SAC HEALTH SYSTEM: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- SAC HEALTH SYSTEM (EIN 33-0664371)
- Tax period
- 2011-07-01 to 2012-06-30
- Filed
- 2013-05-07
- IRS object ID
- 201321279349301282
- Schema version
- 2011v1.5
- 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) |
|---|---|---|
| Timestamp | 2013-05-07T14:18:08-05:00 | Timestamp |
| Tax Period End Date | 2012-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 910189318 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MOSS ADAMS LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 SECOND STREET 9TH FLOOR | AddressLine1 |
| City | SAN FRANCISCO | City |
| State | CA | State |
| ZIP Code | 94105 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 330664371 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SAC HEALTH SYSTEM | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | SACH | NameControl |
| Phone | 9093827110 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1454 E 2ND ST | AddressLine1 |
| City | SAN BERNARDINO | City |
| State | CA | State |
| ZIP Code | 94208 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | HOLLY YONEMOTO | Name |
| Title | VP/COO/CFO | Title |
| Phone | 9093827110 | Phone |
| Date Signed | 2013-05-06 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | RENIE BURBANK | Name |
| PTIN | P00159653 | PTIN |
| Phone | 4159561500 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | HOLLY YONEMOTO | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1454 E 2ND ST | AddressLine1 |
| City | SAN BERNARDINO | City |
| State | CA | State |
| ZIP Code | 94208 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 7837165 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | N/A | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1995 | YearFormation |
| State Legal Domicile | CA | StateLegalDomicile |
| Activity Or Mission Description | PROVIDE OUR COMMUNITIES WITH PRIMARY HEALTH CARE SERVICES, DENTAL CARE & BEHAVIORAL MEDICINE SERVICES. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 12 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 12 | NbrIndependentVotingMembers |
| Total Nbr Employees | 84 | TotalNbrEmployees |
| Total Nbr Volunteers | 11 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 4384496 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 4563334 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 2613399 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 3239553 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 1020 | InvestmentIncomePriorYear |
| Investment Income Current Year | 1220 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 37088 | OtherRevenuePriorYear |
| Other Revenue Current Year | 33058 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 7036003 | TotalRevenuePriorYear |
| Total Revenue Current Year | 7837165 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 4787889 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 4802395 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 2195953 | OtherExpensePriorYear |
| Other Expenses Current Year | 2853329 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 6983842 | TotalExpensesPriorYear |
| Total Expenses Current Year | 7655724 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 52161 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 181441 | RevenuesLessExpensesCY |
| Total Assets BOY | 2836944 | TotalAssetsBOY |
| Total Assets EOY | 3541288 | TotalAssetsEOY |
| Total Liabilities BOY | 758628 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 1281531 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 2078316 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 2259757 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | SOCIAL 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. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 4158539 | Expense |
| Revenue | 3239553 | Revenue |
| Description | 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 2011 THROUGH JUNE 30, 2012. SACHS HAD PROVIDED 20,083 MEDICAL SERVICES; 8,298 DENTAL SERVICES AND 875 BEHAVIORAL SERVICES. | Description |
| Total Program Service Expense | 4158539 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 1 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 1 | ReportOtherAssets |
| Report Other Liabilities | 1 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 0 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transaction Related Entity | 0 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 14 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 84 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 12 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 12 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | CA | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | HOLLY YONEMOTO | NamePerson |
| Telephone Number | 9093827110 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1455 E 3RD STREET | AddressLine1 |
| City | SAN BERNARDINO | City |
| State | CA | State |
| ZIP Code | 92410 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | X | InfoInScheduleOPartVII |
Form990 Part VII Section A Form990PartVIISectionA (18 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|
| CARLTON LOFGREN MD | |||||||
| BOARD CHAIRMAN | 0.50 | X | X | 0 | 0 | 0 | |
| JUAN CARLOS BELLIARD | |||||||
| BOARD CO-CHAIRMAN | 0.50 | X | X | 0 | 0 | 0 | |
| MARILYN HERMANN | |||||||
| SECRETARY | 0.50 | X | X | 0 | 0 | 0 | |
| ERIC NGO MD | |||||||
| BOARD MEMBER | 0.50 | X | 0 | 0 | 0 | ||
| DAVID GORDON WREN | |||||||
| BOARD MEMBER | 0.50 | X | 0 | 0 | 0 | ||
| ANN ATKINSON | |||||||
| BOARD MEMBER | 0.50 | X | 0 | 0 | 0 | ||
| STEVEN LAWRENCE MOHR | |||||||
| BOARD MEMBER | 0.50 | X | 0 | 0 | 0 | ||
| EDELWEISS RAMAL | |||||||
| BOARD MEMBER | 0.50 | X | 0 | 0 | 0 | ||
| DAISY DELEON | |||||||
| BOARD MEMBER | 0.50 | X | 0 | 0 | 0 | ||
| CINTIA RAMIREZ | |||||||
| BOARD MEMBER | 0.50 | X | 0 | 0 | 0 | ||
| VERONICA REYES | |||||||
| BOARD MEMBER | 0.50 | X | 0 | 0 | 0 | ||
| KISHA NORRIS | |||||||
| BOARD MEMBER | 0.50 | X | 0 | 0 | 0 | ||
| ANITA ADORADOR | |||||||
| CHIEF PATIENT CARE OFFICER | 40.00 | X | 111181 | 0 | 28387 | ||
| DANIEL GIANG MD | |||||||
| CHIEF MEDICAL OFFICER | 8.00 | X | 60637 | 0 | 0 | ||
| NANCY YOUNG | |||||||
| PRESIDENT/CEO | 40.00 | X | 197561 | 0 | 30579 | ||
| HOLLY YONEMOTO | |||||||
| VICE PRESIDENT COO/CFO | 40.00 | X | 138237 | 0 | 30584 | ||
| CYNTHIA KARYN ROLLINS | |||||||
| CHIEF FINANCIAL OFFICER | 40.00 | X | 112058 | 0 | 13178 | ||
| CAMILLE EUGENIO | |||||||
| CONTROLLER | 40.00 | 126338 | 0 | 29770 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 746012 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 132498 | TotalOtherCompensation |
| Number Individuals GT100 K | 5 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (2 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| LOMA LINDA UNIV SCHOOL OF DENTISTRY | |||||
| 11092 ANDERSON STREET | LOMA LINDA | CA | 92354 | LEASE DENTISTS | 417775 |
| LOMA LINDA UNIV HEALTH CARE | |||||
| 11175 CAMPUS STREET SUITE 11120 | LOMA LINDA | CA | 92354 | LEASE PHYSICIANS | 343132 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 2 | NumberOfContractorsGT100K |
| Federated Campaigns | 12683 | FederatedCampaigns |
| Government Grants | 318936 | GovernmentGrants |
| All Other Contributions | 4231715 | AllOtherContributions |
| Total Contributions | 4563334 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| PATIENT CARE REVENUE | 621400 | 3076036 | 3076036 |
| ALL OTHER PROGRAM REV | 621940 | 163517 | 163517 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 3239553 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1220 | TotalRevenueColumn |
| Exclusion | $1,220 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 33058 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 33058 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 33058 | TotalRevenueColumn |
| Exclusion | $33,058 | ExclusionAmount |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 7837165 | TotalRevenueColumn |
| Related Or Exempt Function Income | 3239553 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $34,278 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 604969 | Total |
| Management And General | 604969 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2435247 | Total |
| Program Services | 1300902 | ProgramServices |
| Management And General | 1134345 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 237981 | Total |
| Program Services | 100387 | ProgramServices |
| Management And General | 137594 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1235687 | Total |
| Program Services | 509459 | ProgramServices |
| Management And General | 726228 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 288511 | Total |
| Program Services | 135943 | ProgramServices |
| Management And General | 152568 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13934 | Total |
| Management And General | 13934 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 24367 | Total |
| Management And General | 24367 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 908357 | Total |
| Program Services | 872985 | ProgramServices |
| Management And General | 35372 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 515587 | Total |
| Program Services | 408195 | ProgramServices |
| Management And General | 107392 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 33600 | Total |
| Management And General | 33600 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 307556 | Total |
| Program Services | 192230 | ProgramServices |
| Management And General | 115326 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 3904 | Total |
| Program Services | 3496 | ProgramServices |
| Management And General | 408 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 46632 | Total |
| Program Services | 39509 | ProgramServices |
| Management And General | 7123 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 140588 | Total |
| Program Services | 3444 | ProgramServices |
| Management And General | 137144 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 99867 | Total |
| Program Services | 75506 | ProgramServices |
| Management And General | 24361 | ManagementAndGeneral |
Other Expenses OtherExpenses (3 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| PURCHASED SERVICES | 519434 | 312232 | 207202 |
| PROV. UNCOLLECTIBLE ACC | 194826 | 194826 | |
| DUES AND SUBSCRIPTIONS | 2833 | 2833 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 41844 | Total |
| Program Services | 6592 | ProgramServices |
| Management And General | 35252 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7655724 | Total |
| Program Services | 4158539 | ProgramServices |
| Management And General | 3497185 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1151540 | BOY |
| EOY | 513868 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 579285 | BOY |
| EOY | 628569 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 180672 | BOY |
| EOY | 298971 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 198327 | BOY |
| EOY | 865681 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 115234 | BOY |
| EOY | 81508 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 14925 | BOY |
| EOY | 16363 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 1945979 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 1102948 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 596961 | BOY |
| EOY | 843031 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 293297 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2836944 | BOY |
| EOY | 3541288 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 681139 | BOY |
| EOY | 908523 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 293297 | EOY |
Other Liabilities OtherLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 77489 | BOY |
| EOY | 79711 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 758628 | BOY |
| EOY | 1281531 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1499030 | BOY |
| EOY | 1631188 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 529137 | BOY |
| EOY | 578420 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 50149 | BOY |
| EOY | 50149 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2078316 | BOY |
| EOY | 2259757 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2836944 | BOY |
| EOY | 3541288 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 181441 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequired |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| 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) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Current Year CurrentYear
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 57351 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 1220 | InvestmentEarningsOrLosses |
| End Of Year Balance | 58571 | EndOfYearBalance |
Current Year Minus1 Year CurrentYearMinus1Year
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 56331 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 1020 | InvestmentEarningsOrLosses |
| End Of Year Balance | 57351 | EndOfYearBalance |
Current Year Minus2 Years CurrentYearMinus2Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 55503 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 828 | InvestmentEarningsOrLosses |
| End Of Year Balance | 56331 | EndOfYearBalance |
Current Year Minus3 Years CurrentYearMinus3Years
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Of Year Balance | 54109 | BeginningOfYearBalance |
| Investment Earnings Or Losses | 1394 | InvestmentEarningsOrLosses |
| End Of Year Balance | 55503 | EndOfYearBalance |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated EOY Balance | 0.14600 | BoardDesignatedEOYBalance |
| Permanent Endowment EOY Balance | 0.85400 | PermanentEndowmentEOYBalance |
| Endowments Held By Unrelated Orgs | 1 | EndowmentsHeldByUnrelatedOrgs |
| Endowments Held By Related Orgs | 0 | EndowmentsHeldByRelatedOrgs |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 662956 | OtherCostOrOtherBasis |
| Depreciation | 527290 | Depreciation |
| Book Value | 135666 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1147057 | OtherCostOrOtherBasis |
| Depreciation | 575658 | Depreciation |
| Book Value | 571399 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 135966 | OtherCostOrOtherBasis |
| Book Value | 135966 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 843031 | TotalOfBookValueLandBuildings |
Other Assets OtherAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | DUE FROM THIRD PARTY | Description |
| Book Value | 293297 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | 293297 | TotalBookValueOtherAssets |
Other Liabilities OtherLiabilities (2 entries)
| DescriptionDescription | AmountAmount |
|---|---|
| DEPOSITS | $600 |
| PAYABLE TO LLUHS/LLU | $79,111 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Amounts | 79711 | TotalOfAmounts |
| Total Revenue | 7837165 | TotalRevenue |
| Total Expenses | 7655724 | TotalExpenses |
| Excess Or Deficit For Year | 181441 | ExcessOrDeficitForYear |
| Excess Or Deficit Per FS | 181441 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 8737165 | TotRevenueEtcAuditedFinclStmt |
| Donated Srvc And Use Of Facilities | 900000 | DonatedSrvcAndUseOfFacilities |
| Revenue Not Rptd F990 | 900000 | RevenueNotRptdF990 |
| Revenue Subtotal | 7837165 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 7837165 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 8555723 | TotExpensesEtcAuditedFinclStmt |
| Donated Services Use Of Facilities | 900000 | DonatedServicesUseOfFacilities |
| Expenses Not Rptd F990 | 900000 | ExpensesNotRptdF990 |
| Expenses Subtotal | 7655723 | ExpensesSubtotal |
| Other Expenses Not Included | 1 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 1 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 7655724 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (3 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| 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: | 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 XIII, LINE 4B - OTHER ADJUSTMENTS: | ROUNDING 1. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Independent Consultant | X | IndependentConsultant |
| Form990 Of Other Organizations | X | Form990OfOtherOrganizations |
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (3 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NANCY YOUNG | |||||||||||||
| 197561 | 0 | 0 | 0 | 0 | 0 | 15713 | 0 | 14866 | 0 | 228140 | 0 | 0 | 0 |
| HOLLY YONEMOTO | |||||||||||||
| 138237 | 0 | 0 | 0 | 0 | 0 | 11201 | 0 | 19383 | 0 | 168821 | 0 | 0 | 0 |
| CAMILLE EUGENIO | |||||||||||||
| 126338 | 0 | 0 | 0 | 0 | 0 | 10443 | 0 | 19327 | 0 | 156108 | 0 | 0 | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (7 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| 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. | |
| FORM 990, PART VII, SECTION A | SACHS LEASES DR GIANG'S SERVICES AS CHIEF MEDICAL OFFICER (0.20 FTE). SACHS PAYS THIS ANNUAL AMOUNT TO AN UNRELATED ORGANIZATION (PROFESSIONAL MEDICAL GROUP) FOR THESE SERVICES. | OFFICERS, DIRECTORS, TRUSTEES, & KEY EMPLOYEES |
| 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. |
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