PENINSULA INSTITUTE FOR COMMUNITY HEALTH INC: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- PENINSULA INSTITUTE FOR COMMUNITY HEALTH INC (EIN 54-1083954)
- Tax period
- 2017-01-01 to 2017-12-31
- Filed
- 2018-04-16
- IRS object ID
- 201801069349300905
- Schema version
- 2017v2.3
- 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 | 2018-04-16T11:26:10-04:00 | ReturnTs |
| Tax Period End | 2017-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 541896113 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ROBINSON FARMER COX ASSOCIATES | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 401 SOUTHLAKE BLVD STE C1 | AddressLine1Txt |
| City | RICHMOND | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 23236 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 541083954 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PENINSULA INSTITUTE FOR COMMUNITY | BusinessNameLine1Txt |
| Business Name Line2 | HEALTH | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PENI | BusinessNameControlTxt |
| Phone | 7573808709 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1033 28TH STREET 2ND FLOOR | AddressLine1Txt |
| City | NEWPORT NEWS | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 23607 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ANGELA FUTRELL | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 7573808709 | PhoneNum |
| Signature | 2018-03-07 | SignatureDt |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | AARON B HAWKINS | PreparerPersonNm |
| PTIN | P01458736 | PTIN |
| Phone | 8043784200 | PhoneNum |
| Preparation | 2018-04-16 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SOUTHEASTERN VIRGINIA HEALTH SYSTEM | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ANGELA FUTRELL | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1033 28TH STREET 2ND FLOOR | AddressLine1Txt |
| City | NEWPORT NEWS | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 23607 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $16,086,369 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.PICH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1978 | FormationYr |
| Legal Domicile State | VA | LegalDomicileStateCd |
| Activity Or Mission | PROVIDE HIGH QUALITY, COMPREHENSIVE, PRIMARY HEALTH CARE SERVICES TO VIRGINIA RESIDENTS LIVING IN HAMPTON ROADS REGARDLESS OF THEIR ABILITY TO PAY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 16 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 16 | VotingMembersIndependentCnt |
| Total Employee | 225 | TotalEmployeeCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $8,535,886 | PYContributionsGrantsAmt |
| CY Contributions Grants | $8,983,567 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $5,245,209 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $7,089,356 | CYProgramServiceRevenueAmt |
| PY Investment Income | $3,359 | PYInvestmentIncomeAmt |
| CY Investment Income | $13,446 | CYInvestmentIncomeAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $13,784,454 | PYTotalRevenueAmt |
| CY Total Revenue | $16,086,369 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $8,628,680 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $9,867,160 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $4,455,292 | PYOtherExpensesAmt |
| CY Other Expenses | $3,972,644 | CYOtherExpensesAmt |
| PY Total Expenses | $13,083,972 | PYTotalExpensesAmt |
| CY Total Expenses | $13,839,804 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $700,482 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $2,246,565 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $8,895,171 | TotalAssetsBOYAmt |
| Total Assets EOY | $10,787,759 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,476,662 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $2,074,225 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $6,418,509 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $8,713,534 | NetAssetsOrFundBalancesEOYAmt |
| Mission | PROVIDING MEDICAL AND DENTAL CARE TO INDIGENT PATIENTS. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $8,650,517 | ExpenseAmt |
| Desc | MEDICAL CARE: PRIMARY MEDICAL CARE, DENTAL SERVICES AND MENTAL HEALTH SERVICES FOR THE MEDICALLY UNDERSERVED AREAS OF NEWPORT NEWS, HAMPTON, SUFFOLK, VIRGINIA BEACH, CHESPEAKE, MATHEWS COUNTY, AND FRANKLIN, VIRGINIA. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,132,665 | ExpenseAmt |
| Desc | CASE MANAGEMENT: ASSISTANCE FOR PATIENTS MANAGING AND COORDINATING CARE FOR COMPLEX AND/OR CHRONIC CONDITIONS. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $252,139 | ExpenseAmt |
| Desc | OTHER PATIENT SERVICES: ENABLING SERVICES TO INCLUDE OUTREACH, PATIENT EDUCATION AND PHARMACY ASSISTANCE FOR MEDICALLY UNDERSERVED POPULATIONS SERVED BY THE HEALTH CENTER. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $10,035,321 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | 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 | Yes (true) | 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 | 40 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | false | BackupWthldComplianceInd |
| Employee | 225 | 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 |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 16 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 16 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ANGELA FUTRELL | PersonNm |
| Phone | 7573808709 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1033 28TH STREET 2ND FLOOR | AddressLine1Txt |
| City | NEWPORT NEWS | CityNm |
| State Abbreviation | VA | StateAbbreviationCd |
| ZIP | 23607 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | Yes (X) | NoListedPersonsCompensatedInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| WANDA ALLEN ESQ | ||||||||
| CHAIR | 6.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| DOROTHY MURRAY | ||||||||
| VICE CHAIR | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| M DENISE COUNCE | ||||||||
| TREASURER | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| ROBERT AYERS | ||||||||
| SECRETARY | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| EUGENE JOHNSON | ||||||||
| PARLIAMENTAR | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| TIFFANY BOWEN | ||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| BARRETT FRANKLIN | ||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| KATHERINE GRANT-DAVIS | ||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| SHEILA HENDERSON | ||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| RUTH HOLMES | ||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| ASA JENRETTE JR | ||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| ARAVIA JOHNSON | ||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| DAVID WHALEY | ||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| CATHY WILLIAMS | ||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| STYLIE WILLIAMS | ||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| SHIRLEY WILLS | ||||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| ANGELA FUTRELL | ||||||||
| CEO | $269,076 | $0 | $18,000 | Yes (X) | ||||
| VALDA BRANCH | ||||||||
| COO | $175,343 | $0 | $12,325 | Yes (X) | ||||
| DAVID LORENZO | ||||||||
| PHYSICIAN | $185,502 | $0 | $8,960 | Yes (X) | ||||
| ANDREI SAN-MARINA | ||||||||
| PHYSICIAN | $174,595 | $0 | $15,188 | Yes (X) | ||||
| CONCEPCION ASPILI | ||||||||
| PHYSICIAN | $172,492 | $0 | $0 | Yes (X) | ||||
| SUFIA B SHAHID | ||||||||
| PHYSICIAN | $161,686 | $0 | $0 | Yes (X) | ||||
| AURORA S BADAVI | ||||||||
| PHYSICIAN | $161,613 | $0 | $0 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,300,307 | TotalReportableCompFromOrgAmt |
| Total Other Compensation | $54,473 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 10 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (4 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt | Business Name Line2ContractorName/BusinessName/BusinessNameLine2Txt |
|---|---|---|---|---|---|---|
| LABCORP | ||||||
| PO BOX 2250 | BURLINGTON | NC | 272162240 | LAB WORK | $252,456 | |
| PENINSULA CLEANING SERVICE | ||||||
| 12610 PATRICK HENRY DR SUITE A | NEWPORT NEWS | VA | 23602 | JANITORIAL | $235,194 | |
| ECLINICALWORKS LLC | ||||||
| 2 TECHNOLOGY DRIVE | WESTBROUGH | MA | 01581 | SOFTWARE | $116,229 | |
| NETWORKING TECHNOLOGIES AND SUPPORT | ||||||
| PO BOX 73232 | RICHMOND | VA | 23235 | IT SUPPORT | $103,233 | INC |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $7,949,113 | GovernmentGrantsAmt |
| All Other Contributions | $1,034,454 | AllOtherContributionsAmt |
| Total Contributions | $8,983,567 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NET PATIENT SERVICE REVENUE | Desc |
| Total Revenue Column | $7,089,356 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $7,089,356 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $7,089,356 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $13,446 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $13,446 | RelatedOrExemptFuncIncomeAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $16,086,369 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $7,102,802 | RelatedOrExemptFuncIncomeAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,184,061 | TotalAmt |
| Program Services | $6,383,432 | ProgramServicesAmt |
| Management And General | $1,800,629 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,112,071 | TotalAmt |
| Program Services | $648,891 | ProgramServicesAmt |
| Management And General | $463,180 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $571,028 | TotalAmt |
| Program Services | $455,730 | ProgramServicesAmt |
| Management And General | $115,298 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,722 | TotalAmt |
| Program Services | $17,589 | ProgramServicesAmt |
| Management And General | $3,133 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $44,393 | TotalAmt |
| Program Services | $37,680 | ProgramServicesAmt |
| Management And General | $6,713 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $935,224 | TotalAmt |
| Program Services | $793,803 | ProgramServicesAmt |
| Management And General | $141,421 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,054,636 | TotalAmt |
| Program Services | $766,698 | ProgramServicesAmt |
| Management And General | $287,938 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $311,894 | TotalAmt |
| Program Services | $37,083 | ProgramServicesAmt |
| Management And General | $274,811 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $981,314 | TotalAmt |
| Program Services | $777,420 | ProgramServicesAmt |
| Management And General | $203,894 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,366 | TotalAmt |
| Program Services | $296 | ProgramServicesAmt |
| Management And General | $12,070 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,799 | TotalAmt |
| Program Services | $4,614 | ProgramServicesAmt |
| Management And General | $15,185 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $269,195 | TotalAmt |
| Program Services | $47,724 | ProgramServicesAmt |
| Management And General | $221,471 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $90,008 | TotalAmt |
| Management And General | $90,008 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| DUES AND PUBLICATIONS | $150,807 | $33,294 | $117,513 |
| RECRUITING | $30,515 | $86 | $30,429 |
| MARKETING | $28,410 | $18,818 | $9,592 |
| TAXES AND LICENSES | $23,341 | $12,163 | $11,178 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20 | TotalAmt |
| Management And General | $20 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,839,804 | TotalAmt |
| Program Services | $10,035,321 | ProgramServicesAmt |
| Management And General | $3,804,483 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,027,518 | BOYAmt |
| EOY | $4,232,495 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,648,660 | BOYAmt |
| EOY | $2,087,361 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,290,935 | BOYAmt |
| EOY | $2,352,719 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $168,466 | BOYAmt |
| EOY | $212,906 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $5,440,071 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $4,370,071 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,236,045 | BOYAmt |
| EOY | $1,070,000 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $523,547 | BOYAmt |
| EOY | $832,278 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,895,171 | BOYAmt |
| EOY | $10,787,759 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $889,673 | BOYAmt |
| EOY | $734,679 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,586,989 | BOYAmt |
| EOY | $1,339,546 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,476,662 | BOYAmt |
| EOY | $2,074,225 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,418,509 | BOYAmt |
| EOY | $8,713,534 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,418,509 | BOYAmt |
| EOY | $8,713,534 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,895,171 | BOYAmt |
| EOY | $10,787,759 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $2,246,565 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $48,459 | NetUnrlzdGainsLossesInvstAmt |
| Prior Period Adjustments | $1 | PriorPeriodAdjustmentsAmt |
| 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) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
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 | $267,806 | OtherCostOrOtherBasisAmt |
| Book Value | $267,806 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,407,949 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,851,983 | DepreciationAmt |
| Book Value | $555,966 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,764,316 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,518,088 | DepreciationAmt |
| Book Value | $246,228 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,070,000 | TotalBookValueLandBuildingsAmt |
| Total Rev Etc Audited Fincl Stmt | $16,319,758 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $48,459 | NetUnrealizedGainsInvstAmt |
| Donated Services And Use Fclts | $184,930 | DonatedServicesAndUseFcltsAmt |
| Revenue Not Reported | $233,389 | RevenueNotReportedAmt |
| Revenue Subtotal | $16,086,369 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $16,086,369 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $14,024,734 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $184,930 | DonatedServicesUseFcltsAmt |
| Expenses Not Reported | $184,930 | ExpensesNotReportedAmt |
| Expenses Subtotal | $13,839,804 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $13,839,804 | TotalExpensesPerForm990Amt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt |
|---|---|---|---|
| ANGELA FUTRELL | |||
| CEO | $269,076 | $18,000 | $287,076 |
| VALDA BRANCH | |||
| COO | $175,343 | $12,325 | $187,668 |
| DAVID LORENZO | |||
| PHYSICIAN | $185,502 | $8,960 | $194,462 |
| ANDREI SAN-MARINA | |||
| PHYSICIAN | $174,595 | $15,188 | $189,783 |
| CONCEPCION ASPILI | |||
| PHYSICIAN | $172,492 | $172,492 | |
| SUFIA B SHAHID | |||
| PHYSICIAN | $161,686 | $161,686 | |
| AURORA S BADAVI | |||
| PHYSICIAN | $161,613 | $161,613 | |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | COMMUNITY HEALTHCARE ASSOCIATES | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | PRINCIPAL OWNER | RelationshipDescriptionTxt |
| Transaction | $10,260 | TransactionAmt |
| Transaction | GRANT WRITING | TransactionDesc |
| Sharing Of Revenues | false | SharingOfRevenuesInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE L, PART V | FormAndLineReferenceDesc |
| Explanation | (A) NAME OF PERSON: COMMUNITY HEALTHCARE ASSOCIATES, INC. (B) RELATIONSHIP BETWEEN INTERESTED PERSON AND ORGANIIZATION: PRINCIPAL OWNER IS FORMER CEO OF THE NONPROFIT. (C) AMOUNT OF TRANSACTION: 16,720 (D) DESCRIPTION OF TRANSACTION: COMPENSATION FOR GRANT WRITING. (E) SHARING OF ORGANIZATION REVENUES?: NO | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 6, PART VI, LINE 11B | THE CFO AND CEO REVIEW THE FORM 990 BEFORE FILING. |
| FORM 990, PAGE 6, PART VI, LINE 12C | THE BOARD IS CHARGED WITH REVIEWING THE POLICIES ANNUALLY OR AS APPROPRIATE. |
| FORM 990, PAGE 6, PART VI, LINE 15A | COMPENSATION NEGOTIATIONS ARE BASED UPON EXPERIENCE AND SKILL SET IN KEEPING WITH FAIR MARKET VALUE AND FORMAL PAY SCALE. |
| FORM 990, PAGE 6, PART VI, LINE 15B | COMPENSATION NEGOTIATIONS ARE BASED UPON EXPERIENCE AND SKILL SET IN KEEPING WITH FAIR MARKET VALUE AND FORMAL PAY SCALE. |
| FORM 990, PAGE 6, PART VI, LINE 19 | GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILBALE UPON REQUEST. |