VALLEY FAMILY HEALTH CARE INC: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
VALLEY FAMILY HEALTH CARE INC (EIN 82-0371383)
Tax period
2016-02-01 to 2017-01-31
Filed
2017-08-15
IRS object ID
201702279349303335
Schema version
2016v3.0
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

FieldValueIRS element (for citing)
Return2017-08-15T14:30:04-06:00ReturnTs
Tax Period End2017-01-31TaxPeriodEndDt

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 Begin2016-02-01TaxPeriodBeginDt

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)
PersonDON NELSONPersonNm
Person TitleCFOPersonTitleTxt
Phone2086429314PhoneNum
Signature2017-06-12SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonBRIAN L RICHINSPreparerPersonNm
PTINP00545131PTIN
Phone2084525625PhoneNum
Preparation2017-06-30PreparationDt

Filing Security Information FilingSecurityInformation

FieldValueIRS element (for citing)
At Submission Creation Device Id1583E04BB3EFF56ABAF5B4B7694F5BAB1370B795AtSubmissionCreationDeviceId
At Submission Filing Device Id1583E04BB3EFF56ABAF5B4B7694F5BAB1370B795AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerDON NELSONPrincipalOfficerNm
Gross Receipts$12,028,086GrossReceiptsAmt
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 Employee158TotalEmployeeCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$4,161,294PYContributionsGrantsAmt
CY Contributions Grants$4,774,458CYContributionsGrantsAmt
PY Program Service Revenue$5,803,033PYProgramServiceRevenueAmt
CY Program Service Revenue$7,248,610CYProgramServiceRevenueAmt
PY Investment Income$4,596PYInvestmentIncomeAmt
CY Investment Income$5,018CYInvestmentIncomeAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$9,968,923PYTotalRevenueAmt
CY Total Revenue$12,028,086CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$6,668,662PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$7,107,667CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$2,138,392PYOtherExpensesAmt
CY Other Expenses$3,669,142CYOtherExpensesAmt
PY Total Expenses$8,807,054PYTotalExpensesAmt
CY Total Expenses$10,776,809CYTotalExpensesAmt
PY Revenues Less Expenses$1,161,869PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$1,251,277CYRevenuesLessExpensesAmt
Total Assets BOY$9,270,611TotalAssetsBOYAmt
Total Assets EOY$11,706,585TotalAssetsEOYAmt
Total Liabilities BOY$547,516TotalLiabilitiesBOYAmt
Total Liabilities EOY$791,936TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$8,723,095NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$10,914,649NetAssetsOrFundBalancesEOYAmt
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$9,368,063ExpenseAmt
Revenue$7,248,610RevenueAmt
DescHEALTH CARE FOR MIGRANT WORKERSDesc
FieldValueIRS element (for citing)
Total Other Prog Srvc Expense$9,368,063TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Revenue$7,248,610TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses$9,368,063TotalProgramServiceExpensesAmt
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 Document22IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld CompliancefalseBackupWthldComplianceInd
Employee158EmployeeCnt
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
CAROL PERALTA
VICE PRESIDE1.00Yes (X)Yes (X)$0$0$0
CARLOS HERNANDEZ
SECRETARY1.00Yes (X)Yes (X)$0$0$0
ROBERT BAROWSKY
TREASURER1.00Yes (X)Yes (X)$0$0$0
BONNIE BRASSEUR
DIRECTOR1.00Yes (X)$0$0$0
ANDY CREECH
DIRECTOR1.00Yes (X)$0$0$0
JONI DELGADO
DIRECTOR1.00Yes (X)$0$0$0
TED PETTET
DIRECTOR1.00Yes (X)$0$0$0
KAREN SANDS
DIRECTOR1.00Yes (X)$0$0$0
KERRI WENGER
DIRECTOR1.00Yes (X)$0$0$0
DON NELSON
CFO40.00Yes (X)$98,535$0$3,941
ROBIN SEBASTION
DOCTOR40.00$205,646$0$2,056Yes (X)
SHARMEEN NELSON
DOCTOR40.00$184,553$0$7,382Yes (X)
SHANNON SCHANTZ
DOCTOR40.00$179,766$0$7,191Yes (X)
PAUL CONCIDINE
DOCTOR40.00$153,706$0$6,148Yes (X)
ROBERT DAVIS
DOCTOR40.00$146,072$0$5,843Yes (X)
TIMOTHY HEINZE
CEO40.00$125,165$0$1,785Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,093,443TotalReportableCompFromOrgAmt
Total Other Compensation$34,346TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K6IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (true)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
Government Grants$4,774,458GovernmentGrantsAmt
Total Contributions$4,774,458TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
430B PROGRAM INCOME$1,059,337$1,059,337
MEDICAID - IDAHO$1,004,832$1,004,832
MEDICARE$812,761$812,761
MEDICAID - OREGON$751,602$751,602
PRIVATE INSURANCE$738,769$738,769

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,881,309TotalRevenueColumnAmt
Related Or Exempt Func Income$2,881,309RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$7,248,610TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$5,018TotalRevenueColumnAmt
Related Or Exempt Func Income$5,018RelatedOrExemptFuncIncomeAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$12,028,086TotalRevenueColumnAmt
Related Or Exempt Func Income$7,253,628RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$5,967,429TotalAmt
Program Services$5,011,405ProgramServicesAmt
Management And General$956,024ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,140,238TotalAmt
Program Services$939,543ProgramServicesAmt
Management And General$200,695ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$48,251TotalAmt
Program Services$17,714ProgramServicesAmt
Management And General$30,537ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
CONSTRUCTION$693,510$693,510
340B PROGRAM$578,472$578,472
CAPITAL OUTLAY$517,435$517,435
340B CONSULTING FEES$260,673$260,673

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$1,570,801TotalAmt
Program Services$1,349,311ProgramServicesAmt
Management And General$221,490ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$10,776,809TotalAmt
Program Services$9,368,063ProgramServicesAmt
Management And General$1,408,746ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,159,745BOYAmt
EOY$1,895,954EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$2,306,439BOYAmt
EOY$2,937,319EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$150,492BOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$816,893BOYAmt
EOY$1,096,293EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$250BOYAmt
EOY$593EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$9,398,270LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$3,622,055LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$4,835,937BOYAmt
EOY$5,776,215EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$855BOYAmt
EOY$211EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$9,270,611BOYAmt
EOY$11,706,585EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$547,516BOYAmt
EOY$791,936EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$547,516BOYAmt
EOY$791,936EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$8,723,095BOYAmt
EOY$10,914,649EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$8,723,095BOYAmt
EOY$10,914,649EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$9,270,611BOYAmt
EOY$11,706,585EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$1,251,277ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$940,277OtherChangesInNetAssetsAmt
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$3,166,039CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$3,383,238CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$3,502,938CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$4,161,294CurrentTaxYearMinus1YearAmt
Current Tax Year$4,774,458CurrentTaxYearAmt
Total$18,987,967TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$3,166,039CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$3,383,238CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$3,502,938CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$4,161,294CurrentTaxYearMinus1YearAmt
Current Tax Year$4,774,458CurrentTaxYearAmt
Total$18,987,967TotalAmt
FieldValueIRS element (for citing)
Public Support Total170$18,987,967PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$3,025CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$2,796CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$2,627CurrentTaxYearMinus2YearsAmt
Total$8,448TotalAmt
FieldValueIRS element (for citing)
Total Support$18,996,415TotalSupportAmt
Gross Receipts Rltd Activities$7,253,628GrossReceiptsRltdActivitiesAmt
Public Support CY1700.99960PublicSupportCY170Pct
Public Support PY1700.99950PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$90,720OtherCostOrOtherBasisAmt
Book Value$90,720BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$9,307,550InvestmentCostOrOtherBasisAmt
Depreciation$3,622,055DepreciationAmt
Book Value$5,685,495BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$5,776,215TotalBookValueLandBuildingsAmt

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 (6 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmt
ROBIN SEBASTION
DOCTOR$205,646$2,056$207,702
SHARMEEN NELSON
DOCTOR$184,553$7,382$191,935
SHANNON SCHANTZ
DOCTOR$179,766$7,191$186,957
PAUL CONCIDINE
DOCTOR$153,706$6,148$159,854
ROBERT DAVIS
DOCTOR$146,072$5,843$151,915
TIMOTHY HEINZE
CEO$125,165$1,785$126,950

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 24ESUPPLIES 100,088 0 0 COMPUTER FEES 66,704 4,830 0 PATIENT STATEMENT FEES 57,921 0 0 SUPPLIES - MEDICAL 57,372 0 0 INJECTIBLES - MEDICAL 47,963 0 0 TELEPHONE - FACILITY 47,133 0 0 SUPPLIES - LAB 46,503 0 0 EQUIPMENT - FEDERAL FUNDS 44,255 0 0 OFFICE PRODUCTS 44,114 0 0 UTILITIES 29,183 10,223 0 TELEPHONE 24,113 13,531 0 AUDIT - ADMIN 0 37,564 0 MAINT/REPAIRS - FACILITY 33,486 0 0 INJECTIBLES - VALE 31,562 0 0 OFFICE SUPPLIES - ADMIN 0 30,026 0 FACILITY REPAIRS/MAINT - 29,486 0 0 PROFESSIONAL DUES/FEES/SU 28,432 0 0 UTILITIES - FACILITY 26,652 0 0 MAINTENANCE AGREEMENTS - 24,325 0 0 COMPUTER/IT SUPPORT 17,752 5,759 0 340B PROCESSING COSTS 23,165 0 0 UTILITIES - FACILITIY 21,958 0 0 LEGAL FEES 0 20,000 0 SUPPLIES - INJECTABLES 19,234 0 0 INSURANCE - FACILITY 19,032 0 0 PAYROLL PROCESSING FEES 0 18,919 0 MAINT/REPAIR - ADMIN FAC 0 18,715 0 CONTRACT MEDICAL 18,534 0 0 MEDICAL SUPPLIES - VALE 17,767 0 0 FACILITY - REPAIRS AND MA 17,427 0 0 CME 15,935 0 0 TELEPHONE - TOTAL 15,612 0 0 MAINTENANCE/REPAIRS - FAC 14,951 0 0 OFFICE PRODUCTS - VALE 14,399 0 0 OFFICE SUPPLIES 14,268 0 0 PRINTING/COPYING - MEDICA 14,069 0 0 ORGANIZATIONAL DUES 0 13,342 0 BANK FEES 13,189 55 0 SUPPLIES - FACILITY 12,823 0 0 OFFICE PRODUCTS - TOTAL 12,750 0 0 EQUIPMENT - MEDICAL 12,681 0 0 TELEPHONE - NYSSA 12,359 0 0 UTILITIES - VALE 11,245 0 0 OTHER - COMMUNITY SERVICE 11,046 0 0 UTILITIES - TOTAL 10,903 0 0 LAB EXPENSES - DENTAL 10,669 0 0 EQUIPMENT 10,639 0 0 TELEPHONE - VALE 10,498 0 0 LAB SUPPLIES - VALE 10,165 0 0 UTILITIES - NYSSA 10,029 0 0 MAINTENANCE & REPAIRS 9,958 0 0 POSTAGE 7,035 2,215 0 INJECTIBLES - NYSSA 9,165 0 0 NON CONSUMABLE OFFICE SUP 8,688 0 0 COMPUTER FEES - DENTAL 8,685 0 0 INJECTIBLES 8,107 0 0 MOVING EXPENSES 8,000 0 0 COMMUNITY SERVICE PROMOTI 7,043 0 0 MEDICAL SUPPLIES - NYSSA 6,972 0 0 CME - MEDICAL 6,804 0 0 INS/BOARD BONDING 0 6,616 0 R & R - OTHER 0 6,475 0 UTILITIES - DENTAL FACILI 6,384 0 0 LAB 6,348 0 0 LAB SUPPLIES - NYSSA 6,239 0 0 MAINT/REPAIR - DENTAL FAC 6,195 0 0 CLEANING COSTS - ADMIN 0 6,000 0 CONTINUING EDUCATION - VA 6,000 0 0 OFFICE PRODUCTS - NYSSA 5,909 0 0 CONFERENCES/WORKSHOPS 0 5,643 0 TELEPHONE - DENTAL FACILI 5,415 0 0 FACILITY INSURANCE - ADMI 0 5,242 0 PROFESSIONAL FEES/DUES/SU 5,099 0 0 MAINT/REPAIR - FACILITY 4,945 0 0 CONTINUING MEDICAL EDUCAT 4,685 0 0 JOB ANNOUNCEMENTS 2,658 1,915 0 EQUIPMENT - ADMINISTRATIO 4,482 0 0 SUPPLIES - COMMUNITY SERV 4,444 0 0 DUES/FEES/SUBSCRIPTIONS 4,382 0 0 EQUIPMENT - ADMIN 4,359 0 0 CONTINUING EDUCATION - NY 4,277 0 0 PRINT/COPYING - ADMIN 0 3,618 0 AUTO MAINT. ADMIN 0 3,038 0 OFFICE SUPPLIES - DENTAL 3,006 0 0 FAC SUPPLIES - ADMIN 0 2,689 0 PROF DUES/SUBSCRIPTIONS 2,681 0 0 INSURANCE-DENTAL ACTIVITY 2,676 0 0 INSURANCE FACILITY - VALE 2,630 0 0 MEDICAL - PRINTING/COPYIN 2,319 0 0 FACILITY SUPPLIES - VALE 2,225 0 0 FACILITY SUPPLIES - NYSSA 2,191 0 0 CONFERENCE/WORKSHOPS 2,184 0 0 OTHER - ADMIN 0 2,173 0 PRINTING & COPYING 2,102 0 0 FACILITY SUPPLIES 1,999 0 0 INSURANCE FACILITY - NYSS 1,919 0 0 CONTRACT - DENTAL 1,838 0 0 ANSWERING SERVICE 1,636 0 0 POSTAGE - VALE 1,632 0 0 DUES/FEES/SUB - DENTAL 1,613 0 0 CONFERENCE WORKSHOPS 1,594 0 0 EQUIPMENT - ADMIN - VALE 1,494 0 0 EQUIP - ADMIN 0 1,494 0 POSTAGE - NYSSA 1,440 0 0 R & R 1,429 0 0 EQUIPMENT - ADMIN - NYSSA 1,359 0 0 R AND R 1,287 0 0 BANK S/C 1,265 0 0 COMMUNITY SERVICE 1,149 0 0 SUPPLIES - DENTAL FACILIT 1,147 0 0 FACILITY EQUIPMENT 1,100 0 0 MAINT AGREE - ADMIN 0 1,088 0 POSTAGE - TOTAL 928 0 0 PRINTING/COPYING 858 0 0 MAINTENANCE AGREE - ADMIN 751 0 0 CONTRACT - MEDICAL 691 0 0 MAINTENANCE CONTRACTS 674 0 0 AUTO MAINT/REPAIRS/INS 661 0 0 REFFERRALS - LAB 600 0 0 PRINTING/COPYING - DENTAL 476 0 0 ANSWERING SERVICE - VALE 409 0 0 ANSWERING SERVICE - NYSSA 409 0 0 MAINTENANCE CONTRACT 337 0 0 CONTRACT-MEDICAL-NYSSA 322 0 0 COMMUNITY PROMOTIONS 0 320 0 R & R - ALL 302 0 0 REFERRALS - LAB 246 0 0 REFERRALS - XRAY - VALE 217 0 0 JOB ANNOUCEMENTS 205 0 0 PRINTING/COPYING - OUTREA 165 0 0 OTHER - DENTAL 140 0 0 MAINTENANCE AGREEMENT - M 120 0 0 OTHER - LAB 113 0 0 OTHER - MEDICAL 92 0 0 REFERRAL/CONTRACT - DENTA 73 0 0 TAXES - PROPERTY 72 0 0 SUPPLIES - OUTREACH 38 0 0 INSURANCE/STAFF BONDING - -172 0 0 TOTAL 1,349,311 221,490 0
FORM 990, PART XI, LINE 9CHANGE IN FIXED ASSETS 940,280 ROUNDING -3 TOTAL 940,277

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