2019-02-01T10:09:10-06:00 2018-06-30 420714325 RSM US LLP 100 INTERNATIONAL DRIVE SUITE 1400 BALTIMORE MD 21202 990 2017-07-01 520988386 COMMUNITY CLINIC INC COMM 3013407525 8630 FENTON STREET 12TH FLOOR SILVER SPRING MD 20910 KATHLEEN KNOLHOFF CEO 3013407525 2019-01-31 1 JULIA FLANNERY CPA P00928918 4102469300 69.174.87.76 2019-01-31 13:18:50 ES P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 4EE6A31F760B3C5EA0809148B0E883CC4242B14C 2017 2019-02-21 02:37:17Z CCI HEALTH & WELLNESS SERVICES KATHLEEN KNOLHOFF 8630 FENTON STREET 12TH FLOOR SILVER SPRING MD 20910 27071148 0 X WWW.CCIWEB.ORG X 1972 MD EMPOWER PATIENTS TO PARTNER WITH STAFF FOR AN UNPARALLED HEALTHCARE EXPERIENCE THROUGH INTEGRATED TEAMS IN A LEARNING ENVIRONMENT, WE DELIVER HIGH QUALITY, AFFORDABLE CARE TO EVERY PATIENT DURING ALL STAGES OF LIFE. 9 9 349 12 0 25533 11182001 10923033 18685930 14163067 16 69 1657888 1893528 31525835 26979697 0 0 0 0 15884475 16896383 0 0 11362 8021857 8220748 23906332 25117131 7619503 1862566 14840783 16817496 1895289 1964975 12945494 14852521 X CCI HEALTH & WELLNESS SERVICES, A GROUP PRACTICE, EMPOWERS PATIENTS TO PARTNER WITH STAFF FOR AN UNPARALLELED HEALTHCARE EXPERIENCE. THROUGH INTEGRATED TEAMS IN A LEARNING ENVIRONMENT, WE DELIVER HIGH-QUALITY, AFFORDABLE CARE TO EVERY PATIENT DURING ALL STAGES OF LIFE. 0 0 13059733 11878428 HEALTH CENTERS: PROVIDE COMPREHENSIVE PRIMARY CARE SERVICES TO ABOUT 76,000 INDIVIDUAL ENCOUNTERS MANY OF WHOM DO NOT HAVE HEALTH INSURANCE. CCI PROVIDES DIRECT CARE FOR PRE-NATAL SERVICES AS WELL AS ADOLESCENT SERVICES. 3509150 WOMAN, INFANTS AND CHILDREN (WIC): NUTRITION COUNSELING TO MORE THAN 32,000 INCOME-ELIGIBLE INFANTS AND CHILDREN AS WELL AS PREGNANT AND BREASTFEEDING WOMEN. 1756434 1452891 COMPREHENSIVE DENTAL SERVICE PROGRAM: PROVIDING MORE THAN 13,000 DENTAL ENCOUNTERS TO ALL PATIENTS IRRESPECTIVE OF THEIR ABILITY TO PAY. 1449019 OTHER 831748 BEHAVIORAL HEALTH: PROVIDES SERVICES TO MORE THAN 5,000 BEHAVIORAL HEALTH ENCOUNTERS TO ALL PATIENTS INCLUDING THOSE WITHOUT INSURANCE. 2280767 18325317 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 2 0 1 349 1 1 1 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 MD X SHELDON KRONZEK 2406381271 8630 FENTON STREET SUITE 1204 SILVER SPRING MD 20910 ERIC STROUD CHAIRPERSON 2.00 X X 0 0 0 ELIZABETH DURHAM CHAIR-ELECT 2.00 X X 0 0 0 JUDITH FALLON SECRETARY 2.00 X X 0 0 0 SHARON THAMES TREASURER 2.00 X X 0 0 0 LORIANN BEHM DIRECTOR 2.00 X 0 0 0 LOUISE BRADFORD DIRECTOR 2.00 X 0 0 0 DELLA COX DIRECTOR 2.00 X 0 0 0 ISAAC MARKS SR DIRECTOR 2.00 X 0 0 0 PETER MBUGUA DIRECTOR 2.00 X 0 0 0 ALEXANDRE NGAMIJE DIRECTOR 2.00 X 0 0 0 CARLA SATINSKY DIRECTOR 2.00 X 0 0 0 ROBERT WISE MD DIRECTOR 2.00 X 0 0 0 KATHLEEN KNOLHOFF CEO 40.00 X 275133 0 8351 SONYA BRUTON COO 40.00 X 256877 0 12365 SHELDON KRONZEK CFO 40.00 X 175826 0 12322 MARCIA LOBRANO MD CMO (TERM 9/27/17) 40.00 X 204926 0 11299 ROBERT BLAKE CMO 40.00 X 169392 0 13834 LIDA ALIMORAD DENTAL DIRECTOR 40.00 X 180900 0 9534 SUSAN GUMPEL PHYSICIAN 40.00 X 171482 0 5377 PARVEJ MALIK PROVIDER - FM 40.00 X 157669 0 13728 MIKEL LARTVI PHYSICIAN 40.00 X 140972 0 3465 KENDRA MCDOW PHYSICIAN 40.00 X 139865 0 8733 1873042 0 99008 15 0 1 0 BLUENOVO INC 8070 GEORGIA AVENUE SILVER SPRING MD 20910 IT CONSULTING 930941 THE KORTH COMPANIES 9101-A GAITHER ROAD GAITHERSBURG MD 20877 CONSTRUCTION 408393 LAB CORPS PO BOX 12140 BURLINGTON NC 60693 LABORATORY SERVICES 374904 GE HEALTHCARE 15724 COLLECTIONS CENTER DRIVE CHICAGO MD 20898 IT PM & EMR CONTRACTOR 261305 EVOVEIP PO BOX 1023 SOUTHEASTERN PA 19398 TELEPHONE SUPPORT 231813 5 10864113 58920 2315 10923033 PATIENT SERVICE FEES 621400 14163067 14163067 14163067 69 69 158717 91451 67266 67266 OTHER HEALTH SERVICES 621400 1394426 1394426 INCENTIVE & OTHER INC. 900099 377243 377243 PHARMACY 621400 54593 54593 1826262 26979697 15612086 0 444578 1034945 1034945 13430255 11138244 2283311 8700 521765 416117 105648 810249 646189 164060 1099169 830587 268582 68294 68294 74384 74384 1650324 1231028 419296 1081406 557622 521122 2662 1807239 1249539 557700 110549 56590 53959 152790 99521 53269 1104194 72237 1031957 71523 45049 26474 MEDICAL SUPPLIES 1478017 1475126 2891 LICENSE 290114 247969 42145 TRANSLATION SERVICES 192903 189301 3602 MEMBERSHIPS 58757 16294 42463 80254 53904 26350 25117131 18325317 6780452 11362 1266973 1530291 704937 239458 1486839 2098345 3934817 951866 23494 60000 223306 269945 12476334 6904030 5650083 5572304 1402055 5911945 100 100 148179 183242 14840783 16817496 1264248 1401177 99545 96107 531496 467691 1895289 1964975 X 12945494 14852521 12945494 14852521 14840783 16817496 1862566 44461 0 X 0 1 X 1 1 1 X 7126065 3912645 3213420 4212181 2750840 1461341 1138088 240545 897543 5572304 DEFERRED RENT 467691 467691 X 27200664 44461 200000 -23494 220967 26979697 0 26979697 25293637 200000 200000 25093637 23494 23494 25117131 PART X, LINE 2: CCI HAS BEEN RECOGNIZED BY THE IRS AS EXEMPT FROM FEDERAL INCOME TAXES UNDER IRC 501(C)(3), EXCEPT FOR TAXES ON INCOME GENERATED FROM UNRELATED BUSINESS ACTIVITIES. CCI HAS ADOPTED ACCOUNTING GUIDANCE REGARDING THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES, WHICH ADDRESSES THE DETERMINATION OF WHETHER TAX BENEFITS CLAIMED OR EXPECTED TO BE CLAIMED ON A TAX RETURN SHOULD BE RECORDED IN THE FINANCIAL STATEMENTS. ACCORDINGLY, NO PROVISION FOR INCOME TAXES IS REFLECTED IN THESE FINANCIAL STATEMENTS. INCOME THAT IS NOT RELATED TO EXEMPT PURPOSES, LESS APPLICABLE DEDUCTIONS, IS SUBJECT TO FEDERAL AND STATE INCOME TAXES. CCI HAD NO UNRELATED BUSINESS INCOME FOR THE YEARS ENDED JUNE 30, 2018 AND 2017. UNDER THIS POLICY, CCI MAY RECOGNIZE THE TAX BENEFIT FROM AN UNCERTAIN TAX POSITION ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WOULD BE SUSTAINED ON EXAMINATION BY TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. MANAGEMENT HAS EVALUATED CCI'S TAX POSITIONS AND HAS CONCLUDED THAT CCI HAS TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENT TO THE FINANCIAL STATEMENTS TO COMPLY WITH PROVISIONS OF THIS GUIDANCE. AS OF JUNE 30, 2018 AND 2017, THERE ARE NO MATERIAL UNRECOGNIZED/DERECOGNIZED TAX BENEFITS OR TAX PENALTIES OR INTEREST. CCI IS NO LONGER SUBJECT TO U.S. FEDERAL, STATE OR LOCAL TAX EXAMINATIONS BY TAX AUTHORITIES FOR YEARS ENDED BEFORE JUNE 30, 2015. PART XI, LINE 2D - OTHER ADJUSTMENTS: LOSS ON DISPENSARY SHUTDOWN -23,494. PART XII, LINE 4B - OTHER ADJUSTMENTS: LOSS ON DISPENSARY SHUTDOWN 23,494. X X 0 0 0 0 0 0 0 1 0 KATHLEEN KNOLHOFF CEO 251133 0 24000 0 0 0 6128 0 2223 0 283484 0 0 0 SONYA BRUTON COO 226214 0 30663 0 0 0 5530 0 6835 0 269242 0 0 0 SHELDON KRONZEK CFO 150726 0 25100 0 0 0 4062 0 8260 0 188148 0 0 0 MARCIA LOBRANO MD CMO (TERM 9/27/17) 184926 0 20000 0 0 0 3237 0 8062 0 216225 0 0 0 ROBERT BLAKE CMO 169292 0 100 0 0 0 4632 0 9202 0 183226 0 0 0 LIDA ALIMORAD DENTAL DIRECTOR 160013 0 20887 0 0 0 3967 0 5567 0 190434 0 0 0 SUSAN GUMPEL PHYSICIAN 171382 0 100 0 0 0 4418 0 959 0 176859 0 0 0 PARVEJ MALIK PROVIDER - FM 157569 0 100 0 0 0 4152 0 9576 0 171397 0 0 0 PART I, LINE 7 DISCRETIONARY BONUSES FOR EXEMPLARY PERFORMANCE AND EXCEEDING GOALS WERE AWARDED DURING THE CALENDAR YEAR. STAFF BONUSES ARE APPROVED BY THE CEO AND ONE ADDITIONAL EXECUTIVE STAFF MEMBER. THE CEO'S BONUS IS APPROVED BY THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS REVIEWED BY THE CEO AND CFO. BOARD MEMBERS RECEIVE AN ELECTRONIC COPY OF THE FORM 990 BEFORE IT IS FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ACTIVITIES OF THE CORPORATION SHALL BE CONDUCTED SO THAT NO PART OF ITS INCOME PROPERTY OR EARNINGS SHALL INURE TO THE BENEFIT OF ANY DIRECTOR, OFFICER, EMPLOYEE OR OTHER INDIVIDUAL, CORPORATION, INSTITUTION OR ASSOCIATION. ANY DIRECTOR HAVING AN OUTSIDE INTEREST IN A MATTER BEFORE THE BOARD SHALL DISCLOSE THE POTENTIAL CONFLICT TO THE BOARD BEFORE IT DELIBERATES AND ACTS ON THE MATTER AND IF THE BOARD DETERMINES A CONFLICT EXISTS, THE MEMBER SHALL ABSTAIN FROM ANY DELIBERATIONS OR VOTE ON THE MATTER. EACH DIRECTOR SHALL SIGN A CONFLICT OF INTEREST STATEMENT UPON JOINING THE BOARD AND SHALL SIGN AN UPDATED STATEMENT ANNUALLY THEREAFTER. FORM 990, PART VI, SECTION B, LINE 15 THE DETERMINATION OF COMPENSATION AMOUNTS FOR THE ORGANIZATION'S CEO OCCURS WHEN THE BOARD EVALUATES THE CEO'S PERFORMANCE AND MAKES THEIR RECOMMENDATION FOR THE SALARY INCREASE. THE DETERMINATION OF COMPENSATION AMOUNTS FOR THE CEO AND KEY EMPLOYEES INCLUDES A REVIEW OF LOCAL & NATIONAL COMPARABLES FOR PROFESSIONALS WITH REQUIRED SKILLS AND BACKGROUND, AS WELL AS A REVIEW OF ORGANIZATION FINANCIALS TO DETERMINE WHAT MAKES SENSE GIVING EXISTING BUDGET CONSTRAINTS. FORM 990, PART VI, SECTION C, LINE 19 COMMUNITY CLINIC, INC. MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST FOR THE SAME PERIOD OF DISCLOSURE AS SET FORTH IN SECTION 6104(D).