VALLEY FAMILY HEALTH CARE INC: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- VALLEY FAMILY HEALTH CARE INC (EIN 82-0371383)
- Tax period
- 2012-02-01 to 2013-01-31
- Filed
- 2013-06-12
- IRS object ID
- 201321639349300802
- Schema version
- 2012v2.1
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2013-06-12T17:10:44-05:00 | Timestamp |
| Tax Period End Date | 2013-01-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BRIAN L RICHINS PC | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 966 W IDAHO AVE | AddressLine1 |
| City | ONTARIO | City |
| State | OR | State |
| ZIP Code | 979142111 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-02-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 820371383 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | VALLEY FAMILY HEALTH CARE INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | VALL | NameControl |
| Phone | 2086429376 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1441 NE 10TH AVE | AddressLine1 |
| City | PAYETTE | City |
| State | ID | State |
| ZIP Code | 83661 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | DON NELSON | Name |
| Title | CHIEF FINANCIAL OFFICER | Title |
| Phone | 2086429376 | Phone |
| Date Signed | 2013-06-12 | DateSigned |
| Authorize Third Party | true | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | BRIAN L RICHINS | Name |
| Phone | 5418895288 | Phone |
| Date Prepared | 2013-06-10 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 8452002 | GrossReceipts |
| Group Return For Affiliates | false | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | N/A | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| State Legal Domicile | ID | StateLegalDomicile |
| Activity Or Mission Description | COMMUNITY HEALTH SERVICES | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 9 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 9 | NbrIndependentVotingMembers |
| Total Nbr Employees | 123 | TotalNbrEmployees |
| Total Gross UBI | 0 | TotalGrossUBI |
| Contributions Grants Prior Year | 6106897 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 3699019 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 3921725 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 4749958 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 2711 | InvestmentIncomePriorYear |
| Investment Income Current Year | 3025 | InvestmentIncomeCurrentYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 10031333 | TotalRevenuePriorYear |
| Total Revenue Current Year | 8452002 | TotalRevenueCurrentYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 5500850 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 5897203 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 4401850 | OtherExpensePriorYear |
| Other Expenses Current Year | 1904093 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 9902700 | TotalExpensesPriorYear |
| Total Expenses Current Year | 7801296 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 128633 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 650706 | RevenuesLessExpensesCY |
| Total Assets BOY | 8068336 | TotalAssetsBOY |
| Total Assets EOY | 8464779 | TotalAssetsEOY |
| Total Liabilities BOY | 1091916 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 942637 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 6976420 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 7522142 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | COMMUNITY HEALTH SERVICES | MissionDescription |
| Significant New Program Services | false | SignificantNewProgramServices |
| Significant Change | false | SignificantChange |
| Description | HEALTH CARE FOR MIGRANT WORKERS AND LOW INCOME PERSONS. ALSO, MENTAL HEALTH AND NUTRITION COUNSELING. | Description |
Activity Other ActivityOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 6897885 | Expense |
| Description | HEALTH CARE FOR MIGRANT WORKERS | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Other Program Service Exp | 6897885 | TotalOfOtherProgramServiceExp |
| Total Program Service Expense | 6897885 | 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 | false | ReportFin48Footnote |
| Independent Audit Financial Stmt | false | 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 | true | 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 |
| Transfers To Exempt Non Chrtbl Org | false | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | false | ActivitiesConductedPartnership |
| Schedule O Required | false | ScheduleORequired |
| Number Forms Transmitted With1096 | 11 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | false | ComplianceWithBackupWitholding |
| Number Of Employees | 123 | 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 |
| Indoor Tanning Services | false | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 9 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 9 | 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 | false | CompensationProcessOther |
| Investment In Joint Venture | false | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | OR | StatesWhereCopyOfReturnIsFiled |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | RIGMOR WILSON | NamePerson |
| Telephone Number | 2086429376 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1441 NE 10TH AVE | AddressLine1 |
| City | PAYETTE | City |
| State | ID | State |
| ZIP Code | 83661 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
| No Listed Persons Compensated | X | NoListedPersonsCompensated |
Form990 Part VII Section A Form990PartVIISectionA (14 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|
| ROBERT BAROWSKY | ||||||
| CHAIRPERSON | 1.00 | X | 0 | 0 | 0 | |
| JONI DELGADO | ||||||
| VICE CHAIR | 1.00 | X | 0 | 0 | 0 | |
| KAREN SANDS | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| CHELLE ROBINS | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| CARLOS HERNANDEZ | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| LOGAN HAMILTON | ||||||
| SEC/TREAS | 1.00 | X | 0 | 0 | 0 | |
| ROGER VAN ZELF | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| JENNIFER MORGAN | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| HENRY HIXSON | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| EDDIE RODRIQUEZ-LOPEZ MD | ||||||
| DOCTOR | 40.00 | 188125 | 0 | 4961 | X | |
| SHARMEEN NELSON | ||||||
| DOCTOR | 40.00 | 180044 | 0 | 6681 | X | |
| BRYAN STONE | ||||||
| DOCTOR | 40.00 | 170041 | 0 | 6481 | X | |
| ROBIN SEBASTION | ||||||
| DOCTOR | 40.00 | 130429 | 0 | 5689 | X | |
| MARNI HANSELL | ||||||
| 128014 | 0 | 5640 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 796653 | TotalReportableCompFromOrg |
| Total Other Compensation | 29452 | TotalOtherCompensation |
| Number Individuals GT100 K | 7 | NumberIndividualsGT100K |
| Formers Listed | false | FormersListed |
| Total Comp GT150 K | true | TotalCompGT150K |
| Compensation From Other Sources | false | CompensationFromOtherSources |
| Government Grants | 3699019 | GovernmentGrants |
| Total Contributions | 3699019 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|
| MISC INCOME | 924602 | 924602 |
| MEDICAID - IDAHO | 823840 | 823840 |
| PRIVATE INSURANCE | 556738 | 556738 |
| PATIENT FEES | 398329 | 398329 |
| MEDICARE | 354438 | 354438 |
Total Oth Program Service Revenue TotalOthProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1692011 | TotalRevenueColumn |
| Related Or Exempt Function Income | 1692011 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 4749958 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 3025 | TotalRevenueColumn |
| Related Or Exempt Function Income | 3025 | RelatedOrExemptFunctionIncome |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 8452002 | TotalRevenueColumn |
| Related Or Exempt Function Income | 4752983 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | X | InfoInScheduleOPartIX |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5075475 | Total |
| Program Services | 4425197 | ProgramServices |
| Management And General | 650278 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 821728 | Total |
| Program Services | 701054 | ProgramServices |
| Management And General | 120674 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 35748 | Total |
| Program Services | 18885 | ProgramServices |
| Management And General | 16863 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| CONTINGENCIES | 153918 | 153918 | |
| CAPITAL OUTLAY | 151197 | 151197 | |
| 340B PROGRAM | 149741 | 149741 | |
| COMPUTER FEES | 109566 | 106691 | 2875 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1303923 | Total |
| Program Services | 1191202 | ProgramServices |
| Management And General | 112721 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7801296 | Total |
| Program Services | 6897885 | ProgramServices |
| Management And General | 903411 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 204256 | BOY |
| EOY | 81775 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1543826 | BOY |
| EOY | 1809849 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 89447 | BOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 407315 | BOY |
| EOY | 896387 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 9182674 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 3505906 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5823492 | BOY |
| EOY | 5676768 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8068336 | BOY |
| EOY | 8464779 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 573102 | BOY |
| EOY | 465555 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 518814 | BOY |
| EOY | 477082 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1091916 | BOY |
| EOY | 942637 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6569537 | BOY |
| EOY | 6855367 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 406883 | BOY |
| EOY | 666775 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6976420 | BOY |
| EOY | 7522142 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8068336 | BOY |
| EOY | 8464779 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 650706 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | -104984 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | false | AccountantCompileOrReview |
| FS Audited | true | FSAudited |
| 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) |
|---|---|---|
| Publicly Supported Org170b1 Avi | X | PubliclySupportedOrg170b1Avi |
Gifts Grants Contrib Received170 GiftsGrantsContribReceived170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 2451853 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 2958712 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 4058784 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 6106897 | CurrentTaxYearMinus1Year |
| Current Tax Year | 3166039 | CurrentTaxYear |
| Total | 18742285 | Total |
Total170 Total170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 2451853 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 2958712 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 4058784 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 6106897 | CurrentTaxYearMinus1Year |
| Current Tax Year | 3166039 | CurrentTaxYear |
| Total | 18742285 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | 18742285 | PublicSupportTotal170 |
Gross Investment Income170 GrossInvestmentIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 22298 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 12507 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 3858 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 2711 | CurrentTaxYearMinus1Year |
| Current Tax Year | 2848 | CurrentTaxYear |
| Total | 44222 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | 18786507 | TotalSupport |
| Gross Receipts From Admissions Etc | 4752983 | GrossReceiptsFromAdmissionsEtc |
| Public Support Pertcentage170 | 0.99760 | PublicSupportPertcentage170 |
| Public Support Pertcent Prior Year | 0.99530 | PublicSupportPertcentPriorYear |
| Thirty Three Percnt Tests CY170 | X | ThirtyThreePercntTestsCY170 |
Schedule D IRS990ScheduleD
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 9182674 | InvestmentCostOrOtherBasis |
| Depreciation | 3505906 | Depreciation |
| Book Value | 5676768 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 5676768 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | MORTGAGES | Description |
| Amount | $477,082 | Amount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 477082 | TotalOfAmounts |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePayment |
| Supplemental Nonqual Retire Plan | false | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | false | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | false | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | false | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | false | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | false | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | false | AnyNonFixedPayments |
| Initial Contract Exception | false | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (3 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Deferred Comp Filing OrgDeferredCompFilingOrg | Total Compensation Filing OrgTotalCompensationFilingOrg |
|---|---|---|---|
| EDDIE RODRIQUEZ-LOPEZ MD | |||
| DOCTOR | 188125 | 4961 | 193086 |
| SHARMEEN NELSON | |||
| DOCTOR | 180044 | 6681 | 186725 |
| BRYAN STONE | |||
| DOCTOR | 170041 | 6481 | 176522 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (8 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| ALL OTHER ACCOMPLISHMENT DESCRIPTION | FORM 990, PAGE 2, PART III, LINE 4D | HEALTH CARE FOR MIGRANT WORKERS |
| ORGANIZATION'S PROCESS USED TO REVIEW FORM 990 | FORM 990, PAGE 6, PART VI, LINE 11B | NO REVIEW WAS OR WILL BE CONDUCTED. |
| ENFORCEMENT OF CONFLICTS POLICY | FORM 990, PAGE 6, PART VI, LINE 12C | POLICY OF ORGANIZATION IS TO REVIEW COMPLIANCE WITH NEW DIRECTORS, OFFICERS, AND KEY EMPLOYEES. |
| COMPENSATION PROCESS FOR TOP OFFICIAL | FORM 990, PAGE 6, PART VI, LINE 15A | BOARD OF DIRECTORS PERFORM EVALUATIONS AND DETERMINE COMPENSATION. |
| GOVERNING DOCUMENTS DISCLOSURE EXPLANATION | FORM 990, PAGE 6, PART VI, LINE 19 | NO DOCUMENTS AVAILABLE TO THE PUBLIC |
| GROUP RETURN METHOD | FORM 990, PAGE 7, PART VII | PARENT ORGANIZATION HAS FILED A SEPARATE RETURN |
| OTHER EXPENSES | FORM 990, PART IX, LINE 24E | MISCELLANEOUS 103,721 0 0 SUPPLIES 78,517 0 0 PATIENT SERVICES 54,940 0 0 SUPPLIES - LAB 54,599 0 0 SUPPLIES - MEDICAL 49,492 0 0 PATIENT STATEMENT FEES 38,670 0 0 TRANSCRIPTION 34,087 0 0 INJECTIBLES - MEDICAL 30,742 0 0 COMPUTER FEES - DENTAL 27,907 0 0 UTILITIES 21,579 3,922 0 PROFESSIONAL DUES/FEES/SU 24,498 0 0 RESERVE 24,000 0 0 TELEPHONE 14,828 9,115 0 FMHA MORTGAGE - PRINCIPAL 22,107 0 0 FMHA MORTGAGE - INTEREST 21,429 0 0 TELEPHONE - FACILITY 21,266 0 0 FACILITY - REPAIRS AND MA 21,020 0 0 PRINTING/COPYING - MEDICA 21,017 0 0 UTILITIES - FACILITIY 19,749 0 0 CME 18,340 0 0 AUDIT - ADMIN 0 18,035 0 ORGANIZATIONAL DUES 0 17,140 0 UTILITIES - FACILITY 17,084 0 0 MAINTENANCE AGREEMENTS - 16,970 0 0 MD CALL COVERAGE 16,823 0 0 PHYSICIAN CALL COVERAGE 15,464 0 0 MAINTENANCE & REPAIRS 14,456 0 0 OFFICE PRODUCTS 14,012 0 0 OFFICE SUPPLIES - ADMIN 0 13,858 0 INSURANCE - FACILITY 13,817 0 0 BANK FEES 13,160 25 0 LAB SUPPLIES - VALE 12,490 0 0 MAINTENANCE/REPAIRS - FAC 11,960 0 0 CME - MEDICAL 11,912 0 0 FACILITY REPAIRS/MAINT - 11,642 0 0 PAYROLL PROCESSING FEES 0 11,595 0 CONTINUING MEDICAL EDUCAT 11,008 0 0 INJECTIBLES - VALE 10,904 0 0 OFFICE SUPPLIES 10,751 0 0 SUPPLIES - INJECTABLES 10,597 0 0 MEDICAL SUPPLIES - VALE 10,594 0 0 COMPUTER/IT SUPPORT 3,801 6,577 0 POSTAGE 8,364 1,716 0 UTILITIES - TOTAL 9,327 0 0 CONTRACT MEDICAL 9,147 0 0 UTILITIES - VALE 8,568 0 0 UTILITIES - NYSSA 8,374 0 0 CONFERENCES/WORKSHOPS 0 7,788 0 TELEPHONE - TOTAL 7,785 0 0 LAB SUPPLIES - NYSSA 7,668 0 0 OR SAFETY NET AGENCY OVER 7,576 0 0 TELEPHONE - NYSSA 7,206 0 0 LAB 7,168 0 0 SUPPLIES - FACILITY 7,063 0 0 OFFICE PRODUCTS - TOTAL 6,614 0 0 MEDICAL SUPPLIES - NYSSA 6,281 0 0 TELEPHONE - VALE 6,199 0 0 INJECTIBLES - NYSSA 5,888 0 0 PROFESSIONAL FEES/DUES/SU 5,811 0 0 OFFICE PRODUCTS - VALE 5,634 0 0 INS/BOARD BONDING 0 5,436 0 INJECTIBLES 5,094 0 0 ARCHITECURAL AND ENGINEER 5,085 0 0 OFFICE SUPPLIES - DENTAL 4,943 0 0 LAB EXPENSES - DENTAL 4,752 0 0 MAINT/REPAIR - FACILITY 4,747 0 0 CONTINUING EDUCATION - VA 4,526 0 0 EQUIPMENT - ADMIN 4,506 0 0 EQUIPMENT - ADMINISTRATIO 4,506 0 0 CONTINUING EDUCATION - NY 4,500 0 0 VEHICLE PAYMENTS 0 4,464 0 TRANSFER FMHA RESERVE 4,354 0 0 MEDICAL - PRINTING/COPYIN 4,332 0 0 OTHER - COMMUNITY SERVICE 4,316 0 0 CONSTRUCTION 4,265 0 0 CONSUMABLE EQUIPMENT - IT 4,174 0 0 FACILITY INSURANCE - ADMI 0 4,145 0 INSURANCE FACILITY - VALE 4,073 0 0 EQUIPMENT - DENTAL 3,877 0 0 UTILITIES - DENTAL FACILI 3,712 0 0 FACILITY SUPPLIES 3,705 0 0 MEDICAL EQUIPMENT - NYSSA 3,617 0 0 MEDICAL EQUIPMENT - VALE 3,617 0 0 EQUIPMENT - MEDICAL 3,522 0 0 COMMUNITY SERVICE PROMOTI 3,397 0 0 OFFICE PRODUCTS - NYSSA 3,153 0 0 CONSUMABLE EQUIPMENT - OF 3,062 0 0 REFERRAL/CONTRACT - DENTA 2,978 0 0 TELEPHONE - DENTAL FACILI 2,902 0 0 DISASTER PREPAREDNES SUPP 2,826 0 0 MAINT/REPAIR - ADMIN FAC 0 2,777 0 PRINTING & COPYING 2,615 0 0 MAINT/REPAIR - DENTAL FAC 2,567 0 0 POSTAGE - VALE 2,550 0 0 CME - DENTAL 2,404 0 0 POSTAGE - NYSSA 2,275 0 0 AUTO MAINT. ADMIN 0 2,238 0 DUES/FEES/SUBSCRIPTIONS 2,207 0 0 CONSUMABLE EQUIPMENT - ME 2,033 0 0 CONTRACT - MEDICAL 1,989 0 0 JOB ANNOUNCEMENTS 1,890 0 0 INSURANCE-DENTAL ACTIVITY 1,886 0 0 FACILITY SUPPLIES - VALE 1,639 0 0 TAXES - PROPERTY 1,634 0 0 R & R 1,610 0 0 DUES/FEES/SUB - DENTAL 1,574 0 0 BANK S/C 1,508 0 0 EQUIPMENT - ADMIN - VALE 1,502 0 0 EQUIPMENT 1,502 0 0 EQUIPMENT - ADMIN - NYSSA 1,502 0 0 EQUIP - ADMIN 0 1,502 0 EQUIPMENT - FACILITY 1,496 0 0 MAINTENANCE CONTRACTS 1,456 0 0 POSTAGE - TOTAL 1,450 0 0 PRINT/COPYING - ADMIN 0 1,405 0 CONSUMABLE EQUIPMENT - FA 1,306 0 0 SUPPLIES - DENTAL FACILIT 1,100 0 0 INSURANCE FACILITY - NYSS 948 0 0 PROMOTIONS/DOOR PRIZES/RE 938 0 0 PROF DUES/SUBSCRIPTIONS 882 0 0 PHARMACEUTICALS - VALE 836 0 0 CONTRACT-MEDICAL-NYSSA 783 0 0 FACILITY SUPPLIES - NYSSA 782 0 0 ANSWERING SERVICE 776 0 0 EQUIPMENT - LAB 775 0 0 MAINTENANCE AGREE - ADMIN 754 0 0 SUPPLIES - COMMUNITY SERV 717 0 0 CONTRACT - DENTAL 685 0 0 RECRUITMENT & RETENTION 668 0 0 FAC SUPPLIES - ADMIN 0 574 0 REFERRALS - LAB 522 0 0 PRINTING/COPYING - DENTAL 504 0 0 PHARMACEUTICALS 493 0 0 PRINTING/COPYING 480 0 0 COMMUNITY SERVICE 450 0 0 MAINT/REPAIRS - FACILITY 440 0 0 SUPPLIES - PHARMACEUTICAL 396 0 0 MAINT AGREE - ADMIN 0 371 0 R AND R 332 0 0 AUTO MAINT/REPAIRS/INS 247 0 0 OTHER FACILITY - VALE 236 0 0 ANSWERING SERVICE - VALE 194 0 0 ANSWERING SERVICE - NYSSA 193 0 0 OTHER - LAB 162 0 0 REFERRALS - XRAY - VALE 145 0 0 MAINTENANCE AGREEMENT - M 120 0 0 CONFERENCE WORKSHOPS 100 0 0 PHARMACEUTICALS - NYSSA 71 0 0 REFFERRALS - LAB 65 0 0 LEGAL FEES 0 38 0 TRANSFERS IN FROM PHS FM -4,354 0 0 TRANSFERS PHS GRANT -24,000 0 0 |
| OTHER CHANGES IN NET ASSETS EXPLANATION | FORM 990, PART XI, LINE 9 | CHANGE IN LONG-TERM DEBT 41,732 ROUNDING 8 CHANGE IN FIXED ASSETS 146,724 |
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