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MUSKINGUM VALLEY HEALTH CENTERS: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
MUSKINGUM VALLEY HEALTH CENTERS (EIN 20-8814374)
Tax period
2012-09-01 to 2013-08-31
Filed
2014-03-28
IRS object ID
201400879349300740
Schema version
2012v2.3
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)
Timestamp2014-03-28T18:16:20-05:00Timestamp
Tax Period End Date2013-08-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1MCLAIN HILL RUGG & ASSOC INCBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1601 UNDERWOOD STAddressLine1
CityZANESVILLECity
StateOHState
ZIP Code43701ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-09-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN208814374EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1MUSKINGUM VALLEY HEALTH CENTERBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlMUSKNameControl
Phone7404545239Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1716 ADAIR AVEAddressLine1
CityZANESVILLECity
StateOHState
ZIP Code437012836ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameREBECCA CARRName
TitleCFOTitle
Phone7404545239Phone
Date Signed2014-03-13DateSigned
Authorize Third PartytrueAuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameHEATHER DOLENName
Phone7404530371Phone
Date Prepared2014-03-28DatePrepared
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonREBECCA CARRNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line1716 ADAIR AVEAddressLine1
CityZANESVILLECity
StateOHState
ZIP Code43701ZIPCode
FieldValueIRS element (for citing)
Gross Receipts11187859GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.MVHEALTHCENTERS.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation2007YearFormation
State Legal DomicileOHStateLegalDomicile
Activity Or Mission DescriptionTO PROVIDE AFFORDABLE, ACCESSIBLE, AND QUALITY HEALTHCARE.ActivityOrMissionDescription
Nbr Voting Members Governing Body13NbrVotingMembersGoverningBody
Nbr Independent Voting Members13NbrIndependentVotingMembers
Total Nbr Employees199TotalNbrEmployees
Total Nbr Volunteers1TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year2914021ContributionsGrantsPriorYear
Contributions Grants Current Year1261875ContributionsGrantsCurrentYear
Program Service Revenue Prior Year9227208ProgramServiceRevenuePriorYear
Program Service Revenue CY9830519ProgramServiceRevenueCY
Investment Income Prior Year575InvestmentIncomePriorYear
Investment Income Current Year1065InvestmentIncomeCurrentYear
Other Revenue Prior Year237281OtherRevenuePriorYear
Other Revenue Current Year94400OtherRevenueCurrentYear
Total Revenue Prior Year12379085TotalRevenuePriorYear
Total Revenue Current Year11187859TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year7854GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY1473GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year7604168SalariesEtcPriorYear
Salaries Etc Current Year7752087SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year3334632OtherExpensePriorYear
Other Expenses Current Year3264175OtherExpensesCurrentYear
Total Expenses Prior Year10946654TotalExpensesPriorYear
Total Expenses Current Year11017735TotalExpensesCurrentYear
Revenues Less Expenses Prior Year1432431RevenuesLessExpensesPriorYear
Revenues Less Expenses CY170124RevenuesLessExpensesCY
Total Assets BOY12827205TotalAssetsBOY
Total Assets EOY12796356TotalAssetsEOY
Total Liabilities BOY3762749TotalLiabilitiesBOY
Total Liabilities EOY3561776TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY9064456NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY9234580NetAssetsOrFundBalancesEOY
Info In Schedule O Part IIIXInfoInScheduleOPartIII
Mission DescriptionTO PROVIDE AFFORDABLE, ACCESSIBLE, AND QUALITY HEALTHCARE.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense8659796Expense
Grants1473Grants
Revenue9740942Revenue
DescriptionMUSKINGUM VALLEY HEALTH CENTER PROVIDES NUMEROUS SERVICES, INCLUDING ADULT PRIMARY CARE, PEDIATRICS, DENTAL, MENTAL HEALTH, OB/GYN , AND PODIATRY SERVICES. THE THREE LARGEST SERVICE PROGRAMS ARE ADULT HEALTH, DENTAL, AND PEDIATRICS. DURING THE YEAR, THE CENTER PROVIDED SERVICES FOR APPROXIMATELY 20,438 PATIENTS RESULTING IN 81,046 VISITS, AND PROVIDED A SLIDING FEE SCALE ADJUSTMENT IN THE AMOUNT OF 838,311.Description

Activity Other ActivityOther

FieldValueIRS element (for citing)
DescriptionNET PATIENT SERVICESDescription
FieldValueIRS element (for citing)
Total Program Service Expense8659796TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentsfalseTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiestrueReportOtherLiabilities
Report Fin48 FootnotetrueReportFin48Footnote
Independent Audit Financial StmtfalseIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingfalseGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntityfalseRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With10967NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees199NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Non Deductible ContributionsfalseNonDeductibleContributions
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Form8899 FiledfalseForm8899Filed
Form1098 C FiledfalseForm1098CFiled
Indoor Tanning ServicesfalseIndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members13NbrVotingGoverningBodyMembers
Number Independent Voting Members13NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MembersfalseElectionOfBoardMembers
Decisions Subject To ApprovalfalseDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonstrueAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
States Where Copy Of Return Is FiledOHStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonREBECCA CARRNamePerson
Telephone Number7408919090TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1716 ADAIR AVEAddressLine1
CityZANESVILLECity
StateOHState
ZIP Code43701ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (21 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationKey EmployeeKeyEmployeeHighest Compensated EmployeeHighestCompensatedEmployee
BRAD BOND
PRESIDENT1.00XX000
COREY HAMILTON
VICE PRESIDE1.00XX000
RANDY COCHRANE
TREASURER1.00XX000
JAN SNOUFFER
SECRETARY1.00XX000
HEATHER COEN
DIRECTOR1.00X000
SUSAN SMALL
DIRECTOR1.00X000
JASON HEINS
DIRECTOR1.00X000
CAROL HOWDYSHELL
DIRECTOR1.00X000
RICHARD HUCK
DIRECTOR1.00X000
CAROLYN JENKINS
DIRECTOR1.00X000
MARY KELLER
DIRECTOR1.00X000
RHONDA SMITH
DIRECTOR1.00X000
DEAN WRIGHT
DIRECTOR1.00X000
DAN ATKINSON
CEO40.00X11234908038
REBECCA CARR
CFO40.00X8519800
DAVID KLEIN MD
CMO40.0021337504824X
BIJAN GOODARZI
PHYSICIAN40.0020454500X
ROGER WARD MD
PHYSICIAN40.00187200016420X
RICHARD ESSIG
PHYSICIAN3.0017594500X
DONOVAN CAMPBELL
PYSICIAN40.0016758404377X
BRIGHAM BURTON
PHYSICIAN40.00140279010286X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1286475TotalReportableCompFromOrg
Total Other Compensation43945TotalOtherCompensation
Number Individuals GT100 K10NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (4 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
ANTHEM BLUE CROSS AND BLUE SHIELD
PO BOX 105673ATLANTAGA30348HEALTH INSURANC562346
OHIO PSYCHIATRIC ASSOCIATION INC
975 BETHESDA DRZANESVILLEOH43701CONTRACTED PROV385250
PATTERSON DENTAL SUPPLY
2128 CITYGATE DRCOLUMBUSOH43219DENTAL SUPPLIES145006
MCKESSON MEDICAL- SURGICAL INC
3000 KENSKIL AVEWASHINGTON COURTHOUSEOH43160MEDICAL SUPPLIE124530
FieldValueIRS element (for citing)
Number Of Contractors GT100 K4NumberOfContractorsGT100K
Related Organizations75000RelatedOrganizations
Government Grants1001022GovernmentGrants
All Other Contributions185853AllOtherContributions
Total Contributions1261875TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionNET PATIENT SERVICESDescription
Business Code623000BusinessCode
Total Revenue Column9830519TotalRevenueColumn
Related Or Exempt Function Income9830519RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue9830519TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column1065TotalRevenueColumn
Exclusion$1,065ExclusionAmount

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionCONTRACT SERVICESDescription
Business Code623000BusinessCode
Total Revenue Column94400TotalRevenueColumn
Related Or Exempt Function Income94400RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Other Revenue94400TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column11187859TotalRevenueColumn
Related Or Exempt Function Income9924919RelatedOrExemptFunctionIncome
Exclusion$1,065ExclusionAmount

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total1473Total
Program Services1473ProgramServices

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total205585Total
Program Services51397ProgramServices
Management And General154188ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total6377952Total
Program Services5102362ProgramServices
Management And General1275590ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total164595Total
Program Services131676ProgramServices
Management And General32919ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total1003955Total
Program Services803164ProgramServices
Management And General200791ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total2490Total
Management And General2490ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total42000Total
Management And General42000ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total1092981Total
Program Services765086ProgramServices
Management And General327895ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total20125Total
Management And General20125ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total970958Total
Program Services781923ProgramServices
Management And General189035ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total45883Total
Program Services45883ProgramServices

Occupancy Occupancy

FieldValueIRS element (for citing)
Total95920Total
Program Services95920ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total48210Total
Management And General48210ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total64696Total
Management And General64696ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total131214Total
Program Services131214ProgramServices

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total489140Total
Program Services489140ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total38140Total
Program Services38140ProgramServices

Other Expenses OtherExpenses (2 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServices
BAD DEBT EXPENSE181390181390
OTHER EXPENSES4102841028

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total11017735Total
Program Services8659796ProgramServices
Management And General2357939ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY6534BOY
EOY562084EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY290072BOY
EOY151647EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY55000BOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY1347973BOY
EOY1300706EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY108199BOY
EOY178290EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
EOY29047EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis11661835LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec1087253LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY10859897BOY
EOY10574582EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY159530BOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY12827205BOY
EOY12796356EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY758324BOY
EOY638300EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY663BOY
EOY663EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY2998029BOY
EOY2922803EOY

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
BOY5733BOY
EOY10EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY3762749BOY
EOY3561776EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY9064456BOY
EOY9116512EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
EOY118068EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY9064456BOY
EOY9234580EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY12827205BOY
EOY12796356EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses170124ReconcilationRevenueExpenses
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedfalseFSAudited
Federal Grant Audit RequiredtrueFederalGrantAuditRequired
Federal Grant Audit PerformedfalseFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2XPubliclySupportedOrg509a2

Gifts Grants Contrib Received509 GiftsGrantsContribReceived509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years1965051CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years2338465CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years6222891CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year2914021CurrentTaxYearMinus1Year
Current Tax Year1261875CurrentTaxYear
Total14702303Total

Gross Receipts From Admissions GrossReceiptsFromAdmissions

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years6281789CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years7468621CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years7804717CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year9346374CurrentTaxYearMinus1Year
Current Tax Year9830519CurrentTaxYear
Total40732020Total

Total509 Total509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years8246840CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years9807086CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years14027608CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year12260395CurrentTaxYearMinus1Year
Current Tax Year11092394CurrentTaxYear
Total55434323Total
FieldValueIRS element (for citing)
Public Support Total50955434323PublicSupportTotal509

Gross Investment Income509 GrossInvestmentIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years1141CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years3038CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years1483CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year575CurrentTaxYearMinus1Year
Current Tax Year1065CurrentTaxYear
Total7302Total

Investment Income And UBTI InvestmentIncomeAndUBTI

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years1141CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years3038CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years1483CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year575CurrentTaxYearMinus1Year
Current Tax Year1065CurrentTaxYear
Total7302Total

Other Income509 OtherIncome509

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years575CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years248CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years175CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year118115CurrentTaxYearMinus1Year
Current Tax Year94400CurrentTaxYear
Total213513Total

Total Support Total TotalSupportTotal

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years8248556CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years9810372CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years14029266CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year12379085CurrentTaxYearMinus1Year
Current Tax Year11187859CurrentTaxYear
Total55655138Total
FieldValueIRS element (for citing)
Public Support Percentage5090.99600PublicSupportPercentage509
Prior Year Support Percentage0.99740PriorYearSupportPercentage
Investment Income Percentage0.00000InvestmentIncomePercentage
Thirty Three Percnt Tests CY509XThirtyThreePercntTestsCY509

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis924000OtherCostOrOtherBasis
Book Value924000BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis8649394OtherCostOrOtherBasis
Depreciation291701Depreciation
Book Value8357693BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis1645385OtherCostOrOtherBasis
Depreciation706941Depreciation
Book Value938444BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis443056OtherCostOrOtherBasis
Depreciation88611Depreciation
Book Value354445BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings10574582TotalOfBookValueLandBuildings

Other Liabilities OtherLiabilities

FieldValueIRS element (for citing)
DescriptionDEFERRED REVENUEDescription
Amount$10Amount
FieldValueIRS element (for citing)
Total Of Amounts10TotalOfAmounts
Footnote In Part XIIIXFootnoteInPartXIII

Form990 Schedule D Part XIII Form990ScheduleDPartXIII

FieldValueIRS element (for citing)
IdentifierLIABILITY UNDER FIN 48 FOOTNOTEIdentifier
Return ReferenceSCHEDULE D, PAGE 3, PART XReturnReference
ExplanationACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITES STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITION TAKEN BY THE CENTER AND TO RECOGNIZE A TAX LIABILITY IF THE CENTER HAS TAKEN AN UNCERTAIN POSITION THAT MORE LIKELY THAN NOT WOULD BE SUSTAINED UPON EXAMINIATION BY THE IRS OR OTHER APPLICABLE TAXING AUTHORITIES. MANAGEMENT HAS ANALYZED THE TAX POSITION TAKEN BY THE CENTER AND HAS CONCLUDED THAT AS OF JUNE 30, 2013, THERE ARE NO UNCERTAIN POSITIONS TAKEN OR EXPECTED TO BE TAKEN THAT WOULD REQUIRE RECOGNITION OF A LIABILITY OR DISCLOSURE IN THE FINANCIAL STATEMENTS. THE CENTER IS THE SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS, HOWEVER, THERE ARE CURRENTLY NO AUDITS FOR ANY TAX PERIODS IN PROGRESS. MANAGEMENT BELIEVES THAT IT IS NO LONGER SUBJECT TO INCOME TAX EXAMINATION FOR YEARS PRIOR TO AUGUST 2009.Explanation

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlanfalseSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (6 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgDeferred Comp Filing OrgDeferredCompFilingOrgTotal Compensation Filing OrgTotalCompensationFilingOrg
DAVID KLEIN MD
CMO2133754824218199
BIJAN GOODARZI
PHYSICIAN204545204545
ROGER WARD MD
PHYSICIAN18720016420203620
RICHARD ESSIG
PHYSICIAN175945175945
DONOVAN CAMPBELL
PYSICIAN1675844377171961
BRIGHAM BURTON
PHYSICIAN14027910286150565

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (7 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
ALL OTHER ACCOMPLISHMENT DESCRIPTIONFORM 990, PAGE 2, PART III, LINE 4DNET PATIENT SERVICES
ORGANIZATION'S PROCESS USED TO REVIEW FORM 990FORM 990, PAGE 6, PART VI, LINE 11BTHE CFO REVIEWS FORM 990 AND AN ELECTRONIC COPY IS PROVIDED TO THE BOARD OF DIRECTORS PRIOR TO FILING.
ENFORCEMENT OF CONFLICTS POLICYFORM 990, PAGE 6, PART VI, LINE 12CBOARD MEMBERS WILL SIGN CONFLICT OF INTEREST AND CONFIDENTIALITY STATEMENT ANNUALLY. FORMS WILL BE FILED WITH THE ORGANIZATION'S PERMANENT RECORDS FOR MEMBERS. THE CEO/HR DIRECTOR REVIEWS AND MAINTAINS THESE FORMS. MVHC BOARD MEMBERS DISCLOSE CONFLICTS OF INTERESTS THAT MIGHT INFLUENCE JUDGEMENT IN BOARD MEMBER'S DECISION MAKING PROCESS. FOLLOWING DISCLOUSRE, MVHC'S BOARD EXECUTIVE COMMITTEE SHALL DETERMINE APPROPRIATE ACTION, RANGING FROM ABSTAINING FROM SPECIFIC BOARD DECISIONS, TO STEPPING DOWN FROM MEMBERSHIP.
COMPENSATION PROCESS FOR TOP OFFICIALFORM 990, PAGE 6, PART VI, LINE 15ATHE COMPENSATION FOR THE OFFICERS IS MONITORED AND DETERMINED BY THE BOARD OF DIRECTORS. THE COMPENSATION PACKAGES ARE BENCHMARKED BASED ON THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTER'S SURVEY INFORMATION. COMPENSATION RANGES ARE REVIEWED AND APPROVED ON AN ANNUAL BASIS AND DOCUMENTED IN THE MINUTES OF THE BOARD MEETING MINUTES.
COMPENSATION PROCESS FOR OFFICERSFORM 990, PAGE 6, PART VI, LINE 15BALL OTHER COMPENSATION IS DETERMINED AND MONITORED BY THE DIRECTOR OF HUMAN RESOURCES, CFO, AND CEO. THESE COMPENSATION RANGES ARE BASED ON THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTER'S COMPENSATION SURVEY. APPROVED COMPENSATION IS DOCUMENTED IN THE INDIVIDUAL'S PERSONNEL FILE AND MONITORED THROUGH THE BUDGETARY PROCESS.
GOVERNING DOCUMENTS DISCLOSURE EXPLANATIONFORM 990, PAGE 6, PART VI, LINE 19THE GOVERNING DOCUMENTS, CONFLICT OF INTERESTPOLICY, AND THE FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST.
REASON FOR NOT UNDERGOING REQUIRED AUDITFORM 990, PAGE 12, PART XII, LINE 3BALL GRANT AND LOAN AWARDING AGENCIES APPROVED EXTENDING THE FISCAL YEAR END TO DECEMBER 31, 2013 IN ORDER TO CHANGE MVHC FISCAL YEAR TO A CALENDAR YEAR. AS A RESULT, ONE AUDIT WILL BE PERFORMED FOR THE SIXTEEN MONTH PERIOD SEPTEMBER 1, 2012 THROUGH DECEMBER 31,2013. A FOUR MONTH 990 WILL ALSO BE COMPLETED.