FURP.ORG / PUBLIC DATA EXPLORER

COMMUNITY HEALTH CENTERS INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
COMMUNITY HEALTH CENTERS INC (EIN 74-2412898)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-08-29
IRS object ID
201332419349300333
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

FieldValueIRS element (for citing)
Timestamp2013-08-29T13:44:00-05:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1WISAN SMITH RACKER & PRESCOTT LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1155 N 400 W STE 400AddressLine1
CitySALT LAKE CITYCity
StateUTState
ZIP Code84103ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN742412898EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1COMMUNITY HEALTH CENTERS INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlCOMMNameControl
Phone8014126920Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1220 WEST 7200 SOUTH SUITE AAddressLine1
CityMIDVALECity
StateUTState
ZIP Code84047ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameDEXTER PEARCEName
TitleEXECUTIVE DIRECTORTitle
Phone8014126920Phone
Date Signed2013-08-23DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameDANIEL P RINEHARTName
Phone8013282011Phone
Date Prepared2013-08-23DatePrepared
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonDEXTER PEARCENameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1220 WEST 7200 SOUTH SUITE AAddressLine1
CityMIDVALECity
StateUTState
ZIP Code84047ZIPCode
FieldValueIRS element (for citing)
Gross Receipts15420132GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteHTTP://WWW.CHC-UT.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1979YearFormation
State Legal DomicileUTStateLegalDomicile
Activity Or Mission DescriptionTO PROVIDE QUALITY, PATIENT-CENTERED PRIMARY HEALTH CARE, DENTAL AND OTHER SERVICES TO THE MEDICALLY UNDERSERVED IN UTAH REGARDLESS OF THEIR ABILITY TO PAY.ActivityOrMissionDescription
Nbr Voting Members Governing Body13NbrVotingMembersGoverningBody
Nbr Independent Voting Members13NbrIndependentVotingMembers
Total Nbr Employees184TotalNbrEmployees
Total Nbr Volunteers16TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year8554196ContributionsGrantsPriorYear
Contributions Grants Current Year8346420ContributionsGrantsCurrentYear
Program Service Revenue Prior Year7485810ProgramServiceRevenuePriorYear
Program Service Revenue CY6946185ProgramServiceRevenueCY
Investment Income Prior Year2127InvestmentIncomePriorYear
Investment Income Current Year76006InvestmentIncomeCurrentYear
Other Revenue Prior Year23683OtherRevenuePriorYear
Other Revenue Current Year38622OtherRevenueCurrentYear
Total Revenue Prior Year16065816TotalRevenuePriorYear
Total Revenue Current Year15407233TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year8594936SalariesEtcPriorYear
Salaries Etc Current Year8693349SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year14258TotalFundrsngExpCurrentYear
Other Expense Prior Year5442408OtherExpensePriorYear
Other Expenses Current Year5715730OtherExpensesCurrentYear
Total Expenses Prior Year14037344TotalExpensesPriorYear
Total Expenses Current Year14409079TotalExpensesCurrentYear
Revenues Less Expenses Prior Year2028472RevenuesLessExpensesPriorYear
Revenues Less Expenses CY998154RevenuesLessExpensesCY
Total Assets BOY5931468TotalAssetsBOY
Total Assets EOY7259283TotalAssetsEOY
Total Liabilities BOY992116TotalLiabilitiesBOY
Total Liabilities EOY1323675TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY4939352NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY5935608NetAssetsOrFundBalancesEOY
Mission DescriptionTO PROVIDE QUALITY, PATIENT-CENTERED PRIMARY HEALTH CARE, DENTAL AND OTHER SERVICES TO THE MEDICALLY UNDERSERVED IN UTAH REGARDLESS OF THEIR ABILITY TO PAY.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense12347161Expense
Revenue6946185Revenue
DescriptionCOMMUNITY HEALTH CENTERS PROVIDED PRIMARY MEDICAL CARE TO 22,000 PATIENTS WITH OVER 72,000 INDIVIDUAL VISITS, ORAL HEALTH CARE TO 2,700 PATIENTS WITH ALMOST 9,000 INDIVIDUAL VISITS AND BEHAVIORAL HEALTH CARE TO OVER 600 PATIENTS WITH OVER 1,100 INDIVIDUAL VISITS. THESE SERVICES ARE PROVIDED THROUGH DIRECT SERVICE HEALTH CLINICS TO LOW INCOME AND MEDICALLY UNDERSERVED POPULATIONS THROUGHOUT THE STATE OF UTAH. PRIMARY MEDICAL CARE INCLUDES A SPECIAL EMPHASIS ON PEDIATRIC MEDICINE, WITH OVER 13,000 WELL CHILD CHECKUPS AND 26,000 VACCINES GIVEN TO CHILDREN UNDER 18. ORAL HEALTH CARE INCLUDES AN EDUCATIONAL OUTREACH PROGRAM AND FLUORIDE TREATMENTS FOR CHILDREN IN LOCAL TITLE I ELEMENTARY SCHOOLS.Description
Total Program Service Expense12347161TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiestrueFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshptrueOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionstrueDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntityfalseRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109631NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees184NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionstrueQuidProQuoContributions
Quid Pro Quo DisclosuretrueQuidProQuoDisclosure
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members13NbrVotingGoverningBodyMembers
Number Independent Voting Members13NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledUTStatesWhereCopyOfReturnIsFiled
Other WebsiteXOtherWebsite
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1COMMUNITY HEALTH CENTERS INCBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number8014126920TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1220 WEST 7200 SOUTH SUITE AAddressLine1
CityMIDVALECity
StateUTState
ZIP Code84047ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (21 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployee
GERRY MARTY
GOVERNOR1.50X30000
JOAQUIN CHAVEZ
GOVERNOR1.50X30000
LIDIA PEREZ
GOVERNOR1.50X30000
CINDY WHITE
GOVERNOR1.50X27500
JOSE MANUEL GAYTAN
GOVERNOR1.50X22500
BONNIE HORROCKS
GOVERNOR1.50X15000
SUZANNE DRAPER
PAST PRESIDE1.50X000X
BOB BUNNELL
PRESIDENT1.50X000X
SUSAN JOHNSTON
GOVERNOR1.50X000
MARK BRUNSON
TREASURER1.50X000X
WESLEY THOMPSON
GOVERNOR1.50X000
RACHAEL HOOLEY
SECRETARY1.50X000X
ROCIO GUZMAN
GOVERNOR1.50X000
JOHN LEWIS
GOVERNOR1.50X000
JOHN HAYNES
GOVERNOR1.50X000
DEXTER PEARCE
EXEC. DIRECT40.00120432013618X
CARL WHITTAKER
PHYSICIAN40.00181272020676X
KEITH HORWOOD
MED. DIR/PHY40.00159432018500X
DAVID GONTRUM
PHYSICIAN40.00148641021400X
DAVID TUROK
PHYSICIAN32.00139599016509X
DAVID ROBINSON
PHYSICIAN40.00138564016921X
FieldValueIRS element (for citing)
Total Reportable Comp From Org889490TotalReportableCompFromOrg
Total Other Compensation107624TotalOtherCompensation
Number Individuals GT100 K6NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
LABORATORY CORP OF AMERICA
PO BOX 12140BURLINGTONNC27216LAB TESTING490390
WASATCH SOFTWARE INC
5242 S COLLEGE DR 200MURRAYUT84123IT SUPPORT145199
ECLINICAL WORKS
TWO TECHNOLOGY DRIVEWESTBOROUGHMA01581WEB/IT SUPPORT128161
MORGAN PAVEMENT
PO BOX 190CLEARFIELDUT84089CONSTRUCTION107550
DYNAMOND BLDG MAINTENANCE
PO BOX 115PROVOUT84603JANITORIAL103542
FieldValueIRS element (for citing)
Number Of Contractors GT100 K5NumberOfContractorsGT100K
Federated Campaigns74473FederatedCampaigns
Fundraising Events2073FundraisingEvents
Government Grants5672117GovernmentGrants
All Other Contributions2597757AllOtherContributions
Noncash Contributions1433607NoncashContributions
Total Contributions8346420TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPATIENT REVENUEDescription
Business Code624100BusinessCode
Total Revenue Column6946185TotalRevenueColumn
Related Or Exempt Function Income6946185RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue6946185TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column76006TotalRevenueColumn
Exclusion$76,006ExclusionAmount
FieldValueIRS element (for citing)
Gross Income Fundraising Events14461GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events2073CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses12899FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column1562TotalRevenueColumn
Exclusion$1,562ExclusionAmount

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionMEDICAL RECORD RECEIPTSDescription
Business Code624110BusinessCode
Total Revenue Column37060TotalRevenueColumn
Exclusion$37,060ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue37060TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column15407233TotalRevenueColumn
Related Or Exempt Function Income6946185RelatedOrExemptFunctionIncome
Exclusion$114,628ExclusionAmount
FieldValueIRS element (for citing)
Info In Schedule O Part IXXInfoInScheduleOPartIX

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total135600Total
Management And General135600ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total6514111Total
Program Services5711856ProgramServices
Management And General794453ManagementAndGeneral
Fundraising7802Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total479821Total
Program Services423784ProgramServices
Management And General55385ManagementAndGeneral
Fundraising652Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total1052857Total
Program Services909783ProgramServices
Management And General141673ManagementAndGeneral
Fundraising1401Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total510960Total
Program Services440224ProgramServices
Management And General70058ManagementAndGeneral
Fundraising678Fundraising

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total12834Total
Management And General12834ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total29045Total
Management And General29045ManagementAndGeneral

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total16999Total
Management And General16999ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total1569583Total
Program Services1228125ProgramServices
Management And General337833ManagementAndGeneral
Fundraising3625Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total351383Total
Program Services231704ProgramServices
Management And General119679ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total817469Total
Program Services728126ProgramServices
Management And General89343ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total56786Total
Program Services23738ProgramServices
Management And General33048ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total64400Total
Program Services64400ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total252276Total
Program Services145097ProgramServices
Management And General107179ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total24695Total
Program Services2945ProgramServices
Management And General21750ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
MEDICAL SUPPLIES22568932256893
SMALL EQUIPMENT/SUPPLIES730305786615164
DUES & FEES691773824530832100
RECRUITMENT41240325538687

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total79920Total
Program Services51822ProgramServices
Management And General28098ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total14409079Total
Program Services12347161ProgramServices
Management And General2047660ManagementAndGeneral
Fundraising14258Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY875190BOY
EOY1300910EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY2313825BOY
EOY2500EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY544590BOY
EOY304215EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY484691BOY
EOY644464EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY103909BOY
EOY87998EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY29566BOY
EOY33082EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis3417637LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec1895068LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY1567700BOY
EOY1522569EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
EOY3351548EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY11997BOY
EOY11997EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY5931468BOY
EOY7259283EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY648927BOY
EOY705329EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY179481BOY
EOY160361EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY163708BOY
EOY457985EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY992116BOY
EOY1323675EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY4666385BOY
EOY5642639EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY272967BOY
EOY292969EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY4939352BOY
EOY5935608EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY5931468BOY
EOY7259283EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses998154ReconcilationRevenueExpenses
Reconciliation Unrealized Invest-1898ReconciliationUnrealizedInvest
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited

FS Audited Basis FSAuditedBasis

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

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org170b1 AviXPubliclySupportedOrg170b1Avi

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years10021326CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years11326568CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years7930152CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year8554196CurrentTaxYearMinus1Year
Current Tax Year8346420CurrentTaxYear
Total46178662Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years10021326CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years11326568CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years7930152CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year8554196CurrentTaxYearMinus1Year
Current Tax Year8346420CurrentTaxYear
Total46178662Total
FieldValueIRS element (for citing)
Amounts Subst Contributors Total4191270AmountsSubstContributorsTotal
Public Support Total17041987392PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years21717CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years9170CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years27CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year2127CurrentTaxYearMinus1Year
Current Tax Year76006CurrentTaxYear
Total109047Total

Other Income170 OtherIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years24065CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year23683CurrentTaxYearMinus1Year
Current Tax Year38622CurrentTaxYear
Total86370Total
FieldValueIRS element (for citing)
Total Support46374079TotalSupport
Gross Receipts From Admissions Etc34749135GrossReceiptsFromAdmissionsEtc
Public Support Pertcentage1700.90540PublicSupportPertcentage170
Public Support Pertcent Prior Year0.91110PublicSupportPertcentPriorYear
Thirty Three Percnt Tests CY170XThirtyThreePercntTestsCY170

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

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

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Investment Cost Or Other Basis89635InvestmentCostOrOtherBasis
Book Value89635BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis465365InvestmentCostOrOtherBasis
Depreciation162878Depreciation
Book Value302487BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Investment Cost Or Other Basis1739981InvestmentCostOrOtherBasis
Depreciation1089817Depreciation
Book Value650164BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Investment Cost Or Other Basis979726InvestmentCostOrOtherBasis
Depreciation589174Depreciation
Book Value390552BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis142930InvestmentCostOrOtherBasis
Depreciation53199Depreciation
Book Value89731BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings1522569TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities (2 entries)

DescriptionDescriptionAmountAmount
GOVERNMENT CONTRACT LIABILITY$366,169
DEFERRED RENT$91,816
FieldValueIRS element (for citing)
Total Of Amounts457985TotalOfAmounts
Tot Revenue Etc Audited Fincl Stmt17885041TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments-1898NetUnrealizedGainsInvestments
Donated Srvc And Use Of Facilities2483806DonatedSrvcAndUseOfFacilities
Other Revenues12899OtherRevenues
Revenue Not Rptd F9902494807RevenueNotRptdF990
Revenue Subtotal15390234RevenueSubtotal
Other Revenues Not Included16999OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt16999RevenueNotRptdOnFinStmt
Total Revenue Per Form99015407233TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt16888785TotExpensesEtcAuditedFinclStmt
Donated Services Use Of Facilities2483806DonatedServicesUseOfFacilities
Other Expenses Included12899OtherExpensesIncluded
Expenses Not Rptd F9902496705ExpensesNotRptdF990
Expenses Subtotal14392080ExpensesSubtotal
Other Expenses Not Included16999OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt16999ExpensesNotRptdOnFinStmt
Total Expenses Per Form99014409079TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
REVENUE AMOUNTS INCLUDED IN FINANCIALS - OTHERSCHEDULE D, PAGE 4, PART XI, LINE 2DFUNDRAISING DIRECT EXPENSES 12,899
REVENUE AMOUNTS INCLUDED ON RETURN - OTHERSCHEDULE D, PAGE 4, PART XI, LINE 4BINVESTMENT MGT FEES RECLASSED 16,999
EXPENSE AMOUNTS INCLUDED IN FINANCIALS - OTHERSCHEDULE D, PAGE 4, PART XII, LINE 2DFUNDRAISING DIRECT EXPENSES 12,899
EXPENSE AMOUNTS INCLUDED ON RETURN - OTHERSCHEDULE D, PAGE 4, PART XII, LINE 4BINVESTMENT MGT FEES RECLASSED 16,999

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1BREAKFAST-MOMSNameOfEvent1
Gross Receipts Event19673GrossReceiptsEvent1
Charitable Contributions Event12073CharitableContributionsEvent1
Gross Revenue Event17600GrossRevenueEvent1
Food And Beverage Event11494FoodAndBeverageEvent1
Other Direct Expenses Event15637OtherDirectExpensesEvent1
Name Of Event25K/1K FUN RUNNameOfEvent2
Gross Receipts Event26861GrossReceiptsEvent2
Gross Revenue Event26861GrossRevenueEvent2
Other Direct Expenses Event25768OtherDirectExpensesEvent2
Gross Receipts Total16534GrossReceiptsTotal
Charitable Contributions Total2073CharitableContributionsTotal
Gross Revenue Total Events14461GrossRevenueTotalEvents
Food And Beverage Total Events1494FoodAndBeverageTotalEvents
Other Direct Expenses Total Events11405OtherDirectExpensesTotalEvents
Direct Expense Summary Events12899DirectExpenseSummaryEvents
Net Income Summary1562NetIncomeSummary

Schedule J IRS990ScheduleJ

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

Form990 Schedule J Part II Form990ScheduleJPartII (5 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgBonus Filing OrgBonusFilingOrgDeferred Comp Filing OrgDeferredCompFilingOrgNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgTotal Compensation Filing OrgTotalCompensationFilingOrg
CARL WHITTAKER
PHYSICIAN9592685346181332543201948
KEITH HORWOOD
MED DIRPHYSICIAN11500344429159572543177932
DAVID GONTRUM
PHYSICIAN10000648635148736527170041
DAVID TUROK
PHYSICIAN1359993600139662543156108
DAVID ROBINSON
PHYSICIAN10000638558138823039155485

Schedule L IRS990ScheduleL

Form990 Schedule L Part IV Form990ScheduleLPartIV

Name Of Interested Person NameOfInterestedPerson

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1INTERMOUNTAIN HEALTHCAREBusinessNameLine1
FieldValueIRS element (for citing)
RelationshipDIREC / OFFICERRelationship
Amount Of Transaction1777009AmountOfTransaction
Description Of TransactionIN-KIND DONATIONSDescriptionOfTransaction
Sharing Of RevenuesfalseSharingOfRevenues

Form990 Schedule L Part V Form990ScheduleLPartV

FieldValueIRS element (for citing)
IdentifierADDITIONAL INFORMATIONIdentifier
Return ReferenceSCHEDULE L PART VReturnReference
Explanation1RELATIONSHIP BETWEEN INTERESTED PERSONS AND ORGANIZATION SUZANNE DRAPER IMMEDIATE PAST PRESIDENT OF THE BOARD OF COMMUNITY HEALTH CENTERS INC IS EMPLOYED BY AND IS AN OFFICER OF INTERMOUNTAIN HEALTHCARE INTERMOUNTAIN HEALTHCARE PROVIDES DONATED SERVICES IN THE FORM OF MEDICAL SERVICES 714357 AND XRAY SERVICES 1062652Explanation

Schedule M IRS990ScheduleM

Drugs And Medical Supplies DrugsAndMedicalSupplies

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Number Of Contributions210NumberOfContributions
Noncash Contribs Rptd F9901433607NoncashContribsRptdF990
Method Of Determining RevenuesFAIR MARKET VALUEMethodOfDeterminingRevenues
FieldValueIRS element (for citing)
Any Property That Must Be HeldfalseAnyPropertyThatMustBeHeld
Review Process Unusual NC GiftsfalseReviewProcessUnusualNCGifts
Third Parties UsedfalseThirdPartiesUsed

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990FORM 990, PAGE 6, PART VI, LINE 11BTHE FINANCE DIRECTOR COMPARES THE FORM 990 TO THE AUDITED FINANCIAL STATEMENTS AND REVIEWS THE VARIOUS OTHER DISCLOSURES WITH THE EXECUTIVE DIRECTOR. A COPY OF THE FORM 990 IS ALSO PRESENTED, DISCUSSED AND APPROVED BY THE BOARD OF GOVERNORS.
ENFORCEMENT OF CONFLICTS POLICYFORM 990, PAGE 6, PART VI, LINE 12CHUMAN RESOURCES REQUIRES ALL NEW EMPLOYEES AND BOARD MEMBERS TO COMPLETE AND SIGN A CONFLICT OF INTEREST STATEMENT. OUR COMPLIANCE OFFICER REVIEWS ALL CONFLICT OF INTEREST STATEMENTS AND INVESTIGATES ANY POTENTIAL CONFLICTS. BOARD MEMBERS DO NOT VOTE ON ISSUES FOR WHICH THEY MAY HAVE A CONFLICT OF INTEREST.
COMPENSATION PROCESS FOR TOP OFFICIALFORM 990, PAGE 6, PART VI, LINE 15AHUMAN RESOURCES CONDUCTS A COMPENSATION STUDY AND MAKE RECOMMENDATIONS TO A COMMITTEE OF THE BOARD CHARGED WITH EVALUATING THE EXECUTIVE DIRECTOR'S JOB PERFORMANCE. THE COMMITTEE THEN APPROVES THE EXECUTIVE DIRECTOR'S COMPENSATION AND RENEWAL OF EMPLOYMENT AGREEMENT.
COMPENSATION PROCESS FOR OFFICERSFORM 990, PAGE 6, PART VI, LINE 15BTHE ORGANIZATION'S OFFICERS' AND KEY EMPLOYEES' COMPENSATION IS DETERMINED BY ANNUAL REVIEW AND APPROVAL BY THE ORGANIZATION'S BOARD OF GOVERNORS.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATIONFORM 990, PAGE 6, PART VI, LINE 19FINANCIAL STATEMENTS, GOVERNING DOCUMENTS, AND COMPANY POLICIES CAN BE OBTAINED BY CONTACTING ELLEN PARRISH EITHER BY PHONE AT 801-858-3455 OR BY MAIL AT 220 WEST 7200 SOUTH, SUITE A, MIDVALE UT 84047.
OTHER FEES FOR SERVICESFORM 990, PART IX, LINE 11GMEDICAL/LAB/X-RAY 527,435 150 0 LAUNDRY SERVICES 50,955 0 0 DENTAL LAB SERVICES 38,482 0 0 EQUIPMENT MAINTENANCE 45,508 216 0 JANITORIAL SERVICES 113,175 7,640 0 MEDICAL WASTE SERVICES 30,819 0 0 SECURITY SERVICES 1,812 0 0 GROUNDS MAINTENANCE 17,436 661 0 PAYROLL SERVICES 0 34,258 0 INTERPRETING SERVICES 3,746 8,280 0 INFORMATION SYSTEM SUPPORT 88,076 155,832 0 AMERICORPS 42,126 0 0 TEMP HELP 56,884 27,233 0 RESIDENTS/FELLOWS 116,998 0 0 COURIER SERVICES 0 17,255 0 MISCELLANEOUS SERVICES 78,209 72,844 0 CONTRACTED PRINTING 16,464 13,464 3,625 0 0 0 BREAKFAST-MOMS MISCELLANEOUS SERVICES 4,619 0 0 0 0 0 5K/1K FUN RUN MISCELLANEOUS SERVICES 3,835 0 0
RECONCILIATION OF CHANGES - OTHERFORM 990, PART XI, LINE 9FUNDRAISING DIRECT EXPENSES 12,899 INVESTMENT MGT FEES RECLASSED -16,999 FUNDRAISING DIRECT EXPENSES -12,899 INVESTMENT MGT FEES RECLASSED 16,999