PAJARO VALLEY COMMUNITY HEALTH TR: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization
PAJARO VALLEY COMMUNITY HEALTH TR (EIN 94-1149702)
Tax period
2011-07-01 to 2012-06-30
Filed
2012-11-13
IRS object ID
201243189349303844
Schema version
2011v1.2
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)
Timestamp2012-11-13T13:46:36-08:00Timestamp
Tax Period End Date2012-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1Hayashi & Wayland CPAsBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line11188 Padre Drive Suite 101AddressLine1
CitySalinasCity
StateCAState
ZIP Code93901ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2011-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN941149702EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1PAJARO VALLEY COMMUNITY HEALTH TRUSTBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlPAJANameControl
Phone8317615639Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line185 NIELSON STAddressLine1
CityWATSONVILLECity
StateCAState
ZIP Code95076ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameCAROLINE EISKAMPName
TitleChairmanTitle
Date Signed2012-11-13DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameMike NolanName
Phone8317596300Phone
FieldValueIRS element (for citing)
Tax Year2011TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonKATHLEEN KINGNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line185 NIELSON STAddressLine1
CityWATSONVILLECity
StateCAState
ZIP Code95076ZIPCode
FieldValueIRS element (for citing)
Gross Receipts5484824GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
All Affiliates IncludedfalseAllAffiliatesIncluded
Organization501c3XOrganization501c3
Web Sitewww.pvhealthtrust.orgWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1998YearFormation
State Legal DomicileCAStateLegalDomicile
Activity Or Mission DescriptionIMPROVE THE HEALTH AND QUALITY OF LIFE FOR ALL PEOPLE OF THE GREATER PAJARO VALLEY BY SUPPORTING PROGRAMS AND ACTIVITIES THAT ENSURE ACCESS TO HIGH QUALITY, CULTURALLY COMPETENT HEALTHCARE SERVICES THAT PROMOTE HEALTH, WELLNESS, AND DISEASE PREVENTION.ActivityOrMissionDescription
Nbr Voting Members Governing Body20NbrVotingMembersGoverningBody
Nbr Independent Voting Members20NbrIndependentVotingMembers
Total Nbr Employees22TotalNbrEmployees
Total Nbr Volunteers188TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year247605ContributionsGrantsPriorYear
Contributions Grants Current Year157883ContributionsGrantsCurrentYear
Program Service Revenue Prior Year55571ProgramServiceRevenuePriorYear
Program Service Revenue CY57801ProgramServiceRevenueCY
Investment Income Prior Year917498InvestmentIncomePriorYear
Investment Income Current Year915541InvestmentIncomeCurrentYear
Other Revenue Prior Year45301OtherRevenuePriorYear
Other Revenue Current Year47983OtherRevenueCurrentYear
Total Revenue Prior Year1265975TotalRevenuePriorYear
Total Revenue Current Year1179208TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year125000GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY150000GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year650993SalariesEtcPriorYear
Salaries Etc Current Year706568SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year92067TotalFundrsngExpCurrentYear
Other Expense Prior Year307047OtherExpensePriorYear
Other Expenses Current Year296204OtherExpensesCurrentYear
Total Expenses Prior Year1083040TotalExpensesPriorYear
Total Expenses Current Year1152772TotalExpensesCurrentYear
Revenues Less Expenses Prior Year182935RevenuesLessExpensesPriorYear
Revenues Less Expenses CY26436RevenuesLessExpensesCY
Total Assets BOY14745582TotalAssetsBOY
Total Assets EOY14657301TotalAssetsEOY
Total Liabilities BOY436838TotalLiabilitiesBOY
Total Liabilities EOY559713TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY14308744NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY14097588NetAssetsOrFundBalancesEOY
Mission DescriptionIMPROVE THE HEALTH AND QUALITY OF LIFE FOR ALL PEOPLE OF THE GREATER PAJARO VALLEY BY SUPPORTING PROGRAMS AND ACTIVITIES THAT ENSURE ACCESS TO HIGH QUALITY, CULTURALLY COMPETENT HEALTHCARE SERVICES THAT PROMOTE HEALTH, WELLNESS, AND DISEASE PREVENTION.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense462903Expense
Revenue57801Revenue
DescriptionDIABETES HEALTH CENTER (DHC) - THE DHC IS A DIRECT SERVICE PROGRAM OPERATED BY THE HEALTH TRUST TO PROVIDE DIABETES PREVENTION, SELF MANAGEMENT EDUCATION AND MEDICAL NUTRITION THERAPY TO ALL WHO NEED THESE SERVICES REGARDLESS OF THEIR ABILITY TO PAY FOR THEM. DURING THE 2011-12 FISCAL YEAR, THE DHC PROVIDED OUTREACH AND EDUCATIONAL SERVICES TO OVER 1,000 PEOPLE AND PROVIDED OVER 2,000 VISITS TO PATIENTS WITH AND WITHOUT DIABETES. THE DHC HAD A SUCCESSFUL LAUNCH OF "SHARED MEDICAL APPOINTMENTS" WITH THE USE OF A PRIVATE PHYSICIAN, AND ALSO SUCCESSFULLY LAUNCHED A CORPORATE WELLNESS PARTNERSHIP WITH PHYSICIANS MEDICAL GROUP.Description

Activity2 Activity2

FieldValueIRS element (for citing)
Expense286312Expense
Grants150000Grants
DescriptionGRANT MAKING - THE HEALTH TRUST AWARDED $150,000 DURING THE 2011-12 FISCAL YEAR, INCLUDING $143,000 IN GRANTS TO COMMUNITY AGENCIES AND $7,000 IN SCHOLARSHIPS TO LOCAL HIGH SCHOOL STUDENTS SEEKING CAREERS IN HEALTH PROFESSIONS. THESE GRANTS SUPPORTED THE STRATEGIC PROGRAM AREAS AND POPULATION GROUPS TARGETED BY THE TRUST.Description

Activity3 Activity3

FieldValueIRS element (for citing)
Expense58755Expense
DescriptionREGIONAL DIABETES COLLABORATIVE (RDC) - THE RDC IS A COLLABORATIVE CONVENED BY THE HEALTH TRUST IN 2002 TO BRING STAKEHOLDERS TOGETHER TO SUPPORT, PROMOTE AND COORDINATE EFFORTS TO PREVENT AND MANAGE DIABETES IN MONTEREY, SAN BENITO AND SANTA CRUZ COUNTIES. WITH 35 MEMBER AGENCIES FROM THE TRI-COUNTY AREA, THE RDC HOLDS GENERAL MEETINGS BI-ANNUALLY AND SPONSORS ACTIVITIES THROUGHOUT THE YEAR TO INCREASE PUBLIC AWARENESS OF DIABETES IN THE REGION, TO PROMOTE BEST PRACTICES IN CLINICAL MANAGEMENT OF DIABETES AND TO IMPROVE ACCESSIBILITY TO TREATMENT, MEDICINES AND EDUCATION. DURING THE 2011-12 FISCAL YEAR, THE RDC CONVENED THE RDC GENERAL MEMBERSHIP AND STEERING COMMITTEE MEETINGS, AS WELL AS HOSTED THE NINTH ANNUAL DIABETES FORUM AND NINTH ANNUAL DIABETES HEALTH FAIR.Description
FieldValueIRS element (for citing)
Total Program Service Expense807970TotalProgramServiceExpense
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 EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetstrueReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
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 OrganizationstrueGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredfalseScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
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 RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionstrueDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntityfalseRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10963NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees22NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Form990-T FiledfalseForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Form8886 T FiledfalseForm8886TFiled
Non Deductible ContributionsfalseNonDeductibleContributions
Non Deductible DisclosurefalseNonDeductibleDisclosure
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Quid Pro Quo DisclosurefalseQuidProQuoDisclosure
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Number Of8282 Filed0NumberOf8282Filed
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Form8899 FiledfalseForm8899Filed
Form1098 C FiledfalseForm1098CFiled
Excess Business HoldingsfalseExcessBusinessHoldings
Taxable DistributionsfalseTaxableDistributions
Distribution To DonorfalseDistributionToDonor
Filed Lieu1041falseFiledLieu1041
Licensed More Than One StatefalseLicensedMoreThanOneState
Indoor Tanning ServicesfalseIndoorTanningServices
Form720 FiledfalseForm720Filed
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members20NbrVotingGoverningBodyMembers
Number Independent Voting Members20NumberIndependentVotingMembers
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
Policies Reference ChaptersfalsePoliciesReferenceChapters
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
Written Policy Or ProcedurefalseWrittenPolicyOrProcedure
States Where Copy Of Return Is FiledCAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonADDRESSEENamePerson
Telephone Number8317615639TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line185 NIELSON STAddressLine1
CityWATSONVILLECity
StateCAState
ZIP Code95076ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (22 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficer
ERIC TAYLOR
Director2.00X000
JOSE CHIBRAS MD
Director2.00X000
SALLY ANDERSON
Director2.00X000
MICHELE VIOLICH MD
Director2.00X000
CARLOS RIVERA
Director2.00X000
EDUARDO MONTESINO
Director2.00X000
BARBARA PALLA MD
Director2.00X000
RICH OTTO
Director2.00X000
SUZANNE MINE-EGUCHI
Director2.00X000
DAVID MESA
Treasurer2.00X000X
GERALD KONDO DDS
Director2.00X000
RONALD JONES
Director2.00X000
ROSIE IBARRA
Director2.00X000
STAN HAJDUK MD
Director2.00X000
CAROLINE EISKAMP
Chairman2.00X000X
EDWARD DIN
Director2.00X000
CATHLEEN CHANDLER-ECKHARDT
Director2.00X000
JAVIER CARRILLO
VICE CHAIR2.00X000X
JUDY CAREY
Director2.00X000
JIM BOOTH
Secretary2.00X000X
STEVE SCHURAY
FINANCE DIREC25.003175508949X
KATHLEEN KING
CEO40.00109616019275X
FieldValueIRS element (for citing)
Total Reportable Comp From Org141371TotalReportableCompFromOrg
Total Other Compensation28224TotalOtherCompensation
Number Individuals GT100 K1NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KfalseTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation

Name Of Contractor NameOfContractor

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1UBS FINANCIAL SERVICES INCBusinessNameLine1

Address Of Contractor AddressOfContractor

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1PO BOX 8149AddressLine1
CityWALNUT CREEKCity
StateCAState
ZIP Code945968149ZIPCode
FieldValueIRS element (for citing)
Description Of ServicesINVESTMENT MGMTDescriptionOfServices
Compensation124635Compensation
FieldValueIRS element (for citing)
Number Of Contractors GT100 K1NumberOfContractorsGT100K
Fundraising Events2045FundraisingEvents
All Other Contributions155838AllOtherContributions
Noncash Contributions32757NoncashContributions
Total Contributions157883TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
MISCELLANEOUS62130012111211
DHC PATIENT FEES6213005659056590
FieldValueIRS element (for citing)
Total Program Service Revenue57801TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column441028TotalRevenueColumn
Exclusion$441,028ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities4722125Securities

Less Cost Oth Basis Sales Expenses LessCostOthBasisSalesExpenses

FieldValueIRS element (for citing)
Securities4247612Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities474513Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column474513TotalRevenueColumn
Related Or Exempt Function Income474513RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Gross Income Fundraising Events105987GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events2045CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses58004FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column47983TotalRevenueColumn
Exclusion$47,983ExclusionAmount

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column1179208TotalRevenueColumn
Related Or Exempt Function Income532314RelatedOrExemptFunctionIncome
Exclusion$489,011ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total150000Total
Program Services150000ProgramServices

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total157948Total
Program Services118461ProgramServices
Management And General23692ManagementAndGeneral
Fundraising15795Fundraising

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total432153Total
Program Services347659ProgramServices
Management And General34655ManagementAndGeneral
Fundraising49839Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total33445Total
Program Services24399ProgramServices
Management And General6660ManagementAndGeneral
Fundraising2386Fundraising

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total35003Total
Program Services24969ProgramServices
Management And General8399ManagementAndGeneral
Fundraising1635Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total48019Total
Program Services35007ProgramServices
Management And General9555ManagementAndGeneral
Fundraising3457Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total0Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total18200Total
Program Services18200ProgramServices

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total124635Total
Management And General124635ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total18842Total
Program Services14613ProgramServices
Management And General1678ManagementAndGeneral
Fundraising2551Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total9674Total
Program Services7900ProgramServices
Management And General552ManagementAndGeneral
Fundraising1222Fundraising

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total26345Total
Program Services13291ProgramServices
Management And General11125ManagementAndGeneral
Fundraising1929Fundraising

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total47351Total
Program Services34738ProgramServices
Management And General12613ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total4024Total
Program Services2894ProgramServices
Management And General1011ManagementAndGeneral
Fundraising119Fundraising

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total0Total

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total4943Total
Management And General4943ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total0Total

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
Printing and Publications203205148125982574
Postage and Shipping16100544661910035
DUPLICATING36453645
BAD DEBT21251600525

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total0Total

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total1152772Total
Program Services807970ProgramServices
Management And General252735ManagementAndGeneral
Fundraising92067Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY62514BOY
EOY103486EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY124BOY
EOY1357EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY95690BOY
EOY23014EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY13524BOY
EOY744339EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
EOY0EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY19013BOY
EOY7977EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis126453LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec96642LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY34754BOY
EOY29811EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY14519963BOY
EOY13747317EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY14745582BOY
EOY14657301EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY71875BOY
EOY260985EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY364963BOY
EOY298728EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY436838BOY
EOY559713EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY13168230BOY
EOY12941029EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY115991BOY
EOY119616EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY1024523BOY
EOY1036943EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY14308744BOY
EOY14097588EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY14745582BOY
EOY14657301EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses26436ReconcilationRevenueExpenses
Reconcilation Other Changes-237592ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit RequiredfalseFederalGrantAuditRequired
Federal Grant Audit PerformedfalseFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org170b1 AviXPubliclySupportedOrg170b1Avi

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years289762CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years231266CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years443079CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year247605CurrentTaxYearMinus1Year
Current Tax Year157883CurrentTaxYear
Total1369595Total

Tax Rev Levied For Org Benefit170 TaxRevLeviedForOrgBenefit170

FieldValueIRS element (for citing)
Total0Total

Value Srvc Fclts Furnished By Govt ValueSrvcFcltsFurnishedByGovt

FieldValueIRS element (for citing)
Total0Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years289762CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years231266CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years443079CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year247605CurrentTaxYearMinus1Year
Current Tax Year157883CurrentTaxYear
Total1369595Total
FieldValueIRS element (for citing)
Amounts Subst Contributors Total0AmountsSubstContributorsTotal
Public Support Total1701369595PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years570607CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years677003CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years585829CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year917498CurrentTaxYearMinus1Year
Current Tax Year441028CurrentTaxYear
Total3191965Total

Net UBI NetUBI

FieldValueIRS element (for citing)
Total0Total

Other Income170 OtherIncome170

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Total Support4561560TotalSupport
Public Support Pertcentage1700.30020PublicSupportPertcentage170
Public Support Pertcent Prior Year0.38310PublicSupportPertcentPriorYear
Thirty Three Percnt Tests PY170XThirtyThreePercntTestsPY170

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

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance1147222BeginningOfYearBalance
Contributions12240Contributions
Investment Earnings Or Losses24090InvestmentEarningsOrLosses
Other Expenditures36653OtherExpenditures
Administrative Expenses9478AdministrativeExpenses
End Of Year Balance1137421EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance958805BeginningOfYearBalance
Contributions14880Contributions
Investment Earnings Or Losses182883InvestmentEarningsOrLosses
Administrative Expenses9346AdministrativeExpenses
End Of Year Balance1147222EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance776860BeginningOfYearBalance
Contributions103245Contributions
Investment Earnings Or Losses88070InvestmentEarningsOrLosses
Administrative Expenses9370AdministrativeExpenses
End Of Year Balance958805EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance0.01000BoardDesignatedEOYBalance
Permanent Endowment EOY Balance0.91000PermanentEndowmentEOYBalance
Term Endowment EOY Balance0.08000TermEndowmentEOYBalance
Endowments Held By Unrelated OrgsfalseEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule RfalseAreRelatedOrgsListedScheduleR

Leasehold Improvements LeaseholdImprovements

FieldValueIRS element (for citing)
Other Cost Or Other Basis38792OtherCostOrOtherBasis
Depreciation12743Depreciation
Book Value26049BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis56268OtherCostOrOtherBasis
Depreciation54121Depreciation
Book Value2147BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis31393OtherCostOrOtherBasis
Depreciation29778Depreciation
Book Value1615BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings29811TotalOfBookValueLandBuildings
Total Book Value Other Assets13747317TotalBookValueOtherAssets

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionACCRUED WORKMANS COMPENSATIONDescription
Amount$298,728Amount
FieldValueIRS element (for citing)
Total Of Amounts298728TotalOfAmounts
Total Revenue1179208TotalRevenue
Total Expenses1152772TotalExpenses
Excess Or Deficit For Year26436ExcessOrDeficitForYear
Net Unrealized GL On Investments-843073NetUnrealizedGLOnInvestments
Other$605,481OtherAmount
Total Adjustments-237592TotalAdjustments
Excess Or Deficit Per FS-211156ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt518824TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments-843073NetUnrealizedGainsInvestments
Donated Srvc And Use Of Facilities249320DonatedSrvcAndUseOfFacilities
Other Revenues58004OtherRevenues
Revenue Not Rptd F990-535749RevenueNotRptdF990
Revenue Subtotal1054573RevenueSubtotal
Investment Expenses Not Included124635InvestmentExpensesNotIncluded
Revenue Not Rptd On Fin Stmt124635RevenueNotRptdOnFinStmt
Total Revenue Per Form9901179208TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt1335461TotExpensesEtcAuditedFinclStmt
Donated Services Use Of Facilities249320DonatedServicesUseOfFacilities
Other Expenses Included58004OtherExpensesIncluded
Expenses Not Rptd F990307324ExpensesNotRptdF990
Expenses Subtotal1028137ExpensesSubtotal
Investment Expenses Not Included2124635InvestmentExpensesNotIncluded2
Expenses Not Rptd On Fin Stmt124635ExpensesNotRptdOnFinStmt
Total Expenses Per Form9901152772TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (5 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Part XPart X : FIN48 FootnoteTHE FINANCIAL ACCOUNTING STANDARDS BOARD ISSUED NEW GUIDANCE ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES. THE TRUST ADOPTED THIS NEW GUIDANCE FOR THE YEAR ENDED JUNE 30, 2010. MANAGEMENT EVALUATED THE TRUST'S TAX POSITIONS AND CONCLUDED THAT THE TRUST HAD TAKEN NO UNCERTAIN TAX POSITIONS THAT REQUIRE ADJUSTMENT TO THE FINANCIAL STATEMENTS TO COMPLY WITH THE PROVISIONS OF THIS GUIDANCE. WITH FEW EXCEPTIONS, THE TRUST IS NO LONGER SUBJECT TO INCOME TAX EXAMINATIONS BY THE U.S. FEDERAL, STATE OR LOCAL TAX AUTHORITIES FOR YEARS BEFORE 2008.
Part XIII, Line 2dPart XIII, Line 2d: Other expenses and losses per audited F/SSPECIAL EVENTS EXPENSE $58004
Part XII, Line 2dPart XII, Line 2d: Other revenue amounts included in F/S but not included on form 990SPECIAL EVENTS EXPENSE $58004
Part XI, Line 8Part XI, Line 8: Other Changes in Net Assets or Fund BalancesDISCONTINUED OPERATIONS - NET ACTIVITY $605481
Part V, Line 4Part V, Line 4: Intended uses of the endowment fund.THE ENDOWMENT FUNDS ARE HELD IN ORDER TO GENERATE REVENUES IN SUPPORT OF HEALTH PROGRAMS FOR SENIORS AND CHILDREN, AND FOR THE UNRESTRICTED USE OF THE TRUST.

Schedule G IRS990ScheduleG

FieldValueIRS element (for citing)
Agreement Ref FundraisingfalseAgreementRefFundraising

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1WINE & ROSES EVENTNameOfEvent1
Gross Receipts Event1102632GrossReceiptsEvent1
Charitable Contributions Event12045CharitableContributionsEvent1
Gross Revenue Event1100587GrossRevenueEvent1
Rent Facility Costs Event12456RentFacilityCostsEvent1
Food And Beverage Event15014FoodAndBeverageEvent1
Entertainment Event1700EntertainmentEvent1
Other Direct Expenses Event136422OtherDirectExpensesEvent1
Name Of Event2MISCELLANEOUS EVENTSNameOfEvent2
Gross Receipts Event25400GrossReceiptsEvent2
Gross Revenue Event25400GrossRevenueEvent2
Other Direct Expenses Event213412OtherDirectExpensesEvent2
Gross Receipts Total108032GrossReceiptsTotal
Charitable Contributions Total2045CharitableContributionsTotal
Gross Revenue Total Events105987GrossRevenueTotalEvents
Rent Facility Costs Total Events2456RentFacilityCostsTotalEvents
Food And Beverage Total Events5014FoodAndBeverageTotalEvents
Entertainment Total Events700EntertainmentTotalEvents
Other Direct Expenses Total Events49834OtherDirectExpensesTotalEvents
Direct Expense Summary Events58004DirectExpenseSummaryEvents
Net Income Summary47983NetIncomeSummary

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Records MaintainedtrueRecordsMaintained

Recipient Table RecipientTable (13 entries)

Address Line1AddressUS/AddressLine1CityAddressUS/CityStateAddressUS/StateZIP CodeAddressUS/ZIPCodeIRC SectionIRCSectionAmount Of Cash GrantAmountOfCashGrantAmount Of Non Cash AssistanceAmountOfNonCashAssistancePurpose Of GrantPurposeOfGrantEIN Of RecipientEINOfRecipient
WOMENCARE
2901 PARK AVENUE STE A1SOQUELCA95073501(c)(3)75000HEALTH INSURANCE EDUC & ACCESS
WATSONVILLE HIGH SCOOL
250 EAST BEACH STREETWATSONVILLECA95076501(c)(3)80000SUPPORT HEALTH STUDIES770375541
WATSONVILLE FAMILY YMCA
27 SUDDEN STREETWATSONVILLECA95076501(c)(3)150000HEALTH FAMILY HOME PROGRAM770020233
SALUD PARA LA GENTE
195 AVIATION WAY SUITE 200WATSONVILLECA95076501(c)(3)116800DENTAL CARE CHILDREN OF MIGRANT ED942705747
PVUSDSTARLGHT & CESAR CHAVEZ
225 HAMMER DRIVEWATSONVILLECA95076501(c)(3)150000DIABETES & CONTRIBUTING FACTORS
PV PREVENTION & STUD ASSIST
336 EAST LAKE AVENUEWATSONVILLECA95076501(c)(3)100000HEALTH INSURANCE EDUC & ACCESS
HEALTH IMPROV PSHIP
1600 GREEN HILLS ROAD STE 101SCOTTS VALLEYCA95066501(c)(3)150000HEALTH INSURANCE ED & ACCESS010826156
GIRL SCOUTS CA CENTRAL COAST
10550 MERRITT STREETCASTROVILLECA95012501(c)(3)75000DIABETES & CONTRIBUTING FACTORS
FAMILY SVCS AGENCY
104 WALNUT AVE STE 208SANTA CRUZCA95060501(c)(3)75000CRISIS COUNSELING SESSIONS941716354
DIENTES COMMUNITY DENTAL CARE
1830 COMMERCIAL WAYSANTA CRUZCA95065501(c)(3)116800DENTAL SERVICES TO LOW INCOME ADULTS770311752
COMMUNITY BRIDGES
236 SANTA CRUZ AVESANTA CRUZCA95003501(c)(3)125000HEALTH INSURANCE ED & ACCESS942460211
COMMUNITY ALLIANCE FAM FARMER
406 MAIN STREET STE 406WATSONVILLECA95076501(c)(3)120000DIABETES & CONTRIBUTING FACTORS
CITY OF WATSONVILLE
231 UNION STREETWATONVILLECA95076GOVT75000SUPPORT YOUTH CAMP946000451
FieldValueIRS element (for citing)
Total Nbr Of501 C3 And Govt Grants8TotalNbrOf501C3AndGovtGrants
Total Nbr Of Other Organizations5TotalNbrOfOtherOrganizations

Form990 Schedule I Part IV Form990ScheduleIPartIV

FieldValueIRS element (for citing)
IdentifierGrantmaker's Description of How Grants are UsedIdentifier
ExplanationALL ORGANIZATIONS APPLYING FOR FUNDING MUST SUBMIT A DETAILED LINE-ITEM BUDGET, INCLUDING INCOME AND EXPENSES FOR THE PROPOSED PROJECT. THEY MUST INDICATE THE AMOUNT PROPOSED FOR FUNDING FROM THE TRUST BY LINE ITEM AND INCLUDE NOTES FOR ANY LINE ITEMS THAT REQUIRE ADDITIONAL EXPLANATION.IF APPROVED FOR FUNDING, GRANTEES MUST SIGN A GRANT CONTRACT IN WHICH THEY AGREE TO USE THE GRANT FUNDS TO ACCOMPLISH THE SPECIFIC OUTCOMES OUTLINED IN THEIR GRANT PROPOSAL. THEY ALSO AGREE TO INFORM THE TRUST IMMEDIATELY IF THEY ARE UNABLE TO PERFORM ON ANY ASPECT OF THE GRANT CONTRACT ACTIVITIES AS OUTLINED IN THE PROPOSAL. THE CONTRACT INDICATES THAT USE OF THESE FUNDS FOR ANY PURPOSE OTHER THAN SET FORTH IN THE GRANT PROPOSAL AND/OR FAILURE TO REPORT CHANGES IMMEDIATELY OR TO PERFORM ON THE CONTRACT OUTCOMES MAY RESULT IN FORFEITURE OF PART OR ALL OF THE GRANT AMOUNT. ALSO REQUIRE GRANTEES TO SUBMIT PROGRESS AND FINAL REPORTS IN WHICH THEY MUST PROVIDE A DETAILED PROGRAM BUDGET THAT COMPARES ACTUAL EXPENDITURES TO THE APPROVED BUDGET.Explanation

Schedule M IRS990ScheduleM

Other Non Cash Contributions Table OtherNonCashContributionsTable

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
DescriptionAUCTION ITEMSDescription
Number Of Contributions134NumberOfContributions
Noncash Contribs Rptd F99032757NoncashContribsRptdF990
Method Of Determining RevenuesAUCTION VALUEMethodOfDeterminingRevenues
FieldValueIRS element (for citing)
Any Property That Must Be HeldfalseAnyPropertyThatMustBeHeld
Review Process Unusual NC GiftstrueReviewProcessUnusualNCGifts
Third Parties UsedfalseThirdPartiesUsed

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (4 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Form 990, Part VI, Line 19Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailableGoverning docs are available upon request.
Form 990, Part VI, Line 15bForm 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key EmployeesOTHER EMPLOYEE COMPENSATION IS DETERMINED BY THE CEO AND REVIEWED WITH THE EXECUTIVE COMMITTEE.
Form 990, Part VI, Line 12cForm 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of ConflictsConflict of interest statements are updated annually as well as when grants are approved to monitor for potential conflicts of interest.
Form 990, Part VI, Line 11Form 990, Part VI, Line 11: Form 990 Review ProcessPajaro Valley Community Health Trust engages a CPA firm to assist with preparation and filing of the Form 990, based on a Audit engagement completed by the same CPA firm. Once the CPA firm has completed a draft of the form 990, a copy will be sent to the Board of Directors for review and approval before the tax return is filed.

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