SOUTHEAST MISSOURI HEALTH NETWORK: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- SOUTHEAST MISSOURI HEALTH NETWORK (EIN 43-1253101)
- Tax period
- 2019-04-01 to 2020-03-31
- Filed
- 2021-01-14
- IRS object ID
- 202120149349300217
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-01-14T10:20:00-06:00 | ReturnTs |
| Tax Period End | 2020-03-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 621804252 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WATKINS UIBERALL PLLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1661 AARON BRENNER DR STE 300 | AddressLine1Txt |
| City | MEMPHIS | CityNm |
| State Abbreviation | TN | StateAbbreviationCd |
| ZIP | 38120 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2019-04-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 431253101 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SOUTHEAST MISSOURI HEALTH NETWORK | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | SOUT | BusinessNameControlTxt |
| Phone | 5733132500 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6738 HIGHWAY 77 | AddressLine1Txt |
| City | BENTON | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 63736 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CHRIS JONES | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 5737482407 | PhoneNum |
| Signature | 2021-01-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | LESLIE D WILLIAMS | PreparerPersonNm |
| PTIN | P01307263 | PTIN |
| Phone | 9017612720 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | CHRIS JONES | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6738 HIGHWAY 77 | AddressLine1Txt |
| City | BENTON | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 63736 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $15,511,968 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.SEMOHEALTHNETWORK.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1978 | FormationYr |
| Legal Domicile State | MO | LegalDomicileStateCd |
| Activity Or Mission | SEMO HEALTH NETWORK IS COMMITTED TO PROVIDING AFFORDABLE, QUALITY HEALTHCARE TO THE COMMUNITIES OF SOUTHEAST MISSOURI. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 188 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | -$1,730 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | -$1,462 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $4,051,686 | PYContributionsGrantsAmt |
| CY Contributions Grants | $4,816,695 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $10,801,063 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $10,399,750 | CYProgramServiceRevenueAmt |
| PY Investment Income | $15,390 | PYInvestmentIncomeAmt |
| CY Investment Income | $8,464 | CYInvestmentIncomeAmt |
| PY Other Revenue | $154,203 | PYOtherRevenueAmt |
| CY Other Revenue | $231,834 | CYOtherRevenueAmt |
| PY Total Revenue | $15,022,342 | PYTotalRevenueAmt |
| CY Total Revenue | $15,456,743 | 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 | $8,992,638 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $9,728,920 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $4,870,831 | PYOtherExpensesAmt |
| CY Other Expenses | $4,781,000 | CYOtherExpensesAmt |
| PY Total Expenses | $13,863,469 | PYTotalExpensesAmt |
| CY Total Expenses | $14,509,920 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,158,873 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $946,823 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $11,786,490 | TotalAssetsBOYAmt |
| Total Assets EOY | $12,726,012 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $4,720,899 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $4,713,598 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $7,065,591 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $8,012,414 | NetAssetsOrFundBalancesEOYAmt |
| Mission | SEMO HEALTH NETWORK IS COMMITTED TO PROVIDING AFFORDABLE, QUALITY HEALTHCARE TO THE COMMUNITIES OF SOUTHEAST MISSOURI. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $11,777,235 | ExpenseAmt |
| Revenue | $10,594,819 | RevenueAmt |
| Desc | SEMO HEALTH NETWORK PROVIDED 25,440 MEDICAL VISITS, 1,139 BEHAVIORAL HEALTH VISITS, 175 OBSTETRICAL AND GYNECOLOGICAL VISITS, 19,602 DENTAL VISITS, AND 143 NUTRITIONAL SERVICES IN SOUTHEAST MISSOURI THROUGH THE OPERATION OF MIGRANT AND COMMUNITY HEALTH CENTERS IN THE CALENDAR YEAR. | Desc |
| Total Program Service Expenses | $11,777,235 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 24 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 188 | EmployeeCnt |
| Employment Tax Returns Filed | 0 | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| 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 | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | 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 | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SARA DEANE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5737482592 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6738 HIGHWAY 77 | AddressLine1Txt |
| City | BENTON | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 63736 | 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 | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| CATHERINE BOCKHOLD | |||||||
| PRESIDENT | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| EVELYN PULLIAM | |||||||
| VICE PRESIDENT | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| MARY DAVIS | |||||||
| TREASURER | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| BYRON MCVAY | |||||||
| SECRETARY | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| VICKI GILLESPIE | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| CINDY AMICK | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| DAVID HOWARD | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| LANCE CRAWFORD | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| DON MILLER | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| RICHARD RICKMAN | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| CHRIS JONES | |||||||
| CEO | 40.00 | Yes (X) | $280,258 | $0 | $19,882 | ||
| SARA BETH DEANE | |||||||
| CFO | 40.00 | Yes (X) | $221,937 | $0 | $19,882 | ||
| SCOTT LAWRENCE | |||||||
| COO | 40.00 | Yes (X) | $115,250 | $0 | $5,309 | ||
| TERESA RICHEY | |||||||
| CHIEF NURSING OFFICER | 40.00 | Yes (X) | $104,998 | $0 | $1,145 | ||
| DR DANIEL DOMJAN | |||||||
| CHIEF MEDICAL OFFICER | 40.00 | Yes (X) | $243,614 | $0 | $19,763 | ||
| DR JOHN MAJORS | |||||||
| DENTIST | 40.00 | $139,427 | $0 | $9,529 | Yes (X) | ||
| DR MACK TAYLOR | |||||||
| DENTIST | 40.00 | $179,357 | $0 | $4,737 | Yes (X) | ||
| DR DEAN CANSLER | |||||||
| DENTIST | 40.00 | $130,136 | $0 | $325 | Yes (X) | ||
| DR NATHAN SPRENGEL | |||||||
| DOCTOR | 40.00 | $234,076 | $0 | $19,882 | Yes (X) | ||
| TRAVIS WEISS | |||||||
| PHYSICIAN ASSISTANT | 40.00 | $157,599 | $0 | $20,932 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,806,652 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $121,386 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 17 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| MEDOVA HEALTHCARE | |||||
| 345 N RIVERVIEW SUITE 600 | WICHITA | KS | 67203 | INSURANCE | $786,831 |
| MCKESSON MEDICAL SURGICAL | |||||
| PO BOX 634404 | CINCINNATI | OH | 45263 | SUPPLIES | $505,816 |
| ATHENA HEALTH | |||||
| PO BOX 415615 | BOSTON | MA | 22410 | EMR SOFTWARE | $359,728 |
| PATRICIA MERKLEY LLC | |||||
| 1747 N KIGNSHIGHWAY | CAPE GIRARDEAU | MO | 63701 | DENTAL SERVICES | $358,727 |
| DR SUSAN SHEETS DDS | |||||
| 2436 MYRA DRIVE | CAPE GIRARDEAU | MO | 63703 | DENTAL SERVICES | $315,999 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 10 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $4,816,695 | GovernmentGrantsAmt |
| Total Contributions | $4,816,695 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE FEES | 621110 | $8,688,772 | $8,688,772 |
| 340B PHARMACY PROGRAM REVENUE | 621110 | $1,710,978 | $1,710,978 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $10,399,750 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $46,959 | TotalRevenueColumnAmt |
| Exclusion | $46,959 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $15,000 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $16,730 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$1,730 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$1,730 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | -$1,730 | UnrelatedBusinessRevenueAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $38,495 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$38,495 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$38,495 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | -$38,495 | RelatedOrExemptFuncIncomeAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OTHER REVENUE | Desc |
| Business | 621110 | BusinessCd |
| Total Revenue Column | $233,564 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $233,564 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $233,564 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $15,456,743 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $10,594,819 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | -$1,730 | UnrelatedBusinessRevenueAmt |
| Exclusion | $46,959 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,032,038 | TotalAmt |
| Program Services | $422,615 | ProgramServicesAmt |
| Management And General | $609,423 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,203,160 | TotalAmt |
| Program Services | $6,293,636 | ProgramServicesAmt |
| Management And General | $909,524 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,493,722 | TotalAmt |
| Program Services | $1,233,148 | ProgramServicesAmt |
| Management And General | $260,574 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $78,874 | TotalAmt |
| Program Services | $15,775 | ProgramServicesAmt |
| Management And General | $63,099 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $84,996 | TotalAmt |
| Program Services | $48,119 | ProgramServicesAmt |
| Management And General | $36,877 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $112,255 | TotalAmt |
| Program Services | $78,078 | ProgramServicesAmt |
| Management And General | $34,177 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $801,338 | TotalAmt |
| Program Services | $748,415 | ProgramServicesAmt |
| Management And General | $52,923 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $857,365 | TotalAmt |
| Program Services | $633,198 | ProgramServicesAmt |
| Management And General | $224,167 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $450,527 | TotalAmt |
| Program Services | $345,387 | ProgramServicesAmt |
| Management And General | $105,140 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $59,985 | TotalAmt |
| Program Services | $23,794 | ProgramServicesAmt |
| Management And General | $36,191 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $170,717 | TotalAmt |
| Program Services | $30,487 | ProgramServicesAmt |
| Management And General | $140,230 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $340,768 | TotalAmt |
| Program Services | $270,875 | ProgramServicesAmt |
| Management And General | $69,893 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $133,955 | TotalAmt |
| Program Services | $65,250 | ProgramServicesAmt |
| Management And General | $68,705 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| CONTRACT LABOR | $810,173 | $810,173 | |
| 340B PHARMACY PROGRAM E | $421,517 | $400,441 | $21,076 |
| UTILITIES | $148,151 | $132,237 | $15,914 |
| DUES & SUBSCRIPTIONS | $117,672 | $61,467 | $56,205 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $192,707 | TotalAmt |
| Program Services | $164,140 | ProgramServicesAmt |
| Management And General | $28,567 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,509,920 | TotalAmt |
| Program Services | $11,777,235 | ProgramServicesAmt |
| Management And General | $2,732,685 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,401,000 | BOYAmt |
| EOY | $1,891,326 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,556,930 | BOYAmt |
| EOY | $3,019,682 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $166,465 | BOYAmt |
| EOY | $145,580 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,807,108 | BOYAmt |
| EOY | $2,021,622 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $85,175 | BOYAmt |
| EOY | $108,764 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $7,962,376 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $2,453,523 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,769,812 | BOYAmt |
| EOY | $5,508,853 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $30,185 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,786,490 | BOYAmt |
| EOY | $12,726,012 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $835,334 | BOYAmt |
| EOY | $959,901 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,752,346 | BOYAmt |
| EOY | $3,107,302 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $133,219 | BOYAmt |
| EOY | $646,395 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,720,899 | BOYAmt |
| EOY | $4,713,598 | 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 | $7,065,591 | BOYAmt |
| EOY | $8,012,414 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,065,591 | BOYAmt |
| EOY | $8,012,414 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,786,490 | BOYAmt |
| EOY | $12,726,012 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $946,823 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,625,337 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,020,826 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $4,030,367 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $4,051,686 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,816,695 | CurrentTaxYearAmt |
| Total | $20,544,911 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,625,337 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,020,826 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $4,030,367 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $4,051,686 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,816,695 | CurrentTaxYearAmt |
| Total | $20,544,911 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $20,544,911 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | $1,009 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $28,351 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $46,959 | CurrentTaxYearAmt |
| Total | $76,319 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $170,097 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $175,512 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $256,580 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $171,879 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $248,564 | CurrentTaxYearAmt |
| Total | $1,022,632 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $21,643,862 | TotalSupportAmt |
| Public Support CY170 | 0.94920 | PublicSupportCY170Pct |
| Public Support PY170 | 0.95300 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $297,454 | OtherCostOrOtherBasisAmt |
| Book Value | $297,454 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $147,461 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $5,799,698 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,363,486 | DepreciationAmt |
| Book Value | $4,583,673 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $45,692 | OtherCostOrOtherBasisAmt |
| Depreciation | $27,987 | DepreciationAmt |
| Book Value | $17,705 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,619,729 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,018,360 | DepreciationAmt |
| Book Value | $601,369 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $52,342 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $43,690 | DepreciationAmt |
| Book Value | $8,652 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $5,508,853 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| DUE TO THIRD PARTIES | $570,059 |
| PATIENT OVERPAYMENT PAYABLE | $76,336 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $646,395 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $15,473,473 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | $16,730 | OtherRevenueAmt |
| Revenue Not Reported | $16,730 | RevenueNotReportedAmt |
| Revenue Subtotal | $15,456,743 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $15,456,743 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $14,526,650 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $16,730 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $16,730 | ExpensesNotReportedAmt |
| Expenses Subtotal | $14,509,920 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $14,509,920 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | RENTAL EXPENSES 16,730. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | RENTAL EXPENSES 16,730. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| 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 (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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CHRIS JONES | ||||||||||||||
| CEO | $280,258 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $19,882 | $0 | $300,140 | $0 | $0 | $0 |
| SARA BETH DEANE | ||||||||||||||
| CFO | $221,937 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $19,882 | $0 | $241,819 | $0 | $0 | $0 |
| DR DANIEL DOMJAN | ||||||||||||||
| CHIEF MEDICAL OFFICER | $243,614 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $19,763 | $0 | $263,377 | $0 | $0 | $0 |
| DR MACK TAYLOR | ||||||||||||||
| DENTIST | $179,357 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $4,737 | $0 | $184,094 | $0 | $0 | $0 |
| DR NATHAN SPRENGEL | ||||||||||||||
| DOCTOR | $234,076 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $19,882 | $0 | $253,958 | $0 | $0 | $0 |
| TRAVIS WEISS | ||||||||||||||
| PHYSICIAN ASSISTANT | $157,599 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $20,932 | $0 | $178,531 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 3 | FormAndLineReferenceDesc |
| Explanation | THE CONTRACTS ARE BROUGHT BEFORE THE BOARD AND THE SALARY IS DISCUSSED AND VOTED ON FOR EACH OFFICER DURING EXECUTIVE SESSIONS. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 IS PREPARED BY THE INDEPENDENT AUDITORS AND REVIEWED BY MANAGEMENT. A COPY IS PROVIDED TO BOARD MEMBERS PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | ANY CONFLICT BROUGHT TO LIGHT IS ADDRESSED AT THE BOARD MEETING AND A PLAN OF ACTION IS DECIDED BY THE BOARD MEMBERS. |
| FORM 990, PART VI, SECTION B, LINE 15A | THE COMPENSATION COMMITTEE MEETS AND REVIEWS PERFORMANCE APPRAISALS PREPARED BY ALL BOARD MEMBERS. THE COMMITTEE ALSO REVIEWS COMPENSATION OF OFFICIALS IN SIMILAR POSITIONS IN LIKE ORGANIZATIONS. AFTER THE REVIEW, THE EXECUTIVE DIRECTOR COMPENSATION IS THEN DETERMINED. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON WRITTEN REQUEST. |
| FORM 990 | THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. |