ANDERSON VALLEY HEALTH CENTER INC: Form 990, tax year 2016

View the entire original 990 at ProPublica ↗

Organization
ANDERSON VALLEY HEALTH CENTER INC (EIN 94-2347424)
Tax period
2016-07-01 to 2017-06-30
Filed
2018-05-10
IRS object ID
201801309349301945
Schema version
2016v3.0
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)
Return2018-05-10T12:04:57-05:00ReturnTs
Tax Period End2017-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN464016990PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1THE PUN GROUP LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1200 E SANDPOINTE AVENUE SUITE 600AddressLine1Txt
CitySANTA ANACityNm
State AbbreviationCAStateAbbreviationCd
ZIP92707ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2016-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN942347424EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ANDERSON VALLEY HEALTH CENTER INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlANDEBusinessNameControlTxt
Phone7078953477PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line113500 AIRPORT ROADAddressLine1Txt
CityBOONEVILLECityNm
State AbbreviationCAStateAbbreviationCd
ZIP954150338ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonCHLOE GUAZZONE-RUGEBREGTPersonNm
Person TitleEXECUTIVE DIRECTORPersonTitleTxt
Phone7078953477PhoneNum
Signature2018-05-10SignatureDt

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonKENNETH HPUNPreparerPersonNm
PTINP01443751PTIN
Phone9497778800PhoneNum
FieldValueIRS element (for citing)
Tax2016TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerCHLOE GUAZZONE-RUGEBREGTPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line113500 AIRPORT ROADAddressLine1Txt
CityBOONVILLECityNm
State AbbreviationCAStateAbbreviationCd
ZIP95415ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$3,332,635GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.AVHC.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1977FormationYr
Legal Domicile StateCALegalDomicileStateCd
Activity Or MissionPROVIDE COMPREHENSIVE AND LOW COST MEDICAL, PSYCHIATRIC AND HEALTH RELATED SERVICES, REGARDLESS OF RACE, COLOR, CREED, NATIONAL ORIGIN, AGE, SEX, SOCIAL OR POLITICAL BELIEFS, HANDICAPPED STATUS OR ABILITY TO PAY; PROVIDE PREVENTATIVE HEALTH EDUCATION IN THE SCHOOLS AND COMMUNITY OF ANDERSON VALLEY, MENDOCINO COUNTY, CALIFORNIA AND ITS ENVIRONS; EDUCATE AND TRAIN PARAMEDICS AND CITIZENRY IN EMERGENCY FIRST AID; ACT AS A COMMUNITY RESOURCE AND AS A CENTER OF HEALTH CARE INFORMATION.ActivityOrMissionDesc
Voting Members Governing Body12VotingMembersGoverningBodyCnt
Voting Members Independent12VotingMembersIndependentCnt
Total Employee27TotalEmployeeCnt
Total Volunteers3TotalVolunteersCnt
Total Gross UBI$2,402TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$1,505,652PYContributionsGrantsAmt
CY Contributions Grants$1,654,708CYContributionsGrantsAmt
PY Program Service Revenue$1,459,813PYProgramServiceRevenueAmt
CY Program Service Revenue$1,674,249CYProgramServiceRevenueAmt
PY Investment Income$0PYInvestmentIncomeAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue$23,055PYOtherRevenueAmt
CY Other Revenue$3,678CYOtherRevenueAmt
PY Total Revenue$2,988,520PYTotalRevenueAmt
CY Total Revenue$3,332,635CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$1,653,305PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$1,819,653CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$851,734PYOtherExpensesAmt
CY Other Expenses$987,320CYOtherExpensesAmt
PY Total Expenses$2,505,039PYTotalExpensesAmt
CY Total Expenses$2,806,973CYTotalExpensesAmt
PY Revenues Less Expenses$483,481PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$525,662CYRevenuesLessExpensesAmt
Total Assets BOY$3,466,473TotalAssetsBOYAmt
Total Assets EOY$4,022,234TotalAssetsEOYAmt
Total Liabilities BOY$1,668,131TotalLiabilitiesBOYAmt
Total Liabilities EOY$1,698,230TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$1,798,342NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$2,324,004NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionANDERSON VALLEY HEALTH CENTER, INC.(AVHC), A CALIFORNIA NOT-FOR-PROFIT ORGANIZATION WAS INCORPORATED IN 1977 FOR THE PURPOSE OF RENDERING PROFESSIONAL MEDICAL AND HEALTH SERVICES TO THE RURAL AREA OF ANDERSON VALLEY. AVHC IS A FEDERALLY QUALIFIED HEALTH CENTER AND, AS THE SOLE PROVIDER OF HEALTH CARE SERVICES IN THE AREA, OFFERS PRIMARY MEDICAL, DENTAL AND BEHAVIORAL HEALTH SERVICES. AVHC DERIVES SUPPORT THROUGH GRANTS AND CONTRACTS WITH THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES AND THE CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY. THE MAJORITY OF THE REVENUE IS DERIVED FROM PATIENT SERVICES AND THE REMAINDER FROM THE AFOREMENTIONED GRANTS AND CONTRACTS AS WELL AS OTHER STATE AND LOCAL GRANTS.AS A NOT-FOR-PROFIT ORGANIZATION RECEIVING PUBLIC FUNDS, AVHC PROVIDES SERVICES TO QUALIFIED INDIVIDUALS ON A SLIDING FEE SCALE AS WELL AS TO PATIENTS WITH MEDICAL AND MEDICARE COVERAGE, PRIVATE INSURANCE AND SELF-PAY STATUS.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$957,327ExpenseAmt
Revenue$959,703RevenueAmt
DescPRIMARY CARE - COMPREHENSIVE PRIMARY CARE FOR ALL AGES WITH AN EMPHASIS ON HEALTH EDUCATION, FAMILY PLANNING, WOMEN'S HEALTH, PHYSICAL EXAMINATIONS FOR SPORTS, DMV, CAMP, SCHOOL AND CHDP, TEEN HEALTH, URGENT CARE, EFERRALS, AND WORKER'S COMPENSATION & SPECIALTY CLINICS.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$543,792ExpenseAmt
Revenue$530,168RevenueAmt
DescDENTAL SERVICES - ANDERSON VALLEY DENTAL CLINIC OFFERS COMPREHENSIVE DENTAL SERVICES. ON STAFF DENTISTRY OFFERS A FULL SCOPE OF DENTAL SERVICES TO PATIENTS OF ALL AGES. CUSTOMARY ORAL CARE SERVICES, PATIENTS REQUIRING SPECIALTY SERVICES ARE OFTEN REFERRED TO OUT OF NETWORK TO PROFESSIONAL PARTNERS. AVHC IS FOCUSED ON THE PREVENTION AND DENTAL SCREENING TO THE COMMUNITY.PREVENTIVE DENTAL SERVICES INCLUDE COMPLETE ORAL EXAMINATIONS, DIGITAL X-RAYS, ROUTINE CLEANING, BASIC PERIODONTAL SERVICES, SEALANT APPLICATION, MERCURY FREE RESTORATIONS, CROWNS/BRIDGES, ROOT CANALS, EXTRACTIONS, COMPLETE AND PARTIAL DENTURES, EMERGENCY TREATMENT, AND SPECIALTY REFERAL.PREVENTIVE PROGRAMS INCLUDE MAJOR DENTAL INSURANCE, DENTI-CAL/MEDICAL, COUNTY MEDICAL SERVIES PROGRAM (CMSP), HEALTH FAMILIES DELTA DENTAL/PREMIER ACCESS, AND SLIDING FEE SCALE.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$172,524ExpenseAmt
Revenue$184,378RevenueAmt
DescBEHAVIORAL HEALTH - STAFF CLINICAL PSYCHOLOGISTS ARE DEDICATED TO IMPROVING THE OVERALL QUALITY OF LIFE FOR CHILDREN, ADULTS AND FAMILIES BY PROVIDING TIME-TESTED AND SKILLS BASED TREATMENTS. QUALIFIED TECHNIQUES ARE USED TO FOSTER A GREATER SENSE OF PEACE AND WELL-BEING.BEHAVIORAL HEALTH SERVICES OF THE HUMAN CONDITION TO INCLUDE BUT NOT LIMITED TO - DEPRESSION, ANXIETY, ADHD, SUBSTANCE USE, COUPLE'S THERAPY, AND TRAUMA RESOLUTION.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$1,673,643TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document20IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee27EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members12GoverningBodyVotingMembersCnt
Independent Voting Member12IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldCAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1FABIOLA CORNEJO-PEREZBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone7078953477PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line113500 AIRPORT ROADAddressLine1Txt
CityBOONVILLECityNm
State AbbreviationCAStateAbbreviationCd
ZIP95415ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
J R COLLINS
BOARD MEMBER, TREASURER2.50Yes (X)Yes (X)$0$0$0
RIC BONNER
BOARD MEMEBR, CHAIR PERSON2.50Yes (X)Yes (X)$0$0$0
ERIC LABOWITZ
BOARD MEMBER2.50Yes (X)$0$0$0
KATHY COX
VICE CHAIR2.50Yes (X)Yes (X)$0$0$0
HEIDI KNOTT GUNDLING
SECRETARY2.50Yes (X)Yes (X)$0$0$0
IVAN JIMENEZ
BOARD MEMBER2.50Yes (X)$0$0$0
DEBORAH COVEY
BOARD MEMBER2.50Yes (X)$0$0$0
CLAY EUBANK
BOARD MEMBER2.50Yes (X)$0$0$0
DREW COLFAX
BOARD MEMBER2.50Yes (X)$0$0$0
MAUREEN HOCHBERG
BOARD MEMBER2.50Yes (X)$0$0$0
ROBERT JASON PINOLI
BOARD MEMBER2.50Yes (X)$0$0$0
LUCI PLANCARTE
BOARD MEMBER2.50Yes (X)$0$0$0
CHLOE GUAZZONE-RUGEBREGT
CEO40.00Yes (X)$96,824$0$0
FABIOLA CORNEJO-PEREZ
COO40.00Yes (X)$50,262$0$0
MARK APFEL
MEDICAL DIRECTOR40.00$177,437$0$0Yes (X)
PHAN TATH
DENTAL DIRECTOR40.00$132,890$0$0Yes (X)
JESSICA MCININCH
PSYCHOLOGIST40.00$120,250$0$0Yes (X)
LOGAN MCGHAN
DOCTOR40.00$141,786$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$719,449TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$0TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K4IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (2 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
ESSENTIAL ACCESS HEALTH
3600 WILSHIRE BLVD SUITE 600LOS ANGELESCA90010HEALTH INSURANCE$271,292
PRICE WATERMAN
125 EAST MILL STREETUKIAHCA95482ACCOUNTING, CFO, PAYROLL AND AP$182,002
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K2CntrctRcvdGreaterThan100KCnt
Government Grants$1,337,082GovernmentGrantsAmt
All Other Contributions$317,626AllOtherContributionsAmt
Total Contributions$1,654,708TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPATIENT SERVICE REVENUDesc
Business624100BusinessCd
Total Revenue Column$1,674,249TotalRevenueColumnAmt
Related Or Exempt Func Income$1,674,249RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$1,674,249TotalProgramServiceRevenueAmt
Fundraising Gross Income$1,276FundraisingGrossIncomeAmt
Fundraising Direct Expenses$0FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,276TotalRevenueColumnAmt
Exclusion$1,276ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescOTHER INCOMEDesc
Business900099BusinessCd
Total Revenue Column$2,402TotalRevenueColumnAmt
Unrelated Business Revenue$2,402UnrelatedBusinessRevenueAmt
FieldValueIRS element (for citing)
Other Revenue Total$2,402OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$3,332,635TotalRevenueColumnAmt
Related Or Exempt Func Income$1,674,249RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$2,402UnrelatedBusinessRevenueAmt
Exclusion$1,276ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$719,449TotalAmt
Program Services$572,363ProgramServicesAmt
Management And General$147,086ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$724,782TotalAmt
Program Services$461,896ProgramServicesAmt
Management And General$262,886ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$375,422TotalAmt
Program Services$248,106ProgramServicesAmt
Management And General$127,316ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$2,246TotalAmt
Management And General$2,246ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$150,799TotalAmt
Management And General$150,799ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$176,144TotalAmt
Program Services$47,368ProgramServicesAmt
Management And General$128,776ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$103,586TotalAmt
Management And General$103,586ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$43,631TotalAmt
Program Services$37,212ProgramServicesAmt
Management And General$6,419ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$50,941TotalAmt
Program Services$14,979ProgramServicesAmt
Management And General$35,962ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$64,584TotalAmt
Program Services$44,499ProgramServicesAmt
Management And General$20,085ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$99,681TotalAmt
Program Services$75,530ProgramServicesAmt
Management And General$24,151ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$18,780TotalAmt
Program Services$6,209ProgramServicesAmt
Management And General$12,571ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
SUPPLIES$145,858$134,225$11,633
PURCHASED SERVICES$71,095$14,820$56,275
COMMUNICATIONS$35,329$8,700$26,629
LICENSES, DUES$24,646$7,736$16,910

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$2,806,973TotalAmt
Program Services$1,673,643ProgramServicesAmt
Management And General$1,133,330ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$855,725BOYAmt
EOY$1,340,767EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$41,475BOYAmt
EOY$181,109EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$186,273BOYAmt
EOY$146,346EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$22,929BOYAmt
EOY$28,794EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$3,833,418LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$1,508,200LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$2,360,071BOYAmt
EOY$2,325,218EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$3,466,473BOYAmt
EOY$4,022,234EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$328,580BOYAmt
EOY$263,192EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$4,997BOYAmt
EOY$155,899EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$1,334,554BOYAmt
EOY$1,279,139EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,668,131BOYAmt
EOY$1,698,230EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,798,342BOYAmt
EOY$1,824,004EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$500,000EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,798,342BOYAmt
EOY$2,324,004EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$3,466,473BOYAmt
EOY$4,022,234EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$525,662ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit RequiredYes (1)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (1)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$1,030,823CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,391,931CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,256,530CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,510,529CurrentTaxYearMinus1YearAmt
Current Tax Year$1,638,584CurrentTaxYearAmt
Total$6,828,397TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$1,030,823CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,391,931CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,256,530CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,510,529CurrentTaxYearMinus1YearAmt
Current Tax Year$1,638,584CurrentTaxYearAmt
Total$6,828,397TotalAmt
FieldValueIRS element (for citing)
Public Support Total170$6,828,397PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years$4,269CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$24,752CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$31,713CurrentTaxYearMinus1YearAmt
Current Tax Year$19,802CurrentTaxYearAmt
Total$80,536TotalAmt
FieldValueIRS element (for citing)
Total Support$6,908,933TotalSupportAmt
Gross Receipts Rltd Activities$6,584,949GrossReceiptsRltdActivitiesAmt
Public Support CY1700.98830PublicSupportCY170Pct
Public Support PY1700.99020PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Land LandGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$32,743InvestmentCostOrOtherBasisAmt
Book Value$32,743BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$3,267,741InvestmentCostOrOtherBasisAmt
Depreciation$1,042,222DepreciationAmt
Book Value$2,225,519BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$532,934InvestmentCostOrOtherBasisAmt
Depreciation$465,978DepreciationAmt
Book Value$66,956BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$2,325,218TotalBookValueLandBuildingsAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$3,332,635TotalRevEtcAuditedFinclStmtAmt
Revenue Not Reported$0RevenueNotReportedAmt
Revenue Subtotal$3,332,635RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$3,332,635TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$2,806,973TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$2,806,973ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$2,806,973TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationTHE HEALTH CENTER HAS BEEN RECOGNIZED AS A NOT-FOR-PROFIT ORGANIZATION UNDER INTERNAL REVENUE CODE SECTION 501(C)3 AND CALIFORNIA REVENUE CODE SECTION 23701(D) AND IS EXEMPT FROM FEDERAL AND CALIFORNIA INCOME TAXES ON RELATED INCOME FOR THE YEARS ENDED JUNE 30, 2017 AND 2016. EFFECTIVE JULY 1, 2009, THE CENTER ADOPTED NEWLY ISSUED GUIDANCE ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES. UNDER THIS NEW GUIDANCE, THE CENTER UTILIZES A TWO-STEP APPROACH TO RECOGNIZING AND MEASURING UNCERTAIN TAX POSITIONS. THE FIRST STEP IS TO EVALUATE THE TAX POSITION FOR RECOGNITION BY DETERMINING IF THE WEIGHT OF AVAILABLE EVIDENCE INDICATES IT IS MORE LIKELY THAN NOT THAT, THE POSITION WILL BE SUSTAINED ON AUDIT, INCLUDING RESOLUTION OF RELATED APPEALS OR LITIGATION PROCESSES. THE SECOND STEP IS TO MEASURE THE TAX BENEFIT AS THE LARGEST AMOUNT, WHICH IS MORE THAN 50% LIKELY OF BEING REALIZED UPON ULTIMATE SETTLEMENT. ADOPTION OF SUCH GUIDANCE DID NOT HAVE A MATERIAL EFFECT TO THE FINANCIAL STATEMENTS. AT JUNE 30, 2017 AND 2016, THERE WERE NO UNCERTAIN TAX POSITIONS.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp

FieldValueIRS element (for citing)
PersonMARK APFELPersonNm
TitleMEDICAL DIRECTORTitleTxt
Base Compensation Filing Org$177,437BaseCompensationFilingOrgAmt
Compensation Based On Rltd Orgs$0CompensationBasedOnRltdOrgsAmt
Bonus Filing Organization$0BonusFilingOrganizationAmount
Bonus Related Organizations$0BonusRelatedOrganizationsAmt
Other Compensation Filing Org$0OtherCompensationFilingOrgAmt
Other Compensation Rltd Orgs$0OtherCompensationRltdOrgsAmt
Deferred Compensation Flng Org$0DeferredCompensationFlngOrgAmt
Deferred Comp Rltd Orgs$0DeferredCompRltdOrgsAmt
Nontaxable Benefits Filing Org$0NontaxableBenefitsFilingOrgAmt
Nontaxable Benefits Rltd Orgs$0NontaxableBenefitsRltdOrgsAmt
Total Compensation Filing Org$177,437TotalCompensationFilingOrgAmt
Total Compensation Rltd Orgs$0TotalCompensationRltdOrgsAmt
Comp Report Prior990 Filing Org$0CompReportPrior990FilingOrgAmt
Comp Report Prior990 Rltd Orgs$0CompReportPrior990RltdOrgsAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 3FormAndLineReferenceDesc
ExplanationTHE PROCESS OF DETERMING COMPENSATION FOR ANDERSON VALLEY HEALTH CENTER'S TOP MANAGEMENT AND KEY EMPLOYEES INVOLVES OUR HUMAN RESOURCES DEPARTMENT. IT IS BASED ON A NUMBER OF CONSIDERATIONS SUCH AS THE NATURE AND SCOPE OF INDIVIDUAL DUTIES, BACKGROUND, EXPERTISE, SIZE, COMPLEXITY OF ORGANIZATION, AND AMOUNT PAID BY SIMILAR ORGANIZATIONS OF SIMILAR SIZE AND TYPE. HUMAN RESOURCES ROUTINELY CONDUCTS SALARY SURVEYS AND PERFORMS ASSESSMENTS OF THE JOB MARKET. THE FINAL DECISION RESTS WITH THE GOVERNING BOARD WHEN THE ANNUAL CORPORATE BUDGET IS REVIEWED AND APPROVED FOR ADOPTION.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION B, LINE 11BTHE FORM 990 IS SUBMITTED TO THE BOARD OF DIRECTORS AND MANAGEMENT FOR REVIEW. UPON FINAL APPROVAL, THE FORM IS FINALIZED AND SUBMITTED TO THE INTERNAL REVENUE SERVICE.
FORM 990, PART VI, SECTION B, LINE 12CANDERSON VALLEY HEALTH CENTER MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY BY HAVING A CORPORATE COMPLIANCE COMMITTEE ACTIVELY AND PERIODICALLY PERFORMING AUDITS TO ENSURE COMPLIANCE. STAFF ARE TRAINED ANNUALLY TO REMIND THEM OF THEIR ONGOING OBLIGATION TO REPORT ANY INCIDENT OF FRAUD OR CONFLICT OF INTEREST. THERE IS A HOTLINE TO CALL WHERE THEY CAN REMAIN ANONYMOUS.
FORM 990, PART VI, SECTION B, LINE 15THE PROCESS OF DETERMING COMPENSATION FOR ANDERSON VALLEY HEALTH CENTER'S TOP MANAGEMENT AND KEY EMPLOYEES INVOLVES OUR HUMAN RESOURCES DEPARTMENT. IT IS BASED ON A NUMBER OF CONSIDERATIONS SUCH AS THE NATURE AND SCOPE OF INDIVIDUAL DUTIES, BACKGROUND, EXPERTISE, SIZE, COMPLEXITY OF ORGANIZATION, AND AMOUNT PAID BY SIMILAR ORGANIZATIONS OF SIMILAR SIZE AND TYPE. HUMAN RESOURCES ROUTINELY CONDUCTS SALARY SURVEYS AND PERFORMS ASSESSMENTS OF THE JOB MARKET. THE FINAL DECISION RESTS WITH THE GOVERNING BOARD WHEN THE ANNUAL CORPORATE BUDGET IS REVIEWED AND APPROVED FOR ADOPTION.
FORM 990, PART VI, SECTION C, LINE 19GOVERNING DOCUMENTS, POLICIES AND FINANCIAL STATEMENTS ARE FURNISHED UPON REQUEST.
FORM 990, PART XII, LINE 2C:ALL REVIEW AND PROCESS FOR THE OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT AUDITOR REMAINS CONSISTENT BETWEEN YEARS.

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