PROGRESSIVE COMMUNITY HEALTH CENTERS INC: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- PROGRESSIVE COMMUNITY HEALTH CENTERS INC (EIN 39-1958810)
- Tax period
- 2012-04-01 to 2013-03-31
- Filed
- 2014-02-15
- IRS object ID
- 201410499349301101
- Schema version
- 2012v2.1
- 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) |
|---|---|---|
| Timestamp | 2014-02-15T09:54:56-06:00 | Timestamp |
| Tax Period End Date | 2013-03-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 390859910 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BAKER TILLY VIRCHOW KRAUSE LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 777 E WISCONSIN AVENUE 32ND FLOOR | AddressLine1 |
| City | MILWAUKEE | City |
| State | WI | State |
| ZIP Code | 53202 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-04-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 391958810 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PROGRESSIVE COMMUNITY HEALTH CENTERS INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | PROG | NameControl |
| Phone | 4149358000 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3522 WEST LISBON AVENUE | AddressLine1 |
| City | MILWAUKEE | City |
| State | WI | State |
| ZIP Code | 53208 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | JENNIFER SEVENICH | Name |
| Title | CEO | Title |
| Phone | 4149358000 | Phone |
| Date Signed | 2014-02-18 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | TROY E MARINE CPA | Name |
| PTIN | P00187863 | PTIN |
| Phone | 4147775500 | Phone |
| Date Prepared | 2014-02-18 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | JENNIFER SEVENICH | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3522 WEST LISBON AVENUE | AddressLine1 |
| City | MILWAUKEE | City |
| State | WI | State |
| ZIP Code | 53208 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 7575830 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.PROGRESSIVECHC.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1999 | YearFormation |
| State Legal Domicile | WI | StateLegalDomicile |
| Activity Or Mission Description | PROGRESSIVE COMMUNITY HEALTH CENTERS EXIST TO IMPROVE THE HEALTH AND QUALITY OF LIFE OF THE COMMUNITY BY PROVIDING CULTURALLY COMPETENT SERVICES THAT ADDRESS IDENTIFIED NEEDS. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 12 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 12 | NbrIndependentVotingMembers |
| Total Nbr Employees | 104 | TotalNbrEmployees |
| Total Nbr Volunteers | 12 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 2534727 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 4395136 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 3444041 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 3169059 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 2673 | InvestmentIncomePriorYear |
| Investment Income Current Year | 2035 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 9810 | OtherRevenuePriorYear |
| Other Revenue Current Year | 9600 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 5991251 | TotalRevenuePriorYear |
| Total Revenue Current Year | 7575830 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 4824901 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 4490609 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 17212 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 1541913 | OtherExpensePriorYear |
| Other Expenses Current Year | 1280953 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 6366814 | TotalExpensesPriorYear |
| Total Expenses Current Year | 5771562 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -375563 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 1804268 | RevenuesLessExpensesCY |
| Total Assets BOY | 2880139 | TotalAssetsBOY |
| Total Assets EOY | 4542786 | TotalAssetsEOY |
| Total Liabilities BOY | 597674 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 456053 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 2282465 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 4086733 | NetAssetsOrFundBalancesEOY |
| Mission Description | PROGRESSIVE COMMUNITY HEALTH CENTERS EXISTS TO IMPROVE THE HEALTH AND QUALITY OF LIFE OF THE COMMUNITY BY PROVIDING CULTURALLY COMPETENT SERVICES THAT ADDRESSES IDENTIFIED NEEDS. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 2949635 | Expense |
| Revenue | 3169059 | Revenue |
| Description | COMMUNITY HEALTHCARE PROVIDER - TO PROVIDE QUALITY PRIMARY MEDICAL AND DENTAL ACCESS TO UNDERINSURED AND UNINSURED COMMUNITY REGARDLESS OF ABILITY TO PAY. THESE SERVICES ALSO INCLUDE SCREENING, EXAMS, URGENT CARE, LAB AND PRENATAL CARE. | Description |
| Total Program Service Expense | 2949635 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 0 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 0 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 56 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 104 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 12 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 12 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 0 | WhistleblowerPolicy |
| Document Retention Policy | 0 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | WI | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PROGRESSIVE COMMUNITY HEALTH CENTERS | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 4149358000 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3522 WEST LISBON AVENUE | AddressLine1 |
| City | MILWAUKEE | City |
| State | WI | State |
| ZIP Code | 53208 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (20 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| JAMES SIMARAS | ||||||||
| PRESIDENT/CHAIRMAN | 0.50 | X | X | 0 | 0 | 0 | ||
| JOHN BALZER | ||||||||
| VICE PRESIDENT | 0.50 | X | X | 0 | 0 | 0 | ||
| CONNIE DEBBINK | ||||||||
| TREASURER | 0.50 | X | X | 0 | 0 | 0 | ||
| BARBARA SPREWER | ||||||||
| SECRETARY | 0.50 | X | X | 0 | 0 | 0 | ||
| MUNEER BAHAUDDEEN | ||||||||
| BOARD MEMBER | 0.50 | X | 0 | 0 | 0 | |||
| JOHN GRANDBERRY | ||||||||
| BOARD MEMBER | 0.50 | X | 0 | 0 | 0 | |||
| NORMA FORTUNE | ||||||||
| BOARD MEMBER | 0.50 | X | 0 | 0 | 0 | |||
| DWIGHT JOHNSON | ||||||||
| BOARD MEMBER | 0.50 | X | 0 | 0 | 0 | |||
| ANTONIO RILEY | ||||||||
| BOARD MEMBER | 0.50 | X | 0 | 0 | 0 | |||
| TCHERNAVIA ROCKER | ||||||||
| BOARD MEMBER | 0.50 | X | 0 | 0 | 0 | |||
| JOHN SIEGER | ||||||||
| BOARD MEMBER | 0.50 | X | 0 | 0 | 0 | |||
| MAETHELL WEBB | ||||||||
| BOARD MEMBER | 0.50 | X | 0 | 0 | 0 | |||
| JENNIFER SEVENICH | ||||||||
| CEO | 40.00 | 156281 | 0 | 13030 | X | |||
| CANDICE COLE | ||||||||
| DIRECTOR OF FINANCE | 40.00 | 69439 | 0 | 3398 | X | |||
| ALLISON KOS MD | ||||||||
| CHIEF MEDICAL OFFICER | 40.00 | 189090 | 0 | 5697 | X | |||
| SUSAN HUNTER | ||||||||
| DIRECTOR OF HUMAN RESOURCES | 40.00 | 109594 | 0 | 2947 | X | |||
| MADELAINE TULLY | ||||||||
| FAMILY PRACTICE | 40.00 | 177025 | 0 | 10924 | X | |||
| MICHAEL BELETE | ||||||||
| FAMILY PRACTICE | 40.00 | 197777 | 0 | 4578 | X | |||
| TIFFANY NGUYEN | ||||||||
| FAMILY PRACTICE | 40.00 | 146444 | 0 | 6083 | X | |||
| KERRI ACKERMAN | ||||||||
| DIRECTOR OF OPERATIONS | 40.00 | 104089 | 0 | 4771 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1149739 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 51428 | TotalOtherCompensation |
| Number Individuals GT100 K | 7 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (2 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| HAMMEL GREEN AND ABRAHAMSON INC | |||||
| PO BOX 86 | MINNEAPOLIS | MN | 554861861 | LEGAL SERVICES | 169362 |
| DYNACARE LABORATORIES | |||||
| 9200 W WISCONSIN AVE | MILWAUKEE | WI | 53226 | LAB SERVICES | 146679 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 2 | NumberOfContractorsGT100K |
| Government Grants | 2261495 | GovernmentGrants |
| All Other Contributions | 2133641 | AllOtherContributions |
| Total Contributions | 4395136 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| PATIENT REVENUES | 621110 | 3010115 | 3010115 |
| OTHER PROGRAM REVENUE | 621110 | 136980 | 136980 |
| MEDICAL RECORDS REQUES | 621110 | 21964 | 21964 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 3169059 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 2035 | TotalRevenueColumn |
| Exclusion | $2,035 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 9600 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 9600 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 9600 | TotalRevenueColumn |
| Exclusion | $9,600 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 7575830 | TotalRevenueColumn |
| Related Or Exempt Function Income | 3169059 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $11,635 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1149737 | Total |
| Program Services | 620858 | ProgramServices |
| Management And General | 528879 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2494913 | Total |
| Program Services | 1246512 | ProgramServices |
| Management And General | 1234976 | ManagementAndGeneral |
| Fundraising | 13425 | Fundraising |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 65038 | Total |
| Program Services | 20162 | ProgramServices |
| Management And General | 43451 | ManagementAndGeneral |
| Fundraising | 1425 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 459244 | Total |
| Program Services | 77807 | ProgramServices |
| Management And General | 379572 | ManagementAndGeneral |
| Fundraising | 1865 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 321677 | Total |
| Program Services | 165168 | ProgramServices |
| Management And General | 156012 | ManagementAndGeneral |
| Fundraising | 497 | Fundraising |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 87207 | Total |
| Program Services | 78533 | ProgramServices |
| Management And General | 8674 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 131151 | Total |
| Program Services | 48764 | ProgramServices |
| Management And General | 82387 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 119846 | Total |
| Program Services | 119841 | ProgramServices |
| Management And General | 5 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 152314 | Total |
| Management And General | 152314 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8686 | Total |
| Management And General | 8686 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| MEDICAL EXPENSES | 302006 | 283670 | 18336 |
| BAD DEBT EXPENSE | 180747 | 793 | 179954 |
| OTHER CONTRACTED SERVIC | 154771 | 154771 | |
| OTHER ADMINISTRATIVE | 144225 | 132756 | 11469 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5771562 | Total |
| Program Services | 2949635 | ProgramServices |
| Management And General | 2804715 | ManagementAndGeneral |
| Fundraising | 17212 | Fundraising |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 420341 | BOY |
| EOY | 655331 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 16547 | BOY |
| EOY | 1814566 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 884178 | BOY |
| EOY | 609481 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 117779 | BOY |
| EOY | 18915 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 2760553 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 1316060 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1441294 | BOY |
| EOY | 1444493 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2880139 | BOY |
| EOY | 4542786 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 558226 | BOY |
| EOY | 443053 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 39448 | BOY |
| EOY | 13000 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 597674 | BOY |
| EOY | 456053 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1959433 | BOY |
| EOY | 1738112 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 323032 | BOY |
| EOY | 2348621 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2282465 | BOY |
| EOY | 4086733 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2880139 | BOY |
| EOY | 4542786 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 1804268 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Separate | X | FinancialStatementSeparate |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 1 | FederalGrantAuditRequired |
| Federal Grant Audit Performed | 1 | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org170b1 Avi | X | PubliclySupportedOrg170b1Avi |
Gifts Grants Contrib Received170 GiftsGrantsContribReceived170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 2147549 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 2699519 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 2713185 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 2534727 | CurrentTaxYearMinus1Year |
| Current Tax Year | 4395136 | CurrentTaxYear |
| Total | 14490116 | Total |
Total170 Total170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 2147549 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 2699519 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 2713185 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 2534727 | CurrentTaxYearMinus1Year |
| Current Tax Year | 4395136 | CurrentTaxYear |
| Total | 14490116 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | 14490116 | PublicSupportTotal170 |
Gross Investment Income170 GrossInvestmentIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 19319 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 13881 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 16271 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 12273 | CurrentTaxYearMinus1Year |
| Current Tax Year | 11635 | CurrentTaxYear |
| Total | 73379 | Total |
Other Income170 OtherIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 10014 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 14557 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 17880 | CurrentTaxYearMinus2Years |
| Total | 42451 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | 14605946 | TotalSupport |
| Gross Receipts From Admissions Etc | 15329464 | GrossReceiptsFromAdmissionsEtc |
| Public Support Pertcentage170 | 0.99210 | PublicSupportPertcentage170 |
| Public Support Pertcent Prior Year | 0.98400 | PublicSupportPertcentPriorYear |
| Thirty Three Percnt Tests CY170 | X | ThirtyThreePercntTestsCY170 |
| General Explanation | SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2008 AMOUNT: $ 10,014. 2009 AMOUNT: $ 14,557. 2010 AMOUNT: $ 17,880. 2011 AMOUNT: $ 0. 2012 AMOUNT: $ 0. | GeneralExplanation |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| 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) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 111569 | OtherCostOrOtherBasis |
| Book Value | 111569 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 759004 | OtherCostOrOtherBasis |
| Depreciation | 361972 | Depreciation |
| Book Value | 397032 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 241661 | OtherCostOrOtherBasis |
| Depreciation | 203917 | Depreciation |
| Book Value | 37744 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 935594 | OtherCostOrOtherBasis |
| Depreciation | 738913 | Depreciation |
| Book Value | 196681 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 712725 | OtherCostOrOtherBasis |
| Depreciation | 11258 | Depreciation |
| Book Value | 701467 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 1444493 | TotalOfBookValueLandBuildings |
| Footnote In Part XIII | X | FootnoteInPartXIII |
| Tot Revenue Etc Audited Fincl Stmt | 7590871 | TotRevenueEtcAuditedFinclStmt |
| Donated Srvc And Use Of Facilities | 15041 | DonatedSrvcAndUseOfFacilities |
| Revenue Not Rptd F990 | 15041 | RevenueNotRptdF990 |
| Revenue Subtotal | 7575830 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 7575830 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 5786603 | TotExpensesEtcAuditedFinclStmt |
| Donated Services Use Of Facilities | 15041 | DonatedServicesUseOfFacilities |
| Expenses Not Rptd F990 | 15041 | ExpensesNotRptdF990 |
| Expenses Subtotal | 5771562 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 5771562 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | Identifier |
| Return Reference | PART X, LINE 2: | ReturnReference |
| Explanation | THE ORGANIZATION HAS RECEIVED NOTIFICATION THAT IT QUALIFIES AS A TAX-EXEMPT ORGANIZATION UNDER SECTION 501(C)(3) OF THE UNITED STATES INTERNAL REVENUE CODE AND CORRESPONDING PROVISIONS OF STATE LAW AND, ACCORDINGLY, IS NOT SUBJECT TO FEDERAL OR STATE INCOME TAX. IN ORDER TO ACCOUNT FOR ANY UNCERTAIN TAX POSITIONS, THE ORGANIZATION DETERMINES WHETHER IT IS MORE LIKELY THAN NOT THAT A TAX POSITION WILL BE SUSTAINED UPON EXAMINATION OF THE TECHNNICAL MERITS OF THE POSITION, ASSUMING THE TAXING AUTHORITY HAS FULL KNOWLEDGE OF ALL INFORMATION. IF THE TAX POSITION DOES NOT MEET THE MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD, THE BENEFIT OF THAT POSITION IS NOT RECOGNIZED IN THE FINANCIAL STATEMENTS. THE ORGANIZATION RECORDED NO ASSETS OR LIABILITIES RELATED TO UNCERTAIN TAX POSITIONS. TAX RETURNS FOR THE YEARS ENDED MARCH 31, 2010 TO PRESENT REMAIN SUBJECT TO EXAMINATION BY THE APPLICABLE TAXING AUTHORITIES. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form990 Of Other Organizations | X | Form990OfOtherOrganizations |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 1 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (5 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JENNIFER SEVENICH | ||||||||||||||
| CEO | 156281 | 0 | 0 | 0 | 0 | 0 | 3005 | 0 | 10025 | 0 | 169311 | 0 | 0 | 0 |
| ALLISON KOS MD | ||||||||||||||
| CHIEF MEDICAL OFFICER | 189090 | 0 | 0 | 0 | 0 | 0 | 3502 | 0 | 2195 | 0 | 194787 | 0 | 0 | 0 |
| MADELAINE TULLY | ||||||||||||||
| FAMILY PRACTICE | 177025 | 0 | 0 | 0 | 0 | 0 | 3404 | 0 | 7520 | 0 | 187949 | 0 | 0 | 0 |
| MICHAEL BELETE | ||||||||||||||
| FAMILY PRACTICE | 197777 | 0 | 0 | 0 | 0 | 0 | 3629 | 0 | 949 | 0 | 202355 | 0 | 0 | 0 |
| TIFFANY NGUYEN | ||||||||||||||
| FAMILY PRACTICE | 146444 | 0 | 0 | 0 | 0 | 0 | 2816 | 0 | 3267 | 0 | 152527 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Reference | PART I, LINE 5 | ReturnReference |
| Explanation | PART OF THE EXECUTIVE DIRECTOR BONUS CRITERIA CONSIST OF ENSURING THE FINANCIAL PERFORMANCE OF THE ORGANIZATION DOES NOT RESULT IN A DEFICIT WITHIN THE FISCAL YEAR. THE POTENTIAL BONUS PAYOUT IS ACCRUED THROUGHOUT THE FISCAL PERIOD. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (4 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | UPON THE COMPLETION OF THE 990 BY THE AUDITING CONTRACTORS IT IS FORWARDED TO THE FINANCE BOARD FOR APPROVAL AND CIRCULATED TO THE BOARD OF DIRECTORS BEFORE SUBMISSION. |
| FORM 990, PART VI, SECTION B, LINE 12C | CONFLICT OF INTEREST POLICIES ARE SIGNED ANNUALLY BY THE BOARD OF DIRECTORS. FOR CONTRACTED EMPLOYEES, CONFLICT OF INTEREST IS ADDRESSED IN THEIR CONTRACT. NO EMPLOYEE, OFFICER OR AGENT SHALL PARTICIPATE IN THE SELECTION, AWARD, OR ADMINISTRATION OF A CONTRACT IN WHICH THEY, OR THEIR IMMEDIATE FAMILY MEMBER, HAS A DIRECT OR INDIRECT FINANCIAL INTEREST. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE PROCESS IS REVIEWED BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS, WITH INPUT FROM THE ORGANIZATION'S DIRECTOR OF HUMAN RESOURCES & OPERATIONS. THE SALARY DATA THAT WAS UTILIZED FROM COMPARISON TO OTHER CHIEF EXECUTIVE OFFICERS OF COMMUNITY HEALTH CENTERS WAS OBTAINED FROM THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS. THE SALARY DATA IS REPORTED BY THE STATE, REGION AND NATIONALLY. ALSO, FOR FURTHER COMPARISON THE EXECUTIVE COMMITTEE REVIEWED THE 990 TAX FORMS OF OTHER LOCAL COMMUNITY HEALTH CENTERS TO OBTAIN THE SALARY INFORMATION OF THEIR CHIEF EXECUTIVE OFFICERS. THE DIRECTOR OF HUMAN RESOURCES & OPERATIONS CONDUCTS AN ANNUAL SALARY REVIEW OF TOP AND KEY MANAGEMENT POSITIONS. THE SALARY DATA IS OBTAINED FROM THE BUREAU OF LABOR STATISTICS, SALARY.COM, AND THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS. ONCE THE RESEARCHED SALARY DATA IS COMPILED THE INFORMATION IS PRESENTED TO THE VICE PRESIDENT/CHIEF OPERATING OFFICER, FOR REVIEW AND DISCUSSION. THEREAFTER, THE INFORMATION IS PRESENTED TO THE CHIEF EXECUTIVE OFFICER FOR FINAL APPROVAL. AFTER APPROVAL BY THE CHIEF EXECUTIVE OFFICER THE ORGANIZATION USES THIS INFORMATION TO DEVELOP A SALARY SCALE, FOR HIRING AND RETENTION OF ALL STAFF. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. |