Attach to Form 990 or Form 990-EZ.
Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
| (i)Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 9 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
| Total | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any unusual grants.) .... | ||||||
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....... | ||||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 4 | Total. Add lines 1 through 3 | ||||||
| 5 | The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f).. | ||||||
| 6 | Public support. Subtract line 5 from line 4. | ||||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | ||||||
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | ||||||
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | ||||||
| 11 | Total support. Add lines 7 through 10. | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 19,185,790 | 16,700,047 | 17,526,766 | 17,123,844 | 17,036,474 | 87,572,921 |
| 2 | Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose...... | 24,896,881 | 26,454,940 | 28,202,852 | 26,250,802 | 25,249,490 | 131,054,965 |
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513... | ||||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | ||||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 6 | Total. Add lines 1 through 5. | 44,082,671 | 43,154,987 | 45,729,618 | 43,374,646 | 42,285,964 | 218,627,886 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons... | 0 | |||||
| b | Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year. | 0 | |||||
| c | Add lines 7a and 7b.. | 0 | |||||
| 8 | Public support. (Subtract line 7c from line 6.) | 218,627,886 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 44,082,671 | 43,154,987 | 45,729,618 | 43,374,646 | 42,285,964 | 218,627,886 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 4,475 | 11,206 | 15,192 | 18,282 | 17,240 | 66,395 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 4,475 | 11,206 | 15,192 | 18,282 | 17,240 | 66,395 |
| 11 | Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. | 40,022 | 79,042 | 119,064 | |||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | 901,469 | 909,764 | 1,712,044 | 1,198,234 | 925,186 | 5,646,697 |
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 44,988,615 | 44,115,979 | 47,456,854 | 44,670,204 | 43,228,390 | 224,460,042 |
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e |
Discount claimed for blockage or other factors (explain in detail in Part VI): |
|||||
| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by .035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | ||
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
||
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | ||
| 4 Amounts paid to acquire exempt-use assets | ||
| 5 Qualified set-aside amounts (prior IRS approval required) | ||
| 6 Other distributions (describe in Part VI). See instructions | ||
| 7Total annual distributions. Add lines 1 through 6. | ||
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
||
| 9 Distributable amount for 2015 from Section C, line 6 | ||
| 10 Line 8 amount divided by Line 9 amount | ||
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2015 |
(iii) Distributable Amount for 2015 |
|
|---|---|---|---|---|
|
1
Distributable amount for 2015 from Section C, line 6 |
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|
2
Underdistributions, if any, for years prior to 2015 (reasonable cause required--see instructions) |
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| 3 Excess distributions carryover, if any, to 2015: | ||||
| a | ||||
| b | ||||
| c | ||||
| d From 2013....... | ||||
| e From 2014....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2015 distributable amount | ||||
|
i
Carryover from 2010 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2015 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2015 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2015, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions) |
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|
6
Remaining underdistributions for 2015. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions) |
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|
7 Excess distributions carryover to 2016. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a | ||||
| b | ||||
| c Excess from 2013....... | ||||
| d From 2014....... | ||||
| e From 2015....... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|---|
| SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: | OTHER INCOME - 2011 AMOUNT: $ 299,042. 2012 AMOUNT: $ 304,068. 2013 AMOUNT: $ 202,028. 2014 AMOUNT: $ 563,575. 2015 AMOUNT: $ 290,001. FORGIVENESS OF DEBT - 2013 AMOUNT: $ 915,012. ADMIN AND SUPPORT SERVICE - 2011 AMOUNT: $ 595,004. 2012 AMOUNT: $ 595,004. 2013 AMOUNT: $ 595,004. 2014 AMOUNT: $ 620,004. 2015 AMOUNT: $ 620,000. MEDICAL RECORDS - 2011 AMOUNT: $ 7,423. 2012 AMOUNT: $ 10,692. 2014 AMOUNT: $ 14,655. 2015 AMOUNT: $ 14,755. VENDING MACHINE - 2015 AMOUNT: $ 430. |
| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at| Return Reference | Explanation |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 4 | THE ORGANIZATION AMENDED ITS BY-LAWS IN JANUARY, 2015. ARTICLES IV, VIII, IX, X AND XI WERE AMENDED TO COMPLY WITH THE NYS REVITALIZATION ACT. THE AMENDMENTS INCLUDED: -CLARIFYING THE STAGGERING OF THE ELECTION OF DIRECTORS AT THE ANNUAL MEETING SO THAT EACH YEAR APPROXIMATELY HALF OF THE -DIRECTORS ARE ELECTED FOR A TWO YEAR TERM; -DELETED THE SECTION ON DIRECTORS REQUESTING A LEAVE OF ABSENCE; ADDED DETAIL ABOUT HOW NOTICE OF A SPECIAL MEETING IS GIVEN TO DIRECTORS; -CLARIFIED HOW A DIRECTOR SUBMITS A WAIVER OF NOTICE; -ADDED DETAIL TO THE SECTION ON ACTIONS OF THE BOARD TO PROHIBIT PROXY VOTING, CLARIFY WHEN A MAJORITY VOTE IS SUFFICIENT FOR ACTION AND WHEN A TWO THIRDS VOTE IS NEEDED, ADOPTING RESOLUTIONS BY WRITTEN CONSENT OUTSIDE OF A MEETING, CLARIFYING ELECTRONIC PARTICIPATION IN MEETINGS BY DIRECTORS; -A DESCRIPTION OF THE COMPONENTS OF THE ANNUAL MEETING; -ADDED A PROHIBITION OF EMPLOYEES SERVING AS OFFICERS OF THE BOARD; -CLARIFICATION OF THE LIMITS ON ACTIONS THAT CAN BE TAKEN BY THE EXECUTIVE COMMITTEE; -CLARIFICATION OF THE DISTINCTION BETWEEN COMMITTEES OF THE BOARD AND COMMITTEES OF THE CORPORATION; -ADDED INFORMATION TO THE DESCRIPTION OF THE RESPONSIBILITY OF THE AUDIT/FINANCE COMMITTEE; -CLARIFICATION OF ACTIONS BY COMMITTEES; ADDED LANGUAGE DESCRIBING THE BOARD'S ADOPTION OF AN INVESTMENT POLICY; -CLARIFICATION OF THE RECORDS OF THE CORPORATION; -THE SECTION ON THE CONFLICT OF INTEREST STATEMENT AND PROHIBITED TRANSACTIONS WAS UPDATED; -UPDATED THE SECTION ON INDEMNIFICATION |
| FORM 990, PART VI, SECTION B, LINE 11 | THE PRESIDENT & CEO, CHIEF FINANCIAL OFFICER AND CONTROLLER REVIEW THE FORM 990 BEFORE IT IS PRESENTED AND REVIEWED BY THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS. THE CHAIR OF FINANCE COMMITTEE THEN PRESENTS THE FORM 990 FOR FULL BOARD REVIEW AT THE BOARD OF DIRECTORS MEETING, BEFORE IT IS FILED WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE CHAIR OF THE BOARD OF DIRECTORS ENSURES THAT ALL BOARD MEMBERS AND THE PRESIDENT & CEO SUBMIT ATTESTATIONS ON AN ANNUAL BASIS. KEY EMPLOYEES SUBMIT THEIR ATTESTATIONS TO THE PRESIDENT AND CEO. ANY CASES OF POTENTIAL CONFLICTS OF INTEREST ARE DEALT WITH APPROPRIATELY. AS PER POLICY, THE THE INDIVIDUAL WITH THE CONFLICT OF INTEREST SHALL ABSTAIN FROM ANY DISCUSSION OF, OR VOTE. |
| FORM 990, PART VI, SECTION B, LINE 15 | WHEN DETERMINING COMPENSATION FOR THE ORGANIZATION'S PRESIDENT & CEO AND OTHER TOP MANAGEMENT OFFICIALS AND KEY EMPLOYEES, THE HUMAN RESOURCES DEPARTMENT CONTACTS THE HR DEPARTMENT OF OTHER COMMUNITY HEALTH CENTERS AND HEALTH INSTITUTIONS FOR COMPARISON OF SALARY, INCLUDING BENEFITS; AND VISITS RELEVANT INTERNET WEBSITES. THE CENTER USED MARKET RESEARCH AND STUDIES TO DETERMINE COMPENSATION. THE CENTER PARTICIPATES IN THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS' (NACHC) ANNUAL HEALTH CENTER SALARY AND BENEFIT SURVEY. DELIBERATIONS AND DECISIONS ARE APPROVED BY THE BOARD AND DOCUMENTED IN THE MINUTES. THIS PROCESS WAS LAST UNDERTAKEN IN 2015. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE CENTER PROVIDES COPIES UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | PAYROLL PROCESSING: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 218,959. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 218,959. FACILITY SERVICE CONTRACT FEES: PROGRAM SERVICE EXPENSES 296,658. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 296,658. EQUIPMENT SERVICE CONTRACT FEES: PROGRAM SERVICE EXPENSES 154,133. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 154,133. CONTRACT SERVICE FEES: PROGRAM SERVICE EXPENSES 315,028. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 315,028. CONSULTANTS: PROGRAM SERVICE EXPENSES 133,076. MANAGEMENT AND GENERAL EXPENSES 632,314. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 765,390. MEDICAL CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 1,161,400. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,161,400. OPHTHALMOLOGY CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 987,650. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 987,650. SPECIALTY CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 189,309. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 189,309. MARKETING & RESEARCH CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 2,866. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,866. PERSONNEL FEES: PROGRAM SERVICE EXPENSES 711,615. MANAGEMENT AND GENERAL EXPENSES 319,571. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,031,186. LABORATORY FEES: PROGRAM SERVICE EXPENSES 173,579. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 173,579. |
| FORM 990, PART XII, LINE 2C: | THE ORGANIZATION'S AUDIT COMMITTEE SHALL BE RESPONSIBLE FOR OVERSEEING THE ACCOUNTING AND FINANCIAL REPORTING PROCESSES OF THE CORPORATION AND THE AUDIT OF THE CORPORATION'S FINANCIAL STATEMENTS. |
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