SONOMA VALLEY COMMUNITY HEALTH CENTER: Form 990, tax year 2023
View the entire original 990 at ProPublica ↗
- Organization
- SONOMA VALLEY COMMUNITY HEALTH CENTER (EIN 68-0286382)
- Tax period
- 2023-01-01 to 2023-12-31
- Filed
- 2024-10-16
- IRS object ID
- 202442909349301479
- Schema version
- 2023v5.1
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2024-10-16T14:37:16-05:00 | ReturnTs |
| Tax Period End | 2023-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 680456752 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DILLWOOD BURKEL & MILLAR LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 175 CONCOURSE BOULEVARD SUITE A | AddressLine1Txt |
| City | SANTA ROSA | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95403 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2023-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 680286382 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SONOMA VALLEY COMMUNITY HEALTH CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | SONO | BusinessNameControlTxt |
| Phone | 7079396070 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 19270 SONOMA HIGHWAY | AddressLine1Txt |
| City | SONOMA | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 954765414 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CHERYL JOHNSON | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 7079396070 | PhoneNum |
| Signature | 2024-10-16 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | Yes (1) | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | CHRISTINA Z HOLLINGSWORTH | PreparerPersonNm |
| PTIN | P02090706 | PTIN |
| Phone | 7075778806 | PhoneNum |
| Preparation | 2024-10-15 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2023 | TaxYr |
| Build TS | 2024-10-15 13:58:12Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | CHERYL JOHNSON | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 19270 SONOMA HIGHWAY | AddressLine1Txt |
| City | SONOMA | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 954765414 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $16,200,937 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | SVCHC.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1992 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | PROVIDING HEALTH CARE SERVICES, ESPECIALLY TO THE UNDERSERVED, REGARDLESS OF ABILITY TO PAY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 116 | TotalEmployeeCnt |
| Total Volunteers | 107 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $5,035,520 | PYContributionsGrantsAmt |
| CY Contributions Grants | $3,901,222 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $8,570,763 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $12,217,609 | CYProgramServiceRevenueAmt |
| PY Investment Income | $26,412 | PYInvestmentIncomeAmt |
| CY Investment Income | $82,106 | CYInvestmentIncomeAmt |
| PY Other Revenue | $3,000 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $13,635,695 | PYTotalRevenueAmt |
| CY Total Revenue | $16,200,937 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $8,295,327 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $8,088,093 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $131,335 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $5,659,432 | PYOtherExpensesAmt |
| CY Other Expenses | $6,037,054 | CYOtherExpensesAmt |
| PY Total Expenses | $13,954,759 | PYTotalExpensesAmt |
| CY Total Expenses | $14,125,147 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$319,064 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $2,075,790 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $15,737,268 | TotalAssetsBOYAmt |
| Total Assets EOY | $16,827,712 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $8,093,100 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $7,107,753 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $7,644,168 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $9,719,959 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO PROVIDE ACCESSIBLE, QUALITY HEALTH CARE TO THOSE WHO NEED IT, ESPECIALLY THE UNDERSERVED. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $7,565,362 | ExpenseAmt |
| Revenue | $5,690,489 | RevenueAmt |
| Desc | FAMILY PRACTICE SERVICES: THE HEALTH CENTER PROVIDES MEDICAL CARE SERVICES FOR INFANTS THROUGH ADULTS, WITH EXTENDED DAY AND EVENING HOURS AND IS OPEN 6 DAYS PER WEEK. SERVICES INCLUDE ROUTINE EXAMINATIONS, IMMUNIZATIONS, PHYSICALS, URGENT CARE AND DIAGNOSIS, AND TREATMENT OF ACUTE AND CHRONIC ILLNESS. IN 2023, 32,375 FQHC VISITS WERE GENERATED ACROSS ALL CLINICS SERVING 6,524 UNDUPLICATED PATIENTS. MEDICAL CLINIC VISITS FOR THE YEAR WERE 19,812 PATIENT VISITS. COMPREHENSIVE PERINATAL SERVICES: THE HEALTH CENTER PROVIDES PRE- AND POST-NATAL OB SERVICES AND EDUCATION TO PREGNANT WOMEN. NURSE EDUCATORS AND NUTRITIONISTS ARE AVAILABLE FULL TIME TO SUPPORT PATIENTS. 799 PATIENT VISITS WERE PROVIDED TO 104 WOMEN PATIENTS. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,778,747 | ExpenseAmt |
| Revenue | $2,448,443 | RevenueAmt |
| Desc | DENTAL SERVICES: SVCHC OFFERS PREVENTATIVE AND RESTORATIVE DENTAL SERVICES TO CHILDREN AND ADULTS. SERVICES INCLUDE X-RAY AND EXAMINATIONS, DEEP CLEANINGS, COMPOSITE FILLINGS AND EXTRACTIONS. IN 2023, THE DENTAL CLINIC HAD 7,758 PATIENT VISITS. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,048,316 | ExpenseAmt |
| Revenue | $917,903 | RevenueAmt |
| Desc | BEHAVIORAL HEALTH SERVICES: SVCHC'S BEHAVIORAL HEALTH CLINICIANS WORK WITH THE PRIMARY CARE TEAM TO EVALUATE THE BARRIERS TO HEALTH AND ADDRESS THOSE BARRIERS BY PROVIDING BRIEF, SOLUTION-FOCUSED INTERVENTIONS. INDIVIDUAL AND GROUP COUNSELING ARE OFFERED THRU FACE-TO-FACE OR VIRTUAL VISITS. IN 2023, THERE WERE 2,112 PATIENT VISITS FOR BEHAVIORAL HEALTH SERVICES. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $928,455 | ExpenseAmt |
| Revenue | $3,160,774 | RevenueAmt |
| Desc | ALTERNATIVE CARE-CHIROPRACTIC: PROVIDE ALTERNATIVE TREATMENTS FOR THOSE WITH CHRONIC PAIN DISEASES. OPTOMETRY SERVICES: PROVIDE VISION SERVICES FOR THOSE IN NEED OF VISION CARE PROVIDED BY AN OPTOMETRIST. GLASSES ARE AVAILABLE TO PATIENTS, BASED ON PRESCRIPTION. OTHER PROGRAM SERVICES: OUTREACH/TRANSPORTATION SERVICES, AND DISCOUNTED DRUG PROGRAM. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $928,455 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Revenue | $3,160,774 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $11,320,880 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | Yes (1) | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | Yes (1) | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 42 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 116 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | CA | StatesWhereCopyOfReturnIsFldCd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GLEN GIBSON CFO | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7079392331 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 19270 SONOMA HIGHWAY | AddressLine1Txt |
| City | SONOMA | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 954765414 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| EMMA MCCULLOCH | ||||||||
| VICE-CHAIR | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| CHARLES ZIPKIN MD | ||||||||
| CHAIR | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| PAMELA STEPHENS | ||||||||
| BOARD SECRETARY | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| MARGARET BASTRESS | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| ROBERT ELDERS ESQ | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| PETER FITZGERALD | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| KARINA FLOREZ | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| SABINA RAFAELA GONZALEZ | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| LINDA MCTAGGART | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| BEN ROOKS | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| CHERYL JOHNSON | ||||||||
| CHIEF EXECUTIVE OFFICER | 40.00 | Yes (X) | $209,740 | $0 | $68,531 | |||
| GLEN GIBSON | ||||||||
| CHIEF FINANCIAL OFFICER | 40.00 | Yes (X) | $191,300 | $0 | $70,401 | |||
| ALISON O'DONNELL | ||||||||
| TREASURER | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| JANET BYRD FNP | ||||||||
| FAMILY NURSE PRACTITIONER | 40.00 | $169,345 | $0 | $75,534 | Yes (X) | |||
| WILLIAM KLAS | ||||||||
| CHIEF MEDICAL DIRECTOR | 40.00 | $273,411 | $0 | $68,558 | Yes (X) | |||
| KIANA GUERRERO MCCORMICK FPP | ||||||||
| FAMILY PRACTICE PHYSICIAN | 40.00 | $166,288 | $0 | $62,558 | Yes (X) | |||
| JENNIFER HASA FPP | ||||||||
| FAMILY PRACTICE PHYSICIAN | 40.00 | $251,300 | $0 | $45,917 | Yes (X) | |||
| ALFRED MCGUIN | ||||||||
| CQI & ECM DIRECTOR | 40.00 | $155,146 | $0 | $18,999 | Yes (X) | |||
| ALVARO GONZALEZ | ||||||||
| OUTREACH DIRECTOR | 40.00 | $113,300 | $0 | $16,038 | Yes (X) | |||
| SEAN O'DONNELL | ||||||||
| IT MANAGER | 40.00 | $109,844 | $0 | $16,991 | Yes (X) | |||
| SARET AZIZIANS FNP | ||||||||
| OUTREACH DIRECTOR | 40.00 | $139,958 | $0 | $42,302 | Yes (X) | |||
| MICHAEL MABANGLO | ||||||||
| DIRECTOR OF IBH | 40.00 | $141,997 | $0 | $49,043 | Yes (X) | |||
| JAKELINE GONZALEZ | ||||||||
| RN | 40.00 | $112,996 | $0 | $25,291 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,034,625 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $560,163 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 12 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| PROVIDER HEALTHCARE LLC | |||||
| 2455 E PARLEYS WAY | SALT LAKE | UT | 84109 | LOCUMS TENENS PLACEMENT | $465,087 |
| MH BILINGS SOLUTIONS | |||||
| 3400 COTTAGE WAY | SACRAMENTO | CA | 95825 | BILLING CONTRACTOR | $377,562 |
| MEDICUS IT LLC | |||||
| 100 NORTH POINT CENTER EAST | ALPHARETTA | GA | 30022 | IT AND NETWORK | $357,317 |
| PIVOT POINT CONSULTING LLC | |||||
| PO BOX 667 | BRENTWOOD | TN | 37024 | IT CONSULTING | $336,119 |
| VLASIS CONSULTING | |||||
| 5172 E WOODWARD AVE | FRESNO | CA | 93727 | CONSULTING | $243,700 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $2,283,806 | GovernmentGrantsAmt |
| All Other Contributions | $1,617,416 | AllOtherContributionsAmt |
| Noncash Contributions | $202,556 | NoncashContributionsAmt |
| Total Contributions | $3,901,222 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENUE | 624100 | $10,166,583 | $10,166,583 |
| OTHER PROGRAM SERVICE REVENUE | 624100 | $2,051,026 | $2,051,026 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $12,217,609 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $82,106 | TotalRevenueColumnAmt |
| Exclusion | $82,106 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $16,200,937 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $12,217,609 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $82,106 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,827,029 | TotalAmt |
| Program Services | $1,479,915 | ProgramServicesAmt |
| Management And General | $341,714 | ManagementAndGeneralAmt |
| Fundraising | $5,400 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,292,326 | TotalAmt |
| Program Services | $4,184,249 | ProgramServicesAmt |
| Management And General | $1,004,198 | ManagementAndGeneralAmt |
| Fundraising | $103,879 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $968,738 | TotalAmt |
| Program Services | $659,006 | ProgramServicesAmt |
| Management And General | $293,985 | ManagementAndGeneralAmt |
| Fundraising | $15,747 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,554,737 | TotalAmt |
| Program Services | $2,170,254 | ProgramServicesAmt |
| Management And General | $384,483 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $245,667 | TotalAmt |
| Program Services | $213,353 | ProgramServicesAmt |
| Management And General | $31,384 | ManagementAndGeneralAmt |
| Fundraising | $930 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $119,924 | TotalAmt |
| Program Services | $64,072 | ProgramServicesAmt |
| Management And General | $55,852 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $275,268 | TotalAmt |
| Program Services | $263,894 | ProgramServicesAmt |
| Management And General | $11,374 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $860,566 | TotalAmt |
| Program Services | $540,820 | ProgramServicesAmt |
| Management And General | $319,746 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $132,316 | TotalAmt |
| Program Services | $127,711 | ProgramServicesAmt |
| Management And General | $4,605 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| COMPUTER AND ELECTRONIC | $632,918 | $621,217 | $10,567 | $1,134 |
| SUPPLIES/LAB AND DIAGNO | $338,667 | $338,667 | ||
| UTILITIES AND TELEPHONE | $284,010 | $140,184 | $140,964 | $2,862 |
| DONATED MEDICAL SUPPLIE | $202,556 | $202,556 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $390,425 | TotalAmt |
| Program Services | $314,982 | ProgramServicesAmt |
| Management And General | $74,060 | ManagementAndGeneralAmt |
| Fundraising | $1,383 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,125,147 | TotalAmt |
| Program Services | $11,320,880 | ProgramServicesAmt |
| Management And General | $2,672,932 | ManagementAndGeneralAmt |
| Fundraising | $131,335 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,245,338 | BOYAmt |
| EOY | $564,814 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,299,198 | BOYAmt |
| EOY | $2,862,875 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,251,604 | BOYAmt |
| EOY | $3,334,934 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $98,040 | BOYAmt |
| EOY | $114,424 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $15,585,769 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $6,763,879 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,626,102 | BOYAmt |
| EOY | $8,821,890 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,216,986 | BOYAmt |
| EOY | $1,128,775 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,737,268 | BOYAmt |
| EOY | $16,827,712 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,613,724 | BOYAmt |
| EOY | $1,827,941 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,087,775 | BOYAmt |
| EOY | $3,952,262 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,391,601 | BOYAmt |
| EOY | $1,327,550 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,093,100 | BOYAmt |
| EOY | $7,107,753 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,644,168 | BOYAmt |
| EOY | $9,306,664 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $413,295 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,644,168 | BOYAmt |
| EOY | $9,719,959 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,737,268 | BOYAmt |
| EOY | $16,827,712 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $2,075,790 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,539,808 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,953,655 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $5,360,723 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $5,035,520 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,901,222 | CurrentTaxYearAmt |
| Total | $20,790,928 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,539,808 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,953,655 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $5,360,723 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $5,035,520 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,901,222 | CurrentTaxYearAmt |
| Total | $20,790,928 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $549,507 | SubstantialContributorsTotAmt |
| Public Support Total170 | $20,241,421 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $10,855 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $8,266 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7,572 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $29,412 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $82,106 | CurrentTaxYearAmt |
| Total | $138,211 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $20,929,139 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $48,813,522 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.96710 | PublicSupportCY170Pct |
| Public Support PY170 | 0.98530 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,538,780 | OtherCostOrOtherBasisAmt |
| Book Value | $1,538,780 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $9,598,670 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,614,638 | DepreciationAmt |
| Book Value | $4,984,032 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $945,715 | OtherCostOrOtherBasisAmt |
| Depreciation | $178,598 | DepreciationAmt |
| Book Value | $767,117 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,258,676 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,817,459 | DepreciationAmt |
| Book Value | $1,441,217 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $243,928 | OtherCostOrOtherBasisAmt |
| Depreciation | $153,184 | DepreciationAmt |
| Book Value | $90,744 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $8,821,890 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OPERATING LEASE RIGHT-OF-USE ASSET | Desc |
| Book Value | $1,128,775 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $1,128,775 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OPERATING LEASE LIABILITIES | Desc |
| Amt | $1,327,550 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,327,550 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $16,200,937 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $16,200,937 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $16,200,937 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $14,125,146 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $14,125,146 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $14,125,146 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION DETERMINES WHETHER ITS TAX POSITIONS ARE "MORE-LIKELY-THAN-NOT" TO BE SUSTAINED UPON EXAMINATION BY THE APPLICABLE TAXING AUTHORITY BASED ON THE TECHNICAL MERITS OF THE POSITIONS. AS OF DECEMBER 31, 2023, THE ORGANIZATION HAS REVIEWED ITS TAX POSITIONS AND HAS CONCLUDED NO RESERVE FOR UNCERTAIN TAX POSITIONS IS REQUIRED. THE ORGANIZATION'S EXEMPT ORGANIZATION INFORMATION RETURNS ARE SUBJECT TO REVIEW THROUGH THREE YEARS AFTER THE DATE OF FILING FOR FEDERAL AND FOUR YEARS AFTER THE DATE OF FILING FOR STATE. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| WILLIAM KLAS | ||||||||||||||
| CHIEF MEDICAL DIRECTOR | $273,411 | $0 | $0 | $0 | $0 | $0 | $24,000 | $0 | $44,558 | $0 | $341,969 | $0 | $0 | $0 |
| JENNIFER HASA FPP | ||||||||||||||
| FAMILY PRACTICE PHYSICIAN | $251,300 | $0 | $0 | $0 | $0 | $0 | $12,515 | $0 | $33,402 | $0 | $297,217 | $0 | $0 | $0 |
| CHERYL JOHNSON | ||||||||||||||
| CHIEF EXECUTIVE OFFICER | $209,740 | $0 | $0 | $0 | $0 | $0 | $30,000 | $0 | $38,531 | $0 | $278,271 | $0 | $0 | $0 |
| GLEN GIBSON | ||||||||||||||
| CHIEF FINANCIAL OFFICER | $191,300 | $0 | $0 | $0 | $0 | $0 | $30,000 | $0 | $40,401 | $0 | $261,701 | $0 | $0 | $0 |
| JANET BYRD FNP | ||||||||||||||
| FAMILY NURSE PRACTITIONER | $169,345 | $0 | $0 | $0 | $0 | $0 | $30,000 | $0 | $45,534 | $0 | $244,879 | $0 | $0 | $0 |
| KIANA GUERRERO MCCORMICK FPP | ||||||||||||||
| FAMILY PRACTICE PHYSICIAN | $166,288 | $0 | $0 | $0 | $0 | $0 | $22,005 | $0 | $40,553 | $0 | $228,846 | $0 | $0 | $0 |
| MICHAEL MABANGLO | ||||||||||||||
| DIRECTOR OF IBH | $141,997 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $49,043 | $0 | $191,040 | $0 | $0 | $0 |
| SARET AZIZIANS FNP | ||||||||||||||
| OUTREACH DIRECTOR | $139,958 | $0 | $0 | $0 | $0 | $0 | $21,002 | $0 | $21,300 | $0 | $182,260 | $0 | $0 | $0 |
| ALFRED MCGUIN | ||||||||||||||
| CQI & ECM DIRECTOR | $155,146 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $18,999 | $0 | $174,145 | $0 | $0 | $0 |
Schedule L IRS990ScheduleL
Grnt Asst Bnft Interested Prsn GrntAsstBnftInterestedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | PAMELA STEPHENS | PersonNm |
| Relationship With Org | BOARD SECRETARY | RelationshipWithOrgTxt |
| Cash Grant | $1,825 | CashGrantAmt |
| Type Of Assistance | INTERNET SERVICE | TypeOfAssistanceTxt |
| Assistance Purpose | TO PROVIDE REAL-TIME ACCESS TO BOARD REPORTS AS A BOARD OFFICER. | AssistancePurposeTxt |
Schedule M IRS990ScheduleM
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 2 | ContributionCnt |
| Noncash Contributions Rpt F990 | $202,556 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | DISTRIBUTION VALUE | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | THE CFO REVIEWS THE DRAFT WITH THE PREPARER. THE CFO REVIEWS WITH THE CEO AND THE FINANCE COMMITTEE. ONCE PASSED BY THE FINANCE COMMITTEE, THE DRAFT IS SENT TO THE BOARD FOR COMMENTS. IF NO OTHER COMMENTS AFTER 7 DAYS, THE CFO APPROVES THE TAX RETURN FOR SUBMISSION TO THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE CONFLICT OF INTEREST POLICY RELATING TO THE BOARD OF DIRECTORS AND OFFICERS IS INCLUDED IN THE BYLAWS OF THE ORGANIZATION. DISCLOSURE OF ANY CONFLICTS IS REQUIRED WHEN A BOARD MEMBER IS ELECTED TO SERVE ON THE BOARD. THE BOARD IS REQUIRED TO COMPLETE THE CONFLICT OF INTEREST STATEMENTS ANNUALLY. CEO MAINTAINS CONFLICT OF INTEREST FILE. RELEVANT EMPLOYEES AND THOSE WHO HAVE INFLUENCE OVER DECISION MAKING OR PURCHASING ARE REQUIRED TO COMPLETE AND SIGN A DISCLOSURE OF WHAT MAY APPEAR AS CONFLICT OF INTEREST. |
| FORM 990, PART VI, SECTION B, LINE 15A | THE ORGANIZATION UTILIZES AN INDEPENDENT COMPENSATION CONSULTANT, A REVIEW OF FORM 990 OF OTHER ORGANIZATIONS, WRITTEN EMPLOYMENT CONTRACTS, A COMPENSATION SURVEY OR STUDY, AND REQUIRES APPROVAL BY THE BOARD TO ESTABLISH REASONABLE COMPENSATION OF INSIDERS. THE BOARD HAS FINAL AUTHORITY OVER THE HIRING, DISMISSAL, AND ANNUAL EVALUATION OF THE CEO. THE CEO EVALUATES THE CFO AND THE MEDICAL DIRECTOR. THE CEO REVIEWS THE CALIFORNIA PRIMARY CARE ASSOCIATION (CPCA) ANNUAL STATE WIDE SALARY SURVEY FOR COMMUNITY HEALTH CENTERS TO SET SALARY RANGES AND WAGES EACH YEAR. |
| FORM 990, PART VI, SECTION C, LINE 18 | UPON REQUEST AND AVAILABLE THROUGH GUIDESTAR/CANDID. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS FORM 990 AND 1023, FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY, AND GOVERNING DOCUMENTS AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST, AND THROUGH GUIDESTAR/CANDID. |
| FORM 990, PART IX, LINE 11G | CONTRACTED CLINICAL SERVICES: PROGRAM SERVICE EXPENSES 1,409,670. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,409,670. OUTSIDE SERVICES: PROGRAM SERVICE EXPENSES 760,584. MANAGEMENT AND GENERAL EXPENSES 384,483. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,145,067. |
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