LIFECARE FAMILY HEALTH AND DENTAL CENTER INC: Form 990, tax year 2024
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- Organization
- LIFECARE FAMILY HEALTH AND DENTAL CENTER INC (EIN 34-1708901)
- Tax period
- 2024-01-01 to 2024-12-31
- Filed
- 2025-09-30
- IRS object ID
- 202512739349300711
- Schema version
- 2024v5.2
- 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 | 2025-09-30T08:09:57-05:00 | ReturnTs |
| Tax Period End | 2024-12-31 | 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 | 2024-01-01 | 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 | 2025-09-29 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
| 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 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2024 | TaxYr |
| Build TS | 2025-03-06 01:10:19Z | 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 | $14,099,355 | 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 PRIMARY CARE HEALTH SERVICES | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 12 | VotingMembersIndependentCnt |
| Total Employee | 142 | TotalEmployeeCnt |
| Total Volunteers | 12 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $4,946,680 | PYContributionsGrantsAmt |
| CY Contributions Grants | $5,259,095 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $9,054,842 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $8,672,589 | CYProgramServiceRevenueAmt |
| PY Investment Income | $45,082 | PYInvestmentIncomeAmt |
| CY Investment Income | $90,451 | CYInvestmentIncomeAmt |
| PY Other Revenue | $136,082 | PYOtherRevenueAmt |
| CY Other Revenue | $77,220 | CYOtherRevenueAmt |
| PY Total Revenue | $14,182,686 | PYTotalRevenueAmt |
| CY Total Revenue | $14,099,355 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | 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 | $8,510,670 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $8,744,617 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $4,466,313 | PYOtherExpensesAmt |
| CY Other Expenses | $5,008,578 | CYOtherExpensesAmt |
| PY Total Expenses | $12,976,983 | PYTotalExpensesAmt |
| CY Total Expenses | $13,753,195 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,205,703 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $346,160 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $9,899,853 | TotalAssetsBOYAmt |
| Total Assets EOY | $12,085,720 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,880,948 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $3,592,972 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $8,018,905 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $8,492,748 | NetAssetsOrFundBalancesEOYAmt |
| Mission | PROVIDE HIGH-QUALITY, COMPREHENSIVE AND AFFORDABLE PRIMARY CARE HEALTH SERVICES THAT IMPROVE OUR PATIENT'S OVERALL HEALTH. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $11,346,705 | ExpenseAmt |
| Revenue | $8,749,809 | 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 | $11,346,705 | 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 | Yes (1) | 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 | 30 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 142 | 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 | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 12 | 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 | |||||||
| IMMEDIATE PAST CHAIR | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| DR DEAN VARIAN | |||||||
| CHAIR | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| GEORGE CRUES | |||||||
| VICE CHAIR | 1.00 | Yes (X) | 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 | ||
| ZACHARY HOSTETLER | |||||||
| SECRETARY | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| GAIL TARANTINO | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| KELLY HENLEY | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| REBEKKA RUSSELL | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| LORA HARLEY | |||||||
| TREASURER | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| ROCIO CHAVARRIA | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| ALLANA HAUT | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| PATRICIA JOHNSON | |||||||
| CFO | 40.00 | Yes (X) | $127,951 | $0 | $14,980 | ||
| ERIC NIEMEYER | |||||||
| CEO | 40.00 | Yes (X) | $182,965 | $0 | $36,192 | ||
| DAVID M COLA | |||||||
| CHIEF MEDICAL OFFICER | 40.00 | $408,710 | $0 | $10,993 | Yes (X) | ||
| THOMAS K MUN | |||||||
| DENTAL DIRECTOR | 40.00 | $209,834 | $0 | $41,773 | Yes (X) | ||
| PHILIP WITHNELL | |||||||
| PHYSICIAN | 40.00 | $200,968 | $0 | $37,799 | Yes (X) | ||
| WILLIAM FISCHER | |||||||
| DENTIST | 40.00 | $208,277 | $0 | $11,166 | Yes (X) | ||
| JANICE TRIEFF | |||||||
| COO | 40.00 | $104,807 | $0 | $23,454 | Yes (X) | ||
| AMANDA ELLIS | |||||||
| ADVANCED PRACTICE PROVIDER MANAGER | 40.00 | $161,500 | $0 | $4,486 | Yes (X) | ||
| KATHERINE NATARO | |||||||
| NURSE PRACTITIONER | 40.00 | $148,854 | $0 | $20,749 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,753,866 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $201,592 | 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 | $318,838 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $3,716,388 | GovernmentGrantsAmt |
| All Other Contributions | $1,542,707 | AllOtherContributionsAmt |
| Noncash Contributions | $1,538,472 | NoncashContributionsAmt |
| Total Contributions | $5,259,095 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT & THIRD PARTY FEE | 621400 | $7,544,423 | $7,544,423 |
| 340B PROGRAM | 621400 | $778,374 | $778,374 |
| INSURANCE INCENTIVES | 621400 | $349,792 | $349,792 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $8,672,589 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $35,137 | TotalRevenueColumnAmt |
| Exclusion | $35,137 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $55,314 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $55,314 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $55,314 | TotalRevenueColumnAmt |
| Exclusion | $55,314 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS INCOME | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $77,220 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $77,220 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $77,220 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $14,099,355 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $8,749,809 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $90,451 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $362,088 | TotalAmt |
| Program Services | $309,860 | ProgramServicesAmt |
| Management And General | $52,228 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,757,085 | TotalAmt |
| Program Services | $5,785,425 | ProgramServicesAmt |
| Management And General | $971,660 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $99,230 | TotalAmt |
| Program Services | $82,361 | ProgramServicesAmt |
| Management And General | $16,869 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,018,558 | TotalAmt |
| Program Services | $851,103 | ProgramServicesAmt |
| Management And General | $167,455 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $507,656 | TotalAmt |
| Program Services | $431,731 | ProgramServicesAmt |
| Management And General | $75,925 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $67,413 | TotalAmt |
| Management And General | $67,413 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,500 | TotalAmt |
| Management And General | $21,500 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,674 | TotalAmt |
| Management And General | $13,674 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $359,656 | TotalAmt |
| Program Services | $129,021 | ProgramServicesAmt |
| Management And General | $230,635 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $151,022 | TotalAmt |
| Program Services | $101,347 | ProgramServicesAmt |
| Management And General | $49,675 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $321,190 | TotalAmt |
| Program Services | $172,367 | ProgramServicesAmt |
| Management And General | $148,823 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $584,573 | TotalAmt |
| Program Services | $274,577 | ProgramServicesAmt |
| Management And General | $309,996 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $215,848 | TotalAmt |
| Program Services | $203,806 | ProgramServicesAmt |
| Management And General | $12,042 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,690 | TotalAmt |
| Program Services | $15,627 | ProgramServicesAmt |
| Management And General | $11,063 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,435 | TotalAmt |
| Program Services | $6,913 | ProgramServicesAmt |
| Management And General | $1,522 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $40,002 | TotalAmt |
| Program Services | $36,632 | ProgramServicesAmt |
| Management And General | $3,370 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $325,574 | TotalAmt |
| Program Services | $167,039 | ProgramServicesAmt |
| Management And General | $158,535 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $50,282 | TotalAmt |
| Program Services | $44,081 | ProgramServicesAmt |
| Management And General | $6,201 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $1,790,151 | $1,780,389 | $9,762 |
| WHOLESALER EXP.-340B PR | $378,129 | $378,129 | |
| REPAIRS AND MAINTENANCE | $190,977 | $164,521 | $26,456 |
| PATIENT SUPPORT | $188,309 | $169,612 | $18,697 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $275,153 | TotalAmt |
| Program Services | $242,164 | ProgramServicesAmt |
| Management And General | $32,989 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,753,195 | TotalAmt |
| Program Services | $11,346,705 | ProgramServicesAmt |
| Management And General | $2,406,490 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,574 | BOYAmt |
| EOY | $16,869 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,988,847 | BOYAmt |
| EOY | $4,195,738 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,278,689 | BOYAmt |
| EOY | $1,186,505 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $437,666 | BOYAmt |
| EOY | $455,468 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $170,100 | BOYAmt |
| EOY | $204,026 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $6,386,030 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $2,568,569 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,439,115 | BOYAmt |
| EOY | $3,817,461 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,188,751 | BOYAmt |
| EOY | $1,263,319 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $282,854 | BOYAmt |
| EOY | $206,150 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $96,257 | BOYAmt |
| EOY | $740,184 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,899,853 | BOYAmt |
| EOY | $12,085,720 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $696,909 | BOYAmt |
| EOY | $915,407 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $925,056 | BOYAmt |
| EOY | $1,813,252 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $258,983 | BOYAmt |
| EOY | $864,313 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,880,948 | BOYAmt |
| EOY | $3,592,972 | 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 | $8,018,905 | BOYAmt |
| EOY | $8,492,748 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,018,905 | BOYAmt |
| EOY | $8,492,748 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,899,853 | BOYAmt |
| EOY | $12,085,720 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $346,160 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $127,683 | 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 | $282,854 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $25,190 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $100,000 | GrantsOrScholarshipsAmt |
| Administrative Expenses | $1,894 | AdministrativeExpensesAmt |
| End Year Balance | $206,150 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $252,404 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $32,474 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $2,024 | AdministrativeExpensesAmt |
| End Year Balance | $282,854 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| 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 Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| 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 Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| 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 |
| 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 | $4,151,851 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,133,393 | DepreciationAmt |
| Book Value | $3,018,458 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $15,054 | OtherCostOrOtherBasisAmt |
| Depreciation | $15,054 | DepreciationAmt |
| Book Value | $0 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,905,553 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,320,581 | DepreciationAmt |
| Book Value | $584,972 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $236,371 | OtherCostOrOtherBasisAmt |
| Depreciation | $99,541 | DepreciationAmt |
| Book Value | $136,830 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $3,817,461 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (3 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| DEPOSITS | $17,500 |
| RIGHT OF USE ASSET | $722,604 |
| OTHER CURRENT ASSETS | $80 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $740,184 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | LEASE LIABILITIES | Desc |
| Amt | $864,313 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $864,313 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $14,065,119 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $127,683 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | $127,683 | RevenueNotReportedAmt |
| Revenue Subtotal | $13,937,436 | RevenueSubtotalAmt |
| Investment Expenses Not Incld | $13,674 | InvestmentExpensesNotIncldAmt |
| Other Revenues Not Included | $148,245 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $161,919 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $14,099,355 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $13,591,276 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $13,591,276 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $13,674 | InvestmentExpensesNotIncld2Amt |
| Other Expenses Not Included | $148,245 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $161,919 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $13,753,195 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 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. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | CREDIT LOSSES 148,245. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | CREDIT LOSSES 148,245. |
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 (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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DAVID M COLA | ||||||||||||||
| CHIEF MEDICAL OFFICER | $313,333 | $0 | $95,377 | $0 | $0 | $0 | $10,993 | $0 | $0 | $0 | $419,703 | $0 | $0 | $0 |
| THOMAS K MUN | ||||||||||||||
| DENTAL DIRECTOR | $208,721 | $0 | $1,113 | $0 | $0 | $0 | $6,457 | $0 | $35,316 | $0 | $251,607 | $0 | $0 | $0 |
| PHILIP WITHNELL | ||||||||||||||
| PHYSICIAN | $200,045 | $0 | $923 | $0 | $0 | $0 | $9,545 | $0 | $28,254 | $0 | $238,767 | $0 | $0 | $0 |
| WILLIAM FISCHER | ||||||||||||||
| DENTIST | $200,359 | $0 | $7,918 | $0 | $0 | $0 | $0 | $0 | $11,166 | $0 | $219,443 | $0 | $0 | $0 |
| ERIC NIEMEYER | ||||||||||||||
| CEO | $182,965 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $36,192 | $0 | $219,157 | $0 | $0 | $0 |
| KATHERINE NATARO | ||||||||||||||
| NURSE PRACTITIONER | $147,931 | $0 | $923 | $0 | $0 | $0 | $0 | $0 | $20,749 | $0 | $169,603 | $0 | $0 | $0 |
| AMANDA ELLIS | ||||||||||||||
| ADVANCED PRACTICE PROVIDER MANAGER | $123,888 | $0 | $37,612 | $0 | $0 | $0 | $3,752 | $0 | $734 | $0 | $165,986 | $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 | $1,538,472 | 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. |