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COMMUNITY HEALTH CENTERS INC: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization
COMMUNITY HEALTH CENTERS INC (EIN 74-2412898)
Tax period
2017-01-01 to 2017-12-31
Filed
2018-11-14
IRS object ID
201803189349312610
Schema version
2017v2.3
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)
Return2018-11-14T16:17:11-07:00ReturnTs
Tax Period End2017-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN870517754PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1WSRP LLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1155 N 400 W STE 400AddressLine1Txt
CitySALT LAKE CITYCityNm
State AbbreviationUTStateAbbreviationCd
ZIP84103ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2017-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN742412898EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1COMMUNITY HEALTH CENTERS INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlCOMMBusinessNameControlTxt
Phone8014126920PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12621 SOUTH 3270 WESTAddressLine1Txt
CityWEST VALLEY CITYCityNm
State AbbreviationUTStateAbbreviationCd
ZIP84119ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDEXTER PEARCEPersonNm
Person TitleEXEC. DIRECTORPersonTitleTxt
Phone3852612730PhoneNum
Signature2018-11-15SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonDANIEL P RINEHART CPAPreparerPersonNm
PTINP01057041PTIN
Phone8013282011PhoneNum
Preparation2018-11-09PreparationDt

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address71.92.235.161IPv4AddressTxt
FieldValueIRS element (for citing)
IP2018-11-14IPDt
IP Tm17:17:11IPTm
IP TimezoneCSIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdD81630A76278F26E9FE34999B3BA87DB3776B056AtSubmissionCreationDeviceId
At Submission Filing Device Id8F75EF8226B8A855965287399EE0B809BAD0E820AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2017TaxYr
Build TS2019-02-21 02:37:17ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Address ChangeYes (X)AddressChangeInd
Principal OfficerDEXTER PEARCEPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line12621 SOUTH 3270 WESTAddressLine1Txt
CityWEST VALLEY CITYCityNm
State AbbreviationUTStateAbbreviationCd
ZIP84119ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$24,035,297GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressHTTP://WWW.CHC-UT.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1979FormationYr
Legal Domicile StateUTLegalDomicileStateCd
Activity Or MissionTO PROVIDE QUALITY, PATIENT-CENTERED PRIMARY HEALTH CARE, DENTAL AND OTHER SERVICES TO THE MEDICALLY UNDERSERVED IN UTAH REGARDLESS OF THEIR ABILITY TO PAY.ActivityOrMissionDesc
Voting Members Governing Body13VotingMembersGoverningBodyCnt
Voting Members Independent9VotingMembersIndependentCnt
Total Employee281TotalEmployeeCnt
Total Volunteers16TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$11,110,032PYContributionsGrantsAmt
CY Contributions Grants$11,873,453CYContributionsGrantsAmt
PY Program Service Revenue$9,936,800PYProgramServiceRevenueAmt
CY Program Service Revenue$11,051,268CYProgramServiceRevenueAmt
PY Investment Income$71,356PYInvestmentIncomeAmt
CY Investment Income$110,200CYInvestmentIncomeAmt
PY Other Revenue$1,058,001PYOtherRevenueAmt
CY Other Revenue$1,000,376CYOtherRevenueAmt
PY Total Revenue$22,176,189PYTotalRevenueAmt
CY Total Revenue$24,035,297CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$13,219,004PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$14,722,363CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$8,415,024PYOtherExpensesAmt
CY Other Expenses$9,143,645CYOtherExpensesAmt
PY Total Expenses$21,634,028PYTotalExpensesAmt
CY Total Expenses$23,866,008CYTotalExpensesAmt
PY Revenues Less Expenses$542,161PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$169,289CYRevenuesLessExpensesAmt
Total Assets BOY$9,581,310TotalAssetsBOYAmt
Total Assets EOY$9,870,902TotalAssetsEOYAmt
Total Liabilities BOY$1,348,525TotalLiabilitiesBOYAmt
Total Liabilities EOY$1,272,718TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$8,232,785NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$8,598,184NetAssetsOrFundBalancesEOYAmt
MissionTO PROVIDE QUALITY, PATIENT-CENTERED PRIMARY HEALTH CARE, DENTAL AND OTHER SERVICES TO THE MEDICALLY UNDERSERVED IN UTAH REGARDLESS OF THEIR ABILITY TO PAY.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$20,964,763ExpenseAmt
Revenue$11,051,268RevenueAmt
DescCOMMUNITY HEALTH CENTERS PROVIDED PRIMARY MEDICAL CARE TO 49,251 PATIENTS WITH 142,906 INDIVIDUAL VISITS, ORAL HEALTH CARE TO 3,906 PATIENTS WITH 13,212 INDIVIDUAL VISITS AND BEHAVIORAL HEALTH CARE TO 1,111 PATIENTS WITH OVER 2,283 INDIVIDUAL VISITS. THESE SERVICES ARE PROVIDED THROUGH DIRECT SERVICE HEALTH CLINICS TO LOW INCOME AND MEDICALLY UNDERSERVED POPULATIONS THROUGHOUT THE STATE OF UTAH. PRIMARY MEDICAL CARE INCLUDES A SPECIAL EMPHASIS ON PEDIATRIC MEDICINE, WITH 20,971 WELL CHILD CHECKUPS AND 37,934 VACCINES GIVEN TO CHILDREN UNDER AGE 18. ORAL HEALTH CARE INCLUDES AN EDUCATIONAL OUTREACH PROGRAM AND FLUORIDE TREATMENTS FOR CHILDREN IN LOCAL TITLE I ELEMENTARY SCHOOLS.Desc
Total Program Service Expenses$20,964,763TotalProgramServiceExpensesAmt
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
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
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 With Officer EntYes (true)BusinessRlnWithOfficerEntInd
Deductible Non Cash ContriYes (true)DeductibleNonCashContriInd
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 Document32IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee281EmployeeCnt
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 ContributionsYes (true)QuidProQuoContributionsInd
Quid Pro Quo Contri DisclYes (true)QuidProQuoContriDisclInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members13GoverningBodyVotingMembersCnt
Independent Voting Member9IndependentVotingMemberCnt
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 CommitteesYes (true)MinutesOfCommitteesInd
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 OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Other WebsiteYes (X)OtherWebsiteInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1COMMUNITY HEALTH CENTERS INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone8014126920PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12621 SOUTH 3270 WESTAddressLine1Txt
CityWEST VALLEY CITYCityNm
State AbbreviationUTStateAbbreviationCd
ZIP84119ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
GERRY MARTY
GOVERNOR1.50Yes (X)$300$0$0
LILI DECAIR
GOVERNOR1.50Yes (X)$300$0$0
JOAQUIN CHAVEZ
GOVERNOR1.50Yes (X)$300$0$0
DUSTIN NYE
GOVERNOR1.50Yes (X)$275$0$0
MARK BRUNSON
PAST PRESIDE1.50Yes (X)$0$0$0
HOLLY HANSEN
GOVERNOR1.50Yes (X)$0$0$0
SHEILA HASSETT
GOVERNOR1.50Yes (X)$0$0$0
JOSIE VALDEZ
GOVERNOR1.50Yes (X)$0$0$0
WILLIAM NELSON
GOVERNOR1.50Yes (X)$0$0$0
ANDREW SORENSON
GOVERNOR1.50Yes (X)$0$0$0
RACHAEL HOOLEY
PRESIDENT1.50Yes (X)$0$0$0Yes (X)
SUSAN JOHNSTON
TREASURER1.50Yes (X)$0$0$0Yes (X)
LINDA STEARNS
SECRETARY1.50Yes (X)$0$0$0Yes (X)
DEXTER PEARCE
EXEC. DIRECT40.00$141,580$0$16,505Yes (X)
FRANK POWERS
PHYSICIAN40.00$282,747$0$26,492Yes (X)
CARL WHITTAKER
PHYSICIAN40.00$272,688$0$25,546Yes (X)
KEITH HORWOOD
PHYSICIAN40.00$223,259$0$23,134Yes (X)
DAVID GONTRUM
PHYSICIAN40.00$211,921$0$21,024Yes (X)
BRADLEY E SCHLEENBAKER
PHYSICIAN40.00$194,095$0$7,206Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,327,465TotalReportableCompFromOrgAmt
Total Other Compensation$119,907TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K6IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
LABORATORY CORP OF AMERICA
PO BOX 12140BURLINGTONNC272162140LAB TESTING$923,482
CRC CONSTRUCTION
7011 S 700 WMIDVALEUT84047REMODEL$848,654
ECLINICAL WORKS LLC
PO BOX 847950BOSTONMA022847950WEB/IT SUPPORT$346,809
WASATCH SOFTWARE INC
5242 S COLLEGE DR 200MURRAYUT84123IT SUPPORT$329,629
MEDICAL PROFESSIONALS
PO BOX 910569SAN DIEGOCA921910569CLINICAL LABOR$236,157
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K7CntrctRcvdGreaterThan100KCnt
Federated Campaigns$32,475FederatedCampaignsAmt
Government Grants$10,062,354GovernmentGrantsAmt
All Other Contributions$1,778,624AllOtherContributionsAmt
Noncash Contributions$1,962,163NoncashContributionsAmt
Total Contributions$11,873,453TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPATIENT REVENUEDesc
Business624100BusinessCd
Total Revenue Column$11,051,268TotalRevenueColumnAmt
Related Or Exempt Func Income$11,051,268RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$11,051,268TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$110,200TotalRevenueColumnAmt
Exclusion$110,200ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtExclusionExclusionAmt
SALES OF PHARMACEUTICALS TO P624110$978,253$978,253
MEDICAL RECORD RECEIPTS624110$22,123$22,123
FieldValueIRS element (for citing)
Other Revenue Total$1,000,376OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$24,035,297TotalRevenueColumnAmt
Related Or Exempt Func Income$11,051,268RelatedOrExemptFuncIncomeAmt
Exclusion$1,110,576ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$156,913TotalAmt
Management And General$156,913ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$11,164,812TotalAmt
Program Services$10,180,222ProgramServicesAmt
Management And General$984,590ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$902,626TotalAmt
Program Services$794,904ProgramServicesAmt
Management And General$107,722ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,670,956TotalAmt
Program Services$1,484,008ProgramServicesAmt
Management And General$186,948ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$827,056TotalAmt
Program Services$728,353ProgramServicesAmt
Management And General$98,703ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$89,380TotalAmt
Management And General$89,380ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$55,928TotalAmt
Management And General$55,928ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$2,620,030TotalAmt
Program Services$2,058,055ProgramServicesAmt
Management And General$561,975ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$684,284TotalAmt
Program Services$375,764ProgramServicesAmt
Management And General$308,520ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$878,313TotalAmt
Program Services$806,566ProgramServicesAmt
Management And General$71,747ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$63,689TotalAmt
Program Services$22,019ProgramServicesAmt
Management And General$41,670ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$71,995TotalAmt
Program Services$71,995ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$275,986TotalAmt
Program Services$247,037ProgramServicesAmt
Management And General$28,949ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$36,384TotalAmt
Program Services$7,141ProgramServicesAmt
Management And General$29,243ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES$3,922,038$3,922,038
SMALL EQUIPMENT/SUPPLIES$98,156$71,268$26,888
PROVIDER TRAINING CME$90,030$90,030
DUES & FEES$80,930$49,036$31,894

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$176,502TotalAmt
Program Services$56,327ProgramServicesAmt
Management And General$120,175ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$23,866,008TotalAmt
Program Services$20,964,763ProgramServicesAmt
Management And General$2,901,245ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,638,991BOYAmt
EOY$469,941EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$2,502BOYAmt
EOY$2,503EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$1,492,000BOYAmt
EOY$1,082,904EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$685,900BOYAmt
EOY$1,220,285EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$159,271BOYAmt
EOY$214,470EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$30,940BOYAmt
EOY$61,028EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$5,071,776LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$3,146,619LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$1,184,311BOYAmt
EOY$1,925,157EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$4,358,900BOYAmt
EOY$4,872,639EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$28,495BOYAmt
EOY$21,975EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$9,581,310BOYAmt
EOY$9,870,902EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,223,313BOYAmt
EOY$1,182,398EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$125,212BOYAmt
EOY$90,320EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,348,525BOYAmt
EOY$1,272,718EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$8,073,425BOYAmt
EOY$8,586,728EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$159,360BOYAmt
EOY$11,456EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$8,232,785BOYAmt
EOY$8,598,184EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$9,581,310BOYAmt
EOY$9,870,902EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$169,289ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$196,110NetUnrlzdGainsLossesInvstAmt
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)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$8,478,307CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$9,430,247CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$10,681,263CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$11,110,032CurrentTaxYearMinus1YearAmt
Current Tax Year$11,873,453CurrentTaxYearAmt
Total$51,573,302TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$8,478,307CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$9,430,247CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$10,681,263CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$11,110,032CurrentTaxYearMinus1YearAmt
Current Tax Year$11,873,453CurrentTaxYearAmt
Total$51,573,302TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$5,634,327SubstantialContributorsTotAmt
Public Support Total170$45,938,975PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$78,032CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$114,417CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$65,116CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$86,153CurrentTaxYearMinus1YearAmt
Current Tax Year$110,200CurrentTaxYearAmt
Total$453,918TotalAmt

Other Income170 OtherIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$27,027CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$21,818CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$498,877CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,058,001CurrentTaxYearMinus1YearAmt
Current Tax Year$1,000,376CurrentTaxYearAmt
Total$2,606,099TotalAmt
FieldValueIRS element (for citing)
Total Support$54,633,319TotalSupportAmt
Gross Receipts Rltd Activities$45,655,997GrossReceiptsRltdActivitiesAmt
Public Support CY1700.84090PublicSupportCY170Pct
Public Support PY1700.87310PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp

FieldValueIRS element (for citing)
Form And Line ReferencePART II, LINE 10FormAndLineReferenceDesc
ExplanationMEDICAL RECORDS & MISC INCOME 2,606,099ExplanationTxt

Schedule B IRS990ScheduleB

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$89,635InvestmentCostOrOtherBasisAmt
Book Value$89,635BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$465,365InvestmentCostOrOtherBasisAmt
Depreciation$279,219DepreciationAmt
Book Value$186,146BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$2,627,511InvestmentCostOrOtherBasisAmt
Depreciation$1,498,284DepreciationAmt
Book Value$1,129,227BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$1,697,867InvestmentCostOrOtherBasisAmt
Depreciation$1,252,507DepreciationAmt
Book Value$445,360BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$191,398InvestmentCostOrOtherBasisAmt
Depreciation$116,609DepreciationAmt
Book Value$74,789BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$1,925,157TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescGOVERNMENT CONTRACT LIABILITYDesc
Amt$90,320Amt
FieldValueIRS element (for citing)
Total Liability$90,320TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$27,028,725TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$196,110NetUnrealizedGainsInvstAmt
Donated Services And Use Fclts$2,797,318DonatedServicesAndUseFcltsAmt
Revenue Not Reported$2,993,428RevenueNotReportedAmt
Revenue Subtotal$24,035,297RevenueSubtotalAmt
Total Revenue Per Form990$24,035,297TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$26,663,326TotExpnsEtcAuditedFinclStmtAmt
Donated Services Use Fclts$2,797,318DonatedServicesUseFcltsAmt
Expenses Not Reported$2,797,318ExpensesNotReportedAmt
Expenses Subtotal$23,866,008ExpensesSubtotalAmt
Total Expenses Per Form990$23,866,008TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE D, PAGE 3, PART XFormAndLineReferenceDesc
ExplanationTHE ORGANIZATION IS A TAX-EXEMPT ORGANIZATION UNDER INTERNAL REVENUE CODE SECTION 501(C)(3) AND, AS REQUIRED, FILES A FORM 990 (RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX) ANNUALLY. THE ORGANIZATION ENGAGES IN NO ACTIVITY CONSTITUTING TAXABLE UNRELATED BUSINESS INCOME. CONSEQUENTLY, THE ORGANIZATION IS NOT SUBJECT TO FEDERAL OR STATE INCOME TAXES ON INCOME PERTAINING TO ITS EXEMPT PURPOSE AND NO INCOME TAX IS REFLECTED IN THE ACCOMPANYING FINANCIAL STATEMENTS. MANAGEMENT HAS DETERMINED THAT THE ORGANIZATION HAS NO UNCERTAIN TAX POSITIONS THAT REQUIRE EITHER RECOGNITION OR DISCLOSURE IN THE FINANCIAL STATEMENTS.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Club Dues Or FeesYes (X)ClubDuesOrFeesInd
Written Policy Ref T And E ExpnssYes (true)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (true)SubstantiationRequiredInd
Compensation CommitteeYes (X)CompensationCommitteeInd
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 OrgBaseCompensationFilingOrgAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmt
DEXTER PEARCE
EXEC. DIRECTOR$141,580$14,158$2,347$158,085
FRANK POWERS
PHYSICIAN$282,747$23,017$3,475$309,239
CARL WHITTAKER
PHYSICIAN$272,688$22,287$3,259$298,234
KEITH HORWOOD
PHYSICIAN$223,259$19,161$3,973$246,393
DAVID GONTRUM
PHYSICIAN$211,921$19,670$1,354$232,945
BRADLEY E SCHLEENBAKER
PHYSICIAN$194,095$5,065$2,141$201,301

Schedule L IRS990ScheduleL

Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp

Name Of Interested NameOfInterested

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1INTERMOUNTAIN HEALTHCAREBusinessNameLine1Txt
FieldValueIRS element (for citing)
Relationship DescriptionDIREC / OFFICERRelationshipDescriptionTxt
Transaction$1,432,000TransactionAmt
TransactionCASH GRANTTransactionDesc
Sharing Of RevenuesfalseSharingOfRevenuesInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE L, PART VFormAndLineReferenceDesc
Explanation(1)RELATIONSHIP BETWEEN INTERESTED PERSONS AND ORGANIZATION: ANDREW SORENSON, MEMBER OF THE BOARD OF COMMUNITY HEALTH CENTERS, INC., IS EMPLOYED BY AND IS AN OFFICER OF INTERMOUNTAIN HEALTHCARE. INTERMOUNTAIN HEALTHCARE PROVIDES AN ANNUAL CASH GRANT AS WELL AS DONATED SERVICES IN THE FORM OF MEDICAL SERVICES AND X-RAY SERVICES.ExplanationTxt

Schedule M IRS990ScheduleM

Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Contribution32718ContributionCnt
Noncash Contributions Rpt F990$1,962,163NoncashContributionsRptF990Amt
Method Of Determining RevenuesAVG MKT COST OF SUPPLIESMethodOfDeterminingRevenuesTxt
FieldValueIRS element (for citing)
Any Property That Must Be HeldfalseAnyPropertyThatMustBeHeldInd
Review Process Unusual NC GiftsfalseReviewProcessUnusualNCGiftsInd
Third Parties UsedfalseThirdPartiesUsedInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE M, PAGE 2, PART IIFormAndLineReferenceDesc
ExplanationREPORTED THE NUMBER OF CONTRIBUTIONS FOR DRUGS AND MEDICAL SUPPLIES.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PAGE 6, PART VI, LINE 11BTHE FINANCE DIRECTOR COMPARES THE FORM 990 TO THE AUDITED FINANCIAL STATEMENTS AND REVIEWS THE VARIOUS OTHER DISCLOSURES WITH THE EXECUTIVE DIRECTOR. A COPY OF THE FORM 990 IS ALSO PRESENTED, DISCUSSED AND APPROVED BY THE BOARD OF GOVERNORS.
FORM 990, PAGE 6, PART VI, LINE 12CHUMAN RESOURCES REQUIRES ALL NEW EMPLOYEES AND BOARD MEMBERS TO COMPLETE AND SIGN A CONFLICT OF INTEREST STATEMENT. OUR COMPLIANCE OFFICER REVIEWS ALL CONFLICT OF INTEREST STATEMENTS AND INVESTIGATES ANY POTENTIAL CONFLICTS. BOARD MEMBERS DO NOT VOTE ON ISSUES FOR WHICH THEY MAY HAVE A CONFLICT OF INTEREST.
FORM 990, PAGE 6, PART VI, LINE 15AHUMAN RESOURCES CONDUCTS A COMPENSATION STUDY AND MAKE RECOMMENDATIONS TO A COMMITTEE OF THE BOARD CHARGED WITH EVALUATING THE EXECUTIVE DIRECTOR'S JOB PERFORMANCE. THE COMMITTEE THEN APPROVES THE EXECUTIVE DIRECTOR'S COMPENSATION AND RENEWAL OF EMPLOYMENT AGREEMENT.
FORM 990, PAGE 6, PART VI, LINE 19FINANCIAL STATEMENTS, GOVERNING DOCUMENTS, AND COMPANY POLICIES CAN BE OBTAINED BY CONTACTING DEXTER PEARCE EITHER BY PHONE AT 801-412-6920 OR BY MAIL AT 2621 SOUTH 3270 WEST, WEST VALLEY CITY, UT 84119.
FORM 990, PART IX, LINE 11GMEDICAL/LAB/X-RAY 1,090,127 118 0 LAUNDRY SERVICES 46,900 0 0 DENTAL LAB SERVICES 54,330 0 0 EQUIPMENT MAINTENANCE 42,321 719 0 JANITORIAL SERVICES 122,262 3,500 0 MEDICAL WASTE SERVICES 36,452 0 0 SECURITY SERVICES 5,452 0 0 GROUNDS MAINTENANCE 22,294 123 0 PAYROLL SERVICES 0 50,390 0 INTERPRETING SERVICES 19,453 3,423 0 INFORMATION SYSTEM SUPPORT 169,278 428,135 0 AMERICORPS 27,083 0 0 TEMP HELP 230,871 16,389 0 RESIDENTS/FELLOWS 102,910 0 0 COURIER SERVICES 0 20,804 0 MISCELLANEOUS SERVICES 65,215 34,608 0 CONTRACTED PRINTING 23,107 3,766 0 TOTAL 2,058,055 561,975 0