COMMUNITY HEALTH CENTER OF CENTRAL WYOMING INC: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- COMMUNITY HEALTH CENTER OF CENTRAL WYOMING INC (EIN 83-0326307)
- Tax period
- 2015-04-01 to 2016-03-31
- Filed
- 2017-02-06
- IRS object ID
- 201700379349300990
- Schema version
- 2015v3.0
- 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 | 2017-02-06T13:33:09-07:00 | ReturnTs |
| Tax Period End | 2016-03-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 208019714 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JDS PROFESSIONAL GROUP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10303 E DRY CREEK RD STE 400 | AddressLine1Txt |
| City | ENGLEWOOD | CityNm |
| State Abbreviation | CO | StateAbbreviationCd |
| ZIP | 80112 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-04-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 830326307 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY HEALTH CENTER OF CENTRAL | BusinessNameLine1Txt |
| Business Name Line2 | WYOMING | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | COMM | BusinessNameControlTxt |
| Phone | 3072336000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5000 BLACKMORE ROAD | AddressLine1Txt |
| City | CASPER | CityNm |
| State Abbreviation | WY | StateAbbreviationCd |
| ZIP | 82609 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | COLE WHITE | PersonNm |
| Person Title | INTERIM CEO | PersonTitleTxt |
| Phone | 3072336000 | PhoneNum |
| Signature | 2017-02-06 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | LORI B BAUER CPA | PreparerPersonNm |
| PTIN | P01260252 | PTIN |
| Phone | 3037710123 | PhoneNum |
| Preparation | 2017-02-06 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | COLE WHITE | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5000 BLACKMORE RD | AddressLine1Txt |
| City | CASPER | CityNm |
| State Abbreviation | WY | StateAbbreviationCd |
| ZIP | 82609 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $10,819,797 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.CHCCW.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1999 | FormationYr |
| Legal Domicile State | WY | LegalDomicileStateCd |
| Activity Or Mission | TO MAINTAIN A HIGH QUALITY PATIENT CARE DELIVERY SYSTEM THAT PROVIDES ACCESS TO COMPREHENSIVE HEALTH CARE SERVICES, REGARDLESS OF ABILITY TO PAY. IT IS THE DESIRE OF CHCCW TO TREAT ALL PATIENTS WITH THE DIGINITY AND RESPECT THEY DESERVE FROM PRE-NATAL CARE TO GERIATRIC CARE, COMPREHENSIVE SERVICES COVER ALL LIFE SPANS, MAKING THE CHCCW A TRUE HEALTHCARE HOME AS STEWARDS OF THE COMMUNITY, THE ORGANIZATION SEEKS TO UNDERSTAND, RESPOND TO, AND SERVE COMMUNITY NEEDS, OFFEREING ASSISTANCE TO THOSE WITH LIMITED OPTIONS AND REMOVING BARRIERS THAT PREVENT PEOPLE FROM ACCESSING CARE. THE VISION OF CHCCW IS FOR CENTRAL WYOMING TO BECOME THE HEALTHIEST REGION IN THE STATE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 164 | TotalEmployeeCnt |
| Total Volunteers | 9 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $3,198,605 | PYContributionsGrantsAmt |
| CY Contributions Grants | $3,953,432 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $8,167,502 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $6,865,285 | CYProgramServiceRevenueAmt |
| PY Investment Income | $634 | PYInvestmentIncomeAmt |
| CY Investment Income | $1,080 | CYInvestmentIncomeAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $11,366,741 | PYTotalRevenueAmt |
| CY Total Revenue | $10,819,797 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $7,480,720 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $7,109,808 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $34,873 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $3,989,146 | PYOtherExpensesAmt |
| CY Other Expenses | $5,430,363 | CYOtherExpensesAmt |
| PY Total Expenses | $11,469,866 | PYTotalExpensesAmt |
| CY Total Expenses | $12,540,171 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$103,125 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$1,720,374 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $13,285,884 | TotalAssetsBOYAmt |
| Total Assets EOY | $11,712,576 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,094,118 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,222,485 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $12,191,766 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $10,490,091 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO MAINTAIN A HIGH QUALITY PATIENT CARE DELIVERY SYSTEM THAT PROVIDES ACCESS TO COMPREHENSIVE HEALTH CARE SERVICES, REGARDLESS OF ABILITY TO PAY. IT IS THE DESIRE OF CHCCW TO TREAT ALL PATIENTS WITH THE DIGINITY AND RESPECT THEY DESERVE FROM PRE-NATAL CARE TO GERIATRIC CARE, COMPREHENSIVE SERVICES COVER ALL LIFE SPANS, MAKING THE CHCCW A TRUE HEALTHCARE HOME AS STEWARDS OF THE COMMUNITY, THE ORGANIZATION SEEKS TO UNDERSTAND, RESPOND TO, AND SERVE COMMUNITY NEEDS, OFFEREING ASSISTANCE TO THOSE WITH LIMITED OPTIONS AND REMOVING BARRIERS THAT PREVENT PEOPLE FROM ACCESSING CARE. THE VISION OF CHCCW IS FOR CENTRAL WYOMING TO BECOME THE HEALTHIEST REGION IN THE STATE. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $5,905,158 | ExpenseAmt |
| Revenue | $5,486,976 | RevenueAmt |
| Desc | MEDICAL FACILITY - THE ORGANIZATION PROVIDES LAB, MULTIPHASIC, PHARMACY, AND MEDICAL SERVICES TO PATIENTS. APPROXIMATELY 28,783 PATIENT VISITS WERE SEEN AT THE MEDICAL FACILITY DURING THE FISCAL YEAR. SERVICES INCLUDE FAMILY MEDICINE, GERIATRIC CARE, PEDIATRICS, INTERNAL MEDICINE AND OBSTETRICS, INPATIENT SERVICES AT WYOMING MEDICAL CENTER AND LONG-TERM CARE FACILITIES, FULL PHARMACY FOR PATIENTS, LABORATORY, X-RAYS, ULSTRASOUNDS, AND OTHER SCREENING AND DIAGNOSTIC TESTS, SUCH AS VISION AND HEARING, PATIENT HEALTH EDUCATION, PATIENT ASSISTANCE, PREVENTATIVE CARE, AND SPANISH TRANSLATION SERVICES. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,078,206 | ExpenseAmt |
| Revenue | $956,669 | RevenueAmt |
| Desc | DENTAL - THE ORGANIZATION'S DENTAL CLINIC OPERATES WITHIN SCOPE AND PROVIDED APPROXIMATELY 5,077 PATIENT VISITS DURING THE FISCAL YEAR. SERVICES INCLUDE DENTAL HYGIENE, GENERAL RESTORATIVE ORAL CARE (FILLINGS), GLOWNS, BRIDGES, ENDODONTIC (ROOT CANALS), EXODONTIA (EXTRACTIONS), PERIODONTAL SURGERY, PROSTHODONTICS (DENTURES, PARTIALS), MINI IMPLANTS FOR DENTURES, EMERGENCY DENTAL APPOINTMENTS, ORAL CANCER SCREENING, AND ELECTRONIC PATIENT RECORDS. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $654,742 | ExpenseAmt |
| Revenue | $421,640 | RevenueAmt |
| Desc | BEHAVIORAL HEALTH - THE ORGANIZATION'S BEHAVIORAL HEALTH DEPARTMENT OPERATES WITHIN SCOPE AND PROVIDED APPROXIMATELY 3,351 PATIENT VISITS DURING THE FISCAL YEAR. SERVICES INLCUDE PSYCHOLOGICAL EVALUATIONS AND TESTING, PERSONAL SKILLS TRAINING, MEDICATION MANAGEMENT, PSYCHOTHERAPY, SOCIAL INTERACTION GROUP THERAPY, BEHAVIORAL MODIFICATION TREATMENT FOR ATTENTION DEFICIT DISORDER, SPECIALIZED TREATMENT (POST TRAUMATIC STRESS DISORDER, PSYCHOLOGICAL TRAUMA AND ABUSE, AUTISM AND ASPERGURS SYNDROME, HEAD INJURIES), AND PSYCHOLOGICAL EVALUATIONS FOR CHRONIC PAIN MANAGEMENT. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $7,638,106 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | 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 | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | 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 | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | Yes (true) | 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 | 24 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 164 | 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 |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | 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 |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE ORGANIZATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3072336000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5000 BLACKMORE RD | AddressLine1Txt |
| City | CASPER | CityNm |
| State Abbreviation | WY | StateAbbreviationCd |
| ZIP | 82609 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| JEFF MURATORE | |||||||
| CHAIR | 10.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| DR SEAN ELLIS | |||||||
| VICE CHAIR | 10.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| DR MATT FREDERIKSEN | |||||||
| SECRETARY | 10.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| SHAUNA OLESON | |||||||
| TREASURER | 10.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| MIKE GILMORE | |||||||
| DIRECTOR | 10.00 | Yes (X) | $0 | $0 | $0 | ||
| DEB JOHNSON | |||||||
| DIRECTOR | 10.00 | Yes (X) | $0 | $0 | $0 | ||
| DR JAMES FOWLER | |||||||
| DIRECTOR | 10.00 | Yes (X) | $0 | $0 | $0 | ||
| JOHN ANGST | |||||||
| DIRECTOR | 10.00 | Yes (X) | $0 | $0 | $0 | ||
| RUBY PERRY | |||||||
| DIRECTOR | 10.00 | Yes (X) | $0 | $0 | $0 | ||
| DR PATRICIA BELL | |||||||
| CHIEF MED. O | 40.00 | Yes (X) | $195,615 | $0 | $24,734 | ||
| DANIEL J MEYERS | |||||||
| CEO | 40.00 | Yes (X) | $163,407 | $0 | $15,286 | ||
| ERIC NIEMEYER | |||||||
| CFO | 40.00 | Yes (X) | $97,947 | $0 | $16,670 | ||
| RYAN BAIR | |||||||
| COO | 40.00 | Yes (X) | $88,062 | $0 | $16,098 | ||
| COLE WHITE | |||||||
| INTERIM CEO | 40.00 | Yes (X) | $3,077 | $0 | $1,484 | ||
| DR PAUL HARNETTY | |||||||
| PHYSICIAN | 40.00 | $273,705 | $0 | $27,575 | Yes (X) | ||
| JERRY JARRARD | |||||||
| PHYSICIAN | 40.00 | $193,095 | $0 | $18,665 | Yes (X) | ||
| DR GRADY SNYDER | |||||||
| PHYSICIAN | 40.00 | $189,750 | $0 | $20,255 | Yes (X) | ||
| DR JUNGSOOK JOHNSON | |||||||
| PHYSICIAN | 40.00 | $150,556 | $0 | $20,571 | Yes (X) | ||
| JESSICA DORNBIER | |||||||
| PHARMACIST | 40.00 | $142,899 | $0 | $13,740 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,498,113 | TotalReportableCompFromOrgAmt |
| Total Other Compensation | $175,078 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 9 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| BARTON ASSOCIATES | |||||
| 300 JUBILEE DR | PEABODY | MA | 01960 | CONTRACT OBGYN | $737,184 |
| PRIORITY MANAGEMENT GROUP INC | |||||
| 700 SCHOOL ST | PAWTUCKET | RI | 02860 | AR MGT | $303,101 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $3,711,978 | GovernmentGrantsAmt |
| All Other Contributions | $241,454 | AllOtherContributionsAmt |
| Noncash Contributions | $180,138 | NoncashContributionsAmt |
| Total Contributions | $3,953,432 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENUE | 624100 | $6,854,913 | $6,854,913 |
| OTHER REVENUE | 624100 | $10,372 | $10,372 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $6,865,285 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,080 | TotalRevenueColumnAmt |
| Exclusion | $1,080 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $10,819,797 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $6,865,285 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $1,080 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $582,249 | TotalAmt |
| Program Services | $388,298 | ProgramServicesAmt |
| Management And General | $191,649 | ManagementAndGeneralAmt |
| Fundraising | $2,302 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,235,393 | TotalAmt |
| Program Services | $3,491,439 | ProgramServicesAmt |
| Management And General | $1,723,258 | ManagementAndGeneralAmt |
| Fundraising | $20,696 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $61,569 | TotalAmt |
| Program Services | $41,060 | ProgramServicesAmt |
| Management And General | $20,266 | ManagementAndGeneralAmt |
| Fundraising | $243 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $759,984 | TotalAmt |
| Program Services | $506,827 | ProgramServicesAmt |
| Management And General | $250,152 | ManagementAndGeneralAmt |
| Fundraising | $3,005 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $470,613 | TotalAmt |
| Program Services | $309,228 | ProgramServicesAmt |
| Management And General | $161,385 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $249,488 | TotalAmt |
| Program Services | $25,744 | ProgramServicesAmt |
| Management And General | $223,744 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $40,400 | TotalAmt |
| Management And General | $40,400 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,201,183 | TotalAmt |
| Program Services | $932,939 | ProgramServicesAmt |
| Management And General | $268,244 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $74,758 | TotalAmt |
| Program Services | $850 | ProgramServicesAmt |
| Management And General | $73,908 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $290,450 | TotalAmt |
| Program Services | $70,066 | ProgramServicesAmt |
| Management And General | $220,384 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $146,512 | TotalAmt |
| Program Services | $4,263 | ProgramServicesAmt |
| Management And General | $142,249 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $77,840 | TotalAmt |
| Program Services | $35,607 | ProgramServicesAmt |
| Management And General | $42,233 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,184 | TotalAmt |
| Program Services | -$1,822 | ProgramServicesAmt |
| Management And General | $22,006 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,332,784 | TotalAmt |
| Program Services | $888,823 | ProgramServicesAmt |
| Management And General | $438,692 | ManagementAndGeneralAmt |
| Fundraising | $5,269 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $48,175 | TotalAmt |
| Management And General | $48,175 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| MEDICAL SUPPLIES & OTHER | $1,625,628 | $671,452 | $951,008 | $3,168 |
| IN KIND VACCINES | $180,138 | $180,138 | ||
| TRAINING & RECRUITMENT | $97,908 | $66,976 | $30,932 | |
| EQUIPMENT R&M | $27,231 | $16,869 | $10,362 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,684 | TotalAmt |
| Program Services | $9,349 | ProgramServicesAmt |
| Management And General | $8,145 | ManagementAndGeneralAmt |
| Fundraising | $190 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,540,171 | TotalAmt |
| Program Services | $7,638,106 | ProgramServicesAmt |
| Management And General | $4,867,192 | ManagementAndGeneralAmt |
| Fundraising | $34,873 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $169,767 | BOYAmt |
| EOY | $113,943 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $517,534 | BOYAmt |
| EOY | $418,234 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $217,473 | BOYAmt |
| EOY | $207,087 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $660,361 | BOYAmt |
| EOY | $344,995 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $290,156 | BOYAmt |
| EOY | $244,686 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $50,751 | BOYAmt |
| EOY | $294,280 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $15,944,102 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $5,854,751 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,379,842 | BOYAmt |
| EOY | $10,089,351 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,285,884 | BOYAmt |
| EOY | $11,712,576 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $757,178 | BOYAmt |
| EOY | $700,637 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $643 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $313,242 | BOYAmt |
| EOY | $521,205 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,698 | BOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,094,118 | BOYAmt |
| EOY | $1,222,485 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,191,766 | BOYAmt |
| EOY | $10,464,961 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $25,130 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,191,766 | BOYAmt |
| EOY | $10,490,091 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,285,884 | BOYAmt |
| EOY | $11,712,576 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$1,720,374 | ReconcilationRevenueExpnssAmt |
| Prior Period Adjustments | $18,699 | 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) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $9,240,080 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $7,773,885 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,835,074 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,198,605 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,953,432 | CurrentTaxYearAmt |
| Total | $27,001,076 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $9,240,080 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $7,773,885 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,835,074 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,198,605 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,953,432 | CurrentTaxYearAmt |
| Total | $27,001,076 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $27,001,076 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $6,149 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,463 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,139 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $634 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,080 | CurrentTaxYearAmt |
| Total | $10,465 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $27,011,541 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $37,921,515 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.99960 | PublicSupportCY170Pct |
| Public Support PY170 | 0.99880 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | false | OtherActivitiesInd |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE C, PART II-B, LINE 1 | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION PAYS DUES TO THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS (NACHC). A PORTION OF THESE DUES MAY BE USED FOR LOBBYING PURPOSES. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,260,084 | OtherCostOrOtherBasisAmt |
| Book Value | $1,260,084 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $9,335,306 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,981,463 | DepreciationAmt |
| Book Value | $7,353,843 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,925,934 | OtherCostOrOtherBasisAmt |
| Depreciation | $527,726 | DepreciationAmt |
| Book Value | $1,398,208 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,422,778 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,345,562 | DepreciationAmt |
| Book Value | $77,216 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $10,089,351 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | ESTIMATED SELF INSURANCE COSTS | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $10,819,797 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Subtotal | $10,819,797 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $10,819,797 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $12,521,472 | TotExpnsEtcAuditedFinclStmtAmt |
| Prior Year Adjustments | -$18,699 | PriorYearAdjustmentsAmt |
| Expenses Not Reported | -$18,699 | ExpensesNotReportedAmt |
| Expenses Subtotal | $12,540,171 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $12,540,171 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE D, PAGE 3, PART X | THE ORGANIZATION HAS PREVIOUSLY RECEIVED NOTICE FROM THE INTERNAL REVENUE SERVICE OF EXEMPTION FROM INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. IN ADDITION, THE ORGANIZATION QUALIFIES FOR THE CHARITABLE CONTRIBUTION DEDUCTION UNDER SECTION 170(B)(1)(A)(VI) AND HAS BEEN CLASSIFIED AS AN ORGANIZATION OTHER THAN A PRIVATE DONATION UNDER 509 (A)(1). ACCORDINGLY, NO FEDERAL INCOME TAXES ARE REFLECTED IN THESE FINANCIAL STATEMENTS. THE ORGANIZATION FOLLOWS ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES WHICH REQUIRES IT TO DETERMINE WHETHER A TAX POSITION (AND THE RELATED TAX BENEFIT) IS MORE LIKELY THAN NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPLICABLE TAXING AUTHORITY, BASED SOLELY ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFIT TO BE RECOGNIZED IS MEASURED AS THE LARGEST AMOUNT OF BENEFIT THAT IS GREATER THAN FIFTY PERCENT LIKELY OF BEING REALIZED UPON SETTLEMENT, PRESUMING THAT THE TAX POSITION IS EXAMINED BY THE APPROPRIATE TAXING AUTHORITY THAT HAS FULL KNOWLEDGE OF ALL RELEVANT INFORMATION. DURING THE YEARS ENDED MARCH 31, 2016 AND 2015, THE ORGANIZATION'S MANAGEMENT EVALUATED ITS TAX POSITIONS TO DETERMINE THE EXISTENCE OF UNCERTAINTIES, AND DID NOT NOTE ANY MATTERS THAT WOULD REQUIRE RECOGNITION OR WHICH MAY HAVE AN AFFECT ON ITS TAX-EXEMPT STATUS. |
| SCHEDULE D, PAGE 4, PART XIII | THE PRIOR PERIOD ADJUSTMENT IS NECESSARY TO BRING THE BEGINNING BALANCES TO ACTUAL. THE PRIOR YEAR RETURN WAS PREPARED BEFORE THE AUDITED FINANCIAL STATEMENTS WERE COMPLETE. THE ADJUSTMENT CORRECTS THE NET ASSETS MOVING FORWARD. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| 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 | Yes (true) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt |
|---|---|---|---|---|
| DR PATRICIA BELL | ||||
| CHIEF MED. OFFICER | $195,615 | $8,954 | $15,780 | $220,349 |
| DANIEL J MEYERS | ||||
| CEO | $163,407 | $9,946 | $5,340 | $178,693 |
| DR PAUL HARNETTY | ||||
| PHYSICIAN | $273,705 | $16,555 | $11,020 | $301,280 |
| JERRY JARRARD | ||||
| PHYSICIAN | $193,095 | $4,200 | $14,465 | $211,760 |
| DR GRADY SNYDER | ||||
| PHYSICIAN | $189,750 | $11,610 | $8,645 | $210,005 |
| DR JUNGSOOK JOHNSON | ||||
| PHYSICIAN | $150,556 | $9,231 | $11,340 | $171,127 |
| JESSICA DORNBIER | ||||
| PHARMACIST | $142,899 | $8,400 | $5,340 | $156,639 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE J, PAGE 1, PART I, LINE 7 | FormAndLineReferenceDesc |
| Explanation | MEDICAL PROFESSIONALS RECEIVED PRODUCTIVITY BONUSES WHICH WERE BONUSES GIVEN TO PROVIDERS BASED ON PRODUCTION GOALS (ENCOUNTERS AND CHARGES) STIPULATED IN THEIR EMPLOYMENT CONTRACTS. | ExplanationTxt |
Schedule M IRS990ScheduleM
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 2447 | ContributionCnt |
| Noncash Contributions Rpt F990 | $180,138 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | false | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | false | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990 - ORGANIZATION'S MISSION | TO MAINTAIN A HIGH QUALITY PATIENT CARE DELIVERY SYSTEM THAT PROVIDES ACCESS TO COMPREHENSIVE HEALTH CARE SERVICES, REGARDLESS OF ABILITY TO PAY. IT IS THE DESIRE OF CHCCW TO TREAT ALL PATIENTS WITH THE DIGINITY AND RESPECT THEY DESERVE FROM PRE-NATAL CARE TO GERIATRIC CARE, COMPREHENSIVE SERVICES COVER ALL LIFE SPANS, MAKING THE CHCCW A TRUE HEALTHCARE HOME AS STEWARDS OF THE COMMUNITY, THE ORGANIZATION SEEKS TO UNDERSTAND, RESPOND TO, AND SERVE COMMUNITY NEEDS, OFFEREING ASSISTANCE TO THOSE WITH LIMITED OPTIONS AND REMOVING BARRIERS THAT PREVENT PEOPLE FROM ACCESSING CARE. THE VISION OF CHCCW IS FOR CENTRAL WYOMING TO BECOME THE HEALTHIEST REGION IN THE STATE. |
| FORM 990, PAGE 6, PART VI, LINE 11B | THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. THE CEO AND CFO REVIEW THE RETURN IN DETAIL WITH THE INDEPENDENT ACCOUNTING FIRM PREPARING THE FORM. UPON COMPLETION OF TOP MANANAGMENT'S REVIEW, A TENTATIVE FINAL DRAFT IS EMAILED/MAILED TO ALL BOARD MEMBERS FOR THEIR REVIEW. ANY QUESTIONS OR RECOMMENDED CHANGES ARE DIRECTED TO THE CFO AND CHANGED IF NECESSARY PRIOR TO FILING. |
| FORM 990, PAGE 6, PART VI, LINE 12C | THE BOARD OF DIRECTORS, THROUGH THE SENIOR MANAGEMENT IS ACCOUNTABLE FOR IMPLEMENTATION, ENFORCEMENT, MONITORING, OVERSIGHT, AND COMMUNICATION OF THE ORGANIZATIONS CONFLICT OF INTEREST POLICY. DEPARTMENTAL DIRECTORS AND SUPERVISORS ARE ACCOUNTABLE FOR IMPLEMENTATION, ENFORCEMENT, MONITORING, OVERSIGHT, AND COMMUNICATION OF THE CONFLICT OF INTEREST POLICY IN THEIR DEPARTMENTS. MEMBERS OF THE BOARD MUST NOT ENGAGE IN ANY ACTIVITIES OR RELATIONSHIPS WHICH MIGHT DIRECTLY OR INDIRECTLY RESULT IN A CONFLICT OF INTEREST, OR IMPAIR THEIR INDEPENDENCE OF JUDGMENT. THEY MUST NOT ACCEPT GIFTS, FAVORS OR BENEFITS THAT MIGHT TEND IN ANY WAY TO INFLUENCE THEM IN PERFORMANCE OF THEIR DUTIES AS TRUSTEES. IF A CONFLICT WAS TO ARISE, THE INTERESTED PERSON WOULD NOT PARTICIPATE IN DECISION MAKING RELATED TO THE CONFLICT. CORPORATE OFFICES AND KEY EMPLOYEES ARE ALSO REQUIRED TO ANNUALLY REVIEW POTENTIAL CONFLICTS OF INTEREST. |
| FORM 990, PAGE 6, PART VI, LINE 15A | (1) REVIEWED BY THE BOARD; (2) MARKET SALARY AND BENEFITS DATA ARE REVIEWED; (3) SEVERAL CANDIDATES ARE CONSIDERED BY EXTENSIVE INTERVIEWING AND (4) BACKGROUND CHECKS. |
| FORM 990, PAGE 6, PART VI, LINE 15B | (1) REVIEWED BY THE BOARD; (2) MARKET SALARY AND BENEFITS DATA ARE REVIEWED; (3) SEVERAL CANDIDATES ARE CONSIDERED BY EXTENSIVE INTERVIEWING AND (4) BACKGROUND CHECKS. |
| FORM 990, PAGE 6, PART VI, LINE 19 | UPON REQUEST. |