2024-11-13T12:45:39-06:00 2023-12-31 910189318 MOSS ADAMS LLP 4747 EXECUTIVE DR SUITE 1300 SAN DIEGO CA 92121 990 2023-01-01 251902459 TUOLUMNE ME-WUK INDIAN HEALTH CENTER INC TUOL 2099285400 18880 CHERRY VALLEY BOULEVARD TUOLUMNE CA 95379 JANET PEPPER CHIEF ADMINISTRATIVE OFFICER 2099285400 2024-11-12 1 0 PATRICIA J MAYER P00188643 8586271400 2023 2024-10-15 13:58:12Z JANET PEPPER 18880 CHERRY VALLEY BOULEVARD TUOLUMNE CA 95379 22521346 0 X TMWIHC.ORG X 2003 CA SEE SCHEDULE O.TO PROVIDE HIGH QUALITY, COMPREHENSIVE, PRIMARY HEALTH CARE FOR THE TUOLUMNE ME-WUK TRIBAL MEMBERS, OTHER NATIVE AMERICANS, AND RESIDENTS OF SURROUNDING COMMUNITIES. 8 8 167 8 0 0 2373251 2943179 17647057 19537539 -53263 31735 5158 8893 19972203 22521346 0 0 0 0 11916413 13173924 0 0 0 6193946 8087039 18110359 21260963 1861844 1260383 15083146 17972834 4811730 5538173 10271416 12434661 X THE MISSION OF THE TUOLUMNE ME WUK INDIAN HEALTH CENTER, INC. IS TO PROVIDE HIGH QUALITY, COMPREHENSIVE HEALTH CARE SERVICES TO THE TUOLUMNE BAND OF THE ME-WUK INDIANS, OTHER NATIVE AMERICANS, AND ALL OTHER RESIDENTS OF OUR COMMUNITY. 0 0 4311005 7505721 THE OUTPATIENT MEDICAL CENTER AT OUR COMMUNITY HEALTH CENTERS ARE OPEN AND AVAILABLE MONDAY THROUGH FRIDAY, FROM 8AM TO 5PM. THE HEALTH CENTERS PROVIDE ALL THE SERVICES OF A FAMILY MEDICAL PRACTICE AS WELL AS BEHAVIORAL HEALTH SERVICES. THE CENTERS PROVIDE CARE ACCESS TO THE TUOLUMNE BAND OF THE ME-WUK INDIANS OF THE TUOLUMNE RESERVATION, TO ALL OTHER NATIVE AMERICANS, AND TO ALL OTHER RESIDENTS OF THE COUNTY OF TUOLUMNE AND SURROUNDING AREAS. ALL OF THESE ARE MEDICALLY UNDER-SERVED AREAS. 2809850 6214862 OUR DENTAL CENTER IS OPEN AND AVAILABLE MONDAY THROUGH FRIDAY, FROM 8AM TO 5PM. IT PROVIDES DENTAL CARE TO THE TUOLUMNE BAND OF ME-WUK INDIANS OF THE TUOLUMNE RESERVATION, TO ALL OTHER NATIVE AMERICANS, AND TO ALL RESIDENTS OF THE COUNTY OF TUOLUMNE AND SURROUNDING AREAS. ALL OF THESE ARE MEDICALLY UNDER-SERVED AREAS. 1238825 2801598 OUR BEHAVIORAL HEALTH AND COUNSELING CENTER IS OPEN AND AVAILABLE MONDAY THROUGH FRIDAY, FROM 8AM TO 5PM. IT PROVIDES BEHAVIORAL HEALTH AND COUNSELING SERVICES TO THE TUOLUMNE BAND OF ME-WUK INDIANS OF THE TUOLUMNE RESERVATION, TO ALL OTHER NATIVE AMERICANS, AND TO ALL RESIDENTS OF THE COUNTY OF TUOLUMNE AND SURROUNDING AREAS. ALL OF THESE ARE MEDICALLY UNDER-SERVED AREAS. 5595724 3015358 THE MISSION OF THE TUOLUMNE ME WUK INDIAN HEALTH CENTER, INC. IS TO OPERATE STATE LICENSED, FAMILY PRACTICE COMMUNITY HEALTH CENTERS THAT WILL PROVIDE HIGH QUALITY, COMPREHENSIVE HEALTH CARE SERVICES FOR NATIVE AMERICANS AND ALL OTHER MEMBERS OF THE COUNTY OF TUOLUMNE. 5595724 3015358 13955404 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 160 0 1 167 1 0 0 0 0 0 0 0 0 0 0 0 0 X 8 8 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X SHANNON RODGERS 2092064740 905 MONO WAY SONORA CA 95370 RENEE WESSELL CHAIRPERSON 1.00 X X 4800 0 0 JANELL LAVELL-BUNCH BOARD MEMBER 1.00 X 4800 0 0 RHIANNON HENDRICKS BOARD MEMBER 1.00 X 4800 0 0 CARLOS GEISDORFF BOARD MEMBER 1.00 X 4800 0 0 AUDREY GOWER BOARD MEMBER 1.00 X 4800 0 0 BRADY DAY BOARD MEMBER 1.00 X 4000 0 0 TY DAY VICE CHAIR 1.00 X X 4800 0 0 LAURA FORDE TREASURER 1.00 X X 4800 0 0 LECIA SCOTFORD CAO (THRU 8/4/23) 40.00 X 293844 0 25297 LYNDON PETERS COMPLIANCE OFFICER (THRU 1/6/23) 40.00 X 16256 0 5284 GARY HALE CFO (THRU 2/7/23) 40.00 X 37356 0 3039 JANET PEPPER CHIEF ADMIN OFFICER (FROM 9/1/23) 40.00 X 184874 0 8083 SHANNON RODGERS CFO (FROM 11/30/23) 40.00 X 131278 0 29649 JAFEH ASKPE COMPLIANCE OFFICER (THRU 10/23/23) 40.00 X 40875 0 0 JOHN NADONE CFO (3/27/23-8/31/23) 40.00 X 82908 0 11295 ERICA VEGA PSYCHIATRIST 40.00 X 313215 0 36862 SHAYNA YOUNG MEDICAL DIRECTOR 40.00 X 337155 0 36784 FELIX CONTE PEDIATRICIAN 40.00 X 297535 0 36645 HOANG NGUYEN DENTAL DIRECTOR 40.00 X 236548 0 25654 REBECCA VIERRA-BRICK FAMILY NURSE PRACTITIONER 40.00 X 176009 0 7324 2185453 0 225916 23 0 1 0 PROVIDER HEALTHCARE LLC 2455 EAST PARLEYS WAY STE 310 SALT LAKE CITY UT 84109 LOCUMS 800935 MOSS ADAMS LLP PO BOX 101822 PASADENA CA 911891822 AUDITING 279660 2 416762 2293425 232992 2943179 PATIENT SERVICES 621400 7505721 7505721 DENTAL SERVICES 621300 6214862 6214862 OTHER MISC PROGRAM REV 900099 3015358 3015358 HEALTH & COUNSELING SERVICES 621300 2801598 2801598 19537539 31735 31735 8893 8893 8893 22521346 19537539 0 40628 907637 516153 391484 9752059 7236563 2515496 256790 179875 76915 1298479 907298 391181 958959 673214 285745 16621 16621 279660 279660 1144372 1144372 98539 98539 695316 20417 674899 243138 18063 225075 401473 3802 397671 75518 23139 52379 69476 28143 41333 195687 195687 740263 740263 168796 555 168241 PHARMACEUTICALS 2147765 2147765 SPECIAL HEALTHCARE FUND 416762 416762 PROGRAM MATERIALS & SUP 409486 398665 10821 DUES, MEMBERSHIP, SUBSC 199547 19946 179601 784620 220672 563948 21260963 13955404 7305559 0 7021398 1968466 53807 7020124 1553217 2237374 262454 396460 42067 112056 10580803 4638556 5648783 5942247 501420 296107 15083146 17972834 1255986 1454102 442977 590169 2639584 2523067 473183 970835 4811730 5538173 X 7735400 9986316 2536016 2448345 10271416 12434661 15083146 17972834 X 1260383 48375 -15805 870292 X 0 1 X 1 1 1 X 3663188 4342753 4121383 2373251 2943179 17443754 12169908 10473959 15483495 17647057 19537539 75311958 15833096 14816712 19604878 20020308 22480718 92755712 0 0 0 92755712 13049 2746 2 31735 47532 13049 2746 2 31735 47532 5158 8893 14051 15846145 14819458 19604880 20025466 22521346 92817295 0.99930 0.99970 0.00050 0.00020 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: MISC INCOME - 2022 AMOUNT: $ 5,158. 2023 AMOUNT: $ 8,893. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 7122329 2500501 4621828 630963 436752 194211 963319 760044 203275 1864192 941259 922933 5942247 SUBSCRIPTION LIABILITY 673395 LEASE LIABILITY 297440 970835 23440013 48375 870292 918667 22521346 0 22521346 21260963 0 21260963 0 21260963 PART XI, LINE 2D - OTHER ADJUSTMENTS: EMPLOYEE RENTENTION TAX CREDIT 870,292. X X 1 0 0 0 0 0 0 1 0 SHAYNA YOUNG MEDICAL DIRECTOR 335655 0 1500 0 0 0 12600 0 24184 0 373939 0 0 0 ERICA VEGA PSYCHIATRIST 311715 0 1500 0 0 0 12646 0 24216 0 350077 0 0 0 FELIX CONTE PEDIATRICIAN 296035 0 1500 0 0 0 12333 0 24312 0 334180 0 0 0 LECIA SCOTFORD CAO (THRU 8/4/23) 205782 0 0 0 88062 0 10374 0 14923 0 319141 0 0 0 HOANG NGUYEN DENTAL DIRECTOR 229048 0 7500 0 0 0 6952 0 18702 0 262202 0 0 0 JANET PEPPER CHIEF ADMIN OFFICER (FROM 9/1/23) 183374 0 1500 0 0 0 7242 0 841 0 192957 0 0 0 REBECCA VIERRA-BRICK FAMILY NURSE PRACTITIONER 174509 0 1500 0 0 0 6859 0 465 0 183333 0 0 0 SHANNON RODGERS CFO (FROM 11/30/23) 129778 0 1500 0 0 0 5466 0 24183 0 160927 0 0 0 PART I, LINE 3 SALARIES OF OFFICERS AND KEY EMPLOYEES ARE DETERMINED BY CONDUCTING SALARY SURVEYS, OBTAINING STATISTICAL SALARY INFORMATION ABOUT EACH POSITION, DUTIES PERFORMED, AND GEOGRAPHICAL REGION OF ORGANIZATION. ALL SALARIES ARE APPROVED BY THE BOARD OF DIRECTORS USING ALL AVAILABLE INFORMATION. PART I, LINE 4A LECIA SCOTFORD RECEIVED A SEVERANCE PAYMENT DURING 2023 IN THE AMOUNT OF $88,062. PART I, LINE 7 SOME INDIVIDUALS REPORTED ON PART VII RECEIVED DISCRETIONARY BONUSES IN 2023. FORM 990, PART VI, SECTION B, LINE 11B A COMPLETE COPY OF THE 990 WAS PROVIDED TO THE FULL BOARD OF DIRECTORS PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C COMPLIANCE OFFICER, CHIEF FINANCIAL OFFICER AND FINANCE CONTROLLER REVIEW CONTRACTS, VENDORS, AND PAYMENTS FOR POTENTIAL CONFLICTS OF INTEREST AND ENFORCE POLICY. IF A CONFLICT ARISES, BOARD MEMBERS WITH A CONFLICT ARE NOT ALLOWED TO VOTE ON THE TRANSACTION. FORM 990, PART VI, SECTION B, LINE 15 SALARIES OF OFFICERS AND KEY EMPLOYEES ARE DETERMINED BY CONDUCTING SALARY SURVEYS, OBTAINING STATISTICAL SALARY INFORMATION ABOUT EACH POSITION, DUTIES PERFORMED, AND GEOGRAPHICAL REGION OF ORGANIZATION. ALL SALARIES ARE APPROVED BY THE BOARD OF DIRECTORS USING ALL AVAILABLE INFORMATION. THE PROCESS IS DOCUMENTED. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE AT ITS OFFICES. FORM 990, PART XI, LINE 9: EMPLOYEE RETENTION TAX CREDIT 870,292. TUOLUMNE BAND OF ME-WUK INDIANS OF THE TUOLUMNE RANCHERIA 19595 MI WU STREET TUOLUMNE CA 95379 770121021 TO PROMOTE THE HEALTH, SAFETY AND WELFARE OF THE INDIAN PEOPLE CA GOVT 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0