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LIFECARE FAMILY HEALTH AND DENTAL CENTER INC: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization
LIFECARE FAMILY HEALTH AND DENTAL CENTER INC (EIN 34-1708901)
Tax period
2021-01-01 to 2021-12-31
Filed
2022-08-17
IRS object ID
202222299349301032
Schema version
2021v4.2
Source
Download XML · Original 990 at ProPublica

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

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2022-08-17T14:26:54-05:00ReturnTs
Tax Period End2021-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN340677006PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1MALONEY NOVOTNY LLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line14774 MUNSON STREET NW SUITE 402AddressLine1Txt
CityCANTONCityNm
State AbbreviationOHStateAbbreviationCd
ZIP447183634ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2021-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN341708901EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1LIFECARE FAMILY HEALTH AND DENTAL CENTERBusinessNameLine1Txt
Business Name Line2INCBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlLIFEBusinessNameControlTxt
Phone3304542000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12725 LINCOLN STREET EASTAddressLine1Txt
CityCANTONCityNm
State AbbreviationOHStateAbbreviationCd
ZIP44707ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonERIC NIEMEYERPersonNm
Person TitleCEOPersonTitleTxt
Phone3304542000PhoneNum
Signature2022-08-15SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstERICPersonFirstNm
Person LastNIEMEYERPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonCHRISTOPHER B ANDERSONPreparerPersonNm
PTINP00226559PTIN
Phone3309669400PhoneNum

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer3TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2021TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerERIC NIEMEYERPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line12725 LINCOLN STREET EASTAddressLine1Txt
CityCANTONCityNm
State AbbreviationOHStateAbbreviationCd
ZIP44707ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$13,357,963GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.LIFECAREFHDC.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1992FormationYr
Legal Domicile StateOHLegalDomicileStateCd
Activity Or MissionPROVIDE HIGH-QUALITY, COMPREHENSIVE AND AFFORDABLE HEALTH SERVICESActivityOrMissionDesc
Voting Members Governing Body12VotingMembersGoverningBodyCnt
Voting Members Independent12VotingMembersIndependentCnt
Total Employee141TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$4,598,589PYContributionsGrantsAmt
CY Contributions Grants$7,373,874CYContributionsGrantsAmt
PY Program Service Revenue$3,824,590PYProgramServiceRevenueAmt
CY Program Service Revenue$5,761,786CYProgramServiceRevenueAmt
PY Investment Income$31,620PYInvestmentIncomeAmt
CY Investment Income$11,693CYInvestmentIncomeAmt
PY Other Revenue$149,540PYOtherRevenueAmt
CY Other Revenue$106,866CYOtherRevenueAmt
PY Total Revenue$8,604,339PYTotalRevenueAmt
CY Total Revenue$13,254,219CYTotalRevenueAmt
PY Grants And Similar Paid$23,956PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$23,112CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$5,928,695PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$6,620,990CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$2,896,563PYOtherExpensesAmt
CY Other Expenses$3,834,304CYOtherExpensesAmt
PY Total Expenses$8,849,214PYTotalExpensesAmt
CY Total Expenses$10,478,406CYTotalExpensesAmt
PY Revenues Less Expenses-$244,875PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$2,775,813CYRevenuesLessExpensesAmt
Total Assets BOY$5,588,946TotalAssetsBOYAmt
Total Assets EOY$7,333,836TotalAssetsEOYAmt
Total Liabilities BOY$2,687,963TotalLiabilitiesBOYAmt
Total Liabilities EOY$1,521,776TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$2,900,983NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$5,812,060NetAssetsOrFundBalancesEOYAmt
MissionPROVIDE HIGH-QUALITY, COMPREHENSIVE AND AFFORDABLE HEALTH SERVICES THAT IMPROVE OUR PATIENT'S OVERALL HEALTH.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$8,788,534ExpenseAmt
Grant$23,112GrantAmt
Revenue$5,868,652RevenueAmt
DescAS A FEDERALLY QUALIFIED HEALTH CENTER (FQHC), LIFECARE FAMILY HEALTH AND DENTAL CENTER PROVIDES QUALITY PREVENTATIVE AND RESTORATIVE PRIMARY HEALTH CARE TO PATIENTS WITH PAYMENT OPTIONS BASED ON A PATIENT'S ABILITY TO PAY. LIFECARE CONTINUALLY IMPROVES ITS SERVICES AND FACILITIES TO DEVELOP A GROWING, FINANCIALLY-SOUND, PROGRESSIVE COMMUNITY HEALTH CENTER.Desc
Total Program Service Expenses$8,788,534TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To IndividualsYes (1)GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash ContriYes (1)DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document28IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee141EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members12GoverningBodyVotingMembersCnt
Independent Voting Member12IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldOHStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1PATRICIA JOHNSONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone3304542000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12725 LINCOLN STREET EASTAddressLine1Txt
CityCANTONCityNm
State AbbreviationOHStateAbbreviationCd
ZIP44707ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
BARBARA FRUSTACI BSN RN
CHAIR1.00Yes (X)Yes (X)$0$0$0
DEAN VARIAN MD
VICE CHAIR1.00Yes (X)Yes (X)$0$0$0
JUDGE STEPHEN BELDEN
IMMEDIATE PAST CHAIR1.00Yes (X)Yes (X)$0$0$0
KELLY HENLEY
TREASURER1.00Yes (X)Yes (X)$0$0$0
ERICA WILSON-DOMER
SECRETARY1.00Yes (X)Yes (X)$0$0$0
LINDA DAHL
DIRECTOR1.00Yes (X)$0$0$0
ALLANA HAUT
DIRECTOR1.00Yes (X)$0$0$0
GEORGE CRUES
DIRECTOR1.00Yes (X)$0$0$0
REBECCA JOHNSON
DIRECTOR1.00Yes (X)$0$0$0
TERRANCE JONES
DIRECTOR1.00Yes (X)$0$0$0
ZACH HOSTETLER
DIRECTOR1.00Yes (X)$0$0$0
GAIL TARANTINO
DIRECTOR1.00Yes (X)$0$0$0
PATRICIA JOHNSON
CFO40.00Yes (X)$83,143$0$6,574
JANET MCPEEK
CEO40.00Yes (X)$128,306$0$13,173
DAVID M COLA
MEDICAL DIRECTOR40.00$304,658$0$10,233Yes (X)
HOUNEINE GASHASH
PHYSIAN40.00$237,709$0$27,229Yes (X)
THOMAS K MUN
DENTAL DIRECTOR40.00$177,567$0$31,700Yes (X)
TIMOTHY HIRST
DENTIST40.00$195,295$0$8,915Yes (X)
BYRON ROSSI
DENTIST40.00$179,427$0$31,426Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,306,105TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$129,250TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K10IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (2 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
ALLSCRIPTS HEALTHCARE LLC
24630 NETWORK PLACECHICAGOIL60673BILLING SERVICES$177,705
FORD AND ASSOCIATES LLC
2626 STATE ROAD SUITE 139CUYAHOGA FALLSOH44223INFO. TECH. MAINT.&CONSULT.$170,338
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K2CntrctRcvdGreaterThan100KCnt
Government Grants$6,245,078GovernmentGrantsAmt
All Other Contributions$1,128,796AllOtherContributionsAmt
Noncash Contributions$1,082,359NoncashContributionsAmt
Total Contributions$7,373,874TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PATIENT & THIRD PARTY FEE621400$4,708,617$4,708,617
340B PROGRAM621400$1,003,061$1,003,061
INSURANCE INCENTIVES621400$50,108$50,108
FieldValueIRS element (for citing)
Total Program Service Revenue$5,761,786TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$14,880TotalRevenueColumnAmt
Exclusion$14,880ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$100,557SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$103,744SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities-$3,187SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$3,187TotalRevenueColumnAmt
Exclusion-$3,187ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescMISCELLANEOUS INCOMEDesc
Business900099BusinessCd
Total Revenue Column$106,866TotalRevenueColumnAmt
Related Or Exempt Func Income$106,866RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$106,866OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$13,254,219TotalRevenueColumnAmt
Related Or Exempt Func Income$5,868,652RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$11,693ExclusionAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$23,112TotalAmt
Program Services$23,112ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$231,196TotalAmt
Program Services$192,683ProgramServicesAmt
Management And General$38,513ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$5,215,503TotalAmt
Program Services$4,321,331ProgramServicesAmt
Management And General$894,172ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$88,633TotalAmt
Program Services$72,623ProgramServicesAmt
Management And General$16,010ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$722,406TotalAmt
Program Services$631,697ProgramServicesAmt
Management And General$90,709ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$363,252TotalAmt
Program Services$318,953ProgramServicesAmt
Management And General$44,299ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$17,265TotalAmt
Management And General$17,265ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$17,900TotalAmt
Management And General$17,900ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$8,356TotalAmt
Management And General$8,356ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$94,614TotalAmt
Program Services$89,512ProgramServicesAmt
Management And General$5,102ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$166,675TotalAmt
Program Services$89,053ProgramServicesAmt
Management And General$77,622ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$330,935TotalAmt
Program Services$210,943ProgramServicesAmt
Management And General$119,992ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$371,377TotalAmt
Program Services$284,735ProgramServicesAmt
Management And General$86,642ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$177,549TotalAmt
Program Services$159,626ProgramServicesAmt
Management And General$17,923ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$6,092TotalAmt
Program Services$4,677ProgramServicesAmt
Management And General$1,415ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$32,114TotalAmt
Program Services$21,727ProgramServicesAmt
Management And General$10,387ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$50,932TotalAmt
Program Services$20,541ProgramServicesAmt
Management And General$30,391ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$199,669TotalAmt
Program Services$140,800ProgramServicesAmt
Management And General$58,869ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$39,812TotalAmt
Program Services$34,985ProgramServicesAmt
Management And General$4,827ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES$1,348,329$1,348,329
PATIENT SUPPORT$206,387$205,571$816
REPAIRS AND MAINTENANCE$197,992$154,988$43,004
WHOLESALER EXP.-340B PR$187,070$187,070

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$381,236TotalAmt
Program Services$275,578ProgramServicesAmt
Management And General$105,658ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$10,478,406TotalAmt
Program Services$8,788,534ProgramServicesAmt
Management And General$1,689,872ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$42,634BOYAmt
EOY$45,263EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$1,194,354BOYAmt
EOY$2,420,413EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$208,960BOYAmt
EOY$1,823EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$822,130BOYAmt
EOY$808,184EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$127,807BOYAmt
EOY$193,203EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$4,154,973LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$1,776,524LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$2,344,964BOYAmt
EOY$2,378,449EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$609,149BOYAmt
EOY$1,206,229EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$236,448BOYAmt
EOY$277,772EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$2,500BOYAmt
EOY$2,500EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$5,588,946BOYAmt
EOY$7,333,836EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$452,878BOYAmt
EOY$479,627EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$1,097,040BOYAmt
EOY$1,042,149EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$1,138,045BOYAmt
EOY$0EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$2,687,963BOYAmt
EOY$1,521,776EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$2,900,983BOYAmt
EOY$5,812,060EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$2,900,983BOYAmt
EOY$5,812,060EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$5,588,946BOYAmt
EOY$7,333,836EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$2,775,813ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$135,264NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit RequiredYes (1)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (1)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

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 D IRS990ScheduleD

Land LandGrp

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

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,594,321OtherCostOrOtherBasisAmt
Depreciation$734,903DepreciationAmt
Book Value$1,859,418BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$15,840OtherCostOrOtherBasisAmt
Depreciation$10,372DepreciationAmt
Book Value$5,468BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,467,611OtherCostOrOtherBasisAmt
Depreciation$1,031,249DepreciationAmt
Book Value$436,362BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$2,378,449TotalBookValueLandBuildingsAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$13,381,127TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$135,264NetUnrealizedGainsInvstAmt
Revenue Not Reported$135,264RevenueNotReportedAmt
Revenue Subtotal$13,245,863RevenueSubtotalAmt
Investment Expenses Not Incld$8,356InvestmentExpensesNotIncldAmt
Revenue Not Reported Fincl Stmt$8,356RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$13,254,219TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$10,470,050TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$10,470,050ExpensesSubtotalAmt
Investment Expenses Not Incld2$8,356InvestmentExpensesNotIncld2Amt
Expenses Not Rpt Fincl Stmt$8,356ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$10,478,406TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationTHE 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.ExplanationTxt

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

FieldValueIRS element (for citing)
Grant TypeDENTAL ASSISTANCEGrantTypeTxt
Recipient437RecipientCnt
Cash Grant$23,112CashGrantAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationTHE LIFECARE DENTAL ASSISTANCE PROGRAM UNDERWRITES 30% OF DENTAL BILLS FOR PATIENTS WHO DO NOT QUALIFY FOR SLIDING SCALE FEES AND DO NOT HAVE ANY OTHER DENTAL INSURANCE.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Substantiation RequiredYes (1)SubstantiationRequiredInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (5 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
DAVID M COLA
MEDICAL DIRECTOR$270,218$0$34,440$0$0$0$10,233$0$0$0$314,891$0$0$0
HOUNEINE GASHASH
PHYSIAN$228,459$0$9,250$0$0$0$8,033$0$19,196$0$264,938$0$0$0
BYRON ROSSI
DENTIST$178,927$0$500$0$0$0$4,165$0$27,261$0$210,853$0$0$0
THOMAS K MUN
DENTAL DIRECTOR$177,067$0$500$0$0$0$5,479$0$26,221$0$209,267$0$0$0
TIMOTHY HIRST
DENTIST$194,855$0$440$0$0$0$8,645$0$270$0$204,210$0$0$0

Schedule M IRS990ScheduleM

Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Noncash Contributions Rpt F990$1,082,359NoncashContributionsRptF990Amt
Method Of Determining RevenuesFAIR MARKET VALUEMethodOfDeterminingRevenuesTxt
FieldValueIRS element (for citing)
Any Property That Must Be Held0AnyPropertyThatMustBeHeldInd
Review Process Unusual NC Gifts0ReviewProcessUnusualNCGiftsInd
Third Parties Used0ThirdPartiesUsedInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11BFORM 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 12CMONITORING 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 15COMPENSATION 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 19AVAILABILITY 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 HALTHOUGH 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.