Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 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) 2014 | (b) 2015 | (c) 2016 | (d) 2017 | (e) 2018 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | ||||||
| 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) 2014 | (b) 2015 | (c) 2016 | (d) 2017 | (e) 2018 | (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) 2014 | (b) 2015 | (c) 2016 | (d) 2017 | (e) 2018 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 17,123,844 | 17,036,474 | 17,323,786 | 16,484,952 | 17,278,074 | 85,247,130 |
| 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 | 26,250,802 | 25,249,490 | 32,297,811 | 36,786,215 | 39,085,518 | 159,669,836 |
| 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 | 43,374,646 | 42,285,964 | 49,621,597 | 53,271,167 | 56,363,592 | 244,916,966 |
| 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.) | 244,916,966 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2014 | (b) 2015 | (c) 2016 | (d) 2017 | (e) 2018 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 43,374,646 | 42,285,964 | 49,621,597 | 53,271,167 | 56,363,592 | 244,916,966 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 18,282 | 17,240 | 11,673 | 13,995 | 33,358 | 94,548 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 18,282 | 17,240 | 11,673 | 13,995 | 33,358 | 94,548 |
| 11 | Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. | 79,042 | 79,042 | ||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | 1,198,234 | 925,186 | 1,614,610 | 1,061,275 | 1,133,729 | 5,933,034 |
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 44,670,204 | 43,228,390 | 51,247,880 | 54,346,437 | 57,530,679 | 251,023,590 |
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
||||
| 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 2018 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-2018 |
(iii) Distributable Amount for 2018 |
|
|---|---|---|---|---|
|
1
Distributable amount for 2018 from Section C, line 6 |
||||
|
2
Underdistributions, if any, for years prior to 2018 (reasonable cause required-- explain in Part VI). See instructions. |
||||
| 3 Excess distributions carryover, if any, to 2018: | ||||
| a From 2013....... | ||||
| b From 2014....... | ||||
| c From 2015....... | ||||
| d From 2016....... | ||||
| e From 2017....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2018 distributable amount | ||||
|
i
Carryover from 2013 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2018 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2018 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2018, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
||||
|
6
Remaining underdistributions for 2018. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
||||
|
7 Excess distributions carryover to 2019. Add lines 3j and 4c. |
||||
| 8 Breakdown of line 7: | ||||
| a Excess from 2014...... | ||||
| b Excess from 2015..... | ||||
| c Excess from 2016..... | ||||
| d Excess from 2017..... | ||||
| e Excess from 2018..... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|---|
| SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: | MISCELLANEOUS - 2014 AMOUNT: $ 563,575. 2015 AMOUNT: $ 290,001. 2016 AMOUNT: $ 685,473. 2017 AMOUNT: $ 133,039. 2018 AMOUNT: $ 200,276. ADMIN AND SUPPORT SERVICE - 2014 AMOUNT: $ 620,004. 2015 AMOUNT: $ 620,000. 2016 AMOUNT: $ 915,000. 2017 AMOUNT: $ 915,000. 2018 AMOUNT: $ 915,000. MEDICAL RECORDS - 2014 AMOUNT: $ 14,655. 2015 AMOUNT: $ 14,755. 2016 AMOUNT: $ 13,755. 2017 AMOUNT: $ 12,753. 2018 AMOUNT: $ 17,938. VENDING MACHINE - 2015 AMOUNT: $ 430. 2016 AMOUNT: $ 382. 2017 AMOUNT: $ 483. 2018 AMOUNT: $ 515. |
| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 4 | THE ORGANIZATION AMENDED ITS BYLAWS DURING 2018 TO IMPLEMENT NEW QUALIFICATIONS FOR BOARD MEMBERS. NO DIRECTOR SHALL BE ELIGIBLE TO APPLY FOR A POSITION AS AN EMPLOYEE OF THE CORPORATION OR RECEIVE COMPENSATION FOR SERVICES TO THE CORPORATION WHILE SERVING ON THE BOARD OR FOR A PERIOD OF SIX MONTHS FOLLOWING THE DATE UPON WHICH HE OR SHE CEASED TO BE A DIRECTOR. ANY INDIVIDUAL WHO HAS SERVED AS AN EMPLOYEE OF THE CORPORATION OR WHO HAS OTHERWISE RECEIVED COMPENSATION FOR SERVICES PROVIDED TO THE CORPORATION SHALL BE INELIGIBLE TO SERVCE ON THE BOARD UNTIL ONE YEAR FOLLOWING THE DATE UPON WHICH HE OR SHE CEASED TO BE AN EMPLOYEE OF THE CORPORATION OR PROVIDE SERVICES TO THE CORPORATION. |
| FORM 990, PART VI, SECTION B, LINE 11B | 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 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 2018. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S FORM 990 AND FORM 1023 ARE AVAILABLE FOR PUBLIC INSPECTION AS REQUIRED UNDER SECTION 6104 OF THE INTERNAL REVENUE CODE. THE RETURN IS POSTED ON GUIDESTAR.ORG AND SIMILAR WEBSITES. IN ADDITION, THE FINANCIAL STATEMENTS, ARTICLES OF INCORPORATION, FORM 990, FORM 1023, AND BY-LAWS ARE ALSO AVAILABLE UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | CONSULTING - ADMINISTRATIVE: PROGRAM SERVICE EXPENSES 319,850. MANAGEMENT AND GENERAL EXPENSES 378,325. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 698,175. SERVICE CONTRACTS: PROGRAM SERVICE EXPENSES 439,877. MANAGEMENT AND GENERAL EXPENSES 77,630. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 517,507. OTHER CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 192,871. MANAGEMENT AND GENERAL EXPENSES 94,751. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 287,622. MEDICAL CONSULTANTS: PROGRAM SERVICE EXPENSES 798,569. MANAGEMENT AND GENERAL EXPENSES 424,434. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,223,003. PERSONNEL FEES: PROGRAM SERVICE EXPENSES 469,570. MANAGEMENT AND GENERAL EXPENSES 176,946. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 646,516. LABORATORY FEES: PROGRAM SERVICE EXPENSES 213,180. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 213,180. DATA PROCESSING: PROGRAM SERVICE EXPENSES 563,217. MANAGEMENT AND GENERAL EXPENSES 315,166. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 878,383. SPECIALTY CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 652,751. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 652,751. OPHTHALMOLOGY CONTRACT SERVICES: PROGRAM SERVICE EXPENSES 1,061,162. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,061,162. PAYROLL PROCESSING: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 197,476. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 197,476. FACILITY SERVICE CONTRACT FEES: PROGRAM SERVICE EXPENSES 165,764. MANAGEMENT AND GENERAL EXPENSES 29,253. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 195,017. MARKETING & RESEARCH: PROGRAM SERVICE EXPENSES 2,217. MANAGEMENT AND GENERAL EXPENSES 5,621. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,838. |
| FORM 990, PART XII, LINE 2C: | THE ORGANIZATION'S AUDIT COMMITTEE SHALL BE RESPONSIBLE FOR OVERSEEING THE ACCOUNTING AND FINANCIAL REPORTING PROCESSES OF THE ORGANIZATION AND THE AUDIT OF THE ORGANIZATION'S FINANCIAL STATEMENTS. |
| Software ID: | |
| Software Version: |