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Nonprofiteer
← COMMONWEALTH HEALTH FREE CLINIC INC

Form 990 for tax year 2023

Filed by COMMONWEALTH HEALTH FREE CLINIC INC.

Totals

Total revenue
$1,115,374
Total expenses
$1,003,005
Contributions and grants received
$952,799
Grants paid
$0
Program service revenue
$159,109
Investment income
$95
Other revenue
$3,371
Total assets, end of year
$1,255,567
Total liabilities, end of year
$64,758
Net assets or fund balances, end of year
$1,190,809
Program services expenses (Part IX)
$989,905
Management and general expenses
$13,100
Fundraising expenses
$0
Program service expenses (Part III)
$989,905

Program services were 98.7% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Line items

Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.

Revenue

Part VIII, the statement of revenue.

  • 1d · Related organizations

    $952,799

  • 2a · Program service revenue: NET PATIENT SERVICE REVENUE

    total $159,109 · related or exempt $159,109

  • 2f · All other program service revenue

    total $0 · related or exempt $0 · unrelated business $0 · excluded $0

  • 3 · Investment income

    total $95 · excluded $95

  • 6c · Rental income or loss

    real property $0 · personal property $0

  • 7c · Gain or loss

    securities $0 · other assets $0

  • 11a · Other revenue: MISCELLANEOUS REVENUE

    total $3,371 · excluded $3,371

  • 11d · All other revenue

    total $0 · related or exempt $0 · unrelated business $0 · excluded $0

  • 11e · Other revenue, total

    $3,371

Functional expenses

Part IX, the statement of functional expenses.

  • 5 · Compensation of officers, directors and key employees

    total $148,193 · program services $148,193

  • 11c · Fees: accounting

    total $4,841 · management and general $4,841

  • 11g · Fees: other

    total $702,976 · program services $698,550 · management and general $4,426 · fundraising $0

  • 12 · Advertising and promotion

    total $910 · management and general $910

  • 13 · Office expenses

    total $51,242 · program services $50,697 · management and general $545

  • 16 · Occupancy

    total $22,602 · program services $22,602

  • 17 · Travel

    total $2,332 · management and general $2,332

  • 22 · Depreciation, depletion and amortization

    total $9,712 · program services $9,712

  • 23 · Insurance

    total $10,647 · program services $10,647

  • 24a · Other expenses: MEDICAL SUPPLIES

    total $49,504 · program services $49,504

  • 24b · Other expenses: OTHER TAXES & LICENSES

    total $46 · management and general $46

  • 24e · All other expenses

    total $0 · program services $0 · management and general $0 · fundraising $0

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $925,655 · end of year $1,006,297

  • 2 · Savings and temporary cash investments

    beginning of year $131,401 · end of year $131,143

  • 3 · Pledges and grants receivable

    beginning of year $42,690 · end of year $45,217

  • 4 · Accounts receivable

    beginning of year $7,696 · end of year $30,125

  • 5 · Loans and receivables from officers and key people

    beginning of year $0 · end of year $0

  • 6 · Loans and receivables from disqualified persons

    beginning of year $0 · end of year $0

  • 10a · Land, buildings and equipment: cost or other basis

    $88,452

  • 10b · Land, buildings and equipment: accumulated depreciation

    $45,667

  • 10c · Land, buildings and equipment, net

    beginning of year $55,278 · end of year $42,785

  • 12 · Investments: other securities

    beginning of year $0

  • 13 · Investments: program-related

    beginning of year $0

  • 15 · Other assets

    beginning of year $0 · end of year $0

  • 17 · Accounts payable and accrued expenses

    beginning of year $28,402 · end of year $8,764

  • 22 · Loans and payables to officers and key people

    beginning of year $0 · end of year $0

  • 25 · Other liabilities

    beginning of year $55,878 · end of year $55,994

  • 27 · Net assets without donor restrictions

    beginning of year $1,078,440 · end of year $1,190,809

Mission and programs · 2023

Mission

THE COMMONWEALTH HEALTH FREE CLINIC PROVIDES BASIC MEDICAL AND DENTAL SERVICES FOR INDIVIDUALS WHO STRUGGLE WITH APPROPRIATE OR AFFORDABLE ACCESS TO HEALTHCARE.

  • COMMONWEALTH HEALTH FREE CLINIC, INC. ("CHFC") OPENED ON JANUARY 2, 1996 TO PROVIDE BASIC MEDICAL AND DENTAL DIAGNOSTIC AND TREATMENT SERVICES FOR THE UNINSURED AND UNDERINSURED OF SOUTH-CENTRAL KENTUCKY. CHFC ALSO SERVES INDIVIDUALS WHO MAY BE COVERED BY SOME FORM OF INSURANCE, BUT WHO ARE UNABLE TO ACCESS A PROVIDER FOR ACUTE OR CHRONIC HEALTH ISSUES. SEE SCHEDULE O FOR ADDTIONAL INFORMATION.

    Expenses $989,905 · Revenue $159,109

As filed on the 2023 return.

Listed in Part VII

  • Dr Mark Yurchisin

    CHAIRMAN

    Total calculated
    $0
    Hours/week
    2

  • Dr Michael Hubbard

    VICE CHAIR

    Total calculated
    $0
    Hours/week
    2

  • Mr David Gray

    EXECUTIVE VICE PRESIDENT

    Total calculated
    $520,051
    From this org
    $0
    From related orgs
    $427,268
    Other
    $92,783
    Hours/week
    2 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $418,139 related
    Bonus
    $0
    Other
    $0 + $9,129 related
    Deferred
    $0 + $57,983 related
    Nontaxable benefits
    $0 + $34,800 related
    Filer's total
    $0 + $520,051 related

  • Mr Joe Natcher

    SECRETARY

    Total calculated
    $0
    Hours/week
    2 + 4 related

  • Ms Connie D Smith

    CEO/PRESIDENT

    Total calculated
    $1,436,253
    From this org
    $0
    From related orgs
    $1,317,162
    Other
    $119,091
    Hours/week
    2 + 52 related

    Schedule J breakdown matched by us

    Base
    $0 + $1,036,405 related
    Bonus
    $0
    Other
    $0 + $280,757 related
    Deferred
    $0 + $98,270 related
    Nontaxable benefits
    $0 + $20,821 related
    Filer's total
    $0 + $1,436,253 related

  • Dr Jacqueline Pope - Tarrenc

    DIRECTOR

    Total calculated
    $7,415
    From this org
    $0
    From related orgs
    $7,415
    Other
    $0
    Hours/week
    2 + 2 related

  • Dr Josh Phillips

    DIRECTOR / DENTIST

    Total calculated
    $168,376
    From this org
    $148,193
    From related orgs
    $0
    Other
    $20,183
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $147,565
    Bonus
    $0
    Other
    $628
    Deferred
    $4,500
    Nontaxable benefits
    $15,683
    Filer's total
    $168,376

  • Mrs Cathy Bishop

    DIRECTOR

    Total calculated
    $0
    Hours/week
    2 + 4 related

  • Mr Wade Stone

    EXECUTIVE VICE PRESIDENT

    Total calculated
    $500,444
    From this org
    $0
    From related orgs
    $438,705
    Other
    $61,739
    Hours/week
    2 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $435,730 related
    Bonus
    $0
    Other
    $0 + $2,975 related
    Deferred
    $0 + $44,704 related
    Nontaxable benefits
    $0 + $17,035 related
    Filer's total
    $0 + $500,444 related

  • Ms Katrina Wood

    EVP/CHIEF NURSING OFFICER

    Total calculated
    $296,006
    From this org
    $0
    From related orgs
    $258,853
    Other
    $37,153
    Hours/week
    2 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $255,207 related
    Bonus
    $0
    Other
    $0 + $3,646 related
    Deferred
    $0 + $6,499 related
    Nontaxable benefits
    $0 + $30,654 related
    Filer's total
    $0 + $296,006 related

  • Ms Michele W Lawless

    EXECUTIVE VICE PRESIDENT / CFO

    Total calculated
    $529,278
    From this org
    $0
    From related orgs
    $481,930
    Other
    $47,348
    Hours/week
    2 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $475,135 related
    Bonus
    $0
    Other
    $0 + $6,795 related
    Deferred
    $0 + $43,823 related
    Nontaxable benefits
    $0 + $3,525 related
    Filer's total
    $0 + $529,278 related

Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead, and on a Form 990-PF Part VIII's — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.

Schedule J

Answered yes

  • 4b · Supplemental nonqualified retirement plan

Answered no

  • 4a · Severance or change-of-control payment
  • 4c · Equity-based compensation arrangement
  • 5a · Pay contingent on this organization's revenues
  • 5b · Pay contingent on a related organization's revenues
  • 6a · Pay contingent on this organization's net earnings
  • 6b · Pay contingent on a related organization's net earnings
  • 7 · Other non-fixed payments
  • 8 · Paid under the initial-contract exception

The filer's explanations (Part III)

Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan
CERTAIN EXECUTIVES OF COMMONWEALTH HEALTH CORPORATION PARTICIPATE IN A SUPPLEMENTAL RETIREMENT PLAN. THE CURRENT YEAR INCREASE IN THE ACCRUED BENEFIT, AS ACTUARIALLY DETERMINED, IS REPORTED AS COMPENSATION. THE FOLLOWING ARE THE INDIVIDUALS PARTICIPATING IN THE PLAN AND THE CURRENT YEAR INCREASES REPORTED AS COMPENSATION: CONNIE SMITH $262,117 WADE STONE $ -0-
Schedule J, Part I, Line 3
THE CEO IS COMPENSATED BY COMMONWEALTH HEALTH CORPORATION (CHC), A RELATED ORGANIZATION. CHC USES THE FOLLOWING METHODS TO ESTABLISH THE COMPENSATION OF THE CEO: - COMPENSATION COMMITTEE - INDEPENDENT COMPENSATION CONSULTANT - WRITTEN EMPLOYMENT CONTRACT - COMPENSATION SURVEY OR STUDY - APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE

Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.

Grants on this return

No itemized grants to organizations on this return.

Related organizations on this return

Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.

Taxable family on this return

Schedule R Parts I, III and IV, as filed. These record ownership and control, not shared board members or money moved.

Related partnerships

Part III: related organizations taxable as a partnership, with the filer's share.

  • MED PLAZA PTRS LTD

    N/A · REAL ESTATE · KY · share of income $0 · share of assets $0

    Directly controlled by NA

Provenance

Return type
form_990
Tax year
2023
Filed
14 February 2025
IRS schema version
2023v6.0
Source object
202510459349301111

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