STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

LA PINE COMMUNITY HEALTH CENTER: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization
LA PINE COMMUNITY HEALTH CENTER (EIN 26-3084386)
Tax period
2019-11-01 to 2020-10-31
Filed
2021-09-14
IRS object ID
202122579349300522
Schema version
2019v5.0
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)
Return2021-09-14T09:50:29-05:00ReturnTs
Tax Period End2020-10-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN930819646PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1JONES & ROTH PCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1300 SW COLUMBIA SUITE 201AddressLine1Txt
CityBENDCityNm
State AbbreviationORStateAbbreviationCd
ZIP97702ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2019-11-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN263084386EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1LA PINE COMMUNITY HEALTH CENTERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlLAPIBusinessNameControlTxt
Phone5415363435PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 3300AddressLine1Txt
CityLA PINECityNm
State AbbreviationORStateAbbreviationCd
ZIP97739ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonCHARLA DEHATEPersonNm
Person TitleCEOPersonTitleTxt
Phone5415363435PhoneNum
Signature2021-09-13SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonBRIAN G NEWTONPreparerPersonNm
PTINP01330154PTIN
Phone5413823590PhoneNum
Preparation2021-09-13PreparationDt
FieldValueIRS element (for citing)
Tax2019TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerCHARLA DEHATEPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 3300AddressLine1Txt
CityLA PINECityNm
State AbbreviationORStateAbbreviationCd
ZIP97739ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$10,326,568GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.LAPINECC.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2008FormationYr
Legal Domicile StateORLegalDomicileStateCd
Activity Or MissionTO PROVIDE PRIMARY CARE, MENTAL HEALTH AND DENTAL SERVICES REGARDLESS OF THE ABILITY TO PAY TO INDIVIDUALS AND FAMILIES IN CENTRAL OREGON.ActivityOrMissionDesc
Voting Members Governing Body10VotingMembersGoverningBodyCnt
Voting Members Independent10VotingMembersIndependentCnt
Total Employee91TotalEmployeeCnt
Total Volunteers10TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$1,712,353PYContributionsGrantsAmt
CY Contributions Grants$3,621,234CYContributionsGrantsAmt
PY Program Service Revenue$5,116,657PYProgramServiceRevenueAmt
CY Program Service Revenue$5,562,134CYProgramServiceRevenueAmt
PY Investment Income$8,992PYInvestmentIncomeAmt
CY Investment Income-$612,901CYInvestmentIncomeAmt
PY Other Revenue$487,285PYOtherRevenueAmt
CY Other Revenue$488,243CYOtherRevenueAmt
PY Total Revenue$7,325,287PYTotalRevenueAmt
CY Total Revenue$9,058,710CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$5,226,805PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$5,766,870CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$2,042,285PYOtherExpensesAmt
CY Other Expenses$2,028,165CYOtherExpensesAmt
PY Total Expenses$7,269,090PYTotalExpensesAmt
CY Total Expenses$7,795,035CYTotalExpensesAmt
PY Revenues Less Expenses$56,197PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$1,263,675CYRevenuesLessExpensesAmt
Total Assets BOY$4,868,011TotalAssetsBOYAmt
Total Assets EOY$11,774,405TotalAssetsEOYAmt
Total Liabilities BOY$586,664TotalLiabilitiesBOYAmt
Total Liabilities EOY$6,229,383TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$4,281,347NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$5,545,022NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTO PROVIDE PRIMARY CARE, MENTAL HEALTH AND DENTAL SERVICES REGARDLESS OF THE ABILITY TO PAY TO INDIVIDUALS AND FAMILIES IN CENTRAL OREGON.MissionDesc
Significant New Program SrvcYes (true)SignificantNewProgramSrvcInd
Significant ChangeYes (true)SignificantChangeInd
Expense$6,047,221ExpenseAmt
Revenue$5,562,134RevenueAmt
DescPROVIDING HEALTHCARE TO THE UNDERSERVED POPULATION (I.E. UNINSURED, UNDERINSURED, MEDICAID AND MEDICARE).Desc
Total Program Service Expenses$6,047,221TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsfalseDonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (true)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document19IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee91EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members10GoverningBodyVotingMembersCnt
Independent Voting Member10IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesfalseMinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldORStatesWhereCopyOfReturnIsFldCd
Other WebsiteYes (X)OtherWebsiteInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonCHARLA DEHATEPersonNm
Phone5415363435PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 3300AddressLine1Txt
CityLA PINECityNm
State AbbreviationORStateAbbreviationCd
ZIP97739ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtKey EmployeeKeyEmployeeIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeIndOfficerOfficerIndIndividual Trustee Or DirectorIndividualTrusteeOrDirectorInd
MICHAEL ALLEN
MEDICAL DIRE40.00Yes (X)$257,894$0$16,248
MARTIN SMART
MD40.00$221,803$0$7,826Yes (X)
BETH BLUMENSTEIN
MD40.00$189,301$0$15,096Yes (X)
CHARLA DEHATE
CEO40.00$156,923$0$14,348Yes (X)
JOAN FRIDERICI
MD40.00$153,761$0$7,483Yes (X)
RITA GOEHRING
NP40.00$140,656$0$12,383Yes (X)
MEGAN LEWIS
NP40.00$133,281$0$12,603Yes (X)
DAVID GOSSER
CHAIR1.00$0$0$0Yes (X)Yes (X)
MARIAN MENGEL
VICE CHAIR1.00$0$0$0Yes (X)Yes (X)
JOAN WALTER
SECRETARY1.00$0$0$0Yes (X)Yes (X)
ELIZABETH TAUSCH
TREASURER1.00$0$0$0Yes (X)Yes (X)
HANNAH OLMSTEAD
BOARD MEMBER1.00$0$0$0Yes (X)
LINDA VASSALLI
BOARD MEMBER1.00$0$0$0Yes (X)
FRANK HERNANDEZ
BOARD MEMBER1.00$0$0$0Yes (X)
RELINDA REYNOLDS
BOARD MEMBER1.00$0$0$0Yes (X)
LYMAN FLENNER III
BOARD MEMBER1.00$0$0$0Yes (X)
TAMMY LESUEUR
BOARD MEMBER1.00$0$0$0Yes (X)
DONNY BURKLOW
BOARD MEMBER1.00$0$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,253,619TotalReportableCompFromOrgAmt
Total Other Compensation$85,987TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K13IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (3 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
SUN INVESTORS BUILDING LEASE
3749 NORWICH AVENUEEUGENEOR97408RENT$202,322
OCHIN
1881 SW NATIO PARKWAYPORLTANDOR97201BILLINGS$187,275
WESTON TECHNOLOGIES
19795 VILLAGE OFFICE CTBENDOR97702IT$142,179
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K3CntrctRcvdGreaterThan100KCnt
Government Grants$3,191,481GovernmentGrantsAmt
All Other Contributions$429,753AllOtherContributionsAmt
Total Contributions$3,621,234TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PATIENT SERVICE REVENUES621300$5,049,979$5,049,979
PAYOR INCENTIVE REVENUES621300$512,155$512,155
FieldValueIRS element (for citing)
Total Program Service Revenue$5,562,134TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,322TotalRevenueColumnAmt
Exclusion$2,322ExclusionAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$25,553RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$25,553RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$25,553TotalRevenueColumnAmt
Exclusion$25,553ExclusionAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$615,223OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other-$615,223OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$615,223TotalRevenueColumnAmt
Related Or Exempt Func Income-$615,223RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$1,063,442GrossSalesOfInventoryAmt
Cost Of Goods Sold$652,635CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$410,807TotalRevenueColumnAmt
Related Or Exempt Func Income$410,807RelatedOrExemptFuncIncomeAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescMISCELLANEOUS INCOMEDesc
Business900099BusinessCd
Total Revenue Column$51,883TotalRevenueColumnAmt
Related Or Exempt Func Income$51,883RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$51,883OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$9,058,710TotalRevenueColumnAmt
Related Or Exempt Func Income$5,409,601RelatedOrExemptFuncIncomeAmt
Exclusion$27,875ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$441,673TotalAmt
Program Services$186,130ProgramServicesAmt
Management And General$255,543ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$4,262,030TotalAmt
Program Services$3,570,590ProgramServicesAmt
Management And General$691,440ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$82,627TotalAmt
Program Services$74,162ProgramServicesAmt
Management And General$8,465ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$591,170TotalAmt
Program Services$500,046ProgramServicesAmt
Management And General$91,124ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$389,370TotalAmt
Program Services$311,496ProgramServicesAmt
Management And General$77,874ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$32,856TotalAmt
Program Services$26,285ProgramServicesAmt
Management And General$6,571ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$33,952TotalAmt
Program Services$27,162ProgramServicesAmt
Management And General$6,790ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$493,641TotalAmt
Program Services$204,264ProgramServicesAmt
Management And General$289,377ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$21,313TotalAmt
Program Services$17,050ProgramServicesAmt
Management And General$4,263ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$119,094TotalAmt
Program Services$87,528ProgramServicesAmt
Management And General$31,566ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$523,581TotalAmt
Program Services$395,092ProgramServicesAmt
Management And General$128,489ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$2,873TotalAmt
Management And General$2,873ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$63,457TotalAmt
Program Services$27,692ProgramServicesAmt
Management And General$35,765ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$23,351TotalAmt
Program Services$18,681ProgramServicesAmt
Management And General$4,670ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$180,617TotalAmt
Program Services$143,590ProgramServicesAmt
Management And General$37,027ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$37,073TotalAmt
Program Services$29,658ProgramServicesAmt
Management And General$7,415ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES$317,407$317,407
RECRUITMENT$88,837$57,292$31,545
DUES AND SUBSCRIPTIONS$58,502$26,213$32,289
TAXES AND LICENSES$30,011$26,883$3,128

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$1,600TotalAmt
Management And General$1,600ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$7,795,035TotalAmt
Program Services$6,047,221ProgramServicesAmt
Management And General$1,747,814ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$774,204BOYAmt
EOY$2,986,157EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$2,290,046BOYAmt
EOY$1,848,616EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$629,656BOYAmt
EOY$545,188EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$5,930BOYAmt
EOY$7,044EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$89,170BOYAmt
EOY$51,330EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$7,389,785LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$1,078,532LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$1,061,946BOYAmt
EOY$6,311,253EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$17,059BOYAmt
EOY$12,799EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
EOY$12,018EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$4,868,011BOYAmt
EOY$11,774,405EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$326,682BOYAmt
EOY$517,972EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$259,982BOYAmt
EOY$5,711,411EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$586,664BOYAmt
EOY$6,229,383EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$4,260,997BOYAmt
EOY$5,206,257EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$20,350BOYAmt
EOY$338,765EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$4,281,347BOYAmt
EOY$5,545,022EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$4,868,011BOYAmt
EOY$11,774,405EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$1,263,675ReconcilationRevenueExpnssAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredYes (true)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (true)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,597,891CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,648,357CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,564,536CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,712,353CurrentTaxYearMinus1YearAmt
Current Tax Year$3,621,234CurrentTaxYearAmt
Total$10,144,371TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,597,891CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,648,357CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,564,536CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,712,353CurrentTaxYearMinus1YearAmt
Current Tax Year$3,621,234CurrentTaxYearAmt
Total$10,144,371TotalAmt
FieldValueIRS element (for citing)
Public Support Total170$10,144,371PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$24,498CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$24,235CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$25,789CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$27,942CurrentTaxYearMinus1YearAmt
Current Tax Year$27,875CurrentTaxYearAmt
Total$130,339TotalAmt
FieldValueIRS element (for citing)
Total Support$10,274,710TotalSupportAmt
Gross Receipts Rltd Activities$30,458,918GrossReceiptsRltdActivitiesAmt
Public Support CY1700.98730PublicSupportCY170Pct
Public Support PY1700.98360PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,597,891CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,648,357CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,564,536CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,712,353CurrentTaxYearMinus1YearAmt
Current Tax Year$3,621,234CurrentTaxYearAmt
Total$10,144,371TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$5,719,858CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$5,953,630CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$5,921,832CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$6,186,139CurrentTaxYearMinus1YearAmt
Current Tax Year$6,677,459CurrentTaxYearAmt
Total$30,458,918TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$7,317,749CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$7,601,987CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$7,486,368CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$7,898,492CurrentTaxYearMinus1YearAmt
Current Tax Year$10,298,693CurrentTaxYearAmt
Total$40,603,289TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$40,603,289PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$24,498CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$24,235CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$25,789CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$27,942CurrentTaxYearMinus1YearAmt
Current Tax Year$27,875CurrentTaxYearAmt
Total$130,339TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$24,498CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$24,235CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$25,789CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$27,942CurrentTaxYearMinus1YearAmt
Current Tax Year$27,875CurrentTaxYearAmt
Total$130,339TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$7,342,247CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$7,626,222CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$7,512,157CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$7,926,434CurrentTaxYearMinus1YearAmt
Current Tax Year$10,326,568CurrentTaxYearAmt
Total$40,733,628TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.99680PublicSupportCY509Pct
Public Support PY5090.99650PublicSupportPY509Pct
Investment Income CY0.00000InvestmentIncomeCYPct
Investment Income PY0.00000InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$403,375OtherCostOrOtherBasisAmt
Book Value$403,375BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$5,578,981OtherCostOrOtherBasisAmt
Depreciation$12,467DepreciationAmt
Book Value$5,566,514BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,345,146OtherCostOrOtherBasisAmt
Depreciation$1,029,804DepreciationAmt
Book Value$315,342BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$62,283OtherCostOrOtherBasisAmt
Depreciation$36,261DepreciationAmt
Book Value$26,022BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$6,311,253TotalBookValueLandBuildingsAmt
Total Rev Etc Audited Fincl Stmt$9,087,740TotalRevEtcAuditedFinclStmtAmt
Donated Services And Use Fclts$29,030DonatedServicesAndUseFcltsAmt
Revenue Not Reported$29,030RevenueNotReportedAmt
Revenue Subtotal$9,058,710RevenueSubtotalAmt
Total Revenue Per Form990$9,058,710TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$7,824,065TotExpnsEtcAuditedFinclStmtAmt
Donated Services Use Fclts$29,030DonatedServicesUseFcltsAmt
Expenses Not Reported$29,030ExpensesNotReportedAmt
Expenses Subtotal$7,795,035ExpensesSubtotalAmt
Total Expenses Per Form990$7,795,035TotalExpensesPerForm990Amt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmt
MICHAEL ALLEN
MEDICAL DIRECTOR$257,894$16,248$274,142
MARTIN SMART
MD$221,803$7,826$229,629
BETH BLUMENSTEIN
MD$189,301$15,096$204,397
CHARLA DEHATE
CEO$156,923$14,348$171,271
JOAN FRIDERICI
MD$153,761$7,483$161,244
RITA GOEHRING
NP$140,656$12,383$153,039

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (9 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PAGE 1, PART I, LINE 6SERVES ON THE BOARD.
FORM 990, PAGE 2, PART III, LINE 2BECAME A TESTING SITE FOR COVID-19
FORM 990, PAGE 2, PART III, LINE 3CLOSED SUNRIVER SITE.
FORM 990, PAGE 6, PART VI, LINE 8BNO COMMITTEE HAS AUTHORITY TO ACT ON BEHALF OF THE BOARD.
FORM 990, PAGE 6, PART VI, LINE 11BTHE BOARD RECEIVES IT ELECTRONICALLY PRIOR TO THE BOARD MEETING FOR THEM TO REVIEW. THE DOCUMENT IS REVIEWED BY THE CEO DURING THE BOARD MEETING. ANY QUESTIONS ARE ANSWERED AT THE BOARD MEETING AND IF NECESSARY THE APPROPRIATE CHANGES ARE MADE. THE BOARD VOTES ON THE APPROVAL OF THE FROM 990 AT THE MEETING.
FORM 990, PAGE 6, PART VI, LINE 12CTHE POLICY IS REVIEWED ANNUALLY WITH THE BOARD MEMBERS, DIRECTORS, MANAGERS AND KEY EMPLOYEES. THE DISCLOSURE STATEMENT AND CONFLICT OF INTEREST ARE SIGNED BY EACH PERSON.
FORM 990, PAGE 6, PART VI, LINE 15AINFORMATION FROM THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS IS ASSESSED AND THE SALARIES ARE BASED ON SURVEYS OF COMMUNITY HEALTH CENTERS IN REGION.
FORM 990, PAGE 6, PART VI, LINE 15BINFORMATION FROM THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS IS ASSESSED AND THE SALARIES ARE BASED ON SURVEYS OF COMMUNITY HEALTH CENTERS IN REGION.
FORM 990, PAGE 6, PART VI, LINE 19DOCUMENTS ARE AVAILABLE UPON REQUEST.