2021-05-13T15:19:41-05:00 2020-06-30 BKD LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2019-07-01 942237120 MARIN COMMUNITY CLINIC % DAVID KLINETOBE MARI 4154481500 9 COMMERCIAL BLVD Suite 100 NOVATO CA 94949 DAVID KLINETOBE CFO 2020-10-29 true Krystal K Creach P01248198 4178658701 2019 2022-09-23 18:48:47Z MARIN COMMUNITY CLINIC MITESH POPAT 9 COMMERCIAL BLVD SUITE 100 NOVATO CA 94949 60518860 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 15 634 49 12500 2515 5773047 8960885 47720068 48010545 384699 1094066 -21497 -10518 53856317 58054978 0 0 0 0 37095072 38313637 14125 0 617061 14442593 14863075 51551790 53176712 2304527 4878266 45784713 48778034 8814791 7409840 36969922 41368194 TO IMPROVE THE HEALTH OF OUR PATIENTS AND COMMUNITY BY PROVIDING HIGH QUALITY, COST-EFFECTIVE, CULTURALLY SENSITIVE, PATIENT-CENTERED HEALTH CARE. false false 34736004 36255665 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. 11546946 9760339 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. 2212120 1994541 BEHAVIORAL HEALTH SERVICES - OFFERED TO CHILDREN, TEENS, AND ADULTS AND INCLUDES PSYCHIATRY AND COUNSELING BY LICENSED CLINICAL SOCIAL WORKERS. 48495070 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 73 0 true 634 true true true 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 377003 0 27283 JOSE CHIBRAS-SAINZ CHIEF MEDICAL OFFICER 40.0 0.0 X 271947 0 14733 DAVID KLINETOBE CHIEF FINANCIAL OFFICER 40.0 0.0 X 258613 0 14227 XAVIER PEREZ MEDICAL DIRECTOR 40.0 0.0 X 244970 0 7609 CONSTANZA KADERA CHIEF DENTAL OFFICER 40.0 0.0 X 221257 0 22900 MELANIE ROSE THOMPSON REGIONAL MEDICAL DIRECTOR 40.0 0.0 X 216821 0 15171 ELIZABETH SHAW MEDICAL DIRECTOR 36.0 0.0 X 213834 0 16245 MAI MAGLIOCCO LEAD PHYSICIAN ADULT MED 40.0 0.0 X 194068 0 25529 CARINA F GONZALEZ ADULT PHYSICIAN 40.0 0.0 X 199487 0 17602 LEAH CANVASSER CHIEF INFORMATION OFFICER 40.0 0.0 X 201526 0 5843 JENNIFER BYER LEAD PHYSICIAN 30.0 0.0 X 186441 0 7075 JOHN E BOLAND III DDS MSD SECRETARY 3.0 0.0 X X 0 0 0 JERRY OKEN TREASURER & 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 FRANK TAVEL MD BOARD MEMBER END 11/2019 1.0 0.0 X 0 0 0 ABIGAIL CADELINA BOARD MEMBER 1.0 0.0 X 0 0 0 MARTHA HANSEN BOARD MEMBER 1.0 0.0 X 0 0 0 MICHAEL HARRIS 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 BOARD MEMBER 1.0 0.0 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 JAMES GERAGHTY BOARD MEMBER BEG 02/2019 1.0 0.0 X 0 0 0 2585967 0 174217 74 false true false WATECH COMPUTER SERVICES 900 DORIS RD AUBURN HILLS MI 48326 IT 498311 MCC BUILDING MAINTENANCE 83 HAMILTON DRIVE STE 104 NOVATO CA 94949 CLEANING & MAINT 369496 UC SCHOOL OF OPTOMETRY 230 MINOR HALL UNIVERSITY OF CA BERKELEY CA 94720 PROFESSIONAL SERVICE 296465 MARIN HEALTH MEDICAL NETWORK 9 COMMERCIAL BLVD STE 200 NOVATO CA 94949 PROFESSIONAL SERVICE 235902 EXPENSE REDUCTION ANALYSTS INC PO BOX 956251 ST LOUIS MO 63195 PROFESSIONAL SERVICE 138466 5 178175 6684254 2098456 129683 8960885 NET PATIENT SERVICE REVENUE 624100 42139540 42139540 CAPITATION REVENUE 624100 3059277 3059277 QUALITY IMPROVEMENT PROGRAM 624100 2678453 2678453 OTHER INCOME 624100 133275 120775 12500 48010545 305923 305923 0 0 23700 23700 0 23700 23700 3204982 2403687 13152 801295 -13152 788143 788143 12825 178175 47043 -34218 -34218 0 0 0 0 0 0 0 58054978 47998045 12500 1083548 0 0 0 0 1415332 738206 677126 0 28148455 26538211 1258481 351763 440296 419068 15558 5670 5656237 5248033 340112 68092 2653317 2451173 170483 31661 0 55933 55933 167422 167422 0 0 0 2651460 2531099 103499 16862 0 1222204 1009603 165498 47103 1062383 884432 138525 39426 0 1697738 1566814 109007 21917 99488 82824 12972 3692 0 223217 185828 29105 8284 62815 62815 0 2073040 1415849 657191 158622 137142 21480 MEDICAL SUPPLIES & DRUGS 4678811 4678811 RECRUITING & RETENTION 406705 338580 53031 15094 LICENSES,DUES,SUBSCRIPTIONS 202028 168188 26343 7497 BAD DEBT 101209 101209 53176712 48495070 4064581 617061 1913927 3734387 10464697 10933894 663423 776657 3785300 3923371 0 0 0 0 0 0 360850 497686 880196 948011 34040765 15767925 19351848 18272840 7418667 7901695 0 0 0 0 0 0 945805 1789493 45784713 48778034 3028353 3567092 0 0 65500 477201 0 0 0 0 0 0 1720938 1383827 0 95820 4000000 1885900 8814791 7409840 X 36608866 40738895 361056 629299 36969922 41368194 45784713 48778034 4878266 -479994 X false true X true true true X 4931780 5194587 5434051 5773047 8960885 30294350 32878812 39109395 44906728 47639308 48010545 212544788 0 0 0 37810592 44303982 50340779 53412355 56971430 242839138 0 0 0 242839138 44999 75949 203588 367318 329623 1021477 0 44999 75949 203588 367318 329623 1021477 0 0 37855591 44379931 50544367 53779673 57301053 243860615 0.99581 0.99680 0.00419 0.00320 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false true 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. 1108290 37410 43366 9069 1093265 1068897 89456 41350 8713 1108290 1027362 93891 43421 8935 1068897 944576 137303 46380 8137 1027362 998294 11490 -11221 46524 7463 944576 1.00000 true false 4533750 4533750 19875604 10168314 9707290 1032789 781403 251386 7058483 4818208 2240275 1540139 1540139 18272840 0 EST DUE TO THIRD PARTIES 1885900 1885900 57287651 -479994 167008 794842 481856 56805795 1249183 1249183 58054978 53302706 167008 60195 227203 53075503 101209 101209 53176712 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, 2020 AND 2019, 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 $43,366 AND $41,350 FOR THE YEARS ENDED JUNE 30, 2020 AND 2019, RESPECTIVELY, WHICH ARE INCLUDED IN CONTRIBUTION REVENUE ON THE STATEMENT OF OPERATIONS. AT JUNE 30, 2020 AND 2019, THE BALANCES OF THE ENDOWMENT FUND WERE $1,093,265 AND $1,108,290, 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: $ 896,051 NET ASSETS RELEASED FROM RESTRICTION (101,209) BAD DEBT EXPENSE ------------ $ 794,842 SCHEDULE D, PART XI, LINE 4B OTHER REVENUE ON FORM 990, PART VIII, LINE 12, BUT NOT ON LINE 1: $ 1,165,374 TEMPORARILY RESTRICTED CONTRIBUTIONS 144,004 CONTRIBUTIONS FOR PROPERTY, PLANT & EQUIPMENT (47,043) SPECIAL EVENT EXPENSES (13,152) LOSS ON DISPOSAL OF ASSETS ------------ $ 1,249,183 SCHEDULE D, PART XII, LINE 2D OTHER EXPENSES ON LINE 1, BUT NOT ON FORM 990, PART IX, LINE 25: $ 47,043 SPECIAL EVENT EXPENSES 13,152 LOSS ON DISPOSAL OF ASSETS ----------- $ 60,195 SCHEDULE D, PART XII, LINE 4B OTHER EXPENSES ON FORM 990, PART IX, LINE 25, BUT NOT ON LINE 1: $ 101,209 BAD DEBT EXPENSE JUDITH SNEAD GRANT WRITI false SUMMER SOLSTICE 191000 178175 12825 750 4842 7500 33951 0 191000 178175 12825 750 4842 7500 33951 47043 -34218 X X false false false false false false false false false DAVID KLINETOBE CHIEF FINANCIAL OFFICER 258613 0 0 0 0 0 7787 0 6440 0 272840 0 0 0 MITESH POPAT CEO 377003 0 0 0 0 0 7188 0 20095 0 404286 0 0 0 ELIZABETH SHAW MEDICAL DIRECTOR 213834 0 0 0 0 0 5783 0 10462 0 230079 0 0 0 XAVIER PEREZ MEDICAL DIRECTOR 244970 0 0 0 0 0 7341 0 268 0 252579 0 0 0 MAI MAGLIOCCO LEAD PHYSICIAN ADULT MED 194068 0 0 0 0 0 6116 0 19413 0 219597 0 0 0 MELANIE ROSE THOMPSON REGIONAL MEDICAL DIRECTOR 216821 0 0 0 0 0 6536 0 8635 0 231992 0 0 0 CARINA F GONZALEZ ADULT PHYSICIAN 199487 0 0 0 0 0 1436 0 16166 0 217089 0 0 0 JENNIFER BYER LEAD PHYSICIAN 186441 0 0 0 0 0 967 0 6108 0 193516 0 0 0 CONSTANZA KADERA CHIEF DENTAL OFFICER 221257 0 0 0 0 0 6713 0 16187 0 244157 0 0 0 LEAH CANVASSER CHIEF INFORMATION OFFICER 201526 0 0 0 0 0 5035 0 808 0 207369 0 0 0 JOSE CHIBRAS-SAINZ CHIEF MEDICAL OFFICER 271947 0 0 0 0 0 8185 0 6548 0 286680 0 0 0 X 3 129683 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.