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 |
||||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (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) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (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) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (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) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (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 on 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) |
||||
| 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): |
|||||
| 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 2022 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-2022 |
(iii) Distributable Amount for 2022 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2022 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2022 (reasonable cause required-- explain in Part VI).
See instructions. |
||||
| 3 Excess distributions carryover, if any, to 2022: | ||||
| a From 2017....... | ||||
| b From 2018....... | ||||
| c From 2019....... | ||||
| d From 2020....... | ||||
| e From 2021....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2022 distributable amount | ||||
|
i
Carryover from 2017 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2022 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2022 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2022, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
||||
|
6
Remaining underdistributions for 2022. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
||||
|
7 Excess distributions carryover to 2023. Add lines 3j and 4c. |
||||
| 8 Breakdown of line 7: | ||||
| a Excess from 2018..... | ||||
| b Excess from 2019..... | ||||
| c Excess from 2020..... | ||||
| d Excess from 2021..... | ||||
| e Excess from 2022..... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|
| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| FORM 990 - ORGANIZATION'S MISSION | THE PURPOSES OF THIS CORPORATION ARE AS FOLLOWS: (A) TO MAKE HEALTH CARE DELIVERY AND ITS SUPPORTING ACTIVITIES A COMMON RESOURCE; (B) TO CARRY ON ANY EDUCATIONAL ACTIVITIES RELATED TO RENDERING CARE TO THE SICK AND INJURED, OR TO THE PROMOTION OF HEALTH, THAT IN THE OPINION OF THE BOARD OF DIRECTORS MAY BE JUSTIFIED BY THE FACILITIES, PERSONNEL, FUNDS, AND OTHER REQUIREMENTS THAT ARE, OR CAN BE, MADE AVAILABLE; (C) TO PARTICIPATE, SO FAR AS CIRCUMSTANCES MAY WARRANT, IN ANY ACTIVITY DESIGNED AND CARRIED ON TO PROMOTE THE GENERAL HEALTH OF THE COMMUNITY; (D) TO DEVELOP HEALTH SERVICES WHICH WILL MAKE QUALITY HEALTH CARE DELIVERY AVAILABLE, ACCESSIBLE AND ACCEPTABLE TO THE RESIDENTS OF THE AREAS SERVED; (E) TO PROVIDE PRIMARY HEALTH SERVICES, INCLUDING, BUT NOT LIMITED TO, THE FOLLOWING: (1) DIAGNOSTIC, TREATMENT, CONSULTATIVE, REFERRAL AND OTHER SERVICES RENDERED BY PHYSICIANS, AND, WHERE FEASIBLE, BY PHYSICIANS, PHYSICIAN ASSISTANTS, NURSE CLINICIANS AND NURSE PRACTITIONERS; (2) DIAGNOSTIC LABORATORY SERVICES; AND (3) PREVENTIVE HEALTH SERVICES, INCLUDING CHILDREN EYE AND EAR EXAMINATIONS, PRENATAL AND POSTPARTUM CARE, PRENATAL SERVICES, WELL CHILD CARE, AND VOLUNTARY FAMILY PLANNING SERVICES; (F) TO COOPERATE AND COORDINATE WITH ORGANIZATIONS, AGENCIES, AND INSTITUTIONS, WHETHER THE SAME BE PUBLIC, PRIVATE OR GOVERNMENTAL, WHICH HAVE AS THEIR OBJECTIVE IMPROVEMENT OF HEALTH AND GENERAL WELFARE; (G) TO IMPROVE AND DISSEMINATE UPON RESIDENTS EDUCATIONAL INFORMATION PERTAINING TO GOOD HEALTH PRACTICES; AND (H) TO ENCOURAGE AND FOSTER THROUGH COMMUNITY EDUCATION THE IMPROVEMENT OF HEALTH CONDITIONS IN THE AREA. |
| FORM 990 | PART IV, LINE 4, LOBBYING A PORTION OF DUES PAID IN FY 2023 TO THE NACHC AND GAPHC MAY BE ATTRIBUTABLE TO LOBBYING. THE AMOUNT IS NOT DETERMINABLE, BUT BELIEVED TO BE INSIGNIFICANT. |
| FORM 990, PAGE 6, PART VI, LINE 11B | THE FORM 990 IS PREPARED BY AN ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. THE CFO WILL REVIEW IN DETAIL WITH THE INDEPENDENT ACCOUNTING FIRM, THEN THE CFO WILL REVIEW WITH THE FINANCE COMMITTEE. A COPY OF THE 990 AND AN EXECUTIVE SUMMARY WILL BE PRESENTED TO THE FULL BOARD PRIOR TO THE RETURN BEING FILED. |
| FORM 990, PAGE 6, PART VI, LINE 12C | THE ORGANIZATION REQUIRES WRITTEN DISCLOSURE CONFIRMATIONS TO BE SUBMITTED AND REVIEWED ANNUALLY WITH RESPECT TO CONFLICTS OF INTEREST. NO BOARD MEMBER MAY BE IN ANY MANNER INTERESTED, EITHER DIRECTLY OR INDIRECTLY, IN HIS OWN NAME OR ANY OTHER PERSON, ASSOCIATION, TRUST OR CORPORATION, IN ANY CONTRACT OR THE PERFORMANCE OF ANY WORK IN THE MAKING OR LETTING OF WHICH SUCH BOARD MEMBER MAY BE CALLED UPON TO ACT OR VOTE. NO SUCH BOARD MEMBER MAY REPRESENT EITHER AS AGENT OR OTHERWISE ANY PERSON, ASSOCIATION, TRUST, OR CORPORATION, WITH RESPECT TO ANY APPLICATION OR BID FOR ANY CONTRACT OR WORK IN REGARD TO WHICH SUCH BOARD MEMBER MAY BE CALLED UPON TO VOTE. NOR MAY ANY SUCH BOARD MEMBER TAKE OR RECEIVE, OR OFFER TO TAKE OR RECEIVE, EITHER DIRECTLY OR INDIRECTLY, ANY MONEY OR OTHER THING OF VALUE AS A GIFT OR BRIBE OR MEANS OF INFLUENCING HIS VOTE OR ACTION IN HIS OFFICIAL CHARACTER. ANY CONTRACT MADE AND PROCURED IN VIOLATION HEREOF IS VOID. NO EMPLOYEE SHALL TAKE OR RECEIVE, OR OFFER TO TAKE OR RECEIVE, EITHER DIRECTLY OR INDIRECTLY, ANY MONEY OR OTHER THING OF VALUE AS A GIFT OR BRIBE OR MEANS OF INFLUENCING HIS ACTION IN HIS OFFICIAL CHARACTER AND NO EMPLOYEE MAY BE IN ANY MANNER INTERESTED EITHER DIRECTLY OR INDIRECTLY IN HIS OWN NAME OR IN THE NAME OF ANY OTHER PERSON, ASSOCIATION, TRUST OR CORPORATION, IN ANY CONTRACT OR THE PERFORMANCE OF ANY WORK IN THE MAKING OR LETTING OF WHICH SUCH EMPLOYEE MAY BE CALLED UPON TO ACT. VIOLATION OF THIS RESOLUTION BY ANY EMPLOYEE WILL RESULT IN THE TERMINATION OF SAID PARTY'S EMPLOYMENT BY AAPHC. |
| FORM 990, PAGE 6, PART VI, LINE 15A | THE ORGANIZATION UTILIZES A PREDEFINED PAY SCALE WITH VARIOUS "STEPS" FOR EACH POSITION AND LEVEL. THE HR DEPARTMENT PERIODICALLY COMPARES THE POSITIONS AND DEPARTMENT RANGES TO MARKET DATA WITH THE USE SALARY SURVEYS FROM NACHC, MGMA AND OTHER RESOURCES. IF THERE IS A RECOMMENDATION THE PAY SCALE BE ADJUSTED TO FALL WITHIN THE RANGE SET BY THE MARKET, THE RECOMMENDATION IS TAKEN BEFORE THE BOARD. THE BOARD DOES NOT APPROVE THE PAY SCALE ANNUALLY, ONLY WHEN ADJUSTMENTS ARE MADE. THE BOARD DOCUMENTS THE REVIEW AND APPROVAL OF ALL ADJUSTMENTS. THE BOARD INDIVIDUALLY COMPLETES A PERFORMANCE ASSESSMENT FOR THE CEO ANNUALLY. THE RESULTS ARE AGGREGATED TO DETERMINE THE OVERALL PAY SCALE ADJUSTMENT REFERENCED ABOVE. THE BOARD CHAIR AND THE FINANCE CHAIR MEET WITH THE CEO TO REVIEW THE RESULTS OF THE EVALUATION AND DISCUSS OPPORTUNITIES FOR THE UPCOMING YEAR. THE BOARD AND FINANCE CHAIR MET LAST FOR SUCH PURPOSE IN CALENDAR YEAR 2023. |
| FORM 990, PAGE 6, PART VI, LINE 15B | SEE 15A ABOVE. CEO, SHELLEY SPIRES, REVIEWS COO AND CFO ANNUALLY, WITH LAST REVIEW IN CALENDAR YEAR 2023. |
| FORM 990, PAGE 6, PART VI, LINE 19 | GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS WILL BE MADE AVAILABLE FOR VIEWING ON-SITE UPON REQUEST. |
| Software ID: | |
| Software Version: |