2017-08-15T12:28:37-05:00 2016-12-31 BKD LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2016-01-01 680165855 SHASTA COMMUNITY HEALTH CENTER % SHERRY CALDWELL CFO SHAS 5302465710 1035 PLACER STREET REDDING CA 96001 SHERRY CALDWELL CFO 5302465710 2017-05-01 true Krystal K Creach P01248198 4178658701 64.22.227.161 43032920172275000017 2017-08-15 P 35B2FEF9FD89B74F90B63698513A1BB518488CA1 1229F85F18D3C1C077FE1D0ACDD4751432A3774C 2016 2021-01-29 14:40:06Z C DEAN GERMANO CEO 1035 PLACER STREET REDDING CA 96001 40100112 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. 13 13 468 15 0 0 7952802 8210388 31759067 31483161 164812 203157 25406 27238 39902087 39923944 0 0 0 0 25887696 27777049 0 0 167825 9356595 9386583 35244291 37163632 4657796 2760312 35971241 41091588 4181227 6552348 31790014 34539240 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 21177376 27118548 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 32,504 PATIENTS (129,910 VISITS) IN 2016. 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. 3263596 2706638 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 2016, SCHCS DENTISTS SERVED 6,970 PATIENTS (17,483 VISITS). 2057365 1657975 SHASTA COMMUNITY HEALTH CENTER IS A MAJOR PROVIDER OF MENTAL HEALTH SERVICES IN SHASTA COUNTY, SEEING 2,002 (10,150 VISITS) PATIENTS DURING 2016. 536948 27035285 true true false true false false false false false false true false false false true true 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 101 0 true 468 true false false false false false false false false false false X 13 13 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 LESLIE WOODSON CHAIRPERSON 4.0 0.5 X X 0 0 0 LYDIA BUCKLEY VICE CHAIRPERSON 2.0 0.5 X X 0 0 0 KERRY FASKING TREASURER 4.0 0.5 X X 0 0 0 RAY HAMBY SECRETARY 4.0 0.5 X X 0 0 0 AMPARO BUCK COMMUNITY MEMBER 2.0 0.5 X 0 0 0 JOHN DI PERRY CONSUMER MEMBER 4.0 0.5 X 0 0 0 JOHN KENNY ESQ COMMUNITY MEMBER 2.0 0.5 X 0 0 0 CLARENCE LIM CONSUMER MEMBER, BEGIN 8/24/16 2.0 0.5 X 0 0 0 WENDY LONGWELL CONSUMER MEMBER 2.0 0.5 X 0 0 0 KRISTIN SADLER CONSUMER MEMBER, BEGIN 8/24/16 2.0 0.5 X 0 0 0 ESTEFANIE SHAFER CONSUMER MEMBER 2.0 0.5 X 0 0 0 BRIAN SPILLANE PHD CONSUMER MEMBER 2.0 0.5 X 0 0 0 MARJORIE STRAIN CONSUMER MEMBER 2.0 0.5 X 0 0 0 MARK KORTH COMMUNITY MEMBER, END 9/22/16 2.0 0.5 X 0 0 0 J RIVER CABANILLAS BELL CONSUMER MEMBER, END 6/23/16 2.0 0.5 X 0 0 0 C DEAN GERMANO CHIEF EXECUTIVE OFFICER 40.0 0.5 X 287060 0 64383 SHERRY CALDWELL CHIEF FINANCIAL OFFICER 40.0 10.0 X 180437 0 14768 JEFFREY BOSWORTH MD CHIEF MEDICAL OFFICER 40.0 0.0 X 309136 0 26930 ROBIN GLASCO CHIEF OF OPERATIONS 40.0 0.0 X 180404 0 26048 LAURENCE HEARD MD PHYSICIAN 40.0 0.0 X 196939 0 28150 PATRICIA SAND MD PHYSICIAN 36.0 0.0 X 197930 0 26514 PAUL DAVAINIS MD PHYSICIAN 42.0 0.0 X 208156 0 31668 RHETT GROVER DO DIRECTOR OF URGENT CARE PRACT 40.0 0.0 X 213549 0 17859 DEBBIE LUPEIKA MD DIRECTOR OF RESIDENCY PROGRAM 43.0 0.0 X 225155 0 34024 MELISSA TASISTA DO MEDICAL DIRECTOR OF FAM PRACT 46.0 0.0 X 227624 0 28374 PAMELA R KNICKERBOCKER DO MEDICAL DIRECTOR 49.0 0.0 X 231188 0 24751 IMRAN KHAN MD MEDICAL DIRECTOR OF PCN 36.0 0.0 X 240658 0 39081 FRANKLIN PIERCE DDS DIRECTOR OF DENTAL OPERATIONS 39.0 0.0 X 179302 0 30907 SEAN DUGAN MD PHYSICIAN 41.0 0.0 X 211880 0 31399 JILL MCCLEAN MD PHYSICIAN 46.0 0.0 X 211943 0 28464 DOUGLAS MCMULLIN MD PHYSICIAN 44.0 0.0 X 235218 0 8268 JOE VILLALOBOS MD PHYSICIAN 43.0 0.0 X 229450 0 31712 NITIN BAGUL MD PHYSICIAN 40.0 0.0 X 271080 0 35395 4037109 0 528695 45 false true false PSYCHIATRIC CTRS AT SAN DIEGO PO BOX 609001 SAN DIEGO CA 92160 MEDICAL SERVICES 177392 LAUNDRY WORLD PO BOX 98 ANDERSON CA 96007 LAUNDRY SERVICES 138606 SHASTA-TEHAMA-TRINITY JOINT PO BOX 496006 REDDING CA 960496006 RENT DENTAL SPACE 134989 BKD LLP PO BOX 1190 SPRINGFIELD MO 658011190 AUDIT/TAX SERVICE 131623 4 6329425 1880963 1451194 8210388 NET PATIENT SERVICE REVENUE 621400 23125810 23125810 340B PROGRAM CONTRACTED PHARMACIES 621400 5623338 5623338 QUALITY IMPROVEMENT BONUS (MCO) 621400 2220439 2220439 MEANINGFUL USE 621400 289000 289000 OTHER 621400 224574 224574 31483161 206875 206875 0 0 27238 27238 0 27238 27238 172450 176168 -3718 -3718 -3718 0 0 0 0 0 0 0 0 0 0 39923944 31483161 230395 0 0 0 0 3270995 2181829 1089166 98189 98189 18920880 14311330 4480209 129341 447000 397933 40667 8400 3399713 2455012 941468 3233 1640272 1218893 411032 10347 0 53622 53622 131623 131623 7147 7147 0 0 1326238 856849 469389 14047 1328 12719 1017115 439430 577685 566599 102486 464113 0 1536577 1097119 439458 34671 27624 7047 0 403811 192363 207948 3500 9762 8150 1612 0 600630 446159 149971 4500 155792 107404 48388 DRUGS 2019789 2018078 1711 MEDICAL & DENTAL SUPPLIES 682773 659333 23440 RECRUITING 240097 27353 212744 BAD DEBT 177192 175502 1690 409098 212921 194820 1357 37163632 27035285 9960522 167825 898913 17792 12001828 12233363 117842 230864 3454953 4976873 0 0 0 0 12249600 14119600 191060 247296 255922 332244 12980413 6271137 6559319 6709276 9788 2023768 0 0 0 0 0 0 232016 200512 35971241 41091588 3054983 4558603 0 0 13485 20589 0 0 0 0 0 0 312033 225508 0 0 800726 1747648 4181227 6552348 X 31717631 34504721 72383 34519 0 0 31790014 34539240 35971241 41091588 2760312 -11086 X false true X true true true X 6230172 11338992 7130411 7952802 8210388 40862765 0 0 6230172 11338992 7130411 7952802 8210388 40862765 0 40862765 73568 69085 201211 199551 234113 777528 0 0 41640293 135799234 0.98133 0.98320 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED true false false true false false true false true 7147 7147 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 $7,147. 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. 1557344 1557344 5436993 2181556 3255437 827750 648015 179735 3400505 2309397 1091108 1757821 1132169 625652 6709276 0 ESTIMATED SELF-INSURANCE COST 329658 DEFERRED RENT 15204 ESTIMATED MEDI-CAL SETTLEMENTS 1364996 DEFERRED COMPENSATION 37790 1747648 X 40103767 -11086 190909 179823 39923944 39923944 37354541 190909 190909 37163632 37163632 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. X X X X X false true false false false false false true false C DEAN GERMANO CHIEF EXECUTIVE OFFICER 237129 49931 60749 3634 351443 0 0 SHERRY CALDWELL CHIEF FINANCIAL OFFICER 161873 18564 6500 8268 195205 0 0 JEFFREY BOSWORTH MD CHIEF MEDICAL OFFICER 297975 11161 13250 13680 336066 0 0 ROBIN GLASCO CHIEF OF OPERATIONS 158592 21812 8225 17823 206452 0 0 LAURENCE HEARD MD PHYSICIAN 176657 20282 9136 19014 225089 0 0 PATRICIA SAND MD PHYSICIAN 167540 30390 8691 17823 224444 0 0 PAUL DAVAINIS MD PHYSICIAN 191245 16911 9264 22404 239824 0 0 RHETT GROVER DO DIRECTOR OF URGENT CARE PRACT 191270 22279 9591 8268 231408 0 0 DEBBIE LUPEIKA MD DIRECTOR OF RESIDENCY PROGRAM 207151 18004 10132 23892 259179 0 0 MELISSA TASISTA DO MEDICAL DIRECTOR OF FAM PRACT 208288 19336 5982 22392 255998 0 0 PAMELA R KNICKERBOCKER DO MEDICAL DIRECTOR 215988 15200 11071 13680 255939 0 0 IMRAN KHAN MD MEDICAL DIRECTOR OF PCN 225558 15100 11789 27292 279739 0 0 FRANKLIN PIERCE DDS DIRECTOR OF DENTAL OPERATIONS 160487 18815 8330 22577 210209 0 0 SEAN DUGAN MD PHYSICIAN 189610 22270 9007 22392 243279 0 0 JILL MCCLEAN MD PHYSICIAN 202489 9454 9284 19180 240407 0 0 DOUGLAS MCMULLIN MD PHYSICIAN 219518 15700 0 8268 243486 0 0 JOE VILLALOBOS MD PHYSICIAN 197074 32376 6770 24942 261162 0 0 NITIN BAGUL MD PHYSICIAN 254120 16960 13003 22392 306475 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 $49,310. 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. KRISTEN ANDERSON SEE PART V 98189 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. X 5 1422444 FMV X MEDICAL EQUIP 3 28710 FMV X MISCELLANEOUS 1 40 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. SCHC PROPERTY CORPORATION 1035 PLACER STREET REDDING CA 96001 463207999 RE HOLDING CA 501(C)(3) 12A I SHASTA CHC true false false false false false false false false false false true false false true true true true false false SCHC PROPERTY CORPORATION K 206340 FMV