01 to 2023-01-31
- Filed
- 2023-12-15
- IRS object ID
- 202313499349301311
- Schema version
- 2022v5.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-12-15T14:55:33-06:00 | ReturnTs |
| Tax Period End | 2023-01-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 390758449 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WIPFLI LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 170 N RADNOR-CHESTER RD SUITE 200 | AddressLine1Txt |
| City | RADNOR | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 19087 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2022-02-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 391664109 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MILWAUKEE HEALTH SERVICES INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MILW | BusinessNameControlTxt |
| Phone | 4143728080 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2555 N MARTIN LUTHER KING DRIVE | AddressLine1Txt |
| City | MILWAUKEE | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53212 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TITO IZARD MD | PersonNm |
| Person Title | PRESIDENT & CEO | PersonTitleTxt |
| Phone | 4143728080 | PhoneNum |
| Signature | 2023-12-12 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | TITO | PersonFirstNm |
| Person Last | IZARD MD | 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 | SOLOMON MARDAKHAEV | PreparerPersonNm |
| PTIN | P01806552 | PTIN |
| Phone | 6105653930 | PhoneNum |
| Preparation | 2023-12-12 | PreparationDt |
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 | TITO IZARD MD | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2555 N MARTIN LUTHER KING DRIVE | AddressLine1Txt |
| City | MILWAUKEE | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53212 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $26,171,298 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.MHSI.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1989 | FormationYr |
| Legal Domicile State | WI | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE MEDICAL AND DENTAL PRIMARY CARE SERVICES TO A MEDICALLY UNDERSERVED POPULATION. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 255 | TotalEmployeeCnt |
| Total Volunteers | 65 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $5,854,507 | PYContributionsGrantsAmt |
| CY Contributions Grants | $6,223,776 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $21,805,580 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $19,278,148 | CYProgramServiceRevenueAmt |
| PY Investment Income | $6,593 | PYInvestmentIncomeAmt |
| CY Investment Income | $6,600 | CYInvestmentIncomeAmt |
| PY Other Revenue | $348,607 | PYOtherRevenueAmt |
| CY Other Revenue | $662,774 | CYOtherRevenueAmt |
| PY Total Revenue | $28,015,287 | PYTotalRevenueAmt |
| CY Total Revenue | $26,171,298 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $6,191 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $19,503 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $13,989,794 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $13,957,466 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $15,250,824 | PYOtherExpensesAmt |
| CY Other Expenses | $13,226,914 | CYOtherExpensesAmt |
| PY Total Expenses | $29,246,809 | PYTotalExpensesAmt |
| CY Total Expenses | $27,203,883 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$1,231,522 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$1,032,585 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $12,836,316 | TotalAssetsBOYAmt |
| Total Assets EOY | $12,585,792 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $5,899,257 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $6,681,318 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $6,937,059 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $5,904,474 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO PROVIDE ACCESSIBLE, QUALITY PRIMARY AND RELATED HEALTH CARE SERVICES TO MILWAUKEE RESIDENTS, WITH OUR CONTINUING EMPHASIS ON MEDICALLY-UNDERSERVED FAMILIES AND INDIVIDUALS. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $22,894,522 | ExpenseAmt |
| Grant | $19,503 | GrantAmt |
| Revenue | $19,921,643 | RevenueAmt |
| Desc | TO PROVIDE ACCESSIBLE, QUALITY PRIMARY AND RELATED HEALTH CARE SERVICES TO MILWAUKEE RESIDENTS, WITH OUR CONTINUING EMPHASIS ON MEDICALLY-UNDERSERVED FAMILIES AND INDIVIDUALS. 14,136 PATIENTS WERE SERVED DURING THE YEAR (RESULTING IN 46,286 ENCOUNTERS).IN NOVEMBER, 2022 MILWAUKEE COUNTY BEHAVIORAL HEALTH DEPARTMENT STARTED TO LEASE SPACE FROM MHSI ISSAC COGGS CLINIC AT 8200 W. SILVER SPRING DRIVE IN MILWAUKEE IN ORDER TO PROVIDE BEHAVIORAL HEALTH CRISIS MANAGEMENT TO THE COMMUNITY. THE SPACE WAS RENOVATED WITH FUNDS FROM THE MILWAUKEE PARTNERSHIP CAMPAIGN AND MILWAUKEE COUNTY. THE LEASED SPACE IS 1,791 SQUARE FEET. THE COST IS $5,626.25 PER MONTH WITH AN ANNUAL INCREASE OF 3% ON A 5 YEAR TERM. | Desc |
| Total Program Service Expenses | $22,894,522 | 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 | 0 | 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 | Yes (1) | 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 | 0 | 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 | 2 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 255 | 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 | WI | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LAURIE YAKE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 4143728080 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2555 N MARTIN LUTHER KING DRIVE | AddressLine1Txt |
| City | MILWAUKEE | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 53212 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Key EmployeeKeyEmployeeInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|---|
| DR TITO IZARD | ||||||||
| PRESIDENT & CEO | 40.00 | Yes (X) | $320,266 | $0 | $13,276 | |||
| LAKESHA LAWRENCE | ||||||||
| PHYSICIAN | 40.00 | $292,235 | $0 | $8,591 | Yes (X) | |||
| KATHERINE D VAN FOSSEN | ||||||||
| PHYSICIAN | 40.00 | $275,757 | $0 | $3,761 | Yes (X) | |||
| JOHN STOCKTON | ||||||||
| PSYCHIATRIST | 40.00 | $270,474 | $0 | $9,873 | Yes (X) | |||
| DR ARONICA WILLIAMS | ||||||||
| CHIEF MEDICAL OFFICER | 40.00 | $224,504 | $0 | $9,546 | Yes (X) | |||
| KIMBERLIE WARD-COOPER | ||||||||
| PHYSICIAN | 40.00 | $183,357 | $0 | $7,431 | Yes (X) | |||
| ARTHUR MINES | ||||||||
| PHYSICIAN | 40.00 | $157,883 | $0 | $11,724 | Yes (X) | |||
| LAURIE YAKE | ||||||||
| CHIEF FINANCE OFFICER | 40.00 | Yes (X) | $124,635 | $0 | $8,639 | |||
| MICHELE LEBOURGEOIS | ||||||||
| CHIEF OPERATING OFFICER | 40.00 | Yes (X) | $122,897 | $0 | $8,913 | |||
| WALTER LANIER | ||||||||
| CHAIRPERSON | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| GINA GREEN-HARRIS | ||||||||
| VICE-CHAIRPERSON | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| JADDIA ARNOLD | ||||||||
| SECRETARY | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| AUDREY SELLERS | ||||||||
| TREASURER | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| KAREN BAKER | ||||||||
| DIRECTOR | 1.00 | $0 | $0 | $0 | Yes (X) | |||
| SIRR GRICE | ||||||||
| DRECTOR | 1.00 | $0 | $0 | $0 | Yes (X) | |||
| LORRAINE HALINKA MALCOE | ||||||||
| DIRECTOR | 1.00 | $0 | $0 | $0 | Yes (X) | |||
| BABETTE HONORE | ||||||||
| DIRECTOR | 1.00 | $0 | $0 | $0 | Yes (X) | |||
| DR PAULA LUCEY | ||||||||
| DIRECTOR (THRU MAY 2022) | 1.00 | $0 | $0 | $0 | Yes (X) | |||
| CURTISS MARSHALL | ||||||||
| DIRECTOR | 1.00 | $0 | $0 | $0 | Yes (X) | |||
| BRIDGETT MOSS | ||||||||
| DIRECTOR | 1.00 | $0 | $0 | $0 | Yes (X) | |||
| ANGELIQUE SHARPE | ||||||||
| DIRECTOR | 1.00 | $0 | $0 | $0 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,972,008 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $81,754 | 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 (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| FAST PACE MEDICAL STAFFING INC | |||||
| 314 E MAIN STREET STE 216 | WATERTOWN | WI | 53094 | MEDICAL STAFFING SERVICES | $911,289 |
| OCHIN | |||||
| 1881 SW NAITO PARKWAY | PORTLAND | OR | 97201 | EMR SOFTWARE | $583,839 |
| MERINO COMPUTER CONCEPTS INC | |||||
| 1822 W KETTLEMAN LANE SUITE 4 | LODI | CA | 95242 | IT SERVICES | $372,017 |
| VVC HOLDING CORP DBA VIRENCE HEALTH TEC | |||||
| PO BOX 840952 | DALLAS | TX | 75284 | EMR SOFTWARE | $255,214 |
| JP CONTRUCTION LLC | |||||
| 1849 N DR MLK DRIVE STE 200 | MILWAUKEE | WI | 53212 | CONSTRUCTION SERVICES | $174,675 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 6 | CntrctRcvdGreaterThan100KCnt |
| Federated Campaigns | $27,032 | FederatedCampaignsAmt |
| Government Grants | $5,763,633 | GovernmentGrantsAmt |
| All Other Contributions | $433,111 | AllOtherContributionsAmt |
| Total Contributions | $6,223,776 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT SERVICE REVENUE | Desc |
| Business | 624100 | BusinessCd |
| Total Revenue Column | $19,278,148 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $19,278,148 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $19,278,148 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $6,600 | TotalRevenueColumnAmt |
| Exclusion | $6,600 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $19,279 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $19,279 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $19,279 | TotalRevenueColumnAmt |
| Exclusion | $19,279 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| INSURANCE CLAIMS | 624100 | $246,544 | $246,544 |
| OUTREACH ENROLLMENT REVENUE | 624100 | $208,560 | $208,560 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $188,391 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $188,391 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $643,495 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $26,171,298 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $19,921,643 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $25,879 | ExclusionAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,503 | TotalAmt |
| Program Services | $19,503 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $834,535 | TotalAmt |
| Program Services | $695,891 | ProgramServicesAmt |
| Management And General | $138,644 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,794,727 | TotalAmt |
| Program Services | $8,180,912 | ProgramServicesAmt |
| Management And General | $1,613,815 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $204,462 | TotalAmt |
| Program Services | $164,995 | ProgramServicesAmt |
| Management And General | $39,467 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,327,681 | TotalAmt |
| Program Services | $1,878,367 | ProgramServicesAmt |
| Management And General | $449,314 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $796,061 | TotalAmt |
| Program Services | $642,397 | ProgramServicesAmt |
| Management And General | $153,664 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,281 | TotalAmt |
| Management And General | $27,281 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $97,022 | TotalAmt |
| Management And General | $97,022 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,052,372 | TotalAmt |
| Program Services | $1,570,450 | ProgramServicesAmt |
| Management And General | $481,922 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,814 | TotalAmt |
| Management And General | $38,814 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $420,059 | TotalAmt |
| Program Services | $365,620 | ProgramServicesAmt |
| Management And General | $54,439 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $837,385 | TotalAmt |
| Program Services | $723,397 | ProgramServicesAmt |
| Management And General | $113,988 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,242,141 | TotalAmt |
| Program Services | $877,459 | ProgramServicesAmt |
| Management And General | $364,682 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,438 | TotalAmt |
| Program Services | $2,512 | ProgramServicesAmt |
| Management And General | $17,926 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $139,412 | TotalAmt |
| Program Services | $139,412 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $267,542 | TotalAmt |
| Program Services | $3,258 | ProgramServicesAmt |
| Management And General | $264,284 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $825,763 | TotalAmt |
| Program Services | $569,616 | ProgramServicesAmt |
| Management And General | $256,147 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $40,339 | TotalAmt |
| Program Services | $209 | ProgramServicesAmt |
| Management And General | $40,130 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| BAD DEBT | $3,938,705 | $3,938,705 | |
| PHARMACEUTICALS | $3,028,048 | $3,028,048 | |
| DUES AND SUBSCRIPTIONS | $53,766 | $8,087 | $45,679 |
| HEALTH PROMOTIONS | $3,541 | $2,500 | $1,041 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $194,286 | TotalAmt |
| Program Services | $83,184 | ProgramServicesAmt |
| Management And General | $111,102 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,203,883 | TotalAmt |
| Program Services | $22,894,522 | ProgramServicesAmt |
| Management And General | $4,309,361 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,999,763 | BOYAmt |
| EOY | $465,045 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $521,679 | BOYAmt |
| EOY | $815,245 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,909,790 | BOYAmt |
| EOY | $2,785,767 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $192,186 | BOYAmt |
| EOY | $151,890 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $568,431 | BOYAmt |
| EOY | $128,315 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $21,527,427 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $13,519,963 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,644,467 | BOYAmt |
| EOY | $8,007,464 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $232,066 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,836,316 | BOYAmt |
| EOY | $12,585,792 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,371,182 | BOYAmt |
| EOY | $2,311,850 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $117,665 | BOYAmt |
| EOY | $117,686 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,098,678 | BOYAmt |
| EOY | $3,873,553 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $311,732 | BOYAmt |
| EOY | $378,229 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,899,257 | BOYAmt |
| EOY | $6,681,318 | 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 | $6,342,908 | BOYAmt |
| EOY | $5,051,730 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $594,151 | BOYAmt |
| EOY | $852,744 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,937,059 | BOYAmt |
| EOY | $5,904,474 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,836,316 | BOYAmt |
| EOY | $12,585,792 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$1,032,585 | ReconcilationRevenueExpnssAmt |
| 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
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $746,728 | OtherCostOrOtherBasisAmt |
| Book Value | $746,728 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $13,785,890 | OtherCostOrOtherBasisAmt |
| Depreciation | $8,089,780 | DepreciationAmt |
| Book Value | $5,696,110 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $416,893 | OtherCostOrOtherBasisAmt |
| Depreciation | $416,893 | DepreciationAmt |
| Book Value | $0 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,346,612 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,001,169 | DepreciationAmt |
| Book Value | $1,345,443 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $231,304 | OtherCostOrOtherBasisAmt |
| Depreciation | $12,121 | DepreciationAmt |
| Book Value | $219,183 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $8,007,464 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| AMOUNTS PAYABLE UNDER FISCAL AGENT RESPONSIBILITIES | $119,919 |
| RIGHT-TO-USE OBLIGATION | $258,310 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $378,229 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $22,232,593 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $22,232,593 | RevenueSubtotalAmt |
| Other Revenues Not Included | $3,938,705 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $3,938,705 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $26,171,298 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $23,265,178 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $23,265,178 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $3,938,705 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $3,938,705 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $27,203,883 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | THE ORGANIZATION RECOGNIZES THE BENEFIT OF A TAX POSITION ONLY AFTER DETERMINING WHETHER IT IS MORE LIKELY THAN NOT THAT THE TAXING AUTHORITY WOULD SUSTAIN THE TAX POSITION UPON EXAMINATION OF THE TECHNICAL MERITS OF THE TAX POSITION ASSUMING THE TAXING AUTHORITY HAS FULL KNOWLEDGE OF ALL INFORMATION. THE ORGANIZATION HAS RECORDED NO ASSETS OR LIABILITIES RELATED TO UNCERTAIN TAX POSITIONS. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | BAD DEBT 3,938,705. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | BAD DEBT 3,938,705. |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | PATIENT ASSISTANCE | GrantTypeTxt |
| Recipient | 26 | RecipientCnt |
| Cash Grant | $19,503 | CashGrantAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION DOCUMENTS ALL RELEVANT INFORMATION PERTAINING TO MEDICAL ASSISTANCE GIVEN TO THE PATIENT, IN THE PATIENT RECORDS. ASSISTANCE WITH TRANSPORTATION IS PROVIDED THROUGH BUS VOUCHERS. THE PATIENT SIGNS FOR THE RECEIPT OF THE BUS VOUCHER AND A RECORD IS MAINTAINED IN THE EIP DEPARTMENT. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| 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 (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 | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DR TITO IZARD | ||||||||||||||
| PRESIDENT & CEO | $320,061 | $0 | $205 | $0 | $0 | $0 | $3,500 | $0 | $9,776 | $0 | $333,542 | $0 | $0 | $0 |
| LAKESHA LAWRENCE | ||||||||||||||
| PHYSICIAN | $292,030 | $0 | $205 | $0 | $0 | $0 | $0 | $0 | $8,591 | $0 | $300,826 | $0 | $0 | $0 |
| KATHERINE D VAN FOSSEN | ||||||||||||||
| PHYSICIAN | $275,552 | $0 | $205 | $0 | $0 | $0 | $3,500 | $0 | $261 | $0 | $279,518 | $0 | $0 | $0 |
| JOHN STOCKTON | ||||||||||||||
| PSYCHIATRIST | $270,269 | $0 | $205 | $0 | $0 | $0 | $3,500 | $0 | $6,373 | $0 | $280,347 | $0 | $0 | $0 |
| DR ARONICA WILLIAMS | ||||||||||||||
| CHIEF MEDICAL OFFICER | $224,299 | $0 | $205 | $0 | $0 | $0 | $3,500 | $0 | $6,046 | $0 | $234,050 | $0 | $0 | $0 |
| KIMBERLIE WARD-COOPER | ||||||||||||||
| PHYSICIAN | $183,154 | $0 | $203 | $0 | $0 | $0 | $0 | $0 | $7,431 | $0 | $190,788 | $0 | $0 | $0 |
| ARTHUR MINES | ||||||||||||||
| PHYSICIAN | $157,666 | $0 | $217 | $0 | $0 | $0 | $3,500 | $0 | $8,224 | $0 | $169,607 | $0 | $0 | $0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 IS REVIEWED BY THE CONTROLLER, CHIEF FINANCIAL OFFICER, AND PRESIDENT/CEO OF THE ORGANIZATION. AFTER SATISFACTORY REVIEW, IT IS PRESENTED TO THE FINANCE COMMITTEE FOR REVIEW. BEFORE FILING WITH THE INTERNAL REVENUE SERVICE, THE FORM 990 IS MADE AVAILABLE TO ALL MEMBERS OF THE BOARD. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION REQUIRES THAT ALL EMPLOYEES AND BOARD MEMBERS DISCLOSE IN WRITING AND UPDATE AT LEAST ANNUALLY, ALL BUSINESS AND IMMEDIATE FAMILY RELATIONSHIPS WHICH MIGHT POTENTIALLY CREATE A CONFLICT OF INTEREST. IN ADDITION, EMPLOYEES WITH NON-COMPETE CONTRACTS MUST DISCLOSE TO THE PRESIDENT/CEO, AND PRESIDENT/CEO MUST DISCLOSE TO THE BOARD CHAIRPERSON, IN WRITING THE SPECIFICS OF ANY PLAN TO ACCEPT OUTSIDE EMPLOYMENT SO THAT OUTSIDE EMPLOYMENT MAY BE DETERMINED IF POTENTIAL CONFLICT EXISTS. NO BOARD MEMBER MAY VOTE ON ANY MATTER WHICH MAY DIRECTLY OR INDIRECTLY RESULT IN FINANCIAL GAIN TO THAT MEMBER, OR WHICH MAY CONFLICT WITH THAT MEMBER'S OBLIGATIONS TO ANOTHER ORGANIZATION'S BOARD OF DIRECTORS. PROVIDED THAT THE BOARD MEMBER HAS FIRST DISCLOSED A CONFLICT OR POTENTIAL CONFLICT, AND ABSTAINS FROM VOTING IN THAT REGARD, HE/SHE MAY PARTICIPATE IN DISCUSSIONS RELATING TO THAT MATTER. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE PROCESS FOR DETERMINING THE EXECUTIVE COMPENSATIONS IS BASED ON PERFORMANCE EVALUATION, ANALYZING COMPENSATION SURVEYS/STUDIES, REVIEW OF 990S OF OTHER ORGANIZATIONS AND APPROVAL OF THE REVISED EMPLOYMENT AGREEMENT BY THE BOARD CHAIR. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. |