VALLEY FAMILY HEALTH CARE INC: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization
VALLEY FAMILY HEALTH CARE INC (EIN 82-0371383)
Tax period
2017-02-01 to 2018-01-31
Filed
2018-07-24
IRS object ID
201802059349300860
Schema version
2017v2.3
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

FieldValueIRS element (for citing)
Return2018-07-24T13:42:16-06:00ReturnTs
Tax Period End2018-01-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN203147422PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BRIAN L RICHINS PCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1131 N WHITLEY DRAddressLine1Txt
CityFRUITLANDCityNm
State AbbreviationIDStateAbbreviationCd
ZIP836192430ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2017-02-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN820371383EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1VALLEY FAMILY HEALTH CARE INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlVALLBusinessNameControlTxt
Phone2086429376PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11441 NE 10TH AVEAddressLine1Txt
CityPAYETTECityNm
State AbbreviationIDStateAbbreviationCd
ZIP83661ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonPAM STAMPFLIPersonNm
Person TitleCFOPersonTitleTxt
Phone2086427364PhoneNum
Signature2018-06-15SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonBRIAN L RICHINSPreparerPersonNm
PTINP00545131PTIN
Phone2084525625PhoneNum
Preparation2018-06-28PreparationDt
FieldValueIRS element (for citing)
Tax2017TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerPAM STAMPFLIPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11441 NE 10TH AVEAddressLine1Txt
CityPAYETTECityNm
State AbbreviationIDStateAbbreviationCd
ZIP83661ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$14,351,899GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressN/AWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Legal Domicile StateIDLegalDomicileStateCd
Activity Or MissionCOMMUNITY HEALTH SERVICESActivityOrMissionDesc
Voting Members Governing Body10VotingMembersGoverningBodyCnt
Voting Members Independent10VotingMembersIndependentCnt
Total Employee190TotalEmployeeCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$4,774,458PYContributionsGrantsAmt
CY Contributions Grants$5,414,386CYContributionsGrantsAmt
PY Program Service Revenue$7,248,610PYProgramServiceRevenueAmt
CY Program Service Revenue$8,930,282CYProgramServiceRevenueAmt
PY Investment Income$5,018PYInvestmentIncomeAmt
CY Investment Income$7,231CYInvestmentIncomeAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$12,028,086PYTotalRevenueAmt
CY Total Revenue$14,351,899CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$7,107,667PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$9,246,008CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$3,669,142PYOtherExpensesAmt
CY Other Expenses$5,459,347CYOtherExpensesAmt
PY Total Expenses$10,776,809PYTotalExpensesAmt
CY Total Expenses$14,705,355CYTotalExpensesAmt
PY Revenues Less Expenses$1,251,277PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$353,456CYRevenuesLessExpensesAmt
Total Assets BOY$11,706,585TotalAssetsBOYAmt
Total Assets EOY$13,942,819TotalAssetsEOYAmt
Total Liabilities BOY$791,936TotalLiabilitiesBOYAmt
Total Liabilities EOY$1,881,452TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$10,914,649NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$12,061,367NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionCOMMUNITY HEALTH SERVICESMissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
DescHEALTH CARE FOR MIGRANT WORKERS AND LOW INCOME PERSONS. ALSO, MENTAL HEALTH AND NUTRITION COUNSELING.Desc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp

FieldValueIRS element (for citing)
Expense$12,565,521ExpenseAmt
Revenue$8,930,282RevenueAmt
DescHEALTH CARE FOR MIGRANT WORKERSDesc
FieldValueIRS element (for citing)
Total Other Prog Srvc Expense$12,565,521TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Revenue$8,930,282TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses$12,565,521TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document21IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld CompliancefalseBackupWthldComplianceInd
Employee190EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members10GoverningBodyVotingMembersCnt
Independent Voting Member10IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldORStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonRIGMOR WILSONPersonNm
Phone2086429376PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11441 NE 10TH AVEAddressLine1Txt
CityPAYETTECityNm
State AbbreviationIDStateAbbreviationCd
ZIP83661ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
HENRY HIXSON
PRESIDENT1.00Yes (X)Yes (X)$0$0$0
ROBERT BAROWSKY
VICE PRESIDE1.00Yes (X)Yes (X)$0$0$0
KERRI WENGER
SECRETARY1.00Yes (X)Yes (X)$0$0$0
RANELLE CROSBY
TREASURER1.00Yes (X)Yes (X)$0$0$0
CARLOS HERNANDEZ
DIRECTOR1.00Yes (X)$0$0$0
ANDY CREECH
DIRECTOR1.00Yes (X)$0$0$0
JONI DELGADO
DIRECTOR1.00Yes (X)$0$0$0
DENNIS STOKES
DIRECTOR1.00Yes (X)$0$0$0
MARIA HIDALGO
DIRECTOR1.00Yes (X)$0$0$0
ARMIDA HERNANDEZ
DIRECTOR1.00Yes (X)$0$0$0
PAM STAMPFLI
CFO40.00Yes (X)$79,519$0$0
GEOFFREY THOMAS
DOCTOR40.00$202,940$0$0Yes (X)
SHANNON SCHANTZ
DOCTOR40.00$180,405$0$0Yes (X)
PAUL CONCIDINE
DOCTOR40.00$159,391$0$0Yes (X)
ROBERT DAVIS
DOCTOR40.00$148,362$0$0Yes (X)
PATRICK BARFIELD
DOCTOR40.00$138,818$0$0Yes (X)
TIMOTHY HEINZE
CEO40.00$158,972$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,068,407TotalReportableCompFromOrgAmt
Indiv Rcvd Greater Than100 K6IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (true)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
Government Grants$5,414,386GovernmentGrantsAmt
Total Contributions$5,414,386TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
340B PROGRAM INCOME$781,864$781,864
MEDICARE$643,585$643,585
MEDICAID - IDAHO$620,595$620,595
340B PROGRAM INCOME$613,324$613,324
PRIVATE INSURANCE$599,880$599,880

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$5,671,034TotalRevenueColumnAmt
Related Or Exempt Func Income$5,671,034RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$8,930,282TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$7,231TotalRevenueColumnAmt
Related Or Exempt Func Income$7,231RelatedOrExemptFuncIncomeAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$14,351,899TotalRevenueColumnAmt
Related Or Exempt Func Income$8,937,513RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$7,629,054TotalAmt
Program Services$6,280,993ProgramServicesAmt
Management And General$1,348,061ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,616,954TotalAmt
Program Services$1,338,374ProgramServicesAmt
Management And General$278,580ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$89,389TotalAmt
Program Services$32,254ProgramServicesAmt
Management And General$57,135ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
CAPITAL OUTLAY$1,862,308$1,862,308
340B PROGRAM$666,771$666,771
IT SUPPLIES$300,333$242,603$57,730
340B CONSULTING FEES$247,555$247,555

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$2,292,991TotalAmt
Program Services$1,894,663ProgramServicesAmt
Management And General$398,328ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$14,705,355TotalAmt
Program Services$12,565,521ProgramServicesAmt
Management And General$2,139,834ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,895,954BOYAmt
EOY$2,742,900EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$2,937,319BOYAmt
EOY$2,636,292EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,096,293BOYAmt
EOY$1,210,406EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$593BOYAmt
EOY$673EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
EOY$38,741EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$10,732,617LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$3,993,139LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$5,776,215BOYAmt
EOY$6,739,478EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
EOY$37,419EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
EOY$536,910EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$211BOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$11,706,585BOYAmt
EOY$13,942,819EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$791,936BOYAmt
EOY$1,766,452EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
EOY$115,000EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$791,936BOYAmt
EOY$1,881,452EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$10,914,649BOYAmt
EOY$12,061,367EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$10,914,649BOYAmt
EOY$12,061,367EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$11,706,585BOYAmt
EOY$13,942,819EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$353,456ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$1,500,174OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedfalseFSAuditedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$3,383,238CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$3,502,938CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$4,161,294CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$4,774,458CurrentTaxYearMinus1YearAmt
Current Tax Year$5,414,386CurrentTaxYearAmt
Total$21,236,314TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$3,383,238CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$3,502,938CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$4,161,294CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$4,774,458CurrentTaxYearMinus1YearAmt
Current Tax Year$5,414,386CurrentTaxYearAmt
Total$21,236,314TotalAmt
FieldValueIRS element (for citing)
Public Support Total170$21,236,314PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,796CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$2,627CurrentTaxYearMinus3YearsAmt
Total$5,423TotalAmt
FieldValueIRS element (for citing)
Total Support$21,241,737TotalSupportAmt
Gross Receipts Rltd Activities$8,937,513GrossReceiptsRltdActivitiesAmt
Public Support CY1700.99970PublicSupportCY170Pct
Public Support PY1700.99960PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Schedule D IRS990ScheduleD

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$10,732,617InvestmentCostOrOtherBasisAmt
Depreciation$3,993,139DepreciationAmt
Book Value$6,739,478BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$6,739,478TotalBookValueLandBuildingsAmt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmt
GEOFFREY THOMAS
DOCTOR$202,940$202,940
SHANNON SCHANTZ
DOCTOR$180,405$180,405
PAUL CONCIDINE
DOCTOR$159,391$159,391
TIMOTHY HEINZE
CEO$158,972$158,972

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PAGE 2, PART III, LINE 4DHEALTH CARE FOR MIGRANT WORKERS
FORM 990, PAGE 6, PART VI, LINE 11BPROVIDE COPY TO ORGANIZATION FOR BOARD MEMBERS TO REVIEW.
FORM 990, PAGE 6, PART VI, LINE 12CPOLICY OF ORGANIZATION IS TO REVIEW COMPLIANCE WITH NEW DIRECTORS, OFFICERS, AND KEY EMPLOYEES.
FORM 990, PAGE 6, PART VI, LINE 15ABOARD OF DIRECTORS PERFORM EVALUATIONS AND DETERMINE COMPENSATION.
FORM 990, PAGE 6, PART VI, LINE 19COPIES AVAILABLE FOR PUBLIC AND PAYETTE, ID ADMINISTRITIVE OFFICES.
FORM 990, PART IX, LINE 24ECOMPUTER FEES 155,788 2,778 0 LOCUMS TENENS - MEDICAL 153,238 0 0 SUPPLIES - MEDICAL 134,273 0 0 SUPPLIES 104,261 0 0 PATIENT STATEMENT FEES 67,972 0 0 INJECTIBLES - MEDICAL 65,647 0 0 TELEPHONE 27,569 28,236 0 UTILITIES 34,055 13,002 0 EQUIPMENT - ADMIN 42,033 0 0 LEGAL FEES 40 40,144 0 TELEPHONE - FACILITY 39,927 0 0 SUPPLIES - LAB 36,923 0 0 PROFESSIONAL DUES/FEES/SU 36,614 0 0 MAINTENANCE AGREEMENTS - 36,500 0 0 AUDIT - ADMIN 0 36,310 0 OFFICE SUPPLIES - ADMIN 0 35,911 0 OFFICE PRODUCTS 33,734 0 0 R & R - ALL 33,423 0 0 340B PROCESSING COSTS 33,055 0 0 UTILITIES - FACILITY 29,764 0 0 MAINT/REPAIR - ADMIN FAC 0 29,380 0 COMPUTER/IT SUPPORT 10,620 17,648 0 OTHER MEDICAL 27,337 0 0 MAINTENANCE & REPAIRS 26,972 0 0 BANK FEES 22,045 3,571 0 CONFERENCES/WORKSHOPS 0 25,572 0 SUPPLIES - INJECTABLES 25,161 0 0 PAYROLL PROCESSING FEES 0 24,823 0 CONTRACT MEDICAL 23,415 0 0 UTILITIES - FACILITIY 22,911 0 0 FACILITY REPAIRS/MAINT - 22,302 0 0 MEDICAL SUPPLIES - VALE 21,746 0 0 TELEPHONE - TOTAL 21,166 0 0 SUPPLIES - FACILITY 20,747 0 0 INJECTIBLES - VALE 20,352 0 0 MAINTENANCE/REPAIRS - FAC 20,180 0 0 PRINTING/COPYING - MEDICA 19,289 0 0 FACILITY - REPAIRS AND MA 18,282 0 0 OTHER - ADMIN 0 18,208 0 OFFICE SUPPLIES - DENTAL 18,132 0 0 SPACE RENT 0 17,394 0 COMPUTER FEES - DENTAL 17,316 0 0 CME 12,280 5,017 0 ORGANIZATIONAL DUES 0 15,622 0 UTILITIES - TOTAL 14,737 0 0 MOVING EXPENSE - R&R 14,484 0 0 EQUIPMENT - IT 2,248 12,104 0 MEDICAL SUPPLIES - NYSSA 14,199 0 0 OTHER - COMMUNITY SERVICE 13,804 0 0 SPACE RENT - IT BUILDING 0 13,640 0 INJECTIBLES - NYSSA 12,905 0 0 R & R - OTHER 385 12,177 0 OFFICE SUPPLIES 12,540 0 0 INSURANCE - FACILITY 12,107 0 0 MAINT/REPAIR - FACILITY 11,260 0 0 FACILITY MAINTENANCE & RE 11,178 0 0 UTILITIES - DENTAL FACILI 11,034 0 0 UTILITIES - NYSSA 10,803 0 0 UTILITIES - VALE 10,490 0 0 COMMUNITY SERVICE PROMOTI 10,387 0 0 POSTAGE 7,993 2,124 0 TELEPHONE - NYSSA 10,093 0 0 R&R - OTHER 10,000 0 0 OFFICE PRODUCTS - TOTAL 9,800 0 0 COMMUNITY SERVICE PROMO 9,538 0 0 OFFICE PRODUCTS - VALE 9,520 0 0 R & R 9,404 0 0 INJECTIBLES 8,984 0 0 MAINT/REPAIR - DENTAL FAC 8,928 0 0 LAB SUPPLIES - VALE 8,912 0 0 FAC SUPPLIES - ADMIN 0 8,601 0 SUPPLIES - DENTAL FACILIT 8,549 0 0 TELEPHONE - VALE 8,532 0 0 CME - MEDICAL 8,531 0 0 EQUIP - DENTAL 8,007 0 0 TELEPHONE - DENTAL FACILI 7,050 0 0 OFFICE PRODUCTS - NYSSA 7,012 0 0 INSURANCE-DENTAL ACTIVITY 6,995 0 0 LAB 6,936 0 0 CONTINUING EDUCATION - VA 6,918 0 0 DUES/FEES/SUB - DENTAL 6,876 0 0 FACILITY INSURANCE - ADMI 0 6,694 0 INS/BOARD BONDING 0 6,502 0 PROFESSIONAL FEES/DUES/SU 6,199 0 0 MAINT/REPAIRS - FACILITY 6,191 0 0 CONTINUING MEDICAL EDUCAT 6,149 0 0 AUTO MAINT/REPAIR/REG/INS 0 5,714 0 EQUIPMENT - MEDICAL 5,624 0 0 LAB EXPENSES - DENTAL 5,340 0 0 FACILITY SUPPLIES 5,118 0 0 LAB SUPPLIES - NYSSA 4,716 0 0 CME - DENTAL 4,632 0 0 PROF DUES/SUBSCRIPTIONS 4,213 0 0 CONTRACT - DENTAL 4,138 0 0 CONFERENCE WORKSHOPS 4,072 0 0 AUTO MAINT. ADMIN 0 3,894 0 CONTINUING EDUCATION - NY 3,884 0 0 R AND R 3,864 0 0 FACILITY SUPPLIES - NYSSA 3,815 0 0 CLEANING COSTS - ADMIN 0 3,500 0 MEDICAL - PRINTING/COPYIN 3,364 0 0 FACILITY SUPPLIES - VALE 3,015 0 0 PRINT/COPYING - ADMIN 0 2,745 0 EQUIPMENT - ADMINISTRATIO 2,631 0 0 JOB ANNOUNCEMENTS 1,687 933 0 ANSWERING SERVICE 2,616 0 0 MAINTENANCE CONTRACTS 2,611 0 0 OTHER - DENTAL 2,503 0 0 REFERRAL/CONTRACT - DENTA 2,496 0 0 MAINT AGREE - ADMIN 0 2,381 0 PRINTING & COPYING 2,341 0 0 MAINTENANCE CONTRACT 2,281 0 0 DUES/FEES/SUBSCRIPTIONS 2,187 0 0 CONTRACT - MEDICAL 1,905 0 0 POSTAGE - VALE 1,836 0 0 PROMOTIONS/DOOR PRIZES/RE 1,750 0 0 EQUIP - ADMIN 0 1,728 0 CONFERENCE/WORKSHOPS 1,725 0 0 POSTAGE - NYSSA 1,620 0 0 COMMUNITY SERVICE 1,609 0 0 INSURANCE FACILITY - VALE 1,480 0 0 CONTRACT-MEDICAL-NYSSA 1,446 0 0 BANK S/C 1,427 0 0 COMMUNITY PROMOTIONS 0 1,368 0 OTHER - MEDICAL 1,159 0 0 POSTAGE - TOTAL 1,098 0 0 MAINTENANCE AGREEMENTS 1,097 0 0 INSURANCE FACILITY - NYSS 1,085 0 0 OTHER - LAB 1,065 0 0 RECRUITMENT & RETENTION 972 0 0 PRINTING/COPYING - DENTAL 903 0 0 MAINTENANCE AGREE - ADMIN 895 0 0 EQUIPMENT - ADMIN - VALE 877 0 0 EQUIPMENT 877 0 0 EQUIPMENT - ADMIN - NYSSA 877 0 0 MOVING EXPENSE - MEDICAL 861 0 0 SUPPLIES - COMMUNITY SERV 803 0 0 PRINTING/COPYING 800 0 0 ANSWERING SERVICE - VALE 587 0 0 ANSWERING SERVICE - NYSSA 587 0 0 BOARD MEETING 0 554 0 MAINTENANCE AGREEMENT - M 540 0 0 REFFERRALS - LAB 466 0 0 REFERRALS - XRAY - VALE 466 0 0 SUPPLIES - DENTAL 398 0 0 INSURANCE/STAFF BONDING - 344 0 0 FACILITY MAINT/REPAIRS 305 0 0 CONFERENCES & WORKSHOPS 185 0 0 JOB ANNOUCEMENTS 172 0 0 REFERRALS - LAB 157 0 0 OTHER - FACILITY 98 56 0 FACILITY - SUPPLIES 152 0 0 PRINTING/COPYING - OUTREA 120 0 0 AUTO MAINT/REPAIRS/INS 30 0 0 SUPPLIES - COMM SERVICE - 7 0 0 ROUNDING 0 -3 0 ROUNDING -13 0 0 TOTAL 1,894,663 398,328 0
FORM 990, PART XI, LINE 9CHANGE IN FIXED ASSETS 1,500,171 ROUNDING 3 TOTAL 1,500,174

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