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Nonprofiteer
← COMMUNITY HEALTH CLINIC INC

Form 990 for tax year 2022

Filed by COMMUNITY HEALTH CLINIC INC.

Totals

Total revenue
$222,191
Total expenses
$262,881
Contributions and grants received
$178,408
Grants paid
$0
Program service revenue
$0
Investment income
$50
Other revenue
$43,733
Total assets, end of year
$54,912
Total liabilities, end of year
$0
Net assets or fund balances, end of year
$54,912
Program services expenses (Part IX)
$227,159
Management and general expenses
$35,722
Fundraising expenses
$0
Program service expenses (Part III)
$227,159

Program services were 86.4% 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.

  • 1e · Government grants (contributions)

    $28,426

  • 1f · All other contributions, gifts and grants

    $149,982

  • 3 · Investment income

    total $50 · excluded $50

  • 8a · Fundraising events: gross income

    $32,570

  • 8b · Fundraising events: direct expenses

    $4,973

  • 8c · Net income from fundraising events

    total $27,597

  • 11a · Other revenue: OTHER REVENUE

    total $16,136 · related or exempt $16,136

  • 11e · Other revenue, total

    $16,136

Functional expenses

Part IX, the statement of functional expenses.

  • 5 · Compensation of officers, directors and key employees

    total $36,138 · program services $3,614 · management and general $32,524

  • 7 · Other salaries and wages

    total $94,727 · program services $94,727

  • 9 · Other employee benefits

    total $233 · program services $233

  • 10 · Payroll taxes

    total $10,444 · program services $7,246 · management and general $3,198

  • 11b · Fees: legal

    total $1,398 · program services $1,398

  • 11c · Fees: accounting

    total $1,840 · program services $1,840

  • 12 · Advertising and promotion

    total $193 · program services $193

  • 13 · Office expenses

    total $14,323 · program services $14,323

  • 16 · Occupancy

    total $13,270 · program services $13,270

  • 17 · Travel

    total $315 · program services $315

  • 22 · Depreciation, depletion and amortization

    total $5,188 · program services $5,188

  • 23 · Insurance

    total $56,591 · program services $56,591

  • 24a · Other expenses: PATIENT CARE SUPPLIES

    total $24,220 · program services $24,220

  • 24b · Other expenses: MISC

    total $2,442 · program services $2,442

  • 24c · Other expenses: MEDICAL WASTE DISPOSAL

    total $398 · program services $398

  • 24d · Other expenses: MERCHANT PROCESSING ACCOU

    total $361 · program services $361

  • 24e · All other expenses

    total $800 · program services $800

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $95,480 · end of year $54,912

  • 2 · Savings and temporary cash investments

    beginning of year $122

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

    $145,178

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

    $145,178

  • 31 · Retained earnings, endowment or other funds

    beginning of year $95,602 · end of year $54,912

Mission and programs · 2022

Mission

TO PROVIDE BASIC HEALTH CARE SERVICES TO THE UNINSURED, LOW-INCOME RESIDENTS OF HARDIN, LARUE, GRAYSON, BRECKENRIDGE AND MEADE COUNTIES OF KENTUCKY.

Activities or mission (Part I)

TO PROVIDE BASIC HEALTH CARE SERVICES TO THE UNINSURED, LOW-INCOME RESIDENTS OF HARDIN AND LARUE COUNTIES IN KENTUCKY.

  • ALL SERVICES ARE PROVIDED FREE OF CHARGE AND ARE AVAILABLE ONLY THOSE PERSONS MEETING CLINIC ELIGIBILITY REQUIREMENTS AND BEGIN WITH A MEDICAL OFFICE VISIT BY WHICH ADDITIONAL SERVICES MAY BE PROVIDED WITH A MEDICAL ORDER. A VOLUNTEER STAFF OF PHYSICIANS, PHYSICIAN ASSISTANTS, AND NURSE PRACTITIONERS PROVIDE MEDICAL OFFICE VISITS EVERY TUESDAY AND THURSDAY EVENING.

    Expenses $192,012

  • HOME MEDICAL EQUIPMENT IS PROVIDED FREE OF CHARGE TO CLINIC PATIENTS WITH CERTAIN MEDICAL CONDITIONS, E.G. ASTHMA, SLEEP APNEA

    Expenses $24,220

  • THE COMMUNITY HEALTH CLINIC HOSTS ITS OWN LICENSED PHARMACY PROVIDING PHARMACY SERVICES ORDERED DURING A MEDICAL OFFICE VISIT.

    Expenses $494

  • THROUGH AN AFFILIATION WITH THE COLLEGE LIONS CLUB CLINIC PATIENTS MAY RECEIVE A REFERRAL FOR VISION CARE. THE COLLEGE LIONS CLUB PROVIDES VOUCHERS FOR LOCAL OPTOMETRY SERVICES AND BASIC EYEWEAR. THE CLINIC LAB IS CLIA WAIVED AND SPONSORED BY LAB CORP. VOLUNTEER LAB TECHNICIANS COLLECT SPECIMENS FOR LAB WORK. CLINIC PATIENTS MUST BE EVALUATED DURING A MEDICAL OFFICE VISIT FIRST BEFORE BEING REFERRED FOR DENTAL CARE. THE COMMUNITY HEALTH CLINIC VOLUNTEER DENTISTS PROVIDE BASIC DENTAL SERVICES. CERTAIN DIAGNOSTIC SERVICES ORDERED THROUGH A CLINIC OFFICE VISIT MAY BE MADE AVAILABLE FREE OF CHARGE. LOCAL SPECIALISTS PROVIDE EVALUATION AND RECOMMENDATIONS FOR CLINIC PATIENTS REFERRED FOR A ONE VISIT COURTESY CONSULTATION. SPECIALIST CONSULTATIONS UNAVAILABLE LOCALLY ARE REFERRED TO U OF L PHYSICIANS ASSOCIATES WHERE SERVICES ARE PROVIDED ON A SLIDING SCALE.

    Expenses $10,433

As filed on the 2022 return. The filer continues this part on Schedule O, which is not shown here.

Listed in Part VII

  • David Zoeller

    CO-MEDICAL D

    Total calculated
    $0
    Hours/week
    2

  • Venus Cornette

    EXECUTIVE DI

    Total calculated
    $36,138
    From this org
    $36,138
    From related orgs
    $0
    Other
    $0
    Hours/week
    30

  • Syed Quadri

    CO-MEDICAL D

    Total calculated
    $0
    Hours/week
    2

  • Charles David Peterson

    BOARD CHAIRM

    Total calculated
    $0
    Hours/week
    2

  • Diane Logsdon

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    2

  • Bryce Shumate

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    2

  • Saadia Qureshi

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    2

  • Steve White

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    2

  • Timothy Sutherland

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    2

  • Michael Harmon

    TREASURER

    Total calculated
    $0
    Hours/week
    2

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.

Grants on this return

No itemized grants to organizations on this return.

Provenance

Return type
form_990
Tax year
2022
Filed
26 October 2023
IRS schema version
2022v5.0
Source object
202303189349303295

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