STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

HOPEWELL HEALTH CENTERS INC: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization
HOPEWELL HEALTH CENTERS INC (EIN 31-1155352)
Tax period
2018-01-01 to 2018-12-31
Filed
2019-11-06
IRS object ID
201933129349302448
Schema version
2018v3.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2019-11-06T16:03:40-07:00ReturnTs
Tax Period End2018-12-31TaxPeriodEndDt
Return Type990ReturnTypeCd
Tax Period Begin2018-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN311155352EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Hopewell Health Centers IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlHOPEBusinessNameControlTxt
Phone7407731006PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO Box 188AddressLine1Txt
CityChillicotheCityNm
State AbbreviationOHStateAbbreviationCd
ZIP45601ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJames MorrisPersonNm
Person TitleDir of Fiscal ServicesPersonTitleTxt
Phone7405945045PhoneNum
Signature2019-10-29SignatureDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address8.21.121.10IPv4AddressTxt
FieldValueIRS element (for citing)
Tax2018TaxYr
Build TS2020-04-17 16:48:07ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerMark BridenbaughPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO Box 188AddressLine1Txt
CityChillicotheCityNm
State AbbreviationOHStateAbbreviationCd
ZIP45601ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$57,992,340GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1985FormationYr
Legal Domicile StateOHLegalDomicileStateCd
Activity Or MissionProvide access to affordable high quality healthcare without discrimination to the residents of southeast Ohio.ActivityOrMissionDesc
Voting Members Governing Body12VotingMembersGoverningBodyCnt
Voting Members Independent12VotingMembersIndependentCnt
Total Employee823TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$7,485,589PYContributionsGrantsAmt
CY Contributions Grants$8,568,431CYContributionsGrantsAmt
PY Program Service Revenue$32,279,962PYProgramServiceRevenueAmt
CY Program Service Revenue$40,949,984CYProgramServiceRevenueAmt
PY Investment Income$0PYInvestmentIncomeAmt
CY Investment Income$3,023CYInvestmentIncomeAmt
PY Other Revenue$4,898,786PYOtherRevenueAmt
CY Other Revenue$8,350,140CYOtherRevenueAmt
PY Total Revenue$44,664,337PYTotalRevenueAmt
CY Total Revenue$57,871,578CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$30,138,179PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$38,923,038CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$12,296,426PYOtherExpensesAmt
CY Other Expenses$16,465,249CYOtherExpensesAmt
PY Total Expenses$42,434,605PYTotalExpensesAmt
CY Total Expenses$55,388,287CYTotalExpensesAmt
PY Revenues Less Expenses$2,229,732PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$2,483,291CYRevenuesLessExpensesAmt
Total Assets BOY$20,364,812TotalAssetsBOYAmt
Total Assets EOY$22,206,440TotalAssetsEOYAmt
Total Liabilities BOY$8,931,523TotalLiabilitiesBOYAmt
Total Liabilities EOY$8,289,860TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$11,433,289NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$13,916,580NetAssetsOrFundBalancesEOYAmt
MissionProvide access to high quality health, dental, mental health services without discrimination to the residents of southeastern Ohio.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$21,613,794ExpenseAmt
Grant$0GrantAmt
Revenue$38,112,679RevenueAmt
DescProvide medical and dental services to rural southern Ohio. Serving Ross, Perry, Hocking, Vinton, Athens, Gallia, Jackson, and Meigs counties.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$27,648,961ExpenseAmt
Grant$0GrantAmt
Revenue$19,289,385RevenueAmt
DescProvide mental health, counseling, and addiction treatment services to rural southern Ohio. Serving Ross, Perry, Athens, Hocking, Vinton, Washington, Meigs, and Jackson counties.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$488,013ExpenseAmt
Grant$0GrantAmt
Revenue$469,513RevenueAmt
DescWIC - Women, Infants and Children nutritional program that helps women, new mothers, and young children eat healthy and stay healthy. Serving Athens and Perry counties.Desc
FieldValueIRS element (for citing)
Total Other Prog Srvc Expense$0TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Grant$0TotalOtherProgSrvcGrantAmt
Total Other Prog Srvc Revenue$0TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses$49,750,768TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent EndowmentsYes (1)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document28IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee823EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members12GoverningBodyVotingMembersCnt
Independent Voting Member12IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldOHStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonBrad NelsonPersonNm
Phone7407731006PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO Box 188AddressLine1Txt
CityChillicotheCityNm
State AbbreviationOHStateAbbreviationCd
ZIP45601ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (27 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
Kathy Cecil
Board President00Yes (X)$0$0$0
Don Poole
Board Vice-President00Yes (X)$0$0$0
John Means
Board Treasurer00Yes (X)$0$0$0
Walter Goble
Board Secretary00Yes (X)$0$0$0
Tom McGuire
Board Member00Yes (X)$0$0$0
Margaret Hill-Daniels
Board Member00Yes (X)$0$0$0
Martha Murphy
Board Member00Yes (X)$0$0$0
Amy Jo Newlun
Board Member00Yes (X)$0$0$0
Jennifer Holt-Hill
Board Member00Yes (X)$0$0$0
Daniel Brown
Board Member00Yes (X)$0$0$0
Gregory Ervin
Board Member00Yes (X)$0$0$0
Peter Howison MD
Board Member00Yes (X)$0$0$0
Mark Bridenbaugh
Chief Executive Officer400$146,363$0$5,720Yes (X)
Eduardo Robles
Chief Medical Officer400$243,052$0$9,302Yes (X)
Bradford Nelson
Chief Financial Officer400$105,553$0$4,128Yes (X)
Sherry Shamblin
Chief Stategy Officer400$107,133$0$4,128Yes (X)
David Schenkelberg
Chief Clinical Officer400$108,127$0$4,207Yes (X)
Damodar Poudel
Regional Medical Director400$285,100$0$11,000Yes (X)
Mary Hanessian
Director of Psychiatry400$267,531$0$10,684Yes (X)
Douglas Carr
Regional Medical Director400$221,453$0$8,749Yes (X)
Darcy Cook
Director of Dentistry400$175,371$0$6,943Yes (X)
Robert Yoho
Director of Pharmacology400$129,142$0$0Yes (X)
Brittane Britton
Dentist400$413,331$0$11,000Yes (X)
Nicholas Gatzulis
Dentist400$404,737$0$11,000Yes (X)
Benjamin Jordan
Psychiatrist400$259,129$0$10,303Yes (X)
Sanju Mahato
Physician400$244,131$0$2,585Yes (X)
Shivaprakash Kudlapur
Physician400$222,760$0$8,470Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$3,332,913TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$108,219TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K35IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmtAddress Line2ContractorAddress/USAddress/AddressLine2Txt
Eclinical Works LLC
PO Box 847950BostonMA02284Electronic Medical Records$758,300
RxStrategies
1900 Glades RdBoca RotonFL33431340B Pharmacy Processing$629,681Suite 350
Jackson & Coker Locumtenens LLC
PO Box 277638AtlantaGA303847638Temporary Healthcare Staffing$433,380
Trizetto
Dept CH 16897PalatineIL60055Claims Processing$281,044
NewEgg Business Inc
17560 Rowland StCity of IndustryCA91748Computer Products$214,069
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K37CntrctRcvdGreaterThan100KCnt
Federated Campaigns$0FederatedCampaignsAmt
Membership Dues$0MembershipDuesAmt
Fundraising$0FundraisingAmt
Related Organizations$0RelatedOrganizationsAmt
Government Grants$7,387,485GovernmentGrantsAmt
All Other Contributions$1,180,946AllOtherContributionsAmt
Noncash Contributions$0NoncashContributionsAmt
Total Contributions$8,568,431TotalContributionsAmt

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$40,949,984TotalRevenueColumnAmt
Related Or Exempt Func Income$40,949,984RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$40,949,984TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,632TotalRevenueColumnAmt
Related Or Exempt Func Income$2,632RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$38,700RealAmt
Personal$0PersonalAmt

Less Rental Expenses LessRentalExpensesGrp

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

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$38,700RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$38,700TotalRevenueColumnAmt
Related Or Exempt Func Income$38,700RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt
Other$121,153OtherAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt
Other$120,762OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt
Other$391OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$391TotalRevenueColumnAmt
Related Or Exempt Func Income$391RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$0FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$0ContriRptFundraisingEventAmt
Fundraising Direct Expenses$0FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Gaming Gross Income$0GamingGrossIncomeAmt
Gaming Direct Expenses$0GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$0GrossSalesOfInventoryAmt
Cost Of Goods Sold$0CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmtExclusionExclusionAmt
340B Program900099$8,274,078$8,274,078$0$0
Medical Records900099$25,472$25,472$0$0

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$11,890TotalRevenueColumnAmt
Related Or Exempt Func Income$11,890RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$8,311,440OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$57,871,578TotalRevenueColumnAmt
Related Or Exempt Func Income$49,303,147RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$30,174,283TotalAmt
Program Services$28,189,543ProgramServicesAmt
Management And General$1,984,740ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$732,130TotalAmt
Program Services$673,750ProgramServicesAmt
Management And General$58,380ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$5,648,837TotalAmt
Program Services$4,876,619ProgramServicesAmt
Management And General$772,218ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$2,367,788TotalAmt
Program Services$2,216,127ProgramServicesAmt
Management And General$151,661ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$2,531,966TotalAmt
Program Services$1,705,768ProgramServicesAmt
Management And General$826,198ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$28,416TotalAmt
Program Services$2,000ProgramServicesAmt
Management And General$26,416ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$46,880TotalAmt
Program Services$29,638ProgramServicesAmt
Management And General$17,242ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt
Fundraising$0FundraisingAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$161,862TotalAmt
Program Services$108,985ProgramServicesAmt
Management And General$52,877ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$5,960,316TotalAmt
Program Services$5,323,950ProgramServicesAmt
Management And General$636,366ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$280,357TotalAmt
Program Services$112,420ProgramServicesAmt
Management And General$167,937ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,626,249TotalAmt
Program Services$1,626,249ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$806,608TotalAmt
Program Services$767,345ProgramServicesAmt
Management And General$39,263ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$206,063TotalAmt
Program Services$126,057ProgramServicesAmt
Management And General$80,006ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$196,889TotalAmt
Program Services$189,499ProgramServicesAmt
Management And General$7,390ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$163,469TotalAmt
Program Services$74,037ProgramServicesAmt
Management And General$89,432ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$679,713TotalAmt
Program Services$412,528ProgramServicesAmt
Management And General$267,185ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$143,896TotalAmt
Program Services$53,666ProgramServicesAmt
Management And General$90,230ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
340B Program$3,473,049$3,103,071$369,978$0
Vehicle Maintenance$68,070$68,070$0$0
Vehicle Lease$65,691$65,691$0$0

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$25,755TotalAmt
Program Services$25,755ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$55,388,287TotalAmt
Program Services$49,750,768ProgramServicesAmt
Management And General$5,637,519ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$4,546BOYAmt
EOY$6,182EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$3,230,470BOYAmt
EOY$3,169,371EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

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

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$5,101,741BOYAmt
EOY$7,034,730EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

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

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

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

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

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

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$17,872BOYAmt
EOY$0EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$50,087BOYAmt
EOY$75,070EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$16,800,417LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$4,898,438LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$11,943,620BOYAmt
EOY$11,901,979EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

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

Investments Other Securities InvestmentsOtherSecuritiesGrp

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

Investments Program Related InvestmentsProgramRelatedGrp

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

Intangible Assets IntangibleAssetsGrp

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

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$16,476BOYAmt
EOY$19,108EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$20,364,812BOYAmt
EOY$22,206,440EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$4,583,082BOYAmt
EOY$3,830,229EOYAmt

Grants Payable GrantsPayableGrp

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

Deferred Revenue DeferredRevenueGrp

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

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

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

Escrow Account Liability EscrowAccountLiabilityGrp

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

Loans From Officers Directors LoansFromOfficersDirectorsGrp

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

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$4,348,441BOYAmt
EOY$4,459,631EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

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

Other Liabilities OtherLiabilitiesGrp

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

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$8,931,523BOYAmt
EOY$8,289,860EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$11,433,289BOYAmt
EOY$13,227,580EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$689,000EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

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

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$11,433,289BOYAmt
EOY$13,916,580EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$20,364,812BOYAmt
EOY$22,206,440EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$2,483,291ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$0NetUnrlzdGainsLossesInvstAmt
Donated Services And Use Fclts$0DonatedServicesAndUseFcltsAmt
Investment Expense$0InvestmentExpenseAmt
Prior Period Adjustments$0PriorPeriodAdjustmentsAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit RequiredYes (1)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (1)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$16,476BeginningYearBalanceAmt
Contributions$0ContributionsAmt
Investment Earnings Or Losses$2,632InvestmentEarningsOrLossesAmt
Grants Or Scholarships$0GrantsOrScholarshipsAmt
Other Expenditures$0OtherExpendituresAmt
Administrative Expenses$0AdministrativeExpensesAmt
End Year Balance$19,108EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$16,476BeginningYearBalanceAmt
Contributions$0ContributionsAmt
Investment Earnings Or Losses$0InvestmentEarningsOrLossesAmt
Grants Or Scholarships$0GrantsOrScholarshipsAmt
Other Expenditures$0OtherExpendituresAmt
Administrative Expenses$0AdministrativeExpensesAmt
End Year Balance$16,476EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$16,476BeginningYearBalanceAmt
Contributions$0ContributionsAmt
Investment Earnings Or Losses$0InvestmentEarningsOrLossesAmt
Grants Or Scholarships$0GrantsOrScholarshipsAmt
Other Expenditures$0OtherExpendituresAmt
Administrative Expenses$0AdministrativeExpensesAmt
End Year Balance$16,476EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$16,011BeginningYearBalanceAmt
Contributions$0ContributionsAmt
Investment Earnings Or Losses$465InvestmentEarningsOrLossesAmt
Grants Or Scholarships$0GrantsOrScholarshipsAmt
Other Expenditures$0OtherExpendituresAmt
Administrative Expenses$0AdministrativeExpensesAmt
End Year Balance$16,476EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$14,947BeginningYearBalanceAmt
Contributions$0ContributionsAmt
Investment Earnings Or Losses$1,064InvestmentEarningsOrLossesAmt
Grants Or Scholarships$0GrantsOrScholarshipsAmt
Other Expenditures$0OtherExpendituresAmt
Administrative Expenses$0AdministrativeExpensesAmt
End Year Balance$16,011EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY1BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0TermEndowmentBalanceEOYPct
Endowments Held Unrelated OrgYes (1)EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$1,084,916InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$0OtherCostOrOtherBasisAmt
Book Value$1,084,916BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$12,253,114InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$0OtherCostOrOtherBasisAmt
Depreciation$2,620,503DepreciationAmt
Book Value$9,632,611BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$751,953InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$0OtherCostOrOtherBasisAmt
Depreciation$303,669DepreciationAmt
Book Value$448,284BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$2,710,434InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$0OtherCostOrOtherBasisAmt
Depreciation$1,974,266DepreciationAmt
Book Value$736,168BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$0InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$0OtherCostOrOtherBasisAmt
Depreciation$0DepreciationAmt
Book Value$0BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$11,901,979TotalBookValueLandBuildingsAmt
Total Rev Etc Audited Fincl Stmt$57,871,578TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$0NetUnrealizedGainsInvstAmt
Donated Services And Use Fclts$0DonatedServicesAndUseFcltsAmt
Recoveries Prior Year Grants$0RecoveriesPriorYearGrantsAmt
Other Revenue$0OtherRevenueAmt
Revenue Not Reported$0RevenueNotReportedAmt
Revenue Subtotal$57,871,578RevenueSubtotalAmt
Investment Expenses Not Incld$0InvestmentExpensesNotIncldAmt
Other Revenues Not Included$0OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$57,871,578TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$55,388,287TotExpnsEtcAuditedFinclStmtAmt
Donated Services Use Fclts$0DonatedServicesUseFcltsAmt
Prior Year Adjustments$0PriorYearAdjustmentsAmt
Losses Reported$0LossesReportedAmt
Other Expenses Included$0OtherExpensesIncludedAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$55,388,287ExpensesSubtotalAmt
Investment Expenses Not Incld2$0InvestmentExpensesNotIncld2Amt
Other Expenses Not Included$0OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$55,388,287TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSchedule D, Part V, Line 4FormAndLineReferenceDesc
ExplanationEndowment fund established to help defray costs associated with uninsured patients.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Mark Bridenbaugh
Chief Executive Officer$146,363$0$0$0$0$0$5,720$0$0$0$152,083$0$0$0
Eduardo Robles
Chief Medical Officer$243,052$0$0$0$0$0$9,302$0$0$0$252,354$0$0$0
Damodar Poudel
Regional Medical Director$285,100$0$0$0$0$0$11,000$0$0$0$296,100$0$0$0
Mary Hanessian
Director of Psychiatry$267,531$0$0$0$0$0$10,684$0$0$0$278,215$0$0$0
Douglas Carr
Regional Medical Director$221,453$0$0$0$0$0$8,749$0$0$0$230,202$0$0$0
Darcy Cook
Director of Dentistry$175,371$0$0$0$0$0$6,943$0$0$0$182,314$0$0$0
Brittane Britton
Dentist$413,331$0$0$0$0$0$11,000$0$0$0$424,331$0$0$0
Nicholas Gatzulis
Dentist$404,737$0$0$0$0$0$11,000$0$0$0$415,737$0$0$0
Benjamin Jordan
Psychiatrist$259,129$0$0$0$0$0$10,303$0$0$0$269,432$0$0$0
Sanju Mahato
Physician$244,131$0$0$0$0$0$2,585$0$0$0$246,716$0$0$0
Shivaprakash Kudlapur
Physician$222,760$0$0$0$0$0$8,470$0$0$0$231,230$0$0$0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Section B, Line 11bThe form 990 is presented to the board members for review prior to submission.
Form 990, Part VI, Section B, Line 12cBoard members are required to complete a questionnaire.
Form 990, Part VI, Section B, Line 15The Board of Directors approves all pay scale and cost of living increases for the year. A review of comparable health centers and salaries in the community are reviewed when making any changes to pay scales.
Form 990, Part VI, Section C, Line 19Information in the organization's governing documents , conflict of interest policy , and financial statements are made available upon request.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1Tri-County Mental Health & Counseling Services IncBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line190 Hospital DriveAddressLine1Txt
CityAthensCityNm
State AbbreviationOHStateAbbreviationCd
ZIP45701ZIPCd
FieldValueIRS element (for citing)
EIN310860366EIN
Primary ActivitiesBehavioral Health CarePrimaryActivitiesTxt
Legal Domicile StateOHLegalDomicileStateCd
Exempt Code Section501(c)(3)ExemptCodeSectionTxt
Public Charity Status7PublicCharityStatusTxt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1Hopewell Health Centers IncBusinessNameLine1Txt
FieldValueIRS element (for citing)
Controlled Organization0ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Reasonable Cause Explanation ReasonableCauseExplanation

FieldValueIRS element (for citing)
ExplanationSubmitted Form 8868 for automatic 6-month extension. Extension accepted on 05/13/2019 extending due date to 11/15/2019.ExplanationTxt