AMADOR HEALTH CENTER INC: Form 990, tax year 2011

View the entire original 990 at ProPublica ↗

Organization: AMADOR HEALTH CENTER INC (EIN 85-0413619)
Tax period: 2011-07-01 to 2012-06-30
Filed: 2013-05-13
IRS object ID: 201321339349304762
Schema version: 2011v1.2
Source: Download XML · Original 990 at ProPublica

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

Return header
Form 990
Schedule A
Schedule D
Schedule O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Timestamp	2013-05-13T15:04:44-07:00	Timestamp
Tax Period End Date	2012-06-30	TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

Field	Value	IRS element (for citing)
Business Name Line1	CLIFFORD ROSS & COOPER LLC	BusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

Field	Value	IRS element (for citing)
Address Line1	1155 COMMERCE STE E	AddressLine1
City	LAS CRUCES	City
State	NM	State
ZIP Code	88011	ZIPCode

Field	Value	IRS element (for citing)
Return Type	990	ReturnType
Tax Period Begin Date	2011-07-01	TaxPeriodBeginDate

Filer Filer

Field	Value	IRS element (for citing)
EIN	850413619	EIN

Name Name

Field	Value	IRS element (for citing)
Business Name Line1	ST LUKE'S HEALTH CARE CLINIC	BusinessNameLine1

Field	Value	IRS element (for citing)
Name Control	STLU	NameControl
Phone	5755275482	Phone

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	999 W AMADOR AVENUE	AddressLine1
City	LAS CRUCES	City
State	NM	State
ZIP Code	88005	ZIPCode

Officer Officer

Field	Value	IRS element (for citing)
Name	DR JOHN ANDAZOLA	Name
Title	PRESIDENT	Title
Phone	5755275482	Phone
Date Signed	2013-05-06	DateSigned
Authorize Third Party	true	AuthorizeThirdParty

Preparer Preparer

Field	Value	IRS element (for citing)
Name	DENISE S COOPER	Name
Phone	5755241040	Phone

Field	Value	IRS element (for citing)
Tax Year	2011	TaxYear
Build TS	2016-02-24 21:20:13Z	BuildTS

Form 990 IRS990

Field	Value	IRS element (for citing)
Name Of Principal Officer Person	PAMELA ANGELL	NameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

Field	Value	IRS element (for citing)
Address Line1	990 W AMADOR	AddressLine1
City	LAS CRUCES	City
State	NM	State
ZIP Code	88005	ZIPCode

Field	Value	IRS element (for citing)
Gross Receipts	338337	GrossReceipts
Group Return For Affiliates	false	GroupReturnForAffiliates
Organization501c3	X	Organization501c3
Web Site	N/A	WebSite
Type Of Organization Corporation	X	TypeOfOrganizationCorporation
Year Formation	1991	YearFormation
State Legal Domicile	NM	StateLegalDomicile
Activity Or Mission Description	The organization addresses the non-emergency health care needs of homeless and indigent persons living within Dona Ana County of New Mexico.	ActivityOrMissionDescription
Nbr Voting Members Governing Body	6	NbrVotingMembersGoverningBody
Nbr Independent Voting Members	6	NbrIndependentVotingMembers
Total Nbr Employees	14	TotalNbrEmployees
Total Nbr Volunteers	4	TotalNbrVolunteers
Total Gross UBI	0	TotalGrossUBI
Contributions Grants Prior Year	255891	ContributionsGrantsPriorYear
Contributions Grants Current Year	338227	ContributionsGrantsCurrentYear
Program Service Revenue CY	0	ProgramServiceRevenueCY
Investment Income Prior Year	89	InvestmentIncomePriorYear
Investment Income Current Year	110	InvestmentIncomeCurrentYear
Other Revenue Current Year	0	OtherRevenueCurrentYear
Total Revenue Prior Year	255980	TotalRevenuePriorYear
Total Revenue Current Year	338337	TotalRevenueCurrentYear
Grants And Similar Amnts CY	0	GrantsAndSimilarAmntsCY
Benefits Paid To Members CY	0	BenefitsPaidToMembersCY
Salaries Etc Prior Year	112528	SalariesEtcPriorYear
Salaries Etc Current Year	195845	SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY	0	TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year	0	TotalFundrsngExpCurrentYear
Other Expense Prior Year	153914	OtherExpensePriorYear
Other Expenses Current Year	54168	OtherExpensesCurrentYear
Total Expenses Prior Year	266442	TotalExpensesPriorYear
Total Expenses Current Year	250013	TotalExpensesCurrentYear
Revenues Less Expenses Prior Year	-10462	RevenuesLessExpensesPriorYear
Revenues Less Expenses CY	88324	RevenuesLessExpensesCY
Total Assets BOY	142012	TotalAssetsBOY
Total Assets EOY	233611	TotalAssetsEOY
Total Liabilities BOY	6074	TotalLiabilitiesBOY
Total Liabilities EOY	9361	TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY	135938	NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY	224250	NetAssetsOrFundBalancesEOY
Mission Description	The organization addresses the	MissionDescription
Significant New Program Services	false	SignificantNewProgramServices
Significant Change	false	SignificantChange
Expense	215974	Expense
Revenue	338337	Revenue
Description	ST. LUKE'S PROVIDES NON-EMERGENCY HEALTH CARE TO THE HOMELESS AND INDIGENT OF DONA ANA COUNTY IN NEW MEXICO.	Description
Total Program Service Expense	215974	TotalProgramServiceExpense
Described In501 C3	true	DescribedIn501C3
Schedule B Required	false	ScheduleBRequired
Political Activities	false	PoliticalActivities
Lobbying Activities	false	LobbyingActivities
Subject To Proxy Tax	false	SubjectToProxyTax
Donor Advised Funds	false	DonorAdvisedFunds
Conservation Easements	false	ConservationEasements
Collections Of Art	false	CollectionsOfArt
Credit Counseling	false	CreditCounseling
Term Or Permanent Endowments	true	TermOrPermanentEndowments
Report Land Bldg Equip	true	ReportLandBldgEquip
Report Invest Oth Securities	false	ReportInvestOthSecurities
Report Prog Rel Invest	false	ReportProgRelInvest
Report Other Assets	true	ReportOtherAssets
Report Other Liabilities	true	ReportOtherLiabilities
Report Fin48 Footnote	false	ReportFin48Footnote
Independent Audit Financial Stmt	true	IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt	false	ConsolidatedAuditFinancialStmt
School	false	School
Foreign Office	false	ForeignOffice
Foreign Activities	false	ForeignActivities
More Than5000 K To Organizations	false	MoreThan5000KToOrganizations
More Than5000 K To Individuals	false	MoreThan5000KToIndividuals
Professional Fundraising	false	ProfessionalFundraising
Fundraising Activities	false	FundraisingActivities
Gaming	false	Gaming
Hospital	false	Hospital
Grants To Organizations	false	GrantsToOrganizations
Grants To Individuals	false	GrantsToIndividuals
Schedule J Required	false	ScheduleJRequired
Tax Exempt Bonds	false	TaxExemptBonds
Excess Benefit Transaction	false	ExcessBenefitTransaction
Prior Excess Benefit Transaction	false	PriorExcessBenefitTransaction
Loan To Officer Or DQP	false	LoanToOfficerOrDQP
Grant To Related Person	false	GrantToRelatedPerson
Bsnss Rltnshp With Organization	false	BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member	false	BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp	false	OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions	false	DeductibleNonCashContributions
Deductible Contributions Of Art	false	DeductibleContributionsOfArt
Terminated	false	Terminated
Partial Liquidation	false	PartialLiquidation
Disregarded Entity	false	DisregardedEntity
Related Entity	false	RelatedEntity
Related Org Controlled Entity	false	RelatedOrgControlledEntity
Transaction Related Entity	false	TransactionRelatedEntity
Activities Conducted Partnership	false	ActivitiesConductedPartnership
Schedule O Required	true	ScheduleORequired
Number Forms Transmitted With1096	2	NumberFormsTransmittedWith1096
Number W2 G Included	0	NumberW2GIncluded
Number Of Employees	14	NumberOfEmployees
Employment Tax Returns Filed	true	EmploymentTaxReturnsFiled
Unrelated Business Income	false	UnrelatedBusinessIncome
Foreign Financial Account	false	ForeignFinancialAccount
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTrans
Taxable Party Notification	false	TaxablePartyNotification
Non Deductible Contributions	false	NonDeductibleContributions
Quid Pro Quo Contributions	false	QuidProQuoContributions
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOf
Funds To Pay Premiums	false	FundsToPayPremiums
Premiums Paid	false	PremiumsPaid
Indoor Tanning Services	false	IndoorTanningServices
Info In Schedule O Part VI	X	InfoInScheduleOPartVI
Nbr Voting Governing Body Members	6	NbrVotingGoverningBodyMembers
Number Independent Voting Members	6	NumberIndependentVotingMembers
Family Or Business Relationship	false	FamilyOrBusinessRelationship
Delegation Of Management Duties	false	DelegationOfManagementDuties
Changes To Organizing Docs	false	ChangesToOrganizingDocs
Material Diversion Or Misuse	false	MaterialDiversionOrMisuse
Members Or Stockholders	false	MembersOrStockholders
Election Of Board Members	false	ElectionOfBoardMembers
Decisions Subject To Approval	false	DecisionsSubjectToApproval
Minutes Of Governing Body	true	MinutesOfGoverningBody
Minutes Of Committees	true	MinutesOfCommittees
Officer Mailing Address	false	OfficerMailingAddress
Local Chapters	false	LocalChapters
Form990 Provided To Governing Body	false	Form990ProvidedToGoverningBody
Conflict Of Interest Policy	false	ConflictOfInterestPolicy
Whistleblower Policy	false	WhistleblowerPolicy
Document Retention Policy	false	DocumentRetentionPolicy
Compensation Process CEO	false	CompensationProcessCEO
Compensation Process Other	false	CompensationProcessOther
Investment In Joint Venture	false	InvestmentInJointVenture
Upon Request	X	UponRequest

The Books Are In Care Of TheBooksAreInCareOf

Field	Value	IRS element (for citing)
Name Person	ST LUKE'S HEALTH CARE CLINIC	NamePerson
Telephone Number	5755275482	TelephoneNumber

Address US AddressUS

Field	Value	IRS element (for citing)
Address Line1	944 W AMADOR	AddressLine1
City	LAS CRUCES	City
State	NM	State
ZIP Code	88005	ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (9 entries)

TitleTitle	Average Hours Per WeekAverageHoursPerWeek	OfficerOfficer	Reportable Comp From OrganizationReportableCompFromOrganization	Reportable Comp From Related OrgsReportableCompFromRelatedOrgs	Other CompensationOtherCompensation	Individual Trustee Or DirectorIndividualTrusteeOrDirector	Key EmployeeKeyEmployee
DR JOHN ANDAZOLA
President	2.00	X	0	0	0
TREVAS YOUNGER
Vice President	2.00	X	0	0	0
AMY COLLINS
Secretary	2.00	X	0	0	0
PATRICK CURRAN
Director	2.00		0	0	0	X
PATRICK LEUNG
Director	2.00		0	0	0	X
MARYANN A DIGMAN
Director	2.00		0	0	0	X
MARY KAY PAPEN
Ex-Officio	2.00		0	0	0	X
CATHERINE KEMMER
Member-at-Large	2.00		0	0	0	X
FRAN ALVIS
Executive Director	40.00		44551	0	2400		X

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	44551	TotalReportableCompFromOrg
Total Other Compensation	2400	TotalOtherCompensation
Formers Listed	false	FormersListed
Total Comp GT150 K	false	TotalCompGT150K
Compensation From Other Sources	false	CompensationFromOtherSources
Government Grants	338227	GovernmentGrants
Total Contributions	338227	TotalContributions

Investment Income InvestmentIncome

Field	Value	IRS element (for citing)
Total Revenue Column	110	TotalRevenueColumn

Total Revenue TotalRevenue

Field	Value	IRS element (for citing)
Total Revenue Column	338337	TotalRevenueColumn
Related Or Exempt Function Income	110	RelatedOrExemptFunctionIncome

Comp Disqual Persons CompDisqualPersons

Field	Value	IRS element (for citing)
Total	44551	Total
Program Services	44551	ProgramServices
Management And General	0	ManagementAndGeneral
Fundraising	0	Fundraising

Other Salaries And Wages OtherSalariesAndWages

Field	Value	IRS element (for citing)
Total	119487	Total
Program Services	96522	ProgramServices
Management And General	22965	ManagementAndGeneral
Fundraising	0	Fundraising

Other Employee Benefits OtherEmployeeBenefits

Field	Value	IRS element (for citing)
Total	16145	Total
Program Services	13885	ProgramServices
Management And General	2260	ManagementAndGeneral
Fundraising	0	Fundraising

Payroll Taxes PayrollTaxes

Field	Value	IRS element (for citing)
Total	15662	Total
Program Services	13469	ProgramServices
Management And General	2193	ManagementAndGeneral
Fundraising	0	Fundraising

Fees For Services Accounting FeesForServicesAccounting

Field	Value	IRS element (for citing)
Total	7582	Total
Program Services	6521	ProgramServices
Management And General	1061	ManagementAndGeneral
Fundraising	0	Fundraising

Fees For Services Other FeesForServicesOther

Field	Value	IRS element (for citing)
Total	65	Total
Program Services	56	ProgramServices
Management And General	9	ManagementAndGeneral
Fundraising	0	Fundraising

Office Expenses OfficeExpenses

Field	Value	IRS element (for citing)
Total	10799	Total
Program Services	9287	ProgramServices
Management And General	1512	ManagementAndGeneral
Fundraising	0	Fundraising

Interest Interest

Field	Value	IRS element (for citing)
Total	50	Total
Program Services	43	ProgramServices
Management And General	7	ManagementAndGeneral
Fundraising	0	Fundraising

Depreciation Depletion DepreciationDepletion

Field	Value	IRS element (for citing)
Total	354	Total
Program Services	304	ProgramServices
Management And General	50	ManagementAndGeneral
Fundraising	0	Fundraising

Insurance Insurance

Field	Value	IRS element (for citing)
Total	4499	Total
Program Services	3869	ProgramServices
Management And General	630	ManagementAndGeneral
Fundraising	0	Fundraising

Other Expenses OtherExpenses (4 entries)

DescriptionDescription	TotalTotal	Program ServicesProgramServices	Management And GeneralManagementAndGeneral
Contract labor	3885	3341	544
Diabetic care	610	525	85
Dues and licenses	320	275	45
Medical supplies	4727	4065	662

All Other Expenses AllOtherExpenses

Field	Value	IRS element (for citing)
Total	21277	Total
Program Services	19261	ProgramServices
Management And General	2016	ManagementAndGeneral
Fundraising	0	Fundraising

Total Functional Expenses TotalFunctionalExpenses

Field	Value	IRS element (for citing)
Total	250013	Total
Program Services	215974	ProgramServices
Management And General	34039	ManagementAndGeneral
Fundraising	0	Fundraising

Cash Non Interest Bearing CashNonInterestBearing

Field	Value	IRS element (for citing)
BOY	115191	BOY
EOY	168873	EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

Field	Value	IRS element (for citing)
BOY	5000	BOY
EOY	45109	EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

Field	Value	IRS element (for citing)
BOY	2358	BOY
EOY	506	EOY

Field	Value	IRS element (for citing)
Land Buildings Equipment Basis	45786	LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec	44549	LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

Field	Value	IRS element (for citing)
BOY	1591	BOY
EOY	1237	EOY

Other Assets Total OtherAssetsTotal

Field	Value	IRS element (for citing)
BOY	17872	BOY
EOY	17886	EOY

Total Assets TotalAssets

Field	Value	IRS element (for citing)
BOY	142012	BOY
EOY	233611	EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

Field	Value	IRS element (for citing)
BOY	2473	BOY
EOY	3392	EOY

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
BOY	3601	BOY
EOY	5969	EOY

Total Liabilities TotalLiabilities

Field	Value	IRS element (for citing)
BOY	6074	BOY
EOY	9361	EOY

Field	Value	IRS element (for citing)
Follow SFAS117	X	FollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	118066	BOY
EOY	206390	EOY

Permanently Restricted Net Assets PermanentlyRestrictedNetAssets

Field	Value	IRS element (for citing)
BOY	17872	BOY
EOY	17860	EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	135938	BOY
EOY	224250	EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

Field	Value	IRS element (for citing)
BOY	142012	BOY
EOY	233611	EOY

Field	Value	IRS element (for citing)
Info In Schedule O Part XI	X	InfoInScheduleOPartXI
Reconcilation Revenue Expenses	88324	ReconcilationRevenueExpenses
Reconcilation Other Changes	-12	ReconcilationOtherChanges
Method Of Accounting Accrual	X	MethodOfAccountingAccrual
Accountant Compile Or Review	false	AccountantCompileOrReview
FS Audited	true	FSAudited
Audit Committee	true	AuditCommittee
Financial Statement Separate	X	FinancialStatementSeparate
Federal Grant Audit Required	false	FederalGrantAuditRequired

Schedule A IRS990ScheduleA

Field	Value	IRS element (for citing)
Publicly Supported Org170b1 Avi	X	PubliclySupportedOrg170b1Avi

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

Field	Value	IRS element (for citing)
Current Tax Year Minus2 Years	141030	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	255891	CurrentTaxYearMinus1Year
Current Tax Year	338227	CurrentTaxYear
Total	735148	Total

Total170 Total170

Field	Value	IRS element (for citing)
Current Tax Year Minus2 Years	141030	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	255891	CurrentTaxYearMinus1Year
Current Tax Year	338227	CurrentTaxYear
Total	735148	Total

Field	Value	IRS element (for citing)
Public Support Total170	735148	PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

Field	Value	IRS element (for citing)
Current Tax Year Minus2 Years	793	CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year	89	CurrentTaxYearMinus1Year
Current Tax Year	110	CurrentTaxYear
Total	992	Total

Field	Value	IRS element (for citing)
Total Support	736140	TotalSupport
Public Support Pertcentage170	0.99870	PublicSupportPertcentage170
Public Support Pertcent Prior Year	0.99780	PublicSupportPertcentPriorYear
Thirty Three Percnt Tests CY170	X	ThirtyThreePercntTestsCY170
Public Support Total509	0	PublicSupportTotal509
Public Support Percentage509	0	PublicSupportPercentage509
Investment Income Percentage	0	InvestmentIncomePercentage

Schedule D IRS990ScheduleD

Current Year CurrentYear

Field	Value	IRS element (for citing)
Beginning Of Year Balance	17872	BeginningOfYearBalance
Contributions	-12	Contributions
End Of Year Balance	17860	EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

Field	Value	IRS element (for citing)
Beginning Of Year Balance	16819	BeginningOfYearBalance
Contributions	1053	Contributions
End Of Year Balance	17872	EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

Field	Value	IRS element (for citing)
Beginning Of Year Balance	16072	BeginningOfYearBalance
Contributions	747	Contributions
End Of Year Balance	16819	EndOfYearBalance

Leasehold Improvements LeaseholdImprovements

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	500	OtherCostOrOtherBasis
Depreciation	500	Depreciation

Equipment Equipment

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	45286	OtherCostOrOtherBasis
Depreciation	44049	Depreciation
Book Value	1237	BookValue

Field	Value	IRS element (for citing)
Total Of Book Value Land Buildings	1237	TotalOfBookValueLandBuildings

Other Assets OtherAssets

Field	Value	IRS element (for citing)
Description	Endowment	Description
Book Value	17886	BookValue

Field	Value	IRS element (for citing)
Total Book Value Other Assets	17886	TotalBookValueOtherAssets

Other Liabilities OtherLiabilities

Field	Value	IRS element (for citing)
Description	Accrued expenses	Description
Amount	$5,969	Amount

Field	Value	IRS element (for citing)
Total Of Amounts	5969	TotalOfAmounts
Total Revenue	338337	TotalRevenue
Total Expenses	250013	TotalExpenses
Excess Or Deficit For Year	88324	ExcessOrDeficitForYear
Excess Or Deficit Per FS	88324	ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt	682986	TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments	-12	NetUnrealizedGainsInvestments
Donated Srvc And Use Of Facilities	344661	DonatedSrvcAndUseOfFacilities
Revenue Not Rptd F990	344649	RevenueNotRptdF990
Revenue Subtotal	338337	RevenueSubtotal
Total Revenue Per Form990	338337	TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt	594674	TotExpensesEtcAuditedFinclStmt
Donated Services Use Of Facilities	351548	DonatedServicesUseOfFacilities
Expenses Not Rptd F990	351548	ExpensesNotRptdF990
Expenses Subtotal	243126	ExpensesSubtotal
Total Expenses Per Form990	243126	TotalExpensesPerForm990

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

IdentifierIdentifier	ExplanationExplanation
Pt VI, Line 11a	The Board of Directors reviews the return after filing.
Pt XI	Difference is unrecognized loss.
Form 990EZ, Part II, Line 24	GRANTS RECEIVABLE INVENTORY PREPAID EXPENSES ENDOWMENT
Form 990EZ, Part II, Line 26	ACCOUNTS PAYABLE ACCRUED EXPENSES
Form 990, Part IX, Line 24f	PATIENT DIRECT CARE SERVICES 404. 347. 57. REPAIR AND MAINTENANCE 2527. 2173. 354. TRAINING 6919. 5950. 969. UTILITIES 4540. 3904. 636. LAB FEES 6887. 6887.