2014-08-15T14:14:57-05:00 2013-09-30 560747981 DIXON HUGHES GOODMAN LLP 500 RIDGEFIELD COURT ASHEVILLE NC 28806 990 2012-10-01 462385383 GATEWAY COMMUNITY HEALTH CENTERS INC GATE 2523844088 1144 NORTH ROAD STREET ELIZABETH CITY NC 27909 SIGNING OFFICER 2523844088 2014-08-15 1 AMY BIBBY P00445891 8282542254 2012 2015-11-30 17:44:51Z X ROSE TURNER 1144 NORTH ROAD STREET ELIZABETH CITY NC 27909 1315301 0 X N/A X 2010 NC TO OPERATE A FEDERALLY QUALIFIED HEALTH CENTER (FHQC) IN NORTHEAST NORTH CAROLINA 9 9 15 0 0 0 1019677 701445 535656 605570 0 0 547 8286 1555880 1315301 0 0 0 0 835164 1025123 0 0 0 384224 467298 1219388 1492421 336492 -177120 547338 451604 222261 303647 325077 147957 X TO OPERATE A COMMUNITY HEALTH CENTER THAT PROVIDES PREVENTIVE AND PRIMARY HEALTH CARE SERVICES, RELATED ENABLING AND ANCILLARY SERVICES, AND OTHER CRITICAL COMMUNITY AND SOCIAL SERVICES REGARDLESS OF A PATIENT'S INSURANCE STATUS OR ABILITY TO PAY TO THE COMMUNITIES OF GATES, CHOWAN, AND PERQUIMANS COUNTIES OF NORTH CAROLINA. 0 0 1126687 605570 GATEWAY COMMUNITY HEALTH CENTERS, INC.(GCHC) IS A PRIVATE, NON-PROFIT 501(C)(3) CORPORATION HEADQUARTERED IN GATESVILLE, NORTH CAROLINA CELEBRATING 35 YEARS OF PROVIDING QUALITY HEALTHCARE SERVICE TO NORTHEASTERN COUNTIES OF NORTH CAROLINA. GCHC WAS ESTABLISHED IN 1979 (AS GATES COUNTY RURAL HEALTH CLINIC) WITH A MISSION TO "ENSURE THE PROVISION OF HIGH QUALITY HEALTH SERVICES TO THE PEOPLE WE SERVE." THE PROJECT BEGAN AS A SHARED PLANNING EFFORT SPEARHEADED BY CONCERNED COMMUNITY LEADERS. THE HEALTH CENTER IS GOVERNED BY A NINE MEMBER VOLUNTEER BOARD OF DIRECTORS WHICH REPRESENTS (A) USERS/PATIENTS OF THE HEALTH CENTERS, (B) COMMUNITY ORGANIZATIONS, GOVERNMENT AND LOCAL BUSINESSES AND (C) THE HEALTH CARE PROFESSION. ACCORDING TO THE US CENSUS, THE 2010 ESTIMATED POPULATION IS 110,877 PERSONS IN TWENTY FOUR UNDUPLICATED ZIP CODES (27818, 27909, 27917, 27919, 27921, 27922, 27926, 27929, 27932, 27934, 27935, 27937, 27938, 27942, 27944, 27946, 27956, 27958, 27973, 27974, 27976, 27979, 27980, 27986) ENCOMPASSING SEVEN NORTH CAROLINA COUNTIES: (CAMDEN, CHOWAN, CURRITUCK, GATES, HERTFORD, PASQUOTANK AND PERQUIMANS). GCHC PROPOSES TO SERVE AT LEAST 2639 USERS BY THE END OF THE PROJECT.SIX OF THE SEVEN COUNTIES ARE HEALTH PROFESSIONAL SHORTAGE AREAS (HPSA) AND MEDICALLY UNDERSERVED AREAS (MUA). THESE AREAS ARE RURAL WITH MANY NEGATIVE SOCIAL AND ECONOMIC FACTORS AFFECTING THE POPULATION. IN ADDITION, THE ENTIRE COMMUNITY SUFFERS FROM SOME OF THE HIGHEST DEATH AND DISEASE RATES IN THE STATE OF NORTH CAROLINA, WHERE HEALTH DISPARITIES ARE SOME OF THE HIGHEST IN THE UNITED STATES. GCHC DESIRES TO CONTINUE PROVIDING MEDICAL SERVICES TO THE RESIDENTS AND SEASONAL AND MIGRANT HEALTH WORKERS IN THE SERVICE AREA AND REMAIN THE PRINCIPAL SOURCE OF SUPPORT FOR THIS INDIGENT MEDICALLY UNDERSERVED COMMUNITY. GIVEN THE POVERTY LEVEL, LACK OF PUBLIC TRANSPORTATION SYSTEM AND HIGH PERCENTAGE OF MIGRANT WORKERS, IT IS APPARENT THAT ACCESS TO PRIMARY HEALTH CARE SERVICES IS OF GREAT CONCERN AND A SUBSTANTIAL NEED FOR THIS TARGETED AREA. THIS POPULATION STRUGGLES WITHOUT HAVING AN ACCESSIBLE PRIMARY CARE PROVIDER THAT ACCEPTS MEDICAID OR OPERATES ON A SLIDING FEE SCHEDULE, AND IT ALSO REPRESENTS A LARGE PORTION OF FAMILIES WHO LACK INSURANCE FOR HEALTHCARE. OUR GOAL IS QUITE SIMPLE - KEEP OUR ORGANIZATION AS THE PRIMARY SAFETY NET PROVIDER OF QUALITY HEALTHCARE SERVICES FOR THOSE IN NEED THROUGH A MEDIUM OF CARE THAT IMPROVE HEALTH OUTCOMES. 1126687 1 0 0 0 0 0 0 0 0 0 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 15 1 0 0 0 0 0 0 0 0 0 0 X 9 9 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 X THE ORGANIZATION 2523844088 1144 NORTH ROAD STREET ELIZABETH CITY NC 27909 JEFF SACKRISON 1.00 X X 0 0 0 REV WESLEY BOONE 1.00 X X 0 0 0 JENNIFER GREENE 1.00 X X 0 0 0 TERRI RIDDICK 1.00 X X 0 0 0 JUDITH AGUILAR 1.00 X X 0 0 0 KAY WIGGINS 1.00 X X 0 0 0 RICHARD OCHOA 1.00 X 0 0 0 PAT BASTEK 1.00 X 0 0 0 FANNIE LANGSTON 1.00 X 0 0 0 GEOFF MARETT 1.00 X 0 0 0 JUDITH AGUILAR 1.00 X 0 0 0 ALTHEA RIDDICK 1.00 X 0 0 0 TIM GRAVGAARD 1.00 X 0 0 0 CAROLYN ALLISON 40.00 X 151596 0 0 ROSE TURNER 40.00 X 0 0 0 RAYETTE POLLARD CASIANO 40.00 X 160316 0 19093 311912 0 19093 2 0 1 0 0 539017 162428 701445 NET PATIENT REVENUE 621400 599252 599252 PRESCRIPTION PROCESS 621400 3644 3644 MEDICAL RECORD TRANSCR 621400 2674 2674 605570 MISCELLANEOUS 900099 8286 8286 8286 1315301 605570 0 8286 151596 151596 760987 648710 112277 6515 4631 1884 51884 45044 6840 54141 45591 8550 4541 4541 343 343 31733 31733 73419 37318 36101 34678 34320 358 180 180 72159 72159 13547 8560 4987 11459 11459 17667 14067 3600 BAD DEBT EXPENSE 189644 189644 MEDICAL SUPPLIES 12494 12494 OTHER EXPENSE 5434 2690 2744 1492421 1126687 365734 0 97290 247344 400 400 327817 117284 5154 1929 79371 19794 66997 59577 49680 25070 547338 451604 11260 52275 211001 251372 222261 303647 X 325077 110573 37384 325077 147957 547338 451604 -177120 0 X X 0 1 X 1 1 1 X 76640 19794 56846 2731 2731 59577 DUE FROM AHA 9110 OTHER RECEIVABLES 15960 25070 DUE TO AHA 171339 DUE TO APS 80033 251372 X 1125657 0 1125657 189644 189644 1315301 1302777 0 1302777 189644 189644 1492421 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: THE CENTER IS A TAX-EXEMPT ORGANIZATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE; ACCORDINGLY, THE ACCOMPANYING FINANCIAL STATEMENTS DO NOT REFLECT A PROVISION OR LIABILITY FOR FEDERAL AND STATE INCOME TAXES. THE CENTER HAS DETERMINED THAT IT DOES NOT HAVE ANY MATERIAL UNRECOGNIZED TAX BENEFITS OR OBLIGATIONS AS OF SEPTEMBER 30, 2013. THE CENTER BELIEVES IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS FOR YEARS PRIOR TO SEPTEMBER 30, 2010. PART XI, LINE 4B - OTHER ADJUSTMENTS: BAD DEBTS NET WITH REVENUE 189,644. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBTS NET WITH REVENUE 189,644. 0 0 0 0 0 0 0 0 0 CAROLYN ALLISON 151596 0 0 0 0 0 0 0 0 0 151596 0 0 0 RAYETTE POLLARD CASIANO 160316 0 0 0 0 0 0 0 19093 0 179409 0 0 0 FORM 990, PART VI, SECTION A, LINE 1 THE EXECUTIVE COMMITEE IS COMPRISED OF THE PRESIDENT, THE VICE PRESIDENT, THE SECRETARY, AND THE TREASURER. THE EXECUTIVE COMMITTEE IS AUTHORIZED TO ACT ON BEHALF OF THE BOARD WITH ALL THE POWERS OF THE BOARD. FORM 990, PART VI, SECTION A, LINE 3 ACCORDING TO A CO-APPLICANT AGREEMENT WITH ALBEMARLE HOSPITAL AUTHORITY TO OPERATE THE FEDERALLY QUALIFIED HEALTH CENTER, THE EXECUTIVE DIRECTOR IS AN EMPLOYEEE OF ALBEMARLE HOSPITAL AUTHORITY. THE EXECUTIVE DIRECTOR HAS THE AUTHORITY TO SELECT, SUPERVISE, AND DISCHARGE ALL GCHC PERSONNEL. THE EXECUTIVE DIRECTOR DEVOTES ALL OF HIS/HER TIME TO THE OPERATIONS OF GCHC, WHILE THE OTHER OFFICERS DEVOTE APPROXIMATELY 1% OF THEIR TIME TO GCHC. FORM 990, PART VI, SECTION B, LINE 11 THE TAX RETURN WAS PREPARED BY AN INDEPENDENT ACCOUNTANT. THE COMPLETED IRS FORM 990 TAX RETURN, ALONG WITH ALL SUPPORTING SCHEDULES, WAS THEN PROVIDED TO BOARD MEMBERS. BOARD MEMBERS REVIEWED THE TAX RETURN BEFORE IT WAS FILED. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD OF DIRECTORS ANNUALLY REVIEWS THE CONFLICT OF INTEREST POLICY AND EACH MEMBER PROVIDES IN WRITING AN ACKNOWLEDGEMENT OF THEIR UNDERSTANDING OF THE POLICY AND DISCLOSURE OF ANY POTENTIAL CONFLICTS. ALL DISCLOSURES ARE PROVIDED TO THE EXECUTIVE COMMITTEE. THE EXECUTIVE COMMITTEE REVIEWS AND FOLLOWS UP ON ANY POTENTIAL ISSUES. IF ANY CONFLICT EXISTS, THAT MEMBER DOES NOT PARTICIPATE IN DISCUSSIONS OR VOTING REGARDING THAT MATTER. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S GOVERNING DOCUMENTS, FINANCIAL STATEMENTS, AND CONFLICT OF INTEREST POLICY ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XII, LINE 2C THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.