VALLEY-WIDE HEALTH SYSTEMS INC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
VALLEY-WIDE HEALTH SYSTEMS INC (EIN 84-0706945)
Tax period
2010-07-01 to 2011-06-30
Filed
2012-03-19
IRS object ID
201220869349300332
Schema version
2010v3.4
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)
Timestamp2012-03-19T17:51:34-07:00Timestamp
Tax Period End Date2011-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1TCA Partners LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line11111 E Herndon Avenue Suite 211AddressLine1
CityFresnoCity
StateCAState
ZIP Code93720ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN840706945EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1Valley-Wide Health Systems IncBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlVALLNameControl
Phone7195895161Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1128 Market StreetAddressLine1
CityAlamosaCity
StateCOState
ZIP Code81101ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameJeanne DarricadesName
TitlePresident and CEOTitle
Phone7195895161Phone
Date Signed2012-01-17DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameJeremy WareName
Phone5594317708Phone
Date Prepared2012-01-02DatePrepared
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonJeanne DarricadesNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1C/O VWHSAddressLine1
Address Line2128 Market StreetAddressLine2
CityAlamosaCity
StateCOState
ZIP Code81101ZIPCode
FieldValueIRS element (for citing)
Gross Receipts27151291GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web Sitewww.vwhs.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1976YearFormation
State Legal DomicileCOStateLegalDomicile
Activity Or Mission DescriptionValley Wide Health Systems is committed to providing safe and effective health care services in a respectful and inclusive manner with special consideration for medically underserved populations.ActivityOrMissionDescription
Nbr Voting Members Governing Body13NbrVotingMembersGoverningBody
Nbr Independent Voting Members13NbrIndependentVotingMembers
Total Nbr Employees430TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year6235072ContributionsGrantsPriorYear
Contributions Grants Current Year6805070ContributionsGrantsCurrentYear
Program Service Revenue Prior Year19469922ProgramServiceRevenuePriorYear
Program Service Revenue CY19963137ProgramServiceRevenueCY
Investment Income Prior Year-52511InvestmentIncomePriorYear
Investment Income Current Year19063InvestmentIncomeCurrentYear
Other Revenue Prior Year246172OtherRevenuePriorYear
Other Revenue Current Year364021OtherRevenueCurrentYear
Total Revenue Prior Year25898655TotalRevenuePriorYear
Total Revenue Current Year27151291TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year27719GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year17553482SalariesEtcPriorYear
Salaries Etc Current Year17434708SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year283733TotalFundrsngExpCurrentYear
Other Expense Prior Year7449910OtherExpensePriorYear
Other Expenses Current Year8403496OtherExpensesCurrentYear
Total Expenses Prior Year25031111TotalExpensesPriorYear
Total Expenses Current Year25838204TotalExpensesCurrentYear
Revenues Less Expenses Prior Year867544RevenuesLessExpensesPriorYear
Revenues Less Expenses CY1313087RevenuesLessExpensesCY
Total Assets BOY17894164TotalAssetsBOY
Total Assets EOY17710808TotalAssetsEOY
Total Liabilities BOY8613216TotalLiabilitiesBOY
Total Liabilities EOY7116773TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY9280948NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY10594035NetAssetsOrFundBalancesEOY
Mission DescriptionValley Wide Health Systems is committed to providing safe and effective health care services in a respectful and inclusive manner with special consideration for medically underserved populations.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense20679893Expense
Grants0Grants
Revenue19963137Revenue
DescriptionValley Wide Health Systems, Inc is a private, non-profit, Community health center, serving 17 counties in southern rural Colorado since 1976, with full Joint Commission accreditation since 1997. The mission of the organization directs Valley-Wide's scope of services, which is to provide quality, comprehensive health care services in a respectful and inclusive manner, with special consideration for medically underserved populations. This specifically includes patients who are uninsured, underinsured, or who have limited access to primary health and dental care services. Valley Wide provides safe and effective comprehensive primary and oral health care services, in addition to a Farmworker Health Service Program that provides services through vouchers in areas of the state that do not house C/MHCs and to improve the health status of underserved and vulnerable populations. In 2010, Valley Wide served 36,353 patients through 147,840 visits and outreach services.Description
Total Of Other Program Service Exp0TotalOfOtherProgramServiceExp
Total Of Other Program Service Grnt0TotalOfOtherProgramServiceGrnt
Total Of Other Program Service Rev0TotalOfOtherProgramServiceRev
Total Program Service Expense20679893TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required0ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities0ReportOtherLiabilities
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 Activities1FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
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 Entity0RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109681NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees430NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members13NbrVotingGoverningBodyMembers
Number Independent Voting Members13NumberIndependentVotingMembers
Family Or Business Relationship1FamilyOrBusinessRelationship
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 Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledCOStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonMandi WeedNamePerson
Telephone Number7195895161TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1128 Market StreetAddressLine1
CityAlamosaCity
StateCOState
ZIP Code81101ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (25 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployee
William Warren
Member2X140000
Vivian Gallegos
Member2X130000
Teresa Martinez
Secretary2X140000
Mary Trujillo-Young
Member2X110000
Julio Paez
Member2X130000
Joseph Gambone DO
Member2X90000
Herman Martinez PhD
Member2X130000
Aurora Martinez
Chair2X120000
Annette Mullikin
Member2X120000
Andrea Balmores
Member2X60000
Kevin Ditmore
Member2X000
Keith Hovland
Treasurer2X000
Lucy Cordova
Vice Chair2X120000
Ricardo Velasquez
Chief Medical Officer40189298018473X
Alonzo Payne
Compliance Officer40000X
Christine Hettinger Hunt
Dir of Program Ops40101329013226X
Jeanne Darricades
President and CEO40000X
Ben Duarte
HR Directer40000X
Mandi Weed
CFO40102146010400X
Nancy Goodare Rosenthal
Dental Director40174558018090X
Marc Rosenthal
Dentist4016399009980X
Vui Mai
Physician40232482010650X
Kristina Steinberg
Physician40151918016725X
Justin Wheeler
Physician40173717010164X
Jason Morgensen
Physician40159040010920X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1461378TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation118628TotalOtherCompensation
Number Individuals GT100 K25NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (5 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
Terras Cleaning LLC
4017 W County Road 8 NorthDel NorteCO81132Janitorial Service387263
HE Whitlock
4808 Dillon DrivePuebloCO81008Construction Contractor1242122
Alcon Construction
12233 Country Road 5 SouthAlamosaCO81101Construction Contractor663407
Linde Healthcare Staffing
PO Box 915241DallasTX75391Contracted Physicians236551
Bassett Construction Company
PO Box 173PuebloCO81002Construction Contractor221181
FieldValueIRS element (for citing)
Number Of Contractors GT100 K8NumberOfContractorsGT100K
Federated Campaigns0FederatedCampaigns
Membership Dues0MembershipDues
Fundraising Events46190FundraisingEvents
Related Organizations0RelatedOrganizations
Government Grants6758880GovernmentGrants
All Other Contributions0AllOtherContributions
Noncash Contributions0NoncashContributions
Total Contributions6805070TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionPatient and Contract ServicesDescription
Business Code623990BusinessCode
Total Revenue Column19963137TotalRevenueColumn
Related Or Exempt Function Income19963137RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Total Oth Program Service Revenue TotalOthProgramServiceRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount
FieldValueIRS element (for citing)
Total Program Service Revenue19963137TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column19063TotalRevenueColumn
Related Or Exempt Function Income19063RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
Related Or Exempt Function Income0RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real45142Real
Personal0Personal

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real0Real
Personal0Personal

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real45142Real
Personal0Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column45142TotalRevenueColumn
Related Or Exempt Function Income45142RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities0Securities
Other0Other
FieldValueIRS element (for citing)
Cntrbtns Rprtd Fundraising Events46190CntrbtnsRprtdFundraisingEvents

Miscellaneous Revenue MiscellaneousRevenue

FieldValueIRS element (for citing)
Total Revenue Column318879TotalRevenueColumn
Related Or Exempt Function Income318879RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue318879TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column27151291TotalRevenueColumn
Related Or Exempt Function Income20346221RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total480178Total
Management And General343188ManagementAndGeneral
Fundraising136990Fundraising

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total14249544Total
Program Services11883439ProgramServices
Management And General2267207ManagementAndGeneral
Fundraising98898Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total260955Total
Program Services197085ProgramServices
Management And General58295ManagementAndGeneral
Fundraising5575Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total1423162Total
Program Services1105188ProgramServices
Management And General295164ManagementAndGeneral
Fundraising22810Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1020869Total
Program Services824560ProgramServices
Management And General179146ManagementAndGeneral
Fundraising17163Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total237435Total
Program Services17182ProgramServices
Management And General220253ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total8698Total
Management And General8698ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total174173Total
Management And General174173ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total25000Total
Management And General25000ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total1067396Total
Program Services1015396ProgramServices
Management And General52000ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total73857Total
Program Services33529ProgramServices
Management And General40328ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total100702Total
Program Services82579ProgramServices
Management And General18123ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total408877Total
Program Services310623ProgramServices
Management And General98254ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total852901Total
Program Services670015ProgramServices
Management And General180589ManagementAndGeneral
Fundraising2297Fundraising

Travel Travel

FieldValueIRS element (for citing)
Total296612Total
Program Services237911ProgramServices
Management And General58701ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total66652Total
Program Services39170ProgramServices
Management And General27482ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total258908Total
Program Services148839ProgramServices
Management And General110069ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total527140Total
Program Services272126ProgramServices
Management And General255014ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total65095Total
Program Services41887ProgramServices
Management And General23208ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
Supplies16017841505577962070
Professional Fees920025836299837260
Bad Debt96130496130400
Postage and Shipping4453829388151500
Equipment Rental311268250373608950

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total401131Total
Program Services217423ProgramServices
Management And General183708ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total25838204Total
Program Services20679893ProgramServices
Management And General4874578ManagementAndGeneral
Fundraising283733Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY95869BOY
EOY52815EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY3740961BOY
EOY1929747EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY1087217BOY
EOY269417EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY952810BOY
EOY1326751EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY373581BOY
EOY346492EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY405130BOY
EOY365669EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis17747070LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec4745495LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY11010120BOY
EOY13001575EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY228476BOY
EOY418342EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY17894164BOY
EOY17710808EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY2059524BOY
EOY1877436EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY2239361BOY
EOY1150732EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY4314331BOY
EOY4088605EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY8613216BOY
EOY7116773EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY9280948BOY
EOY10594035EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY0EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY9280948BOY
EOY10594035EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY17894164BOY
EOY17710808EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses1313087ReconcilationRevenueExpenses
Reconcilation Other Changes0ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review1AccountantCompileOrReview
FS Audited1FSAudited
Audit Committee1AuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit Required1FederalGrantAuditRequired
Federal Grant Audit Performed1FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org170b1 AviXPubliclySupportedOrg170b1Avi

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years5221264CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years5277000CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years5701560CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year6235072CurrentTaxYearMinus1Year
Current Tax Year6805070CurrentTaxYear
Total29239966Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years5221264CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years5277000CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years5701560CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year6235072CurrentTaxYearMinus1Year
Current Tax Year6805070CurrentTaxYear
Total29239966Total
FieldValueIRS element (for citing)
Public Support Total17029239966PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years148805CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years80019CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years56358CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year69663CurrentTaxYearMinus1Year
Current Tax Year64205CurrentTaxYear
Total419050Total

Other Income170 OtherIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years453078CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years177630CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years305326CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year198772CurrentTaxYearMinus1Year
Current Tax Year318879CurrentTaxYear
Total1453685Total
FieldValueIRS element (for citing)
Total Support31112701TotalSupport
Public Support Pertcentage1700.93981PublicSupportPertcentage170
Public Support Pertcent Prior Year0.9412PublicSupportPertcentPriorYear
Thirty Three Percnt Tests CY170XThirtyThreePercntTestsCY170
General ExplanationNone.GeneralExplanation

Schedule C IRS990ScheduleC

Total Grassroots Lobbying TotalGrassrootsLobbying

FieldValueIRS element (for citing)
Filing Organizations Totals0FilingOrganizationsTotals

Total Direct Lobbying TotalDirectLobbying

FieldValueIRS element (for citing)
Filing Organizations Totals75882FilingOrganizationsTotals

Total Lobbying Expenditures TotalLobbyingExpenditures

FieldValueIRS element (for citing)
Filing Organizations Totals75882FilingOrganizationsTotals

Other Exempt Purpose Expenditures OtherExemptPurposeExpenditures

FieldValueIRS element (for citing)
Filing Organizations Totals25762322FilingOrganizationsTotals

Total Exempt Purpose Expenditures TotalExemptPurposeExpenditures

FieldValueIRS element (for citing)
Filing Organizations Totals25838204FilingOrganizationsTotals

Lobbying Nontaxable LobbyingNontaxableAmount

FieldValueIRS element (for citing)
Filing Organizations Totals1000000FilingOrganizationsTotals

Grassroots Nontaxable GrassrootsNontaxableAmount

FieldValueIRS element (for citing)
Filing Organizations Totals250000FilingOrganizationsTotals

Tot Lobbying Grassroot Minus Non Tx TotLobbyingGrassrootMinusNonTx

FieldValueIRS element (for citing)
Filing Organizations Totals0FilingOrganizationsTotals

Tot Lobby Expend Mns Lobbying Nontx TotLobbyExpendMnsLobbyingNontx

FieldValueIRS element (for citing)
Filing Organizations Totals0FilingOrganizationsTotals

Lobbying Nontaxable Amount2 LobbyingNontaxableAmount2

FieldValueIRS element (for citing)
Current Year Minus30CurrentYearMinus3
Current Year Minus20CurrentYearMinus2
Current Year Minus11000000CurrentYearMinus1
Current Year1000000CurrentYear
Total2000000Total
FieldValueIRS element (for citing)
Lobbying Ceiling$3,000,000LobbyingCeilingAmount

Total Lobbying Expenditures2 TotalLobbyingExpenditures2

FieldValueIRS element (for citing)
Current Year Minus30CurrentYearMinus3
Current Year Minus20CurrentYearMinus2
Current Year Minus1281183CurrentYearMinus1
Current Year75882CurrentYear
Total357065Total

Grassroots Nontaxable Amount2 GrassrootsNontaxableAmount2

FieldValueIRS element (for citing)
Current Year Minus30CurrentYearMinus3
Current Year Minus20CurrentYearMinus2
Current Year Minus1250000CurrentYearMinus1
Current Year250000CurrentYear
Total500000Total
FieldValueIRS element (for citing)
Grassroots Ceiling$750,000GrassrootsCeilingAmount

Grassroots Lobbying Expenditures GrassrootsLobbyingExpenditures

FieldValueIRS element (for citing)
Current Year Minus30CurrentYearMinus3
Current Year Minus20CurrentYearMinus2
Current Year Minus119485CurrentYearMinus1
Current Year0CurrentYear
Total19485Total

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Investment Cost Or Other Basis600486InvestmentCostOrOtherBasis
Other Cost Or Other Basis0OtherCostOrOtherBasis
Book Value600486BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis10862444InvestmentCostOrOtherBasis
Other Cost Or Other Basis0OtherCostOrOtherBasis
Depreciation4745495Depreciation
Book Value6116949BookValue

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Investment Cost Or Other Basis0InvestmentCostOrOtherBasis
Other Cost Or Other Basis0OtherCostOrOtherBasis
Depreciation0Depreciation
Book Value0BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Investment Cost Or Other Basis4123892InvestmentCostOrOtherBasis
Other Cost Or Other Basis0OtherCostOrOtherBasis
Depreciation0Depreciation
Book Value4123892BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Investment Cost Or Other Basis2160248InvestmentCostOrOtherBasis
Other Cost Or Other Basis0OtherCostOrOtherBasis
Depreciation0Depreciation
Book Value2160248BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings13001575TotalOfBookValueLandBuildings
Total Revenue27151291TotalRevenue
Total Expenses25838204TotalExpenses
Excess Or Deficit For Year1313087ExcessOrDeficitForYear
Net Unrealized GL On Investments0NetUnrealizedGLOnInvestments
Donated Services And Facilities0DonatedServicesAndFacilities
Investment Expenses0InvestmentExpenses
Prior Period Adjustments0PriorPeriodAdjustments
Other$0OtherAmount
Total Adjustments0TotalAdjustments
Excess Or Deficit Per FS1313087ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt27151291TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments0NetUnrealizedGainsInvestments
Donated Srvc And Use Of Facilities0DonatedSrvcAndUseOfFacilities
Recoveries Of Prior Year Grants0RecoveriesOfPriorYearGrants
Other Revenues0OtherRevenues
Revenue Not Rptd F9900RevenueNotRptdF990
Revenue Subtotal27151291RevenueSubtotal
Investment Expenses Not Included0InvestmentExpensesNotIncluded
Other Revenues Not Included0OtherRevenuesNotIncluded
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form99027151291TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt25838204TotExpensesEtcAuditedFinclStmt
Donated Services Use Of Facilities0DonatedServicesUseOfFacilities
Prior Year Adjustments0PriorYearAdjustments
Losses Reported0LossesReported
Other Expenses Included0OtherExpensesIncluded
Expenses Not Rptd F9900ExpensesNotRptdF990
Expenses Subtotal25838204ExpensesSubtotal
Investment Expenses Not Included20InvestmentExpensesNotIncluded2
Other Expenses Not Included0OtherExpensesNotIncluded
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form99025838204TotalExpensesPerForm990

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1Charity PlayNameOfEvent1
Gross Receipts Event146190GrossReceiptsEvent1
Charitable Contributions Event146190CharitableContributionsEvent1
Gross Revenue Event10GrossRevenueEvent1
Cash Prizes Event10CashPrizesEvent1
Non Cash Prizes Event10NonCashPrizesEvent1
Rent Facility Costs Event10RentFacilityCostsEvent1
Food And Beverage Event10FoodAndBeverageEvent1
Entertainment Event10EntertainmentEvent1
Other Direct Expenses Event10OtherDirectExpensesEvent1
Food And Beverage Other Events0FoodAndBeverageOtherEvents
Entertainment Other Events0EntertainmentOtherEvents
Gross Receipts Total46190GrossReceiptsTotal
Charitable Contributions Total46190CharitableContributionsTotal
Gross Revenue Total Events0GrossRevenueTotalEvents
Cash Prizes Total Events0CashPrizesTotalEvents
Non Cash Prizes Total Events0NonCashPrizesTotalEvents
Rent Facility Costs Total Events0RentFacilityCostsTotalEvents
Food And Beverage Total Events0FoodAndBeverageTotalEvents
Entertainment Total Events0EntertainmentTotalEvents
Other Direct Expenses Total Events0OtherDirectExpensesTotalEvents
Direct Expense Summary Events0DirectExpenseSummaryEvents
Net Income Summary0NetIncomeSummary

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan0SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (7 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
Ricardo Velasquez
189298000000011307020060502118270
Nancy Goodare Rosenthal
174558000000011201018575901806860
Vui Mai
2324820225960119400003864027088202170150
Marc Rosenthal
16399000000003550016754001675400
Justin Wheeler
17371701971203220003624019737501600960
Kristina Steinberg
151918028650413000110080166204000
Jason Morgensen
1590400133910424000010920018759101514490

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
F990_P00_S00_L0AForm 990, Header, Line APaper Filing Pursuant to Notice 2012-4.
F990_P06_S0A_L02Form 990, Part VI, Section A, Line 2Dental director (officer) is married to a key employee with salary greater than $150,000
F990_P06_S0B_L11aForm 990, Part VI, Section B, Line 11aThe 990 is reviewed at the monthly Board of Directors meeting prior to submission of the 990 to the Internal Revenue Service.
F990_P06_S0B_L12cForm 990, Part VI, Section B, Line 12cReviewed annually; conflicts are declared at the beginning of each Board of Directors meeting. Employees are required to update on an annual basis.
F990_P06_S0B_L15Form 990, Part VI, Section B, Line 15Market survey from numerous sources, including CCHN, BofL and Mountain State Employers.
F990_P06_S0C_L19Form 990, Part VI, Section C, Line 19Upon request

Reasonable Cause Explanation ReasonableCauseExplanation

FieldValueIRS element (for citing)
ExplanationAdditional time to gather information for return.Explanation

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