CHURCHILL COMMUNITY HOSPITAL INC: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization: CHURCHILL COMMUNITY HOSPITAL INC (EIN 88-0252723)
Tax period: 2019-01-01 to 2019-12-31
Filed: 2020-11-10
IRS object ID: 202023159349304062
Schema version: 2019v5.1
Source: Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header
Form 990
Schedule A
Schedule D
Schedule I
Schedule O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2020-11-10T14:10:36-06:00	ReturnTs
Tax Period End	2019-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	823358910	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	LANE & ASSOCIATES LLC	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	301 W TOLAS PLACE	AddressLine1Txt
City	FALLON	CityNm
State Abbreviation	NV	StateAbbreviationCd
ZIP	89406	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2019-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	880252723	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	CHURCHILL COMMUNITY HOSPITAL INC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	CHUR	BusinessNameControlTxt
Phone	7754234230	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	301 W TOLAS PLACE	AddressLine1Txt
City	FALLON	CityNm
State Abbreviation	NV	StateAbbreviationCd
ZIP	89406	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	GARY IMELLI	PersonNm
Person Title	TREASURER	PersonTitleTxt
Phone	7754235868	PhoneNum
Signature	2020-11-05	SignatureDt

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	JOSEPH W LANE	PreparerPersonNm
PTIN	P00099864	PTIN
Phone	7754236505	PhoneNum
Self Employed	Yes (X)	SelfEmployedInd

Filing Security Information FilingSecurityInformation

IP Address IPAddress

Field	Value	IRS element (for citing)
I Pv4 Address	64.88.174.3	IPv4AddressTxt

Field	Value	IRS element (for citing)
IP	2020-11-05	IPDt
IP Tm	13:43:16	IPTm
IP Timezone	PS	IPTimezoneCd
Filing License Type	P	FilingLicenseTypeCd
At Submission Creation Device Id	BFAB8E6D79C0EC2B1B2E29E5248E395DB96411C9	AtSubmissionCreationDeviceId
At Submission Filing Device Id	CE970F7D56C6413C8DE7F4EA2AD4A7750B1A700F	AtSubmissionFilingDeviceId

Field	Value	IRS element (for citing)
Tax	2019	TaxYr
Build TS	2021-01-29 14:40:06Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Principal Officer	GARY IMELLI	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	3322 AUSTIN HWY	AddressLine1Txt
City	FALLON	CityNm
State Abbreviation	NV	StateAbbreviationCd
ZIP	89406	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$218,993	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	N/A	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1989	FormationYr
Legal Domicile State	NV	LegalDomicileStateCd
Activity Or Mission	PROVIDE SUPPORT FOR HEALTHCARE IN THE COMMUNITY. THE ORGANIZATION ASSISTS THE COMMUNITY HOSPITAL WITH EQUIPMENT AND BUILDING PURCHASES. THE ORGANIZATION BUILDS AUXILIARY BUILDINGS AS NEEDED FOR THE COMMUNITY HOSPITAL TO CONTINUE TO PROVIDE QUALITY HEALTHCARE IN A RURAL AREA.	ActivityOrMissionDesc
Voting Members Governing Body	7	VotingMembersGoverningBodyCnt
Voting Members Independent	7	VotingMembersIndependentCnt
Total Employee	0	TotalEmployeeCnt
Total Volunteers	0	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$35,687	PYContributionsGrantsAmt
CY Contributions Grants	$11,475	CYContributionsGrantsAmt
PY Program Service Revenue	$0	PYProgramServiceRevenueAmt
CY Program Service Revenue	$0	CYProgramServiceRevenueAmt
PY Investment Income	$196,661	PYInvestmentIncomeAmt
CY Investment Income	$181,318	CYInvestmentIncomeAmt
PY Other Revenue	-$8,048	PYOtherRevenueAmt
CY Other Revenue	-$16,066	CYOtherRevenueAmt
PY Total Revenue	$224,300	PYTotalRevenueAmt
CY Total Revenue	$176,727	CYTotalRevenueAmt
PY Grants And Similar Paid	$169,288	PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid	$50,210	CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members	$0	PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$0	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$0	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$37,851	PYOtherExpensesAmt
CY Other Expenses	$32,011	CYOtherExpensesAmt
PY Total Expenses	$207,139	PYTotalExpensesAmt
CY Total Expenses	$82,221	CYTotalExpensesAmt
PY Revenues Less Expenses	$17,161	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$94,506	CYRevenuesLessExpensesAmt
Total Assets BOY	$3,437,576	TotalAssetsBOYAmt
Total Assets EOY	$3,532,082	TotalAssetsEOYAmt
Total Liabilities BOY	$0	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$0	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$3,437,576	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$3,532,082	NetAssetsOrFundBalancesEOYAmt
Mission	PROVIDE SUPPORT FOR HEALTHCARE IN THE COMMUNITY INCLUDING BUILDING AND MAINTAINING AUXILIARY BUILDINGS FOR THE COMMUNITY HOSPITAL.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$78,481	ExpenseAmt
Grant	$50,210	GrantAmt
Desc	PROVIDE A BUILDING FOR THE HOSPITAL AUXILIARY TO OPERATE A THRIFT STORE FOR WHICH THE PROCEEDS ARE USED TO PURCHASE EQUIPMENT FOR THE HOSPITAL AND SUPPLY SCHOLARSHIPS FOR FUTURE MEDICAL STUDENTS.	Desc
Total Program Service Expenses	$78,481	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (1)	DescribedInSection501c3Ind
Schedule B Required	0	ScheduleBRequiredInd
Political Campaign Acty	0	PoliticalCampaignActyInd
Lobbying Activities	0	LobbyingActivitiesInd
Subject To Proxy Tax	0	SubjectToProxyTaxInd
Donor Advised Fund	0	DonorAdvisedFundInd
Conservation Easements	0	ConservationEasementsInd
Collections Of Art	0	CollectionsOfArtInd
Credit Counseling	0	CreditCounselingInd
Donor Rstr Or Quasi Endowments	0	DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment	Yes (1)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	Yes (1)	ReportInvestmentsOtherSecInd
Report Program Related Invst	0	ReportProgramRelatedInvstInd
Report Other Assets	0	ReportOtherAssetsInd
Report Other Liabilities	0	ReportOtherLiabilitiesInd
Include FIN48 Footnote	0	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	0	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	0	ConsolidatedAuditFinclStmtInd
School Operating	0	SchoolOperatingInd
Foreign Office	0	ForeignOfficeInd
Foreign Activities	0	ForeignActivitiesInd
More Than5000 K To Org	0	MoreThan5000KToOrgInd
More Than5000 K To Individuals	0	MoreThan5000KToIndividualsInd
Professional Fundraising	0	ProfessionalFundraisingInd
Fundraising Activities	0	FundraisingActivitiesInd
Gaming Activities	0	GamingActivitiesInd
Operate Hospital	0	OperateHospitalInd
Grants To Organizations	Yes (1)	GrantsToOrganizationsInd
Grants To Individuals	0	GrantsToIndividualsInd
Schedule J Required	0	ScheduleJRequiredInd
Tax Exempt Bonds	0	TaxExemptBondsInd
Engaged In Excess Benefit Trans	0	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	0	PYExcessBenefitTransInd
Loan Outstanding	0	LoanOutstandingInd
Grant To Related Person	0	GrantToRelatedPersonInd
Business Rln With Org Mem	0	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	0	BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent	0	BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri	0	DeductibleNonCashContriInd
Deductible Art Contribution	0	DeductibleArtContributionInd
Terminate Operations	0	TerminateOperationsInd
Partial Liquidation	0	PartialLiquidationInd
Disregarded Entity	0	DisregardedEntityInd
Related Entity	0	RelatedEntityInd
Related Organization Ctrl Ent	0	RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	0	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	0	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (1)	ScheduleORequiredInd
IRP Document	2	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Employee	0	EmployeeCnt
Unrelated Bus Incm Over Limit	0	UnrelatedBusIncmOverLimitInd
Foreign Financial Account	0	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	0	ProhibitedTaxShelterTransInd
Taxable Party Notification	0	TaxablePartyNotificationInd
Nondeductible Contributions	0	NondeductibleContributionsInd
Quid Pro Quo Contributions	0	QuidProQuoContributionsInd
Form8282 Property Disposed Of	0	Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct	0	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	0	PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services	0	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	0	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	0	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	7	GoverningBodyVotingMembersCnt
Independent Voting Member	7	IndependentVotingMemberCnt
Family Or Business Rln	0	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	0	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	Yes (1)	MembersOrStockholdersInd
Election Of Board Members	Yes (1)	ElectionOfBoardMembersInd
Decisions Subject To Approva	0	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (1)	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	0	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (1)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	0	ConflictOfInterestPolicyInd
Whistleblower Policy	0	WhistleblowerPolicyInd
Document Retention Policy	0	DocumentRetentionPolicyInd
Compensation Process CEO	0	CompensationProcessCEOInd
Compensation Process Other	0	CompensationProcessOtherInd
Investment In Joint Venture	0	InvestmentInJointVentureInd
States Where Copy Of Return Is Fld	NV	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	LANE & ASSOCIATES LLC	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	7754236505	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	301 WEST TOLAS PLACE	AddressLine1Txt
City	FALLON	CityNm
State Abbreviation	NV	StateAbbreviationCd
ZIP	89406	ZIPCd

Field	Value	IRS element (for citing)
No Listed Persons Compensated	Yes (X)	NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (7 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	OfficerOfficerInd
MIKE BERNEY
DIRECTOR	1.00	Yes (X)	$0	$0	$0
TIMOTHY HOCKENBERRY
DIRECTOR	1.00	Yes (X)	$0	$0	$0
KENNETH TEDFORD
DIRECTOR	1.00	Yes (X)	$0	$0	$0
KURT HENNING
DIRECTOR	1.00	Yes (X)	$0	$0	$0
GARY IMELLI
TREASURER	1.00		$0	$0	$0	Yes (X)
LYNN PEARCE
PRESIDENT	1.00		$0	$0	$0	Yes (X)
STUART RICHARDSON
SECRETARY	1.00		$0	$0	$0	Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$0	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$0	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	0	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	0	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	0	TotalCompGreaterThan150KInd
Compensation From Other Srcs	0	CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K	0	CntrctRcvdGreaterThan100KCnt
All Other Contributions	$11,475	AllOtherContributionsAmt
Total Contributions	$11,475	TotalContributionsAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$48,690	TotalRevenueColumnAmt
Exclusion	$48,690	ExclusionAmt

Gross Rents GrossRentsGrp

Field	Value	IRS element (for citing)
Real	$26,200	RealAmt

Less Rental Expenses LessRentalExpensesGrp

Field	Value	IRS element (for citing)
Real	$42,266	RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Real	-$16,066	RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	-$16,066	TotalRevenueColumnAmt
Exclusion	-$16,066	ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

Field	Value	IRS element (for citing)
Securities	$132,628	SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

Field	Value	IRS element (for citing)
Securities	$0	SecuritiesAmt

Gain Or Loss GainOrLossGrp

Field	Value	IRS element (for citing)
Securities	$132,628	SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$132,628	TotalRevenueColumnAmt
Exclusion	$132,628	ExclusionAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$176,727	TotalRevenueColumnAmt
Related Or Exempt Func Income	$0	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$165,252	ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$50,210	TotalAmt
Program Services	$50,210	ProgramServicesAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$3,740	TotalAmt
Management And General	$3,740	ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$28,037	TotalAmt
Program Services	$28,037	ProgramServicesAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$50	TotalAmt
Program Services	$50	ProgramServicesAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$184	TotalAmt
Program Services	$184	ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$82,221	TotalAmt
Program Services	$78,481	ProgramServicesAmt
Management And General	$3,740	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$224,301	BOYAmt
EOY	$184,458	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$964,162	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$205,333	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$773,131	BOYAmt
EOY	$758,829	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
BOY	$2,435,618	BOYAmt
EOY	$2,588,795	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
BOY	$4,526	BOYAmt
EOY	$0	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$3,437,576	BOYAmt
EOY	$3,532,082	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Field	Value	IRS element (for citing)
Org Does Not Follow FASB117	Yes (X)	OrgDoesNotFollowFASB117Ind

Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$0	EOYAmt

Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp

Field	Value	IRS element (for citing)
BOY	$3,437,576	BOYAmt
EOY	$3,532,082	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$3,437,576	BOYAmt
EOY	$3,532,082	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$3,437,576	BOYAmt
EOY	$3,532,082	EOYAmt

Field	Value	IRS element (for citing)
Reconcilation Revenue Expnss	$94,506	ReconcilationRevenueExpnssAmt
Other Changes In Net Assets	$0	OtherChangesInNetAssetsAmt
Method Of Accounting Cash	Yes (X)	MethodOfAccountingCashInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	0	FSAuditedInd
Federal Grant Audit Required	0	FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Hospital	Yes (X)	HospitalInd

Schedule D IRS990ScheduleD

Land LandGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$406,379	OtherCostOrOtherBasisAmt
Book Value	$406,379	BookValueAmt

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$557,783	OtherCostOrOtherBasisAmt
Depreciation	$205,333	DepreciationAmt
Book Value	$352,450	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$758,829	TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp

Field	Value	IRS element (for citing)
Desc	MUTUAL FUNDS	Desc
Book Value	$2,588,795	BookValueAmt
Method Valuation	C	MethodValuationCd

Field	Value	IRS element (for citing)
Total Book Value Securities	$2,588,795	TotalBookValueSecuritiesAmt

Schedule I IRS990ScheduleI

Field	Value	IRS element (for citing)
Grant Records Maintained	Yes (1)	GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	BANNER HEALTH	BusinessNameLine1Txt

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	2901 N CENTRAL AVE	AddressLine1Txt
City	PHOENIX	CityNm
State Abbreviation	AZ	StateAbbreviationCd
ZIP	85012	ZIPCd

Field	Value	IRS element (for citing)
Recipient EIN	450233470	RecipientEIN
IRC Section	501(C)(3)	IRCSectionDesc
Cash Grant	$50,210	CashGrantAmt
Purpose Of Grant	PATIENT ASSISTANCE AND PHYSICAL IMPROVEMENTS (NEW FLOORING, ROOM RENOVATIONS, ETC.)	PurposeOfGrantTxt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	PART I, LINE 2:	FormAndLineReferenceDesc
Explanation	ORGANIZATION AWARDS FUNDS TO HOSPITAL FOR SPECIFIC PURCHASES. ORGANIZATION CHECKS PROGRESS OF STUDENTS AWARDED SCHOLARSHIPS.	ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 6	INDIVIDUALS IN THE COMMUNITY MAY BECOME A MEMBER BY PAYING AN ANNUAL $5 MEMBERSHIP FEE.
FORM 990, PART VI, SECTION A, LINE 7A	OFFICERS ARE ELECTED ANNUALLY AT A MEETING OF THE MEMBERSHIP.
FORM 990, PART VI, SECTION B, LINE 11B	THE PRESIDENT OF THE ORGANIZATION REVIEWS, APPROVES AND SIGNS THE FORM 990.
FORM 990, PART VI, SECTION C, LINE 19	UPON REQUEST THE COPIES OF THE ORGANIZATIONS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE MADE AVAILABLE.
FORM 990, PART VII CONTACT ADDRESSES FOR OFFICERS, DIRECTORS, ETC	MIKE BERNEY - 120 N. BAILEY, FALLON, NV 89406. GARY IMELLI - 3322 AUSTIN HWY, FALLON, NV 89406. LYNN PEARCE - 1175 GUMMOW DRIVE, FALLON, NV 89406. STUART RICHARDSON - 229 BENCH ROAD, FALLON, NV 89406. TIMOTHY HOCKENBERRY - 801 E. WILLIAMS AVE, FALLON, NV 89406. KENNETH TEDFORD - 1750 MANCHESTER CIR, FALLON, NV 89406. KURT HENNING - 1351 W WILLIAMS AVE, FALLON, NV 89406.