STRATEGY STUDIO / PUBLIC DATA EXPLORER

DOUGLAS COUNTY PUBLIC HEALTH SERVICES GROUP INC: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization
DOUGLAS COUNTY PUBLIC HEALTH SERVICES GROUP INC (EIN 43-1747760)
Tax period
2020-03-01 to 2021-02-28
Filed
2022-01-17
IRS object ID
202210179349300131
Schema version
2020v4.1
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2022-01-17T16:52:08-06:00ReturnTs
Tax Period End2021-02-28TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BKD LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1910 E ST LOUIS 200/PO BOX 1190AddressLine1Txt
CitySPRINGFIELDCityNm
State AbbreviationMOStateAbbreviationCd
ZIP658062523ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2020-03-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN431747760EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1DOUGLAS COUNTY PUBLIC HEALTH SVCS GROUP INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% RANDALL GANNInCareOfNm
Business Name ControlDOUGBusinessNameControlTxt
Phone4176835739PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1504 NW 10TH AVE PO BOX 1359AddressLine1Txt
CityAVACityNm
State AbbreviationMOStateAbbreviationCd
ZIP65608ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonTIMOTHY SHRYACKPersonNm
Person TitleCHIEF EXECUTIVE OFFIPersonTitleTxt
Phone4176835739PhoneNum
Signature2021-07-12SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstTIMOTHYPersonFirstNm
Person LastSHRYACKPersonLastNm
FieldValueIRS element (for citing)
SSNXXX-XX-XXXXSSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonKrystal K CreachPreparerPersonNm
PTINP01248198PTIN
Phone4178658701PhoneNum

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer2TrustedCustomerCd
FieldValueIRS element (for citing)
Tax2020TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1MISSOURI OZARKS COMMUNITY HEALTHBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerTIMOTHY SHRYACKPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1504 NW 10TH AVE PO BOX 1359AddressLine1Txt
CityAVACityNm
State AbbreviationMOStateAbbreviationCd
ZIP65608ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$15,749,227GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.MO-OZARKS.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1996FormationYr
Legal Domicile StateMOLegalDomicileStateCd
Activity Or MissionTO PROVIDE AFFORDABLE, ACCESSIBLE, QUALITY HEALTH CARE TO ALL WITHIN THE SERVICE AREA. SERVICES WILL BE PROVIDED WITHOUT REGARD TO AGE, RACE, CREED, DISABILITY OR STATUS.ActivityOrMissionDesc
Voting Members Governing Body10VotingMembersGoverningBodyCnt
Voting Members Independent10VotingMembersIndependentCnt
Total Employee128TotalEmployeeCnt
Total Volunteers10TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$4,645,896PYContributionsGrantsAmt
CY Contributions Grants$6,658,220CYContributionsGrantsAmt
PY Program Service Revenue$8,654,531PYProgramServiceRevenueAmt
CY Program Service Revenue$8,973,850CYProgramServiceRevenueAmt
PY Investment Income$41,097PYInvestmentIncomeAmt
CY Investment Income$42,899CYInvestmentIncomeAmt
PY Other Revenue$98,238PYOtherRevenueAmt
CY Other Revenue$57,422CYOtherRevenueAmt
PY Total Revenue$13,439,762PYTotalRevenueAmt
CY Total Revenue$15,732,391CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$8,028,674PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$8,710,820CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$22,000PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$31,000CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$31,000CYTotalFundraisingExpenseAmt
PY Other Expenses$4,603,486PYOtherExpensesAmt
CY Other Expenses$4,379,243CYOtherExpensesAmt
PY Total Expenses$12,654,160PYTotalExpensesAmt
CY Total Expenses$13,121,063CYTotalExpensesAmt
PY Revenues Less Expenses$785,602PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$2,611,328CYRevenuesLessExpensesAmt
Total Assets BOY$13,967,943TotalAssetsBOYAmt
Total Assets EOY$17,119,943TotalAssetsEOYAmt
Total Liabilities BOY$2,224,693TotalLiabilitiesBOYAmt
Total Liabilities EOY$2,599,355TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$11,743,250NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$14,520,588NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionIT IS THE MISSION OF THE DOUGLAS COUNTY PUBLIC HEALTH SERVICES GROUP, INC. DBA/MISSOURI OZARKS COMMUNITY HEALTH, TO PROVIDE QUALITY, AFFORDABLE PRIMARY MEDICAL, DENTAL, AND BEHAVIORAL HEALTH CARE TO ALL.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$6,310,160ExpenseAmt
Revenue$5,354,706RevenueAmt
DescDURING FISCAL YEAR 2021, MISSOURI OZARKS COMMUNITY HEALTH (MOCH) HAD 26,592 MEDICAL ENCOUNTERS (VISITS) THAT PROVIDED QUALITY CARE TO THE RURAL POPULATION OF DOUGLAS, OZARK, WRIGHT, AND TEXAS COUNTIES IN MISSOURI. MOCH STRIVES TO PROVIDE THIS QUALITY CARE THROUGH A VARIETY OF MEDICAL SERVICES THAT INCLUDE, BUT ARE NOT LIMITED TO, ADULT MEDICINE, PEDIATRIC CARE, ADOLESCENT HEALTH, NUTRITIONAL HEALTH, URGENT MEDICAL CARE, LABORATORY AND RADIOLOGY TESTING, AND PHARMACY SERVICES. FOR SERVICES OUTSIDE OF MOCH'S SCOPE AND ABILITY, PATIENTS ARE REFERRED TO ORGANIZATIONS NEAR OUR SERVICE AREA THAT CAN PROVIDE THE QUALITY OF CARE THAT MOCH PATIENTS EXPECT FOR MEDICAL ENCOUNTERS.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$3,723,157ExpenseAmt
Revenue$3,304,031RevenueAmt
DescMISSOURI OZARKS COMMUNITY HEALTH PROVIDES QUALITY PREVENTATIVE AND RESTORATIVE DENTAL CARE IN DOUGLAS, OZARK, WRIGHT, AND TEXAS COUNTIES IN MISSOURI. DURING THE FISCAL YEAR, THE ORGANIZATION HAD 8,591 DENTAL ENCOUNTERS (VISITS).Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$349,146ExpenseAmt
Revenue$261,774RevenueAmt
DescMISSOURI OZARKS COMMUNITY HEALTH PROVIDES QUALITY BEHAVIORAL HEALTH SERVICES TO DOUGLAS, OZARK, WRIGHT, AND TEXAS COUNTIES IN MISSOURI. THESE SERVICES INCLUDE, BUT ARE NOT LIMITED TO, INDIVIDUAL COUNSELING, FAMILY COUNSELING, CONSULTATION, REFERRAL FOR LONG-TERM PSYCHOTHERAPY, MEDICATION EVALUATION, AND SUBSTANCE ABUSE COUNSELING. DURING THE FISCAL YEAR, THE ORGANIZATION HAD 2,410 BEHAVIORAL HEALTH ENCOUNTERS (VISITS).Desc
FieldValueIRS element (for citing)
Total Other Prog Srvc Expense$173,970TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Revenue$53,339TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses$10,556,433TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesYes (true)LobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsfalseDonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsYes (true)ReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (true)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingYes (true)ProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContriYes (true)DeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee128EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members10GoverningBodyVotingMembersCnt
Independent Voting Member10IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyfalseForm990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonRANDALL GANNPersonNm
Phone4176835739PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1504 NW 10TH AVE PO BOX 1359AddressLine1Txt
CityAVACityNm
State AbbreviationMOStateAbbreviationCd
ZIP65608ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtHighest Compensated EmployeeHighestCompensatedEmployeeIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndIndividual Trustee Or DirectorIndividualTrusteeOrDirectorInd
SELMA TAYLOR
PHYSICIAN40.00.0Yes (X)$268,849$0$8,576
JOSHUA WOLFE
PHYSICIAN40.00.0Yes (X)$225,687$0$7,168
SYBIL FORTNER
DENTAL DIRECTOR40.00.0Yes (X)$222,296$0$7,246
CODY THRESS
DENTIST40.00.0Yes (X)$206,124$0$3,193
MICHAEL BALL
PHYSICIAN40.00.0Yes (X)$181,075$0$6,129
TIM SHRYACK
CHIEF EXECUTIVE OFFICER40.00.0$155,536$0$5,125Yes (X)
RANDALL GANN
CHIEF FINANCIAL OFFICER40.00.0$104,681$0$2,974Yes (X)
JENNIFER HEINLEIN
CHIEF OPERATIONS OFFICER40.00.0$98,789$0$2,871Yes (X)
CAROL CUNNINGHAM
PRESIDENT2.00.0$0$0$0Yes (X)Yes (X)
RHONDA SUTER
VICE PRESIDENT2.00.0$0$0$0Yes (X)Yes (X)
JASON DIAL
DIRECTOR1.00.0$0$0$0Yes (X)
DONALD PINCKNEY
TREASURER2.00.0$0$0$0Yes (X)Yes (X)
VALERIE REESE
DIRECTOR1.00.0$0$0$0Yes (X)
JACKIE SMITH
DIRECTOR1.00.0$0$0$0Yes (X)
BART ELLISON
SECRETARY2.00.0$0$0$0Yes (X)Yes (X)
RON SCHEETS
DIRECTOR1.00.0$0$0$0Yes (X)
SHELDON SHAVER
DIRECTOR1.00.0$0$0$0Yes (X)
ANN LEONARD
DIRECTOR1.00.0$0$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,463,037TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$43,282TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K22IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (2 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
NEXTGEN HEALTHCARE INC
PO BOX 511449LOS ANGELESCA90051REVENUE CYCLE MGMT$288,968
JMARK
1550 E REPUBLIC RDSPRINGFIELDMO65804IT SERVICES$232,131
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K2CntrctRcvdGreaterThan100KCnt
Government Grants$6,553,323GovernmentGrantsAmt
All Other Contributions$104,897AllOtherContributionsAmt
Noncash Contributions$143,000NoncashContributionsAmt
Total Contributions$6,658,220TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (4 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT SERVICE REVENUE624100$8,717,833$8,717,833
HEALTH & FITNESS CENTER713940$78,741$78,741
OTHER CLINIC REVENUE621400$126,276$126,276
EHR INCENTIVE REVENUE621400$51,000$51,000
FieldValueIRS element (for citing)
Total Program Service Revenue$8,973,850TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$26,569TotalRevenueColumnAmt
Exclusion$26,569ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$23,734RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$23,734RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$23,734TotalRevenueColumnAmt
Exclusion$23,734ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$33,166SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$16,836SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$16,330SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$16,330TotalRevenueColumnAmt
Exclusion$16,330ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$0FundraisingGrossIncomeAmt
Fundraising Direct Expenses$0FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gaming Gross Income$0GamingGrossIncomeAmt
Gaming Direct Expenses$0GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$0GrossSalesOfInventoryAmt
Cost Of Goods Sold$0CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescGAIN ON INVESTMENT IN EQUITY INVESTEEDesc
Business900099BusinessCd
Total Revenue Column$33,688TotalRevenueColumnAmt
Exclusion$33,688ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$33,688OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$15,732,391TotalRevenueColumnAmt
Related Or Exempt Func Income$8,973,850RelatedOrExemptFuncIncomeAmt
Exclusion$100,321ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$369,976TotalAmt
Management And General$369,976ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$7,011,254TotalAmt
Program Services$6,249,951ProgramServicesAmt
Management And General$761,303ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$168,615TotalAmt
Program Services$153,104ProgramServicesAmt
Management And General$15,511ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$640,545TotalAmt
Program Services$546,094ProgramServicesAmt
Management And General$94,451ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$520,430TotalAmt
Program Services$443,690ProgramServicesAmt
Management And General$76,740ManagementAndGeneralAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$2,740TotalAmt
Management And General$2,740ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$90,755TotalAmt
Management And General$90,755ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$31,000TotalAmt
Fundraising$31,000FundraisingAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$838,865TotalAmt
Program Services$237,653ProgramServicesAmt
Management And General$601,212ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$89,347TotalAmt
Program Services$67,508ProgramServicesAmt
Management And General$21,839ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$700,356TotalAmt
Program Services$529,169ProgramServicesAmt
Management And General$171,187ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$43,122TotalAmt
Program Services$32,582ProgramServicesAmt
Management And General$10,540ManagementAndGeneralAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$325,994TotalAmt
Program Services$246,311ProgramServicesAmt
Management And General$79,683ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$51,372TotalAmt
Program Services$38,815ProgramServicesAmt
Management And General$12,557ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$33,379TotalAmt
Program Services$25,220ProgramServicesAmt
Management And General$8,159ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$39,622TotalAmt
Management And General$39,622ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$738,867TotalAmt
Program Services$601,556ProgramServicesAmt
Management And General$137,311ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$64,189TotalAmt
Program Services$48,499ProgramServicesAmt
Management And General$15,690ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
Medical Supplies & Drugs$1,241,774$1,241,774
LICENSES, DUES, SUBSCRIPTIONS$85,268$64,426$20,842
PHARMACY PROVIDER TAX$19,225$19,225
Recruiting & Retention$12,955$9,788$3,167

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$1,413TotalAmt
Program Services$1,068ProgramServicesAmt
Management And General$345ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$13,121,063TotalAmt
Program Services$10,556,433ProgramServicesAmt
Management And General$2,533,630ManagementAndGeneralAmt
Fundraising$31,000FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$233,167BOYAmt
EOY$1,256,437EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$3,497,796BOYAmt
EOY$4,664,099EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$604,737BOYAmt
EOY$571,928EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,150,268BOYAmt
EOY$1,453,673EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

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

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

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

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

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

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$253,886BOYAmt
EOY$286,656EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$136,313BOYAmt
EOY$164,475EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$11,176,453LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$5,488,895LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$5,782,527BOYAmt
EOY$5,687,558EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$734,044BOYAmt
EOY$1,123,283EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

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

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$120,226BOYAmt
EOY$156,501EOYAmt

Intangible Assets IntangibleAssetsGrp

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

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$1,454,979BOYAmt
EOY$1,755,333EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$13,967,943BOYAmt
EOY$17,119,943EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$875,607BOYAmt
EOY$975,134EOYAmt

Grants Payable GrantsPayableGrp

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

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$6,515BOYAmt
EOY$1,085,330EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

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

Escrow Account Liability EscrowAccountLiabilityGrp

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

Loans From Officers Directors LoansFromOfficersDirectorsGrp

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

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$900,163BOYAmt
EOY$538,891EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

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

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$442,408BOYAmt
EOY$0EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$2,224,693BOYAmt
EOY$2,599,355EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$11,695,997BOYAmt
EOY$14,463,698EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$47,253BOYAmt
EOY$56,890EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$11,743,250BOYAmt
EOY$14,520,588EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$13,967,943BOYAmt
EOY$17,119,943EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$2,611,328ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$166,010NetUnrlzdGainsLossesInvstAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

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

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$3,140,817CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$5,459,185CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$4,455,213CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$4,645,896CurrentTaxYearMinus1YearAmt
Current Tax Year$6,658,220CurrentTaxYearAmt
Total$24,359,331TotalAmt

Tax Rev Levied Orgnztnl Bnft170 TaxRevLeviedOrgnztnlBnft170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$3,140,817CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$5,459,185CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$4,455,213CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$4,645,896CurrentTaxYearMinus1YearAmt
Current Tax Year$6,658,220CurrentTaxYearAmt
Total$24,359,331TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$221,391SubstantialContributorsTotAmt
Public Support Total170$24,137,940PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$40,700CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$58,595CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$77,013CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$62,034CurrentTaxYearMinus1YearAmt
Current Tax Year$50,303CurrentTaxYearAmt
Total$288,645TotalAmt

Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Income170 OtherIncome170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Total Support$24,647,976TotalSupportAmt
Gross Receipts Rltd Activities$38,721,788GrossReceiptsRltdActivitiesAmt
Public Support CY1700.97931PublicSupportCY170Pct
Public Support PY1700.97303PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

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

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Total Grassroots LobbyingTotalGrassrootsLobbyingGrp
Total Direct LobbyingTotalDirectLobbyingGrp
Total Lobbying ExpendTotalLobbyingExpendGrp
Other Exempt Purpose ExpendOtherExemptPurposeExpendGrp
Total Exempt Purpose ExpendTotalExemptPurposeExpendGrp
Lobbying Nontaxable AmountLobbyingNontaxableAmountGrp
Grassroots NontaxableGrassrootsNontaxableGrp
Tot Lbbyng Grassroot Mns Non TxTotLbbyngGrassrootMnsNonTxGrp
Tot Lbby Expend Mns Lbbyng Non TxTotLbbyExpendMnsLbbyngNonTxGrp
VolunteersfalseVolunteersInd
Paid Staff Or ManagementfalsePaidStaffOrManagementInd
Media AdvertisementsfalseMediaAdvertisementsInd
Mailings MembersfalseMailingsMembersInd
Publications Or BroadcastfalsePublicationsOrBroadcastInd
Grants Other OrganizationsfalseGrantsOtherOrganizationsInd
Direct Contact LegislatorsfalseDirectContactLegislatorsInd
Rallies DemonstrationsfalseRalliesDemonstrationsInd
Other ActivitiesYes (true)OtherActivitiesInd
Other Activities$20,000OtherActivitiesAmt
Total Lobbying Expenditures$20,000TotalLobbyingExpendituresAmt
Not Described Section501c3falseNotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE C, PART II-B, LINE 1(I)FormAndLineReferenceDesc
ExplanationOTHER LOBBYING ACTIVITIES: THE ORGANIZATION PAYS DUES TO THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS. A PORTION OF THESE DUES MAY BE ATTRIBUTABLE TO LOBBYING ACTIVITIES.ExplanationTxt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp
CY Minus3 Yr Endwmt FundCYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt FundCYMinus4YrEndwmtFundGrp

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$149,760OtherCostOrOtherBasisAmt
Book Value$149,760BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$7,280,167OtherCostOrOtherBasisAmt
Depreciation$3,689,600DepreciationAmt
Book Value$3,590,567BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$179,970OtherCostOrOtherBasisAmt
Depreciation$19,060DepreciationAmt
Book Value$160,910BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$3,566,556OtherCostOrOtherBasisAmt
Depreciation$1,780,235DepreciationAmt
Book Value$1,786,321BookValueAmt
FieldValueIRS element (for citing)
Other Land BuildingsOtherLandBuildingsGrp
Total Book Value Land Buildings$5,687,558TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (2 entries)

DescDescBook ValueBookValueAmt
OTHER RECEIVABLES$55,333
EST AMOUNTS DUE FROM 3RD PARTY$1,700,000
FieldValueIRS element (for citing)
Total Book Value Other Assets$1,755,333TotalBookValueOtherAssetsAmt
Total Rev Etc Audited Fincl Stmt$15,888,764TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$166,010NetUnrealizedGainsInvstAmt
Other Revenue$128,060OtherRevenueAmt
Revenue Not Reported$294,070RevenueNotReportedAmt
Revenue Subtotal$15,594,694RevenueSubtotalAmt
Other Revenues Not Included$137,697OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$137,697RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$15,732,391TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$13,121,063TotExpnsEtcAuditedFinclStmtAmt
Expenses Subtotal$13,121,063ExpensesSubtotalAmt
Total Expenses Per Form990$13,121,063TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE D, PART X, LINE 2UNCERTAIN TAX POSITIONS: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS.
SCHEDULE D, PART XI, LINE 2DOTHER REVENUE ON LINE 1, BUT NOT ON FORM 990, PART VIII, LINE 12: $ 128,060 NET ASSETS RELEASED FROM RESTRICTION
SCHEDULE D, PART XI, LINE 4BOTHER REVENUE ON FORM 990, PART VIII, LINE 12, BUT NOT ON LINE 1: $ 137,697 TEMPORARILY RESTRICTED CONTRIBUTIONS

Schedule G IRS990ScheduleG

FieldValueIRS element (for citing)
Solicitation Of Non Govt GrantsYes (X)SolicitationOfNonGovtGrantsInd
Solicitation Of Govt GrantsYes (X)SolicitationOfGovtGrantsInd
Agrmt Prof Fundraising ActyYes (true)AgrmtProfFundraisingActyInd

Fundraiser Activity Info FundraiserActivityInfoGrp

FieldValueIRS element (for citing)
PersonCOMMUNITY ASSET BUILDERSPersonNm
ActivityGRANTActivityTxt
Fundraiser Control Of FundsfalseFundraiserControlOfFundsInd
Gross Receipts$3,620,120GrossReceiptsAmt
Retained By Contractor$31,000RetainedByContractorAmt
Net To Organization$3,589,120NetToOrganizationAmt
FieldValueIRS element (for citing)
Total Gross Receipts$3,620,120TotalGrossReceiptsAmt
Total Retained By Contractors$31,000TotalRetainedByContractorsAmt
Total Net To Organization$3,589,120TotalNetToOrganizationAmt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgYes (true)CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
TIM SHRYACK
CHIEF EXECUTIVE OFFICER$147,104$0$8,432$0$0$0$5,125$0$0$0$160,661$0$0$0
SELMA TAYLOR
PHYSICIAN$259,239$0$9,610$0$0$0$8,576$0$0$0$277,425$0$0$0
SYBIL FORTNER
DENTAL DIRECTOR$202,398$0$19,898$0$0$0$7,246$0$0$0$229,542$0$0$0
JOSHUA WOLFE
PHYSICIAN$207,436$0$18,251$0$0$0$7,168$0$0$0$232,855$0$0$0
MICHAEL BALL
PHYSICIAN$177,520$0$3,555$0$0$0$6,129$0$0$0$187,204$0$0$0
CODY THRESS
DENTIST$191,403$0$14,721$0$0$0$3,193$0$0$0$209,317$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE J, PART I, LINE 5AFormAndLineReferenceDesc
ExplanationPROVIDER BONUS CONTINGENT ON GROSS CHARGES: PROVIDERS RECEIVE BONUSES ON HIRING DATE ANNIVERSARY EQUALING A PERCENTAGE OF THE CHARGES THE GENERATE OVER THEIR PRIOR 365 DAYS.ExplanationTxt

Schedule M IRS990ScheduleM

FieldValueIRS element (for citing)
Works Of ArtWorksOfArtGrp
Art Historical TreasuresArtHistoricalTreasuresGrp
Art Fractional InterestArtFractionalInterestGrp
Books And PublicationsBooksAndPublicationsGrp
Clothing And Household GoodsClothingAndHouseholdGoodsGrp
Cars And Other VehiclesCarsAndOtherVehiclesGrp
Boats And PlanesBoatsAndPlanesGrp
Intellectual PropertyIntellectualPropertyGrp
Securities Publicly TradedSecuritiesPubliclyTradedGrp
Securities Closely Held StockSecuritiesCloselyHeldStockGrp
Secur Prtnrshp Trust IntrstsSecurPrtnrshpTrustIntrstsGrp
Securities MiscellaneousSecuritiesMiscellaneousGrp
Qualified Contrib Hist StructQualifiedContribHistStructGrp
Qualified Contrib OtherQualifiedContribOtherGrp
Real Estate ResidentialRealEstateResidentialGrp
Real Estate CommercialRealEstateCommercialGrp
Real Estate OtherRealEstateOtherGrp
CollectiblesCollectiblesGrp
Food InventoryFoodInventoryGrp

Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Contribution2ContributionCnt
Noncash Contributions Rpt F990$143,000NoncashContributionsRptF990Amt
Method Of Determining RevenuesFMVMethodOfDeterminingRevenuesTxt
FieldValueIRS element (for citing)
TaxidermyTaxidermyGrp
Historical ArtifactsHistoricalArtifactsGrp
Scientific SpecimensScientificSpecimensGrp
Archaeological ArtifactsArchaeologicalArtifactsGrp
Any Property That Must Be HeldfalseAnyPropertyThatMustBeHeldInd
Review Process Unusual NC GiftsfalseReviewProcessUnusualNCGiftsInd
Third Parties UsedfalseThirdPartiesUsedInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE M, PART 1, COLUMN BFormAndLineReferenceDesc
ExplanationNUMBER OF CONTRIBUTORS OR ITEMS CONTRIBUTED: THE NUMBERS REPORTED IN COLUMN B REPRESENT CONTRIBUTIONS FROM ONE DONOR PER CONTRIBUTION TYPE.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART I, LINE 1ORGANIZATION'S MISSION OR MOST SIGNIFICANT ACTIVITIES: THE MISSION OF THE DOUGLAS COUNTY PUBLIC HEALTH SERVICES GROUP, INC.(DCPHSG), DOING BUSINESS AS MISSOURI OZARKS COMMUNITY HEALTH (MOCH), IS, AS A COMMUNITY HEALTH CENTER, TO PROVIDE AFFORDABLE, ACCESSIBLE, QUALITY HEALTH CARE TO ALL WITHIN THE DESIGNATED SERVICE AREA. THESE SERVICES WILL BE PROVIDED WITHOUT REGARD TO AGE, RACE, CREED, DISABILITY OR ECONOMIC STATUS. THESE SERVICES CONSIST OF USUAL AND CUSTOMARY SERVICES AS DEFINED BY THE TERM PRIMARY MEDICAL, MENTAL AND DENTAL HEALTH CARE NEEDS.
FORM 990, PART I, LINE 6VOLUNTEERS: THE ORGANIZATION HAS A VOLUNTEER BOARD OF DIRECTORS.
FORM 990, PART III, LINE 4DOTHER PROGRAM SERVICES: MISSOURI OZARKS COMMUNITY HEALTH OPERATES A WELLNESS CENTER THAT SERVES, ON AVERAGE, 950 MEMBERS MONTHLY. THE WELLNESS CENTER PROMOTES HEALTHY LIFESTYLE CHANGES THROUGH EXERCISE AND FITNESS PROGRAMS.
FORM 990, PART VI, SECTION B, LINE 11BREVIEW OF THE FORM 990: THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. THE DRAFT FORM 990 IS INITIALLY REVIEWED IN DETAIL BY THE CEO AND CFO. AFTER ANY REVISIONS ARE MADE BY THE CEO AND CFO, THE FORM IS FILED WITH THE INTERNAL REVENUE SERVICE. AFTER THE RETURN IS FILED, A COPY OF THE FINAL 990 IS GIVEN TO THE BOARD.
FORM 990, PART VI, SECTION B, LINE 12CMONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY: THE ORGANIZATION HAS A WRITTEN CONFLICT OF INTEREST POLICY. COMPLIANCE WITH THIS POLICY IS REVIEWED AT STAFF MEETINGS AND MONTHLY BOARD MEETINGS, AS THE NEED ARISES. ANY DUALITY OF INTEREST OR POSSIBLE CONFLICT OF INTEREST ON THE PART OF ANY DIRECTOR SHALL BE DISCLOSED TO OTHER MEMBERS OF THE BOARD OF DIRECTORS. TO THIS END, EACH DIRECTOR SHALL UPON ELECTION AND ANNUALLY THEREAFTER, PREPARE AND FILE WITH THE SECRETARY, A WRITTEN DECLARATION OF INTERESTS AND ACTIVITIES WHICH CREATE OR MIGHT CREATE DUAL INTEREST OR CONFLICT OF INTEREST ON THE PART OF THE DIRECTORS. SAID DECLARATIONS SHALL BE AVAILABLE FOR REVIEW BY ALL DIRECTORS AT ALL TIMES. ANY DIRECTOR HAVING A DUALITY OF INTEREST OR POSSIBLE CONFLICT OF INTEREST ON ANY MATTER SHALL NOT VOTE OR USE HIS/HER PERSONAL INFLUENCE ON THE MATTER AND HE/SHE SHALL NOT BE COUNTED IN DETERMINING THE QUORUM FOR THE MEETING. THE MINUTES SHALL REFLECT THE DISCLOSURE, THE ABSTENTION FROM VOTING, AND THE QUORUM STATUS. THE FOREGOING REQUIREMENTS, HOWEVER, SHALL NOT BE CONSTRUED AS PREVENTING THE DIRECTOR FROM STATING HIS/HER POSITION ON THE MATTER NOR FROM ANSWERING PERTINENT QUESTIONS OF OTHER MEMBERS, SINCE HIS/HER KNOWLEDGE MAY BE OF GREAT ASSISTANCE TO THE BOARD.
FORM 990, PART VI, SECTION B, LINE 15ACOMPENSATION REVIEW POLICY: THE BOARD REVIEWS THE CEO'S COMPENSATION ANNUALLY USING THE NACHC SALARY SURVEY AND STATE OF MISSOURI SALARY COMPARABILITY DATA. USING THAT DATA, AND PERFORMANCE EVALUATION, THE WAGE IS ADJUSTED. THE BOARD VOTES ON ANY SALARY ADJUSTMENT, INCLUDING BONUSES, AND THE ACTIONS TAKEN BY THE BOARD ARE DOCUMENTED IN THE BOARD MINUTES. THE CEO PERFORMS ANNUAL REVIEW AS SUPERVISOR FOR ALL OTHER OFFICERS. ALL OTHER COMPENSATION IS DETERMINED BY THE CEO USING GUIDANCE FROM THE STATE OF MISSOURI AND IS BASED ON MERIT. A REVIEW OF THE COMPENSATION OF THE CEO WAS COMPLETED IN 2020.
FORM 990, PART VI, SECTION C, LINE 19DOCUMENT AVAILABILITY: THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY CAN BE VIEWED AT THE ORGANIZATION'S FACILITY, UPON REQUEST. THE ORGANIZATION'S FINANCIAL STATEMENTS MAY BE AVAILABLE UPON WRITTEN REQUEST IF THE ORGANIZATION DEEMS THE REQUEST FOR VIEWING IS APPROPRIATE. WRITTEN REQUESTS SHOULD INCLUDE WHY THE INTERESTED PARTY REQUESTS TO VIEW THE FINANCIAL STATEMENTS.