MARIN COMMUNITY CLINIC: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- MARIN COMMUNITY CLINIC (EIN 94-2237120)
- Tax period
- 2015-07-01 to 2016-06-30
- Filed
- 2017-01-20
- IRS object ID
- 201740209349300104
- Schema version
- 2015v3.0
- 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 | 2017-01-20T08:39:55-06:00 | ReturnTs |
| Tax Period End | 2016-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BKD LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 910 E ST LOUIS 200/PO BOX 1190 | AddressLine1Txt |
| City | SPRINGFIELD | CityNm |
| State Abbreviation | MO | StateAbbreviationCd |
| ZIP | 658062523 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 942237120 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MARIN COMMUNITY CLINIC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % DAVID KLINETOBE | InCareOfNm |
| Business Name Control | MARI | BusinessNameControlTxt |
| Phone | 4154481500 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 9 COMMERCIAL BLVD STE 100 | AddressLine1Txt |
| City | NOVATO | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 94949 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | LINDA TAVASZI | PersonNm |
| Person Title | CHIEF EXECUTIVE OFFI | PersonTitleTxt |
| Signature | 2016-10-27 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Brian D Todd | PreparerPersonNm |
| PTIN | P00422601 | PTIN |
| Phone | 4178658701 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MARIN COMMUNITY CLINICS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | LINDA TAVASZI | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1177 E FRANCISCO BLVD | AddressLine1Txt |
| City | SAN RAFAEL | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 94901 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $37,855,591 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.MARINCLINIC.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1973 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | TO IMPROVE THE HEALTH OF OUR PATIENTS AND COMMUNITY BY PROVIDING HIGH QUALITY, COST-EFFECTIVE, CULTURALLY SENSITIVE, PATIENT-CENTERED HEALTH CARE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 15 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 15 | VotingMembersIndependentCnt |
| Total Employee | 401 | TotalEmployeeCnt |
| Total Volunteers | 15 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $3,807,704 | PYContributionsGrantsAmt |
| CY Contributions Grants | $4,931,780 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $31,360,014 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $32,878,812 | CYProgramServiceRevenueAmt |
| PY Investment Income | $12 | PYInvestmentIncomeAmt |
| CY Investment Income | $30,962 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$12,275 | PYOtherRevenueAmt |
| CY Other Revenue | -$10,146 | CYOtherRevenueAmt |
| PY Total Revenue | $35,155,455 | PYTotalRevenueAmt |
| CY Total Revenue | $37,831,408 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $207,930 | 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 | $20,308,639 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $23,999,407 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $32,382 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $77,139 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $77,139 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $10,682,514 | PYOtherExpensesAmt |
| CY Other Expenses | $12,019,936 | CYOtherExpensesAmt |
| PY Total Expenses | $31,231,465 | PYTotalExpensesAmt |
| CY Total Expenses | $36,096,482 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $3,923,990 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,734,926 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $33,931,470 | TotalAssetsBOYAmt |
| Total Assets EOY | $38,222,103 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $8,409,944 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $10,979,643 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $25,521,526 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $27,242,460 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO IMPROVE THE HEALTH OF OUR PATIENTS AND COMMUNITY BY PROVIDING HIGH QUALITY, COST-EFFECTIVE, CULTURALLY SENSITIVE, PATIENT-CENTERED HEALTH CARE. | MissionDesc |
| Significant New Program Srvc | Yes (true) | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $19,051,122 | ExpenseAmt |
| Revenue | $20,654,547 | RevenueAmt |
| Desc | PRIMARY CARE - PEDIATRIC CARE (INCLUDING AFTER HOURS), ADULT CARE (INCLUDING AFTER HOURS), TEEN HEALTH CARE, IMMUNIZATIONS, ANNUAL CHECKUPS, CHRONIC CARE MANAGEMENT, FAMILY PLANNING FOR MEN AND WOMEN, OBSTETRICS AND GYNECOLOGY, INCLUDING BREAST AND CERVICAL SCREENING AND EDUCATION, POST-NATAL CARE, AND REFERRALS FOR SPECIALTY CARE. PHYSICAL MEDICINE AND REHABILITATION, NEUROLOGY, NUTRITION, ORTHOPEDIC SURGERY, COMPLEMENTARY AND ALTERNATIVE MEDICINE, UROLOGY, GASTROENTEROLOGY, DIAGNOSTIC RADIOLOGY, COVERAGE FOR EMERGENCIES DURING AND AFTER HOURS, CANCER SERVICE, VISION SERVICES. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $4,099,608 | ExpenseAmt |
| Revenue | $10,271,069 | RevenueAmt |
| Desc | ORAL HEALTH - PREVENTIVE AND RESTORATIVE DENTISTRY. SERVICES INCLUDE: EXAMS AND X-RAYS, ORAL HYGIENE INSTRUCTIONS, CLEANINGS, TOOTH DECAY REMOVAL AND FILLINGS, EXTRACTIONS, ROOT CANALS AND CROWNS DENTURES. EXPANDED SERVICES SEVEN DAYS A WEEK, DENTAL EMERGENCY SERVICES. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $723,460 | ExpenseAmt |
| Revenue | $1,627,663 | RevenueAmt |
| Desc | BEHAVIORAL HEALTH SERVICES - OFFERED TO CHILDREN, TEENS, AND ADULTS AND INCLUDES PSYCHIATRY AND COUNSELING BY LICENSED CLINICAL SOCIAL WORKERS. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $241,154 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Revenue | $325,533 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $24,115,344 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | Yes (true) | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | Yes (true) | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (true) | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 65 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 401 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 15 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 15 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | Yes (true) | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | false | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | CA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DAVID KLINETOBE | PersonNm |
| Phone | 4155268532 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 9 COMMERCIAL BLVD SUITE 100 | AddressLine1Txt |
| City | NOVATO | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 94949 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (25 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| JOHN E BOLAND III DDS MSD | |||||||||
| CHAIR | 3.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| GRACE HUGHES | |||||||||
| CHAIR ELECT | 3.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| DANIEL A SEGEDIN | |||||||||
| TREASURER | 3.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| ALYSSA H MORRIS | |||||||||
| SECRETARY | 3.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| VRANNA LYNN HINCK | |||||||||
| MEMBER-AT-LARGE | 3.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| WILLIAM KERR | |||||||||
| BOARD MEMBER | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| CRISTINA A MACKENZIE CHCCHPC | |||||||||
| BOARD MEMBER | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| FRANK TAVEL | |||||||||
| BOARD MEMBER | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| NILDES CARDOSO | |||||||||
| BOARD MEMBER | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| MARTHA J HANSEN | |||||||||
| BOARD MEMBER | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| MICHAEL S HARRIS | |||||||||
| BOARD MEMBER | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| SUE MACE | |||||||||
| BOARD MEMBER | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| TEO MARTINEZ | |||||||||
| BOARD MEMBER | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| VERONICA RODRIGUEZ | |||||||||
| BOARD MEMBER | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| STACY SCOTT | |||||||||
| BOARD MEMBER | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| LINDA TAVASZI PHD | |||||||||
| CHIEF EXECUTIVE OFFICER | 40.0 | 0.0 | Yes (X) | $238,461 | $0 | $7,272 | |||
| DAVID KLINETOBE | |||||||||
| CHIEF FINANCIAL OFFICER | 40.0 | 0.0 | Yes (X) | $198,961 | $0 | $1,845 | |||
| MARGARET DRACKER | |||||||||
| CHIEF OPERATIONS OFFICER | 40.0 | 0.0 | $192,714 | $0 | $38,280 | Yes (X) | |||
| MITESH POPAT MD | |||||||||
| CHIEF MEDICAL OFFICER | 40.0 | 0.0 | $245,227 | $0 | $31,324 | Yes (X) | |||
| CONSTANZA KADERA DDS | |||||||||
| CHIEF DENTAL OFFICER | 40.0 | 0.0 | $183,458 | $0 | $37,171 | Yes (X) | |||
| BABAK ETTEKAL | |||||||||
| MEDICAL DIRECTOR | 40.0 | 0.0 | $197,098 | $0 | $32,394 | Yes (X) | |||
| PAUL KIM | |||||||||
| DENTIST | 40.0 | 0.0 | $145,986 | $0 | $30,237 | Yes (X) | |||
| LEAH CANVASSER | |||||||||
| IT DIRECTOR | 40.0 | 0.0 | $151,486 | $0 | $9,928 | Yes (X) | |||
| JEANETTE KROLIKOWSKI | |||||||||
| PHYSICIAN | 32.0 | 0.0 | $145,860 | $0 | $14,049 | Yes (X) | |||
| MIKOYAN M LAGRIMAS | |||||||||
| DENTIST | 40.0 | 0.0 | $145,850 | $0 | $12,566 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,845,101 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $215,066 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 31 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (4 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| MCC BUILDING MAINTENANCE | |||||
| 7049 REDWOOD BLVD STE 108 | NOVATO | CA | 94945 | CLEANING & MAINTENAN | $220,814 |
| WATECH COMPUTER SERVICES | |||||
| 1866 STAR BATT DRIVE | ROCHESTER HILLS | MI | 48309 | COMPUTER SERVICES | $157,246 |
| FOWLER ELECTRIC | |||||
| 44 SPRAUER ROAD | PETALUMA | CA | 94952 | ELECTRICAL SERVICES | $136,144 |
| BKD LLP CPA ADVISORS | |||||
| PO BOX 1190 | SPRINGFIELD | MO | 658011190 | AUDIT/TAX/CONSULTING | $101,020 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $86,364 | FundraisingAmt |
| Government Grants | $3,222,340 | GovernmentGrantsAmt |
| All Other Contributions | $1,623,076 | AllOtherContributionsAmt |
| Total Contributions | $4,931,780 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (5 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 624100 | $28,200,415 | $28,200,415 |
| EHR INCENTIVE | 624100 | $369,750 | $369,750 |
| OTHER INCOME | 624100 | $48,270 | $48,270 |
| CAPITATION REVENUE | 624100 | $2,752,210 | $2,752,210 |
| QUALITY IMPROVEMENT PROGRAM | 624100 | $1,508,167 | $1,508,167 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $32,878,812 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $34,199 | TotalRevenueColumnAmt |
| Exclusion | $34,199 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $10,800 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $10,800 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $10,800 | TotalRevenueColumnAmt |
| Exclusion | $10,800 | ExclusionAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $3,237 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$3,237 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$3,237 | TotalRevenueColumnAmt |
| Exclusion | -$3,237 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contri Rpt Fundraising Event | $86,364 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $20,946 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$20,946 | TotalRevenueColumnAmt |
| Exclusion | -$20,946 | ExclusionAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $37,831,408 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $32,878,812 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $20,816 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,174,713 | TotalAmt |
| Program Services | $928,980 | ProgramServicesAmt |
| Management And General | $245,733 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,446,947 | TotalAmt |
| Program Services | $11,517,105 | ProgramServicesAmt |
| Management And General | $5,929,842 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $191,293 | TotalAmt |
| Program Services | $111,948 | ProgramServicesAmt |
| Management And General | $79,345 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,667,548 | TotalAmt |
| Program Services | $2,338,457 | ProgramServicesAmt |
| Management And General | $1,329,091 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,518,906 | TotalAmt |
| Program Services | $1,031,679 | ProgramServicesAmt |
| Management And General | $487,227 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $32,127 | TotalAmt |
| Management And General | $32,127 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $161,943 | TotalAmt |
| Management And General | $161,943 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $77,139 | TotalAmt |
| Fundraising | $77,139 | FundraisingAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,985,996 | TotalAmt |
| Program Services | $2,299,370 | ProgramServicesAmt |
| Management And General | $686,626 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,447,488 | TotalAmt |
| Program Services | $845,224 | ProgramServicesAmt |
| Management And General | $602,264 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $664,251 | TotalAmt |
| Program Services | $97,467 | ProgramServicesAmt |
| Management And General | $566,784 | ManagementAndGeneralAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,111,193 | TotalAmt |
| Program Services | $798,418 | ProgramServicesAmt |
| Management And General | $312,775 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $70,426 | TotalAmt |
| Program Services | $19,466 | ProgramServicesAmt |
| Management And General | $50,960 | ManagementAndGeneralAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $111,572 | TotalAmt |
| Program Services | $58,858 | ProgramServicesAmt |
| Management And General | $52,714 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $241,274 | TotalAmt |
| Management And General | $241,274 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,596,449 | TotalAmt |
| Program Services | $1,083,743 | ProgramServicesAmt |
| Management And General | $512,706 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $153,895 | TotalAmt |
| Program Services | $4,533 | ProgramServicesAmt |
| Management And General | $149,362 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES & DRUGS | $2,825,463 | $2,825,463 | |
| RECRUITING & RETENTION | $273,727 | $1,747 | $271,980 |
| LICENSES, DUES, SUBSCRIPTIONS | $156,785 | $50,942 | $105,843 |
| BAD DEBT | $100,882 | $100,882 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $86,465 | TotalAmt |
| Program Services | $1,062 | ProgramServicesAmt |
| Management And General | $85,403 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,096,482 | TotalAmt |
| Program Services | $24,115,344 | ProgramServicesAmt |
| Management And General | $11,903,999 | ManagementAndGeneralAmt |
| Fundraising | $77,139 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,391,782 | BOYAmt |
| EOY | $9,140,311 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,056 | BOYAmt |
| EOY | $2,502 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $392,837 | BOYAmt |
| EOY | $1,081,339 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,155,000 | BOYAmt |
| EOY | $2,541,688 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $243,401 | BOYAmt |
| EOY | $430,327 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $490,087 | BOYAmt |
| EOY | $568,941 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $31,989,283 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $10,138,976 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,743,106 | BOYAmt |
| EOY | $21,850,307 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $2,540,624 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $503,201 | BOYAmt |
| EOY | $66,064 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $33,931,470 | BOYAmt |
| EOY | $38,222,103 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,758,638 | BOYAmt |
| EOY | $1,934,484 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $109,920 | BOYAmt |
| EOY | $139,806 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,826,386 | BOYAmt |
| EOY | $5,680,353 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $715,000 | BOYAmt |
| EOY | $3,225,000 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,409,944 | BOYAmt |
| EOY | $10,979,643 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,271,737 | BOYAmt |
| EOY | $27,005,878 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $249,789 | BOYAmt |
| EOY | $236,582 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,521,526 | BOYAmt |
| EOY | $27,242,460 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $33,931,470 | BOYAmt |
| EOY | $38,222,103 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $1,734,926 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $6,431 | NetUnrlzdGainsLossesInvstAmt |
| Prior Period Adjustments | -$20,423 | PriorPeriodAdjustmentsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | 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 (true) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $6,700,469 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,648,719 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $4,147,883 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,807,704 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,931,780 | CurrentTaxYearAmt |
| Total | $23,236,555 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $22,023,420 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $22,508,006 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $27,309,884 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $31,360,014 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $32,878,812 | CurrentTaxYearAmt |
| Total | $136,080,136 | TotalAmt |
Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Tax Rev Levied Orgnztnl Bnft509 TaxRevLeviedOrgnztnlBnft509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Govt Furn Srvc Fclts Vl509 GovtFurnSrvcFcltsVl509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $28,723,889 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $26,156,725 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $31,457,767 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $35,167,718 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $37,810,592 | CurrentTaxYearAmt |
| Total | $159,316,691 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $159,316,691 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $7,341 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $10,804 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $10,803 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $10,812 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $44,999 | CurrentTaxYearAmt |
| Total | $84,759 | TotalAmt |
Post1975 UBTI Post1975UBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $7,341 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $10,804 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $10,803 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $10,812 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $44,999 | CurrentTaxYearAmt |
| Total | $84,759 | TotalAmt |
Net Income From Other UBI NetIncomeFromOtherUBIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $28,731,230 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $26,167,529 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $31,468,570 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $35,178,530 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $37,855,591 | CurrentTaxYearAmt |
| Total | $159,401,450 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99947 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99970 | PublicSupportPY509Pct |
| Investment Income CY | 0.00053 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00030 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbyingGrp | |
| Total Direct Lobbying | TotalDirectLobbyingGrp | |
| Total Lobbying Expend | TotalLobbyingExpendGrp | |
| Other Exempt Purpose Expend | OtherExemptPurposeExpendGrp | |
| Total Exempt Purpose Expend | TotalExemptPurposeExpendGrp | |
| Lobbying Nontaxable Amount | LobbyingNontaxableAmountGrp | |
| Grassroots Nontaxable | GrassrootsNontaxableGrp | |
| Tot Lbbyng Grassroot Mns Non Tx | TotLbbyngGrassrootMnsNonTxGrp | |
| Tot Lbby Expend Mns Lbbyng Non Tx | TotLbbyExpendMnsLbbyngNonTxGrp | |
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Mailings Members | false | MailingsMembersInd |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $12,825 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $12,825 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE C, PART II-B, QUESTION 1I | FormAndLineReferenceDesc |
| Explanation | OTHER LOBBYING ACTIVITIES: THE ORGANIZATION PAYS ANNUAL DUES OF $12,825 TO CALIFORNIA PRIMARY CARE ASSOCIATION (CPCA) - A PORTION OF WHICH MAY BE ATTRIBUTABLE TO LOBBYING. | ExplanationTxt |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp |
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $998,294 | BeginningYearBalanceAmt |
| Contributions | $11,490 | ContributionsAmt |
| Investment Earnings Or Losses | -$11,221 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $46,524 | GrantsOrScholarshipsAmt |
| Administrative Expenses | $7,463 | AdministrativeExpensesAmt |
| End Year Balance | $944,576 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $561,023 | BeginningYearBalanceAmt |
| Contributions | $436,320 | ContributionsAmt |
| Investment Earnings Or Losses | $20,129 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $13,546 | GrantsOrScholarshipsAmt |
| Administrative Expenses | $5,632 | AdministrativeExpensesAmt |
| End Year Balance | $998,294 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $284,517 | BeginningYearBalanceAmt |
| Contributions | $254,780 | ContributionsAmt |
| Investment Earnings Or Losses | $36,996 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $12,992 | GrantsOrScholarshipsAmt |
| Administrative Expenses | $2,278 | AdministrativeExpensesAmt |
| End Year Balance | $561,023 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $273,816 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $25,170 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $12,628 | GrantsOrScholarshipsAmt |
| Administrative Expenses | $1,841 | AdministrativeExpensesAmt |
| End Year Balance | $284,517 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $272,888 | BeginningYearBalanceAmt |
| Contributions | $11,544 | ContributionsAmt |
| Investment Earnings Or Losses | $2,701 | InvestmentEarningsOrLossesAmt |
| Grants Or Scholarships | $11,544 | GrantsOrScholarshipsAmt |
| Administrative Expenses | $1,773 | AdministrativeExpensesAmt |
| End Year Balance | $273,816 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 1.00000 | PrmnntEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | Yes (true) | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | false | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $0 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $4,533,750 | OtherCostOrOtherBasisAmt |
| Book Value | $4,533,750 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $16,335,983 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,124,365 | DepreciationAmt |
| Book Value | $12,211,618 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,063,360 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,782,281 | DepreciationAmt |
| Book Value | $2,281,079 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,727,102 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,232,330 | DepreciationAmt |
| Book Value | $2,494,772 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $0 | InvestmentCostOrOtherBasisAmt |
| Other Cost Or Other Basis | $329,088 | OtherCostOrOtherBasisAmt |
| Book Value | $329,088 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $21,850,307 | TotalBookValueLandBuildingsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | EST DUE TO THIRD PARTIES | Desc |
| Amt | $3,225,000 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $3,225,000 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $37,871,886 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $6,431 | NetUnrealizedGainsInvstAmt |
| Donated Services And Use Fclts | $117,963 | DonatedServicesAndUseFcltsAmt |
| Other Revenue | $173,505 | OtherRevenueAmt |
| Revenue Not Reported | $297,899 | RevenueNotReportedAmt |
| Revenue Subtotal | $37,573,987 | RevenueSubtotalAmt |
| Other Revenues Not Included | $257,421 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $257,421 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $37,831,408 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $36,137,746 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $117,963 | DonatedServicesUseFcltsAmt |
| Other Expenses Included | $24,183 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $142,146 | ExpensesNotReportedAmt |
| Expenses Subtotal | $35,995,600 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $100,882 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $100,882 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $36,096,482 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE D, PART V, LINE 4 | ENDOWMENT FUNDS: THE MARIN COMMUNITY FOUNDATION (THE FOUNDATION) RECEIVES DONATIONS AND MANAGES AN ENDOWMENT FUND, THE MARIN COMMUNITY CLINIC ENDOWMENT OF THE MARIN COMMUNITY FOUNDATION. THE ASSETS FROM THIS AND OTHER ENDOWMENTS ARE MAINTAINED IN THE FOUNDATION'S ENDOWMENT FUND AND ARE POOLED ON A MARKET VALUE BASIS. INVESTMENT RETURN FROM SECURITIES IN THE ENDOWMENT FUND IS ALLOCATED TO THE INDIVIDUAL ENDOWMENTS BASED ON THE RELATIONSHIP OF THE FAIR VALUE OF THE INTEREST OF EACH ENDOWMENT TO THE TOTAL FAIR VALUE OF THE ENDOWMENT FUND, AS ADJUSTED FOR ADDITIONS TO OR DEDUCTIONS FROM THESE ACCOUNTS. THE FOUNDATION MAKES QUARTERLY DISTRIBUTIONS TO THE ORGANIZATION FOR INVESTMENT RETURNS RECEIVED ON THESE ENDOWMENTS BASED ON THE FOUNDATION'S SPENDING POLICY. AS THE SPENDING POLICY IS AT THE DISCRETION OF THE FOUNDATION AND CAN BE CHANGED, THE ENDOWMENT CONTRIBUTIONS ARE CONSIDERED CONDITIONAL AND ARE NOT RECORDED AS ASSETS OF THE ORGANIZATION. DURING THE YEARS ENDED JUNE 30, 2016 AND 2015, THE FOUNDATION'S SPENDING POLICY WAS TO DISTRIBUTE 5.5% OF THE ROLLING 12 QUARTER AVERAGE OF THE MARKET VALUE OF THE POOLED FUND. THE ORGANIZATION RECEIVED DISTRIBUTIONS OF $46,524 AND $13,547 FOR THE YEARS ENDED JUNE 30, 2016 AND 2015, RESPECTIVELY, WHICH ARE INCLUDED IN THE STATEMENT OF OPERATIONS. AT JUNE 30, 2016 AND 2015, THE BALANCE OF THE ENDOWMENT FUND WAS $944,576 AND $998,294, RESPECTIVELY. |
| 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 2D | OTHER REVENUE ON LINE 1, BUT NOT ON FORM 990, PART VIII, LINE 12: $ 274,387 NET ASSETS RELEASED FROM RESTRICTION (100,882) BAD DEBT EXPENSE ------------ $ 173,505 |
| SCHEDULE D, PART XI, LINE 4B | OTHER REVENUE ON FORM 990, PART VIII, LINE 12, BUT NOT ON LINE 1: $ 281,604 TEMPORARILY RESTRICTED CONTRIBUTIONS (20,946) SPECIAL EVENT EXPENSES (3,237) LOSS ON DISPOSAL OF ASSETS ------------ $ 257,421 |
| SCHEDULE D, PART XII, LINE 2D | OTHER EXPENSES ON LINE 1, BUT NOT ON FORM 990, PART IX, LINE 25: $ 20,946 SPECIAL EVENT EXPENSES 3,237 LOSS ON DISPOSAL OF ASSETS ----------- $ 24,183 |
| SCHEDULE D, PART XII, LINE 4B | OTHER EXPENSES ON FORM 990, PART IX, LINE 25, BUT NOT ON LINE 1: $ 100,882 BAD DEBT EXPENSE |
Schedule G IRS990ScheduleG
| Field | Value | IRS element (for citing) |
|---|---|---|
| Mail Solicitations | Yes (X) | MailSolicitationsInd |
| Email Solicitations | Yes (X) | EmailSolicitationsInd |
| Phone Solicitations | Yes (X) | PhoneSolicitationsInd |
| In Person Solicitations | Yes (X) | InPersonSolicitationsInd |
| Solicitation Of Non Govt Grants | Yes (X) | SolicitationOfNonGovtGrantsInd |
| Solicitation Of Govt Grants | Yes (X) | SolicitationOfGovtGrantsInd |
| Special Fundraising Events | Yes (X) | SpecialFundraisingEventsInd |
| Agrmt Prof Fundraising Acty | Yes (true) | AgrmtProfFundraisingActyInd |
Fundraiser Activity Info FundraiserActivityInfoGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JUDITH SNEAD | PersonNm |
| Activity | GRANT FUNDR | ActivityTxt |
| Fundraiser Control Of Funds | false | FundraiserControlOfFundsInd |
| Gross Receipts | $1,025,000 | GrossReceiptsAmt |
| Retained By Contractor | $77,139 | RetainedByContractorAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Gross Receipts | $1,025,000 | TotalGrossReceiptsAmt |
| Total Retained By Contractors | $77,139 | TotalRetainedByContractorsAmt |
| Licensed States | CA | LicensedStatesCd |
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | SUMMER SOLSTICE | Event1Nm |
| Gross Receipts Event1 | $86,364 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $86,364 | CharitableContriEvent1Amt |
| Rent Facility Costs Event1 | $770 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $361 | FoodAndBeverageEvent1Amt |
| Entertainment Event1 | $500 | EntertainmentEvent1Amt |
| Other Direct Expenses Event1 | $19,315 | OtherDirectExpensesEvent1Amt |
| Other Events Total | 0 | OtherEventsTotalCnt |
| Gross Receipts Total | $86,364 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $86,364 | CharitableContributionsTotAmt |
| Rent Fclty Costs Total Events | $770 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $361 | FoodAndBeverageTotalEventsAmt |
| Entertainment Total Events | $500 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $19,315 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $20,946 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$20,946 | NetIncomeSummaryAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (10 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| LINDA TAVASZI PHD | ||||||||||||||
| CHIEF EXECUTIVE OFFICER | $235,799 | $0 | $0 | $0 | $2,662 | $0 | $6,804 | $0 | $468 | $0 | $245,733 | $0 | $0 | $0 |
| DAVID KLINETOBE | ||||||||||||||
| CHIEF FINANCIAL OFFICER | $198,961 | $0 | $0 | $0 | $0 | $0 | $1,845 | $0 | $0 | $0 | $200,806 | $0 | $0 | $0 |
| BABAK ETTEKAL | ||||||||||||||
| MEDICAL DIRECTOR | $196,969 | $0 | $0 | $0 | $129 | $0 | $2,616 | $0 | $29,778 | $0 | $229,492 | $0 | $0 | $0 |
| PAUL KIM | ||||||||||||||
| DENTIST | $145,711 | $0 | $0 | $0 | $275 | $0 | $4,659 | $0 | $25,578 | $0 | $176,223 | $0 | $0 | $0 |
| LEAH CANVASSER | ||||||||||||||
| IT DIRECTOR | $148,778 | $0 | $0 | $0 | $2,708 | $0 | $2,294 | $0 | $7,634 | $0 | $161,414 | $0 | $0 | $0 |
| JEANETTE KROLIKOWSKI | ||||||||||||||
| PHYSICIAN | $145,721 | $0 | $0 | $0 | $139 | $0 | $0 | $0 | $14,049 | $0 | $159,909 | $0 | $0 | $0 |
| MIKOYAN M LAGRIMAS | ||||||||||||||
| DENTIST | $145,734 | $0 | $0 | $0 | $116 | $0 | $4,432 | $0 | $8,134 | $0 | $158,416 | $0 | $0 | $0 |
| MARGARET DRACKER | ||||||||||||||
| CHIEF OPERATIONS OFFICER | $192,059 | $0 | $0 | $0 | $655 | $0 | $5,408 | $0 | $32,872 | $0 | $230,994 | $0 | $0 | $0 |
| MITESH POPAT MD | ||||||||||||||
| CHIEF MEDICAL OFFICER | $245,112 | $0 | $0 | $0 | $115 | $0 | $6,780 | $0 | $24,544 | $0 | $276,551 | $0 | $0 | $0 |
| CONSTANZA KADERA DDS | ||||||||||||||
| CHIEF DENTAL OFFICER | $183,230 | $0 | $0 | $0 | $228 | $0 | $5,987 | $0 | $31,184 | $0 | $220,629 | $0 | $0 | $0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART III, LINE 2 | NEW PROGRAM SERVICES: DURING THE FISCAL YEAR, THE FOLLOWING SERVICES WERE ADDED TO THE ORGANIZATION'S SCOPE OF SERVICES: PHYSICAL MEDICINE AND REHABILITATION, DIAGNOSTIC RADIOLOGY, NUTRITION, AND EMERGENCY COVERAGE DURING AND AFTER HOURS. |
| FORM 990, PART III, LINE 4D | OTHER PROGRAM SERVICES: HEALTH EDUCATION - ASTHMA, CARDIO, CHRONIC PAIN, DIABETES, HEALTHY EATING. |
| FORM 990, PART VI, SECTION A, LINE 4 | CHANGES TO ORGANIZATIONAL DOCUMENTS: DURING FY16, THE ORGANIZATION AMENDED ITS BYLAWS TO INCLUDE THE FOLLOWING SIGNIFICANT CHANGES: - ADDITION OF AN ANNUAL REVIEW AND APPROVAL OF THE CASH AND BOARD DESIGNATED FUNDS POLICY AND INVESTMENT POLICY STATEMENT. - BOARD APPROVAL NECESSARY TO AUTHORIZE THE USE OF BOARD DESIGNATED SPECIAL RESERVE WITH A 2/3 MAJORITY VOTE. - MODIFICATION OF THE 2/3 VOTE REQUIREMENT WOULD REQUIRE A 2/3 VOTE FOR PASSAGE. |
| FORM 990, PART VI, SECTION B, LINE 11B | 990 REVIEW POLICY: THE AUDIT COMMITTEE REVIEWS THE FORM 990 PRIOR TO FILING AND WORKS WITH THE EXECUTIVE COMMITTEE AND MANAGEMENT TO IMPLEMENT ANY CHANGES. THE EXECUTIVE COMMITTEE REPORTS TO THE BOARD AND THE BOARD APPROVES THE FORM 990 WHICH IS RECORDED IN ITS REGULAR MEETING MINUTES. |
| FORM 990, PART VI, SECTION B, LINES 12B & 12C | MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY: ANNUALLY MEMBERS OF THE BOARD AS WELL AS MCC KEY EMPLOYEES ARE PROVIDED WITH A COPY OF THE CURRENT CONFLICT OF INTEREST POLICY. BOARD MEMBERS AS WELL AS MCC KEY EMPLOYEES ARE REQUIRED TO SELF DISCLOSE ANY POTENTIAL CONFLICT OF INTEREST. CONTRACTS AND MAJOR PURCHASES ARE ALSO SCRUTINIZED FOR POTENTIAL CONFLICT OF INTEREST. THE POLICIES OF MARIN COMMUNITY CLINIC BOARD OF DIRECTORS REQUIRE REGULAR DISCLOSURE OF MEMBER (1) AFFILIATIONS (AS TRUSTEE, BOARD MEMBER, OFFICER, EMPLOYEE, ADVISORY COMMITTEE MEMBER, DEVELOPMENT COMMITTEE MEMBER, VOLUNTEER, ETC.) WITH ANY OTHER ORGANIZATION WITH WHICH MCC MAY HAVE A FINANCIAL RELATIONSHIP, AND (2) AFFILIATIONS OF PERSONS WITH WHOM YOU HAVE A CLOSE PERSONAL RELATIONSHIP (SUCH AS A MEMBER OF THE YOUR IMMEDIATE FAMILY OR A MEMBER OF YOUR HOUSEHOLD) WITH ANY OTHER ORGANIZATION WITH WHICH THE MCC MAY HAVE A FINANCIAL RELATIONSHIP. EMPLOYEES, VOLUNTEERS AND BOARD MEMBERS HAVE A CONTINUING RESPONSIBILITY TO ADVISE THE BOARD SECRETARY OF ADDITIONAL AFFILIATIONS AS THEY MAY ARISE. ANY CONFLICT OF INTEREST WILL BE REVIEWED ON A CASE BY CASE BASIS ALONG WITH ANY APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION. |
| FORM 990, PART VI, SECTION B, LINES 15A & 15B | COMPENSATION SETTING PROCEDURE: THE ORGANIZATION'S HR DIRECTOR OBTAINS INDUSTRY COMPENSATION DATA FROM LOCAL AND STATE RESOURCES TO BE USED FOR COMPARISON PURPOSES. DATA FROM ASSOCIATION SURVEYS (NACHC, CPCA) AND ANY RECOMMENDATIONS ARE REVIEWED AND REPORTED TO THE EXECUTIVE COMMITTEE FOR APPROVAL AND DISCUSSION. THE BOARD REVIEWS THE CEO'S PAY RATE ANNUALLY OR AS NECESSARY IF THERE IS A CHANGE IN STAFF. REVIEW OF OTHER OFFICER OR KEY EMPLOYEE COMPENSATION: CEO REVIEWED 2015 BY BOARD CHAIR CFO REVIEWED 2015 BY CEO COO REVIEWED 2015 BY CEO CMO REVIEWED 2015 BY CEO CDO REVIEWED 2015 BY CEO |
| FORM 990, PART VI, SECTION C, LINE 19 | DOCUMENT DISCLOSURE: THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE UPON WRITTEN REQUEST. REQUESTED DOCUMENTS WILL BE MAILED TO THE REQUESTOR. |
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