BOUNDARY REGIONAL COMMUNITY HEALTH CENTER INC: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- BOUNDARY REGIONAL COMMUNITY HEALTH CENTER INC (EIN 04-3634356)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-11-11
- IRS object ID
- 201333169349302083
- 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 | 2013-11-11T15:38:51-06:00 | Timestamp |
| Tax Period End Date | 2012-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 410746749 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3000 NORTHUP WAY SUITE 200 | AddressLine1 |
| City | BELLEVUE | City |
| State | WA | State |
| ZIP Code | 98004 | 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 | 043634356 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BOUNDARY REGIONAL HEALTH CENTER INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | BOUN | NameControl |
| Phone | 2082678422 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 30410 HIGHWAY 200 | AddressLine1 |
| City | PONDERAY | City |
| State | ID | State |
| ZIP Code | 83852 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | VICTORIA MCCLELLAN KING CEO | Name |
| Title | CEO | Title |
| Phone | 2082678422 | Phone |
| Date Signed | 2013-11-08 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | DANIEL M FREIN | Name |
| PTIN | P00856532 | PTIN |
| Phone | 4252506100 | Phone |
| Date Prepared | 2013-11-08 | 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) |
|---|---|---|
| Address Change | X | AddressChange |
Doing Business As DoingBusinessAs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KANIKSU HEALTH SERVICE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | VICTORIA MCCLELLAN KING | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 30410 HIGHWAY 200 | AddressLine1 |
| City | PONDERAY | City |
| State | ID | State |
| ZIP Code | 83852 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 5821536 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | N/A | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 2002 | YearFormation |
| State Legal Domicile | ID | StateLegalDomicile |
| Activity Or Mission Description | THE MISSION OF KANKSU HEALTH SERVICES IS TO PROVIDE HIGH QUALITY, COST EFFECTIVE, CULTURALLY SENSITIVE HEALTH CARE SERVICES. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 9 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 9 | NbrIndependentVotingMembers |
| Total Nbr Employees | 103 | TotalNbrEmployees |
| Total Nbr Volunteers | 9 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 2441291 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 1718254 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 3247881 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 4103282 | 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 | 5689172 | TotalRevenuePriorYear |
| Total Revenue Current Year | 5821536 | 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 | 3801786 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 4407170 | 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 | 1514734 | OtherExpensePriorYear |
| Other Expenses Current Year | 1556046 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 5316520 | TotalExpensesPriorYear |
| Total Expenses Current Year | 5963216 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 372652 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | -141680 | RevenuesLessExpensesCY |
| Total Assets BOY | 2761411 | TotalAssetsBOY |
| Total Assets EOY | 2770913 | TotalAssetsEOY |
| Total Liabilities BOY | 2337821 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 2489003 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 423590 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 281910 | NetAssetsOrFundBalancesEOY |
| Mission Description | THE MISSION OF KANIKSU HEALTH SERVICES IS TO PROVIDE HIGH QUALITY, COST EFFECTIVE, CULTURALLY SENSITIVE HEALTH CARE SERVICES. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 5030808 | Expense |
| Revenue | 3973133 | Revenue |
| Description | KANIKSU HEALTH SERVICES (CENTER) PROVIDED MEDICAL VISITS AND DENTAL VISITS TO THE CITIZENS OF BOUNDARY AND BONNER COUNTIES. THESE SERVICES WERE PROVIDED TO ALL WHO NEEDED MEDICAL OR DENTAL ATTENTION REGARDLESS OF A PERSONS ABILITY TO PAY. THE CENTER UTILIZES A SLIDING FEE SCHEDULE UP TO 200% OF THE FEDERAL POVERTY GUIDELINES. FOR APPLICANTS THAT QUALIFY BASED ON INCOME AND FAMILY SIZE, A PORTION OF OR ALL THEIR CHARGES MAY BE FORGONE FOR A NOMINAL FEE OR A PERCENTAGE OF CHARGES. | Description |
| Total Program Service Expense | 5030808 | 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 | 0 | 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 | 1 | 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 | 11 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 103 | 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 |
| Indoor Tanning Services | 0 | 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 | 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 | 0 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| Other Explain In Sch O | X | OtherExplainInSchO |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE ORGANIZATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 2082678422 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 30410 HIGHWAY 200 | AddressLine1 |
| City | PONDERAY | City |
| State | ID | State |
| ZIP Code | 83852 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (16 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| STEVE FOORD | |||||||
| BOARD SECRETARY | 2.00 | X | 0 | 0 | 0 | ||
| KRIS TAYLOR | |||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||
| SUSAN EDWARDS | |||||||
| BOARD SECRETARY | 2.00 | X | 0 | 0 | 0 | ||
| STEPHEN ACKER | |||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||
| RAY MILLER | |||||||
| BOARD CHAIRMAN | 2.00 | X | 0 | 0 | 0 | ||
| SHEILA FARMINAUMICK | |||||||
| BOARD VICE CHAIR | 2.00 | X | 0 | 0 | 0 | ||
| MARY READER | |||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||
| ERIN DELUDE | |||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||
| JOE ENGLISH | |||||||
| DIRECTOR | 2.00 | X | 0 | 0 | 0 | ||
| VICTORIA MCCLELLAN KING | |||||||
| CHIEF EXECUTIVE OFFICER | 40.00 | 100048 | 0 | 6529 | X | ||
| KEVIN KNEPPER | |||||||
| CHIEF FINANCIAL OFFICER | 40.00 | 82598 | 0 | 6517 | X | ||
| TOM LAWRENCE MD | |||||||
| CHIEF MEDICAL OFFICER | 40.00 | 189119 | 0 | 7030 | X | ||
| WARD LEEDY | |||||||
| EMPLOYEE | 40.00 | 204090 | 0 | 7030 | X | ||
| JAMIE HETTICK | |||||||
| EMPLOYEE | 40.00 | 162240 | 0 | 6529 | X | ||
| JEFFERY FOWLER | |||||||
| EMPLOYEE | 40.00 | 157015 | 0 | 6780 | X | ||
| STEVEN PUFFER | |||||||
| EMPLOYEE | 40.00 | 140332 | 0 | 6780 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1035442 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 47195 | TotalOtherCompensation |
| Number Individuals GT100 K | 6 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
| Number Of Contractors GT100 K | 0 | NumberOfContractorsGT100K |
| Government Grants | 1718254 | GovernmentGrants |
| Total Contributions | 1718254 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome | ExclusionExclusionAmount |
|---|---|---|---|---|
| PATIENT SERVICE REVENU | 621110 | 3973133 | 3973133 | |
| MISCELLANEOUS | 561499 | 130149 | $130,149 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 4103282 | TotalProgramServiceRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 5821536 | TotalRevenueColumn |
| Related Or Exempt Function Income | 3973133 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $130,149 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 402005 | Total |
| Program Services | 364251 | ProgramServices |
| Management And General | 37754 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3276183 | Total |
| Program Services | 2972283 | ProgramServices |
| Management And General | 303900 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 39394 | Total |
| Program Services | 34326 | ProgramServices |
| Management And General | 5068 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 363384 | Total |
| Program Services | 325229 | ProgramServices |
| Management And General | 38155 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 326204 | Total |
| Program Services | 291953 | ProgramServices |
| Management And General | 34251 | ManagementAndGeneral |
Fees For Services Management FeesForServicesManagement
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 57953 | Total |
| Program Services | 32628 | ProgramServices |
| Management And General | 25325 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2335 | Total |
| Program Services | 1643 | ProgramServices |
| Management And General | 692 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 15098 | Total |
| Program Services | 10621 | ProgramServices |
| Management And General | 4477 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 274328 | Total |
| Program Services | 192975 | ProgramServices |
| Management And General | 81353 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 199840 | Total |
| Program Services | 133031 | ProgramServices |
| Management And General | 66809 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 337775 | Total |
| Program Services | 165510 | ProgramServices |
| Management And General | 172265 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 71313 | Total |
| Program Services | 34943 | ProgramServices |
| Management And General | 36370 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 67614 | Total |
| Program Services | 33131 | ProgramServices |
| Management And General | 34483 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 15129 | Total |
| Program Services | 12847 | ProgramServices |
| Management And General | 2282 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| SUPPLIES AND POSTAGE | 180526 | 176942 | 3584 |
| BAD DEBT | 124214 | 124214 | |
| MISC | 104431 | 51171 | 53260 |
| EQUIPMENT MAINTENANCE A | 51643 | 48468 | 3175 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 53847 | Total |
| Program Services | 24642 | ProgramServices |
| Management And General | 29205 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5963216 | Total |
| Program Services | 5030808 | ProgramServices |
| Management And General | 932408 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 75342 | BOY |
| EOY | 101484 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 557420 | BOY |
| EOY | 455921 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6604 | BOY |
| EOY | 30392 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 2651352 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 468236 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2122045 | BOY |
| EOY | 2183116 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2761411 | BOY |
| EOY | 2770913 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 829660 | BOY |
| EOY | 1042806 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1508161 | BOY |
| EOY | 1446197 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2337821 | BOY |
| EOY | 2489003 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 423590 | BOY |
| EOY | 281910 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 423590 | BOY |
| EOY | 281910 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2761411 | BOY |
| EOY | 2770913 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | -141680 | 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 | 1 | FederalGrantAuditRequired |
| Federal Grant Audit Performed | 1 | 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 | 1455776 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 1509963 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 1702521 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 2441291 | CurrentTaxYearMinus1Year |
| Current Tax Year | 1718254 | CurrentTaxYear |
| Total | 8827805 | Total |
Total170 Total170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 1455776 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 1509963 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 1702521 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 2441291 | CurrentTaxYearMinus1Year |
| Current Tax Year | 1718254 | CurrentTaxYear |
| Total | 8827805 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | 8827805 | PublicSupportTotal170 |
| Total Support | 8827805 | TotalSupport |
| Public Support Pertcentage170 | 1.00000 | PublicSupportPertcentage170 |
| Public Support Pertcent Prior Year | 1.00000 | PublicSupportPertcentPriorYear |
| Thirty Three Percnt Tests CY170 | X | ThirtyThreePercntTestsCY170 |
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
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 266881 | OtherCostOrOtherBasis |
| Book Value | 266881 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1708242 | OtherCostOrOtherBasis |
| Depreciation | 66447 | Depreciation |
| Book Value | 1641795 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 581166 | OtherCostOrOtherBasis |
| Depreciation | 388949 | Depreciation |
| Book Value | 192217 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 95063 | OtherCostOrOtherBasis |
| Depreciation | 12840 | Depreciation |
| Book Value | 82223 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 2183116 | TotalOfBookValueLandBuildings |
| Footnote In Part XIII | X | FootnoteInPartXIII |
| Tot Revenue Etc Audited Fincl Stmt | 5821536 | TotRevenueEtcAuditedFinclStmt |
| Revenue Not Rptd F990 | 0 | RevenueNotRptdF990 |
| Revenue Subtotal | 5821536 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 5821536 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 5963216 | TotExpensesEtcAuditedFinclStmt |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 5963216 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 5963216 | 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 | THE CENTER HAS RECEIVED A DETERMINATION LETTER FROM THE IRS THAT STATES IT IS EXEMPT FROM FEDERAL INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. ACCORDINGLY, NO PROVISION FOR INCOME TAXES IS SHOWN IN THE FINANCIAL STATEMENTS. MANAGEMENT EVALUATED THE CENTERS TAX POSITIONS AND CONCLUDED THAT THE CENTER HAD TAKEN NO SIGNIFICANT UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENTS TO THE FINANCIAL STATEMENTS TO COMPLY WITH THE PROVISIONS OF TOPIC 740 OF THE ACCOUNTING STANDARDS CODIFICATION. THE CENTER IS NO LONGER SUBJECT TO U.S. FEDERAL INCOME TAX EXAMINATIONS BY TAX AUTHORITIES FOR THE YEARS BEFORE 2009. | Explanation |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (4 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| TOM LAWRENCE MD | ||||||||||||||
| CHIEF MEDICAL OFFICER | 189119 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 7030 | 0 | 196149 | 0 | 5594 | 0 |
| WARD LEEDY | ||||||||||||||
| EMPLOYEE | 204090 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 7030 | 0 | 211120 | 0 | 5580 | 0 |
| JAMIE HETTICK | ||||||||||||||
| EMPLOYEE | 162240 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 6529 | 0 | 168769 | 0 | 0 | 0 |
| JEFFERY FOWLER | ||||||||||||||
| EMPLOYEE | 157015 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 6780 | 0 | 163795 | 0 | 4710 | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (6 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | THE CFO WILL REVIEW A DRAFT COPY OF THE IRS FROM 990 PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | CONFLICTS OF INTEREST ARE REVIEWED ANNUALLY FOR THE BOARD OF DIRECTORS AND ANNUALLY AT CONTRACT RENEWAL FOR KEY EMPLOYEEES. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE KANIKSU HEALTH SERVICES COMPENSATI0N MODEL - AS APPROVED BY THE BOARD OF DIRECTORS (BOD) - IS A COMPENSATION SCHEDULE BASED ON THE MOST RECENT NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTER (NACHC) REGION 10 (WASHINGTON, OREGON, IDAHO) COMPENSATION SURVEY BASED ON SIZE OF THE ORGANIZATION - ANNUAL REVENUES, SCOPE OF RESPONSIBILITY, YEARS OF EXPERIENCE AND EDUCATIONAL DEGREES, CERTIFICATIONS, ETC. ALL JOB CATEGORIES (INCLUDING CEO, OTHER OFFICERS AND KEY EMPLOYEES, ALL CLINICAL PROVIDERS AND ALL STAFF) HAVE AN ASSOCIATED COMPENSATION MODEL - THIS APPROACH HAS BEEN APPROVED BY THE BOD. THIS IS USED FOR ALL NEW HIRES AND IS EVALUATED ANNUALLY TO BE SURE THAT THERE IS INTERNAL EQUITY AMONG EMPLOYEES, ETC. THIS COMPENSATION MODEL IS ADJUSTED ANNUALLY BASED ON THE MOST RECENT NACHC DATA - RANGES OF SALARY ARE REVIEWED. IT IS THE GOAL OF KHS TO BE IN THE MEDIAN RANGE OF THE COMPENSATION MODEL - THIS APPROACH HAS BEEN APPROVED BY THE BOD. ANY ADJUSTMENTS MADE TO CURRENT EMPLOYEES WILL BE BASED ON AVAILABILITY OF BUDGET AS APPROVED BY THE BOD AND WILL BE DETERMINED BY "RANGE MOVEMENT" FOR STAFF POSITIONS AND FOR MAINTAINING COMPETITIVE RECRUITMENT AND RETENTION FOR PROVIDERS AS COMPARED TO THE OTHER COMMUNITY HEALTH CENTERS IN IDAHO AND IN REGION 10. DECISIONS ARE MADE BY THOSE WITHOUT CONFLICT AND THE DECISIONS ARE DOCUMENTED. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE CENTER DOES NOT MAKE THE GOVERNING DOCUMENTS AVAILABLE TO THE PUBLIC. AS A RESULT OF A FEDERAL AWARD, THE ORGANIZATION IS REQUIRED TO UNDERGO AN AUDIT AS REQUIRED BY THE SINGLE AUDIT ACT. THE CENTER'S FINANCIAL STATEMENTS ARE AVAILABLE ON THE FEDERAL AUDIT CLEARINGHOUSE WEBSITE. |
| FORM 990, PART XII, LINE 2C: | THE OVERSIGHT PROCESS AND METHOD FOR SELECTING THE INDEPENDENT AUDITOR HAS NOT CHANGED FROM PRIOR YEARS. |
| FORM 990, PART XII, LINE 3B: | THE CENTER IS SUBJECT TO THE PROVISIONS OF THE SINGLE AUDIT ACT AS A RESULT OF A FEDERAL AWARD. AS SUCH, THE CENTER IS REQUIRED TO UNDERGO AN AUDIT AS REQUIRED BY THE SINGLE AUDIT ACT AND OMB CIRCULAR A-133. THE SINGLE AUDIT HAS BEEN COMPLETED FOR THE REPORTING YEAR. |
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