NEIGHBORHOOD HEALTH CENTER: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- NEIGHBORHOOD HEALTH CENTER (EIN 27-3524752)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-11-14
- IRS object ID
- 202223189349317437
- 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 | 2022-11-14T17:12:00-06:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 910189318 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MOSS ADAMS LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 805 SW BROADWAY STE 1200 | AddressLine1Txt |
| City | PORTLAND | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97205 | 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 | 273524752 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NEIGHBORHOOD HEALTH CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | NEIG | BusinessNameControlTxt |
| Phone | 5039413033 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7320 SW HUNZIKER ROAD SUITE 300 | AddressLine1Txt |
| City | PORTLAND | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97223 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | BLAIN A WEST | PersonNm |
| Person Title | CFO/COO | PersonTitleTxt |
| Phone | 5039413033 | PhoneNum |
| Signature | 2022-11-09 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | BLAIN | PersonFirstNm |
| Person Last | WEST | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | XXX-XX-XXXX | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | WENDY CAMPOS | PreparerPersonNm |
| PTIN | P00448102 | PTIN |
| Phone | 5032421447 | PhoneNum |
| Preparation | 2022-11-09 | PreparationDt |
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 | BLAIN A WEST | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7320 SW HUNZIKER ROAD SUITE 300 | AddressLine1Txt |
| City | PORTLAND | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97223 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $29,235,957 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.NHCOREGON.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2010 | FormationYr |
| Legal Domicile State | OR | LegalDomicileStateCd |
| Activity Or Mission | NEIGHBORHOOD HEALTH CENTER WAS CREATED TO MEET THE HEALTH CARE NEEDS OF UNDERSERVED, AT RISK MEMBERS OF OUR COMMUNITIES, INCLUDING MEDICAID AND MEDICARE PATIENTS AS WELL AS THE UNINSURED. NEIGHBORHOOD HEALTH CENTER STRIVES TO COLLABORATE WITH COMMUNITY PARTNERS, COUNTY, LOCAL AND STATE OFFICIALS, AS WELL AS OTHER HEALTH CARE PROFESSIONALS AND WILL CONTINUE TO DEVELOP PARTNERSHIPS TO OFFER HIGH QUALITY HEALTH CARE TO THE COMMUNITIES IN WHICH WE SERVE. NEIGHBORHOOD HEALTH CENTER OFFERS HEALTH CARE SERVICES USING A TEAM BASED CARE MODEL, WITH CREATING A "HEALTH HOME" FOR ITS PATIENTS AT THE CORE OF ITS VALUES. CURRENT LOCATIONS INCLUDE BEAVERTON, CANBY, HILLSBORO, MILWAUKIE AND OREGON CITY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 240 | TotalEmployeeCnt |
| Total Volunteers | 9 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $7,298,203 | PYContributionsGrantsAmt |
| CY Contributions Grants | $6,193,423 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $19,803,151 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $23,042,495 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,203 | PYInvestmentIncomeAmt |
| CY Investment Income | $39 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $27,102,557 | PYTotalRevenueAmt |
| CY Total Revenue | $29,235,957 | 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 | $16,930,973 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $18,711,621 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $7,984,195 | PYOtherExpensesAmt |
| CY Other Expenses | $8,767,358 | CYOtherExpensesAmt |
| PY Total Expenses | $24,915,168 | PYTotalExpensesAmt |
| CY Total Expenses | $27,478,979 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $2,187,389 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,756,978 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $25,142,257 | TotalAssetsBOYAmt |
| Total Assets EOY | $27,154,161 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $15,274,076 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $15,529,002 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $9,868,181 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $11,625,159 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE MISSION OF NEIGHBORHOOD HEALTH CENTER IS TO INCREASE ACCESS TO HEALTH CARE SERVICES IN THE COMMUNITIES IN WHICH WE SERVE, BY PROVIDERS WHO ARE PASSIONATE ABOUT QUALITY HEALTH CARE FOR EACH INDIVIDUAL AND FAMILY MEMBER. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $18,962,617 | ExpenseAmt |
| Revenue | $19,386,256 | RevenueAmt |
| Desc | PATIENT SERVICES - MEDICAL: TO OPERATE COMMUNITY MEDICAL HEALTH CENTERS TO INCREASE ACCESS TO COMPREHENSIVE AND PREVENTIVE MEDICAL SERVICES AND TO IMPROVE HEALTH CARE STATUS OF THE VULNERABLE AND UNDERSERVED POPULATIONS OF THE COMMUNITIES IN WHICH THE ORGANIZATION OPERATES. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $3,883,909 | ExpenseAmt |
| Revenue | $3,656,239 | RevenueAmt |
| Desc | PATIENT SERVICES - DENTAL: TO OPERATE COMMUNITY DENTAL CENTERS TO INCREASE ACCESS TO COMPREHENSIVE AND PREVENTIVE DENTAL SERVICES AND TO IMPROVE HEALTH CARE STATUS OF THE VULNERABLE AND UNDERSERVED POPULATIONS OF THE COMMUNITIES IN WHICH THE ORGANIZATION OPERATES. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $22,846,526 | 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 | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | 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 | Yes (1) | 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 | 135 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 240 | 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 | 0 | QuidProQuoContributionsInd |
| 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 | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | 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 | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | OR | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | BLAIN A WEST CFOCOO | PersonNm |
| Phone | 5039413028 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7320 SW HUNZIKER ROAD SUITE 300 | AddressLine1Txt |
| City | PORTLAND | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97223 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| DONALDA DODSON | ||||||||
| BOARD CO-CHAIR | 3.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| BRITTANY MARKS | ||||||||
| BOARD CO-CHAIR | 3.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| ALAN HODGE | ||||||||
| BOARD TREASURER | 3.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| MARY TANSKI | ||||||||
| BOARD SECRETARY | 3.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| WAYNE SCHMIDT | ||||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| ERIC BOOTH | ||||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| STEVE KINDER | ||||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| RUDY MAZZA | ||||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| DEB MERRICK | ||||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| JERI WEEKS | ||||||||
| CEO | 40.00 | Yes (X) | $321,826 | $0 | $27,109 | |||
| BLAIN A WEST | ||||||||
| CFO/COO | 40.00 | Yes (X) | $291,468 | $0 | $27,914 | |||
| KRISTINE ANN KRUGER | ||||||||
| INTERIM CHIEF MEDICAL OFFICER | 30.00 | Yes (X) | $203,737 | $0 | $20,590 | |||
| JONATHAN HALL | ||||||||
| CHIEF DENTAL OFFICER | 40.00 | Yes (X) | $207,021 | $0 | $29,517 | |||
| ANN TSENG | ||||||||
| CHIEF MEDICAL OFFICER | 40.00 | Yes (X) | $84,973 | $0 | $2,549 | |||
| ZACHARY ROSKO DIRECTOR OF | ||||||||
| PHARMACY AND CARE | 40.00 | $212,858 | $0 | $20,652 | Yes (X) | |||
| GREGORY GUFFANTI | ||||||||
| PHYSICIAN | 36.00 | $219,185 | $0 | $25,962 | Yes (X) | |||
| ANNA CHRISTINE MIKULIC | ||||||||
| PHYSICIAN | 40.00 | $203,083 | $0 | $18,592 | Yes (X) | |||
| EMILY CRISTINA VIGGIANO | ||||||||
| PHYSICIAN | 36.00 | $200,641 | $0 | $21,489 | Yes (X) | |||
| OTUODITA EJIASA | ||||||||
| PHYSICIAN | 40.00 | $217,978 | $0 | $20,523 | Yes (X) | |||
| WYATT WILSON | ||||||||
| PHYSICIAN | 40.00 | $182,657 | $0 | $21,357 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,345,427 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $236,254 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 43 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| OCHIN | |||||
| PO BOX 5426 | PORTLAND | OR | 97228 | PROFESSIONAL SERVICES | $760,637 |
| PAVELCOMM | |||||
| 1640 NW 14TH AVE | PORTLAND | OR | 97209 | PROFESSIONAL SERVICES | $444,870 |
| LIFEWORKS | |||||
| 5415 SW WESTGATE DR | PORTLAND | OR | 97221 | PROFESSIONAL SERVICES | $202,207 |
| PASSPORT TO LANGUAGES | |||||
| 3912 SW 43RD | PORTLAND | OR | 97221 | PROFESSIONAL SERVICES | $166,077 |
| JESS COLUMBO | |||||
| 2323 KAUFFMAN AVE | VANCOUVER | WA | 98660 | PROFESSIONAL SERVICES | $145,559 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $5,451,345 | GovernmentGrantsAmt |
| All Other Contributions | $742,078 | AllOtherContributionsAmt |
| Noncash Contributions | $45,435 | NoncashContributionsAmt |
| Total Contributions | $6,193,423 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT SERVICES | Desc |
| Business | 621110 | BusinessCd |
| Total Revenue Column | $23,042,495 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $23,042,495 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $23,042,495 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $39 | TotalRevenueColumnAmt |
| Exclusion | $39 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $29,235,957 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $23,042,495 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $39 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,450,215 | TotalAmt |
| Program Services | $1,106,764 | ProgramServicesAmt |
| Management And General | $343,451 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,285,749 | TotalAmt |
| Program Services | $11,899,409 | ProgramServicesAmt |
| Management And General | $1,386,340 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,060,949 | TotalAmt |
| Program Services | $929,050 | ProgramServicesAmt |
| Management And General | $131,899 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,800,799 | TotalAmt |
| Program Services | $1,596,199 | ProgramServicesAmt |
| Management And General | $204,600 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,113,909 | TotalAmt |
| Program Services | $983,437 | ProgramServicesAmt |
| Management And General | $130,472 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $140,137 | TotalAmt |
| Management And General | $140,137 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $450,919 | TotalAmt |
| Management And General | $450,919 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,185,128 | TotalAmt |
| Program Services | $1,714,264 | ProgramServicesAmt |
| Management And General | $470,864 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $31,634 | TotalAmt |
| Program Services | $21,583 | ProgramServicesAmt |
| Management And General | $10,051 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $628,085 | TotalAmt |
| Program Services | $279,727 | ProgramServicesAmt |
| Management And General | $348,358 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $711,890 | TotalAmt |
| Program Services | $625,153 | ProgramServicesAmt |
| Management And General | $86,737 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,779,366 | TotalAmt |
| Program Services | $1,041,418 | ProgramServicesAmt |
| Management And General | $737,948 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $84,089 | TotalAmt |
| Program Services | $69,692 | ProgramServicesAmt |
| Management And General | $14,397 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $53,386 | TotalAmt |
| Program Services | $36,643 | ProgramServicesAmt |
| Management And General | $16,743 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $46,921 | TotalAmt |
| Program Services | $3,045 | ProgramServicesAmt |
| Management And General | $43,876 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $341,872 | TotalAmt |
| Program Services | $278,842 | ProgramServicesAmt |
| Management And General | $63,030 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $87,344 | TotalAmt |
| Program Services | $60,883 | ProgramServicesAmt |
| Management And General | $26,461 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $1,606,191 | $1,606,191 | |
| PATIENT ASSISTANCE | $395,397 | $395,397 | |
| INTERPRETATION SERVICES | $117,404 | $117,404 | |
| DUES & SUBSCRIPTIONS | $107,172 | $81,110 | $26,062 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $423 | TotalAmt |
| Program Services | $315 | ProgramServicesAmt |
| Management And General | $108 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,478,979 | TotalAmt |
| Program Services | $22,846,526 | ProgramServicesAmt |
| Management And General | $4,632,453 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,287,774 | BOYAmt |
| EOY | $8,960,548 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,646,469 | BOYAmt |
| EOY | $3,574,829 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $147,109 | BOYAmt |
| EOY | $192,359 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $459,595 | BOYAmt |
| EOY | $573,708 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $3,482,822 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $2,253,473 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,030,713 | BOYAmt |
| EOY | $1,229,349 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,100,000 | BOYAmt |
| EOY | $1,100,000 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,470,597 | BOYAmt |
| EOY | $11,523,368 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,142,257 | BOYAmt |
| EOY | $27,154,161 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,450,439 | BOYAmt |
| EOY | $2,454,815 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $552,029 | BOYAmt |
| EOY | $547,928 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $958,624 | BOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,312,984 | BOYAmt |
| EOY | $12,526,259 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,274,076 | BOYAmt |
| EOY | $15,529,002 | 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 | $9,860,093 | BOYAmt |
| EOY | $11,617,071 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,088 | BOYAmt |
| EOY | $8,088 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,868,181 | BOYAmt |
| EOY | $11,625,159 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,142,257 | BOYAmt |
| EOY | $27,154,161 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $1,756,978 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| 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) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $10,225 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,267,056 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,706,607 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $7,298,203 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $6,193,423 | CurrentTaxYearAmt |
| Total | $18,475,514 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $15,988,685 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $15,182,093 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $16,363,924 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $19,803,151 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $23,042,495 | CurrentTaxYearAmt |
| Total | $90,380,348 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $15,998,910 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $17,449,149 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $19,070,531 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $27,101,354 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $29,235,918 | CurrentTaxYearAmt |
| Total | $108,855,862 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | $5,000 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $335,284 | CurrentTaxYearAmt |
| Total | $340,284 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | $5,000 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $335,284 | CurrentTaxYearAmt |
| Total | $340,284 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $108,515,578 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | $1,203 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $39 | CurrentTaxYearAmt |
| Total | $1,242 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | $1,203 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $39 | CurrentTaxYearAmt |
| Total | $1,242 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $15,998,910 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $17,449,149 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $19,070,531 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $27,102,557 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $29,235,957 | CurrentTaxYearAmt |
| Total | $108,857,104 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99690 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99980 | PublicSupportPY509Pct |
| Investment Income CY | 0.00000 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00000 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
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
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $521,253 | OtherCostOrOtherBasisAmt |
| Depreciation | $275,938 | DepreciationAmt |
| Book Value | $245,315 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,961,569 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,977,535 | DepreciationAmt |
| Book Value | $984,034 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,229,349 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | RIGHT-OF-USE ASSETS | Desc |
| Book Value | $11,523,368 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $11,523,368 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| FINANCE LEASES | $111,760 |
| OPERATING LEASES | $12,414,499 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $12,526,259 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $29,235,957 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $29,235,957 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $29,235,957 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $27,478,979 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $27,478,979 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $27,478,979 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION IS RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS A QUALIFIED TAX-EXEMPT ENTITY UNDER THE PROVISIONS OF INTERNAL REVENUE CODE SECTION 501(C)(3). NO PROVISION FOR INCOME TAXES IS MADE IN THE ACCOMPANYING FINANCIAL STATEMENTS, AS THE ORGANIZATION HAS NO ACTIVITIES SUBJECT TO UNRELATED BUSINESS INCOME TAX. THE ORGANIZATION RECOGNIZES THE TAX POSITION FROM UNCERTAIN TAX POSITIONS ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITIONS WILL BE SUSTAINED ON EXAMINATION BY THE TAX AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX POSITION IS MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. THE ORGANIZATION RECOGNIZES INTEREST AND PENALTIES RELATED TO INCOME TAX MATTERS IN ADMINISTRATIVE EXPENSE. THE ORGANIZATION HAD NO UNRECOGNIZED TAX POSITIONS AT DECEMBER 31, 2021 AND 2020. NO INTEREST AND PENALTIES WERE ACCRUED FOR THE YEAR. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | Yes (1) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| 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 (10 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JERI WEEKS | ||||||||||||||
| CEO | $298,890 | $0 | $22,936 | $0 | $0 | $0 | $25,887 | $0 | $1,222 | $0 | $348,935 | $0 | $0 | $0 |
| BLAIN A WEST | ||||||||||||||
| CFO/COO | $269,099 | $0 | $22,369 | $0 | $0 | $0 | $23,793 | $0 | $4,121 | $0 | $319,382 | $0 | $0 | $0 |
| GREGORY GUFFANTI | ||||||||||||||
| PHYSICIAN | $208,880 | $0 | $10,305 | $0 | $0 | $0 | $17,840 | $0 | $8,122 | $0 | $245,147 | $0 | $0 | $0 |
| OTUODITA EJIASA | ||||||||||||||
| PHYSICIAN | $211,746 | $0 | $6,232 | $0 | $0 | $0 | $17,624 | $0 | $2,899 | $0 | $238,501 | $0 | $0 | $0 |
| JONATHAN HALL | ||||||||||||||
| CHIEF DENTAL OFFICER | $188,009 | $0 | $19,012 | $0 | $0 | $0 | $17,271 | $0 | $12,246 | $0 | $236,538 | $0 | $0 | $0 |
| ZACHARY ROSKO DIRECTOR OF | ||||||||||||||
| PHARMACY AND CARE | $201,358 | $0 | $11,500 | $0 | $0 | $0 | $17,085 | $0 | $3,567 | $0 | $233,510 | $0 | $0 | $0 |
| KRISTINE ANN KRUGER | ||||||||||||||
| INTERIM CHIEF MEDICAL OFFICER | $203,737 | $0 | $0 | $0 | $0 | $0 | $16,581 | $0 | $4,009 | $0 | $224,327 | $0 | $0 | $0 |
| EMILY CRISTINA VIGGIANO | ||||||||||||||
| PHYSICIAN | $194,698 | $0 | $5,943 | $0 | $0 | $0 | $16,279 | $0 | $5,210 | $0 | $222,130 | $0 | $0 | $0 |
| ANNA CHRISTINE MIKULIC | ||||||||||||||
| PHYSICIAN | $196,038 | $0 | $7,045 | $0 | $0 | $0 | $16,855 | $0 | $1,737 | $0 | $221,675 | $0 | $0 | $0 |
| WYATT WILSON | ||||||||||||||
| PHYSICIAN | $175,462 | $0 | $7,195 | $0 | $0 | $0 | $15,031 | $0 | $6,326 | $0 | $204,014 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 1A | FormAndLineReferenceDesc |
| Explanation | ALL EMPLOYEES INCLUDING THOSE LISTED ON FORM 990 PART VII RECEIVE FITNESS CLUB MEMBERSHIP REIMBURSEMENT. | ExplanationTxt |
Schedule M IRS990ScheduleM
Other Non Cash Contri Table OtherNonCashContriTableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Desc | EQUIPMENT | Desc |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $45,435 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | COMPARABLE VALUE | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | MEMBERS OF STAFF GATHER THE INFORMATION FOR THE FORM 990, REVIEW THIS INFORMATION WITH THE CFO, AND THEN FORWARD TO MOSS ADAMS, AN INDEPENDENT CPA FIRM, WHO PREPARES THE FORM 990. ONCE THE RETURN IS COMPLETED IT IS REVIEWED BY MEMBERS OF STAFF, THE CFO AND CEO. A COPY OF THE FORM 990 IS EMAILED TO THE BOARD OF DIRECTORS PRIOR TO FILING AT WHICH TIME COMMENTS AND QUESTIONS ARE ACCEPTED. |
| FORM 990, PART VI, SECTION B, LINE 12C | BOARD MEMBERS ARE REQUIRED TO COMPLETE AN ANNUAL CONFLICT OF INTEREST AFFIDAVIT. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE ORGANIZATION SURVEYS EXECUTIVE MARKET DATA AND MEMBERS OF THE BOARD TO APPROVE CEO, CFO/COO, CDO, AND CMO COMPENSATION RANGE. THIS PROCESS WAS LAST COMPLETED IN 2019. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |