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UNITED NEIGHBORHOOD HEALTH SERVICES INC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
UNITED NEIGHBORHOOD HEALTH SERVICES INC (EIN 62-1032792)
Tax period
2010-02-01 to 2011-01-31
Filed
2011-10-06
IRS object ID
201112799349300821
Schema version
2010v3.4
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)
Timestamp2011-10-06T15:26:12-05:00Timestamp
Tax Period End Date2011-01-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1MATHENEY STEES & ASSOCIATES PCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line16136 SHALLOWFORD ROAD SUITE 101AddressLine1
CityCHATTANOOGACity
StateTNState
ZIP Code374217214ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-02-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN621032792EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1UNITED NEIGHBORHOOD HEALTH SERVICES INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlUNITNameControl
Phone6152888902Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1617 SOUTH 8TH STREETAddressLine1
CityNASHVILLECity
StateTNState
ZIP Code37206ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMARY BUFWACKName
TitleCEOTitle
Phone6152888902Phone
Date Signed2011-10-06DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameWILLIAM C MATHENEYName
Phone4238947400Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonMARY BUFWACKNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1617 SOUTH 8TH STREETAddressLine1
CityNASHVILLECity
StateTNState
ZIP Code37206ZIPCode
FieldValueIRS element (for citing)
Gross Receipts14302955GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.UNITEDNEIGHBORHOOD.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1976YearFormation
State Legal DomicileTNStateLegalDomicile
Activity Or Mission DescriptionUNITED NEIGHBORHOOD HEALTH SERVICES, INC. OPERATES HEALTH CARE CENTERS LOCATED IN THE STATE OF TENNESSEE IN THE COUNTIES OF DAVIDSON AND TROUSDALE. THE CENTER PROVIDES A BROAD RANGE OF HEALTH SERVICES TO A LARGELY MEDICALLY UNDERSERVED POPULATION.ActivityOrMissionDescription
Nbr Voting Members Governing Body16NbrVotingMembersGoverningBody
Nbr Independent Voting Members16NbrIndependentVotingMembers
Total Nbr Employees194TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year7847210ContributionsGrantsPriorYear
Contributions Grants Current Year2140271ContributionsGrantsCurrentYear
Program Service Revenue Prior Year6518227ProgramServiceRevenuePriorYear
Program Service Revenue CY12132082ProgramServiceRevenueCY
Investment Income Prior Year5519InvestmentIncomePriorYear
Investment Income Current Year2043InvestmentIncomeCurrentYear
Other Revenue Prior Year13582OtherRevenuePriorYear
Other Revenue Current Year28559OtherRevenueCurrentYear
Total Revenue Prior Year14384538TotalRevenuePriorYear
Total Revenue Current Year14302955TotalRevenueCurrentYear
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 Year9196393SalariesEtcPriorYear
Salaries Etc Current Year8999292SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year4535078OtherExpensePriorYear
Other Expenses Current Year6249026OtherExpensesCurrentYear
Total Expenses Prior Year13731471TotalExpensesPriorYear
Total Expenses Current Year15248318TotalExpensesCurrentYear
Revenues Less Expenses Prior Year653067RevenuesLessExpensesPriorYear
Revenues Less Expenses CY-945363RevenuesLessExpensesCY
Total Assets BOY9694424TotalAssetsBOY
Total Assets EOY8675138TotalAssetsEOY
Total Liabilities BOY1341523TotalLiabilitiesBOY
Total Liabilities EOY1267600TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY8352901NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY7407538NetAssetsOrFundBalancesEOY
Mission DescriptionUNITED NEIGHBORHOOD HEALTH SERVICES, INC. OPERATES HEALTH CARE CENTERS LOCATED IN THE STATE OF TENNESSEE IN THE COUNTIES OF DAVIDSON AND TROUSDALE. THE CENTER PROVIDES A BROAD RANGE OF HEALTH SERVICES TO A LARGELY MEDICALLY UNDERSERVED POPULATION.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense13335941Expense
Revenue12160641Revenue
DescriptionUNITED NEIGHBORHOOD HEALTH SERVICES, INC. OPERATES A COMMUNITY BASED HEALTHCARE CLINIC PROVIDING HEALTHCARE SERVICES TO APPROXIMATELY 81,000 VISITS.Description
Total Program Service Expense13335941TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
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 Footnote1ReportFin48Footnote
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 Required1ScheduleJRequired
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 With10963NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees194NumberOfEmployees
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 Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Other WebsiteXOtherWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonMARY BUFWACKNamePerson
Telephone Number6152288902TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1617 SOUTH 8TH STREETAddressLine1
CityNASHVILLECity
StateTNState
ZIP Code37206ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (21 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployee
JENNIFER HAMILTON
BOARD PRESIDENT2.00XX000
SHIRLEY MCCLENDON
BOARD VICE PRESIDENT2.00XX000
MARY ROBERTSON
BOARD SECRETARY2.00XX000
GLENN HUNTER
BOARD TREASURER2.00XX000
MARC HILL
BOARD MEMBER2.00X000
BRENDA MARROW
BOARD MEMBER2.00X000
SCOTT MERTIE
BOARD MEMBER2.00X000
CLARENCE SMITH
BOARD MEMBER2.00X000
HARVEY SPERLING
BOARD MEMBER2.00X000
SHIRLEY BASS
BOARD MEMBER2.00X000
MANUEL VALENZUELA
BOARD MEMBER2.00X000
RONNIE STEINE
BOARD MEMBER2.00X000
KEN MCNIGHT
BOARD MEMBER2.00X000
DENIES ALPER
BOARD MEMBER2.00X000
MICHAEL JOHNSON
BOARD MEMBER2.00X000
JACK MCCULLUM
BOARD MEMBER2.00X000
MARY BUFWACK
CEO35.00X13458704773X
KEITH JUNIOR MD
CMO35.00X19059008680X
LATONYA KNOTT
PHYSICIAN35.00X1397990444
SMITA BAJPAI
PHYSICIAN35.001393520450X
ADA-NKEM EMUWA
PHYSICIAN35.0013310000X
FieldValueIRS element (for citing)
Total Reportable Comp From Org737428TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation14347TotalOtherCompensation
Number Individuals GT100 K5NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
WELLSPRING BUILDERS INC
301 S PERIMETER PARK DR STE 214NASHVILLETN37211MEDICAL SERVICES442837
LABORATORY CORP OF AMERICA
PO BOX 12140BURLINGTONNC27216MEDICAL SERVICES400000
MCKESSON MEDICAL SURGICAL INC
PO BOX 740215CINCINNATIOH45274MEDICAL SERVICES262325
VANDERBILT MEDICAL CENTER
1211 MEDICAL CENTER DRIVENASHVILLETN37232MEDICAL/PSYCHIATRY192572
AXIOS INFORMATION TECHNOLOGIES
PO BOX 158400NASHVILLETN37215MEDICAL SERVICES182436
FieldValueIRS element (for citing)
Number Of Contractors GT100 K7NumberOfContractorsGT100K
Government Grants1914724GovernmentGrants
All Other Contributions225547AllOtherContributions
Total Contributions2140271TotalContributions

Program Service Revenue ProgramServiceRevenue (5 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
DEPARTMENT OF HEALTH A90009951350605135060
TENNCARE MANAGED CARE90009926655252665525
MEDICAID MANAGED CARE90009912790001279000
TENNESSEE DEPARTMENT O900099616941616941
SELF-PAY900099574205574205

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column1861351TotalRevenueColumn
Related Or Exempt Function Income1861351RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue12132082TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column2043TotalRevenueColumn
Exclusion$2,043ExclusionAmount

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
MEDICAL RECORDS9000991660616606
OTHER REVENUE9000991195311953
FieldValueIRS element (for citing)
Total Other Revenue28559TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column14302955TotalRevenueColumn
Related Or Exempt Function Income12160641RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$2,043ExclusionAmount

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total7296063Total
Program Services6397243ProgramServices
Management And General898820ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total1134592Total
Program Services994819ProgramServices
Management And General139773ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total568637Total
Program Services498572ProgramServices
Management And General70065ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total6226Total
Management And General6226ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total355557Total
Program Services370ProgramServices
Management And General355187ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total9881Total
Management And General9881ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total159283Total
Management And General159283ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total332721Total
Program Services304939ProgramServices
Management And General27782ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total80598Total
Program Services71716ProgramServices
Management And General8882ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total15394Total
Program Services3565ProgramServices
Management And General11829ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total26357Total
Program Services26357ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total512076Total
Program Services469318ProgramServices
Management And General42758ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total42308Total
Program Services37646ProgramServices
Management And General4662ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
PROVISION FOR BAD DEBTS15794261579426
CONTRACTUAL SERVICES99553594135754178
PHARMACEUTICALS638868638868
LABORATORY389478389478
TELEPHONE EXPENSE29192425975432170

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total813394Total
Program Services722513ProgramServices
Management And General90881ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total15248318Total
Program Services13335941ProgramServices
Management And General1912377ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1700BOY
EOY129289EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY947419BOY
EOY500124EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY777073BOY
EOY863242EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY1959808BOY
EOY696122EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY54644BOY
EOY43071EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis9445967LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec3014117LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY5953780BOY
EOY6431850EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY0BOY
EOY11440EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY9694424BOY
EOY8675138EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY548212BOY
EOY812397EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY107600BOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY685711BOY
EOY455203EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY1341523BOY
EOY1267600EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY8352901BOY
EOY7407538EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY8352901BOY
EOY7407538EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY9694424BOY
EOY8675138EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses-945363ReconcilationRevenueExpenses
Reconcilation Other Changes0ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit Required1FederalGrantAuditRequired
Federal Grant Audit Performed1FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years3824154CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years5158898CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years5705734CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year7847210CurrentTaxYearMinus1Year
Current Tax Year2005296CurrentTaxYear
Total24541292Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years3218901CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years3936816CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years5056016CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year6518227CurrentTaxYearMinus1Year
Current Tax Year12132082CurrentTaxYear
Total30862042Total

Value Of Svcs Fclts Furnishd By Govt ValueOfSvcsFcltsFurnishdByGovt

FieldValueIRS element (for citing)
Current Tax Year134975CurrentTaxYear
Total134975Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years7043055CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years9095714CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years10761750CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year14365437CurrentTaxYearMinus1Year
Current Tax Year14272353CurrentTaxYear
Total55538309Total

Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Amts From Subst Contributors AmtsFromSubstContributors

FieldValueIRS element (for citing)
Total0Total

Support From DQ Ps Etc SupportFromDQPsEtc

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Public Support Total50955538309PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years24764CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years44572CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years10085CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year5519CurrentTaxYearMinus1Year
Current Tax Year2043CurrentTaxYear
Total86983Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years24764CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years44572CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years10085CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year5519CurrentTaxYearMinus1Year
Current Tax Year2043CurrentTaxYear
Total86983Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years25128CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years34304CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years7407CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year13582CurrentTaxYearMinus1Year
Current Tax Year28559CurrentTaxYear
Total108980Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years7092947CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years9174590CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years10779242CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year14384538CurrentTaxYearMinus1Year
Current Tax Year14302955CurrentTaxYear
Total55734272Total
FieldValueIRS element (for citing)
Public Support Percentage5090.99650PublicSupportPercentage509
Prior Year Support Percentage0.99270PriorYearSupportPercentage
Investment Income Percentage0.00160InvestmentIncomePercentage
Prior Yr Invest Income Percentage0.00070PriorYrInvestIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

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)
Other Cost Or Other Basis749417OtherCostOrOtherBasis
Book Value749417BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis5097987OtherCostOrOtherBasis
Depreciation1154879Depreciation
Book Value3943108BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis213355OtherCostOrOtherBasis
Depreciation139359Depreciation
Book Value73996BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis1061744OtherCostOrOtherBasis
Depreciation735965Depreciation
Book Value325779BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis2323464OtherCostOrOtherBasis
Depreciation983914Depreciation
Book Value1339550BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings6431850TotalOfBookValueLandBuildings
Total Revenue14302955TotalRevenue
Total Expenses15248318TotalExpenses
Excess Or Deficit For Year-945363ExcessOrDeficitForYear
Total Adjustments0TotalAdjustments
Excess Or Deficit Per FS-945363ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt14302955TotRevenueEtcAuditedFinclStmt
Revenue Not Rptd F9900RevenueNotRptdF990
Revenue Subtotal14302955RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form99014302955TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt15248318TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal15248318ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form99015248318TotalExpensesPerForm990

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII

FieldValueIRS element (for citing)
Name PersonKEITH JUNIOR MDNamePerson
Base Compensation Filing Org190590BaseCompensationFilingOrg
Comp Based On Related Orgs0CompBasedOnRelatedOrgs
Bonus Filing Org0BonusFilingOrg
Bonus Related Orgs0BonusRelatedOrgs
Other Compensation Filing Org0OtherCompensationFilingOrg
Other Compensation Related Orgs0OtherCompensationRelatedOrgs
Deferred Comp Filing Org0DeferredCompFilingOrg
Deferred Comp Related Orgs0DeferredCompRelatedOrgs
Nontaxable Benefits Filing Org8680NontaxableBenefitsFilingOrg
Nontaxable Benefits Related Orgs0NontaxableBenefitsRelatedOrgs
Total Compensation Filing Org199270TotalCompensationFilingOrg
Total Compensation Related Orgs0TotalCompensationRelatedOrgs
Comp Report Prior990 Filing Org0CompReportPrior990FilingOrg
Comp Report Prior990 Related Orgs0CompReportPrior990RelatedOrgs

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
FORM 990, PART VI, SECTION B, LINE 11BEFORE FORM 990 IS FILED, IT IS REVIEWED BY THE CHIEF FINANCIAL OFFICER AND THE CHIEF EXECUTIVE OFFICER. IF ERRORS OR QUESTIONS ARISE, THESE ARE RESOLVED BEFORE FILING.
THE ORGANIZATIONS CONFLICT OF INTEREST POLICY IS REVIEWED ANNUALLY FOR ALL STAFF. FORMS ARE COMPLETED ANNUALLY BY BOARD MEMBERS. PROVIDERS HAVE CLAUSES IN CONTRACT THAT REQUIRE REPORTING. ALL CONTRACTS ARE REVIEWED FOR ANY CONFLICTS OF INTEREST.FORM 990, PART VI, SECTION B, LINE 12C
COMPENSATION FOR THE CEO AND TOP MANAGEMENT STAFF IS DETERMINED THROUGH COMPARISON WITH NATIONAL INFORMATION ON COMPENSATION FOR OTHER COMMUNITY HEALTH CENTERS. EFFORTS ARE MADE TO HAVE THIS LEVEL AT THE MEDIAN LEVEL. THE CEO AND MANAGEMENT OFFICIALS SALARIES ARE REVIEWED ANNUALLY BY THE BOARD OF DIRECTORS AND REVISED IF NEEDED, DEPENDING UPON THE FINANCIAL POSITION OF THE ORGANIZATION. BENEFITS FOR THE CEO AND TOP MANAGEMENT OFFICIALS ARE DONE EXACTLY LIKE THOSE OF OTHER EXEMPT STAFF.FORM 990, PART VI, SECTION B, LINE 15
THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE IN TWO WAYS. THESE DOCUMENTS MAY BE REQUESTED FROM THE ORGANIZATION'S BUSINESS OFFICE AND CAN BE OBTAINED WITHIN 5 BUSINESS DAYS. INFORMATION IS ALSO AVAILABLE ON A WEBSITE FOR NON-PROFITS: GIVINGMATTERS.COMFORM 990, PART VI, SECTION C, LINE 19
THE BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF INDEPENDENT AUDITORS.FORM 990, PART XII, LINE 2C