Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and 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 |
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Calendar year
(or fiscal year beginning in)
![]() |
(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | 4,380,166 | 3,374,946 | 3,550,141 | 5,409,276 | 4,840,940 | 21,555,469 |
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.... | 0 | |||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | 0 | |||||
| 4 | Total. Add lines 1 through 3 | 4,380,166 | 3,374,946 | 3,550,141 | 5,409,276 | 4,840,940 | 21,555,469 |
| 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) .. | 0 | |||||
| 6 | Public support. Subtract line 5 from line 4. | 21,555,469 | |||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 4,380,166 | 3,374,946 | 3,550,141 | 5,409,276 | 4,840,940 | 21,555,469 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | 19,248 | 39,493 | 52,339 | 4,241 | 2,473 | 117,794 |
| 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.).. | 46,434 | -30,273 | -7,282 | 1,091,905 | 976,192 | 2,076,976 |
| 11 | Total support. Add lines 7 through 10 | 23,750,239 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | ||||||
| 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 | ||||||
| 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 | ||||||
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons | ||||||
| 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. | ||||||
| c | Add lines 7a and 7b.. | ||||||
| 8 | Public support. (Subtract line 7c from line 6.) | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | ||||||
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | ||||||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | ||||||
| 11 | Net income from unrelated business activities not included on line 10b, whether or not the business is regularly carried on. | ||||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | ||||||
| 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) |
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| 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): |
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| 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 0.015 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 0.035 | 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 | 1 | |
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
2 | |
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | 3 | |
| 4 Amounts paid to acquire exempt-use assets | 4 | |
| 5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) | 5 | |
| 6 Other distributions (describe in Part VI). See instructions | 6 | |
| 7Total annual distributions. Add lines 1 through 6. | 7 | |
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
8 | |
| 9 Distributable amount for 2021 from Section C, line 6 | 9 | |
| 10 Line 8 amount divided by Line 9 amount | 10 | |
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2021 |
(iii) Distributable Amount for 2021 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2021 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2021 (reasonable cause required-- explain in Part VI). See instructions. |
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| 3 Excess distributions carryover, if any, to 2021: | ||||
| a From 2016....... | ||||
| b From 2017....... | ||||
| c From 2018....... | ||||
| d From 2019....... | ||||
| e From 2020....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2021 distributable amount | ||||
|
i
Carryover from 2016 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2021 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2021 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2021, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
6
Remaining underdistributions for 2021. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
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7 Excess distributions carryover to 2022. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2017..... | ||||
| b Excess from 2018..... | ||||
| c Excess from 2019..... | ||||
| d Excess from 2020..... | ||||
| e Excess from 2021..... | ||||
| Facts And Circumstances Test |
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| Return Reference | Explanation |
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| 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 I, LINE 6 | NUMBER OF VOLUNTEERS: THE TOTAL NUMBER OF VOLUNTEERS INCLUDE NON-COMPENSATED MEMBERS OF THE BOARD OF DIRECTORS. |
| FORM 990, PART III, LINE 4C | PROGRAM SERVICES: FOR PATIENTS NEEDING BEHAVIORAL AND MENTAL HEALTH SERVICES, THE ORGANIZATION EMPLOYS A CLINICAL PSYCHOLOGIST AND A LICENSED CLINICAL SOCIAL WORKER AS WELL AS PARTNERS WITH PATHWAYS COMMUNITY BEHAVIORAL HEALTH CARE, A NOT-FOR-PROFIT COMMUNITY MENTAL HEALTH COMPANY. COMMITTED TO PROVIDING EXCEPTIONAL CARE FOR THE MIND, BODY, AND SPIRIT, COMMUNITY HEALTH CENTER OF CENTRAL MISSOURI OFFERS HIGHLY TRAINED PROFESSIONALS TO PROVIDE BEHAVIORAL HEALTH AND ADDICTION SERVICES FOR INDIVIDUALS AND THEIR FAMILIES IN A CARING AND CONFIDENTIAL MANNER. THE ORGANIZATION KNOWS THAT MENTAL, EMOTIONAL AND BEHAVIORAL WELLNESS CONTRIBUTE TO PHYSICAL WELL BEING. THEREFORE, IT INTEGRATES BEHAVIORAL HEALTH SERVICES INTO ITS DISEASE MANAGEMENT AND PRIMARY/PREVENTATIVE CARE. THE ORGANIZATION'S PROFESSIONALS WORK TOGETHER TO PROVIDE TOOLS AND TREATMENTS INCLUDING: ASSESSMENT AND PRIVATE CONSULTATIONS, GROUP THERAPY SESSIONS, PHARMACOLOGICAL SUPPORT, FAMILY COUNSELING, AND OUTSIDE REFERRALS FOR MORE SPECIALIZED CARE. |
| FORM 990, PART VI, SECTION B, LINE 11B | 990 REVIEW PROCESS: THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. PRIOR TO FILING, THE FORM 990 IS FIRST REVIEWED BY TOP MANAGEMENT. ONCE MANAGEMENT IS CONFIDENT WITH THE RETURN, A FINAL DRAFT IS E-MAILED TO EACH BOARD MEMBER FOR REVIEW. |
| FORM 990, PART VI, SECTION B, LINE 12C | CONFLICT OF INTEREST POLICY: THE CONFLICT OF INTEREST POLICY IS REVIEWED AND SIGNED ANNUALLY BY BOARD MEMBERS AND ADMINISTRATIVE TEAM MEMBERS. POLICY: CONFLICT OF INTEREST AVOIDANCE PROCEDURES HELP BOARD MEMBERS, CONSULTANTS, EMPLOYEES AND THOSE WHO PROVIDE SERVICES OR FURNISH GOODS TO THE COMMUNITY HEALTH CENTER OF CENTRAL MISSOURI IDENTIFY SITUATIONS THAT ARE OR MAY BE A CONFLICT OF INTEREST OR THE APPEARANCE OF CONFLICT OF INTEREST. A. CONFLICT OF INTEREST DEFINED. THE FOLLOWING CIRCUMSTANCES SHALL BE DEEMED TO CREATE CONFLICTS OF INTEREST: 1. OUTSIDE INTERESTS. (I) A CONTRACT OR TRANSACTION BETWEEN COMMUNITY HEALTH CENTER OF CENTRAL MISSOURI AND A RESPONSIBLE PERSON OR FAMILY MEMBER. (II) A CONTRACT OR TRANSACTION BETWEEN COMMUNITY HEALTH CENTER OF CENTRAL MISSOURI AND AN ENTITY IN WHICH A RESPONSIBLE PERSON OR FAMILY MEMBER HAS A MATERIAL FINANCIAL INTEREST OR OF WHICH SUCH PERSON IS A DIRECTOR, OFFICER, AGENT, PARTNER, EMPLOYEE, ASSOCIATE, TRUSTEE, PERSONAL REPRESENTATIVE, RECEIVER, GUARDIAN, CUSTODIAN, CONSERVATOR, OR OTHER LEGAL REPRESENTATIVE. 2. OUTSIDE ACTIVITIES. (I) A RESPONSIBLE PERSON COMPETING WITH COMMUNITY HEALTH CENTER OF CENTRAL MISSOURI IN THE RENDERING OF SERVICES OR ANY OTHER CONTRACT OR TRANSACTION WITH A THIRD PARTY. (II) A RESPONSIBLE PERSON'S HAVING A MATERIAL FINANCIAL INTEREST IN; OR SERVING AS A DIRECTOR, OFFICER, EMPLOYEE, AGENT, PARTNER, ASSOCIATE, TRUSTEE, PERSONAL REPRESENTATIVE, RECEIVER, GUARDIAN, CUSTODIAN, CONSERVATOR, OR OTHER LEGAL REPRESENTATIVE OF, OR CONSULTANT TO; AN ENTITY OR INDIVIDUAL THAT COMPETES WITH COMMUNITY HEALTH CENTER OF CENTRAL MISSOURI IN THE PROVISION OF SERVICES OR IN ANY OTHER CONTRACT OR TRANSACTION WITH A THIRD PARTY. 3. GIFTS, GRATUITIES AND ENTERTAINMENT. A RESPONSIBLE PERSON ACCEPTING GIFTS, ENTERTAINMENT, OR OTHER FAVORS FROM ANY INDIVIDUAL OR ENTITY THAT: (I) DOES OR IS SEEKING TO DO BUSINESS WITH, OR IS A COMPETITOR OF COMMUNITY HEALTH CENTER OF CENTRAL MISSOURI; OR (II) HAS RECEIVED, IS RECEIVING, OR IS SEEKING TO RECEIVE A LOAN OR GRANT, OR TO SECURE OTHER FINANCIAL COMMITMENTS FROM COMMUNITY HEALTH CENTER OF CENTRAL MISSOURI; (III) IS A CHARITABLE ORGANIZATION; UNDER CIRCUMSTANCES WHERE IT MIGHT BE INFERRED THAT SUCH ACTION WAS INTENDED TO INFLUENCE OR POSSIBLY WOULD INFLUENCE THE RESPONSIBLE PERSON IN THE PERFORMANCE OF HIS OR HER DUTIES. THIS DOES NOT PRECLUDE THE ACCEPTANCE OF ITEMS OF NOMINAL OR INSIGNIFICANT VALUE OR ENTERTAINMENT OF NOMINAL OR INSIGNIFICANT VALUE THAT ARE NOT RELATED TO ANY PARTICULAR TRANSACTION OR ACTIVITY OF COMMUNITY HEALTH CENTER OF CENTRAL MISSOURI. B. PROCEDURES 1. BOARD MEMBERSHIP. NO BOARD MEMBER MAY BE AN EMPLOYEE OF THE COMMUNITY HEALTH CENTER OF CENTRAL MISSOURI OR IMMEDIATE FAMILY MEMBER OF AN EMPLOYEE. 2. BOARD PARTICIPATION. BEFORE BOARD OR COMMITTEE ACTION ON A CONTRACT OR TRANSACTION INVOLVING A CONFLICT OF INTEREST OR APPEARANCE OF A CONFLICT OF INTEREST, A DIRECTOR OR COMMITTEE MEMBER HAVING A CONFLICT OF INTEREST AND WHO IS IN ATTENDANCE AT THE MEETING SHALL DISCLOSE ALL FACTS MATERIAL TO THE CONFLICT OF INTEREST. SUCH DISCLOSURE SHALL BE REFLECTED IN THE MINUTES OF THE MEETING. 3. RESPONSIBLE PERSONS WHO ARE NOT MEMBERS OF THE BOARD OF DIRECTORS OF COMMUNITY HEALTH CENTER OF CENTRAL MISSOURI, OR WHO HAVE A CONFLICT OF INTEREST WITH RESPECT TO A CONTRACT OR TRANSACTION THAT IS NOT THE SUBJECT OF BOARD OR COMMITTEE ACTION, SHALL DISCLOSE TO THE CHAIR OR THE CHAIR'S DESIGNEE ANY CONFLICT OF INTEREST THAT SUCH RESPONSIBLE PERSON HAS WITH RESPECT TO A CONTRACT OR TRANSACTION. SUCH DISCLOSURE SHALL BE MADE AS SOON AS THE CONFLICT OF INTEREST IS KNOWN TO THE RESPONSIBLE PERSON. THE RESPONSIBLE PERSON SHALL REFRAIN FROM ANY ACTION THAT MAY AFFECT COMMUNITY HEALTH CENTER OF CENTRAL MISSOURI'S PARTICIPATION IN SUCH CONTRACT OR TRANSACTION. IN THE EVENT IT IS NOT ENTIRELY CLEAR THAT A CONFLICT OF INTEREST EXISTS, THE INDIVIDUAL WITH THE CONFLICT SHALL DISCLOSE THE CIRCUMSTANCES TO THE BOARD PRESIDENT WHO SHALL DISCLOSE THE CIRCUMSTANCES AND DETERMINE WHETHER THERE IS AN EXISTING CONFLICT OF INTEREST THAT IS SUBJECT TO THIS POLICY. |
| FORM 990, PART VI, SECTION B, LINE 15A | COMPENSATION REVIEW POLICY: IN FY 2022, THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS CONDUCTED AN ANNUAL PERFORMANCE AND COMPENSATION REVIEW FOR THE CEO. MPCA SALARY DATA WAS USED AS COMPARABILITY DATA. THE BOARD'S DELIBERATIONS AND DECISIONS ARE DOCUMENTED IN THE EXECUTIVE COMMITTEE MINUTES. |
| FORM 990, PART VI, SECTION C, LINE 19 | DOCUMENT DISCLOSURE POLICY: THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON WRITTEN REQUEST FOR A LEGITIMATE BUSINESS PURPOSE (AS DETERMINED BY TOP MANAGEMENT). APPROVED DOCUMENTS WILL BE DISTRIBUTED VIA MAIL. |
| FORM 990 PART IX LINE 11G | DESCRIPTION:CONTRACT SERVICES TOTAL FEES:4065729 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:DATA PROCESSING TOTAL FEES:123370 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:JANITORIAL SERVICES TOTAL FEES:147897 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:UNIFORM SERVICES TOTAL FEES:35927 |
| Software ID: | |
| Software Version: |