PRIMARY HEALTH SERVICES CENTER: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- PRIMARY HEALTH SERVICES CENTER (EIN 72-1347028)
- Tax period
- 2020-01-01 to 2020-12-31
- Filed
- 2021-11-11
- IRS object ID
- 202143159349302459
- Schema version
- 2020v4.1
- 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 | 2021-11-11T10:33:38-05:00 | ReturnTs |
| Tax Period End | 2020-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Steven M DeRouen & Associates | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | P O Box 4265 | AddressLine1Txt |
| City | Lake Charles | CityNm |
| State Abbreviation | LA | StateAbbreviationCd |
| ZIP | 70606 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 721347028 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Primary Health Services Center Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PRIM | BusinessNameControlTxt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 7495 | AddressLine1Txt |
| City | Monroe | CityNm |
| State Abbreviation | LA | StateAbbreviationCd |
| ZIP | 71211 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Catherine Tonore | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 3183881250 | PhoneNum |
| Signature | 2021-11-02 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | Catherine | PersonFirstNm |
| Person Last | Tonore | PersonLastNm |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Steven M DeRouen | PreparerPersonNm |
| PTIN | P01050140 | PTIN |
| Phone | 3375134915 | PhoneNum |
| Preparation | 2021-11-11 | PreparationDt |
| Self Employed | Yes (X) | SelfEmployedInd |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 0 | TrustedCustomerCd |
| OOB Security Verification | 00 | OOBSecurityVerificationCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Catherine Tonore | PrincipalOfficerNm |
| Gross Receipts | $13,733,187 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.phsccenter.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1997 | FormationYr |
| Legal Domicile State | LA | LegalDomicileStateCd |
| Activity Or Mission | To provide quality, comprehensive, compassionate, and culturally appropriate primary and preventive healthcare services to residents in medically underserved North Louisiana. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 182 | TotalEmployeeCnt |
| Total Volunteers | 10 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $4,830,565 | PYContributionsGrantsAmt |
| CY Contributions Grants | $5,758,642 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $6,866,705 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $7,580,164 | CYProgramServiceRevenueAmt |
| PY Investment Income | $123,145 | PYInvestmentIncomeAmt |
| CY Investment Income | $195,406 | CYInvestmentIncomeAmt |
| PY Other Revenue | $22,236 | PYOtherRevenueAmt |
| CY Other Revenue | $198,975 | CYOtherRevenueAmt |
| PY Total Revenue | $11,842,651 | PYTotalRevenueAmt |
| CY Total Revenue | $13,733,187 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $8,984,436 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $9,966,854 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $3,235,332 | PYOtherExpensesAmt |
| CY Other Expenses | $2,973,698 | CYOtherExpensesAmt |
| PY Total Expenses | $12,219,768 | PYTotalExpensesAmt |
| CY Total Expenses | $12,940,552 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$377,117 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $792,635 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $15,565,339 | TotalAssetsBOYAmt |
| Total Assets EOY | $17,539,018 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $3,259,937 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $4,440,981 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $12,305,402 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $13,098,037 | NetAssetsOrFundBalancesEOYAmt |
| Mission | To provide quality, comprehensive, compassionate, and culturally appropriate primary and preventive healthcare services to residents in medically underserved North Louisiana. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $10,395,577 | ExpenseAmt |
| Revenue | $7,580,164 | RevenueAmt |
| Desc | To provide quality, comprehensive, compassionate, and culturally appropriate primary and preventive healthcare services to residents in medically underserved North Louisiana. | Desc |
| Total Program Service Expenses | $10,395,577 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| 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 | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | 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 | false | 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 | Yes (true) | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | false | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 40 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | false | BackupWthldComplianceInd |
| Employee | 182 | 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 | Yes (true) | 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 | Yes (true) | 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 | Yes (true) | 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 | Treshan Williams | PersonNm |
| Phone | 3183881250 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2913 Betin Avenue | AddressLine1Txt |
| City | Monroe | CityNm |
| State Abbreviation | LA | StateAbbreviationCd |
| ZIP | 71201 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (25 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|---|---|
| Catherine Tonore | |||||||||
| CEO | 40.00 | 0.00 | Yes (X) | $715,445 | $0 | $44,995 | |||
| Ginny Norris | |||||||||
| COO | 40.00 | 0.00 | Yes (X) | $340,181 | $0 | $22,375 | |||
| John Coats | |||||||||
| Physician | 40.00 | 0.00 | $284,615 | $0 | $1,984 | Yes (X) | |||
| Pamela Chisley | |||||||||
| Grant Management | 40.00 | 0.00 | $247,933 | $0 | $11,615 | Yes (X) | |||
| Mark Meredith | |||||||||
| Dentist | 40.00 | 0.00 | $226,922 | $0 | $8,308 | Yes (X) | |||
| Treshan Williams Jr | |||||||||
| CFO | 40.00 | 0.00 | Yes (X) | $201,848 | $0 | $10,618 | |||
| Long Truong | |||||||||
| Dentist | 40.00 | 0.00 | $199,673 | $0 | $10,093 | Yes (X) | |||
| Minh Le | |||||||||
| Dental | 40.00 | 0.00 | $175,750 | $0 | $11,568 | Yes (X) | |||
| Byron Hammer | |||||||||
| Psychiatrist | 40.00 | 0.00 | $167,250 | $0 | $0 | Yes (X) | |||
| Victoria Elliott | |||||||||
| Operations Manager | 40.00 | 0.00 | $148,577 | $0 | $7,374 | Yes (X) | |||
| Cynthia Paige | |||||||||
| Quality Director | 40.00 | 0.00 | $155,000 | $0 | $0 | Yes (X) | |||
| Adrian Washington | |||||||||
| Family Nurse Practitioner | 40.00 | 0.00 | $147,500 | $0 | $5,400 | Yes (X) | |||
| Linda Reid | |||||||||
| Womens Health Nurse Practiti | 40.00 | 0.00 | $146,500 | $0 | $5,360 | Yes (X) | |||
| Amber Robertson | |||||||||
| Family Nurse Practitioner | 40.00 | 0.00 | $144,692 | $0 | $0 | Yes (X) | |||
| Elton Farrar | |||||||||
| Pharmacist | 40.00 | 0.00 | $143,600 | $0 | $384 | Yes (X) | |||
| Sallie Evans | |||||||||
| Board Member | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| Shelia Riley | |||||||||
| Board Member | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| Leon Smith | |||||||||
| Board Member | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| Arnita Spencer | |||||||||
| Board Member | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| Betty Ann Bullock | |||||||||
| Board Member | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| Cathy Holmes-Giles | |||||||||
| Board Member | 2.00 | 0.00 | $0 | $0 | $0 | Yes (X) | |||
| Bertha Williams | |||||||||
| Treasurer | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| Vanessa Johnson | |||||||||
| President | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| Sandra Daigre | |||||||||
| Secretary | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| Willie Robinson Sr | |||||||||
| Vice President | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $3,445,486 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $140,074 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 24 | 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 |
|---|---|---|---|---|---|
| Chauvin Lane Enterprises LLC | |||||
| 409 Chauvin Lane | Monroe | LA | 71211 | Medical Director | $147,000 |
| Jan Randolph | |||||
| PO Box 2434 | Corrales | NM | 87048 | Grant Consulting | $159,500 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $5,706,742 | GovernmentGrantsAmt |
| All Other Contributions | $51,900 | AllOtherContributionsAmt |
| Total Contributions | $5,758,642 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Patient Services | 621300 | $7,572,417 | $7,572,417 |
| Medical Records Income | 621300 | $7,747 | $7,747 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $7,580,164 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $195,406 | TotalRevenueColumnAmt |
| Exclusion | $195,406 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $4,500 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $4,500 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,500 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $4,500 | RelatedOrExemptFuncIncomeAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Miscellaneous Income | 621300 | $18,644 | $18,644 |
| Insurance Recoveries | 621300 | $175,831 | $175,831 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $194,475 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $13,733,187 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $7,779,139 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $195,406 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,836,173 | TotalAmt |
| Program Services | $2,410,747 | ProgramServicesAmt |
| Management And General | $425,426 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,680,135 | TotalAmt |
| Program Services | $5,678,115 | ProgramServicesAmt |
| Management And General | $1,002,020 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $172,168 | TotalAmt |
| Program Services | $146,343 | ProgramServicesAmt |
| Management And General | $25,825 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $278,378 | TotalAmt |
| Program Services | $253,621 | ProgramServicesAmt |
| Management And General | $24,757 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,380 | TotalAmt |
| Program Services | $14,472 | ProgramServicesAmt |
| Management And General | $9,908 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $37,589 | TotalAmt |
| Program Services | $22,312 | ProgramServicesAmt |
| Management And General | $15,277 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $487,921 | TotalAmt |
| Program Services | $27,254 | ProgramServicesAmt |
| Management And General | $460,667 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,613 | TotalAmt |
| Program Services | $20,613 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $289,623 | TotalAmt |
| Program Services | $139,335 | ProgramServicesAmt |
| Management And General | $150,288 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $73,848 | TotalAmt |
| Program Services | $29,539 | ProgramServicesAmt |
| Management And General | $44,309 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $259,298 | TotalAmt |
| Program Services | $220,403 | ProgramServicesAmt |
| Management And General | $38,895 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $44,554 | TotalAmt |
| Management And General | $44,554 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $147,806 | TotalAmt |
| Program Services | $125,635 | ProgramServicesAmt |
| Management And General | $22,171 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $318,558 | TotalAmt |
| Program Services | $270,774 | ProgramServicesAmt |
| Management And General | $47,784 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $195,984 | TotalAmt |
| Program Services | $166,586 | ProgramServicesAmt |
| Management And General | $29,398 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Medical Supply and Services | $400,566 | $400,566 | |
| Repairs and Maintenance | $319,238 | $271,352 | $47,886 |
| Rental Expense | $188,512 | $160,235 | $28,277 |
| Dues and Permits | $53,434 | $53,434 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $111,774 | TotalAmt |
| Program Services | $37,675 | ProgramServicesAmt |
| Management And General | $74,099 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,940,552 | TotalAmt |
| Program Services | $10,395,577 | ProgramServicesAmt |
| Management And General | $2,544,975 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $52,153 | BOYAmt |
| EOY | $1,654,282 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,238,344 | BOYAmt |
| EOY | $1,459,236 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,519,896 | BOYAmt |
| EOY | $1,403,418 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $276,907 | BOYAmt |
| EOY | $215,286 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,433,394 | BOYAmt |
| EOY | $9,433,394 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $76,548 | BOYAmt |
| EOY | $99,102 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $7,304,790 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $4,054,661 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,943,926 | BOYAmt |
| EOY | $3,250,129 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,000 | BOYAmt |
| EOY | $10,000 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,171 | BOYAmt |
| EOY | $14,171 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,565,339 | BOYAmt |
| EOY | $17,539,018 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $496,089 | BOYAmt |
| EOY | $459,402 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,734,576 | BOYAmt |
| EOY | $3,980,857 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $29,272 | BOYAmt |
| EOY | $722 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,259,937 | BOYAmt |
| EOY | $4,440,981 | 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 | $10,785,506 | BOYAmt |
| EOY | $11,694,619 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,519,896 | BOYAmt |
| EOY | $1,403,418 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,305,402 | BOYAmt |
| EOY | $13,098,037 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,565,339 | BOYAmt |
| EOY | $17,539,018 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $792,635 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| 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) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| 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) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,467,285 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,797,514 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $4,291,834 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $4,406,885 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $5,758,642 | CurrentTaxYearAmt |
| Total | $21,722,160 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $5,296,239 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $6,083,902 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $6,226,474 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $6,866,705 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $7,580,164 | CurrentTaxYearAmt |
| Total | $32,053,484 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $8,763,524 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $9,881,416 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $10,518,308 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $11,273,590 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $13,338,806 | CurrentTaxYearAmt |
| Total | $53,775,644 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $53,775,644 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $95,364 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $98,366 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $105,275 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $123,145 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $195,406 | CurrentTaxYearAmt |
| Total | $617,556 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $95,364 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $98,366 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $105,275 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $123,145 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $195,406 | CurrentTaxYearAmt |
| Total | $617,556 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | $22,236 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $198,975 | CurrentTaxYearAmt |
| Total | $221,211 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $8,858,888 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $9,979,782 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $10,623,583 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $11,418,971 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $13,733,187 | CurrentTaxYearAmt |
| Total | $54,614,411 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.98460 | PublicSupportCY509Pct |
| Public Support PY509 | 0.98580 | PublicSupportPY509Pct |
| Investment Income CY | 0.01000 | InvestmentIncomeCYPct |
| Investment Income PY | 0.01000 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Other income Part II line 10 or Part III line 12 | FormAndLineReferenceDesc |
| Explanation | Other income includes: Property Rental Income $4,500, Other Income $18,644, and Insurance Reimbursement Proceeds $175,831. | ExplanationTxt |
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 | $436,999 | OtherCostOrOtherBasisAmt |
| Book Value | $436,999 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,092,223 | OtherCostOrOtherBasisAmt |
| Depreciation | $644,222 | DepreciationAmt |
| Book Value | $1,448,001 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,775,568 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,410,439 | DepreciationAmt |
| Book Value | $1,365,129 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $3,250,129 | TotalBookValueLandBuildingsAmt |
Closely Held Equity Interests CloselyHeldEquityInterestsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Book Value | $10,000 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $10,000 | TotalBookValueSecuritiesAmt |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Utility Deposits | Desc |
| Book Value | $14,171 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $14,171 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Accrued Interest Payable | Desc |
| Amt | $722 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $722 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $13,733,187 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Subtotal | $13,733,187 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $13,733,187 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $12,940,552 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $12,940,552 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $12,940,552 | TotalExpensesPerForm990Amt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| 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 | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (true) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (13 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt |
|---|---|---|---|---|---|---|
| Ginny Norris PhD | ||||||
| COO | $252,470 | $81,711 | $6,000 | $11,109 | $11,266 | $362,556 |
| Catherine Tonore | ||||||
| CEO | $487,580 | $208,700 | $19,165 | $33,729 | $11,266 | $760,440 |
| Minh Le | ||||||
| Dental | $159,327 | $16,423 | $5,935 | $5,633 | $187,318 | |
| Treshan Williams Jr | ||||||
| CFO | $131,538 | $70,310 | $4,985 | $5,633 | $212,466 | |
| Pamela Chisley | ||||||
| Grant Management | $166,154 | $73,079 | $8,700 | $5,982 | $5,633 | $259,548 |
| Byron Hammer | ||||||
| Psychiatrist | $167,250 | $167,250 | ||||
| Cynthia Paige | ||||||
| Quality Director | $134,769 | $20,231 | $155,000 | |||
| Mark Meredith | ||||||
| Dentist | $207,692 | $19,230 | $8,308 | $235,230 | ||
| Adrian Washington | ||||||
| Family Nurse Practitioner | $135,000 | $12,500 | $5,400 | $152,900 | ||
| Long Truong | ||||||
| Dentist | $178,846 | $20,827 | $6,462 | $3,631 | $209,766 | |
| John Coats | ||||||
| Physician | $260,577 | $24,038 | $1,984 | $286,599 | ||
| Linda Reid | ||||||
| Womens Health Nurse Practitioner | $134,000 | $12,500 | $5,360 | $151,860 | ||
| Victoria Elliott | ||||||
| Operations Manager | $95,885 | $52,692 | $3,738 | $3,636 | $155,951 | |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Other non-fixed payments (Part I, line 7) | FormAndLineReferenceDesc |
| Explanation | Employees receive bonus compensation based on positive annual evaluations. Bonuses are approved by management and the Board of Directors. Also, employees received COVID related hazard bonus pay during 2020. | ExplanationTxt |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (5 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| Randy Morgan | |||
| Brother of CEO | $79,305 | Employee Wages - Security Director | false |
| Dr Ginny Tonore PhD | |||
| Daughter of CEO | $362,556 | Employee Wages - COO | false |
| Belinda Morgan | |||
| Sister-in-Law of CEO | $60,453 | Employee Wages - KidMed Coordinator | false |
| Gerald Tonore | |||
| Husband of CEO | $92,900 | Employee Wages - Pharmacy Director | false |
| Catherine E Tonore | |||
| Daughter of CEO | $44,625 | Employee Wages - COVID-19 Director | false |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Supplemental Information for Schedule L | FormAndLineReferenceDesc |
| Explanation | Randy Morgan is employed by Primary Health Services Center, Inc. and serves the Organization as Security Officer.Dr. Ginny Tonore is employed by Primary Health Services Center, Inc. and serves the Organization as Chief Operating Officer.Belinda Morgan is employed by Primary Health Services Center, Inc. and servces the Organization as KidMed Corrdinator.Gerald Tonore is employed by Primary Health Services Center, Inc. and servces the Organization as the Pharmacy Director. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Officer directors etc family relationship Part VI line 2 | The brother of the Chief Executive Officer serves as the Security Director for the organization. The daughter of the Chief Executive Officer serves as the Behavioral Health Program Director and Chief Operating Officer for the organization. The sister-in-law of the Chief Executive Officer serves as the KidMed Coordinator for the organization. The husband of the Chief Executive Officer serves as the Pharmacy Director for the organization. The daughter of the Chief Executive Officer serves as the COVID-19 Director during the peak of the COVID-19 pandemic. |
| Form 990 governing body review Part VI line 11 | The Form 990 is reviewed and approved by the Board of Directors prior to issuance. |
| Conflict of interest policy compliance Part VI line 12c | The Organization reviews conflict of interest issues as they arise and takes appropriate action. |
| CEO executive director top management comp Part VI line 15a | The Board of Directors performs a comparability study of similar organizations to determine all salaries. |
| Other officer or key employee compensation Part VI line 15b | The Board of Directors performs a comparability study of similar organizations to determine all salaries. |
| Governing documents etc available to public Part VI line 19 | The Centers governing documents, conflict of interest policy, and financial statements are made available to the public upon request. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Healthcare Vision Inc | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2913 Bentin Avenue | AddressLine1Txt |
| City | Monroe | CityNm |
| State Abbreviation | LA | StateAbbreviationCd |
| ZIP | 71201 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 471697044 | EIN |
| Primary Activities | New Market Tax Credit trans to develop healthcare building | PrimaryActivitiesTxt |
| Legal Domicile State | LA | LegalDomicileStateCd |
| Exempt Code Section | 501 c 3 | ExemptCodeSectionTxt |
| Public Charity Status | 12a | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Primary Health Services Center Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | Yes (true) | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (true) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | false | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Explanation of information on Schedule R | FormAndLineReferenceDesc |
| Explanation | Healthcare Vision, Inc., Transaction Type 1k, $113,680 (Annual), Cost Basis | ExplanationTxt |