2022-04-26T15:02:44-05:00 2021-06-30 BKD LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2020-07-01 942237120 MARIN COMMUNITY CLINIC % DAVID KLINETOBE MARI 4154481500 9 COMMERCIAL BLVD Suite 100 NOVATO CA 94949 DAVID KLINETOBE CFO 1111111111 2022-05-15 true DAVID KLINETOBE 999009999 Krystal K Creach P01248198 4178658701 2 2020 2022-09-23 18:48:47Z MARIN COMMUNITY CLINIC MITESH POPAT 9 COMMERCIAL BLVD SUITE 100 NOVATO CA 94949 65627680 false X WWW.MARINCLINIC.ORG X 1973 CA TO IMPROVE THE HEALTH OF OUR PATIENTS AND COMMUNITY BY PROVIDING HIGH QUALITY, COST-EFFECTIVE, CULTURALLY SENSITIVE, PATIENT-CENTERED HEALTH CARE. 15 15 664 8 0 0 8960885 12007352 48010545 52682044 1094066 352847 -10518 -14512 58054978 65027731 0 0 0 0 38313637 43217734 0 0 693534 14863075 17284414 53176712 60502148 4878266 4525583 48778034 54207311 7409840 7225961 41368194 46981350 TO IMPROVE THE HEALTH OF OUR PATIENTS AND COMMUNITY BY PROVIDING HIGH QUALITY, COST-EFFECTIVE, CULTURALLY SENSITIVE, PATIENT-CENTERED HEALTH CARE. false false 40538178 41726172 PRIMARY CARE - PEDIATRIC CARE (INCLUDING AFTER HOURS), ADULT CARE (INCLUDING AFTER HOURS), TEEN HEALTH CARE, IMMUNIZATIONS, ANNUAL CHECKUPS, CHRONIC CARE MANAGEMENT, FAMILY PLANNING FOR MEN AND WOMEN, OBSTETRICS AND GYNECOLOGY, INCLUDING BREAST AND CERVICAL SCREENING AND EDUCATION, POST-NATAL CARE, AND REFERRALS FOR SPECIALTY CARE. PHYSICAL MEDICINE AND REHABILITATION, NEUROLOGY, NUTRITION, ORTHOPEDIC SURGERY, COMPLEMENTARY AND ALTERNATIVE MEDICINE, UROLOGY, GASTROENTEROLOGY, DIAGNOSTIC RADIOLOGY, COVERAGE FOR EMERGENCIES DURING AND AFTER HOURS, CANCER SERVICE, VISION SERVICES. 12392706 9075919 ORAL HEALTH - PREVENTIVE AND RESTORATIVE DENTISTRY. SERVICES INCLUDE: EXAMS AND X-RAYS, ORAL HYGIENE INSTRUCTIONS, CLEANINGS, TOOTH DECAY REMOVAL AND FILLINGS, EXTRACTIONS, ROOT CANALS AND CROWNS DENTURES. EXPANDED SERVICES SEVEN DAYS A WEEK, DENTAL EMERGENCY SERVICES. 2478867 1879953 BEHAVIORAL HEALTH SERVICES - OFFERED TO CHILDREN, TEENS, AND ADULTS AND INCLUDES PSYCHIATRY AND COUNSELING BY LICENSED CLINICAL SOCIAL WORKERS. 55409751 true true false true false false false false false true true false false false true false true false false false false false false false true false false false false true false false false false false false false false true false false false false false false false false true 60 0 true 664 true false false false false false false false false false false false false X 15 15 false false false false false false false true true false false true true true true true true true true false CA X DAVID KLINETOBE 4155268532 9 COMMERCIAL BLVD SUITE 100 NOVATO CA 94949 MITESH POPAT CEO 40.0 0.0 X 380362 0 29351 JOSE CHIBRAS-SAINZ CHIEF MEDICAL OFFICER 40.0 0.0 X 276816 0 16193 DAVID KLINETOBE CHIEF FINANCIAL OFFICER 40.0 0.0 X 273444 0 15177 MELANIE ROSE THOMPSON REGIONAL MEDICAL DIRECTOR 40.0 0.0 X 264028 0 13718 XAVIER PEREZ MEDICAL DIRECTOR 40.0 0.0 X 257548 0 7892 CONSTANZA KADERA CHIEF DENTAL OFFICER 40.0 0.0 X 226553 0 19736 ELIZABETH SHAW MEDICAL DIRECTOR 36.0 0.0 X 226306 0 18680 CARINA F GONZALEZ ADULT PHYSICIAN 40.0 0.0 X 206139 0 19002 PETER ALLEN NOVOTA PHYSICIAN 40.0 0.0 X 205911 0 19092 LEAH CANVASSER CHIEF INFORMATION OFFICER 40.0 0.0 X 217680 0 6721 TRACEY HESSEL ASS MED DIR 32.0 0.0 X 210522 0 6701 JOHN E BOLAND III DDS MSD SECRETARY 3.0 0.0 X X 0 0 0 JERRY OKEN IMMEDIATE PAST CHR 3.0 0.0 X X 0 0 0 DANIEL A SEGEDIN CHAIR ELECT 3.0 0.0 X X 0 0 0 ALYSSA MORRIS BOARD MEMBER 1.0 0.0 X 0 0 0 ABIGAIL CADELINA BOARD MEMBER 1.0 0.0 X 0 0 0 STACY SCOTT BOARD MEMBER 1.0 0.0 X 0 0 0 ELIZABETH VILLALOBOS BOARD MEMBER 1.0 0.0 X 0 0 0 CRISTINA A MACKENZIE CHC CH CHAIR 3.0 0.0 X X 0 0 0 FRESHTE KASHANI MEMBER-AT-LARGE 3.0 0.0 X X 0 0 0 MARTIN WEIL TREASURER 3.0 0.0 X X 0 0 0 ANA TAFOLL BOARD MEMBER 1.0 0.0 X 0 0 0 WADE FLORES BOARD MEMBER 1.0 0.0 X 0 0 0 JIM TAVASZI BOARD MEMBER BEG 10/20 1.0 0.0 X 0 0 0 NELSON BRANCO BOARD MEMBER BEG 10/20 1.0 0.0 X 0 0 0 JAMES GERAGHTY BOARD MEMBER END 03/21 1.0 0.0 X 0 0 0 KATHLEEN ROCHE BOARD MEMBER BEG 05/21 1.0 0.0 X 0 0 0 2745309 0 172263 80 false true false WATECH COMPUTER SERVICES 900 DORIS RD AUBURN HILLS MI 48326 IT 615833 MARIN HEALTH MEDICAL NETWORK 9 COMMERCIAL BLVD STE 200 NOVATO CA 94949 PROFESSIONAL SERVICE 347820 UC SCHOOL OF OPTOMETRY 230 MINOR HALL UNIVERSITY OF CA BERKELEY CA 94720 PROFESSIONAL SERVICE 323590 MEYLAN CONSTRUCTION INC 3145 KERNER BLVD STE A SAN RAFAEL CA 94901 CONSTRUCTION CONTRAC 312830 QUATTRO SOLAR INC 25 HAMILTON DR STE D NOVATO CA 94949 SOLAR CONTRACTOR 228116 5 190258 7010684 4806410 1081216 12007352 NET PATIENT SERVICE REVENUE 624100 45636556 45636556 CAPITATION REVENUE 624100 3546951 3546951 QUALITY IMPROVEMENT PROGRAM 624100 3297078 3297078 OTHER INCOME 624100 201459 201459 52682044 143213 143213 0 0 37918 37918 0 37918 37918 746728 530691 6403 216037 -6403 209634 209634 10425 190258 62855 -52430 -52430 0 0 0 0 0 0 0 65027731 52682044 338335 0 0 0 0 1613729 915395 698334 0 32115281 30180957 1524768 409556 442885 421825 15261 5799 6083991 5639329 369717 74945 2961848 2733883 191891 36074 0 23879 23879 182101 182101 0 0 0 3220259 3084730 126196 9333 0 1457595 1209933 190719 56943 1211177 1013892 151925 45360 0 2020442 1883526 111939 24977 51117 42791 6412 1914 0 168077 140699 21083 6295 59600 59600 0 2128585 1501643 626942 178655 155373 23282 MEDICAL SUPPLIES & DRUGS 5986480 5986480 RECRUITING & RETENTION 353998 296338 44402 13258 LICENSES, DUES, SUBSCRIPTION 242449 202957 30412 9080 60502148 55409751 4398863 693534 3734387 1888668 10933894 12438284 776657 1294249 3923371 6016579 0 0 0 0 0 0 497686 628760 948011 754474 37366569 17881706 18272840 19484863 7901695 9413453 0 0 0 0 0 0 1789493 2287981 48778034 54207311 3567092 4642903 0 0 477201 87893 0 0 0 0 0 0 1383827 0 95820 79165 1885900 2416000 7409840 7225961 X 40738895 45213166 629299 1768184 41368194 46981350 48778034 54207311 4525583 1212573 -125000 X false true X true true true X 5194587 5434051 5773047 8960885 12007352 37369922 39109395 44906728 47639308 47998044 52682044 232335519 0 0 0 44303982 50340779 53412355 56958929 64689396 269705441 0 0 0 269705441 75949 203588 367318 329623 181131 1157609 0 75949 203588 367318 329623 181131 1157609 0 0 44379931 50544367 53779673 57288552 64870527 270863050 0.99573 0.99581 0.00427 0.00419 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 28500 28500 false SCHEDULE C, PART II-B, QUESTION 1I OTHER LOBBYING ACTIVITIES: THE ORGANIZATION PAYS ANNUAL DUES TO CALIFORNIA PRIMARY CARE ASSOCIATION (CPCA) - A PORTION OF WHICH MAY BE ATTRIBUTABLE TO LOBBYING. 1093265 557001 45461 9737 1595068 1108290 37410 43366 9069 1093265 1068897 89456 41350 8713 1108290 1027362 93891 43421 8935 1068897 944576 137303 46380 8137 1027362 1.00000 true false 5457750 5457750 20972349 11362804 9609545 1424452 932283 492169 7937149 5586619 2350530 1574869 1574869 19484863 0 EST DUE TO THIRD PARTIES 2416000 2416000 64480879 1212573 79021 956623 2248217 62232662 2795069 2795069 65027731 60650427 79021 69258 148279 60502148 60502148 SCHEDULE D, PART V, LINE 4 ENDOWMENT FUNDS: THE MARIN COMMUNITY FOUNDATION (THE FOUNDATION) RECEIVES DONATIONS AND MANAGES AN ENDOWMENT FUND, THE MARIN COMMUNITY CLINIC ENDOWMENT OF THE MARIN COMMUNITY FOUNDATION. THE ASSETS FROM THIS AND OTHER ENDOWMENTS ARE MAINTAINED IN THE FOUNDATION'S ENDOWMENT FUND AND ARE POOLED ON A MARKET VALUE BASIS. INVESTMENT RETURN FROM SECURITIES IN THE ENDOWMENT FUND IS ALLOCATED TO THE INDIVIDUAL ENDOWMENTS BASED ON THE RELATIONSHIP OF THE FAIR VALUE OF THE INTEREST OF EACH ENDOWMENT TO THE TOTAL FAIR VALUE OF THE ENDOWMENT FUND, AS ADJUSTED FOR ADDITIONS TO OR DEDUCTIONS FROM THESE ACCOUNTS. THE FOUNDATION MAKES QUARTERLY DISTRIBUTIONS TO THE ORGANIZATION FOR INVESTMENT RETURNS RECEIVED ON THESE ENDOWMENTS BASED ON THE FOUNDATION'S SPENDING POLICY. AS THE SPENDING POLICY IS AT THE DISCRETION OF THE FOUNDATION AND CAN BE CHANGED, THE ENDOWMENT CONTRIBUTIONS ARE CONSIDERED CONDITIONAL AND ARE NOT RECORDED AS ASSETS OF THE ORGANIZATION. DURING THE YEARS ENDED JUNE 30, 2021 AND 2020, THE FOUNDATION'S SPENDING POLICY WAS TO DISTRIBUTE 4.50 PERCENT OF THE ROLLING 12 QUARTER AVERAGE OF THE MARKET VALUE OF THE POOLED FUND. THE ORGANIZATION RECEIVED DISTRIBUTIONS OF $45,461 AND $43,366 FOR THE YEARS ENDED JUNE 30, 2021 AND 2020, RESPECTIVELY, WHICH ARE INCLUDED IN CONTRIBUTION REVENUE ON THE STATEMENT OF OPERATIONS. AT JUNE 30, 2021 AND 2020, THE BALANCES OF THE ENDOWMENT FUND WERE $1,595,068 AND $1,093,265, RESPECTIVELY. SCHEDULE D, PART X, LINE 2 UNCERTAIN TAX POSITIONS: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. SCHEDULE D, PART XI, LINE 2D OTHER REVENUE ON LINE 1, BUT NOT ON FORM 990, PART VIII, LINE 12: $ 956,623 NET ASSETS RELEASED FROM RESTRICTION SCHEDULE D, PART XI, LINE 4B OTHER REVENUE ON FORM 990, PART VIII, LINE 12, BUT NOT ON LINE 1: $ 2,821,695 TEMPORARILY RESTRICTED CONTRIBUTIONS 42,632 CONTRIBUTIONS FOR PROPERTY, PLANT & EQUIPMENT (62,855) SPECIAL EVENT EXPENSES (6,403) LOSS ON DISPOSAL OF ASSETS ------------ $ 2,795,069 SCHEDULE D, PART XII, LINE 2D OTHER EXPENSES ON LINE 1, BUT NOT ON FORM 990, PART IX, LINE 25: $ 62,855 SPECIAL EVENT EXPENSES 6,403 LOSS ON DISPOSAL OF ASSETS ----------- $ 69,258 JUDITH SNEAD GRANT WRITI false SUMMER SOLSTICE 200683 190258 10425 115 7133 55607 0 200683 190258 10425 115 7133 55607 62855 -52430 X X false false false false false false false false false DAVID KLINETOBE CHIEF FINANCIAL OFFICER 268444 0 5000 0 0 0 8223 0 6954 0 288621 0 MITESH POPAT CEO 340362 0 40000 0 0 0 7361 0 21990 0 409713 0 ELIZABETH SHAW MEDICAL DIRECTOR 226306 0 0 0 0 0 5921 0 12759 0 244986 0 XAVIER PEREZ MEDICAL DIRECTOR 257548 0 0 0 0 0 7490 0 402 0 265440 0 MELANIE ROSE THOMPSON REGIONAL MEDICAL DIRECTOR 264028 0 0 0 0 0 7968 0 5750 0 277746 0 CARINA F GONZALEZ ADULT PHYSICIAN 206139 0 0 0 0 0 2112 0 16890 0 225141 0 PETER ALLEN NOVOTA PHYSICIAN 205911 0 0 0 0 0 0 0 19092 0 225003 0 TRACEY HESSEL ASS MED DIR 210522 0 0 0 0 0 6303 0 398 0 217223 0 CONSTANZA KADERA CHIEF DENTAL OFFICER 226553 0 0 0 0 0 6945 0 12791 0 246289 0 LEAH CANVASSER CHIEF INFORMATION OFFICER 212680 0 5000 0 0 0 6331 0 390 0 224401 0 JOSE CHIBRAS-SAINZ CHIEF MEDICAL OFFICER 276816 0 0 0 0 0 0 0 16193 0 293009 0 X 1 1015403 FMV X 1 65813 FMV false false false SCHEDULE M, PART I, LINE 20, COLUMN (B) NUMBER OF CONTRIBUTIONS: THE NUMBERS ENTERED IN COLUMN B REPRESENT THE NUMBER OF DONORS WHO CONTRIBUTED THESE ITEMS DURING THE YEAR. FORM 990, PART VI, SECTION B, LINE 11B 990 REVIEW POLICY: THE AUDIT COMMITTEE REVIEWS THE FORM 990 PRIOR TO FILING AND WORKS WITH THE EXECUTIVE COMMITTEE AND MANAGEMENT TO IMPLEMENT ANY CHANGES. THE EXECUTIVE COMMITTEE REPORTS TO THE BOARD AND THE BOARD APPROVES THE FORM 990 SUBMISSION WHICH IS RECORDED IN ITS REGULAR MEETING MINUTES. FORM 990, PART VI, SECTION B, LINE 12C MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY: ANNUALLY MEMBERS OF THE BOARD AS WELL AS MCC KEY EMPLOYEES ARE PROVIDED WITH A COPY OF THE CURRENT CONFLICT OF INTEREST POLICY. BOARD MEMBERS AS WELL AS MCC KEY EMPLOYEES ARE REQUIRED TO SELF-DISCLOSE ANY POTENTIAL CONFLICT OF INTEREST. CONTRACTS AND MAJOR PURCHASES ARE ALSO SCRUTINIZED FOR POTENTIAL CONFLICT OF INTEREST. THE POLICIES OF MARIN COMMUNITY CLINIC BOARD OF DIRECTORS REQUIRE REGULAR DISCLOSURE OF MEMBER (1) AFFILIATIONS (AS TRUSTEE, BOARD MEMBER, OFFICER, EMPLOYEE, ADVISORY COMMIT MEMBER, DEVELOPMENT COMMITTEE MEMBER, VOLUNTEER, ETC.) WITH ANY OTHER ORGANIZATION WITH WHICH MCC MAY HAVE A FINANCIAL RELATIONSHIP, AND (2) AFFILIATIONS OF PERSONS WITH WHOM YOU HAVE A CLOSE PERSONAL RELATIONSHIP (SUCH AS A MEMBER OF THE IMMEDIATE FAMILY OR A MEMBER OF HOUSEHOLD) WITH ANY OTHER ORGANIZATION WITH WHICH THE MCC MAY HAVE A FINANCIAL RELATIONSHIP. EMPLOYEES, VOLUNTEERS AND BOARD MEMBERS HAVE A CONTINUING RESPONSIBILITY TO ADVISE THE BOARD SECRETARY OF ADDITIONAL AFFILIATIONS AS THEY MAY ARISE. ANY CONFLICT OF INTEREST WILL BE REVIEWED ON A CASE BY CASE BASIS ALONG WITH ANY APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION. FORM 990, PART VI, SECTION B, LINE 15A COMPENSATION SETTING PROCEDURE: THE ORGANIZATION'S HR DIRECTOR OBTAINS INDUSTRY COMPENSATION DATA FROM LOCAL AND STATE RESOURCES TO BE USED FOR COMPARISON PURPOSES. DATA FROM ASSOCIATION SURVEYS (NACHC, CPCA, PAYSCALE) AND ANY RECOMMENDATIONS ARE REVIEWED AND REPORTED TO THE EXECUTIVE COMMITTEE FOR APPROVAL AND DISCUSSION. THE BOARD REVIEWS THE CEO'S PAY RATE ANNUALLY OR AS NECESSARY IF THERE IS A CHANGE IN STAFF. FORM 990, PART VI, SECTION B, LINE 15B COMPENSATION SETTING PROCEDURE: THE ORGANIZATION'S HR DIRECTOR OBTAINS INDUSTRY COMPENSATION DATA FROM LOCAL AND STATE RESOURCES TO BE USED FOR COMPARISON PURPOSES. DATA FROM ASSOCIATION SURVEYS (NACHC, CPCA, PAYSCALE) AND ANY RECOMMENDATIONS ARE REVIEWED AND REPORTED TO THE CEO. THE CEO REVIEWS THE PAY RATE ANNUALLY OR AS NECESSARY IF THERE IS A CHANGE IN STAFF. THE BOARD THEN APPROVES ANY INCREASES IN COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENT DISCLOSURE: THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON WRITTEN REQUEST. REQUESTED DOCUMENTS WILL BE MAILED TO THE REQUESTOR.