WILLAMETTE FAMILY MEDICAL CENTER: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- WILLAMETTE FAMILY MEDICAL CENTER (EIN 93-1180397)
- Tax period
- 2021-07-01 to 2022-06-30
- Filed
- 2023-05-11
- IRS object ID
- 202311319349307486
- Schema version
- 2021v4.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-05-11T19:24:47-04:00 | ReturnTs |
| Tax Period End | 2022-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 931235599 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KUENZI & COMPANY LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 650 HAWTHORNE AVE SE STE 110 | AddressLine1Txt |
| City | SALEM | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97301 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 931180397 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WILLAMETTE FAMILY MEDICAL CENTER I | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | WILL | BusinessNameControlTxt |
| Phone | 5035856388 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 435 LANCASTER DRIVE NE | AddressLine1Txt |
| City | SALEM | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97301 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | OLIVIA GALVEZ | PersonNm |
| Person Title | PRESIDENT & CEO | PersonTitleTxt |
| Phone | 5035856388 | PhoneNum |
| Signature | 2023-03-28 | SignatureDt |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | OLIVIA | PersonFirstNm |
| Person Last | GALVEZ | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | ADEN L KUENZI | PreparerPersonNm |
| PTIN | P00443475 | PTIN |
| Phone | 5033997306 | PhoneNum |
| Preparation | 2023-05-11 | PreparationDt |
| Self Employed | Yes (X) | SelfEmployedInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WMFC HEALTH | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | OLIVIA GALVEZ | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 435 LANCASTER DRIVE NE | AddressLine1Txt |
| City | SALEM | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97301 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $30,504,669 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.WFMCHEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Activity Or Mission | PROVIDING HEALTH CARE SERVICES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 5 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 3 | VotingMembersIndependentCnt |
| Total Employee | 90 | TotalEmployeeCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $4,180 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,132,705 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $22,879,788 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $29,481,877 | CYProgramServiceRevenueAmt |
| PY Investment Income | $196,424 | PYInvestmentIncomeAmt |
| CY Investment Income | -$112,699 | CYInvestmentIncomeAmt |
| PY Other Revenue | $20,173 | PYOtherRevenueAmt |
| CY Other Revenue | $2,786 | CYOtherRevenueAmt |
| PY Total Revenue | $23,100,565 | PYTotalRevenueAmt |
| CY Total Revenue | $30,504,669 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $7,788,310 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $6,288,471 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $16,476,900 | PYOtherExpensesAmt |
| CY Other Expenses | $22,446,829 | CYOtherExpensesAmt |
| PY Total Expenses | $24,265,210 | PYTotalExpensesAmt |
| CY Total Expenses | $28,735,300 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$1,164,645 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,769,369 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $14,879,725 | TotalAssetsBOYAmt |
| Total Assets EOY | $14,474,913 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,241,149 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $66,968 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $12,638,576 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $14,407,945 | NetAssetsOrFundBalancesEOYAmt |
| Mission | PROVIDING HEALTH CARE SERVICES. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $27,977,461 | ExpenseAmt |
| Revenue | $29,481,877 | RevenueAmt |
| Desc | PROVIDING HEALTH CARE SERVICES TO UNDERSERVED POPULATIONS IN MARION AND POLK COUNTY, OREGON. | Desc |
| Total Program Service Expenses | $27,977,461 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | false | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | false | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 6 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 90 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 5 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 3 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | false | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | OR | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | OLIVIA GALVEZ | PersonNm |
| Phone | 5035856388 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 435 LANCASTER DRIVE NE | AddressLine1Txt |
| City | SALEM | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97301 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (11 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| ROBERT L STEELE MD | ||||||||
| PRESIDENT (F | 40.00 | Yes (X) | $331,131 | $0 | $8,000 | |||
| OLIVIA GALVEZ | ||||||||
| PRESIDENT & | 40.00 | $250,628 | $0 | $6,913 | Yes (X) | Yes (X) | ||
| JANICE HAZEL | ||||||||
| CFO | 40.00 | $198,658 | $0 | $4,400 | Yes (X) | Yes (X) | ||
| MICHAEL BRONCHEAU | ||||||||
| DIRECTOR | 1.00 | $0 | $0 | $0 | Yes (X) | |||
| JAQUELINE LEUNG | ||||||||
| DIRECTOR | 1.00 | $0 | $0 | $0 | Yes (X) | |||
| MARCUS GIPSON | ||||||||
| DIRECTOR | 1.00 | $0 | $0 | $0 | Yes (X) | |||
| EDWIN N CENTERWALL | ||||||||
| PHYSICIAN | 40.00 | $209,464 | $0 | $5,923 | Yes (X) | |||
| CLAUDIA GARCIA | ||||||||
| HUMAN RESOUR | 40.00 | $188,876 | $0 | $3,680 | Yes (X) | |||
| RAHWA GESSESE HANNA | ||||||||
| PHYSICIAN | 40.00 | $114,585 | $0 | $3,107 | Yes (X) | |||
| ELAINE E HANKS | ||||||||
| PHYSICIAN | 40.00 | $112,285 | $0 | $3,278 | Yes (X) | |||
| KRISTEN JAMSA | ||||||||
| PHYSICIAN | 40.00 | $151,524 | $0 | $5,334 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,557,151 | TotalReportableCompFromOrgAmt |
| Total Other Compensation | $40,635 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 19 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Business Name Line2ContractorName/BusinessName/BusinessNameLine2Txt | Address Line1ContractorAddress/USAddress/AddressLine1Txt | Address Line2ContractorAddress/USAddress/AddressLine2Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|---|---|
| NEXTGEN HEALTHCARE | |||||||
| NEXTGEN HEALTHCARE | PO BOX 511449 | PO BOX 511449 | LOS ANGELES | CA | 90051 | EMR SERVICES | $151,536 |
| THERECOM | |||||||
| THERECOM | 9715 KEY WEST AVE | 9715 KEY WEST AVENUE | ROCKVILLE | MD | 20850 | DATA COLLECTION | $105,195 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $1,066,500 | GovernmentGrantsAmt |
| All Other Contributions | $66,205 | AllOtherContributionsAmt |
| Total Contributions | $1,132,705 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | HEALTHCARE SERVICE REVENUE | Desc |
| Business | 624100 | BusinessCd |
| Total Revenue Column | $29,481,877 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $29,481,877 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $29,481,877 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$112,699 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | -$112,699 | RelatedOrExemptFuncIncomeAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $2,786 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $2,786 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $2,786 | TotalRevenueColumnAmt |
| Exclusion | $2,786 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $30,504,669 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $29,369,178 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $2,786 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $460,598 | TotalAmt |
| Program Services | $414,539 | ProgramServicesAmt |
| Management And General | $46,059 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $339,130 | TotalAmt |
| Program Services | $305,217 | ProgramServicesAmt |
| Management And General | $33,913 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,906,313 | TotalAmt |
| Program Services | $4,415,682 | ProgramServicesAmt |
| Management And General | $490,631 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $129,583 | TotalAmt |
| Program Services | $116,625 | ProgramServicesAmt |
| Management And General | $12,958 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $446,820 | TotalAmt |
| Program Services | $402,138 | ProgramServicesAmt |
| Management And General | $44,682 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,027 | TotalAmt |
| Program Services | $5,424 | ProgramServicesAmt |
| Management And General | $603 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,616 | TotalAmt |
| Program Services | $10,893 | ProgramServicesAmt |
| Management And General | $2,723 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,375 | TotalAmt |
| Program Services | $15,500 | ProgramServicesAmt |
| Management And General | $3,875 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $77,164 | TotalAmt |
| Program Services | $57,873 | ProgramServicesAmt |
| Management And General | $19,291 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $158,988 | TotalAmt |
| Program Services | $143,089 | ProgramServicesAmt |
| Management And General | $15,899 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $59,337 | TotalAmt |
| Program Services | $53,403 | ProgramServicesAmt |
| Management And General | $5,934 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,546 | TotalAmt |
| Program Services | $5,891 | ProgramServicesAmt |
| Management And General | $655 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,104 | TotalAmt |
| Program Services | $24,394 | ProgramServicesAmt |
| Management And General | $2,710 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $317,631 | TotalAmt |
| Program Services | $285,867 | ProgramServicesAmt |
| Management And General | $31,764 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $161,957 | TotalAmt |
| Program Services | $145,761 | ProgramServicesAmt |
| Management And General | $16,196 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SERVICE EXPENSE | $20,812,407 | $20,812,407 | |
| MEDICALSUPPLIES | $493,249 | $493,249 | |
| SUBCONTRACTED SERVICES | $101,101 | $90,991 | $10,110 |
| REPAIRS AND MAINTENANCE | $81,238 | $73,114 | $8,124 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $117,116 | TotalAmt |
| Program Services | $105,404 | ProgramServicesAmt |
| Management And General | $11,712 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,735,300 | TotalAmt |
| Program Services | $27,977,461 | ProgramServicesAmt |
| Management And General | $757,839 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $130,873 | BOYAmt |
| EOY | $558,462 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,683,630 | BOYAmt |
| EOY | $4,863,802 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $6,909,644 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $2,140,046 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,745,159 | BOYAmt |
| EOY | $4,769,598 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,312,936 | BOYAmt |
| EOY | $4,279,730 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,127 | BOYAmt |
| EOY | $3,321 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,879,725 | BOYAmt |
| EOY | $14,474,913 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $46,465 | BOYAmt |
| EOY | $66,968 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,128,184 | BOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,066,500 | BOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,241,149 | BOYAmt |
| EOY | $66,968 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Org Does Not Follow FASB117 | Yes (X) | OrgDoesNotFollowFASB117Ind |
Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,638,576 | BOYAmt |
| EOY | $14,407,945 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,638,576 | BOYAmt |
| EOY | $14,407,945 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,879,725 | BOYAmt |
| EOY | $14,474,913 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $1,769,369 | ReconcilationRevenueExpnssAmt |
| Method Of Accounting Cash | Yes (X) | MethodOfAccountingCashInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | false | FSAuditedInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $506,014 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $272,028 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $17,684 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $4,180 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,132,705 | CurrentTaxYearAmt |
| Total | $1,932,611 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $12,902,820 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $19,287,492 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $19,941,621 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $23,078,440 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $29,481,877 | CurrentTaxYearAmt |
| Total | $104,692,250 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $13,408,834 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $19,559,520 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $19,959,305 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $23,082,620 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $30,614,582 | CurrentTaxYearAmt |
| Total | $106,624,861 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $106,624,861 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,747 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $136,743 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $31,254 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $20,173 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | -$112,699 | CurrentTaxYearAmt |
| Total | $78,218 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,747 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $136,743 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $31,254 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $20,173 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | -$112,699 | CurrentTaxYearAmt |
| Total | $78,218 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $13,411,581 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $19,696,263 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $19,990,559 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $23,102,793 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $30,501,883 | CurrentTaxYearAmt |
| Total | $106,703,079 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99930 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99780 | PublicSupportPY509Pct |
| Investment Income CY | 0.00000 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00000 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $363,911 | OtherCostOrOtherBasisAmt |
| Book Value | $363,911 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,356,768 | OtherCostOrOtherBasisAmt |
| Depreciation | $892,291 | DepreciationAmt |
| Book Value | $2,464,477 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,049,587 | OtherCostOrOtherBasisAmt |
| Depreciation | $544,791 | DepreciationAmt |
| Book Value | $1,504,796 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,139,378 | OtherCostOrOtherBasisAmt |
| Depreciation | $702,964 | DepreciationAmt |
| Book Value | $436,414 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $4,769,598 | TotalBookValueLandBuildingsAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt |
|---|---|---|---|---|
| ROBERT L STEELE MD | ||||
| PRESIDENT (FORMER) | $200,000 | $131,131 | $8,000 | $339,131 |
| OLIVIA GALVEZ | ||||
| PRESIDENT & CEO | $189,615 | $61,013 | $6,913 | $257,541 |
| JANICE HAZEL | ||||
| CFO | $110,000 | $88,658 | $4,400 | $203,058 |
| EDWIN N CENTERWALL | ||||
| PHYSICIAN | $164,999 | $44,465 | $5,923 | $215,387 |
| CLAUDIA GARCIA | ||||
| HUMAN RESOURCES | $92,000 | $96,876 | $3,680 | $192,556 |
| KRISTEN JAMSA | ||||
| PHYSICIAN | $102,692 | $48,832 | $5,334 | $156,858 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 6, PART VI, LINE 11B | THE OFFICERS REVIEW AND APPROVE THE FORM 990 PRIOR TO SIGNING. |
| FORM 990, PAGE 6, PART VI, LINE 12C | BOARD MEMBERS ARE REQUIRED TO DISCLOSE ANY ACTUAL OR POTENTIAL CONFLICTS OF INTEREST. |
| FORM 990, PAGE 6, PART VI, LINE 15A | THE BOARD OF DIRECTORS APPROVE THE CEO SALARY. |
| FORM 990, PAGE 6, PART VI, LINE 19 | NO OTHER DOCUMENTS ARE AVAILABLE TO THE PUBLIC. |
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