HEALTHCARE FOUNDATION OF NORTHERN AND CENTRAL CALIFORNIA: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization
HEALTHCARE FOUNDATION OF NORTHERN AND CENTRAL CALIFORNIA (EIN 86-1174825)
Tax period
2021-01-01 to 2021-12-31
Filed
2022-11-14
IRS object ID
202213189349318371
Schema version
2021v4.2
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2022-11-14T17:46:55-06:00ReturnTs
Tax Period End2021-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN910189318PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1MOSS ADAMS LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line13121 W MARCH LN STE 200AddressLine1Txt
CitySTOCKTONCityNm
State AbbreviationCAStateAbbreviationCd
ZIP952192367ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2021-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN861174825EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1HEALTHCARE FOUNDATION OF NORTHERN ANDBusinessNameLine1Txt
Business Name Line2CENTRAL CALIFORNIABusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlHEALBusinessNameControlTxt
Phone9165527629PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11215 K STREET 700AddressLine1Txt
CitySACRAMENTOCityNm
State AbbreviationCAStateAbbreviationCd
ZIP95814ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJENNIFER M NEWMANPersonNm
Person TitleCFOPersonTitleTxt
Phone9165527629PhoneNum
Signature2022-11-11SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstJENNIFERPersonFirstNm
Person LastNEWMANPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonTRACY S PAGLIAPreparerPersonNm
PTINP00366884PTIN
Phone2099556100PhoneNum
Preparation2022-11-11PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer3TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2021TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Address ChangeYes (X)AddressChangeInd
Principal OfficerJENNIFER M NEWMANPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11215 K STREET 700AddressLine1Txt
CitySACRAMENTOCityNm
State AbbreviationCAStateAbbreviationCd
ZIP95814ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$337,857GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressN/AWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2006FormationYr
Legal Domicile StateCALegalDomicileStateCd
Activity Or MissionTO SUPPORT A WIDE RANGE OF HEALTH CARE ISSUES IN CALIFORNIA.ActivityOrMissionDesc
Voting Members Governing Body25VotingMembersGoverningBodyCnt
Voting Members Independent24VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$650,638PYContributionsGrantsAmt
CY Contributions Grants$336,045CYContributionsGrantsAmt
PY Program Service Revenue$0PYProgramServiceRevenueAmt
CY Program Service Revenue$0CYProgramServiceRevenueAmt
PY Investment Income$4,271PYInvestmentIncomeAmt
CY Investment Income$1,812CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$654,909PYTotalRevenueAmt
CY Total Revenue$337,857CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$0PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$675,368PYOtherExpensesAmt
CY Other Expenses$360,036CYOtherExpensesAmt
PY Total Expenses$675,368PYTotalExpensesAmt
CY Total Expenses$360,036CYTotalExpensesAmt
PY Revenues Less Expenses-$20,459PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$22,179CYRevenuesLessExpensesAmt
Total Assets BOY$1,309,108TotalAssetsBOYAmt
Total Assets EOY$202,252TotalAssetsEOYAmt
Total Liabilities BOY$1,134,575TotalLiabilitiesBOYAmt
Total Liabilities EOY$49,898TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$174,533NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$152,354NetAssetsOrFundBalancesEOYAmt
MissionTO SPONSOR AND SUPPORT A WIDE RANGE OF HEALTH CARE ISSUES AND RESEARCH IN THE AREA OF HEALTH CARE IN CALIFORNIA.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$271,047ExpenseAmt
Grant$0GrantAmt
Revenue$0RevenueAmt
DescSTANFORD HOSPITAL & CLINICS COMMUNITY PARTNERSHIP PROGRAM:SUPPORT OF THE MEDICAL RESPITE PROGRAM TO IMPROVE THE ACCESS TO HEALTHCARE, QUALITY OF LIFE AND FUNCTIONAL STATUS OF HOMELESS PATIENTS DISCHARGED FROM HOSPITALS IN SANTA CLARA COUNTY.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$65,388ExpenseAmt
Grant$0GrantAmt
Revenue$0RevenueAmt
DescEL CAMINO HOSPITAL AND HEALTHCARE DISTRICT:SUPPORT OF THE MEDICAL RESPITE PROGRAM TO IMPROVE THE ACCESS TO HEALTHCARE, QUALITY OF LIFE AND FUNCTIONAL STATUS OF HOMELESS PATIENTS DISCHARGED FROM HOSPITALS IN SANTA CLARA COUNTY.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$336,435TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment0ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document1IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee0EmployeeCnt
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members25GoverningBodyVotingMembersCnt
Independent Voting Member24IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldCAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1JENNIFER M NEWMANBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone9165527629PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11215 K STREET SUITE 700AddressLine1Txt
CitySACRAMENTOCityNm
State AbbreviationCAStateAbbreviationCd
ZIP95814ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (31 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
BRYAN J BUCKLEW
PRESIDENT/CEO0.5040.00Yes (X)Yes (X)$0$650,077$52,266
MARY JO JACOBSON PT
CHAIR (AS OF 12/21)0.501.00Yes (X)Yes (X)$0$0$0
EDMUNDO CASTANEDA
CHAIR (THRU 11/21)0.501.00Yes (X)Yes (X)$0$0$0
TODD A SUNTRAPAK
PAST CHAIR0.501.00Yes (X)Yes (X)$0$0$0
SIRI NELSON
SECRETARY/TREASURER0.501.00Yes (X)Yes (X)$0$0$0
BRIAN ALEXANDER
DIRECTOR0.501.00Yes (X)$0$0$0
AIMEE BREWER
DIRECTOR (THRU 9/21)0.501.00Yes (X)$0$0$0
IRENE CHAVEZ
DIRECTOR0.501.00Yes (X)$0$0$0
CARMELA COYLE
DIRECTOR0.501.00Yes (X)$0$0$0
ABHISHEK DOSI
DIRECTOR (THRU 10/21)0.501.00Yes (X)$0$0$0
JEFF ELLER
DIRECTOR (THRU 4/21)0.501.00Yes (X)$0$0$0
RON GROEPPER
DIRECTOR0.501.00Yes (X)$0$0$0
MITCHELL J HANNA
DIRECTOR0.501.00Yes (X)$0$0$0
TYLER HEDDEN
DIRECTOR (THRU 10/21)0.501.00Yes (X)$0$0$0
CHAD R HICKERSON MAOD
DIRECTOR0.501.00Yes (X)$0$0$0
KEN KELLER
DIRECTOR0.501.00Yes (X)$0$0$0
PAUL E LORENZ
DIRECTOR0.501.00Yes (X)$0$0$0
ANN LUCENA
DIRECTOR0.501.00Yes (X)$0$0$0
JOHN MCCORMICK
DIRECTOR0.501.00Yes (X)$0$0$0
STEVEN J PACKER MD
DIRECTOR0.501.00Yes (X)$0$0$0
GINO PATRIZIO JD MHA
DIRECTOR0.501.00Yes (X)$0$0$0
MATT REES
DIRECTOR0.501.00Yes (X)$0$0$0
TOMI RYBA
DIRECTOR0.501.00Yes (X)$0$0$0
BALJEET SANGHA MPH FACHE
DIRECTOR0.501.00Yes (X)$0$0$0
RICK SHUMWAY
DIRECTOR0.501.00Yes (X)$0$0$0
BRADLEY SIMMONS
DIRECTOR0.501.00Yes (X)$0$0$0
STEVEN STARK
DIRECTOR0.501.00Yes (X)$0$0$0
JANET WAGNER RN
DIRECTOR0.501.00Yes (X)$0$0$0
DONALD J WILEY
DIRECTOR0.501.00Yes (X)$0$0$0
DANIEL WOLCOTT
DIRECTOR0.501.00Yes (X)$0$0$0
JENNIFER NEWMAN
CFO0.501.00Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$650,077TotReportableCompRltdOrgAmt
Total Other Compensation$52,266TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other SrcsYes (1)CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (3 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
COUNTY OF SANTA CLARA OFFICE OF SUPPORTI
2310 N 1ST ST 201SAN JOSECA951311040RESPITE SERVICES$706,808
PENINSULA HEALTHCARE CONNECTION INC
33 ENCINA AVE 103PALO ALTOCA94301RESPITE SERVICES$175,000
COMMUNITY HOMELESS SOLUTIONS
PO BOX 1340MARINACA93933RESPITE SERVICES$127,098
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K3CntrctRcvdGreaterThan100KCnt
All Other Contributions$336,045AllOtherContributionsAmt
Total Contributions$336,045TotalContributionsAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,812TotalRevenueColumnAmt
Exclusion$1,812ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$337,857TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$1,812ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$23,528TotalAmt
Management And General$23,528ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$60,606TotalAmt
Program Services$60,606ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$593TotalAmt
Program Services$520ProgramServicesAmt
Management And General$73ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (2 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
CASE MANAGEMENT$209,921$209,921
PATIENT/CLIENT SUPPORT$65,388$65,388

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$360,036TotalAmt
Program Services$336,435ProgramServicesAmt
Management And General$23,601ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$1,309,108BOYAmt
EOY$202,252EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$1,309,108BOYAmt
EOY$202,252EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$34,238BOYAmt
EOY$16,275EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$72,069BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,028,268BOYAmt
EOY$33,623EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,134,575BOYAmt
EOY$49,898EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$174,533BOYAmt
EOY$152,354EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$174,533BOYAmt
EOY$152,354EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,309,108BOYAmt
EOY$202,252EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$22,179ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consol And Sep Basis Fincl StmtYes (X)ConsolAndSepBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3Yes (X)SupportingOrganization509a3Ind
Supporting Org Type1Yes (X)SupportingOrgType1Ind
IRS Written DeterminationYes (X)IRSWrittenDeterminationInd
Supported Organizations1SupportedOrganizationsCnt

Supported Org Information SupportedOrgInformationGrp

Supported Organization Name SupportedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1HOSPITAL COUNCIL - NORTHERN & CENTRAL CALIFORNIABusinessNameLine1Txt
FieldValueIRS element (for citing)
EIN941533644EIN
Organization Type10OrganizationTypeCd
Governing Document ListedYes (1)GoverningDocumentListedInd
Support$0SupportAmt
Other Support$0OtherSupportAmt
FieldValueIRS element (for citing)
Supported Organizations Total1SupportedOrganizationsTotalCnt
Support Sum$0SupportSumAmt
Other Support Sum$0OtherSupportSumAmt

Form990 Sch A Supporting Org Form990SchASupportingOrgGrp

FieldValueIRS element (for citing)
Listed By Name Governing DocYes (1)ListedByNameGoverningDocInd
Suprt Org No IRS Determination0SuprtOrgNoIRSDeterminationInd
Supported Org Section C456Yes (1)SupportedOrgSectionC456Ind
Supported Org QualifiedYes (1)SupportedOrgQualifiedInd
Suprt Exclusively Sec170c2 BYes (1)SuprtExclusivelySec170c2BInd
Supported Org Not Organized US0SupportedOrgNotOrganizedUSInd
Organization Change Suprt Org0OrganizationChangeSuprtOrgInd
Support Non Supported Org0SupportNonSupportedOrgInd
Payment Substantial Contribtr0PaymentSubstantialContribtrInd
Loan Disqualified Person0LoanDisqualifiedPersonInd
Controlled Disqualified Prsn0ControlledDisqualifiedPrsnInd
Disqualified Prsn Controll Int0DisqualifiedPrsnControllIntInd
Disqualified Prsn Ownr Int0DisqualifiedPrsnOwnrIntInd
Excess Business Holdings Rules0ExcessBusinessHoldingsRulesInd
Contribution Controller0ContributionControllerInd
Contribution Family0ContributionFamilyInd
Contribution35 Controlled0Contribution35ControlledInd

Form990 Sch A Type1 Suprt Org Form990SchAType1SuprtOrgGrp

FieldValueIRS element (for citing)
Power Appoint Majority Dir TrstYes (1)PowerAppointMajorityDirTrstInd
Operate Benefit Non Suprt Org0OperateBenefitNonSuprtOrgInd

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART IV, SECTION A, LINE 3B:AS PART OF THE REQUIREMENTS OF SUPPORTING A 501(C)(6) ORGANIZATION, HEALTHCARE FOUNDATION OF NORTHERN AND CENTRAL CALIFORNIA (HFNCC) CONFIRMS EACH YEAR THAT ITS SUPPORTED ORGANIZATION, HOSPITAL COUNCIL - NORTHERN & CENTRAL CALIFORNIA (HCNCC), QUALIFIES AS A 501(C)(3) PUBLIC CHARITY UNDER 509(A)(2) THROUGH REGULAR CONSULTATIONS, AN ANNUAL REVIEW OF FORM 990, AND COMPLETION OF THE SCHEDULE A, PART III PUBLIC SUPPORT TEST. THIS PROCESS WAS UNDERTAKEN IN 2022 TO VERIFY THAT HCNCC CONTINUED TO QUALIFY TO BE A SUPPORTED ORGANIZATION OF HFNCC.
PART IV, SECTION A, LINE 3C:TO THE KNOWLEDGE OF HEALTHCARE FOUNDATION OF NORTHERN AND CENTRAL CALIFORNIA ALL SUPPORT PROVIDED TO HOSPITAL COUNCIL - NORTHERN & CENTRAL CALIFORNIA WAS USED EXCLUSIVELY FOR 170(C)(2) PURPOSES AS CONFIRMED THROUGH REGULAR REPORTS.

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

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

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Total Book Value Land Buildings$0TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescFUNDS HELD FOR PROJECTSDesc
Amt$33,623Amt
FieldValueIRS element (for citing)
Total Liability$33,623TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$337,857TotalRevEtcAuditedFinclStmtAmt
Revenue Not Reported$0RevenueNotReportedAmt
Revenue Subtotal$337,857RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$337,857TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$360,036TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$360,036ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$360,036TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationTHE FOUNDATION IS A NONPROFIT PUBLIC BENEFIT CORPORATION AND IS EXEMPT FROM INCOME TAXES UNDER INTERNAL REVENUE CODE SECTION 501(C)(3) AND CALIFORNIA REVENUE AND TAX CODE SECTION 23701E. ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN INCLUDED IN THE ACCOMPANYING FINANCIAL STATEMENTS. IN THE EVENT THE FOUNDATION HAD A TAX PROVISION THAT WAS UNCERTAIN OF BEING SUSTAINED, THE FOUNDATION WOULD APPLY THE MINIMUM PROBABILITY THRESHOLD TO DETERMINE WHETHER A FINANCIAL STATEMENT LIABILITY OR BENEFIT SHOULD BE RECOGNIZED. THERE WERE NO UNCERTAIN TAX POSITIONS AS OF DECEMBER 31, 2021 OR 2020.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp

FieldValueIRS element (for citing)
PersonBRYAN J BUCKLEWPersonNm
TitlePRESIDENT/CEOTitleTxt
Base Compensation Filing Org$0BaseCompensationFilingOrgAmt
Compensation Based On Rltd Orgs$510,592CompensationBasedOnRltdOrgsAmt
Bonus Filing Organization$0BonusFilingOrganizationAmount
Bonus Related Organizations$129,760BonusRelatedOrganizationsAmt
Other Compensation Filing Org$0OtherCompensationFilingOrgAmt
Other Compensation Rltd Orgs$9,725OtherCompensationRltdOrgsAmt
Deferred Compensation Flng Org$0DeferredCompensationFlngOrgAmt
Deferred Comp Rltd Orgs$20,300DeferredCompRltdOrgsAmt
Nontaxable Benefits Filing Org$0NontaxableBenefitsFilingOrgAmt
Nontaxable Benefits Rltd Orgs$31,966NontaxableBenefitsRltdOrgsAmt
Total Compensation Filing Org$0TotalCompensationFilingOrgAmt
Total Compensation Rltd Orgs$702,343TotalCompensationRltdOrgsAmt
Comp Report Prior990 Filing Org$0CompReportPrior990FilingOrgAmt
Comp Report Prior990 Rltd Orgs$0CompReportPrior990RltdOrgsAmt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 4BBRYAN J. BUCKLEW AGREED TO PARTICIPATE IN CAP-EX IN PLACE OF A TRADITIONAL SERP. PLEASE SEE THE FORM 990 FOR RELATED ORGANIZATION, HOSPITAL COUNCIL - NORTHERN & CENTRAL CALIFORNIA (HCNCC).
PART II:THE FOUNDATION'S OFFICER WAS PAID WAGE COMPENSATION BY CALIFORNIA ASSOCIATION OF HOSPITALS AND HEALTH SYSTEMS (CAHHS) FOR SERVICES PROVIDED TO HOSPITAL COUNCIL - NORTHERN & CENTRAL CALIFORNIA (HCNCC). SEE COMPENSATION AMOUNTS ON SCHEDULE J, PART II. THE COMPENSATION PAID BY CAHHS WAS REIMBURSED BY HCNCC UNDER A LEASED EMPLOYEE ARRANGEMENT. THE FOUNDATION DID NOT REIMBURSE CAHHS FOR ANY COMPENSATION REPORTED.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 6THE FOUNDATION'S SOLE MEMBER IS HOSPITAL COUNCIL - NORTHERN & CENTRAL CALIFORNIA, A CALIFORNIA NONPROFIT MUTUAL BENEFIT CORPORATION.
FORM 990, PART VI, SECTION A, LINE 7ATHE SOLE MEMBER, HOSPITAL COUNCIL - NORTHERN & CENTRAL CALIFORNIA ELECTS THE FOUNDATION'S BOARD OF DIRECTORS.
FORM 990, PART VI, SECTION A, LINE 7BTHE SOLE MEMBER HAS CERTAIN RESERVED POWERS: A. MATERIALLY CHANGING THE PHILOSOPHY, OBJECTIVES AND PURPOSES OF THE FOUNDATION; B. ENGAGING IN ANY MERGER, CONSOLIDATION, AFFILIATION, OR DISSOLUTION OF THE FOUNDATION; C. ENGAGING IN ANY SALE, LEASE, DISPOSITION OR HYPOTHECATION OF ANY ASSET OWNED BY THE FOUNDATION, WHERE THE MARKET VALUE OF SUCH ASSET EQUALS OR EXCEEDS $100,000.00; D. ENTERING INTO ANY CONTRACT, LEASE, OR OTHER OBLIGATION NOT OTHERWISE APPROVED IN THE ANNUAL BUDGET THAT CREATES AN AGGREGATE OBLIGATION FOR THE FOUNDATION IN EXCESS OF $100,000.00 IN ANY CONSECUTIVE TWELVE (12) MONTHS; E. ENTERING INTO ANY CONTRACT, LEASE OR OTHER OBLIGATION NOT OTHERWISE APPROVED IN THE ANNUAL BUDGET WHERE THE DURATION OF THE FOUNDATION'S OBLIGATION IS IN EXCESS OF 24 MONTHS; F. ADMISSION OF ANY OTHER MEMBERS; G. RELINQUISHING OR ALTERING THE TAX-EXEMPT STATUS OF THE FOUNDATION; H. MATERIALLY CHANGING THE CORPORATE STRUCTURE OF THE FOUNDATION OR ANY OF ITS COMPONENT PARTS; AND I. AMENDING, RESTATING, OR RESCINDING THE ARTICLES OF INCORPORATION OR BYLAWS OF THE FOUNDATION.
FORM 990, PART VI, SECTION B, LINE 11BTHE AUDIT COMMITTEE REVIEWS AND APPROVES THE FORM 990 WITH MANAGEMENT PRIOR TO FILING. THE FOUNDATION'S GOVERNING BODY IS PROVIDED WITH A COPY OF FORM 990 PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12CTHE CONFLICT OF INTEREST POLICY COVERS EACH MEMBER OF THE BOARD OF DIRECTORS; THE PRESIDENT/CHIEF EXECUTIVE OFFICER; CHIEF FINANCIAL OFFICER; KEY EMPLOYEES; ANY PERSON WHO HAS HELD ONE OF THOSE POSITIONS DURING THE PRECEDING FIVE YEARS; FAMILY MEMBERS; AND CERTAIN CONTROLLED ORGANIZATIONS (INTERESTED PERSONS). ALL INTERESTED PERSONS ANNUALLY SIGN A STATEMENT THAT AFFIRMS RECEIPT AND AGREEMENT TO COMPLY WITH THE POLICY AND TO DISCLOSE ANY FINANCIAL INTERESTS OR FAMILY RELATIONSHIPS THAT COULD GIVE RISE TO A CONFLICT OF INTEREST. EACH INTERESTED PERSON IS REQUIRED TO DISCLOSE TO THE BOARD (OR COMMITTEE THEREOF), ALL MATERIAL FACTS REGARDING THE FINANCIAL INTEREST OR RELATIONSHIP IN THE TRANSACTION. WITH REGARD TO AN INTERESTED PERSON, THE BOARD OR COMMITTEE DETERMINES IF A CONFLICT OF INTEREST EXISTS. THE INSIDER(S) INVOLVED WITH THE TRANSACTION WILL NOT BE PRESENT DURING THE BOARD OR COMMITTEE'S DISCUSSION OR DETERMINATION OF WHETHER A CONFLICT OF INTEREST EXISTS, AND MAY NOT VOTE ON THE TRANSACTION OR COUNTED IN DETERMINATION OF A QUORUM. ALL PROCEEDINGS ARE DOCUMENTED IN MEETING MINUTES.
FORM 990, PART VI, SECTION C, LINE 19FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICIES ARE NOT AVAILABLE TO THE PUBLIC.
FORM 990, PART IX, LINE 11GPROFESSIONAL SERVICES - POST DOC: PROGRAM SERVICE EXPENSES 60,606. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 60,606.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1HOSPITAL COUNCIL - NORTHERN & CENTRAL CALIFORNIABusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11215 K STREET SUITE 700AddressLine1Txt
CitySACRAMENTOCityNm
State AbbreviationCAStateAbbreviationCd
ZIP95814ZIPCd
FieldValueIRS element (for citing)
EIN941533644EIN
Primary ActivitiesMEMBERSHIP SERVICES TO NORTHERN AND CENTRAL CALIFORNIA HOSPITALSPrimaryActivitiesTxt
Legal Domicile StateCALegalDomicileStateCd
Exempt Code Section501(C)(6)ExemptCodeSectionTxt
Direct Controlling NAN/ADirectControllingNACd
Controlled Organization0ControlledOrganizationInd

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1HEALTHPLUS SHARED SERVICES INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11215 K STREET SUITE 700AddressLine1Txt
CitySACRAMENTOCityNm
State AbbreviationCAStateAbbreviationCd
ZIP95814ZIPCd
FieldValueIRS element (for citing)
EIN942685988EIN
Primary ActivitiesPROVIDING BUSINESS SERVICES FOR HOSPITALSPrimaryActivitiesTxt
Legal Domicile StateCALegalDomicileStateCd
Direct Controlling NAN/ADirectControllingNACd
Entity TypeCEntityTypeTxt
Controlled Organization0ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

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