2018-07-31T12:07:39-05:00 2017-12-31 BKD LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2017-01-01 680165855 SHASTA COMMUNITY HEALTH CENTER % SHERRY CALDWELL CFO SHAS 5302465710 1035 PLACER STREET REDDING CA 96001 SHERRY CALDWELL CFO 5302465710 2018-06-19 true Krystal K Creach P01248198 4178658701 2017 2022-09-23 18:48:47Z C DEAN GERMANO CEO 1035 PLACER STREET REDDING CA 96001 47502364 false X WWW.SHASTAHEALTH.ORG X 1988 CA CREATE A SEAMLESS SYSTEM OF ACCESS TO COMPASSIONATE, HIGH QUALITY, COST-EFFECTIVE PRIMARY AND PREVENTIVE HEALTH CARE FOR ALL RESIDENTS OF THE COMMUNITY IT SERVES. 15 15 484 15 68826 57805 8210388 8787916 31483161 37543512 203157 169085 27238 25949 39923944 46526462 0 0 0 0 27777049 30442641 0 0 191504 9386583 9855447 37163632 40298088 2760312 6228374 41091588 51022314 6552348 10779078 34539240 40243236 X CREATE A SEAMLESS SYSTEM OF ACCESS TO COMPASSIONATE, HIGH QUALITY, COST-EFFECTIVE PRIMARY AND PREVENTIVE HEALTH AND DENTAL CARE FOR ALL RESIDENTS OF THE COMMUNITY IT SERVES, PARTICULARLY FOR THOSE RESIDENTS WHO ARE ECONOMICALLY OR OTHERWISE DISADVANTAGED. false false 23638031 32292164 SHASTA COMMUNITY HEALTH CENTER (SCHC) IS A KEY PROVIDER OF THE HEALTH CARE SAFETY NET SERVICES IN NORTHERN CALIFORNIA, PROVIDING MEDICAL, MENTAL HEALTH AND SUBSTANCE ABUSE SERVICES TO 34,162 PATIENTS (142,276 VISITS) IN 2017. SCHC ALSO HAS AN EXTENSIVE OUTREACH TO THE HOMELESS PROGRAM, SERVICES FOR HIV PATIENTS AND IS ONE OF THE FEW MEDICAL RESOURCES FOR THE LOW INCOME POPULATIONS, ESPECIALLY THOSE WITH INCOME BELOW 200% OF THE FEDERAL POVERTY GUIDELINE AND THE UNINSURED. 3631681 3335027 SHASTA COMMUNITY HEALTH CENTERS DENTISTS PROVIDE DENTAL SERVICES TO THE LOW INCOME POPULATIONS: THOSE WITH INCOME BELOW 200% OF THE FEDERAL POVERTY GUIDELINE, THE HOMELESS POPULATION, AND THE UNINSURED. DURING 2017, SCHCS DENTISTS SERVED 8,041 PATIENTS (21,513 VISITS). 1915460 1916321 SHASTA COMMUNITY HEALTH CENTER IS A MAJOR PROVIDER OF MENTAL HEALTH SERVICES IN SHASTA COUNTY, SEEING 1,861 (9,546 VISITS) PATIENTS DURING 2017. 533883 29719055 true true false true false false false false false false true false false true true false false true false false false false false false false false false false false true false false false false false false true false true false false false false true true true false false true 84 0 true 484 true false false false false false false false false false false X 15 15 false false false false false false false true true false false true true true true true true true true false CA X SHERRY CALDWELL CFO 5302465763 1035 PLACER STREET REDDING CA 96001 KERRY FASKING CHAIRPERSON 3.0 0.5 X X 0 0 0 LYDIA BUCKLEY VICE CHAIRPERSON 3.0 0.5 X X 0 0 0 JOHN DI PERRY TREASURER 3.0 0.5 X X 0 0 0 RAY HAMBY SECRETARY 3.0 0.5 X X 0 0 0 MARGARET BECK COMMUNITY MEMBER 2.0 0.5 X 0 0 0 AMPARO BUCK COMMUNITY MEMBER 2.0 0.5 X 0 0 0 MARK ELIASON COMMUNITY AND PROVIDER MEMBER 2.0 0.5 X 0 0 0 JOHN KENNY COMMUNITY MEMBER 2.0 0.5 X 0 0 0 CLARENCE LIM CONSUMER MEMBER 2.0 0.5 X 0 0 0 WENDY LONGWELL CONSUMER MEMBER 2.0 0.5 X 0 0 0 KIM MIRANDA COMMUINTY AND PROVIDER MEMBER 2.0 0.5 X 0 0 0 ESTEFANIE SHAFER CONSUMER MEMBER 2.0 0.5 X 0 0 0 BRIAN SPILLANE CONSUMER MEMBER 2.0 0.5 X 0 0 0 MAJORIE STRAIN CONSUMER MEMBER 2.0 0.5 X 0 0 0 DOT VAN CLEAVE CONSUMER MEMBER 2.0 0.5 X 0 0 0 C DEAN GERMANO CHIEF EXECUTIVE OFFICER 40.0 0.5 X 285218 0 44655 SHERRY CALDWELL CHIEF FINANCIAL OFFICER 40.0 10.25 X 186352 0 14816 ROBIN GLASCO CHIEF OF OPERATIONS 40.0 0.0 X 181415 0 27553 JEFREY BOSWORTH MD CHIEF MEDICAL OFFICER 40.0 0.0 X 342457 0 21816 DOROTHY BRATTON-SANDOVAL PA PHYSICIAN ASSISTANT 40.0 0.0 X 163796 0 35153 FRANKLIN PIERCE DDS DIRECTOR OF DENTAL OPERATIONS 39.0 0.0 X 177409 0 33164 IMRAN KHAN MD MEDICAL DIRECTOR OF PCN 36.0 0.0 X 245029 0 41247 ELAINE LARAWAY MD MEDICAL DIRECTOR 40.0 0.0 X 187793 0 34692 PATRICIA SAND MD PHYSICIAN 36.0 0.0 X 213121 0 33690 RHETT GROVER DO DIRECTOR OF URGENT CARE PRACT 40.0 0.0 X 213536 0 39441 PAUL DAVAINIS MD PHYSICIAN 42.0 0.0 X 221854 0 34397 DEBBIE LUPEIKA MD DIRECTOR OF RESIDENCY PROGRAM 43.0 0.0 X 243392 0 38069 MELISSA TASISTA DO MEDICAL DIRECTOR OF FAM PRACT 46.0 0.0 X 244963 0 30256 NITIN BAGUL MD PHYSICIAN 40.0 0.0 X 279682 0 37660 KELLY CARTER MD PEDIATRICIAN 40.0 0.0 X 260636 0 42742 PAMELA KNICKERBOCKER DO MEDICAL DIRECTOR 49.0 0.0 X 255627 0 36486 DOUGLAS MCMULLIN MD PHYSICIAN 44.0 0.0 X 252093 0 8316 SEAN DUGAN MD PHYSICIAN 41.0 0.0 X 247119 0 35761 4201492 0 589914 51 false true false PSYCHIATRIC CTRS AT SAN DIEGO PO BOX 609001 SAN DIEGO CA 92160 PSYCHIATRIC SERVICES 183086 MICHAEL OLINGER PO BOX 98 ANDERSON CA 96007 LAUNDRY & MATS 155885 SHASTA TEHAMA JOINT COLLEGE PO BOX 496006 REDDING CA 960496006 RENTAL SPACE 138394 BKD LLP PO BOX 1190 SPRINGFIELD MO 658011190 AUDIT/TAX SERVICE 160293 4 8172846 615070 1469740 8787916 NET PATIENT SERVICE REVENUE 621400 28951080 28951080 340B PROGRAM CONTRACTED PHARMACIES 621400 4657009 4657009 QUALITY IMPROVEMENT BONUS (MCO) 621400 3020192 3020192 MEANINGFUL USE 621400 680000 680000 OTHER 621400 131365 62539 68826 103866 103866 37543512 245195 245195 0 0 25949 25949 0 25949 25949 899792 975902 -76110 -76110 -76110 0 0 0 0 0 0 0 0 0 0 46526462 37474686 68826 195034 0 0 0 0 3335283 2231002 1104281 254177 254177 20659185 16045200 4470806 143179 565773 462592 96681 6500 3906661 2860780 1026610 19271 1721562 1295480 414628 11454 0 88688 88688 165273 165273 7843 12 7831 0 0 1470976 931412 539564 14553 47 14506 984744 459256 525488 679096 146786 532310 0 1357621 922699 426322 8600 34261 25184 9077 0 467541 202065 262976 2500 133120 7002 126118 0 568795 442099 126696 143234 93260 49974 DRUGS AND MEDICATIONS 2127973 2125731 2242 MEDICAL SUPPLIES AND DRUGS 705403 684306 21097 RECRUITMENT 239164 94813 144351 BAD DEBT 205416 203264 2152 461746 231888 229858 40298088 29719055 10387529 191504 17792 21670 12233363 13213122 230864 574516 4976873 4386020 0 0 0 0 14119600 19797704 247296 297097 332244 293283 11964633 6541141 6709276 5423492 2023768 2186887 0 0 0 0 0 0 200512 4828523 41091588 51022314 4558603 4041847 0 0 20589 11083 0 0 0 0 0 0 225508 4125140 0 0 1747648 2601008 6552348 10779078 X 34504721 40134797 34519 108439 0 0 34539240 40243236 41091588 51022314 X 6228374 76622 -601000 X false true true true true X 11338992 7130411 7952802 8210388 8787916 43420509 0 0 11338992 7130411 7952802 8210388 8787916 43420509 0 43420509 69085 201211 199551 234113 245195 949155 0 0 44369664 150968391 0.97861 0.98133 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED true false false true false false true false true 7843 7843 false SCHEDULE C, PART II-B, LINES 1A, D, G & I LOBBYING EXPENSES: SHASTA COMMUNITY HEALTH CENTER (SCHC) PAYS DUES TO THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS (NACHC) AND TO THE CALIFORNIA PRIMARY CARE ASSOCIATION (CPCA). OF THESE DUES, A SMALL PORTION IS USED FOR LOBBYING PURPOSES FOR A TOTAL OF $7,843. AS PERTINENT MATTERS ARISE, SCHCS PROFESSIONAL ASSOCIATIONS ADVISE IT OF OPPORTUNITIES TO CONTACT APPROPRIATE OFFICIALS OF THE STATE, LOCAL AND FEDERAL GOVERNMENTS TO EMPHASIZE THE NEEDS OF THE UNINSURED AND UNDERSERVED IN SCHCS COMMUNITIES AND THEIR CONSTITUENTS. BOTH EMPLOYEES AND BOARD MEMBERS ARE INVOLVED IN THESE ACTIVITIES THROUGH THE USE OF E-MAIL, PHONE CALLS AND FAX. SCHC SENDS A FEW EMPLOYEES AND BOARD MEMBERS TO "A DAY AT THE CAPITAL" IN SACRAMENTO, CA, WHERE THEY MEET WITH REPRESENTATIVES AND SENATORS TO DISCUSS CURRENT HEALTH RELATED POLICIES AND LEGISLATURE AND ATTEMPT TO INFLUENCE REFORM. 953579 953579 5436993 2430162 3006831 827750 681727 146023 3428566 2338242 1090324 1317745 1091010 226735 5423492 DEPOSITS 293991 ESTIMATED MEDI-CAL SETTLEMENTS 4527112 DUE FROM RELATED PARTY 7420 4828523 0 ESTIMATED SELF-INSURANCE COST 410000 ESTIMATED MEDI-CAL SETTLEMENTS 2123578 DEFERRED COMPENSATION 67430 2601008 46841202 76622 162008 238630 46602572 -76110 -76110 46526462 40536206 162008 76110 238118 40298088 40298088 SCHEDULE D, PART X, LINE 2 UNCERTAIN TAX POSITIONS: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. SCHEDULE D, PART XI, LINE 4B AMOUNTS INCLUDED ON FORM 990, PART VIII, LINE 12, BUT NOT ON LINE 1: $ (11,555) LOSS ON DISPOSAL OF PROPERTY (64,555) LOSS ON TRANSFER OF ASSETS TO SUBSIDIARY ---------- $ (76,110) SCHEDULE D, PART XII, LINE 2D AMOUNTS INCLUDED ON LINE 1 BUT NOT ON FORM 990, PART IX, LINE 25: $ 11,555 LOSS ON DISPOSAL OF PROPERTY 64,555 LOSS ON TRANSFER OF ASSETS TO SUBSIDIARY --------- $ 76,110 X X X X X false true false false false false false true false C DEAN GERMANO CHIEF EXECUTIVE OFFICER 248031 0 37187 0 0 41377 0 3278 0 329873 0 0 0 SHERRY CALDWELL CHIEF FINANCIAL OFFICER 173752 0 12600 0 0 6500 0 8316 0 201168 0 0 0 ROBIN GLASCO CHIEF OF OPERATIONS 168457 0 12958 0 0 8573 0 18980 0 208968 0 0 0 JEFREY BOSWORTH MD CHIEF MEDICAL OFFICER 318394 0 24063 0 0 13500 0 8316 0 364273 0 0 0 DOROTHY BRATTON-SANDOVAL PA PHYSICIAN ASSISTANT 156204 0 7592 0 0 8085 0 27068 0 198949 0 0 0 FRANKLIN PIERCE DDS DIRECTOR OF DENTAL OPERATIONS 164091 0 13318 0 0 8511 0 24653 0 210573 0 0 0 IMRAN KHAN MD MEDICAL DIRECTOR OF PCN 226929 0 18100 0 0 11879 0 29368 0 286276 0 0 0 ELAINE LARAWAY MD MEDICAL DIRECTOR 163783 0 24010 0 0 8274 0 26418 0 222485 0 0 0 PATRICIA SAND MD PHYSICIAN 173378 0 39743 0 0 8901 0 24789 0 246811 0 0 0 RHETT GROVER DO DIRECTOR OF URGENT CARE PRACT 189816 0 23720 0 0 9973 0 29468 0 252977 0 0 0 PAUL DAVAINIS MD PHYSICIAN 204454 0 17400 0 0 9929 0 24468 0 256251 0 0 0 DEBBIE LUPEIKA MD DIRECTOR OF RESIDENCY PROGRAM 225592 0 17800 0 0 11001 0 27068 0 281461 0 0 0 MELISSA TASISTA DO MEDICAL DIRECTOR OF FAM PRACT 226763 0 18200 0 0 5788 0 24468 0 275219 0 0 0 NITIN BAGUL MD PHYSICIAN 257902 0 21780 0 0 13192 0 24468 0 317342 0 0 0 KELLY CARTER MD PEDIATRICIAN 227893 0 32743 0 0 10674 0 32068 0 303378 0 0 0 PAMELA KNICKERBOCKER DO MEDICAL DIRECTOR 234927 0 20700 0 0 12018 0 24468 0 292113 0 0 0 DOUGLAS MCMULLIN MD PHYSICIAN 234973 0 17120 0 0 0 0 0 8316 0 260409 0 0 0 SEAN DUGAN MD PHYSICIAN 224089 0 23030 0 0 11293 0 24468 0 282880 0 0 0 SCHEDULE J, PART I, LINE 4B SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN: C. DEAN GERMANO, CEO, IS COVERED BY A 457(F) SUPPLEMENTAL RETIREMENT AGREEMENT FROM SHASTA COMMUNITY HEALTH CENTER WHICH WAS FUNDED THIS YEAR BY $29,640. SCHEDULE J, PART I, LINE 7 NON-FIXED PAYMENTS: SENIOR MANAGEMENT BONUSES ARE DETERMINED EACH YEAR BASED ON INTERNAL METRICS AND INDIVIDUAL PERFORMANCE. ALL CLINICIANS GET PAID A MONTHLY BONUS BASED ON THE AMOUNT OF ENCOUNTERS OVER BUDGETED EXPECTATIONS. 0 KRISTEN ANDERSON SEE PART V 144931 EMPLOYEE COMP & BENEFITS false PETER SAND SEE PART V 38024 EMPLOYEE COMP & BENEFITS false SARA CHOUDHRY SEE PART V 71222 EMPLOYEE COMP & BENEFITS false SCHEDULE L, PART IV, LINE 1 RELATIONSHIP BETWEEN INTERESTED PERSON AND THE ORGANIZATION: KRISTEN ANDERSON IS THE DAUGHTER OF JEFFREY BOSWORTH, CHIEF MEDICAL OFFICER OF SHASTA COMMUNITY HEALTH CENTER. PETER SAND IS THE SON OF PATRICIA SAND, DIRECTOR OF PEDIATRICS OF SHASTA COMMUNITY HEALTH CENTER. SARAH CHOUDHRY IS THE WIFE OF IMRAN KHAN, DIRECTOR OF PCN OF SHASTA COMMUNITY HEALTH CENTER. X 18 1469740 FMV false true false SCHEDULE M, PART I, COLUMN B NUMBER OF CONTRIBUTIONS: THE NUMBER OF CONTRIBUTIONS WAS DETERMINED BY THE NUMBER OF CONTRIBUTORS. FORM 990, PART III, LINE 4D OTHER PROGRAM SERVICES: COMMUNITY EDUCATION WE HAVE EXPANDED OUR COMMUNITY EDUCATION TO HELP OUR PATIENTS MANAGE AND COPE WITH CHRONIC HEALTH ISSUES. CLASSES ON DIABETES, SMOKING CESSATION, HEALTHIER LIVING, AND YOGA ARE OFFERED. FORM 990, PART VI, SECTION B, LINE 11 FORM 990 BOARD REVIEW POLICY: THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. THE CHIEF FINANCIAL OFFICER AND DIRECTOR OF FINANCE DO AN EXTENSIVE REVIEW OF THE FORM WITH THE CURRENT CPA FIRM. THE BOARD OF DIRECTORS IS PROVIDED A COMPLETE COPY OF THE FORM 990 THROUGH EMAIL DISTRIBUTION. THE DIRECTORS ARE GIVEN A PERIOD OF ONE WEEK TO REVIEW THE FORM 990, TO COMMENT AND TO ASK ANY PERTINENT QUESTIONS. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST POLICY COMPLIANCE: SHASTA COMMUNITY HEALTH CENTER (SCHC) IS COMMITTED TO STRICT COMPLIANCE OF ITS CONFLICT OF INTEREST POLICY. THE BOARD, OFFICERS, AND MANAGEMENT EMPLOYEES HAVE THE RESPONSIBILITY OF ADMINISTERING THE AFFAIRS OF SCHC HONESTLY AND PRUDENTLY AND OF EXERCISING THEIR BEST CARE, SKILL, AND JUDGMENT FOR THE SOLE BENEFIT OF SCHC. THE INTERESTS OF THE ORGANIZATION MUST BE THE FIRST PRIORITY IN ALL DECISIONS AND ACTIONS. IT IS THE POLICY OF SCHC'S BOARD THAT THE EXISTENCE OF ANY CONFLICTS OF INTEREST BE DISCLOSED BEFORE ANY TRANSACTION IS CONSUMMATED. IT IS THE CONTINUING RESPONSIBILITY OF THE BOARD, OFFICERS, AND MANAGEMENT EMPLOYEES TO SCRUTINIZE ITS TRANSACTIONS AND OUTSIDE BUSINESS INTERESTS AND RELATIONSHIPS FOR POTENTIAL CONFLICTS AND TO IMMEDIATELY MAKE SUCH DISCLOSURES. DISCLOSURE IS MADE TO THE CHIEF EXECUTIVE OFFICER (OR IF HE OR SHE IS THE ONE WITH THE CONFLICT, THEN TO THE BOARD CHAIR), WHO BRINGS THE MATTER TO THE ATTENTION OF THE BOARD, OR A DULY CONSTITUTED COMMITTEE THEREOF. DISCLOSURE INVOLVING DIRECTORS IS MADE TO THE BOARD CHAIR, (OR IF HE OR SHE IS THE ONE WITH THE CONFLICT, THEN TO THE BOARD VICE-CHAIR). THE BOARD, OR A DULY CONSTITUTED COMMITTEE THEREOF, DETERMINES WHETHER A CONFLICT EXISTS AND IN THE CASE OF AN EXISTING CONFLICT, WHETHER THE CONTEMPLATED TRANSACTION MAY BE AUTHORIZED AS JUST, FAIR, AND REASONABLE TO SCHC. ANY CONFLICTS OF INTEREST ARE PROMPTLY ADDRESSED AND THE PERSON WITH THE CONFLICT IS EXCLUDED FROM THE DISCUSSION AND APPROVAL OF ANY RELATED TRANSACTIONS. FORM 990, PART VI, SECTION B, LINES 15A & 15B COMPENSATION DETERMINATION POLICY: SHASTA COMMUNITY HEALTH CENTER (SCHC) DOES AN ANNUAL SALARY SURVEY FOR ALL EMPLOYEES, INCLUDING OFFICERS AND KEY EMPLOYEES. THIS REVIEW IS CONDUCTED BY THE HR MANAGERS WORKING IN CONJUNCTION WITH AN OUTSIDE CONSULTANT. THE REVIEW FOR EACH POSITION CONSISTS OF MARKET SALARY SURVEYS, INCLUDING INDUSTRY SPECIFIC AND REGIONAL DATA. THE RESULTS OF THIS INFORMATION ARE REVIEWED BY SENIOR MANAGEMENT. THIS REVIEW USUALLY IS CONTEMPORANEOUSLY CONDUCTED DURING THE ANNUAL EVALUATION PERIOD. THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS DIRECTLY REVIEWS THE RESULTS OF CHIEF EXECUTIVE OFFICER'S SURVEY RESULTS. ALL CHANGES ARE THEN DOCUMENTED IN THE CEO'S CONTRACT ADDENDUM. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENT DISCLOSURE: THE ORGANIZATION PROVIDES TO INTERESTED PARTIES FINANCIAL STATEMENTS, IRS FORM 990, AND OTHER DOCUMENTS AND POLICIES UPON REQUEST. FORM 990, PART XI, LINE 9 OTHER CHANGES IN NET ASSETS: $ (601,000) TRANSFER TO SUBSIDIARY SCHC PROPERTY CORPORATION 1035 PLACER STREET REDDING CA 96001 463207999 RE HOLDING CA 501(C)(3) 12A I SHASTA CHC true ANDERSON PROPERTY CORPORATION 2965 EAST STREET ANDERSON CA 96007 815371499 RE HOLDING CA 501(C)(3) 12A I SHASTA CHC true false false false false false false false false false true false false true true true true true false SCHC PROPERTY CORPORATION K 211124 FMV ANDERSON PROPERTY CORPORATION R 601000 FMV