SHASTA COMMUNITY HEALTH CENTER: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- SHASTA COMMUNITY HEALTH CENTER (EIN 68-0165855)
- Tax period
- 2019-01-01 to 2019-12-31
- Filed
- 2020-09-04
- IRS object ID
- 202012489349300316
- Schema version
- 2019v5.1
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule J
- Schedule L
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2020-09-04T12:28:22-05:00 | ReturnTs |
| Tax Period End | 2019-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BKD LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 910 E ST LOUIS 200/PO BOX 1190 | AddressLine1Txt |
| City | SPRINGFIELD | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 658062523 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2019-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 680165855 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SHASTA COMMUNITY HEALTH CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % SHERRY CALDWELL CFO | InCareOfNm |
| Business Name Control | SHAS | BusinessNameControlTxt |
| Phone | 5302465710 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1035 PLACER STREET | AddressLine1Txt |
| City | REDDING | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 96001 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SHERRY CALDWELL | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 5302465710 | PhoneNum |
| Signature | 2020-08-07 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Krystal K Creach | PreparerPersonNm |
| PTIN | P01248198 | PTIN |
| Phone | 4178658701 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 167.68.126.162 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Federal Original Submission Id | 43032920202485000448 | FederalOriginalSubmissionId |
| Federal Original Submission Id | 2020-09-04 | FederalOriginalSubmissionIdDt |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 924B2A98979A186BB7133534B94B929F6E7F7EF2 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 9ED1AFD43ECA266599EA2022F4AABFE45DA09571 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2020-11-19 02:30:22Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | C DEAN GERMANO CEO | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1035 PLACER STREET | AddressLine1Txt |
| City | REDDING | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 96001 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $54,629,858 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.SHASTAHEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1988 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | CREATE A SEAMLESS SYSTEM OF ACCESS TO COMPASSIONATE, HIGH QUALITY, COST-EFFECTIVE PRIMARY AND PREVENTIVE HEALTH CARE FOR ALL RESIDENTS OF THE COMMUNITY IT SERVES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 14 | VotingMembersIndependentCnt |
| Total Employee | 559 | TotalEmployeeCnt |
| Total Volunteers | 20 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $9,808,323 | PYContributionsGrantsAmt |
| CY Contributions Grants | $10,368,544 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $42,687,088 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $43,969,737 | CYProgramServiceRevenueAmt |
| PY Investment Income | $264,524 | PYInvestmentIncomeAmt |
| CY Investment Income | $205,917 | CYInvestmentIncomeAmt |
| PY Other Revenue | $31,861 | PYOtherRevenueAmt |
| CY Other Revenue | $32,979 | CYOtherRevenueAmt |
| PY Total Revenue | $52,791,796 | PYTotalRevenueAmt |
| CY Total Revenue | $54,577,177 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $33,836,172 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $38,047,894 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $250,792 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $10,864,957 | PYOtherExpensesAmt |
| CY Other Expenses | $12,553,820 | CYOtherExpensesAmt |
| PY Total Expenses | $44,701,129 | PYTotalExpensesAmt |
| CY Total Expenses | $50,601,714 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $8,090,667 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $3,975,463 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $58,752,091 | TotalAssetsBOYAmt |
| Total Assets EOY | $62,357,680 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $10,465,562 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $9,664,048 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $48,286,529 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $52,693,632 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | CREATE A SEAMLESS SYSTEM OF ACCESS TO COMPASSIONATE, HIGH QUALITY, COST-EFFECTIVE PRIMARY AND PREVENTIVE HEALTH AND DENTAL CARE FOR ALL RESIDENTS OF THE COMMUNITY IT SERVES, PARTICULARLY FOR THOSE RESIDENTS WHO ARE ECONOMICALLY OR OTHERWISE DISADVANTAGED. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $29,907,193 | ExpenseAmt |
| Revenue | $36,482,596 | RevenueAmt |
| Desc | SHASTA COMMUNITY HEALTH CENTER (SCHC) IS A KEY PROVIDER OF THE HEALTH CARE SAFETY NET SERVICES IN NORTHERN CALIFORNIA, PROVIDING MEDICAL, MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES TO 30,497 PATIENTS (106,389 VISITS) IN 2019. SCHC ALSO HAS AN EXTENSIVE OUTREACH TO THE HOMELESS PROGRAM, SERVICES FOR HIV PATIENTS AND IS ONE OF THE FEW MEDICAL RESOURCES FOR THE LOW INCOME POPULATIONS, ESPECIALLY THOSE WITH INCOME BELOW 200% OF THE FEDERAL POVERTY GUIDELINE AND THE UNINSURED. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $3,944,934 | ExpenseAmt |
| Revenue | $5,604,665 | RevenueAmt |
| Desc | SHASTA COMMUNITY HEALTH CENTERS DENTISTS PROVIDE DENTAL SERVICES TO THE LOW INCOME POPULATIONS: THOSE WITH INCOME BELOW 200% OF THE FEDERAL POVERTY GUIDELINE, THE HOMELESS POPULATION, AND THE UNINSURED. DURING 2019, SCHCS DENTISTS SERVED 7,572 PATIENTS (20,702 VISITS). | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $3,320,505 | ExpenseAmt |
| Revenue | $1,882,486 | RevenueAmt |
| Desc | SHASTA COMMUNITY HEALTH CENTER IS A MAJOR PROVIDER OF MENTAL HEALTH SERVICES IN SHASTA COUNTY, SEEING 1,885 (12,592 VISITS) PATIENTS DURING 2019. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $517,646 | TotalOtherProgSrvcExpenseAmt |
| Total Program Service Expenses | $37,690,278 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | Yes (true) | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | Yes (true) | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (true) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 93 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 559 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 14 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | CA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | SHERRY CALDWELL CFO | PersonNm |
| Phone | 5302465763 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1035 PLACER STREET | AddressLine1Txt |
| City | REDDING | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 96001 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (40 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|---|---|
| C DEAN GERMANO | |||||||||
| CHIEF EXECUTIVE OFFICER | 40.0 | 0.5 | Yes (X) | $386,994 | $0 | $61,234 | |||
| JEFFREY BOSWORTH MD | |||||||||
| CHIEF MEDICAL OFFICER | 40.0 | 0.0 | Yes (X) | $365,732 | $0 | $30,084 | |||
| PAMELA KNICKERBOCKER | |||||||||
| MEDICAL DIRECTOR - FELLOWSHIP | 40.0 | 0.0 | $333,757 | $0 | $43,007 | Yes (X) | |||
| NATALIE NELSON MD | |||||||||
| PHYSICIAN | 40.0 | 0.0 | $298,120 | $0 | $28,611 | Yes (X) | |||
| SEAN DUGAN MD | |||||||||
| PHYSICIAN | 40.31 | 0.0 | $278,359 | $0 | $38,894 | Yes (X) | |||
| KELLY CARTER MD | |||||||||
| PEDIATRICIAN | 36.0 | 0.0 | $267,143 | $0 | $45,567 | Yes (X) | |||
| DEBBIE LUPEIKA MD | |||||||||
| DIRECTOR OF RESIDENCY PROGRAM | 40.0 | 0.0 | $268,870 | $0 | $38,961 | Yes (X) | |||
| JOE VILLALOBOS MD | |||||||||
| PHYSICIAN | 45.7 | 0.0 | $259,745 | $0 | $42,452 | Yes (X) | |||
| IMRAN KHAN MD | |||||||||
| MEDICAL DIRECTOR OF PCN | 33.92 | 0.0 | $258,183 | $0 | $38,544 | Yes (X) | |||
| DOUGLAS MCMULLIN MD | |||||||||
| ASST MED DIRECTOR - RESIDENCY | 36.62 | 0.0 | $261,198 | $0 | $17,382 | Yes (X) | |||
| ELAINE LARAWAY MD | |||||||||
| MEDICAL DIRECTOR - SHASTA LAKE | 32.0 | 0.0 | $232,284 | $0 | $40,278 | Yes (X) | |||
| RHETT GROVER DO | |||||||||
| MED DIRECTOR - URGENT CARE | 32.0 | 0.0 | $226,444 | $0 | $45,260 | Yes (X) | |||
| JILL MCCLEAN | |||||||||
| PHYSICIAN | 41.86 | 0.0 | $236,866 | $0 | $33,636 | Yes (X) | |||
| DEEPIKA SAINI MD | |||||||||
| MEDICAL DIRECTOR OF PEDIATRICS | 32.0 | 0.0 | $231,766 | $0 | $36,809 | Yes (X) | |||
| PAUL DAVAINIS MD | |||||||||
| MED DIRECTOR - ANDERSON | 42.0 | 0.0 | $222,941 | $0 | $36,751 | Yes (X) | |||
| MELISSA TASISTA DO | |||||||||
| MED DIRECTOR - FAMILY PRACTICE | 36.92 | 0.0 | $220,249 | $0 | $38,317 | Yes (X) | |||
| SHERRY CALDWELL | |||||||||
| CHIEF FINANCIAL OFFICER | 40.0 | 0.5 | Yes (X) | $224,893 | $0 | $15,768 | |||
| FRANKLIN PIERCE DDS | |||||||||
| DENTAL DIRECTOR | 38.76 | 0.0 | $192,180 | $0 | $33,063 | Yes (X) | |||
| J BRANDON THORNOCK | |||||||||
| CHIEF OPERATIONS OFFICER | 40.0 | 0.0 | Yes (X) | $186,295 | $0 | $35,375 | |||
| CHARLES KITZMAN | |||||||||
| CHIEF INFORMATION OFFICER | 40.0 | 0.5 | Yes (X) | $187,353 | $0 | $24,446 | |||
| DOROTHY BRATTON-SANDOV | |||||||||
| PROGRAM DIRECTOR OF FELLOWSHIP | 40.0 | 0.0 | $174,887 | $0 | $30,769 | Yes (X) | |||
| HAROLD CARLSON | |||||||||
| CHIEF OF PLANNING & DEVELOPMEN | 40.0 | 0.0 | Yes (X) | $186,727 | $0 | $18,663 | |||
| ANA NAVARRO | |||||||||
| CHIEF COMPLIANCE OFFICER | 40.0 | 0.5 | Yes (X) | $156,860 | $0 | $27,987 | |||
| KERRY FASKING | |||||||||
| CHAIRPERSON | 3.0 | 0.5 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| JOHN KENNY | |||||||||
| VICE CHAIRPERSON | 3.0 | 0.5 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| WENDY LONGWELL | |||||||||
| TREASURER | 3.0 | 0.5 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| ESTEFANIE SHAFER | |||||||||
| SECRETARY | 3.0 | 0.5 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| MARGARET BECK CLU | |||||||||
| COMMUNITY MEMBER | 3.0 | 0.5 | $0 | $0 | $0 | Yes (X) | |||
| AMPARO BUCK | |||||||||
| COMMUNITY MEMBER | 3.0 | 0.5 | $0 | $0 | $0 | Yes (X) | |||
| MARK ELIASON BSN RN | |||||||||
| COMMUNITY AND PROVIDER MEMBER | 3.0 | 0.5 | $0 | $0 | $0 | Yes (X) | |||
| DAWN FOWLER | |||||||||
| COMM AND PROVIDE MBR BEG 12/19 | 3.0 | 0.5 | $0 | $0 | $0 | Yes (X) | |||
| RAY HAMBY | |||||||||
| CONSUMER MEMBER | 3.0 | 0.5 | $0 | $0 | $0 | Yes (X) | |||
| SANDRA HARP | |||||||||
| CONSUMER MEMBER | 3.0 | 0.5 | $0 | $0 | $0 | Yes (X) | |||
| DENNIS HARRISON | |||||||||
| CONSUMER MEMBER BEG 12/19 | 3.0 | 0.5 | $0 | $0 | $0 | Yes (X) | |||
| MIKE MANGAS | |||||||||
| COMMUNITY MEMBER BEG 07/19 | 3.0 | 0.5 | $0 | $0 | $0 | Yes (X) | |||
| DOT VAN CLEAVE | |||||||||
| CONSUMER MEMBER | 3.0 | 0.5 | $0 | $0 | $0 | Yes (X) | |||
| KIM MIRANDA | |||||||||
| COMM AND PROVIDE MBR END 08/19 | 3.0 | 0.5 | $0 | $0 | $0 | Yes (X) | |||
| BRIAN SPILLANE | |||||||||
| CONSUMER MEMBER END 10/19 | 3.0 | 0.5 | $0 | $0 | $0 | Yes (X) | |||
| LEANN OWENS | |||||||||
| CONSUMER MEMBER END 10/19 | 3.0 | 0.5 | $0 | $0 | $0 | Yes (X) | |||
| JOSEPH MELVIN | |||||||||
| CONSUMER MEMBER | 3.0 | 0.5 | $0 | $0 | $0 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $5,657,846 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $801,858 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 62 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| ACCESS NURSE PM | |||||
| 1431 CENTERPOINT BLVD SUITE 110 | KNOXVILLE | TN | 37932 | CALL SERVICE | $106,908 |
| BKD LLP | |||||
| 910 E ST LOUIS ST 200 | SPRINGFIELD | MO | 65806 | AUDIT, TAX SERVICES | $110,730 |
| CAR KENNEDY PETERSON FROST | |||||
| 420 REDCLIFF DRIVE | REDDING | CA | 96002 | ATTORNEY | $102,522 |
| CLINICIANS TELEMED MEDICAL GROUP IN | |||||
| 1801 16TH STREET STE B | BAKERSFIELD | CA | 93301 | TELEHEALTH SERVICE | $288,063 |
| PSYCHIATRIC CTRS AT SAN DIEGO | |||||
| PO BOX 609001 | SAN DIEGO | CA | 92160 | PSYCHIATRIC SERVICES | $187,795 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 7 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $9,460,035 | GovernmentGrantsAmt |
| All Other Contributions | $908,509 | AllOtherContributionsAmt |
| Noncash Contributions | $1,358,793 | NoncashContributionsAmt |
| Total Contributions | $10,368,544 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 621400 | $34,104,019 | $34,104,019 |
| 340B PROGRAM CONTRACTED PHARMACIES | 621400 | $6,877,083 | $6,877,083 |
| QUALITY IMPROVEMENT BONUS (MCO) | 621400 | $2,575,300 | $2,575,300 |
| MEANINGFUL USE | 621400 | $119,000 | $119,000 |
| PRECEPTOR INCOME | 621400 | $116,847 | $116,847 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $177,488 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $177,488 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $43,969,737 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $258,598 | TotalRevenueColumnAmt |
| Exclusion | $258,598 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $32,979 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $32,979 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $32,979 | TotalRevenueColumnAmt |
| Exclusion | $32,979 | ExclusionAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $52,681 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$52,681 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$52,681 | TotalRevenueColumnAmt |
| Exclusion | -$52,681 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $0 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $0 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $0 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $0 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $54,577,177 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $43,969,737 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $238,896 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,930,311 | TotalAmt |
| Program Services | $3,021,900 | ProgramServicesAmt |
| Management And General | $1,703,021 | ManagementAndGeneralAmt |
| Fundraising | $205,390 | FundraisingAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $281,818 | TotalAmt |
| Program Services | $281,818 | ProgramServicesAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,881,264 | TotalAmt |
| Program Services | $20,644,610 | ProgramServicesAmt |
| Management And General | $5,236,654 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $717,512 | TotalAmt |
| Program Services | $601,210 | ProgramServicesAmt |
| Management And General | $116,302 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,130,041 | TotalAmt |
| Program Services | $3,178,343 | ProgramServicesAmt |
| Management And General | $930,408 | ManagementAndGeneralAmt |
| Fundraising | $21,290 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,106,948 | TotalAmt |
| Program Services | $1,643,298 | ProgramServicesAmt |
| Management And General | $448,538 | ManagementAndGeneralAmt |
| Fundraising | $15,112 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $41,964 | TotalAmt |
| Management And General | $41,964 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $114,980 | TotalAmt |
| Management And General | $114,980 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,802 | TotalAmt |
| Program Services | $328 | ProgramServicesAmt |
| Management And General | $10,474 | ManagementAndGeneralAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,569,623 | TotalAmt |
| Program Services | $1,860,223 | ProgramServicesAmt |
| Management And General | $709,400 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $530 | TotalAmt |
| Management And General | $530 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,164,049 | TotalAmt |
| Program Services | $598,473 | ProgramServicesAmt |
| Management And General | $565,576 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,012,827 | TotalAmt |
| Program Services | $219,314 | ProgramServicesAmt |
| Management And General | $793,513 | ManagementAndGeneralAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,756,162 | TotalAmt |
| Program Services | $1,095,754 | ProgramServicesAmt |
| Management And General | $660,408 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $55,964 | TotalAmt |
| Program Services | $43,004 | ProgramServicesAmt |
| Management And General | $12,960 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $511,896 | TotalAmt |
| Program Services | $303,387 | ProgramServicesAmt |
| Management And General | $208,509 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $226,742 | TotalAmt |
| Program Services | $7,899 | ProgramServicesAmt |
| Management And General | $218,843 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $775,051 | TotalAmt |
| Program Services | $497,364 | ProgramServicesAmt |
| Management And General | $268,687 | ManagementAndGeneralAmt |
| Fundraising | $9,000 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $152,011 | TotalAmt |
| Program Services | $87,756 | ProgramServicesAmt |
| Management And General | $64,255 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| DRUGS AND MEDICATIONS | $2,028,636 | $2,025,499 | $3,137 |
| MEDICAL AND DENTAL SUPPLIES | $744,548 | $725,928 | $18,620 |
| BAD DEBTS | $572,001 | $570,303 | $1,698 |
| RECRUITMENT COSTS | $270,691 | $8,828 | $261,863 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $545,343 | TotalAmt |
| Program Services | $275,039 | ProgramServicesAmt |
| Management And General | $270,304 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $50,601,714 | TotalAmt |
| Program Services | $37,690,278 | ProgramServicesAmt |
| Management And General | $12,660,644 | ManagementAndGeneralAmt |
| Fundraising | $250,792 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,076 | BOYAmt |
| EOY | $21,132 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,855,230 | BOYAmt |
| EOY | $12,596,613 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $576,688 | BOYAmt |
| EOY | $648,743 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,728,058 | BOYAmt |
| EOY | $5,841,846 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,698,184 | BOYAmt |
| EOY | $18,756,224 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $226,066 | BOYAmt |
| EOY | $171,828 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $455,419 | BOYAmt |
| EOY | $1,323,244 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $16,402,496 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $7,013,039 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,600,508 | BOYAmt |
| EOY | $9,389,457 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,167,585 | BOYAmt |
| EOY | $10,694,209 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,425,277 | BOYAmt |
| EOY | $2,914,384 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $58,752,091 | BOYAmt |
| EOY | $62,357,680 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,085,349 | BOYAmt |
| EOY | $4,144,918 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,457 | BOYAmt |
| EOY | $24,026 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,067,559 | BOYAmt |
| EOY | $3,934,481 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,297,197 | BOYAmt |
| EOY | $1,560,623 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,465,562 | BOYAmt |
| EOY | $9,664,048 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $48,158,019 | BOYAmt |
| EOY | $52,618,388 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $128,510 | BOYAmt |
| EOY | $75,244 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $48,286,529 | BOYAmt |
| EOY | $52,693,632 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $58,752,091 | BOYAmt |
| EOY | $62,357,680 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $3,975,463 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $431,640 | NetUnrlzdGainsLossesInvstAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $7,952,802 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $8,210,388 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $8,787,916 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $9,808,323 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $10,368,544 | CurrentTaxYearAmt |
| Total | $45,127,973 | TotalAmt |
Tax Rev Levied Orgnztnl Bnft170 TaxRevLeviedOrgnztnlBnft170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $7,952,802 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $8,210,388 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $8,787,916 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $9,808,323 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $10,368,544 | CurrentTaxYearAmt |
| Total | $45,127,973 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $0 | SubstantialContributorsTotAmt |
| Public Support Total170 | $45,127,973 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $199,551 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $234,113 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $271,144 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $300,227 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $291,577 | CurrentTaxYearAmt |
| Total | $1,296,612 | TotalAmt |
Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $46,424,585 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $187,442,565 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.97207 | PublicSupportCY170Pct |
| Public Support PY170 | 0.97200 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbyingGrp | |
| Total Direct Lobbying | TotalDirectLobbyingGrp | |
| Total Lobbying Expend | TotalLobbyingExpendGrp | |
| Other Exempt Purpose Expend | OtherExemptPurposeExpendGrp | |
| Total Exempt Purpose Expend | TotalExemptPurposeExpendGrp | |
| Lobbying Nontaxable Amount | LobbyingNontaxableAmountGrp | |
| Grassroots Nontaxable | GrassrootsNontaxableGrp | |
| Tot Lbbyng Grassroot Mns Non Tx | TotLbbyngGrassrootMnsNonTxGrp | |
| Tot Lbby Expend Mns Lbbyng Non Tx | TotLbbyExpendMnsLbbyngNonTxGrp | |
| Volunteers | Yes (true) | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | Yes (true) | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | Yes (true) | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $10,802 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $10,802 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE C, PART II-B, LINES 1A, D, G & I | FormAndLineReferenceDesc |
| Explanation | LOBBYING EXPENSES: SHASTA COMMUNITY HEALTH CENTER (SCHC) PAYS DUES TO THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS (NACHC) AND TO THE CALIFORNIA PRIMARY CARE ASSOCIATION (CPCA). OF THESE DUES, A SMALL PORTION IS USED FOR LOBBYING PURPOSES FOR A TOTAL OF $10,802. AS PERTINENT MATTERS ARISE, SCHCS PROFESSIONAL ASSOCIATIONS ADVISE IT OF OPPORTUNITIES TO CONTACT APPROPRIATE OFFICIALS OF THE STATE, LOCAL AND FEDERAL GOVERNMENTS TO EMPHASIZE THE NEEDS OF THE UNINSURED AND UNDERSERVED IN SCHCS COMMUNITIES AND THEIR CONSTITUENTS. BOTH EMPLOYEES AND BOARD MEMBERS ARE INVOLVED IN THESE ACTIVITIES THROUGH THE USE OF E-MAIL, PHONE CALLS AND FAX. SCHC SENDS A FEW EMPLOYEES AND BOARD MEMBERS TO "A DAY AT THE CAPITAL" IN SACRAMENTO, CA, WHERE THEY MEET WITH REPRESENTATIVES AND SENATORS TO DISCUSS CURRENT HEALTH RELATED POLICIES AND LEGISLATURE AND ATTEMPT TO INFLUENCE REFORM. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,031,432 | OtherCostOrOtherBasisAmt |
| Book Value | $4,031,432 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,644,594 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,836,242 | DepreciationAmt |
| Book Value | $2,808,352 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $762,688 | OtherCostOrOtherBasisAmt |
| Depreciation | $539,683 | DepreciationAmt |
| Book Value | $223,005 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,096,514 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,340,600 | DepreciationAmt |
| Book Value | $1,755,914 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,867,268 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,296,514 | DepreciationAmt |
| Book Value | $570,754 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $9,389,457 | TotalBookValueLandBuildingsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)
| DescDesc | AmtAmt |
|---|---|
| ESTIMATED SELF-INSURANCE | $750,000 |
| EST MEDI-CAL SETTLEMENT | $643,634 |
| DEFERRED COMPENSATION | $147,560 |
| CAPITAL LEASES | $19,429 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,560,623 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $54,786,562 | TotalRevEtcAuditedFinclStmtAmt |
| Donated Services And Use Fclts | $156,704 | DonatedServicesAndUseFcltsAmt |
| Revenue Not Reported | $156,704 | RevenueNotReportedAmt |
| Revenue Subtotal | $54,629,858 | RevenueSubtotalAmt |
| Other Revenues Not Included | -$52,681 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | -$52,681 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $54,577,177 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $50,379,459 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $156,704 | DonatedServicesUseFcltsAmt |
| Other Expenses Included | -$378,959 | OtherExpensesIncludedAmt |
| Expenses Not Reported | -$222,255 | ExpensesNotReportedAmt |
| Expenses Subtotal | $50,601,714 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $50,601,714 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| 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 4B | AMOUNTS INCLUDED ON FORM 990, PART VIII, LINE 12, BUT NOT ON LINE 1: $ ( 52,681) LOSS ON DISPOSAL OF PROPERTY |
| SCHEDULE D, PART XII, LINE 2D | AMOUNTS INCLUDED ON LINE 1 BUT NOT ON FORM 990, PART IX, LINE 25: $ 52,681 LOSS ON DISPOSAL OF PROPERTY (431,640) NET UNREALIZED LOSS ON INVESTMENT ----------- $ (378,959) |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (true) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (23 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| SHERRY CALDWELL | ||||||||||||||
| CHIEF FINANCIAL OFFICER | $192,468 | $0 | $32,425 | $0 | $0 | $0 | $6,500 | $0 | $9,268 | $0 | $240,661 | $0 | $0 | $0 |
| CHARLES KITZMAN | ||||||||||||||
| CHIEF INFORMATION OFFICER | $163,780 | $0 | $23,573 | $0 | $0 | $0 | $8,361 | $0 | $16,085 | $0 | $211,799 | $0 | $0 | $0 |
| JEFFREY BOSWORTH MD | ||||||||||||||
| CHIEF MEDICAL OFFICER | $316,006 | $0 | $49,726 | $0 | $0 | $0 | $13,999 | $0 | $16,085 | $0 | $395,816 | $0 | $0 | $0 |
| DOROTHY BRATTON-SANDOVAL PA | ||||||||||||||
| PROGRAM DIRECTOR OF FELLOWSHIP | $169,355 | $0 | $5,532 | $0 | $0 | $0 | $8,784 | $0 | $21,985 | $0 | $205,656 | $0 | $0 | $0 |
| FRANKLIN PIERCE DDS | ||||||||||||||
| DENTAL DIRECTOR | $185,289 | $0 | $6,891 | $0 | $0 | $0 | $6,571 | $0 | $26,492 | $0 | $225,243 | $0 | $0 | $0 |
| IMRAN KHAN MD | ||||||||||||||
| MEDICAL DIRECTOR OF PCN | $246,233 | $0 | $11,950 | $0 | $0 | $0 | $12,238 | $0 | $26,306 | $0 | $296,727 | $0 | $0 | $0 |
| ELAINE LARAWAY MD | ||||||||||||||
| MEDICAL DIRECTOR - SHASTA LAKE | $217,275 | $0 | $15,009 | $0 | $0 | $0 | $11,271 | $0 | $29,007 | $0 | $272,562 | $0 | $0 | $0 |
| DEEPIKA SAINI MD | ||||||||||||||
| MEDICAL DIRECTOR OF PEDIATRICS | $218,229 | $0 | $13,537 | $0 | $0 | $0 | $10,503 | $0 | $26,306 | $0 | $268,575 | $0 | $0 | $0 |
| RHETT GROVER DO | ||||||||||||||
| MED DIRECTOR - URGENT CARE | $211,675 | $0 | $14,769 | $0 | $0 | $0 | $11,253 | $0 | $34,007 | $0 | $271,704 | $0 | $0 | $0 |
| PAUL DAVAINIS MD | ||||||||||||||
| MED DIRECTOR - ANDERSON | $211,722 | $0 | $11,219 | $0 | $0 | $0 | $10,445 | $0 | $26,306 | $0 | $259,692 | $0 | $0 | $0 |
| DEBBIE LUPEIKA MD | ||||||||||||||
| DIRECTOR OF RESIDENCY PROGRAM | $258,664 | $0 | $10,206 | $0 | $0 | $0 | $12,655 | $0 | $26,306 | $0 | $307,831 | $0 | $0 | $0 |
| MELISSA TASISTA DO | ||||||||||||||
| MED DIRECTOR - FAMILY PRACTICE | $199,704 | $0 | $20,545 | $0 | $0 | $0 | $12,924 | $0 | $25,393 | $0 | $258,566 | $0 | $0 | $0 |
| JILL MCCLEAN | ||||||||||||||
| PHYSICIAN | $208,223 | $0 | $28,643 | $0 | $0 | $0 | $10,551 | $0 | $23,085 | $0 | $270,502 | $0 | $0 | $0 |
| JOE VILLALOBOS MD | ||||||||||||||
| PHYSICIAN | $233,463 | $0 | $26,282 | $0 | $0 | $0 | $12,145 | $0 | $30,307 | $0 | $302,197 | $0 | $0 | $0 |
| PAMELA KNICKERBOCKER DO | ||||||||||||||
| MEDICAL DIRECTOR - FELLOWSHIP | $278,097 | $0 | $55,660 | $0 | $0 | $0 | $14,000 | $0 | $29,007 | $0 | $376,764 | $0 | $0 | $0 |
| DOUGLAS MCMULLIN MD | ||||||||||||||
| ASST MED DIRECTOR - RESIDENCY | $247,827 | $0 | $13,371 | $0 | $0 | $0 | $0 | $0 | $17,382 | $0 | $278,580 | $0 | $0 | $0 |
| KELLY CARTER MD | ||||||||||||||
| PEDIATRICIAN | $259,363 | $0 | $7,780 | $0 | $0 | $0 | $11,560 | $0 | $34,007 | $0 | $312,710 | $0 | $0 | $0 |
| SEAN DUGAN MD | ||||||||||||||
| PHYSICIAN | $245,831 | $0 | $32,528 | $0 | $0 | $0 | $12,588 | $0 | $26,306 | $0 | $317,253 | $0 | $0 | $0 |
| NATALIE NELSON MD | ||||||||||||||
| PHYSICIAN | $250,083 | $0 | $48,037 | $0 | $0 | $0 | $12,526 | $0 | $16,085 | $0 | $326,731 | $0 | $0 | $0 |
| J BRANDON THORNOCK | ||||||||||||||
| CHIEF OPERATIONS OFFICER | $165,361 | $0 | $20,934 | $0 | $0 | $0 | $8,589 | $0 | $26,786 | $0 | $221,670 | $0 | $0 | $0 |
| HAROLD CARLSON | ||||||||||||||
| CHIEF OF PLANNING & DEVELOPMEN | $168,665 | $0 | $18,062 | $0 | $0 | $0 | $7,895 | $0 | $10,768 | $0 | $205,390 | $0 | $0 | $0 |
| C DEAN GERMANO | ||||||||||||||
| CHIEF EXECUTIVE OFFICER | $257,412 | $0 | $129,582 | $0 | $0 | $0 | $57,739 | $0 | $3,495 | $0 | $448,228 | $0 | $0 | $0 |
| ANA NAVARRO | ||||||||||||||
| CHIEF COMPLIANCE OFFICER | $145,325 | $0 | $11,535 | $0 | $0 | $0 | $7,604 | $0 | $20,383 | $0 | $184,847 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE J, PART I, LINE 4B | SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: C. DEAN GERMANO, CEO, IS COVERED BY A 457(F) SUPPLEMENTAL RETIREMENT AGREEMENT FROM SHASTA COMMUNITY HEALTH CENTER WHICH WAS FUNDED THIS YEAR BY $44,650. |
| SCHEDULE J, PART I, LINE 7 | NON-FIXED PAYMENTS: SENIOR MANAGEMENT BONUSES ARE DETERMINED EACH YEAR BASED ON INTERNAL METRICS AND INDIVIDUAL PERFORMANCE. ALL CLINICIANS GET PAID A MONTHLY BONUS BASED ON THE AMOUNT OF ENCOUNTERS OVER BUDGETED EXPECTATIONS. |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| KRISTEN ANDERSON | |||
| SEE PART V | $189,134 | EMPLOYEE COMP & BENEFITS | false |
| SARA CHOUDHRY | |||
| SEE PART V | $92,684 | EMPLOYEE COMP & BENEFITS | false |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE L, PART IV, LINE 1 | FormAndLineReferenceDesc |
| Explanation | RELATIONSHIP BETWEEN INTERESTED PERSON AND THE ORGANIZATION: KRISTEN ANDERSON IS THE DAUGHTER OF JEFFREY BOSWORTH, CHIEF MEDICAL OFFICER OF SHASTA COMMUNITY HEALTH CENTER. SARAH CHOUDHRY IS THE WIFE OF IMRAN KHAN, DIRECTOR OF PCN OF SHASTA COMMUNITY HEALTH CENTER. | ExplanationTxt |
Schedule M IRS990ScheduleM
| Field | Value | IRS element (for citing) |
|---|---|---|
| Works Of Art | WorksOfArtGrp | |
| Art Historical Treasures | ArtHistoricalTreasuresGrp | |
| Art Fractional Interest | ArtFractionalInterestGrp | |
| Books And Publications | BooksAndPublicationsGrp | |
| Clothing And Household Goods | ClothingAndHouseholdGoodsGrp | |
| Cars And Other Vehicles | CarsAndOtherVehiclesGrp | |
| Boats And Planes | BoatsAndPlanesGrp | |
| Intellectual Property | IntellectualPropertyGrp | |
| Securities Publicly Traded | SecuritiesPubliclyTradedGrp | |
| Securities Closely Held Stock | SecuritiesCloselyHeldStockGrp | |
| Secur Prtnrshp Trust Intrsts | SecurPrtnrshpTrustIntrstsGrp | |
| Securities Miscellaneous | SecuritiesMiscellaneousGrp | |
| Qualified Contrib Hist Struct | QualifiedContribHistStructGrp | |
| Qualified Contrib Other | QualifiedContribOtherGrp | |
| Real Estate Residential | RealEstateResidentialGrp | |
| Real Estate Commercial | RealEstateCommercialGrp | |
| Real Estate Other | RealEstateOtherGrp | |
| Collectibles | CollectiblesGrp | |
| Food Inventory | FoodInventoryGrp |
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 20 | ContributionCnt |
| Noncash Contributions Rpt F990 | $1,344,653 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Taxidermy | TaxidermyGrp | |
| Historical Artifacts | HistoricalArtifactsGrp | |
| Scientific Specimens | ScientificSpecimensGrp | |
| Archaeological Artifacts | ArchaeologicalArtifactsGrp |
Other Non Cash Contri Table OtherNonCashContriTableGrp (2 entries)
| Non Cash CheckboxNonCashCheckboxInd | DescDesc | ContributionContributionCnt | Noncash Contributions Rpt F990NoncashContributionsRptF990Amt | Method Of Determining RevenuesMethodOfDeterminingRevenuesTxt |
|---|---|---|---|---|
| Yes (X) | BUS PASSES | 1 | $11,010 | FMV |
| Yes (X) | GAS CARDS | 1 | $3,130 | FMV |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | Yes (true) | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | false | ThirdPartiesUsedInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE M, PART I, COLUMN B | FormAndLineReferenceDesc |
| Explanation | NUMBER OF CONTRIBUTIONS: THE NUMBER OF CONTRIBUTIONS WAS DETERMINED BY THE NUMBER OF CONTRIBUTORS. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART III, LINE 4D | OTHER PROGRAM SERVICES: COMMUNITY EDUCATION WE HAVE EXPANDED OUR COMMUNITY EDUCATION TO HELP OUR PATIENTS MANAGE AND COPE WITH CHRONIC HEALTH ISSUES. CLASSES ON DIABETES, SMOKING CESSATION, HEALTHIER LIVING, AND YOGA ARE OFFERED. |
| FORM 990, PART VI, SECTION B, LINE 11 | FORM 990 BOARD REVIEW POLICY: THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. THE CHIEF FINANCIAL OFFICER AND DIRECTOR OF FINANCE DO AN EXTENSIVE REVIEW OF THE FORM WITH THE CURRENT CPA FIRM. THE BOARD OF DIRECTORS IS PROVIDED A COMPLETE COPY OF THE FORM 990 THROUGH EMAIL DISTRIBUTION. THE DIRECTORS ARE GIVEN A PERIOD OF ONE WEEK TO REVIEW THE FORM 990, TO COMMENT AND TO ASK ANY PERTINENT QUESTIONS. |
| FORM 990, PART VI, SECTION B, LINE 12C | CONFLICT OF INTEREST POLICY COMPLIANCE: SHASTA COMMUNITY HEALTH CENTER (SCHC) IS COMMITTED TO STRICT COMPLIANCE OF ITS CONFLICT OF INTEREST POLICY. THE BOARD, OFFICERS, AND MANAGEMENT EMPLOYEES HAVE THE RESPONSIBILITY OF ADMINISTERING THE AFFAIRS OF SCHC HONESTLY AND PRUDENTLY AND OF EXERCISING THEIR BEST CARE, SKILL, AND JUDGMENT FOR THE SOLE BENEFIT OF SCHC. THE INTERESTS OF THE ORGANIZATION MUST BE THE FIRST PRIORITY IN ALL DECISIONS AND ACTIONS. IT IS THE POLICY OF SCHC'S BOARD THAT THE EXISTENCE OF ANY CONFLICTS OF INTEREST BE DISCLOSED BEFORE ANY TRANSACTION IS CONSUMMATED. IT IS THE CONTINUING RESPONSIBILITY OF THE BOARD, OFFICERS, AND MANAGEMENT EMPLOYEES TO SCRUTINIZE ITS TRANSACTIONS AND OUTSIDE BUSINESS INTERESTS AND RELATIONSHIPS FOR POTENTIAL CONFLICTS AND TO IMMEDIATELY MAKE SUCH DISCLOSURES. DISCLOSURE IS MADE TO THE CHIEF EXECUTIVE OFFICER (OR IF HE OR SHE IS THE ONE WITH THE CONFLICT, THEN TO THE BOARD CHAIR), WHO BRINGS THE MATTER TO THE ATTENTION OF THE BOARD, OR A DULY CONSTITUTED COMMITTEE THEREOF. DISCLOSURE INVOLVING DIRECTORS IS MADE TO THE BOARD CHAIR, (OR IF HE OR SHE IS THE ONE WITH THE CONFLICT, THEN TO THE BOARD VICE-CHAIR). THE BOARD, OR A DULY CONSTITUTED COMMITTEE THEREOF, DETERMINES WHETHER A CONFLICT EXISTS AND IN THE CASE OF AN EXISTING CONFLICT, WHETHER THE CONTEMPLATED TRANSACTION MAY BE AUTHORIZED AS JUST, FAIR, AND REASONABLE TO SCHC. ANY CONFLICTS OF INTEREST ARE PROMPTLY ADDRESSED AND THE PERSON WITH THE CONFLICT IS EXCLUDED FROM THE DISCUSSION AND APPROVAL OF ANY RELATED TRANSACTIONS. |
| FORM 990, PART VI, SECTION B, LINES 15A & 15B | COMPENSATION DETERMINATION POLICY: SHASTA COMMUNITY HEALTH CENTER (SCHC) DOES AN ANNUAL SALARY SURVEY FOR ALL EMPLOYEES, INCLUDING OFFICERS AND KEY EMPLOYEES. THIS REVIEW IS CONDUCTED BY THE HR MANAGERS WORKING IN CONJUNCTION WITH AN OUTSIDE CONSULTANT. THE REVIEW FOR EACH POSITION CONSISTS OF MARKET SALARY SURVEYS, INCLUDING INDUSTRY SPECIFIC AND REGIONAL DATA. THE RESULTS OF THIS INFORMATION ARE REVIEWED BY SENIOR MANAGEMENT. THIS REVIEW USUALLY IS CONTEMPORANEOUSLY CONDUCTED DURING THE ANNUAL EVALUATION PERIOD. THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS DIRECTLY REVIEWS THE RESULTS OF CHIEF EXECUTIVE OFFICER'S SURVEY RESULTS. ALL CHANGES ARE THEN DOCUMENTED IN THE CEO'S CONTRACT ADDENDUM. |
| FORM 990, PART VI, SECTION C, LINE 19 | DOCUMENT DISCLOSURE: THE ORGANIZATION PROVIDES TO INTERESTED PARTIES FINANCIAL STATEMENTS, IRS FORM 990, AND OTHER DOCUMENTS AND POLICIES UPON REQUEST. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| SCHC PROPERTY CORPORATION | ||||||||||
| 1035 PLACER STREET | REDDING | CA | 96001 | 463207999 | RE HOLDING | CA | 501(C)(3) | 12A I | SHASTA CHC | Yes (true) |
| ANDERSON PROPERTY CORPORATION | ||||||||||
| 2965 EAST STREET | ANDERSON | CA | 96007 | 815371499 | RE HOLDING | CA | 501(C)(3) | 12A I | SHASTA CHC | Yes (true) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (true) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (true) | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| SCHC PROPERTY CORPORATION | ||
| K | $206,053 | FMV |
| ANDERSON PROPERTY CORPORATION | ||
| K | $156,780 | FMV |