COMMUNITY HEALTH IMPROVEMENT CENTER: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- COMMUNITY HEALTH IMPROVEMENT CENTER (EIN 37-0961830)
- Tax period
- 2018-07-01 to 2019-06-30
- Filed
- 2020-02-25
- IRS object ID
- 202040569349300934
- Schema version
- 2018v3.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2020-02-25T15:50:22-06:00 | ReturnTs |
| Tax Period End | 2019-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 371074029 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MCK CPAS & ADVISORS | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1353 E MOUND RD SUITE 300 | AddressLine1Txt |
| City | DECATUR | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 62526 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2018-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 370961830 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY HEALTH IMPROVEMENT CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | COMM | BusinessNameControlTxt |
| Phone | 2178779117 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 320 E CENTRAL AVENUE | AddressLine1Txt |
| City | DECATUR | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 62521 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TANYA ANDRICKS | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 2173305993 | PhoneNum |
| Signature | 2020-02-25 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | CATHY J MANSUR | PreparerPersonNm |
| PTIN | P00105773 | PTIN |
| Phone | 2178752655 | PhoneNum |
| Preparation | 2020-02-25 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 173.161.31.25 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2020-02-25 | IPDt |
| IP Tm | 15:50:22 | IPTm |
| IP Timezone | CS | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 5DD958866F91A3D911EAEA9DE96C611663C6160A | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | F44792E1D959B098F94D9CF4B5C45145630CCB1E | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2020-09-22 18:59:49Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CROSSING HEALTHCARE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | TANYA ANDRICKS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 320 E CENTRAL AVE | AddressLine1Txt |
| City | DECATUR | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 62521 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $36,818,174 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | CROSSINGHEALTHCARE.ORG | WebsiteAddressTxt |
| Type Of Organization Trust | Yes (X) | TypeOfOrganizationTrustInd |
| Formation | 1972 | FormationYr |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Activity Or Mission | THE CENTER'S MISSION IS TO STRIVE TO PROVIDE EXCEPTIONAL, COMPASSIONATE, AND COMPREHENSIVE HEALTH CARE TO THE UNDERSERVED OF CENTRAL ILLINOIS WHILE ENCOURAGING PROFESSIONAL GROWTH, TEAMWORK, AND RESPECT TOWARD OUR COWORKERS IN THE CLINIC AND THROUGHOUT THE COMMUNITY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 188 | TotalEmployeeCnt |
| Total Volunteers | 10 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $9,079,198 | PYContributionsGrantsAmt |
| CY Contributions Grants | $28,876,803 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $6,693,864 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $6,933,964 | CYProgramServiceRevenueAmt |
| PY Investment Income | $985 | PYInvestmentIncomeAmt |
| CY Investment Income | $276,612 | CYInvestmentIncomeAmt |
| PY Other Revenue | $229,066 | PYOtherRevenueAmt |
| CY Other Revenue | $730,795 | CYOtherRevenueAmt |
| PY Total Revenue | $16,003,113 | PYTotalRevenueAmt |
| CY Total Revenue | $36,818,174 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $6,713,790 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $7,416,289 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $3,035,204 | PYOtherExpensesAmt |
| CY Other Expenses | $4,274,091 | CYOtherExpensesAmt |
| PY Total Expenses | $9,748,994 | PYTotalExpensesAmt |
| CY Total Expenses | $11,690,380 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $6,254,119 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $25,127,794 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $8,620,794 | TotalAssetsBOYAmt |
| Total Assets EOY | $36,207,151 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $514,054 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $2,972,617 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $8,106,740 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $33,234,534 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE CENTER'S MISSION IS TO STRIVE TO PROVIDE EXCEPTIONAL, COMPASSIONATE, AND COMPREHENSIVE HEALTH CARE TO THE UNDERSERVED OF CENTRAL ILLINOIS WHILE ENCOURAGING PROFESSIONAL GROWTH, TEAMWORK, AND RESPECT TOWARD OUR COWORKERS IN THE CLINIC AND THROUGHOUT THE COMMUNITY. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $8,560,638 | ExpenseAmt |
| Revenue | $35,232,660 | RevenueAmt |
| Desc | CLINIC SERVICES: PRIMARY MEDICAL CARE SERVICES | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $683,830 | ExpenseAmt |
| Revenue | $760,136 | RevenueAmt |
| Desc | MENTAL HEALTH - COUNSELING, BEHAVIORAL HEALTH TESTING, REFERRAL SERVICE FOR SERIOUS MENTAL HEALTH DISORDERS. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $498,046 | ExpenseAmt |
| Revenue | $323,277 | RevenueAmt |
| Desc | PRENATAL SERVICES - COMPLETE PRENATAL SERVICES FOR MOMS-TO-BE | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $38,351 | ExpenseAmt |
| Revenue | $502,102 | RevenueAmt |
| Desc | LAB SERVICES: CLINICAL LABORATORY SERVICES PROVIDED IN-HOUSE AND BY OUTSIDE LAB SERVICE. SOCIAL SERVICES/HEALTH EDUCATION: DIETARY COUNSELING, HEALTH EDUCATION SESSIONS, PREVENTION AND AWARENESS ACTIVITIES RELATED TO CHRONIC HEALTH PROBLEMS OR DISEASES. DENTAL CLINIC SUBSIDY: CONTRACTUAL ARRANGEMENT WITH LOCAL HEALTH DEPARTMENT FOR EMERGENCY DENTAL SERVICES AND ROUTINE EXTRACTIONS. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $38,351 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Revenue | $502,102 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $9,780,865 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| 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 | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 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 | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| 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 | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 14 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 188 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | 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 |
| States Where Copy Of Return Is Fld | IL | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TOM WEST | PersonNm |
| Phone | 2173305993 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 320 E CENTRAL AVENUE | AddressLine1Txt |
| City | DECATUR | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 62521 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| JOSEPH SCHRODT | ||||||||
| PRESIDENT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| APRIL INGRAM | ||||||||
| VICE PRESIDE | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| JONATHON KECK | ||||||||
| SECRETARY | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| MIKE HENEGHAN | ||||||||
| TREASURER | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| MARY KATE CHALMERS | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| ROBERT TOM CRAWFORD | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| KRYSTAL JOHNSON | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| DR STEVE HUSS | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| GABRIELE DAVIS | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| KAREN LARSON | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| TANYA ANDRICKS | ||||||||
| CEO | 40.00 | Yes (X) | $189,122 | $0 | $9,456 | |||
| THOMAS WEST | ||||||||
| CFO | 40.00 | Yes (X) | $145,162 | $0 | $7,258 | |||
| DANA RAY | ||||||||
| MEDICAL DIRE | 40.00 | $271,155 | $0 | $13,558 | Yes (X) | |||
| ROHIDAS PATIL | ||||||||
| PHYSICIAN | 40.00 | $367,219 | $0 | $18,361 | Yes (X) | |||
| TRICIA SCERBA | ||||||||
| PHYSICIAN | 40.00 | $210,933 | $0 | $10,547 | Yes (X) | |||
| DIMA ALFAKARA | ||||||||
| PHYSICIAN | 40.00 | $177,960 | $0 | $8,898 | Yes (X) | |||
| DENNIS COSTERISAN | ||||||||
| PHYSICIAN | 40.00 | $152,679 | $0 | $7,634 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,514,230 | TotalReportableCompFromOrgAmt |
| Total Other Compensation | $75,712 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 7 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| NETSMART TECHNOLOGIES INC | |||||
| 4950 COLLEGE BOULEVARD | OVERLAND PARK | KS | 66211 | COMPUTER SERVIC | $414,529 |
| VITA CENTER FOR WOMEN | |||||
| ONE MEMORIAL DR SUITE 300 | DECATUR | IL | 62526 | HEALTH SERVICES | $365,201 |
| FQHC HEALTH NETWORK | |||||
| 1000 W HARLEM AVENUE | MONMOUTH | IL | 61462 | PROVIDER NETWOR | $352,126 |
| HENRY SCHEIN | |||||
| DEPT CH10241 | PALATINE | IL | 60055 | HEALTH SERVICES | $315,646 |
| KB COMPUTER CONSULTING INC | |||||
| 510 E APPLE ORCHARD RD 103 | SPRINGFIELD | IL | 62703 | CONSULTING | $133,116 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 8 | CntrctRcvdGreaterThan100KCnt |
| Federated Campaigns | $60,869 | FederatedCampaignsAmt |
| Government Grants | $3,004,560 | GovernmentGrantsAmt |
| All Other Contributions | $25,811,374 | AllOtherContributionsAmt |
| Total Contributions | $28,876,803 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENUE | 524114 | $6,119,390 | $6,119,390 |
| 340B PHARMACY REVENUE | 524114 | $814,574 | $814,574 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $6,933,964 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $276,612 | TotalRevenueColumnAmt |
| Exclusion | $276,612 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| CONTRACTUAL SERVICES | 900099 | $635,564 | $635,564 |
| OTHER INCOME | $95,026 | $95,026 | |
| GAIN - FIXED ASSET DISPOSAL | $205 | $205 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $730,795 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $36,818,174 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $7,664,759 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $276,612 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $605,439 | TotalAmt |
| Program Services | $203,366 | ProgramServicesAmt |
| Management And General | $402,073 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,808,042 | TotalAmt |
| Program Services | $4,925,422 | ProgramServicesAmt |
| Management And General | $882,620 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $181,204 | TotalAmt |
| Program Services | $144,907 | ProgramServicesAmt |
| Management And General | $36,297 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $325,741 | TotalAmt |
| Program Services | $260,491 | ProgramServicesAmt |
| Management And General | $65,250 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $495,863 | TotalAmt |
| Program Services | $396,536 | ProgramServicesAmt |
| Management And General | $99,327 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $43,903 | TotalAmt |
| Management And General | $43,903 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $32,368 | TotalAmt |
| Management And General | $32,368 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,239,423 | TotalAmt |
| Program Services | $1,199,468 | ProgramServicesAmt |
| Management And General | $39,955 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,266 | TotalAmt |
| Program Services | $33,266 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $75,621 | TotalAmt |
| Program Services | $65,878 | ProgramServicesAmt |
| Management And General | $9,743 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $326,706 | TotalAmt |
| Program Services | $302,838 | ProgramServicesAmt |
| Management And General | $23,868 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $140,436 | TotalAmt |
| Program Services | $49,153 | ProgramServicesAmt |
| Management And General | $91,283 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $343,777 | TotalAmt |
| Program Services | $336,901 | ProgramServicesAmt |
| Management And General | $6,876 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $46,484 | TotalAmt |
| Program Services | $35,543 | ProgramServicesAmt |
| Management And General | $10,941 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| PROVISION FOR BAD DEBTS | $1,033,923 | $1,033,923 | |
| MEDICAL AND LAB SUPPLIES | $611,157 | $611,157 | |
| DUES & SUBSCRIPTIONS | $175,584 | $35,117 | $140,467 |
| INSTRUMENTS & EQUIPMENT | $70,930 | $70,930 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $100,513 | TotalAmt |
| Program Services | $75,969 | ProgramServicesAmt |
| Management And General | $24,544 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,690,380 | TotalAmt |
| Program Services | $9,780,865 | ProgramServicesAmt |
| Management And General | $1,909,515 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $200 | BOYAmt |
| EOY | $200 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $758,102 | BOYAmt |
| EOY | $7,895,967 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $46,061 | BOYAmt |
| EOY | $41,614 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,133,570 | BOYAmt |
| EOY | $1,132,379 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $109,000 | BOYAmt |
| EOY | $154,891 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $28,725,025 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,994,166 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,297,568 | BOYAmt |
| EOY | $26,730,859 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $276,293 | BOYAmt |
| EOY | $251,241 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,620,794 | BOYAmt |
| EOY | $36,207,151 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $514,054 | BOYAmt |
| EOY | $2,931,403 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $41,214 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $514,054 | BOYAmt |
| EOY | $2,972,617 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,882,460 | BOYAmt |
| EOY | $28,274,104 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $224,280 | BOYAmt |
| EOY | $4,960,430 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,106,740 | BOYAmt |
| EOY | $33,234,534 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,620,794 | BOYAmt |
| EOY | $36,207,151 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $25,127,794 | ReconcilationRevenueExpnssAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,328,017 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,483,405 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,941,073 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $6,079,198 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,876,803 | CurrentTaxYearAmt |
| Total | $19,708,496 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,328,017 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,483,405 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,941,073 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $6,079,198 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,876,803 | CurrentTaxYearAmt |
| Total | $19,708,496 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $19,708,496 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $680 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $652 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $333 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $985 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $276,612 | CurrentTaxYearAmt |
| Total | $279,262 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $180,775 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $190,848 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $445,678 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $229,066 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $730,795 | CurrentTaxYearAmt |
| Total | $1,777,162 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $21,764,920 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $14,587,689 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.90550 | PublicSupportCY170Pct |
| Public Support PY170 | 0.93550 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SUPPORTING SCHEDULE | CAMPUS PROJECT 25,000,000 |
| PART II, LINE 10 | MISCELLANEOUS 1,777,162 |
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 | $424,551 | OtherCostOrOtherBasisAmt |
| Book Value | $424,551 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,506,513 | OtherCostOrOtherBasisAmt |
| Depreciation | $604,614 | DepreciationAmt |
| Book Value | $4,901,899 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $43,874 | OtherCostOrOtherBasisAmt |
| Depreciation | $18,133 | DepreciationAmt |
| Book Value | $25,741 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,593,496 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,371,419 | DepreciationAmt |
| Book Value | $1,222,077 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $20,156,591 | OtherCostOrOtherBasisAmt |
| Book Value | $20,156,591 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $26,730,859 | TotalBookValueLandBuildingsAmt |
| Total Rev Etc Audited Fincl Stmt | $36,818,174 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Subtotal | $36,818,174 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $36,818,174 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $11,690,380 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $11,690,380 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $11,690,380 | TotalExpensesPerForm990Amt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt |
|---|---|---|---|
| TANYA ANDRICKS | |||
| CEO | $189,122 | $9,456 | $198,578 |
| THOMAS WEST | |||
| CFO | $145,162 | $7,258 | $152,420 |
| DANA RAY | |||
| MEDICAL DIRECTOR | $271,155 | $13,558 | $284,713 |
| ROHIDAS PATIL | |||
| PHYSICIAN | $367,219 | $18,361 | $385,580 |
| TRICIA SCERBA | |||
| PHYSICIAN | $210,933 | $10,547 | $221,480 |
| DIMA ALFAKARA | |||
| PHYSICIAN | $177,960 | $8,898 | $186,858 |
| DENNIS COSTERISAN | |||
| PHYSICIAN | $152,679 | $7,634 | $160,313 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990 - ORGANIZATION'S MISSION | THE CENTER'S MISSION IS TO STRIVE TO PROVIDE EXCEPTIONAL, COMPASSIONATE, AND COMPREHENSIVE HEALTH CARE TO THE UNDERSERVED OF CENTRAL ILLINOIS WHILE ENCOURAGING PROFESSIONAL GROWTH, TEAMWORK, AND RESPECT TOWARD OUR COWORKERS IN THE CLINIC AND THROUGHOUT THE COMMUNITY. |
| FORM 990, PAGE 2, PART III, LINE 4D | LAB SERVICES: CLINICAL LABORATORY SERVICES PROVIDED IN-HOUSE AND BY OUTSIDE LAB SERVICE. SOCIAL SERVICES/HEALTH EDUCATION: DIETARY COUNSELING, HEALTH EDUCATION SESSIONS, PREVENTION AND AWARENESS ACTIVITIES RELATED TO CHRONIC HEALTH PROBLEMS OR DISEASES. DENTAL CLINIC SUBSIDY: CONTRACTUAL ARRANGEMENT WITH LOCAL HEALTH DEPARTMENT FOR EMERGENCY DENTAL SERVICES AND ROUTINE EXTRACTIONS. |
| FORM 990, PAGE 6, PART VI, LINE 11B | THE CENTER'S EXECUTIVE DIRECTOR AND CFO REVIEW AND APPROVE THE 990 BEFORE IT IS FILED. |
| FORM 990, PAGE 6, PART VI, LINE 12C | BOARD MEMBERS ARE REQUIRED TO DECLARE ANY SUSPECTED OR ACTUAL DIRECT CONFLICT OF INTEREST. |
| FORM 990, PAGE 6, PART VI, LINE 15A | COMPENSATION FOR THE CENTER'S CEO IS DETERMINED BY THE BOARD'S REVIEW AND APPROVAL. |
| FORM 990, PAGE 6, PART VI, LINE 15B | COMPENSATION FOR THE CENTER'S OFFICERS AND KEY EMPLOYEES IS DETERMINED BY THE EXECUTIVE DIRECTOR'S REVIEW AND APPROVAL BASED ON CASH FLOW, THE BOARD'S APPROVAL AND THE CURRENT MARKET RATE FOR SALARIES. |
| FORM 990, PAGE 6, PART VI, LINE 19 | THE CENTER MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | CONTRACTUAL SERVICES 1,199,468 0 0 PAYROLL PROCESSING 0 39,955 0 TOTAL 1,199,468 39,955 0 |