OAK ORCHARD COMMUNITY INC: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- OAK ORCHARD COMMUNITY INC (EIN 16-1020913)
- Tax period
- 2016-01-01 to 2016-12-31
- Filed
- 2017-05-23
- IRS object ID
- 201701439349300710
- Schema version
- 2016v3.0
- 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 | 2017-05-23T09:21:25-05:00 | ReturnTs |
| Tax Period End | 2016-12-31 | 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 | 2016-01-01 | 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 | 2017-05-22 | 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 |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 4.14.157.194 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2017-05-22 | IPDt |
| IP Tm | 10:18:33 | IPTm |
| IP Timezone | ED | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | F810F9FE0C4C4DAD171A8C8E72DF89C05E51BF9A | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 98BDDCC52433D8D851CADA15A4F2C730E12DEB4D | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | 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 | $15,334,451 | 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 | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 225 | TotalEmployeeCnt |
| Total Volunteers | 11 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $4,119,512 | PYContributionsGrantsAmt |
| CY Contributions Grants | $4,933,886 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $9,320,765 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $10,088,258 | CYProgramServiceRevenueAmt |
| PY Investment Income | $394 | PYInvestmentIncomeAmt |
| CY Investment Income | -$10,842 | CYInvestmentIncomeAmt |
| PY Other Revenue | $131,006 | PYOtherRevenueAmt |
| CY Other Revenue | $13,930 | CYOtherRevenueAmt |
| PY Total Revenue | $13,571,677 | PYTotalRevenueAmt |
| CY Total Revenue | $15,025,232 | 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 | $8,191,297 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $9,901,219 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $3,610,299 | PYOtherExpensesAmt |
| CY Other Expenses | $4,637,597 | CYOtherExpensesAmt |
| PY Total Expenses | $11,801,596 | PYTotalExpensesAmt |
| CY Total Expenses | $14,538,816 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,770,081 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $486,416 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $9,772,773 | TotalAssetsBOYAmt |
| Total Assets EOY | $10,319,727 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,704,489 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $2,765,027 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $7,068,284 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $7,554,700 | 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 | $6,654,686 | ExpenseAmt |
| Revenue | $6,844,854 | 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 | $2,692,616 | ExpenseAmt |
| Revenue | $2,535,148 | RevenueAmt |
| Desc | REGIONAL DENTAL SERVICES OFFERED TO MIGRANT FARM WORKERS AND THE GENERAL PUBLIC. APPROXIMATELY 7,000 INDIVIDUALS SERVED. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $631,465 | ExpenseAmt |
| Revenue | $722,186 | 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 | $1,666,108 | ExpenseAmt |
| Desc | OTHER SERVICES OFFERED TO MIGRANT FARM WORKERS AND THE GENERAL PUBLIC. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $1,666,108 | TotalOtherProgSrvcExpenseAmt |
| Total Program Service Expenses | $11,644,875 | 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 | 29 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 225 | 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 |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | 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 (19 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 | ||||||||
| VICE CHAIR | 3.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| JEFFREY PARTYKA | ||||||||
| SECRETARY | 1.00 | Yes (X) | 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 | ||||||||
| BOARD MEMBER | 3.00 | Yes (X) | $0 | $0 | $0 | |||
| EVELYN STELMACH | ||||||||
| BOARD MEMBER | 1.00 | 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) | $135,289 | $0 | $5,924 | ||
| CAROL A WHITE | ||||||||
| CFO | 40.00 | Yes (X) | $98,376 | $0 | $5,924 | |||
| NANCY CIAVARRI MD | ||||||||
| CHIEF MEDICAL OFFICER | 35.00 | $179,333 | $0 | $5,924 | Yes (X) | |||
| JAMES GOETZ MD | ||||||||
| PEDIATRICIAN | 20.00 | $157,340 | $0 | $5,924 | Yes (X) | |||
| ROBERT WHELPLAY | ||||||||
| PHYSICIAN | 40.00 | $170,320 | $0 | $5,924 | Yes (X) | |||
| DANIELLE RENODIN-MEAD | ||||||||
| PEDIATRICIAN | 32.00 | $161,021 | $0 | $0 | Yes (X) | |||
| KENYA MCINTOSH | ||||||||
| PHYSICIAN | 40.00 | $164,888 | $0 | $0 | Yes (X) | |||
| RANIA KARAM-BAYOUMI | ||||||||
| PHYSICIAN | 40.00 | $165,763 | $0 | $5,924 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,232,330 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $35,544 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 19 | 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 | $185,900 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $4,418,576 | GovernmentGrantsAmt |
| All Other Contributions | $515,310 | AllOtherContributionsAmt |
| Total Contributions | $4,933,886 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| OTHER THIRD PARTY PAYORS | 621400 | $6,935,467 | $6,935,467 |
| MEDICARE/MEDICAID PMTS | 621400 | $3,152,791 | $3,152,791 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $10,088,258 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $359 | TotalRevenueColumnAmt |
| Exclusion | $359 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $298,018 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $309,219 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$11,201 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$11,201 | TotalRevenueColumnAmt |
| Exclusion | -$11,201 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $13,930 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $13,930 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $13,930 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $15,025,232 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $10,102,188 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$10,842 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $430,770 | TotalAmt |
| Program Services | $111,154 | ProgramServicesAmt |
| Management And General | $319,616 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,019,585 | TotalAmt |
| Program Services | $6,577,888 | ProgramServicesAmt |
| Management And General | $1,441,697 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $768,488 | TotalAmt |
| Program Services | $548,842 | ProgramServicesAmt |
| Management And General | $219,646 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $682,376 | TotalAmt |
| Program Services | $540,437 | ProgramServicesAmt |
| Management And General | $141,939 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,367 | TotalAmt |
| Management And General | $21,367 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $58,531 | TotalAmt |
| Management And General | $58,531 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $874,639 | TotalAmt |
| Program Services | $685,180 | ProgramServicesAmt |
| Management And General | $189,459 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $127,553 | TotalAmt |
| Program Services | $62,295 | ProgramServicesAmt |
| Management And General | $65,258 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $281,924 | TotalAmt |
| Program Services | $226,352 | ProgramServicesAmt |
| Management And General | $55,572 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $383,556 | TotalAmt |
| Program Services | $338,536 | ProgramServicesAmt |
| Management And General | $45,020 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $109,636 | TotalAmt |
| Program Services | $58,523 | ProgramServicesAmt |
| Management And General | $51,113 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $68,963 | TotalAmt |
| Program Services | $60,328 | ProgramServicesAmt |
| Management And General | $8,635 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $398,339 | TotalAmt |
| Program Services | $327,340 | ProgramServicesAmt |
| Management And General | $70,999 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $40,967 | TotalAmt |
| Program Services | $30,357 | ProgramServicesAmt |
| Management And General | $10,610 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| PATIENT CARE SUPPLIES | $954,709 | $954,709 | |
| PHARMACEUTICALS | $560,445 | $560,445 | |
| OTHER EXPENSES | $408,077 | $213,598 | $194,479 |
| BAD DEBT EXPENSE | $348,891 | $348,891 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,538,816 | TotalAmt |
| Program Services | $11,644,875 | ProgramServicesAmt |
| Management And General | $2,893,941 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,672,689 | BOYAmt |
| EOY | $3,254,505 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $355,774 | BOYAmt |
| EOY | $99,263 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $487,583 | BOYAmt |
| EOY | $188,871 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,031,791 | BOYAmt |
| EOY | $1,323,839 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $10,230,894 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $4,853,371 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,074,549 | BOYAmt |
| EOY | $5,377,523 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $150,387 | BOYAmt |
| EOY | $75,726 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,772,773 | BOYAmt |
| EOY | $10,319,727 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $900,577 | BOYAmt |
| EOY | $1,114,694 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,911 | BOYAmt |
| EOY | $54,058 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,762,585 | BOYAmt |
| EOY | $1,577,176 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,416 | BOYAmt |
| EOY | $19,099 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,704,489 | BOYAmt |
| EOY | $2,765,027 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,068,284 | BOYAmt |
| EOY | $7,554,700 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,068,284 | BOYAmt |
| EOY | $7,554,700 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,772,773 | BOYAmt |
| EOY | $10,319,727 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $486,416 | 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 | $616,997 | OtherCostOrOtherBasisAmt |
| Book Value | $616,997 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,004,435 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,850,470 | DepreciationAmt |
| Book Value | $4,153,965 | 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 | $2,514,413 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,907,852 | DepreciationAmt |
| Book Value | $606,561 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $5,377,523 | TotalBookValueLandBuildingsAmt |
| Total Rev Etc Audited Fincl Stmt | $14,676,341 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | -$348,891 | OtherRevenueAmt |
| Revenue Not Reported | -$348,891 | RevenueNotReportedAmt |
| Revenue Subtotal | $15,025,232 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $15,025,232 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $14,189,925 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $14,189,925 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $348,891 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $348,891 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $14,538,816 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | PROVISION FOR DOUBTFUL ACCOUNTS -348,891. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | PROVISION FOR DOUBTFUL ACCOUNTS 348,891. |
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 | $179,333 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $5,924 | $0 | $185,257 | $0 | $0 | $0 |
| JAMES GOETZ MD | ||||||||||||||
| PEDIATRICIAN | $157,340 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $5,924 | $0 | $163,264 | $0 | $0 | $0 |
| ROBERT WHELPLAY | ||||||||||||||
| PHYSICIAN | $170,320 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $5,924 | $0 | $176,244 | $0 | $0 | $0 |
| DANIELLE RENODIN-MEAD | ||||||||||||||
| PEDIATRICIAN | $161,021 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $161,021 | $0 | $0 | $0 |
| KENYA MCINTOSH | ||||||||||||||
| PHYSICIAN | $164,888 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $164,888 | $0 | $0 | $0 |
| RANIA KARAM-BAYOUMI | ||||||||||||||
| PHYSICIAN | $165,763 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $5,924 | $0 | $171,687 | $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. |