MYCARE HEALTH CENTER: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- MYCARE HEALTH CENTER (EIN 37-1593312)
- Tax period
- 2018-01-01 to 2018-12-31
- Filed
- 2019-11-07
- IRS object ID
- 201903119349300615
- Schema version
- 2018v3.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2019-11-07T08:07:03-06:00 | ReturnTs |
| Tax Period End | 2018-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 382706146 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | YEO & YEO PC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 3275 | AddressLine1Txt |
| City | SAGINAW | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48605 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2018-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 371593312 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MYCARE HEALTH CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MYCA | BusinessNameControlTxt |
| Phone | 5866199986 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6800 EAST 10 MILE ROAD | AddressLine1Txt |
| City | CENTER LINE | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48015 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | KAREN WOOD | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 5866499986 | PhoneNum |
| Signature | 2019-10-24 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | BRIAN R DIXON | PreparerPersonNm |
| PTIN | P01321580 | PTIN |
| Phone | 9897939830 | PhoneNum |
| Preparation | 2019-10-30 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 70.34.166.253 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2019-11-07 | IPDt |
| IP Tm | 08:07:03 | IPTm |
| IP Timezone | CS | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 1CD4615D66FC0C825FE3C3B785772D485C107217 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 737A3B877C7B33C039D624E1942B5CD8B6791E98 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2020-03-31 21:24:44Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | KAREN WOOD | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6800 EAST 10 MILE ROAD | AddressLine1Txt |
| City | CENTER LINE | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48015 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $5,048,463 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.MYCAREHEALTHCENTER.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2010 | FormationYr |
| Legal Domicile State | MI | LegalDomicileStateCd |
| Activity Or Mission | TO IMPROVE THE HEALTH AND WELLNESS OF OUR COMMUNITY BY DELIVERY QUALITY CARE TO ALL PEOPLE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 54 | TotalEmployeeCnt |
| Total Volunteers | 10 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $1,703,731 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,927,981 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $3,221,614 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $3,081,183 | CYProgramServiceRevenueAmt |
| PY Investment Income | $1,776 | PYInvestmentIncomeAmt |
| CY Investment Income | $21,212 | CYInvestmentIncomeAmt |
| CY Other Revenue | $1,500 | CYOtherRevenueAmt |
| PY Total Revenue | $4,927,121 | PYTotalRevenueAmt |
| CY Total Revenue | $5,031,876 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $2,246,213 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $2,787,951 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $3,008,821 | PYOtherExpensesAmt |
| CY Other Expenses | $2,514,443 | CYOtherExpensesAmt |
| PY Total Expenses | $5,255,034 | PYTotalExpensesAmt |
| CY Total Expenses | $5,302,394 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$327,913 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$270,518 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $3,005,042 | TotalAssetsBOYAmt |
| Total Assets EOY | $3,364,784 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $252,519 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $882,779 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $2,752,523 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $2,482,005 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO IMPROVE THE HEALTH AND WELLNESS OF OUR COMMUNITY BY DELIVERY QUALITY CARE TO ALL PEOPLE. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $3,691,428 | ExpenseAmt |
| Revenue | $3,082,683 | RevenueAmt |
| Desc | PRIMARY HEALTH CARE SERVICES | Desc |
| Total Program Service Expenses | $3,691,428 | 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 | Yes (true) | 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 | 23 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 54 | 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 | false | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | false | 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 | MI | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JAMIE WETHERELL CFO | PersonNm |
| Phone | 5866199986 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6800 EAST 10 MILE ROAD | AddressLine1Txt |
| City | CENTER LINE | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48015 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| TIM JOHNSON | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DAVID CLAYTON | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| TERESA THIENEL | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| LORETTA BROWNLEE | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JOSEPH MIHELICH | |||||||
| VICE PRESIDE | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| SHARRON GALLOP | |||||||
| TREASURER | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| PHILESHA GOUGH | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| ALYIA HAKIM | |||||||
| PRESIDENT | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| SUSAN DOHERTY | |||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| MIMI SULLIVAN PHILLIPS | |||||||
| SECRETARY | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| ALEKSANDER DOMICZEK | |||||||
| CMO | 40.00 | $165,107 | $0 | $13,079 | Yes (X) | ||
| KAREN WOOD | |||||||
| CEO | 40.00 | $112,499 | $0 | $9,185 | Yes (X) | ||
| JAMIE WETHERELL | |||||||
| CFO | 40.00 | $103,205 | $0 | $12,142 | Yes (X) | ||
| HEATHER SCIFORD | |||||||
| COO | 40.00 | $97,710 | $0 | $5,975 | Yes (X) | ||
| SUSAN ZIELONKA | |||||||
| PHYSICIAN | 40.00 | $139,750 | $0 | $7,966 | Yes (X) | ||
| VASUDEVA MANDAVA | |||||||
| PHYSICIAN | 40.00 | $113,725 | $0 | $13,024 | Yes (X) | ||
| ADRIANNE COUWLIER | |||||||
| NP | 40.00 | $104,423 | $0 | $9,927 | Yes (X) | ||
| SCOTT MCCORMICK | |||||||
| PHYSICIAN AS | 40.00 | $100,540 | $0 | $4,555 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $936,959 | TotalReportableCompFromOrgAmt |
| Total Other Compensation | $75,853 | 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 (3 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | Address Line2ContractorAddress/USAddress/AddressLine2Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|---|
| BESSE MEDICAL SUPPLY | ||||||
| 9075 CENTRE POINTE DR | STE 140 | WEST CHESTER | OH | 45069 | PHARMACEUTICALS | $440,348 |
| BLUE CROSS BLUE SHIELD | ||||||
| 225 NORTH MICHIGAN AVE | CHICAGO | IL | 60601 | HEALTH INS. | $237,710 | |
| DELIVER DENTAL SOLUTIONS | ||||||
| 79 ALEXANDRINE STREET WEST | 3RD FLOOR | DETROIT | MI | 48201 | DENTAL | $139,975 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 3 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $1,927,981 | GovernmentGrantsAmt |
| Total Contributions | $1,927,981 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT REVENUE | 624100 | $3,072,984 | $3,072,984 |
| 340B PHARMACY REVENUE | 624100 | $8,199 | $8,199 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $3,081,183 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,018 | TotalRevenueColumnAmt |
| Exclusion | $2,018 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $35,781 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $16,587 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $19,194 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $19,194 | TotalRevenueColumnAmt |
| Exclusion | $19,194 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OTHER INCOME | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $1,500 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,500 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $1,500 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,031,876 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,082,683 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $21,212 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $518,903 | TotalAmt |
| Program Services | $194,392 | ProgramServicesAmt |
| Management And General | $324,511 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,903,002 | TotalAmt |
| Program Services | $1,363,887 | ProgramServicesAmt |
| Management And General | $539,115 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,771 | TotalAmt |
| Program Services | $1,436 | ProgramServicesAmt |
| Management And General | $1,335 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $192,911 | TotalAmt |
| Program Services | $82,987 | ProgramServicesAmt |
| Management And General | $109,924 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $170,364 | TotalAmt |
| Program Services | $134,793 | ProgramServicesAmt |
| Management And General | $35,571 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $78,129 | TotalAmt |
| Management And General | $78,129 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,920 | TotalAmt |
| Management And General | $26,920 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $517,127 | TotalAmt |
| Program Services | $478,017 | ProgramServicesAmt |
| Management And General | $39,110 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,969 | TotalAmt |
| Program Services | $11,446 | ProgramServicesAmt |
| Management And General | $1,523 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $99,276 | TotalAmt |
| Program Services | $68,316 | ProgramServicesAmt |
| Management And General | $30,960 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $142,095 | TotalAmt |
| Program Services | $72,829 | ProgramServicesAmt |
| Management And General | $69,266 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $207,656 | TotalAmt |
| Program Services | $151,968 | ProgramServicesAmt |
| Management And General | $55,688 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,615 | TotalAmt |
| Program Services | $12,150 | ProgramServicesAmt |
| Management And General | $15,465 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,813 | TotalAmt |
| Program Services | $10,653 | ProgramServicesAmt |
| Management And General | $14,160 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,946 | TotalAmt |
| Management And General | $10,946 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $147,721 | TotalAmt |
| Program Services | $110,793 | ProgramServicesAmt |
| Management And General | $36,928 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $78,055 | TotalAmt |
| Program Services | $45,407 | ProgramServicesAmt |
| Management And General | $32,648 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| PHARMACY | $514,569 | $514,569 | |
| BAD DEBT | $303,633 | $303,633 | |
| RECRUITMENT | $91,303 | $18,445 | $72,858 |
| FURNITURE AND EQUIPMENT | $46,036 | $5,629 | $40,407 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $185,580 | TotalAmt |
| Program Services | $110,078 | ProgramServicesAmt |
| Management And General | $75,502 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,302,394 | TotalAmt |
| Program Services | $3,691,428 | ProgramServicesAmt |
| Management And General | $1,610,966 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $226,607 | BOYAmt |
| EOY | $151,997 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $254,744 | BOYAmt |
| EOY | $256,762 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $62,296 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,537,794 | BOYAmt |
| EOY | $1,972,097 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,500 | BOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $81,140 | BOYAmt |
| EOY | $17,859 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $1,478,896 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $579,708 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $897,672 | BOYAmt |
| EOY | $899,188 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,585 | BOYAmt |
| EOY | $4,585 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,005,042 | BOYAmt |
| EOY | $3,364,784 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $236,312 | BOYAmt |
| EOY | $430,280 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,207 | BOYAmt |
| EOY | $48,946 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $403,553 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $252,519 | BOYAmt |
| EOY | $882,779 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,752,523 | BOYAmt |
| EOY | $2,482,005 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,752,523 | BOYAmt |
| EOY | $2,482,005 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,005,042 | BOYAmt |
| EOY | $3,364,784 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$270,518 | 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 | $727,863 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,123,598 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,254,097 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,703,731 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,927,981 | CurrentTaxYearAmt |
| Total | $7,737,270 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $727,863 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,123,598 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,254,097 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,703,731 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,927,981 | CurrentTaxYearAmt |
| Total | $7,737,270 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $7,737,270 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,343 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,205 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $440 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,776 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,018 | CurrentTaxYearAmt |
| Total | $6,782 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $293,693 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $27,251 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $12,457 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year | $1,500 | CurrentTaxYearAmt |
| Total | $334,901 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $8,078,953 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $6,304,297 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.95770 | PublicSupportCY170Pct |
| Public Support PY170 | 0.94500 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II, LINE 10 | FormAndLineReferenceDesc |
| Explanation | MEDICAL DIRECTOR INCOME 8,000 340B PHARMACY 25,105 OTHER INCOME 301,796 | ExplanationTxt |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $927,751 | OtherCostOrOtherBasisAmt |
| Depreciation | $288,694 | DepreciationAmt |
| Book Value | $639,057 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $524,718 | OtherCostOrOtherBasisAmt |
| Depreciation | $288,371 | DepreciationAmt |
| Book Value | $236,347 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $26,427 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,643 | DepreciationAmt |
| Book Value | $23,784 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $899,188 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | THIRD PARTY COST SETTLEMENTS | Desc |
| Amt | $403,553 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $403,553 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $5,043,776 | TotalRevEtcAuditedFinclStmtAmt |
| Donated Services And Use Fclts | $11,900 | DonatedServicesAndUseFcltsAmt |
| Revenue Not Reported | $11,900 | RevenueNotReportedAmt |
| Revenue Subtotal | $5,031,876 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $5,031,876 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $5,314,294 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $11,900 | DonatedServicesUseFcltsAmt |
| Expenses Not Reported | $11,900 | ExpensesNotReportedAmt |
| Expenses Subtotal | $5,302,394 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $5,302,394 | TotalExpensesPerForm990Amt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ALEKSANDER DOMICZEK | PersonNm |
| Title | CMO | TitleTxt |
| Base Compensation Filing Org | $165,107 | BaseCompensationFilingOrgAmt |
| Deferred Compensation Flng Org | $1,477 | DeferredCompensationFlngOrgAmt |
| Nontaxable Benefits Filing Org | $11,602 | NontaxableBenefitsFilingOrgAmt |
| Total Compensation Filing Org | $178,186 | TotalCompensationFilingOrgAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 6, PART VI, LINE 11B | THE CEO, CFO, AND FINANCE COMMITTEE REVIEW AND APPROVE THE 990 PRIOR TO FILING AND A COPY IS PRESENTED TO THE BOARD OF DIRECTORS AT THE NEXT REGULAR MEETING. |
| FORM 990, PAGE 6, PART VI, LINE 15A | CEO COMPENSATION IS COMPETITIVE BASED ON INDUSTRY STANDARDS WITHIN OUR GEOGRAPHIC AREA AND APPROVED BY THE BOARD OF DIRECTORS. |
| FORM 990, PAGE 6, PART VI, LINE 15B | OTHER OFFICERS OR KEY EMPLOYEE COMPENSATION IS COMPETITIVE BASED ON INDUSTRY STANDARDS WITHIN OUR GEOGRAPHIC AREA AND APPROVED BY THE BOARD OF DIRECTORS. |
| FORM 990, PAGE 6, PART VI, LINE 19 | GOVERNING DOCUMENTS MADE AVAILABLE UPON REQUEST. |