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) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | 9,710,722 | 13,803,551 | 30,881,879 | 23,497,699 | 23,303,847 | 101,197,698 |
| 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 | 9,710,722 | 13,803,551 | 30,881,879 | 23,497,699 | 23,303,847 | 101,197,698 |
| 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. | 101,197,698 | |||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 9,710,722 | 13,803,551 | 30,881,879 | 23,497,699 | 23,303,847 | 101,197,698 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | 790,279 | 209,312 | 200,707 | 1,143,286 | 1,998,117 | 4,341,701 |
| 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.).. | 10,449 | -4,944 | 15,821 | 210,085 | -23,870 | 207,541 |
| 11 | Total support. Add lines 7 through 10 | 105,746,940 | |||||
Calendar year (or fiscal
year beginning in) ![]() |
(a) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (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) 2019 | (b) 2020 | (c) 2021 | (d) 2022 | (e) 2023 | (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 2023 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-2023 |
(iii) Distributable Amount for 2023 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2023 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2023 (reasonable cause required-- explain in Part VI).
See instructions. |
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| 3 Excess distributions carryover, if any, to 2023: | ||||
| a From 2018....... | ||||
| b From 2019....... | ||||
| c From 2020....... | ||||
| d From 2021....... | ||||
| e From 2022....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2023 distributable amount | ||||
|
i
Carryover from 2018 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2023 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2023 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2023, 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 2023. 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 2024. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2019..... | ||||
| b Excess from 2020..... | ||||
| c Excess from 2021..... | ||||
| d Excess from 2022..... | ||||
| e Excess from 2023..... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|---|
| Schedule A, Part II, Line 10 Other Income | DESCRIPTION - GAIN/LOSS FROM EQUITY INVESTEE, COLUMN A - 10449.0, COLUMN B - -4944.0, COLUMN C - 15821.0, COLUMN D - 210085.0, COLUMN E - -23870.0, COLUMN F - 207541.0; |
| Software ID: | 23017437 |
| Software Version: | 2023v6.0 |
| Return Reference | Explanation |
|---|---|
| Form 990, Part III, Line 1 ORGANIZATION MISSION | OUR MISSION: IMPROVING OUR COMMUNITY'S HEALTH THROUGH ACCESS AND RELATIONSHIPS OUR VISION: PARTNERING TO PROVIDE ESSENTIAL LEADERSHIP IN HEALTHCARE FOR THE UNDERSERVED OUR CORE VALUES: TO IMPROVE OUR COMMUNITY'S HEALTH BECAUSE "I2 CARE" *INNOVATION - WE WILL INNOVATE TO MEET OUR PATIENTS' NEEDS TO ACCESS PRIMARY MEDICAL, DENTAL, VISION, AND BEHAVIORAL HEALTHCARE BY DESIGNING PROCESSES THAT KEEP US FLEXIBLE AND RESPONSIVE - WHERE WE CAN BUILD SOLID RELATIONSHIPS *INTEGRITY - WE WILL SPEAK AND ACT IN AN HONEST AND ETHICAL MANNER *COLLABORATION - WE WILL WORK TOGETHER AS A TEAM TO PROVIDE QUALITY HEALTH SERVICES WITH PARTNERSHIPS TO PROVIDE INTEGRATED SERVICES. WE WILL FOSTER AND MAINTAIN KEY COMMUNITY RELATIONSHIPS TO LEVERAGE OUR EXPERTISE AND IMPROVE THE HEALTH OF OUR COMMUNITIES *ACCOUNTABILITY - WE WILL BE FINANCIALLY ACCOUNTABLE AND TAKE A LONG-TERM APPROACH TO DECISIONS ENSURING SUSTAINABLE PRACTICES THUS ESTABLISHING A FIRM FOUNDATION FOR THE FUTURE *RESPECT - WE WILL CREATE CARING RELATIONSHIPS WITH OUR PATIENTS AND COMMUNITIES BASED ON COMPASSION, TAKING CARE TO PROTECT INDIVIDUAL DIGNITY IN DIVERSE POPULATIONS *EXCELLENCE - WE WILL PURSUE EXCELLENCE IN OUR SERVICE, FACILITIES AND INTERACTIONS, STRIVING TO IMPROVE THE QUALITY OF OUR PATIENT-CENTERED HEALTHCARE |
| Form 990, Part III, Line 4a MEDICAL SERVICES | MEDICAL PROGRAM SERVICES INCLUDE: FAMILY MEDICINE, PEDIATRIC CARE, INTERNAL MEDICINE, GERIATRIC CARE, PAIN MANAGEMENT, PRIMARY & PREVENTIVE HEALTH, IMMUNIZATIONS, CHRONIC DISEASE MANAGEMENT, GYNECOLOGY/WOMEN'S HEALTH (INCLUDING SHOW ME HEALTHY WOMEN), PRENATAL CARE, IN-PATIENT SERVICES FOR NEWBORNS, NURSERY CARE, OUTPATIENT PROCEDURES (CIRCUMCISIONS, COLPOSCOPY, SPIROMETRY, ENDOMETRIAL BIOPSY, EKG & STRESS TESTING, IMPLANON, VASECTOMY, MINOR SKIN PROCEDURES, JOINT INJECTIONS), DIABETES EDUCATION, DIETARY COUNSELING, WEIGHT MANAGEMENT SUPPORT, IN-SCHOOL PRIMARY CARE, LAB SERVICES, OPTOMETRY, BEHAVIORAL HEALTH COUNSELING, PSYCHIATRIC CARE AND GROUP THERAPY. |
| Form 990, Part III, Line 4b DENTAL SERVICES | DENTAL PROGRAM SERVICES INCLUDE: GENERAL DENTISTRY, PEDIATRIC DENTISTRY, ORAL HYGIENE, URGENT DENTAL CARE, ORAL SURGERY, DENTURES AND PARTIALS, MOBILE DENTAL CARE AND IN-SCHOOL PREVENTIVE SERVICES. |
| Form 990, Part VI, Line 11b Review of form 990 by governing body | THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE FINANCE DEPARTMENT OF THE ORGANIZATION. PRIOR TO FILING, A DRAFT OF THE 990 IS FIRST REVIEWED BY SENIOR MANAGEMENT. AFTER ANY CHANGES ARE MADE, A FINAL DRAFT IS PROVIDED TO THE BOARD OF DIRECTORS BEFORE FILING. |
| Form 990, Part VI, Line 12c Conflict of interest policy | MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY: THE ORGANIZATION'S CONFLICT OF INTEREST POLICY IS EVALUATED WITH ALL EMPLOYEES UPON HIRE AND ON A YEARLY BASIS WITH ALL EMPLOYEE AND BOARD MEMBERS IN CONJUNCTION WITH CORPORATE COMPLIANCE TRAINING. A COPY OF THE CONFLICT OF INTEREST STATEMENT SHALL BE PROVIDED ANNUALLY TO EACH DIRECTOR AND OFFICER TO REVIEW AND ACKNOWLEDGE FOR THE PURPOSE OF IDENTIFYING CONFLICTS OR POTENTIAL CONFLICTS OF INTEREST. A CONFLICT OF INTEREST SHALL EXIST WHEN, IN THE OPINION OF THE BOARD, A BOARD MEMBER OR FAMILY MEMBER OF A BOARD MEMBER HAS A RELATIONSHIP WHICH WOULD INTERFERE WITH THE EXERCISE OF INDEPENDENT JUDGEMENT IN CARRYING OUT THE RESPONSIBILITIES OF A DIRECTOR OR AS FURTHER EXPRESSLY DEFINED BY THE CORPORATION'S CODE OF CONDUCT. FOR PURPOSES OF THIS SECTION, FAMILY MEMBER IS DEFINED AS A DIRECTOR'S SPOUSE, PARENTS, CHILDREN AND SIBLINGS, WHETHER BY BLOOD, MARRIAGE OR ADOPTION, OR ANY ONE RESIDING IN SUCH PERSON'S HOME. THE BOARD OF DIRECTORS SHALL NOT APPROVE ANY ACTION OR TRANSACTION BEARING UPON THE CONFLICT UNLESS THE FOLLOWING PROCEDURES ARE OBSERVED: A) THE AFFECTED DIRECTOR OR OTHER DIRECTOR(S) SHALL MAKE KNOWN THAT A CONFLICT EXISTS AND THE AFFECTED DIRECTOR SHALL WITHDRAW FROM THE MEETING FOR AS LONG AS THE MATTER REMAINS UNDER CONSIDERATION. SHOULD THE MATTER BE BROUGHT TO A VOTE OF THE DIRECTORS, THE AFFECTED DIRECTOR SHALL NEITHER BE PRESENT NOR CAST A VOTE. B) IF THE WITHDRAWAL OF THE AFFECTED DIRECTOR RESULTS IN THE ABSENCE OF QUORUM, NO ACTION SHALL BE TAKEN ON THE MATTER UNTIL A QUORUM OF DISINTERESTED DIRECTORS IN PRESENT. C) IF A) AND B) DO NOT OCCUR, THE BOARD OF DIRECTORS SHALL NOT GO FORWARD WITH A TRANSACTION OR ARRANGEMENT IN WHICH AN AFFECTED DIRECTOR ACKNOWLEDGES THAT A CONFLICT OF INTEREST EXISTS, OR WHERE A MAJORITY OF THE OTHER DIRECTORS DETERMINE THAT A CONFLICT OF INTEREST EXISTS. |
| Form 990, Part VI, Line 15a Process to establish compensation of top management official | ANNUALLY, THE CHIEF EXECUTIVE OFFICER'S COMPENSATION IS EVALUATED AND VOTED ON BY THE BOARD OF DIRECTORS AFTER REVIEWING PERFORMANCE AND COMPARABILITY DATA OF CEO'S/EXECUTIVE DIRECTORS AT LIKE HEALTH CARE FACILITIES. THE OCCURRENCE OF THIS REVIEW IS DOCUMENTED IN THE EXECUTIVE COMMITTEE BOARD MINUTES. |
| Form 990, Part VI, Line 19 Required documents available to the public | GOVERNING DOCUMENTS, INCLUDING THE CONFLICT OF INTEREST POLICY AND AUDITED FINANCIAL STATEMENTS, ARE AVAILABLE BY WRITTEN REQUEST AND MAY BE VIEWED AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE. |
| Software ID: | 23017437 |
| Software Version: | 2023v6.0 |