FURP.ORG / PUBLIC DATA EXPLORER

CHAPA-DE INDIAN HEALTH PROGRAM INC: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization
CHAPA-DE INDIAN HEALTH PROGRAM INC (EIN 94-2583156)
Tax period
2021-07-01 to 2022-06-30
Filed
2023-05-13
IRS object ID
202311339349301886
Schema version
2021v4.2
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

FieldValueIRS element (for citing)
Return2023-05-13T20:39:51-05:00ReturnTs
Tax Period End2022-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN680037990PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1GILBERT CPASBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line12880 GATEWAY OAKS DR STE 100AddressLine1Txt
CitySACRAMENTOCityNm
State AbbreviationCAStateAbbreviationCd
ZIP95833ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2021-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN942583156EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1CHAPA-DE INDIAN HEALTH PROGRAM INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlCHAPBusinessNameControlTxt
Phone5308872800PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line111670 ATWOOD ROADAddressLine1Txt
CityAUBURNCityNm
State AbbreviationCAStateAbbreviationCd
ZIP95603ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonSIERK HAITSMAPersonNm
Person TitleCFOPersonTitleTxt
Phone5308872800PhoneNum
Signature2023-05-12SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstSIERKPersonFirstNm
Person LastHAITSMAPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonKEITH R GLENPreparerPersonNm
PTINP01317613PTIN
Phone9166466464PhoneNum
Preparation2023-05-12PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer3TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2021TaxYr
Build TS2023-04-26 12:10:37ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerLISA DAVIESPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line111670 ATWOOD ROADAddressLine1Txt
CityAUBURNCityNm
State AbbreviationCAStateAbbreviationCd
ZIP95603ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$65,032,823GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.CHAPA-DE.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1979FormationYr
Legal Domicile StateCALegalDomicileStateCd
Activity Or MissionPROVIDES COMPREHENSIVE HEALTH CARE AND ANCILLARY SERVICES TO THE NATIVE-AMERICAN POPULATION OF SIERRA, PLACER AND NEVADA COUNTIES OF CALIFORNIA.ActivityOrMissionDesc
Voting Members Governing Body5VotingMembersGoverningBodyCnt
Voting Members Independent5VotingMembersIndependentCnt
Total Employee309TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$17,847,918PYContributionsGrantsAmt
CY Contributions Grants$17,794,216CYContributionsGrantsAmt
PY Program Service Revenue$38,852,079PYProgramServiceRevenueAmt
CY Program Service Revenue$44,382,616CYProgramServiceRevenueAmt
PY Investment Income$1,962,180PYInvestmentIncomeAmt
CY Investment Income$2,763,810CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$81,774CYOtherRevenueAmt
PY Total Revenue$58,662,177PYTotalRevenueAmt
CY Total Revenue$65,022,416CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$23,705,459PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$25,723,337CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$11,825,705PYOtherExpensesAmt
CY Other Expenses$13,749,047CYOtherExpensesAmt
PY Total Expenses$35,531,164PYTotalExpensesAmt
CY Total Expenses$39,472,384CYTotalExpensesAmt
PY Revenues Less Expenses$23,131,013PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$25,550,032CYRevenuesLessExpensesAmt
Total Assets BOY$171,407,470TotalAssetsBOYAmt
Total Assets EOY$178,697,226TotalAssetsEOYAmt
Total Liabilities BOY$19,381,307TotalLiabilitiesBOYAmt
Total Liabilities EOY$13,939,657TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$152,026,163NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$164,757,569NetAssetsOrFundBalancesEOYAmt
MissionPROVIDES COMPREHENSIVE HEALTH CARE AND ANCILLARY SERVICES TO THE NATIVE-AMERICAN POPULATION OF SIERRA, PLACER AND NEVADA COUNTIES OF CALIFORNIA.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$26,777,137ExpenseAmt
Revenue$44,382,616RevenueAmt
DescPRIMARY HEALTH CARE PROGRAM- CHAPA-DE INDIAN PROGRAM, INC PROVIDED COMPREHENSIVE HEALTH SERVICES TO THE NATIVE-AMERICAN POPULATION AND OTHER RESIDENTS OF SIERRA, PLACER, AND NEVADA COUNTIES OF CALIFORNIA. COMPREHENSIVE HEALTH SERVICES INCLUDE DIRECT PATIENT CARE, IMMUNIZATIONS, HEALTH PROMOTION AND DISEASE PREVENTION, DRUG ABUSE AND EDUCATION/PREVENTION PROGRAMS, AND DENTAL CARE.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
DescDIABETES PREVENTION PROGRAM-THIS PROGRAM PROVIDES DIABETES PREVENTION, MANAGEMENT AND LIFESTYLE EDUCATION, AND TESTING SERVICES TO NATIVE- AMERICAN PATIENTS DURING THE FISCAL YEAR. THESE PATIENTS LIVE PRIMARILY IN SIERRA, PLACER, AND NEVADA COUNTIES OF CALIFORNIA.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$26,777,137TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other SecYes (1)ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document104IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee309EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members5GoverningBodyVotingMembersCnt
Independent Voting Member5IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldCAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1SIERK HAITSMABusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone5308872800PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line111670 ATWOOD ROADAddressLine1Txt
CityAUBURNCityNm
State AbbreviationCAStateAbbreviationCd
ZIP95603ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
JASON CAMP
BOARD MEMBER2.00Yes (X)$0$0$0
GENE WHITEHOUSE
SECRETARY2.00Yes (X)$0$0$0Yes (X)
BRENDA ADAMS
CHAIR2.00Yes (X)$0$0$0Yes (X)
DAVID KEYSER
VICE-CHAIR2.00Yes (X)$0$0$0Yes (X)
JOHN L WILLIAMS
BOARD MEMBER2.00Yes (X)$0$0$0
LISA DAVIES
CHIEF EXECUTIVE OFFICER40.00$409,814$0$40,102Yes (X)
SIERK HAITSMA
CHIEF FINANCIAL OFFICER40.00$277,181$0$24,133Yes (X)
DARLA CLARK
CHIEF OPERATIONS OFFICER40.00$261,513$0$33,709Yes (X)
ALINEA STEVENS
MEDICAL DIRECTOR32.00$282,270$0$50,234Yes (X)
PAULINE KARUNAKARAN
DENTAL DIRECTOR40.00$250,316$0$25,874Yes (X)
ANTHONY REYES
CHIEF ADMINISTRATIVE OFFICER40.00$205,772$0$33,335Yes (X)
ERIC OSBORN
CHIEF INFORMATION OFFICER40.00$214,189$0$14,304Yes (X)
NICOLE CONZONER
DIRECTOR OF NURSING40.00$163,734$0$43,726Yes (X)
AMY EARGLE
BEHAVIORAL HEALTH DIRECTOR36.00$161,028$0$9,289Yes (X)
WILLIAM JORNLIN
PHYSICIAN40.00$253,367$0$46,749Yes (X)
RICHARD MALEK
PSYCHIATRIST40.00$264,601$0$630Yes (X)
MARLOWE DIECKMANN
PHYSICIAN40.00$223,828$0$38,851Yes (X)
SHARI FOX
PSYCHIATRIST32.00$249,082$0$12,380Yes (X)
BENJAMIN OLDACH
PHYSICIAN40.00$225,890$0$26,761Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$3,442,585TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$400,077TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K14IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
RCP CONSTRUCTION INC
5180 GOLDEN FOOTHILLS PKWY 110EL DORADO HILLSCA95762BUILDING CONTRACTOR$2,614,537
EFFORT PHARMACY SERVICES INC
3215 PENNINGTON ROAD3215 PENNINGTLIVE OAKCA95953PHARMACY SERVICES$1,849,842
DEACON CONSTRUCTION LLC
7745 GREENBACK LANE 250CITRUS HEIGHTSCA95610BUILDING CONTRACTOR$1,287,231
UNITED BUILDING MAINTENANCE INC
8211 SIERRA COLLEGE BVLD STE 420ROSEVILLECA95661JANITORIAL SERVICES$331,798
ECLINICALWORKS
PO BOX 847950BOSTONMA022847950SOFTWARE LICENSE & SUPPORT$309,008
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K5CntrctRcvdGreaterThan100KCnt
Government Grants$17,794,216GovernmentGrantsAmt
Total Contributions$17,794,216TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescHEALTH SERVICESDesc
Business621400BusinessCd
Total Revenue Column$44,382,616TotalRevenueColumnAmt
Related Or Exempt Func Income$44,382,616RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$44,382,616TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$2,774,217TotalRevenueColumnAmt
Exclusion$2,774,217ExclusionAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$10,407SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities-$10,407SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$10,407TotalRevenueColumnAmt
Related Or Exempt Func Income-$10,407RelatedOrExemptFuncIncomeAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescOTHERDesc
Total Revenue Column$81,774TotalRevenueColumnAmt
Related Or Exempt Func Income$81,774RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$81,774OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$65,022,416TotalRevenueColumnAmt
Related Or Exempt Func Income$44,453,983RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$2,774,217ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$2,515,237TotalAmt
Program Services$1,829,857ProgramServicesAmt
Management And General$685,380ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$17,476,475TotalAmt
Program Services$12,785,099ProgramServicesAmt
Management And General$4,691,376ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$4,297,379TotalAmt
Program Services$2,991,175ProgramServicesAmt
Management And General$1,306,204ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,434,246TotalAmt
Program Services$998,302ProgramServicesAmt
Management And General$435,944ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$414,307TotalAmt
Program Services$326,534ProgramServicesAmt
Management And General$87,773ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$66,266TotalAmt
Program Services$52,227ProgramServicesAmt
Management And General$14,039ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$193,039TotalAmt
Management And General$193,039ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$3,689,185TotalAmt
Program Services$2,907,615ProgramServicesAmt
Management And General$781,570ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$161,883TotalAmt
Program Services$3,315ProgramServicesAmt
Management And General$158,568ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$592,519TotalAmt
Program Services$80,068ProgramServicesAmt
Management And General$512,451ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$1,204,090TotalAmt
Program Services$55,899ProgramServicesAmt
Management And General$1,148,191ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$108,424TotalAmt
Program Services$84,667ProgramServicesAmt
Management And General$23,757ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$1,819,573TotalAmt
Program Services$269,491ProgramServicesAmt
Management And General$1,550,082ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$158,089TotalAmt
Management And General$158,089ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES$3,402,044$3,376,812$25,232
PATIENT RELATED COSTS$642,616$609,985$32,631
BUILDING AND EQUIPMENT$631,436$203,508$427,928
OTHER PERSONNEL RELATED$224,646$68,675$155,971

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$440,930TotalAmt
Program Services$133,908ProgramServicesAmt
Management And General$307,022ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$39,472,384TotalAmt
Program Services$26,777,137ProgramServicesAmt
Management And General$12,695,247ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$6,400BOYAmt
EOY$5,800EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$35,279,557BOYAmt
EOY$31,857,443EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$2,160,222BOYAmt
EOY$304,399EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$3,312,912BOYAmt
EOY$5,755,059EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$175,432BOYAmt
EOY$184,221EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$60,710,134LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$20,732,000LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$29,620,139BOYAmt
EOY$39,978,134EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$100,592,350BOYAmt
EOY$100,300,972EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$260,458BOYAmt
EOY$311,198EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$171,407,470BOYAmt
EOY$178,697,226EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$4,175,320BOYAmt
EOY$3,329,103EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$15,205,987BOYAmt
EOY$10,610,554EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$19,381,307BOYAmt
EOY$13,939,657EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$152,026,163BOYAmt
EOY$164,757,569EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$152,026,163BOYAmt
EOY$164,757,569EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$171,407,470BOYAmt
EOY$178,697,226EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$25,550,032ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst-$12,818,626NetUnrlzdGainsLossesInvstAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit RequiredYes (1)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (1)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$11,043,154CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$11,517,833CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$25,916,727CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$17,847,918CurrentTaxYearMinus1YearAmt
Current Tax Year$17,794,216CurrentTaxYearAmt
Total$84,119,848TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$11,043,154CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$11,517,833CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$25,916,727CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$17,847,918CurrentTaxYearMinus1YearAmt
Current Tax Year$17,794,216CurrentTaxYearAmt
Total$84,119,848TotalAmt
FieldValueIRS element (for citing)
Public Support Total170$84,119,848PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$245,453CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$876,819CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,693,657CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,962,180CurrentTaxYearMinus1YearAmt
Current Tax Year$2,689,607CurrentTaxYearAmt
Total$7,467,716TotalAmt
FieldValueIRS element (for citing)
Total Support$91,587,564TotalSupportAmt
Public Support CY1700.91850PublicSupportCY170Pct
Public Support PY1700.94170PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$11,825,678OtherCostOrOtherBasisAmt
Book Value$11,825,678BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$44,011,645OtherCostOrOtherBasisAmt
Depreciation$16,898,225DepreciationAmt
Book Value$27,113,420BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$4,872,811OtherCostOrOtherBasisAmt
Depreciation$3,833,775DepreciationAmt
Book Value$1,039,036BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$39,978,134TotalBookValueLandBuildingsAmt

Other Securities OtherSecuritiesGrp

FieldValueIRS element (for citing)
DescINVESTMENTSDesc
Book Value$100,300,972BookValueAmt
Method ValuationFMethodValuationCd
FieldValueIRS element (for citing)
Total Book Value Securities$100,300,972TotalBookValueSecuritiesAmt
Total Rev Etc Audited Fincl Stmt$52,010,751TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst-$12,818,626NetUnrealizedGainsInvstAmt
Revenue Not Reported-$12,818,626RevenueNotReportedAmt
Revenue Subtotal$64,829,377RevenueSubtotalAmt
Investment Expenses Not Incld$193,039InvestmentExpensesNotIncldAmt
Revenue Not Reported Fincl Stmt$193,039RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$65,022,416TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$39,279,345TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$39,279,345ExpensesSubtotalAmt
Investment Expenses Not Incld2$193,039InvestmentExpensesNotIncld2Amt
Expenses Not Rpt Fincl Stmt$193,039ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$39,472,384TotalExpensesPerForm990Amt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (14 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
LISA DAVIES
CHIEF EXECUTIVE OFFICER$360,814$0$49,000$0$0$0$17,400$0$22,702$0$449,916$0$0$0
ALINEA STEVENS
MEDICAL DIRECTOR$252,438$0$29,832$0$0$0$15,486$0$34,748$0$332,504$0$0$0
SIERK HAITSMA
CHIEF FINANCIAL OFFICER$246,005$0$31,176$0$0$0$14,760$0$9,373$0$301,314$0$0$0
WILLIAM JORNLIN
PHYSICIAN$239,330$0$14,037$0$0$0$12,000$0$34,749$0$300,116$0$0$0
DARLA CLARK
CHIEF OPERATIONS OFFICER$231,688$0$29,825$0$0$0$14,050$0$19,659$0$295,222$0$0$0
PAULINE KARUNAKARAN
DENTAL DIRECTOR$231,857$0$18,459$0$0$0$13,911$0$11,963$0$276,190$0$0$0
RICHARD MALEK
PSYCHIATRIST$258,101$0$6,500$0$0$0$0$0$630$0$265,231$0$0$0
MARLOWE DIECKMANN
PHYSICIAN$219,778$0$4,050$0$0$0$4,102$0$34,749$0$262,679$0$0$0
SHARI FOX
PSYCHIATRIST$238,745$0$10,337$0$0$0$0$0$12,380$0$261,462$0$0$0
BENJAMIN OLDACH
PHYSICIAN$221,840$0$4,050$0$0$0$3,996$0$22,765$0$252,651$0$0$0
ANTHONY REYES
CHIEF ADMINISTRATIVE OFFICER$189,637$0$16,135$0$0$0$11,527$0$21,808$0$239,107$0$0$0
ERIC OSBORN
CHIEF INFORMATION OFFICER$197,949$0$16,240$0$0$0$2,400$0$11,904$0$228,493$0$0$0
NICOLE CONZONER
DIRECTOR OF NURSING$150,254$0$13,480$0$0$0$9,316$0$34,410$0$207,460$0$0$0
AMY EARGLE
BEHAVIORAL HEALTH DIRECTOR$147,972$0$13,056$0$0$0$8,779$0$510$0$170,317$0$0$0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11BTHE FORM 990 IS PRESENTED BY THE CFO TO THE FULL BOARD OF DIRECTORS AND IS APPROVED FOR FILING. THE CHAIRPERSON IS AUTHORIZED TO SIGN THE FORM 990 AFTER THE APPROVAL BY THE FULL BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION B, LINE 12CTHE ORGANIZATION PERFORMS AN ANNUAL EVALUATION OF ALL POTENTIAL CONFLICT OF INTEREST SITUATIONS.
FORM 990, PART VI, SECTION B, LINE 15THE BOARD OF DIRECTORS HIRES CEO AND TOP MANAGEMENT OF THE ORGANIZATION. THE COMPENSATION AMOUNT IS BASED ON PREVAILING SALARIES IN THE AREA AND THE EXPERIENCE AND QUALIFICATIONS OF THE EMPLOYEE. THIS PROCESS WAS LAST UNDERTAKEN IN 2020.
FORM 990, PART VI, SECTION C, LINE 19DOCUMENTS ARE AVAILABLE UPON REQUEST FROM THE GENERAL PUBLIC.