LA CLINICA DEL VALLE FAMILY HEALTH CARE CENTER INC: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization
LA CLINICA DEL VALLE FAMILY HEALTH CARE CENTER INC (EIN 94-3096772)
Tax period
2017-06-01 to 2018-05-31
Filed
2018-11-30
IRS object ID
201803359349300000
Schema version
2017v2.2
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 ReturnHeader

FieldValueIRS element (for citing)
Return2018-11-30T21:44:59-08:00ReturnTs
Tax Period End2018-05-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN930745639PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1KDP Certified Public Accountants LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1640 SUPERIOR CTAddressLine1Txt
CityMEDFORDCityNm
State AbbreviationORStateAbbreviationCd
ZIP975046181ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2017-06-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN943096772EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1LA CLINICA DEL VALLEBusinessNameLine1Txt
Business Name Line2FAMILY HEALTH CARE CENTER INCBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlLACLBusinessNameControlTxt
Phone5415356239PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line13617 SOUTH PACIFIC HIGHWAYAddressLine1Txt
CityMEDFORDCityNm
State AbbreviationORStateAbbreviationCd
ZIP97501ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJILL BOROVANSKYPersonNm
Person TitleCFOPersonTitleTxt
Signature2018-11-30SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonSusan E St Range CPAPreparerPersonNm
PTINP00541289PTIN
Phone5417736633PhoneNum
FieldValueIRS element (for citing)
Tax2017TaxYr
Build TS2019-02-21 02:37:17ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerJILL BOROVANSKYPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line13617 S PACIFIC HWYAddressLine1Txt
CityMEDFORDCityNm
State AbbreviationORStateAbbreviationCd
ZIP97501ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$31,995,226GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
All Affiliates IncludedfalseAllAffiliatesIncludedInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.LACLINICAHEALTH.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1988FormationYr
Legal Domicile StateORLegalDomicileStateCd
Activity Or MissionLa Clinica provides primary and preventive medical, dental, behavioral health, and other health promotion services to underserved and low-income patients.ActivityOrMissionDesc
Voting Members Governing Body13VotingMembersGoverningBodyCnt
Voting Members Independent13VotingMembersIndependentCnt
Total Employee470TotalEmployeeCnt
Total Volunteers25TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$9,318,199PYContributionsGrantsAmt
CY Contributions Grants$9,277,208CYContributionsGrantsAmt
PY Program Service Revenue$21,919,273PYProgramServiceRevenueAmt
CY Program Service Revenue$21,726,141CYProgramServiceRevenueAmt
PY Investment Income$13,489PYInvestmentIncomeAmt
CY Investment Income$43,296CYInvestmentIncomeAmt
PY Other Revenue$622,993PYOtherRevenueAmt
CY Other Revenue$948,581CYOtherRevenueAmt
PY Total Revenue$31,873,954PYTotalRevenueAmt
CY Total Revenue$31,995,226CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$24,677,287PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$24,783,299CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$200,304CYTotalFundraisingExpenseAmt
PY Other Expenses$6,620,273PYOtherExpensesAmt
CY Other Expenses$6,391,164CYOtherExpensesAmt
PY Total Expenses$31,297,560PYTotalExpensesAmt
CY Total Expenses$31,174,463CYTotalExpensesAmt
PY Revenues Less Expenses$576,394PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$820,763CYRevenuesLessExpensesAmt
Total Assets BOY$28,379,498TotalAssetsBOYAmt
Total Assets EOY$29,114,623TotalAssetsEOYAmt
Total Liabilities BOY$4,735,449TotalLiabilitiesBOYAmt
Total Liabilities EOY$4,528,342TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$23,644,049NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$24,586,281NetAssetsOrFundBalancesEOYAmt
MissionLa Clinica provides primary and preventive medical, dental, behavioral health, and other health promotion services to underserved and low-income patients.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$29,461,560ExpenseAmt
Revenue$22,526,816RevenueAmt
DescLa Clinica provides comprehensive primary and preventive medical and dental care, as well as integrated behavioral health, prenatal care and gynecology, physical therapy, acupuncture, and advanced care in rheumatology and gastroenterology. We engage 400 employees who provide high quality services at nineteen service sites. To help our community access care, we accept all insurance types and offer a generous sliding scale for low-income uninsured and underinsured patients.Desc
Total Program Service Expenses$29,461,560TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsYes (true)TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (true)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesYes (true)FundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Invest Tax Exempt BondsfalseInvestTaxExemptBondsInd
Escrow AccountfalseEscrowAccountInd
On Behalf Of IssuerfalseOnBehalfOfIssuerInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document45IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee470EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Form990 T FiledfalseForm990TFiledInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Form8282 Filed0Form8282FiledCnt
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Form8899 FiledindfalseForm8899Filedind
Form1098 C FiledfalseForm1098CFiledInd
DAF Excess Business HoldingsfalseDAFExcessBusinessHoldingsInd
Taxable DistributionsfalseTaxableDistributionsInd
Distribution To DonorfalseDistributionToDonorInd
Org Filed In Lieu Of Form1041falseOrgFiledInLieuOfForm1041Ind
Licensed More Than One StatefalseLicensedMoreThanOneStateInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members13GoverningBodyVotingMembersCnt
Independent Voting Member13IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldORStatesWhereCopyOfReturnIsFldCd
Other WebsiteYes (X)OtherWebsiteInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonFAITH HARRISPersonNm
Phone5415123167PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line13617 S PACIFIC HWYAddressLine1Txt
CityMEDFORDCityNm
State AbbreviationORStateAbbreviationCd
ZIP97501ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndHighest Compensated EmployeeHighestCompensatedEmployeeIndFormer Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd
SARA COLLINS
BOARD MEMBER2.000.00Yes (X)$0$0$0
CHARLIE BAUER
BOARD MEMBER2.000.00Yes (X)$0$0$0
MINOR MATTHEWS
BOARD MEMBER2.000.00Yes (X)$0$0$0
BRAD RUSSELL
Vice President2.000.00Yes (X)$0$0$0
PAUL NICHOLSON
BOARD MEMBER2.000.00Yes (X)$0$0$0
MONICA MORALES
BOARD MEMBER2.000.00Yes (X)$0$0$0
KEITH CASEBOLT
Treasurer2.000.00Yes (X)$0$0$0
TIGHE O'MEARA
BOARD MEMBER2.000.00Yes (X)$0$0$0
GERALD POWELL
BOARD MEMBER2.000.00Yes (X)$0$0$0
MARY SINCLAIR
Secretary2.000.00Yes (X)$0$0$0
LINDA REID
BOARD MEMBER2.000.00Yes (X)$0$0$0
DANIELLE MANCUSO
BOARD MEMBER2.000.00Yes (X)$0$0$0
BRENDA JOHNSON RN MBA
CEO40.000.00Yes (X)$209,848$0$14,689Yes (X)
IDA SAITO
COO40.000.00$118,419$0$6,828Yes (X)
JILL BOROVANSKY
CFO40.000.00$93,967$0$0Yes (X)
DANIEL J SENGENBERGER
MED OFF FOR OPS40.000.00$228,943$0$15,026Yes (X)
JUSTIN R ADAMS
CHIEF MED OFFICER40.000.00$224,129$0$6,264Yes (X)
PHILIP GETSINGER
DENTIST40.000.00$203,717$0$9,605Yes (X)
AMY B FINE
CHIEF DENT OFFICER40.000.00$201,896$0$9,620Yes (X)
TYLER SCOTT
DENTIST40.000.00$199,744$0$9,603Yes (X)
ANGELICA RUPPE
FORMER CFO40.000.00$91,869$0$6,431Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,572,532TotalReportableCompFromOrgAmt
Total Other Compensation$78,066TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K7IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedYes (true)FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (4 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
OCHIN-OREGON COMMUNITY HEALTH INFO NETWORK
1881 SW NAITO PARKWAYPORTLANDOR97501MEDICAL BILLING$1,041,502
VITUS CONSTRUCTION INC
1912 SECOND AVEGOLD HILLOR97525CONSTRUCTION$174,529
OBRIEN DENTAL LAB INC
4311 SW RESEARCH WAYCORVALLISOR97333DENTAL LABS$132,148
SANITECH BUILDING MAINTENANCE
1960 TABLE ROCK ROADMEDFORDOR97501JANITORIAL SERVICES$154,262
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K4CntrctRcvdGreaterThan100KCnt
Government Grants$8,110,010GovernmentGrantsAmt
All Other Contributions$1,167,198AllOtherContributionsAmt
Noncash Contributions$15,533NoncashContributionsAmt
Total Contributions$9,277,208TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescNET PATIENT FEESDesc
Business621110BusinessCd
Total Revenue Column$21,726,141TotalRevenueColumnAmt
Related Or Exempt Func Income$21,726,141RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$21,726,141TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$29,540TotalRevenueColumnAmt
Exclusion$29,540ExclusionAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Personal$8,358PersonalAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Personal$8,358PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$8,358TotalRevenueColumnAmt
Exclusion$8,358ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$13,756SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$13,756SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$13,756TotalRevenueColumnAmt
Exclusion$13,756ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$139,548FundraisingGrossIncomeAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$139,548TotalRevenueColumnAmt
Exclusion$139,548ExclusionAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescMISC. INCOMEDesc
Business621110BusinessCd
Total Revenue Column$800,675TotalRevenueColumnAmt
Related Or Exempt Func Income$800,675RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Other Revenue Total$800,675OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$31,995,226TotalRevenueColumnAmt
Related Or Exempt Func Income$22,526,816RelatedOrExemptFuncIncomeAmt
Exclusion$191,202ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$443,751TotalAmt
Program Services$443,751ProgramServicesAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$20,054,993TotalAmt
Program Services$19,689,858ProgramServicesAmt
Management And General$270,931ManagementAndGeneralAmt
Fundraising$94,204FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$2,522,735TotalAmt
Program Services$2,478,010ProgramServicesAmt
Management And General$32,364ManagementAndGeneralAmt
Fundraising$12,361FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,761,820TotalAmt
Program Services$1,729,452ProgramServicesAmt
Management And General$24,039ManagementAndGeneralAmt
Fundraising$8,329FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$663,549TotalAmt
Program Services$585,782ProgramServicesAmt
Management And General$76,612ManagementAndGeneralAmt
Fundraising$1,155FundraisingAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$349,222TotalAmt
Program Services$205,676ProgramServicesAmt
Management And General$132,851ManagementAndGeneralAmt
Fundraising$10,695FundraisingAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$24,627TotalAmt
Program Services$24,627ProgramServicesAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$724,146TotalAmt
Program Services$658,523ProgramServicesAmt
Management And General$65,623ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$108,849TotalAmt
Program Services$86,229ProgramServicesAmt
Management And General$22,620ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
CONTRACTUAL$1,760,210$1,468,368$283,547$8,295
SUPPLIES$1,364,675$1,290,100$70,441$4,134
PROFESSIONAL FEES$499,897$286,951$210,553$2,393
MISCELLANEOUS$355,430$142,660$159,261$53,509

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$540,559TotalAmt
Program Services$371,573ProgramServicesAmt
Management And General$163,757ManagementAndGeneralAmt
Fundraising$5,229FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$31,174,463TotalAmt
Program Services$29,461,560ProgramServicesAmt
Management And General$1,512,599ManagementAndGeneralAmt
Fundraising$200,304FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$6,164,092BOYAmt
EOY$9,042,398EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$100,000BOYAmt
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$4,584,129BOYAmt
EOY$2,677,950EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$53,341BOYAmt
EOY$61,904EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$201,374BOYAmt
EOY$202,288EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$22,202,522LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$6,658,781LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$15,862,957BOYAmt
EOY$15,543,741EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$831,186BOYAmt
EOY$916,268EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$134,375BOYAmt
EOY$121,875EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$448,044BOYAmt
EOY$548,199EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$28,379,498BOYAmt
EOY$29,114,623EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$2,307,899BOYAmt
EOY$1,949,406EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
EOY$389,140EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$1,979,506BOYAmt
EOY$1,641,597EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$448,044BOYAmt
EOY$548,199EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$4,735,449BOYAmt
EOY$4,528,342EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$22,716,408BOYAmt
EOY$23,673,558EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$100,000BOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$827,641BOYAmt
EOY$912,723EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$23,644,049BOYAmt
EOY$24,586,281EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$28,379,498BOYAmt
EOY$29,114,623EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$820,763ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$121,469NetUnrlzdGainsLossesInvstAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredYes (true)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (true)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$5,352,376CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$6,375,860CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$9,713,470CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$9,318,199CurrentTaxYearMinus1YearAmt
Current Tax Year$9,277,208CurrentTaxYearAmt
Total$40,037,113TotalAmt

Tax Rev Levied Orgnztnl Bnft170 TaxRevLeviedOrgnztnlBnft170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$5,352,376CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$6,375,860CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$9,713,470CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$9,318,199CurrentTaxYearMinus1YearAmt
Current Tax Year$9,277,208CurrentTaxYearAmt
Total$40,037,113TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$0SubstantialContributorsTotAmt
Public Support Total170$40,037,113PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$9,484CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$8,083CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$11,025CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$8,138CurrentTaxYearMinus1YearAmt
Current Tax Year$8,358CurrentTaxYearAmt
Total$45,088TotalAmt

Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$15,870CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$15,870CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$15,870CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$17,854CurrentTaxYearMinus1YearAmt
Current Tax Year$13,756CurrentTaxYearAmt
Total$79,220TotalAmt

Other Income170 OtherIncome170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Total Support$40,161,421TotalSupportAmt
Public Support CY1700.99690PublicSupportCY170Pct
Public Support PY1700.99650PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$831,816BeginningYearBalanceAmt
Investment Earnings Or Losses$93,014InvestmentEarningsOrLossesAmt
Administrative Expenses$7,932AdministrativeExpensesAmt
End Year Balance$916,268EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$747,301BeginningYearBalanceAmt
Investment Earnings Or Losses$90,375InvestmentEarningsOrLossesAmt
Administrative Expenses$6,490AdministrativeExpensesAmt
End Year Balance$831,186EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$777,977BeginningYearBalanceAmt
Investment Earnings Or Losses-$24,398InvestmentEarningsOrLossesAmt
Administrative Expenses$6,278AdministrativeExpensesAmt
End Year Balance$747,301EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$753,479BeginningYearBalanceAmt
Investment Earnings Or Losses$24,498InvestmentEarningsOrLossesAmt
End Year Balance$777,977EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$687,890BeginningYearBalanceAmt
Investment Earnings Or Losses$65,589InvestmentEarningsOrLossesAmt
End Year Balance$753,479EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY1.00000BoardDesignatedBalanceEOYPct
Endowments Held Unrelated OrgYes (true)EndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgfalseEndowmentsHeldRelatedOrgInd
Related Org List Sch RfalseRelatedOrgListSchRInd

Land LandGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,998,879OtherCostOrOtherBasisAmt
Book Value$2,998,879BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$15,531,287OtherCostOrOtherBasisAmt
Depreciation$3,821,050DepreciationAmt
Book Value$11,710,237BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$3,647,836OtherCostOrOtherBasisAmt
Depreciation$2,837,731DepreciationAmt
Book Value$810,105BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$24,520OtherCostOrOtherBasisAmt
Book Value$24,520BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$15,543,741TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescDEFERRED COMPENSATIONDesc
Amt$548,199Amt
FieldValueIRS element (for citing)
Total Liability$548,199TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$32,116,695TotalRevEtcAuditedFinclStmtAmt
Net Unrealized Gains Invst$121,469NetUnrealizedGainsInvstAmt
Revenue Not Reported$121,469RevenueNotReportedAmt
Revenue Subtotal$31,995,226RevenueSubtotalAmt
Total Revenue Per Form990$31,995,226TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$31,174,463TotExpnsEtcAuditedFinclStmtAmt
Expenses Subtotal$31,174,463ExpensesSubtotalAmt
Total Expenses Per Form990$31,174,463TotalExpensesPerForm990Amt

Schedule G IRS990ScheduleG

FieldValueIRS element (for citing)
Agrmt Prof Fundraising ActyfalseAgrmtProfFundraisingActyInd

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1RAISE YOUR HEART FOR HEALTHEvent1Nm
Gross Receipts Event1$139,548GrossReceiptsEvent1Amt
Gross Revenue Event1$139,548GrossRevenueEvent1Amt
Gross Receipts Total$139,548GrossReceiptsTotalAmt
Gross Revenue Total Events$139,548GrossRevenueTotalEventsAmt
Net Income Summary$139,548NetIncomeSummaryAmt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Independent ConsultantYes (X)IndependentConsultantInd
Form990 Of Other OrganizationsYes (X)Form990OfOtherOrganizationsInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd
Rebuttable Presumption ProcfalseRebuttablePresumptionProcInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmt
AMY B FINE
CHIEF DENT OFFICER$201,896$9,620$211,516
ANGELICA RUPPE
FORMER CFO$91,869$6,431$98,300
BRENDA JOHNSON RN MBA
CEO$209,848$14,689$224,537
DANIEL J SENGENBERGER
MED OFF FOR OPS$225,120$15,026$243,969$3,823
JUSTIN R ADAMS
CHIEF MED OFFICER$218,794$6,264$230,393$5,335
PHILIP GETSINGER
DENTIST$203,717$9,605$213,322
TYLER SCOTT
DENTIST$199,744$9,603$209,347

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (6 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Line 11b: Form 990 Review ProcessTHE FORM 990 PREPARER PROVIDES A DRAFT COPY OF THE FORM 990 TO THE CFO AND THE ACCOUNTING COORDINATOR. A COPY OF THE FORM 990 IS ALSO PROVIDED TO THE FINANCE/AUDIT COMMITTEE FOR REVIEW. FINALLY, THE BOARD IS NOTIFIED OF ANY FINDINGS AND PROVIDED A FINAL DRAFT TO REVIEW PRIOR TO FILING. AFTER FINAL REVIEW, THE FORM 990 PREPARER IS NOTIFIED TO FILE THE FORM 990. A REPORT IS THEN PROVIDED TO THE FULL BOARD OF DIRECTORS ON THE RESULTS OF THE FORM 990.
Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of ConflictsTHE ORGANIZATION HAS A WRITTEN CONFLICT OF INTEREST POLICY IN PLACE THAT IS DISTRIBUTED TO ALL NEW HIRES AND REVIEWED ANNUALLY FOR UPDATES. THE POLICY STATES THAT ANY CONFLICTS OF INTEREST BE DISCLOSED AS SOON AS THE WORKFORCE MEMBER BECOMES AWARE OF THE CONFLICT.
Form 990, Part VI, Line 15a: Compensation Review & Approval Process - CEO, Top ManagementTHE BOARD OF DIRECTORS ARE RESPONSIBLE TO HIRE AND REMOVE THE CHIEF EXECUTIVE OFFICER, SUPPORT AND ASSESS HIS OR HER PERFORMANCE, AND ENSURE THAT THE CHIEF EXECUTIVE HAS THE MORAL AND PROFESSIONAL SUPPORT NEEDED TO FURTHER THE GOALS OF THE ORGANIZATION.EACH YEAR A MARKET REVIEW IS PERFORMED FOR A COMPETITIVE ANALYSIS OF SALARIES IN THE LOCAL AND REGIONAL AREAS FOR THE CEO AND THE HUMAN RESOURCE DIRECTOR INFORMS THE BOARD CHAIR OF ANY RELEVANT PAY CHANGES THAT ARE DUE TO OCCUR. NEXT, THE EXECUTIVE COMMITTEE MEETS TO DISCUSS THE PAY CHANGE AND A VOTE IS HELD IN JUNE TO ADOPT THE PAY CHANGE OR NOT DEPENDING UPON THE BUDGETED FINANCIAL FORECAST OF THE ORGANIZATION.
Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key EmployeesEACH YEAR A MARKET REVIEW IS PERFORMED FOR A COMPETITIVE ANALYSIS OF SALARIES IN THE LOCAL AND REGIONAL AREAS FOR ALL POSITIONS IN THE ORGANIZATION. THE HUMAN RESOURCE DIRECTOR COMPILES THE INFORMATION, AND AFTER APPROVAL FROM THE CEO, IT IS GIVEN TO THE ACCOUNTING COORDINATOR WHO INPUTS THE DATA INTO THE FORECASTED BUDGET FOR THE NEXT FISCAL YEAR. INCREASES IN BASE PAY MAY BE INCLUDED FOR NEW BUDGET PERIODS (BEGINNING IN JUNE) IF THE FOLLOWING IS TRUE:1. FINANCIAL FORECAST FOR THE ORGANIZATION IS HEALTHY;2. IF THE SALARY FOR THE JOB POSITION HAS FALLEN BELOW THE AVERAGE MARKET RANGE AND PAY THRESHOLD FOR THE ORGANIZATION;3. THE BOARD OF DIRECTORS HAS REVIEWED AND APPROVED THE NEW BUDGET INCLUDING THE CHANGES TO SALARIES AND WAGES.
Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailableLA CLINICA DEL VALLE MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST AS PER THE FOLLOWING POLICY GUIDELINES:THE AUDITED FINANCIAL STATEMENTS WILL BE DISTRIBUTED TO THE BOARD OF DIRECTORS, TO REGULATORY AGENCIES AND TO ORGANIZATIONS ENTITLED TO RECEIVE A COPY DUE TO CONTRACTUAL AGREEMENT. THE AUTHORITY TO DISTRIBUTE THE STATEMENTS TO OTHER INDIVIDUALS OR FIRMS REQUESTING THEM WILL BE LEFT TO THE DISCRETION OF THE CHIEF EXECUTIVE OFFICER AND THE CHIEF FINANCIAL OFFICER.
FORM 990, PART I, LINE 1 - ORG. MISSIONLa Clinica serves the people who need us the most through exceptional, affordable, and compassionate care, inspiring all those we touch to lead full and healthy lives.

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