CHICAGO FAMILY HEALTH CENTER INC: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- CHICAGO FAMILY HEALTH CENTER INC (EIN 36-2893854)
- Tax period
- 2018-07-01 to 2019-06-30
- Filed
- 2020-07-14
- IRS object ID
- 202041969349304444
- 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 | 2020-07-14T18:16:47-05:00 | ReturnTs |
| Tax Period End | 2019-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 381357951 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PLANTE & MORAN PLLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10 S RIVERSIDE PLAZA 9TH FLOOR | AddressLine1Txt |
| City | CHICAGO | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60606 | 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 | 362893854 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHICAGO FAMILY HEALTH CENTER INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CHIC | BusinessNameControlTxt |
| Phone | 7737685000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 9119 SOUTH EXCHANGE AVENUE | AddressLine1Txt |
| City | CHICAGO | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60617 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | BARRETT HATCHES | PersonNm |
| Person Title | CHIEF EXECUTIVE OFFICER | PersonTitleTxt |
| Phone | 7737685000 | PhoneNum |
| Signature | 2020-07-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KIMBERLY A HAUMANN | PreparerPersonNm |
| PTIN | P00546491 | PTIN |
| Phone | 3122071040 | PhoneNum |
| Preparation | 2020-07-14 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 38.124.75.191 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2020-07-14 | IPDt |
| IP Tm | 07:39:32 | IPTm |
| IP Timezone | CD | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 1482B6645712D6CE117815FC7BF73FCDF250C4F3 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | BARRETT HATCHES | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 9119 SOUTH EXCHANGE AVENUE | AddressLine1Txt |
| City | CHICAGO | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60617 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $25,748,789 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | CHICAGOFAMILYHEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1976 | FormationYr |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE HEALTHCARE SERVICES TO ALL PATIENTS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 330 | TotalEmployeeCnt |
| Total Volunteers | 11 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $7,865,145 | PYContributionsGrantsAmt |
| CY Contributions Grants | $8,795,348 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $15,663,575 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $16,711,380 | CYProgramServiceRevenueAmt |
| PY Investment Income | $188,715 | PYInvestmentIncomeAmt |
| CY Investment Income | $213,096 | CYInvestmentIncomeAmt |
| PY Other Revenue | $29,160 | PYOtherRevenueAmt |
| CY Other Revenue | $28,965 | CYOtherRevenueAmt |
| PY Total Revenue | $23,746,595 | PYTotalRevenueAmt |
| CY Total Revenue | $25,748,789 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $17,224,856 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $17,662,550 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $330,310 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $7,783,913 | PYOtherExpensesAmt |
| CY Other Expenses | $8,710,218 | CYOtherExpensesAmt |
| PY Total Expenses | $25,008,769 | PYTotalExpensesAmt |
| CY Total Expenses | $26,372,768 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$1,262,174 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$623,979 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $26,088,400 | TotalAssetsBOYAmt |
| Total Assets EOY | $27,023,204 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $6,494,943 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $7,978,941 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $19,593,457 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $19,044,263 | NetAssetsOrFundBalancesEOYAmt |
| Mission | CHICAGO FAMILY HEALTH CENTER WILL PROMOTE HEALTH, WORK TO PREVENT DISEASE AND PROVIDE TREATMENT THROUGH THE DELIVERY OF QUALITY, ACCESSIBLE PRIMARY HEALTHCARE THAT IS CULTURALLY SENSITIVE, AFFORDABLE, AND RESPONSIVE TO COMMUNITY AND INDIVIDUAL NEEDS. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $20,064,708 | ExpenseAmt |
| Revenue | $16,020,994 | RevenueAmt |
| Desc | PUBLIC HEALTH SERVICES SECTION 330: THIS PROGRAM PROVIDES COMPREHENSIVE HEALTHCARE AND DENTAL SERVICES ON THE SOUTH SIDE OF CHICAGO. THE PROGRAM INCLUDES PREVENTIVE SCREENING AND TREATMENT, PRENATAL HEALTH CARE, COUNSELING, AND CASE MANAGEMENT. THE CENTER HAD 6 SITES SERVICING MORE THAN 33,500 PATIENTS THROUGH MORE THAN 110,000 VISITS. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $357,213 | ExpenseAmt |
| Revenue | $432,689 | RevenueAmt |
| Desc | THE ILLINOIS BREAST AND CERVICAL CANCER SCREENING PROGRAM (IBCCP) IS A FEDERALLY AND STATE FUNDED PROGRAM THAT OFFERS FREE MAMMOGRAMS, BREAST EXAMS, PELVIC EXAMS, AND PAP TESTS TO ELIGIBLE, UNINSURED WOMEN. SERVICES CAN ALSO BE AUTHORIZED FOR WOMEN OR MEN WITH ABNORMAL FINDINGS WHO ARE OUTSIDE THE NORMAL IBCCP AGE RANGE BUT MEET OTHER IBCCP CRITERIA. PARTICIPANTS WHO ARE ENROLLED IN THE IBCCP PROGRAM AND DIAGNOSED WITH CANCER THROUGH THE PROGRAM'S SCREENING AND TESTS ARE ELIGIBLE TO RECEIVE TREATMENT BENEFITS. MAMMOGRAMS AND CANCER TREATMENT ARE PROVIDED AT PARTNER HOSPITALS. CFHC REIMBURSES EACH PARTNER HOSPITAL FOR IBCCP SERVICES. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $250,809 | ExpenseAmt |
| Revenue | $257,697 | RevenueAmt |
| Desc | THE WOMEN, INFANTS AND CHILDREN (WIC) PROGRAM IS A FOOD ASSISTANCE PROGRAM FOR WOMEN, INFANTS, AND CHILDREN. IT HELPS PREGNANT WOMEN, NEW MOTHERS AND YOUNG CHILDREN EAT WELL AND STAY HEALTHY. WOMEN AND THEIR CHILDREN WHO ARE PREGNANT, BREASTFEEDING OR JUST HAD A BABY, INFANTS AND CHILDREN UNDER 5 YEARS OLD, FAMILIES WITH A LOW TO MEDIUM INCOME CAN RECEIVED SPECIAL CHECKS TO BUY HEALTHY FOODS - LIKE MILK, JUICE, EGGS, CHEESE, CEREAL, DRY BEANS OR PEAS, AND PEANUT BUTTER, INFORMATION ABOUT NUTRITION AND HEALTH INFORMATION AND HELP ABOUT BREASTFEEDING, AND HELP IN FINDING HEALTH CARE AND OTHER SERVICES. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $20,672,730 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 48 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 330 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | IL | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JOSEPH MOLDOVAN | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7733642206 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 9119 SOUTH EXCHANGE AVENUE | AddressLine1Txt |
| City | CHICAGO | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60617 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (27 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| NICK VALADEZ | |||||||||
| CHAIR OF THE BOARD | 2.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| NORA REYES | |||||||||
| VICE-CHAIR OF THE BOARD | 2.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| JULIUS ALEXANDER | |||||||||
| TREASUER | 2.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| FULTON NOLEN | |||||||||
| SECRETARY | 2.00 | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| CHERYL BRISCOE | |||||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| MARK BRUMMEL | |||||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| MARY JULIA MUNOZ | |||||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| LYLETH RODRIGUEZ | |||||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| JAMES SIMMONS | |||||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| LUPE VALADEZ | |||||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| TONY ZIAK | |||||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| BARRETT HATCHES | |||||||||
| CHIEF EXECUTIVE OFFICER | 39.00 | 1.00 | Yes (X) | $299,112 | $0 | $43,605 | |||
| MELISSA E DUPLANTIS | |||||||||
| CHIEF BEHAVIORAL HEALTH OFFICER | 40.00 | 0.00 | Yes (X) | $93,956 | $0 | $17,988 | |||
| JOSEPH MOLDOVAN | |||||||||
| CHIEF FINANCIAL OFFICER | 40.00 | 0.00 | Yes (X) | $46,364 | $0 | $1,690 | |||
| LAUREN A SULLIVAN | |||||||||
| CHIEF INFORMATION OFFICER | 40.00 | 0.00 | Yes (X) | $146,700 | $0 | $22,842 | |||
| STEPHANIE WILLDING | |||||||||
| CHIEF OFFICER FOR STRATEGY,PLANNING,DEVELOPMENT | 40.00 | 0.00 | Yes (X) | $102,327 | $0 | $13,512 | |||
| JAMES P VALEK | |||||||||
| CHIEF MEDICAL OFFICER | 40.00 | 0.00 | Yes (X) | $236,294 | $0 | $49,936 | |||
| ZAKEYA ATIA | |||||||||
| INTERIM CHIEF FINANCIAL OFFICER | 40.00 | 0.00 | Yes (X) | $69,660 | $0 | $0 | |||
| DEE N LAGIOIA | |||||||||
| CHIEF OPERATING OFFICER (END 2/18) | 40.00 | 0.00 | Yes (X) | $22,573 | $0 | $1,389 | |||
| FRANK BRADTKE | |||||||||
| CHIEF OPERATING OFFICER (END 11/18) | 40.00 | 0.00 | Yes (X) | $116,770 | $0 | $22,841 | |||
| JOSEPH ERIC BOKLAGE | |||||||||
| CHIEF ADMIN OFFICER (END 10/18) | 40.00 | 0.00 | Yes (X) | $159,706 | $0 | $32,833 | |||
| MONICA MOORE | |||||||||
| MEDICAL DIRECTOR, WOMEN'S HEALTH | 36.00 | 0.00 | $216,528 | $0 | $45,812 | Yes (X) | |||
| RAMON C CABE | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $208,963 | $0 | $32,173 | Yes (X) | |||
| LISA D DANIEL | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $193,286 | $0 | $1,141 | Yes (X) | |||
| JACQUELINE GERVAIS | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $285,323 | $0 | $41,153 | Yes (X) | |||
| PRAMODE K KESHAVA | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $212,742 | $0 | $51,271 | Yes (X) | |||
| JOSEPH THOMAS | |||||||||
| PHYSICIAN (END 4/19) | 30.00 | 0.00 | $230,563 | $0 | $19,583 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,640,867 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $397,769 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 24 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| CARDINAL HEALTH | |||||
| 3740 COLLECTIONS CENTER DRIVE | CHICAGO | IL | 60693 | PATIENT BILLING SERVICES | $363,658 |
| HENRY SCHEIN INC | |||||
| DEPARTMENT CH 10241 | PALATINE | IL | 60055 | HOSTING FOR NEXTGEN | $294,715 |
| MCKESSON MEDICAL SURGICAL | |||||
| PO BOX 936279 | ATLANTA | GA | 31193 | DENTAL/MEDICAL SUPPLIES | $243,746 |
| ATHENAHEALTH INC | |||||
| PO BOX 415615 | BOSTON | MA | 02241 | CONSTRUCTION MANAGEMENT | $236,342 |
| ROSELAND MEDICAL CENTER LLC | |||||
| 77 W WASHINGTON SUITE 405 | CHICAGO | IL | 60602 | 34OB SUPPLIES | $231,328 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 18 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $7,688,931 | GovernmentGrantsAmt |
| All Other Contributions | $1,106,417 | AllOtherContributionsAmt |
| Total Contributions | $8,795,348 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PRIVATE CARE | 621300 | $11,809,393 | $11,809,393 |
| HMO INCENTIVE REVENUE | 621300 | $2,656,894 | $2,656,894 |
| CAPITATION REVENUE | 621300 | $2,245,093 | $2,245,093 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $16,711,380 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $213,096 | TotalRevenueColumnAmt |
| Exclusion | $213,096 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $28,965 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $28,965 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $28,965 | TotalRevenueColumnAmt |
| Exclusion | $28,965 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $25,748,789 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $16,711,380 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $242,061 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,500,098 | TotalAmt |
| Program Services | $645,042 | ProgramServicesAmt |
| Management And General | $840,055 | ManagementAndGeneralAmt |
| Fundraising | $15,001 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,145,258 | TotalAmt |
| Program Services | $11,500,934 | ProgramServicesAmt |
| Management And General | $1,482,635 | ManagementAndGeneralAmt |
| Fundraising | $161,689 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $158,045 | TotalAmt |
| Program Services | $45,593 | ProgramServicesAmt |
| Management And General | $111,634 | ManagementAndGeneralAmt |
| Fundraising | $818 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,859,149 | TotalAmt |
| Program Services | $2,302,806 | ProgramServicesAmt |
| Management And General | $518,109 | ManagementAndGeneralAmt |
| Fundraising | $38,234 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $129,628 | TotalAmt |
| Program Services | $5,297 | ProgramServicesAmt |
| Management And General | $124,331 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $103,715 | TotalAmt |
| Management And General | $103,715 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,525 | TotalAmt |
| Management And General | $14,525 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,539,728 | TotalAmt |
| Program Services | $1,848,604 | ProgramServicesAmt |
| Management And General | $679,301 | ManagementAndGeneralAmt |
| Fundraising | $11,823 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,696,186 | TotalAmt |
| Program Services | $1,791,609 | ProgramServicesAmt |
| Management And General | $877,334 | ManagementAndGeneralAmt |
| Fundraising | $27,243 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,721 | TotalAmt |
| Program Services | $13,740 | ProgramServicesAmt |
| Management And General | $19,909 | ManagementAndGeneralAmt |
| Fundraising | $72 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $226,434 | TotalAmt |
| Program Services | $32,008 | ProgramServicesAmt |
| Management And General | $193,994 | ManagementAndGeneralAmt |
| Fundraising | $432 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,223,537 | TotalAmt |
| Program Services | $1,055,446 | ProgramServicesAmt |
| Management And General | $153,850 | ManagementAndGeneralAmt |
| Fundraising | $14,241 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $154,094 | TotalAmt |
| Program Services | $53,300 | ProgramServicesAmt |
| Management And General | $100,777 | ManagementAndGeneralAmt |
| Fundraising | $17 | FundraisingAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| SUPPLIES | $1,175,814 | $1,153,795 | $16,006 | $6,013 |
| PRINTING AND POSTAGE | $74,287 | $42,596 | $24,736 | $6,955 |
| LICENSES AND DUES | $61,841 | $11,943 | $49,553 | $345 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $276,708 | TotalAmt |
| Program Services | $170,017 | ProgramServicesAmt |
| Management And General | $59,264 | ManagementAndGeneralAmt |
| Fundraising | $47,427 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,372,768 | TotalAmt |
| Program Services | $20,672,730 | ProgramServicesAmt |
| Management And General | $5,369,728 | ManagementAndGeneralAmt |
| Fundraising | $330,310 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,903,508 | BOYAmt |
| EOY | $1,422,680 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,162,811 | BOYAmt |
| EOY | $732,368 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $888,487 | BOYAmt |
| EOY | $941,766 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,378,328 | BOYAmt |
| EOY | $1,932,744 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,190,190 | BOYAmt |
| EOY | $7,119,000 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $107,040 | BOYAmt |
| EOY | $374,335 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $18,952,584 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $7,155,679 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,550,684 | BOYAmt |
| EOY | $11,796,905 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,311,209 | BOYAmt |
| EOY | $2,425,743 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $281,435 | BOYAmt |
| EOY | $277,310 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $314,708 | BOYAmt |
| EOY | $353 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,088,400 | BOYAmt |
| EOY | $27,023,204 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,796,088 | BOYAmt |
| EOY | $2,545,403 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,340,256 | BOYAmt |
| EOY | $5,253,328 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $358,599 | BOYAmt |
| EOY | $180,210 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,494,943 | BOYAmt |
| EOY | $7,978,941 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,462,269 | BOYAmt |
| EOY | $18,615,721 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $131,188 | BOYAmt |
| EOY | $428,542 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,593,457 | BOYAmt |
| EOY | $19,044,263 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,088,400 | BOYAmt |
| EOY | $27,023,204 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$623,979 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $60,260 | NetUnrlzdGainsLossesInvstAmt |
| Investment Expense | $14,525 | InvestmentExpenseAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $7,594,044 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $8,730,111 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7,745,372 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $7,865,144 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $8,795,348 | CurrentTaxYearAmt |
| Total | $40,730,019 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $7,594,044 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $8,730,111 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7,745,372 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $7,865,144 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $8,795,348 | CurrentTaxYearAmt |
| Total | $40,730,019 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $40,730,019 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $117,074 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $112,839 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $142,942 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $217,875 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $256,586 | CurrentTaxYearAmt |
| Total | $847,316 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $41,577,335 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $74,122,866 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.97960 | PublicSupportCY170Pct |
| Public Support PY170 | 0.99000 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $730,212 | OtherCostOrOtherBasisAmt |
| Book Value | $730,212 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $13,792,173 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,102,923 | DepreciationAmt |
| Book Value | $9,689,250 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $706,206 | OtherCostOrOtherBasisAmt |
| Depreciation | $757,571 | DepreciationAmt |
| Book Value | -$51,365 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,723,993 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,295,185 | DepreciationAmt |
| Book Value | $1,428,808 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $11,796,905 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MHN ACO, LLC | Desc |
| Book Value | $2,425,743 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $2,425,743 | TotalBookValueSecuritiesAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | INTERCOMPANY PAYABLES | Desc |
| Amt | $180,210 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $180,210 | TotalLiabilityAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (10 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BARRETT HATCHES | ||||||||||||||
| CHIEF EXECUTIVE OFFICER | $284,112 | $0 | $15,000 | $0 | $0 | $0 | $32,322 | $0 | $11,283 | $0 | $342,717 | $0 | $0 | $0 |
| LAUREN A SULLIVAN | ||||||||||||||
| CHIEF INFORMATION OFFICER | $146,700 | $0 | $0 | $0 | $0 | $0 | $22,842 | $0 | $0 | $0 | $169,542 | $0 | $0 | $0 |
| JAMES P VALEK | ||||||||||||||
| CHIEF MEDICAL OFFICER | $229,274 | $0 | $7,020 | $0 | $0 | $0 | $22,798 | $0 | $27,138 | $0 | $286,230 | $0 | $0 | $0 |
| JOSEPH ERIC BOKLAGE | ||||||||||||||
| CHIEF ADMIN OFFICER (END 10/18) | $159,706 | $0 | $0 | $0 | $0 | $0 | $14,574 | $0 | $18,259 | $0 | $192,539 | $0 | $0 | $0 |
| MONICA MOORE | ||||||||||||||
| MEDICAL DIRECTOR, WOMEN'S HEALTH | $205,021 | $0 | $11,507 | $0 | $0 | $0 | $20,336 | $0 | $25,476 | $0 | $262,340 | $0 | $0 | $0 |
| RAMON C CABE | ||||||||||||||
| PHYSICIAN | $188,285 | $0 | $20,678 | $0 | $0 | $0 | $22,306 | $0 | $9,867 | $0 | $241,136 | $0 | $0 | $0 |
| LISA D DANIEL | ||||||||||||||
| PHYSICIAN | $193,286 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $1,141 | $0 | $194,427 | $0 | $0 | $0 |
| JACQUELINE GERVAIS | ||||||||||||||
| PHYSICIAN | $257,902 | $0 | $27,421 | $0 | $0 | $0 | $31,139 | $0 | $10,014 | $0 | $326,476 | $0 | $0 | $0 |
| PRAMODE K KESHAVA | ||||||||||||||
| PHYSICIAN | $202,053 | $0 | $10,689 | $0 | $0 | $0 | $31,231 | $0 | $20,040 | $0 | $264,013 | $0 | $0 | $0 |
| JOSEPH THOMAS | ||||||||||||||
| PHYSICIAN (END 4/19) | $230,563 | $0 | $0 | $0 | $0 | $0 | $16,354 | $0 | $3,229 | $0 | $250,146 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 7 | FormAndLineReferenceDesc |
| Explanation | BONUSES FOR MANAGEMENT AND CEO ARE DETERMINED BASED ON GOALS AND DISCRETION. PROVIDERS IS BASED ON PRODUCTIVITY TARGETS. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | DIRECTOR GUADALUPE (LUPE) VALADEZ AND CHAIRMAN NICK VALADEZ HAVE A FATHER SON RELATIONSHIP. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE BOARD RETAINS THE SERVICES OF AN INDEPENDENT CPA FIRM TO PREPARE THE ORGANIZATION'S FORM 990 TAX RETURN. MANAGEMENT REVIEWS THE COMPLETED FORM 990 AND PROVIDES A FULL COPY TO ALL MEMBERS OF THE BOARD. THE BOARD IS PROVIDED AN OPPORTUNITY TO ASK ANY QUESTIONS DIRECTLY TO ORGANIZATION MANAGEMENT OR THE CONTACT AT THE INDEPENDENT CPA FIRM. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE CENTER REVIEWS ANNUAL CONFLICT OF INTEREST STATEMENTS FROM THE BOARD AND SENIOR STAFF AT THE NOVEMBER BOARD MEETING. IN THE STATEMENTS, ALL BOARD MEMBERS AND SENIOR STAFF DISCLOSE THEIR CONFLICTS, POTENTIAL CONFLICTS, AND SITUATIONS THAT COULD BE PERCEIVED TO BE CONFLICTS. THE CENTER THAN EVALUATES THESE STATEMENTS. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE CEO AND OTHER KEY EMPLOYEES COMPENSATION IS EVALUATED ANNUALLY BY THE BOARD OF DIRECTOR'S EXECUTIVE COMMITTEE. THE CENTER NEGOTIATED BASED ON THE 990S FROM SIMILAR ORGANIZATIONS IN THE GREATER CHICAGO AREA. COMPENSATION AMOUNTS WERE SET AT THE LOWER END OF COMPARABLE ORGANIZATIONS. |
| FORM 990, PART VI, SECTION C, LINE 18 | THESE DOCUMENTS ARE AVAILABLE UPON REQEUST TO THE CENTER. |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE AVAILABLE THROUGH APPLICABLE GOVERNMENTAL AGENCIES; THE CONFLICT OF INTEREST POLICY IS AVAILABLE UPON WRITTEN REQUEST TO THE ORGANIZATION. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| CHICAGO FAMILY HEALTH CENTER FOUNDATION | ||||||||||
| 9119 SOUTH EXCHANGE AVE | CHICAGO | IL | 60617 | 453732286 | SUPPORTING ORGANIZATION FOR CFHC | IL | 501(C)(3) | 509(A)(3) | CFHC | Yes (1) |
| CFHC TITLE HOLDING CORPORATION NFP | ||||||||||
| 9119 SOUTH EXCHANGE AVE | CHICAGO | IL | 60617 | 454956964 | HOLDING CORPORATION FOR CFHC | IL | 501(C)(2) | CFHC | Yes (1) | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| CFHC TITLE HOLDING CORPORATION NFP | ||
| K | $115,000 | RECORDS MAINTAINED AT COST |
| CFHC FOUNDATION | ||
| Q | $19,715 | RECORDS MAINTAINED AT COST |