2021-05-16T12:33:37-05:00 2020-06-30 910189318 MOSS ADAMS LLP 3121 W MARCH LN STE 200 STOCKTON CA 952192367 990 2019-07-01 942492609 NORTHEASTERN RURAL HEALTH CLINICS INC NORT 5302515000 1850 SPRING RIDGE DRIVE SUSANVILLE CA 96130 MICHAEL SCHAUB CEO 5302515000 2021-05-13 1 TRACY S PAGLIA P00366884 2099556100 2021-05-06 2019 2022-09-23 18:48:47Z MICHAEL SCHAUB 1850 SPRING RIDGE DRIVE SUSANVILLE CA 96130 11527380 0 X WWW.NORTHEASTERNHEALTH.ORG X 1977 CA PROVIDE ACCESS TO QUALITY HEALTH CARE SERVICES TO SOCIALLY/ECONOMICALLY DEPRESSED IN LASSEN CTY, CA. 9 9 149 9 0 0 3188692 3452038 10405794 8065075 3624 0 1645 -2739 13599755 11514374 0 0 0 0 8290342 8039183 0 0 0 6079093 5611307 14369435 13650490 -769680 -2136116 5414407 5641880 8283538 10647127 -2869131 -5005247 OUR MISSION IS TO PROVIDE QUALITY, COMPREHENSIVE, PREVENTIVE, AND ACCESSIBLE HEALTH CARE SERVICES, REGARDLESS OF ABILITY TO PAY; AND TO MEET THE CHANGING NEEDS OF OUR COMMUNITIES WITH CREATIVITY AND INNOVATION. 0 0 10474131 0 8065075 PROVIDE QUALITY HEALTH CARE TO RURAL AND LOW INCOME POPULATION REGARDLESS OF ABILITY TO PAY SERVICES INCLUDE PRIMARY CARE, OB, DIAGNOSTIC LAB TESTING, PHARMACY SERVICES, EDUCATION AND BEHAVIORAL HEALTH 49,498 PATIENT VISITS ARE RECORDED FOR FISCAL YEAR ENDED JUNE 30, 2020. 10474131 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 8 0 1 149 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X X LACEY LIVELY 5302515000 1850 SPRING RIDGE DRIVE SUSANVILLE CA 96130 STEVEN BRAATZ PROVIDER 40.00 X 328900 0 21108 KIMBERLY CLINITE PROVIDER 40.00 X 264876 0 29329 RACHEL PETERSON PROVIDER 40.00 X 261156 0 30569 SAMUEL CARLTON PROVIDER 40.00 X 217782 0 29946 MICHAEL SCHAUB CEO 40.00 X 189000 0 15584 NAOMI REA CMO 40.00 X 175309 0 10414 LYNN HUDGENS CEO (THRU 5/31/20) 40.00 X 184500 0 0 LACEY LIVELY CFO 40.00 X 150000 0 10456 MARGE GARROD CHAIRMAN OF BOARD 2.00 X X 0 0 0 EULA JOHNSON VICE CHAIR 2.00 X X 0 0 0 CARROL CURRY SECRETARY 2.00 X X 0 0 0 LINDSEY MARTIN TREASURER 2.00 X X 0 0 0 KATIE ANDERSON BOARD MEMBER 2.00 X 0 0 0 FRANKIE LUALLEN BOARD MEMBER 2.00 X 0 0 0 SANDY RAFFLESON BOARD MEMBER 2.00 X 0 0 0 MARK SOLOMON BOARD MEMBER 2.00 X 0 0 0 ERIKA TOMLINSOM BOARD MEMBER 2.00 X 0 0 0 MIKE O'KELLY TREASURER (THRU 4/24/20) 2.00 X X 0 0 0 SOPHIA WAGES BOARD MEMBER (THRU 4/29/20) 2.00 X 0 0 0 RICHARD ST PETER BOARD MEMBER (THRU 4/24/20) 2.00 X 0 0 0 ROSS STEVENSON SECRETARY (THRU 4/28/20) 2.00 X X 0 0 0 DANIEL KAZAKOS CFO (THRU 7/10/19) 40.00 X 0 0 0 1771523 0 147406 13 0 1 0 NORTH AMERICAN MENTAL HEALTH SERVICES 2165 LAKSPUR LANE REDDING CA 96002 EMPLOYEE HEALTH BENEFITS 528394 BARTON ASSOCIATES INC PO BOX 417844 BOSTON MA 02241 LOCUM TENENS 309269 COMP HEALTH MEDICAL STAFFING PO BOX 972651 DALLAS TX 75397 LOCUM TENENS 255060 NATIONWIDE TRUST COMPANY FSB PO BOX 183046 COLUMBUS OH 43271 RETIREMENT PLAN ADMINISTRATOR 239761 ECLINCIALWORKS LLC PO BOX 847950 BOSTON MA 022847950 ELECTRONIC HEALTH RECORDS SYSTEM 181858 14 2887487 564551 3452038 NET PATIENT SERVICE REVENUE 621400 6403771 6403771 PHARMACY REVENUE 621400 1661304 1661304 8065075 7125 13006 -5881 -5881 -5881 MISCELLANEOUS INCOME 900099 3142 3142 3142 11514374 8065075 0 -2739 X 663813 147398 516415 5909493 4811050 1098443 26273 16425 9848 983693 655602 328091 455911 327166 128745 15000 15000 20870 20870 102290 102290 2366542 2339422 27120 15733 12064 3669 343005 231549 111456 394284 20154 374130 412903 203042 209861 24785 12393 12392 44371 25367 19004 2328 2328 339013 301881 37132 55894 25574 30320 340B PROGRAMS 698403 698403 MEDICAL SUPPLIES & LAB 497030 497030 WIC PROGRAMS 108426 108426 LICENSES AND REGISTRATI 26125 21787 4338 144305 19398 124907 13650490 10474131 3176359 0 1379544 1802025 1116987 1195542 154625 131492 8183459 5751224 2763251 2432235 0 80586 5414407 5641880 1592950 2004608 1984943 3494013 3319463 3196575 3338113 8283538 10647127 X -2936786 -5026110 67655 20863 -2869131 -5005247 5414407 5641880 -2136116 0 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 288555 288555 6396868 4636291 1760577 367719 207737 159982 1130317 907196 223121 2432235 X 11527380 0 11527380 -13006 -13006 11514374 13663496 13006 13006 13650490 0 13650490 PART X, LINE 2: THE CENTER IS A NONPROFIT CORPORATION UNDER SECTION 501(C)(3) AND HAVE BEEN GRANTED TAX-EXEMPT STATUSES BY THE INTERNAL REVENUE SERVICE AND THE CALIFORNIA REVENUE AND TAXATION CODE. AS OF JUNE 30, 2020 AND 2019, THE CENTER HAD NO UNRECOGNIZED TAX POSITIONS OR UNCERTAIN TAX POSITIONS REQUIRING ACCRUAL. THEREFORE, NO PROVISION FOR INCOME TAXES HAS BEEN PROVIDED IN THE FINANCIAL STATEMENTS. PART XI, LINE 4B - OTHER ADJUSTMENTS: RENTAL EXPENSES -13,006. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 13,006. X 0 0 0 0 0 0 0 0 0 STEVEN BRAATZ PROVIDER 245000 0 83900 0 0 0 600 0 20508 0 350008 0 0 0 KIMBERLY CLINITE PROVIDER 230000 0 34876 0 0 0 25 0 29304 0 294205 0 0 0 RACHEL PETERSON PROVIDER 240000 0 21156 0 0 0 0 0 30569 0 291725 0 0 0 SAMUEL CARLTON PROVIDER 215500 0 2282 0 0 0 600 0 29346 0 247728 0 0 0 MICHAEL SCHAUB CEO 189000 0 0 0 0 0 0 0 15584 0 204584 0 0 0 NAOMI REA CMO 146078 0 29231 0 0 0 600 0 9814 0 185723 0 0 0 LYNN HUDGENS CEO (THRU 5/31/20) 184500 0 0 0 0 0 0 0 0 0 184500 0 0 0 LACEY LIVELY CFO 150000 0 0 0 0 0 600 0 9856 0 160456 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B ONCE THE FORMS ARE COMPLETED THE CHIEF FINANCIAL OFFICER WILL PRESENT THE DOCUMENTS TO THE BOARD OF DIRECTORS. THE BOARD WILL THEN ACCEPT THE DOCUMENTS THROUGH A RECORDED VOTE. FORM 990 WILL THEN BE SUBMITTED TO THE IRS. FORM 990, PART VI, SECTION B, LINE 12C DUTY TO DISCLOSE - IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICT OF INTEREST, AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF THE FINANCIAL INTEREST AND BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE BOARD OR EXECUTIVE COMMITTEE. RECUSAL TO SELF - ANY DIRECTOR MAY RECUSE HIM OR HER AT ANY TIME FROM INVOLVEMENT IN ANY DECISION OR DISCUSSION IN WHICH THE DIRECTOR BELIEVES HE OR SHE HAS OR MAY HAVE A CONFLICT OF INTEREST, WITHOUT GOING THROUGH THE PROCESS FOR DETERMINING WHETHER A CONFLICT OF INTEREST EXISTS. DETERMINING WHETHER A CONFLICT OF INTEREST EXISTS - AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, HE/SHE SHALL LEAVE THE BOARD OR EXECUTIVE COMMITTEE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING BOARD OR EXECUTIVE COMMITTEE MEMBERS SHALL DECIDE IF A CONFLICT OF INTEREST EXISTS. ADDRESSING THE CONFLICT OF INTEREST A. AN INTERESTED PERSON MAY MAKE A PRESENTATION AT THE BOARD OR EXECUTIVE COMMITTEE MEETING, BUT AFTER THE PRESENTATION, HE/SHE SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT INVOLVING THE POSSIBLE CONFLICT OF INTEREST. B. THE CHAIRPERSON OF THE BOARD OR EXECUTIVE COMMITTEE SHALL, IF APPROPRIATE, APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT. C. AFTER EXERCISING DUE DILIGENCE, THE BOARD OR EXECUTIVE COMMITTEE SHALL DETERMINE WHETHER NRHC CAN OBTAIN WITH REASONABLE EFFORTS A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. D. IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY POSSIBLE UNDER CIRCUMSTANCES NOT PRODUCING A CONFLICT OF INTEREST, THE BOARD OR EXECUTIVE COMMITTEE SHALL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED DIRECTORS WHETHER THE TRANSACTION OR ARRANGEMENT IS IN NRHC'S BEST INTEREST, FOR ITS OWN BENEFIT, AND WHETHER IT IS FAIR AND REASONABLE. IN CONFORMITY WITH THE ABOVE DETERMINATION, IT SHALL MAKE ITS DECISION AS TO WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION FOR CEO IS DETERMINED BY THE BOARD OF DIRECTORS. THE BOARD USES COMPARISON DATA CATALOGS RELATED TO THE FQHC INDUSTRY. THESE CATALOGS ARE ISSUED ANNUALLY BY MULTIPLE INDUSTRY LEADERS SUCH AS NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS (NATIONAL OVERVIEW), CALIFORNIA PRIMARY CARE ASSOCIATION (STATE OVERVIEW), HEALTH ALLIANCE OF NORTHERN CALIFORNIA, (REGIONAL OVERVIEW). GEOGRAPHICAL LOCATION AND COMPETITIVE LOCAL MARKET RATES ARE ALSO CONSIDERED AS WELL AS RELATED JOB EXPERIENCE OF THE SELECTED PERSON. THIS INFORMATION IS DISCUSSED DURING CLOSED SESSION AT THE BOARD OF DIRECTORS MEETING AND IS VOTED ON. ONCE PASSED IT IS THEN RECORDED IN BOARD MINUTES AND IS MEMORIALIZED IN THE EMPLOYMENT CONTRACT BETWEEN NORTHEASTERN'S BOD AND SELECTED PERSON. THE BOD ANNUALLY REVIEWS AND APPROVES A SALARY SCALE FOR ALL EMPLOYMENT POSITIONS AT THE CLINIC. THE POSITION OF CEO IS ALSO INCLUDED IN THE SCALE. THE SAME DATA CATALOGS LISTED ABOVE ARE USED TO CREATE, ADJUST AND APPROVE THE SALARY SCALE. FORM 990, PART VI, SECTION C, LINE 19 SOME OF THESE ITEMS ARE AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G MEDICAL CONTRACTUAL SERVICES: PROGRAM SERVICE EXPENSES 1,051,845. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,051,845. RECRUITMENT & PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 14,811. MANAGEMENT AND GENERAL EXPENSES 27,120. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 41,931. LOCUM TENANS: PROGRAM SERVICE EXPENSES 1,272,766. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,272,766.