2017-05-12T12:20:53-05:00 2016-06-30 381357951 PLANTE & MORAN PLLC 10 S RIVERSIDE PLAZA 9TH FLOOR CHICAGO IL 60606 990 2015-07-01 362893854 CHICAGO FAMILY HEALTH CENTER INC CHIC 7737685000 9119 SOUTH EXCHANGE AVENUE CHICAGO IL 60617 BARRETT HATCHES CHIEF EXECUTIVE OFFICER 7737685000 2017-05-05 1 KIMBERLY A HAUMANN P00546491 3122071040 2017-05-05 2015 2021-01-29 14:40:06Z BARRETT HATCHES 9119 SOUTH EXCHANGE AVENUE CHICAGO IL 60617 22192649 0 X CHICAGOFAMILYHEALTH.ORG X 1976 IL TO PROVIDE HEALTHCARE SERVICES TO ALL PATIENTS. 11 11 305 11 0 0 7594044 8730111 13734320 13302035 117074 160503 0 0 21445438 22192649 0 0 0 0 12567035 13494267 0 0 215596 6494731 6565374 19061766 20059641 2383672 2133008 23887656 26375544 7612726 6926541 16274930 19449003 CHICAGO FAMILY HEALTH CENTER WILL PROMOTE HEALTH, WORK TO PREVENT DISEASE AND PROVIDE TREATMENT THROUGH THE DELIVERY OF QUALITY, ACCESSIBLE PRIMARY HEALTHCARE THAT IS CULTURALLY SENSITIVE, AFFORDABLE, AND RESPONSIVE TO COMMUNITY AND INDIVIDUAL NEEDS. 0 0 16201317 12436579 PUBLIC HEALTH SERVICE SECTION 330: THIS PROGRAM PROVIDES COMPREHENSIVE HEALTH AND DENTAL SERVICES ON THE SOUTH SIDE OF CHICAGO. THE PROGRAM INCLUDES PREVENTIVE SCREENING AND TREATMENT, PRENATAL HEALTH CARE, COUNSELING AND CASE MANAGEMENT. THE CENTER HAS 5 SITES SERVICING 30,318 PATIENTS WITH 102,457 MEDICAL AND DENTAL VISITS THIS YEAR. 229158 290887 THE ILLINOIS BREAST AND CERVICAL CANCER PROGRAM (IBCCP) IS A FEDERALLY AND STATE FUNDED PROGRAM THAT OFFERS FREE MAMMOGRAMS, BREAST EXAMS, PELVIC EXAMS, AND PAP TESTS TO ELIGIBLE, UNINSURED WOMEN. SERVICES CAN ALSO BE AUTHORIZED FOR WOMEN OR MEN WITH ABNORMAL FINDINGS WHO ARE OUTSIDE THE NORMAL IBCCP AGE RANGE BUT MEET OTHER IBCCP CRITERIA. PARTICIPANTS WHO ARE ENROLLED IN THE IBCCP PROGRAM AND DIAGNOSED WITH CANCER THROUGH THE PROGRAM'S SCREENING AND TESTS ARE ELIGIBLE TO RECEIVE TREATMENT BENEFITS. MAMMOGRAMS AND CANCER TREATMENT ARE PROVIDED AT PARTNER HOSPITALS. CFHC REIMBURSES EACH PARTNER HOSPITAL FOR IBCCP SERVICES. 472379 574569 FAMILY CASE MANAGEMENT IS A STATE FUNDED PROGRAM THAT ASSISTS PREGNANT WOMEN BY PROVIDING SERVICES THAT INCLUDE RISK ASSESSMENTS AND REFERRALS. THE PREGNANT CLIENT IS FOLLOWED THROUGHOUT THE PREGNANCY AND UP TO ONE YEAR AFTER THE BIRTH OF THE BABY. UPON DELIVERY, THE INFANT IS ALSO TRACKED FOR WELL BABY VISITS, IMMUNIZATION AND NORMAL DEVELOPMENT. THERE ARE 1,098 PARTICIPANTS EACH MONTH FOR THIS PROGRAM. 16902854 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 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 1 1 1 0 0 1 48 0 1 305 1 0 0 0 0 0 0 0 0 0 0 X 11 11 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 IL X ERIC BOKLAGE 7737685000 9119 SOUTH EXCHANGE AVENUE CHICAGO IL 60617 NORA REYES CHAIR OF BOARD 2.00 1.00 X X 0 0 0 NICK VALADEZ VICE CHAIR OF BOARD 2.00 1.00 X X 0 0 0 JULIUS ALEXANDER TREASURER OF BOARD 2.00 1.00 X X 0 0 0 FULTON NOLEN JR SECRETARY OF BOARD 3.00 X X 0 0 0 REV MARK BRUMMEL CMF MEMBER 3.00 X 0 0 0 JULIA MUNOZ MEMBER 3.00 X 0 0 0 JAMES SIMMONS MEMBER 3.00 X 0 0 0 LYLET RODRIGUEZ MEMBER 3.00 X 0 0 0 LUPE VALADEZ MEMBER 3.00 X 0 0 0 ANTHONY ZIAK MEMBER 3.00 X 0 0 0 TORIN EDMOND MEMBER 3.00 X 0 0 0 ATIA ZAKEYA A CHIEF FINANCIAL OFFICER 38.00 2.00 X 151396 0 1599 HATCHES BARRETT CHIEF EXECUTIVE OFFICER 38.00 2.00 X 236706 0 7244 LAGIOIA DEE N CHIEF OPERATING OFFICER 40.00 X 128710 0 1142 TOREN CARL B CHIEF MEDICAL OFFICER 40.00 X 242947 0 13428 JAMES VALEK CHIEF MEDICAL OFFICER 40.00 X 25512 0 577 CABE RAMON C PHYSICIAN 40.00 X 199144 0 1177 GERVAIS JACQUELINE PHYSICIAN 40.00 X 247020 0 9176 KESHAVA PRAMODE K PHYSICIAN 40.00 X 197449 0 17042 MICHEL MARJORIE G PHYSICIAN 40.00 X 201949 0 16521 SEARLES ERICKA PHYSICIAN 40.00 X 182706 0 12534 1813539 0 80440 25 0 1 0 QUALITY SYSTEMS INC PO BOX 511449 LOS ANGELES CA 90051 BILLING SERVICES 794809 OSIS PO BOX 772852 CHICAGO IL 60677 NEXTGEN HOSTING SERVICES 575262 CARDINAL HEALTH BANK OF AMERICA LOCKBOX SERVICES CHICAGO IL 60693 340B DISTRIBUTOR 220891 CLEANWAY MAINTENANCE PO BOX 95882 HOFFMAN ESTATES IL 60195 CLEANING SERVICES 172508 CONSILIUM STAFFING LLC 6225 N STATE HWY 161 IRVING TX 75038 TEMP AGENCY - PROVIDERS 104608 5 8690870 39241 8730111 PRIVATE CARE 621300 9837747 9837747 CAPITATION REVENUE 621300 2109138 2109138 HMO INCENTIVE REVENUE 621300 1355150 1355150 13302035 112839 112839 47664 0 47664 47664 47664 22192649 13349699 0 112839 X 2116740 1905066 190507 21167 9168191 8251372 825137 91682 107373 96635 9664 1074 1330360 1160049 157565 12746 771603 694443 69444 7716 77665 77665 81300 81300 15262 15262 2456841 1358626 1038815 59400 29207 29207 209587 138461 62505 8621 517641 429387 86152 2102 909805 829371 76395 4039 22000 19800 1980 220 77677 52903 24251 523 222560 192434 28613 1513 749773 670770 75036 3967 118035 107600 9911 524 MEDICAL/DENTAL SUPPLIES 783861 783861 MEDICAL WASTE REMOVAL 112942 96614 16328 LICENSE & DUES 70936 70936 OTHER EXPENSES 59908 59908 50374 44526 5546 302 20059641 16902854 2941191 215596 5723087 7004304 838393 1990260 723680 706471 1726072 1220162 7190190 7190190 61165 91532 10867870 4298818 6898123 6569052 240541 1261361 190053 302832 296352 39380 23887656 26375544 2621686 2126187 6443 0 4984597 4800354 7612726 6926541 X 16246303 19416619 28627 32384 16274930 19449003 23887656 26375544 2133008 1041063 0 X 0 1 X 1 1 1 X 9806850 13937408 9059407 7594044 8730111 49127820 9806850 13937408 9059407 7594044 8730111 49127820 49127820 14955 100057 96111 117074 112839 441036 49568856 66623541 0.99110 0.99310 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 567474 567474 7730182 2650806 5079376 553080 336509 216571 577711 269222 308489 1439423 1042281 397142 6569052 X X X 0 0 0 0 0 0 0 0 0 ATIA ZAKEYA A CHIEF FINANCIAL OFFICER 151396 0 0 0 0 0 0 0 1599 0 152995 0 0 0 HATCHES BARRETT CHIEF EXECUTIVE OFFICER 236706 0 0 0 0 0 0 0 7244 0 243950 0 0 0 TOREN CARL B CHIEF MEDICAL OFFICER 230498 0 12449 0 0 0 7670 0 5758 0 256375 0 0 0 CABE RAMON C PHYSICIAN 182277 0 16867 0 0 0 0 0 1177 0 200321 0 0 0 GERVAIS JACQUELINE PHYSICIAN 233644 0 13376 0 0 0 6630 0 2546 0 256196 0 0 0 KESHAVA PRAMODE K PHYSICIAN 193629 0 3820 0 0 0 6444 0 10598 0 214491 0 0 0 MICHEL MARJORIE G PHYSICIAN 197089 0 4860 0 0 0 7286 0 9235 0 218470 0 0 0 SEARLES ERICKA PHYSICIAN 178966 0 3740 0 0 0 6670 0 5864 0 195240 0 0 0 FORM 990, PART VI, SECTION A, LINE 2 DIRECTOR GUADALUPE (LUPE) VALADEZ AND CHAIRMAN NICK VALADEZ HAVE A FATHER SON RELATIONSHIP. FORM 990, PART VI, SECTION B, LINE 11 THE BOARD RETAINS THE SERVICES OF AN INDEPENDENT CPA FIRM TO PREPARE THE ORGANIZATION'S FORM 990 TAX RETURN. MANAGEMENT REVIEWS THE COMPLETED FORM 990 AND PROVIDES A FULL COPY TO ALL MEMBERS OF THE BOARD. THE BOARD IS PROVIDED AN OPPORTUNITY TO ASK ANY QUESTIONS DIRECTLY TO ORGANIZATION MANAGEMENT OR THE CONTACT AT THE INDEPENDENT CPA FIRM. FORM 990, PART VI, SECTION B, LINE 12C THE CENTER REVIEWS ANNUAL CONFLICT OF INTEREST STATEMENTS FROM THE BOARD AND SENIOR STAFF AT THE NOVEMBER BOARD MEETING. IN THE STATEMENTS, ALL BOARD MEMBERS AND SENIOR STAFF DISCLOSE THEIR CONFLICTS, POTENTIAL CONFLICTS, AND SITUATIONS THAT COULD BE PERCEIVED TO BE CONFLICTS. THE CENTER THAN EVALUATES THESE STATEMENTS. FORM 990, PART VI, SECTION B, LINE 15 THE CEO AND OTHER KEY EMPLOYEES COMPENSATION IS EVALUATED ANNUALLY BY THE BOARD OF DIRECTOR'S EXECUTIVE COMMITTEE. THE CENTER NEGOTIATED BASED ON THE 990S FROM SIMILAR ORGANIZATIONS IN THE GREATER CHICAGO AREA. COMPENSATION AMOUNTS WERE SET AT THE LOWER END OF COMPARABLE ORGANIZATIONS. FORM 990, PART VI, SECTION C, LINE 18 THESE DOCUMENTS ARE AVAILABLE UPON REQEUST TO THE CENTER. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS AND FINANCIAL STATEMENTS ARE AVAILABLE THROUGH APPLICABLE GOVERNMENTAL AGENCIES; THE CONFLICT OF INTEREST POLICY IS AVAILABLE UPON WRITTEN REQUEST TO THE ORGANIZATION. FORM 990, PART IX, LINE 11G CONTRACTED AGENCY STAFF - PROVIDER: PROGRAM SERVICE EXPENSES 571,128. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 571,128. CONTRACTED AGENCY STAFF - OTHER: PROGRAM SERVICE EXPENSES 46,170. MANAGEMENT AND GENERAL EXPENSES 46,170. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 92,340. ORGANIZATION CONTRACTED STAFF: PROGRAM SERVICE EXPENSES 20,785. MANAGEMENT AND GENERAL EXPENSES 20,785. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 41,570. PAYROLL PROCESSING: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 57,672. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 57,672. DOCUMENT DESTRUCTION: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 14,021. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 14,021. AFTER HOURS TELEPHONE ANSWERING SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 19,165. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 19,165. REMINDER CALLS - OUTSIDE SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 38,519. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 38,519. PATIENT SERVICES : PROGRAM SERVICE EXPENSES 100,124. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 100,124. CLEANING SERVICES : PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 234,340. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 234,340. ELIGIBILITY VERIFICATION SERVICES: PROGRAM SERVICE EXPENSES 17,702. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 17,702. LANDSCAPING: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 33,005. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 33,005. ELECTRONIC HALTH RECORDS/BILLING SERVICES - NEXTGEN: PROGRAM SERVICE EXPENSES 376,841. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 376,841. EXTERMINATING SERVICES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 10,046. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 10,046. LAUNDRY - PHYSICIAN UNIFORMS: PROGRAM SERVICE EXPENSES 9,723. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 9,723. POSTAGE: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 17,308. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 17,308. OTHER: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 368,218. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 368,218. SECURITY SERVICE: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 41,637. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 41,637. LAB SERVICES - DENTAL: PROGRAM SERVICE EXPENSES 88,726. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 88,726. OFF SITE STORAGES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 58,269. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 58,269. CREDENTIALING EXPENSES: PROGRAM SERVICE EXPENSES 21,321. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 21,321. PROFESSIONAL SERVICES - CONSULTANT: PROGRAM SERVICE EXPENSES 76,904. MANAGEMENT AND GENERAL EXPENSES 79,660. FUNDRAISING EXPENSES 59,400. TOTAL EXPENSES 215,964. PROFESSIONAL SERVICES - LAB MEDICAL: PROGRAM SERVICE EXPENSES 29,202. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 29,202. CHICAGO FAMILY HEALTH CENTER FOUNDATION 9119 SOUTH EXCHANGE AVE CHICAGO IL 60617 453732286 SUPPORTING ORGANIZATION FOR CFHC IL 501(C)(3) 509(A)(3) CFHC 1 CFHC TITLE HOLDING CORPORATION NFP 9119 SOUTH EXCHANGE AVE CHICAGO IL 60617 454956964 HOLDING CORPORATION FOR CFHC IL 501(C)(2) CFHC 1 0 0 0 0 0 0 0 0 0 0 1 1 0 1 1 1 1 0 0 CFHC TITLE HOLDING CORPORATION NFP K 115500 FMV CFHC TITLE HOLDING CORPORATION NFP Q 54 FMV CHICAGO FAMILY HEALTH CENTER FOUNDATION Q 138983 FMV CHICAGO FAMILY HEALTH CENTER FOUNDATION P 6035 FMV