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KANSAS CITY CARE CLINIC: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization
KANSAS CITY CARE CLINIC (EIN 43-0967292)
Tax period
2019-04-01 to 2020-03-31
Filed
2020-10-30
IRS object ID
202013049349300206
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

FieldValueIRS element (for citing)
Return2020-10-30T08:46:23-05:00ReturnTs
Tax Period End2020-03-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BKD LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line11201 Walnut Suite 1700AddressLine1Txt
CityKansas CityCityNm
State AbbreviationMOStateAbbreviationCd
ZIP641062246ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2019-04-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN430967292EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1KANSAS CITY CARE CLINICBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% GEORGE A BARRETOInCareOfNm
Business Name ControlKANSBusinessNameControlTxt
Phone8167535144PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line13515 BROADWAYAddressLine1Txt
CityKANSAS CITYCityNm
State AbbreviationMOStateAbbreviationCd
ZIP64111ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonWIL FRANKLINPersonNm
Person TitleCEOPersonTitleTxt
Phone8167535144PhoneNum
Signature2021-02-15SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonMichael J EnglePreparerPersonNm
PTINP00482834PTIN
Phone8162216300PhoneNum
Preparation2021-02-15PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address167.68.126.162IPv4AddressTxt
FieldValueIRS element (for citing)
Federal Original Submission Id43372220203045000000FederalOriginalSubmissionId
Federal Original Submission Id2020-10-30FederalOriginalSubmissionIdDt
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id83308F0D317DAFE6265870FC3D5F92CA49B998B3AtSubmissionCreationDeviceId
At Submission Filing Device Id67BEB7763AD19E9793F31E2A9F6A7AB8E10E21E3AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2019TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1KC CARE HEALTH CENTERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerWIL FRANKLINPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line13515 BROADWAYAddressLine1Txt
CityKANSAS CITYCityNm
State AbbreviationMOStateAbbreviationCd
ZIP64111ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$18,804,506GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.KCCARE.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1971FormationYr
Legal Domicile StateMOLegalDomicileStateCd
Activity Or MissionTO PROMOTE HEALTH AND WELLNESS BY PROVIDING QUALITY CARE, ACCESS, RESEARCH AND EDUCATION TO THE UNDERSERVED AND ALL PEOPLE IN OUR COMMUNITY.ActivityOrMissionDesc
Voting Members Governing Body11VotingMembersGoverningBodyCnt
Voting Members Independent11VotingMembersIndependentCnt
Total Employee231TotalEmployeeCnt
Total Volunteers858TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$9,681,622PYContributionsGrantsAmt
CY Contributions Grants$9,364,785CYContributionsGrantsAmt
PY Program Service Revenue$7,863,123PYProgramServiceRevenueAmt
CY Program Service Revenue$9,288,565CYProgramServiceRevenueAmt
PY Investment Income$9,076PYInvestmentIncomeAmt
CY Investment Income$14,309CYInvestmentIncomeAmt
PY Other Revenue$350,991PYOtherRevenueAmt
CY Other Revenue$29,954CYOtherRevenueAmt
PY Total Revenue$17,904,812PYTotalRevenueAmt
CY Total Revenue$18,697,613CYTotalRevenueAmt
PY Grants And Similar Paid$14,399PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$18,385CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$10,258,821PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$11,660,094CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$563,902CYTotalFundraisingExpenseAmt
PY Other Expenses$6,549,832PYOtherExpensesAmt
CY Other Expenses$6,568,169CYOtherExpensesAmt
PY Total Expenses$16,823,052PYTotalExpensesAmt
CY Total Expenses$18,246,648CYTotalExpensesAmt
PY Revenues Less Expenses$1,081,760PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$450,965CYRevenuesLessExpensesAmt
Total Assets BOY$5,790,894TotalAssetsBOYAmt
Total Assets EOY$6,619,291TotalAssetsEOYAmt
Total Liabilities BOY$1,418,143TotalLiabilitiesBOYAmt
Total Liabilities EOY$1,819,987TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$4,372,751NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$4,799,304NetAssetsOrFundBalancesEOYAmt
MissionTHE MISSION OF KC CARE HEALTH CENTER IS TO PROMOTE HEALTH AND WELLNESS BY PROVIDING QUALITY CARE, ACCESS, RESEARCH AND EDUCATION TO THE UNDERSERVED AND ALL PEOPLE IN OUR COMMUNITY.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$13,425,407ExpenseAmt
Grant$18,385GrantAmt
Revenue$8,867,685RevenueAmt
DescKC CARE PROVIDES AFFORDABLE HEALTHCARE TO THOUSANDS OF LOW-INCOME, UNINSURED, AND UNDER-INSURED INDIVIDUALS IN THE KANSAS CITY, MISSOURI AREA. IN THE LAST FISCAL YEAR, KC CARE SERVED 11,443 PATIENTS IN PRIMARY CARE, 1,819 IN BEHAVIORAL HEALTH, AND 1,363 IN DENTAL CARE. THE PHARMACY DISPENSED 33,582 PRESCRIPTIONS. KC CARE SERVED 19,108 PATIENTS THROUGH 109,316 TOTAL ENCOUNTERS ACROSS ALL PROGRAMS, INCLUDING CASE MANAGEMENT, EDUCATION, AND OUTREACH. MORE THAN 850 VOLUNTEERS PROVIDED 18,000+ HOURS OF SERVICE TO KC CARE, INCLUDING 208 TEACHING AND MEDICAL STUDENTS THAT GAINED 4,022 HOURS OF PRACTICAL EXPERIENCE.Desc
Total Program Service Expenses$13,425,407TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsYes (true)DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (true)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesYes (true)FundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsYes (true)GrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document33IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee231EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsYes (true)QuidProQuoContributionsInd
Quid Pro Quo Contri DisclYes (true)QuidProQuoContriDisclInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members11GoverningBodyVotingMembersCnt
Independent Voting Member11IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldMOStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonGEORGE A BARRETOPersonNm
Phone8167772766PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line13515 BROADWAYAddressLine1Txt
CityKANSAS CITYCityNm
State AbbreviationMOStateAbbreviationCd
ZIP64111ZIPCd
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd

Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeIndIndividual Trustee Or DirectorIndividualTrusteeOrDirectorInd
CRAIG A DIETZ
CHIEF MEDICAL OFFICER40.00.0Yes (X)$219,617$0$21,457
BLAIR THEDINGER
ASSOCIATE MEDICAL DIRECTOR40.00.0$196,331$0$19,166Yes (X)
GEORGE A BARRETO
CFO40.00.0Yes (X)$159,982$0$24,058
DENNIS DUNMYER
CHIEF OPERATING OFFICER40.00.0Yes (X)$142,775$0$32,998
WIL FRANKLIN
CEO (START 5/02/2019)40.00.0Yes (X)$146,823$0$20,648
KAMILE JOHNSON
VP, PHARMACY SERVICES40.00.0$147,304$0$17,219Yes (X)
Margaret Boehm
DIRECTOR OF ORAL HEALTH40.00.0$131,519$0$27,454Yes (X)
Teresa Mathis
Chief Complliance Officer40.00.0$123,941$0$23,075Yes (X)
Douglas Day
Marketing/Developing Officer40.00.0$116,149$0$22,388Yes (X)
KATE MCKINNEY
DIRECTOR1.00.0$0$0$0Yes (X)
BERT MALONE
DIRECTOR/CHAIR1.00.0Yes (X)$0$0$0Yes (X)
NIKKI BEARD
DIRECTOR1.00.0$0$0$0Yes (X)
TOM NAGEL
DIRECTOR/TREASURER1.00.0Yes (X)$0$0$0Yes (X)
CHADWICK BROOKS
DIRECTOR/SECRETARY1.00.0Yes (X)$0$0$0Yes (X)
KAREN E JONES
DIRECTOR1.00.0$0$0$0Yes (X)
W DRUE THOMAS JR
DIRECTOR1.00.0$0$0$0Yes (X)
CAROL THRANE
DIRECTOR1.00.0$0$0$0Yes (X)
ANDAND RAJARA
DIRECTOR1.00.0$0$0$0Yes (X)
LAURA FOLEY
DIRECTOR1.00.0$0$0$0Yes (X)
CHRISTOPHER CARTER
DIRECTOR1.00.0$0$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,384,441TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$208,463TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K17IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (3 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
CORNERSTONES OF CARE
300 E 36TH STKANSAS CITYMO64111PRACTITIONER SERVICE$225,300
IDEOLITY
5800 FOXRIDGE DRMISSIONKS66202TECHNOLOGY$136,420
ECLINICALWORKS LLC
2 TECHNOLOGY DRWESTBOROUGHMA01581EHR$107,667
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K3CntrctRcvdGreaterThan100KCnt
Federated Campaigns$30,005FederatedCampaignsAmt
Fundraising$113,898FundraisingAmt
Government Grants$7,155,768GovernmentGrantsAmt
All Other Contributions$2,065,114AllOtherContributionsAmt
Total Contributions$9,364,785TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Program Service Fee621400$8,925,885$8,925,885
CLINICAL TRIALS900099$340,703$340,703
MEDICAL RECORDS FEES900099$21,977$21,977
_
_
FieldValueIRS element (for citing)
Total Program Service Revenue$9,288,565TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$8,640TotalRevenueColumnAmt
Exclusion$8,640ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$0RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$51,580SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$45,911SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$5,669SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$5,669TotalRevenueColumnAmt
Exclusion$5,669ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$65,991FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$113,898ContriRptFundraisingEventAmt
Fundraising Direct Expenses$60,982FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$5,009TotalRevenueColumnAmt
Exclusion$5,009ExclusionAmt
FieldValueIRS element (for citing)
Gaming Gross Income$0GamingGrossIncomeAmt
Gaming Direct Expenses$0GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$0GrossSalesOfInventoryAmt
Cost Of Goods Sold$0CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmt
REBATE INCOME900099$8,567$8,567
All Other Misc Revenue900099$16,378$16,378

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$16,378TotalRevenueColumnAmt
Exclusion$16,378ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$24,945OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$18,697,613TotalRevenueColumnAmt
Related Or Exempt Func Income$9,288,565RelatedOrExemptFuncIncomeAmt
Exclusion$44,263ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$18,385TotalAmt
Program Services$18,385ProgramServicesAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$842,452TotalAmt
Program Services$145,349ProgramServicesAmt
Management And General$697,103ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$8,822,524TotalAmt
Program Services$6,937,444ProgramServicesAmt
Management And General$1,523,317ManagementAndGeneralAmt
Fundraising$361,763FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$143,566TotalAmt
Program Services$132,087ProgramServicesAmt
Management And General$4,591ManagementAndGeneralAmt
Fundraising$6,888FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,142,663TotalAmt
Program Services$703,589ProgramServicesAmt
Management And General$414,783ManagementAndGeneralAmt
Fundraising$24,291FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$708,889TotalAmt
Program Services$557,423ProgramServicesAmt
Management And General$122,398ManagementAndGeneralAmt
Fundraising$29,068FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$93,322TotalAmt
Management And General$93,322ManagementAndGeneralAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$920TotalAmt
Management And General$920ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$870,031TotalAmt
Program Services$643,630ProgramServicesAmt
Management And General$181,048ManagementAndGeneralAmt
Fundraising$45,353FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$83,546TotalAmt
Program Services$9,986ProgramServicesAmt
Management And General$13,669ManagementAndGeneralAmt
Fundraising$59,891FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$3,383,940TotalAmt
Program Services$3,159,634ProgramServicesAmt
Management And General$213,700ManagementAndGeneralAmt
Fundraising$10,606FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$391,861TotalAmt
Program Services$4,299ProgramServicesAmt
Management And General$376,043ManagementAndGeneralAmt
Fundraising$11,519FundraisingAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$101,268TotalAmt
Program Services$81,513ProgramServicesAmt
Management And General$19,461ManagementAndGeneralAmt
Fundraising$294FundraisingAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$23,290TotalAmt
Program Services$13,689ProgramServicesAmt
Management And General$9,261ManagementAndGeneralAmt
Fundraising$340FundraisingAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$1,431TotalAmt
Program Services$1,431ProgramServicesAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$175,740TotalAmt
Program Services$134,629ProgramServicesAmt
Management And General$36,645ManagementAndGeneralAmt
Fundraising$4,466FundraisingAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$57,932TotalAmt
Program Services$40,530ProgramServicesAmt
Management And General$16,057ManagementAndGeneralAmt
Fundraising$1,345FundraisingAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
Medical Supplies$376,321$376,321
Payments to Subrecipients$268,042$268,042
Equipment Rental & Maint$515,502$50,664$464,779$59
_$0

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$225,023TotalAmt
Program Services$146,762ProgramServicesAmt
Management And General$70,242ManagementAndGeneralAmt
Fundraising$8,019FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$18,246,648TotalAmt
Program Services$13,425,407ProgramServicesAmt
Management And General$4,257,339ManagementAndGeneralAmt
Fundraising$563,902FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$800BOYAmt
EOY$1,100EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$688,704BOYAmt
EOY$738,609EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$2,071,612BOYAmt
EOY$1,906,467EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$722,388BOYAmt
EOY$1,222,317EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$68,191BOYAmt
EOY$103,166EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$132,662BOYAmt
EOY$250,919EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$4,811,783LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$2,792,955LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$1,756,868BOYAmt
EOY$2,018,828EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$177,143BOYAmt
EOY$160,501EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$172,526BOYAmt
EOY$217,384EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$5,790,894BOYAmt
EOY$6,619,291EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,354,096BOYAmt
EOY$1,711,140EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$21,139BOYAmt
EOY$108,847EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$42,908BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,418,143BOYAmt
EOY$1,819,987EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$2,519,199BOYAmt
EOY$3,296,075EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,853,552BOYAmt
EOY$1,503,229EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$4,372,751BOYAmt
EOY$4,799,304EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$5,790,894BOYAmt
EOY$6,619,291EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$450,965ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$24,412NetUnrlzdGainsLossesInvstAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredYes (true)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (true)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$9,090,445CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$10,970,289CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$9,731,021CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$9,681,622CurrentTaxYearMinus1YearAmt
Current Tax Year$9,364,785CurrentTaxYearAmt
Total$48,838,162TotalAmt

Tax Rev Levied Orgnztnl Bnft170 TaxRevLeviedOrgnztnlBnft170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$9,090,445CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$10,970,289CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$9,731,021CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$9,681,622CurrentTaxYearMinus1YearAmt
Current Tax Year$9,364,785CurrentTaxYearAmt
Total$48,838,162TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$3,760,868SubstantialContributorsTotAmt
Public Support Total170$45,077,294PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$3,210CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$3,325CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$3,350CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$3,522CurrentTaxYearMinus1YearAmt
Current Tax Year$8,640CurrentTaxYearAmt
Total$22,047TotalAmt

Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Income170 OtherIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$3,008CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$6,552CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$91,601CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$445,319CurrentTaxYearMinus1YearAmt
Current Tax Year$24,945CurrentTaxYearAmt
Total$571,425TotalAmt
FieldValueIRS element (for citing)
Total Support$49,431,634TotalSupportAmt
Gross Receipts Rltd Activities$23,439,081GrossReceiptsRltdActivitiesAmt
Public Support CY1700.91191PublicSupportCY170Pct
Public Support PY1700.90647PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$189,445BeginningYearBalanceAmt
Investment Earnings Or Losses-$15,722InvestmentEarningsOrLossesAmt
Administrative Expenses$920AdministrativeExpensesAmt
End Year Balance$172,803EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$183,145BeginningYearBalanceAmt
Investment Earnings Or Losses$7,164InvestmentEarningsOrLossesAmt
Administrative Expenses$864AdministrativeExpensesAmt
End Year Balance$189,445EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$167,422BeginningYearBalanceAmt
Investment Earnings Or Losses$16,548InvestmentEarningsOrLossesAmt
Administrative Expenses$825AdministrativeExpensesAmt
End Year Balance$183,145EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$149,907BeginningYearBalanceAmt
Investment Earnings Or Losses$18,240InvestmentEarningsOrLossesAmt
Administrative Expenses$725AdministrativeExpensesAmt
End Year Balance$167,422EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$156,102BeginningYearBalanceAmt
Investment Earnings Or Losses-$5,496InvestmentEarningsOrLossesAmt
Administrative Expenses$695AdministrativeExpensesAmt
End Year Balance$149,911EndYearBalanceAmt
FieldValueIRS element (for citing)
Prmnnt Endowment Balance EOY0.62300PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.37700TermEndowmentBalanceEOYPct
Endowments Held Unrelated OrgfalseEndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgfalseEndowmentsHeldRelatedOrgInd
LandLandGrp

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,974,480OtherCostOrOtherBasisAmt
Depreciation$1,466,646DepreciationAmt
Book Value$1,507,834BookValueAmt
FieldValueIRS element (for citing)
Leasehold ImprovementsLeaseholdImprovementsGrp

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,837,303OtherCostOrOtherBasisAmt
Depreciation$1,326,309DepreciationAmt
Book Value$510,994BookValueAmt
FieldValueIRS element (for citing)
Other Land BuildingsOtherLandBuildingsGrp
Total Book Value Land Buildings$2,018,828TotalBookValueLandBuildingsAmt
Total Rev Etc Audited Fincl Stmt$20,902,567TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst-$24,412NetUnrealizedGainsInvstAmt
Donated Services And Use Fclts$2,214,882DonatedServicesAndUseFcltsAmt
Other Revenue$15,404OtherRevenueAmt
Revenue Not Reported$2,205,874RevenueNotReportedAmt
Revenue Subtotal$18,696,693RevenueSubtotalAmt
Investment Expenses Not Incld$920InvestmentExpensesNotIncldAmt
Revenue Not Reported Fincl Stmt$920RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$18,697,613TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$20,476,014TotExpnsEtcAuditedFinclStmtAmt
Donated Services Use Fclts$2,214,882DonatedServicesUseFcltsAmt
Other Expenses Included$15,404OtherExpensesIncludedAmt
Expenses Not Reported$2,230,286ExpensesNotReportedAmt
Expenses Subtotal$18,245,728ExpensesSubtotalAmt
Investment Expenses Not Incld2$920InvestmentExpensesNotIncld2Amt
Expenses Not Rpt Fincl Stmt$920ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$18,246,648TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
SCHEDULE D, PART V, LINE 4THE POLSKY ENDOWMENT WAS ESTABLISHED IN 2010 WITH AN INITIAL GIFT OF $50,000 FROM THE NORMAN AND ELAINE POLSKY FAMILY SUPPORTING FOUNDATION AND A MATCHING CONTRIBUTION FROM THE CLINIC OF $50,000, BOTH OF WHICH ARE TO BE HELD IN PERPETUITY, AS REQUIRED BY THE ENDOWMENT AGREEMENT (THE AGREEMENT). THE AGREEMENT SPECIFIES INVESTMENT AND SPENDING POLICIES FOR ENDOWMENT ASSETS THAT ATTEMPT TO PROVIDE A PREDICTABLE STREAM OF FUNDING TO PROGRAMS AND OTHER ITEMS SUPPORTED BY THE ENDOWMENT WHILE SEEKING TO MAINTAIN THE PURCHASING POWER OF THE ENDOWMENT. THE CLINIC EXPECTS ITS ENDOWMENT FUNDS TO PROVIDE AN AGGREGATE RATE OF RETURN THAT IS CONSISTENT WITH AVERAGE U.S. EQUITY SECURITY RETURNS. ACTUAL RETURNS IN ANY GIVEN YEAR MAY VARY FROM THIS AMOUNT. TO SATISFY ITS LONG-TERM RATE OF RETURN OBJECTIVES, THE CLINIC RELIES ON A TOTAL RETURN STRATEGY IN WHICH INVESTMENT RETURNS ARE ACHIEVED THROUGH BOTH CURRENT YIELD (INVESTMENT INCOME SUCH AS DIVIDENDS AND INTEREST) AND CAPITAL APPRECIATION (BOTH REALIZED AND UNREALIZED). THE CLINIC TARGETS A DIVERSIFIED ASSET ALLOCATION THAT PLACES A GREATER EMPHASIS ON USA DIVERSIFIED EQUITY BASED MUTUAL FUNDS TO ACHIEVE ITS LONG-TERM RETURN OBJECTIVES WITHIN PRUDENT RISK CONSTRAINTS. THE AGREEMENT REQUIRES ALL EARNINGS ON ENDOWMENT ASSETS TO BE ACCUMULATED IN THE FUND FOR AN INITIAL FIVE YEAR PERIOD AND THEN MAY BE APPROPRIATED FOR EXPENDITURE FOR SPECIFIC PROJECTS OR PROGRAMS AS SPECIFIED IN THE ENDOWMENT AGREEMENT.
SCHEDULE D, PART X, LINE 2MANAGEMENT HAS EVALUATED THEIR INCOME TAX PROVISIONS 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 FUNDRAISING EVENT EXPENSES $ 15,404 SCHEDULE D, PART XII, LINE 2D FUNDRAISING EVENT EXPENSES $ 15,404

Schedule G IRS990ScheduleG

FieldValueIRS element (for citing)
Licensed StatesMOLicensedStatesCd

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1THE BLOOM PARTYEvent1Nm
Gross Receipts Event1$128,735GrossReceiptsEvent1Amt
Charitable Contri Event1$73,139CharitableContriEvent1Amt
Gross Revenue Event1$55,596GrossRevenueEvent1Amt
Rent Facility Costs Event1$12,555RentFacilityCostsEvent1Amt
Food And Beverage Event1$20,738FoodAndBeverageEvent1Amt
Entertainment Event1$3,724EntertainmentEvent1Amt
Other Direct Expenses Event1$12,582OtherDirectExpensesEvent1Amt
Event2BEAT GOES ONEvent2Nm
Gross Receipts Event2$51,154GrossReceiptsEvent2Amt
Charitable Contri Event2$40,759CharitableContriEvent2Amt
Gross Revenue Event2$10,395GrossRevenueEvent2Amt
Rent Facility Costs Event2$7,122RentFacilityCostsEvent2Amt
Food And Beverage Event2$48FoodAndBeverageEvent2Amt
Entertainment Event2$600EntertainmentEvent2Amt
Other Direct Expenses Event2$3,613OtherDirectExpensesEvent2Amt
Other Events Total0OtherEventsTotalCnt
Gross Receipts Total$179,889GrossReceiptsTotalAmt
Charitable Contributions Tot$113,898CharitableContributionsTotAmt
Gross Revenue Total Events$65,991GrossRevenueTotalEventsAmt
Rent Fclty Costs Total Events$19,677RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events$20,786FoodAndBeverageTotalEventsAmt
Entertainment Total Events$4,324EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events$16,195OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$60,982DirectExpenseSummaryEventsAmt
Net Income Summary$5,009NetIncomeSummaryAmt

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (true)GrantRecordsMaintainedInd

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

FieldValueIRS element (for citing)
Grant TypeASSISTANCE TO INDIVIDUALSGrantTypeTxt
Recipient4893RecipientCnt
Cash Grant$18,385CashGrantAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE I, PART I, LINE 2FormAndLineReferenceDesc
ExplanationASSISTANCE TO INDIVIDUALS IS PRIMARILY FOR CITY TRANSPORTATION PROVIDED TO PATIENTS WHO COME TO THE CLINIC. MANY OF THE PATIENTS WHOM THE CLINIC SERVES DO NOT HAVE TRANSPORTATION TO COME AND RECEIVE HEALTH CARE. THE CLINIC WILL PROVIDE TRANSPORTATION VOUCHERS TO ANY INDIVIDUAL IF THEY MEET THE FEDERAL POVERTY GUIDELINES OR THE CLINICS OWN POVERTY THRESHOLD REQUIREMENTS.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Form990 Of Other OrganizationsYes (X)Form990OfOtherOrganizationsInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
CRAIG A DIETZ
CHIEF MEDICAL OFFICER$202,383$0$0$0$17,234$0$13,111$0$8,346$0$241,074$0$0$0
GEORGE A BARRETO
CFO$138,841$0$10,000$0$11,141$0$9,850$0$14,208$0$184,040$0$0$0
DENNIS DUNMYER
CHIEF OPERATING OFFICER$132,662$0$0$0$10,113$0$9,026$0$23,972$0$175,773$0$0$0
KAMILE JOHNSON
VP, PHARMACY SERVICES$145,903$0$0$0$1,401$0$4,616$0$12,603$0$164,523$0$0$0
WIL FRANKLIN
CEO (START 5/02/2019)$112,556$0$25,000$0$9,267$0$3,604$0$17,044$0$167,471$0$0$0
BLAIR THEDINGER
ASSOCIATE MEDICAL DIRECTOR$166,347$0$0$0$29,984$0$5,997$0$13,169$0$215,497$0$0$0
Margaret Boehm
DIRECTOR OF ORAL HEALTH$130,236$0$0$0$1,283$0$1,895$0$25,559$0$158,973$0$0$0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11BAN INDEPENDENT ACCOUNTING FIRM PREPARES THE 990 AFTER THE COMPLETION OF THE FINANCIAL AUDIT. THE 990 WORKPAPERS ARE COMPLETED BY THE CHIEF FINANCIAL OFFICER. THE 990 DRAFT IS REVIEWED BY THE ORGANIZATION'S CHIEF FINANCIAL OFFICER AND THE FINANCE AND OPERATIONS COMMITTEE. ANY CHANGES REQUESTED ARE MADE BY THE ACCOUNTING FIRM. THE 990 DRAFT IS THEN PROVIDED TO ALL GOVERNING BOARD MEMBERS (EITHER AT THE NEXT SCHEDULED BOARD MEETING OR INCLUDED IN THE BOARD PACKET MAILING) WITH A RESPONSE TIME FOR QUESTIONS AND/OR COMMENTS. DISCUSSION TAKES PLACE AT THE ACTUAL BOARD MEETING, ISSUES ARE TAKEN TO THE ACCOUNTING FIRM FOR RESOLUTION. THE FINAL 990 IS PROVIDED TO THE BOARD PRIOR TO ITS FILING WITH THE IRS.
FORM 990, PART VI, SECTION B, LINE 12CTHE CLINIC'S CONFLICT OF INTEREST POLICY STATES THAT EMPLOYEES, BOARD MEMBERS AND VOLUNTEERS SHOULD AVOID ANY ACTIVITY, INVESTMENT, OR INTEREST THAT MAY REFLECT UNFAVORABLY ON THE REPUTATION OF THE CLINIC. EMPLOYEES, BOARD MEMBERS AND VOLUNTEERS ARE EXPECTED TO SEEK CLARIFICATION OF, AND DISCUSS, ANY QUESTIONS ABOUT POTENTIAL CONFLICTS OF INTEREST WITH THEIR SUPERVISOR, OR ANOTHER CLINIC MANAGER OR DIRECTOR. THE CONFLICT OF INTEREST POLICY IS INCLUDED IN THE EMPLOYEE, BOARD MEMBER AND VOLUNTEER HANDBOOKS. ANNUAL SURVEYS ARE COMPLETED BY THE CLINIC OFFICERS, DIRECTORS, AND KEY EMPLOYEES TO UPDATE ANY CONFLICTS OF INTEREST. IF A CONFLICT ARISES, THE OFFICER, DIRECTOR, OR KEY EMPLOYEE ABSTAINS FROM THE VOTE ON THE CONFLICTED POSITION TO MAKE SURE ALL CONTRACTS AND AGREEMENTS ARE KEPT RELATIONSHIP-FREE REGARDING NEGOTIATIONS AND COMMUNICATION.
FORM 990, PART VI, SECTION B, LINE 15ATHE CEO RECEIVES JOB PERFORMANCE REVIEW AND COMPENSATION ASSESSMENT ANNUALLY BY THE EXECUTIVE BOARD WHICH RECOMMENDS TO THE BOARD OF DIRECTORS FOR OFFICIAL VOTE. IN ADDITION, THE CEO IS RESPONSIBLE FOR THE ANNUAL PERFORMANCE REVIEW OF ALL THE OTHER CHIEF OFFICERS OF THE ORGANIZATION. IN THE PERFORMANCE REVIEW, MERIT INCREASE IS COMPUTED BASED ON PERFORMANCE OF THE REVIEW. THE CHIEF OFFICERS AND MANAGERS WILL ALSO PROVIDE ANNUAL PERFORMANCE REVIEWS OF ALL STAFF WITH MERIT INCREASE COMPUTED BASED ON PERFORMANCE OF THE REVIEW. IN ADDITION, THE CHIEF HUMAN RESOURCES OFFICER WILL PERFORM A COMPREHENSIVE REVIEW OF ALL POSITIONS, JOB DESCRIPTIONS AND DUTIES, AND DO A COMPARATIVE RATE STUDY TO THE JOB MARKET. BASED ON THAT STUDY, THE CEO AND PRESIDENT COULD/MIGHT MAKE PROPER MARKET ADJUSTMENTS. IN 2019, THE REVIEW WAS CONDUCTED BY THE BOARD PRESIDENT/CHAIRMAN.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST.