MIDLAND COMMUNITY HEALTHCARE SERVICES: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- MIDLAND COMMUNITY HEALTHCARE SERVICES (EIN 83-0358685)
- Tax period
- 2011-01-01 to 2011-12-31
- Filed
- 2012-10-25
- IRS object ID
- 201223009349300752
- Schema version
- 2011v1.2
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule J
- Schedule M
- Schedule O
- Reasonable Cause Explanation
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2012-10-25T11:13:10-07:00 | Timestamp |
| Tax Period End Date | 2011-12-31 | TaxPeriodEndDate |
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 830358685 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MIDLAND COMMUNITY HEALTHCARE SERVICES | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | MIDL | NameControl |
| Phone | 4325700238 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 5576 | AddressLine1 |
| City | Midland | City |
| State | TX | State |
| ZIP Code | 79704 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Adrienne Handley | Name |
| Title | CFO | Title |
| Phone | 4325700238 | Phone |
| Date Signed | 2012-10-25 | DateSigned |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Tom Harrell | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 North Marienfeld Ste 1090 | AddressLine1 |
| City | Midland | City |
| State | TX | State |
| ZIP Code | 79701 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 8264880 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.midlandchs.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 2003 | YearFormation |
| State Legal Domicile | TX | StateLegalDomicile |
| Activity Or Mission Description | Midland Community Healthcare Services provides affordable, comprehensive, accessible, culturally appropriate, cost-effective primary health care to residents mainly in Midland County, especially individuals/families with limited resources or other barriers to health care to improve their overall health status. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 12 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 12 | NbrIndependentVotingMembers |
| Total Nbr Employees | 130 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 2633305 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 2432235 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 5922079 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 5832293 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 0 | InvestmentIncomePriorYear |
| Investment Income Current Year | 352 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 0 | OtherRevenuePriorYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 8555384 | TotalRevenuePriorYear |
| Total Revenue Current Year | 8264880 | 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 | 5936699 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 6371291 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 1401 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 2051885 | OtherExpensePriorYear |
| Other Expenses Current Year | 2122338 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 7988584 | TotalExpensesPriorYear |
| Total Expenses Current Year | 8493629 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 566800 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -228749 | RevenuesLessExpensesCY |
| Total Assets BOY | 3670273 | TotalAssetsBOY |
| Total Assets EOY | 3464216 | TotalAssetsEOY |
| Total Liabilities BOY | 730889 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 753581 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 2939384 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 2710635 | NetAssetsOrFundBalancesEOY |
| Mission Description | Midland Community Healthcare Services provides affordable, comprehensive, accessible, culturally appropriate, cost-effective primary health care to residents mainly in Midland County, especially individuals/families with limited resources or other barriers to health care to improve their overall health status. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 5456699 | Expense |
| Grants | 1224841 | Grants |
| Revenue | 5832645 | Revenue |
| Description | To continue the efforts to secure BPHC FQHC funding to provide primary health care services to the uninsured, underinsured, and underserved population of Midland County and the surrounding areas. | Description |
| Total Of Other Program Service Exp | 0 | TotalOfOtherProgramServiceExp |
| Total Of Other Program Service Grnt | 0 | TotalOfOtherProgramServiceGrnt |
| Total Of Other Program Service Rev | 0 | TotalOfOtherProgramServiceRev |
| Total Program Service Expense | 5456699 | 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 | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | 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 | 1 | 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 |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 0 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 130 | 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 |
| Form8899 Filed | 0 | Form8899Filed |
| Form1098 C Filed | 0 | Form1098CFiled |
| 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 | 1 | MembersOrStockholders |
| Election Of Board Members | 1 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 1 | 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 | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | TX | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Midland Community Healthcare Services | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 4325700238 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 600 N Marienfeld Ste 1090 | AddressLine1 |
| City | Midland | City |
| State | TX | State |
| ZIP Code | 79701 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (20 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| Virginia Davis | ||||||||
| Consumer Member | 0 | X | 0 | 0 | 0 | |||
| Ted Kerr | ||||||||
| President | 0 | X | 0 | 0 | 0 | |||
| Sarana Savage | ||||||||
| Member | 0 | X | 0 | 0 | 0 | |||
| Jesse Silvas | ||||||||
| Consumer Member | 0 | X | 0 | 0 | 0 | |||
| Jan G Singleton | ||||||||
| Consumer Member | 0 | X | 0 | 0 | 0 | |||
| Lydia Frescaz | ||||||||
| Secretary - Consumer Member | 0 | X | 0 | 0 | 0 | |||
| Tom Harrell | ||||||||
| Treasure | 0 | X | 0 | 0 | 0 | |||
| Misti King | ||||||||
| Consumer Member | 0 | X | 0 | 0 | 0 | |||
| Betty Lathan | ||||||||
| Consumer Member | 0 | X | 0 | 0 | 0 | |||
| Erica McCoy | ||||||||
| Consumer Member | 0 | X | 0 | 0 | 0 | |||
| Sybil Schroeder | ||||||||
| Member | 0 | X | 0 | 0 | 0 | |||
| Tulsi Singh | ||||||||
| Vice President | 1 | X | 0 | 0 | 0 | |||
| Michael Austin | ||||||||
| CEO | 40 | 97863 | 0 | 0 | X | X | ||
| Adrienne Handley | ||||||||
| CFO | 40 | 86936 | 0 | 0 | X | X | ||
| Eliseo Rivera | ||||||||
| CMO | 40 | 170522 | 0 | 0 | X | X | ||
| Wellington F Ballesteros | ||||||||
| Physican | 40 | 191932 | 0 | 191932 | X | |||
| Mini Gopolan | ||||||||
| Physician | 4 | 158524 | 0 | 158524 | X | |||
| Ambreen Mujahid | ||||||||
| Physician | 40 | 155875 | 0 | 155875 | X | |||
| Tareq Hulali | ||||||||
| Physician | 40 | 163580 | 0 | 163580 | X | |||
| Frederico Ilang-Ilang | ||||||||
| Physician | 40 | 154660 | 0 | 154660 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1179892 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 824571 | TotalOtherCompensation |
| Number Individuals GT100 K | 9 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (4 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation | Address Line2AddressOfContractor/AddressUS/AddressLine2 |
|---|---|---|---|---|---|---|
| Texas Tech University Health Science Center | ||||||
| 800 W 4th | Odessa | TX | 79763 | .75 FTE OB-GYN | 197917 | |
| Howard's Janitorial Services | ||||||
| PO Box 8755 | Midland | TX | 79708 | Janitorial services | 114000 | |
| PSS-West Texas | ||||||
| 530 32nd Street | Lubbock | TX | 794042118 | Medical and Dental supplies | 141712 | |
| Citadel Investigations and Security | ||||||
| 110 W Louisiana | Midland | TX | 79701 | Security personnel at two sites | 117464 | Suite 270 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 4 | NumberOfContractorsGT100K |
| Federated Campaigns | 0 | FederatedCampaigns |
| Membership Dues | 0 | MembershipDues |
| Fundraising Events | 0 | FundraisingEvents |
| Related Organizations | 0 | RelatedOrganizations |
| Government Grants | 1224841 | GovernmentGrants |
| All Other Contributions | 1207394 | AllOtherContributions |
| Noncash Contributions | 63577 | NoncashContributions |
| Total Contributions | 2432235 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Patient Fees | Description |
| Business Code | 621110 | BusinessCode |
| Total Revenue Column | 5668606 | TotalRevenueColumn |
| Related Or Exempt Function Income | 5668606 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
Total Oth Program Service Revenue TotalOthProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 163687 | TotalRevenueColumn |
| Related Or Exempt Function Income | 163687 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 5832293 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 352 | TotalRevenueColumn |
| Related Or Exempt Function Income | 352 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
| Personal | 0 | Personal |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 0 | Securities |
| Other | 0 | Other |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Income Fundraising Events | 0 | GrossIncomeFundraisingEvents |
| Cntrbtns Rprtd Fundraising Events | 0 | CntrbtnsRprtdFundraisingEvents |
| Fundraising Direct Expenses | 0 | FundraisingDirectExpenses |
Net Income From Fundraising Events NetIncomeFromFundraisingEvents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 0 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 8264880 | TotalRevenueColumn |
| Related Or Exempt Function Income | 5832645 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1179892 | Total |
| Program Services | 945093 | ProgramServices |
| Management And General | 234799 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3934800 | Total |
| Program Services | 2641987 | ProgramServices |
| Management And General | 1292813 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 901064 | Total |
| Program Services | 403557 | ProgramServices |
| Management And General | 497507 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 355535 | Total |
| Program Services | 249053 | ProgramServices |
| Management And General | 106482 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 34850 | Total |
| Management And General | 34850 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 541448 | Total |
| Program Services | 201742 | ProgramServices |
| Management And General | 339706 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 43694 | Total |
| Management And General | 43694 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 109218 | Total |
| Program Services | 37124 | ProgramServices |
| Management And General | 70693 | ManagementAndGeneral |
| Fundraising | 1401 | Fundraising |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 31231 | Total |
| Program Services | 26201 | ProgramServices |
| Management And General | 5030 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 26609 | Total |
| Program Services | 9003 | ProgramServices |
| Management And General | 17606 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 20823 | Total |
| Program Services | 4221 | ProgramServices |
| Management And General | 16602 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 12735 | Total |
| Management And General | 12735 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 299217 | Total |
| Program Services | 180152 | ProgramServices |
| Management And General | 119065 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 49171 | Total |
| Management And General | 49171 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral | FundraisingFundraising |
|---|---|---|---|---|
| Medical and Dental Supplies | 668025 | 668025 | 0 | 0 |
| Maintenance and Repairs | 17873 | 0 | 17873 | 0 |
| Rent | 102353 | 17329 | 85024 | 0 |
| Utilities | 108632 | 53446 | 55186 | 0 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 56459 | Total |
| Program Services | 19766 | ProgramServices |
| Management And General | 36693 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8493629 | Total |
| Program Services | 5456699 | ProgramServices |
| Management And General | 3035529 | ManagementAndGeneral |
| Fundraising | 1401 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 349370 | BOY |
| EOY | 235134 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 250497 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 135209 | BOY |
| EOY | 152905 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 495055 | BOY |
| EOY | 432976 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 125845 | BOY |
| EOY | 69683 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 16717 | BOY |
| EOY | 15664 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 3484282 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 1176925 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2548077 | BOY |
| EOY | 2307357 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3670273 | BOY |
| EOY | 3464216 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 136599 | BOY |
| EOY | 107751 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 35000 | EOY |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 198456 | BOY |
| EOY | 56941 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 395834 | BOY |
| EOY | 553889 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 730889 | BOY |
| EOY | 753581 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2939384 | BOY |
| EOY | 2710635 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2939384 | BOY |
| EOY | 2710635 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3670273 | BOY |
| EOY | 3464216 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | -228749 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 1 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | 1 | FederalGrantAuditRequired |
| Federal Grant Audit Performed | 1 | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
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) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 130000 | OtherCostOrOtherBasis |
| Book Value | 130000 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 1930281 | OtherCostOrOtherBasis |
| Depreciation | 389314 | Depreciation |
| Book Value | 1540967 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 0 | OtherCostOrOtherBasis |
| Depreciation | 0 | Depreciation |
| Book Value | 0 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 1307680 | OtherCostOrOtherBasis |
| Depreciation | 737380 | Depreciation |
| Book Value | 570300 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 116321 | OtherCostOrOtherBasis |
| Depreciation | 50231 | Depreciation |
| Book Value | 66090 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 2307357 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| Accrued Expenses | $498,854 |
| Current Maturities of Long Term Debt | $55,035 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 553889 | TotalOfAmounts |
| Total Revenue | 8264880 | TotalRevenue |
| Total Expenses | 8493629 | TotalExpenses |
| Excess Or Deficit For Year | -228749 | ExcessOrDeficitForYear |
| Net Unrealized GL On Investments | 0 | NetUnrealizedGLOnInvestments |
| Donated Services And Facilities | 0 | DonatedServicesAndFacilities |
| Investment Expenses | 0 | InvestmentExpenses |
| Prior Period Adjustments | 0 | PriorPeriodAdjustments |
| Other | $0 | OtherAmount |
| Total Adjustments | 0 | TotalAdjustments |
| Excess Or Deficit Per FS | -228749 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 8264528 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 0 | NetUnrealizedGainsInvestments |
| Donated Srvc And Use Of Facilities | 0 | DonatedSrvcAndUseOfFacilities |
| Recoveries Of Prior Year Grants | 0 | RecoveriesOfPriorYearGrants |
| Other Revenues | 0 | OtherRevenues |
| Revenue Not Rptd F990 | 0 | RevenueNotRptdF990 |
| Revenue Subtotal | 8264528 | RevenueSubtotal |
| Investment Expenses Not Included | 0 | InvestmentExpensesNotIncluded |
| Other Revenues Not Included | 352 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 352 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 8264880 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 8493629 | TotExpensesEtcAuditedFinclStmt |
| Donated Services Use Of Facilities | 0 | DonatedServicesUseOfFacilities |
| Prior Year Adjustments | 0 | PriorYearAdjustments |
| Losses Reported | 0 | LossesReported |
| Other Expenses Included | 0 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 8493629 | ExpensesSubtotal |
| Investment Expenses Not Included2 | 0 | InvestmentExpensesNotIncluded2 |
| Other Expenses Not Included | 0 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 8493629 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | SchD_P12_S00_L04b | Identifier |
| Return Reference | Schedule D, Part XII, Line 4b | ReturnReference |
| Explanation | Investment return | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 | 0 | 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)
| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Wellington F Ballesteros | |||||||||||||
| 162332 | 0 | 29600 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 191932 | 0 | 0 | 0 |
| Mini Gopolan | |||||||||||||
| 157024 | 0 | 1500 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 158524 | 0 | 0 | 0 |
| Tareq Hulali | |||||||||||||
| 154080 | 0 | 9500 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 163580 | 0 | 0 | 0 |
| Frederico Ilang-Ilang | |||||||||||||
| 152660 | 0 | 2000 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 154660 | 0 | 0 | 0 |
| Ambreen Mujahid | |||||||||||||
| 152615 | 0 | 3260 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 155875 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | SchJ_P01_S00_L03 | Identifier |
| Return Reference | Schedule J, Part I, Line 3 | ReturnReference |
| Explanation | The HR Manager performs a salary survey annually for all positions. The survey is categorized into five levels per employee type, which defines experience, skill level, education, and knowledge. Performance evaluations are performed annually for all employees, including the CEO, by their supervisor. The Board of Directors reviews the CEO's performance. Raises are provided based on the salary scale and performance review. | Explanation |
Schedule M IRS990ScheduleM
Drugs And Medical Supplies DrugsAndMedicalSupplies
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Number Of Contributions | 2010 | NumberOfContributions |
| Noncash Contribs Rptd F990 | 34859 | NoncashContribsRptdF990 |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenues |
Other Non Cash Contributions Table OtherNonCashContributionsTable (3 entries)
| Non Cash CheckboxNonCashCheckbox | DescriptionDescription | Number Of ContributionsNumberOfContributions | Noncash Contribs Rptd F990NoncashContribsRptdF990 | Method Of Determining RevenuesMethodOfDeterminingRevenues |
|---|---|---|---|---|
| X | Office Supplies | 5 | 2000 | FMV |
| X | Various Computer Software | 1 | 23728 | FMV |
| X | Office Furniture | 1 | 2990 | FMV |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of8283 Received | 0 | NumberOf8283Received |
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeld |
| Review Process Unusual NC Gifts | 1 | ReviewProcessUnusualNCGifts |
| Third Parties Used | 0 | ThirdPartiesUsed |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (8 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| F990_P06_S0A_L06 | Form 990, Part VI, Section A, Line 6 | The organization has nonstockholding members. |
| F990_P06_S0A_L07a | Form 990, Part VI, Section A, Line 7a | Per the bylaws of the organization, all members of the Board of Directors vote to accept new members. |
| F990_P06_S0A_L07b | Form 990, Part VI, Section A, Line 7b | Per the bylaws of the organization, the Board of Directors approves policies and procedures; finacial reports; structural changes, and certain purchases. |
| F990_P06_S0B_L11b | Form 990, Part VI, Section B, Line 11b | The form 990 is presented to the Finance Committee, who reviews the document and makes a recommendation for approval to the Board of Directors. Once the 990 is approvd by the Board of Directors, the 990 is filed. |
| F990_P06_S0B_L12c | Form 990, Part VI, Section B, Line 12c | All members of the Board of Directors, officers, and key employees are required to complete and sign a conflict of interest form annually. Any disclosure is presented to the Board of Directors for action consiting either of separation from duties or limitation of voting rights or duties depending on the conflict of interest activity. |
| F990_P06_S0B_L15 | Form 990, Part VI, Section B, Line 15 | An anual performance evaluation is completed by either the Boad of Directors or the employee's supervisor for all officers and employees. The performance evaluation is scored with the score relating to a particurlar percentage based on a range set forth by the organization at the beginning of the year. A salary ad wage analysis is performed annually using date from federal and state sources. Any adjustment to the officer or employee's wage is based on both the performance evaluation and wage survey. |
| F990_P06_S0C_L19 | Form 990, Part VI, Section C, Line 19 | All governing documents, conflict of interest policy, and financial statements available to the public upon request. |
| F990_P12_S00_L02c | Form 990, Part XII, Line 2c | Finance Committee reviews financial statements, audit, and the selection of the auditor and presents these items to the full Board of Directors for ratification. |
Reasonable Cause Explanation ReasonableCauseExplanation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Explanation | Midland Community Healthcare Services was in the process of completing it's single point audit when the 990 came due. Two forms 8869 were completed and approved by the IRS, allowing the organization to extend it's tax return due date. | Explanation |