2014-05-15T16:11:34-05:00 2013-06-30 910189318 MOSS ADAMS LLP 101 SECOND STREET 9TH FLOOR SAN FRANCISCO CA 94105 990 2012-07-01 330664371 SAC HEALTH SYSTEM SACH 9093827110 1454 E 2ND ST SAN BERNARDINO CA 94208 HOLLY YONEMOTO 9093827110 2014-05-15 1 RENIE BURBANK P00159653 4159561500 2012 2015-11-30 17:44:51Z HOLLY YONEMOTO 1454 E 2ND ST SAN BERNARDINO CA 94208 8887768 0 X N/A X 1995 CA PROVIDE OUR COMMUNITIES WITH PRIMARY HEALTH CARE SERVICES, DENTAL CARE & BEHAVIORAL MEDICINE SERVICES. 10 10 110 11 0 0 4563334 4851059 3239553 3681201 1220 1406 33058 354102 7837165 8887768 0 0 0 0 4802395 5475120 0 0 0 2853329 3719371 7655724 9194491 181441 -306723 3541288 5431386 1281531 3461070 2259757 1970316 X SEE SCHEDULE OSOCIAL ACTION COMMUNITY HEALTH SYSTEM IS COMMITTED TO PROVIDING ACCESSIBLE, WHOLE-PERSON HEALTH CARE TO ALL THOSE IN NEED. SACHS EMPOWERS FAMILIES TO LIVE VIBRANT AND HEALTHY LIVES THROUGH THE DELIVERY OF CULTURALLY SENSITIVE AND HIGH-QUALITY, COMPREHENSIVE SERVICES. 0 0 4743069 3681201 SACHS IS A THREE CLINIC SYSTEM THAT PROVIDES LOW COST COMMUNITY HEALTH SERVICES TO THE UNDERSERVED COMMUNITIES IN THE INLAND EMPIRE. DURING THE PERIOD FROM JULY, 1 2012 THROUGH JUNE 30, 2013. SACHS HAD PROVIDED 19,006 MEDICAL AND BEHAVIORAL SERVICES TO 6,516 PATIENTS AND 6,720 DENTAL SERVICES TO 2,965 PATIENTS. 4743069 1 1 0 0 0 0 0 0 0 1 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 0 0 0 0 0 0 0 0 0 1 23 0 1 110 1 0 0 0 0 0 0 0 0 0 0 X 10 10 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X HOLLY YONEMOTO 9093827110 1455 E 3RD STREET SAN BERNARDINO CA 92410 X DR CARLTON LOFGREN 0.50 X X 0 0 0 DR JUAN CARLOS BELLIARD 0.50 X X 0 0 0 DR MARILYN HERRMANN 0.50 X X 0 0 0 ANN ATKINSON 0.50 X 0 0 0 RUAL CASTILLO 0.50 X 0 0 0 DR DAISY DELEON 0.50 X 0 0 0 DR RICHARD HART 0.50 X 0 0 0 STEVE MOHR 0.50 X 0 0 0 DR ERIC NGO 0.50 X 0 0 0 DR EDELWEISS RAMAL 0.50 X 0 0 0 DR KENNETH HART 40.00 X 0 0 0 NANCY YOUNG 40.00 X 178757 0 42928 HOLLY YONEMOTO 40.00 X 171836 0 45365 ANITA ADORAOR 40.00 X 114669 0 27161 465262 0 115454 3 0 1 0 LOMA LINDA UNIV HEALTH CARE 11175 CAMPUS STREET SUITE 11120 LOMA LINDA CA 92354 PHYSICIAN SERVICES 683631 LOMA LINDA UNIV SCHOOL OF DENTISTRY 11092 ANDERSON STREET LOMA LINDA CA 92354 DENTIST SERVICES 569396 CONCEPTOS CLEANING SERVICE 18665 GRANITE AVENUE RIVERSIDE CA 92508 JANITORIAL SERVICES 109739 3 1669370 3181689 4851059 PATIENT CARE REVENUE 621400 3681201 3681201 3681201 1406 1406 29750 0 29750 29750 29750 OTHER REVENUE 900099 324352 324352 324352 8887768 3681201 0 355508 X 542029 542029 2916918 1558209 1358709 272639 145643 126996 1433835 765950 667885 309699 165440 144259 32990 17623 15367 59739 31912 27827 1538845 822046 716799 96392 51492 44900 87809 46907 40902 259658 259658 3009 1607 1402 42145 22514 19631 250621 133881 116740 103857 55480 48377 PURCHASED SERVICES 681078 363830 317248 MEDICAL SUPPLIES 241763 129149 112614 REPAIRS AND MAINTENANCE 178715 95469 83246 TRAINING 39100 20887 18213 103650 55372 48278 9194491 4743069 4451422 0 513868 757141 628569 692743 298971 228943 865681 531662 81508 85049 16363 69214 3409187 1353570 843031 2055617 293297 1011017 3541288 5431386 908523 1542808 293297 1011017 79711 907245 1281531 3461070 X 1631188 1277574 578420 642593 50149 50149 2259757 1970316 3541288 5431386 X -306723 17287 -5 X X 0 1 X 1 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 58571 1428 59999 57351 1220 58571 56331 1020 57351 55503 828 56331 54109 1394 55503 0.07200 0.92800 1 0 1667247 610563 1056684 1188375 743007 445368 553565 553565 2055617 DUE FROM THIRD PARTY 1011017 1011017 DEPOSITS 600 PAYABLE TO LLUHS/LLU 906645 907245 X 9805055 17287 900000 917287 8887768 0 8887768 10094496 900000 900000 9194496 -5 -5 9194491 DESCRIPTION OF INTENDED USE OF ENDOWMENT FUNDS: PART V, LINE 4: THE PRINCIPAL OF THIS PERMANENT FUND TOGETHER WITH ANY ADDITIONS SHALL BE PRESERVED IN PERPETUITY AND SHALL NOT BE DRAWN UPON. HOWEVER, THE INCOME OF THIS FUND MAY BE EXPENDED ONLY AS OPERATING FUNDS FOR THE SACHS CLINICS DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X, LINE 2: THE ORGANIZATION FOLLOWS THE PROVISIONS OF FASB ASC 740-10, INCOME TAXES, RELATING TO ACCOUNTING FOR UNCERTAIN TAX POSITIONS, WHICH HAS NO FINANCIAL STATEMENT IMPACT TO THE ORGANIZATION. THE ORGANIZATION RECOGNIZES THE TAX BENEFIT FROM UNCERTAIN TAX POSITIONS ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITIONS WILL BE SUSTAINED ON EXAMINATION BY THE TAX AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFIT IS MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. PART XII, LINE 4B - OTHER ADJUSTMENTS: AUDITED FINANCIAL STATEMENT ROUNDING -5. X X X X X X 0 0 0 0 0 0 0 0 0 NANCY YOUNG 178757 0 0 0 0 0 28349 0 14579 0 221685 0 0 0 HOLLY YONEMOTO 171836 0 0 0 0 0 22597 0 22768 0 217201 0 0 0 FORM 990, PART VI, SECTION B, LINE 11 THE FORM 990 IS REVIEWED BY FINANCE COMMITTEE AND MANAGEMENT. A PAPER COPY OF THE RETURN IS MADE AVAILABLE TO THE FINANCE/AUDIT COMMITTEE AND THE BOARD FOR REVIEW AND COMMENT BEFORE FILING WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C GENERAL COUNSEL ANNUALLY OBTAINS STATEMENTS OF DISCLOSURE FROM TRUSTEES, OFFICERS, ADMINISTRATORS, KEY EMPLOYEES AND OTHERS WHO MAKE OR AFFECT SIGNIFICANT DECISIONS AND REVIEWS THE FINDINGS WITH APPROPRIATE BOARDS AND COMMITTEES. THE BOARD OF TRUSTEES MAKES THE DECISIONS REGARDING QUESTIONS WHICH HAVE NOT BEEN SATISFACTORILY ANSWERED AFTER ADMINISTRATIVE CONSIDERATION. FORM 990, PART VI, SECTION B, LINE 15 IN APRIL OF 2010, SAC HEALTH SYSTEM HAD AN EVALUATION BY THE LLUAHSC'S HUMAN RESOURCES DEPARTMENT FOR EXECUTIVE COMPENSATION. THE MARKET RATE ANALYSIS OF EXECUTIVE COMPENSATION WAS EXECUTED BY USING REGIONAL COMPARATIVE DATA AND THE RATES WERE RECOMMENDED FOR APPROVAL. THE CURRENT WAGE RATE SCALE REMAINS THE SAME BASED ON THIS INITIAL REVIEW. FORM 990, PART VI, SECTION C, LINE 19 SAC HEALTH SYSTEM WILL MAKE ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC UPON REQUEST AND IN ACCORDANCE WITH IRS GUIDELINES. THE CONFLICT OF INTEREST POLICY IS POSTED ON THE ORGANIZATION'S INTERNAL WEBSITE FOR EMPLOYEES. THE FINANCIAL INFORMATION IS INCLUDED IN THE IRS FORM 990 WHICH IS AVAILABLE TO THE PUBLIC ON THE GUIDESTAR WEBSITE. OFFICERS, DIRECTORS, TRUSTEES, & KEY EMPLOYEES FORM 990, PART VII, SECTION A SACHS LEASES DR GIANG'S SERVICES AS CHIEF MEDICAL OFFICER (0.20 FTE). SACHS PAYS AN ANNUAL AMOUNT TO AN UNRELATED ORGANIZATION (PROFESSIONAL MEDICAL GROUP) FOR THESE SERVICES. OTHER FEES FORM 990, PART IX, LINE 11G NON-EMPLOYEE SERVICES: PROGRAM SERVICE EXPENSES 822,046. MANAGEMENT AND GENERAL EXPENSES 716,799. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,538,845. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 9: AUDITED FINANCIAL STATEMENT ROUNDING -5. FORM 990, PART XII, LINE 2B THE FINANCIAL STATEMENTS OF SAC HEALTH SYSTEM WERE AUDITED BY AN INDEPENDENT ACCOUNTING FIRM. FORM 990, PART XII, LINE 2C SAC HEALTH SYSTEM'S FINANCE/AUDIT COMMITTEE OF THE BOARD OF DIRECTORS ASSUMES THE RESPONSIBILITY FOR OVERSIGHT OF SAC HEALTH SYSTEM'S FINANCIAL STATEMENT AUDIT AND SELECTION OF THE INDEPENDENT FIRM. THERE HAVE BEEN NO CHANGES TO THIS PROCESS FROM PRIOR YEAR.