COMMUNITY HEALTH CENTERS INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- COMMUNITY HEALTH CENTERS INC (EIN 74-2412898)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-11-15
- IRS object ID
- 202203199349307170
- 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 | 2022-11-15T11:20:17-05:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 870517754 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WSRP LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 155 N 400 W STE 400 | AddressLine1Txt |
| City | SALT LAKE CITY | CityNm |
| State Abbreviation | UT | StateAbbreviationCd |
| ZIP | 84103 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 742412898 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY HEALTH CENTERS INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | COMM | BusinessNameControlTxt |
| Phone | 8014126920 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2621 SOUTH 3270 WEST | AddressLine1Txt |
| City | WEST VALLEY CITY | CityNm |
| State Abbreviation | UT | StateAbbreviationCd |
| ZIP | 84119 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JENNIFER THOMAS | PersonNm |
| Person Title | INTERIM EXEC DIRECTR | PersonTitleTxt |
| Phone | 3852612730 | PhoneNum |
| Signature | 2022-10-29 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | JENNIFER | PersonFirstNm |
| Person Last | THOMAS | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DANIEL P RINEHART CPA | PreparerPersonNm |
| PTIN | P01057041 | PTIN |
| Phone | 8013282011 | PhoneNum |
| Preparation | 2022-10-29 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JENNIFER THOMAS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2621 S 3270 W | AddressLine1Txt |
| City | WEST VALLEY CITY | CityNm |
| State Abbreviation | UT | StateAbbreviationCd |
| ZIP | 84119 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $31,656,733 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | HTTP://WWW.CHC-UT.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1979 | FormationYr |
| Legal Domicile State | UT | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE QUALITY, PATIENT-CENTERED PRIMARY HEALTH CARE, DENTAL AND OTHER SERVICES TO THE MEDICALLY UNDERSERVED IN UTAH REGARDLESS OF THEIR ABILITY TO PAY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 13 | VotingMembersIndependentCnt |
| Total Employee | 379 | TotalEmployeeCnt |
| Total Volunteers | 13 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $11,659,256 | PYContributionsGrantsAmt |
| CY Contributions Grants | $16,725,604 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $10,423,185 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $12,046,709 | CYProgramServiceRevenueAmt |
| PY Investment Income | $108,817 | PYInvestmentIncomeAmt |
| CY Investment Income | $230,782 | CYInvestmentIncomeAmt |
| PY Other Revenue | $760,507 | PYOtherRevenueAmt |
| CY Other Revenue | $2,310,106 | CYOtherRevenueAmt |
| PY Total Revenue | $22,951,765 | PYTotalRevenueAmt |
| CY Total Revenue | $31,313,201 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $14,814,674 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $15,879,368 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $8,492,089 | PYOtherExpensesAmt |
| CY Other Expenses | $9,789,296 | CYOtherExpensesAmt |
| PY Total Expenses | $23,306,763 | PYTotalExpensesAmt |
| CY Total Expenses | $25,668,664 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$354,998 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $5,644,537 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $15,007,059 | TotalAssetsBOYAmt |
| Total Assets EOY | $18,547,739 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $4,805,834 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $2,444,225 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $10,201,225 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $16,103,514 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO PROVIDE QUALITY, PATIENT-CENTERED PRIMARY HEALTH CARE, DENTAL AND OTHER SERVICES TO THE MEDICALLY UNDERSERVED IN UTAH REGARDLESS OF THEIR ABILITY TO PAY. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $21,852,023 | ExpenseAmt |
| Revenue | $12,046,709 | RevenueAmt |
| Desc | COMMUNITY HEALTH CENTERS PROVIDED PRIMARY MEDICAL CARE TO 42,926 PATIENTS WITH 109,956 INDIVIDUAL VISITS, ORAL HEALTH CARE TO 2,457 PATIENTS WITH 9,188 INDIVIDUAL VISITS AND BEHAVIORAL HEALTH CARE TO 1,266 PATIENTS WITH 3,328 INDIVIDUAL VISITS. THESE SERVICES ARE PROVIDED THROUGH DIRECT SERVICE HEALTH CLINICS TO LOW INCOME AND MEDICALLY UNDERSERVED POPULATIONS THROUGHOUT THE STATE OF UTAH. PRIMARY MEDICAL CARE INCLUDES A SPECIAL EMPHASIS ON PEDIATRIC MEDICINE, WITH 17,658 WELL CHILD CHECKUPS AND 31,667 VACCINES GIVEN TO CHILDREN UNDER AGE 18. CHC ALSO PROVIDED ORAL HEALTH CARE EDUCATION, OUTREACH AND TREATMENTS TO CHILDREN OF MIGRANT FARMWORKERS IN UTAH COUNTY THROUGH A PARTNER ORGANIZATION, COMMUNITY HEALTH CONNECT. THIS PROGRAM BENEFITED 5,132 CHILDREN IN 2021. | Desc |
| Total Program Service Expenses | $21,852,023 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | 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 | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | 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 | Yes (true) | 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 | 32 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 379 | 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 |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| 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 | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 13 | 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 | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY HEALTH CENTERS INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8014126920 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2621 SOUTH 3270 WEST | AddressLine1Txt |
| City | WEST VALLEY CITY | CityNm |
| State Abbreviation | UT | StateAbbreviationCd |
| ZIP | 84119 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (22 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | OfficerOfficerInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|---|
| FRANK POWERS | ||||||||
| PHYSICIAN | 40.00 | Yes (X) | $281,641 | $0 | $46,342 | |||
| ANDREW GARRISON | ||||||||
| MED DIRECTOR | 40.00 | $290,395 | $0 | $30,246 | Yes (X) | |||
| CARL WHITTAKER | ||||||||
| PHYSICIAN | 40.00 | Yes (X) | $249,247 | $0 | $45,076 | |||
| DAVID GONTRUM | ||||||||
| PHYSICIAN | 40.00 | Yes (X) | $219,595 | $0 | $26,157 | |||
| BETTY LIU | ||||||||
| PHYSICIAN | 40.00 | Yes (X) | $202,757 | $0 | $38,500 | |||
| KEITH HORWOOD | ||||||||
| PHYSICIAN | 40.00 | Yes (X) | $206,156 | $0 | $34,767 | |||
| DEXTER PEARCE | ||||||||
| EXEC. DIRECT | 40.00 | $155,370 | $0 | $23,240 | Yes (X) | |||
| BILL HOFFMAN | ||||||||
| FINANCE DIRE | 40.00 | $120,457 | $0 | $19,448 | Yes (X) | |||
| JENNIFER THOMAS | ||||||||
| INTERIM EXEC | 40.00 | $107,883 | $0 | $28,643 | Yes (X) | |||
| ALINE ASHTON | ||||||||
| GOVERNOR | 1.50 | $0 | $0 | $0 | Yes (X) | |||
| SHAWN BROOKS | ||||||||
| GOVERNOR | 1.50 | $0 | $0 | $0 | Yes (X) | |||
| ROBERT BUNNELL | ||||||||
| GOVERNOR | 1.50 | $0 | $0 | $0 | Yes (X) | |||
| LILI DECAIR | ||||||||
| GOVERNOR | 1.50 | $0 | $0 | $0 | Yes (X) | |||
| JERRY FENN | ||||||||
| GOVERNOR | 1.50 | $0 | $0 | $0 | Yes (X) | |||
| HOLLY HANSEN | ||||||||
| GOVERNOR | 1.50 | $0 | $0 | $0 | Yes (X) | |||
| SHEILA HASSETT | ||||||||
| GOVERNOR | 1.50 | $0 | $0 | $0 | Yes (X) | |||
| RACHAEL HOOLEY | ||||||||
| SECRETARY | 1.50 | $0 | $0 | $0 | Yes (X) | Yes (X) | ||
| SUSAN JOHNSTON | ||||||||
| TREASURER | 1.50 | $0 | $0 | $0 | Yes (X) | Yes (X) | ||
| GERRY MARTY | ||||||||
| GOVERNOR | 1.50 | $0 | $0 | $0 | Yes (X) | |||
| TERESA MOLINA | ||||||||
| GOVERNOR | 1.50 | $0 | $0 | $0 | Yes (X) | |||
| WILLIAM NELSON | ||||||||
| PRESIDENT | 1.50 | $0 | $0 | $0 | Yes (X) | Yes (X) | ||
| LINDA STEARNS | ||||||||
| GOVERNOR | 1.50 | $0 | $0 | $0 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,833,501 | TotalReportableCompFromOrgAmt |
| Total Other Compensation | $292,419 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 41 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| ECLINICAL WORKS LLC | |||||
| PO BOX 847950 | BOSTON | MA | 022847950 | WEB MEDICAL REC | $451,641 |
| WASATCH SOFTWARE INC | |||||
| 5242 S COLLEGE DR 200 | MURRAY | UT | 84123 | IT SERVICES | $358,328 |
| 340BASICS | |||||
| 161 GAITHER DR STE 201 | MT LAURELK | NJ | 08054 | TPA SERVICES | $245,361 |
| ALL STREAM | |||||
| PO BOX 734521 | CHICAGO | IL | 606734521 | TELECOM SERVICE | $139,206 |
| MEDICAL PROFESSIONALS | |||||
| PO BOX 910569 | SAN DIEGO | CA | 921910569 | TEMP EMPLOYMENT | $119,069 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $11,676,552 | GovernmentGrantsAmt |
| All Other Contributions | $5,049,052 | AllOtherContributionsAmt |
| Noncash Contributions | $2,146,146 | NoncashContributionsAmt |
| Total Contributions | $16,725,604 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT REVENUE | Desc |
| Business | 621400 | BusinessCd |
| Total Revenue Column | $12,046,709 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $12,046,709 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $12,046,709 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $119,340 | TotalRevenueColumnAmt |
| Exclusion | $119,340 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $454,974 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $343,532 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $111,442 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $111,442 | TotalRevenueColumnAmt |
| Exclusion | $111,442 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt | ExclusionExclusionAmt |
|---|---|---|---|---|
| SALES OF PHARMACEUTICALS TO P | 446110 | $2,288,787 | $2,288,787 | |
| MEDICAL RECORD RECEIPTS | 621400 | $21,319 | $21,319 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $2,310,106 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $31,313,201 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $14,335,496 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $252,101 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $775,682 | TotalAmt |
| Management And General | $775,682 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,785,110 | TotalAmt |
| Program Services | $10,683,175 | ProgramServicesAmt |
| Management And General | $1,101,935 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,000,649 | TotalAmt |
| Program Services | $847,197 | ProgramServicesAmt |
| Management And General | $153,452 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,490,952 | TotalAmt |
| Program Services | $1,348,311 | ProgramServicesAmt |
| Management And General | $142,641 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $826,975 | TotalAmt |
| Program Services | $700,156 | ProgramServicesAmt |
| Management And General | $126,819 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $39,015 | TotalAmt |
| Management And General | $39,015 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $65,696 | TotalAmt |
| Management And General | $65,696 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,801,272 | TotalAmt |
| Program Services | $1,876,575 | ProgramServicesAmt |
| Management And General | $924,697 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $563,470 | TotalAmt |
| Program Services | $413,648 | ProgramServicesAmt |
| Management And General | $149,822 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $912,977 | TotalAmt |
| Program Services | $833,018 | ProgramServicesAmt |
| Management And General | $79,959 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,438 | TotalAmt |
| Program Services | $7,965 | ProgramServicesAmt |
| Management And General | $1,473 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $70,881 | TotalAmt |
| Program Services | $61,026 | ProgramServicesAmt |
| Management And General | $9,855 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | -$18,232 | TotalAmt |
| Management And General | -$18,232 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $199,760 | TotalAmt |
| Program Services | $168,792 | ProgramServicesAmt |
| Management And General | $30,968 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $46,757 | TotalAmt |
| Program Services | $12,202 | ProgramServicesAmt |
| Management And General | $34,555 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $4,513,927 | $4,513,927 | |
| SMALL EQUIPMENT/SUPPLIES | $200,467 | $177,933 | $22,534 |
| BANK FEES | $99,893 | $57,459 | $42,434 |
| DUES & FEES | $96,440 | $65,530 | $30,910 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $187,535 | TotalAmt |
| Program Services | $85,109 | ProgramServicesAmt |
| Management And General | $102,426 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,668,664 | TotalAmt |
| Program Services | $21,852,023 | ProgramServicesAmt |
| Management And General | $3,816,641 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,681,416 | BOYAmt |
| EOY | $4,852,538 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,500 | BOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,602,068 | BOYAmt |
| EOY | $3,303,475 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $713,321 | BOYAmt |
| EOY | $835,363 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $181,558 | BOYAmt |
| EOY | $171,299 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $90,924 | BOYAmt |
| EOY | $206,390 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $4,199,262 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $2,858,253 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,374,017 | BOYAmt |
| EOY | $1,341,009 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,339,280 | BOYAmt |
| EOY | $7,814,877 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,975 | BOYAmt |
| EOY | $22,788 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,007,059 | BOYAmt |
| EOY | $18,547,739 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,641,587 | BOYAmt |
| EOY | $2,071,666 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,164,247 | BOYAmt |
| EOY | $372,559 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,805,834 | BOYAmt |
| EOY | $2,444,225 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,137,125 | BOYAmt |
| EOY | $15,947,356 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $64,100 | BOYAmt |
| EOY | $156,158 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,201,225 | BOYAmt |
| EOY | $16,103,514 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,007,059 | BOYAmt |
| EOY | $18,547,739 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $5,644,537 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $257,752 | NetUnrlzdGainsLossesInvstAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $11,873,453 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $11,468,827 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $11,816,893 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $11,659,256 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $16,725,604 | CurrentTaxYearAmt |
| Total | $63,544,033 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $11,873,453 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $11,468,827 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $11,816,893 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $11,659,256 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $16,725,604 | CurrentTaxYearAmt |
| Total | $63,544,033 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $63,544,033 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $110,200 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $146,498 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $110,170 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $72,610 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $119,340 | CurrentTaxYearAmt |
| Total | $558,818 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,000,376 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $885,478 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $533,588 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $14,508 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $21,319 | CurrentTaxYearAmt |
| Total | $2,455,269 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $66,558,120 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $61,324,461 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.95470 | PublicSupportCY170Pct |
| Public Support PY170 | 0.93510 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II, LINE 10 | FormAndLineReferenceDesc |
| Explanation | MEDICAL RECORDS & MISC INCOME 2,433,950 | ExplanationTxt |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $89,635 | InvestmentCostOrOtherBasisAmt |
| Book Value | $89,635 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $516,216 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $383,438 | DepreciationAmt |
| Book Value | $132,778 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $1,683,146 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $913,964 | DepreciationAmt |
| Book Value | $769,182 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $1,802,774 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $1,480,584 | DepreciationAmt |
| Book Value | $322,190 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $107,491 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $80,267 | DepreciationAmt |
| Book Value | $27,224 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,341,009 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | GOVERNMENT CONTRACT LIABILITY | Desc |
| Amt | $372,559 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $372,559 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $34,046,409 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $257,752 | NetUnrealizedGainsInvstAmt |
| Donated Services And Use Fclts | $2,475,456 | DonatedServicesAndUseFcltsAmt |
| Revenue Not Reported | $2,733,208 | RevenueNotReportedAmt |
| Revenue Subtotal | $31,313,201 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $31,313,201 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $28,144,120 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $2,475,456 | DonatedServicesUseFcltsAmt |
| Expenses Not Reported | $2,475,456 | ExpensesNotReportedAmt |
| Expenses Subtotal | $25,668,664 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $25,668,664 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE D, PAGE 3, PART X | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION IS A TAX-EXEMPT ORGANIZATION UNDER INTERNAL REVENUE CODE SECTION 501(C)(3) AND, AS REQUIRED, FILES A FORM 990 (RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX) ANNUALLY. THE ORGANIZATION ENGAGES IN NO ACTIVITY CONSTITUTING TAXABLE UNRELATED BUSINESS INCOME. CONSEQUENTLY, THE ORGANIZATION IS NOT SUBJECT TO FEDERAL OR STATE INCOME TAXES ON INCOME PERTAINING TO ITS EXEMPT PURPOSE AND NO INCOME TAX IS REFLECTED IN THE ACCOMPANYING FINANCIAL STATEMENTS. MANAGEMENT HAS DETERMINED THAT THE ORGANIZATION HAS NO UNCERTAIN TAX POSITIONS THAT REQUIRE EITHER RECOGNITION OR DISCLOSURE IN THE FINANCIAL STATEMENTS. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| 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 (7 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt |
|---|---|---|---|---|---|
| FRANK POWERS | |||||
| PHYSICIAN | $258,191 | $23,450 | $28,562 | $17,780 | $327,983 |
| ANDREW GARRISON | |||||
| MED DIRECTOR/PHYS | $273,545 | $16,850 | $29,000 | $1,246 | $320,641 |
| CARL WHITTAKER | |||||
| PHYSICIAN | $222,247 | $27,000 | $25,598 | $19,478 | $294,323 |
| DAVID GONTRUM | |||||
| PHYSICIAN | $219,595 | $22,108 | $4,049 | $245,752 | |
| BETTY LIU | |||||
| PHYSICIAN | $202,757 | $21,047 | $17,453 | $241,257 | |
| KEITH HORWOOD | |||||
| PHYSICIAN | $195,206 | $10,950 | $20,957 | $13,810 | $240,923 |
| DEXTER PEARCE | |||||
| EXEC. DIRECTOR | $155,370 | $15,686 | $7,554 | $178,610 | |
Schedule M IRS990ScheduleM
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $324,427 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | AVG MKT COST OF SUPPLIES | MethodOfDeterminingRevenuesTxt |
Other Non Cash Contri Table OtherNonCashContriTableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Desc | VACCINES | Desc |
| Contribution | 31961 | ContributionCnt |
| Noncash Contributions Rpt F990 | $1,821,719 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | STATE DEPT OF HEALTH AR | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | false | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | false | ThirdPartiesUsedInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE M, PAGE 2, PART II | FormAndLineReferenceDesc |
| Explanation | REPORTED THE NUMBER OF CONTRIBUTIONS FOR DRUGS AND MEDICAL SUPPLIES, AND THE NUMBER OF DONATED VACCINES. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 6, PART VI, LINE 11B | THE FINANCE DIRECTOR COMPARES THE FORM 990 TO THE AUDITED FINANCIAL STATEMENTS AND REVIEWS THE VARIOUS OTHER DISCLOSURES WITH THE EXECUTIVE DIRECTOR. A COPY OF THE FORM 990 IS ALSO PRESENTED, DISCUSSED AND APPROVED BY THE BOARD OF GOVERNORS. |
| FORM 990, PAGE 6, PART VI, LINE 12C | HUMAN RESOURCES REQUIRES ALL NEW EMPLOYEES AND BOARD MEMBERS TO COMPLETE AND SIGN A CONFLICT OF INTEREST STATEMENT. OUR COMPLIANCE OFFICER REVIEWS ALL CONFLICT OF INTEREST STATEMENTS AND INVESTIGATES ANY POTENTIAL CONFLICTS. BOARD MEMBERS DO NOT VOTE ON ISSUES FOR WHICH THEY MAY HAVE A CONFLICT OF INTEREST. |
| FORM 990, PAGE 6, PART VI, LINE 15A | HUMAN RESOURCES CONDUCTS A COMPENSATION STUDY AND MAKE RECOMMENDATIONS TO A COMMITTEE OF THE BOARD CHARGED WITH EVALUATING THE EXECUTIVE DIRECTOR'S JOB PERFORMANCE. THE COMMITTEE THEN APPROVES THE EXECUTIVE DIRECTOR'S COMPENSATION AND RENEWAL OF EMPLOYMENT AGREEMENT. |
| FORM 990, PAGE 6, PART VI, LINE 19 | FINANCIAL STATEMENTS, GOVERNING DOCUMENTS, AND COMPANY POLICIES CAN BE OBTAINED BY CONTACTING DEXTER PEARCE EITHER BY PHONE AT 801-412-6920 OR BY MAIL AT 2621 SOUTH 3270 WEST, WEST VALLEY CITY, UT 84119. |
| FORM 990, PART IX, LINE 11G | MEDICAL/LAB/X-RAY 351,992 9,902 0 LAUNDRY SERVICES 53,538 1,712 0 DENTAL LAB SERVICES 37,403 0 0 EQUIPMENT MAINTENANCE 30,578 1,325 0 JANITORIAL SERVICES 83,886 12,251 0 MEDICAL WASTE SERVICES 27,283 0 0 SECURITY SERVICES 3,952 171 0 GROUNDS MAINTENANCE 19,427 0 0 PAYROLL SERVICES 0 87,031 0 INTERPRETING SERVICES 9,351 1,327 0 INFORMATION SYSTEM SUPPORT 93,007 696,995 0 TEMP HELP 105,939 13,151 0 RESIDENTS/FELLOWS 84,140 0 0 340B PROGRAM ADMIN FEES 897,272 0 0 COURIER SERVICES 0 30,701 0 MISCELLANEOUS SERVICES 64,603 28,299 0 CONTRACTED PRINTING 14,204 3,885 0 OTHER EXPENSES 0 37,947 0 TOTAL 1,876,575 924,697 0 |
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