2018-05-11T16:32:38-05:00 2017-06-30 381357951 PLANTE & MORAN PLLC 10 S Riverside Plaza 9th Floor Chicago IL 60606 990 2016-07-01 362893854 CHICAGO FAMILY HEALTH CENTER INC CHIC 7737685000 9119 SOUTH EXCHANGE AVENUE CHICAGO IL 60617 BARRETT HATCHES CHIEF EXECUTIVE OFFICER 7737685000 2018-05-02 1 Kimberly A Haumann P00546491 3122071040 2018-05-02 2016 2022-09-23 18:48:47Z BARRETT HATCHES 9119 SOUTH EXCHANGE AVENUE CHICAGO IL 60617 22599870 0 X CHICAGOFAMILYHEALTH.ORG X 1976 IL TO PROVIDE HEALTHCARE SERVICES TO ALL PATIENTS. 11 11 298 11 0 0 8730111 7745372 13302035 14711556 160503 139542 0 3400 22192649 22599870 0 0 0 0 13494267 14843859 0 30300 243631 6565374 7419788 20059641 22293947 2133008 305923 26375544 27089065 6926541 6592461 19449003 20496604 X Chicago Family Health Center will promote health, work to prevent disease and provide treatment through the delivery of quality, accessible primary healthcare that is culturally sensitive, affordable, and responsive to community and individual needs. 0 1 17942528 14357590 Public Health Service Section 330: this program provides comprehensive health and dental services on the south side of Chicago. The program includes preventive screening and treatment, prenatal health care, counseling and case management. The center has 5 sites servicing 30,946 patients with 11,627 medical and dental visits this year. 299280 353966 THE ILLINOIS BREAST AND CERVICAL CANCER PROGRAM (IBCCP) IS A FEDERALLY AND STATE FUNDED PROGRAM THAT OFFERS FREE MAMMOGRAMS, BREAST EXAMS, PELVIC EXAMS, AND PAP TESTS TO ELIGIBLE, UNINSURED WOMEN. SERVICES CAN ALSO BE AUTHORIZED FOR WOMEN OR MEN WITH ABNORMAL FINDINGS WHO ARE OUTSIDE THE NORMAL IBCCP AGE RANGE BUT MEET OTHER IBCCP CRITERIA. PARTICIPANTS WHO ARE ENROLLED IN THE IBCCP PROGRAM AND DIAGNOSED WITH CANCER THROUGH THE PROGRAM'S SCREENING AND TESTS ARE ELIGIBLE TO RECEIVE TREATMENT BENEFITS. MAMMOGRAMS AND CANCER TREATMENT ARE PROVIDED AT PARTNER HOSPITALS. CFHC REIMBURSES EACH PARTNER HOSPITAL FOR IBCCP SERVICES. 18241808 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 74 0 1 298 1 0 0 0 0 0 0 0 0 0 0 X 11 11 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 IL X ERIC BOKLAGE 7737685000 9119 SOUTH EXCHANGE AVENUE CHICAGO IL 60617 Nora Reyes Chair 1.50 1.50 X X 0 0 0 Nick Valadez Vice Chair 1.50 1.50 X X 0 0 0 Julius Alexander Treasurer 1.50 1.50 X X 0 0 0 Fulton Nolen Jr Secretary 2.00 1.00 X X 0 0 0 Rev Mark Brummel CMF Member 2.00 1.00 X 0 0 0 Torin Edmond Member 2.00 1.00 X 0 0 0 Mary Julia Munoz Member 2.00 1.00 X 0 0 0 Lylet Rodriguez Member 3.00 0.00 X 0 0 0 James Simmons Member 2.00 1.00 X 0 0 0 Lupe Valadez Member 2.00 1.00 X 0 0 0 Tony Ziak Member 2.00 1.00 X 0 0 0 Barrett Hatches Chief Executive Officer 38.00 2.00 X 260530 0 8106 Zakeya A Atia Chief Financial Officer 39.00 1.00 X 56490 0 3985 Joseph Eric Boklage Chief Administrative Officer 40.00 0.00 X 119028 0 7537 Dee N LaGioia Chief Operating Officer 40.00 0.00 X 129572 0 6665 James P Valek Chief Medical Officer 40.00 0.00 X 244313 0 25115 Stephanie Willding Chief Officer for Strategy, Planning, Development 40.00 0.00 X 93026 0 8178 Ramon C Cabe Physician 40.00 0.00 X 200271 0 8002 Jacqueline Gervais Physician 40.00 0.00 X 250500 0 14750 Monica Moore Medical Director, Women's Health 40.00 0.00 X 167800 0 16467 Pramode K Keshava Physician 40.00 0.00 X 190857 0 21109 Marjorie G Michel Physician 40.00 0.00 X 194461 0 15354 CARL TOREN FORMER CHIEF MEDICAL OFFICER 40.00 0.00 X 188458 0 10589 2095306 0 145857 36 1 1 0 QUALITY SYSTEMS INC PO BOX 511449 LOS ANGELES CA 90051 Billing Services 763152 OSIS PO BOX 772852 chiCAGO IL 60677 Nextgen hosting services 587896 Barton & Associates Inc 300 Jubikee Drive Peabody MA 01960 Locum tenens staffing 404419 CLEANWAY MAINTENANCE PO BOX 95882 HOFFMAN ESTATES IL 60195 Cleaning Services 236093 CONSILIUM STAFFING LLC 6225 N STATE HWY 161 SUITE 400 IRVING TX 75038 TEMP STAFFING AGENCY 158280 7 7522311 223061 7745372 PRIVATE CARE 621300 10733690 10733690 CAPITATION REVENUE 621300 2626783 2626783 HMO INCENTIVE REVENUE 621300 1351083 1351083 14711556 139542 139542 3400 0 3400 3400 3400 22599870 14711556 0 142942 X 1103388 385300 691675 26413 11462810 9743389 1604793 114628 119587 101649 16742 1196 1363043 1108164 242265 12614 795031 675777 111304 7950 90009 90009 81650 81650 30300 30300 18821 18821 2702949 2255075 430265 17609 34536 34536 494670 450937 41537 2196 732938 627125 94469 11344 1280784 1163318 112266 5200 36464 30994 5105 365 134327 114178 18806 1343 754806 688075 63380 3351 106382 96977 8933 472 Medical/Dental Supplies 864967 735222 121095 8650 LICENSES AND DUES 65628 65628 FUNDRAISING 2858 2858 LATE CHARGES 893 893 17106 17106 22293947 18241808 3808508 243631 7004304 3628599 1990260 2109048 706471 1262423 1220162 2718108 7190190 7190190 91532 89636 12675754 5045769 6569052 7629985 1261361 1933783 302832 285740 39380 241553 26375544 27089065 2126187 1729908 4800354 4618953 0 243600 6926541 6592461 X 19416619 20461842 32384 34762 19449003 20496604 26375544 27089065 305923 741678 0 X 0 1 X 1 1 1 X 13937408 9059407 7594044 8730111 7745372 47066342 13937408 9059407 7594044 8730111 7745372 47066342 47066342 100057 96111 117074 112839 142942 569023 47635365 61877033 0.98810 0.99110 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 567474 567474 8721536 3018558 5702978 553080 387139 165941 592211 401106 191105 2241453 1238966 1002487 7629985 MHN ACO, LLC 1933783 F 1933783 INTERCOMPANY PAYABLES 243600 243600 1 THOUGHTFIRE 318 MAIN STREET SUITE 220 EVANSVILLE IN 47708 FUNDRAISING CONSULTING 0 10000 30300 -20300 10000 30300 -20300 X X X 1 0 0 0 0 0 0 0 0 Barrett Hatches Chief Executive Officer 235530 0 25000 0 0 0 0 0 8106 0 268636 0 0 0 James P Valek Chief Medical Officer 219750 0 24563 0 0 0 5053 0 20062 0 269428 0 0 0 Ramon C Cabe Physician 179830 0 20441 0 0 0 0 0 8002 0 208273 0 0 0 Jacqueline Gervais Physician 230542 0 19958 0 0 0 6625 0 8125 0 265250 0 0 0 Monica Moore Medical Director, Women's Health 167800 0 0 0 0 0 2302 0 14165 0 184267 0 0 0 Pramode K Keshava Physician 190857 0 0 0 0 0 6503 0 14606 0 211966 0 0 0 Marjorie G Michel Physician 194461 0 0 0 0 0 7307 0 8047 0 209815 0 0 0 CARL TOREN FORMER CHIEF MEDICAL OFFICER 72442 0 3516 0 112500 0 2295 0 8294 0 199047 0 0 0 Part I, Line 4a CARL TOREN RECEIVED A SEVERANCE PAYMENT OF $112,500 IN THE CALENDAR YEAR ENDING 12/31/16. THE SEVERANCE WAS PAID IN SIX EQUAL INSTALLMENTS OF $18,750. Form 990, Part III, line 3 THE FAMILY CASE MANAGEMENT PROGRAM WAS DISCONTINUED IN JUNE OF 2016. Form 990, Part VI, Section A, line 2 DIRECTOR GUADALUPE (LUPE) VALADEZ AND CHAIRMAN NICK VALADEZ HAVE A FATHER SON RELATIONSHIP. Form 990, Part VI, Section B, line 11b THE BOARD RETAINS THE SERVICES OF AN INDEPENDENT CPA FIRM TO PREPARE THE ORGANIZATION'S FORM 990 TAX RETURN. MANAGEMENT REVIEWS THE COMPLETED FORM 990 AND PROVIDES A FULL COPY TO ALL MEMBERS OF THE BOARD. THE BOARD IS PROVIDED AN OPPORTUNITY TO ASK ANY QUESTIONS DIRECTLY TO ORGANIZATION MANAGEMENT OR THE CONTACT AT THE INDEPENDENT CPA FIRM. Form 990, Part VI, Section B, line 12c THE CENTER REVIEWS ANNUAL CONFLICT OF INTEREST STATEMENTS FROM THE BOARD AND SENIOR STAFF AT THE NOVEMBER BOARD MEETING. IN THE STATEMENTS, ALL BOARD MEMBERS AND SENIOR STAFF DISCLOSE THEIR CONFLICTS, POTENTIAL CONFLICTS, AND SITUATIONS THAT COULD BE PERCEIVED TO BE CONFLICTS. THE CENTER THAN EVALUATES THESE STATEMENTS. Form 990, Part VI, Section B, line 15 THE CEO AND OTHER KEY EMPLOYEES COMPENSATION IS EVALUATED ANNUALLY BY THE BOARD OF DIRECTOR'S EXECUTIVE COMMITTEE. THE CENTER NEGOTIATED BASED ON THE 990S FROM SIMILAR ORGANIZATIONS IN THE GREATER CHICAGO AREA. COMPENSATION AMOUNTS WERE SET AT THE LOWER END OF COMPARABLE ORGANIZATIONS. Form 990, Part VI, Section C, line 18 THESE DOCUMENTS ARE AVAILABLE UPON REQEUST TO THE CENTER. Form 990, Part VI, Section C, line 19 GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE AVAILABLE THROUGH APPLICABLE GOVERNMENTAL AGENCIES; THE CONFLICT OF INTEREST POLICY IS AVAILABLE UPON WRITTEN REQUEST TO THE ORGANIZATION. Form 990, Part IX, line 11g Contracted Agency Staff - Provider: Program service expenses 1,015,890. Management and general expenses 0. Fundraising expenses 0. Total expenses 1,015,890. Contracted Agency Staff - Other: Program service expenses 44,075. Management and general expenses 44,075. Fundraising expenses 0. Total expenses 88,150. Organization Contracted Staff: Program service expenses 250. Management and general expenses 250. Fundraising expenses 0. Total expenses 500. Security Service: Program service expenses 0. Management and general expenses 59,693. Fundraising expenses 0. Total expenses 59,693. Lab Services - Dental: Program service expenses 37,139. Management and general expenses 0. Fundraising expenses 0. Total expenses 37,139. Off Site Storages: Program service expenses 0. Management and general expenses 42,478. Fundraising expenses 0. Total expenses 42,478. Credentialing Expenses: Program service expenses 21,931. Management and general expenses 0. Fundraising expenses 0. Total expenses 21,931. Professional Services - Lab Medical: Program service expenses 39,819. Management and general expenses 0. Fundraising expenses 0. Total expenses 39,819. Outside contracted services: Program service expenses 1,052,148. Management and general expenses 247,736. Fundraising expenses 80. Total expenses 1,299,964. CONSULTANTS: Program service expenses 43,823. Management and general expenses 36,033. Fundraising expenses 17,529. Total expenses 97,385. CHICAGO FAMILY HEALTH CENTER FOUNDATION 9119 SOUTH EXCHANGE AVE CHICAGO IL 60617 453732286 SUPPORTING ORGANIZATION FOR CFHC IL 501(c)(3) 509(A)(3) CFHC 1 CFHC TITLE HOLDING CORPORATION NFP 9119 SOUTH EXCHANGE AVE CHICAGO IL 60617 454956964 HOLDING CORPORATION FOR CFHC IL 501(c)(2) CFHC 1 0 0 0 0 0 0 0 0 0 0 1 1 0 1 1 0 1 0 0 CFHC TITLE HOLDING CORPORATION NFP K 115000 RECORDS MAINTAINED AT COST CFHC FOUNDATION Q 33683 RECORDS MAINTAINED AT COST