ARIZONA ASSOCIATION OF COMMUNITY HEALTH CENTERS INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
ARIZONA ASSOCIATION OF COMMUNITY HEALTH CENTERS INC (EIN 86-0494702)
Tax period
2012-04-01 to 2013-03-31
Filed
2014-02-12
IRS object ID
201430439349302023
Schema version
2012v2.3
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)
Timestamp2014-02-12T16:00:06-06:00Timestamp
Tax Period End Date2013-03-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1FESTER & CHAPMAN PCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line18283 N HAYDEN RD STE 200AddressLine1
CitySCOTTSDALECity
StateAZState
ZIP Code852582456ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-04-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN860494702EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1ARIZONA ASSOCIATION OF COMMUNITYBusinessNameLine1
Business Name Line2HEALTH CENTERS INCBusinessNameLine2
FieldValueIRS element (for citing)
Name ControlARIZNameControl
Phone6022530090Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1700 E JEFFERSON STREETAddressLine1
Address Line2ROOM/SUITE 100AddressLine2
CityPHOENIXCity
StateAZState
ZIP Code85034ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJOHN MCDONALDName
TitleCEOTitle
Phone6022530090Phone
Date Signed2014-02-10DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameRACHEL R LOCKE CPAName
Phone6022643077Phone
Date Prepared2014-02-12DatePrepared
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonJOHN MCDONALD CEONameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1700 E JEFFERSON STREET SUITE 100AddressLine1
CityPHOENIXCity
StateAZState
ZIP Code85034ZIPCode
FieldValueIRS element (for citing)
Gross Receipts3314415GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.AACHC.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1997YearFormation
State Legal DomicileAZStateLegalDomicile
Activity Or Mission DescriptionPROMOTION AND IMPROVEMENT OF PRIMARY MEDICAL CARE TO MEDICALLY UNDERSERVED POPULATIONS OF AZ. ENHANCEMENT OF PRODUCTIVITY, FINANCIAL PERFORMANCE, CLINICAL CAPABILITY, COMMUNITY DEVELOPMENT, AND CLINIC SERVICES TO MEMBER CLINICS. FORMULATION AND ADVOCATION OF LEGISLATION AND APPROPRIATIONS FOR PRIMARY CARE PROGRAMS FOR LOW-INCOME UNINSURED AZ RESIDENTS UTILIZING PRIMARY CARE FACILITY GRANTS, PRIMARY CARE PROVIDER LOAN REPAYMENT PROGRAM, AND UNIVERSITY OF AZ MEDICAL STUDENT LOAN PROGRAM. MAINTENANCE OF AUDITING, PATIENT SATISFACTION SURVEYS, PRACTICE MANAGEMENT INFORMATION SYSTEMS, & QUALITY ASSURANCE SYSTEMS. REPRESENTATION OF MEMBERS ON DEVELOPMENT OF COST-BASED REIMBURSEMENT METHODOLOGY FOR AHCCCS PATIENTS. REPRESENTATION OF MEMBERS ON VARIOUS STATE-WIDE HEALTH CARE TASK FORCES, STUDY COMMITTIES, AND HEALTH CARE COALITIONS.ActivityOrMissionDescription
Nbr Voting Members Governing Body22NbrVotingMembersGoverningBody
Nbr Independent Voting Members22NbrIndependentVotingMembers
Total Nbr Employees47TotalNbrEmployees
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year1658391ContributionsGrantsPriorYear
Contributions Grants Current Year2083063ContributionsGrantsCurrentYear
Program Service Revenue Prior Year171754ProgramServiceRevenuePriorYear
Program Service Revenue CY378323ProgramServiceRevenueCY
Investment Income Prior Year4662InvestmentIncomePriorYear
Investment Income Current Year11474InvestmentIncomeCurrentYear
Other Revenue Prior Year1742075OtherRevenuePriorYear
Other Revenue Current Year841555OtherRevenueCurrentYear
Total Revenue Prior Year3576882TotalRevenuePriorYear
Total Revenue Current Year3314415TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year1573088SalariesEtcPriorYear
Salaries Etc Current Year1879792SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year1557334OtherExpensePriorYear
Other Expenses Current Year1408973OtherExpensesCurrentYear
Total Expenses Prior Year3130422TotalExpensesPriorYear
Total Expenses Current Year3288765TotalExpensesCurrentYear
Revenues Less Expenses Prior Year446460RevenuesLessExpensesPriorYear
Revenues Less Expenses CY25650RevenuesLessExpensesCY
Total Assets BOY1823209TotalAssetsBOY
Total Assets EOY1290172TotalAssetsEOY
Total Liabilities BOY1009215TotalLiabilitiesBOY
Total Liabilities EOY450528TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY813994NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY839644NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionPROMOTION AND IMPROVEMENT OF PRIMARY MEDICAL CARE TO MEDICALLY UNDERSERVED POPULATIONS OF AZ. ENHANCEMENT OF PRODUCTIVITY, FINANCIAL PERFORMANCE, CLINICAL CAPABILITY, COMMUNITY DEVELOPMENT, AND CLINIC SERVICES TO MEMBER CLINICS. FORMULATION AND ADVOCATION OF LEGISLATION AND APPROPRIATIONS FOR PRIMARY CARE PROGRAMS FOR LOW-INCOME UNINSURED AZ RESIDENTS UTILIZING PRIMARY CARE FACILITY GRANTS, PRIMARY CARE PROVIDER LOAN REPAYMENT PROGRAM, AND UNIVERSITY OF AZ MEDICAL STUDENT LOAN PROGRAM. MAINTENANCE OF AUDITING, PATIENT SATISFACTION SURVEYS, PRACTICE MANAGEMENT INFORMATION SYSTEMS, & QUALITY ASSURANCE SYSTEMS. REPRESENTATION OF MEMBERS ON DEVELOPMENT OF COST-BASED REIMBURSEMENT METHODOLOGY FOR AHCCCS PATIENTS. REPRESENTATION OF MEMBERS ON VARIOUS STATE-WIDE HEALTH CARE TASK FORCES, STUDY COMMITTIES, AND HEALTH CARE COALITIONS.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense2584026Expense
DescriptionPROMOTION AND IMPROVEMENT OF PRIMARY MEDICAL CARE TO MEDICALLY UNDERSERVED POPULATIONS OF ARIZONA.Description
Total Program Service Expense2584026TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntitytrueRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10969NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees47NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members22NbrVotingGoverningBodyMembers
Number Independent Voting Members22NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledAZStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonARIZONA ASSOCIATION OF COMMUNITYNamePerson
Telephone Number6022530090TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1700 E JEFFERSON STREET SUITE 100AddressLine1
CityPHOENIXCity
StateAZState
ZIP Code85034ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (24 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployee
ELADIO PEREIRA MD
MEMBER AT-LA2.00X000
ARTHUR MARTINEZ MD
DIRECTOR2.00X000
KATHY BYRNE
TREASURER2.00X000X
JOHN SWAGERT MD
DIRECTOR2.00X000
CLARENCE VATNE
DIRECTOR2.00X000
PEGGY NIES
DIRECTOR2.00X000
JENNIFER GINGER RYAN
DIRECTOR2.00X000
JAMES WELDEN
DIRECTOR2.00X000
DAVID ROGERS
MEMBER AT-LA2.00X000
AVEIN SAATY-TAFOYA
VICE PRESIDE2.00X000X
BETTY MATHIS
DIRECTOR2.00X000
DIANNA GONZALES
DIRECTOR2.00X000
FRAN DRIVER
DIRECTOR2.00X000
LISA CUMMINGS
DIRECTOR2.00X000
LIZ LATHEM
SECRETARY2.00X000X
WALTER MURILLO
DIRECTOR2.00X000
LINDA COWAN
DIRECTOR2.00X000
TRAVIS J ROBINETTE
PRESIDENT2.00X000X
WILLIAM F VANASKIE
DIRECTOR2.00X000
ROBERT BABYAR
DIRECTOR2.00X000
ANN ROGGENBUCK
DIRECTOR2.00X000
JOSEPH ENGELKEN
DIRECTOR2.00X000
JOHN MCDONALD
CEO40.00163700010961X
TARA PLESE
DIR EXTERNAL40.00101344013420X
FieldValueIRS element (for citing)
Total Reportable Comp From Org265044TotalReportableCompFromOrg
Total Other Compensation24381TotalOtherCompensation
Number Individuals GT100 K2NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources
Government Grants2083063GovernmentGrants
Total Contributions2083063TotalContributions

Program Service Revenue ProgramServiceRevenue (3 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
REGISTRATIONS AND CONTRACTS621990165738165738
MEMBERSHIP DUES & ASSESSMENTS621990145585145585
RECRUITING REVENUE6219906700067000
FieldValueIRS element (for citing)
Total Program Service Revenue378323TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column11474TotalRevenueColumn
Exclusion$11,474ExclusionAmount

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
TAPI621990837161837161
OTHER62199043944394
FieldValueIRS element (for citing)
Total Other Revenue841555TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column3314415TotalRevenueColumn
Related Or Exempt Function Income1219878RelatedOrExemptFunctionIncome
Exclusion$11,474ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total174661Total
Program Services145006ProgramServices
Management And General29655ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total1432082Total
Program Services1188933ProgramServices
Management And General243149ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total118751Total
Program Services98589ProgramServices
Management And General20162ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total28052Total
Program Services23289ProgramServices
Management And General4763ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total126246Total
Program Services104811ProgramServices
Management And General21435ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total13002Total
Program Services11201ProgramServices
Management And General1801ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total12240Total
Program Services10545ProgramServices
Management And General1695ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total8688Total
Program Services7485ProgramServices
Management And General1203ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total587Total
Program Services439ProgramServices
Management And General148ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total34344Total
Program Services27953ProgramServices
Management And General6391ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total121854Total
Program Services106699ProgramServices
Management And General15155ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total108750Total
Program Services85482ProgramServices
Management And General23268ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total160478Total
Program Services113930ProgramServices
Management And General46548ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total27888Total
Program Services7266ProgramServices
Management And General20622ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total14498Total
Program Services14498ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
CONSULTING & OUTSIDE SERV32356626319160375
SUBCONTRACT200006200006
BAD DEBT124892124892
MISCELLANEOUS787681999258776

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total179412Total
Program Services154711ProgramServices
Management And General24701ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total3288765Total
Program Services2584026ProgramServices
Management And General704739ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1130622BOY
EOY611828EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY143434BOY
EOY166190EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY138736BOY
EOY77394EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY26564BOY
EOY45916EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis265713LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec160900LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY112481BOY
EOY104813EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
BOY271372BOY
EOY284031EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY1823209BOY
EOY1290172EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY88096BOY
EOY176144EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY83325BOY
EOY82944EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY837794BOY
EOY191440EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY1009215BOY
EOY450528EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY813994BOY
EOY839644EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY813994BOY
EOY839644EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY1823209BOY
EOY1290172EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses25650ReconcilationRevenueExpenses
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement SeparateXFinancialStatementSeparate
FieldValueIRS element (for citing)
Audit CommitteetrueAuditCommittee
Federal Grant Audit RequiredtrueFederalGrantAuditRequired
Federal Grant Audit PerformedtrueFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org170b1 AviXPubliclySupportedOrg170b1Avi

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years1616897CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years1579134CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years1737642CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year1658391CurrentTaxYearMinus1Year
Current Tax Year2083063CurrentTaxYear
Total8675127Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years1616897CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years1579134CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years1737642CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year1658391CurrentTaxYearMinus1Year
Current Tax Year2083063CurrentTaxYear
Total8675127Total
FieldValueIRS element (for citing)
Public Support Total1708675127PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years8395CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year4662CurrentTaxYearMinus1Year
Current Tax Year15868CurrentTaxYear
Total28925Total

Other Income170 OtherIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years972803CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years393518CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years1181637CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year1742075CurrentTaxYearMinus1Year
Current Tax Year837161CurrentTaxYear
Total5127194Total
FieldValueIRS element (for citing)
Total Support13831246TotalSupport
Gross Receipts From Admissions Etc1219878GrossReceiptsFromAdmissionsEtc
Public Support Pertcentage1700.62720PublicSupportPertcentage170
Public Support Pertcent Prior Year0.59670PublicSupportPertcentPriorYear
Thirty Three Percnt Tests CY170XThirtyThreePercntTestsCY170

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis101284OtherCostOrOtherBasis
Depreciation42860Depreciation
Book Value58424BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis141931OtherCostOrOtherBasis
Depreciation112029Depreciation
Book Value29902BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis22498OtherCostOrOtherBasis
Depreciation6011Depreciation
Book Value16487BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings104813TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
REFUNDABLE ADVANCE$126,249
DUE TO TAPI$65,191
FieldValueIRS element (for citing)
Total Of Amounts191440TotalOfAmounts
Tot Revenue Etc Audited Fincl Stmt3314415TotRevenueEtcAuditedFinclStmt
Revenue Subtotal3314415RevenueSubtotal
Total Revenue Per Form9903314415TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt3288765TotExpensesEtcAuditedFinclStmt
Expenses Subtotal3288765ExpensesSubtotal
Total Expenses Per Form9903288765TotalExpensesPerForm990

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Written Employment ContractXWrittenEmploymentContract
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII

FieldValueIRS element (for citing)
Name PersonJOHN MCDONALDNamePerson
TitleCEOTitle
Base Compensation Filing Org155167BaseCompensationFilingOrg
Bonus Filing Org8533BonusFilingOrg
Deferred Comp Filing Org2838DeferredCompFilingOrg
Nontaxable Benefits Filing Org8123NontaxableBenefitsFilingOrg
Total Compensation Filing Org174661TotalCompensationFilingOrg

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
ORGANIZATION'S MISSIONFORM 990 - ORGANIZATION'S MISSIONPROMOTION AND IMPROVEMENT OF PRIMARY MEDICAL CARE TO MEDICALLY UNDERSERVED POPULATIONS OF AZ. ENHANCEMENT OF PRODUCTIVITY, FINANCIAL PERFORMANCE, CLINICAL CAPABILITY, COMMUNITY DEVELOPMENT, AND CLINIC SERVICES TO MEMBER CLINICS. FORMULATION AND ADVOCATION OF LEGISLATION AND APPROPRIATIONS FOR PRIMARY CARE PROGRAMS FOR LOW-INCOME UNINSURED AZ RESIDENTS UTILIZING PRIMARY CARE FACILITY GRANTS, PRIMARY CARE PROVIDER LOAN REPAYMENT PROGRAM, AND UNIVERSITY OF AZ MEDICAL STUDENT LOAN PROGRAM. MAINTENANCE OF AUDITING, PATIENT SATISFACTION SURVEYS, PRACTICE MANAGEMENT INFORMATION SYSTEMS, & QUALITY ASSURANCE SYSTEMS. REPRESENTATION OF MEMBERS ON DEVELOPMENT OF COST-BASED REIMBURSEMENT METHODOLOGY FOR AHCCCS PATIENTS. REPRESENTATION OF MEMBERS ON VARIOUS STATE-WIDE HEALTH CARE TASK FORCES, STUDY COMMITTIES, AND HEALTH CARE COALITIONS.
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990FORM 990, PAGE 6, PART VI, LINE 11BTHE ORGANIZATION PROVIDED A COPY OF THE 990, VIA EMAIL, TO THE GOVERNING BODY BEFORE IT WAS FILED. ANY QUESTIONS AND COMMENTS ARE RESOLVED PRIOR TO SUBMISSION.
ENFORCEMENT OF CONFLICTS POLICYFORM 990, PAGE 6, PART VI, LINE 12CEACH DIRECTOR, PRINCIPAL OFFICER, AND MEMBER OF A COMMITTEE WITH BOARD-DELEGATED POWERS, AND KEY EMPLOYEES SIGN A STATEMENT EACH YEAR AFFIRMING THEY HAVE RECEIVED A COPY OF THE POLICY AND THAT THEY HAVE READ AND UNDERSTAND THE POLICY. AN INTERESTED PERSON MAY DISCLOSE THE EXISTENCE OF A POSSIBLE CONFLICT TO THE COMMITTEE WITH BOARD-DELEGATED POWERS, IN WHICH THEREAFTER THE BOARD WILL DETERMINE APPROPRIATE ACTION BY MAJORITY VOTE.
COMPENSATION PROCESS FOR TOP OFFICIALFORM 990, PAGE 6, PART VI, LINE 15AA CONSULTANT WAS HIRED TO DO A SURVEY OF COMPARABLE POSITIONS.
COMPENSATION PROCESS FOR OFFICERSFORM 990, PAGE 6, PART VI, LINE 15BA CONSULTANT WAS HIRED TO DO A SALARY SURVEY OF COMPARABLE POSITIONS.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATIONFORM 990, PAGE 6, PART VI, LINE 19THE GOVERNING DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1CHC COLLABORATIVE VENTURESBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1700 E JEFFERSON STREET SUITE 100AddressLine1
CityPHOENIXCity
StateAZState
ZIP Code85034ZIPCode
FieldValueIRS element (for citing)
EIN860873658EIN
Primary ActivitiesADMIN SERVPrimaryActivities
Legal Domicile StateAZLegalDomicileState
Exempt Code Section3ExemptCodeSection
Public Charity Status7PublicCharityStatus

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1AACHCBusinessNameLine1
FieldValueIRS element (for citing)
Controlled OrgfalseControlledOrg
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents RoyaltiesfalseReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other OrgfalseGiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other OrgfalseGiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other OrgfalseLoansOrGuaranteesFromOtherOrg
Dividends Related OrganizationfalseDividendsRelatedOrganization
Sale Of Assets To Other OrgfalseSaleOfAssetsToOtherOrg
Purchase Of Assets From Other OrgfalsePurchaseOfAssetsFromOtherOrg
Exchange Of AssetsfalseExchangeOfAssets
Rental Of Facilities To Other OrgsfalseRentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other OrgsfalseRentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other OrgsfalsePerformOfServicesForOtherOrgs
Perform Of Services By Other OrgsfalsePerformOfServicesByOtherOrgs
Sharing Of FacilitiesfalseSharingOfFacilities
Sharing Of Paid EmployeesfalseSharingOfPaidEmployees
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrg
Reimbursement Paid By Other OrgtrueReimbursementPaidByOtherOrg
Other Transfer To Other OrgfalseOtherTransferToOtherOrg
Other Transfer From Other OrgfalseOtherTransferFromOtherOrg

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