2016-05-09T09:00:18-05:00 2015-09-30 350921680 CROWE HORWATH LLP 330 E Jefferson Blvd PO Box 7 South Bend IN 466240007 990 2014-10-01 351875364 Heart City Health Center Inc HEAR 5742930052 236 Simpson Avenue Elkhart IN 46516 Dr Omobola Olaniyan Interim CEO 2016-05-06 true Erica Cherry P01320580 5742323992 2014 2016-08-17 19:52:53Z Vernita Todd 236 Simpson Avenue Elkhart IN 46516 11456556 false X www.heartcityhealth.org X 1993 IN Heart City Health Center, Inc. is a federally qualified health center (FQHC) providing comprehensive primary healthcare and education for the Elkhart Community. 10 10 155 14 -34733 -34733 2274992 2823114 4449681 5385650 28658 54032 -66639 117732 6686692 8380528 0 100000 0 0 4160534 5378058 0 0 0 1751569 1867913 5912103 7345971 774589 1034557 8436475 9635191 610383 892152 7826092 8743039 Heart City Health Center, Inc. (Heart City) is a non-profit, Federally Qualified Health Center (FQHC) providing affordable, high quality, primary health and dental care to Elkhart County residents. (Continued in Schedule O) false false 5399448 100000 5098490 HEART CITY HEALTH CENTER, INC. (HEART CITY) PROVIDES PRIMARY HEALTHCARE IN THE AREA OF ADULTS AND PEDIATRICS TO THE PRIMARILY MEDICARE, MEDICAID, AND UNINSURED POPULATION OF ELKHART COUNTY. DURING THE YEAR ENDED SEPTEMBER 30, 2015, HEART CITY PROVIDED 38,442 PATIENT VISITS TO 12,943 UNDUPLICATED PATIENTS. (CONTINUED IN SCHEDULE O) 402667 431326 HEART CITY HEALTH CENTER, INC.'S (HEART CITY) LICENSED DENTISTS AND HYGIENISTS PROVIDE A LOW-COST OPTION FOR QUALITY GENERAL DENTISTRY SERVICES TO PEOPLE OF ALL AGES, INCOMES AND BACKGROUNDS, BUT PRIMARILY SERVES MEDICAID AND UNINSURED PATIENTS. DURING THE YEAR ENDED SEPTEMBER 30, 2015, HEART CITY SERVED 1,660 UNDUPLICATED PATIENTS IN 3,756 VISITS. VARIOUS DENTAL SERVICES PROVIDED INCLUDE: EXAMINATIONS; TREATMENT PLANNING; CHILDREN'S DENTISTRY; CLEANING/DENTAL HYGIENE; EXTRACTIONS; FILLINGS; RADIOGRAPHS; AND PATIENT EDUCATION. 5802115 true true false false false false false false false false true false false false true true true false false false false false false false false false false false true true false false false false false false false false true false false false false false false false false true 12 0 true 155 true true true false false false false false false false false false X 10 10 false false false false false false false true true false false true true true true true true true false false IN X Patricia Klinger 5749701448 236 SIMPSON AVENUE ELKHART IN 46516 R Sue Ickes Chair 1.00 X X 0 0 0 Rod Roberson Vice President 1.00 X X 0 0 0 Ileana Martin Secretary 1.00 X X 0 0 0 Tammy Friesen Treasurer 1.00 X X 0 0 0 Teddy Brown Board Member 1.00 X 0 0 0 Nicole Williams-Goodwin Board Member 1.00 X 0 0 0 Dr Anthereca Lane MD Board Member 1.00 X 0 0 0 Anthony Hunt Board Member 1.00 X 0 0 0 Phillip Hill Board Member 1.00 X 0 0 0 Delia Vazquez Board Member 1.00 X 0 0 0 Bruce Beyler Board Member - Partial Year 1.00 X 0 0 0 Alvero Marquez Board Member - Partial Year 1.00 X 0 0 0 Dr Omobola Olaniyan CMO 40.00 X 203101 0 11941 Vernita L Todd CEO 40.00 X 155580 0 18138 Diana Nita Partial Year - CFO 40.00 X 78966 0 2199 Dr Erin Farrell Pediatrician 40.00 X 146126 0 10082 Dr Christine Dankwa Pediatrician 40.00 X 128553 0 11654 Dr Meenakshi Gupta Pediatrician 40.00 X 144025 0 3962 Dr Dwight Carson Physician 40.00 X 137024 0 5925 Dr James Jackson Physician 40.00 X 127176 0 5475 1120551 0 69376 7 false true false MAJORITY BUILDERS INC 62900 US31 SOUTH SOUTH BEND IN 46614 LEASEHOLD IMPROVEMENT 425520 STAFF CARE INC PO Box 281923 Atlanta GA 303841923 LOCUM TENENS COVERAGE 211795 ELKHART GENERAL HOSPITAL PO BOX 1329 ELKHART IN 46515 PHARMACIST CHARGES 168156 BARNES & THORNBURG LLP 121 WEST FRANKLIN STREET SUITE 200 ELKHART IN 465163200 LEGAL FEES 114545 4 25000 0 0 0 2667235 130879 101386 2823114 Medical services 624100 4965286 4965286 Dental services 624100 420364 420364 0 0 0 0 5385650 37765 37765 0 0 2073984 2057717 16267 0 16267 16267 1127744 1018311 109433 144166 -34733 Vending income 900099 1358 1358 Medical records 900099 5537 5537 Miscellaneous revenue 900099 1404 1404 0 0 0 0 8299 8380528 5529816 -34733 62331 100000 100000 406101 251900 154201 0 4207449 3378678 828771 0 29677 23541 6136 0 381400 292468 88932 0 353431 282832 70599 0 28338 21940 6398 0 31423 19858 11565 0 0 0 0 0 11338 11338 396002 367001 29001 0 94702 77606 17096 0 579586 493278 86308 0 20273 12698 7575 0 208658 147248 61410 0 52556 9905 42651 0 57163 34785 22378 0 187807 148157 39650 0 34031 20052 13979 0 Bad debt expense 75085 75085 0 0 Dues & subscriptions 45818 11027 34791 0 Employee relations 41599 31848 9751 0 Licenses 542 542 0 0 2992 1666 1326 0 7345971 5802115 1543856 0 1050 1050 3446331 3947390 107406 107555 728895 776692 0 0 0 387717 319185 46432 128390 4500800 1692416 2928444 2808384 785162 1530636 5038 15909 0 0 0 8436475 9635191 440383 622152 100000 0 170000 170000 610383 892152 X 7826092 8743039 0 7826092 8743039 8436475 9635191 X 1034557 -117810 200 X false true X true true true X 1867200 2004919 1812985 2274992 2823114 10783210 4759275 4807703 4171875 5091337 6301527 25131717 21787 30239 12600 9563 8299 82488 6648262 6842861 5997460 7375892 9132940 35997415 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 35997415 19405 34057 35818 28668 37765 155713 19405 34057 35818 28668 37765 155713 0 0 0 0 0 0 6667667 6876918 6033278 7404560 9170705 36153128 0.9957 0.9956 0.0043 0.0043 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 213700 213700 936300 175556 760744 2562317 904184 1658133 778490 612676 165814 9993 0 9993 2808384 Drugs and pharmaceuticals held for others 170000 170000 X 9310453 -117810 40562 1018511 941263 8369190 11338 0 11338 8380528 8393506 40562 1018311 1058873 7334633 11338 0 11338 7345971 Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote The organization is exempt from income taxes on income from related activities under section 501(c)(3) of the U.S. Internal Revenue Code and corresponding state tax law. Accordingly, no provision has been made for federal or state income taxes. A tax position is recognized as a benefit only if it is "more likely than not" that the tax position would be sustained in a tax examination, with a tax examination being presumed to occur. The amount recognized is the largest amount of tax benefit that is greater than 50% likely of being realized on examination. For tax positions not meeting the "more likely than not" test, no tax benefit is recorded. Due to its tax-exempt status, the Organization is not generally subject to U.S. federal income tax or state income tax. The Organization's Form 990 has not been subject to examination by the Internal Revenue Service or the state of Indiana for the last three years. The Organization does not expect the total amount of unrecognized tax benefits to significantly change in the next 12 months. The Organization recognized interest and/or penalties related to income tax matters in income tax expense. The Organization did not have any amounts accrued for interest and penalties at September 30, 2015 and 2014. Schedule D, Part XI, Line 2(d) Other revenues in audited financial statements not in form 990 cost of goods sold - 1018311 Change in Beneficial Interest-Community Foundation - 200 Schedule D, Part XII, Line 2(d) Other expenses in audited financial statements not in form 990 cost of goods sold - 1018311 true Scholarship grant 1 100000 0 n/a n/a Schedule I, Part I, Line 2 Description Of Procedure For Monitoring Use Of Grant Funds The organization has a grant agreement with the individual scholarship recipient and Marian University, whereby the organization selects a student to receive scholarship funds to be used exclusively to offset the student's cost of tuition and fees. The scholarship funds, which are distributed per the terms of the grant agreement, are paid directly to Marian University to ensure proper use. Schedule I, Part I, Line 2 Procedures for monitoring use of grant funds. The organization has a grant agreement with the individual scholarship recipient and Marian University, whereby the organization selects a student to receive scholarship funds to be used exclusively to offset the student's cost of tuition and fees. The scholarship funds, which are distributed per the terms of the grant agreement, are paid directly to Marian University to ensure proper use. X false true X X false false false false false false false false false Dr Omobola Olaniyan CMO 190248 0 12853 0 0 0 4822 0 7119 0 215042 0 0 0 Vernita L Todd CEO 120877 0 34703 0 0 0 3168 0 14970 0 173718 0 0 0 Dr Erin Farrell Pediatrician 139498 0 6628 0 0 0 3549 0 6533 0 156208 0 0 0 Schedule J, Part I, Line 1a Tax indemnification and gross-up payments The organization provided for the gross up of bonus payments to officers and highest compensated employees, which was included in the individuals' taxable compensation. Schedule J, Part I, Line 1b Written policy regarding payment or reimbursement of expenses The organization does not follow a written policy regarding the gross-up payments provided to officers and highest compensated employees, however these payments are approved by the organization's board of directors. X 12 101386 Market value 0 false true false Schedule M, Part I Explanations of reporting method for number of contributions Drugs and medical supplies: DRUGS AND MEDICAL SUPPLIES: NUMBER OF CONTRIBUTIONS. Form 990, Part III, Line 1 ORGANIZATION'S MISSION (CONTINUED FROM PART III) WE OFFER A SLIDING FEE SCALE BASED ON INCOME AND FAMILY SIZE FOR THE UNINSURED AND ALSO ACCEPT MEDICAID, MEDICARE AND SOME PRIVATE INSURANCES. HEART CITY IS COMMITTED TO REDUCING HEALTH DISPARITIES AMONG RESIDENTS BY PROVIDING PROFESSIONAL AND RESPECTFUL SERVICE TO THE ELKHART COMMUNITY THROUGH EDUCATION AND HIGH QUALITY PRIMARY MEDICAL CARE FOR THOSE IN NEED AND EXPERIENCING BARRIERS TO TRADITIONAL HEALTH CARE. THE MAJORITY OF HEART CITY'S PATIENTS ARE AT 100% OR BELOW THE FEDERAL POVERTY GUIDELINES, AND ALMOST 50% OF PATIENTS ARE UNDER THE AGE OF 18. HEART CITY IS ONE OF THE FEW SITES IN THE ELKHART AREA THAT PROVIDES SERVICES TO MEDICAID PATIENTS AND THE UNINSURED POPULATION. Form 990, Part III, Line 4a PROGRAM SERVICE ACCOMPLISHMENTS (CONTINUED FROM PART III) VARIOUS MEDICAL SERVICES PROVIDED INCLUDE: PRIMARY AND PREVENTIVE CARE; PHYSICAL EXAMINATIONS; EMPLOYMENT/SPORTS/SCHOOL PHYSICALS; WELL CHILD CHECKS; IMMUNIZATION; WOMEN'S HEALTH; CHRONIC DISEASES MANAGEMENT; BREAST AND CERVICAL CANCER SCREENINGS; LABORATORY WORK; HEALTH AND WELLNESS EDUCATION; AND DIABETES SCREENING AND TREATMENT. HEART CITY ALSO DISPENSES PRESCRIPTIONS TO THE PRIMARILY MEDICARE, MEDICAID, AND UNINSURED POPULATION IN ELKHART COUNTY. HEART CITY'S PATIENT MEDICINE ASSISTANCE PROGRAM (MAP) WORKS WITH SEVERAL DRUG COMPANIES TO PROVIDE ASSISTANCE FOR PEOPLE HAVING TROUBLE AFFORDING NAME BRAND MEDICATIONS. HEART CITY'S MAP COORDINATOR HELPS PATIENTS SEE IF THEY ARE ELIGIBLE FOR THE PROGRAM, AND ALSO ASSISTS IN THE COMPLETION OF MAP APPLICATIONS. IN ADDITION, TO HELP ENSURE THAT PATIENTS HAVE ACCESS TO THE CARE THEY NEED, PRESCRIPTIONS WRITTEN BY HEART CITY PRACTITIONERS CAN BE FILLED AT REDUCED PRICES AT THE ONSITE PHARMACY. HEART CITY PARTICIPATES IN A 340B FEDERAL GOVERNMENT PROGRAM TO PROVIDE LOW COST PRESCRIPTION DRUGS TO PATIENTS WITHOUT INSURANCE. DURING THE YEAR ENDED SEPTEMBER 30, 2015, HEART CITY'S PHARMACY FILLED 40,206 PRESCRIPTIONS AND SERVED 3,235 PATIENTS. Form 990, Part VI, Line 15b PROCESS USED TO ESTABLISH COMPENSATION OF OTHER OFFICERS/KEY EMPLOYEES THE ORGANIZATION'S CEO COMPLETES AN ANNUAL PERFORMANCE EVALUATION FOR THE CFO; BASED ON THE OUTCOME OF THE PERFORMANCE EVALUATION AND THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS (NACHC) SALARY SURVEYS, THE CFO'S COMPENSATION IS REVIEWED AND ADJUSTED AS NECESSARY. THE ORGANIZATION'S CEO ALSO COMPLETES AN ANNUAL PERFORMANCE EVALUATION FOR THE CMO; BASED ON THE OUTCOME OF THE PERFORMANCE EVALUATION AND GENERAL COMPENSATION GUIDELINES SET BY THE BOARD, THE CMO'S EMPLOYMENT CONTRACT IS UPDATED AS NECESSARY. THESE PERFORMANCE EVALUATIONS AND COMPENSATION/EMPLOYMENT CONTRACT UPDATES WERE LAST COMPLETED DURING THE FISCAL YEAR ENDED SEPTEMBER 30, 2015. Form 990, Part VI, Line 1a Delegate broad authority to a committee The Executive Committee shall consist of the following officers of the Corporation, all of whom shall have the right to vote: Chairperson, Vice Chair, Secretary and Treasurer. The Chief Executive Officer shall be a non-voting member of the Executive Committee. The Executive Committee shall have the following general authority: The Executive Committee shall be comprised exclusively of Board members and shall act for the Corporation in the interim periods between meetings of the Board of Directors only with respect to matters of an urgent nature and then to the maximum extent feasible, in compliance with the established policies and expressed positions of the Board. Any such actions by the Executive Committee on behalf of the corporation shall require ratification at the following regular or special meeting where a quorum is present. The chairperson of the Board of Directors or any three (3) Executive Committee members convenes. Said written notice shall be delivered to the remaining members of the Executive Committee. A majority of the officers present and in person, shall constitute a quorum for the transaction of Executive Committee business.The Executive Committee shall consist of the following officers of the Corporation, all of whom shall have the right to vote: Chairperson, Vice Chair, Secretary and Treasurer. The Chief Executive Officer shall be a non-voting member of the Executive Committee. The Executive Committee shall have the following general authority: The Executive Committee shall be comprised exclusively of Board members and shall act for the Corporation in the interim periods between meetings of the Board of Directors only with respect to matters of an urgent nature and then to the maximum extent feasible, in compliance with the established policies and expressed positions of the Board. Any such actions by the Executive Committee on behalf of the corporation shall require ratification at the following regular or special meeting where a quorum is present. The chairperson of the Board of Directors or any three (3) Executive Committee members convenes. Said written notice shall be delivered to the remaining members of the Executive Committee. A majority of the officers present and in person, shall constitute a quorum for the transaction of Executive Committee business Form 990, Part VI, Line 11b Review of form 990 by governing body The organization's Form 990 is reviewed in detail by executive management. A board meeting Is then held to present and review a final draft of the full Form 990, including all applicable schedules; each board member is provided a copy of the return at the board meeting and is allowed to ask any questions they may have. Once all questions are answered, the board votes to approve submission before the return is filed with the IRS. Form 990, Part VI, Line 12c Conflict of interest policy An annual conflict of interest form is filled out by each board member, which is verified by our independent auditors. All other employees sign the code of conduct policy at time of hire which covers conflicts of interest. The CEO and the Board Liaison review the conflict of interest forms to determine if any potential conflicts of interest exist. If a potential conflict of interest is determined to exist, the CEO and Executive Committee of the board, consisting of the Chair, Vice Chair, Secretary and Treasurer, meet to discuss whether any actual conflicts of interest exist. Although no conflicts have been noted in the past, if a conflict of interest was to arise, restrictions would be imposed and the board member would be required to excuse themselves from any discussions and/or votes related to the conflicting issue. Form 990, Part VI, Line 15a Process to establish compensation of top management official Compensation for the organization's CEO is determined by the board of directors based on a performance evaluation. Each board member completes an evaluation, and then the Executive Committee reports the findings and any changes in compensation to the CEO. Any changes in compensation are based on the National Association of Community Health Centers (NACHC) salary surveys. This process is performed annually, and was last done during the organization's fiscal year ended September 30, 2015. The evaluation and review process is documented in the board meeting minutes. Form 990, Part VI, Line 19 Required documents available to the public Governing documents, conflict of interest policies, and financial statements are not required disclosures pursuant to Internal Revenue Code (IRC) Section 6104. These documents are not available to the public at this time. Form 990, Part XI, Line 9 Other changes in net assets or fund balances Change in Beneficial Interest-Community Foundation - 200;