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COASTAL FAMILY HEALTH CENTER INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
COASTAL FAMILY HEALTH CENTER INC (EIN 64-0592416)
Tax period
2011-01-01 to 2011-12-31
Filed
2012-03-30
IRS object ID
201241109349300604
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2012-03-30T12:10:05-07:00Timestamp
Tax Period End Date2011-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN631110081EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1S W Chiepalich CPA P CBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line15905 Airport BlvdAddressLine1
CityMobileCity
StateALState
ZIP Code36608ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN640592416EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Coastal Family Health Center IncBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlCOASNameControl
Phone2283742494Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1P O Box 475AddressLine1
CityBiloxCity
StateMSState
ZIP Code39533ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameAngel GreerName
TitleChief Executive OfficerTitle
Phone2283742494Phone
Date Signed2012-03-30DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameSteve ChiepalichName
PTINP01277684PTIN
Phone2516103792Phone
Date Prepared2012-03-30DatePrepared
Self EmployedXSelfEmployed
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonAngel GreerNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1P O Box 475AddressLine1
CityBiloxiCity
StateMSState
ZIP Code39533ZIPCode
FieldValueIRS element (for citing)
Gross Receipts14137510GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteCoastalfamilyhealth.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1976YearFormation
State Legal DomicileMSStateLegalDomicile
Activity Or Mission DescriptionThe purpose of Coastal Family Health Center, Inc. is to provide quality health care and social services to all persons regardless of economin status with the understanding that the term health is an inclusive one that seeks to improve the quality of life for the whole community.ActivityOrMissionDescription
Nbr Voting Members Governing Body16NbrVotingMembersGoverningBody
Nbr Independent Voting Members16NbrIndependentVotingMembers
Total Nbr Employees234TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year10205420ContributionsGrantsPriorYear
Contributions Grants Current Year9048249ContributionsGrantsCurrentYear
Program Service Revenue Prior Year4716298ProgramServiceRevenuePriorYear
Program Service Revenue CY5055558ProgramServiceRevenueCY
Investment Income Prior Year185858InvestmentIncomePriorYear
Investment Income Current Year-22753InvestmentIncomeCurrentYear
Other Revenue Prior Year27923OtherRevenuePriorYear
Other Revenue Current Year15980OtherRevenueCurrentYear
Total Revenue Prior Year15135499TotalRevenuePriorYear
Total Revenue Current Year14097034TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year9513882SalariesEtcPriorYear
Salaries Etc Current Year8840454SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year6327441OtherExpensePriorYear
Other Expenses Current Year5172627OtherExpensesCurrentYear
Total Expenses Prior Year15841323TotalExpensesPriorYear
Total Expenses Current Year14013081TotalExpensesCurrentYear
Revenues Less Expenses Prior Year-705824RevenuesLessExpensesPriorYear
Revenues Less Expenses CY83953RevenuesLessExpensesCY
Total Assets BOY13824027TotalAssetsBOY
Total Assets EOY13820252TotalAssetsEOY
Total Liabilities BOY997898TotalLiabilitiesBOY
Total Liabilities EOY910170TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY12826129NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY12910082NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionThe purpose of Coastal Family Health Center, Inc. is to provide quality health care and social services to all persons regardless of economic status with the understanding that the term health is an inclusive one that seeks to improve the quality of life for the whole community.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense6858755Expense
Revenue0Revenue
DescriptionMedical Services - Providing high quality medical services primarily to the uninsured and the under-insured is one of our primary exempt purposes. During 2011, our organization had 73,795 patient medical appointments for various medical conditions which were seen by family physicians or physician assistants, internists, pediatricians, or nurse practitioners. These appointments involved a total of 27,143 of our patients.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense588469Expense
Revenue0Revenue
DescriptionHIV Services - Our organization provided, on an outpatient basis, high-quality early intervention services and primary care related services to HIV patients. We provide a continuum of HIV preventions for at-risk individuals, and care for individuals who are HIV-infected. During 2011, we provided these services to approximately 350 such patients, who had a cumulative total of approximately 1,000 appointments.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense668940Expense
Revenue0Revenue
DescriptionDental Services - Our organization also provides dental services primarily to the uninsured and the under-insured. During 2011, we had 8,903 dental appointments provided by one of our dentists to 4,673 of our dental patients.Description

Activity Other ActivityOther

FieldValueIRS element (for citing)
Expense4295695Expense
Revenue80000Revenue
DescriptionOther servicesDescription
FieldValueIRS element (for citing)
Total Of Other Program Service Exp4295695TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt0TotalOfOtherProgramServiceGrnt
Total Of Other Program Service Rev80000TotalOfOtherProgramServiceRev
Total Program Service Expense12411859TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities0ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required0ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity0RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109640NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees234NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members16NbrVotingGoverningBodyMembers
Number Independent Voting Members16NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body0Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy0WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonKatherine HillNamePerson
Telephone Number2283742494TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line11046 Division StreetAddressLine1
CityBiloxiCity
StateMSState
ZIP Code39533ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (17 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployee
Kwantrell Green
President2X000
Karlyn Stephens
Vice-President1X000
Stephanie Barnes Taylor
Secretary1X000
Brandon Jacobs
Treasurer1X000
Judy Jones
Director1X000
Paulette Briscoe
Director1X000
Christine McLeod
Director1X000
Sally Bevill
Director1X000
Ethel Davis
Director1X000
Joe Hudson
Director1X000
Lenore Johns
Director1X000
Jessica Mardis
Director1X000
Crystal Nuss
Director1X000
Bertha Oatis
Director1X000
Jerlean Osborne
Director1X000
Judy Roberts
Director1X000
Angel Greer
Chief Executive Officer4012710700X
FieldValueIRS element (for citing)
Total Reportable Comp From Org127107TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation0TotalOtherCompensation
Number Individuals GT100 K13NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K0TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Laboratory Corporation of America
P O Box 12140BurlingtonNC27216Medical lab tests445158
Reeves Construction Inc
P O Box 1829LaurelMS39441Clinic construction313825
AT & T
85 AnnexAtlantaGA30385Communication services166686
Emmon Enterprises LLC
PonchatoulaPonchatoulaLA70454Janitorial114253
Mike Dorcik P A
12511 McCully DriveBiloxMS39532Contract medical services123700
FieldValueIRS element (for citing)
Number Of Contractors GT100 K5NumberOfContractorsGT100K
Federated Campaigns0FederatedCampaigns
Membership Dues0MembershipDues
Fundraising Events0FundraisingEvents
Related Organizations0RelatedOrganizations
Government Grants7784710GovernmentGrants
All Other Contributions1263539AllOtherContributions
Noncash Contributions0NoncashContributions
Total Contributions9048249TotalContributions

Program Service Revenue ProgramServiceRevenue (4 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeUnrelated Business RevenueUnrelatedBusinessRevenueExclusionExclusionAmount
Medical services621990456130945613090$0
Dental services6212103953153953150$0
Optometry services62132080000800000$0
HIV services62199018934189340$0

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount
FieldValueIRS element (for citing)
Total Program Service Revenue5055558TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column4723TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$4,723ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real0Real
Personal0Personal

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities0Securities
Other13000Other

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities0Securities
Other40476Other

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities0Securities
Other-27476Other

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column-27476TotalRevenueColumn
Related Or Exempt Function Income-27476RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount
FieldValueIRS element (for citing)
Cntrbtns Rprtd Fundraising Events0CntrbtnsRprtdFundraisingEvents

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column15980TotalRevenueColumn
Related Or Exempt Function Income15980RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue15980TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column14097034TotalRevenueColumn
Related Or Exempt Function Income5044062RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$4,723ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total127107Total
Management And General127107ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total6992617Total
Program Services6329717ProgramServices
Management And General662900ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total259561Total
Program Services230662ProgramServices
Management And General28899ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total899449Total
Program Services805999ProgramServices
Management And General93450ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total561720Total
Program Services499320ProgramServices
Management And General62400ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total2503Total
Management And General2503ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total24583Total
Management And General24583ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total41468Total
Management And General41468ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total834779Total
Program Services554224ProgramServices
Management And General280555ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total53257Total
Program Services44555ProgramServices
Management And General8702ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total673815Total
Program Services582621ProgramServices
Management And General91194ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total113174Total
Program Services86984ProgramServices
Management And General26190ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
Medical, dental & lab supplies1042079104207900
Contract lab & medical services1114764111476400
Licenses & dues1005143919017861260
Education, dues & publications10137186049153220

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total165691Total
Program Services115868ProgramServices
Management And General49823ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total14013081Total
Program Services12411859ProgramServices
Management And General1601222ManagementAndGeneral
Fundraising0Fundraising

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY1765112BOY
EOY2270555EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY50625BOY
EOY514608EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY2208948BOY
EOY1544046EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY37871BOY
EOY36318EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY88608BOY
EOY56644EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis13006481LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec3611615LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY9669148BOY
EOY9394866EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY3715BOY
EOY3215EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY13824027BOY
EOY13820252EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY972185BOY
EOY616521EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY25713BOY
EOY293649EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY997898BOY
EOY910170EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY12826129BOY
EOY12910082EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY12826129BOY
EOY12910082EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY13824027BOY
EOY13820252EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses83953ReconcilationRevenueExpenses
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee0AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit Required1FederalGrantAuditRequired
Federal Grant Audit Performed1FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org170b1 AviXPubliclySupportedOrg170b1Avi

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years17068057CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years10110515CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years9216936CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year10282880CurrentTaxYearMinus1Year
Current Tax Year9116771CurrentTaxYear
Total55795159Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years17068057CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years10110515CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years9216936CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year10282880CurrentTaxYearMinus1Year
Current Tax Year9116771CurrentTaxYear
Total55795159Total
FieldValueIRS element (for citing)
Public Support Total17055795159PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years59508CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years42640CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years35068CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year10250CurrentTaxYearMinus1Year
Current Tax Year4723CurrentTaxYear
Total152189Total

Other Income170 OtherIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years22605CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years43604CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years5121CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year27923CurrentTaxYearMinus1Year
Current Tax Year15980CurrentTaxYear
Total115233Total
FieldValueIRS element (for citing)
Total Support56062581TotalSupport
Public Support Pertcentage1700.99523PublicSupportPertcentage170
Public Support Pertcent Prior Year0.99514PublicSupportPertcentPriorYear
Thirty Three Percnt Tests CY170XThirtyThreePercntTestsCY170
General ExplanationSmall, inconsequential cash receipts throughout the year.GeneralExplanation

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis352951OtherCostOrOtherBasis
Book Value352951BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis10025086OtherCostOrOtherBasis
Depreciation1891891Depreciation
Book Value8133195BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis85910OtherCostOrOtherBasis
Depreciation2148Depreciation
Book Value83762BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis2444880OtherCostOrOtherBasis
Depreciation1717576Depreciation
Book Value727304BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis97654OtherCostOrOtherBasis
Depreciation0Depreciation
Book Value97654BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings9394866TotalOfBookValueLandBuildings
Total Revenue14097034TotalRevenue
Total Expenses14013081TotalExpenses
Excess Or Deficit For Year83953ExcessOrDeficitForYear
Net Unrealized GL On Investments0NetUnrealizedGLOnInvestments
Donated Services And Facilities0DonatedServicesAndFacilities
Investment Expenses0InvestmentExpenses
Prior Period Adjustments0PriorPeriodAdjustments
Other$0OtherAmount
Total Adjustments0TotalAdjustments
Excess Or Deficit Per FS83953ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt14193032TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments0NetUnrealizedGainsInvestments
Donated Srvc And Use Of Facilities68522DonatedSrvcAndUseOfFacilities
Recoveries Of Prior Year Grants0RecoveriesOfPriorYearGrants
Other Revenues0OtherRevenues
Revenue Not Rptd F99068522RevenueNotRptdF990
Revenue Subtotal14124510RevenueSubtotal
Investment Expenses Not Included0InvestmentExpensesNotIncluded
Other Revenues Not Included-27476OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt-27476RevenueNotRptdOnFinStmt
Total Revenue Per Form99014097034TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt14109079TotExpensesEtcAuditedFinclStmt
Donated Services Use Of Facilities68522DonatedServicesUseOfFacilities
Prior Year Adjustments0PriorYearAdjustments
Losses Reported0LossesReported
Other Expenses Included27476OtherExpensesIncluded
Expenses Not Rptd F99095998ExpensesNotRptdF990
Expenses Subtotal14013081ExpensesSubtotal
Investment Expenses Not Included20InvestmentExpensesNotIncluded2
Other Expenses Not Included0OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form99014013081TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
SchD_P12_S00_L04bSchedule D, Part XII, Line 4bLoss on sale of assets other than inventory netted in revenues on tax return.
SchD_P13_S00_L02dSchedule D, Part XIII, Line 2dLoss on sale of assets other than inventory netted in revenues on tax return.

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
F990_P03_S00_L04dForm 990, Part III, Line 4dIn addition to the above services, our organization provides mental health, lab, nutrition, patient transportation, OB/GYN, pharmacy, and other ancillary services. Our pharmacy fills over 150 prescriptions per day and our total patient count is over 30,000.
F990_P06_S0B_L11aForm 990, Part VI, Section B, Line 11aThe Form 990 is reviewed in detail with the Chief Financial Officer before filing. The Form 990 is reviewed and signed by the Chief Executive Officer. It is subsequently discussed on a cursory basis with the Board by the organization's independent auditor.
F990_P06_S0B_L12cForm 990, Part VI, Section B, Line 12cThe Conflict of Interest Policy is monitored and enforced by management through close oversight of, and frequent interaction with, department heads and the Board.
F990_P06_S0B_L15Form 990, Part VI, Section B, Line 15A comprehensive market survey was performed in 2008 by the Board's Personnel Committee to evaluate and adjust the Chief Executive Officer's compensation package to reflect the local market.
F990_P06_S0C_L19Form 990, Part VI, Section C, Line 19Form 990, Part VI, Section C, Line 19 - The organization is not required to, and does not, make its governing documents or conflict of interest policy available to the public. Its Form 990, however, is prepared from its annual audited financial statements and, as such, its annual financial statements are available to the public through review of its annual tax return.