Attach to Form 990 or Form 990-EZ.
Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.
| (i)Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 9 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
| Total | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any unusual grants.) .... | 1,558,224 | 1,430,113 | 1,512,080 | 2,074,595 | 1,919,378 | 8,494,390 |
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf....... | ||||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 4 | Total. Add lines 1 through 3 | 1,558,224 | 1,430,113 | 1,512,080 | 2,074,595 | 1,919,378 | 8,494,390 |
| 5 | The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f).. | ||||||
| 6 | Public support. Subtract line 5 from line 4. | 8,494,390 | |||||
Calendar year
(or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | 1,558,224 | 1,430,113 | 1,512,080 | 2,074,595 | 1,919,378 | 8,494,390 |
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | 1,978 | 1,361 | 666 | 600 | 715 | 5,320 |
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | 10,054 | 11,602 | 12,955 | 3,633 | 15,242 | 53,486 |
| 11 | Total support. Add lines 7 through 10. | 8,553,196 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | ||||||
| 2 | Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose...... | ||||||
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513... | ||||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | ||||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 6 | Total. Add lines 1 through 5. | ||||||
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons... | ||||||
| b | Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year. | ||||||
| c | Add lines 7a and 7b.. | ||||||
| 8 | Public support. (Subtract line 7c from line 6.) | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2011 | (b) 2012 | (c) 2013 | (d) 2014 | (e) 2015 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | ||||||
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | ||||||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | ||||||
| 11 | Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on. | ||||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | ||||||
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e |
Discount claimed for blockage or other factors (explain in detail in Part VI): |
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| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by .035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | ||
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
||
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | ||
| 4 Amounts paid to acquire exempt-use assets | ||
| 5 Qualified set-aside amounts (prior IRS approval required) | ||
| 6 Other distributions (describe in Part VI). See instructions | ||
| 7Total annual distributions. Add lines 1 through 6. | ||
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
||
| 9 Distributable amount for 2015 from Section C, line 6 | ||
| 10 Line 8 amount divided by Line 9 amount | ||
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2015 |
(iii) Distributable Amount for 2015 |
|
|---|---|---|---|---|
|
1
Distributable amount for 2015 from Section C, line 6 |
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|
2
Underdistributions, if any, for years prior to 2015 (reasonable cause required--see instructions) |
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| 3 Excess distributions carryover, if any, to 2015: | ||||
| a | ||||
| b | ||||
| c | ||||
| d From 2013....... | ||||
| e From 2014....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2015 distributable amount | ||||
|
i
Carryover from 2010 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from 3f. | ||||
| 4Distributions for 2015 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2015 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from 4. | ||||
|
5
Remaining underdistributions for years prior to 2015, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions) |
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|
6
Remaining underdistributions for 2015. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions) |
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|
7 Excess distributions carryover to 2016. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a | ||||
| b | ||||
| c Excess from 2013....... | ||||
| d From 2014....... | ||||
| e From 2015....... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|---|
| PART II, LINE 10 | OTHER INCOME 53,486 |
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Attach to Form 990 or 990-EZ.
Information about Schedule O (Form 990 or 990-EZ) and its instructions is at| Return Reference | Explanation |
|---|---|
| FORM 990 - ORGANIZATION'S MISSION | "DESERT SENITA DELIVERS A BROAD RANGE OF PRIMARY HEALTH CARE SERVICES IN A CULTURALLY-APPROPRIATE MANNER TO ALL PATIENTS. OUR MISSION IS TO IMPROVE THE HEALTH STATUS OF OUR PATIENTS BY PROVIDING ACCESSIBLE AND COMPREHENSIVE HIGH-QUALITY PRIMARY HEALTH CARE SERVICES, AND PROMOTING PREVENTIVE CARE AND HEALTH EDUCATION." DESERT SENITA COMMUNITY HEALTH CENTER IS THE SOLE PROVIDER OF PRIMARY HEALTH AND DENTAL SERVICES IN THE ENTIRE RURAL, FRONTIER AJO PRIMARY CARE AREA, A GEOGRAPHICALLY-ISOLATED AREA ROUGHLY 2/3 THE SIZE OF THE STATE OF CONNECTICUT AND SURROUNDED ON ALL SIDES BY FEDERAL LANDS, WITH A POPULATION OF APPROXIMATELY 4,000 RESIDENTS. DESERT SENITA CURRENTLY PROVIDES SERVICES TO ABOUT 75% OF LOCAL RESIDENTS, AND TYPICALLY RECORDS OVER 15,000 PATIENT VISITS A YEAR. THE DESERT SENITA ORGANIZATION HAS EVOLVED FROM A HOSPITAL AND OUTPATIENT FACILITY WHICH WAS RUN BY A LARGE MINING COMPANY UNTIL IT CEASED LOCAL OPERATIONS IN 1986. FOLLOWING THE MINE CLOSURE, THE HOSPITAL CLOSED AND THE OUTPATIENT TREATMENT FACILITY RELOCATED TO THE MINE'S FORMER SINGLE MEN'S DORMITORY, IN A MORE CENTRAL AREA OF THE AJO COMMUNITY. THE HEALTH CENTER WAS THEN RUN BY HOSPITAL MANAGEMENT ORGANIZATIONS HIRED BY THE MINING COMPANY FOR A FEW YEARS, PRIOR TO BECOMING AN INDEPENDENTLY-RUN FACILITY IN THE LATE 1990S. DESERT SENITA HAS BEEN AN INDEPENDENT, OUTPATIENT TREATMENT FACILITY SINCE 1997 AND BECAME A FEDERALLY QUALIFIED HEALTH CENTER (FQHC) IN 2001. THE HEALTH CENTER PROVIDES HEALTH CARE FOR THE ENTIRE FAMILY, INCLUDING PREVENTATIVE AND PRIMARY HEALTH CARE SERVICES, DENTAL SERVICES, BEHAVIORAL HEALTH SERVICES, OUTREACH AND EDUCATION PROGRAMS, AND ELIGIBILITY ASSISTANCE FOR AHCCCS AND OTHER SLIDING FEE SCALE AND DISCOUNTED SERVICES PROGRAMS. DESERT SENITA EXPANDED ITS DENTAL SERVICES IN EARLY 2009, MOVING TO A RENOVATED FACILITY WHICH DOUBLED THE NUMBER OF OPERATORIES FROM 3 TO 6. THE RENOVATED DENTAL BUILDING IS 2400+ SQUARE FEET, FEATURING A MODERN DESIGN AND SETTING. A COMBINATION OF STATE, LOCAL, AND FOUNDATION GRANTS PROVIDED THE FUNDING FOR THE MAJORITY OF THE RENOVATION, AND NO ADDITIONAL DEBT WAS INCURRED IN THE COMPLETION OF THE EXPANSION PROJECT. THE EXPANDED SPACE AND MODERN DESIGN IS ALLOWING A DENTIST AND DENTAL HYGIENIST TO EASILY ACCOMMODATE DEMAND AND TO OPERATE EFFICIENTLY AND PRODUCTIVELY. IN JANUARY 2010 DESERT SENITA IMPLEMENTED IN-HOUSE PHARMACY SERVICES AT ITS MAIN MEDICAL FACILITY SITE. DESERT SENITA RECEIVED PHARMACY SERVICE EXPANSION FUNDING TO IMPLEMENT IN-HOUSE PHARMACY SERVICES IN LATE 2008, AND ALSO APPLIED FOR AND SUBSEQUENTLY WAS AWARDED FEDERAL STIMULUS FUNDING IN MID-2009 FOR THE BUILDING EXPANSION NECESSARY TO ACCOMMODATE THE IN-HOUSE PHARMACY. |
| FORM 990, PART VI | IN VARIOUS POLICIES. LINE 13: THE ORGANIZATION HAS NO FORMAL WHISTLEBLOWER POLICY; HOWEVER, THEY ENSURE NO ADVERSE OR PUNITIVE ACTION WILL BE TAKEN AGAINST EMPLOYEES IN VARIOUS POLICIES. |
| FORM 990, PAGE 6, PART VI, LINE 11B | REVIEWED BY THE CEO, FINANCE MANAGER AND REVIEWED BY THE FINANCE COMMITTEE WHICH CONSISTS OF THREE BOARD MEMBERS. |
| FORM 990, PAGE 6, PART VI, LINE 12C | THE CONFLICT OF INTEREST POLICY INCLUDES ALL EMPLOYEES, BOARD MEMBERS, AND VOLUNTEERS. A CONFLICT OF INTEREST DETERMINATION CAN BE MADE IF IT IS REPORTED TO ANY DEPARTMENT HEAD, MANAGEMENT STAFF MEMBER, OR BOARD MEMBERS, EITHER VERBALLY OR IN WRITING. CONFLICTS WOULD BE FORWARDED ON TO THE RISK MANAGER AND/OR THE CEO, AND REVIEWED, THEN WOULD BE REPORTED TO THE BOARD AS PART OF OUR QUARTERLY QUALITY IMPROVEMENT REPORTING PROCESS. IF A CONFLICT OF INTEREST IS REVEALED, THEN THE PERSON WOULD BE PRECLUDED FROM VOTING ON OR HAVING ANY SORT OF A DECISION-MAKING AUTHORITY. IN ADDITION, AS PART OF OUR CORPORATE COMPLIANCE PROGRAM WE DID IMPLEMENT ANONYMOUS REPORTING ON LINE WITH LIGHTHOUSE ON 12/28/2013. |
| FORM 990, PAGE 6, PART VI, LINE 15A | USE OF NACHC AND ARIZONA-BASED COMPENSATION DATA. LAST MARKET STUDY PERFORMED IN 2010. |
| FORM 990, PAGE 6, PART VI, LINE 15B | USE OF NACHC AND ARIZONA-BASED COMPENSATION DATA. LAST MARKET STUDY PERFORMED IN 2010. |
| FORM 990, PAGE 6, PART VI, LINE 19 | INQUIRIES REGARDING GOVERNING DOCUMENTS, SUCH AS ARTICLES OF INCORPORATION AND BY-LAWS, ARE DIRECTED TO ACCESS THE ARIZONA CORPORATE COMMISSION WEBSITE. CONFLICT OF INTEREST POLICY IS PROVIDED UPON REQUEST TO DSCHC MANAGEMENT. FINANCIAL STATEMENT IS INCLUDED AS PART OF FORM 990 AND POSTED ON THE GUIDESTAR WEBSITE; CURRENT FINANCIAL (INCOME) STATEMENT MUST BE REQUESTED FROM DSCHC MANAGEMENT, AND IT CAN BE PRODUCED BY PEACHTREE ACCOUNTING SYSTEM. |
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