ADAMS COUNTY HEALTH CENTER INC: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- ADAMS COUNTY HEALTH CENTER INC (EIN 20-8341138)
- Tax period
- 2012-10-01 to 2013-09-30
- Filed
- 2014-02-12
- IRS object ID
- 201430439349302203
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2014-02-12T16:40:56-06:00 | Timestamp |
| Tax Period End Date | 2013-09-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DINGUS ZARECOR & ASSOCIATES | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 12015 E MAIN STE A | AddressLine1 |
| City | SPOKANE VALLEY | City |
| State | WA | State |
| ZIP Code | 99206 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-10-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 208341138 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ADAMS COUNTY HEALTH CENTER INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | ADAM | NameControl |
| Phone | 2082534242 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 428 | AddressLine1 |
| City | COUNCIL | City |
| State | ID | State |
| ZIP Code | 836120428 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | DENISE LANGSTON-GROVES | Name |
| Title | EXECUTIVE DIRECTOR/CFO | Title |
| Phone | 2082534242 | Phone |
| Date Signed | 2014-02-05 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | THOMAS DINGUS | Name |
| Phone | 5092420874 | Phone |
| Date Prepared | 2014-02-12 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | DENISE LANGSTON-GROVES | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 428 | AddressLine1 |
| City | COUNCIL | City |
| State | ID | State |
| ZIP Code | 836120428 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 1858258 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.ADAMS-COUNTY-HEALTH-CENTER.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 2007 | YearFormation |
| State Legal Domicile | ID | StateLegalDomicile |
| Activity Or Mission Description | ADAMS COUNTY HEALTH CENTER PROVIDES HIGH QUALITY HEALTH SERVICES TO RESIDENTS OF ADAMS COUNTY AND THE SURROUNDING AREA, REGARDLESS OF SOCIAL OR ECONOMIC STATUS. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 10 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 10 | NbrIndependentVotingMembers |
| Total Nbr Employees | 37 | TotalNbrEmployees |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 671607 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 618732 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 1107856 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 1229791 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 8861 | InvestmentIncomePriorYear |
| Investment Income Current Year | 8200 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 2277 | OtherRevenuePriorYear |
| Other Revenue Current Year | 1535 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 1790601 | TotalRevenuePriorYear |
| Total Revenue Current Year | 1858258 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 1050541 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 1120170 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 548298 | OtherExpensePriorYear |
| Other Expenses Current Year | 619246 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 1598839 | TotalExpensesPriorYear |
| Total Expenses Current Year | 1739416 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 191762 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 118842 | RevenuesLessExpensesCY |
| Total Assets BOY | 1279431 | TotalAssetsBOY |
| Total Assets EOY | 1358639 | TotalAssetsEOY |
| Total Liabilities BOY | 204419 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 164785 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 1075012 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 1193854 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | ADAMS COUNTY HEALTH CENTER PROVIDES HIGH QUALITY HEALTH SERVICES TO RESIDENTS OF ADAMS COUNTY AND THE SURROUNDING AREA, REGARDLESS OF SOCIAL OR ECONOMIC STATUS. | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Expense | 1179840 | Expense |
| Revenue | 1229791 | Revenue |
| Description | ADAMS COUNTY HEALTH CENTER (THE HEALTH CENTER) IS A FEDERALLY QUALIFIED HEALTH CENTER, WHICH PROVIDES PRIMARY AND PREVENTATIVE HEALTH AND DENTAL CARE, OBSTETRIC CARE, PSYCHOSOCIAL REHABILITATION SERVICES, COUNSELING SERVICES, TELEPHARMACY, AND X-RAY AND LABORATORY SERVICES. THE CENTER PROVIDED HEALTH SERVICES FOR 3,731 PATIENTS, PHYSICAL THERAPY SERVICES FOR 687 PATIENTS, DENTAL SERVICES FOR 1,266 PATIENTS AND MENTAL HEALTH SERVICES FOR 1,701 PATIENTS FOR THE YEAR ENDED SEPTEMBER 30, 2013. THE HEALTH CENTER PROVIDES CARE TO PERSONS COVERED BY GOVERNMENTAL PROGRAMS AT BELOW COST AND TO INDIVIDUALS WHO ARE UNABLE TO PAY. THE UNREIMBURSED VALUE OF PROVIDING CARE TO THESE PATIENTS WAS 93,089 FOR CHARITY CARE AND SLIDING FEE, 94,882 FOR MEDICARE, AND 92,007 FOR OTHER THIRD-PARTY PAYORS FOR THE YEAR ENDED SEPTEMEBER 30, 2013. THE HEALTH CENTER HAS NUMEROUS INDIVIDUALS ACCESSING SLIDING FEE DISCOUNTS FOR SERVICES RENDERED. A TOTAL OF 625 INDIVIDUALS HAD ACCESS TO THE SLIDING FEE PROGRAM, WITH INCOMES BELOW 200% OF FPL, WHO WERE ELGIBLE FOR ONE OR MORE OF THE THREE FOLLOWING PROGRAMS: PROGRAM CHARITY SLIDING FEE DISCOUNT EXPENDED MEDICAL SERVICES 27,713 PHYSICAL THERAPY 230 DENTAL SERVICES 59,022 MENTAL HEALTH SERVICES 785 THE PROGRAMS HIGHLIGHTED ABOVE PROVIDED HEALTH CARE SERVICES TO UNINSURED INDIVIDUALS WHO MAY HAVE OTHERWISE NOT RECEIVED SUCH SERVICES DUE TO FINANCIAL BARRIERS. | Description |
| Total Program Service Expense | 1179840 | TotalProgramServiceExpense |
| Described In501 C3 | true | DescribedIn501C3 |
| Schedule B Required | false | ScheduleBRequired |
| Political Activities | false | PoliticalActivities |
| Lobbying Activities | false | LobbyingActivities |
| Subject To Proxy Tax | false | SubjectToProxyTax |
| Donor Advised Funds | false | DonorAdvisedFunds |
| Conservation Easements | false | ConservationEasements |
| Collections Of Art | false | CollectionsOfArt |
| Credit Counseling | false | CreditCounseling |
| Term Or Permanent Endowments | false | TermOrPermanentEndowments |
| Report Land Bldg Equip | true | ReportLandBldgEquip |
| Report Invest Oth Securities | false | ReportInvestOthSecurities |
| Report Prog Rel Invest | false | ReportProgRelInvest |
| Report Other Assets | false | ReportOtherAssets |
| Report Other Liabilities | true | ReportOtherLiabilities |
| Report Fin48 Footnote | true | ReportFin48Footnote |
| Independent Audit Financial Stmt | true | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | false | ConsolidatedAuditFinancialStmt |
| School | false | School |
| Foreign Office | false | ForeignOffice |
| Foreign Activities | false | ForeignActivities |
| More Than5000 K To Organizations | false | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividuals |
| Professional Fundraising | false | ProfessionalFundraising |
| Fundraising Activities | false | FundraisingActivities |
| Gaming | false | Gaming |
| Hospital | false | Hospital |
| Grants To Organizations | false | GrantsToOrganizations |
| Grants To Individuals | false | GrantsToIndividuals |
| Schedule J Required | false | ScheduleJRequired |
| Tax Exempt Bonds | false | TaxExemptBonds |
| Excess Benefit Transaction | false | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | false | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | false | LoanToOfficerOrDQP |
| Grant To Related Person | false | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | false | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | false | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | false | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | false | DeductibleNonCashContributions |
| Deductible Contributions Of Art | false | DeductibleContributionsOfArt |
| Terminated | false | Terminated |
| Partial Liquidation | false | PartialLiquidation |
| Disregarded Entity | false | DisregardedEntity |
| Related Entity | false | RelatedEntity |
| Related Org Controlled Entity | false | RelatedOrgControlledEntity |
| Transaction Related Entity | false | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | true | ScheduleORequired |
| Number Forms Transmitted With1096 | 6 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | true | ComplianceWithBackupWitholding |
| Number Of Employees | 37 | NumberOfEmployees |
| Employment Tax Returns Filed | true | EmploymentTaxReturnsFiled |
| Unrelated Business Income | false | UnrelatedBusinessIncome |
| Foreign Financial Account | false | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTrans |
| Taxable Party Notification | false | TaxablePartyNotification |
| Non Deductible Contributions | false | NonDeductibleContributions |
| Quid Pro Quo Contributions | false | QuidProQuoContributions |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | false | FundsToPayPremiums |
| Premiums Paid | false | PremiumsPaid |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 10 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 10 | NumberIndependentVotingMembers |
| Family Or Business Relationship | false | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | false | DelegationOfManagementDuties |
| Changes To Organizing Docs | false | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuse |
| Members Or Stockholders | false | MembersOrStockholders |
| Election Of Board Members | false | ElectionOfBoardMembers |
| Decisions Subject To Approval | false | DecisionsSubjectToApproval |
| Minutes Of Governing Body | true | MinutesOfGoverningBody |
| Minutes Of Committees | true | MinutesOfCommittees |
| Officer Mailing Address | false | OfficerMailingAddress |
| Local Chapters | false | LocalChapters |
| Form990 Provided To Governing Body | true | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | true | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | true | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | true | RegularMonitoringEnforcement |
| Whistleblower Policy | true | WhistleblowerPolicy |
| Document Retention Policy | true | DocumentRetentionPolicy |
| Compensation Process CEO | true | CompensationProcessCEO |
| Compensation Process Other | true | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | ID | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | DENISE LANGSTON-GROVES | NamePerson |
| Telephone Number | 2082534242 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 428 | AddressLine1 |
| City | COUNCIL | City |
| State | ID | State |
| ZIP Code | 83612 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (11 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer |
|---|---|---|---|---|---|---|
| KARI DAWN IVESON | ||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | |
| SHARON LEE | ||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | |
| DANA HARRY | ||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | |
| NELLO JENKINS | ||||||
| TREASURER | 6.00 | X | 0 | 0 | 0 | X |
| KEITH TRAPPETT | ||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | |
| DORIS CROSSLEY | ||||||
| SECRETARY | 2.00 | X | 0 | 0 | 0 | X |
| SHIRLEY HALSEY | ||||||
| CHAIR | 10.00 | X | 0 | 0 | 0 | X |
| JACK RUBELT | ||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | |
| MENDY STANFORD | ||||||
| VICE CHAIR | 6.00 | X | 0 | 0 | 0 | X |
| GENE FOSTER | ||||||
| TRUSTEE | 2.00 | X | 0 | 0 | 0 | |
| DENISE LANGSTON-GROVES | ||||||
| EXECUTIVE DI | 40.00 | 99557 | 0 | 8596 | X | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 99557 | TotalReportableCompFromOrg |
| Total Other Compensation | 8596 | TotalOtherCompensation |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | false | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
| Government Grants | 618172 | GovernmentGrants |
| All Other Contributions | 560 | AllOtherContributions |
| Noncash Contributions | 360 | NoncashContributions |
| Total Contributions | 618732 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | PATIENT SERVICE REVENUE, NET | Description |
| Business Code | 624100 | BusinessCode |
| Total Revenue Column | 1229791 | TotalRevenueColumn |
| Related Or Exempt Function Income | 1229791 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 1229791 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 8200 | TotalRevenueColumn |
| Exclusion | $8,200 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | OTHER REVENUE | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 1535 | TotalRevenueColumn |
| Exclusion | $1,535 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 1535 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1858258 | TotalRevenueColumn |
| Related Or Exempt Function Income | 1229791 | RelatedOrExemptFunctionIncome |
| Exclusion | $9,735 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 115311 | Total |
| Management And General | 115311 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 839918 | Total |
| Program Services | 509851 | ProgramServices |
| Management And General | 330067 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 31609 | Total |
| Program Services | 17413 | ProgramServices |
| Management And General | 14196 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 50604 | Total |
| Program Services | 21910 | ProgramServices |
| Management And General | 28694 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 82728 | Total |
| Program Services | 43910 | ProgramServices |
| Management And General | 38818 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 24227 | Total |
| Management And General | 24227 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 167075 | Total |
| Program Services | 151779 | ProgramServices |
| Management And General | 15296 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3798 | Total |
| Program Services | 2758 | ProgramServices |
| Management And General | 1040 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 194201 | Total |
| Program Services | 180484 | ProgramServices |
| Management And General | 13717 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 37180 | Total |
| Program Services | 18476 | ProgramServices |
| Management And General | 18704 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 25812 | Total |
| Program Services | 16544 | ProgramServices |
| Management And General | 9268 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 18755 | Total |
| Program Services | 15307 | ProgramServices |
| Management And General | 3448 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7813 | Total |
| Program Services | 6978 | ProgramServices |
| Management And General | 835 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 103993 | Total |
| Program Services | 99618 | ProgramServices |
| Management And General | 4375 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 11434 | Total |
| Program Services | 699 | ProgramServices |
| Management And General | 10735 | ManagementAndGeneral |
Other Expenses OtherExpenses (2 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| OTHER EXPENSES | 24958 | 12892 | 12066 |
| INDIRECT COSTS ALLOCATED | 81221 | -81221 |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1739416 | Total |
| Program Services | 1179840 | ProgramServices |
| Management And General | 559576 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 91720 | BOY |
| EOY | 114741 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 536084 | BOY |
| EOY | 610256 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4673 | BOY |
| EOY | 17299 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 79480 | BOY |
| EOY | 135478 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2930 | BOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 39666 | BOY |
| EOY | 29895 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 1036588 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 585618 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 461128 | BOY |
| EOY | 450970 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 63750 | BOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1279431 | BOY |
| EOY | 1358639 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 52384 | BOY |
| EOY | 61613 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 152035 | BOY |
| EOY | 103172 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 204419 | BOY |
| EOY | 164785 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1075012 | BOY |
| EOY | 1193854 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1075012 | BOY |
| EOY | 1193854 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1279431 | BOY |
| EOY | 1358639 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 118842 | ReconcilationRevenueExpenses |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Separate | X | FinancialStatementSeparate |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | true | AuditCommittee |
| Federal Grant Audit Required | true | FederalGrantAuditRequired |
| Federal Grant Audit Performed | true | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule D IRS990ScheduleD
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 387410 | OtherCostOrOtherBasis |
| Depreciation | 138498 | Depreciation |
| Book Value | 248912 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 649178 | OtherCostOrOtherBasis |
| Depreciation | 447120 | Depreciation |
| Book Value | 202058 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 450970 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | CAPITAL LEASE OBLIGATIONS | Description |
| Amount | $103,172 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 103172 | TotalOfAmounts |
| Footnote In Part XIII | X | FootnoteInPartXIII |
| Tot Revenue Etc Audited Fincl Stmt | 1858258 | TotRevenueEtcAuditedFinclStmt |
| Revenue Subtotal | 1858258 | RevenueSubtotal |
| Total Revenue Per Form990 | 1858258 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 1739416 | TotExpensesEtcAuditedFinclStmt |
| Expenses Subtotal | 1739416 | ExpensesSubtotal |
| Total Expenses Per Form990 | 1739416 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | LIABILITY UNDER FIN 48 FOOTNOTE | Identifier |
| Return Reference | SCHEDULE D, PAGE 3, PART X | ReturnReference |
| Explanation | THE CENTER IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, NO PROVISION FOR INCOME TAX IS NECESSARY. THE CENTER EVALUTES UNCERTAIN TAX POSITIONS WHEREBY THE EFFECT OF THE UNCERTAINTY WOULD BE RECORDED IF THE OUTCOME WAS CONSIDERED PROBABLE AND REASONABLY ESTIMABLE. AS OF SEPTEMBER 30, 2013 AND 2012, THE CENTER HAD NO UNCERTAIN TAX POSITIONS REQUIRING ACCRUAL. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (7 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| ADDITIONAL INFORMATION | FORM 990 | IN OCTOBER 2011, ACHC WAS NOTIFIED THAT IT WAS SELECTED AS 1 OF 500 FQHC'S NATIONWIDE TO PARTICIPATE IN THE FQHC ADVANCED PRIMARY CARE PRACTICE (APCP) DEMONSTRATION BEING CONDUCTED BY THE CENTER FOR MEDICARE AND MEDICAID SERVICES. APCP'S/MEDICAL HOMES PROVIDE PATIENTS WITH COORDINATED HEALTH CARE DELIVERY, DEVELOP STRONG PHYSICIAN - PATIENT RELATIONSHIPS, ENCOURAGE COMMUNICATION, AND INCORPORATE ELECTRONIC SYSTEMS TO IMPROVED HEALTH OUTCOMES. THE HEALTH CENTER SUCCESSFULLY IMPLEMENTED BOTH ELECTRONIC PRACTICE MANAGEMENT (EPM) AND ELECTRONIC HEALTH RECORD (EHR) SOFTWARE PROGRAMS DURING THE YEAR ENDED SEPTEMBER 30, 2012. THE HEALTH CENTER PROVIDES MEETING ROOM SPACE, FREE OF CHARGE, TO SOUTHWEST DISTRICT HEALTH DEPARTMENT'S WIC PROGRAM WHICH HOLDS CLINICS EVERY OTHER MONTH ON THE SECOND TUESDAY OF THE MONTH. THE HEALTH CENTER'S LEADERSHIP WAS INSTRUMENTAL IN THE DEVELOPMENT OF COUNCIL'S "COMMUNITY HEALTH ADVOCACY TEAM" (CHAT). DURING 2013 CHAT HELD NINE CONSECUTIVE WEEKLY LIFE/HEALTH/PARENTING IMPROVEMENT CLASSES, WHICH WERE DUBBED "SAVE OUR SHIPS" (SOS), AT THE HEALTH CENTER. SOS CLASSES INCLUDED THE FOLLOWING SUBJECT MATTER: TIME MANAGEMENT; NUTRITION/GENERAL HEALTH; MEALS/SHOPPING/BUDGETS; FRUGAL LIVING; SELF RESCUE; DISCIPLINE; HEALTH AND HYGIENE; CRISIS MANAGEMENT; WHERE TO GO FROM HERE. THIS PROJECT WAS DONE IN CONJUNCTION WITH THE "WE CAN" PROGRAM WHERE THE HEALTH CENTER TEACHES CHILDREN ABOUT NUTRITION AND PHYSICAL ACTIVITY. |
| FIRST ACCOMPLISHMENT DESCRIPTION | FORM 990, PAGE 2, PART III, LINE 4A | VALUE OF PROVIDING CARE TO THESE PATIENTS WAS 93,089 FOR CHARITY CARE AND SLIDING FEE, 94,882 FOR MEDICARE, AND 92,007 FOR OTHER THIRD-PARTY PAYORS FOR THE YEAR ENDED SEPTEMEBER 30, 2013. THE HEALTH CENTER HAS NUMEROUS INDIVIDUALS ACCESSING SLIDING FEE DISCOUNTS FOR SERVICES RENDERED. A TOTAL OF 625 INDIVIDUALS HAD ACCESS TO THE SLIDING FEE PROGRAM, WITH INCOMES BELOW 200% OF FPL, WHO WERE ELGIBLE FOR ONE OR MORE OF THE THREE FOLLOWING PROGRAMS: PROGRAM CHARITY SLIDING FEE DISCOUNT EXPENDED MEDICAL SERVICES 27,713 PHYSICAL THERAPY 230 DENTAL SERVICES 59,022 MENTAL HEALTH SERVICES 785 THE PROGRAMS HIGHLIGHTED ABOVE PROVIDED HEALTH CARE SERVICES TO UNINSURED INDIVIDUALS WHO MAY HAVE OTHERWISE NOT RECEIVED SUCH SERVICES DUE TO FINANCIAL BARRIERS. |
| ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 | FORM 990, PAGE 6, PART VI, LINE 11B | A COPY OF THE 990 IS PROVIDED TO THE CFO/EXECUTIVE DIRECTOR WHO REVIEWS THE FORM, SCHEDULES AND RELATED ATTACHMENTS. ANY COMMENTS OR QUESTIONS ARE ADDRESSED WITH THE PREPARER AND A FINAL DRAFT IS PRESENTED TO THE BOARD OF DIRECTORS WHO THEN APPROVE THE 990. ONCE MANAGEMENT IS SATISFIED WITH THE 990, THE CFO SIGNS THE FORM 8879-EO AUTHORIZING THE PREPARER TO E-FILE THE RETURN. |
| ENFORCEMENT OF CONFLICTS POLICY | FORM 990, PAGE 6, PART VI, LINE 12C | IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICT OF INTEREST, AN INTERESTED PARTY MUST DISCLOSE THE EXISTENCE OF THE FINANCIAL INTEREST AND BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE EXECUTIVE DIRECTOR AND/OR BOARD OF TRUSTEES DESCRIBING THE PROPOSED TRANSACTION OR ARRANGEMENT. AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS AND AFTER ANY DISCUSSION WITH THE INTERESTED PARTY THE EXECUTIVE DIRECTOR AND/OR THE BOARD OF TRUSTEES SHALL DETERMINE IF A CONFLICT OF INTEREST EXISTS. IF IT IS DETERMINED THAT A CONFLICT OF INTEREST EXISTS, THEN THE EXECUTIVE DIRECTOR AND/OR THE BOARD OF TRUSTEES SHALL INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT. AFTER EXERCISING DUE DILIGENCE, THE EXECUTIVE DIRECTOR AND/OR THE BOARD OF TRUSTEES SHALL DETERMINE WHETHER THE HEALTH CENTER CAN OBTAIN WITH REASONABLE EFFORTS A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. IF A MORE ADVANTAGEOUS TRANSACTION IS NOT REASONABLY POSSIBLE UNDER CIRCUMSTANCES NOT PRODUCING A CONFLICT OF INTEREST, THE EXECUTIVE DIRECTOR AND/OR THE BOARD OF TRUSTEES SHALL DETERMINE WHETHER THE TRANSACTION OR ARRANGEMENT IS IN THE HEALTH CENTER'S BEST INTEREST, FOR ITS OWN BENEFIT, AND WHETHER IT IS FAIR AND REASONABLE. IN CONFORMITY WITH THE ABOVE DECISION AS TO WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT IT SHALL BE CONCLUDED. VIOLATIONS OF THE CONFLICT OF INTEREST POLICY CAN RESULT IN DISCIPLINARY AND CORRECTIVE ACTION BEING TAKEN UP TO AND INCLUDING TERMINATION. |
| COMPENSATION PROCESS FOR TOP OFFICIAL | FORM 990, PAGE 6, PART VI, LINE 15A | THE BOARD OF TRUSTEES EVALUATES THE EXECUTIVE DIRECTOR/CFO'S PERFORMANCE AND COMPENSATION ANNUALLY. SOURCES UTILIZED BY THE BOARD WHEN DETERMINING COMPENSATION INCLUDE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS AND STATE OF IDAHO SALARY SURVEYS AS WELL AS PERSONAL CONTACT WITH IDAHO COMMUNITY HEALTH CENTERS. SALARY CHANGES ARE DISCUSSED AND APPROVED BY UNANIMOUS VOTE OF THE BOARD OF TRUSTEES AND ARE INCLUDED IN THE MINUTES OF THE MEETING AT WHICH THE ACTION IS TAKEN. |
| COMPENSATION PROCESS FOR OFFICERS | FORM 990, PAGE 6, PART VI, LINE 15B | THE EXECUTIVE DIRECTOR/CFO IS THE ONLY OFFICER OR KEY EMPLOYEE. SEE 990, PART VI, LINE 15A. |
| GOVERNING DOCUMENTS DISCLOSURE EXPLANATION | FORM 990, PAGE 6, PART VI, LINE 19 | THE HEALTH CENTER MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
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