2018-11-15T10:55:37-06:00 2018-06-30 410746749 CLIFTONLARSONALLEN LLP 1301 W 22ND ST STE 1100 OAK BROOK IL 60523 990 2017-07-01 363317058 ACCESS COMMUNITY HEALTH NETWORK ACCE 3125262100 600 WEST FULTON 2ND FLOOR CHICAGO IL 60661 MAHOMED OUEDRAOGO CHIEF FINANCIAL OFFICER 3125262088 2018-11-14 1 CHRIS MANDERFIELD P01238973 6305738600 2018-11-13 67.137.57.251 2018-11-14 13:41:13 CS P 50B5ED40640626E3ACEBEF22A0FBEFD7F66F664C 80C43226D4E09B8617C70E8679C144E30C781DB8 2017 2019-02-21 02:37:17Z MAHOMED OUEDRAOGO 600 WEST FULTON 2ND FLOOR CHICAGO IL 60661 131133546 0 X WWW.ACCESSCOMMUNITYHEALTH.NET X 1984 IL ACCESS PARTNERS WITH PATIENTS AT ALL POINTS OF CARE, PROVIDING HIGH QUALITY, PATIENT-CENTERED HEALTH SERVICES ACCESSIBLE TO ALL IN THEIR OWN COMMUNITIES. 19 19 1139 0 0 0 20569932 20318442 107435089 109243640 0 49204 2618052 1522260 130623073 131133546 0 0 0 0 74102551 69926970 0 0 0 58428416 59842257 132530967 129769227 -1907894 1364319 51743609 56576965 20829491 24274993 30914118 32301972 X ACCESS PARTNERS WITH PATIENTS AT ALL POINTS OF CARE, PROVIDING HIGH QUALITY, PATIENT-CENTERED HEALTH SERVICES ACCESSIBLE TO ALL IN THEIR OWN COMMUNITIES. 0 0 103173649 110765900 COMMUNITY HEALTH CENTERS - ACCESS OFFERS A FULL RANGE OF COMPREHENSIVE, QUALITY HEALTH CARE SERVICES CONVENIENTLY LOCATED RIGHT IN YOUR COMMUNITY. OUR PRIMARY CARE SERVICES INCLUDE: FAMILY PRACTICE, INTERNAL MEDICINE, PEDIATRICS, SCHOOL AND SPORTS PHYSICALS, OBSTETRIC/GYNECOLOGICAL AND MIDWIFERY SERVICES, AND MANAGEMENT OF CHRONIC DISEASES, SUCH AS DIABETES, ASTHMA, AND HIGH BLOOD PRESSURE. OTHER SERVICES AVAILABLE AT SELECT SITES INCLUDE: LOW-COST BREAST AND CERVICAL CANCER SCREENINGS, BEHAVIORAL HEALTH SERVICES, HIV/AIDS COUNSELING, TESTING AND PRIMARY CARE, SUBSTANCE ABUSE TREATMENT PROGRAM, CASE MANAGEMENT, AND SPECIALTY CARE SERVICES.THIS YEAR ACCESS SERVED MORE THAN 177,000 LOW-INCOME INDIVIDUALS AND FAMILIES, INCLUDING 36,000 UNINSURED PATIENTS. 103173649 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 320 0 1 1139 1 0 0 0 0 0 0 0 0 0 0 X 19 19 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 IL X X MAHOMED QUEDRAOGO 3125262100 600 WEST FULTON STREET SUITE 200 CHICAGO IL 60661 BENA SULLIVAN CHAIRWOMAN EMERITUS 1.00 X X 0 0 0 DONNA SIMMONS CHAIRWOMAN 1.00 X X 0 0 0 TERRY BROWN TREASURER 1.00 X X 0 0 0 DENISE KITCHEN BOARD MEMBER 1.00 X 0 0 0 PATRICIA BOBB BOARD MEMBER 1.00 X 0 0 0 VIRGINIA OVIEDO BOARD MEMBER 1.00 X 0 0 0 PERLA HERRERA SECRETARY 1.00 X X 0 0 0 ERIN STARKEY BOARD MEMBER 1.00 X 0 0 0 TOMMY FITZGIBBON VICE CHAIRMAN 1.00 X X 0 0 0 RYAN HART BOARD MEMBER 1.00 X 0 0 0 DR CHARLES DESHAZER BOARD MEMBER 1.00 X 0 0 0 EVE SALAZAR BOARD MEMBER 1.00 X 0 0 0 ERICK OSORIO BOARD MEMBER 1.00 X 0 0 0 PETER MCNERNEY BOARD MEMBER 1.00 X 0 0 0 MATTHEW BERKLEY BOARD MEMBER 1.00 X 0 0 0 SHARON GIBSON BOARD MEMBER 1.00 X 0 0 0 LILIA GONZALEZ BOARD MEMBER 1.00 X 0 0 0 MIRIAM MOBLEY-SMITH BOARD MEMBER 1.00 X 0 0 0 LIZ VAZQUEZ BOARD MEMBER 1.00 X 0 0 0 DONNA THOMPSON CHIEF EXECUTIVE OFFICER 40.00 X 890915 0 3379 JAIRO MEJIA CHIEF MEDICAL OFFICER 40.00 X 402541 0 18939 MAHOMED OUEDRAOGO CHIEF FINANCIAL OFFICER 40.00 X 432585 0 22458 ETTA ISH HENDERSON CHIEF COMPLIANCE OFFICER 40.00 X 153577 0 14331 ANN LUNDY CHIEF OPERATING OFFICER 40.00 X 309461 0 16611 TARIQ BUTT VP OF HEALTH AFFAIRS 40.00 X 326063 0 19702 ELEVA RILEY VP HUMAN RESOURCES 40.00 X 257063 0 9259 CRISTINA SOTELINO VP OF COMMUNIATIONS AND CO 40.00 X 171499 0 22284 EDWARD LAMPLEY PHYSICIAN 40.00 X 313117 0 774 PAULA CAVENS PHYSICIAN 40.00 X 312445 0 8548 LEMUEL SHAFFER PHYSICIAN 40.00 X 276562 0 7424 NARAYAN PRABHAKAR PHYSICIAN 40.00 X 287871 0 18795 ANDRES MAFLA PHYSICIAN 40.00 X 275152 0 22063 4408851 0 184567 111 0 1 0 GDI SERVICES INC 4952 W 128TH PL ALSIP IL 60803 MAINTENANCE SERVICES 1338386 AMERICAN SECURITY GUARD SERVICES INC 1515 S HARLEM AVE FOREST PARK IL 601302620 SECURITY SERVICE 802343 LABCORP PO BOX 2270 BURLINGTON NC 272162270 LAB SERVICES 780071 MEDIX STAFFING SOLUTIONS 222 S RIVERSIDE PLAZA CHICAGO IL 60606 CONSULTANT/TEMP STAFF SERVICE 556143 EMCOR SERVICES TEAM MECHANICAL INC 431 LEXINGTON DR BUFFALO GROVE IL 60089 MAINTENANCE SERVICES 455818 28 41793 19131066 1145583 20318442 NET PATIENT SERVICE REVENUE 621498 66604646 66604646 340B 621498 25946603 25946603 CAPITATION REVENUE 621498 10683111 10683111 CARE COORDINATION FEES 621498 4842011 4842011 AFFILIATE CONTRACTS 621498 1167269 1167269 109243640 49204 49204 OTHER 621498 1522260 1522260 1522260 131133546 110765900 0 49204 2548444 1946403 602041 55690507 42534267 13156240 232625 179732 52893 7460132 5363715 2096417 3995262 3079410 915852 358264 358264 91739 91739 12479872 8725508 3754364 223598 46722 176876 1032879 599530 433349 224490 185694 38796 14192674 12049230 2143444 271048 130980 140068 62433 37066 25367 244750 220679 24071 5934131 5055281 878850 688121 135017 553104 340B PHARMACY AND FEES 12341381 12341381 MEDICAL AND PHARMACY SU 3933589 3933589 REFERRED MEDICAL SERVIC 2826682 2826682 OTHER 2715310 1568172 1147138 2221296 2214591 6705 129769227 103173649 26595578 0 7009224 12913083 5389684 3106397 9839976 7215029 2315721 2811230 77758693 50596542 25560175 27162151 1397585 1628829 1971490 51743609 56576965 13405669 12164945 4170184 8057205 3253638 4052843 20829491 24274993 X 29051260 30897152 1862858 1404820 30914118 32301972 51743609 56576965 1364319 23515 20 0 X X 0 1 X 1 1 1 X 930666 930666 22193398 8930989 13262409 19489090 14523684 4965406 35145539 27141869 8003670 27162151 DEFERRED RENT OBLIGATION 1168108 457(B) PLAN PARTICIPANT LIABILITY 1971490 OTHER LIABILITIES 913245 4052843 X 128935765 23515 -2221296 -2197781 131133546 0 131133546 127547931 0 127547931 2221296 2221296 129769227 PART X, LINE 2: ACCESS IS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE IRC. IN ADDITION, ACCESS QUALIFIES FOR THE CHARITABLE CONTRIBUTION DEDUCTION UNDER SECTION 170(B)(1)(A) AND HAS BEEN CLASSIFIED AS AN ORGANIZATION THAT IS NOT A PRIVATE FOUNDATION WITHIN THE MEANING OF SECTION 509(A) OF THE IRC. ACCESS HAD NO UNRELATED BUSINESS INCOME DURING FISCAL YEARS 2017 AND 2018, AND THEREFORE, NO PROVISION FOR FEDERAL OR STATE INCOME TAXES HAS BEEN MADE IN THE ACCOMPANYING FINANCIAL STATEMENTS. ACCESS DETERMINED THAT IT WAS NOT REQUIRED TO RECORD A LIABILITY RELATED TO UNCERTAIN TAX POSITIONS. PART XI, LINE 2D - OTHER ADJUSTMENTS: BAD DEBT EXPENSE -2,221,296. PART XII, LINE 4B - OTHER ADJUSTMENTS: BAD DEBT EXPENSE 2,221,296. X 0 0 X X 0 1 0 0 0 0 0 0 0 DONNA THOMPSON CHIEF EXECUTIVE OFFICER 530915 0 360000 0 0 0 0 0 3379 0 894294 0 0 0 JAIRO MEJIA CHIEF MEDICAL OFFICER 332541 0 70000 0 0 0 0 0 18939 0 421480 0 0 0 MAHOMED OUEDRAOGO CHIEF FINANCIAL OFFICER 344113 0 88472 0 0 0 0 0 22458 0 455043 0 0 0 ETTA ISH HENDERSON CHIEF COMPLIANCE OFFICER 119959 0 33618 0 0 0 0 0 14331 0 167908 0 0 0 ANN LUNDY CHIEF OPERATING OFFICER 239461 0 70000 0 0 0 0 0 16611 0 326072 0 0 0 TARIQ BUTT VP OF HEALTH AFFAIRS 286063 0 40000 0 0 0 0 0 19702 0 345765 0 0 0 ELEVA RILEY VP HUMAN RESOURCES 196746 0 60317 0 0 0 0 0 9259 0 266322 0 0 0 CRISTINA SOTELINO VP OF COMMUNIATIONS AND CO 133513 0 37986 0 0 0 0 0 22284 0 193783 0 0 0 EDWARD LAMPLEY PHYSICIAN 313117 0 0 0 0 0 0 0 774 0 313891 0 0 0 PAULA CAVENS PHYSICIAN 312245 0 200 0 0 0 0 0 8548 0 320993 0 0 0 LEMUEL SHAFFER PHYSICIAN 276362 0 200 0 0 0 0 0 7424 0 283986 0 0 0 NARAYAN PRABHAKAR PHYSICIAN 287371 0 500 0 0 0 0 0 18795 0 306666 0 0 0 ANDRES MAFLA PHYSICIAN 274952 0 200 0 0 0 0 0 22063 0 297215 0 0 0 PART I, LINE 1A THE CEO'S EMPLOYMENT AGREEMENT INCLUDES A PROVISION FOR THE ORGANIZATION TO REIMBURSE THE CEO FOR THE INITIATION FEE, CLUB DUES, ASSESSMENTS, SPECIAL ASSESSMENTS, AND EXPENSES FOR A PROFESSIONAL OR SOCIAL CLUBS OF THE CEO'S CHOOSING. PART I, LINE 4B THE FOLLOWING INDIVIDUALS PARTICIPATED IN A NON-QUALIFIED 457(B) DEFERRED COMPENSATION PLAN; DONNA THOMPSON, MAHOMED OUEDRAOGO, ANN LUNDY, JAIRO MEJIA, AND TARIQ BUTT. FORM 990, PART VI, SECTION B, LINE 11B THE RETURN WAS E-MAILED TO ALL BOARD MEMBERS FOR REVIEW AND APPROVAL. FORM 990, PART VI, SECTION B, LINE 12C THE BOARD IS REQUIRED TO COMPLETE CONFLICT OF INTEREST STATEMENTS ON AN ANNUAL BASIS AND SUBMIT TO THE CORPORATE COMPLIANCE OFFICER. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION COMMITTEE REVIEWS THE SALARIES OF THE SENIOR LEADERSHIP TEAM ON AN ANNUAL BASIS. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS ARE MADE PUBLIC UPON WRITTEN REQUEST. FORM 990, PART XII, LINE 2C THE ORGANIZATION'S BOARD OF DIRECTORS ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.