CHRIST HEALTH CENTER INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- CHRIST HEALTH CENTER INC (EIN 20-1935552)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-10-28
- IRS object ID
- 202213019349300041
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-10-28T09:58:59-05:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 630590670 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Kassouf & Co PC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2101 Highland Ave S Suite 300 | AddressLine1Txt |
| City | Birmingham | CityNm |
| State Abbreviation | AL | StateAbbreviationCd |
| ZIP | 352054009 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 201935552 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Christ Health Center Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CHRI | BusinessNameControlTxt |
| Phone | 2053809455 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5720 1st Ave S | AddressLine1Txt |
| City | Birmingham | CityNm |
| State Abbreviation | AL | StateAbbreviationCd |
| ZIP | 352122522 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Robert Rex Record | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 2053809455 | PhoneNum |
| Signature | 2022-08-22 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | Robert | PersonFirstNm |
| Person Last | Rex Record | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | William P Bach | PreparerPersonNm |
| PTIN | P01315784 | PTIN |
| Phone | 2054432500 | PhoneNum |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Robert Rex Record | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5720 1st Ave S | AddressLine1Txt |
| City | Birmingham | CityNm |
| State Abbreviation | AL | StateAbbreviationCd |
| ZIP | 352122522 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $18,759,436 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.christhealthcenter.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2004 | FormationYr |
| Legal Domicile State | AL | LegalDomicileStateCd |
| Activity Or Mission | We demonstrate the love and power of Jesus Christ by providing excellent, affordable healthcare and participating in the development of the communities we serve. | ActivityOrMissionDesc |
| Voting Members Governing Body | 15 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 15 | VotingMembersIndependentCnt |
| Total Employee | 177 | TotalEmployeeCnt |
| Total Volunteers | 8 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $5,241,064 | PYContributionsGrantsAmt |
| CY Contributions Grants | $5,414,818 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $10,239,725 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $12,048,841 | CYProgramServiceRevenueAmt |
| PY Investment Income | $21,099 | PYInvestmentIncomeAmt |
| CY Investment Income | $5,892 | CYInvestmentIncomeAmt |
| PY Other Revenue | $228,762 | PYOtherRevenueAmt |
| CY Other Revenue | $1,289,885 | CYOtherRevenueAmt |
| PY Total Revenue | $15,730,650 | PYTotalRevenueAmt |
| CY Total Revenue | $18,759,436 | 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 | $7,715,169 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $8,458,533 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $4,943,413 | PYOtherExpensesAmt |
| CY Other Expenses | $5,381,121 | CYOtherExpensesAmt |
| PY Total Expenses | $12,658,582 | PYTotalExpensesAmt |
| CY Total Expenses | $13,839,654 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $3,072,068 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $4,919,782 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $11,653,363 | TotalAssetsBOYAmt |
| Total Assets EOY | $15,647,506 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,421,958 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $318,601 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $10,231,405 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $15,328,905 | NetAssetsOrFundBalancesEOYAmt |
| Mission | We demonstrate the love and power of Jesus Christ by providing excellent, affordable healthcare and participating in the development of the communities we serve. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $10,665,597 | ExpenseAmt |
| Revenue | $10,228,722 | RevenueAmt |
| Desc | To provide medical and dental services to the indigent and uninsured. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,446,222 | ExpenseAmt |
| Revenue | $3,110,004 | RevenueAmt |
| Desc | To provide a pharmacy to the indigent and uninsured. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $12,111,819 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | 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 | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 24 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 177 | 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 | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| 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 | 15 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 15 | 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 | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | AL | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Robert R Record | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2053809455 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5720 First Avenue South | AddressLine1Txt |
| City | Birmingham | CityNm |
| State Abbreviation | AL | StateAbbreviationCd |
| ZIP | 352122522 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (26 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 |
|---|---|---|---|---|---|---|---|
| Robert R Record MD | |||||||
| CEO/Physician | 40.00 | Yes (X) | Yes (X) | $250,000 | $0 | $6,635 | |
| Elizabeth Livesay | |||||||
| Chief Financial Officer | 40.00 | Yes (X) | Yes (X) | $43,727 | $0 | $5,510 | |
| Elizabeth Fourie | |||||||
| Chief Revenue Officer | 40.00 | Yes (X) | Yes (X) | $127,462 | $0 | $10,678 | |
| Amelia Morton Haueter CRNP | |||||||
| Chief Medical Officer | 40.00 | Yes (X) | Yes (X) | $160,000 | $0 | $15,115 | |
| Brant McDuffie | |||||||
| Chairman | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Steve Blair | |||||||
| Vice Chair | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Tracy Hipps | |||||||
| Secretary | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Stephen J Rowe | |||||||
| Treasurer | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Gil Murdock | |||||||
| Director | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| Stephen Thomas DMD | |||||||
| Director | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| Shannon Riley | |||||||
| Director | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| Dilma Carter | |||||||
| Director | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| Tarana Billups | |||||||
| Director | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| John O'Neil | |||||||
| Director | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| Mike Flink | |||||||
| Director | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| Robert Yoe | |||||||
| Director | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| Marion H Sims | |||||||
| Program Director | 40.00 | Yes (X) | Yes (X) | $235,978 | $0 | $19,371 | |
| Courtney Winston | |||||||
| Director | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| Barry Howton | |||||||
| Director | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| Cory Harris | |||||||
| Chief Operating Officer | 40.00 | Yes (X) | Yes (X) | $138,000 | $0 | $16,432 | |
| Christson Adedoyin | |||||||
| Director | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| Gavin Brunsvold | |||||||
| Employee | 40.00 | $276,500 | $0 | $20,587 | Yes (X) | ||
| English H Gonzales | |||||||
| Employee | 40.00 | $215,308 | $0 | $11,925 | Yes (X) | ||
| Cleon L Rogers | |||||||
| Employee | 40.00 | $206,615 | $0 | $18,490 | Yes (X) | ||
| Charles Henry Davis III | |||||||
| Employee | 40.00 | $253,423 | $0 | $19,606 | Yes (X) | ||
| David Villanueva | |||||||
| Employee | 40.00 | $189,962 | $0 | $16,910 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,096,975 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $161,259 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 17 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $4,257,787 | GovernmentGrantsAmt |
| All Other Contributions | $1,157,031 | AllOtherContributionsAmt |
| Total Contributions | $5,414,818 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Medical Collections | 621110 | $8,103,471 | $8,103,471 |
| Pharmacy Collections | 541511 | $3,110,004 | $3,110,004 |
| Contract Revenues | 621110 | $830,151 | $830,151 |
| Dental Collections | 621110 | $5,215 | $5,215 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $12,048,841 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,892 | TotalRevenueColumnAmt |
| Exclusion | $5,892 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Debt Forgiveness | 900099 | $1,110,100 | $1,110,100 |
| Incentives | 900099 | $111,665 | $111,665 |
| Rent | 900099 | $48,000 | $48,000 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $20,120 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $20,120 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $1,289,885 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $18,759,436 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $13,338,726 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $5,892 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $719,189 | TotalAmt |
| Program Services | $719,189 | ProgramServicesAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,499,020 | TotalAmt |
| Program Services | $5,408,189 | ProgramServicesAmt |
| Management And General | $1,090,831 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $722,450 | TotalAmt |
| Program Services | $594,289 | ProgramServicesAmt |
| Management And General | $128,161 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $517,874 | TotalAmt |
| Program Services | $436,753 | ProgramServicesAmt |
| Management And General | $81,121 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $297,490 | TotalAmt |
| Program Services | $184,703 | ProgramServicesAmt |
| Management And General | $112,787 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $80,259 | TotalAmt |
| Program Services | $80,259 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $143,586 | TotalAmt |
| Program Services | $34,264 | ProgramServicesAmt |
| Management And General | $109,322 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $124,668 | TotalAmt |
| Program Services | $118,435 | ProgramServicesAmt |
| Management And General | $6,233 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $551,789 | TotalAmt |
| Program Services | $529,578 | ProgramServicesAmt |
| Management And General | $22,211 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $66,401 | TotalAmt |
| Program Services | $66,401 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $417,708 | TotalAmt |
| Program Services | $396,823 | ProgramServicesAmt |
| Management And General | $20,885 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $161,575 | TotalAmt |
| Program Services | $107,825 | ProgramServicesAmt |
| Management And General | $53,750 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| Pharmacy expenses | $1,460,742 | $1,460,742 |
| Billing | $589,892 | $589,892 |
| Dental and medical supp | $544,426 | $544,426 |
| Bad debt expense | $280,505 | $280,505 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $662,080 | TotalAmt |
| Program Services | $559,546 | ProgramServicesAmt |
| Management And General | $102,534 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,839,654 | TotalAmt |
| Program Services | $12,111,819 | ProgramServicesAmt |
| Management And General | $1,727,835 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,685,186 | BOYAmt |
| EOY | $8,350,894 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $40,765 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $637,824 | BOYAmt |
| EOY | $1,119,132 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $211,947 | BOYAmt |
| EOY | $306,201 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $100,753 | BOYAmt |
| EOY | $87,252 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $7,377,700 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,634,438 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,017,653 | BOYAmt |
| EOY | $5,743,262 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,653,363 | BOYAmt |
| EOY | $15,647,506 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $224,359 | BOYAmt |
| EOY | $268,001 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $87,499 | BOYAmt |
| EOY | $50,000 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,110,100 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $600 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,421,958 | BOYAmt |
| EOY | $318,601 | 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 | $10,231,405 | BOYAmt |
| EOY | $15,228,905 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $100,000 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,231,405 | BOYAmt |
| EOY | $15,328,905 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,653,363 | BOYAmt |
| EOY | $15,647,506 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $4,919,782 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $9,212 | NetUnrlzdGainsLossesInvstAmt |
| Donated Services And Use Fclts | $168,505 | DonatedServicesAndUseFcltsAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| 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) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,832,505 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,001,585 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,561,335 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $5,241,064 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $5,414,818 | CurrentTaxYearAmt |
| Total | $19,051,307 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,832,505 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,001,585 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,561,335 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $5,241,064 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $5,414,818 | CurrentTaxYearAmt |
| Total | $19,051,307 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $19,051,307 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $967 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,027 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $25,153 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $21,099 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $5,892 | CurrentTaxYearAmt |
| Total | $57,138 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $19,108,445 | TotalSupportAmt |
| Public Support CY170 | 0.99700 | PublicSupportCY170Pct |
| Public Support PY170 | 0.99660 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $455,810 | OtherCostOrOtherBasisAmt |
| Book Value | $455,810 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,960,212 | OtherCostOrOtherBasisAmt |
| Depreciation | $183,891 | DepreciationAmt |
| Book Value | $3,776,321 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $359,889 | OtherCostOrOtherBasisAmt |
| Depreciation | $91,488 | DepreciationAmt |
| Book Value | $268,401 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,601,789 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,359,059 | DepreciationAmt |
| Book Value | $1,242,730 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $5,743,262 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Garnishments | Desc |
| Amt | $600 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $600 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $18,973,263 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $9,212 | NetUnrealizedGainsInvstAmt |
| Donated Services And Use Fclts | $204,616 | DonatedServicesAndUseFcltsAmt |
| Revenue Not Reported | $213,828 | RevenueNotReportedAmt |
| Revenue Subtotal | $18,759,435 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $18,759,435 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $13,875,763 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $36,111 | DonatedServicesUseFcltsAmt |
| Expenses Not Reported | $36,111 | ExpensesNotReportedAmt |
| Expenses Subtotal | $13,839,652 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $13,839,652 | TotalExpensesPerForm990Amt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 (9 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Gavin Brunsvold | ||||||||||||||
| Employee | $276,500 | $0 | $0 | $0 | $0 | $0 | $8,295 | $0 | $12,292 | $0 | $297,087 | $0 | $0 | $0 |
| Charles Henry Davis III | ||||||||||||||
| Employee | $253,423 | $0 | $0 | $0 | $0 | $0 | $7,314 | $0 | $12,292 | $0 | $273,029 | $0 | $0 | $0 |
| Robert R Record MD | ||||||||||||||
| CEO/Physician | $250,000 | $0 | $0 | $0 | $0 | $0 | $6,635 | $0 | $0 | $0 | $256,635 | $0 | $0 | $0 |
| Marion H Sims | ||||||||||||||
| Program Director | $235,978 | $0 | $0 | $0 | $0 | $0 | $7,079 | $0 | $12,292 | $0 | $255,349 | $0 | $0 | $0 |
| English H Gonzales | ||||||||||||||
| Employee | $215,308 | $0 | $0 | $0 | $0 | $0 | $6,439 | $0 | $5,486 | $0 | $227,233 | $0 | $0 | $0 |
| Cleon L Rogers | ||||||||||||||
| Employee | $206,615 | $0 | $0 | $0 | $0 | $0 | $6,198 | $0 | $12,292 | $0 | $225,105 | $0 | $0 | $0 |
| David Villanueva | ||||||||||||||
| Employee | $189,962 | $0 | $0 | $0 | $0 | $0 | $4,618 | $0 | $12,292 | $0 | $206,872 | $0 | $0 | $0 |
| Amelia Morton Haueter CRNP | ||||||||||||||
| Chief Medical Officer | $160,000 | $0 | $0 | $0 | $0 | $0 | $4,800 | $0 | $10,315 | $0 | $175,115 | $0 | $0 | $0 |
| Cory Harris | ||||||||||||||
| Chief Operating Officer | $138,000 | $0 | $0 | $0 | $0 | $0 | $4,140 | $0 | $12,292 | $0 | $154,432 | $0 | $0 | $0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section B, line 11b | A final draft of the tax return will be circulated to the Board of Directors for its review and recommendation to the full board. |
| Form 990, Part VI, Section B, line 12c | An annual review is conducted of the board members' professional relationships and results are reported to the Chair and Secretary. |
| Form 990, Part VI, Section C, line 19 | The organization's governing documents, conflict of interest policy, and financial statements are available to the public on site with a three day advance notice. |
| Form 990, Part XII, Line 2c | There have been no changes to the Organization's oversight or selection process during the tax year. |