2022-09-23T15:42:03-05:00 2021-12-31 410746749 CLIFTONLARSONALLEN LLP 227 WEST TRADE STREET SUITE 800 CHARLOTTE NC 28202 990 2021-01-01 571092940 AFFINITY HEALTH CENTER AFFI 8039096363 455 LAKESHORE PARKWAY ROCK HILL SC 29730 ANITA CASE CHIEF EXECUTIVE OFFICER 8039096363 2022-09-22 1 ANITA CASE 999009999 JOHN NORMAN P01506766 7049985200 2022-09-22 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z ANITA CASE 455 LAKESHORE PARKWAY ROCK HILL SC 29730 20654145 0 X AFFINITYHEALTHCENTER.ORG X 2000 SC TO PROVIDE HIGH-QUALITY COMPREHENSIVE HEALTHCARE WITH COMPASSION, DIGNITY AND RESPECT. 14 14 122 56 0 0 5823703 5903475 13079570 14653441 269 602 89904 96627 18993446 20654145 1108174 1313950 0 0 5258069 5811686 0 0 8403 12246686 12830844 18612929 19956480 380517 697665 20811428 21220850 4215216 3647242 16596212 17573608 TO SERVE THE HEALTHCARE NEEDS OF OUR COMMUNITY BY PROVIDING ACCESS TO HIGH-QUALITY, COMPREHENSIVE CARE WITH COMPASSION, DIGNITY AND RESPECT. 0 0 17575085 1244274 14712330 HEALTHCARE IS PROVIDED IN A DIGNIFIED, COMPASSIONATE MANNER. WITH THE ACCESS TO QUALITY CARE, PATIENTS CAN LIVE LONGER AND HEALTHIER LIVES. HEALTHCARE SERVICES AT AFFINITY HEALTH CENTER INCLUDE 1) PRIMARY CARE, 2) HIV SPECIALTY CARE, 3) ORAL HEALTH CARE, 4) BEHAVIORAL HEALTH SERVICES, 5) DENTAL CARE, AND 6) SPECIALTY CARE REFERRALS. AHC HEALTHCARE SERVICES ARE PROVIDED WITHOUT REGARD FOR ABILITY TO PAY, AND CHARGES ARE BASED ON A SLIDING FEE SCALE. 1161142 69676 SUPPORT SERVICES ARE INTENDED TO HELP PATIENTS ENGAGE IN AND REMAIN ENGAGED IN MEDICAL TREATMENT AND TO ASSIST THEM WITH REDUCING ANY BARRIERS TO CARE. SERVICES INCLUDE 1) MEDICAL CASE MANAGEMENT AND CARE COORDINATION, 2) HEALTH EDUCATION, 3) OUTREACH TO THOSE OUT OF CARE, 4) EDUCATIONAL AND THERAPEUTIC SUPPORT GROUPS, 5) REFERRAL SERVICES AND ASSISTANCE WITH ACCESSING PUBLIC BENEFITS, 6) HOUSING SERVICES, 7) TRANSPORTATION ASSISTANCE TO MEDICAL APPOINTMENTS, 8) FOOD ASSITANCE, AND 9) INTERPRETING SERVICES. ALL SUPPORT SERVICES ARE PROVIDED AT NO COST TO THE PATIENT. 368542 AFFINITY HEALTH CENTER (AHC) PROVIDES HEALTH EDUCATION SERVICES TO THE COMMUNITY WHICH INCLUDE INFORMATION ABOUT HIV AND OTHER SEXUALLY TRANSMITTED DISEASES. AHC PROVIDES FREE, CONFIDENTIAL, RAPID (20 MINUTE) HIV AND HEPATITIS C SCREENING AS WELL AS FREE SCREENING FOR OTHER SEXUALLY TRANSMITTED DISEASES. AHC ASSISTS WITH ACCESSING PREP SERVICES TO PREVENT HIV. AHC HAS A PEER PROGRAM THAT UTILIZES PEOPLE LIVING WITH HIV TO PROVIDE SUPPORT TO OTHERS LIVING WITH THIS DISEASE, HIV. ALL PREVENTION SERVICES ARE PROVIDED AT NO COST TO THE RECIPIENT. 19104769 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 43 0 122 1 0 0 0 0 0 0 0 0 0 0 0 0 X 14 14 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 SC X X X BRYAN C MARTIN 8039099718 455 LAKESHORE PARKWAY ROCK HILL SC 29730 JENNIFER MCDANIEL BOARD SECRETARY 1.00 X X 0 0 0 DWIGHT BURNS BOARD CHAIR 1.00 X X 0 0 0 SUZANNE WRIGHT DIRECTOR 1.00 X 0 0 0 JARVIS HAMLIN DIRECTOR 1.00 X 0 0 0 SALLY BAKER BOARD TREASURER 1.00 X X 0 0 0 JOE TERRIOUS NEAL DIRECTOR 1.00 X 0 0 0 STEPHEN COOLEY DIRECTOR 1.00 X 0 0 0 RONNIE DUNCAN BOARD VICECHAIR 1.00 X X 0 0 0 NINA FEEMSTER DIRECTOR 1.00 X 0 0 0 ANTHONY HILL DIRECTOR 1.00 X 0 0 0 AMY NEWTON DIRECTOR 1.00 X 0 0 0 TED GARCIA DIRECTOR 1.00 X 0 0 0 DAPHNE CARTER DIRECTOR 1.00 X 0 0 0 ADALI GUTIERREZ PEREZ DIRECTOR 1.00 X 0 0 0 ANITA CASE CHIEF EXECUTIVE OFFICER 40.00 X 151221 0 7116 BRYAN MARTIN CHIEF FINANCIAL OFFICER 40.00 X 110956 0 7601 DARLENE CHRISMON-WASHINGTON PSYCHIATRIC NURSE PRACTITIONER 40.00 X 137244 0 13372 J CRAIG CHARLES CHIEF MEDICAL OFFICER 40.00 X 253828 0 12099 SUSAN COLLINS DENTIST 40.00 X 155401 0 14116 RHONNIE SONG PHYSICIAN 40.00 X 176877 0 2583 BRITTANY WATSON PHYSICIAN 40.00 X 222028 0 5366 1207555 0 62253 10 0 1 0 LABORATORY CORPORATION OF AMERICA PO BOX 2270 BURLINGTON NC 27216 MEDICAL LAB SERVICES 493613 SERVCOM USA LLC 3284 LAKE WYLIE DRIVE ROCK HILL SC 29730 INFORMATION TECHNOLOGY SERVICES 200863 MEDCLAIM COMPREHENSIVE 18264 LAKE HARBOR LANE PRAIRIEVILLE LA 70769 REVENUE CYCLE CONSULTING 123084 3 5432599 470876 51115 5903475 340B PHARMACY REV 624100 13031847 13031847 PATIENT SERVICE REV 624100 1621594 1621594 14653441 602 602 37738 0 37738 37738 37738 MISC. REVENUE 621400 58889 58889 58889 20654145 14712330 0 38340 X 1313950 1313950 253685 217810 35425 450 4647633 4241749 400152 5732 554090 503375 49983 732 356278 323457 32622 199 34598 34598 30756 30756 2884158 2864594 19548 16 29692 3914 25778 152901 133075 19638 188 346736 313819 32461 456 157631 138469 18932 230 12552 2283 10269 39231 29574 9631 26 72184 61497 10580 107 426970 379836 47027 107 36556 28651 7859 46 PHARMACEUTICALS 7932619 7932619 SUPPLIES 503975 494384 9543 48 OTHER 170285 121713 48506 66 19956480 19104769 843308 8403 6254096 6850041 1019079 965901 1022058 1057882 115779 95019 112710 129912 8648762 1502027 7561321 7146735 4726385 4975360 20811428 21220850 1662626 1717325 534025 319167 2018565 1610750 4215216 3647242 X 16596212 17573608 16596212 17573608 20811428 21220850 697665 279731 0 X X 0 1 X 1 1 1 X 3786577 3769554 3906068 5823703 5903475 23189377 18738 21600 21600 22950 22950 107838 3805315 3791154 3927668 5846653 5926425 23297215 23297215 697 22787 38515 35062 38340 135401 7738 3981 52703 58889 123311 23555927 56955716 0.98900 0.99210 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 284126 284126 7200084 715715 6484369 65772 26674 39098 1098780 759638 339142 7146735 X 20692842 88315 88315 20604527 49618 49618 20654145 20044795 88315 88315 19956480 0 19956480 PART X, LINE 2: AFFINITY HEALTH CENTER IS EXEMPT FROM INCOME TAX UNDER INTERNAL REVENUE CODE SECTION 501(C)(3), AND IS NOT CLASSIFIED AS A PRIVATE FOUNDATION. AFFINITY HEALTH CENTER'S INCOME TAX RETURNS ARE SUBJECT TO REVIEW AND EXAMINATION BY FEDERAL, STATE, AND LOCAL AUTHORITIES. THE ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX-EXEMPT STATUS. THE ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME OR EXCISE OF OTHER TAXES. GENERALLY ACCEPTED ACCOUNTING PRINCIPLES REQUIRE AN ORGANIZATION TO RECOGNIZE A TAX BENEFIT OR EXPENSE FROM UNCERTAIN TAX POSITION IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY THE TAX AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. MANAGEMENT BELIEVES THE ORGANIZATION HAD NO UNCERTAIN TAX POSITIONS AS OF DECEMBER 31, 2021 OR 2020. PART XI, LINE 4B - OTHER ADJUSTMENTS: LOSS ON ASSET DISPOSAL MISCELLANEOUS INCOME 49,016. INTEREST INCOME 602. 1 OFF-SITE SPECIALTY CARE VISITS 494 40007 FMV MEDICATIONS 423 18510 FMV INSURANCE PREMIUMS/COPAYS 470 1138822 FMV MEDICAL SUPPLIES 94 18721 FMV HOUSING 23 17874 FMV TRANSPORTATION 286 17809 FMV FOOD ASSISTANCE, TRANSLATOR SERVICES, OTHER ASSISTANCE 362 62207 FMV PART I, LINE 2: AFFINITY HEALTH CENTER PROVIDES ASSISTANCE TO CLIENTS BASED ON NEED FOR EXPENSES SUCH AS SPECIALTY CARE, MEDICATIONS, HOUSING, INSURANCE PREMIUMS, EMERGENCY FOOD, AND TRANSPORTATION TO MEDICAL APPOINTMENTS. PAYMENTS ARE MADE DIRECTLY TO OUTSIDE SERVICE PROVIDERS RATHER THAN TO CLIENTS. AHC REQUIRES SUPERVISORY APPROVAL OF ALL PAYMENT REQUESTS. THE FINANCE DEPARTMENT VERIFIES APPROPRIATE DOCUMENTATION IS SUBMITTED FOR EXPENDITURES. PRIOR TO SIGNING CHECKS, THE CHIEF EXECUTIVE OFFICER REVIEWS ALL DOCUMENTATION TO ENSURE APPROPRIATE USE OF FUNDS. AN OFFICER OF THE BOARD OF DIRECTORS SIGNS OFF ON ANY PAYMENTS OVER $5,000. X X X 0 0 0 0 0 0 0 0 0 J CRAIG CHARLES CHIEF MEDICAL OFFICER 243095 0 10733 0 0 0 0 0 12099 0 265927 0 0 0 BRITTANY WATSON PHYSICIAN 203773 0 18255 0 0 0 0 0 5366 0 227394 0 0 0 RHONNIE SONG PHYSICIAN 166999 0 9878 0 0 0 0 0 2583 0 179460 0 0 0 SUSAN COLLINS DENTIST 151470 0 3931 0 0 0 0 0 14116 0 169517 0 0 0 ANITA CASE CHIEF EXECUTIVE OFFICER 146975 0 4246 0 0 0 0 0 7116 0 158337 0 0 0 DARLENE CHRISMON-WASHINGTON PSYCHIATRIC NURSE PRACTITIONER 127275 0 9969 0 0 0 0 0 13372 0 150616 0 0 0 X VACINNES - VFC 12 23939 COST X PROGRAM SUPPLIES 8 16096 COST X GIFT CARDS 3 11080 COST 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B ORGANIZATION'S FORM 990 IS GIVEN ANNUALLY TO THE ENTIRE BOARD FOLLOWING REVIEW BY MANAGEMENT IN ITS ENTIRETY FOR FULL REVIEW. FORM 990, PART VI, SECTION B, LINE 12C AFFINITY HEALTH CENTER (AHC) HAS A CONFLICT OF INTEREST POLICY WHICH IS REVIEWED WITH NEW BOARD MEMBERS DURING BOARD ORIENTATION. AT THAT TIME BOARD MEMBERS INDICATE IN WRITING ANY CONFLICTS OF INTEREST WITH AHC. OFFICERS AND DIRECTORS ARE REQUIRED TO DISCLOSE ON AN ANNUAL BASIS ANY POTENTIAL CONFLICTS OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15 AFFINITY HEALTH CENTER (AHC) HIRED AN INDEPENDENT HUMAN RESOURCES CONSULTANT IN 2020 TO CONDUCT A SALARY SURVEY AND RECOMMEND SALARY RANGES FOR ALL POSITIONS INCLUDING THE CHIEF EXECUTIVE OFFICER (CEO). IN 2020 AHC'S BOARD OF DIRECTORS APPROVED THE REVISED RANGES. THE ANNUAL PERFORMANCE REVIEWS FOR OTHER OFFICERS OR KEY EMPLOYEES IS CONDUCTED IN ACCORDANCE WITH AHC POLICY BY APPROPRIATE SUPERVISOR. DETERMINATION OF ANNUAL COMPENSATION ADJUSTMENTS WITH IN APPROVED RANGES IS DETERMINED BY THE CEO. FORM 990, PART VI, SECTION C, LINE 19 AFFINITY HEALTH CENTER PROVIDES THESE DOCUMENTS TO THE PUBLIC UPON REQUEST. FORM 990, PART IX, LINE 11G PHYSICIAN ON-SITE: PROGRAM SERVICE EXPENSES 5,500. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 5,500. DENTIST ON-SITE: PROGRAM SERVICE EXPENSES 37,013. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 37,013. LAB SERVICES: PROGRAM SERVICE EXPENSES 476,749. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 476,749. 340B PROGRAM CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 2,121,039. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,121,039. OTHER PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 224,293. MANAGEMENT AND GENERAL EXPENSES 19,548. FUNDRAISING EXPENSES 16. TOTAL EXPENSES 243,857. FORM 990, PART XII, LINE 2C THE PROCESS HAS NOT CHANGED FROM PRIOR YEAR.