VALLEY FAMILY HEALTH CARE INC: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization
VALLEY FAMILY HEALTH CARE INC (EIN 82-0371383)
Tax period
2013-02-01 to 2014-01-31
Filed
2014-07-11
IRS object ID
201441929349300524
Schema version
2013v3.1
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)
Return2014-07-11T14:55:42-05:00ReturnTs
Tax Period End2014-01-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN203147422PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1BRIAN L RICHINS PCBusinessNameLine1

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1966 W IDAHO AVEAddressLine1
CityONTARIOCity
StateORState
ZIP Code979142111ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2013-02-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN820371383EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1VALLEY FAMILY HEALTH CARE INCBusinessNameLine1
FieldValueIRS element (for citing)
Business Name ControlVALLBusinessNameControlTxt
Phone2086429376PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11441 NE 10TH AVEAddressLine1
CityPAYETTECity
StateIDState
ZIP Code83661ZIPCode

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDON NELSONPersonNm
Person TitleCHIEF FINANCIAL OFFICERPersonTitleTxt
Phone2086429376PhoneNum
Signature2014-06-18SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonBRIAN L RICHINSPreparerPersonNm
PTINP00545131PTIN
Phone5418895288PhoneNum
Preparation2014-06-18PreparationDt
FieldValueIRS element (for citing)
Tax2013TaxYr
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Gross Receipts$7,951,339GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressN/AWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Legal Domicile StateIDLegalDomicileStateCd
Activity Or MissionCOMMUNITY HEALTH SERVICESActivityOrMissionDesc
Voting Members Governing Body9VotingMembersGoverningBodyCnt
Voting Members Independent9VotingMembersIndependentCnt
Total Employee141TotalEmployeeCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$3,699,019PYContributionsGrantsAmt
CY Contributions Grants$3,383,238CYContributionsGrantsAmt
PY Program Service Revenue$4,749,958PYProgramServiceRevenueAmt
CY Program Service Revenue$4,565,305CYProgramServiceRevenueAmt
PY Investment Income$3,025PYInvestmentIncomeAmt
CY Investment Income$2,796CYInvestmentIncomeAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$8,452,002PYTotalRevenueAmt
CY Total Revenue$7,951,339CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$5,897,203PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$6,088,472CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$1,904,093PYOtherExpensesAmt
CY Other Expenses$2,146,276CYOtherExpensesAmt
PY Total Expenses$7,801,296PYTotalExpensesAmt
CY Total Expenses$8,234,748CYTotalExpensesAmt
PY Revenues Less Expenses$650,706PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$283,409CYRevenuesLessExpensesAmt
Total Assets BOY$8,464,775TotalAssetsBOYAmt
Total Assets EOY$7,906,318TotalAssetsEOYAmt
Total Liabilities BOY$942,637TotalLiabilitiesBOYAmt
Total Liabilities EOY$455,759TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$7,522,138NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$7,450,559NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionCOMMUNITY HEALTH SERVICESMissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
DescHEALTH CARE FOR MIGRANT WORKERS AND LOW INCOME PERSONS. ALSO, MENTAL HEALTH AND NUTRITION COUNSELING.Desc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp

FieldValueIRS element (for citing)
Expense$7,194,336ExpenseAmt
DescHEALTH CARE FOR MIGRANT WORKERSDesc
FieldValueIRS element (for citing)
Total Other Prog Srvc Expense$7,194,336TotalOtherProgSrvcExpenseAmt
Total Program Service Expenses$7,194,336TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document4IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld CompliancefalseBackupWthldComplianceInd
Employee141EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members9GoverningBodyVotingMembersCnt
Independent Voting Member9IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldORStatesWhereCopyOfReturnIsFldCd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonRIGMOR WILSONPersonNm
Phone2086429376PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11441 NE 10TH AVEAddressLine1
CityPAYETTECity
StateIDState
ZIP Code83661ZIPCode
FieldValueIRS element (for citing)
Info In Schedule O Part VIIYes (X)InfoInScheduleOPartVIIInd
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
ROBERT BAROWSKY
CHAIRPERSON1.00Yes (X)$0$0$0
JONI DELGADO
VICE CHAIR1.00Yes (X)$0$0$0
KAREN SANDS
DIRECTOR1.00Yes (X)$0$0$0
CHELLE ROBINS
DIRECTOR1.00Yes (X)$0$0$0
CARLOS HERNANDEZ
DIRECTOR1.00Yes (X)$0$0$0
LOGAN HAMILTON
SEC/TREAS1.00Yes (X)$0$0$0
ROGER VAN ZELF
DIRECTOR1.00Yes (X)$0$0$0
JENNIFER MORGAN
DIRECTOR1.00Yes (X)$0$0$0
HENRY HIXSON
DIRECTOR1.00Yes (X)$0$0$0
SHARMEEN NELSON
DOCTOR40.00$183,841$0$7,354Yes (X)
GEOFFREY THOMAS
40.00$180,472$0$7,219Yes (X)
BRYAN STONE
DOCTOR40.00$173,944$0$6,958Yes (X)
ROBIN SEBASTION
DOCTOR40.00$169,510$0$6,780Yes (X)
EDDIE RODRIQUEZ-LOPEZ MD
DOCTOR40.00$123,438$0$2,469Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$831,205TotalReportableCompFromOrgAmt
Total Other Compensation$30,780TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K6IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
Government Grants$3,383,238GovernmentGrantsAmt
Total Contributions$3,383,238TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PRIVATE INSURANCE$744,483$744,483
MISC INCOME$711,876$711,876
MEDICAID - IDAHO$492,593$492,593
MEDICARE$486,828$486,828
PATIENT FEES$387,761$387,761

Total Oth Program Service Rev TotalOthProgramServiceRevGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,741,764TotalRevenueColumnAmt
Related Or Exempt Func Income$1,741,764RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$4,565,305TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,796TotalRevenueColumnAmt
Related Or Exempt Func Income$2,796RelatedOrExemptFuncIncomeAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$7,951,339TotalRevenueColumnAmt
Related Or Exempt Func Income$4,568,101RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$5,197,321TotalAmt
Program Services$4,419,975ProgramServicesAmt
Management And General$777,346ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$891,151TotalAmt
Program Services$782,974ProgramServicesAmt
Management And General$108,177ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$39,945TotalAmt
Program Services$17,196ProgramServicesAmt
Management And General$22,749ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
FMHA MORTGAGE - PRINCIPAL$462,318$462,318
340B PROGRAM$224,681$224,681
340B CONSULTING FEES$111,100$111,100
SUPPLIES$80,718$80,718

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$1,227,514TotalAmt
Program Services$1,095,374ProgramServicesAmt
Management And General$132,140ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$8,234,748TotalAmt
Program Services$7,194,336ProgramServicesAmt
Management And General$1,040,412ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$81,771BOYAmt
EOY$184,306EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$1,809,849BOYAmt
EOY$1,487,595EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$896,387BOYAmt
EOY$822,898EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$9,288,852LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$3,877,333LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$5,676,768BOYAmt
EOY$5,411,519EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$8,464,775BOYAmt
EOY$7,906,318EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$465,555BOYAmt
EOY$455,759EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$477,082BOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$942,637BOYAmt
EOY$455,759EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$7,086,725BOYAmt
EOY$6,640,907EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$435,413BOYAmt
EOY$809,652EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$7,522,138BOYAmt
EOY$7,450,559EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$8,464,775BOYAmt
EOY$7,906,318EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$283,409ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$211,830OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredYes (true)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (true)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

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

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,958,712CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$4,058,784CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$6,106,897CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$3,166,039CurrentTaxYearMinus1YearAmt
Current Tax Year$3,383,238CurrentTaxYearAmt
Total$19,673,670TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$2,958,712CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$4,058,784CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$6,106,897CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$3,166,039CurrentTaxYearMinus1YearAmt
Current Tax Year$3,383,238CurrentTaxYearAmt
Total$19,673,670TotalAmt
FieldValueIRS element (for citing)
Public Support Total170$19,673,670PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$12,507CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$3,858CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$2,711CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$2,848CurrentTaxYearMinus1YearAmt
Total$21,924TotalAmt
FieldValueIRS element (for citing)
Total Support$19,695,594TotalSupportAmt
Gross Receipts Rltd Activities$4,568,101GrossReceiptsRltdActivitiesAmt
Public Support CY1700.99890PublicSupportCY170Pct
Public Support PY1700.99760PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Schedule D IRS990ScheduleD

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$9,288,852InvestmentCostOrOtherBasisAmt
Depreciation$3,877,333DepreciationAmt
Book Value$5,411,519BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$5,411,519TotalBookValueLandBuildingsAmt

Schedule J IRS990ScheduleJ

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

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmt
SHARMEEN NELSON
DOCTOR$183,841$7,354$191,195
GEOFFREY THOMAS
$180,472$7,219$187,691
BRYAN STONE
DOCTOR$173,944$6,958$180,902
ROBIN SEBASTION
DOCTOR$169,510$6,780$176,290

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PAGE 2, PART III, LINE 4DHEALTH CARE FOR MIGRANT WORKERS
FORM 990, PAGE 6, PART VI, LINE 11BPROVIDE COPY TO ORGANIZATION FOR BOARD MEMBERS TO REVIEW.
FORM 990, PAGE 6, PART VI, LINE 12CPOLICY OF ORGANIZATION IS TO REVIEW COMPLIANCE WITH NEW DIRECTORS, OFFICERS, AND KEY EMPLOYEES.
FORM 990, PAGE 6, PART VI, LINE 15ABOARD OF DIRECTORS PERFORM EVALUATIONS AND DETERMINE COMPENSATION.
FORM 990, PAGE 6, PART VI, LINE 19COPIES AVAILABLE FOR PUBLIC AND PAYETTE, ID ADMINISTRITIVE OFFICES.
FORM 990, PAGE 7, PART VIIPARENT ORGANIZATION HAS FILED A SEPARATE RETURN
FORM 990, PART IX, LINE 24ECOMPUTER FEES 71,053 2,446 0 OFFICE PRODUCTS 66,167 0 0 PATIENT STATEMENT FEES 53,336 0 0 SUPPLIES - LAB 48,048 0 0 EQUIPMENT - MEDICAL 39,008 0 0 CAPITAL OUTLAY 36,778 0 0 INJECTIBLES - MEDICAL 32,652 0 0 SUPPLIES - MEDICAL 29,827 0 0 CONFERENCES/WORKSHOPS 0 29,176 0 UTILITIES 23,686 5,314 0 PROFESSIONAL DUES/FEES/SU 26,927 0 0 AUDIT - ADMIN 0 26,400 0 CME 24,480 0 0 340B PROCESSING COSTS 23,062 0 0 TELEPHONE 14,967 7,737 0 UTILITIES - FACILITIY 22,153 0 0 TELEPHONE - FACILITY 22,072 0 0 MAINTENANCE AGREEMENTS - 20,292 0 0 UTILITIES - FACILITY 18,949 0 0 MAINTENANCE & REPAIRS 15,881 0 0 BANK FEES 15,416 95 0 MAINTENANCE/REPAIRS - FAC 13,920 0 0 CONTRACT MEDICAL 13,833 0 0 INSURANCE - FACILITY 13,530 0 0 OFFICE SUPPLIES 13,527 0 0 FACILITY REPAIRS/MAINT - 13,520 0 0 CME - MEDICAL 13,490 0 0 PRINTING/COPYING - MEDICA 13,452 0 0 EQUIPMENT - FACILITY - NY 13,424 0 0 ORGANIZATIONAL DUES 2,200 10,879 0 PAYROLL PROCESSING FEES 0 12,696 0 INJECTIBLES - VALE 12,368 0 0 EQUIPMENT 12,076 0 0 INJECTIBLES - NYSSA 11,617 0 0 POSTAGE 8,799 2,515 0 R & R - OTHER 6,082 5,221 0 FMHA MORTGAGE - INTEREST 11,043 0 0 OFFICE PRODUCTS - VALE 10,708 0 0 FACILITY - REPAIRS AND MA 9,960 0 0 LAB SUPPLIES - VALE 9,580 0 0 LAB 9,491 0 0 TELEPHONE - TOTAL 9,381 0 0 UTILITIES - TOTAL 9,227 0 0 OFFICE PRODUCTS - TOTAL 9,153 0 0 UTILITIES - VALE 8,971 0 0 UTILITIES - NYSSA 8,159 0 0 COMPUTER FEES - DENTAL 7,840 0 0 OFFICE SUPPLIES - ADMIN 0 7,634 0 TELEPHONE - NYSSA 7,593 0 0 CONTINUING EDUCATION - VA 7,576 0 0 CONTINUING MEDICAL EDUCAT 7,384 0 0 MEDICAL SUPPLIES - VALE 7,312 0 0 SUPPLIES - INJECTABLES 7,311 0 0 LAB SUPPLIES - NYSSA 7,272 0 0 OFFICE PRODUCTS - NYSSA 6,846 0 0 R & R 6,782 0 0 TELEPHONE - VALE 6,476 0 0 CONTINUING EDUCATION - NY 5,999 0 0 SUPPLIES - FACILITY 5,950 0 0 INS/BOARD BONDING 0 5,947 0 MAINT/REPAIR - FACILITY 5,733 0 0 CONFERENCE WORKSHOPS 5,646 0 0 TRANSCRIPTION 5,511 0 0 FACILITY INSURANCE - ADMI 0 5,498 0 OTHER - COMMUNITY SERVICE 5,098 0 0 UTILITIES - DENTAL FACILI 5,020 0 0 MEDICAL SUPPLIES - NYSSA 4,960 0 0 LAB EXPENSES - DENTAL 4,804 0 0 EQUIPMENT - ADMINISTRATIO 4,446 0 0 EQUIPMENT - ADMIN 4,446 0 0 COMMUNITY SERVICE PROMOTI 4,404 0 0 PROFESSIONAL FEES/DUES/SU 4,402 0 0 DUES/FEES/SUBSCRIPTIONS 4,385 0 0 SUPPLIES - OUTREACH 4,378 0 0 MAINT/REPAIR - DENTAL FAC 4,336 0 0 MAINT/REPAIR - ADMIN FAC 0 4,276 0 INSURANCE FACILITY - VALE 4,051 0 0 DUES/FEES/SUB - DENTAL 3,828 0 0 INJECTIBLES 3,700 0 0 OFFICE SUPPLIES - DENTAL 3,350 0 0 MEDICAL EQUIPMENT - NYSSA 3,294 0 0 TELEPHONE - DENTAL FACILI 2,906 0 0 PROF DUES/SUBSCRIPTIONS 2,887 0 0 MOVING EXPENSE 2,846 0 0 CME - DENTAL 2,750 0 0 AUTO MAINT. ADMIN 0 2,602 0 MEDICAL - PRINTING/COPYIN 2,558 0 0 MEDICAL EQUIPMENT - VALE 2,510 0 0 COMPUTER/IT SUPPORT 2,494 12 0 TAXES - PROPERTY 2,350 0 0 POSTAGE - VALE 2,346 0 0 TRANSFER FMHA RESERVE 2,177 0 0 PRINT/COPYING - ADMIN 0 2,074 0 POSTAGE - NYSSA 2,070 0 0 CONTRACT - DENTAL 2,062 0 0 MAINTENANCE/REPAIR - ONT 1,986 0 0 INSURANCE-DENTAL ACTIVITY 1,916 0 0 PRINTING & COPYING 1,734 0 0 JOB ANNOUNCEMENTS 1,626 0 0 BANK S/C 1,536 0 0 EQUIPMENT - ADMIN - VALE 1,482 0 0 EQUIP - ADMIN 1,482 0 0 EQUIPMENT - ADMIN - NYSSA 1,482 0 0 REFERRALS - LAB 1,398 0 0 CONTRACT - MEDICAL 1,341 0 0 POSTAGE - TOTAL 1,334 0 0 COMMUNITY PROMOTIONS 1,280 0 0 ANSWERING SERVICE 1,168 0 0 MAINTENANCE AGREE - ADMIN 990 0 0 INSURANCE FACILITY - NYSS 948 0 0 MD CALL COVERAGE 948 0 0 FACILITY SUPPLIES - VALE 913 0 0 FACILITY SUPPLIES 864 0 0 SUPPLIES - COMMUNITY SERV 831 0 0 COMMUNITY SERVICE 800 0 0 PRINTING/COPYING 773 0 0 VEHICLE PAYMENTS 0 744 0 R AND R 737 0 0 MAINT/REPAIRS - FACILITY 668 0 0 CONTRACT-MEDICAL-NYSSA 666 0 0 EQUIPMENT - FACILITY 568 0 0 MAINTENANCE CONTRACTS 539 0 0 PRINTING/COPYING - DENTAL 536 0 0 MAINT AGREE - ADMIN 0 493 0 FACILITY SUPPLIES - NYSSA 491 0 0 CONFERENCE/WORKSHOPS 478 0 0 LEGAL FEES 354 100 0 R & R - ALL 453 0 0 MAINTENANCE CONTRACT 336 0 0 FAC SUPPLIES - ADMIN 0 281 0 SUPPLIES - DENTAL FACILIT 268 0 0 ANSWERING SERVICE - NYSSA 247 0 0 ANSWERING SERVICE - VALE 247 0 0 AUTO MAINT/REPAIRS/INS 231 0 0 OTHER FACILITY - VALE 225 0 0 REFFERRALS - LAB 220 0 0 OTHER - LAB 215 0 0 PHYSICIAN CALL COVERAGE 200 0 0 DISASTER PREPAREDNES SUPP 185 0 0 MAINTENANCE AGREEMENT - M 120 0 0 JOB ANNOUCEMENTS 111 0 0 REFERRALS - XRAY - VALE 102 0 0 PHARMACEUTICALS - VALE 86 0 0 PHARMACEUTICALS 63 0 0 SUPPLIES - PHARMACEUTICAL 19 0 0 TRANSFERS IN FROM PHS FM -2,177 0 0
FORM 990, PART XI, LINE 9CHANGE IN LONG-TERM DEBT 477,082 CHANGE IN FIXED ASSETS 265,251 ROUNDING 1

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