PRIMA MEDICAL FOUNDATION: Form 990, tax year 2013

View the entire original 990 at ProPublica ↗

Organization
PRIMA MEDICAL FOUNDATION (EIN 27-1376321)
Tax period
2013-01-01 to 2013-12-31
Filed
2014-11-14
IRS object ID
201433189349306643
Schema version
2013v3.0
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

FieldValueIRS element (for citing)
Return2014-11-14T15:15:35-06:00ReturnTs
Tax Period End2013-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN910189318PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1MOSS ADAMS LLPBusinessNameLine1

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1101 SECOND STREET 9TH FLOORAddressLine1
CitySAN FRANCISCOCity
StateCAState
ZIP Code94105ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2013-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN271376321EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1PRIMA MEDICAL FOUNDATIONBusinessNameLine1
FieldValueIRS element (for citing)
Business Name ControlPRIMBusinessNameControlTxt
Phone4158425031PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1HANGAR 4 4 HAMILTON LANDING NO 100AddressLine1
CityNOVATOCity
StateCAState
ZIP Code94949ZIPCode

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonWAYNE FAIRCHILDPersonNm
Person TitleCEOPersonTitleTxt
Phone4158425031PhoneNum
Signature2014-11-13SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonRENIE BURBANKPreparerPersonNm
PTINP00159653PTIN
Phone4159561500PhoneNum
FieldValueIRS element (for citing)
Tax2013TaxYr
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerWAYNE FAIRCHILDPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1HANGAR 4 4 HAMILTON LANDING NO 100AddressLine1
CityNOVATOCity
StateCAState
ZIP Code94949ZIPCode
FieldValueIRS element (for citing)
Gross Receipts$40,559,086GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.PRIMAMEDGROUP.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2010FormationYr
Legal Domicile StateCALegalDomicileStateCd
Activity Or MissionTO PROVIDE THE RECRUITMENT AND RETENTION OF PHYSICIANS, BECOME THE MODEL OF CHOICE FOR PHYSICIANS, IMPROVE CLINICAL QUALITY, PATIENT ACCESS AND ENHANCE ON-GOING STABILITY AND FINANCIAL VIABILITY FOR PHYSICIANS AND THEIR SPONSERS.ActivityOrMissionDesc
Voting Members Governing Body12VotingMembersGoverningBodyCnt
Voting Members Independent12VotingMembersIndependentCnt
Total Employee150TotalEmployeeCnt
Total Volunteers12TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$6,581,810PYContributionsGrantsAmt
CY Contributions Grants$11,202,923CYContributionsGrantsAmt
PY Program Service Revenue$27,435,521PYProgramServiceRevenueAmt
CY Program Service Revenue$29,176,179CYProgramServiceRevenueAmt
PY Investment Income$0PYInvestmentIncomeAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue$350,000PYOtherRevenueAmt
CY Other Revenue$179,984CYOtherRevenueAmt
PY Total Revenue$34,367,331PYTotalRevenueAmt
CY Total Revenue$40,559,086CYTotalRevenueAmt
PY Grants And Similar Paid$2,247PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$7,748,166PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$9,034,020CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$26,604,206PYOtherExpensesAmt
CY Other Expenses$30,061,082CYOtherExpensesAmt
PY Total Expenses$34,354,619PYTotalExpensesAmt
CY Total Expenses$39,095,102CYTotalExpensesAmt
PY Revenues Less Expenses$12,712PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$1,463,984CYRevenuesLessExpensesAmt
Total Assets BOY$10,431,543TotalAssetsBOYAmt
Total Assets EOY$11,733,596TotalAssetsEOYAmt
Total Liabilities BOY$10,394,912TotalLiabilitiesBOYAmt
Total Liabilities EOY$10,232,981TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$36,631NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$1,500,615NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTO PROVIDE THE RECRUITMENT AND RETENTION OF PHYSICIANS, BECOME THE MODEL OF CHOICE FOR PHYSICIANS, IMPROVE CLINICAL QUALITY, PATIENT ACCESS AND ENHANCE ON-GOING STABILITY AND FINANCIAL VIABILITY FOR PHYSICIANS AND THEIR SPONSERS.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$35,253,992ExpenseAmt
Revenue$29,176,179RevenueAmt
DescPRIMARY CARE PROGRAM PROVIDES MARIN & SONOMA COUNTY COMMUNITY WITH PRIMARY CARE SERVICES FOR ADULTS & CHILDREN IN NOVATO, SAUSALITO, PRIMA KIDS IN MILL VALLEY, SONOMA, TAMALPAIS & TERRA LINDA.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
DescOBGYN PROGRAM PROVIDES OBGYN SERVICES INCLUDING LABOR & DELIVERY TO MARIN & SONOMA COUNTIES AS WELL AS PROVIDES PHYSICIAN & CNM HOSPITALISTS CALL COVERAGE FOR MARIN GENERAL HOSPITAL AND SONOMA VALLEY HOSPITAL.Desc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
DescSEE SCHEDULE OPRIMA MEDICAL FOUNDATION PROVIDES SURGICAL SERVICES FOR MARIN & SONOMA COUNTIES IN THE AREAS OF GENERAL SURGERY, ORTHOPEDICS, AND BREAST ONCOLOGY. IN ADDITION, THE COMPANY PROVIDES INTESIVIST SERVICES AND OFFERS A PEDIATRIC AFTER HOURS CLINIC AND HOSPITALIST CALL COVERAGE.PMF IS A NONPROFIT PUBLIC BENEFIT CORPORATION WHICH PROVIDES MEDICAL SERVICES PURSUANT TO A PROFESSIONAL SERVICES AGREEMENT WITH THE PRIMA MEDICAL GROUP, INC., A CALIFORNIA PROFESSIONAL MEDICAL CORPORATION. PMF PROVIDES THESE MEDICAL SERVICES TO BOTH INSURED AND UNINSURED RESIDENTS LOCATED PRIMARILY IN MARIN AND SONOMA COUNTIES IN CALIFORNIA. THESE SERVICES ARE PROVIDED AT TWELVE OUTPATIENT CLINICS THAT IT OWNS AND OPERATES AND AT THREE LOCAL HOSPITALS. THE MEDICAL SERVICES ENCOMPASS MULTIPLE SPECIALTIES INCLUDING: INTERNAL MEDICINE, FAMILY MEDICINE, GENERAL PRACTICE, GERIATRICS, PEDIATRICS, OBSTETRICS, GYNECOLOGY, INFECTIOUS DISEASE, GENERAL SURGERY, COLORECTAL SURGERY, BREAST SURGERY, BARIATRICS, ORTHOPEDICS, DERMATOLOGY, PULMONARY MEDICINE, AND CRITICAL CARE. THESE SERVICES ARE FUNDED BY PATIENT, INSURANCE AND OTHER THIRD PARTY BILLINGS AND BY COLLECTIONS, CONTRIBUTIONS AND LOANS FROM LOCAL HOSPITALS. PATIENTS ARE SERVED WITHOUT LIMITATION BASED ON THEIR ABILITY TO PAY, PROVIDED THEY ARE RESIDENTS OF MARIN OR SONOMA COUNTIES.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$35,253,992TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Temp Or Permanent Endowments0TempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With Officer Ent0BusinessRlnWithOfficerEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control Ent0TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document40IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee150EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members12GoverningBodyVotingMembersCnt
Independent Voting Member12IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn Body0Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn0AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc0RegularMonitoringEnfrcInd
Whistleblower Policy0WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldCAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonCHERI HAWKINSPersonNm
Phone4158425031PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1HANGAR 4 4 HAMILTON LANDING STE 100AddressLine1
CityNOVATOCity
StateCAState
ZIP Code94949ZIPCode

Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
LEE DOMANICO
CHAIRMAN1.00Yes (X)Yes (X)$0$0$0
KELLY MATHER
VICE CHAIRMAN1.00Yes (X)Yes (X)$0$0$0
DAVID COX
TREASURER1.00Yes (X)Yes (X)$0$0$0
MARK WEXMAN
SECRETARY1.00Yes (X)Yes (X)$0$0$0
HARVEY BICKOFF
BOARD MEMBER1.00Yes (X)$0$0$0
NELSON BRANCO MD
BOARD MEMBER1.00Yes (X)$0$0$0
ROBERT COHEN MD
BOARD MEMBER1.00Yes (X)$0$0$0
CHARLES T FISCHER MD
BOARD MEMBER1.00Yes (X)$0$0$0
JOSEPH HABIS MD
BOARD MEMBER1.00Yes (X)$0$0$0
JUSTUS LEACHMAN
BOARD MEMBER1.00Yes (X)$0$0$0
ROBERT NEWBURY MD
BOARD MEMBER1.00Yes (X)$0$0$0
JOEL SKLAR MD
BOARD MEMBER1.00Yes (X)$0$0$0
DENNIS MONDRAGON
INTERIM CEO40.00Yes (X)$165,810$0$17,829
SUSAN SCHNEIDER
MANAGER OF AFTER HOURS CLINIC - RN40.00$130,002$0$13,538Yes (X)
MELANIE WICE
DIRECTOR OF MIDWIFERY40.00$122,418$0$8,312Yes (X)
PATRICIA MARSHALL PARNELL
DIRECTOR OF SPECIALITY SERVICES40.00$114,666$0$7,165Yes (X)
LINDA WRIGHT
NURSE PRACTITIONER40.00$110,222$0$7,050Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$643,118TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$53,894TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K5IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (2 entries)

Address Line1ContractorAddress/USAddress/AddressLine1CityContractorAddress/USAddress/CityStateContractorAddress/USAddress/StateZIP CodeContractorAddress/USAddress/ZIPCodeServicesServicesDescCompensationCompensationAmt
BLACKHAWK MANAGEMENT GROUP LLC
160 CHURCHILL LANENOVATOCA94945MANAGEMENT CONSULTING$330,000
MOSS ADAMS LLP
PO BOX 748369LOS ANGELESCA900748369ACCOUNTING SERVICES$187,805
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K2CntrctRcvdGreaterThan100KCnt
Government Grants$778,672GovernmentGrantsAmt
All Other Contributions$10,424,251AllOtherContributionsAmt
Total Contributions$11,202,923TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
NET PATIENT SERVICES621400$23,155,591$23,155,591
OTHER HMO REVENUE621400$4,724,994$4,724,994
CAPITATION PREMIUM621400$1,295,594$1,295,594
FieldValueIRS element (for citing)
Total Program Service Revenue$29,176,179TotalProgramServiceRevenueAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$179,984RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$179,984RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$179,984TotalRevenueColumnAmt
Exclusion$179,984ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$40,559,086TotalRevenueColumnAmt
Related Or Exempt Func Income$29,176,179RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$179,984ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$183,638TotalAmt
Program Services$183,638ProgramServicesAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$6,230,159TotalAmt
Program Services$6,230,159ProgramServicesAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$76,326TotalAmt
Program Services$76,326ProgramServicesAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$1,763,087TotalAmt
Program Services$1,763,087ProgramServicesAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$780,810TotalAmt
Program Services$780,810ProgramServicesAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$22,240,432TotalAmt
Program Services$19,755,003ProgramServicesAmt
Management And General$2,485,429ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$336,243TotalAmt
Management And General$336,243ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$184,515TotalAmt
Management And General$184,515ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$551,009TotalAmt
Management And General$551,009ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$163,631TotalAmt
Program Services$163,631ProgramServicesAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,092,982TotalAmt
Program Services$1,092,982ProgramServicesAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$124,503TotalAmt
Program Services$124,503ProgramServicesAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$2,432,427TotalAmt
Program Services$2,432,427ProgramServicesAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$11,679TotalAmt
Program Services$11,679ProgramServicesAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$122,292TotalAmt
Program Services$122,292ProgramServicesAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$77,306TotalAmt
Program Services$77,306ProgramServicesAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$664,092TotalAmt
Program Services$664,092ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$93,847TotalAmt
Program Services$70,797ProgramServicesAmt
Management And General$23,050ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (2 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmt
DRUGS AND IMMUNIZATIONS$1,431,242$1,431,242
TRIAGE SERVICE$181,215$181,215

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$353,667TotalAmt
Program Services$92,803ProgramServicesAmt
Management And General$260,864ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$39,095,102TotalAmt
Program Services$35,253,992ProgramServicesAmt
Management And General$3,841,110ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,666,574BOYAmt
EOY$727,612EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$3,801,628BOYAmt
EOY$3,617,707EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$170,871BOYAmt
EOY$204,463EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$592,712BOYAmt
EOY$503,351EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$5,562,177LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$2,016,671LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$4,025,738BOYAmt
EOY$3,545,506EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$174,020BOYAmt
EOY$3,134,957EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$10,431,543BOYAmt
EOY$11,733,596EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,074,229BOYAmt
EOY$2,129,445EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$254,115BOYAmt
EOY$1,050EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$9,066,568BOYAmt
EOY$8,102,486EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$10,394,912BOYAmt
EOY$10,232,981EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$36,631BOYAmt
EOY$1,500,615EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$36,631BOYAmt
EOY$1,500,615EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$10,431,543BOYAmt
EOY$11,733,596EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$1,463,984ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years$3,554,177CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$3,522,954CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$6,581,810CurrentTaxYearMinus1YearAmt
Current Tax Year$11,202,923CurrentTaxYearAmt
Total$24,861,864TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years$9,900,417CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$23,396,678CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$27,435,521CurrentTaxYearMinus1YearAmt
Current Tax Year$29,356,163CurrentTaxYearAmt
Total$90,088,779TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years$13,454,594CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$26,919,632CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$34,017,331CurrentTaxYearMinus1YearAmt
Current Tax Year$40,559,086CurrentTaxYearAmt
Total$114,950,643TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$114,950,643PublicSupportTotal509Amt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years$13,454,594CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$26,919,632CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$34,017,331CurrentTaxYearMinus1YearAmt
Current Tax Year$40,559,086CurrentTaxYearAmt
Total$114,950,643TotalAmt
FieldValueIRS element (for citing)
First5 Years509Yes (X)First5Years509Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,382,983OtherCostOrOtherBasisAmt
Depreciation$867,028DepreciationAmt
Book Value$1,515,955BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$576,578OtherCostOrOtherBasisAmt
Depreciation$249,388DepreciationAmt
Book Value$327,190BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$2,602,616OtherCostOrOtherBasisAmt
Depreciation$900,255DepreciationAmt
Book Value$1,702,361BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$3,545,506TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp

FieldValueIRS element (for citing)
DescRELATED PARTY RECEIVABLESDesc
Book Value$3,134,957BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Other Assets$3,134,957TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (4 entries)

DescDescAmtAmt
PAYABLE TO PRIMA MEDICAL GROUP$969,410
RELATED PARTY PAYABLES$3,908,517
LINE OF CREDIT$2,000,000
DEFERRED RENT LIABILITY$1,224,559
FieldValueIRS element (for citing)
Total Liability$8,102,486TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$40,559,086TotalRevEtcAuditedFinclStmtAmt
Revenue Not Reported$0RevenueNotReportedAmt
Revenue Subtotal$40,559,086RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$40,559,086TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$39,095,102TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported$0ExpensesNotReportedAmt
Expenses Subtotal$39,095,102ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$39,095,102TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationTHE FOUNDATION ACCOUNTS FOR UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH ASC 740. ASC 740 CLARIFIES THE ACCOUNTING FOR INCOME TAXES BY PRESENTING A MINIMUM PROBABILITY THRESHOLD THAT A TAX POSITION MUST MEET BEFORE A FINANCIAL STATEMENT BENEFIT IS RECOGNIZED. THE MINIMUM THRESHOLD IS DEFINED BY ASC 740 AS A TAX POSITION THAT IS MORE LIKELY THAN NOT TO BE SUSTAINED UPON EXAMINATION BY THE APPLICABLE TAXING AUTHORITY, INCLUDING RESOLUTION OF ANY RELATED APPEALS OR LITIGATION PROCESSES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFIT TO BE RECOGNIZED IS MEASURED AS THE LARGEST AMOUNT OF BENEFIT THAT IS GREATER THAN FIFTY PERCENT OF BEING REALIZED UPON ULTIMATE SETTLEMENT. AS OF DECEMBER 31, 2013, THE FOUNDATION HAD NO UNCERTAIN TAX POSITIONS.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Written Employment ContractYes (X)WrittenEmploymentContractInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp

FieldValueIRS element (for citing)
PersonDENNIS MONDRAGONPersonNm
TitleINTERIM CEOTitleTxt
Base Compensation Filing Org$165,810BaseCompensationFilingOrgAmt
Compensation Based On Rltd Orgs$0CompensationBasedOnRltdOrgsAmt
Bonus Filing Organization$0BonusFilingOrganizationAmount
Bonus Related Organizations$0BonusRelatedOrganizationsAmt
Other Compensation Filing Org$0OtherCompensationFilingOrgAmt
Other Compensation Rltd Orgs$0OtherCompensationRltdOrgsAmt
Deferred Compensation Flng Org$0DeferredCompensationFlngOrgAmt
Deferred Comp Rltd Orgs$0DeferredCompRltdOrgsAmt
Nontaxable Benefits Filing Org$17,829NontaxableBenefitsFilingOrgAmt
Nontaxable Benefits Rltd Orgs$0NontaxableBenefitsRltdOrgsAmt
Total Compensation Filing Org$183,639TotalCompensationFilingOrgAmt
Total Compensation Rltd Orgs$0TotalCompensationRltdOrgsAmt
Comp Report Prior990 Filing Org$0CompReportPrior990FilingOrgAmt
Comp Report Prior990 Rltd Orgs$0CompReportPrior990RltdOrgsAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 7AKEY PERSONS DESIGNATED TO APPOINT MEMBERS OF THE GOVERNING BODY INCLUDE SENIOR MANAGEMENT OF MARIN GENERAL HOSPITAL, MERITAGE MEDICAL NETWORK & PRIMA MEDICAL GROUP.
FORM 990, PART VI, SECTION B, LINE 11PRIMA MEDICAL FOUNDATION'S FORM 990 IS REVIEWED BY THE CONTROLLER AND THE CEO OR COO. IT IS ALSO READILY AVAILABLE TO THE BOARD OF DIRECTORS UPON REQUEST.
FORM 990, PART VI, SECTION B, LINE 15THE CEO AND COO'S COMPENSATION ARE SET BY THE FOUNDATION'S BOARD THROUGH NEGOTIATION REGARDING COMPLETE LISTING OF DUTIES AND AGREEMENT TO ACCOMPLISH CERTAIN GOALS. COMPARABILITY DATA WAS USED TO THE EXTENT THAT IT WAS AVAILABLE AND A WRITTEN CONTRACT WAS SIGNED. OTHER KEY EMPLOYEES IN PMF ARE GENERALLY HIRED THROUGH RECRUITING AGENCIES. SALARY IS ESTABLISHED AT MARKET RATES REPRESENTED IN THE REGION BY JOB TITLE AND DESCRIPTION OF DUTIES TO BE ACCOMPLISHED. THESE ARE COMPARED WITH OTHER SALARY SURVEYS AND PUBLICATIONS SUCH AS MGMA.
FORM 990, PART VI, SECTION C, LINE 19PRIMA MEDICAL FOUNDATION MAKES THIS INFORMATION READILY AVAILABLE FOR PUBLIC INSPECTION DURING REGULAR BUSINESS HOURS AT THEIR PRINCIPAL OFFICE.
990, PART XII, LINE 2CAUDIT COMMITTEE AND OVERSIGHT - THERE HAVE BEEN NO CHANGES TO THIS PROCESS FROM PRIOR YEAR.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1MARIN GENERAL HOSPITALBusinessNameLine1

US Address USAddress

FieldValueIRS element (for citing)
Address Line1250 BON AIR ROADAddressLine1
CityGREENBRAECity
StateCAState
ZIP Code94904ZIPCode
FieldValueIRS element (for citing)
EIN942823538EIN
Primary ActivitiesHOSPITALPrimaryActivitiesTxt
Legal Domicile StateCALegalDomicileStateCd
Exempt Code Section501(C)(3)ExemptCodeSectionTxt
Public Charity Status3PublicCharityStatusTxt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1MARIN GENERAL HOSPITALBusinessNameLine1
FieldValueIRS element (for citing)
Controlled Organization0ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgYes (1)GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of Facilities0SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

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