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COMMUNITY HEALTH DEVELOPMENT INC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
COMMUNITY HEALTH DEVELOPMENT INC (EIN 74-2269739)
Tax period
2010-10-01 to 2011-09-30
Filed
2012-07-06
IRS object ID
201241889349300214
Schema version
2010v3.2
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 ReturnHeader

FieldValueIRS element (for citing)
Timestamp2012-07-06T09:44:13-07:00Timestamp
Tax Period End Date2011-09-30TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1ScottSingletonFincher & CoBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line14815 King Street Suite AAddressLine1
CityGreenvilleCity
StateTXState
ZIP Code75401ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-10-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN742269739EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1COMMUNITY HEALTH DEVELOPMENT INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlCOMMNameControl
Phone8302785604Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line1908 SOUTH EVANSAddressLine1
CityUVALDECity
StateTXState
ZIP Code78801ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameMAYELA CASTANONName
TitleCFOTitle
Date Signed2012-07-06DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
NameThomas L NelsonName
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Gross Receipts8009678GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
All Affiliates IncludedfalseAllAffiliatesIncluded
Organization501c3XOrganization501c3
Web SiteN/AWebSite
Activity Or Mission DescriptionPROVIDE PRIMARY HEALTH CARE AND DENTAL SERVICES TO THE LOCAL SERVICE AREA.ActivityOrMissionDescription
Nbr Voting Members Governing Body11NbrVotingMembersGoverningBody
Nbr Independent Voting Members11NbrIndependentVotingMembers
Total Nbr Employees128TotalNbrEmployees
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year4176266ContributionsGrantsPriorYear
Contributions Grants Current Year5108627ContributionsGrantsCurrentYear
Program Service Revenue Prior Year2751514ProgramServiceRevenuePriorYear
Program Service Revenue CY2896637ProgramServiceRevenueCY
Investment Income Prior Year5486InvestmentIncomePriorYear
Investment Income Current Year4414InvestmentIncomeCurrentYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year6933266TotalRevenuePriorYear
Total Revenue Current Year8009678TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year4317977SalariesEtcPriorYear
Salaries Etc Current Year4383575SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year2413619OtherExpensePriorYear
Other Expenses Current Year2413061OtherExpensesCurrentYear
Total Expenses Prior Year6731596TotalExpensesPriorYear
Total Expenses Current Year6796636TotalExpensesCurrentYear
Revenues Less Expenses Prior Year201670RevenuesLessExpensesPriorYear
Revenues Less Expenses CY1213042RevenuesLessExpensesCY
Total Assets BOY6405120TotalAssetsBOY
Total Assets EOY7701073TotalAssetsEOY
Total Liabilities BOY936777TotalLiabilitiesBOY
Total Liabilities EOY1019688TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY5468343NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY6681385NetAssetsOrFundBalancesEOY
Mission DescriptionPROVIDE PRIMARY HEALTH CARE AND DENTAL SERVICES TO THE LOCAL SERVICE AREA.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense5728379Expense
Revenue7383765Revenue
DescriptionOPERATED A COMMUNITY HEALTH CENTER WHICH PROVIDED PRIMARY HEALTH CARE AND DENTAL SERVICES TO THE INDIGENT POPULATION IN ITS SERVICE AREA. THE ORGANIZATION IS FUNDED PRIMARILY BY THE U S DEPARTMENT OF HEALTH AND HUMAN SERVICES AND THE TEXAS DEPARTMENT OF HEALTH.Description
Total Program Service Expense5728379TotalProgramServiceExpense
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 LiabilitiesfalseReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
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
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
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 ContributionstrueDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntityfalseRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredfalseScheduleORequired
Number Forms Transmitted With109637NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees128NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Form990-T FiledfalseForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Form8886 T FiledfalseForm8886TFiled
Non Deductible ContributionsfalseNonDeductibleContributions
Non Deductible DisclosurefalseNonDeductibleDisclosure
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Quid Pro Quo DisclosurefalseQuidProQuoDisclosure
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Number Of8282 Filed0NumberOf8282Filed
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Form8899 FiledfalseForm8899Filed
Form1098 C FiledfalseForm1098CFiled
Excess Business HoldingsfalseExcessBusinessHoldings
Taxable DistributionsfalseTaxableDistributions
Distribution To DonorfalseDistributionToDonor
Filed Lieu1041falseFiledLieu1041
Licensed More Than One StatefalseLicensedMoreThanOneState
Indoor Tanning ServicesfalseIndoorTanningServices
Form720 FiledfalseForm720Filed
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members11NbrVotingGoverningBodyMembers
Number Independent Voting Members11NumberIndependentVotingMembers
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 AddresstrueOfficerMailingAddress
Local ChaptersfalseLocalChapters
Policies Reference ChaptersfalsePoliciesReferenceChapters
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
Written Policy Or ProcedurefalseWrittenPolicyOrProcedure
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonMAYELA CASTANON CFO -NamePerson
Telephone Number8302785604TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line1908 SOUTH EVANSAddressLine1
CityUVALDECity
StateTXState
ZIP Code78801ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (20 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationHighest Compensated EmployeeHighestCompensatedEmployeeIndividual Trustee Or DirectorIndividualTrusteeOrDirector
SCOTT GRAHAM
COO40.00X7185200
RICHARD G HASSAN
DENTIST40.009947707968X
REYES LOPEZ
SECRETARY/TREAS1.00000X
RANDY SCHEIDE
VICE CHAIR1.00000X
RACHEL A GONZALES-HANSON
CEO40.00X16609100
NORIS GARCIA
Director1.00000X
MONICA GONZALES
Chairman1.00000X
MAYELA CASTANON
CFO40.00X8132800
MARYANN GAMBLE
PHYSICIAN40.00161206010672X
MARIANO PARGAS
Director1.00000X
LINDA MASSEY
Director1.00000X
GREGORY L BABER
CHIEF DENTAL OFFIC40.00170294010925X
GREGORY BABER
CDO40.00X17029400
GILBERTO TORRES
Director1.00000X
FRANCES CANALES
Director1.00000X
FIDELIS E AMADI
PHYSICIAN40.00165335011020X
DELORES QUIROZ
PDO40.00X6273700
BEATRICE GARCIA
Director1.00000X
ANITA SHAKELFORD
Director1.00000X
AMANDA HADLEY
Director1.00000X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1148614TotalReportableCompFromOrg
Total Other Compensation40585TotalOtherCompensation
Number Individuals GT100 K5NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (3 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
MG TRUST COMPANY
PO BOX 46546DENVERCO80201RETIREMENT PLAN158368
LAB CORP
PO BOX 12140BURLINGTONNC27216LAB SERVICE
BLUE CROSS BLUE SHIELD
PO BOX 66049DALLASTX75266HEALTH INSURANCE462154
FieldValueIRS element (for citing)
Number Of Contractors GT100 K135119NumberOfContractorsGT100K
Government Grants3238174GovernmentGrants
All Other Contributions1870453AllOtherContributions
Noncash Contributions495682NoncashContributions
Total Contributions5108627TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionMEDICAL SERVICE FEESDescription
Total Revenue Column2896637TotalRevenueColumn
Related Or Exempt Function Income2896637RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue2896637TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column4414TotalRevenueColumn
Exclusion$4,414ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Total Other Revenue0TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column8009678TotalRevenueColumn
Related Or Exempt Function Income2896637RelatedOrExemptFunctionIncome
Exclusion$4,414ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total552302Total
Program Services242146ProgramServices
Management And General310156ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total3063092Total
Program Services2740805ProgramServices
Management And General322287ManagementAndGeneral

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total0Total

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total478812Total
Program Services455665ProgramServices
Management And General23147ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total289369Total
Program Services240187ProgramServices
Management And General49182ManagementAndGeneral

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total0Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total0Total

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total0Total

Advertising Advertising

FieldValueIRS element (for citing)
Total0Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total542172Total
Program Services484184ProgramServices
Management And General57988ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total145570Total
Program Services145570ProgramServices

Travel Travel

FieldValueIRS element (for citing)
Total65564Total
Program Services27751ProgramServices
Management And General37813ManagementAndGeneral

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total21003Total
Program Services4519ProgramServices
Management And General16484ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total0Total

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total372797Total
Program Services372797ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total31782Total
Program Services25521ProgramServices
Management And General6261ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
Printing and Publications415412947712064
OTHER685533358734966
EQUIPMENT RENTS & MAINTENANCE17024752954117293
DONATED PHARMACY495581495466115
CONSULTANT & CONTRACTED SERV41129337523436059

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total46958Total
Program Services2516ProgramServices
Management And General44442ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total6796636Total
Program Services5728379ProgramServices
Management And General1068257ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY631648BOY
EOY1047178EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY256279BOY
EOY423958EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY197679BOY
EOY181938EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY311713BOY
EOY286838EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
EOY0EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
EOY0EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY43580BOY
EOY63633EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis7669097LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec1971569LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY4964221BOY
EOY5697528EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
EOY0EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY6405120BOY
EOY7701073EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY534385BOY
EOY622968EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
EOY19313EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY402392BOY
EOY377407EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY936777BOY
EOY1019688EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY5459659BOY
EOY6051446EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY8684BOY
EOY629939EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY5468343BOY
EOY6681385EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY6405120BOY
EOY7701073EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses1213042ReconcilationRevenueExpenses
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit RequiredtrueFederalGrantAuditRequired
Federal Grant Audit PerformedtrueFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org170b1 AviXPubliclySupportedOrg170b1Avi

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years3139103CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years3736847CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years5727445CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year4176266CurrentTaxYearMinus1Year
Current Tax Year4487128CurrentTaxYear
Total21266789Total

Tax Rev Levied For Org Benefit170 TaxRevLeviedForOrgBenefit170

FieldValueIRS element (for citing)
Total0Total

Value Srvc Fclts Furnished By Govt ValueSrvcFcltsFurnishedByGovt

FieldValueIRS element (for citing)
Total0Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years3139103CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years3736847CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years5727445CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year4176266CurrentTaxYearMinus1Year
Current Tax Year4487128CurrentTaxYear
Total21266789Total
FieldValueIRS element (for citing)
Amounts Subst Contributors Total0AmountsSubstContributorsTotal
Public Support Total17021266789PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years90486CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years-46196CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years11723CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year5486CurrentTaxYearMinus1Year
Current Tax Year4414CurrentTaxYear
Total65913Total

Net UBI NetUBI

FieldValueIRS element (for citing)
Total0Total

Other Income170 OtherIncome170

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Total Support21332702TotalSupport
Public Support Pertcentage1700.99690PublicSupportPertcentage170
Public Support Pertcent Prior Year0.99620PublicSupportPertcentPriorYear
Thirty Three Percnt Tests CY170XThirtyThreePercntTestsCY170

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 Basis145203OtherCostOrOtherBasis
Book Value145203BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis5261098OtherCostOrOtherBasis
Depreciation1094330Depreciation
Book Value4166768BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis1235189OtherCostOrOtherBasis
Depreciation877239Depreciation
Book Value357950BookValue

Other Land Buildings OtherLandBuildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis1027607OtherCostOrOtherBasis
Book Value1027607BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings5697528TotalOfBookValueLandBuildings
Total Revenue8009678TotalRevenue
Total Expenses6796636TotalExpenses
Excess Or Deficit For Year1213042ExcessOrDeficitForYear
Excess Or Deficit Per FS1213042ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt8009678TotRevenueEtcAuditedFinclStmt
Revenue Subtotal8009678RevenueSubtotal
Total Revenue Per Form9908009678TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt6796636TotExpensesEtcAuditedFinclStmt
Expenses Subtotal6796636ExpensesSubtotal
Total Expenses Per Form9906796636TotalExpensesPerForm990

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
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
Rebuttable Presumption ProcedurefalseRebuttablePresumptionProcedure

Form990 Schedule J Part II Form990ScheduleJPartII (5 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgTotal Compensation Filing OrgTotalCompensationFilingOrgNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg
RACHEL A GONZALES-HANSON
166091166091
MARYANN GAMBLE
16120617187810672
GREGORY L BABER
17029418121910925
GREGORY BABER
170294170294
FIDELIS E AMADI
16533517635511020

Schedule M IRS990ScheduleM

Drugs And Medical Supplies DrugsAndMedicalSupplies

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Number Of Contributions1NumberOfContributions
Noncash Contribs Rptd F990495682NoncashContribsRptdF990
Method Of Determining RevenuesFAIR VALUEMethodOfDeterminingRevenues
FieldValueIRS element (for citing)
Any Property That Must Be HeldfalseAnyPropertyThatMustBeHeld
Review Process Unusual NC GiftsfalseReviewProcessUnusualNCGifts
Third Parties UsedfalseThirdPartiesUsed

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Form 990, Part VI, Line 19Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailableNo documents available to the public.
Form 990, Part VI, Line 15bForm 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key EmployeesTHE SALARY FOR THE CHIEF EXECUTIVE OFFICER IS APPROVED BY THE BOARD OF DIRECTORS FOLLOWING DISCUSSION AND REVIEW OF COMPARABLE SALARIES AS PUBLISHED BY THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERSSALARIES FOR OTHER KEY EMPLOYEES ARE REVIEWED AND APPROVED IN THE CENTER'S BUDGET FOLLOWING A REVIEW OF COMPARABLE SALARIES AS PUBLISHED BY THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS
Form 990, Part VI, Line 12cForm 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of ConflictsBOARD MEMBERS ARE REQUESTED TO IDENTIFY ANY CONFLICTS OF INTEREST AT EACH BOARD MEETING
Form 990, Part VI, Line 9Form 990, Part VI, Line 9: Officer, Director, Trustee, Key Employee Mailing AddressDOLORES D. QUIROZ 10672 CASSOWAY COURTSAN DIEGO, CA 92131
Form 990, Part VI, Line 11Form 990, Part VI, Line 11: Form 990 Review ProcessA copy of the 990 was reviewed by the Board of Directors Finance Committee prior to filing.