2022-11-14T07:55:11-06:00 2021-12-31 FORVIS LLP 312 WALNUT STREET SUITE 3000 CINCINNATI OH 45202 990 2021-01-01 812171085 MY COMMUNITY HEALTH CENTER % KELLY LORENZ MYCO 3303636242 2600 7TH STREET SW CANTON OH 44710 KELLY LORENZ CFO 3303636242 2022-11-15 true Kelly Lorenz 999009999 Aaron Hershberger P00961884 5136218300 2 2021 2022-09-23 18:48:47Z TERRY REGULA 2600 7TH STREET SW CANTON OH 44710 8459363 false X WWW.MYCOMHC.ORG X 2016 OH TO PROVIDE COMPASSIONATE CARE TO ALL; HEALING AND LEARNING TOGETHER. 11 11 96 9 0 3891548 3355795 3951109 5000515 5650 0 19 103053 7848326 8459363 0 0 0 0 4004014 4398189 0 0 0 2819382 3014433 6823396 7412622 1024930 1046741 3081082 4110237 490049 472463 2591033 3637774 X MY COMMUNITY HEALTH CENTER (MCHC) IS A GRASSROOTS, COMMUNITY-BASED 501(C)(3) OHIO NONPROFIT ORGANIZATION WHOSE MISSION IS TO PROVIDE COMPASSIONATE CARE TO ALL, HEALING AND LEARNING TOGETHER. MCHC'S GOAL IS TO BE RESPONSIVE TO THE NEEDS OF THE COMMUNITIES IT SERVES, BUT WITH CONTINUED EMPHASIS ON THE UNDERSERVED AND THOSE WITHOUT ACCESS TO CARE, REGARDLESS OF RACE, ECONOMIC STATUS, AGE, SEX, SEXUAL ORIENTATION, OR DISABILITY. false false 5459084 5000515 My Community Health Center (MCHC) is a grassroots, community based 501(c)(3) Ohio nonprofit organization whose mission is to provide compassionate care to all, healing and learning together. MCHC's goal is to be responsive to the needs of the communities it serves, but with continued emphasis on the underserved and those without access to care, regardless of race, economic status, age, sex, sexual orientation, or disability. MCHC established itself as a community clinic site in August 2017 and has been active as a Community Health Care provider since. The organization believes in training the next generation of health care providers. As such, MCHC has established a relationship with three residency programs for their residents to provide outpatient, continuity of care at MCHC: Internal Medicine, Family Medicine & Obstetrics and Gynecology. The Internal Medicine also provides a rich learning environment for pharmacy residents. In addition to providers, MCHC is a clinical site for nursing and medical assistant students. In September 2019, MCHC received full designation from the Federal Health Resources and Services Administration (HRSA) to be Federally Qualified Health Center. In 2021, MCHC underwent an Operational Site Visit from Health Resources and Services Administration (HRSA). The survey's outcome was a report from HRSA with no findings. Services provided by MCHC include Family Practice, Internal Medicine, Prenatal Services, Postpartum Care, Well Child & Pediatric Care, screenings, Chronic Disease Management, Dental Care (by referral), Laboratory, Behavioral Health (including individuals/groups), Family Planning, Outreach, Health Education (including nutrition), Eligibility Assistance, and Case Management. These outpatient primary health services are provided to the medically underserved populations in stark county, Ohio and surrounding communities. The organization received approval to open a second site in Magnolia, Ohio, a HRSA designated underserved area in September 2019. This fully functioning satellite office began operations in January 2020 and provides most of the same health center services as described above. In March of 2020 to meet the challenging issues of COVID-19 with our patients, MCHC added telehealth services and in 2021 we continued to provide this service and provided close to 3,800 telehealth visits. In total for 2021, MCHC provided care to approximately 10,300 patients with close to 32,100 medical visits. Since Federally Qualified Health Care Centers were one of the first providers of the COVID-19 vaccination, MCHC began providing the Moderna vaccine to their patients and the community beginning in January 2021 through April. COVID-19 vaccination clinics were held at both locations, canton and magnolia and were held during the week and on Saturdays. In Magnolia, we held the Saturday clinic at Sandy Valley School. During this time period, we administered over 4,200 vaccines. We had 8 volunteers assisting us with this service to our patients and the community. In addition to specific vaccine clinics, MCHC continues to administer COVID-19 vaccines throughout the year. Total vaccines administered to patients and the community in 2021 overall were close to 5,100. To improve safety within the workplace, we implemented COVID-19 vaccine mandates for our employees as well as Occupational Safety and Health Administration (OSHA) Emergency Temporary Standards. MCHC employs more than 70 employees, many from the local community. staff are fluent in English, Spanish, and American sign language (contracted translation services for other languages) and effective at working with people at all levels of literacy. Our Obstetrical Program is unique in the fact that we are the largest OB provider for Medicaid patients in stark county. Due to the ongoing pandemic, MCHC had to suspend the Centering Program. Community collaboration is important to MCHC. Below is a brief description of collaborations with community partners: OB department collaborates with stark county and canton city health departments on the thrive initiative to reduce infant mortality. The internal medicine division collaborates with access health to provide community health workers for high-risk diabetics in the practice. MCHC collaborates with beacon pharmacy to provide prescription medications at a reduced cost to patients. In September 2021, MCHC's Canton location received accreditation from the National Committee for Quality Assurance (NCQA) as a Patient Centered Medical Home (PCMH). This designation demonstrates our commitment to improving the quality of health care for our patients. In 2021, we made several improvements to our information technology infrastructure. We initiated a Quality information software and patient registration software. We invested in upgrading our financial reporting software as well as our payroll software. The software upgrades allow us to provide additional services for stakeholders while improving efficiencies. Participation in community events was limited in 2021 due to the pandemic. MCHC's staff participated in community and a back-to school event in an impoverished neighborhood. Collaboration with the City of Canton, Canton for All People, and Stark Fresh resulted in a plan to open a combination health center and grocery store in an area of Canton which is a food and health care desert. Plans are being finalized. The opening of the new site is most likely going to be in 2023. 5459084 true true false false false false false false false false true false false false false false true false false false false false false false false false false false false true false false false false false false false false false false false false false false false false false true 8 0 96 true false false false false false false false false false false false false X 11 11 false false false false false false false true true false false true true true true true true true false false X KELLY LORENZ 3303631310 2600 7TH STREET SW CANTON OH 44710 JOHN SUTTON MD CMO 40.0 0.0 X 233025 0 18658 TERRY REGULA CEO 40.0 0.0 X 206311 0 24080 ROBIN KOLLMAN MD PHYSICIAN 40.0 0.0 X 186192 0 17814 KELLY LORENZ CFO 40.0 0.0 X 102612 0 9368 MARIA HEEGE PRESIDENT 1.0 0.0 X X 0 0 0 CYRILIA PRATT SECRETARY 1.0 0.0 X X 0 0 0 SUSAN MERCER MD TREASURER 1.0 0.0 X X 0 0 0 JAMES ANDERSON DIRECTOR 1.0 0.0 X 0 0 0 MAUREEN ATER DIRECTOR 1.0 0.0 X 0 0 0 RENEE BACKIE DIRECTOR 1.0 0.0 X 0 0 0 STEVE JACKSON DIRECTOR - TERM ENDED 1.0 0.0 X 0 0 0 LINDA MUIR DIRECTOR 1.0 0.0 X 0 0 0 SATYNNE PYLES DIRECTOR 1.0 0.0 X 0 0 0 KEVIN SMITH DIRECTOR 1.0 0.0 X 0 0 0 ELONDA WILLIAMS DIRECTOR 1.0 0.0 X 0 0 0 LINDA WOODLOCK DIRECTOR - TERM ENDED 1.0 0.0 X 0 0 0 JEFFREY ZELLERS DIRECTOR 1.0 0.0 X 0 0 0 728140 0 69920 4 false true false ALLSCRIPTS HEALTHCARE LLC 24630 NETWORK PLACE CHICAGO IL 60673 EHR HOST, BILL SRV 459843 AULTMAN HEALTH FOUNDATION 2600 6TH STREET SW CANTON OH 44710 MASTER SVC AGREEMENT 895285 AULTMAN HOSPITAL 2600 6TH STREET SW CANTON OH 44710 PHY PRECEPTORS 944172 CANTOM MEDICAL EDUCATION FOUNDATION 2600 - 6TH STREET SW CANTON OH 44710 PHY PRECEPTORS 115503 4 1054321 2301474 3355795 PATIENT SERVICE REVENUE 621400 4861864 4861864 QUALITY INCENTIVE REVENUE 621400 138651 138651 5000515 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Other Revenue 900099 103053 103053 103053 8459363 5000515 103053 0 0 0 0 594054 490247 103807 0 2985149 2455044 530105 75816 64805 11011 447707 382684 65023 295463 252551 42912 0 12000 12000 59788 59788 0 0 0 1669193 1079089 590104 0 5862 5862 152811 98788 54023 96405 62323 34082 0 356854 356854 3052 3052 0 2894 2894 0 0 70669 51553 19116 76645 37964 38681 Medications 171678 171678 MEDICAL SUPPLIES & EQUIPMENT 268055 268055 Other Expenses 68527 44301 24226 7412622 5459084 1953538 0 2251742 3209204 0 0 0 143015 470226 436854 0 0 0 0 0 0 35825 52050 39042 49838 339521 120245 284247 219276 0 0 0 0 0 0 0 0 0 0 3081082 4110237 490049 472463 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 490049 472463 X 2369663 3524849 221370 112925 2591033 3637774 3081082 4110237 1046741 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 333824 120042 213782 5697 203 5494 219276 8459363 8459363 8459363 7412622 7412622 7412622 X X X X false false false false false false false false false JOHN SUTTON MD CMO 229735 0 2600 0 690 0 6788 0 11870 0 251683 0 TERRY REGULA CEO 194650 0 10000 0 1661 0 24080 0 0 0 230391 0 ROBIN KOLLMAN MD PHYSICIAN 186192 0 0 0 0 0 4604 0 13210 0 204006 0 SCHEDULE J, PART I, LINE 3 COMPENSATION OF CEO THE BOARD OF DIRECTORS DECIDES AND APPROVES THE CEO'S COMPENSATION. THE COMPENSATION IS THEN REVIEWED BY THE HUMAN RESOURCES MANAGER. FORM 990, PART VI, SECTION B, LINE 11B PROCESS TO REVIEW THE FORM 990 THE FORM 990 WAS PREPARED BY AN INDEPENDENT CPA FIRM BASED ON INFORMATION PROVIDED BY THE ORGANIZATION'S CFO. THE CEO AND CFO CAREFULLY REVIEWED AND ANALYZED THE TAX RETURN, RECONCILING THE GENERAL LEDGER AMOUNTS TO THE APPROPRIATE SCHEDULES ON THE FORM 990 AND COMPARING THOSE AMOUNTS TO THE AUDITED FINANCIAL STATEMENTS. A COMPLETE COPY OF THE 990 WAS THEN SENT VIA EMAIL TO THE BOARD OF DIRECTORS FOR THEIR REVIEW PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C ORGANIZATION'S PRACTICE FOR MONITORING COMPLIANCE THE ORGANIZATION'S CONFLICT OF INTEREST POLICY APPLIES TO CLINIC BOARD MEMBERS, EMPLOYEES, CONSULTANTS AND THOSE WHO FURNISH GOODS OR SERVICES TO THE ORGANIZATION. EACH BOARD MEMBER IS REQUIRED TO COMPLETE A CERTIFICATION OF AGREEMENT WITH THE CONFLICT OF INTEREST POLICY AND DISCLOSE ANY KNOWN CONFLICTS OF INTEREST UPON HIS OR HER ELECTION OR REELECTION TO THE BOARD AND ANNUALLY THEREAFTER. WHENEVER THE CHIEF EXECUTIVE OFFICER, KEY MANAGEMENT PERSONNEL OR ANY BOARD MEMBER HAS A CONFLICT OF INTEREST OR A PERCEIVED CONFLICT OF INTEREST WITH MCHC, HE OR SHE IS REQUIRED TO NOTIFY THE FULL BOARD OF SUCH CONFLICT IN WRITING USING THE ANNUAL CERTIFICATION FORM. WHEN ANY CONFLICT OF INTEREST IS RELEVANT TO A MATTER THAT COMES UNDER CONSIDERATION OR REQUIRES ACTION BY THE BOARD, OR A BOARD COMMITTEE, THE INTERESTED PERSON IS REQUIRED TO CALL IT TO THE ATTENTION OF THE BOARD CHAIR AND MUST LEAVE THE MEETING DURING BOARD OR COMMITTEE DISCUSSION OR DECISION ON THE MATTER. HOWEVER, THAT PERSON IS ALLOWED TO PROVIDE THE BOARD OR APPLICABLE COMMITTEE WITH ANY AND ALL RELEVANT INFORMATION ON THE PARTICULAR MATTER. BOARD MEMBERS WHO VIOLATE THE CONFLICT OF INTEREST POLICY MAY, DEPENDING ON THE SEVERITY OF THE VIOLATION, BE SUBJECT TO ORAL ADMONISHMENT OR REMOVAL FROM THEIR POSITION. FORM 990, PART VI, SECTION B, LINE 15A COMPENSATION REVIEW PROCESS FOR THE CEO THE ANNUAL REVIEW FOR THE CEO WAS DONE IN JULY OF 2021. THE BOARD OF DIRECTORS DECIDES AND APPROVES THE CEO'S COMPENSATION. THE COMPENSATION IS THEN REVIEWED BY THE HUMAN RESOURCE MANAGER. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF INTEREST, AND FINANCIAL STATEMENTS MY COMMUNITY HEALTH CENTER MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST FORM 990 PART IX LINE 11G DESCRIPTION:OTHER FEES FOR SERVICE TOTAL FEES:1669193