2025-10-02T17:59:01-05:00 2024-12-31 390859910 BAKER TILLY ADVISORY GROUP LP 101 SECOND STREET SUITE 900 SAN FRANCISCO CA 94105 990 2024-01-01 237310613 WEST COUNTY HEALTH CENTERS INC WEST 7078695977 PO BOX 1449 GUERNEVILLE CA 95446 JASON CUNNINGHAM DO CHIEF EXECUTIVE OFFICER 7078695977 2025-10-02 1 0 MICHAEL LUMSDEN P01262236 4159561500 2025-10-02 2024 2025-03-06 01:10:19Z JASON CUNNINGHAM DO PO BOX 1449 GUERNEVILLE CA 95446 30892515 0 X WWW.WCHEALTH.ORG X 1973 CA WEST COUNTY HEALTH CENTERS INC. IS A PRIVATE, NON-PROFIT FEDERALLY QUALIFIED HEALTH CENTER PROVIDING QUALITY HEALTH SERVICES TO THE WHOLE COMMUNITY REGARDLESS OF ABILITY TO PAY. 14 14 266 15 0 0 6707663 7063708 18513785 23366254 136635 77247 72935 385306 25431018 30892515 0 0 0 0 16249820 17970162 0 0 0 11481750 12654639 27731570 30624801 -2300552 267714 29779485 30953228 16568280 17493750 13211205 13459478 X TO PROVIDE COMPREHENSIVE, QUALITY, AND ACCESSIBLE HEALTH CARE SERVICES TO THE COMMUNITIES OF WESTERN SONOMA COUNTY. 0 0 18880682 0 23366254 WEST COUNTY HEALTH CENTER OFFERS A FULL SCOPE OF PRIMARY MEDICAL, DENTAL CARE, MENTAL HEALTH, AND CONFIDENTIAL TEEN SERVICES AT 11 SITES THROUGHOUT WESTERN SONOMA COUNTY. OUR HIGHLY QUALIFIED HEALTH CARE TEAM CONSISTS OF PHYSICIANS, MID-LEVEL PROVIDERS (FAMILY NURSE PRACTITIONERS AND PHYSICIAN ASSISTANTS), DENTISTS, PSYCHOTHERAPISTS, AND NURSES, AND ARE SUPPORTED BY MEDICAL AND DENTAL ASSISTANTS, OUTREACH WORKERS, AND ADMINISTRATIVE STAFF. ALL OF OUR EMPLOYEES ARE COMMITTED TO PROVIDING COMPASSIONATE AND ACCESSIBLE CARE FOR ALL MEMBERS OF OUR DIVERSE COMMUNITY. MANY OF OUR STAFF MEMBERS ARE BILINGUAL IN SEVERAL LANGUAGES, INCLUDING SPANISH AND VIETNAMESE. WEST COUNTY HEALTH CENTERS DELIVERS HEALTH CARE TO AN IMPORTANT CROSS-SECTION OF OUR COMMUNITY, INCLUDING ELEMENTARY AGE CHILDREN WHOSE PARENTS CANNOT OTHERWISE AFFORD THE MEDICAL CARE NEEDED TO KEEP THEM HEALTHY AND ACTIVE IN SCHOOLS; THOSE WHO ARE NOT ACCEPTED ELSEWHERE DUE TO HIV/AIDS, HOMELESSNESS, MENTAL ILLNESS OR ADDICTION; THOSE IN THE COMMUNITY WHO LACK THE FINANCIAL RESOURCES TO PAY FOR QUALITY HEALTH CARE; AS WELL AS MANY OTHERS. NO PATIENT IS TURNED AWAY FROM WEST COUNTY HEALTH CENTER FOR LACK OF FUNDS. 18880682 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 34 0 1 266 1 0 0 0 0 0 0 0 0 0 0 0 0 X 14 14 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X ROBERT HEINEMEIER 7078695977 PO BOX 1449 GUERNEVILLE CA 95446 JASON CUNNINGHAM DO CHIEF EXECUTIVE OFFICER 40.00 X 256759 0 18852 RAIN MOORE MD CHIEF MEDICAL OFFICER, OCCIDENTAL 40.00 X 228528 0 14617 DAVID THAI DDS DENTAL DIRECTOR 40.00 X 210177 0 14967 DEETTE DEVILLE MD CHIEF MEDICAL OFFICER, RUSSIAN RIVER 40.00 X 206820 0 17789 ADAM FRANCIS MD CHIEF MEDICAL OFFICER, GRAVENSTEIN 40.00 X 210709 0 11838 ANDREA SEIFFERTT DO SITE MEDICAL DIRECTOR 40.00 X 189992 0 14409 ANN-ELIZABETH GREIGO MD PHYSICIAN 40.00 X 195018 0 3808 BROOKE VEZINO MD PHYSICIAN 40.00 X 181087 0 15852 ELLEN BAUER PHD CHIEF ADMINISTRATIVE OFFICER 40.00 X 175812 0 13562 CARROLL BROWN FNP/PA 40.00 X 176338 0 3962 MICHAEL KOZART MD CHIEF PSYCHIATRIST 40.00 X 172584 0 4416 ROBERT HEINEMEIER CHIEF FINANCIAL OFFICER 40.00 X 0 0 0 JOHN KORNFELD PHD BOARD PRESIDENT 1.00 X X 0 0 0 DEBRA JOHNSON BOARD VICE PRESIDENT 1.00 X X 0 0 0 MARY KUSSMAUL BOARD SECRETARY 1.00 X X 0 0 0 DWIGHT CARY BOARD TREASURER 1.00 X X 0 0 0 MORGAN CONWAY-O'NEILL BOARD MEMBER (START 11/2024) 1.00 X 0 0 0 ANGELES DAVID BOARD MEMBER 1.00 X 0 0 0 ELIOT ENRIQUEZ BOARD MEMBER 1.00 X 0 0 0 ALICE FIDDIAN-GREEN BOARD MEMBER 1.00 X 0 0 0 JANET FLORES BOARD MEMBER (START 9/2024) 1.00 X 0 0 0 PAULETTE HALL BOARD MEMBER 1.00 X 0 0 0 HENRY JAKE HAMLIN BOARD MEMBER 1.00 X 0 0 0 JENNIFER NICHOLS BOARD MEMBER (THROUGH 4/2024) 1.00 X 0 0 0 WHITNEY REULING BOARD MEMBER 1.00 X 0 0 0 ALAN SIEGLE BOARD MEMBER 1.00 X 0 0 0 MERI HARDING STORINO BOARD MEMBER 1.00 X 0 0 0 2203824 0 134072 33 0 1 0 SCANSTAT TECHNOLOGIES PO BOX 201327 DALLAS TX 753201327 CONTRACTED REFERRALS SERVICES 594235 KLH CONSULTING INC 2324 BETHARDS DRIVE SANTA ROSA CA 95405 IT CONSULTING SERVICES 591096 MAXIMON VENTURES LLC 900 PACIFIC COAST HWY STE 105 HUNTINGTON BEACH CA 92648 CONSULTING - CFO / IT / ACCOUNTING 508327 DR CATALYST LLC PO BOX 255436 SACRAMENTO CA 95865 CONTRACTED VIRTUAL SERVICES 234426 WRITE CHOICE NETWORK 19152 247TH AVENUE BETTENDORF IA 52722 CONSULTING - GRANTS & COMPLIANCE 214992 5 5003695 2060013 7063708 NET PATIENT SERVICE REVENUE 621400 16845949 16845949 340B PHARMACY REVENUE 456110 6036452 6036452 CAPITATION REVENUE 621400 417568 417568 OTHER REVENUE 523000 66285 66285 23366254 64464 64464 12783 12783 67000 0 67000 67000 67000 INSURANCE SETTLEMENTS 900099 318306 318306 318306 30892515 23366254 0 462553 1675430 915445 759985 13361025 8517809 4843216 210996 132341 78655 1609779 1007988 601791 1112932 698079 414853 53804 53804 77232 77232 2729993 101299 2628694 17088 37 17051 471479 96069 375410 1117083 25020 1092063 1703038 1527402 175636 44090 13318 30772 68557 40454 28103 358450 327267 31183 1102234 1000198 102036 351569 121824 229745 MEDICAL SUPPLIES/DRUGS 4426930 4336807 90123 DUES, FEES, MEMBERSHIPS 114467 4043 110424 EQUIPMENT EXPENSES 13698 13698 TAXES & LICENSES 4927 1584 3343 30624801 18880682 11744119 0 52859 277374 3630572 2708513 728138 127609 2928446 2962491 504114 585693 407052 396592 22078962 5287027 17096999 16791935 255573 251404 4175732 6851617 29779485 30953228 2251732 2447834 734517 860900 9454958 9246512 406627 381930 3720446 4556574 16568280 17493750 X 12732747 12840821 478458 618657 13211205 13459478 29779485 30953228 267714 -19441 0 X 0 1 X 1 1 1 X 9712542 10808632 9915724 6707663 7063708 44208269 9712542 10808632 9915724 6707663 7063708 44208269 3989755 40218514 27536 36305 78118 209570 144247 495776 46694 318306 365000 45069045 86167673 0.89240 0.92900 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: INSURANCE PROCEEDS / SETTLEMENTS - 2022 AMOUNT: $ 46,694. 2024 AMOUNT: $ 318,306. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 7500 7500 0 PART II-B, LINE 1: DURING 2024, THE ORGANIZATION PAID DUES TO THE CALIFORNIA PRIMARY CARE ASSOCIATION; A PORTION OF THOSE DUES ($7,500) HAVE BEEN INDICATED AS USED FOR LOBBYING ACTIVITIES PERTAINING TO THE HEALTHCARE INDUSTRY. 1095744 1095744 17018969 3245272 13773697 1599045 998760 600285 2075144 1042995 1032149 290060 290060 16791935 DEPOSITS 33188 ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS 3948186 OPERATING LEASE RIGHT-OF-USE ASSETS 2870243 6851617 ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS 1582125 OPERATING LEASE LIABILITIES 2974449 4556574 X 30873074 -19441 -19441 30892515 0 30892515 30624801 0 30624801 0 30624801 PART X, LINE 2: THE CENTER IS A NONPROFIT CORPORATION UNDER INTERNAL REVENUE CODE SECTION 501(C)(3) AND HAS BEEN GRANTED TAX-EXEMPT STATUSES BY THE INTERNAL REVENUE SERVICE AND THE CALIFORNIA REVENUE AND TAXATION CODE. AS OF DECEMBER 31, 2024, THE CENTER HAD NO UNRECOGNIZED TAX POSITIONS OR UNCERTAIN TAX POSITIONS REQUIRING ACCRUAL. THEREFORE, NO PROVISION FOR INCOME TAXES HAS BEEN PROVIDED IN THE FINANCIAL STATEMENTS. X X 0 0 0 0 0 0 0 0 0 JASON CUNNINGHAM DO CHIEF EXECUTIVE OFFICER 246025 0 10734 0 0 0 5367 0 13485 0 275611 0 0 0 RAIN MOORE MD CHIEF MEDICAL OFFICER, OCCIDENTAL 198819 0 29709 0 0 0 4571 0 10046 0 243145 0 0 0 DAVID THAI DDS DENTAL DIRECTOR 201770 0 8407 0 0 0 4204 0 10763 0 225144 0 0 0 DEETTE DEVILLE MD CHIEF MEDICAL OFFICER, RUSSIAN RIVER 197983 0 8837 0 0 0 4418 0 13371 0 224609 0 0 0 ADAM FRANCIS MD CHIEF MEDICAL OFFICER, GRAVENSTEIN 187709 0 23000 0 0 0 1767 0 10071 0 222547 0 0 0 ANDREA SEIFFERTT DO SITE MEDICAL DIRECTOR 182392 0 7600 0 0 0 3800 0 10609 0 204401 0 0 0 ANN-ELIZABETH GREIGO MD PHYSICIAN 172018 0 23000 0 0 0 3120 0 688 0 198826 0 0 0 BROOKE VEZINO MD PHYSICIAN 173596 0 7491 0 0 0 3745 0 12107 0 196939 0 0 0 ELLEN BAUER PHD CHIEF ADMINISTRATIVE OFFICER 158231 0 17581 0 0 0 3516 0 10046 0 189374 0 0 0 CARROLL BROWN FNP/PA 167520 0 8818 0 0 0 3527 0 435 0 180300 0 0 0 MICHAEL KOZART MD CHIEF PSYCHIATRIST 165681 0 6903 0 0 0 3452 0 964 0 177000 0 0 0 A CALIFORNIA MUNICIPAL FINANCE AUTHORITY 201563466 13048VQH4 2020-10-14 10519473 CONSTRUCTION OF NEW HEALTH CENTER BUILDING 0 0 0 A 375000 10519473 281118 210389 519600 9319407 188959 2022 0 0 1 1 A 0 0 1 1 0 0.00000 0.00000 0.00000 0 0 1 A 0 1 0 0 0 0 0 0 1 A 1 FORM 990, PART VI, SECTION A, LINE 3 THE ORGANIZATION'S CHIEF FINANCIAL OFFICER IS A CONSULTANT EMPLOYED BY MAXIMON VENTURES, LLC. TOTAL COMPENSATION PAID TO MAXIMON VENTURES, LLC DURING THE 2024 TAX YEAR WAS $508,327, WHICH INCLUDED $295,000 FOR THE SERVICES OF THE CHIEF FINANCIAL OFFICER; THE REMAINDER WAS PAID TO MAXIMON VENTURES, LLC IN EXCHANGE FOR VARIOUS IT AND ACCOUNTING SERVICES. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY AN INDEPENDENT TAX ACCOUNTANT IN CONJUNCTION WITH THE ORGANIZATION'S FINANCE AND ACCOUNTING STAFF. A DRAFT FORM 990 IS PREPARED AND REVIEWED BY THE CFO; ADJUSTMENTS ARE MADE (AS NECESSARY). A COMPLETE COPY OF THE FORM 990 IS THEN MADE AVAILABLE TO THE ENTIRE BOARD FOR REVIEW AND COMMENT PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION HAS A WRITTEN CONFLICT OF INTEREST POLICY WHICH COVERS ALL BOARD MEMBERS, OFFICERS, AND KEY EMPLOYEES. UNDER THE POLICY, EACH BOARD MEMBERS IS REQUIRED TO COMPLETE AN ANNUAL CONFLICT-OF-INTEREST DISCLOSURE STATEMENT; ADDITIONAL, EACH OFFICER AND KEY EMPLOYEE IS REQUIRED TO PROVIDE A WRITTEN DISCLOSURE OF REAL OR APPARENT CONFLICTS WHEN THEY ARISE. THE COMPLETED STATEMENTS ARE PROVIDED TO THE CHIEF EXECUTIVE OFFICER AND BOARD CHAIR FOR THEIR REVIEW AND ARE MAINTAINED IN THE BOARD RECORDS. SHOULD AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST BE IDENTIFIED, THE CEO (IN THE CASE OF AN EMPLOYEE) OR THE BOARD CHAIR (IN THE CASE OF BOARD MEMBERS AND/OR THE CEO) SHALL VOTE ON WHETHER TO PROCEED WITH THE POTENTIAL TRANSACTION OR ARRANGEMENT. CONFLICTED INDIVIDUALS ARE NOT ALLOWED TO PARTICIPATE IN THE DELIBERATION OR DECISION IN REGARDS TO THE POTENTIAL OR ACTUAL CONFLICT. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF DIRECTORS REVIEWS THE CEO'S COMPENSATION ANNUALLY, UTILIZING PUBLICLY AVAILABLE COMPENSATION INFORMATION OF SIMILARLY SITUATED EMPLOYEES IN SIMILAR ORGANIZATIONS TO SUBSTANTIATE ITS DECISION. SALARIES FOR ALL REMAINING OFFICERS AND KEY EMPLOYEES ARE DETERMINED BY THE CEO, WHO UTILIZES PUBLICLY AVAILABLE COMPENSATION INFORMATION OF SIMILARLY SITUATED EMPLOYEES. IN ADDITION, THE BOARD APPROVES ANNUAL SALARY INCREASES FOR ALL STAFF DURING THE BUDGETING PROCESS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST.