EMANATE HEALTH HOSPICE: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- EMANATE HEALTH HOSPICE (EIN 95-3493611)
- Tax period
- 2016-01-01 to 2016-12-31
- Filed
- 2017-11-15
- IRS object ID
- 201703199349309140
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-11-15T12:57:25-06:00 | ReturnTs |
| Tax Period End | 2016-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 330155525 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HBLA CERTIFIED PUBLIC ACCOUNTANTS INC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 19600 FAIRCHILD STE 320 | AddressLine1Txt |
| City | IRVINE | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 92612 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 953493611 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CITRUS VALLEY HOSPICE INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CITR | BusinessNameControlTxt |
| Phone | 6268592263 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 140 W COLLEGE ST PO BOX 6108 | AddressLine1Txt |
| City | COVINA | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 917225108 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | RAJESH K SHARMA | PersonNm |
| Person Title | EVP/CFO | PersonTitleTxt |
| Phone | 6269387577 | PhoneNum |
| Signature | 2017-11-13 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | EDWARD E BENOE | PreparerPersonNm |
| PTIN | P00032866 | PTIN |
| Phone | 9498332815 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 64.88.174.3 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2017-11-13 | IPDt |
| IP Tm | 16:33:08 | IPTm |
| IP Timezone | PS | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | EC13839738164EED488155B78300B3671934DCB4 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 311E1895E5ACC19E8D72624E0BDD30A09D7651E0 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | ROBERT H CURRY | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 140 W COLLEGE ST PO BOX 6108 | AddressLine1Txt |
| City | COVINA | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 917225108 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $7,785,639 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | CVHP.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1979 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | SERVICES PROVIDED TO TERMINALLY ILL PATIENTS AND HOME HEALTH CARE NURSING SERVICES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 21 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 19 | VotingMembersIndependentCnt |
| Total Employee | 93 | TotalEmployeeCnt |
| Total Volunteers | 90 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $536,000 | PYContributionsGrantsAmt |
| CY Contributions Grants | $13,408 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $7,491,824 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $6,977,844 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$211,311 | PYInvestmentIncomeAmt |
| CY Investment Income | $30,697 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $7,816,513 | PYTotalRevenueAmt |
| CY Total Revenue | $7,021,949 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $6,043,472 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $6,319,720 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $2,443,197 | PYOtherExpensesAmt |
| CY Other Expenses | $2,386,955 | CYOtherExpensesAmt |
| PY Total Expenses | $8,486,669 | PYTotalExpensesAmt |
| CY Total Expenses | $8,706,675 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$670,156 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$1,684,726 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $7,914,225 | TotalAssetsBOYAmt |
| Total Assets EOY | $7,278,563 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,109,028 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $2,949,164 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $5,805,197 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $4,329,399 | NetAssetsOrFundBalancesEOYAmt |
| Mission | OUR MISSION IS TO HELP PEOPLE KEEP WELL IN BODY, MIND AND SPIRIT BY PROVIDING QUALITY HEALTH CARE SERVICES IN A SAFE, COMPASSIONATE ENVIRONMENT. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $7,719,913 | ExpenseAmt |
| Revenue | $6,977,844 | RevenueAmt |
| Desc | HOME HEALTH CARE - A TOTAL OF 11,372 TOTAL HOME VISITS DURING THE YEAR. HOSPICE CARE - A PROGRAM TO PROVIDE HOSPICE CARE AND IN HOUSE SERVICES TO TERMINALLY ILL PATIENTS IN THE COMMUNITY, REGARDLESS OF A PATIENT'S ABILITY TO PAY. | Desc |
| Total Program Service Expenses | $7,719,913 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (1) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 18 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 93 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Form8899 Filedind | 0 | Form8899Filedind |
| Form1098 C Filed | 0 | Form1098CFiledInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 21 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 19 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | CA | StatesWhereCopyOfReturnIsFldCd |
| 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 | RAJESH K SHARMA EXECUTIVE VPCFO | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6269387577 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 140 W COLLEGE ST PO BOX 6108 | AddressLine1Txt |
| City | COVINA | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 917225108 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (36 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| ROBERT H CURRY | ||||||||
| PARENT PRESIDENT, CEO, BOD | 2.00 | 38.00 | Yes (X) | Yes (X) | $0 | $1,288,100 | $24,888 | |
| HAROLD BORAK SR | ||||||||
| BOARD OF DIRECTORS | 3.00 | Yes (X) | $0 | $0 | $0 | |||
| CLIFFORD CHRIST | ||||||||
| TREASURER | 3.00 | Yes (X) | $0 | $0 | $0 | |||
| NAJI KANDALAFT MD | ||||||||
| BOARD OF DIRECTORS | 3.00 | Yes (X) | $0 | $60,709 | $0 | |||
| OJ RODRIGUEZ | ||||||||
| BOARD OF DIRECTORS | 3.00 | Yes (X) | $0 | $0 | $0 | |||
| WALTER ALLEN III | ||||||||
| CHAIR | 3.00 | Yes (X) | $0 | $0 | $0 | |||
| ROBERT DUNCAN | ||||||||
| VICE CHAIR | 3.00 | Yes (X) | $0 | $0 | $0 | |||
| PATRICIA HANES PHD | ||||||||
| SECRETARY | 3.00 | Yes (X) | $0 | $0 | $0 | |||
| RAYMOND MATTES IHM | ||||||||
| BOARD OF DIRECTORS | 3.00 | Yes (X) | $0 | $0 | $0 | |||
| ANNA LEUNG MD | ||||||||
| BOARD OF DIRECTORS | 3.00 | Yes (X) | $0 | $0 | $0 | |||
| MARY KIRCHEN IHM | ||||||||
| BOARD OF DIRECTORS | 3.00 | Yes (X) | $0 | $0 | $0 | |||
| PHILIP MALDONADO DDS | ||||||||
| BOARD OF DIRECTORS | 3.00 | Yes (X) | $0 | $0 | $0 | |||
| MARY JANE BETTFREUND | ||||||||
| BOARD OF DIRECTORS | 3.00 | Yes (X) | $0 | $0 | $0 | |||
| SHARON YEE MD | ||||||||
| BOARD OF DIRECTORS | 3.00 | Yes (X) | $0 | $0 | $0 | |||
| DONALD BOSS ESQ | ||||||||
| BOARD OF DIRECTORS | 3.00 | Yes (X) | $0 | $0 | $0 | |||
| THOMAS BRYAN MD | ||||||||
| BOARD OF DIRECTORS | 3.00 | Yes (X) | $0 | $0 | $0 | |||
| GARY MATTHEWSON | ||||||||
| BOARD OF DIRECTORS | 3.00 | Yes (X) | $0 | $0 | $0 | |||
| BERNARD BOLLINGER JR ESQ | ||||||||
| BOARD OF DIRECTORS | 3.00 | Yes (X) | $0 | $0 | $0 | |||
| SUBHASH DHAND MD | ||||||||
| BOARD OF DIRECTORS | 3.00 | Yes (X) | $0 | $6,488 | $0 | |||
| GEORGE FERENCZI MD | ||||||||
| BOARD OF DIRECTORS | 3.00 | Yes (X) | $0 | $0 | $0 | |||
| ARTHUR LUDWICK | ||||||||
| BOARD OF DIRECTORS | 3.00 | Yes (X) | $0 | $0 | $0 | |||
| PATSY GORRELL | ||||||||
| BOARD OF DIRECTORS | 3.00 | Yes (X) | $0 | $0 | $0 | |||
| ROBINSON BARON | ||||||||
| BOARD OF DIRECTORS | 3.00 | Yes (X) | $0 | $0 | $0 | |||
| JAQUELINE BRACY MD | ||||||||
| BOARD OF DIRECTORS | 3.00 | Yes (X) | $0 | $0 | $0 | |||
| J PAUL HOLLAND MD | ||||||||
| BOARD OF DIRECTORS | 3.00 | Yes (X) | $0 | $0 | $0 | |||
| GURJEET KALKAT MD | ||||||||
| BOARD OF DIRECTORS | 3.00 | Yes (X) | $0 | $0 | $0 | |||
| JEFFREY SHAPIRO MD | ||||||||
| BOARD OF DIRECTORS | 3.00 | Yes (X) | $0 | $0 | $0 | |||
| GORDON SHIPP | ||||||||
| BOARD OF DIRECTORS | 3.00 | Yes (X) | $0 | $0 | $0 | |||
| EARL WASHINGTON | ||||||||
| BOARD OF DIRECTORS | 3.00 | Yes (X) | $0 | $0 | $0 | |||
| LANCE WILCHNER DNP | ||||||||
| BOARD OF DIRECTORS | 3.00 | Yes (X) | $0 | $0 | $0 | |||
| RAJESH SHARMA | ||||||||
| EXECUTIVE VP/CFO | 2.00 | 38.00 | Yes (X) | $0 | $726,109 | $19,197 | ||
| CHRISTINA TINCHER | ||||||||
| HOME HOSPICE R.N. | 40.00 | $0 | $223,670 | $23,318 | Yes (X) | |||
| JEAN HUNN | ||||||||
| ADMINISTRATOR HOSPICE HH | 40.00 | $0 | $193,490 | $1,886 | Yes (X) | |||
| NELLY BERZUNZA | ||||||||
| HOME HOSPICE R.N. | 40.00 | $0 | $176,142 | $18,453 | Yes (X) | |||
| CHRISTINE SANCHEZ | ||||||||
| HH NURSE NAVIGATOR | 40.00 | $0 | $129,069 | $18,936 | Yes (X) | |||
| NANETTE VILLANUEVA | ||||||||
| CASE MGR HOSPICE HH | 40.00 | $0 | $127,399 | $17,213 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,931,176 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $123,891 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 17 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LEUNG JONATHAN K MD | BusinessNameLine1Txt |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 415 W CARROLL AVE 100 | AddressLine1Txt |
| City | GLENDORA | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 91741 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | MEDICAL P/S | ServicesDesc |
| Compensation | $137,405 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $13,408 | RelatedOrganizationsAmt |
| Total Contributions | $13,408 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT REV/MEDICARE/M | 621610 | $6,976,149 | $6,976,149 |
| OTHER OPERATING REVENU | 621610 | $1,695 | $1,695 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $6,977,844 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $79,495 | TotalRevenueColumnAmt |
| Exclusion | $79,495 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $714,892 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $763,690 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -$48,798 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$48,798 | TotalRevenueColumnAmt |
| Exclusion | -$48,798 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $7,021,949 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $6,977,844 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $30,697 | 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 | $102,914 | TotalAmt |
| Program Services | $91,331 | ProgramServicesAmt |
| Management And General | $11,583 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,469,639 | TotalAmt |
| Program Services | $3,929,776 | ProgramServicesAmt |
| Management And General | $539,863 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $134,310 | TotalAmt |
| Program Services | $118,771 | ProgramServicesAmt |
| Management And General | $15,539 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,244,055 | TotalAmt |
| Program Services | $1,088,434 | ProgramServicesAmt |
| Management And General | $155,621 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $368,802 | TotalAmt |
| Program Services | $325,834 | ProgramServicesAmt |
| Management And General | $42,968 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,785 | TotalAmt |
| Management And General | $3,785 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $194,115 | TotalAmt |
| Program Services | $182,804 | ProgramServicesAmt |
| Management And General | $11,311 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $577,071 | TotalAmt |
| Program Services | $557,151 | ProgramServicesAmt |
| Management And General | $19,920 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $115,002 | TotalAmt |
| Program Services | $104,674 | ProgramServicesAmt |
| Management And General | $10,328 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $153 | TotalAmt |
| Program Services | $153 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $145,511 | TotalAmt |
| Program Services | $120,774 | ProgramServicesAmt |
| Management And General | $24,737 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,824 | TotalAmt |
| Program Services | $1,824 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| PURCHASED SERVICES/ PUR | $886,258 | $786,507 | $99,751 |
| EQUIPMENT RENTAL AND MA | $186,202 | $154,548 | $31,654 |
| OTHER EXPENSES | $111,192 | $108,029 | $3,163 |
| UTILITIES | $97,286 | $80,747 | $16,539 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $68,556 | TotalAmt |
| Program Services | $68,556 | ProgramServicesAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,706,675 | TotalAmt |
| Program Services | $7,719,913 | ProgramServicesAmt |
| Management And General | $986,762 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,095,669 | BOYAmt |
| EOY | $1,444,232 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,379 | BOYAmt |
| EOY | $15,234 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $6,008,638 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $5,313,314 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $802,407 | BOYAmt |
| EOY | $695,324 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,091,854 | BOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,914,916 | BOYAmt |
| EOY | $5,123,773 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,914,225 | BOYAmt |
| EOY | $7,278,563 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,109,028 | BOYAmt |
| EOY | $2,949,164 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,109,028 | BOYAmt |
| EOY | $2,949,164 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $863,699 | BOYAmt |
| EOY | -$717,263 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $519 | BOYAmt |
| EOY | $80,433 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,940,979 | BOYAmt |
| EOY | $4,966,229 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,805,197 | BOYAmt |
| EOY | $4,329,399 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,914,225 | BOYAmt |
| EOY | $7,278,563 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$1,684,726 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $208,928 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $292,262 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $282,834 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $13,911 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $536,000 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $13,408 | CurrentTaxYearAmt |
| Total | $1,138,415 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $9,103,654 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $9,023,785 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7,793,243 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $7,491,824 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $6,977,844 | CurrentTaxYearAmt |
| Total | $40,390,350 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $9,395,916 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $9,306,619 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7,807,154 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $8,027,824 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $6,991,252 | CurrentTaxYearAmt |
| Total | $41,528,765 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $41,528,765 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $24,567 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $18,875 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $15,467 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $29,315 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $79,495 | CurrentTaxYearAmt |
| Total | $167,719 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $24,567 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $18,875 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $15,467 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $29,315 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $79,495 | CurrentTaxYearAmt |
| Total | $167,719 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $9,420,483 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $9,325,494 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7,822,621 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $8,057,139 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $7,070,747 | CurrentTaxYearAmt |
| Total | $41,696,484 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99600 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99750 | PublicSupportPY509Pct |
| Investment Income CY | 0.00400 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00250 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
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
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $4,940,979 | BeginningYearBalanceAmt |
| Contributions | $25,250 | ContributionsAmt |
| End Year Balance | $4,966,229 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $4,717,997 | BeginningYearBalanceAmt |
| Contributions | $222,982 | ContributionsAmt |
| End Year Balance | $4,940,979 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $4,707,697 | BeginningYearBalanceAmt |
| Contributions | $10,300 | ContributionsAmt |
| End Year Balance | $4,717,997 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $4,707,647 | BeginningYearBalanceAmt |
| Contributions | $50 | ContributionsAmt |
| End Year Balance | $4,707,697 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $4,707,122 | BeginningYearBalanceAmt |
| Contributions | $525 | ContributionsAmt |
| End Year Balance | $4,707,647 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 1.00000 | PrmnntEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | Yes (1) | EndowmentsHeldRelatedOrgInd |
| Related Org List Sch R | Yes (1) | RelatedOrgListSchRInd |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,892,754 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,477,000 | DepreciationAmt |
| Book Value | $415,754 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,115,884 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,836,314 | DepreciationAmt |
| Book Value | $279,570 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $695,324 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | BENEFICIAL INTEREST IN CVHF | Desc |
| Book Value | $5,123,773 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $5,123,773 | TotalBookValueOtherAssetsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $7,121,000 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $7,121,000 | RevenueSubtotalAmt |
| Other Revenues Not Included | -$99,051 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | -$99,051 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $7,021,949 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $8,702,000 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $8,702,000 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $4,675 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $4,675 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $8,706,675 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | PERMANENTLY RESTRICTED ASSETS ARE RESTRICTED INVESTMENTS TO BE HELD IN PERPETUITY, THE INCOME FROM WHICH IS EXPENDABLE TO SUPPORT HEALTH CARE SERVICES. |
| PART X, LINE 2: | ACCOUNTING STANDARDS CODIFICATION (ASC) 740, INCOME TAXES, CLARIFIES THE ACCOUNTING FOR INCOME TAXES BY PRESCRIBING A MINIMUM RECOGNITION THRESHOLD THAT A TAX POSITION IS REQUIRED TO MEET BEFORE BEING RECOGNIZED IN THE FINANCIAL STATEMENTS. ASC 740 ALSO PROVIDES GUIDANCE ON DERECOGNITION, MEASUREMENT, CLASSIFICATION, INTEREST AND PENALTIES, DISCLOSURE, AND TRANSITION. THE GUIDANCE IS APPLICABLE TO PASS-THROUGH ENTITIES AND TAX-EXEMPT ORGANIZATIONS. NO SIGNIFICANT TAX LIABILITY FOR TAX BENEFITS, INTEREST, OR PENALTIES WAS ACCRUED AT DECEMBER 31, 2016 OR 2015. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | ROUNDING DIFFERENCE -270. CHANGE IN BENEFICIAL INTEREST -117,100. INVESTMENT FEES 3,785. PROVISION FOR BAD DEBTS 1,126. TRANSFERS FROM CITRUS VALLEY HEALTH FOUNDATION 13,408. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | INVESTMENT FEES 3,785. ROUNDING DIFFERENCE -236. PROVISION FOR BAD DEBTS 1,126. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (5 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ROBERT H CURRY | ||||||||||||||
| PARENT PRESIDENT, CEO, BOD | $0 | $868,458 | $0 | $398,352 | $0 | $21,290 | $0 | $10,600 | $0 | $14,288 | $0 | $1,312,988 | $0 | $0 |
| RAJESH SHARMA | ||||||||||||||
| EXECUTIVE VP/CFO | $0 | $549,461 | $0 | $163,534 | $0 | $13,114 | $0 | $9,600 | $0 | $9,597 | $0 | $745,306 | $0 | $0 |
| CHRISTINA TINCHER | ||||||||||||||
| HOME HOSPICE R.N. | $0 | $223,529 | $0 | $109 | $0 | $32 | $0 | $3,017 | $0 | $20,301 | $0 | $246,988 | $0 | $0 |
| JEAN HUNN | ||||||||||||||
| ADMINISTRATOR HOSPICE HH | $0 | $186,088 | $0 | $101 | $0 | $7,301 | $0 | $446 | $0 | $1,440 | $0 | $195,376 | $0 | $0 |
| NELLY BERZUNZA | ||||||||||||||
| HOME HOSPICE R.N. | $0 | $175,903 | $0 | $109 | $0 | $130 | $0 | $4,660 | $0 | $13,793 | $0 | $194,595 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 3 | FormAndLineReferenceDesc |
| Explanation | ESTABLISHING THE COMPENSATION OF THE ORGANIZATION'S PRESIDENT/CEO - CITRUS VALLEY HOSPICE, INC. IS AN AFFILIATE OF CITRUS VALLEY HEALTH PARTNERS, INC. (CVHP). CVHP USES A COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, WRITTEN EMPLOYMENT CONTRACT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S PRESIDENT/CEO. PLEASE SEE ADDITIONAL EXPLANATION AT SCHEDULE O FOR FORM 990, PART VI, SECTION B, LINE 15. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (14 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THE SOLE MEMBER OF THIS ORGANIZATION IS CITRUS VALLEY HEALTH PARTNERS, INC., A CALIFORNIA NONPROFIT PUBLIC BENEFIT CORPORATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE SOLE MEMBER OF THIS ORGANIZATION IS CITRUS VALLEY HEALTH PARTNERS, INC. THE MEMBER THROUGH THE BOARD OF DIRECTORS HAS THE RIGHT TO ELECT OR APPOINT ONE OR MORE MEMBERS OF THE ORGANIZATION'S GOVERNING BODY. |
| FORM 990, PART VI, SECTION A, LINE 7B | DECISIONS OF THE GOVERNING BODY ARE SUBJECT TO THE APPROVAL OF THE ORGANIZATION'S SOLE MEMBER, CITRUS VALLEY HEALTH PARTNERS. |
| FORM 990, PART VI, SECTION B, LINE 11B | STAFF ACCOUNTANTS, ACCOUNTING MANAGER AND VICE PRESIDENT OF CORPORATE FINANCE REVIEW FORM 990 FOR ACCURACY AND COMPLETENESS UPON RECEIVING IT FROM THE CPA TAX PREPARER. FORM 990 IS FORWARDED TO RAJESH SHARMA, EVP & CFO, FOR THE FINAL REVIEW. TAX PREPARER PRESENTS FORM 990 TO THE AUDIT AND COMPLIANCE COMMITTEE FOR APPROVAL. BOARD DELEGATED REVIEW AND APPROVAL TO THE AUDIT AND COMPLIANCE COMMITTEE. |
| FORM 990, PART VI, SECTION B, LINE 12C | ALL BOARD MEMBERS, KEY EMPLOYEES, AND MANAGEMENT ARE COVERED BY THE CONFLICT OF INTEREST POLICY. DETERMINATIONS OF CONFLICT AND REVIEW OF CONFLICT ARE PERFORMED AT THESE VARIOUS LEVELS OF THE ORGANIZATION. APPROPRIATE ACTION DEPENDING ON THE CONFLICT IS TAKEN BY MANAGEMENT, KEY EMPLOYEES, AND THE BOARD. DISCLOSURE FORMS ARE REQUIRED ANNUALLY BY EACH MEMBER OF THE BOARD OF DIRECTORS, KEY EMPLOYEES, AND MANAGEMENT. |
| FORM 990, PART VI, SECTION B, LINE 15 | EXECUTIVE PAY AT CITRUS VALLEY HEALTH PARTNERS FOLLOWS MARKET-BASED PAY PRACTICES FOR HEALTHCARE ORGANIZATIONS OF SIMILAR SIZE AND TYPE IN THE SOUTHERN CALIFORNIA AREA. SALARY RANGES FOR EXECUTIVES WORKING AT CVHP FACILITIES FALL WITHIN THE MIDDLE OF THE MARKET, JUST AS THEY DO FOR ALL EMPLOYEES OF OUR ORGANIZATION. EVERY POSITION IN THE ORGANIZATION HAS A SALARY RANGE ATTACHED TO IT THAT REPRESENTS WHAT OTHERS DOING A SIMILAR JOB IN OTHER ORGANIZATIONS ARE LIKELY TO BE PAID. THE LONG-STANDING PAY PHILOSOPHY FOR CVHP HAS BEEN TO POSITION OUR SALARY RANGES IN THE MIDDLE OF OUR LOCAL LABOR MARKET; WE DON'T WANT TO LAG THE LOCAL MARKET, NOR DO WE WANT TO LEAD THE MARKET, SINCE THAT IS NOT A STRATEGY WE CAN AFFORD TO SUSTAIN OVER TIME. WE RELY ON MARKET STUDIES TO DETERMINE WHERE OUR PAY PRACTICES ARE RELATIVE TO OTHER HOSPITALS IN SOUTHERN CALIFORNIA. FOR EXECUTIVE PAY, WE USE THE NATIONALLY-RECOGNIZED AND RESPECTED FIRM, HEWITT ASSOCIATES LLC, AN AON HEWITT COMPANY (AON), TO ANALYZE OUR EXECUTIVE PAY PROGRAM AND DETERMINE WHERE IT FALLS IN OUR MARKET. THIS STUDY IS PERFORMED EVERY OTHER YEAR. THE MOST RECENT EXECUTIVE COMPENSATION DATA IS DATED APRIL 2016. AS PART OF THEIR EXECUTIVE COMPENSATION REVIEW, AON ALSO ISSUES AN OPINION LETTER REGARDING THE REASONABLENESS OF THE PAY PROGRAM FOR A NOT-FOR-PROFIT ORGANIZATION LIKE OURS THAT IS SUBJECT TO THE REQUIREMENTS OF SECTION 4958 OF THE INTERNAL REVENUE CODE AND UNITED STATES TREASURY DEPARTMENT REGULATIONS. IN THEIR APRIL 20, 2016, OPINION LETTER, AON WROTE, "THIS LETTER IS TO INDICATE THAT WE HAVE REVIEWED THE CURRENT COMPENSATION LEVELS, STRUCTURE, AND ADMINISTRATION OF THE EXECUTIVE COMPENSATION PROGRAM AT THE CITRUS VALLEY HEALTH PARTNERS. THE FOLLOWING REVIEW IS BASED UPON OUR COMPREHENSIVE REPORT ENTITLED: ALIGNING EXECUTIVE COMPENSATION AND STRATEGY. THIS REPORT WAS PRESENTED TO THE COMPENSATION COMMITTEE ON APRIL 20TH AND DISCUSSED IN DETAIL. BASED UPON THIS REVIEW, WE FIND THEM IN SUBSTANTIAL COMPLIANCE WITH ALL CURRENT RULES, REGULATIONS, AND GUIDELINES GOVERNING EXECUTIVE COMPENSATION IN NOT-FOR-PROFIT (501.C) CORPORATIONS. FURTHER, THE LEVELS OF COMPENSATION AWARDED TO THE VARIOUS EXECUTIVES, BOTH IN TERMS OF OPPORTUNITY AND ACTUAL AMOUNTS, ARE CONSISTENT AND REASONABLE WITH PREVAILING MARKET TRENDS AND PRACTICES. LASTLY, THE GOVERNING PRACTICES OF THE COMPENSATION COMMITTEE ARE CONSISTENT WITH SARBANES-OXLEY GUIDELINES AND SECTION 4958 (INTERMEDIATE SANCTIONS) GUIDELINES FOR INDEPENDENCE." THE EXECUTIVE POSITIONS THAT ARE INCLUDED IN THE BIENNIAL EXECUTIVE COMPENSATION REVIEW INCLUDE THE PRESIDENT/CEO, CHIEF MEDICAL OFFICER/CHIEF INFORMATION OFFICER, CHIEF FINANCIAL OFFICER, CHIEF NURSING OFFICER, CHIEF HUMAN RESOURCES OFFICER, CHIEF CLINICAL SERVICES OFFICER, CHIEF STRATEGY OFFICER, CHIEF COMPLIANCE OFFICER, CHIEF TRANSFORMATION OFFICER, CHIEF COMMUNICATIONS & ADVOCACY OFFICER, AND CEO (CITRUS VALLEY HEALTH FOUNDATION). CITRUS VALLEY HEALTH PARTNERS' (CVHP) EXECUTIVE COMPENSATION PHILOSOPHY IS DESIGNED TO ASSIST CVHP IN ATTRACTING AND RETAINING THE CALIBER OF EXECUTIVE REQUIRED TO ENABLE CVHP TO FULFILL ITS MISSION OF PROVIDING HIGH QUALITY HEALTHCARE FOR ALL PERSONS REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES, IMPROVING THE QUALITY OF LIFE IN THE COMMUNITIES CVHP SERVES, PROMOTING PATIENT AND EMPLOYEE SATISFACTION, AND ENSURING FINANCIAL STABILITY. A SUBSTANTIAL PORTION OF EXECUTIVE COMPENSATION IS PERFORMANCE BASED AND IS LINKED TO ORGANIZATIONAL GOALS APPROVED IN ADVANCE BY THE HUMAN RESOURCES AND COMPENSATION COMMITTEE. THESE GOALS INCLUDE ATTAINMENT OF ANNUAL AND LONG-TERM FINANCIAL PERFORMANCE, CERTAIN HEALTHCARE QUALITY STANDARDS AND CVHP'S COMMITMENT TO SERVING THE POOR AND DISENFRANCHISED IN THE COMMUNITIES IT SERVES. TOTAL COMPENSATION, WHICH INCLUDES BASE SALARY, ANNUAL AND LONG-TERM INCENTIVE COMPENSATION, IS ESTABLISHED TO APPROXIMATE THE PREVAILING MARKET CONDITIONS FOR EXECUTIVES OF COMPANIES OF SIMILAR SIZE AND REVENUE. |
| FORM 990, PART VI, SECTION C, LINE 19 | UPON REQUEST AN AUDIT REPORT IS AVAILABLE AS REQUIRED. NO OTHER DOCUMENTS ARE AVAILABLE. |
| FORM 990, PART IX, LINE 24E | CONTRACT LABOR: PROGRAM SERVICE EXPENSES 67,430. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 67,430. PROVISION FOR BAD DEBTS: PROGRAM SERVICE EXPENSES 1,126. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,126. |
| FORM 990, PART XI, LINE 9: | CHANGE IN BENEFICIAL INTEREST CVHF 208,928. |
| FORM 990, PART XII, LINES 2B: | AUDITED FINANCIAL STATEMENTS THE FINANCIAL STATEMENTS OF CITRUS VALLEY HEALTH PARTNERS, INC. AND ITS AFFILIATES, CITRUS VALLEY MEDICAL CENTER, INC., CITRUS VALLEY HOSPICE, FOOTHILL PRESBYTERIAN HOSPITAL, CITRUS VALLEY HEALTH FOUNDATION, INC., GLENDORA SURGERY CENTER, AND COVINA VALLEY MANAGEMENT, INC., WERE AUDITED ON A CONSOLIDATED BASIS. |
| FORM 990, PART XII, LINE 2C | AUDIT AND COMPLIANCE COMMITTEE THE BOARD OF DIRECTORS HAS CONSTITUTED AN AUDIT AND COMPLIANCE COMMITTEE AND DELEGATED TO THAT COMMITTEE THE RESPONSIBILITY FOR ENGAGING INDEPENDENT AUDITORS AND MONITORING THE AUDIT PROCESS. THIS STRUCTURE HAS BEEN IN EFFECT IN PRIOR YEARS AND WAS NOT CHANGED IN 2016. |
| FORM 990, PART VII, SECTION A, LINE 1A AND SCHEDULE J | REPORTABLE COMPENSATION FROM RELATED ORGANIZATIONS THE OFFICERS REPORTED ON PART VII OF FORM 990 AND SCHEDULE J RECEIVE THEIR ENTIRE COMPENSATION FROM CITRUS VALLEY HEALTH PARTNERS (CVHP). THE IRS INSTRUCTIONS TO FORM 990 REQUIRE THAT ALL COMPENSATION PAID BY A RELATED ORGANIZATION MUST BE DISCLOSED IN THE 990 RETURN FOR EACH AFFILIATED ENTITY. THEREFORE, THE OFFICER COMPENSATION REPORTED IN THE 990 RETURNS FOR CITRUS VALLEY MEDICAL CENTER, INC., CITRUS VALLEY HOSPICE, INC., FOOTHILL PRESBYTERIAN HOSPITAL AND CITRUS VALLEY HEALTH FOUNDATION, INC., ALL ORGANIZATIONS RELATED TO CVHP, CONSTITUTE THE COMPENSATION PAID BY CVHP AND DOES NOT REPRESENT ADDITIONAL COMPENSATION TO SUCH OFFICERS. |
| PART VII, SECTION A | REPORTABLE HOURS FOR RELATED ORGANIZATIONS THE OFFICERS SERVE AS CORPORATE OFFICERS FOR CITRUS VALLEY HEALTH PARTNERS (CVHP), CITRUS VALLEY MEDICAL CENTER, INC. (CVMC), CITRUS VALLEY HOSPICE (CVH), INC., FOOTHILL PRESBYTERIAN HOSPITAL (FPH) AND CITRUS VALLEY HEALTH FOUNDATION, INC. (CVHF), ALL AFFILIATES OF THE TAXPAYER. THE NUMBER OF HOURS (PER WEEK) DEVOTED BY THE CORPORATE OFFICERS TO THE AFFILIATES ARE AS FOLLOWS: ROBERT CURRY DEVOTED 4, 14, 2, 2, AND 18 HOURS TO FPH, CVMC, CVHF, CVH, AND CVHP, RESPECTIVELY. RAJESH SHARMA DEVOTED 4,14, 2, 2, AND 18 HOURS TO FPH, CVMC, CVHF, CVH, AND CVHP, RESPECTIVELY. |
| 990 PART V LINE 7H | FILING OF FORM 1098C THE ORGANIZATION DID NOT RECEIVE ANY CONTRIBUTIONS OF AUTOMOBILES, BOATS, AIRPLANES OR OTHER VEHICLES. CONSEQUENTLY NO FORMS 1098C WERE FILED. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (4 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| CITRUS VALLEY HEALTH PARTNERS INC | ||||||||||
| 140 W COLLEGE STREET PO BOX 6108 | COVINA | CA | 917225108 | 953885523 | EXEMPT ORGANIZATION SUPPORT & MANAGEMENT | CA | 501(C)(3) | LINE 12B, II | N/A | 0 |
| CITRUS VALLEY MEDICAL CENTER INC | ||||||||||
| 140 W COLLEGE STREET PO BOX 6108 | COVINA | CA | 917225108 | 956006469 | ACUTE CARE HOSPITAL | CA | 501(C)(3) | LINE 3 | N/A | 0 |
| CITRUS VALLEY HEALTH FOUNDATION INC | ||||||||||
| 140 W COLLEGE STREET PO BOX 6108 | COVINA | CA | 917225108 | 952534063 | EXEMPT ORGANIZATION PUBLIC SUPPORT | CA | 501(C)(3) | LINE 7 | N/A | 0 |
| FOOTHILL PRESBYTERIAN HOSPITAL INC | ||||||||||
| 140 W COLLEGE STREET PO BOX 6108 | COVINA | CA | 917225108 | 952413054 | ACUTE CARE HOSPITAL | CA | 501(C)(3) | LINE 3 | N/A | 0 |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| GLENDORA SURGERY CENTER | |||||||||
| 315 E ROUTE 66 101 | GLENDORA | CA | 91740 | 510492499 | OUTPATIENT SURGERY CENTER | CA | N/A | S | 0 |
| COVINA VALLEY MANAGEMENT INC | |||||||||
| 210 W SAN BERNARDINO ROAD | COVINA | CA | 91723 | 812647150 | MANAGEMENT SERVICES | CA | N/A | C | 0 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | FORM 990, SCHEDULE R, PART V, NUMBER 2, CODE O: | FormAndLineReferenceDesc |
| Explanation | THE EXECUTIVE SALARIES ARE PROCESSED THROUGH CITRUS VALLEY HEALTH PARTNERS. THE SALARIES REPORTED ON FORM 990 ARE PROCESSED THROUGH CITRUS VALLEY HEALTH PARTNERS. CITRUS VALLEY HEALTH PARTNERS ACTS AS A COMMON PAYMASTER FOR AFFILIATED ENTITIES, CITRUS VALLEY MEDICAL CENTER, CITRUS VALLEY HEALTH FOUNDATION AND CITRUS VALLEY HOSPICE. CITRUS VALLEY HEALTH PARTNERS FILED ONE FORM W-3 WHICH SHOWS A COMBINED NUMBER OF 3,243 EMPLOYEES. THE NUMBER OF EMPLOYEES FOR EACH ENTITY IS REPORTED SEPARATELY ON ITS OWN FORM 990 PART I LINE 5. CITRUS VALLEY MEDICAL CENTER'S FORM 990 REPORTED A TOTAL OF 2,787 EMPLOYEES, CITRUS VALLEY HOSPICE'S FORM 990 REPORTED 93 EMPLOYEES, CITRUS VALLEY HEALTH FOUNDATION'S FORM 990 REPORTED 7 EMPLOYEES AND CITRUS VALLEY HEALTH PARTNER'S FORM 990 REPORTED 356 EMPLOYEES. THE FILING ORGANIZATION FILES ITS OWN FORM W-3, HOWEVER AMOUNTS REPORTED ON SCHEDULE R, PART V, NUMBER 2, CODE O REPRESENT SHARED EMPLOYEE EXPENSES THAT OCCUR BETWEEN THE AFFILIATES. | ExplanationTxt |
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