2017-05-09T15:01:04-05:00 2016-06-30 420714325 RSM US LLP 100 INTERNATIONAL DRIVE SUITE 1400 BALTIMORE MD 21202 990 2015-07-01 520988386 COMMUNITY CLINIC INC COMM 3013407525 8630 FENTON STREET 12TH FLOOR SILVER SPRING MD 20910 KATHLEEN KNOLHOFF MPH CEO 3013407525 2017-05-08 1 JULIA FLANNERY CPA P00928918 4102469300 2015 2021-01-29 14:40:06Z CCI HEALTH & WELLNESS SERVICES KATHLEEN KNOLHOFF MPH 8630 FENTON STREET 12TH FLOOR SILVER SPRING MD 20910 21323406 0 X WWW.CCIWEB.ORG X 1972 MD EMPOWER PATIENTS TO PARTNER WITH STAFF FOR AN UNPARALLELED HEATHCARE EXPERIENCE. THROUGH INTEGRATED TEAMS IN A LEARNING ENVIRONMENT, WE DELIVER HIGH QUALITY, AFFORDABLE CARE TO EVERY PATIENT DURING ALL STAGES OF LIFE. 9 9 304 15 0 0 9346021 9420692 8752075 9739951 4244 86 1538034 2162677 19640374 21323406 0 0 0 0 13191864 14581597 0 0 3503 6194653 7270510 19386517 21852107 253857 -528701 8485590 7813494 2629047 2485652 5856543 5327842 X CCI HEALTH & WELLNESS SERVICES, A GROUP PRACTICE, EMPOWERS PATIENTS TO PARTNER WITH STAFF FOR AN UNPARALLELED HEALTHCARE EXPERIENCE. THROUGH INTEGRATED TEAMS IN A LEARNING ENVIRONMENT, WE DELIVER HIGH-QUALITY, AFFORDABLE CARE TO EVERY PATIENT DURING ALL STAGES OF LIFE. 0 0 12918512 7228963 HEALTH CENTERS: PROVIDE COMPREHENSIVE PRIMARY CARE SERVICES TO MORE THAN 70,000 INDIVIDUAL ENCOUNTERS, MANY OF WHOM DO NOT HAVE ANY HEALTH INSURANCE. CCI-TAYA PROVIDES TEENS AND YOUNG ADULTS WITH AFFORDABLE, TIMELY AND CULTURALLY COMPETENT, DIRECT CLINICAL CARE AND EDUCATIONAL OUTREACH SERVICES. 3866483 WOMAN, INFANTS AND CHILDREN (WIC): NUTRITION COUNSELING TO MORE THAN 32,000 INCOME-ELIGIBLE INFANTS AND CHILDREN, AS WELL AS PREGNANT AND BREASTFEEDING WOMEN. 1614205 2072951 COMPREHENSIVE DENTAL SERVICE PROGRAM PROVIDING MORE THAN 13,000 DENTAL ENCOUNTERS TO PATIENTS PRIMARILY ON MEDICAID OR UN-INSURED. 1307336 OTHER 438037 BEHAVIORAL HEALTH 1745373 18399200 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 15 0 1 304 1 0 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 MD X SHELDON KRONZET 2406381271 8630 FENTON STREET SUITE 1204 SILVER SPRING MD 20910 ERIC STROUD CHAIRPERSON 2.00 X X 0 0 0 PETER MBUGUA CHAIR-ELECT 2.00 X X 0 0 0 BETH DURHAM SECRETARY 2.00 X X 0 0 0 SHARON THAMES TREASURER 2.00 X X 0 0 0 LORIANN BEHM DIRECTOR 2.00 X 0 0 0 LOUISE BRADFORD DIRECTOR 2.00 X 0 0 0 DELLA COX DIRECTOR 2.00 X 0 0 0 ISAAC MARKS SR DIRECTOR 2.00 X 0 0 0 ROBERT WISE MD DIRECTOR 2.00 X 0 0 0 KATHLEEN KNOLHOFF CEO 40.00 X 240000 0 1850 CHRISTOPHER TORONTOW COO 40.00 X 179245 0 14830 JIAQI TAO CFO (THRU 6/10/15) 40.00 X 74564 0 0 SHELDON KRONZEK CFO (BEG 8/1/15) 40.00 X 52856 0 2382 MARCIA LOBRANO MD CMO 40.00 X 213973 0 6631 PARVEJ MALIK MD PHYSICIAN 40.00 X 147706 0 11975 LIDA ALIMORAD DENTAL DIRECTOR 40.00 X 145248 0 5936 MARGARET CHANG MD MEDICAL SVCS. CNT. MGR 40.00 X 139128 0 6097 HELENE FELMAN PHYSICIAN 40.00 X 130819 0 14584 JENNIFER CRAWFORD BEHAVIORAL HEALTH DIRECTOR 40.00 X 129537 0 11225 1453076 0 75510 14 0 1 0 BLUENOVO INC 8070 GEORGIA AVENUE SILVER SPRING MD 20910 IT CONSULTING 1228564 LAB CORPS 358 SOUTH MAIN STREET BURLINGTON NC 27215 LABORATORY SERVICES 342349 GE HEALTHCARE 15724 COLLECTIONS CENTER DRIVE CHICAGO IL 60693 IT PM & EMR CONTRACTOR 309381 J&L MAINTENANCE PO BOX 10325 GAITHERSBURG MD 20898 JANITORIAL SERVICES 109325 4 9382390 38302 9420692 PATIENT SERVICE FEES 621400 9739951 9739951 9739951 86 86 OTHER HEALTH SERVICES 621110 1307336 1307336 INCENTIVE & OTHER INCO 900099 855341 855341 2162677 21323406 11047287 0 855427 833215 833215 11898617 10666674 1231943 169465 160798 8667 742826 706308 36518 937474 797445 140029 17985 17985 60568 60568 1777448 1322232 455216 920746 668515 248728 3503 1818047 1646436 171611 78940 42297 36643 148122 109615 38507 756994 677367 79627 58869 54847 4022 MEDICAL SUPPLIES 1180023 1180023 LICENSE 208246 192051 16195 TRANSLATION SERVICES 138313 131013 7300 MEMBERSHIPS 50292 26798 23494 55917 16781 39136 21852107 18399200 3449404 3503 2343752 1602190 109036 108952 427109 626889 731903 801951 137802 212428 9255298 4911928 4626545 4343370 100 100 109343 117614 8485590 7813494 1310000 1272965 124085 194820 667860 480828 527102 537039 2629047 2485652 X 5856543 5327842 5856543 5327842 8485590 7813494 -528701 0 X 0 1 X 1 1 1 X 5128177 2765528 2362649 3037230 2060533 976697 1089891 85867 1004024 4343370 DEFERRED RENT 537039 537039 X 21623406 300000 300000 21323406 0 21323406 22152107 300000 300000 21852107 0 21852107 PART X, LINE 2: CCI HAS BEEN RECOGNIZED BY THE INTERNAL REVENUE SERVICE (IRS) AS EXEMPT FROM FEDERAL INCOME TAXES UNDER IRC 501(C)(3), EXCEPT FOR TAXES ON INCOME GENERATED FROM UNRELATED BUSINESS ACTIVITIES. CCI HAS ADOPTED ACCOUNTING GUIDANCE REGARDING THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES, WHICH ADDRESSES THE DETERMINATION OF WHETHER TAX BENEFITS CLAIMED OR EXPECTED TO BE CLAIMED ON A TAX RETURN SHOULD BE RECORDED IN THE FINANCIAL STATEMENTS. UNDER THIS POLICY, CCI MAY RECOGNIZE THE TAX BENEFIT FROM AN UNCERTAIN TAX POSITION ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WOULD BE SUSTAINED ON EXAMINATION BY TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. MANAGEMENT HAS EVALUATED CCI'S TAX POSITIONS AND HAS CONCLUDED THAT CCI HAS TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENT TO THE FINANCIAL STATEMENTS TO COMPLY WITH PROVISIONS OF THIS GUIDANCE. AS OF JUNE 30, 2016 AND 2015, THERE ARE NO MATERIAL UNRECOGNIZED/DERECOGNIZED TAX BENEFITS OR TAX PENALTIES OR INTEREST. CCI IS NO LONGER SUBJECT TO U.S. FEDERAL, STATE OR LOCAL TAX EXAMINATIONS BY TAX AUTHORITIES FOR YEARS ENDED BEFORE JUNE 30, 2013. X X 0 0 0 0 0 0 0 0 0 KATHLEEN KNOLHOFF CEO 240000 0 0 0 0 0 1250 0 600 0 241850 0 0 0 CHRISTOPHER TORONTOW COO 178969 0 0 0 276 0 1250 0 13580 0 194075 0 0 0 MARCIA LOBRANO MD CMO 213800 0 0 0 173 0 1200 0 5431 0 220604 0 0 0 PARVEJ MALIK MD PHYSICIAN 147586 0 0 0 120 0 1250 0 10725 0 159681 0 0 0 LIDA ALIMORAD DENTAL DIRECTOR 145144 0 0 0 104 0 1300 0 4636 0 151184 0 0 0 FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS REVIEWED BY THE CFO. BOARD MEMBERS RECEIVE AN ELECTONIC COPY OF THE FORM 990 BEFORE IT IS FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ACTIVITIES OF THE CORPORATION SHALL BE CONDUCTED SO THAT NO PART OF ITS INCOME PROPERTY OR EARNINGS SHALL INURE TO THE BENEFIT OF ANY DIRECTOR, OFFICER, EMPLOYEE OR OTHER INDIVIDUAL, CORPORATION, INSTITUTION OR ASSOCIATION. ANY DIRECTOR HAVING AN OUTSIDE INTEREST IN A MATTER BEFORE THE BOARD SHALL DISCLOSE THE POTENTIAL CONFLICT TO THE BOARD BEFORE IT DELIBERATES AND ACTS ON THE MATTER AND IF THE BOARD DETERMINES A CONFLICT EXISTS, THE MEMBER SHALL ABSTAIN FROM ANY DELIBERATIONS OR VOTE ON THE MATTER. EACH DIRECTOR SHALL SIGN A CONFLICT OF INTEREST STATEMENT UPON JOINING THE BOARD AND SHALL SIGN AN UPDATED STATEMENT ANNUALLY THEREAFTER. FORM 990, PART VI, SECTION B, LINE 15 THE DETERMINATION OF COMPENSATION AMOUNTS FOR THE ORGANIZATION'S CEO OCCURS WHEN THE BOARD EVALUATES THE CEO'S PERFORMANCE AND MAKES THEIR RECOMMENDATION FOR THE SALARY INCREASE. THE DETERMINATION OF COMPENSATION AMOUNTS FOR THE CEO AND KEY EMPLOYEES INCLUDES A REVIEW OF LOCAL & NATIONAL COMPARABLES FOR PROFESSIONALS WITH REQUIRED SKILLS AND BACKGROUND, AS WELL AS A REVIEW OF ORGANIZATION FINANCIALS TO DETERMINE WHAT MAKES SENSE GIVING EXISTING BUDGET CONSTRAINTS. HUMAN RESOURCES & FINANCE ARE KEY CONTRIBUTORS TO SUCH A DECISION, AS IS THE ORGANIZATION'S MANAGEMENT. THE STEPS IN THIS PROCESS ARE DOCUMENTED BY THE BOARD AND HUMAN RESOURCES. FORM 990, PART VI, SECTION C, LINE 19 COMMUNITY CLINIC, INC. MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST FOR THE SAME PERIOD OF DISCLOSURE AS SET FORTH IN SECTION 6104(D).