LA CLINICA DEL VALLE FAMILY HEALTH CARE CENTER INC: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- LA CLINICA DEL VALLE FAMILY HEALTH CARE CENTER INC (EIN 94-3096772)
- Tax period
- 2020-06-01 to 2021-05-31
- Filed
- 2022-03-30
- IRS object ID
- 202210899349300746
- Schema version
- 2020v4.2
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-03-30T14:16:32-05:00 | ReturnTs |
| Tax Period End | 2021-05-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 910189318 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MOSS ADAMS LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 221 STEWART AVENUE SUITE 301 | AddressLine1Txt |
| City | MEDFORD | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97501 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-06-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 943096772 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LA CLINICA DEL VALLE | BusinessNameLine1Txt |
| Business Name Line2 | FAMILY HEALTH CARE CENTER INC | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | LACL | BusinessNameControlTxt |
| Phone | 5415356239 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 931 CHEVY WAY | AddressLine1Txt |
| City | MEDFORD | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97504 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JILL BOROVANSKY | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 5415356239 | PhoneNum |
| Signature | 2022-03-20 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | JILL | PersonFirstNm |
| Person Last | BOROVANSKY | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | APRIL STITH | PreparerPersonNm |
| PTIN | P01245039 | PTIN |
| Phone | 5418571040 | PhoneNum |
| Preparation | 2022-03-20 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| 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) |
|---|---|---|
| Principal Officer | JILL BOROVANSKY | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 931 CHEVY WAY | AddressLine1Txt |
| City | MEDFORD | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97504 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $49,363,762 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.LACLINICAHEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1988 | FormationYr |
| Legal Domicile State | OR | LegalDomicileStateCd |
| Activity Or Mission | LA CLINICA PROVIDES PRIMARY AND PREVENTIVE MEDICAL, DENTAL, BEHAVIORAL HEALTH, AND OTHER HEALTH PROMOTION SERVICES TO UNDERSERVED AND LOW-INCOME PATIENTS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 14 | VotingMembersIndependentCnt |
| Total Employee | 475 | TotalEmployeeCnt |
| Total Volunteers | 39 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $10,651,483 | PYContributionsGrantsAmt |
| CY Contributions Grants | $18,466,192 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $30,058,126 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $30,697,042 | CYProgramServiceRevenueAmt |
| PY Investment Income | $84,933 | PYInvestmentIncomeAmt |
| CY Investment Income | $61,643 | CYInvestmentIncomeAmt |
| PY Other Revenue | $243,166 | PYOtherRevenueAmt |
| CY Other Revenue | $138,885 | CYOtherRevenueAmt |
| PY Total Revenue | $41,037,708 | PYTotalRevenueAmt |
| CY Total Revenue | $49,363,762 | 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 | $28,869,831 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $28,401,084 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $205,309 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $9,619,129 | PYOtherExpensesAmt |
| CY Other Expenses | $10,218,996 | CYOtherExpensesAmt |
| PY Total Expenses | $38,488,960 | PYTotalExpensesAmt |
| CY Total Expenses | $38,620,080 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $2,548,748 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $10,743,682 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $39,966,031 | TotalAssetsBOYAmt |
| Total Assets EOY | $46,429,450 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $12,786,106 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $8,221,041 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $27,179,925 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $38,208,409 | NetAssetsOrFundBalancesEOYAmt |
| Mission | LA CLINICA PROVIDES PRIMARY AND PREVENTIVE MEDICAL, DENTAL, BEHAVIORAL HEALTH, AND OTHER HEALTH PROMOTION SERVICES TO UNDERSERVED AND LOW-INCOME PATIENTS. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $29,767,298 | ExpenseAmt |
| Revenue | $30,835,927 | RevenueAmt |
| Desc | LA CLINICA PROVIDES COMPREHENSIVE PREVENTIVE MEDICAL AND DENTAL CARE, AS WELL AS INTEGRATED BEHAVIORAL HEALTH, PRENATAL CARE AND GYNECOLOGY, PHYSICAL THERAPY, ACUPUNCTURE, AND ADVANCED CARE IN RHEUMATOLOGY AND GASTROENTEROLOGY. WE ENGAGE OVER 400 EMPLOYEES WHO PROVIDE HIGH QUALITY SERVICES AT TWENTY-FIVE SERVICE SITES, INCLUDING TWO SITES THAT HOUSE A COMMUNITY PHARMACY. THE COMMUNITY PHARMACIES PROVIDE DIRECT PATIENT BENEFIT BY OFFERING LOW PRESCRIPTION COSTS AND RETAIL PHARMACY ACCESS TO THOSE WE SERVE AND THEIR FAMILIES. TO HELP OUR COMMUNITY ACCESS CARE, WE ACCEPT ALL INSURANCE TYPES AND OFFER A GENEROUS SLIDING SCALE FOR LOW-INCOME UNINSURED AND UNDERINSURED PATIENTS. WE ALSO UTILIZE THE FEDERAL 340B DRUG PRICING PROGRAM TO OFFER DEEPLY DISCOUNTED MEDICATIONS TO OUR PATIENTS. | Desc |
| Total Program Service Expenses | $29,767,298 | 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 | Yes (1) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | 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 | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | 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 | 0 | 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 | 475 | 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 |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| 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 | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 14 | 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 | Yes (1) | 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 | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | OR | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FAITH HARRIS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5415123167 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 931 CHEVY WAY | AddressLine1Txt |
| City | MEDFORD | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97504 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (22 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| TIGHE O'MEARA | |||||||
| PRESIDENT | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| LINDA REID | |||||||
| VICE PRESIDENT | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| SARA COLLINS | |||||||
| SECRETARY | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| MONICA MORALES | |||||||
| TREASURER | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| BRAD RUSSELL | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| CHRIS ALFTINE | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| DANIELLE MANCUSO | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| JON IVY | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| DANNI SWAFFORD | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| VICTORIA BENCOMO | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| CHRISIE VAN AKEN | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| PAUL ROSTYKUS | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| JEANNE PICKENS | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| LINDSEY TRAUTMAN | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| BRENDA JOHNSON RN MBA | |||||||
| CEO | 40.00 | Yes (X) | $248,684 | $0 | $19,500 | ||
| JILL BOROVANSKY | |||||||
| CFO | 40.00 | Yes (X) | $151,008 | $0 | $5,537 | ||
| TARA JEANNOT | |||||||
| COO | 40.00 | Yes (X) | $125,839 | $0 | $0 | ||
| JUSTIN R ADAMS MD | |||||||
| CHIEF MEDICAL OFFICER | 40.00 | $255,673 | $0 | $12,488 | Yes (X) | ||
| DANIEL J SENGENBERGER MD | |||||||
| CHIEF MEDICAL OFFICER FOR OPERATIONS | 40.00 | $242,681 | $0 | $11,367 | Yes (X) | ||
| AMY B FINE | |||||||
| CHIEF DENTAL OFFICER | 40.00 | $233,508 | $0 | $13,388 | Yes (X) | ||
| TYLER SCOTT | |||||||
| DENTIST | 40.00 | $214,419 | $0 | $10,237 | Yes (X) | ||
| ELIZABETH BANOWETZ | |||||||
| MD | 40.00 | $212,980 | $0 | $10,334 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,684,792 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $82,851 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 8 | 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 |
|---|---|---|---|---|---|
| OCHIN-OR COMMUNITY HEALTH INFO NETWORK | |||||
| 1881 SW NAITO PKWY | PORTLAND | OR | 97501 | EMR/OUTSOURCED BILLING SERVICES | $1,148,896 |
| VITUS CONSTRUCTION INC | |||||
| PO BOX 1097 | GOLD HILL | OR | 97525 | CONSTRUCTION SERVICES | $683,472 |
| HIGH COUNTRY RX RELIEF LLC | |||||
| 2299 BUTTE FALLS HWY | EAGLE POINT | OR | 97524 | PHARMACY SERVICES | $656,866 |
| SANITECH BUILDING MAINTENANCE | |||||
| 1960 TABLE ROCK ROAD | MEDFORD | OR | 97501 | JANITORIAL SERVICES | $220,431 |
| PARDENT LABORATORY | |||||
| 1726 E MCANDREWS | MEDFORD | OR | 97504 | DENTAL LABS | $167,992 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $16,071,852 | GovernmentGrantsAmt |
| All Other Contributions | $2,394,340 | AllOtherContributionsAmt |
| Total Contributions | $18,466,192 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NET PATIENT FEES | Desc |
| Business | 621110 | BusinessCd |
| Total Revenue Column | $30,697,042 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $30,697,042 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $30,697,042 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $43,936 | TotalRevenueColumnAmt |
| Exclusion | $43,936 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $17,707 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $17,707 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $17,707 | TotalRevenueColumnAmt |
| Exclusion | $17,707 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISC INCOME | Desc |
| Business | 621110 | BusinessCd |
| Total Revenue Column | $138,885 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $138,885 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $138,885 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $49,363,762 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $30,835,927 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $61,643 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $510,655 | TotalAmt |
| Program Services | $510,655 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,015,390 | TotalAmt |
| Program Services | $18,154,919 | ProgramServicesAmt |
| Management And General | $3,709,185 | ManagementAndGeneralAmt |
| Fundraising | $151,286 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,975,319 | TotalAmt |
| Program Services | $3,322,115 | ProgramServicesAmt |
| Management And General | $636,070 | ManagementAndGeneralAmt |
| Fundraising | $17,134 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,899,720 | TotalAmt |
| Program Services | $1,526,727 | ProgramServicesAmt |
| Management And General | $356,863 | ManagementAndGeneralAmt |
| Fundraising | $16,130 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,068,647 | TotalAmt |
| Program Services | $800,418 | ProgramServicesAmt |
| Management And General | $267,524 | ManagementAndGeneralAmt |
| Fundraising | $705 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,404 | TotalAmt |
| Program Services | $2,554 | ProgramServicesAmt |
| Management And General | $848 | ManagementAndGeneralAmt |
| Fundraising | $2 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $46,775 | TotalAmt |
| Program Services | $35,095 | ProgramServicesAmt |
| Management And General | $11,649 | ManagementAndGeneralAmt |
| Fundraising | $31 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $37,878 | TotalAmt |
| Program Services | $16,361 | ProgramServicesAmt |
| Management And General | $21,240 | ManagementAndGeneralAmt |
| Fundraising | $277 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,898,219 | TotalAmt |
| Program Services | $2,769,115 | ProgramServicesAmt |
| Management And General | $123,429 | ManagementAndGeneralAmt |
| Fundraising | $5,675 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $878,012 | TotalAmt |
| Program Services | $106,121 | ProgramServicesAmt |
| Management And General | $770,667 | ManagementAndGeneralAmt |
| Fundraising | $1,224 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,079 | TotalAmt |
| Program Services | $5,510 | ProgramServicesAmt |
| Management And General | $2,555 | ManagementAndGeneralAmt |
| Fundraising | $14 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $169,764 | TotalAmt |
| Program Services | $115,790 | ProgramServicesAmt |
| Management And General | $53,680 | ManagementAndGeneralAmt |
| Fundraising | $294 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $158,985 | TotalAmt |
| Management And General | $158,985 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,025,160 | TotalAmt |
| Program Services | $153,376 | ProgramServicesAmt |
| Management And General | $871,784 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $157,130 | TotalAmt |
| Program Services | $34,498 | ProgramServicesAmt |
| Management And General | $122,632 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| CONTRACTUAL | $2,646,103 | $1,608,349 | $1,027,510 | $10,244 |
| MISCELLANEOUS EXPENSES | $320,799 | $283,438 | $37,283 | $78 |
| RECRUITMENT AND OTHER P | $220,113 | $68,497 | $151,155 | $461 |
| EQUIPMENT REPAIRS AND S | $202,079 | $108,212 | $93,867 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $377,849 | TotalAmt |
| Program Services | $145,548 | ProgramServicesAmt |
| Management And General | $230,547 | ManagementAndGeneralAmt |
| Fundraising | $1,754 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,620,080 | TotalAmt |
| Program Services | $29,767,298 | ProgramServicesAmt |
| Management And General | $8,647,473 | ManagementAndGeneralAmt |
| Fundraising | $205,309 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,921,988 | BOYAmt |
| EOY | $17,610,140 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $257,570 | BOYAmt |
| EOY | $790,563 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,559,331 | BOYAmt |
| EOY | $4,625,116 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $118,215 | BOYAmt |
| EOY | $149,282 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $152,892 | BOYAmt |
| EOY | $311,767 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $29,886,280 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $8,791,017 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,461,406 | BOYAmt |
| EOY | $21,095,263 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $900,334 | BOYAmt |
| EOY | $1,221,057 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $96,871 | BOYAmt |
| EOY | $84,367 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $497,424 | BOYAmt |
| EOY | $541,895 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $39,966,031 | BOYAmt |
| EOY | $46,429,450 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,006,019 | BOYAmt |
| EOY | $3,462,008 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,277 | BOYAmt |
| EOY | $35,975 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,958,438 | BOYAmt |
| EOY | $3,856,075 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,311,948 | BOYAmt |
| EOY | $325,088 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $497,424 | BOYAmt |
| EOY | $541,895 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,786,106 | BOYAmt |
| EOY | $8,221,041 | 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 | $26,044,591 | BOYAmt |
| EOY | $36,987,352 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,135,334 | BOYAmt |
| EOY | $1,221,057 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,179,925 | BOYAmt |
| EOY | $38,208,409 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $39,966,031 | BOYAmt |
| EOY | $46,429,450 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $10,743,682 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $284,802 | NetUnrlzdGainsLossesInvstAmt |
| 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 | $9,318,199 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $9,277,208 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $9,687,448 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $10,655,075 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $18,466,192 | CurrentTaxYearAmt |
| Total | $57,404,122 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $9,318,199 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $9,277,208 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $9,687,448 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $10,655,075 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $18,466,192 | CurrentTaxYearAmt |
| Total | $57,404,122 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $57,404,122 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $8,138 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $8,358 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus1 Year | $84,933 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $43,936 | CurrentTaxYearAmt |
| Total | $145,365 | TotalAmt |
Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $17,854 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $13,756 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $9,591 | CurrentTaxYearMinus2YearsAmt |
| Total | $41,201 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $57,590,688 | TotalSupportAmt |
| Public Support CY170 | 0.99680 | PublicSupportCY170Pct |
| Public Support PY170 | 0.99650 | 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
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $900,334 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $320,723 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $1,221,057 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $956,842 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | -$47,960 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $8,548 | AdministrativeExpensesAmt |
| End Year Balance | $900,334 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $916,268 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $48,373 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $7,798 | AdministrativeExpensesAmt |
| End Year Balance | $956,843 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $831,816 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $93,014 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $7,932 | AdministrativeExpensesAmt |
| End Year Balance | $916,898 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $747,301 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $90,375 | InvestmentEarningsOrLossesAmt |
| Administrative Expenses | $6,490 | AdministrativeExpensesAmt |
| End Year Balance | $831,186 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 1.00000 | PrmnntEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | Yes (1) | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,122,779 | OtherCostOrOtherBasisAmt |
| Book Value | $4,122,779 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $21,233,002 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,450,535 | DepreciationAmt |
| Book Value | $15,785,793 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,530,499 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,340,482 | DepreciationAmt |
| Book Value | $1,186,691 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $21,095,263 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DEFERRED COMP | Desc |
| Amt | $541,895 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $541,895 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $49,648,562 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $284,800 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | $284,800 | RevenueNotReportedAmt |
| Revenue Subtotal | $49,363,762 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $49,363,762 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $38,620,080 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $38,620,080 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $38,620,080 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | LA CLINICA HAS BEEN RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND IS EXEMPT FROM FEDERAL AND STATE INCOME TAXES ON RELATED ACTIVITIES. NO TAX PROVISION HAS BEEN MADE IN THE ACCOMPANYING STATEMENT OF ACTIVITIES. LA CLINICA RECOGNIZES THE TAX BENEFIT FROM UNCERTAIN TAX POSITIONS ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITIONS WILL BE SUSTAINED ON EXAMINATION BY THE TAX AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFIT IS MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. LA CLINICA RECOGNIZES INTEREST AND PENALTIES RELATED TO INCOME TAX MATTERS IN OPERATING EXPENSES. AS OF MAY 31, 2021, THERE WERE NO SUCH UNCERTAIN TAX POSITIONS. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 (7 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BRENDA JOHNSON RN MBA | ||||||||||||||
| CEO | $248,342 | $0 | $0 | $0 | $342 | $0 | $19,500 | $0 | $0 | $0 | $268,184 | $0 | $0 | $0 |
| JILL BOROVANSKY | ||||||||||||||
| CFO | $149,808 | $0 | $0 | $0 | $1,200 | $0 | $5,537 | $0 | $0 | $0 | $156,545 | $0 | $0 | $0 |
| JUSTIN R ADAMS MD | ||||||||||||||
| CHIEF MEDICAL OFFICER | $251,562 | $0 | $0 | $0 | $4,111 | $0 | $12,488 | $0 | $0 | $0 | $268,161 | $0 | $0 | $0 |
| DANIEL J SENGENBERGER MD | ||||||||||||||
| CHIEF MEDICAL OFFICER FOR OPERATIONS | $238,569 | $0 | $0 | $0 | $4,112 | $0 | $11,367 | $0 | $0 | $0 | $254,048 | $0 | $0 | $0 |
| AMY B FINE | ||||||||||||||
| CHIEF DENTAL OFFICER | $233,508 | $0 | $0 | $0 | $0 | $0 | $13,388 | $0 | $0 | $0 | $246,896 | $0 | $0 | $0 |
| TYLER SCOTT | ||||||||||||||
| DENTIST | $214,419 | $0 | $0 | $0 | $0 | $0 | $10,237 | $0 | $0 | $0 | $224,656 | $0 | $0 | $0 |
| ELIZABETH BANOWETZ | ||||||||||||||
| MD | $210,012 | $0 | $0 | $0 | $2,968 | $0 | $10,334 | $0 | $0 | $0 | $223,314 | $0 | $0 | $0 |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | STATE OF OREGON OREGON FACILITIES AUTHORITY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 936001787 | BondIssuerEIN |
| Bond Issued | 2018-10-31 | BondIssuedDt |
| Issue Price | $4,105,473 | IssuePriceAmt |
| Purpose | CHEVY WAY BUILDING | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Total Proceeds | $4,105,473 | TotalProceedsAmt |
| Substantial Completion | 2018 | SubstantialCompletionYr |
| Refunding Tax Exempt Bonds | 0 | RefundingTaxExemptBondsInd |
| Refunding Taxable Bonds | 0 | RefundingTaxableBondsInd |
| Final Allocation Made | Yes (1) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | 0 | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | 0 | MgmtContractBondFincdPropInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Private Bus Use By Others | 0.00000 | PrivateBusUseByOthersPct |
| Private Bus Concerning UBI | 0.00000 | PrivateBusConcerningUBIPct |
| Total Private Business Use | 0.00000 | TotalPrivateBusinessUsePct |
| Bond Iss Meet Prvt Sec Pymt Test | Yes (1) | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | Yes (1) | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | 0 | RebateNotDueYetInd |
| Exception To Rebate | 0 | ExceptionToRebateInd |
| No Rebate Due | 0 | NoRebateDueInd |
| Variable Rate Issue | 0 | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | 0 | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | Yes (1) | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | Yes (1) | ProceduresCorrectiveActionInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 7A | A NOMINATING COMMITTEE SHALL NOMINATE CANDIDATES FOR BOARD APPROVAL TO FILL BOARD MEMBER VACANCIES. THE NOMINATING COMMITTEE SHALL MAINTAIN A CURRENT PROFILE OF THE BOARD'S MEMBERSHIP COMPOSITION TO GUIDE THE SELECTION PROCESS. IT SHALL REVIEW THE PERFORMANCE OF INCUMBENT BOARD MEMBERS WHO ARE ELIGIBLE FOR RE-ELECTION, AND IF APPROPRIATE, RECOMMEND THEM TO THE BOARD OF DIRECTORS FOR NOMINATION AND RE-ELECTION. THE COMMITTEE SHALL, SUBJECT TO THE REQUIREMENTS SET FORTH IN THE BY-LAWS, ALSO NOMINATE MEMBERS-AT-LARGE. CANDIDATES NOMINATED TO FILL BOARD POSITIONS WILL BE ELECTED BY A MAJORITY VOTE OF THE MEMBERS AT A BOARD MEETING AT WHICH A QUORUM IS PRESENT. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 PREPARER PROVIDES A DRAFT COPY OF THE FORM 990 TO THE CFO AND THE ACCOUNTING MANAGER. A COPY OF THE FORM 990 IS ALSO PROVIDED TO THE FINANCE/AUDIT COMMITTEE FOR REVIEW. FINALLY, THE BOARD IS NOTIFIED OF ANY FINDINGS AND PROVIDED A FINAL DRAFT TO REVIEW PRIOR TO FILING. AFTER FINAL REVIEW, THE FORM 990 PREPARER IS NOTIFIED TO FILE THE FORM 990. A REPORT IS THEN PROVIDED TO THE FULL BOARD OF DIRECTORS ON THE RESULTS OF THE FORM 990. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION HAS A WRITTEN CONFLICT OF INTEREST POLICY IN PLACE THAT IS DISTRIBUTED TO ALL NEW HIRES AND INCOMING BOTKRD MEMBERS AND REVIEWED ANNUALLY FOR UPDATES. THE POLICY STATES THAT ANY CONFLICTS OF INTEREST BE DISCLOSED AS SOON AS THE WORKFORCE OR BOARD MEMBER BECOMES AWARE OF THE CONFLICT. CONFLICT OF INTEREST DISCLOSURE FORMS ARE COMPLETED BY ALL BOARD MEMBERS EACH YEAR. |
| FORM 990, PART VI, SECTION B, LINE 15 | 15A: THE BOARD OF DIRECTORS IS RESPONSIBLE TO HIRE AND REMOVE THE CHIEF EXECUTIVE OFFICER, SUPPORT AND ASSESS HIS OR HER PERFORMANCE, AND ENSURE THAT THE CHIEF EXECUTIVE HAS THE MORAL AND PROFESSIONAL SUPPORT NEEDED TO FURTHER THE GOALS OF THE ORGANIZATION. EACH YEAR A MARKET REVIEW IS PERFORMED FOR A COMPETITIVE ANALYSIS OF SALARIES IN THE LOCAL AND REGIONAL AREAS FOR THE CEO. THE AUTHOR OF THE MARKET REVIEW INDICATES A RANGE IN WHICH THE CEO'S SALARY SHOULD SIT AND REPORTS THIS TO THE PRESIDENT. THE EXECUTIVE COMMITTEE MEETS TO DISCUSS A PAY CHANGE AND MAKES A RECOMMENDATION TO THE BOARD, WHICH VOTE IN JUNE TO ADOPT THE PAY CHANGE OR NOT DEPENDING UPON THE BUDGETED FINANCIAL FORECAST OF THE ORGANIZATION. 15B: EACH YEAR A MARKET REVIEW IS PERFORMED FOR A COMPETITIVE ANALYSIS OF SALARIES IN THE LOCAL AND REGIONAL AREAS FOR ALL POSITIONS IN THE ORGANIZATION. THE HUMAN RESOURCE DIRECTOR COMPILES THE INFORMATION, AND AFTER APPROVAL FROM THE CEO, IT IS GIVEN TO THE ACCOUNTING MANAGER, WHO INPUTS THE DATA INTO THE FORECASTED BUDGET FOR THE NEXT FISCAL YEAR. INCREASES IN BASE PAY MAY BE INCLUDED FOR NEW BUDGET PERIODS (BEGINNING IN JUNE) IF THE FOLLOWING IS TRUE: 1. FINANCIAL FORECAST FOR THE ORGANIZATION IS HEALTHY; 2. THE SALARY FOR THE JOB POSITION HAS FALLEN BELOW THE AVERAGE MARKET RANGE AND PAY THRESHOLD FOR THE ORGANIZATION; 3. THE BOARD OF DIRECTORS HAS REVIEWED AND APPROVED THE NEW BUDGET INCLUDING THE CHANGES TO SALARIES AND WAGES. |
| FORM 990, PART VI, SECTION C, LINE 19 | LA CLINICA DEL VALLE MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST AS PER THE FOLLOWING POLICY GUIDELINES: THE AUDITED FINANCIAL STATEMENTS WILL BE DISTRIBUTED TO THE BOARD OF DIRECTORS, TO REGULATORY AGENCIES AND TO ORGANIZATIONS ENTITLED TO RECEIVE A COPY DUE TO CONTRACTUAL AGREEMENT. THE AUTHORITY TO DISTRIBUTE THE STATEMENTS TO OTHER INDIVIDUALS OR FIRMS REQUESTING THEM WILL BE LEFT TO THE DISCRETION OF THE CHIEF EXECUTIVE OFFICERAND THE CHIEF FINANCIAL OFFICER. |
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