2021-05-13T16:06:32-05:00 2020-06-30 200079326 DINGUS ZARECOR & ASSOCIATES PLLC 12015 E MAIN AVE SPOKANE VALLEY WA 99206 990 2019-07-01 205934739 FAMILY MEDICINE RESIDENCY OF IDAHO INC FAMI 2083676071 777 N RAYMOND STREET BOISE ID 83701 BRENT HINES CFO 2089548680 2021-04-26 true THOMAS DINGUS P00951009 5092420874 2021-05-13 2019 2022-09-23 18:48:47Z TED EPPERLY 777 N RAYMOND ST BOISE ID 83704 53143531 false X WWW.FMRIDAHO.ORG X 2006 ID FAMILY MEDICINE RESIDENCY OF IDAHO MAINTAINS A PROGRAM DESIGNED TO FURTHER THE EDUCATION OF GRADUATE PHYSICIANS IN THE MEDICAL SPECIALTY OF FAMILY MEDICINE AND FAMILY PRACTICE, PROVIDES CLINICAL TRAINING IN FAMILY PRACTICE THROUGH THE ESTABLISHMENT AND OPERATION OF A MODEL CLINIC, CONDUCTS A MEDICAL EDUCATION PROGRAM INCLUDING OPERATION OF THE MODEL CLINIC, PROMOTES A PROFESSIONALLY ATTRACTIVE ENVIRONMENT FOR THE RECRUITMENT AND RETENTION OF MEDICAL MANPOWER AND SUPPORTS HEALTH EDUCATION ACTIVITIES AND PROGRAMS FOR THE GENERAL PUBLIC WHILE SERVING THE UNDER-SERVED CITIZENS OF IDAHO. 18 18 385 0 10694873 14103988 34893152 37462212 -16984 19336 1682312 1557995 47253353 53143531 0 0 25325857 27460313 0 3500 21753278 23989950 47079135 51450263 174218 1693268 11979324 16994554 3969176 7300537 8010148 9694017 X FAMILY MEDICINE RESIDENCY OF IDAHO MAINTAINS A PROGRAM DESIGNED TO FURTHER THE EDUCATION OF GRADUATE PHYSICIANS IN THE MEDICAL SPECIALTY OF FAMILY MEDICINE AND FAMILY PRACTICE, PROVIDES CLINICAL TRAINING IN FAMILY PRACTICE THROUGH THE ESTABLISHMENT AND OPERATION OF A MODEL CLINIC, CONDUCTS A MEDICAL EDUCATION PROGRAM INCLUDING OPERATION OF THE MODEL CLINIC, PROMOTES A PROFESSIONALLY ATTRACTIVE ENVIRONMENT FOR THE RECRUITMENT AND RETENTION OF MEDICAL MANPOWER AND SUPPORTS HEALTH EDUCATION ACTIVITIES AND PROGRAMS FOR THE GENERAL PUBLIC WHILE SERVING THE UNDER-SERVED CITIZENS OF IDAHO. false false 32983786 21953928 THE CLINIC PROVIDES MEDICAL AND BEHAVIORAL HEALTH SERVICES TO NON-INSURED AND UNDER-INSURED AT-RISK PATIENT POPULATIONS, AS WELL AS MEDICAL SERVICES WITH TRANSLATION PROVIDED FOR NON-ENGLISH SPEAKING POPULATIONS. THE CLINIC PROVIDES CARE TO PATIENTS WHILE PROVIDING AN EDUCATIONAL SETTING WHICH FURTHERS THE MEDICAL TRAINING OF RESIDENTS. THE CLINIC HAD 89,966 FQHC AND AN ADDITIONAL 13,903 HOSPITAL OR OFFSITE ENCOUNTERS DURING THE YEAR. FAMILY MEDICINE RESIDENCY OF IDAHO PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS. UNREIMBURSED CHARGES FOR SLIDING FEE DISCOUNTS AND CHARITY CARE WAS 1,213,898 FOR THE YEAR. 11589414 5650 THE RESIDENCY PROVIDES EDUCATIONAL TRAINING EXPERIENCE FOR PRIMARY CARE RESIDENTS AND FELLOWS. DURING THE YEAR THE RESIDENCY HAD 62 RESIDENTS AND 4 FELLOWS. 1436274 15502634 THE RYAN WHITE CLINIC PROVIDES EARLY INTERVENTION MEDICAL SERVICES AND CARE TO PATIENTS WITH OR AT RISK FOR HIV DISEASE. THE CLINIC HAD 2,661 ENCOUNTERS DURING THE YEAR. 46009474 true true false false false false false false false true true false false false false true true false false false false false false false false false false false false true false false false false false false false false true false false false false true false false false true 78 0 true 385 true false false false false false true true false false false false false false X 18 18 true false false false false true true true true false false true true true true true true true true false X BRENT HINES 2085142500 777 N RAYMOND ST BOISE ID 83704 DENISE CHUCKOVICH CHAIR 1.00 X X 0 0 0 JIM MONTGOMERY VICE CHAIR 1.00 X X 0 0 0 RUSSELL CENTANNI SECRETARY 1.00 X X 0 0 0 HAROLD WARD TREASURER 1.00 X X 0 0 0 LES BOCK BOARD MEMBER 1.00 X 0 0 0 SUE CHEW BOARD MEMBER 1.00 X 0 0 0 LINDA CLARK BOARD MEMBER 1.00 X 0 0 0 KATHY HOLLEY BOARD MEMBER 1.00 X 0 0 0 TONY HOWARD BOARD MEMBER 1.00 X 0 0 0 BESSIE KATSILOMETES BOARD MEMBER 1.00 X 0 0 0 MARK MERING BOARD MEMBER 1.00 X 0 0 0 LISA NELSON BOARD MEMBER 1.00 X 0 0 0 ALAN PURCELL BOARD MEMBER 1.00 X 0 0 0 CAROL RAINS BOARD MEMBER 1.00 X 0 0 0 HEIDI THOMPSON BOARD MEMBER 1.00 X 0 0 0 JIM TROUNSON BOARD MEMBER 1.00 X 0 0 0 OFELIA VILLERO BOARD MEMBER 1.00 X 0 0 0 BRENDEN WARWICK BOARD MEMBER 1.00 X 0 0 0 TED EPPERLY CEO 40.00 X 448868 0 18627 BRENT HINES CFO 40.00 X 152469 0 18762 KEVIN RICH VP MEDICAL A 40.00 X 267990 0 40770 JUSTIN GLASS PROGRAM DIRE 40.00 X 251021 0 17014 KIM STUTZMAN PROGRAM DIRE 40.00 X 248380 0 40199 PENNY BEACH CMO 40.00 X 232543 0 36385 ABBY DAVIDS FM FACULTY 40.00 X 239153 0 24209 DANIELLE DAVIES FM FACULTY 40.00 X 218865 0 22996 JUSTIN BAILEY FM FACULTY 40.00 X 218663 0 38649 ELIZABETH ATNIP FM FACULTY 40.00 X 222640 0 14631 MARVIN ALVISO FM FACULTY 40.00 X 209976 0 29532 2710568 301774 50 false true false SALTZER MEDICAL GROUP PA 215 E HAWAII AVE NAMPA ID 83686 PEDIATRICIANS 1325603 STABILITY NETWORKS 2404 BANK DRIVE SUITE 100 BOISE ID 83705 IT SERVICES 314100 INDEMAND INTERPRETING PO BOX 67 DETROIT MI 48267 INTERPRETING 199176 CHANGE HEALTHCARE PO BOX 1236 BUTLER PA 16003 NURSING 197236 INTERPATH LABORATORY PO BOX 1208 PENDLETON OR 97801 DIAGNOSTIC/LAB 116459 5 9810007 4293981 55906 14103988 NET PATIENT SERVICES 624100 37456562 37456562 TRAINING COURSES 611430 5650 5650 37462212 19336 19336 CASE MANAGEMENT 624100 1496245 1496245 OTHER REVENUE 900099 61750 61750 1557995 53143531 37462212 1577331 1653654 1075021 578633 21788719 18632680 3156039 290307 234183 56124 2100917 1682917 418000 1626716 1301353 325363 24646 2677 21969 51387 51387 5840 5840 4095236 3978294 116942 6384 6384 998046 841954 156092 1045460 805661 239799 896779 791387 105392 133947 110894 23053 341656 260436 81220 293700 264017 29683 249188 235173 14015 MEDICAL SUPPLIES & DRUGS 15333842 15333842 LICENSES, DUES & SUBSCRIP 352240 318553 33687 161599 134048 24051 3500 51450263 46009474 5437289 3500 3272411 2448211 2066468 6047908 727048 2040848 2617442 3067381 573884 782805 1273609 1052644 3439074 2325104 1076881 1113970 371581 440787 11979324 16994554 3956846 3339746 12330 3960791 3969176 7300537 X 6900697 8593016 1109451 1101001 8010148 9694017 11979324 16994554 1693268 -9399 X false true X true true true X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 983301 1000 -8398 -5840 969063 946967 500 41169 -5335 983301 866135 85705 -4873 946967 750735 119654 -4254 866135 761283 -6704 -3844 750735 1.00000 true false 1164411 614722 549689 2274663 1710382 564281 1113970 X 53886634 -9399 758342 748943 53137691 5840 5840 53143531 52202765 758342 758342 51444423 5840 5840 51450263 SCHEDULE D, PAGE 3, PART X THE RESIDENCY IS QUALIFIED AS EXEMPT FROM FEDERAL INCOME TAX UNDER INTERNAL REVENUE CODE SECTION 501(C)(3). ACCORDINGLY, NO PROVISION FOR INCOME TAX IS NECESSARY. THE RESIDENCY EVALUATES UNCERTAIN TAX POSITIONS WHEREBY THE EFFECT OF THE UNCERTAINTY WOULD BE RECORDED IF THE OUTCOME WAS CONSIDERED PROBABLE AND REASONABLY ESTIMABLE. AS OF JUNE 30, 2020 AND 2019, THE RESIDENCY HAD NO UNCERTAIN TAX POSITIONS REQUIRING ACCRUAL. X X false false false false false false false false false TED EPPERLY CEO 383408 65460 16600 2027 467495 BRENT HINES CFO 152469 8682 10080 171231 KEVIN RICH VP MEDICAL AFFAIRS 238961 27925 1104 16600 24170 308760 JUSTIN GLASS PROGRAM DIRECTOR 225546 25475 15248 1766 268035 KIM STUTZMAN PROGRAM DIRECTOR 219035 29345 15316 24883 288579 PENNY BEACH CMO 213118 19425 14865 21520 268928 ABBY DAVIDS FM FACULTY 207503 31650 14202 10007 263362 DANIELLE DAVIES FM FACULTY 197360 21505 13003 9993 241861 JUSTIN BAILEY FM FACULTY 198948 19715 14146 24503 257312 ELIZABETH ATNIP FM FACULTY 194465 15675 12500 6666 7965 237271 MARVIN ALVISO FM FACULTY 184876 25100 9965 19567 239508 X 1 55660 FMV X 1 246 FMV false true false FORM 990 - ORGANIZATION'S MISSION FAMILY MEDICINE RESIDENCY OF IDAHO MAINTAINS A PROGRAM DESIGNED TO FURTHER THE EDUCATION OF GRADUATE PHYSICIANS IN THE MEDICAL SPECIALTY OF FAMILY MEDICINE AND FAMILY PRACTICE, PROVIDES CLINICAL TRAINING IN FAMILY PRACTICE THROUGH THE ESTABLISHMENT AND OPERATION OF A MODEL CLINIC, CONDUCTS A MEDICAL EDUCATION PROGRAM INCLUDING OPERATION OF THE MODEL CLINIC, PROMOTES A PROFESSIONALLY ATTRACTIVE ENVIRONMENT FOR THE RECRUITMENT AND RETENTION OF MEDICAL MANPOWER AND SUPPORTS HEALTH EDUCATION ACTIVITIES AND PROGRAMS FOR THE GENERAL PUBLIC WHILE SERVING THE UNDER-SERVED CITIZENS OF IDAHO. FORM 990, PART III AS OF JUNE 30, 2007, FAMILY PRACTICE RESIDENCY OF IDAHO, INC (THE PRACTICE) DEVELOPED AND MAINTAINED A PROGRAM DESIGNED TO FURTHER THE EDUCATION OF GRADUATE PHYSICIANS IN THE MEDICAL SPECIALTY OF FAMILY MEDICINE AND FAMILY PRACTICE, PROVIDED CLINICAL TRAINING IN FAMILY PRACTICE THROUGH THE ESTABLISHMENT AND OPERATION OF A MODEL CLINIC, CONDUCTED A MEDICAL EDUCATION PROGRAM INCLUDING OPERATION OF A MODEL CLINIC, PROMOTED A PROFESSIONALLY ATTRACTIVE ENVIRONMENT FOR THE RECRUITMENT AND RETENTION OF MEDICAL MANPOWER AND SUPPORTED HEALTH EDUCATION ACTIVITIES AND PROGRAMS FOR THE GENERAL PUBLIC WHILE SERVING THE UNDER-SERVED CITIZENS OF IDAHO. ON JULY 1, 2007, THE PRACTICE TRANSFERRED ITS ASSETS AND LIABILITIES TO FAMILY MEDICINE RESIDENCY OF IDAHO, INC. (FAMILY MEDICINE) IN ORDER TO FURTHER ITS EXEMPT PURPOSE. FAMILY MEDICINE WAS APPROVED BY THE CENTERS FOR MEDICARE AND MEDICAID SERVICES AS A FEDERALLY-QUALIFIED HEALTH CENTER LOOK-A-LIKE FACILITY (FQHC-LA) IN JUNE 2007. FAMILY MEDICINE CURRENTLY OPERATES THE RESIDENCY PROGRAM PREVIOUSLY OPERATED UNDER THE PRACTICE. IN OCTOBER 2013, THE RESIDENCY WAS AWARDED A CONSOLIDATED HEALTH CENTERS GRANT FROM THE US DEPARTMENT OF HEALTH AND HUMAN SERVICES FOR ADDITIONAL SITES AND INCREASED CAPACITY. THE RESIDENCY OPERATES AS A DUAL STATUS ORGANIZATION, WITH ONE SITE BEING AN FQHC-LA CLINIC AND OTHER SITES BEING CONSOLIDATED HEALTH CENTER GRANT SITES. THE FQHC-LA CLINIC BECAME A CONSOLIDATED HEALTH CENTER GRANT SITE EFFECTIVE AUGUST 23, 2015. SHOULD FAMILY MEDICINE CEASE TO QUALIFY FOR FQHC-LA OR SIMILAR STATUS, ALL ASSETS AND LIABILITIES OF FAMILY MEDICINE WILL THEN BE TRANSFERRED BACK TO THE PRACTICE IN ORDER TO CONTINUE ITS EXEMPT PURPOSE. FORM 990, PAGE 6, PART VI, LINE 2 TED EPPERLY JIM TROUNSON CEO BOARD MEMBER BUSINESS RELATIONSHIP FORM 990, PAGE 6, PART VI, LINE 7A ONE POSITION ON THE BOARD IS FILLED BY A PERSON WHO IS A SENIOR EXECUTIVE OF ST. ALPHONSUS REGIONAL MEDICAL CENTER AND ONE FILLED BY A PERSON WHO IS A SENIOR EXECUTIVE OF ST. LUKE'S REGIONAL MEDICAL CENTER. THESE SUPPORTING HOSPITALS NOMINATE INDIVIDUALS WHO ARE WILLING TO SERVE ON THE BOARD OF THE ORGANIZATION. FORM 990, PAGE 6, PART VI, LINE 7B ONE SENIOR EXECUTIVE FROM EACH SUPPORTING HOSPITAL SERVE ON THE BOARD OF DIRECTORS AND HAS VOTING RIGHTS. THESE INDIVIDUALS ARE NOMINATED BY THE HOSPITALS, IMPACTING THE DECISIONS OF THE ORGANIZATION. FORM 990, PAGE 6, PART VI, LINE 11B A COPY OF THE 990 IS PROVIDED TO THE CEO, CFO, AND THE FINANCE COMMITTEE WHO REVIEW THE FORM, SCHEDULES AND RELATED ATTACHMENTS. ANY COMMENTS OR QUESTIONS ARE ADDRESSED WITH THE PREPARER. ONCE MANAGEMENT IS SATISFIED WITH THE 990, A COPY IS SUBMITTED TO THE ENTIRE BOARD FOR APPROVAL. WHEN THE BOARD AND MANAGEMENT AGREE THE RETURN IS COMPLETE AND ACCURATE, FINAL APPROVAL IS GIVEN TO THE PREPARER BEFORE FINALIZING THE RETURN. FORM 990, PAGE 6, PART VI, LINE 12C THE CONFLICT OF INTEREST POLICY IS CURRENTLY ENFORCED THROUGH SELF DISCLOSURE, SUBMITTED TO THE HUMAN RESOURCE DEPARTMENT IMMEDIATELY. IF CONFLICTS ARE REPORTED OR DISCOVERED, FMRI ADDRESSES THE SITUATION ACCORDINGLY. FMRI HAS A FORMAL CONFLICT OF INTEREST STATEMENT AND MANDATES THE BOARD, OFFICERS, AND KEY EMPLOYEES TO READ AND SIGN ON AN ANNUAL BASIS. FORM 990, PAGE 6, PART VI, LINE 15A THE BOARD OF DIRECTORS APPROVE MANAGEMENT COMPENSATION EACH YEAR BASED ON RECOMMENDATIONS FROM THE BOARD PRESIDENT FOR CEO COMPENSATION AND THE FINANCE COMMITTEE FOR OTHER TOP MANAGEMENT OFFICIALS. THE BOARD SETS THE CEO'S SALARY BASED ON MARKET CONDITIONS, LONGEVITY, KEY ACCOMPLISHMENTS, AND HOW THE RESIDENCY HAS BEEN ADVANCED OVER THE EVALUATION PERIOD BECAUSE OF INDIVIDUAL ACCOMPLISHMENTS. FORM 990, PAGE 6, PART VI, LINE 15B SEE FORM 990, PART VI, LINE 15A FORM 990, PAGE 6, PART VI, LINE 19 FMRI MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. FAMILY PRACTICE RESIDENCY OF IDAHO 777 N RAYMOND ST BOISE ID 83704 820315641 MEDICAL ED ID 501C 7 N/A false false false false false false false false false false false false false false false false false false false false