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FIRST CHOICE COMMUNITY HEALTHCARE INC: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
FIRST CHOICE COMMUNITY HEALTHCARE INC (EIN 85-0224409)
Tax period
2016-01-01 to 2016-12-31
Filed
2017-11-15
IRS object ID
201703199349305285
Schema version
2016v3.0
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)
Return2017-11-15T10:29:09-06:00ReturnTs
Tax Period End2016-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN205949532PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1RICCI & COMPANY LLCBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line16200 UPTOWN BLVD NE STE 400AddressLine1Txt
CityALBUQUERQUECityNm
State AbbreviationNMStateAbbreviationCd
ZIP87110ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2016-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN850224409EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1FIRST CHOICE COMMUNITY HEALTHCARE INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlFIRSBusinessNameControlTxt
Phone5058737400PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12001 N CENTRO FAMILIAR BLVD SWAddressLine1Txt
CityALBUQUERQUECityNm
State AbbreviationNMStateAbbreviationCd
ZIP87105ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonCHRISTOPHER GRASTYPersonNm
Person TitleCFOPersonTitleTxt
Phone5058737400PhoneNum
Signature2017-11-14SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJOHN GRISHAMPreparerPersonNm
PTINP00647648PTIN
Phone5053380800PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address204.98.120.221IPv4AddressTxt
FieldValueIRS element (for citing)
IP2017-11-14IPDt
IP Tm15:49:33IPTm
IP TimezoneMSIPTimezoneCd
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device IdBE740F495818E5C1A3DA0E43E0123D734025DE64AtSubmissionCreationDeviceId
At Submission Filing Device IdBE740F495818E5C1A3DA0E43E0123D734025DE64AtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2021-01-29 14:40:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerCHRISTOPHER GRASTYPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line12001 N CENTRO FAMILIAR BLVD SWAddressLine1Txt
CityALBUQUERQUECityNm
State AbbreviationNMStateAbbreviationCd
ZIP87105ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$34,231,460GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.FCCH.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1973FormationYr
Legal Domicile StateNMLegalDomicileStateCd
Activity Or MissionTO PROVIDE COMPREHENSIVE HEALTH CARE FOR THE TOTAL PERSON, THROUGH THE MEDIUM OF MANAGING AND OPERATING COORDINATED HEALTH FACILITIES AND ITS PROGRAMS.ActivityOrMissionDesc
Voting Members Governing Body13VotingMembersGoverningBodyCnt
Voting Members Independent13VotingMembersIndependentCnt
Total Employee489TotalEmployeeCnt
Total Volunteers34TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$11,034,843PYContributionsGrantsAmt
CY Contributions Grants$11,465,229CYContributionsGrantsAmt
PY Program Service Revenue$23,812,414PYProgramServiceRevenueAmt
CY Program Service Revenue$22,740,389CYProgramServiceRevenueAmt
PY Investment Income$1,039PYInvestmentIncomeAmt
CY Investment Income-$16,658CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue-$7,056CYOtherRevenueAmt
PY Total Revenue$34,848,296PYTotalRevenueAmt
CY Total Revenue$34,181,904CYTotalRevenueAmt
PY Grants And Similar Paid$10,000PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$9,000CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$25,953,684PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$26,068,400CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$94,664CYTotalFundraisingExpenseAmt
PY Other Expenses$9,872,972PYOtherExpensesAmt
CY Other Expenses$9,899,446CYOtherExpensesAmt
PY Total Expenses$35,836,656PYTotalExpensesAmt
CY Total Expenses$35,976,846CYTotalExpensesAmt
PY Revenues Less Expenses-$988,360PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$1,794,942CYRevenuesLessExpensesAmt
Total Assets BOY$22,782,164TotalAssetsBOYAmt
Total Assets EOY$21,810,470TotalAssetsEOYAmt
Total Liabilities BOY$2,545,196TotalLiabilitiesBOYAmt
Total Liabilities EOY$3,366,608TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$20,236,968NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$18,443,862NetAssetsOrFundBalancesEOYAmt
MissionTO PROVIDE PRIMARY MEDICAL AND DENTAL CARE INCLUDING HEALTH EDUCATION TO RESIDENTS OF BERNALILLO, VALENCIA, AND SANTA FE COUNTIES OF NEW MEXICO.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$28,761,610ExpenseAmt
Grant$9,000GrantAmt
Revenue$22,740,389RevenueAmt
DescTHROUGH ITS NINE HEALTH CENTERS, THE ORGANIZATION (FCCH) PROVIDES MEDICAL, DENTAL, BEHAVIORAL HEALTH & NUTRITION SERVICES, AND HEALTH EDUCATION TO MODERATE AND LOW INCOME RESIDENTS OF BERNALILLO, VALENCIA AND SANTA FE COUNTIES OF NEW MEXICO. FCCH'S CLIENTS ARE CULTURALLY AND ECONOMICALLY DIVERSE.Desc
Total Program Service Expenses$28,761,610TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional FundraisingYes (1)ProfessionalFundraisingInd
Fundraising ActivitiesYes (1)FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To IndividualsYes (1)GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash ContriYes (1)DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document48IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee489EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo ContributionsYes (1)QuidProQuoContributionsInd
Quid Pro Quo Contri DisclYes (1)QuidProQuoContriDisclInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members13GoverningBodyVotingMembersCnt
Independent Voting Member13IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn Body0Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn0AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldNMStatesWhereCopyOfReturnIsFldCd
Other WebsiteYes (X)OtherWebsiteInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1THE ORGANIZATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone5058737400PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line12001 N CENTRO FAMILIAR BLVD SWAddressLine1Txt
CityALBUQUERQUECityNm
State AbbreviationNMStateAbbreviationCd
ZIP87105ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (24 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
PAUL LUNA
PRESIDENT1.00Yes (X)Yes (X)$0$0$0
GRACE CHAVEZ
VICE-PRESIDENT1.00Yes (X)Yes (X)$0$0$0
FLOYD WILSON
TREASURER1.00Yes (X)Yes (X)$0$0$0
ROD MERCURE
SECRETARY1.00Yes (X)Yes (X)$0$0$0
SARA BACA
DIRECTOR1.00Yes (X)$0$0$0
LUCY JOJOLA
DENTAL DIRECTOR1.00Yes (X)$0$0$0
MARY DOMINGUEZ
DIRECTOR1.00Yes (X)$0$0$0
LOURDES ORTIZ
DIRECTOR1.00Yes (X)$0$0$0
CHARLES RING
DIRECTOR1.00Yes (X)$0$0$0
PATRICIA WEST
DIRECTOR1.00Yes (X)$0$0$0
GLORIA SUE DOHERTY
DIRECTOR1.00Yes (X)$0$0$0
DR PAUL HOPKINS
DIRECTOR1.00Yes (X)$0$0$0
DR JOSE MARTINEZ
DIRECTOR1.00Yes (X)$0$0$0
ROBERT DEFELICE
CEO40.00Yes (X)$173,496$0$25,732
CHRISTOPHER GRASTY
CFO40.00Yes (X)$101,657$0$18,370
MELISSA MANLOVE
COO40.00Yes (X)$118,347$0$35,426
NORMA BOYD
HR DIRECTOR40.00Yes (X)$95,684$0$17,210
FRANCISCO CRESPIN
MEDICAL DIRECTOR40.00Yes (X)$200,595$0$8,989
JEREMIAH DYE
DENTAL DIRECTOR40.00Yes (X)$182,519$0$39,646
SAVERIO SAVA
CLINICAL SUPERVISOR40.00$225,563$0$40,758Yes (X)
RICHARD ARIES
CLINICAL SUPERVISOR40.00$180,642$0$39,831Yes (X)
WILL KAUFMAN
PHYSICIAN40.00$207,833$0$11,000Yes (X)
MARK BRUM
DENTIST40.00$172,885$0$39,570Yes (X)
JESSICA MONTHAN
PHYSICIAN40.00$185,211$0$8,040Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,844,432TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$284,572TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K43IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
TRICORE REFERENCE LABORATORIES
1001 WOODWARD PL NEALBUQUERQUENM87102LABORATORY TESTING SERVICES$1,417,276
HENRY SCHEIN INC
DEPT CH 10241PALATINEIL60055MEDICAL & DENTAL SUPPLIES$737,396
CARDINAL HEALTH
7001 CARDINAL PLACEDUBLINOH43017PHARMACEUTICALS$731,684
CERNER HEALTHCARE SOLUTIONS
PO BOX 412732KANSAS CITYMO64141ELECTRONIC MEDICAL RECORDS$284,866
THE HARTFORD
ONE HARTFORD PLACEHARTFORDCT06155EMPLOYEE BENEFITS$223,669
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K12CntrctRcvdGreaterThan100KCnt
Fundraising$100,321FundraisingAmt
Government Grants$9,869,298GovernmentGrantsAmt
All Other Contributions$1,495,610AllOtherContributionsAmt
Noncash Contributions$1,465,076NoncashContributionsAmt
Total Contributions$11,465,229TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
PATIENT CARE REVENUE621400$22,600,533$22,600,533
OTHER MEDICAL REVENUE621400$139,856$139,856
FieldValueIRS element (for citing)
Total Program Service Revenue$22,740,389TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$3,503TotalRevenueColumnAmt
Exclusion$3,503ExclusionAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Other$20,161OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Other-$20,161OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$20,161TotalRevenueColumnAmt
Exclusion-$20,161ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$22,339FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$100,321ContriRptFundraisingEventAmt
Fundraising Direct Expenses$29,395FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column-$7,056TotalRevenueColumnAmt
Exclusion-$7,056ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$34,181,904TotalRevenueColumnAmt
Related Or Exempt Func Income$22,740,389RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion-$23,714ExclusionAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$9,000TotalAmt
Program Services$9,000ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$872,298TotalAmt
Program Services$695,778ProgramServicesAmt
Management And General$175,632ManagementAndGeneralAmt
Fundraising$888FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$20,550,438TotalAmt
Program Services$16,391,801ProgramServicesAmt
Management And General$4,137,712ManagementAndGeneralAmt
Fundraising$20,925FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$1,198,405TotalAmt
Program Services$962,256ProgramServicesAmt
Management And General$236,149ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,910,827TotalAmt
Program Services$1,521,368ProgramServicesAmt
Management And General$389,459ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,536,432TotalAmt
Program Services$1,228,035ProgramServicesAmt
Management And General$308,397ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$29,143TotalAmt
Management And General$29,143ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$57,867TotalAmt
Management And General$57,867ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$99,073TotalAmt
Program Services$35,156ProgramServicesAmt
Management And General$63,917ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$2,074TotalAmt
Program Services$1,796ProgramServicesAmt
Management And General$278ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$769,853TotalAmt
Program Services$619,975ProgramServicesAmt
Management And General$147,803ManagementAndGeneralAmt
Fundraising$2,075FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$846,221TotalAmt
Program Services$475,576ProgramServicesAmt
Management And General$370,645ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$478,144TotalAmt
Program Services$368,963ProgramServicesAmt
Management And General$109,181ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$28,278TotalAmt
Program Services$14,668ProgramServicesAmt
Management And General$13,610ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$16,984TotalAmt
Program Services$1,940ProgramServicesAmt
Management And General$15,044ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$7,718TotalAmt
Management And General$7,718ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$884,049TotalAmt
Program Services$696,299ProgramServicesAmt
Management And General$187,750ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$21,325TotalAmt
Management And General$21,325ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (3 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
CLINICAL SERVICES/SUPPL$5,151,267$5,041,792$109,475
CONTRACT SERVICES$1,441,336$657,562$712,998$70,776
DUES AND LICENSES$66,114$39,645$26,469

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$35,976,846TotalAmt
Program Services$28,761,610ProgramServicesAmt
Management And General$7,120,572ManagementAndGeneralAmt
Fundraising$94,664FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$3,829,051BOYAmt
EOY$3,353,719EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$3,864,850BOYAmt
EOY$3,870,179EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$2,489,386BOYAmt
EOY$2,735,279EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$431,033BOYAmt
EOY$364,778EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$248,599BOYAmt
EOY$241,787EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$18,731,137LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$7,486,409LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$11,919,245BOYAmt
EOY$11,244,728EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$22,782,164BOYAmt
EOY$21,810,470EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$2,510,444BOYAmt
EOY$3,264,027EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$34,752BOYAmt
EOY$102,581EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$2,545,196BOYAmt
EOY$3,366,608EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$20,218,858BOYAmt
EOY$18,371,848EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$18,110BOYAmt
EOY$72,014EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$20,236,968BOYAmt
EOY$18,443,862EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$22,782,164BOYAmt
EOY$21,810,470EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$1,794,942ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$1,836NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit RequiredYes (1)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (1)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

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 C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact LegislatorsYes (1)DirectContactLegislatorsInd
Direct Contact Legislators$10,007DirectContactLegislatorsAmt
Rallies Demonstrations0RalliesDemonstrationsInd
Other Activities0OtherActivitiesInd
Total Lobbying Expenditures$10,007TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationTHE ORGANIZATION HIRED AN INDIVIDUAL TO EDUCATE CITY AND STATE LEGISLATORS TO PROMOTE AND CONTINUE HEALTHCARE INITIATIVES THAT BENEFIT WOMEN, CHILDREN, AND FAMILIES OF MODERATE TO LOW INCOME NEW MEXICANS LIVING IN BERNALILLO, VALENCIA, AND SANTA FE COUNTIES. LOBBYING WAS PERFORMED FOR CAPITAL OUTLAY APPROPRIATIONS OPPORTUNITIES, EDGEWOOD COMMONS PROJECT, ETC.ExplanationTxt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,017,822OtherCostOrOtherBasisAmt
Book Value$1,017,822BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$8,850,643OtherCostOrOtherBasisAmt
Depreciation$2,272,730DepreciationAmt
Book Value$6,577,913BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$3,446,011OtherCostOrOtherBasisAmt
Depreciation$1,013,361DepreciationAmt
Book Value$2,432,650BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$5,416,661OtherCostOrOtherBasisAmt
Depreciation$4,200,318DepreciationAmt
Book Value$1,216,343BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$11,244,728TotalBookValueLandBuildingsAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$35,281,097TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$1,836NetUnrealizedGainsInvstAmt
Donated Services And Use Fclts$1,075,680DonatedServicesAndUseFcltsAmt
Other Revenue$29,395OtherRevenueAmt
Revenue Not Reported$1,106,911RevenueNotReportedAmt
Revenue Subtotal$34,174,186RevenueSubtotalAmt
Other Revenues Not Included$7,718OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt$7,718RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$34,181,904TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$37,074,203TotExpnsEtcAuditedFinclStmtAmt
Donated Services Use Fclts$1,075,680DonatedServicesUseFcltsAmt
Other Expenses Included$29,395OtherExpensesIncludedAmt
Expenses Not Reported$1,105,075ExpensesNotReportedAmt
Expenses Subtotal$35,969,128ExpensesSubtotalAmt
Other Expenses Not Included$7,718OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt$7,718ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$35,976,846TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART X, LINE 2:FCCH HAS CONCLUDED NO MATERIAL UNCERTAIN TAX POSITIONS HAVE BEEN TAKEN ON ANY OPEN TAX RETURNS. FOR THE CURRENT YEAR, FCCH BELIEVES ALL TAX POSITIONS ARE FULLY SUPPORTABLE BY EXISTING FEDERAL LAW AND RELATED INTERPRETATIONS AND THERE ARE NO UNCERTAIN TAX POSITIONS TO CONSIDER.
PART XI, LINE 2D - OTHER ADJUSTMENTS:RECLASSED DIRECT FUNDRAISING EXPENSES 29,395.
PART XI, LINE 4B - OTHER ADJUSTMENTS:RECLASSED INTEREST EXPENSE 7,718.
PART XII, LINE 2D - OTHER ADJUSTMENTS:RECLASSED FUNDRAISING EXPENSES 29,395.
PART XII, LINE 4B - OTHER ADJUSTMENTS:RECLASSED INTEREST EXPENSE 7,718.

Schedule G IRS990ScheduleG

FieldValueIRS element (for citing)
Solicitation Of Non Govt GrantsYes (X)SolicitationOfNonGovtGrantsInd
Solicitation Of Govt GrantsYes (X)SolicitationOfGovtGrantsInd
Special Fundraising EventsYes (X)SpecialFundraisingEventsInd
Agrmt Prof Fundraising ActyYes (1)AgrmtProfFundraisingActyInd

Fundraiser Activity Info FundraiserActivityInfoGrp

Organization Business Name OrganizationBusinessName

FieldValueIRS element (for citing)
Business Name Line1MOTIVA CORPORATIONBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1306 PLAZA CONSUELOAddressLine1Txt
CityBERNALILLOCityNm
State AbbreviationNMStateAbbreviationCd
ZIP87004ZIPCd
FieldValueIRS element (for citing)
ActivityGRANT & LOBBYING ACTIVITYActivityTxt
Fundraiser Control Of Funds0FundraiserControlOfFundsInd
Gross Receipts$0GrossReceiptsAmt
Retained By Contractor$49,607RetainedByContractorAmt
Net To Organization-$49,607NetToOrganizationAmt
FieldValueIRS element (for citing)
Total Retained By Contractors$49,607TotalRetainedByContractorsAmt
Total Net To Organization-$49,607TotalNetToOrganizationAmt
Licensed StatesNMLicensedStatesCd

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1FARM GALAEvent1Nm
Gross Receipts Event1$87,560GrossReceiptsEvent1Amt
Charitable Contri Event1$71,295CharitableContriEvent1Amt
Gross Revenue Event1$16,265GrossRevenueEvent1Amt
Rent Facility Costs Event1$10,407RentFacilityCostsEvent1Amt
Food And Beverage Event1$5,178FoodAndBeverageEvent1Amt
Entertainment Event1$900EntertainmentEvent1Amt
Other Direct Expenses Event1$3,527OtherDirectExpensesEvent1Amt
Event2GOLF TOURNAMENTEvent2Nm
Gross Receipts Event2$35,100GrossReceiptsEvent2Amt
Charitable Contri Event2$29,026CharitableContriEvent2Amt
Gross Revenue Event2$6,074GrossRevenueEvent2Amt
Rent Facility Costs Event2$5,040RentFacilityCostsEvent2Amt
Food And Beverage Event2$1,594FoodAndBeverageEvent2Amt
Other Direct Expenses Event2$2,749OtherDirectExpensesEvent2Amt
Gross Receipts Total$122,660GrossReceiptsTotalAmt
Charitable Contributions Tot$100,321CharitableContributionsTotAmt
Gross Revenue Total Events$22,339GrossRevenueTotalEventsAmt
Rent Fclty Costs Total Events$15,447RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events$6,772FoodAndBeverageTotalEventsAmt
Entertainment Total Events$900EntertainmentTotalEventsAmt
Oth Direct Expnss Total Events$6,276OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$29,395DirectExpenseSummaryEventsAmt
Net Income Summary-$7,056NetIncomeSummaryAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE G, PART I, LINE 2B, COLUMN (V)FormAndLineReferenceDesc
ExplanationTHE ORGANIZATION PAID THE FUNDRAISER FOR HELP WITH OBTAINING GOVERNMENT GRANTS AND NON-GOVERNMENT GRANTS AS WELL AS ASSIST WITH EVENT PLANNING.ExplanationTxt

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

FieldValueIRS element (for citing)
Grant TypeSCHOLARSHIPSGrantTypeTxt
Recipient9RecipientCnt
Cash Grant$9,000CashGrantAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationALL HIGH SCHOOL SENIORS WHO ATTEND SCHOOL IN THE NEIGHBORHOODS OF FCCH HEALTH CENTERS THAT ARE PLANNING TO ENGAGE IN FURTHER STUDIES TOWARD A CAREER IN HEALTHCARE ARE ELIGIBLE TO APPLY. THIS INCLUDES TECHNICAL/VOCATIONAL SCHOOLS, COLLEGES AND UNIVERSITIES. THE STUDENTS ARE REQUIRED TO HAVE TWO LETTERS OF RECOMMENDATION. ADDITIONALLY, THE STUDENT IS REQUIRED TO HAVE A MINIMUM G.P.A. OF 2.50. THIS LATTER REQUIREMENT IS WAIVED FOR STUDENTS ATTENDING ALTERNATIVE HIGH SCHOOLS, SUCH AS FREEDOM HIGH IN ALBUQUERQUE. THE PACKAGES ARE REVIEWED BY MEMBERS OF THE BOARD OF DIRECTORS AND RECIPIENTS ARE THEN NOTIFIED OF THEIR SELECTION.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
ROBERT DEFELICE
CEO$173,496$0$0$0$0$0$15,702$0$10,030$0$199,228$0$0$0
MELISSA MANLOVE
COO$118,347$0$0$0$0$0$9,944$0$25,482$0$153,773$0$0$0
FRANCISCO CRESPIN
MEDICAL DIRECTOR$200,595$0$0$0$0$0$5,856$0$3,133$0$209,584$0$0$0
JEREMIAH DYE
DENTAL DIRECTOR$182,519$0$0$0$0$0$15,100$0$24,546$0$222,165$0$0$0
SAVERIO SAVA
CLINICAL SUPERVISOR$225,563$0$0$0$0$0$16,212$0$24,546$0$266,321$0$0$0
RICHARD ARIES
CLINICAL SUPERVISOR$180,642$0$0$0$0$0$14,949$0$24,882$0$220,473$0$0$0
WILL KAUFMAN
PHYSICIAN$207,833$0$0$0$0$0$9,635$0$1,365$0$218,833$0$0$0
MARK BRUM
DENTIST$172,885$0$0$0$0$0$14,208$0$25,362$0$212,455$0$0$0
JESSICA MONTHAN
PHYSICIAN$185,211$0$0$0$0$0$6,675$0$1,365$0$193,251$0$0$0

Schedule M IRS990ScheduleM

Intellectual Property IntellectualPropertyGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Contribution1ContributionCnt
Noncash Contributions Rpt F990$456,300NoncashContributionsRptF990Amt
Method Of Determining RevenuesIT LICENSE COSTMethodOfDeterminingRevenuesTxt

Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Contribution14160ContributionCnt
Noncash Contributions Rpt F990$955,628NoncashContributionsRptF990Amt
Method Of Determining RevenuesPER UNIT COSTMethodOfDeterminingRevenuesTxt

Other Non Cash Contri Table OtherNonCashContriTableGrp (2 entries)

Non Cash CheckboxNonCashCheckboxIndDescDescContributionContributionCntNoncash Contributions Rpt F990NoncashContributionsRptF990AmtMethod Of Determining RevenuesMethodOfDeterminingRevenuesTxt
Yes (X)BOOKS & PUBLICATIONS6677$50,748COST
Yes (X)ABBOTT LABS GLUCOMETERS1$2,400COST
FieldValueIRS element (for citing)
Any Property That Must Be Held0AnyPropertyThatMustBeHeldInd
Review Process Unusual NC Gifts0ReviewProcessUnusualNCGiftsInd
Third Parties Used0ThirdPartiesUsedInd

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (8 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11BTHE BOARD OF DIRECTORS (BOD) DELEGATES THE REVIEW OF THE FORM 990 TO THE ORGANIZATION'S MANAGEMENT. THE CFO, CONTROLLER, CEO, AND INTERNAL AUDITOR REVIEW THE FORM 990 PRIOR TO ITS FILING. A COPY OF THE AUDITED FINANCIAL STATEMENTS IS FORWARDED TO ALL BOARD MEMBERS. THE BOD THEN REVIEW THE AUDITED FINANCIALS WITH THE ORGANIZATION'S MANAGEMENT AND REPRESENTATIVES OF THE AUDIT FIRM.
FORM 990, PART VI, SECTION B, LINE 12CTHE CONFLICT OF INTEREST POLICY IS REVIEWED WITH EACH BOARD MEMBER AS WELL AS NEW HIRE DURING ORIENTATION.
FORM 990, PART VI, SECTION B, LINE 15THE BOARD HIRES THE CEO AND DETERMINES THE SALARY. OTHER KEY EMPLOYEES ARE HIRED SIMILIAR TO REGULAR EMPLOYEES. THEIR SALARY IS BASED OFF A SALARY SCHEDULE, EMPLOYEE'S LEVEL OF EDUCATION, AND YEARS OF EXPERIENCE.
FORM 990, PART VI, SECTION C, LINE 18THE CFO, CHRISTOPHER GRASTY, IS IN POSSESSION OF THE BOOKS AND RECORDS OF THE ORGANIZATION IN THE ALBUQUERQUE OFFICE LOCATION.
FORM 990, PART VI, SECTION C, LINE 19THE FINANCIAL RECORDS AND GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST AT THE ORGANIZATION'S ALBUQUERQUE OFFICE.
FORM 990, PART XII, LINE 2C:THE AUDIT SELECTION AND REVIEW PROCESS HAS NOT CHANGED - IT IS THE SAME AS IN THE PRIOR YEAR.
FORM 990, SCHEDULE B NONCASH DONATIONS EXPLANATION:THE ORGANIZATION RECEIVES SAMPLES OF VARIOUS PHARMACEUTICAL DRUGS FOR DISTRIBUTION AT CLINICS THROUGHOUT THE YEAR. THE COMPANIES WHICH PROVIDE THE SAMPLES IN VARYING QUANTITIES ARE INCLUDED ON SCHEDULE B. THE CALCULATION OF THE DONATIONS OF THESE SAMPLES ARE ESTIMATED BASED ON THE NUMBER OF UNITS DONATED.
FORM 990, SCHEDULE A PART I, SCHEDULE H EXPLANATION:THE ORGANIZATION OPERATES HEALTH CLINICS AND, AS SUCH, HAS RECEIVED TAX-EXEMPT STATUS UNDER IRC SECTION 170(B)(1)(A)(III). HOWEVER, IT IS NOT LICENSED BY THE STATE OF NEW MEXICO AS A HOSPITAL AND, PURSUANT TO SCHEDULE H INSTRUCTIONS, IS NOT REQUIRED TO FILE SCHEDULE H OR CHECK "YES" TO ITEM 20 IN PART IV OF PAGE 3 OF FORM 990.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1FIRST CHOICE COMMUNITY HEALTHCARE INC MEDICAL DISABILITY TRUSTBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line12001 N CENTRO FAMILIAR BLVD SWAddressLine1Txt
CityALBUQUERQUECityNm
State AbbreviationNMStateAbbreviationCd
ZIP87105ZIPCd
FieldValueIRS element (for citing)
EIN850342798EIN
Primary ActivitiesPROVIDE MEDICAL, DENTAL AND DISABILITY BENEFITS TO PARTICIPANTSPrimaryActivitiesTxt
Legal Domicile StateNMLegalDomicileStateCd
Exempt Code Section501(C)(9)ExemptCodeSectionTxt
Direct Controlling NAN/ADirectControllingNACd
Controlled Organization0ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other OrgYes (1)TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp

Other Organization Name OtherOrganizationName

FieldValueIRS element (for citing)
Business Name Line1FIRST CHOICE COMMUNITY HEALTHCARE INC MEDICAL DISABILITY TRUSTBusinessNameLine1Txt
FieldValueIRS element (for citing)
Transaction TypeRTransactionTypeTxt
Involved$1,523,000InvolvedAmt
Method Of Amount DeterminationTRNSFR TO PAY FOR MEDICAL CLAIMSMethodOfAmountDeterminationTxt