INDIAN HEALTH CENTER OF SANTA CLARA VALLEY: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- INDIAN HEALTH CENTER OF SANTA CLARA VALLEY (EIN 94-2476242)
- Tax period
- 2016-07-01 to 2017-06-30
- Filed
- 2018-05-15
- IRS object ID
- 201801359349311635
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2018-05-15T17:18:59-05:00 | ReturnTs |
| Tax Period End | 2017-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 946214841 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Armanino LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 50 W San Fernando St Ste 500 | AddressLine1Txt |
| City | San Jose | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95113 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 942476242 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Indian Health Center | BusinessNameLine1Txt |
| Business Name Line2 | of Santa Clara Valley | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | INDI | BusinessNameControlTxt |
| Phone | 4084453400 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1333 Meridian Avenue | AddressLine1Txt |
| City | San Jose | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95125 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Jeff Cherniss | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 4084453400 | PhoneNum |
| Signature | 2018-05-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Lawrence S Kuechler | PreparerPersonNm |
| PTIN | P00233621 | PTIN |
| Phone | 4082006400 | PhoneNum |
| Preparation | 2018-05-15 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Jeff Cherniss | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1333 Meridian Avenue | AddressLine1Txt |
| City | San Jose | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95125 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $28,598,081 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.indianhealthcenter.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1977 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | Help ensure the survival and healing of American Indians/Alaskan Natives and our community. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 290 | TotalEmployeeCnt |
| Total Volunteers | 15 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $6,870,782 | PYContributionsGrantsAmt |
| CY Contributions Grants | $8,910,583 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $17,500,754 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $19,657,799 | CYProgramServiceRevenueAmt |
| PY Investment Income | $8,481 | PYInvestmentIncomeAmt |
| CY Investment Income | $4,868 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $4,565 | CYOtherRevenueAmt |
| PY Total Revenue | $24,380,017 | PYTotalRevenueAmt |
| CY Total Revenue | $28,577,815 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $1,463 | 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 | $14,773,875 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $17,689,230 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $8,721,424 | PYOtherExpensesAmt |
| CY Other Expenses | $10,476,761 | CYOtherExpensesAmt |
| PY Total Expenses | $23,496,762 | PYTotalExpensesAmt |
| CY Total Expenses | $28,165,991 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $883,255 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $411,824 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $21,981,446 | TotalAssetsBOYAmt |
| Total Assets EOY | $23,523,731 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $3,254,030 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $4,384,491 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $18,727,416 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $19,139,240 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | The mission of the Indian Health Center of Santa Clara Valley is to help ensure the survival and healing of American Indians/Alaskan Natives and our community by providing high quality, comprehensive health care and wellness services. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $16,104,319 | ExpenseAmt |
| Revenue | $16,603,401 | RevenueAmt |
| Desc | Medical Services: A broad range of primary health services for low-income children, families, and adults including general medical care, immunization, comprehensive prenatal and postnatal care, cancer prevention and screening, chronic disease management, and geriatric health services. 20,014 people were served during the year. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $2,599,878 | ExpenseAmt |
| Revenue | $2,754,319 | RevenueAmt |
| Desc | Dental Services: A broad range of restorative, preventive, and general dentistry services. 4,157 people were served during the year. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,995,019 | ExpenseAmt |
| Revenue | $183,382 | RevenueAmt |
| Desc | Counseling Services: Individual and group mental health counseling, psychiatric care, a state-cerified outpatient substance abuse program, and traditional American Indian ceremonies and gatherings. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp (2 entries)
| ExpenseExpenseAmt | RevenueRevenueAmt | DescDesc |
|---|---|---|
| $860,043 | $96,241 | Nutrition Services: WIC (Woman-Infant-Children): Food vouchers, nutrition counseling, and breastfeeding support for low-income women and their children. |
| $995,177 | $25,576 | Community Wellness Services: Health education, an award-winning and evidence-based diabetes prevention program, fitness in a state-of-the-art facility, nutrition counseling, case management, community outreach, and integrated wellness and medical services. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $1,855,220 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Revenue | $121,817 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $22,554,436 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | Yes (1) | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 65 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 290 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | CA | StatesWhereCopyOfReturnIsFldCd |
| Own Website | Yes (X) | OwnWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Jeff Cherniss | PersonNm |
| Phone | 4084453400 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1333 Meridian Avenue | AddressLine1Txt |
| City | San Jose | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95125 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|
| PABLO Viramontes | ||||||||
| President | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Chris Mele | ||||||||
| vice president | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Angel Riotutar | ||||||||
| Secretary | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| MIke Liu | ||||||||
| Treasurer | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| Amy Lopez | ||||||||
| Board Member | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Mike Roman | ||||||||
| Board Member | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Cheryl Marsden | ||||||||
| Board Member | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Paulette Pico | ||||||||
| Board Member | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| Sonya Tetnowski | ||||||||
| CEO | 40.00 | Yes (X) | $210,316 | $0 | $22,372 | |||
| Ira Singh | ||||||||
| COO | 40.00 | Yes (X) | $172,718 | $0 | $2,366 | |||
| Jeff Cherniss | ||||||||
| CFO-Hire 10/17/16 | 40.00 | Yes (X) | $37,667 | $0 | $3,548 | |||
| Anupama Balakrishnan | ||||||||
| CMO | 36.00 | Yes (X) | $177,579 | $0 | $10,979 | |||
| Deborah Baker | ||||||||
| CHRO-Term 10/5/17 | 40.00 | Yes (X) | $156,938 | $0 | $907 | |||
| Jesse Rokicki-Parashar | ||||||||
| Director of Clinical Quali | 36.00 | $172,601 | $0 | $23,914 | Yes (X) | |||
| Elizabeth McCraven | ||||||||
| Physician Associate Director | 40.00 | $194,932 | $0 | $12,972 | Yes (X) | |||
| Sonya Lobana | ||||||||
| Physician Associate Director | 40.00 | $195,426 | $0 | $5,863 | Yes (X) | |||
| Gerald Bausek | ||||||||
| Psychiatrist | 40.00 | $304,147 | $0 | $18,703 | Yes (X) | |||
| Maria Esmundo | ||||||||
| Physician Internal Medicine | 34.00 | $152,856 | $0 | $9,893 | Yes (X) | |||
| Barbara Miao | ||||||||
| CFO- Former | 40.00 | $105,521 | $0 | $4,450 | Yes (X) | |||
| Ria Paul | ||||||||
| CMO- Former | 40.00 | $147,825 | $0 | $5,765 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,028,526 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $121,732 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 24 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| FTG BUILDERS INC | |||||
| 2975 Scott Blvd Suite 100 | SANTA CLARA | CA | 95054 | Clinic Renovation | $2,528,363 |
| CFL CHILDREN'S MEDICAL ASSOCIATES INC | |||||
| 2039 Forest Ave Suite 304 | san jose | CA | 95128 | Contract Pediatric Provider | $1,100,000 |
| UNIVERSITY HEALTHCARE ALLIANCE | |||||
| 7999 Gateway Blvd | Newark | CA | 94560 | residency Program | $1,000,000 |
| ROBERt HALF INTERATIONAL INC | |||||
| 2613 Camino Ramon | SAN RAMON | CA | 94583 | Temp Agency | $665,995 |
| Hunter Health Clinic INC | |||||
| 2318 E Central | Wichita | KS | 67214 | Contracted Clinic | $121,187 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 22 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $7,289,837 | GovernmentGrantsAmt |
| All Other Contributions | $1,620,746 | AllOtherContributionsAmt |
| Noncash Contributions | $1,188,946 | NoncashContributionsAmt |
| Total Contributions | $8,910,583 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Medical services | 621110 | $16,903,480 | $16,903,480 |
| Dental services | 621110 | $2,754,319 | $2,754,319 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $19,657,799 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,868 | TotalRevenueColumnAmt |
| Exclusion | $4,868 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $19,711 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $20,266 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$555 | TotalRevenueColumnAmt |
| Exclusion | -$555 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS INCOME | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $5,120 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $5,120 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $5,120 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $28,577,815 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $19,662,919 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $4,313 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,071,674 | TotalAmt |
| Program Services | $204,098 | ProgramServicesAmt |
| Management And General | $867,576 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,115,801 | TotalAmt |
| Program Services | $11,260,273 | ProgramServicesAmt |
| Management And General | $1,855,528 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $156,670 | TotalAmt |
| Program Services | $128,569 | ProgramServicesAmt |
| Management And General | $28,101 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,256,743 | TotalAmt |
| Program Services | $1,784,255 | ProgramServicesAmt |
| Management And General | $472,488 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,088,342 | TotalAmt |
| Program Services | $890,971 | ProgramServicesAmt |
| Management And General | $197,371 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $42,820 | TotalAmt |
| Management And General | $42,820 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $164,443 | TotalAmt |
| Program Services | $143 | ProgramServicesAmt |
| Management And General | $164,300 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $58,147 | TotalAmt |
| Management And General | $58,147 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,437,036 | TotalAmt |
| Program Services | $2,579,070 | ProgramServicesAmt |
| Management And General | $857,966 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,440 | TotalAmt |
| Program Services | $751 | ProgramServicesAmt |
| Management And General | $11,689 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $77,452 | TotalAmt |
| Program Services | $44,147 | ProgramServicesAmt |
| Management And General | $33,305 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,735,519 | TotalAmt |
| Program Services | $1,428,682 | ProgramServicesAmt |
| Management And General | $306,837 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $151,482 | TotalAmt |
| Program Services | $74,826 | ProgramServicesAmt |
| Management And General | $76,656 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $75,458 | TotalAmt |
| Program Services | $75,458 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $982,109 | TotalAmt |
| Program Services | $953,798 | ProgramServicesAmt |
| Management And General | $28,311 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $125,452 | TotalAmt |
| Program Services | $46,996 | ProgramServicesAmt |
| Management And General | $78,456 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| supplies | $2,273,867 | $2,131,963 | $141,904 |
| Communications | $411,607 | $366,073 | $45,534 |
| DUES & SUBSCRIPTIIONS | $283,417 | $190,220 | $93,197 |
| Recruitment & Training | $244,806 | $146,459 | $98,347 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $400,706 | TotalAmt |
| Program Services | $247,684 | ProgramServicesAmt |
| Management And General | $153,022 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,165,991 | TotalAmt |
| Program Services | $22,554,436 | ProgramServicesAmt |
| Management And General | $5,611,555 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,041,284 | BOYAmt |
| EOY | $4,502,671 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,256,969 | BOYAmt |
| EOY | $2,261,159 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $962,993 | BOYAmt |
| EOY | $1,327,137 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,485,759 | BOYAmt |
| EOY | $2,956,849 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $200,089 | BOYAmt |
| EOY | $384,105 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $16,841,482 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $4,749,672 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,034,352 | BOYAmt |
| EOY | $12,091,810 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,981,446 | BOYAmt |
| EOY | $23,523,731 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,348,584 | BOYAmt |
| EOY | $2,526,056 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,905,446 | BOYAmt |
| EOY | $1,858,435 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,254,030 | BOYAmt |
| EOY | $4,384,491 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,727,416 | BOYAmt |
| EOY | $19,129,240 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $10,000 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,727,416 | BOYAmt |
| EOY | $19,139,240 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,981,446 | BOYAmt |
| EOY | $23,523,731 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $411,824 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | 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 | $5,287,767 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $6,505,354 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $6,726,750 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $6,870,782 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $8,910,583 | CurrentTaxYearAmt |
| Total | $34,301,236 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $5,287,767 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $6,505,354 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $6,726,750 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $6,870,782 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $8,910,583 | CurrentTaxYearAmt |
| Total | $34,301,236 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $34,301,236 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $9,032 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $7,606 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $8,412 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $8,481 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,868 | CurrentTaxYearAmt |
| Total | $38,399 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $329,056 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $87,729 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $238,129 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $22,536 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $24,831 | CurrentTaxYearAmt |
| Total | $702,281 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $35,041,916 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $62,637,993 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.97890 | PublicSupportCY170Pct |
| Public Support PY170 | 0.96910 | 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 D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,254,126 | OtherCostOrOtherBasisAmt |
| Book Value | $2,254,126 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $8,867,617 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,879,765 | DepreciationAmt |
| Book Value | $5,987,852 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,146,478 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,650,090 | DepreciationAmt |
| Book Value | $3,496,388 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $492,121 | OtherCostOrOtherBasisAmt |
| Depreciation | $164,245 | DepreciationAmt |
| Book Value | $327,876 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $81,140 | OtherCostOrOtherBasisAmt |
| Depreciation | $55,572 | DepreciationAmt |
| Book Value | $25,568 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $12,091,810 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $28,577,815 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $28,577,815 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $28,577,815 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $28,165,991 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $28,165,991 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $28,165,991 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part X, Line 2: | FormAndLineReferenceDesc |
| Explanation | IHCSCV has adopted the accounting guidance related to uncertain tax positions, and has evaluated its tax positions and believes that all of the positions taken by IHCSCV in its federal and state exempt organization tax returns are more likely than not to be sustained upon examination. IHCSCV's returns are subject to examination by federal and state taxing authorities generally for three years (federal) and four years (state) after they are filed. | ExplanationTxt |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | Comedy Jam | Event1Nm |
| Gross Receipts Event1 | $19,711 | GrossReceiptsEvent1Amt |
| Gross Revenue Event1 | $19,711 | GrossRevenueEvent1Amt |
| Rent Facility Costs Event1 | $4,228 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $7,931 | FoodAndBeverageEvent1Amt |
| Other Direct Expenses Event1 | $8,107 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $19,711 | GrossReceiptsTotalAmt |
| Gross Revenue Total Events | $19,711 | GrossRevenueTotalEventsAmt |
| Rent Fclty Costs Total Events | $4,228 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $7,931 | FoodAndBeverageTotalEventsAmt |
| Oth Direct Expnss Total Events | $8,107 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $20,266 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$555 | NetIncomeSummaryAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Sonya Tetnowski | ||||||||||||||
| CEO | $210,000 | $0 | $316 | $0 | $0 | $0 | $219 | $0 | $22,153 | $0 | $232,688 | $0 | $0 | $0 |
| Ira Singh | ||||||||||||||
| COO | $172,402 | $0 | $316 | $0 | $0 | $0 | $813 | $0 | $1,553 | $0 | $175,084 | $0 | $0 | $0 |
| Anupama Balakrishnan | ||||||||||||||
| CMO | $176,217 | $0 | $1,362 | $0 | $0 | $0 | $4,422 | $0 | $6,557 | $0 | $188,558 | $0 | $0 | $0 |
| Deborah Baker | ||||||||||||||
| CHRO-Term 10/5/17 | $156,622 | $0 | $316 | $0 | $0 | $0 | $0 | $0 | $907 | $0 | $157,845 | $0 | $0 | $0 |
| Jesse Rokicki-Parashar | ||||||||||||||
| Director of Clinical Quali | $171,761 | $0 | $840 | $0 | $0 | $0 | $4,458 | $0 | $19,456 | $0 | $196,515 | $0 | $0 | $0 |
| Elizabeth McCraven | ||||||||||||||
| Physician Associate Director | $194,616 | $0 | $316 | $0 | $0 | $0 | $4,327 | $0 | $8,645 | $0 | $207,904 | $0 | $0 | $0 |
| Sonya Lobana | ||||||||||||||
| Physician Associate Director | $195,110 | $0 | $316 | $0 | $0 | $0 | $4,277 | $0 | $1,586 | $0 | $201,289 | $0 | $0 | $0 |
| Gerald Bausek | ||||||||||||||
| Psychiatrist | $303,827 | $0 | $320 | $0 | $0 | $0 | $3,432 | $0 | $15,271 | $0 | $322,850 | $0 | $0 | $0 |
| Maria Esmundo | ||||||||||||||
| Physician Internal Medicine | $152,540 | $0 | $316 | $0 | $0 | $0 | $3,828 | $0 | $6,065 | $0 | $162,749 | $0 | $0 | $0 |
| Barbara Miao | ||||||||||||||
| CFO- Former | $105,521 | $0 | $0 | $0 | $0 | $0 | $766 | $0 | $3,684 | $0 | $109,971 | $0 | $0 | $0 |
| Ria Paul | ||||||||||||||
| CMO- Former | $147,825 | $0 | $0 | $0 | $0 | $0 | $2,177 | $0 | $3,588 | $0 | $153,590 | $0 | $0 | $0 |
Schedule M IRS990ScheduleM
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $1,188,946 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | fair market value | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part I, Column (b): | FormAndLineReferenceDesc |
| Explanation | the number reported is the number of contributors | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section B, line 11b | A copy of the Form 990 is provided to the governing board before it is filed. |
| Form 990, Part VI, Section B, line 12c | Policy & Procedure require that employees disclose any actual or potential conflict of interest and to contact administration with any questions related to conflicts. |
| Form 990, Part VI, Section B, line 15 | HR subscribes to 3 surveys and analyzed all positions in 2016. The Organization's board members reviewed and approved the compensation for the CEO based upon comparability data from 3 surveys. |
| Form 990, Part VI, Section C, line 19 | Indian Health Center of Santa Clara Valley's governing documents, conflict of interest policies, and financial statements are made available to the public upon request. |
| Form 990, Part IX, line 11g | Contractual Services: Program service expenses 2,210,014. Management and general expenses 794,518. Fundraising expenses 0. Total expenses 3,004,532. Professional Fees: Program service expenses 369,056. Management and general expenses 63,448. Fundraising expenses 0. Total expenses 432,504. |
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