CENTRAL CITY COMMUNITY HEALTH CENTER INC: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- CENTRAL CITY COMMUNITY HEALTH CENTER INC (EIN 95-4492570)
- Tax period
- 2020-07-01 to 2021-06-30
- Filed
- 2022-01-31
- IRS object ID
- 202210319349300426
- Schema version
- 2020v4.1
- 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 | 2022-01-31T10:46:03-06:00 | ReturnTs |
| Tax Period End | 2021-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WITHUMSMITHBROWNPC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 SPECTRUM CENTER DRIVE STE 1000 | AddressLine1Txt |
| City | IRVINE | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 92618 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 954492570 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Central City Community Health Center Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % DR ROSEMARY REYES | InCareOfNm |
| Business Name Control | CENT | BusinessNameControlTxt |
| Phone | 3237240019 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2019 Saturn Street | AddressLine1Txt |
| City | Monterey Park | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 91755 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DR ROSEMARY REYES | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 3237240019 | PhoneNum |
| Signature | 2022-01-20 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | DR ROSEMARY | PersonFirstNm |
| Person Last | REYES | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | TASHA J OTSUJI | PreparerPersonNm |
| PTIN | P00846495 | PTIN |
| Phone | 9492612808 | PhoneNum |
Additional Filer Information AdditionalFilerInformation
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | TrustedCustomerGrp |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Change | Yes (X) | AddressChangeInd |
| Principal Officer | Dr Rosemary Reyes | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2019 Saturn Street | AddressLine1Txt |
| City | Monterey Park | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 91755 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $43,383,311 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.CENTRALCITYHEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1994 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE HEALTH CARE SERVICES TO UNDERSERVED COMMUNITIES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 354 | TotalEmployeeCnt |
| Total Volunteers | 9 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $6,853,982 | PYContributionsGrantsAmt |
| CY Contributions Grants | $6,742,234 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $34,200,874 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $36,334,716 | CYProgramServiceRevenueAmt |
| PY Investment Income | $64,094 | PYInvestmentIncomeAmt |
| CY Investment Income | $39,052 | CYInvestmentIncomeAmt |
| PY Other Revenue | $50,461 | PYOtherRevenueAmt |
| CY Other Revenue | $267,309 | CYOtherRevenueAmt |
| PY Total Revenue | $41,169,411 | PYTotalRevenueAmt |
| CY Total Revenue | $43,383,311 | 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 | $18,419,591 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $17,608,746 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $16,079,483 | PYOtherExpensesAmt |
| CY Other Expenses | $17,582,673 | CYOtherExpensesAmt |
| PY Total Expenses | $34,499,074 | PYTotalExpensesAmt |
| CY Total Expenses | $35,191,419 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $6,670,337 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $8,191,892 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $27,033,417 | TotalAssetsBOYAmt |
| Total Assets EOY | $35,317,348 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $30,323,000 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $31,048,286 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$3,289,583 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $4,269,062 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO PROVIDE HEALTH CARE SERVICES TO UNDERSERVED COMMUNITIES. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $26,955,818 | ExpenseAmt |
| Revenue | $36,602,025 | RevenueAmt |
| Desc | TO PROVIDE QUALITY HEALTH AND HUMAN SERVICES TO THE MEDICALLY UNDERSERVED AND LOW INCOME POPULATIONS IN A CULTURALLY SENSITIVE MANNER. CENTRAL CITY COMMUNITY HEALTH CENTER, INC. PROVIDES COMPREHENSIVE PRIMARY CARE, DENTAL, OBSTETRICS/GYNECOLOGY, FAMILY PLANNING, MENTAL HEALTH SERVICES, CHIROPRACTIC CARE, FAMILY PRACTICE, PEDIATRICS, PODIATRY, DRUG/HIV/STD TESTING, ONSITE MEDICAL ELIGIBILITY ASSISTANCE, CHRONIC DISEASE MANAGEMENT, AND HIV/AIDS CASE MANAGEMENT SERVICES. SERVICES ARE ALSO CONDUCTED THROUGH SITERUN PREVENTION PROGRAMS, INCLUDING THE COMPREHENSIVE PERINATAL SERVICES PROGRAM, VACCINE FOR CHILDREN PROGRAM, CHILD HEALTH AND DISABILITY PROGRAM, FAMILY PLANNING, ACCESS, CARE AND TREATMENT (FAMILY PACT), AND ITS SOUTH LOS ANGELESBASED MOBILE CLINIC PROVIDES THE SAME CARE TO AREA HOMELESS SHELTERS AND RESIDENTIAL FACILITIES FOR MENTALLY ILL ADULTS. IN 2020, 33750 PATIENTS WERE SERVED AND OVER 190,000 ENCOUNTERS WERE PROVIDED. | Desc |
| Total Program Service Expenses | $26,955,818 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | Yes (true) | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | Yes (true) | DisregardedEntityInd |
| Related Entity | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 120 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 354 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (true) | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | false | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | CA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DR ROSEMARY REYES | PersonNm |
| Phone | 3237240019 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2019 SATURN STREET | AddressLine1Txt |
| City | Monterey Park | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 91755 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Key EmployeeKeyEmployeeInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|---|---|
| Omar Moreno | |||||||||
| CEO & CFO (Through 5/20/21) | 40.0 | 0.0 | Yes (X) | $738,487 | $0 | $31,398 | |||
| Michael Choi | |||||||||
| INTERNIST | 40.0 | 0.0 | $297,873 | $0 | $2,182 | Yes (X) | |||
| Rosemary Reyes | |||||||||
| CMO/Interim CEO | 40.0 | 0.0 | Yes (X) | $265,502 | $0 | $28,158 | |||
| Shafeeq Shamsid-Deen | |||||||||
| Lead Physician Residential | 40.0 | 0.0 | $206,525 | $0 | $57,144 | Yes (X) | |||
| Michael Jordan Vizcarra | |||||||||
| OB-GYN | 40.0 | 0.0 | $205,069 | $0 | $24,474 | Yes (X) | |||
| Nickolas L Lind | |||||||||
| Lead Physician | 40.0 | 0.0 | $211,174 | $0 | $3,185 | Yes (X) | |||
| Charles Tuan Nguyen | |||||||||
| Psychiatrist | 25.0 | 0.0 | $212,240 | $0 | $0 | Yes (X) | |||
| Swati Purohit | |||||||||
| Pediatrician | 40.0 | 0.0 | $183,324 | $0 | $0 | Yes (X) | |||
| REGGIE PANIS | |||||||||
| CFO (through 2/16/21) | 40.0 | 0.0 | Yes (X) | $144,825 | $0 | $0 | |||
| Luis Marten | |||||||||
| Chairman | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| Larry Landless | |||||||||
| Secretary | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| Violi Wong | |||||||||
| Treasurer | 2.0 | 0.0 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| Stella Marten | |||||||||
| Board Member | 2.0 | 0.0 | $0 | $0 | $0 | Yes (X) | |||
| Maria Duran | |||||||||
| Board Member | 2.0 | 0.0 | $0 | $0 | $0 | Yes (X) | |||
| Melana Smith | |||||||||
| Board Member | 2.0 | 0.0 | $0 | $0 | $0 | Yes (X) | |||
| Juan Duran | |||||||||
| Board Member | 2.0 | 0.0 | $0 | $0 | $0 | Yes (X) | |||
| Dee M Libertine | |||||||||
| Board Member | 2.0 | 0.0 | $0 | $0 | $0 | Yes (X) | |||
| Jacqueline Bravo | |||||||||
| Board Member | 2.0 | 0.0 | $0 | $0 | $0 | Yes (X) | |||
| Javier Pulidao | |||||||||
| Board Member (Through 6/21/21) | 2.0 | 0.0 | $0 | $0 | $0 | Yes (X) | |||
| Gilbert Varela | |||||||||
| INTERIM CEO 5/19/21 - 6/2/21 | 40.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,465,019 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $146,541 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 37 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Creative Solutions at work | |||||
| 9234 Aero Drive | PICO RIVERA | CA | 90660 | Construction Service | $1,500,000 |
| Macman Management Healthcare Servic | |||||
| 1300 National Drive Ste 175 | SACRAMENTO | CA | 95834 | Billing Services | $509,531 |
| KPG Healthcare LLC | |||||
| PO Box 840202 | LOS ANGELES | CA | 900840202 | Clinic Provider | $479,870 |
| Dale J Brent MD | |||||
| 4955 Van Nuys Blvd Ste 411 | SHERMAN OAKS | CA | 91403 | Clinic Provider | $405,075 |
| Varela Medical Group Inc | |||||
| 5233 E Beverly Blvd | LOS ANGELES | CA | 90022 | Clinic Provider | $384,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 26 | CntrctRcvdGreaterThan100KCnt |
| Federated Campaigns | $150,000 | FederatedCampaignsAmt |
| Government Grants | $5,670,606 | GovernmentGrantsAmt |
| All Other Contributions | $921,628 | AllOtherContributionsAmt |
| Noncash Contributions | $24,164 | NoncashContributionsAmt |
| Total Contributions | $6,742,234 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 621110 | $32,137,238 | $32,137,238 |
| PHARMACY REVENUE | 621110 | $3,398,285 | $3,398,285 |
| ADULT DAY CARE | 621110 | $799,193 | $799,193 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $36,334,716 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $39,052 | TotalRevenueColumnAmt |
| Exclusion | $39,052 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $0 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $0 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $0 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $0 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| INSURANCE STOCK CONVERSION | 909999 | $131,143 | $131,143 |
| MEDI-CAL EHR INCENTIVE | 909999 | $93,500 | $93,500 |
| OTHER MISC INCOME | 909999 | $42,666 | $42,666 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $267,309 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $43,383,311 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $36,602,025 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $39,052 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,116,275 | TotalAmt |
| Program Services | $862,751 | ProgramServicesAmt |
| Management And General | $253,524 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,769,646 | TotalAmt |
| Program Services | $10,635,945 | ProgramServicesAmt |
| Management And General | $3,133,701 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $98,000 | TotalAmt |
| Program Services | $77,612 | ProgramServicesAmt |
| Management And General | $20,388 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,475,281 | TotalAmt |
| Program Services | $1,168,366 | ProgramServicesAmt |
| Management And General | $306,915 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,149,544 | TotalAmt |
| Program Services | $910,395 | ProgramServicesAmt |
| Management And General | $239,149 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $186,804 | TotalAmt |
| Management And General | $186,804 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,485,480 | TotalAmt |
| Program Services | $5,613,849 | ProgramServicesAmt |
| Management And General | $1,871,631 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,223 | TotalAmt |
| Program Services | $5,223 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,058,290 | TotalAmt |
| Program Services | $799,667 | ProgramServicesAmt |
| Management And General | $258,623 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $663,418 | TotalAmt |
| Management And General | $663,418 | ManagementAndGeneralAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,302,474 | TotalAmt |
| Program Services | $1,792,986 | ProgramServicesAmt |
| Management And General | $509,488 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $294,369 | TotalAmt |
| Program Services | $227,253 | ProgramServicesAmt |
| Management And General | $67,116 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $89,445 | TotalAmt |
| Program Services | $89,445 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $494,174 | TotalAmt |
| Program Services | $381,502 | ProgramServicesAmt |
| Management And General | $112,672 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $814,537 | TotalAmt |
| Program Services | $628,822 | ProgramServicesAmt |
| Management And General | $185,715 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $297,076 | TotalAmt |
| Program Services | $229,343 | ProgramServicesAmt |
| Management And General | $67,733 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $2,473,908 | $2,473,908 | |
| DUES AND SUBSCRIPTIONS | $271,331 | $209,468 | $61,863 |
| REPAIRS AND MAINTENANCE | $305,796 | $236,075 | $69,721 |
| EQUIPMENT RENTAL AND LEA | $211,200 | $163,046 | $48,154 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $629,148 | TotalAmt |
| Program Services | $450,162 | ProgramServicesAmt |
| Management And General | $178,986 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $35,191,419 | TotalAmt |
| Program Services | $26,955,818 | ProgramServicesAmt |
| Management And General | $8,235,601 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,000 | BOYAmt |
| EOY | $1,000 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,691,638 | BOYAmt |
| EOY | $19,752,502 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $63,628 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,751,033 | BOYAmt |
| EOY | $2,641,368 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $263,416 | BOYAmt |
| EOY | $258,601 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $15,922,685 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $5,271,716 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,131,823 | BOYAmt |
| EOY | $10,650,969 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,194,507 | BOYAmt |
| EOY | $987,466 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $961,814 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,033,417 | BOYAmt |
| EOY | $35,317,348 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,726,174 | BOYAmt |
| EOY | $2,962,976 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $296,079 | BOYAmt |
| EOY | $172,954 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,525,739 | BOYAmt |
| EOY | $2,500,000 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,775,008 | BOYAmt |
| EOY | $25,412,356 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,323,000 | BOYAmt |
| EOY | $31,048,286 | 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 | -$3,289,583 | BOYAmt |
| EOY | $4,269,062 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$3,289,583 | BOYAmt |
| EOY | $4,269,062 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,033,417 | BOYAmt |
| EOY | $35,317,348 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $8,191,892 | ReconcilationRevenueExpnssAmt |
| Prior Period Adjustments | -$633,247 | PriorPeriodAdjustmentsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | 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 (true) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | 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 | $4,460,941 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $5,859,060 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $5,500,119 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $6,853,982 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $6,742,234 | CurrentTaxYearAmt |
| Total | $29,416,336 | TotalAmt |
Tax Rev Levied Orgnztnl Bnft170 TaxRevLeviedOrgnztnlBnft170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,460,941 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $5,859,060 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $5,500,119 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $6,853,982 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $6,742,234 | CurrentTaxYearAmt |
| Total | $29,416,336 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $0 | SubstantialContributorsTotAmt |
| Public Support Total170 | $29,416,336 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $173 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $47 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,823 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $64,094 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $39,052 | CurrentTaxYearAmt |
| Total | $105,189 | TotalAmt |
Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $29,521,525 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $161,849,423 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.99644 | PublicSupportCY170Pct |
| Public Support PY170 | 0.99760 | 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,483,339 | OtherCostOrOtherBasisAmt |
| Book Value | $2,483,339 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $10,514,279 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,154,000 | DepreciationAmt |
| Book Value | $7,360,279 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Leasehold Improvements | LeaseholdImprovementsGrp |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,370,305 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,028,174 | DepreciationAmt |
| Book Value | $342,131 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,554,762 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,089,542 | DepreciationAmt |
| Book Value | $465,220 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $10,650,969 | TotalBookValueLandBuildingsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| STATE MEDI-CAL PAYABLE S/T | $10,099,991 |
| STATE MEDI-CAL PAYABLE L/T | $15,312,365 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $25,412,356 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $43,383,311 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Subtotal | $43,383,311 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $43,383,311 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $35,191,419 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $35,191,419 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $35,191,419 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE D: PART X LINE 2 - INCOME TAX FOOTNOTE | FormAndLineReferenceDesc |
| Explanation | THE HEALTH CENTER IS A NON-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE "CODE") AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(a)(1) OF THE CODE. THE HEALTH CENTER IS ALSO EXEMPT FROM STATE INCOME TAXES ON RELATED INCOME. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA PRESRIBE REQUIREMENTS FOR THE RECOGNITION OF INCOME TAXES IN FINANCIAL STATEMENTS, AND THE AMOUNTS RECOGNIZED ARE AFFECTED BY INCOME TAX POSITIONS TAKEN BY THE CENTER IN ITS TAX RETURNS. THE HEALTH CENTER'S STATUS AS AN EXEMPT CENTER IS DEFINED AS AN INCOME TAX POSITION UNDER THESE REQUIREMENTS. WHILE MANAGEMENT BELIEVES IT HAS COMPLIED WITH THE INTERNAL REVENUE CODE, THE SUSTAINABILITY OF SOME INCOME TAX POSITIONS TAKEN BY THE HEALTH CENTER IN ITS TAX RETURNS MAY BE UNCERTAIN. THERE ARE MINIMUM THRESHOLDS OF LIKELIHOOD THAT UNCERTAIN TAX POSITIONS ARE REQUIRED TO MEET BEFORE BEING RECOGNIZED IN THE FINANCIAL STATEMENTS. MANAGEMENT DOES NOT BELIEVE THAT THE HEALTH CENTER HAS ANY MATERIAL UNCERTAIN TAX POSTIIONS AS OF JUNE 30, 2021, OR 2020. IN THE EVENT INTEREST AND PENALTIES ARE DUE RELATING TO AN UNSUSTAINBALBLE TAX POSTION, THEY WOULD BE TREATED AS A COMPONENT OF INCOME TAX EXPENSE. DURING THE YEARS ENDED JUNE 30, 2021 AND 2020, THERE WERE NO INTEREST OR PENALTIES RELATING TO UNSUSTAINABLE TAX POSTIONS THAT WERE RECONGIZED IN THESE FINANCIAL STATEMENTS. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 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 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Omar Moreno | |||||||||||||
| CEO & CFO (Through 5/20/21) | $607,398 | $0 | $131,089 | $0 | $0 | $0 | $19,500 | $0 | $11,898 | $0 | $769,885 | $0 | |
| Rosemary Reyes | |||||||||||||
| CMO/Interim CEO | $265,502 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $28,158 | $0 | $293,660 | $0 | |
| Michael Choi | |||||||||||||
| INTERNIST | $297,873 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $2,182 | $0 | $300,055 | $0 | $0 |
| Charles Tuan Nguyen | |||||||||||||
| Psychiatrist | $212,240 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $212,240 | $0 | $0 |
| Nickolas L Lind | |||||||||||||
| Lead Physician | $211,174 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $3,185 | $0 | $214,359 | $0 | |
| Shafeeq Shamsid-Deen | |||||||||||||
| Lead Physician Residential | $206,525 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $57,144 | $0 | $263,669 | $0 | |
| Michael Jordan Vizcarra | |||||||||||||
| OB-GYN | $205,069 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $24,474 | $0 | $229,543 | $0 | |
| Swati Purohit | |||||||||||||
| Pediatrician | $183,324 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $183,324 | $0 | $0 |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| VARELA MEDICAL GROUP INC | |||
| OWNED BY FORMER EXECUTIVE DIRECTOR, GILBERT VARELA | $324,000 | see part v | false |
| ALLIANCE HEALTH SYSTEMS | |||
| OWNED BY FORMER EXECUTIVE DIRECTOR, GILBERT VARELA | $480,628 | SEE PART V | false |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART IV, LINE 1, COLUMN D: | ORGANIZATION PAID VARELA MEDICAL GROUP FOR MEDICAL SERVICES PROVIDED TO THE ORGANIZATION. THE OWNER OF VARELA MEDICAL GROUP IS A FORMER CEO, GILBERT VARELA, WHO ALSO SERVED AS AN INTERIM CEO FOR LESS THAN A MONTH DURING THE CURRENT TAX YEAR while the Board selected a replacement. |
| PART IV, LINE 2, COLUMN D | ALLIANCE HEALTH SYSTEMS IS AN INDEPENDENT PRACTICE ASSOCIATION 100% OWNED BY THE FORMER CEO, GILBERT VARELA, who ALSO served AS AN INTERIM CEO FOR less than a month DURING THE CURRENT TAX YEAR while the Board selected a replacement. THE ORGANIZATION RECEIVES A CAPITATED PAYMENT ON A PER MEMBER PER MONTH BASIS FOR PRIMARY CARE SERVICES PROVIDED BY THE ORGANIZATION. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (12 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | MARIA AND JUAN DURAN HAVE A FAMILY RELATIONSHIP. LUIS AND STELLA MARTEN HAVE A FAMILY RELATIONSHIP. |
| FORM 990, PART VI, SECTION B, LINE 11B | A DRAFT COPY OF IRS FORM 990 WAS DISTRIBUTED TO THE FULL BOARD OF DIRECTORS AS WELL AS CEO AND FISCAL DIRECTOR OF THE ORGANIZATION FOR REVIEW AND APPROVAL PRIOR TO SUBMISSION. |
| FORM 990, PART VI, SECTION B, LINE 12C: | ONCE A YEAR DURING A BOARD MEETING, EACH BOARD MEMBER IS GIVEN A STATEMENT TO SIGN STATING THERE ARE NO CONFLICTS OF INTEREST THAT HAVE OCCURRED OR WILL OCCUR DURING THE PAST AND SUBSEQUENT TIME REMAINING AS A BOARD MEMBER. |
| FORM 990, PART VI, SECTION B, LINE 15 | FOR ALL KEY POSITIONS OF THE ORGANIZATION, THE BOARD OF DIRECTORS OBTAIN AND DOCUMENT THE SALARY SURVEYS THAT HAVE BEEN PREPARED BY INDEPENDENT ORGANIZATIONS. IN ADDITION, THE BOARD OF DIRECTORS OBTAIN SALARY INFORMATION FROM COMPARABLE ORGANIZATIONS TO PROVIDE GUIDANCE IN SETTING THE COMPENSATION OF EACH OF THE POSITIONS. TAKEN INTO CONSIDERATION IN MAKING THE PROPER COMPARISONS ARE THE SIZE AND REVENUES OF THE ORGANIZATIONS. UPON COMPLETE SATISFACTION OF THE COMPARISONS AND SALARY RANGES, THE BOARD MOTIONS TO APPROVE THE COMPENSATION AT THEIR MEETING. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY, AND AUDITED FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST VIA PHONE OR WRITTEN REQUEST. THESE DOCUMENTS ARE MADE AVAILABLE AT THE ORGANIZATION'S OFFICE BY APPOINTMENT. |
| FORM 990 PART IX LINE 11G | DESCRIPTION:CONTRACTUAL - FINANCIAL TOTAL FEES:79120 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:CONTRACTUAL - ADMINISTRATIVE TOTAL FEES:597396 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:CONTRACTUAL - FACILITY TOTAL FEES:171900 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:CONTRACTUAL - MEDICAL/MENTAL TOTAL FEES:5115181 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:CONTRACTUAL - DENTAL TOTAL FEES:5500 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:CONSULTANTS - OTHERS TOTAL FEES:982250 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:BILLING SERVICES TOTAL FEES:534133 |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HEALTH GUARD INLAND LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 268 MCARTHUR WAY | AddressLine1Txt |
| City | UPLAND | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 91786 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 263522465 | EIN |
| Primary Activities | ADULT DAYCARE | PrimaryActivitiesTxt |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Total Income | $799,193 | TotalIncomeAmt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CCCHC INC | BusinessNameLine1Txt |
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