CHRIST HEALTH CENTER INC: Form 990, tax year 2014
View the entire original 990 at ProPublica ↗
- Organization
- CHRIST HEALTH CENTER INC (EIN 20-1935552)
- Tax period
- 2014-01-01 to 2014-12-31
- Filed
- 2015-10-22
- IRS object ID
- 201522959349301202
- Schema version
- 2014v5.0
- 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 | 2015-10-22T10:16:22-05:00 | ReturnTs |
| Tax Period End | 2014-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 630813240 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PEARCE BEVILL LEESBURG MOORE PC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 110 OFFICE PARK DR | AddressLine1Txt |
| City | BIRMINGHAM | CityNm |
| State Abbreviation | AL | StateAbbreviationCd |
| ZIP | 35223 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2014-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 201935552 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHRIST HEALTH CENTER INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CHRI | BusinessNameControlTxt |
| Phone | 2053809433 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5720 FIRST AVENUE SOUTH | AddressLine1Txt |
| City | BIRMINGHAM | CityNm |
| State Abbreviation | AL | StateAbbreviationCd |
| ZIP | 35212 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ROBERT REX RECORD | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 2053809433 | PhoneNum |
| Signature | 2015-10-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | HAL COONS III | PreparerPersonNm |
| PTIN | P00406106 | PTIN |
| Phone | 2053235440 | PhoneNum |
| Preparation | 2015-10-13 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2014 | TaxYr |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ROBERT REX RECORD | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5720 FIRST AVENUE SOUTH | AddressLine1Txt |
| City | BIRMINGHAM | CityNm |
| State Abbreviation | AL | StateAbbreviationCd |
| ZIP | 35222 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $2,758,346 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.CHRISTHEALTHCENTER.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2004 | FormationYr |
| Legal Domicile State | AL | LegalDomicileStateCd |
| Activity Or Mission | WE DEMONSTRATE THE LOVE AND POWER OF JESUS CHRIST BY PROVIDING EXCELLENT, AFFORDABLE HEALTHCARE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 12 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 12 | VotingMembersIndependentCnt |
| Total Employee | 44 | TotalEmployeeCnt |
| Total Volunteers | 17 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $463,492 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,061,130 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $822,487 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $1,696,621 | CYProgramServiceRevenueAmt |
| PY Investment Income | $668 | PYInvestmentIncomeAmt |
| CY Investment Income | $595 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $1,286,647 | PYTotalRevenueAmt |
| CY Total Revenue | $2,758,346 | 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 | $802,089 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $1,596,740 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $9,478 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $520,995 | PYOtherExpensesAmt |
| CY Other Expenses | $1,216,818 | CYOtherExpensesAmt |
| PY Total Expenses | $1,323,084 | PYTotalExpensesAmt |
| CY Total Expenses | $2,813,558 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$36,437 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$55,212 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $427,986 | TotalAssetsBOYAmt |
| Total Assets EOY | $477,713 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $93,897 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $198,836 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $334,089 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $278,877 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | WE DEMONSTRATE THE LOVE AND POWER OF JESUS CHRIST BY PROVIDING EXCELLENT, AFFORABLE HEALTHCARE AND PARTICIPATING IN THE DEVELOPMENT OF THE COMMUNITIES WE SERVE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | Yes (1) | SignificantChangeInd |
| Expense | $2,084,222 | ExpenseAmt |
| Revenue | $1,313,663 | RevenueAmt |
| Desc | TO PROVIDE MEDICAL AND DENTAL SERVICES TO THE INDIGENT AND UNINSURED. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $269,417 | ExpenseAmt |
| Revenue | $382,958 | RevenueAmt |
| Desc | TO PROVIDE A PHARMACY TO THE INDIGENT AND UNINSURED. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $2,353,639 | 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 | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 44 | 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 | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 12 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 12 | 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 | 0 | 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 | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | AL | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ROBERT R RECORD | PersonNm |
| Phone | 2053809455 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5720 FIRST AVENUE SOUTH | AddressLine1Txt |
| City | BIRMINGHAM | CityNm |
| State Abbreviation | AL | StateAbbreviationCd |
| ZIP | 352122522 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (15 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|
| DR JEREMY W ALLEN | ||||||
| CHAIR | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| STEPHEN T HIPPS | ||||||
| SECRETARY | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| ROGER L ELLENBURG | ||||||
| TREASURER | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| JOHN S BLAIR | ||||||
| INDIVIDUAL DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |
| JOHN F SADDLER | ||||||
| INDIVIDUAL DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |
| BRANTLEY T MCDUFFIE | ||||||
| INDIVIDUAL DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |
| SHANNON S RILEY | ||||||
| INDIVIDUAL DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |
| ANNETTA NUNN | ||||||
| INDIVIDUAL DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |
| HARRIETTE J TONEY | ||||||
| INDIVIDUAL DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |
| GIL MURDOCK | ||||||
| INDIVIDUAL DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |
| MR STEPHEN THOMAS | ||||||
| INDIVIDUAL DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | |
| DR ROBERT RECORD | ||||||
| CEO/PHYSICIAN | 40.00 | Yes (X) | $150,032 | $0 | $0 | |
| MICHAEL J BENEDICT | ||||||
| CHIEF OPERATING OFFICER | 40.00 | Yes (X) | $11,673 | $0 | $0 | |
| LAUREN N HOWTON | ||||||
| CHIEF FINANCIAL OFFICER | 40.00 | Yes (X) | $26,073 | $0 | $0 | |
| SARAH V MALCOM | ||||||
| CHIEF FINANCIAL OFFICER | 40.00 | Yes (X) | $29,728 | $0 | $0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $217,506 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $0 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 1 | 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 |
| Fundraising | $13,320 | FundraisingAmt |
| Government Grants | $668,750 | GovernmentGrantsAmt |
| All Other Contributions | $379,060 | AllOtherContributionsAmt |
| Total Contributions | $1,061,130 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| MEDICAL COLLECTIONS | 621110 | $984,936 | $984,936 |
| PHARMACY COLLECTIONS | 541511 | $382,958 | $382,958 |
| DENTAL COLLECTIONS | 621110 | $328,727 | $328,727 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $1,696,621 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $595 | TotalRevenueColumnAmt |
| Exclusion | $595 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $13,320 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $0 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,758,346 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,696,621 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $595 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $217,506 | TotalAmt |
| Program Services | $90,019 | ProgramServicesAmt |
| Management And General | $127,487 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,185,734 | TotalAmt |
| Program Services | $1,040,507 | ProgramServicesAmt |
| Management And General | $145,227 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $93,572 | TotalAmt |
| Program Services | $77,200 | ProgramServicesAmt |
| Management And General | $16,372 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $99,928 | TotalAmt |
| Program Services | $80,942 | ProgramServicesAmt |
| Management And General | $18,986 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $88,133 | TotalAmt |
| Program Services | $20,329 | ProgramServicesAmt |
| Management And General | $67,804 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,102 | TotalAmt |
| Program Services | $3,102 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $53,867 | TotalAmt |
| Program Services | $32,029 | ProgramServicesAmt |
| Management And General | $21,838 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $102,280 | TotalAmt |
| Program Services | $97,166 | ProgramServicesAmt |
| Management And General | $5,114 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $218,128 | TotalAmt |
| Program Services | $208,272 | ProgramServicesAmt |
| Management And General | $9,856 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,862 | TotalAmt |
| Program Services | $7,862 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $55,773 | TotalAmt |
| Program Services | $52,984 | ProgramServicesAmt |
| Management And General | $2,789 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,971 | TotalAmt |
| Program Services | $24,535 | ProgramServicesAmt |
| Management And General | $14,436 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| PHARMACY EXPENSES | $269,417 | $269,417 |
| DENTAL & MEDICAL SUPPLI | $118,848 | $118,848 |
| LAB FEES | $81,268 | $81,268 |
| BAD DEBT EXPENSE | $80,414 | $80,414 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $98,755 | TotalAmt |
| Program Services | $68,745 | ProgramServicesAmt |
| Management And General | $20,532 | ManagementAndGeneralAmt |
| Fundraising | $9,478 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,813,558 | TotalAmt |
| Program Services | $2,353,639 | ProgramServicesAmt |
| Management And General | $450,441 | ManagementAndGeneralAmt |
| Fundraising | $9,478 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $143,178 | BOYAmt |
| EOY | $113,662 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,145 | BOYAmt |
| EOY | $102,509 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $299 | BOYAmt |
| EOY | $47,016 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,421 | BOYAmt |
| EOY | $10,669 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $599,814 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $395,957 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $143,610 | BOYAmt |
| EOY | $203,857 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $108,333 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $427,986 | BOYAmt |
| EOY | $477,713 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,988 | BOYAmt |
| EOY | $117,927 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $80,909 | BOYAmt |
| EOY | $80,909 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $93,897 | BOYAmt |
| EOY | $198,836 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $316,589 | BOYAmt |
| EOY | $278,877 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,500 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $334,089 | BOYAmt |
| EOY | $278,877 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $427,986 | BOYAmt |
| EOY | $477,713 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$55,212 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| 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 | $342,255 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $390,307 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $423,995 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $463,492 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,047,810 | CurrentTaxYearAmt |
| Total | $2,667,859 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $342,255 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $390,307 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $423,995 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $463,492 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,047,810 | CurrentTaxYearAmt |
| Total | $2,667,859 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $2,667,859 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,324 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $633 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $754 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $668 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $595 | CurrentTaxYearAmt |
| Total | $3,974 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $2,671,833 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $1,696,621 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.99850 | PublicSupportCY170Pct |
| Public Support PY170 | 0.99700 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
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
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $8,918 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $256 | DepreciationAmt |
| Book Value | $8,662 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $590,896 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $395,701 | DepreciationAmt |
| Book Value | $195,195 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $203,857 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $3,114,250 | TotalRevEtcAuditedFinclStmtAmt |
| Donated Services And Use Fclts | $355,904 | DonatedServicesAndUseFcltsAmt |
| Revenue Not Reported | $355,904 | RevenueNotReportedAmt |
| Revenue Subtotal | $2,758,346 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $2,758,346 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $3,169,462 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $355,904 | DonatedServicesUseFcltsAmt |
| Expenses Not Reported | $355,904 | ExpensesNotReportedAmt |
| Expenses Subtotal | $2,813,558 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $2,813,558 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | AS OF DECEMBER 31, 2014, THE CENTER HAS NO UNCERTAIN TAX POSITIONS THAT QUALIFY FOR RECOGNITION OR DISCLOSURE IN THE FINANCIAL STATEMENTS. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DR ROBERT RECORD | PersonNm |
| Title | CEO/PHYSICIAN | TitleTxt |
| Base Compensation Filing Org | $150,032 | BaseCompensationFilingOrgAmt |
| Compensation Based On Rltd Orgs | $0 | CompensationBasedOnRltdOrgsAmt |
| Bonus Filing Organization | $0 | BonusFilingOrganizationAmount |
| Bonus Related Organizations | $0 | BonusRelatedOrganizationsAmt |
| Other Compensation Filing Org | $0 | OtherCompensationFilingOrgAmt |
| Other Compensation Rltd Orgs | $0 | OtherCompensationRltdOrgsAmt |
| Deferred Compensation Flng Org | $0 | DeferredCompensationFlngOrgAmt |
| Deferred Comp Rltd Orgs | $0 | DeferredCompRltdOrgsAmt |
| Nontaxable Benefits Filing Org | $0 | NontaxableBenefitsFilingOrgAmt |
| Nontaxable Benefits Rltd Orgs | $0 | NontaxableBenefitsRltdOrgsAmt |
| Total Compensation Filing Org | $150,032 | TotalCompensationFilingOrgAmt |
| Total Compensation Rltd Orgs | $0 | TotalCompensationRltdOrgsAmt |
| Comp Report Prior990 Filing Org | $0 | CompReportPrior990FilingOrgAmt |
| Comp Report Prior990 Rltd Orgs | $0 | CompReportPrior990RltdOrgsAmt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 3 | FormAndLineReferenceDesc |
| Explanation | THE BOARD VOTES ON ALL SALARIES. COMPENSATION FOR DR. ROBERT RECORD INCLUDES HIS SERVICES AS PHYSICIAN AND AS CEO OF THE CENTER. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART III, LINE 3 | IN 2014, THE ORGANIZATION BECAME A FEDERALLY QUALIFIED HEALTH CENTER (FQHC) RECEIVING GRANTS UNDER SECTION 330 OF THE PUBLIC HEALTH SERVICE ACT. FQHCS MUST SERVE AN UNDERSERVED AREA OR POPULATION, OFFER A SLIDING FEE SCALE, PROVIDE COMPREHENSIVE SERVICES, HAVE AN ONGOING QUALITY ASSURANCE PROGRAM, AND HAVE A GOVERNING BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION A, LINE 8B | THERE ARE NO COMMITTEES ACTING ON BEHALF OF THE GOVERNING BOARD. |
| FORM 990, PART VI, SECTION B, LINE 11 | A FINAL DRAFT OF THE TAX RETURN WILL BE CIRCULATED TO THE BOARD OF DIRECTORS FOR REVIEW AND RECCOMMENDATION TO THE FULL BOARD. |
| FORM 990, PART VI, SECTION B, LINE 12C | AN ANNUAL REVIEW IS CONDUCTED OF THE BOARD MEMBER'S PROFESSIONAL RELATIONSHIPS AND RESULTS ARE REPORTED TO THE CHAIR AND SECRETARY. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC ON SITE WITH A THREE DAY ADVANCE NOTICE. |
| FORM 990, PART VII, SECTION A | COMPENSATION FOR DR. ROBERT RECORD INCLUDES HIS SERVICES AS PHYSICIAN AND AS CEO OF THE CENTER. |