COMMUNITY HEALTH CENTERS INC: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- COMMUNITY HEALTH CENTERS INC (EIN 74-2412898)
- Tax period
- 2015-01-01 to 2015-12-31
- Filed
- 2016-11-14
- IRS object ID
- 201643199349307014
- Schema version
- 2015v2.1
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-11-14T13:11:32-06:00 | ReturnTs |
| Tax Period End | 2015-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 870517754 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WSRP LLC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 155 N 400 W STE 400 | AddressLine1Txt |
| City | SALT LAKE CITY | CityNm |
| State Abbreviation | UT | StateAbbreviationCd |
| ZIP | 84103 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 742412898 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY HEALTH CENTERS INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | COMM | BusinessNameControlTxt |
| Phone | 8014126920 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 220 WEST 7200 SOUTH SUITE A | AddressLine1Txt |
| City | MIDVALE | CityNm |
| State Abbreviation | UT | StateAbbreviationCd |
| ZIP | 84047 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DEXTER PEARCE | PersonNm |
| Person Title | EXEC. DIRECTOR | PersonTitleTxt |
| Phone | 8018583452 | PhoneNum |
| Signature | 2016-11-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DANIEL P RINEHART CPA | PreparerPersonNm |
| PTIN | P01057041 | PTIN |
| Phone | 8013282011 | PhoneNum |
| Preparation | 2016-11-11 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2017-02-10 21:41:12Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | DEXTER PEARCE | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1798 SOUTH WEST TEMPLE SUITE A-100 | AddressLine1Txt |
| City | SALT LAKE CITY | CityNm |
| State Abbreviation | UT | StateAbbreviationCd |
| ZIP | 84115 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $20,769,330 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | HTTP://WWW.CHC-UT.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1979 | FormationYr |
| Legal Domicile State | UT | LegalDomicileStateCd |
| Activity Or Mission | TO 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 Body | 17 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 13 | VotingMembersIndependentCnt |
| Total Employee | 256 | TotalEmployeeCnt |
| Total Volunteers | 10 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $9,430,247 | PYContributionsGrantsAmt |
| CY Contributions Grants | $10,681,263 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $8,387,732 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $8,750,940 | CYProgramServiceRevenueAmt |
| PY Investment Income | $81,545 | PYInvestmentIncomeAmt |
| CY Investment Income | -$38,478 | CYInvestmentIncomeAmt |
| PY Other Revenue | $21,818 | PYOtherRevenueAmt |
| CY Other Revenue | $487,857 | CYOtherRevenueAmt |
| PY Total Revenue | $17,921,342 | PYTotalRevenueAmt |
| CY Total Revenue | $19,881,582 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $10,507,579 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $11,528,627 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $30 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $6,883,420 | PYOtherExpensesAmt |
| CY Other Expenses | $7,346,472 | CYOtherExpensesAmt |
| PY Total Expenses | $17,390,999 | PYTotalExpensesAmt |
| CY Total Expenses | $18,875,099 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $530,343 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,006,483 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $8,480,659 | TotalAssetsBOYAmt |
| Total Assets EOY | $8,758,972 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,933,530 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,171,682 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $6,547,129 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $7,587,290 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO 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 Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $16,508,087 | ExpenseAmt |
| Revenue | $8,750,940 | RevenueAmt |
| Desc | COMMUNITY HEALTH CENTERS PROVIDED PRIMARY MEDICAL CARE TO 33,000 PATIENTS WITH OVER 92,000 INDIVIDUAL VISITS, ORAL HEALTH CARE TO 4,800 PATIENTS WITH OVER 12,700 INDIVIDUAL VISITS AND BEHAVIORAL HEALTH CARE TO OVER 600 PATIENTS WITH OVER 1,200 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 JUST UNDER 15,000 WELL CHILD CHECKUPS AND 32,000 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 | $16,508,087 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | Yes (true) | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | Yes (true) | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 30 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 256 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (true) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (true) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 17 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 13 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | UT | StatesWhereCopyOfReturnIsFldCd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY HEALTH CENTERS INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8014126920 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 220 WEST 7200 SOUTH SUITE A | AddressLine1Txt |
| City | MIDVALE | CityNm |
| State Abbreviation | UT | StateAbbreviationCd |
| ZIP | 84047 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| GERRY MARTY | |||||||
| GOVERNOR | 1.50 | Yes (X) | $300 | $0 | $0 | ||
| JOAQUIN CHAVEZ | |||||||
| GOVERNOR | 1.50 | Yes (X) | $300 | $0 | $0 | ||
| LIDIA PEREZ | |||||||
| GOVERNOR | 1.50 | Yes (X) | $200 | $0 | $0 | ||
| GERALD JONES | |||||||
| GOVERNOR | 1.50 | Yes (X) | $100 | $0 | $0 | ||
| SUZANNE DRAPER | |||||||
| PAST PRESIDE | 1.50 | Yes (X) | $0 | $0 | $0 | ||
| BOB BUNNELL | |||||||
| PAST PRESIDE | 1.50 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| MARTHA MENDES | |||||||
| SECRETARY | 1.50 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| LILI DECAIR | |||||||
| GOVERNOR | 1.50 | Yes (X) | $0 | $0 | $0 | ||
| MARK BRUNSON | |||||||
| PRESIDENT | 1.50 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| JOHN LEWIS | |||||||
| GOVERNOR | 1.50 | Yes (X) | $0 | $0 | $0 | ||
| JOHN HAYNES | |||||||
| GOVERNOR | 1.50 | Yes (X) | $0 | $0 | $0 | ||
| HOLLY HANSEN | |||||||
| GOVERNOR | 1.50 | Yes (X) | $0 | $0 | $0 | ||
| VASANTHI SEKHAR | |||||||
| PAST TREASUR | 1.50 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| SHEILA HASSETT | |||||||
| GOVERNOR | 1.50 | Yes (X) | $0 | $0 | $0 | ||
| JOSIE VALDEZ | |||||||
| GOVERNOR | 1.50 | Yes (X) | $0 | $0 | $0 | ||
| WILLIAM NELSON | |||||||
| GOVERNOR | 1.50 | Yes (X) | $0 | $0 | $0 | ||
| ANDREW SORENSON | |||||||
| TREASURER | 1.50 | Yes (X) | $0 | $0 | $0 | Yes (X) | |
| DEXTER PEARCE | |||||||
| EXEC. DIRECT | 40.00 | $124,746 | $0 | $12,806 | Yes (X) | ||
| CARL WHITTAKER | |||||||
| PHYSICIAN | 40.00 | $223,826 | $0 | $24,961 | Yes (X) | ||
| FRANK POWERS | |||||||
| PHYSICIAN | 40.00 | $221,230 | $0 | $25,111 | Yes (X) | ||
| KEITH HORWOOD | |||||||
| ASSTMEDDIR/P | 40.00 | $175,446 | $0 | $20,533 | Yes (X) | ||
| DAVID GONTRUM | |||||||
| PHYSICIAN | 40.00 | $170,184 | $0 | $19,055 | Yes (X) | ||
| ANDREW GARRISON | |||||||
| PHYSICIAN | 40.00 | $151,810 | $0 | $17,667 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,068,142 | TotalReportableCompFromOrgAmt |
| Total Other Compensation | $120,133 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 6 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| LABORATORY CORP OF AMERICA | |||||
| PO BOX 12140 | BURLINGTON | NC | 272162140 | LAB TESTING | $573,591 |
| MEDICAL PROFESSIONALS | |||||
| PO BOX 910569 | SAN DIEGO | CA | 921910569 | CLINICAL LABOR | $280,212 |
| WASATCH SOFTWARE INC | |||||
| 5242 S COLLEGE DR 200 | MURRAY | UT | 84123 | IT SUPPORT | $212,055 |
| ECLINICAL WORKS LLC | |||||
| PO BOX 847950 | BOSTON | MA | 022847950 | WEB/IT SUPPORT | $211,335 |
| DYNAMOND BLDG MAINTENANCE | |||||
| PO BOX 1017 | PLEASANT GROVE | UT | 840621017 | JANITORIAL | $129,787 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 6 | CntrctRcvdGreaterThan100KCnt |
| Federated Campaigns | $183,354 | FederatedCampaignsAmt |
| Government Grants | $8,183,418 | GovernmentGrantsAmt |
| All Other Contributions | $2,314,491 | AllOtherContributionsAmt |
| Noncash Contributions | $1,719,259 | NoncashContributionsAmt |
| Total Contributions | $10,681,263 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT REVENUE | Desc |
| Business | 624100 | BusinessCd |
| Total Revenue Column | $8,750,940 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $8,750,940 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $8,750,940 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $65,116 | TotalRevenueColumnAmt |
| Exclusion | $65,116 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $773,134 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $873,370 | SecuritiesAmt |
| Other | $3,358 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -$100,236 | SecuritiesAmt |
| Other | -$3,358 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$103,594 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | -$3,358 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | -$100,236 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $10,455 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $11,020 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$565 | TotalRevenueColumnAmt |
| Exclusion | -$565 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| SALES OF PHARMACEUTICALS TO P | 624110 | $471,439 | $471,439 |
| MEDICAL RECORD RECEIPTS | 624110 | $16,983 | $16,983 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $488,422 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $19,881,582 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $8,747,582 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $452,737 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $138,452 | TotalAmt |
| Management And General | $138,452 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,737,237 | TotalAmt |
| Program Services | $7,843,180 | ProgramServicesAmt |
| Management And General | $894,057 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $882,211 | TotalAmt |
| Program Services | $787,057 | ProgramServicesAmt |
| Management And General | $95,154 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,111,190 | TotalAmt |
| Program Services | $1,002,764 | ProgramServicesAmt |
| Management And General | $108,426 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $659,537 | TotalAmt |
| Program Services | $588,401 | ProgramServicesAmt |
| Management And General | $71,136 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,522 | TotalAmt |
| Program Services | $1,831 | ProgramServicesAmt |
| Management And General | $24,691 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $44,747 | TotalAmt |
| Management And General | $44,747 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,404 | TotalAmt |
| Management And General | $15,404 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,275,734 | TotalAmt |
| Program Services | $1,824,322 | ProgramServicesAmt |
| Management And General | $451,412 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $536,191 | TotalAmt |
| Program Services | $329,416 | ProgramServicesAmt |
| Management And General | $206,775 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $770,708 | TotalAmt |
| Program Services | $699,427 | ProgramServicesAmt |
| Management And General | $71,281 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $67,878 | TotalAmt |
| Program Services | $25,729 | ProgramServicesAmt |
| Management And General | $42,119 | ManagementAndGeneralAmt |
| Fundraising | $30 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $63,436 | TotalAmt |
| Program Services | $63,436 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $244,253 | TotalAmt |
| Program Services | $213,368 | ProgramServicesAmt |
| Management And General | $30,885 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $31,526 | TotalAmt |
| Program Services | $5,747 | ProgramServicesAmt |
| Management And General | $25,779 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $2,821,127 | $2,821,127 | |
| SMALL EQUIPMENT/SUPPLIES | $124,192 | $95,708 | $28,484 |
| DUES & FEES | $98,745 | $67,257 | $31,488 |
| RECRUITMENT | $92,778 | $53,008 | $39,770 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $133,231 | TotalAmt |
| Program Services | $86,309 | ProgramServicesAmt |
| Management And General | $46,922 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,875,099 | TotalAmt |
| Program Services | $16,508,087 | ProgramServicesAmt |
| Management And General | $2,366,982 | ManagementAndGeneralAmt |
| Fundraising | $30 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,387,751 | BOYAmt |
| EOY | $1,075,370 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,500 | BOYAmt |
| EOY | $2,500 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $508,944 | BOYAmt |
| EOY | $1,070,512 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $595,936 | BOYAmt |
| EOY | $687,755 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $103,989 | BOYAmt |
| EOY | $169,042 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $81,722 | BOYAmt |
| EOY | $59,053 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $3,869,605 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $2,649,273 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,322,984 | BOYAmt |
| EOY | $1,220,332 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,464,836 | BOYAmt |
| EOY | $4,447,411 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,997 | BOYAmt |
| EOY | $26,997 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,480,659 | BOYAmt |
| EOY | $8,758,972 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,137,682 | BOYAmt |
| EOY | $1,099,250 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $197,976 | BOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $597,872 | BOYAmt |
| EOY | $72,432 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,933,530 | BOYAmt |
| EOY | $1,171,682 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,239,753 | BOYAmt |
| EOY | $7,331,391 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $307,376 | BOYAmt |
| EOY | $255,899 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,547,129 | BOYAmt |
| EOY | $7,587,290 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,480,659 | BOYAmt |
| EOY | $8,758,972 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $1,006,483 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $33,678 | NetUnrlzdGainsLossesInvstAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $8,554,196 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $8,346,420 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $8,478,307 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $9,430,247 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $10,681,263 | CurrentTaxYearAmt |
| Total | $45,490,433 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $8,554,196 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $8,346,420 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $8,478,307 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $9,430,247 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $10,681,263 | CurrentTaxYearAmt |
| Total | $45,490,433 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $4,291,262 | SubstantialContributorsTotAmt |
| Public Support Total170 | $41,199,171 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,127 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $76,006 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $78,032 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $114,417 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $65,116 | CurrentTaxYearAmt |
| Total | $335,698 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $23,683 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $38,622 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $27,027 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $21,818 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $498,877 | CurrentTaxYearAmt |
| Total | $610,027 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $46,436,158 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $39,099,924 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.88720 | PublicSupportCY170Pct |
| Public Support PY170 | 0.89190 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II, LINE 10 | FormAndLineReferenceDesc |
| Explanation | MEDICAL RECORDS & MISC INCOME 610,027 | ExplanationTxt |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $89,635 | InvestmentCostOrOtherBasisAmt |
| Book Value | $89,635 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $465,365 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $232,682 | DepreciationAmt |
| Book Value | $232,683 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $1,738,597 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $1,328,398 | DepreciationAmt |
| Book Value | $410,199 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $1,419,920 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $1,000,297 | DepreciationAmt |
| Book Value | $419,623 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $156,088 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $87,896 | DepreciationAmt |
| Book Value | $68,192 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,220,332 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| GOVERNMENT CONTRACT LIABILITY | $48,853 |
| DEFERRED RENT | $23,579 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $72,432 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $21,891,927 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $33,678 | NetUnrealizedGainsInvstAmt |
| Donated Services And Use Fclts | $1,977,770 | DonatedServicesAndUseFcltsAmt |
| Other Revenue | $14,378 | OtherRevenueAmt |
| Revenue Not Reported | $2,025,826 | RevenueNotReportedAmt |
| Revenue Subtotal | $19,866,101 | RevenueSubtotalAmt |
| Other Revenues Not Included | $15,481 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $15,481 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $19,881,582 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $20,851,766 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $1,977,770 | DonatedServicesUseFcltsAmt |
| Other Expenses Included | $14,378 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $1,992,148 | ExpensesNotReportedAmt |
| Expenses Subtotal | $18,859,618 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $15,481 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $15,481 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $18,875,099 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE D, PAGE 4, PART XI, LINE 2D | FUNDRAISING DIRECT EXPENSES 11,020 LOSS ON DISPOSAL OF FIXED ASSET 3,358 |
| SCHEDULE D, PAGE 4, PART XI, LINE 4B | INVESTMENT MGT FEES RECLASSED 15,404 FUNDRAISING REVENUE 77 |
| SCHEDULE D, PAGE 4, PART XII, LINE 2D | FUNDRAISING DIRECT EXPENSES 11,020 LOSS ON DISPOSAL OF FIXED ASSET 3,358 |
| SCHEDULE D, PAGE 4, PART XII, LINE 4B | INVESTMENT MGT FEES RECLASSED 15,404 FUNDRAISING REVENUE 77 |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | Yes (true) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (true) | SubstantiationRequiredInd |
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (5 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt |
|---|---|---|---|---|---|
| CARL WHITTAKER | |||||
| PHYSICIAN | $176,861 | $46,965 | $22,383 | $2,578 | $248,787 |
| FRANK POWERS | |||||
| PHYSICIAN | $173,639 | $47,591 | $22,123 | $2,988 | $246,341 |
| KEITH HORWOOD | |||||
| ASSTMEDDIR/PHYSICIAN | $148,553 | $26,893 | $17,545 | $2,988 | $195,979 |
| DAVID GONTRUM | |||||
| PHYSICIAN | $161,334 | $8,850 | $17,018 | $2,037 | $189,239 |
| ANDREW GARRISON | |||||
| PHYSICIAN | $121,810 | $30,000 | $15,181 | $2,486 | $169,477 |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | INTERMOUNTAIN HEALTHCARE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | DIREC / OFFICER | RelationshipDescriptionTxt |
| Transaction | $1,380,000 | TransactionAmt |
| Transaction | IN-KIND DONATIONS | TransactionDesc |
| Sharing Of Revenues | false | SharingOfRevenuesInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE L, PART V | FormAndLineReferenceDesc |
| Explanation | (1)RELATIONSHIP BETWEEN INTERESTED PERSONS AND ORGANIZATION: SUZANNE DRAPER, IMMEDIATE PAST PRESIDENT OF THE BOARD OF COMMUNITY HEALTH CENTERS, INC., IS EMPLOYED BY AND IS AN OFFICER OF INTERMOUNTAIN HEALTHCARE. INTERMOUNTAIN HEALTHCARE PROVIDES DONATED SERVICES IN THE FORM OF MEDICAL SERVICES AND X-RAY SERVICES. | ExplanationTxt |
Schedule M IRS990ScheduleM
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 31545 | ContributionCnt |
| Noncash Contributions Rpt F990 | $1,719,259 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | AVG MKT COST OF SUPPLIES | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | false | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | false | ThirdPartiesUsedInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE M, PAGE 2, PART II | FormAndLineReferenceDesc |
| Explanation | REPORTED THE NUMBER OF CONTRIBUTIONS FOR DRUGS AND MEDICAL SUPPLIES. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 6, PART VI, LINE 11B | THE 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 12C | HUMAN 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 15A | HUMAN 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 19 | FINANCIAL STATEMENTS, GOVERNING DOCUMENTS, AND COMPANY POLICIES CAN BE OBTAINED BY CONTACTING DEXTER PEARCE EITHER BY PHONE AT 801-858-3455 OR BY MAIL AT 220 WEST 7200 SOUTH, SUITE A, MIDVALE UT 84047. |
| FORM 990, PART IX, LINE 11G | MEDICAL/LAB/X-RAY 715,236 200 0 LAUNDRY SERVICES 47,514 0 0 DENTAL LAB SERVICES 86,003 0 0 EQUIPMENT MAINTENANCE 38,940 223 0 JANITORIAL SERVICES 121,800 7,276 0 MEDICAL WASTE SERVICES 36,832 0 0 SECURITY SERVICES 4,422 0 0 GROUNDS MAINTENANCE 20,760 231 0 PAYROLL SERVICES 0 45,171 0 INTERPRETING SERVICES 10,448 5,735 0 INFORMATION SYSTEM SUPPORT 120,864 267,993 0 AMERICORPS 45,833 0 0 TEMP HELP 289,132 1,021 0 RESIDENTS/FELLOWS 129,376 0 0 COURIER SERVICES 26,237 22,806 0 MISCELLANEOUS SERVICES 130,925 95,740 0 CONTRACTED PRINTING 0 5,016 0 |
| FORM 990, PART XI, LINE 9 | FUNDRAISING DIRECT EXPENSES 11,020 LOSS ON DISPOSAL OF FIXED ASSET 3,358 INVESTMENT MGT FEES RECLASSED -15,404 FUNDRAISING REVENUE -77 FUNDRAISING DIRECT EXPENSES -11,020 LOSS ON DISPOSAL OF FIXED ASSET -3,358 INVESTMENT MGT FEES RECLASSED 15,404 FUNDRAISING REVENUE 77 |