DOUGLAS COUNTY PUBLIC HEALTH SERVICES GROUP INC: Form 990, tax year 2019
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- Organization
- DOUGLAS COUNTY PUBLIC HEALTH SERVICES GROUP INC (EIN 43-1747760)
- Tax period
- 2019-03-01 to 2020-02-29
- Filed
- 2021-01-15
- IRS object ID
- 202110159349300606
- Schema version
- 2019v5.1
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule G
- Schedule J
- Schedule M
- Schedule O
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-01-15T08:06:22-06:00 | ReturnTs |
| Tax Period End | 2020-02-29 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BKD LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 910 E ST LOUIS 200/PO BOX 1190 | AddressLine1Txt |
| City | SPRINGFIELD | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 658062523 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2019-03-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 431747760 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DOUGLAS COUNTY PUBLIC HEALTH SVCS GROUP INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % RANDALL GANN | InCareOfNm |
| Business Name Control | DOUG | BusinessNameControlTxt |
| Phone | 4176835739 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 504 NW 10TH AVE PO BOX 1359 | AddressLine1Txt |
| City | AVA | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 65608 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TIMOTHY SHRYACK | PersonNm |
| Person Title | CHIEF EXECUTIVE OFFI | PersonTitleTxt |
| Signature | 2020-11-30 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Krystal K Creach | PreparerPersonNm |
| PTIN | P01248198 | PTIN |
| Phone | 4178658701 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MISSOURI OZARKS COMMUNITY HEALTH | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | TIMOTHY SHRYACK | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 504 NW 10TH AVE PO BOX 1359 | AddressLine1Txt |
| City | AVA | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 65608 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $14,028,929 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.MO-OZARKS.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1996 | FormationYr |
| Legal Domicile State | MO | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE AFFORDABLE, ACCESSIBLE, QUALITY HEALTH CARE TO ALL WITHIN THE SERVICE AREA. SERVICES WILL BE PROVIDED WITHOUT REGARD TO AGE, RACE, CREED, DISABILITY OR STATUS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 122 | TotalEmployeeCnt |
| Total Volunteers | 10 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $4,455,213 | PYContributionsGrantsAmt |
| CY Contributions Grants | $4,645,896 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $7,645,699 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $8,654,531 | CYProgramServiceRevenueAmt |
| PY Investment Income | $45,194 | PYInvestmentIncomeAmt |
| CY Investment Income | $41,097 | CYInvestmentIncomeAmt |
| PY Other Revenue | $66,042 | PYOtherRevenueAmt |
| CY Other Revenue | $98,238 | CYOtherRevenueAmt |
| PY Total Revenue | $12,212,148 | PYTotalRevenueAmt |
| CY Total Revenue | $13,439,762 | 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 | $6,832,940 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $8,028,674 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $21,996 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $22,000 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $22,000 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $4,206,576 | PYOtherExpensesAmt |
| CY Other Expenses | $4,603,486 | CYOtherExpensesAmt |
| PY Total Expenses | $11,061,512 | PYTotalExpensesAmt |
| CY Total Expenses | $12,654,160 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,150,636 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $785,602 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $13,290,400 | TotalAssetsBOYAmt |
| Total Assets EOY | $13,967,943 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,286,865 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $2,224,693 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $11,003,535 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $11,743,250 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | IT IS THE MISSION OF THE DOUGLAS COUNTY PUBLIC HEALTH SERVICES GROUP, INC. DBA/MISSOURI OZARKS COMMUNITY HEALTH, TO PROVIDE QUALITY, AFFORDABLE PRIMARY MEDICAL, DENTAL, AND BEHAVIORAL HEALTH CARE TO ALL. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $5,723,221 | ExpenseAmt |
| Revenue | $4,804,362 | RevenueAmt |
| Desc | DURING FISCAL YEAR 2020, MISSOURI OZARKS COMMUNITY HEALTH (MOCH) HAD 27,072 MEDICAL ENCOUNTERS (VISITS) THAT PROVIDED QUALITY CARE TO THE RURAL POPULATION OF DOUGLAS, OZARK, WRIGHT, AND TEXAS COUNTIES IN MISSOURI. MOCH STRIVES TO PROVIDE THIS QUALITY CARE THROUGH A VARIETY OF MEDICAL SERVICES THAT INCLUDE, BUT ARE NOT LIMITED TO, ADULT MEDICINE, PEDIATRIC CARE, ADOLESCENT HEALTH, NUTRITIONAL HEALTH, URGENT MEDICAL CARE, LABORATORY AND RADIOLOGY TESTING, AND PHARMACY SERVICES. FOR SERVICES OUTSIDE OF MOCH'S SCOPE AND ABILITY, PATIENTS ARE REFERRED TO ORGANIZATIONS NEAR OUR SERVICE AREA THAT CAN PROVIDE THE QUALITY OF CARE THAT MOCH PATIENTS EXPECT FOR MEDICAL ENCOUNTERS. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $3,746,322 | ExpenseAmt |
| Revenue | $3,633,567 | RevenueAmt |
| Desc | MISSOURI OZARKS COMMUNITY HEALTH PROVIDES QUALITY PREVENTATIVE AND RESTORATIVE DENTAL CARE IN DOUGLAS, OZARK, WRIGHT, AND TEXAS COUNTIES IN MISSOURI. DURING THE FISCAL YEAR, THE ORGANIZATION HAD 11,850 DENTAL ENCOUNTERS (VISITS). | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $184,165 | ExpenseAmt |
| Revenue | $130,545 | RevenueAmt |
| Desc | MISSOURI OZARKS COMMUNITY HEALTH PROVIDES QUALITY BEHAVIORAL HEALTH SERVICES TO DOUGLAS, OZARK, WRIGHT, AND TEXAS COUNTIES IN MISSOURI. THESE SERVICES INCLUDE, BUT ARE NOT LIMITED TO, INDIVIDUAL COUNSELING, FAMILY COUNSELING, CONSULTATION, REFERRAL FOR LONG-TERM PSYCHOTHERAPY, MEDICATION EVALUATION, AND SUBSTANCE ABUSE COUNSELING. DURING THE FISCAL YEAR, THE ORGANIZATION HAD 1,309 BEHAVIORAL HEALTH ENCOUNTERS (VISITS). | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $167,969 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Revenue | $86,057 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $9,821,677 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | Yes (true) | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | Yes (true) | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 122 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | false | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | RANDALL GANN | PersonNm |
| Phone | 4176835739 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 504 NW 10TH AVE PO BOX 1359 | AddressLine1Txt |
| City | AVA | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 65608 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|---|
| SELMA TAYLOR | ||||||||
| PHYSICIAN | 40.0 | 0.0 | Yes (X) | $272,166 | $0 | $4,058 | ||
| SYBIL FORTNER | ||||||||
| DENTAL DIRECTOR | 40.0 | 0.0 | Yes (X) | $216,995 | $0 | $6,740 | ||
| JOSHUA WOLFE | ||||||||
| PHYSICIAN | 40.0 | 0.0 | Yes (X) | $216,432 | $0 | $3,223 | ||
| MICHAEL BALL | ||||||||
| PHYSICIAN | 40.0 | 0.0 | Yes (X) | $194,974 | $0 | $5,660 | ||
| BRETT DURBIN | ||||||||
| DENTIST | 40.0 | 0.0 | Yes (X) | $181,170 | $0 | $5,682 | ||
| TIM SHRYACK | ||||||||
| CHIEF EXECUTIVE OFFICER | 40.0 | 0.0 | $163,206 | $0 | $4,888 | Yes (X) | ||
| RANDALL GANN | ||||||||
| CHIEF FINANCIAL OFFICER | 40.0 | 0.0 | $97,711 | $0 | $2,822 | Yes (X) | ||
| JENNIFER HEINLEIN | ||||||||
| CHIEF OPERATIONS OFFICER | 40.0 | 0.0 | $82,822 | $0 | $2,605 | Yes (X) | ||
| CAROL CUNNINGHAM | ||||||||
| PRESIDENT | 1.0 | 0.0 | $0 | $0 | $0 | Yes (X) | Yes (X) | |
| RHONDA SUTER | ||||||||
| VICE PRESIDENT | 1.0 | 0.0 | $0 | $0 | $0 | Yes (X) | Yes (X) | |
| DONALD PINCKNEY | ||||||||
| TREASURER | 1.0 | 0.0 | $0 | $0 | $0 | Yes (X) | Yes (X) | |
| JASON DIAL | ||||||||
| DIRECTOR | 1.0 | 0.0 | $0 | $0 | $0 | Yes (X) | ||
| VERLIN ROGERS | ||||||||
| DIRECTOR | 1.0 | 0.0 | $0 | $0 | $0 | Yes (X) | ||
| VALERIE REESE | ||||||||
| DIRECTOR | 1.0 | 0.0 | $0 | $0 | $0 | Yes (X) | ||
| JACKIE SMITH | ||||||||
| DIRECTOR | 1.0 | 0.0 | $0 | $0 | $0 | Yes (X) | ||
| BART ELLISON | ||||||||
| SECRETARY | 1.0 | 0.0 | $0 | $0 | $0 | Yes (X) | Yes (X) | |
| RON SCHEETS | ||||||||
| DIRECTOR | 1.0 | 0.0 | $0 | $0 | $0 | Yes (X) | ||
| SHELDON SHAVER | ||||||||
| DIRECTOR | 1.0 | 0.0 | $0 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,425,476 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $35,678 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 13 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| NEXTGEN HEALTHCARE INC | |||||
| PO BOX 511449 | LOS ANGELES | CA | 90051 | REVENUE CYCLE MGMT | $341,042 |
| JMARK | |||||
| 601 N NATIONAL | SPRINFIELD | MO | 65802 | IT SERVICES | $263,110 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $4,526,773 | GovernmentGrantsAmt |
| All Other Contributions | $119,123 | AllOtherContributionsAmt |
| Noncash Contributions | $135,224 | NoncashContributionsAmt |
| Total Contributions | $4,645,896 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 624100 | $8,417,861 | $8,417,861 |
| HEALTH & FITNESS CENTER | 713940 | $114,181 | $114,181 |
| EHR INCENTIVE REVENUE | 621400 | $68,000 | $68,000 |
| OTHER CLINIC REVENUE | 621400 | $54,489 | $54,489 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $8,654,531 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $34,513 | TotalRevenueColumnAmt |
| Exclusion | $34,513 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $27,521 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $27,521 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $27,521 | TotalRevenueColumnAmt |
| Exclusion | $27,521 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $591,977 | SecuritiesAmt |
| Other | $3,774 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $589,167 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $2,810 | SecuritiesAmt |
| Other | $3,774 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $6,584 | TotalRevenueColumnAmt |
| Exclusion | $6,584 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $0 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $0 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $0 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $0 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | GAIN ON INVESTMENT IN EQUITY INVESTEE | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $70,717 | TotalRevenueColumnAmt |
| Exclusion | $70,717 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $70,717 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $13,439,762 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $8,654,531 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $139,335 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $354,054 | TotalAmt |
| Management And General | $354,054 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,443,402 | TotalAmt |
| Program Services | $5,667,855 | ProgramServicesAmt |
| Management And General | $775,547 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $156,161 | TotalAmt |
| Program Services | $139,011 | ProgramServicesAmt |
| Management And General | $17,150 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $604,186 | TotalAmt |
| Program Services | $504,509 | ProgramServicesAmt |
| Management And General | $99,677 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $470,871 | TotalAmt |
| Program Services | $393,188 | ProgramServicesAmt |
| Management And General | $77,683 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,271 | TotalAmt |
| Management And General | $4,271 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $63,759 | TotalAmt |
| Management And General | $63,759 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,000 | TotalAmt |
| Fundraising | $22,000 | FundraisingAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $967,312 | TotalAmt |
| Program Services | $227,962 | ProgramServicesAmt |
| Management And General | $739,350 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $126,105 | TotalAmt |
| Program Services | $83,710 | ProgramServicesAmt |
| Management And General | $42,395 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $602,914 | TotalAmt |
| Program Services | $400,223 | ProgramServicesAmt |
| Management And General | $202,691 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $84,542 | TotalAmt |
| Program Services | $56,120 | ProgramServicesAmt |
| Management And General | $28,422 | ManagementAndGeneralAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $249,528 | TotalAmt |
| Program Services | $165,640 | ProgramServicesAmt |
| Management And General | $83,888 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $150,451 | TotalAmt |
| Program Services | $99,871 | ProgramServicesAmt |
| Management And General | $50,580 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $46,664 | TotalAmt |
| Program Services | $30,976 | ProgramServicesAmt |
| Management And General | $15,688 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $49,541 | TotalAmt |
| Management And General | $49,541 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $733,968 | TotalAmt |
| Program Services | $601,477 | ProgramServicesAmt |
| Management And General | $132,491 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $60,688 | TotalAmt |
| Program Services | $40,286 | ProgramServicesAmt |
| Management And General | $20,402 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES & DRUGS | $1,280,374 | $1,280,374 | |
| LICENSES, DUES, SUBSCRIPTIONS | $81,637 | $54,192 | $27,445 |
| RECRUITING & RETENTION | $69,499 | $46,134 | $23,365 |
| PHARMACY PROVIDER TAX | $26,035 | $26,035 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,198 | TotalAmt |
| Program Services | $4,114 | ProgramServicesAmt |
| Management And General | $2,084 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,654,160 | TotalAmt |
| Program Services | $9,821,677 | ProgramServicesAmt |
| Management And General | $2,810,483 | ManagementAndGeneralAmt |
| Fundraising | $22,000 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $216,395 | BOYAmt |
| EOY | $233,167 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,524,114 | BOYAmt |
| EOY | $3,497,796 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $115,222 | BOYAmt |
| EOY | $604,737 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $872,837 | BOYAmt |
| EOY | $1,150,268 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $304,250 | BOYAmt |
| EOY | $253,886 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $58,843 | BOYAmt |
| EOY | $136,313 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $11,587,760 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $5,805,233 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,228,425 | BOYAmt |
| EOY | $5,782,527 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $734,044 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $46,947 | BOYAmt |
| EOY | $120,226 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $923,367 | BOYAmt |
| EOY | $1,454,979 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,290,400 | BOYAmt |
| EOY | $13,967,943 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $718,982 | BOYAmt |
| EOY | $875,607 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,363 | BOYAmt |
| EOY | $6,515 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $998,520 | BOYAmt |
| EOY | $900,163 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $560,000 | BOYAmt |
| EOY | $442,408 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,286,865 | BOYAmt |
| EOY | $2,224,693 | 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 | $10,946,968 | BOYAmt |
| EOY | $11,695,997 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $56,567 | BOYAmt |
| EOY | $47,253 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,003,535 | BOYAmt |
| EOY | $11,743,250 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,290,400 | BOYAmt |
| EOY | $13,967,943 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $785,602 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$45,887 | NetUnrlzdGainsLossesInvstAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | 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 (true) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | 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 | $3,364,408 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,140,817 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $5,459,185 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $4,455,213 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,645,896 | CurrentTaxYearAmt |
| Total | $21,065,519 | TotalAmt |
Tax Rev Levied Orgnztnl Bnft170 TaxRevLeviedOrgnztnlBnft170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,364,408 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,140,817 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $5,459,185 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $4,455,213 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,645,896 | CurrentTaxYearAmt |
| Total | $21,065,519 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $301,052 | SubstantialContributorsTotAmt |
| Public Support Total170 | $20,764,467 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $36,086 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $40,700 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $58,595 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $77,013 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $62,034 | CurrentTaxYearAmt |
| Total | $274,428 | TotalAmt |
Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $21,339,947 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $34,555,106 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.97303 | PublicSupportCY170Pct |
| Public Support PY170 | 0.96538 | 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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbyingGrp | |
| Total Direct Lobbying | TotalDirectLobbyingGrp | |
| Total Lobbying Expend | TotalLobbyingExpendGrp | |
| Other Exempt Purpose Expend | OtherExemptPurposeExpendGrp | |
| Total Exempt Purpose Expend | TotalExemptPurposeExpendGrp | |
| Lobbying Nontaxable Amount | LobbyingNontaxableAmountGrp | |
| Grassroots Nontaxable | GrassrootsNontaxableGrp | |
| Tot Lbbyng Grassroot Mns Non Tx | TotLbbyngGrassrootMnsNonTxGrp | |
| Tot Lbby Expend Mns Lbbyng Non Tx | TotLbbyExpendMnsLbbyngNonTxGrp | |
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $15,787 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $15,787 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE C, PART II-B, LINE 1(I) | FormAndLineReferenceDesc |
| Explanation | OTHER LOBBYING ACTIVITIES: THE ORGANIZATION PAYS DUES TO THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS. A PORTION OF THESE DUES MAY BE ATTRIBUTABLE TO LOBBYING ACTIVITIES. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $149,760 | OtherCostOrOtherBasisAmt |
| Book Value | $149,760 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,324,403 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,417,239 | DepreciationAmt |
| Book Value | $3,907,164 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $179,970 | OtherCostOrOtherBasisAmt |
| Depreciation | $19,060 | DepreciationAmt |
| Book Value | $160,910 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,841,591 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,368,934 | DepreciationAmt |
| Book Value | $1,472,657 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $92,036 | OtherCostOrOtherBasisAmt |
| Book Value | $92,036 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $5,782,527 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| OTHER RECEIVABLES | $54,979 |
| EST AMOUNTS DUE FROM 3RD PARTY | $1,400,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $1,454,979 | TotalBookValueOtherAssetsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | EST AMT DUE TO 3RD PTY PYRS | Desc |
| Amt | $442,408 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $442,408 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $13,399,415 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$45,887 | NetUnrealizedGainsInvstAmt |
| Other Revenue | $145,775 | OtherRevenueAmt |
| Revenue Not Reported | $99,888 | RevenueNotReportedAmt |
| Revenue Subtotal | $13,299,527 | RevenueSubtotalAmt |
| Other Revenues Not Included | $140,235 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $140,235 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $13,439,762 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $12,650,386 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | -$3,774 | OtherExpensesIncludedAmt |
| Expenses Not Reported | -$3,774 | ExpensesNotReportedAmt |
| Expenses Subtotal | $12,654,160 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $12,654,160 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE D, PART X, LINE 2 | UNCERTAIN TAX POSITIONS: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. |
| SCHEDULE D, PART XI, LINE 2D | OTHER REVENUE ON LINE 1, BUT NOT ON FORM 990, PART VIII, LINE 12: $ 145,775 NET ASSETS RELEASED FROM RESTRICTION |
| SCHEDULE D, PART XI, LINE 4B | OTHER REVENUE ON FORM 990, PART VIII, LINE 12, BUT NOT ON LINE 1: $ 136,461 TEMPORARILY RESTRICTED CONTRIBUTIONS 3,774 GAIN ON SALE OF FF&E --------- $ 140,235 |
| SCHEDULE D, PART XII, LINE 4B | OTHER EXPENSE ON FORM 990, PART IX, LINE 25, BUT NOT ON LINE 1: $ (3,774) GAIN ON SALE OF FF&E |
Schedule G IRS990ScheduleG
| Field | Value | IRS element (for citing) |
|---|---|---|
| Solicitation Of Non Govt Grants | Yes (X) | SolicitationOfNonGovtGrantsInd |
| Solicitation Of Govt Grants | Yes (X) | SolicitationOfGovtGrantsInd |
| Agrmt Prof Fundraising Acty | Yes (true) | AgrmtProfFundraisingActyInd |
Fundraiser Activity Info FundraiserActivityInfoGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | COMMUNITY ASSET BUILDERS | PersonNm |
| Activity | GRANT | ActivityTxt |
| Fundraiser Control Of Funds | false | FundraiserControlOfFundsInd |
| Gross Receipts | $4,571,058 | GrossReceiptsAmt |
| Retained By Contractor | $22,000 | RetainedByContractorAmt |
| Net To Organization | $4,549,058 | NetToOrganizationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Gross Receipts | $4,571,058 | TotalGrossReceiptsAmt |
| Total Retained By Contractors | $22,000 | TotalRetainedByContractorsAmt |
| Total Net To Organization | $4,549,058 | TotalNetToOrganizationAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | Yes (true) | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | Yes (true) | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| TIM SHRYACK | ||||||||||||||
| CHIEF EXECUTIVE OFFICER | $152,165 | $0 | $11,041 | $0 | $0 | $0 | $4,888 | $0 | $0 | $0 | $168,094 | $0 | $0 | $0 |
| SELMA TAYLOR | ||||||||||||||
| PHYSICIAN | $261,229 | $0 | $10,937 | $0 | $0 | $0 | $4,058 | $0 | $0 | $0 | $276,224 | $0 | $0 | $0 |
| SYBIL FORTNER | ||||||||||||||
| DENTAL DIRECTOR | $202,801 | $0 | $14,194 | $0 | $0 | $0 | $6,740 | $0 | $0 | $0 | $223,735 | $0 | $0 | $0 |
| JOSHUA WOLFE | ||||||||||||||
| PHYSICIAN | $194,270 | $0 | $22,162 | $0 | $0 | $0 | $3,223 | $0 | $0 | $0 | $219,655 | $0 | $0 | $0 |
| MICHAEL BALL | ||||||||||||||
| PHYSICIAN | $190,617 | $0 | $4,357 | $0 | $0 | $0 | $5,660 | $0 | $0 | $0 | $200,634 | $0 | $0 | $0 |
| BRETT DURBIN | ||||||||||||||
| DENTIST | $164,681 | $0 | $16,489 | $0 | $0 | $0 | $5,682 | $0 | $0 | $0 | $186,852 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE J, PART I, LINE 5A | PROVIDER BONUS CONTINGENT ON GROSS CHARGES: PROVIDERS RECEIVE BONUSES ON HIRING DATE ANNIVERSARY EQUALING A PERCENTAGE OF THE CHARGES THE GENERATE OVER THEIR PRIOR 365 DAYS. |
| SCHEDULE J, PART I, LINE 6A | BONUS CONTINGENT ON REVENUE: IN 2019, TIM SHRYACK, CEO, RECEIVED A BONUS BASED ON THE PERCENTAGE OF OPERATING INCOME. THIS BONUS WAS BOARD APPROVED. |
Schedule M IRS990ScheduleM
| Field | Value | IRS element (for citing) |
|---|---|---|
| Works Of Art | WorksOfArtGrp | |
| Art Historical Treasures | ArtHistoricalTreasuresGrp | |
| Art Fractional Interest | ArtFractionalInterestGrp | |
| Books And Publications | BooksAndPublicationsGrp | |
| Clothing And Household Goods | ClothingAndHouseholdGoodsGrp | |
| Cars And Other Vehicles | CarsAndOtherVehiclesGrp | |
| Boats And Planes | BoatsAndPlanesGrp | |
| Intellectual Property | IntellectualPropertyGrp | |
| Securities Publicly Traded | SecuritiesPubliclyTradedGrp | |
| Securities Closely Held Stock | SecuritiesCloselyHeldStockGrp | |
| Secur Prtnrshp Trust Intrsts | SecurPrtnrshpTrustIntrstsGrp | |
| Securities Miscellaneous | SecuritiesMiscellaneousGrp | |
| Qualified Contrib Hist Struct | QualifiedContribHistStructGrp | |
| Qualified Contrib Other | QualifiedContribOtherGrp | |
| Real Estate Residential | RealEstateResidentialGrp | |
| Real Estate Commercial | RealEstateCommercialGrp | |
| Real Estate Other | RealEstateOtherGrp | |
| Collectibles | CollectiblesGrp | |
| Food Inventory | FoodInventoryGrp |
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $135,224 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FMV OF VACCINES | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Taxidermy | TaxidermyGrp | |
| Historical Artifacts | HistoricalArtifactsGrp | |
| Scientific Specimens | ScientificSpecimensGrp | |
| Archaeological Artifacts | ArchaeologicalArtifactsGrp | |
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | false | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | false | ThirdPartiesUsedInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE M, PART 1, COLUMN B | FormAndLineReferenceDesc |
| Explanation | NUMBER OF CONTRIBUTORS OR ITEMS CONTRIBUTED: THE NUMBERS REPORTED IN COLUMN B REPRESENT CONTRIBUTIONS FROM ONE DONOR PER CONTRIBUTION TYPE. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART I, LINE 1 | ORGANIZATION'S MISSION OR MOST SIGNIFICANT ACTIVITIES: THE MISSION OF THE DOUGLAS COUNTY PUBLIC HEALTH SERVICES GROUP, INC.(DCPHSG), DOING BUSINESS AS MISSOURI OZARKS COMMUNITY HEALTH (MOCH), IS, AS A COMMUNITY HEALTH CENTER, TO PROVIDE AFFORDABLE, ACCESSIBLE, QUALITY HEALTH CARE TO ALL WITHIN THE DESIGNATED SERVICE AREA. THESE SERVICES WILL BE PROVIDED WITHOUT REGARD TO AGE, RACE, CREED, DISABILITY OR ECONOMIC STATUS. THESE SERVICES CONSIST OF USUAL AND CUSTOMARY SERVICES AS DEFINED BY THE TERM PRIMARY MEDICAL, MENTAL AND DENTAL HEALTH CARE NEEDS. |
| FORM 990, PART I, LINE 6 | VOLUNTEERS: THE ORGANIZATION HAS A VOLUNTEER BOARD OF DIRECTORS. |
| FORM 990, PART III, LINE 4D | OTHER PROGRAM SERVICES: MISSOURI OZARKS COMMUNITY HEALTH OPERATES A WELLNESS CENTER THAT SERVES, ON AVERAGE, 950 MEMBERS MONTHLY. THE WELLNESS CENTER PROMOTES HEALTHY LIFESTYLE CHANGES THROUGH EXERCISE AND FITNESS PROGRAMS. |
| FORM 990, PART VI, SECTION B, LINE 11B | REVIEW OF THE FORM 990: THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. THE DRAFT FORM 990 IS INITIALLY REVIEWED IN DETAIL BY THE CEO AND CFO. AFTER ANY REVISIONS ARE MADE BY THE CEO AND CFO, THE FORM IS FILED WITH THE INTERNAL REVENUE SERVICE. AFTER THE RETURN IS FILED, A COPY OF THE FINAL 990 IS GIVEN TO THE BOARD. |
| FORM 990, PART VI, SECTION B, LINE 12C | MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY: THE ORGANIZATION HAS A WRITTEN CONFLICT OF INTEREST POLICY. COMPLIANCE WITH THIS POLICY IS REVIEWED AT STAFF MEETINGS AND MONTHLY BOARD MEETINGS, AS THE NEED ARISES. ANY DUALITY OF INTEREST OR POSSIBLE CONFLICT OF INTEREST ON THE PART OF ANY DIRECTOR SHALL BE DISCLOSED TO OTHER MEMBERS OF THE BOARD OF DIRECTORS. TO THIS END, EACH DIRECTOR SHALL UPON ELECTION AND ANNUALLY THEREAFTER, PREPARE AND FILE WITH THE SECRETARY, A WRITTEN DECLARATION OF INTERESTS AND ACTIVITIES WHICH CREATE OR MIGHT CREATE DUAL INTEREST OR CONFLICT OF INTEREST ON THE PART OF THE DIRECTORS. SAID DECLARATIONS SHALL BE AVAILABLE FOR REVIEW BY ALL DIRECTORS AT ALL TIMES. ANY DIRECTOR HAVING A DUALITY OF INTEREST OR POSSIBLE CONFLICT OF INTEREST ON ANY MATTER SHALL NOT VOTE OR USE HIS/HER PERSONAL INFLUENCE ON THE MATTER AND HE/SHE SHALL NOT BE COUNTED IN DETERMINING THE QUORUM FOR THE MEETING. THE MINUTES SHALL REFLECT THE DISCLOSURE, THE ABSTENTION FROM VOTING, AND THE QUORUM STATUS. THE FOREGOING REQUIREMENTS, HOWEVER, SHALL NOT BE CONSTRUED AS PREVENTING THE DIRECTOR FROM STATING HIS/HER POSITION ON THE MATTER NOR FROM ANSWERING PERTINENT QUESTIONS OF OTHER MEMBERS, SINCE HIS/HER KNOWLEDGE MAY BE OF GREAT ASSISTANCE TO THE BOARD. |
| FORM 990, PART VI, SECTION B, LINE 15A | COMPENSATION REVIEW POLICY: THE BOARD REVIEWS THE CEO'S COMPENSATION ANNUALLY USING THE NACHC SALARY SURVEY AND STATE OF MISSOURI SALARY COMPARABILITY DATA. USING THAT DATA, AND PERFORMANCE EVALUATION, THE WAGE IS ADJUSTED. THE BOARD VOTES ON ANY SALARY ADJUSTMENT, INCLUDING BONUSES, AND THE ACTIONS TAKEN BY THE BOARD ARE DOCUMENTED IN THE BOARD MINUTES. THE CEO PERFORMS ANNUAL REVIEW AS SUPERVISOR FOR ALL OTHER OFFICERS. ALL OTHER COMPENSATION IS DETERMINED BY THE CEO USING GUIDANCE FROM THE STATE OF MISSOURI AND IS BASED ON MERIT. A REVIEW OF THE COMPENSATION OF THE CEO WAS COMPLETED IN 2019. |
| FORM 990, PART VI, SECTION C, LINE 19 | DOCUMENT AVAILABILITY: THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY CAN BE VIEWED AT THE ORGANIZATION'S FACILITY, UPON REQUEST. THE ORGANIZATION'S FINANCIAL STATEMENTS MAY BE AVAILABLE UPON WRITTEN REQUEST IF THE ORGANIZATION DEEMS THE REQUEST FOR VIEWING IS APPROPRIATE. WRITTEN REQUESTS SHOULD INCLUDE WHY THE INTERESTED PARTY REQUESTS TO VIEW THE FINANCIAL STATEMENTS. |