Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 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 |
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Calendar year
(or fiscal year beginning in)
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(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | ||||||
| 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 | ||||||
| 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. | ||||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | ||||||
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | ||||||
| 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.).. | ||||||
| 11 | Total support. Add lines 7 through 10 | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 1,279,489 | 2,181,100 | 3,460,589 | |||
| 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 | 21,301,073 | 22,185,267 | 22,733,938 | 25,966,071 | 21,561,542 | 113,747,891 |
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513 ..... | 0 | |||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | 0 | |||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge | 0 | |||||
| 6 | Total. Add lines 1 through 5 | 22,580,562 | 22,185,267 | 22,733,938 | 25,966,071 | 23,742,642 | 117,208,480 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons | 0 | |||||
| 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. | 0 | |||||
| c | Add lines 7a and 7b.. | ||||||
| 8 | Public support. (Subtract line 7c from line 6.) | 117,208,480 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 22,580,562 | 22,185,267 | 22,733,938 | 25,966,071 | 23,742,642 | 117,208,480 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 49,043 | 2,376 | 573 | 4,783 | 290 | 57,065 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | 0 | |||||
| c | Add lines 10a and 10b. | 49,043 | 2,376 | 573 | 4,783 | 290 | 57,065 |
| 11 | Net income from unrelated business activities not included on line 10b, whether or not the business is regularly carried on. | 0 | |||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | 0 | |||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 22,629,605 | 22,187,643 | 22,734,511 | 25,970,854 | 23,742,932 | 117,265,545 |
| 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) |
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| 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 0.015 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 0.035 | 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 | 1 | |
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
2 | |
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | 3 | |
| 4 Amounts paid to acquire exempt-use assets | 4 | |
| 5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) | 5 | |
| 6 Other distributions (describe in Part VI). See instructions | 6 | |
| 7Total annual distributions. Add lines 1 through 6. | 7 | |
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
8 | |
| 9 Distributable amount for 2021 from Section C, line 6 | 9 | |
| 10 Line 8 amount divided by Line 9 amount | 10 | |
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2021 |
(iii) Distributable Amount for 2021 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2021 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2021 (reasonable cause required-- explain in Part VI). See instructions. |
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| 3 Excess distributions carryover, if any, to 2021: | ||||
| a From 2016....... | ||||
| b From 2017....... | ||||
| c From 2018....... | ||||
| d From 2019....... | ||||
| e From 2020....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2021 distributable amount | ||||
|
i
Carryover from 2016 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2021 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2021 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2021, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
6
Remaining underdistributions for 2021. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
7 Excess distributions carryover to 2022. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2017..... | ||||
| b Excess from 2018..... | ||||
| c Excess from 2019..... | ||||
| d Excess from 2020..... | ||||
| e Excess from 2021..... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|
| Software ID: | 21013475 |
| Software Version: | 2021v4.0 |
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| Client Note 1 | Client Note 1 - NOTE 1: PART IV 28C/SCH LROCKY MOUNTAIN CARE, LLC PROVIDES MANAGEMENT SERVICES FOR VALI DIVISION OF WASATCH, INC. ROCKY MOUNTAIN CARE, LLC IS A DISREGARDED ENTITY INTO ROCKY MOUNTAIN HOME HEALTH, LLC. |
| Client Note 2 | Client Note 2 - NOTE 2: PART IV 28C/SCH LRocky Mountain Care - Holladay, Inc., a 501(c)(3) organization, provides room and board services to patients of Vali Division of Wasatch and also leases equipment and vehicles to Vali. |
| Client Note 3 | Client Note 3 - NOTE 3: PART IV 28C/SCH LBCVV, Inc., a 501(c)(3) organization, provides room and board services to patients of Vali Division of Wasatch. |
| Client Note 4 | Client Note 4 - NOTE 4: PART IV 28C/SCH LBCCU, Inc., a 501(c)(3) organization, provides room and board services to patients of Vali Division of Wasatch. |
| Client Note 5 | Client Note 5 - NOTE 5: PART IV 28C/SCH LRocky Mountain Care - Tooele, Inc., a 501(c)(3) organization, provides room and board services to patients of Vali Division of Wasatch. |
| Client Note 6 | Client Note 6 - NOTE 6: PART IV 28C/SCH LALTA RESOURCE MANAGEMENT, LLC PROVIDES MEDICAL BILLING SERVICES FOR VALI DIVISION OF WASATCH, INC. |
| Form 990, Part VI, Line 9: Officer, Director, Trustee, Key Employee Mailing Address | Troy Thompson 3333 South State Street Salt Lake City, UT 84115Joseph Parks 2013 S 4000 W. Delta, UT 84624 |
| Form 990, Part VI, Line 11b: Form 990 Review Process | A COPY OF THE FORM 990 IS REVIEWED BY AN OFFICER AND TRUSTEE BEFORE IT IS ISSUED. |
| Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts | There is ongoing communication between officers and trustees regarding business transactions. |
| Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees | The board meets with an independent consultant to review and approve compensation with comparability data and performance measures. |
| Form 990, Part VI, Line 19: Other Organization Documents Publicly Available | GOVERNING DOCS, POLICIES AND FINANCIAL STATEMENTS WILL BE MADE AVAILABLE UPON REQUEST. |
| Form 990, Part IX, Line 24e: Other Expenses | Auto Expense: Column (A) - Total = $386437; Column (B) - Program Services = $380488; Column (C) - Management & General = $5949; Column (D) - Fundraising = $0 |
| Form 990, Part IX, Line 24e: Other Expenses | Bad Debt: Column (A) - Total = $417769; Column (B) - Program Services = $417769; Column (C) - Management & General = $0; Column (D) - Fundraising = $0 |
| Form 990, Part IX, Line 24e: Other Expenses | Closing Cost & Legal Fee - Evn: Column (A) - Total = $65479; Column (B) - Program Services = $0; Column (C) - Management & General = $65479; Column (D) - Fundraising = $0 |
| Form 990, Part IX, Line 24e: Other Expenses | Construction in process - Evan: Column (A) - Total = $11219; Column (B) - Program Services = $0; Column (C) - Management & General = $11219; Column (D) - Fundraising = $0 |
| Form 990, Part IX, Line 24e: Other Expenses | Dues & Subscriptions: Column (A) - Total = $46674; Column (B) - Program Services = $46674; Column (C) - Management & General = $0; Column (D) - Fundraising = $0 |
| Form 990, Part IX, Line 24e: Other Expenses | Employee Recruitment: Column (A) - Total = $98633; Column (B) - Program Services = $98633; Column (C) - Management & General = $0; Column (D) - Fundraising = $0 |
| Form 990, Part IX, Line 24e: Other Expenses | Equipment Rental: Column (A) - Total = $2237; Column (B) - Program Services = $2237; Column (C) - Management & General = $0; Column (D) - Fundraising = $0 |
| Form 990, Part IX, Line 24e: Other Expenses | Licenses & Fees: Column (A) - Total = $7171; Column (B) - Program Services = $4019; Column (C) - Management & General = $3152; Column (D) - Fundraising = $0 |
| Form 990, Part IX, Line 24e: Other Expenses | MEALS & ENTERTAINMENT: Column (A) - Total = $7270; Column (B) - Program Services = $2985; Column (C) - Management & General = $4285; Column (D) - Fundraising = $0 |
| Form 990, Part IX, Line 24e: Other Expenses | Minor Equipment: Column (A) - Total = $1780; Column (B) - Program Services = $1780; Column (C) - Management & General = $0; Column (D) - Fundraising = $0 |
| Form 990, Part IX, Line 24e: Other Expenses | Patient Ancillary costs: Column (A) - Total = $379197; Column (B) - Program Services = $379197; Column (C) - Management & General = $0; Column (D) - Fundraising = $0 |
| Form 990, Part IX, Line 24e: Other Expenses | PENALTIES & LATE CHARGES: Column (A) - Total = $9844; Column (B) - Program Services = $375; Column (C) - Management & General = $9469; Column (D) - Fundraising = $0 |
| Form 990, Part IX, Line 24e: Other Expenses | Property Taxes: Column (A) - Total = $86751; Column (B) - Program Services = $85404; Column (C) - Management & General = $1347; Column (D) - Fundraising = $0 |
| Form 990, Part IX, Line 24e: Other Expenses | Public Relation: Column (A) - Total = $13826; Column (B) - Program Services = $13826; Column (C) - Management & General = $0; Column (D) - Fundraising = $0 |
| Form 990, Part IX, Line 24e: Other Expenses | Repairs & Maintenance: Column (A) - Total = $75777; Column (B) - Program Services = $75777; Column (C) - Management & General = $0; Column (D) - Fundraising = $0 |
| Form 990, Part IX, Line 24e: Other Expenses | Sales Tax: Column (A) - Total = $821; Column (B) - Program Services = $821; Column (C) - Management & General = $0; Column (D) - Fundraising = $0 |
| Form 990, Part IX, Line 24e: Other Expenses | Seminars & Education: Column (A) - Total = $371608; Column (B) - Program Services = $371608; Column (C) - Management & General = $0; Column (D) - Fundraising = $0 |
| Form 990, Part IX, Line 24e: Other Expenses | SUPPORT SERVICES: Column (A) - Total = $279894; Column (B) - Program Services = $0; Column (C) - Management & General = $279894; Column (D) - Fundraising = $0 |
| Form 990, Part IX, Line 24e: Other Expenses | Survey and Engineering: Column (A) - Total = $11500; Column (B) - Program Services = $0; Column (C) - Management & General = $11500; Column (D) - Fundraising = $0 |
| Form 990, Part IX, Line 24e: Other Expenses | UNIFORMS : Column (A) - Total = $255; Column (B) - Program Services = $255; Column (C) - Management & General = $0; Column (D) - Fundraising = $0 |
| Software ID: | 21013475 |
| Software Version: | 2021v4.0 |