2017-04-29T12:30:00-07:00 2016-12-31 472251777 CHW LLP 7797 N First Street Suite 15 Fresno CA 93720 990 2016-01-01 952671433 Open Door Community Health Centers OPEN 7078268633 670 Ninth Street Suite 203 Arcata CA 95521 James Bella CFO 7078268633 2017-04-17 1 Jeremy Ware P00642659 5595495400 2017-04-15 96.67.208.101 2016 2021-01-29 14:40:06Z James Bella 670 Ninth Street Suite 203 Arcata CA 95521 65629322 0 X www.opendoorhealth.com X 1971 CA Open Door Community Health Centers (ODCHC) exists to provide primary health care - medical, dental and behavioral - and health care education to the residents of Del Norte and Humboldt Counties, California and surrounding rural areas, ODCHC operates 14 clinics and three mobile clinics. In 2016, ODCHC served 55,159 unique individuals, providing 269,015 provider/patient/encounters. Of its patients, 22% are known to live at or below 100% FPL and, cumulatively, 40% are known to live at or below 200% FPL; 5% are uninsured and 75% rely on some form of public insurance. ODCHC provides health care services to all who seek it regardless of the inability to pay. 11 11 697 0 0 0 7632262 8968611 49202749 56069972 15412 16340 672789 574399 57523212 65629322 0 0 0 0 34077839 37559388 0 0 0 22114904 24672280 56192743 62231668 1330469 3397654 32706613 49787673 16647933 30307044 16058680 19480629 Open Door Community Health Centers (ODCHC) exists to provide primary health care - medical, dental and behavioral - and health care education to the residents of Del Norte and Humboldt Counties, California and surrounding rural areas, ODCHC operates 14 clinics and three mobile clinics. In 2016, ODCHC served 55,159 unique individuals, providing 269,015 provider/patient/encounters. Of its patients, 22% are known to live at or below 100% FPL and, cumulatively, 40% are known to live at or below 200% FPL; 5% are uninsured and 75% rely on some form of public insurance. ODCHC provides health care services to all who seek it regardless of the inability to pay. 0 0 52295420 0 50665058 Open Door Community Health Centers (ODCHC) exists to provide primary health care - medical, dental and behavioral - and health care education to the residents of Del Norte and Humboldt Counties, California and surrounding rural areas, ODCHC operates 14 clinics and three mobile clinics. In 2016, ODCHC served 55,159 unique individuals, providing 269,015 provider/patient/encounters. Of its patients, 22% are known to live at or below 100% FPL and, cumulatively, 40% are known to live at or below 200% FPL; 5% are uninsured and 75% rely on some form of public insurance. ODCHC provides health care services to all who seek it regardless of the inability to pay. 0 0 0 52295420 1 0 0 0 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 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 59 0 1 697 1 0 0 0 0 0 0 X 11 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X James A Bella Jr 7078268633 670 Ninth Street Number 203 Arcata CA 95521 Sydney Fisher Larson President 1 0 X 0 0 0 Kathleen E Moxon Vice President 1 0 X 0 0 0 Felicia Oldfather Treasurer 1 0 X 0 0 0 Cyn Van Fleet Secretary 1 0 X 0 0 0 Zuretti Goosby Board Member 1 0 X 0 0 0 Elizabeth Murguia Board Member 1 0 X 0 0 0 Jim Pfingstel Board Member 1 0 X 0 0 0 Neal Sanders Board Member 1 0 X 0 0 0 Lindsay Righter Board Member 1 0 X 0 0 0 Connie Stewart Board Member 1 0 X 0 0 0 Alison Talbot Board Member 1 0 X 0 0 0 Cheyenne Spetzler COO 40 0 X 208958 0 0 Hermann Spetzler CEO 40 0 X 339630 0 0 James A Bella CFO 40 0 X 215755 0 0 Willard Hunter Co- Medical Director 40 0 X 278247 0 0 Julie Ohnemus Co-Medical Director 40 0 X 238814 0 0 Carter Wright Dentist 40 0 X 258903 0 0 Jason Christensen Physician 40 0 X 238588 0 0 Kelvin Vu Physician 40 0 X 263528 0 0 2042423 0 0 56 0 1 0 Barton Associates PO Box 417844 Boston MA 02241 Professional Recruiting 1156211 OCHIN Inc 707 SW Washington Street Suite 1200 Portland OR 97205 Software Support 1396350 CompHealth 35 Nutmeg Drive Trumbull CT 06611 Professional Recruiting 1002145 Above and Beyond Cleaning Services 1570 McCullen Avenue Eureka CA 95503 Janitorial 496776 Pacific Builders 880 L Street Arcata CA 95521 Construction Services 329036 6 0 0 0 0 8894451 74160 67015 8968611 Net patient service revenue 621400 50665058 50665058 0 0 5404914 5404914 0 0 56069972 16340 0 0 16340 0 0 0 0 0 0 0 0 0 0 0 0 0 Meaningful use and other incentives 621400 556750 556750 0 0 17649 17649 0 0 574399 65629322 56644371 0 16340 1281404 517061 764343 29143016 24201657 4941359 912875 759371 153504 3977824 2611053 1366771 2244269 1823764 420505 2668874 2598992 69882 51037 35463 15574 28264 20071 8193 4036969 4015976 20993 11022 4707 6315 369773 265952 103821 2335030 1541879 793151 2984591 2416344 568247 342126 139276 202850 477200 453638 23562 1728252 1549015 179237 273517 219399 54118 Supplies 8688622 8574219 114403 0 Postage and shipping 118707 107594 11113 0 Equipment 534862 433588 101274 0 23434 6401 17033 62231668 52295420 9936248 0 31585 29762 9564364 13245219 1798494 2167924 3268220 3085940 562090 578780 416689 877541 31086670 14252167 15922200 16834503 0 1142971 12968004 32706613 49787673 3365256 4301625 239687 303076 9560777 21423516 3482213 4278827 16647933 30307044 X 16058680 19480629 0 0 0 0 16058680 19480629 32706613 49787673 3397654 24295 0 0 0 0 X 0 1 X 1 1 1 X 11476605 7249433 6600287 7632262 8968611 41927198 26903549 31029815 39259510 49202749 50665058 197060681 38380154 38279248 45859797 56835011 59633669 238987879 0 0 0 0 0 0 238987879 14356 16002 20166 15412 16340 82276 14356 16002 20166 15412 16340 82276 673811 1160448 586500 297500 574399 3292658 39068321 39455698 46466463 57147923 60224408 242362813 0.98607 0.98309 0.00034 0.00038 X Schedule A, Part III, Line 12 Other revenues. 0 3151196 3151196 0 14816291 6100867 8715424 0 3028208 1510260 1517948 0 8107118 6641040 1466078 0 1983857 0 1983857 16834503 Investments 1074674 Assets limited as to use 11893330 12968004 Third party settlements 4278827 4278827 X 65629322 0 0 0 0 0 65629322 0 0 0 65629322 62231668 0 0 0 0 0 62231668 0 0 0 62231668 Schedule D, Part X, Line 2 The Center has been recognized by the Internal Revenue Service as a non-profit corporation as described in Sec. 501(c)(3) of the Internal Revenue Code (IRC) and is exempt from federal and state income taxes on related income pursuant to Sec. 501(a) of the IRC and California Revenue and Taxation code Section 23701(d). Tax returns are generally open and subject to examination by the appropriate government agencies in the United States and California for three years after they are filed. X X 0 0 0 0 0 0 0 0 0 Hermann Spetzler CEO 338630 0 1000 0 0 0 0 0 0 0 339630 0 0 0 Cheyenne Spetzler COO 207958 0 1000 0 0 0 0 0 0 0 208958 0 0 0 James A Bella CFO 214755 0 1000 0 0 0 0 0 0 0 215755 0 0 0 Willard Hunter Co- Medical Director 260182 0 18065 0 0 0 0 0 0 0 278247 0 0 0 Julie Ohnemus Co-Medical Director 222984 0 15830 0 0 0 0 0 0 0 238814 0 0 0 Kelvin Vu Physician 243349 0 20179 0 0 0 0 0 0 0 263528 0 0 0 Jason Christensen Physician 219858 0 18730 0 0 0 0 0 0 0 238588 0 0 0 Carter Wright Dentist 208397 0 50506 0 0 0 0 0 0 0 258903 0 0 0 X 1 3150 FMV X 2 63865 FMV 0 0 1 0 Form 990, Part VI, Section B, Line 11b Working closely with the appropriate management staff, the CFO gathers and presents the data to the CPA preparing the Form 990 and then presents the draft Form 990 to the Finance Committee of the Board of Directors prior to the Board's review and formal acceptance in a monthly meeting. Form 990, Part VI, Section B, Line 12c Personnel Policies require disclosure of any transactions or business situations (involving the employee and immediate family) which may present a conflict of interest by providing financial benefit resulting from that employees relationship with ODCHC. Board members receive no compensation for their services and are required to provide written Conflict of Interest agreements which are reviewed periodically. Form 990, Part VI, Section B, Line 15 The Board of Directors reviews local, state and national independently prepared salary surveys of community health centers periodically. This data is evaluated in aggregate and with consideration for comparable scope of duties, unique rural conditions, and general economic conditions as well as the economic stability and viability of the organization. Form 990, Part VI, Section C, Line 19 Available upon request.