2020-04-25T12:16:01-05:00 2019-06-30 BKD LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2018-07-01 942237120 MARIN COMMUNITY CLINIC % DAVID KLINETOBE MARI 4154481500 9 COMMERCIAL BLVD Suite 100 NOVATO CA 94949 MITESH POPAT CHIEF EXECUTIVE OFFI 2019-11-08 true Krystal K Creach P01248198 4178658701 64.22.227.161 43032920201165000003 2020-04-25 P 74C51B083D6172D3D43AC87F1A33B4712A418457 EADA8263F67F30EEC173F90D1C5FD4FB3EC213FF 2018 2021-01-29 14:40:06Z MARIN COMMUNITY CLINICS MITESH POPAT 9 COMMERCIAL BLVD SUITE 100 NOVATO CA 94949 53950963 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. 16 16 584 50 80760 28048 5434051 5773047 44906728 47720068 103913 384699 -13681 -21497 50431011 53856317 0 0 0 0 32480782 37095072 40381 14125 497682 14147909 14442593 46669072 51551790 3761939 2304527 42408899 45784713 8043966 8814791 34364933 36969922 TO IMPROVE THE HEALTH OF OUR PATIENTS AND COMMUNITY BY PROVIDING HIGH QUALITY, COST-EFFECTIVE, CULTURALLY SENSITIVE, PATIENT-CENTERED HEALTH CARE. false false 31763575 32926847 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. 13079119 12884418 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. 1868445 1908803 BEHAVIORAL HEALTH SERVICES - OFFERED TO CHILDREN, TEENS, AND ADULTS AND INCLUDES PSYCHIATRY AND COUNSELING BY LICENSED CLINICAL SOCIAL WORKERS. 46711139 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 false false false false false false false false false true 65 0 true 584 true true true false false false false false false false false false false false X 16 16 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 JOHN E BOLAND III DDS MSD SECRETARY & IMMEDIATE PAST CHR 3.0 0.0 X X 0 0 0 JERRY OKEN CHAIR 3.0 0.0 X X 0 0 0 DANIEL A SEGEDIN TREASURER 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 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 ELECT 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 BEG 09/2018 1.0 0.0 X 0 0 0 WADE FLORES BOARD MEMBER BEG 08/2018 1.0 0.0 X 0 0 0 JAMES GERAGHTY BOARD MEMBER BEG 02/2019 1.0 0.0 X 0 0 0 NILDES CARDOSO BOARD MEMBER END 08/2018 1.0 0.0 X 0 0 0 DAVID KLINETOBE CHIEF FINANCIAL OFFICER 40.0 0.0 X 237185 0 14200 MITESH POPAT CEO 40.0 0.0 X 331501 0 29562 CONSTANZA KADERA CHIEF DENTAL OFFICER 40.0 0.0 X 208827 0 19415 LEAH CANVASSER CHIEF INFORMATION OFFICER 40.0 0.0 X 194981 0 6135 JOSE CHIBRAS-SAINZ CHIEF MEDICAL OFFICER 40.0 0.0 X 247388 0 14931 BABAK ETTEKAL MEDICAL DIRECTOR 32.0 0.0 X 173523 0 12768 ELIZABETH SHAW MEDICAL DIRECTOR 36.0 0.0 X 204466 0 17714 XAVIER PEREZ MEDICAL DIRECTOR 40.0 0.0 X 234950 0 7180 MAI MAGLIOCCO LEAD PHYSICIAN ADULT MED 40.0 0.0 X 177507 0 26107 MARIA LUZ WEBSTER-LONGIN PHYSICIAN 32.0 0.0 X 207851 0 29574 IRINA V OLMEZOVA ASSOCIATE DENTIST DIRECTOR 40.0 0.0 X 178400 0 22763 2396579 0 200349 67 false true false UC SCHOOL OF OPTOMETRY 230 MINOR HALL UNIVERSITY OF CA BERKELEY CA 94720 PROFESSIONAL SERVICE 362720 MCC BUILDING MAINTENANCE 83 HAMILTON DRIVE STE 104 NOVATO CA 94949 CLEANING AND MAINTEN 355520 PRIMA MEDICAL FOUNDATION 9 COMMERCIAL BLVD STE 200 NOVATO CA 94949 PROFESSIONAL SERVICE 280984 EXPENSE REDUCTION ANALYSTS INC PO BOX 956251 ST LOUIS MO 63195 PROFESSIONAL SERVICE 118044 BKD LLP CPA ADVISORS PO BOX 1190 SPRINGFIELD MO 65801 AUDIT/TAX/COST RPT 115731 7 236250 4527981 1008816 5773047 NET PATIENT SERVICE REVENUE 624100 42009975 42009975 EHR INCENTIVE 624100 195500 195500 OTHER INCOME 624100 142214 61454 80760 CAPITATION REVENUE 624100 3019509 3019509 QUALITY IMPROVEMENT PROGRAM 624100 2352870 2352870 47720068 349168 349168 0 0 18150 18150 0 18150 18150 90530 24673 30326 65857 -30326 35531 35531 0 236250 39647 -39647 -39647 0 0 0 0 0 0 0 53856317 47639308 80760 363202 0 0 0 0 1304125 691677 612448 0 27854738 26327205 1248160 279373 380568 364916 11684 3968 5303628 4947150 305018 51460 2252013 2089648 140726 21639 0 57075 57075 134850 134850 0 14125 14125 0 2733567 2482985 234106 16476 0 1014061 892812 106935 14314 1005396 889706 102032 13658 0 1703793 1579172 115138 9483 92581 81927 9396 1258 0 165481 146439 16794 2248 68119 68119 0 2067689 1422942 644747 149569 134390 15179 BAD DEBT 120936 120936 MEDICAL SUPPLIES & DRUGS 4626828 4094425 469551 62852 LICENSES, DUES, SUBSCRIPTIONS 198385 175557 20133 2695 RECRUITING & RETENTION 304263 269252 30878 4133 51551790 46711139 4342969 497682 1841427 1913927 6813214 10464697 559433 663423 4342973 3785300 0 0 0 0 0 0 472395 360850 776931 880196 33213126 13861278 19833778 19351848 6889492 7418667 0 0 0 0 0 0 879256 945805 42408899 45784713 2655748 3028353 0 0 65500 65500 0 0 0 0 0 0 1822718 1720938 0 0 3500000 4000000 8043966 8814791 X 33957974 36608866 406959 361056 0 0 34364933 36969922 42408899 45784713 2304527 300462 X false true X true true true X 3807704 4931780 5194587 5434051 5773047 25141169 31360014 32878812 39109395 44906728 47639308 195894257 0 0 0 35167718 37810592 44303982 50340779 53412355 221035426 0 0 0 221035426 10812 44999 75949 203588 367318 702666 0 10812 44999 75949 203588 367318 702666 0 0 35178530 37855591 44379931 50544367 53779673 221738092 0.99683 0.99904 0.00317 0.00096 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. 1068897 89456 41350 8713 1108290 1027362 93891 43421 8935 1068897 944576 137303 46380 8137 1027362 998294 11490 -11221 46524 7463 944576 561023 436320 20129 13546 5632 998294 1.00000 true false 4533750 4533750 19831578 9019285 10812293 1027869 620333 407536 6675487 4221660 2453827 1144442 1144442 19351848 0 EST DUE TO THIRD PARTIES 4000000 4000000 54005599 300462 38880 152249 491591 53514008 342309 342309 53856317 51539707 38880 69973 108853 51430854 120936 120936 51551790 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, 2019 AND 2018, THE FOUNDATION'S SPENDING POLICY WAS TO DISTRIBUTE 4.5% AND 4.75% OF THE ROLLING 12 QUARTER AVERAGE OF THE MARKET VALUE OF THE POOLED FUND. THE ORGANIZATION RECEIVED DISTRIBUTIONS OF $41,350 AND $43,421 FOR THE YEARS ENDED JUNE 30, 2019 AND 2018, RESPECTIVELY, WHICH ARE INCLUDED IN THE STATEMENT OF OPERATIONS. AT JUNE 30, 2019 AND 2018, THE BALANCE OF THE ENDOWMENT FUND WAS $1,108,290 AND $1,068,897, 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: $ 273,185 NET ASSETS RELEASED FROM RESTRICTION (120,936) BAD DEBT EXPENSE ------------ $ 152,249 SCHEDULE D, PART XI, LINE 4B OTHER REVENUE ON FORM 990, PART VIII, LINE 12, BUT NOT ON LINE 1: $ 287,282 TEMPORARILY RESTRICTED CONTRIBUTIONS 125,000 CONTRIBUTION FOR PROPERTY, PLANT, & EQUIPMENT (39,647) SPECIAL EVENT EXPENSES (30,326) LOSS ON DISPOSAL OF ASSETS ------------ $ 342,309 SCHEDULE D, PART XII, LINE 2D OTHER EXPENSES ON LINE 1, BUT NOT ON FORM 990, PART IX, LINE 25: $ 39,647 SPECIAL EVENT EXPENSES 30,326 LOSS ON DISPOSAL OF ASSETS ----------- $ 69,973 SCHEDULE D, PART XII, LINE 4B OTHER EXPENSES ON FORM 990, PART IX, LINE 25, BUT NOT ON LINE 1: $ 120,936 BAD DEBT EXPENSE PRG CONSULTING 5340 SOUTH QUEBEC STREET SUITE 250 GREENWOOD VILLAGE CO 80111 LETTER WRITING false 0 0 SUMMER SOLSTICE 236250 236250 4010 2192 33445 0 236250 236250 4010 2192 33445 39647 -39647 X X false false false false false false false false false DAVID KLINETOBE CHIEF FINANCIAL OFFICER 237185 0 0 0 0 0 7142 0 7058 0 251385 0 MITESH POPAT CEO 331501 0 0 0 0 0 6981 0 22581 0 361063 0 BABAK ETTEKAL MEDICAL DIRECTOR 173523 0 0 0 0 0 5546 0 7222 0 186291 0 ELIZABETH SHAW MEDICAL DIRECTOR 204466 0 0 0 0 0 5583 0 12131 0 222180 0 XAVIER PEREZ MEDICAL DIRECTOR 234950 0 0 0 0 0 7044 0 136 0 242130 0 MAI MAGLIOCCO LEAD PHYSICIAN ADULT MED 177507 0 0 0 0 0 5590 0 20517 0 203614 0 MARIA LUZ WEBSTER-LONGIN PHYSICIAN 207851 0 0 0 0 0 4137 0 25437 0 237425 0 IRINA V OLMEZOVA ASSOCIATE DENTIST DIRECTOR 178400 0 0 0 0 0 5720 0 17043 0 201163 0 CONSTANZA KADERA CHIEF DENTAL OFFICER 208827 0 0 0 0 0 6145 0 13270 0 228242 0 LEAH CANVASSER CHIEF INFORMATION OFFICER 194981 0 0 0 0 0 4696 0 1439 0 201116 0 JOSE CHIBRAS-SAINZ CHIEF MEDICAL OFFICER 247388 0 0 0 0 0 7457 0 7474 0 262319 0 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 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.