2022-05-12T07:30:09-05:00 2021-06-30 390758449 WIPFLI LLP PO BOX 12237 GREEN BAY WI 543072237 990 2020-07-01 680262003 MENDOCINO COAST CLINICS INC MEND 7079641251 205 SOUTH STREET FORT BRAGG CA 95437 LUCRESHA RENTERIA EXEC DIRECTOR 7079641251 2022-05-11 1 LUCRESHA RENTERIA 999009999 TERRI REXRODE CPA MST P00096513 9206620016 2022-05-11 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z LUCRESHA RENTERIA 205 SOUTH STREET FORT BRAGG CA 95437 13339112 0 X WWW.MENDOCINOCOASTCLINICS.ORG X 1994 CA MENDOCINO COAST CLINICS, INC. PROVIDES HEALTH CARE SERVICES TO ALL WITHOUT REGARD TO RACE, CREED, NATIONAL ORIGIN, PHYSICAL DISABILITY, SEXUAL ORIENTATION OR ABILITY TO PAY FOR SERVICES TO THE EXTENT THE SERVICES ARE AVAILABLE AT THESE FACILITIES. 10 10 139 15 0 0 4014322 4220799 9045452 8857849 1226 6522 206407 208497 13267407 13293667 6452 3500 0 0 8426855 7822121 0 0 0 4576324 4361175 13009631 12186796 257776 1106871 9370618 9586994 3921031 3030536 5449587 6556458 X MENDOCINO COAST CLINICS, INC. PROVIDES HEALTH CARE SERVICES TO ALL WITHOUT REGARD TO RACE, CREED, NATIONAL ORIGIN, PHYSICAL DISABILITY, SEXUAL ORIENTATION OR ABILITY TO PAY FOR SERVICES TO THE EXTENT THE SERVICES ARE AVAILABLE AT THESE FACILITIES. 0 0 4571085 3500 4557367 MENDOCINO COAST CLINICS, INC. IS A PRIMARY CARE CLINIC PROVIDING MEDICAL SERVICES.DURING THE CURRENT FISCAL YEAR, MENDOCINO COAST CLINICS PROVIDED 17,282 MEDICAL VISITS. 1315866 989311 MENDOCINO COAST CLINICS, INC. IS A PRIMARY CARE CLINIC PROVIDING DENTAL SERVICES. DURING THE CURRENT FISCAL YEAR, MENDOCINO COAST CLINICS PROVIDED 6,946 DENTAL VISITS. 1087470 1348896 MENDOCINO COAST CLINICS, INC. IS A PRIMARY CARE CLINIC PROVIDING PEDIATRICS SERVICES. DURING THE CURRENT FISCAL YEAR, MENDOCINO COAST CLINICS PROVIDED 4,424 PEDIATRIC VISITS. 860068 821241 MENDOCINO COAST CLINICS, INC. IS A PRIMARY CARE CLINIC PROVIDING OB/GYN SERVICES. DURING THE CURRENT FISCAL YEAR, MENDOCINO COAST CLINICS PROVIDED 2,902 OB/GYN VISITS. 869344 1092807 MENDOCINO COAST CLINICS, INC. IS A PRIMARY CARE CLINIC PROVIDING BEHAVIORAL HEALTH SERVICES. DURING THE CURRENT FISCAL YEAR, MENDOCINO COAST CLINICS PROVIDED 6,180 BEHAVIORAL HEALTH VISITS. 74531 225852 MENDOCINO COAST CLINICS, INC. IS A PRIMARY CARE CLINIC PROVIDING WELLNESS CENTER SERVICES. 1803943 2139900 8778364 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 56 0 139 1 0 0 0 0 0 0 0 0 0 0 0 0 X 10 10 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X WIPFLI LLP 7074631463 125 E MILL ST UKIAH CA 95482 YADIRA SANCHEZ DIRECTOR 4.00 X 0 0 0 ARACELI RIVAS DIRECTOR 4.00 X 0 0 0 CLAUDIA BOUDREAU DIRECTOR 4.00 X 0 0 0 CHRISTOPHER KNOERDEL DIRECTOR 4.00 X 0 0 0 TREVOR ORCHARD VICE CHARI 4.00 X X 0 0 0 CLARE BERCOT ZWERLING DIRECTOR 4.00 X 0 0 0 RIO PARFREY SECRETARY 4.00 X X 0 0 0 DAPHNE HANEY TREASURER 4.00 X X 0 0 0 CHRISTINE KELLY DIRECTOR 4.00 X 0 0 0 KELLY GRIMES CHAIR 4.00 X X 0 0 0 LAWRENCE GOLDYN MEDICAL DIRECTOR 40.00 X 209912 0 31085 LUCRESHA RENTERIA EXECUTIVE DIRECTOR 40.00 X 150281 0 35660 MERYL SCHLINGHEYDE COO 40.00 X 94962 0 13382 JUDITH WATERMAN CONTRACTED CFO 3.00 X 0 0 0 CHRISTOPHER ROBSHAW PEDIATRICIAN 40.00 X 231915 0 37411 BRENT WRIGHT OB/GYN PHYSICIAN 40.00 X 242785 0 27411 WENDY CARVAJAL DENTIST 40.00 X 145252 0 859 JAMES THOMAS PHYSICIANS ASSISTANT 40.00 X 135869 0 0 TADEUS ULATOWSKI DENTIST 40.00 X 132319 0 0 1343295 0 145808 4 0 1 0 MACMAN MANAGEMENT HEALTHCARE 1930 DEL PASO RD SUITE 120 SACRAMENTO CA 95834 BILLING SERVICE 263476 WIPFLI LLC PO BOX 3160 MILWAUKEE WI 532013160 FINANCIAL SERVICES 255450 GABRIEL'S CLEANING SERVICE PO BOX 2221 FORT BRAGG CA 95437 CLEANING SERVICE 206674 COMPHEALTH PO BOX 972651 DALLAS TX 753972651 CONTRACTED PROVIDER SERVICES 132363 4 3591253 629546 4220799 PATIENT SERVICE FEES 621400 8857849 8857849 8857849 1522 1522 5000 0 5000 5000 5000 76317 45445 30872 30872 OTHER INCOME 900099 118125 118125 MEANINGFUL USE INCENTIVE 621110 59500 59500 177625 13293667 9035474 0 37394 3500 3500 539150 190428 348722 5697260 4977780 719480 125501 113935 11566 1021649 868046 153603 438561 365303 73258 34855 34855 3070 3070 127340 127340 1037761 1037761 82340 82340 166229 121297 44932 619448 619448 441821 432399 9422 9671 9671 31132 25347 5785 63221 38101 25120 194676 153699 40977 50137 16657 33480 SUPPLIES-PHARMACEUTICAL 570730 570730 SUPPLIES - PHARMACEUTIC 419965 419965 SUPPLIES-CLINICAL 314273 314273 194506 166904 27602 12186796 8778364 3408432 0 3357427 2861177 10125 10131 165231 100547 1234283 1505447 140518 696949 7372467 2959724 4463034 4412743 9370618 9586994 1164932 1024730 525737 687239 2227637 1318567 2725 3921031 3030536 X 5449587 6556458 5449587 6556458 9370618 9586994 1106871 0 X 0 1 X 1 1 1 X PART IV, SECTION A, LINE 3B: ALTHOUGH THIS ORGANIZATION IS CLASSIFIED AS A HOSPITAL FOR IRS PUBLIC CHARITY STATUS, IT IS NOT A LICENSED HOSPITAL AND THEREFORE, FORM 990, SCHEDULE H, HOSPITALS, IS NOT REQUIRED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 433924 433924 5620753 1839119 3781634 38590 21243 17347 1279200 1099362 179838 4412743 13293667 0 13293667 0 13293667 12186796 0 12186796 0 12186796 CRAB FUNDRAISER 76317 76317 45445 76317 76317 45445 45445 30872 X 0 0 0 0 0 0 0 0 0 BRENT WRIGHT OB/GYN PHYSICIAN 242785 0 0 0 0 0 7603 0 19808 0 270196 0 0 0 CHRISTOPHER ROBSHAW PEDIATRICIAN 231915 0 0 0 0 0 9446 0 27965 0 269326 0 0 0 LAWRENCE GOLDYN MEDICAL DIRECTOR 209912 0 0 0 0 0 8577 0 22508 0 240997 0 0 0 LUCRESHA RENTERIA EXECUTIVE DIRECTOR 150281 0 0 0 0 0 6265 0 29395 0 185941 0 0 0 FORM 990, PART VI, SECTION A, LINE 3 WIPFLI LLP CONTRACTED CFO JUDITH P. WATERMAN $34,855 FORM 990, PART VI, SECTION B, LINE 11B CONFLICT OF INTEREST STATEMENTS ARE UPDATED AND REVIEWED PERIODICALLY BY THE BOARD OF DIRECTORS. THE BOARD OF DIRECTORS WILL REVIEW ANY POTENTIAL CONFLICTS AND TAKE APPROPRIATE ACTION. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST STATEMENTS ARE UPDATED AND REVIEWED ANNUALLY. THE CONFLICT OF INTEREST POLICY APPLIES TO EMPLOYEES, OFFICERS AND THE BOARD OF DIRECTORS. THE GOVERNING BOARD OR COMMITTEE DETERMINES IF THERE IS A CONFLICT OF INTEREST. THE BOARD OR COMMITTEE REVIEWS THE CONFLICT. THE BOARD OF DIRECTORS OR OUTSIDE ADVISOR WILL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION IF NEEDED. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION OF KEY EMPLOYEES IS REVIEWED BY THE FULL BOARD OF DIRECTORS WHO ARE INDEPENDENT FROM THOSE IN WHICH COMPENSATION IS BEING REVIEWED. THE BOARD OF DIRECTORS APPROVE AND DOCUMENT ANY CHANGES TO COMPENSATION. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS ARE MADE AVAILABLE UPON REQUEST.