FIVE RIVERS HEALTH CENTERS: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- FIVE RIVERS HEALTH CENTERS (EIN 45-0914398)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-08-23
- IRS object ID
- 201332359349300303
- 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 | 2013-08-23T08:24:48-05:00 | Timestamp |
| Tax Period End Date | 2012-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 310800053 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLARK SCHAEFER HACKETT & CO | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2525 N LIMESTONE STREET | AddressLine1 |
| City | SPRINGFIELD | City |
| State | OH | State |
| ZIP Code | 45503 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 450914398 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FIVE RIVERS HEALTH CENTERS | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | FIVE | NameControl |
| Phone | 9377344141 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3535 SALEM AVENUE NO 100 | AddressLine1 |
| City | DAYTON | City |
| State | OH | State |
| ZIP Code | 454062645 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | GINA MCFARLANE-EL | Name |
| Title | CEO | Title |
| Phone | 9377344141 | Phone |
| Date Signed | 2013-08-22 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | DEVESH KAMAL CPA | Name |
| PTIN | P00201226 | PTIN |
| Phone | 9373992000 | Phone |
| Date Prepared | 2013-08-20 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-02-24 21:20:13Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | GINA MCFARLANE-EL | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3535 SALEM AVENUE NO 100 | AddressLine1 |
| City | DAYTON | City |
| State | OH | State |
| ZIP Code | 454062645 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 9530803 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | HTTP://WWW.FIVERIVERSHEALTHCENTERS.ORG/ | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 2011 | YearFormation |
| State Legal Domicile | OH | StateLegalDomicile |
| Activity Or Mission Description | FIVE RIVER HEALTH CENTERS AIMS TO LIVE OUT OUR MISSION FOR OUR PATIENTS - "YOUR HEALTHCARE MATTERS!" | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 13 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 13 | NbrIndependentVotingMembers |
| Total Nbr Employees | 36 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 4700300 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 7464399 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 2399574 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 2066404 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 0 | InvestmentIncomePriorYear |
| Investment Income Current Year | 0 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 0 | OtherRevenuePriorYear |
| Other Revenue Current Year | 0 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 7099874 | TotalRevenuePriorYear |
| Total Revenue Current Year | 9530803 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 142132 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 820524 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 6465564 | OtherExpensePriorYear |
| Other Expenses Current Year | 9488848 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 6607696 | TotalExpensesPriorYear |
| Total Expenses Current Year | 10309372 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 492178 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -778569 | RevenuesLessExpensesCY |
| Total Assets BOY | 1691723 | TotalAssetsBOY |
| Total Assets EOY | 1688835 | TotalAssetsEOY |
| Total Liabilities BOY | 1199545 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 1975226 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 492178 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | -286391 | NetAssetsOrFundBalancesEOY |
| Mission Description | FIVE RIVERS HEALTH CENTERS ARE COMMITTED TO PROVIDING QUALITY, COST-EFFECTIVE CARE FOR OUR PATIENTS AND COMMUNITY, WITH RESPECT AND DIGNITY, AND WITHOUT REGARD TO ABILITY TO PAY, WHILE PROVIDING A SUPERIOR EDUCATIONAL EXPERIENCE FOR RESIDENTS AND OTHER LEARNERS. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 9356537 | Expense |
| Revenue | 2066404 | Revenue |
| Description | PROVIDE QUALITY, COST-EFFECTIVE CARE FOR OUR PATIENTS AND COMMUNITY WITH RESPECT AND DIGNITY, AND WITHOUT REGARD TO ABILITY TO PAY, WHILE PROVIDING A SUPERIOR EDUCATIONAL EXPERIENCE FOR RESIDENTS AND OTHER LEARNERS. IN 2012, CARE WAS PROVIDED TO APPROXIMATELY 15,000 PATIENTS. | Description |
| Total Program Service Expense | 9356537 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 0 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 0 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 39 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 36 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Excess Business Holdings | 0 | ExcessBusinessHoldings |
| Taxable Distributions | 0 | TaxableDistributions |
| Distribution To Donor | 0 | DistributionToDonor |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 13 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 13 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 0 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DAVID BRIDGE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 9377346844 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3535 SALEM AVENUE SUITE 100 | AddressLine1 |
| City | DAYTON | City |
| State | OH | State |
| ZIP Code | 45406 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (15 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation |
|---|---|---|---|---|---|---|
| DR MARGARET DUNN | ||||||
| PRESIDENT | 1.00 | X | X | 0 | 0 | 0 |
| ANN SCHUERMAN | ||||||
| SECRETARY/TREASURER | 1.00 | X | X | 0 | 0 | 0 |
| AMY WIEDEMAN | ||||||
| VICE PRESIDENT | 1.00 | X | X | 0 | 0 | 0 |
| RICHARD GOSHAY | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| RONA CLARK | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| JANIESHA HENDERSON | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| WANDA GUY | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| DWIGHT BROWN | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| JEFF COOPER | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| DEBRA MCCATHRON | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| VERA CROWE | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| DIANE WELBORN | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| JANET BEARFIELD | ||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |
| DAVE BRIDGE | ||||||
| CFO | 40.00 | X | 83605 | 0 | 5589 | |
| GINA MCFARLANE-EL | ||||||
| EXECUTIVE DIRECTOR | 40.00 | X | 90597 | 0 | 9133 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 174202 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 14722 | TotalOtherCompensation |
| Number Individuals GT100 K | 0 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 0 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (3 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| WRIGHT STATE UNIVERSITY | |||||
| 3640 COLONEL GLENN HWY | DAYTON | OH | 45435 | MEDICAL SERVICES | 933021 |
| SAMARITAN FAMILY CARE INC | |||||
| 40 W 4TH STREET 1700 | DAYTON | OH | 45402 | MEDICAL SERVICES | 130638 |
| BONE AND JOINT SURGEONS INC | |||||
| 9000 N MAIN STREET STE 303 | DAYTON | OH | 45415 | MEDICAL SERVICES | 102000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 3 | NumberOfContractorsGT100K |
| All Other Contributions | 7464399 | AllOtherContributions |
| Total Contributions | 7464399 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (5 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| MEDICAID, NET | 621400 | 1555009 | 1555009 |
| MEDICARE, NET | 621400 | 268767 | 268767 |
| FIRST AND THIRD PARTIE | 621400 | 200296 | 200296 |
| OTHER GOVERNEMENTAL | 621400 | 38308 | 38308 |
| MISCELLANEOUS | 624100 | 4024 | 4024 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 2066404 | TotalProgramServiceRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 9530803 | TotalRevenueColumn |
| Related Or Exempt Function Income | 2066404 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 188924 | Total |
| Management And General | 188924 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 534949 | Total |
| Program Services | 441224 | ProgramServices |
| Management And General | 93725 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 38717 | Total |
| Program Services | 19743 | ProgramServices |
| Management And General | 18974 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 57934 | Total |
| Program Services | 37478 | ProgramServices |
| Management And General | 20456 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 39889 | Total |
| Management And General | 39889 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 975836 | Total |
| Program Services | 973770 | ProgramServices |
| Management And General | 2066 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1332 | Total |
| Program Services | 157 | ProgramServices |
| Management And General | 1175 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 107739 | Total |
| Program Services | 92485 | ProgramServices |
| Management And General | 15254 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1001196 | Total |
| Program Services | 979077 | ProgramServices |
| Management And General | 22119 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8721 | Total |
| Program Services | 2287 | ProgramServices |
| Management And General | 6434 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 20804 | Total |
| Program Services | 11102 | ProgramServices |
| Management And General | 9702 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 63522 | Total |
| Program Services | 63522 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 87964 | Total |
| Program Services | 81825 | ProgramServices |
| Management And General | 6139 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| LEASED EMPLOYEES | 4358467 | 4313346 | 45121 |
| CONTRACT SERVICES | 1810637 | 1676770 | 133867 |
| PHARMACY COSTS | 415093 | 415093 | |
| MEMBERSHIP DUES | 249220 | 1704 | 247516 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 348428 | Total |
| Program Services | 246954 | ProgramServices |
| Management And General | 101474 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 10309372 | Total |
| Program Services | 9356537 | ProgramServices |
| Management And General | 952835 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 545084 | BOY |
| EOY | 338455 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 868166 | BOY |
| EOY | 1128284 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 18999 | BOY |
| EOY | 26144 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 299429 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 103477 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 259474 | BOY |
| EOY | 195952 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1691723 | BOY |
| EOY | 1688835 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 179246 | BOY |
| EOY | 71824 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1020299 | BOY |
| EOY | 1903402 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1199545 | BOY |
| EOY | 1975226 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 492178 | BOY |
| EOY | -286391 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 492178 | BOY |
| EOY | -286391 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1691723 | BOY |
| EOY | 1688835 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | -778569 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Separate | X | FinancialStatementSeparate |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | X | PubliclySupportedOrg509a2 |
Gifts Grants Contrib Received509 GiftsGrantsContribReceived509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | 4700300 | CurrentTaxYearMinus1Year |
| Current Tax Year | 7464399 | CurrentTaxYear |
| Total | 12164699 | Total |
Gross Receipts From Admissions GrossReceiptsFromAdmissions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | 996783 | CurrentTaxYearMinus1Year |
| Current Tax Year | 2066404 | CurrentTaxYear |
| Total | 3063187 | Total |
Total509 Total509
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | 5697083 | CurrentTaxYearMinus1Year |
| Current Tax Year | 9530803 | CurrentTaxYear |
| Total | 15227886 | Total |
Amts Recd From Disqual Persons AmtsRecdFromDisqualPersons
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Amts From Subst Contributors AmtsFromSubstContributors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
Support From DQ Ps Etc SupportFromDQPsEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 0 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | 15227886 | PublicSupportTotal509 |
Total Support Total TotalSupportTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | 5697083 | CurrentTaxYearMinus1Year |
| Current Tax Year | 9530803 | CurrentTaxYear |
| Total | 15227886 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| First5 Years509 | X | First5Years509 |
| General Explanation | SCHEDULE A, PART IV, SUPPLEMENTAL INFORMATION: THE ORGANIZATION WAS FORMED ON MAY 23, 2011 THUS CREATING A SHORT-YEAR TAX RETURN FOR 2011. | GeneralExplanation |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 239027 | OtherCostOrOtherBasis |
| Depreciation | 95675 | Depreciation |
| Book Value | 143352 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 60402 | OtherCostOrOtherBasis |
| Depreciation | 7802 | Depreciation |
| Book Value | 52600 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 195952 | TotalOfBookValueLandBuildings |
Other Liabilities OtherLiabilities (3 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| ACCRUED PAYROLL AND WITHHOLDING | $52,765 |
| ACCRUED LEASED PAYROLL AND BENEFITS | $1,418,820 |
| OTHER ACCRUED LIABILITIES | $431,817 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 1903402 | TotalOfAmounts |
| Footnote In Part XIII | X | FootnoteInPartXIII |
| Tot Revenue Etc Audited Fincl Stmt | 9530803 | TotRevenueEtcAuditedFinclStmt |
| Revenue Not Rptd F990 | 0 | RevenueNotRptdF990 |
| Revenue Subtotal | 9530803 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 9530803 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 10309372 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 10309372 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 10309372 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Identifier | DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | Identifier |
| Return Reference | PART X, LINE 2: | ReturnReference |
| Explanation | FIVE RIVERS HEALTH CENTER IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODT. HOWEVER, INCOME FROM CERTAIN ACTIVITIES NOT DIRECTLY RELATED TO THE CENTER'S TAX-EXEMPT PURPOSE IS SUBJECT TO TAXATION AS UNRELATED BUSINESS INCOME. THE CENTER'S REPORTING RETURNS ARE SUBJECT TO AUDIT BY FEDERAL AND STATE TAXING AUTHORITIES. THE CENTER'S OPEN AUDIT PERIOD IS 2011. NO INCOME TAX PROVISION HAS BEEN INCLUDED IN THE FINANCIAL STATEMENTS AS THE CENTER HAS DETERMINED IT DOES NOT HAVE UNRELATED BUSINESS INCOME SUBJECT TO TAXATION. | Explanation |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (6 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | THE FINANCE COMMITTEE WILL REVIEW THE 990 AND APPROVE THE REPORT. AFTER APPROVING THE 990, THE FINANCE COMMITTEE WILL TAKE THE 990 TO THE BOARD FOR BOARD APPROVAL. |
| FORM 990, PART VI, SECTION B, LINE 12C | EMPLOYEES ARE REQUIRED TO DISCLOSE ANY POTENTIAL CONFLICTS OF INTEREST. OPERATING POLICIES HAVE BEEN IMPLEMENTED TO DETECT POTENTIAL CONFLICTS OF INTEREST. CONTRACTS OR EXPENDITURES THAT ARE GREATER THAN $50,000 MUST HAVE BOARD APPROVAL. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE COMPENSATION COMMITTEE USES MARKET DATA TO DETERMINE SALARIES. |
| FORM 990, PART VI, SECTION C, LINE 18 | THE ORGANIZATIONS 990 IS AVAILABLE FOR PUBLIC INSPECTION UPON REQUEST. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION DOES NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC. |
| THE FINANCE COMMITTEE FOR THE ORGANIZATION SELECTS AN INDEPENDENT ACCOUNTING FIRM TO CONDUCT THE AUDIT OF THE FINANCIAL STATEMENTS AND PROVIDES OVERSIGHT FOR THE WORK THAT IS CONDUCTED. THIS REPRESENTS NO CHANGE IN THE PROCESS FROM PROCEDURES CONDUCTED IN PRIOR PERIODS. |
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