2018-04-28T10:00:07-05:00 2017-09-30 350921680 CROWE HORWATH LLP 225 West Wacker Drive Suite 2600 Chicago IL 606061224 990 2016-10-01 351875364 Heart City Health Center Inc HEAR 5742930052 236 Simpson Avenue Elkhart IN 46516 Esleen Fultz CEO 2018-04-25 true Danielle Tewes P01327423 3128997000 2016 2021-01-29 14:40:06Z Esleen Fultz 236 Simpson Avenue Elkhart IN 46516 10212792 false X www.heartcityhealth.org X 1993 IN Heart City Health Center, Inc. is a federally qualified health center (FQHC) providing comprehensive primary healthcare and education for the Elkhart Community. 7 7 144 12 -19151 -16675 3222231 3181102 4547107 5554278 12624 40774 197329 226738 7979291 9002892 0 0 5584981 5280892 0 0 2600017 2741042 8184998 8021934 -205707 980958 9434343 10498357 760187 725718 8674156 9772639 Heart City Health Center, Inc. (Heart City) is a non-profit, Federally Qualified Health Center (FQHC) providing affordable, high quality, primary health, dental and pharmaceutical care to Elkhart County residents. WE OFFER A SLIDING FEE SCALE BASED ON INCOME AND FAMILY SIZE FOR THE UNINSURED, UNDER-INSURED AND ALSO ACCEPT MEDICAID, MEDICARE AND SOME PRIVATE INSURANCES. HEART CITY IS COMMITTED TO REDUCING HEALTH DISPARITIES AMONG RESIDENTS BY PROVIDING PROFESSIONAL AND RESPECTFUL SERVICE TO THE ELKHART COMMUNITY THROUGH EDUCATION AND HIGH QUALITY PRIMARY MEDICAL CARE FOR THOSE IN NEED AND EXPERIENCING BARRIERS TO TRADITIONAL HEALTH CARE. THE MAJORITY OF HEART CITY'S PATIENTS ARE AT 100% OR BELOW THE FEDERAL POVERTY GUIDELINES, AND ALMOST 50% OF PATIENTS ARE UNDER THE AGE OF 18. HEART CITY IS ONE OF THE FEW SITES IN THE ELKHART AREA THAT PROVIDES SERVICES TO MEDICAID PATIENTS AND THE UNINSURED POPULATION. false false 5476137 5275726 HEART CITY HEALTH CENTER, INC. (HEART CITY) PROVIDES PRIMARY HEALTHCARE IN THE AREA OF ADULTS AND PEDIATRICS TO THE PRIMARILY MEDICARE, MEDICAID, AND UNINSURED POPULATION OF ELKHART COUNTY. DURING THE YEAR ENDED SEPTEMBER 30, 2017, HEART CITY PROVIDED 30,045 PATIENT VISITS TO 12,371 UNDUPLICATED PATIENTS. HEART CITY ALSO HAS AN ONSITE PHARMACY AT OUR SIMPSON STREET LOCATION WHICH PROVIDES CONVENIENT PRESCRIPTION SERVICES TO OUR PATIENTS AND THE COMMUNITY. DURING THE YEAR ENDED SEPTEMBER 30, 2017 THE PHARMACY FILLED 30,304 PRESCRIPTIONS FOR 2,470 PATIENTS. 623894 519157 HEART CITY HEALTH CENTER, INC.'S (HEART CITY) LICENSED DENTISTS AND HYGIENISTS PROVIDE A LOW-COST OPTION FOR QUALITY GENERAL DENTISTRY SERVICES TO PEOPLE OF ALL AGES, INCOMES AND BACKGROUNDS, BUT PRIMARILY SERVES MEDICAID AND UNINSURED PATIENTS. DURING THE YEAR ENDED SEPTEMBER 30, 2017, HEART CITY SERVED 1,641 UNDUPLICATED PATIENTS PROVIDING 3,847 VISITS. VARIOUS DENTAL SERVICES PROVIDED INCLUDE: EXAMINATIONS; TREATMENT PLANNING; CHILDREN'S DENTISTRY; CLEANING/DENTAL HYGIENE; EXTRACTIONS; FILLINGS; RADIOGRAPHS; AND PATIENT EDUCATION. 6100031 true true false false false false false false false false true false false false true true true false false false false false false false false false false false false true false false false false false false false false true false false false false false false false false true 20 0 true 144 true true true false false false false false false false false false X 7 7 false false true false false false false true true false false true true true true true true true false false IN X Patricia Klinger 5749701448 236 SIMPSON AVENUE ELKHART IN 46516 Rod Roberson Chairman 1.0 X X 0 0 0 Tammy Friesen Vice-Chair 1.0 X X 0 0 0 Anthony Hunt Treasurer 1.0 X X 0 0 0 Ileana Martin Secretary-Partial Year 1.0 X X 0 0 0 Tara Morris Secretary 1.0 X X 0 0 0 Teddy Brown Board Member-Partial Year 1.0 X 0 0 0 Phillip Hill Board Member-Partial Year 1.0 X 0 0 0 Delia Vazquez Board Member 1.0 X 0 0 0 Ana Rosa Garcia Board Member 1.0 X 0 0 0 Angelia Washington Board Member-As of February 2017 1.0 X 0 0 0 Dr Omobola Olaniyan CMO 40.0 X 221591 0 15372 Esleen Fultz CEO 40.0 X 83393 0 3109 Patricia Klinger CFO 40.0 X 74472 0 12527 Dr Martina McGowan COO 40.0 X 129369 0 8446 Dr Erin Farrell Pediatrician 40.0 X 118657 0 14659 Dr Meenakshi Gupta Pediatrician 40.0 X 145257 0 4390 Dr James Jackson Physician 40.0 X 158516 0 9752 Dr Christine Dankwa Pediatrician 40.0 X 154634 0 3768 Dr Mary Pat McManmon Physician 32.0 X 110754 0 10136 Dr Robert McClure Physician 0.0 X 109381 0 13559 1306024 0 95718 8 true true false MAJORITY BUILDERS INC 62900 US 31 SOUTH SOUTH BEND IN 46614 GENERAL CONTRACTOR MEDICAL OFFICE REMODEL 491157 STAFF CARE INC PO Box 281923 Atlanta GA 303841923 LOCUM TENENS COVERAGE 192517 ELKHART GENERAL HOSPITAL PO BOX 1329 ELKHART IN 46515 PHARMACIST CHARGES 172942 COMPHEALTH ASSOCIATES P O Box 972651 Dallas TX 753972651 LOCUM TENENS COVERAGE 145213 4 25000 0 0 0 3055224 100878 32645 3181102 Medical services 624100 5035121 5035121 Dental services 624100 519157 519157 0 0 0 0 5554278 52958 52958 0 0 336876 0 336322 12738 554 -12738 -12184 -12184 1082294 860840 221454 240605 -19151 Medical records 900099 5007 5007 Miscellaneous revenue 900099 277 277 0 0 0 0 5284 9002892 5794883 -19151 46058 X 0 0 0 0 0 0 0 0 655462 486311 169151 0 0 0 0 0 3893523 2907821 985702 0 29178 19175 10003 0 369278 253828 115450 0 333451 224674 108777 0 0 0 0 0 27874 0 27874 0 35400 0 35400 0 0 0 0 0 0 0 13297 13297 1027318 979340 47978 0 88754 88754 0 0 480303 406896 73407 0 61702 41859 19843 0 0 0 0 0 253131 169943 83188 0 55028 7623 47405 0 0 0 0 0 59882 29433 30449 0 0 0 0 0 0 0 0 0 211619 145371 66248 0 37839 25085 12754 0 Recruitment 213491 199421 14070 0 Bad Debt 62129 62129 0 0 Dues & Subscriptions 47674 8061 39613 0 Employee Relations 49908 33904 16004 0 15693 10403 5290 0 8021934 6100031 1921903 0 1050 1050 3607976 4128116 107689 107051 659308 756341 0 0 0 0 0 248230 241033 72764 130051 4915752 1716102 2955976 3199650 1760924 1912217 20426 22848 0 0 0 9434343 10498357 575187 565718 75000 50000 110000 110000 760187 725718 X 8674156 9772639 8674156 9772639 9434343 10498357 X 980958 115103 2422 X false true X true true true X 1812985 2274992 2823114 3222231 3181102 13314424 4171875 5091337 6301527 5509601 5794883 26869223 12600 9563 8299 10095 5284 45841 0 0 5997460 7375892 9132940 8741927 8981269 40229488 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 40229488 35818 28668 37765 50695 52958 205904 0 35818 28668 37765 50695 52958 205904 0 0 0 0 0 0 0 6033278 7404560 9170705 8792622 9034227 40435392 0.9949 0.9951 0.0051 0.0049 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 213700 213700 936300 222371 713929 3332912 1126710 2206202 428726 367021 61705 4114 4114 3199650 Drugs and pharmaceuticals held for others 110000 110000 X 9986801 115103 18841 0 863262 997206 8989595 13297 0 13297 9002892 8888318 18841 860840 879681 8008637 13297 0 13297 8021934 Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote The organization is exempt from income taxes on income from related activities under section 501(c)(3) of the U.S. Internal Revenue Code and corresponding state tax law. Accordingly, no provision has been made for federal or state income taxes. A tax position is recognized as a benefit only if it is "more likely than not" that the tax position would be sustained in a tax examination, with a tax examination being presumed to occur. The amount recognized is the largest amount of tax benefit that is greater than 50% likely of being realized on examination. For tax positions not meeting the "more likely than not" test, no tax benefit is recorded. Due to its tax-exempt status, the Organization is not generally subject to U.S. federal income tax or state income tax. The Organization's Form 990 has not been subject to examination by the Internal Revenue Service or the state of Indiana for the last three years. The Organization does not expect the total amount of unrecognized tax benefits to significantly change in the next 12 months. The Organization recognizes interest and/or penalties related to income tax matters in income tax expense. The Organization did not have any amounts accrued for interest and penalties at September 30, 2017 and 2016. Schedule D, Part XI, Line 2(d) Other revenues in audited financial statements not in form 990 COST OF GOODS SOLD-PHARMACY - 860840 CHANGE IN BENEFICIAL INTEREST-COMMUNITY FOUNDATAION - 2422 Schedule D, Part XII, Line 2(d) Other expenses in audited financial statements not in form 990 COST OF GOODS SOLD-PHARMACY - 860840 X false true X X false false false false false false false false false Dr Omobola Olaniyan CMO 217441 0 4150 0 0 0 5152 0 10220 0 236963 0 0 0 Dr James Jackson Physician 157658 0 858 0 0 0 0 0 9752 0 168268 0 0 0 Dr Christine Dankwa Pediatrician 152773 0 1861 0 0 0 0 0 3768 0 158402 0 0 0 Dr Robert McClure Physician 109381 0 0 0 0 0 2897 0 10662 0 122940 0 0 0 Schedule J, Part I, Line 1a Tax indemnification and gross-up payments The organization provided for the gross up of bonus payments to officers and highest compensated employees, which was included in the individuals' taxable compensation. Schedule J, Part I, Line 1b Written policy regarding payment or reimbursement of expenses The organization does not follow a written policy regarding the gross-up payments provided to officers and highest compensated employees, however these payments are approved by the organization's board of directors. X 54 32645 Market value 0 false true false Schedule M, Part I Explanations of reporting method for number of contributions Drugs and medical supplies - Number of contributions Form 990, Part III, Line 4a PROGRAM SERVICE ACCOMPLISHMENTS (CONTINUED FROM PART III) VARIOUS MEDICAL SERVICES PROVIDED INCLUDE: PRIMARY AND PREVENTIVE CARE; PHYSICAL EXAMINATIONS; EMPLOYMENT/SPORTS/SCHOOL PHYSICALS; WELL CHILD CHECKS; IMMUNIZATION; WOMEN'S HEALTH; CHRONIC DISEASES MANAGEMENT; BREAST AND CERVICAL CANCER SCREENINGS; LABORATORY WORK; HEALTH AND WELLNESS EDUCATION; AND DIABETES SCREENING AND TREATMENT. HEART CITY ALSO DISPENSES PRESCRIPTIONS TO THE PRIMARILY MEDICARE, MEDICAID, AND UNINSURED POPULATION IN ELKHART COUNTY. HEART CITY'S PATIENT MEDICINE ASSISTANCE PROGRAM (MAP) WORKS WITH SEVERAL DRUG COMPANIES TO PROVIDE ASSISTANCE FOR PEOPLE HAVING TROUBLE AFFORDING NAME BRAND MEDICATIONS. HEART CITY'S MAP COORDINATOR HELPS PATIENTS SEE IF THEY ARE ELIGIBLE FOR THE PROGRAM, AND ALSO ASSISTS IN THE COMPLETION OF MAP APPLICATIONS. IN ADDITION, TO HELP ENSURE THAT PATIENTS HAVE ACCESS TO THE CARE THEY NEED, PRESCRIPTIONS WRITTEN BY HEART CITY PRACTITIONERS CAN BE FILLED AT REDUCED PRICES AT THE ONSITE PHARMACY. HEART CITY PARTICIPATES IN A 340B FEDERAL GOVERNMENT PROGRAM TO PROVIDE LOW COST PRESCRIPTION DRUGS TO PATIENTS WITHOUT INSURANCE. DURING THE YEAR ENDED SEPTEMBER 30, 2017, HEART CITY'S PHARMACY FILLED 30,304 PRESCRIPTIONS AND SERVED 2,470 PATIENTS. Form 990, Part VI, Line 15b PROCESS USED TO ESTABLISH COMPENSATION OF OTHER OFFICERS/KEY EMPLOYEES THE ORGANIZATION'S CEO COMPLETES AN ANNUAL PERFORMANCE EVALUATION FOR THE CFO; BASED ON THE OUTCOME OF THE PERFORMANCE EVALUATION AND THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS (NACHC) SALARY SURVEYS, THE CFO'S COMPENSATION IS REVIEWED AND ADJUSTED AS NECESSARY. THE ORGANIZATION'S CEO ALSO COMPLETES AN ANNUAL PERFORMANCE EVALUATION FOR THE CMO; BASED ON THE OUTCOME OF THE PERFORMANCE EVALUATION AND GENERAL COMPENSATION GUIDELINES SET BY THE BOARD, THE CMO'S EMPLOYMENT CONTRACT IS UPDATED AS NECESSARY. THESE PERFORMANCE EVALUATIONS AND COMPENSATION/EMPLOYMENT CONTRACT UPDATES WERE LAST COMPLETED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2017. Form 990, Part VI, Line 1a Delegate broad authority to a committee The Executive Committee shall consist of the following officers of the Corporation, all of whom shall have the right to vote: Chairperson, Vice Chair, Secretary and Treasurer. The Chief Executive Officer shall be a non-voting member of the Executive Committee. The Executive Committee shall have the following general authority: The Executive Committee shall be comprised exclusively of Board members and shall act for the Corporation in the interim periods between meetings of the Board of Directors only with respect to matters of an urgent nature and then to the maximum extent feasible, in compliance with the established policies and expressed positions of the Board. Any such actions by the Executive Committee on behalf of the corporation shall require ratification at the following regular or special meeting where a quorum is present. The chairperson of the Board of Directors or any three (3) Executive Committee members convenes. Said written notice shall be delivered to the remaining members of the Executive Committee. A majority of the officers present and in person, shall constitute a quorum for the transaction of Executive Committee business. Form 990, Part VI, Line 4 Significant changes to organizational documents The bylaws were revised to ensure that there are provision(s) prohibiting any current board member(s) from being an employee of the health center or an immediate family member of an employee. A provision clearly prohibiting the CEO from being a voting member of the board was also added. Form 990, Part VI, Line 11b Review of form 990 by governing body The organization's Form 990 is reviewed in detail by executive management. A board meeting is then held to present and review a final draft of the full Form 990, including all applicable schedules; each board member is provided a copy of the return at the board meeting and is allowed to ask any questions they may have. Once all questions are answered, the board votes to approve submission before the return is filed with the IRS. Form 990, Part VI, Line 12c Conflict of interest policy An annual conflict of interest form is filled out by each board member, which is verified by our independent auditors. All other employees sign the code of conduct policy at time of hire which covers conflicts of interest. The CEO and the Board Liaison review the conflict of interest forms to determine if any potential conflicts of interest exist. If a potential conflict of interest is determined to exist, the CEO and Executive Committee of the board, consisting of the Chair, Vice Chair, Secretary and Treasurer, meet to discuss whether any actual conflicts of interest exist. Although no conflicts have been noted in the past, if a conflict of interest was to arise, restrictions would be imposed and the board member would be required to excuse themselves from any discussions and/or votes related to the conflicting issue. Form 990, Part VI, Line 15a Process to establish compensation of top management official Compensation for the organization's CEO is determined by the board of directors based on a performance evaluation. Each board member completes an evaluation, and then the Executive Committee reports the findings and any changes in compensation to the CEO. Any changes in compensation are based on the National Association of Community Health Centers (NACHC) salary surveys. This process is performed annually, and was last done November of 2016. The evaluation and review process is documented in the board meeting minutes. Form 990, Part VI, Line 19 Required documents available to the public Governing documents, conflict of interest policies, and financial statements are not required disclosures pursuant to Internal Revenue Code (IRC) Section 6104. These documents are not available to the public at this time. Form 990, Part IX, Line 11g Other Fees Contracted Services-EHR/PM Fees - Total Expense: 478745, Program Service Expense: 478745, Management and General Expenses: 0, Fundraising Expenses: 0; Contracted Services-Medical Coverage - Total Expense: 319067, Program Service Expense: 319067, Management and General Expenses: 0, Fundraising Expenses: 0; Interpreting Services - Total Expense: 69185, Program Service Expense: 69185, Management and General Expenses: 0, Fundraising Expenses: 0; Security - Total Expense: 36121, Program Service Expense: 21088, Management and General Expenses: 15033, Fundraising Expenses: 0; Telephone - Total Expense: 74273, Program Service Expense: 50624, Management and General Expenses: 23649, Fundraising Expenses: 0; Other Contracted Services - Total Expense: 49927, Program Service Expense: 40631, Management and General Expenses: 9296, Fundraising Expenses: 0; Form 990, Part XI, Line 9 Other changes in net assets or fund balances CHANGE IN BENEFICIAL INTEREST-COMMUNITY FOUNDATION - 2422;