2020-06-04T22:21:40-05:00 2019-06-30 910189318 MOSS ADAMS LLP 101 SECOND STREET SUITE 900 SAN FRANCISCO CA 94105 990 2018-07-01 237221695 OLE HEALTH OLEH 7072541770 1141 PEAR TREE LANE NO 100 NAPA CA 94558 ROSE MACISAAC CFO 7072541770 2020-06-02 1 MICHAEL LUMSDEN P01262236 4159561500 2020-06-02 76.14.38.113 2020-06-02 14:12:52 PD P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 00C4359F54289D19625D58AABAD73364CEA05A5F 2018 2021-01-29 14:40:06Z X ALICIA HARDY 1141 PEAR TREE LANE NO 100 NAPA CA 94558 29810477 0 X WWW.OLEHEALTH.ORG X 1972 CA OLE HEALTH IS THE MEDICAL HOME FOR THE COMMUNITY'S UNDERSERVED PATIENTS. 13 13 272 15 0 0 6182508 4783286 24171160 24595817 392292 420791 67528 10583 30813488 29810477 0 0 0 0 20910808 19960485 0 0 295617 6576230 7858557 27487038 27819042 3326450 1991435 36877895 38677755 6021635 5695894 30856260 32981861 OLE HEALTH IS DEDICATED TO PROVIDING HIGH-QUALITY PRIMARY HEALTH CARE TO OUR ENTIRE COMMUNITY. 0 0 16693361 0 20601613 OLE HEALTH IS A FEDERALLY QUALIFIED HEALTH CENTER (FQHC) AND THE ONLY NOT-FOR-PROFIT HEALTH CENTER IN NAPA COUNTY. THE HEALTH CENTER PROVIDES AFFORDABLE MEDICAL, PERINATAL, AND NUTRITION CARE TO APPROXIMATELY 30,000 PATIENTS PER YEAR. 3048062 0 3362868 THE DENTAL SERVICES PROGRAM AT OLE HEALTH PROVIDES AFFORDABLE DENTAL CARE TO APPROXIMATELY 6,000 PATIENTS PER YEAR. 844821 0 631336 THE MENTAL HEALTH PROGRAM AT OLE HEALTH PROVIDES AFFORDABLE MENTAL HEALTH CARE TO APPROXIMATELY 2,600 PATIENTS PER YEAR. 20586244 1 1 0 0 0 0 0 1 0 0 1 0 0 1 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 37 0 1 272 1 0 0 0 0 0 0 0 0 0 0 0 0 X 13 13 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X ROSE MACISAAC 7072665739 1141 PEAR TREE LANE SUITE 100 NAPA CA 94558 RICHARD JONES CHAIR 1.00 2.00 X X 0 0 0 MAIRA AYALA VICE CHAIR 1.00 1.00 X X 0 0 0 PETE RICHMOND SECRETARY THROUGH 5/2019 / DIRECTOR 1.00 0.00 X X 0 0 0 ANTHONY ZAND SECRETARY EFFECTIVE 6/2019 1.00 0.00 X X 0 0 0 PATRICIA MCFARLAND TREASURER 1.00 0.00 X X 0 0 0 LYNN ARTHUR BOARD MEMBER THROUGH 5/2019 1.00 0.00 X 0 0 0 JOE CARRILLO MD BOARD MEMBER 1.00 0.00 X 0 0 0 KEVIN FITZPATRICK BOARD MEMBER THROUGH 8/2018 1.00 0.00 X 0 0 0 TERESA FOSTER BOARD MEMBER 1.00 0.00 X 0 0 0 ROSE HARI BOARD MEMBER 1.00 0.00 X 0 0 0 MADELINE HERNANDEZ BOARD MEMBER 1.00 0.00 X 0 0 0 BEATRICE LABASTIDA BOARD MEMBER 1.00 0.00 X 0 0 0 JO MOORE BOARD MEMBER 1.00 0.00 X 0 0 0 ARTHUR ROOSA BOARD MEMBER 1.00 0.00 X 0 0 0 DAWNIELLE THORNBURGH BOARD MEMBER 1.00 0.00 X 0 0 0 ALICIA HARDY CHIEF EXECUTIVE OFFICER 38.00 2.00 X 279959 0 23478 BILL DEANE CFO THROUGH 6/2019 31.00 9.00 X 69108 0 7116 DAVID GORCHOFF MD CHIEF MEDICAL OFFICER 40.00 0.00 X 240711 0 6793 VINCE FILANOVA DDS CHIEF DENTAL OFFICER 40.00 0.00 X 224151 0 16728 ANDREW TORGE CHIEF HUMAN RESOURCES OFFICER 40.00 0.00 X 164836 0 14260 GARY FEDLER CHIEF INFORMATION OFFICER 40.00 0.00 X 181894 0 22880 GABRIELA BERMUDEZ MD MEDICAL DIRECTOR, UPVALLEY 40.00 0.00 X 236999 0 33036 JENNIFER ANN WILSON MD FAMILY PHYSICIAN 40.00 0.00 X 217675 0 20567 TESSA WYBORNY MD PEDIATRICIAN 40.00 0.00 X 187850 0 16089 ALLISON CRISP DO MEDICAL DIRECTOR, PEDIATRIC SERVICES 40.00 0.00 X 187280 0 10757 SANA JIVRAJ MD FAMILY PHYSICIAN 40.00 0.00 X 181837 0 10699 2172300 0 182403 36 0 1 0 RESOURCE DESIGN INTERIORS 747 FRONT STREET SUITE 100 SAN FRANCISCO CA 94111 INTERIOR DESIGN 201863 E CLINICAL WORKS LLC TWO TECHNOLOGY DRIVE WESTBOROUGH MA 01581 SOFTWARE MAINTENANCE AND SUPPORT 171652 WIPFLI LLP 680 WEST SHAW AVENUE FRESNO CA 93704 ACCOUNTING CONSULTANT 133034 TPX COMMUNICATIONS 515 S FLOWER STREET 45TH FLOOR LOS ANGELES CA 90071 COMMUNICATIONS/IT/CONNECTIVITY SERVICES 115879 HARVEY KATZMAN 12317 MELANIE COURT NEVADA CITY CA 95959 CONTRACTED SERVICES 113821 5 3435120 1348166 4783286 NET PATIENT SERV REV 621400 15869822 15869822 340B COMPLIANCE REBATES 621400 3818100 3818100 CAPITATION REVENUE 621400 3220642 3220642 PHC PROVIDER INCENTIVES 621400 1687253 1687253 24595817 413870 413870 6921 0 6921 6921 6921 OTHER REVENUE 900099 10583 10583 10583 29810477 24595817 0 431374 1358625 488384 870241 14657124 11192520 3269986 194618 502801 397792 96625 8384 2314287 1776354 489056 48877 1127648 864835 243647 19166 75131 75131 168791 9375 159416 825440 635243 190197 134178 51944 82192 42 396187 244454 142954 8779 184281 67655 113944 2682 1297402 1060618 225994 10790 40226 27378 12567 281 69492 24927 43903 662 49422 49422 696596 573783 122813 111660 73241 37083 1336 MEDICAL/PHARM SUPPLIES 2453256 2453256 REPAIRS AND MAINTENANCE 401308 51768 349540 ARTWORK 245238 245238 EQUIPMENT LEASING 118562 78717 39845 591387 219340 372047 27819042 20586244 6937181 295617 6037235 3430185 2280816 424646 670265 1450469 1525082 0 50000 14330990 14330990 46678 46678 370211 672974 7976450 5893918 2769648 2082532 8020474 9895935 1528278 1671588 1899266 2020710 36877895 38677755 5430761 4713673 21041 613781 569833 368440 6021635 5695894 X 26021609 31673463 4834651 1308398 30856260 32981861 36877895 38677755 1991435 134166 0 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 X 0 4269517 3107696 1161821 2850675 2344585 506090 856258 441637 414621 2082532 DUE FROM RELATED ORGANIZATIONS 24547 QUALITY IMPROVEMENT PROGRAM RECEIVABLE 750000 DEPOSITS 15155 340B PROGRAM RECEIVABLE 455713 AMOUNTS DUE FROM THIRD-PARTY PAYORS 527969 OTHER ASSETS 247326 2020710 X PART III, LINE 4: DURING THE 6/30/2019 FISCAL YEAR, OLE HEALTH ACQUIRED A PUBLIC ART SCULPTURE FOR THE SOUTH NAPA CAMPUS LOCATION. PART X, LINE 2: THE ORGANIZATION IS A NONPROFIT CORPORATION UNDER INTERNAL REVENUE CODE SECTION 501(C)(3) AND HAS BEEN GRANTED TAX-EXEMPT STATUS BY THE INTERNAL REVENUE SERVICE AND THE CALIFORNIA REVENUE AND TAXATION CODE. AS OF JUNE 30, 2019 AND 2018, THE ORGANIZATION HAD NO UNRECOGNIZED TAX POSITIONS OR UNCERTAIN TAX POSITIONS REQUIRING ACCRUAL. THEREFORE, NO PROVISION FOR INCOME TAXES HAS BEEN PROVIDED IN THE CONSOLIDATED FINANCIAL STATEMENTS. X 1 1 X X 0 0 0 0 0 0 0 0 0 ALICIA HARDY CHIEF EXECUTIVE OFFICER 271888 0 7500 0 571 0 10319 0 13159 0 303437 0 0 0 DAVID GORCHOFF MD CHIEF MEDICAL OFFICER 194903 0 10101 0 35707 0 5948 0 845 0 247504 0 0 0 VINCE FILANOVA DDS CHIEF DENTAL OFFICER 218855 0 102 0 5194 0 8142 0 8586 0 240879 0 0 0 ANDREW TORGE CHIEF HUMAN RESOURCES OFFICER 153557 0 3703 0 7576 0 6842 0 7418 0 179096 0 0 0 GARY FEDLER CHIEF INFORMATION OFFICER 139534 0 12101 0 30259 0 6312 0 16568 0 204774 0 0 0 GABRIELA BERMUDEZ MD MEDICAL DIRECTOR, UPVALLEY 233055 0 443 0 3501 0 9829 0 23207 0 270035 0 0 0 JENNIFER ANN WILSON MD FAMILY PHYSICIAN 209061 0 372 0 8242 0 6291 0 14276 0 238242 0 0 0 TESSA WYBORNY MD PEDIATRICIAN 184448 0 363 0 3039 0 7503 0 8586 0 203939 0 0 0 ALLISON CRISP DO MEDICAL DIRECTOR, PEDIATRIC SERVICES 184364 0 352 0 2564 0 7535 0 3222 0 198037 0 0 0 SANA JIVRAJ MD FAMILY PHYSICIAN 176087 0 1779 0 3971 0 2113 0 8586 0 192536 0 0 0 PART I, LINE 1A VINCE FILANOVA, CHIEF DENTAL OFFICER, RECEIVED A TAXABLE HOUSING ALLOWANCE DURING THE 2018 CALENDAR WHICH WAS INCLUDED IN HIS 2018 FORM W-2. GABRIELA BERMUDEZ MD TOP FIVE HIGHEST COMPENSATED EMPLOYEE EMPLOYEE RETENTION X 50000 50000 0 0 1 50000 FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION CONTRACTED WITH BILL DEANE, AN INDEPENDENT CONSULTANT EMPLOYED WITH WIPFLI, LLP, TO FULFILL THE ROLE OF INTERIM CFO UNTIL AUGUST 2018, WHEN THE INTERIM TITLE WAS REMOVED AND HE WAS ELEVATED TO A FULL-TIME EMPLOYEE. PAYMENTS MADE TO WIPFLI, LLP IN EXCHANGE FOR THESE SERVICES TOTALED $112,655 FOR THE 2018 CALENDAR YEAR AND $32,270 FOR THE 6/30/2019 FISCAL YEAR. FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION UTILIZED A PROFESSIONAL ACCOUNTING FIRM TO PREPARE THE FORM 990, WHO WORKED IN CONJUNCTION WITH THE ORGANIZATION'S FINANCE AND ACCOUNTING TEAM TO GATHER THE REQUIRED INFORMATION. UPON REVIEW OF THE FORM 990 AMONGST THE ORGANIZATION'S MANAGEMENT TEAM, THE FORM 990 WAS THEN SENT TO THE AUDIT & BENEFITS COMMITTEE OF THE BOARD OF DIRECTORS FOR REVIEW AND APPROVAL. THE AUDIT COMMITTEE ALSO PRESENTS THE RESULTS OF ITS REVIEW PROCESS TO THE BOARD OF DIRECTORS, WHO RECEIVES A COPY OF THE FORM PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C ALL EMPLOYEES AND BOARD MEMBERS MUST COMPLETE AND SIGN A CONFLICT OF INTEREST DISCLOSURE STATEMENT ANNUALLY. IT IS ALSO THE CONTINUING RESPONSIBILITY OF THE BOARD, OFFICERS, AND MANAGEMENT EMPLOYEES TO SCRUTINIZE THEIR TRANSACTIONS, OUTSIDE BUSINESS INTERESTS, AND RELATIONSHIPS FOR POTENTIAL CONFLICTS AND TO IMMEDIATELY MAKE SUCH DISCLOSURES. TRANSACTIONS WITH PARTIES WITH WHOM A CONFLICTING INTEREST EXISTS MAY BE UNDERTAKEN ONLY IF ALL OF THE FOLLOWING ARE OBSERVED: (1) THE CONFLICTING INTEREST IS FULLY DISCLOSED; (2) THE PERSON WITH THE CONFLICT OF INTEREST IS EXCLUDED FROM THE DISCUSSION AND APPROVAL OF SUCH TRANSACTION; (3) A COMPETITIVE BID OR COMPARABLE VALUATION EXISTS; AND (4) THE BOARD HAS DETERMINED THAT THE TRANSACTION IS IN THE BEST INTEREST OF THE ORGANIZATION. DISCLOSURE FROM EMPLOYEES OF THE ORGANIZATION SHOULD BE MADE TO THE CHIEF EXECUTIVE OFFICER (OR IF HE/SHE IS THE ONE WITH THE CONFLICT, THEN TO THE BOARD CHAIR); DISCLOSURES INVOLVING DIRECTORS SHOULD BE MADE TO THE BOARD CHAIR (OR IF HE/SHE IS THE ONE WITH THE CONFLICT, THEN TO THE BOARD VICE CHAIR). FORM 990, PART VI, SECTION B, LINE 15 THE CEO AND CFO SALARIES ARE APPROVED BY THE BOARD OF DIRECTORS AFTER PERFORMANCE REVIEWS AND COMPENSATION STUDIES. THE OTHER KEY LEADERSHIP POSITIONS ARE BASED ON A COMPENSATION STUDY DONE BY AN INDEPENDENT FIRM EVERY TWO TO THREE YEARS. IF NECESSARY TO EVALUATE OUTSIDE OF THAT TIME PERIOD, THE HUMAN RESOURCES DEPARTMENT WILL EVALUATE BY SOLICITING EXTERNAL COMPENSATION DATA AND PLACE THE POSITION APPROPRIATELY WITHIN THE ORGANIZATIONAL STRUCTURE. FORM 990, PART VI, SECTION C, LINE 19 THE AUDITED FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY, AND GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST. OLE HEALTH FOUNDATION 1141 PEAR TREE LANE SUITE 100 NAPA CA 94558 680149424 FUNDRAISING CA 501(C)(3) LINE 12A, I OLE HEALTH 1 OLE HEALTH NMTC 1141 PEAR TREE LANE SUITE 100 NAPA CA 94558 815395044 NMTC FINANCING FOR EXEMPT ACTIVITIES CA 501(C)(3) LINE 12A, I OLE HEALTH 1 1 1 0 1 0 0 0 0 0 0 1 1 1 1 1 0 1 0 0 OLE HEALTH FOUNDATION A 10701 BOOK VALUE OLE HEALTH FOUNDATION O 303742 BOOK VALUE OLE HEALTH NMTC B 143310 BOOK VALUE OLE HEALTH NMTC D 29651000 LOAN GUARANTEE AMOUNT OLE HEALTH NMTC K 85718 BOOK VALUE