COMMUNITY HEALTH CENTER ASSOCIATION OF CONNECTICUT INC: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- COMMUNITY HEALTH CENTER ASSOCIATION OF CONNECTICUT INC (EIN 22-3036666)
- Tax period
- 2015-07-01 to 2016-06-30
- Filed
- 2017-05-12
- IRS object ID
- 201711329349305911
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule J
- Schedule L
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-05-12T15:11:57-05:00 | ReturnTs |
| Tax Period End | 2016-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 061354191 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | VISCONTI & ASSOCIATES PC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 444 FOXON ROAD FL RD | AddressLine1Txt |
| City | EAST HAVEN | CityNm |
| State Abbreviation | CT | StateAbbreviationCd |
| ZIP | 065132037 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 223036666 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY HEALTH CENTER ASSOCIATION OF | BusinessNameLine1Txt |
| Business Name Line2 | CONNECTICUT INC | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | COMM | BusinessNameControlTxt |
| Phone | 8606677820 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1484 HIGHLAND AVE NO 2 | AddressLine1Txt |
| City | CHESHIRE | CityNm |
| State Abbreviation | CT | StateAbbreviationCd |
| ZIP | 06410 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | EVELYN BARNUM | PersonNm |
| Person Title | CHIEF EXECUTIVE OFFICER | PersonTitleTxt |
| Phone | 8606677820 | PhoneNum |
| Signature | 2017-05-12 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JOHN J VISCONTI | PreparerPersonNm |
| PTIN | P00027180 | PTIN |
| Phone | 2038652927 | PhoneNum |
| Preparation | 2017-05-12 | 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 | EVELYN BARNUM | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1484 HIGHLAND AVE | AddressLine1Txt |
| City | CHESHIRE | CityNm |
| State Abbreviation | CT | StateAbbreviationCd |
| ZIP | 06410 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $8,139,303 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.CHCACT.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1989 | FormationYr |
| Legal Domicile State | CT | LegalDomicileStateCd |
| Activity Or Mission | PROMOTING QUALITY HEALTH CARE AND SOCIAL SERVICES TO CONNECTICUT'S UNDERSERVED POPULATIONS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 16 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 16 | VotingMembersIndependentCnt |
| Total Employee | 58 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $5,446,823 | PYContributionsGrantsAmt |
| CY Contributions Grants | $8,135,801 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| PY Investment Income | $2,865 | PYInvestmentIncomeAmt |
| CY Investment Income | $702 | CYInvestmentIncomeAmt |
| PY Other Revenue | $2,916 | PYOtherRevenueAmt |
| CY Other Revenue | $2,800 | CYOtherRevenueAmt |
| PY Total Revenue | $5,452,604 | PYTotalRevenueAmt |
| CY Total Revenue | $8,139,303 | 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 | $1,615,759 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $2,155,889 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $3,809,309 | PYOtherExpensesAmt |
| CY Other Expenses | $5,930,172 | CYOtherExpensesAmt |
| PY Total Expenses | $5,425,068 | PYTotalExpensesAmt |
| CY Total Expenses | $8,086,061 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $27,536 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $53,242 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $3,021,681 | TotalAssetsBOYAmt |
| Total Assets EOY | $3,733,333 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,034,843 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $2,693,253 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $986,838 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $1,040,080 | NetAssetsOrFundBalancesEOYAmt |
| Mission | PROVIDED TECHNICAL AND EDUCATIONAL ASSISTANCE TO COMMUNITY HEALTH CENTERS IN CONNECTICUT. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $7,160,693 | ExpenseAmt |
| Desc | PROVIDED TECHNICAL AND EDUCATIONAL ASSISTANCE TO COMMUNITY HEALTH CENTERS IN CONNECTICUT. | Desc |
| Total Program Service Expenses | $7,160,693 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | 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 | Yes (1) | 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 | Yes (1) | 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 | Yes (1) | 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 | 38 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 58 | 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 | 16 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 16 | 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 | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | 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 | CT | StatesWhereCopyOfReturnIsFldCd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DEBORAH AMODIO-GROSS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8606677820 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1484 HIGHLAND AVE SUITE 2 | AddressLine1Txt |
| City | CHESHIRE | CityNm |
| State Abbreviation | CT | StateAbbreviationCd |
| ZIP | 06410 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd |
|---|---|---|---|---|---|---|
| EUGENE MARKET | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| ARVIND SHAW | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| LUDWIG SPINELLI | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| DONALD THOMPSON | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| KATHERINE YACAVONE | ||||||
| SECRETARY | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| CRAIG GLOVER | ||||||
| TREASURER | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| JENNIFER E GRANGER | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| JAMES H MALONEY | ||||||
| BOARD CHAIR | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| MICHAEL TAYLOR | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| SUZANNE LAGARDE MD | ||||||
| BOARD VICE CHAIR | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) |
| GREGORY STANTON | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| JOANNE BORDUAS | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| DR DOUGLAS BRUCE | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| NICHELLE MULLINS | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| SUSAN WALKAMA | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| KIMBERLY BEAUREGARD | ||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |
| EVELYN A BARNUM | ||||||
| CHIEF EXECUTIVE OFFICER | 37.50 | $203,126 | $0 | $47,197 | Yes (X) | |
| MOLLIE MELBOURNE | ||||||
| CHIEF OPERATING OFFICER | 37.50 | $134,658 | $0 | $37,779 | Yes (X) | |
| PHILIP RENDA | ||||||
| CHIEF INFORMATAION OFFICER | 37.50 | $134,806 | $0 | $7,647 | Yes (X) | |
| JEFFREY HUGHES | ||||||
| CHIEF FINANCIAL OFFICER | 37.50 | $45,064 | $0 | $11,162 | Yes (X) | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $517,654 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $103,785 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 3 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Membership Dues | $187,500 | MembershipDuesAmt |
| Government Grants | $7,584,350 | GovernmentGrantsAmt |
| All Other Contributions | $363,951 | AllOtherContributionsAmt |
| Noncash Contributions | $6,000 | NoncashContributionsAmt |
| Total Contributions | $8,135,801 | TotalContributionsAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $702 | TotalRevenueColumnAmt |
| Exclusion | $702 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OTHER | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $2,800 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $2,800 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $2,800 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $8,139,303 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $2,800 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $702 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $776,878 | TotalAmt |
| Program Services | $561,800 | ProgramServicesAmt |
| Management And General | $215,078 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $977,282 | TotalAmt |
| Program Services | $843,458 | ProgramServicesAmt |
| Management And General | $133,824 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $401,729 | TotalAmt |
| Program Services | $315,649 | ProgramServicesAmt |
| Management And General | $86,080 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,871 | TotalAmt |
| Program Services | $1,428 | ProgramServicesAmt |
| Management And General | $2,443 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $107,132 | TotalAmt |
| Program Services | $33,139 | ProgramServicesAmt |
| Management And General | $73,993 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $91,747 | TotalAmt |
| Program Services | $68,830 | ProgramServicesAmt |
| Management And General | $22,917 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $63,033 | TotalAmt |
| Program Services | $40,629 | ProgramServicesAmt |
| Management And General | $22,404 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,180 | TotalAmt |
| Program Services | $3,485 | ProgramServicesAmt |
| Management And General | $14,695 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| CONTRACTUAL AGREEMENTS | $4,163,263 | $4,163,263 | |
| CONSULTANT AND PROFESSI | $1,033,000 | $751,972 | $281,028 |
| CONSUMABLE SUPPLIES | $288,444 | $246,550 | $41,894 |
| TELEPHONE | $46,985 | $46,943 | $42 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $114,517 | TotalAmt |
| Program Services | $83,547 | ProgramServicesAmt |
| Management And General | $30,970 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,086,061 | TotalAmt |
| Program Services | $7,160,693 | ProgramServicesAmt |
| Management And General | $925,368 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,144,754 | BOYAmt |
| EOY | $800,539 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $359,130 | BOYAmt |
| EOY | $253,572 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $746,615 | BOYAmt |
| EOY | $1,458,325 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,463 | BOYAmt |
| EOY | $2,953 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $38,876 | BOYAmt |
| EOY | $37,619 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $1,346,774 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $194,934 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $684,612 | BOYAmt |
| EOY | $1,151,840 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $31,231 | BOYAmt |
| EOY | $28,485 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,021,681 | BOYAmt |
| EOY | $3,733,333 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $915,400 | BOYAmt |
| EOY | $1,737,170 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $395,091 | BOYAmt |
| EOY | $193,515 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $724,352 | BOYAmt |
| EOY | $762,568 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,034,843 | BOYAmt |
| EOY | $2,693,253 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $986,838 | BOYAmt |
| EOY | $1,040,080 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $986,838 | BOYAmt |
| EOY | $1,040,080 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,021,681 | BOYAmt |
| EOY | $3,733,333 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $53,242 | 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) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,922,039 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,345,214 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $4,962,778 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $5,210,817 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $7,852,043 | CurrentTaxYearAmt |
| Total | $26,292,891 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $3,922,039 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,345,214 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $4,962,778 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $5,210,817 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $7,852,043 | CurrentTaxYearAmt |
| Total | $26,292,891 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $26,292,891 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,319 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,603 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,121 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,866 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $702 | CurrentTaxYearAmt |
| Total | $9,611 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $147,147 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $233,273 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $176,182 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $238,921 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $280,558 | CurrentTaxYearAmt |
| Total | $1,076,081 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $27,378,583 | TotalSupportAmt |
| Public Support CY170 | 0.96030 | PublicSupportCY170Pct |
| Public Support PY170 | 0.96190 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: | FormAndLineReferenceDesc |
| Explanation | CONTRACTED SERVICES REVENUE - 2011 AMOUNT: $ 147,147. 2012 AMOUNT: $ 233,273. 2013 AMOUNT: $ 176,182. 2014 AMOUNT: $ 238,921. 2015 AMOUNT: $ 280,558. | ExplanationTxt |
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) |
|---|---|---|
| Political Expenditures | $69,784 | PoliticalExpendituresAmt |
Total Direct Lobbying TotalDirectLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Total | $69,784 | FilingOrganizationsTotalAmt |
Total Lobbying Expend TotalLobbyingExpendGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Total | $69,784 | FilingOrganizationsTotalAmt |
Other Exempt Purpose Expend OtherExemptPurposeExpendGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Total | $8,016,277 | FilingOrganizationsTotalAmt |
Total Exempt Purpose Expend TotalExemptPurposeExpendGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Total | $8,086,061 | FilingOrganizationsTotalAmt |
Lobbying Nontaxable Amount LobbyingNontaxableAmountGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Total | $554,303 | FilingOrganizationsTotalAmt |
Grassroots Nontaxable GrassrootsNontaxableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Total | $138,576 | FilingOrganizationsTotalAmt |
Tot Lbbyng Grassroot Mns Non Tx TotLbbyngGrassrootMnsNonTxGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Total | $0 | FilingOrganizationsTotalAmt |
Tot Lbby Expend Mns Lbbyng Non Tx TotLbbyExpendMnsLbbyngNonTxGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Total | $0 | FilingOrganizationsTotalAmt |
Avg Lobbying Nontaxable Amount AvgLobbyingNontaxableAmountGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year Minus2 | $404,504 | CurrentYearMinus2Amt |
| Current Year Minus1 | $421,253 | CurrentYearMinus1Amt |
| Current Year | $554,303 | CurrentYearAmt |
| Total | $1,380,060 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Lobbying Ceiling | $2,070,090 | LobbyingCeilingAmt |
Avg Total Lobbying Expend AvgTotalLobbyingExpendGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year Minus2 | $56,147 | CurrentYearMinus2Amt |
| Current Year Minus1 | $53,042 | CurrentYearMinus1Amt |
| Current Year | $69,784 | CurrentYearAmt |
| Total | $178,973 | TotalAmt |
Avg Grassroots Nontaxable AvgGrassrootsNontaxableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Year Minus2 | $101,126 | CurrentYearMinus2Amt |
| Current Year Minus1 | $105,313 | CurrentYearMinus1Amt |
| Current Year | $138,576 | CurrentYearAmt |
| Total | $345,015 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grassroots Ceiling | $517,523 | GrassrootsCeilingAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II A- LINE 1 | FormAndLineReferenceDesc |
| Explanation | $65,038 WAS PAID TO A QUALIFIED CONSULTING FIRM FOR LOBBYING AND GOVERNMENTAL RELATIONS SERVICES RELATED TO THE MONITORING OF LEGISLATION THAT AFFECTS PRIMARY HEALTH CARE. THE REMAINING $4,746 REPRESENTS AN ALLOCATION OF STAFF WAGES FOR TIME SPENT ON SIMILAR ACTIVITIES | ExplanationTxt |
Schedule D IRS990ScheduleD
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $1,059,150 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $26,817 | DepreciationAmt |
| Book Value | $1,032,333 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $11,776 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $11,776 | DepreciationAmt |
| Book Value | $0 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $248,349 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $128,842 | DepreciationAmt |
| Book Value | $119,507 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $27,499 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $27,499 | DepreciationAmt |
| Book Value | $0 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,151,840 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $8,139,303 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $8,139,303 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $8,139,303 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $8,086,061 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $8,086,061 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $8,086,061 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | MANAGEMENT IS NOT AWARE OF ANY UNCERTAIN TAX POSITIONS TAKEN BY CHCACT. THE TAX YEARS ENDED JUNE 30, 2013 THROUGH JUNE 30, 2016 REMAIN SUBJECT TO EXAMINATION BY MAJOR TAX JURISDICTIONS, | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Idemnification Gross Up Pmts | Yes (X) | IdemnificationGrossUpPmtsInd |
| Written Policy Ref T And E Expnss | Yes (1) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | 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 (2 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| EVELYN A BARNUM | ||||||||||||||
| CHIEF EXECUTIVE OFFICER | $203,126 | $0 | $0 | $0 | $0 | $0 | $11,390 | $0 | $35,807 | $0 | $250,323 | $0 | $0 | $0 |
| MOLLIE MELBOURNE | ||||||||||||||
| CHIEF OPERATING OFFICER | $134,658 | $0 | $0 | $0 | $0 | $0 | $5,043 | $0 | $32,736 | $0 | $172,437 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 1A | FormAndLineReferenceDesc |
| Explanation | WRITTEN POLICY REGARDING TAX INDEMNIFICATION ADHERED TO BY MANAGEMENT. | ExplanationTxt |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | EVELYN BARNUM CEO | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | CEO IS ON THE BOARD OF CHN. CHCACT HAS NO CONTROL OR INTEREST IN CHN. | RelationshipDescriptionTxt |
| Transaction | NONE OF SIGNIFICANCE. | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | FIFTEEN MEMBERS OF THE ORGANIZATION ARE FEDERALLY QUALIFIED HEALTH CENTERS AND ONE MEMBER HAS FEDERALLY QUALIFIED LOOK A LIKE STATUS. ALL MEMBERS ARE LOCATED IN CONNECTICUT |
| FORM 990, PART VI, SECTION A, LINE 7A | THE CHIEF EXECUTIVE OFFICER OF EACH OF ITS MEMBER HEALTH CENTERS IS A BOARD MEMBER OF CHCACT. |
| FORM 990, PART VI, SECTION B, LINE 11 | THE 990 RETURN IS REVIEWED BY MANAGEMENT AND THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE CHIEF FINANCIAL OFFICER IS RESPONSIBLE FOR MONITORING AND ENFORCING COMPLIANCE WITH THE POLICY AND UPDATING RELATED DOCUMENTATION. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS PREPARES A WRITTEN REVIEW OF THE CEO'S PERFORMANCE EACH YEAR. THE COMMITTEE THEN USES THAT PERFORMANCE REVIEW, THE AGENCY'S ESTABLISHED RANGES FOR THAT PAY GRADE LEVEL, AND AVAILABLE SALARY SURVEY RESOURCES TO DETERMINE HER COMPENSATION. THE CEO SIMILARLY DETERMINES THE COMPENSATION OF THE CFO, CIO & COO BASED ON AN ANNUAL WRITTEN PERFORMANCE REVIEW & THE ESTABLISHED AGENCY PAY GRADE RANGES. |
| FORM 990, PART VI, SECTION C, LINE 19 | DOCUMENTS ARE AVAILABLE UPON REQUEST WITH THE APPROVAL OF THE CHIEF EXECUTIVE OFFICER. |
| FORM 990, PART VII | EUGENE MARKET - 94 CONNECTICUT BOULEVARD, EAST HARTFORD, CT 06108. ARVIND SHAW - 40 MANSFIELD AVENEUE, WILLIMANTIC, CT 06226. LUDWIG SPINELLI - 471 BARNUM AVENUE, BRIDGEPORT, CT 06608. DONALD THOMPSON - 80 PHOENIX AVENUE, WATERBURY, CT 06702. KATHERINE YACAVONE - 46 ALBION STREET, BRIDGEPORT, CT 06605. CRAIG GLOVER - 120 CONNECTICUT AVENUE, NORWALK, CT 06854. JENNIFER E GRANGER - 34 EAST TOWN ST., NORWICH, CT 06360. JAMES H. MALONEY - 120 MAIN STREET, 4TH FLOOR, DANBURY, CT 06810. MICHAEL TAYLOR - 400-428 COLUMBUS AVENUE, NEW HAVEN, CT 06519. SUZANNE LAGARDE, MD - 374 GRAND AVENUE, NEW HAVEN, CT 06513. GREGORY STANTON - 500 ALBANY AVENUE, HARTFORD, CT 06120. JOANNE BORDUAS - 459 MIGEON AVENUE, TORRINGTON, CT 06790. DR. DOUGLAS BRUCE - 400-428 COLUMBUS AVENUE, NEW HAVEN, CT 06519. NICHELLE MULLINS - 21 GRAND STREET, HARTFORD, CT 06106. SUSAN WALKAMA - 10 NORTH MAIN STREET, BRISTOL, CT 06010. KIMBERLY BEAUREGARD - 281 MAIN STREET, EAST HARTFORD, CT 06108. |
| FORM 990, PART XII, LINE 2C: | THE FINANCE/AUDIT COMMITTEE REVIEWS AND APPROVES THE AUDITED FINANCIAL STATEMENTS AND RECOMMENDS ACCEPTAANCE TO THE FULL BOARD. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY HEALTH NETWORK OF CT | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 11 FAIRFIELD BOULEVARD | AddressLine1Txt |
| City | WALLINGFORD | CityNm |
| State Abbreviation | CT | StateAbbreviationCd |
| ZIP | 06492 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 061429341 | EIN |
| Primary Activities | ADMINISTRATIVE SERVICES ORGANIZATION FOR MEDICAID POPULATION OF CT. | PrimaryActivitiesTxt |
| Legal Domicile State | CT | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(4) | ExemptCodeSectionTxt |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Controlled Organization | 0 | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| COMMUNITY HEALTH NETWORK OF CT | ||
| C | $15,000 | FAIR MARKET VALUE |
| COMMUNITY HEALTH NETWORK OF CT | ||
| N | $6,000 | FAIR MARKET VALUE |