Totals
- Total revenue
- $4,128,061
- Total expenses
- $2,804,055
- Contributions and grants received
- $1,927,855
- Grants paid
- $0
- Program service revenue
- $2,180,717
- Investment income
- $9,795
- Other revenue
- $9,694
- Total assets, end of year
- $4,618,289
- Total liabilities, end of year
- $115,403
- Net assets or fund balances, end of year
- $4,502,886
- Program services expenses (Part IX)
- $2,503,112
- Management and general expenses
- $300,943
- Fundraising expenses
- $0
- Program service expenses (Part III)
- $2,503,112
Program services were 89.3% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.
Line items
Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.
Revenue
Part VIII, the statement of revenue.
-
1d · Related organizations
$1,839,363
-
1e · Government grants (contributions)
$23,344
-
1f · All other contributions, gifts and grants
$65,148
-
2a · Program service revenue: PATIENT SERVICE REVENU
total $1,807,385 · related or exempt $1,807,385
-
2b · Program service revenue: 340B PROGRAM REVENUE
total $323,343 · related or exempt $323,343
-
2c · Program service revenue: HEALTH CONNECTIONS
total $49,989 · related or exempt $49,989
-
3 · Investment income
total $9,795 · excluded $9,795
-
11a · Other revenue: INCOME FROM COOPERATIV
total $9,694 · excluded $9,694
-
11e · Other revenue, total
$9,694
Functional expenses
Part IX, the statement of functional expenses.
-
5 · Compensation of officers, directors and key employees
total $273,041 · management and general $273,041
-
7 · Other salaries and wages
total $1,482,356 · program services $1,482,356
-
8 · Pension plan contributions
total $43,305 · program services $43,305
-
9 · Other employee benefits
total $122,216 · program services $122,216
-
10 · Payroll taxes
total $126,525 · program services $115,238 · management and general $11,287
-
11b · Fees: legal
total $6,628 · program services $6,037 · management and general $591
-
11g · Fees: other
total $160,219 · program services $145,926 · management and general $14,293
-
12 · Advertising and promotion
total $11,426 · program services $11,426
-
13 · Office expenses
total $54,047 · program services $54,047
-
14 · Information technology
total $150,505 · program services $150,505
-
16 · Occupancy
total $34,572 · program services $34,572
-
17 · Travel
total $8,235 · program services $7,500 · management and general $735
-
22 · Depreciation, depletion and amortization
total $97,007 · program services $97,007
-
23 · Insurance
total $11,160 · program services $10,164 · management and general $996
-
24a · Other expenses: MEDICAL SUPPLIES
total $154,433 · program services $154,433
-
24b · Other expenses: RECRUITING & RETENTION
total $45,654 · program services $45,654
-
24c · Other expenses: EDUCATION
total $14,456 · program services $14,456
-
24d · Other expenses: MEMBERSHIP DUES
total $8,270 · program services $8,270
Balance sheet
Part X, book values.
-
1 · Cash, non-interest-bearing
beginning of year $1,443,489 · end of year $1,085,145
-
2 · Savings and temporary cash investments
beginning of year $514,067 · end of year $1,522,449
-
4 · Accounts receivable
beginning of year $176,017 · end of year $172,550
-
8 · Inventories for sale or use
beginning of year $4,859 · end of year $4,740
-
9 · Prepaid expenses and deferred charges
beginning of year $30,386 · end of year $19,344
-
10a · Land, buildings and equipment: cost or other basis
$1,798,096
-
10b · Land, buildings and equipment: accumulated depreciation
$277,180
-
10c · Land, buildings and equipment, net
beginning of year $872,233 · end of year $1,520,916
-
12 · Investments: other securities
beginning of year $204,109 · end of year $212,419
-
13 · Investments: program-related
beginning of year $80,726 · end of year $80,726
-
17 · Accounts payable and accrued expenses
beginning of year $123,662 · end of year $115,403
-
19 · Deferred revenue
beginning of year $23,344 · end of year $0
-
27 · Net assets without donor restrictions
beginning of year $2,291,715 · end of year $2,981,970
-
28 · Net assets with donor restrictions
beginning of year $887,165 · end of year $1,520,916
Mission and programs · 2022
Mission
WE PROVIDE QUALITY HEALTHCARE TO OUR COMMUNITY.
-
CHALLIS AREA HEALTH CENTER OPERATES A FEDERALLY QUALIFIED HEALTH CENTER LOCATED IN CHALLIS, IDAHO.
Expenses $2,503,112 · Revenue $2,180,717
As filed on the 2022 return.
Listed in Part VII
-
Thomas FifeTHOMAS FIFE
PHYSICIAN ASSISTANT
- Total calculated
- $194,899
- From this org
- $177,181
- From related orgs
- $0
- Other
- $17,718
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $172,118
- Bonus
- $5,063
- Other
- $0
- Deferred
- $0
- Nontaxable benefits
- $17,718
- Filer's total
- $194,899
-
Miles HaeberleMILES HAEBERLE
PHYSICIAN ASSISTANT
- Total calculated
- $175,573
- From this org
- $159,612
- From related orgs
- $0
- Other
- $15,961
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $152,442
- Bonus
- $7,170
- Other
- $0
- Deferred
- $0
- Nontaxable benefits
- $15,961
- Filer's total
- $175,573
-
Stephen D RembelskiSTEPHEN D REMBELSKI
CHIEF EXECUTIVE OFFICER
- Total calculated
- $170,561
- From this org
- $155,055
- From related orgs
- $0
- Other
- $15,506
- Hours/week
- 50
Schedule J breakdown matched by us
- Base
- $147,774
- Bonus
- $7,281
- Other
- $0
- Deferred
- $0
- Nontaxable benefits
- $15,506
- Filer's total
- $170,561
-
S Max SmithS MAX SMITH
PHYSICIAN ASSISTANT
- Total calculated
- $163,560
- From this org
- $148,691
- From related orgs
- $0
- Other
- $14,869
- Hours/week
- 40
Schedule J breakdown matched by us
- Base
- $141,807
- Bonus
- $6,884
- Other
- $0
- Deferred
- $0
- Nontaxable benefits
- $14,869
- Filer's total
- $163,560
-
M Chad BanksM CHAD BANKS
PHYSICIAN ASSISTANT
- Total calculated
- $149,306
- From this org
- $135,733
- From related orgs
- $0
- Other
- $13,573
- Hours/week
- 40
-
Sharlene MillerSHARLENE MILLER
CHIEF FINANCIAL OFFICER
- Total calculated
- $90,684
- From this org
- $82,440
- From related orgs
- $0
- Other
- $8,244
- Hours/week
- 40 + 4.5 related
-
JD BennettsJD BENNETTS
CHAIR
- Total calculated
- $0
- Hours/week
- 1.5 + 0.75 related
-
Robert BorenROBERT BOREN
VICE CHAIR & DIRECTOR
- Total calculated
- $0
- Hours/week
- 1.2 + 0.75 related
-
Raynae ChamberlainRAYNAE CHAMBERLAIN
DIRECTOR & VICE CHAIR
- Total calculated
- $0
- Hours/week
- 1.2 + 0.6 related
-
Corinne JonesCORINNE JONES
SECRETARY
- Total calculated
- $0
- Hours/week
- 1.2
-
Teila LeuzingerTEILA LEUZINGER
TREASURER
- Total calculated
- $0
- Hours/week
- 1.5 + 0.6 related
-
Shelbie BryantSHELBIE BRYANT
DIRECTOR
- Total calculated
- $0
- Hours/week
- 1.2 + 0.6 related
-
Jen ButterfieldJEN BUTTERFIELD
DIRECTOR
- Total calculated
- $0
- Hours/week
- 1.2
-
Matt CahoonMATT CAHOON
DIRECTOR
- Total calculated
- $0
- Hours/week
- 1.2
-
Betsy DoughtyBETSY DOUGHTY
DIRECTOR
- Total calculated
- $0
- Hours/week
- 1.2 + 0.6 related
-
Stephanie StrandSTEPHANIE STRAND
DIRECTOR
- Total calculated
- $0
- Hours/week
- 1.2 + 0.6 related
-
Rayna WestergardRAYNA WESTERGARD
DIRECTOR
- Total calculated
- $0
- Hours/week
- 1.2
Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead, and on a Form 990-PF Part VIII's — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.
Schedule J
Answered yes
- 3 · Form 990 of other organizations
- 3 · Compensation survey or study
- 3 · Approval by the board or compensation committee
- 5a · Pay contingent on this organization's revenues
Answered no
- 4a · Severance or change-of-control payment
- 4b · Supplemental nonqualified retirement plan
- 4c · Equity-based compensation arrangement
- 5b · Pay contingent on a related organization's revenues
- 6a · Pay contingent on this organization's net earnings
- 6b · Pay contingent on a related organization's net earnings
- 7 · Other non-fixed payments
- 8 · Paid under the initial-contract exception
The filer's explanations (Part III)
- PART I, LINE 5
- ALL EMPLOYEES PARTICIPATE IN AN INCENTIVE COMPENSATION PROGRAM. REVENUE-RELATED GOALS COMPRISE 25 PERCENT OF THE INCENTIVE COMPENSATION DETERMINATION. PATIENT SATISFACTION, QUALITY MEASURES AND PATIENT VOLUME COMPRISE THE OTHER 75 PERCENT. THE INCENTIVE COMPENSATION AMOUNTS CAN BE UP TO 5 PERCENT OF EACH INDIVIDUAL'S TOTAL COMPENSATION.
Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.
Grants on this return
No itemized grants to organizations on this return.
Related organizations on this return
Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.
-
NORTH CUSTER HOSPITAL DISTRICT
115 · EMERGENCY & PRIMARY HEALTHCARE · ID
Provenance
- Return type
- form_990
- Tax year
- 2022
- Filed
- 30 July 2024
- IRS schema version
- 2022v5.0
- Source object
- 202422159349301007
Check it against the return as filed: the GivingTuesday Data Lake hosts a public copy of the original XML.
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