OAK ORCHARD COMMUNITY INC: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- OAK ORCHARD COMMUNITY INC (EIN 16-1020913)
- Tax period
- 2017-01-01 to 2017-12-31
- Filed
- 2018-06-28
- IRS object ID
- 201841799349301019
- Schema version
- 2017v2.2
- 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 | 2018-06-28T15:39:04-05:00 | ReturnTs |
| Tax Period End | 2017-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 161131146 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BONADIO & CO LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 171 SULLYS TRAIL SUITE 201 | AddressLine1Txt |
| City | PITTSFORD | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 14534 | 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 | 161020913 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OAK ORCHARD COMMUNITY HEALTH CENTERINC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | OAKO | BusinessNameControlTxt |
| Phone | 5856375319 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 300 WEST AVENUE | AddressLine1Txt |
| City | BROCKPORT | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 14420 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CAROL WHITE | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 5856373905 | PhoneNum |
| Signature | 2018-06-21 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KAREN HIGNETT | PreparerPersonNm |
| PTIN | P01366951 | PTIN |
| Phone | 5853811000 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JAMES CUMMINGS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 300 WEST AVENUE | AddressLine1Txt |
| City | BROCKPORT | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 14420 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $17,568,360 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.OAKORCHARDHEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1973 | FormationYr |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Activity Or Mission | TO MEET THE HEALTH CARE AND WELLNESS NEEDS OF ALL CHILDREN AND ADULTS BY PROVIDING EXCELLENT MEDICAL, DENTAL, OPTOMETRY, AND OUTREACH SERVICES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 13 | VotingMembersIndependentCnt |
| Total Employee | 254 | TotalEmployeeCnt |
| Total Volunteers | 13 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $4,933,886 | PYContributionsGrantsAmt |
| CY Contributions Grants | $6,760,356 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $10,088,258 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $10,806,972 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$10,842 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,032 | CYInvestmentIncomeAmt |
| PY Other Revenue | $13,930 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $15,025,232 | PYTotalRevenueAmt |
| CY Total Revenue | $17,568,360 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $9,901,219 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $10,717,626 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $4,637,597 | PYOtherExpensesAmt |
| CY Other Expenses | $5,211,466 | CYOtherExpensesAmt |
| PY Total Expenses | $14,538,816 | PYTotalExpensesAmt |
| CY Total Expenses | $15,929,092 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $486,416 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,639,268 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $10,319,727 | TotalAssetsBOYAmt |
| Total Assets EOY | $11,934,157 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,765,027 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $2,740,189 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $7,554,700 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $9,193,968 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO MEET THE HEALTH CARE AND WELLNESS NEEDS OF ALL CHILDREN AND ADULTS BY PROVIDING EXCELLENT MEDICAL, DENTAL, OPTOMETRY, AND OUTREACH SERVICES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $8,058,058 | ExpenseAmt |
| Revenue | $8,258,234 | RevenueAmt |
| Desc | REGIONAL MEDICAL SERVICES OFFERED TO MIGRANT FARM WORKERS AND THE GENERAL PUBLIC. APPROXIMATELY 15,500 INDIVIDUALS SERVED. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $2,547,819 | ExpenseAmt |
| Revenue | $1,884,035 | RevenueAmt |
| Desc | REGIONAL DENTAL SERVICES OFFERED TO MIGRANT FARM WORKERS AND THE GENERAL PUBLIC. APPROXIMATELY 6,900 INDIVIDUALS SERVED. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $569,116 | ExpenseAmt |
| Revenue | $488,976 | RevenueAmt |
| Desc | REGIONAL OPTOMETRY SERVICES OFFERED TO MIGRANT FARM WORKERS AND THE GENERAL PUBLIC. APPROXIMATELY 2,000 INDIVIDUALS SERVED. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,422,338 | ExpenseAmt |
| Revenue | $175,727 | RevenueAmt |
| Desc | OTHER SERVICES OFFERED TO MIGRANT FARM WORKERS AND THE GENERAL PUBLIC. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $1,422,338 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Revenue | $175,727 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $12,597,331 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 20 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 254 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 13 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | NY | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CAROL WHITE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5856373905 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 300 WEST AVENUE | AddressLine1Txt |
| City | BROCKPORT | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 14420 | ZIPCd |
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 |
|---|---|---|---|---|---|---|---|---|
| KAREN WATT | ||||||||
| CHAIR | 4.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| DAVID JEWELL PHD | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JEFFREY PARTYKA | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| MICHAEL SAYERS | ||||||||
| TREASURER | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| LORIENDA SMITH | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| GEORGE SOKOLSKY | ||||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| RITA WAGNER | ||||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| GARY SKOOG | ||||||||
| VICE CHAIR | 3.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| EVELYN STELMACH | ||||||||
| SECRETARY | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| LISA SAEVA | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| BETTY GARCIA MATTHEWSON | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JAMES CUMMINGS | ||||||||
| PRESIDENT/CEO | 40.00 | Yes (X) | Yes (X) | $139,876 | $0 | $5,364 | ||
| MARGARET M KRIZAN PHD | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| SUSAN MEYER | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| SCOTT VALET MD | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| KATHY WILLIAMS | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| CAROL A WHITE | ||||||||
| CFO | 40.00 | Yes (X) | $95,232 | $0 | $5,364 | |||
| NANCY CIAVARRI MD | ||||||||
| CHIEF MEDICAL OFFICER | 40.00 | $187,200 | $0 | $5,760 | Yes (X) | |||
| JAMES GOETZ MD | ||||||||
| PEDIATRICIAN | 23.00 | $170,849 | $0 | $5,364 | Yes (X) | |||
| ROBERT WHELPLEY | ||||||||
| PHYSICIAN | 40.00 | $179,841 | $0 | $5,760 | Yes (X) | |||
| DANIELLE RENODIN-MEAD | ||||||||
| PEDIATRICIAN | 32.00 | $159,821 | $0 | $0 | Yes (X) | |||
| KEITH FULEKI | ||||||||
| PHYSICIAN | 40.00 | $201,538 | $0 | $5,760 | Yes (X) | |||
| RANIA KARAM-BAYOUMI | ||||||||
| PHYSICIAN | 40.00 | $160,807 | $0 | $5,760 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,295,164 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $39,132 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 18 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ECLINICAL WORKS LLC | BusinessNameLine1Txt |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2 TECHNOLOGY DRIVE | AddressLine1Txt |
| City | WESTBOROUGH | CityNm |
| State Abbreviation | MA | StateAbbreviationCd |
| ZIP | 01581 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | SOFTWARE | ServicesDesc |
| Compensation | $200,869 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $4,528,711 | GovernmentGrantsAmt |
| All Other Contributions | $2,231,645 | AllOtherContributionsAmt |
| Total Contributions | $6,760,356 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| OTHER THIRD PARTY PAYORS | 621400 | $5,406,088 | $5,406,088 |
| MEDICARE/MEDICAID PMTS | 621400 | $2,922,576 | $2,922,576 |
| 340B PHARMACY INCOME | 900099 | $2,478,308 | $2,478,308 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $10,806,972 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,032 | TotalRevenueColumnAmt |
| Exclusion | $1,032 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $17,568,360 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $10,806,972 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,032 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $455,283 | TotalAmt |
| Program Services | $119,232 | ProgramServicesAmt |
| Management And General | $336,051 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,858,975 | TotalAmt |
| Program Services | $7,293,057 | ProgramServicesAmt |
| Management And General | $1,565,918 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $773,964 | TotalAmt |
| Program Services | $494,645 | ProgramServicesAmt |
| Management And General | $279,319 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $629,404 | TotalAmt |
| Program Services | $492,510 | ProgramServicesAmt |
| Management And General | $136,894 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $35,481 | TotalAmt |
| Management And General | $35,481 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,080 | TotalAmt |
| Management And General | $30,080 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,014,885 | TotalAmt |
| Program Services | $707,611 | ProgramServicesAmt |
| Management And General | $307,274 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $204,774 | TotalAmt |
| Program Services | $138,478 | ProgramServicesAmt |
| Management And General | $66,296 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $307,109 | TotalAmt |
| Program Services | $246,897 | ProgramServicesAmt |
| Management And General | $60,212 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $451,007 | TotalAmt |
| Program Services | $398,807 | ProgramServicesAmt |
| Management And General | $52,200 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $137,019 | TotalAmt |
| Program Services | $39,752 | ProgramServicesAmt |
| Management And General | $97,267 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $67,089 | TotalAmt |
| Program Services | $58,689 | ProgramServicesAmt |
| Management And General | $8,400 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $448,318 | TotalAmt |
| Program Services | $367,405 | ProgramServicesAmt |
| Management And General | $80,913 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $44,780 | TotalAmt |
| Program Services | $26,042 | ProgramServicesAmt |
| Management And General | $18,738 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| PHARMACEUTICALS | $873,319 | $873,319 | |
| PATIENT CARE SUPPLIES | $842,339 | $842,339 | |
| OTHER EXPENSES | $484,725 | $228,007 | $256,718 |
| BAD DEBT EXPENSE | $270,541 | $270,541 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,929,092 | TotalAmt |
| Program Services | $12,597,331 | ProgramServicesAmt |
| Management And General | $3,331,761 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,254,505 | BOYAmt |
| EOY | $4,613,455 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $99,263 | BOYAmt |
| EOY | $483,450 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $188,871 | BOYAmt |
| EOY | $149,135 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,323,839 | BOYAmt |
| EOY | $1,242,340 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $10,636,519 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $5,299,071 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,377,523 | BOYAmt |
| EOY | $5,337,448 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $75,726 | BOYAmt |
| EOY | $108,329 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,319,727 | BOYAmt |
| EOY | $11,934,157 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,114,694 | BOYAmt |
| EOY | $1,246,637 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $54,058 | BOYAmt |
| EOY | $106,260 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,577,176 | BOYAmt |
| EOY | $1,366,835 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,099 | BOYAmt |
| EOY | $20,457 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,765,027 | BOYAmt |
| EOY | $2,740,189 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,554,700 | BOYAmt |
| EOY | $9,193,968 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,554,700 | BOYAmt |
| EOY | $9,193,968 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,319,727 | BOYAmt |
| EOY | $11,934,157 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $1,639,268 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | 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 (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | 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 | $654,598 | OtherCostOrOtherBasisAmt |
| Book Value | $654,598 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,111,826 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,096,521 | DepreciationAmt |
| Book Value | $4,015,305 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $95,049 | OtherCostOrOtherBasisAmt |
| Depreciation | $95,049 | DepreciationAmt |
| Book Value | $0 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,775,046 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,107,501 | DepreciationAmt |
| Book Value | $667,545 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $5,337,448 | TotalBookValueLandBuildingsAmt |
| Total Rev Etc Audited Fincl Stmt | $17,297,819 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | -$270,541 | OtherRevenueAmt |
| Revenue Not Reported | -$270,541 | RevenueNotReportedAmt |
| Revenue Subtotal | $17,568,360 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $17,568,360 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $15,658,551 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $15,658,551 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $270,541 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $270,541 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $15,929,092 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | PROVISION FOR DOUBTFUL ACCOUNTS -270,541. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | PROVISION FOR DOUBTFUL ACCOUNTS 270,541. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NANCY CIAVARRI MD | ||||||||||||||
| CHIEF MEDICAL OFFICER | $187,200 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $5,760 | $0 | $192,960 | $0 | $0 | $0 |
| JAMES GOETZ MD | ||||||||||||||
| PEDIATRICIAN | $170,849 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $5,364 | $0 | $176,213 | $0 | $0 | $0 |
| ROBERT WHELPLEY | ||||||||||||||
| PHYSICIAN | $179,841 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $5,760 | $0 | $185,601 | $0 | $0 | $0 |
| DANIELLE RENODIN-MEAD | ||||||||||||||
| PEDIATRICIAN | $159,821 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $159,821 | $0 | $0 | $0 |
| KEITH FULEKI | ||||||||||||||
| PHYSICIAN | $201,538 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $5,760 | $0 | $207,298 | $0 | $0 | $0 |
| RANIA KARAM-BAYOUMI | ||||||||||||||
| PHYSICIAN | $160,807 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $5,760 | $0 | $166,567 | $0 | $0 | $0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 IS MADE AVAILABLE TO ALL BOARD MEMBERS FOR THEIR REVIEW AT A BOARD MEETING, PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | ANNUALLY THE ORGANIZATION REQUIRES OFFICERS, DIRECTORS, AND KEY EMPLOYEES TO COMPLETE IN WRITING A CONFLICT OF INTEREST STATEMENT. |
| FORM 990, PART VI, SECTION B, LINE 15 | ALL SALARIES ARE REVIEWED BY BOARD MEMBERS BASED ON MARKET TRENDS FOR EACH OFFICER AND KEY EMPLOYEE. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION COMPLIES WITH ALL APPLICABLE FEDERAL AND STATE REGULATIONS. |
| PART XII, LINE 2C | THE ORGANIZATION HAS NOT CHANGED ITS PROCESS FROM THE PRIOR YEAR. |