MANIFEST MEDEX: Form 990, tax year 2015

View the entire original 990 at ProPublica ↗

Organization
MANIFEST MEDEX (EIN 27-2367522)
Tax period
2015-01-01 to 2015-12-31
Filed
2016-07-28
IRS object ID
201612169349300541
Schema version
2015v2.1
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

FieldValueIRS element (for citing)
Return2016-07-28T08:54:27-07:00ReturnTs
Tax Period End2015-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN330313836PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1MACHER & CLARK CPASBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line13689 ARLINGTON AVEAddressLine1Txt
CityRiversideCityNm
State AbbreviationCAStateAbbreviationCd
ZIP92506ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2015-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN272367522EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1INLAND EMPIRE EHR RESOURCE CENTERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlINLABusinessNameControlTxt

US Address USAddress

FieldValueIRS element (for citing)
Address Line13993 JURUPA AVEAddressLine1Txt
CityRiversideCityNm
State AbbreviationCAStateAbbreviationCd
ZIP925062246ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDOLORES GREENPersonNm
Person TitleCEOPersonTitleTxt
Phone9516863343PhoneNum
Signature2016-07-12SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonDAVID C MACHER CPAPreparerPersonNm
PTINP00058198PTIN
Phone9517870330PhoneNum
FieldValueIRS element (for citing)
Tax2015TaxYr
Build TS2016-12-15 16:53:06ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Gross Receipts$4,105,152GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Type Of Organization OtherYes (X)TypeOfOrganizationOtherInd
Other Organization DscELECTOtherOrganizationDsc
Formation2010FormationYr
Legal Domicile StateCALegalDomicileStateCd
Activity Or MissionTO PROVIDE ASSISTANCE AND DIRECTION TO VARIOUS ORGANIZATIONS FOR THE SUCCESSFUL IMPLEMENTATION OF ELECTRONIC HEALTH RECORDS PROCEDURES WITHIN THE MEDICAL COMMUNITY.ActivityOrMissionDesc
Voting Members Governing Body8VotingMembersGoverningBodyCnt
Voting Members Independent0VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$511,907PYContributionsGrantsAmt
CY Contributions Grants$502,560CYContributionsGrantsAmt
PY Program Service Revenue$1,640,920PYProgramServiceRevenueAmt
CY Program Service Revenue$3,602,592CYProgramServiceRevenueAmt
CY Investment Income$0CYInvestmentIncomeAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$2,152,827PYTotalRevenueAmt
CY Total Revenue$4,105,152CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$695,664PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$1,865,185CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$2,239,653PYOtherExpensesAmt
CY Other Expenses$1,680,712CYOtherExpensesAmt
PY Total Expenses$2,935,317PYTotalExpensesAmt
CY Total Expenses$3,545,897CYTotalExpensesAmt
PY Revenues Less Expenses-$782,490PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$559,255CYRevenuesLessExpensesAmt
Total Assets BOY$1,266,920TotalAssetsBOYAmt
Total Assets EOY$1,917,605TotalAssetsEOYAmt
Total Liabilities BOY$1,166,811TotalLiabilitiesBOYAmt
Total Liabilities EOY$1,258,241TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$100,109NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$659,364NetAssetsOrFundBalancesEOYAmt
MissionTO PROVIDE ASSISTANCE AND DIRECTION TO VARIOUS ORGANIZATIONS FOR THE SUCCESSFUL IMPLEMENTATION OF ELECTRONIC HEALTH RECORDS PROCEDURES WITHIN THE MEDICAL COMMUNITY.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$3,486,714ExpenseAmt
Revenue$3,602,592RevenueAmt
DescCALHIPSO AWARD, SACRAMENTO, CALIFORNIA, AND HEALTH INFORMATION EXCHANGE SERVICE FEES.Desc
Total Program Service Expenses$3,486,714TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentfalseReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (true)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredfalseScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document5IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee0EmployeeCnt
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
DAF Excess Business HoldingsfalseDAFExcessBusinessHoldingsInd
Taxable DistributionsfalseTaxableDistributionsInd
Distribution To DonorfalseDistributionToDonorInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members8GoverningBodyVotingMembersCnt
Independent Voting Member0IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (true)DelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOfalseCompensationProcessCEOInd
Compensation Process OtherfalseCompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldCAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonDOLORES GREENPersonNm
Phone9516863343PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line13993 JURUPA AVEAddressLine1Txt
CityRiversideCityNm
State AbbreviationCAStateAbbreviationCd
ZIP925062246ZIPCd
FieldValueIRS element (for citing)
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (8 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
DOLORES GREEN
CEO5.000.00Yes (X)Yes (X)$0$0$0
BRADLEY GILBERT
BOARD CHAIRMAN2.500.00Yes (X)Yes (X)$0$0$0
LEROY OUNANIAN
SECRETARYTREASURER2.500.00Yes (X)Yes (X)$0$0$0
MICHAEL DEERING
MEMBER1.000.00Yes (X)$0$0$0
CHRISTOPHER HANCOCK
MEMBER1.000.00Yes (X)$0$0$0
WILLIAM HENNING
MEMBER1.000.00Yes (X)$0$0$0
TAREK MAHDI
MEMBER1.000.00Yes (X)$0$0$0
JAMES PETERSON
MEMBER1.000.00Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$0TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KfalseTotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
Government Grants$2,560GovernmentGrantsAmt
All Other Contributions$500,000AllOtherContributionsAmt
Total Contributions$502,560TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescHI EXCHANGE SERVICESDesc
Business519100BusinessCd
Total Revenue Column$3,602,592TotalRevenueColumnAmt
Related Or Exempt Func Income$3,602,592RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$3,602,592TotalProgramServiceRevenueAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$4,105,152TotalRevenueColumnAmt
Related Or Exempt Func Income$3,602,592RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$1,865,185TotalAmt
Program Services$1,865,185ProgramServicesAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$59,183TotalAmt
Management And General$59,183ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$675TotalAmt
Program Services$675ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$53,804TotalAmt
Program Services$53,804ProgramServicesAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$14,688TotalAmt
Program Services$14,688ProgramServicesAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$58,200TotalAmt
Program Services$58,200ProgramServicesAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$38,944TotalAmt
Program Services$38,944ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$21,338TotalAmt
Program Services$21,338ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
PLATINUM SERVICE PARTNER$1,058,181$1,058,181
FIDUCIARY AGENT EXPENSES$205,255$205,255
BAD DEBTS$32,000$32,000
CONSULTING FEES$95,040$95,040

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$43,404TotalAmt
Program Services$43,404ProgramServicesAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$3,545,897TotalAmt
Program Services$3,486,714ProgramServicesAmt
Management And General$59,183ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$660,318BOYAmt
EOY$1,174,708EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$597,720BOYAmt
EOY$731,680EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$8,882BOYAmt
EOY$11,217EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$1,266,920BOYAmt
EOY$1,917,605EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$969,226BOYAmt
EOY$233,438EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$188,467BOYAmt
EOY$1,014,520EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$9,118BOYAmt
EOY$10,283EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$1,166,811BOYAmt
EOY$1,258,241EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$100,109BOYAmt
EOY$659,364EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$100,109BOYAmt
EOY$659,364EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$1,266,920BOYAmt
EOY$1,917,605EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$559,255ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$404,558CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$708,666CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,720,147CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$511,907CurrentTaxYearMinus1YearAmt
Current Tax Year$502,560CurrentTaxYearAmt
Total$3,847,838TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$404,558CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$708,666CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,720,147CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$511,907CurrentTaxYearMinus1YearAmt
Current Tax Year$502,560CurrentTaxYearAmt
Total$3,847,838TotalAmt
FieldValueIRS element (for citing)
Public Support Total170$3,847,838PublicSupportTotal170Amt
Total Support$3,847,838TotalSupportAmt
Public Support CY1701.00000PublicSupportCY170Pct
Public Support PY1701.00000PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Schedule D IRS990ScheduleD

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescACCRUED LIABILITIESDesc
Amt$10,283Amt
FieldValueIRS element (for citing)
Total Liability$10,283TotalLiabilityAmt
Total Rev Etc Audited Fincl Stmt$4,105,152TotalRevEtcAuditedFinclStmtAmt
Revenue Subtotal$4,105,152RevenueSubtotalAmt
Total Revenue Per Form990$4,105,152TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$3,545,897TotExpnsEtcAuditedFinclStmtAmt
Expenses Subtotal$3,545,897ExpensesSubtotalAmt
Total Expenses Per Form990$3,545,897TotalExpensesPerForm990Amt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Management duties delegation Part VI line 3THE ORGANIZATIONS MANAGEMENT DUTIES ARE PERFORMED BY THE MANAGEMENT OF RIVERSIDE COUNTY MEDICAL ASSOCIATION (RCMA) MANAGEMENT PERSONNEL. THE ORGANIZATION REIMBURSES RCMA, OR ITS DESIGNEE, FOR THE SERVICES OF ADMINISTRATION AND PROGRAM SERVICE PERSONNEL.
Form 990 governing body review Part VI line 11COPY OF FORM 990 IS SENT TO CEO WHO REVIEWS IT AND GIVES IT TO A BOARD MEMBER FOR REVIEW AND APPROVAL BEFORE IT IS FILED.
Conflict of interest policy compliance Part VI line 12cOFFICERS AND DIRECTORS ARE REQUIRED TO COMPLETE NEW DISCLOSURE DOCUMENTS ANNUALLY.
Governing documents etc available to public Part VI line 19UPON REQUEST THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FIANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC AT THE CENTERS OFFICE IN RIVERSIDE, CALIFORNIA.

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