FURP.ORG / PUBLIC DATA EXPLORER

FIRST CHOICE COMMUNITY HEALTHCARE INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
FIRST CHOICE COMMUNITY HEALTHCARE INC (EIN 85-0342798)
Tax period
2012-01-01 to 2012-12-31
Filed
2013-10-31
IRS object ID
201333049349300323
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)
Timestamp2013-10-31T10:15:29-05:00Timestamp
Tax Period End Date2012-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN850203431EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1REDW LLCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1Post Office Box 93656AddressLine1
CityAlbuquerqueCity
StateNMState
ZIP Code871993656ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN850342798EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1First Choice Community Healthcare IncBusinessNameLine1
Business Name Line2Medical/Disability TrustBusinessNameLine2
FieldValueIRS element (for citing)
Name ControlFIRSNameControl
Phone5058737400Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line12001 N Centro Familiar Blvd SWAddressLine1
CityAlbuquerqueCity
StateNMState
ZIP Code87105ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameRobert DefeliceName
TitleCEOTitle
Phone5058737400Phone
Date Signed2013-08-12DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameAlly Towle CPAName
PTINP00693045PTIN
Phone5059983200Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-02-25 16:41:14ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonRobert DeFeliceNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line12001 N Centro Familiar Blvd SWAddressLine1
CityAlbuquerqueCity
StateNMState
ZIP Code87105ZIPCode
FieldValueIRS element (for citing)
Gross Receipts1774088GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501cXOrganization501c
Web SiteN/AWebSite
Type Of Organization TrustXTypeOfOrganizationTrust
Year Formation1981YearFormation
State Legal DomicileNMStateLegalDomicile
Activity Or Mission DescriptionTo provide health and disability benefits covering persons employed by First Choice Community Healthcare, Inc. and who elect to participate in the trust.ActivityOrMissionDescription
Nbr Voting Members Governing Body0NbrVotingMembersGoverningBody
Nbr Independent Voting Members0NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year0ContributionsGrantsCurrentYear
Program Service Revenue Prior Year1996833ProgramServiceRevenuePriorYear
Program Service Revenue CY1774088ProgramServiceRevenueCY
Investment Income Prior Year0InvestmentIncomePriorYear
Investment Income Current Year0InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year1996833TotalRevenuePriorYear
Total Revenue Current Year1774088TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year0SalariesEtcPriorYear
Salaries Etc Current Year0SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year1996833OtherExpensePriorYear
Other Expenses Current Year1774088OtherExpensesCurrentYear
Total Expenses Prior Year1996833TotalExpensesPriorYear
Total Expenses Current Year1774088TotalExpensesCurrentYear
Revenues Less Expenses Prior Year0RevenuesLessExpensesPriorYear
Revenues Less Expenses CY0RevenuesLessExpensesCY
Total Assets BOY222405TotalAssetsBOY
Total Assets EOY198003TotalAssetsEOY
Total Liabilities BOY222405TotalLiabilitiesBOY
Total Liabilities EOY198003TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY0NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY0NetAssetsOrFundBalancesEOY
Mission DescriptionTo provide health and disability benefits covering persons employed by First Choice Community Healthcare, Inc. and who elect to participate in the trust.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
DescriptionProvide medical, dental and disability benefits to all participants and their dependents.Description
Described In501 C30DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip0ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities1ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required0ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity1RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10962NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees0NumberOfEmployees
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members0NbrVotingGoverningBodyMembers
Number Independent Voting Members0NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body0Form990ProvidedToGoverningBody
Conflict Of Interest Policy0ConflictOfInterestPolicy
Whistleblower Policy0WhistleblowerPolicy
Document Retention Policy0DocumentRetentionPolicy
Compensation Process CEO0CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1The OrganizationBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number5058737400TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12001 N Centro Familiar Blvd SWAddressLine1
CityAlbuquerqueCity
StateNMState
ZIP Code87105ZIPCode
FieldValueIRS element (for citing)
No Listed Persons CompensatedXNoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA

FieldValueIRS element (for citing)
Name PersonFirst Choice Community HealthcareNamePerson
TitleTrusteeTitle
Average Hours Per Week1.00AverageHoursPerWeek
Institutional TrusteeXInstitutionalTrustee
Reportable Comp From Organization0ReportableCompFromOrganization
Reportable Comp From Related Orgs0ReportableCompFromRelatedOrgs
Other Compensation0OtherCompensation
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation0TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K0TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation

Name Of Contractor NameOfContractor

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1Meritain HealthBusinessNameLine1

Address Of Contractor AddressOfContractor

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO Box 285AddressLine1
CityPeoriaCity
StateILState
ZIP Code61650ZIPCode
FieldValueIRS element (for citing)
Description Of ServicesHealth Insurance ClaimsDescriptionOfServices
Compensation360051Compensation
FieldValueIRS element (for citing)
Number Of Contractors GT100 K1NumberOfContractorsGT100K

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionContributionsDescription
Business Code525100BusinessCode
Total Revenue Column1774088TotalRevenueColumn
Related Or Exempt Function Income1774088RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue1774088TotalProgramServiceRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column1774088TotalRevenueColumn
Related Or Exempt Function Income1774088RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Other Expenses OtherExpenses (3 entries)

DescriptionDescriptionTotalTotal
Benefits Paid for Parti1393739
Reinsurance Expense259935
Administrative Expenses120414

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total1774088Total

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY65711BOY
EOY41622EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY156694BOY
EOY156381EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY222405BOY
EOY198003EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY22340BOY
EOY58003EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY200065BOY
EOY140000EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY222405BOY
EOY198003EOY
FieldValueIRS element (for citing)
Do Not Follow SFAS117XDoNotFollowSFAS117

Cap Stck Trst Prin Current Funds CapStckTrstPrinCurrentFunds

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Paid In Cap Srpls Land Bldg Eqp Fund PaidInCapSrplsLandBldgEqpFund

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Retained Earnings Endowment Etc RetainedEarningsEndowmentEtc

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY222405BOY
EOY198003EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses0ReconcilationRevenueExpenses
Reconcilation Other Changes0ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement SeparateXFinancialStatementSeparate
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Total Of Book Value Land Buildings0TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionDue to SponsorDescription
Amount$140,000Amount
FieldValueIRS element (for citing)
Total Of Amounts140000TotalOfAmounts
Tot Revenue Etc Audited Fincl Stmt1774088TotRevenueEtcAuditedFinclStmt
Revenue Not Rptd F9900RevenueNotRptdF990
Revenue Subtotal1774088RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form9901774088TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt1774088TotExpensesEtcAuditedFinclStmt
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal1774088ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form9901774088TotalExpensesPerForm990

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (3 entries)

Return ReferenceReturnReferenceExplanationExplanation
Form 990, Part VI, Section B, line 11The Form 990 is reviewed by its trustee's, First Choice Community Healthcare, Inc, CFO.
Form 990, Part VI, Section C, line 19The trustee's CFO is in possession of the documents which are available upon request at the Albuquerque office location.
PART XII, LINE 2CThe trustee's Finance Committee and Board oversee the audit. This was also the process in the prior year.

Schedule R IRS990ScheduleR

Form990 Schedule R Part II Form990ScheduleRPartII

Name Of Disregarded Entity NameOfDisregardedEntity

FieldValueIRS element (for citing)
Business Name Line1First Choice Community Healthcare IncBusinessNameLine1

Address US AddressUS

FieldValueIRS element (for citing)
Address Line12001 N Centro Familiar Blvd SWAddressLine1
CityAlbuquerqueCity
StateNMState
ZIP Code87105ZIPCode
FieldValueIRS element (for citing)
EIN850224409EIN
Primary ActivitiesProvide medical and dental care and health education at selected locationsPrimaryActivities
Legal Domicile StateNMLegalDomicileState
Exempt Code Section501(c)(3)ExemptCodeSection
Public Charity Status170(b)(1)(A)(iii)PublicCharityStatus
Direct Controlling Entity NAN/ADirectControllingEntityNA
Controlled Org0ControlledOrg
FieldValueIRS element (for citing)
Receipt Of Int Ann Rents Royalties0ReceiptOfIntAnnRentsRoyalties
Gift Grant Or Cap Contr To Other Org0GiftGrantOrCapContrToOtherOrg
Gift Grant Or Cap Contr Fr Other Org0GiftGrantOrCapContrFrOtherOrg
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrg
Loans Or Guarantees From Other Org0LoansOrGuaranteesFromOtherOrg
Dividends Related Organization0DividendsRelatedOrganization
Sale Of Assets To Other Org0SaleOfAssetsToOtherOrg
Purchase Of Assets From Other Org0PurchaseOfAssetsFromOtherOrg
Exchange Of Assets0ExchangeOfAssets
Rental Of Facilities To Other Orgs0RentalOfFacilitiesToOtherOrgs
Rental Of Facilities Fr Other Orgs0RentalOfFacilitiesFrOtherOrgs
Perform Of Services For Other Orgs0PerformOfServicesForOtherOrgs
Perform Of Services By Other Orgs0PerformOfServicesByOtherOrgs
Sharing Of Facilities0SharingOfFacilities
Sharing Of Paid Employees0SharingOfPaidEmployees
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrg
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrg
Other Transfer To Other Org0OtherTransferToOtherOrg
Other Transfer From Other Org0OtherTransferFromOtherOrg