2017-01-13T16:46:45-06:00 2016-01-31 454084437 Warren Averett LLC 3815 Interstate Ct Montgomery AL 36109 990 2015-02-01 630568762 Health Services Inc HEAL 3344205001 PO Drawer 70365 Montgomery AL 361070365 GILBERT F DARRINGTON Chief Executive Officer 3344205001 2017-01-10 1 Tatia W Knight CPA P00848736 3342712200 2017-01-10 2015 2021-01-29 14:40:06Z X GILBERT F DARRINGTON PO Drawer 70365 Montgomery AL 361070365 23601563 0 X WWW.HEALTHSERVICESINC.ORG X 1968 AL TO PROVIDE HEALTHCARE TO THE MEDICALLY UNDERSERVED 18 18 308 18 0 0 7351600 8398385 14679841 14999819 329941 129822 48078 71539 22409460 23599565 0 0 0 0 14539193 14803169 0 0 0 7059947 7685135 21599140 22488304 810320 1111261 19774059 20521092 3314795 3032011 16459264 17489081 Health Services, Inc. (HSI) is a medical home providing access to affordable primary, preventive and wellness services distinguished by compassion, quality, integrity and respect in Montgomery and surrounding areas. 0 0 16390741 15071358 HSI SERVED APPROXIMATELY 30,000 PATIENTS ACCOUNTING FOR APPROXIMATELY 117,000 VISITS DURING THE YEAR. THE VISITS COVERED A BROAD RANGE OF SERVICES INCLUDING GENERAL WELLNESS AND PRIMARY CARE, PEDIATRICS, DENTISTRY, OPTOMETRY, OB/GYN AND FAMILY PLANNING AND FAMILY CARE; COUNSELING AND PSYCHIATRY FOR VARIOUS TREATMENT AND DISORDERS IN CHILDREN AND ADULTS; MILITARY AND VETERAN RESOURCES, SPECIALTY REFERRALS, ENROLLMENT SERVICES AND THE WOMEN, INFANTS & CHILDREN (WIC) PROGRAM. 16390741 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 1 207 0 1 308 1 0 0 0 0 0 0 0 0 0 0 X 18 18 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X X SUSIE JONES 3344205001 PO DRAWER 70365 Montgomery AL 36107 CODY BUTTS dIRECTOR 1.00 0.00 X 0 0 0 JANICE DURR DIRECTOR 1.00 0.00 X 0 0 0 JAMES BROWN DIRECTOR 1.00 0.00 X 0 0 0 JOSIE KNOTT DIRECTOR 1.00 0.00 X 0 0 0 JUDY TAYLOR DIRECTOR 1.00 0.00 X 0 0 0 MOLLY STONE DIRECTOR 1.00 0.00 X 0 0 0 ELIZABETH CALDWELL DIRECTOR 1.00 0.00 X 0 0 0 DR WILLIAM ABERNATHY DIRECTOR 1.00 0.00 X 0 0 0 PAMELA STEWART DIRECTOR 1.00 0.00 X 0 0 0 NICOLETTE RUSSELL DIRECTOR 1.00 0.00 X 0 0 0 CLAUDE DOUGLAS VICE CHAIR 1.00 0.00 X X 0 0 0 CLASSIE THOMAS PAST CHAIR 1.00 0.00 X 0 0 0 CAROLE ASKEW DIRECTOR 1.00 0.00 X 0 0 0 ANITA ARCHIE DIRECTOR 1.00 0.00 X 0 0 0 SANDRA BERRY SECRETARY 1.00 0.00 X X 0 0 0 JAUNITA OWES CHAIR 1.00 0.00 X X 0 0 0 JESSIE BINION DIRECTOR 1.00 0.00 X 0 0 0 WILLIAM LOVE DIRECTOR 1.00 0.00 X 0 0 0 GEORGE WALDROP CFO 40.00 0.00 X 134174 0 0 BIANCA GRANGER COO 40.00 0.00 X 112716 0 0 GILBERT DARRINGTON CEO 40.00 0.00 X 36294 0 0 MAHMOOD ZAIED DOCTOR/CHIEF OF PEDIATRICS 57.70 0.00 X 288351 0 4241 GEORGE THOMAS CMO/DOCTOR 55.90 0.00 X 272478 0 4169 ABDULSATTAR ZIDAN DOCTOR 53.50 0.00 X 359820 0 1128 ALBERT HOLLOWAY CMO/DOCTOR 37.00 0.00 X 430961 0 3299 THEODORE SMITH JR DOCTOR/ASSISTANT MEDICAL DIRECTOR (INPATIENT) 40.00 0.00 X 302182 0 3833 CLIFFORD BERNELL MAPP FORMER CEO 40.00 0.00 X 264419 0 72517 2201395 0 89187 30 1 1 0 PRIORITY MANAGEMENT GROUP 700 SCHOOL STREET PAWTUCKET RI 02860 AR/BILLING CONTRACTOR 889177 LABORATORY CORPORATION OF AMERICA 3221 3RD AVENUE SOUTH BIRMINGHAM AL 35222 LAB CONTRACTOR 697124 ASPIRE STAFFING LLC 1113-C PERRY HILL ROAD MONTGOMERY AL 36109 STAFFING CONTRACTOR 534691 MONTGOMERY COUNTY HEALTH DEPARTMENT 3060 MOBILE HIGHWAY MONTGOMERY AL 36108 occupancy costs 289128 AMERISOURCEBERGEN-BIRMINGHAM PO BOX 905223 CHARLOTTE NC 28290 Pharmaceuticals 268859 20 20370 8365323 12692 8398385 MEDICARE/MEDICAID 524114 12323688 12323688 SELF PAY 900099 1085119 1085119 THIRD PARTY INSURANCE 524292 1009142 1009142 340 (b) PHARMACY PROGRAM 446110 272288 272288 GIFT OF LIFE 900099 193086 193086 116496 116496 14999819 130630 130630 1190 1998 -808 -808 -808 MISCELLANEOUS 900099 36730 36730 MEDICAL RECORDS 900099 34809 34809 71539 23599565 15071358 0 129822 X 2356745 1754142 602603 10733267 8257755 2475512 865359 656490 208869 847798 637701 210097 34467 34467 33969 33969 3374345 1795756 1578589 162520 64402 98118 54891 29206 25685 1579199 1214149 365050 176983 104768 72215 47738 29792 17946 88394 49828 38566 206022 206022 146567 22480 124087 SUPPLIES AND PHARMACEUT 1240120 1122170 117950 EQUIPMENT RENTAL 436474 403983 32491 DUES AND SUBSCRIPTIONS 57045 15060 41985 MISCELLANEOUS 46401 27037 19364 22488304 16390741 6097563 0 140117 599481 1183129 794414 586066 1355579 963493 1004018 66095 86825 450712 375693 5112581 2804523 2267837 2308058 101199 171784 750519 585862 13264892 13239378 19774059 20521092 1658341 1539079 1483039 1321148 44089 129326 171784 3314795 3032011 X 16452025 17474842 7239 14239 16459264 17489081 19774059 20521092 X 1111261 -81444 X 0 1 X 1 1 1 X 19872217 6899354 7108625 7351600 8398385 49630181 19872217 6899354 7108625 7351600 8398385 49630181 49630181 5045 3499 2795 329941 130630 471910 43318 41344 43700 48078 71539 247979 50350070 0.98570 0.98960 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 289944 289944 1709489 582107 1127382 362254 248284 113970 2452259 1772805 679454 298635 201327 97308 2308058 Due from Health Services Holding Company, Inc. 202485 note receivable - montgomery hsi investment fund, llc 13036893 13239378 DEFERRED COMPENSATION 171784 171784 X Part X, Line 2: The Organization is exempt from income taxes under Section 501(c)(3) of the Internal Revenue Code (IRC) and similar provisions of Alabama law and is classified by the Internal Revenue Service as an organization other than a private foundation. As of and for the year ended January 31, 2016, the Organization had no uncertain tax positions that qualify for recognition or disclosure in the financial statements and no interest and penalties related to income taxes. X X 1 0 0 0 0 0 0 1 0 MAHMOOD ZAIED DOCTOR/CHIEF OF PEDIATRICS 280101 0 8250 0 0 0 0 0 4241 0 292592 0 0 0 GEORGE THOMAS CMO/DOCTOR 263478 0 9000 0 0 0 0 0 4169 0 276647 0 0 0 ABDULSATTAR ZIDAN DOCTOR 250657 0 109163 0 0 0 0 0 1128 0 360948 0 0 0 ALBERT HOLLOWAY CMO/DOCTOR 227125 0 203836 0 0 0 0 0 3299 0 434260 0 0 0 THEODORE SMITH JR DOCTOR/ASSISTANT MEDICAL DIRECTOR (I 219684 0 82498 0 0 0 0 0 3833 0 306015 0 0 0 CLIFFORD BERNELL MAPP FORMER CEO 264419 0 0 0 0 0 70585 0 1932 0 336936 0 0 0 Part I, Line 3 CEO has a written contract that was approved by the board. Part I, Line 7 EMPLOYED PROVIDERS (MEDICAL DOCTORS, PHYSICIAN ASSISTANTS, AND NURSE PRACTITIONERS) RECEIVED INCENTIVES BASED UPON TOTAL ENCOUNTERS. Adolescent & Pediatircs CMO/Doctor of Health Services, Inc. was a former CMO with interested person 106365 rent payments 0 Form 990, Page 1, B The return was amended and affected various lines - total revenues decreased by $108,405, total expenses decreased by $153,911, revenues less expenses decreased by $80,240, total assets decreased by $244,071, total liabilities decreased by $148,133, and total net assets decreased by $95,938. Total program service expenses increased by $967,374 while management and general expenses decreased by $1,121,285. Form 990, Part VI, Section B, line 11 The Controller, CFO, and CEO review support documents and tax return. Form 990, Part VI, Section B, line 12c It is monitored by the corporate compliance officer. Form 990, Part VI, Section B, line 15 The board of directors utilize an independent national legal firm of the organization's association to determine appropriate CEO compensation. Other key employee compensation is determined by using published materials and local comparability data. Form 990, Part VI, Section C, line 19 Governing documents are made available to the public upon request. Form 990, Part IX, line 11g Contractual costs: Program service expenses 1,795,756. Management and general expenses 1,578,589. Fundraising expenses 0. Total expenses 3,374,345. Form 990, Part XI, line 9: impairment of goodwill -81,444. ALABAMA HEALTCARE CONSORTIUM LLC 2731 ML KING JR BLVD TUSCALOOSA AL 35401 201031600 TECHNOLOGICAL GRANTS AL 501(C)3 Line 7 0 HEALTH SERVICES HOLDING CO INC 1845 CHERRY STREET mONTGOMERY AL 36106 460790158 PROMOTE HEALTH SERVICES INC AL 501(C)2 HEALTH SERVICES INC 0 0 0 0 1 0 0 0 0 0 0 1 0 0 0 1 0 1 0 0 health services holding company inc K 307626 cash