2013-05-07T14:18:08-05:00 2012-06-30 910189318 MOSS ADAMS LLP 101 SECOND STREET 9TH FLOOR SAN FRANCISCO CA 94105 990 2011-07-01 330664371 SAC HEALTH SYSTEM SACH 9093827110 1454 E 2ND ST SAN BERNARDINO CA 94208 HOLLY YONEMOTO 9093827110 2013-05-06 1 RENIE BURBANK P00159653 4159561500 2011 2016-02-25 16:41:14Z HOLLY YONEMOTO 1454 E 2ND ST SAN BERNARDINO CA 94208 7837165 0 X N/A X 1995 CA PROVIDE OUR COMMUNITIES WITH PRIMARY HEALTH CARE SERVICES, DENTAL CARE & BEHAVIORAL MEDICINE SERVICES. 12 12 84 11 0 0 4384496 4563334 2613399 3239553 1020 1220 37088 33058 7036003 7837165 0 0 0 0 4787889 4802395 0 0 0 2195953 2853329 6983842 7655724 52161 181441 2836944 3541288 758628 1281531 2078316 2259757 X 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. 0 0 4158539 3239553 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. 4158539 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 0 1 14 0 1 84 1 0 0 0 0 0 0 0 0 0 0 X 12 12 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 CARLTON LOFGREN MD 0.50 X X 0 0 0 JUAN CARLOS BELLIARD 0.50 X X 0 0 0 MARILYN HERMANN 0.50 X X 0 0 0 ERIC NGO MD 0.50 X 0 0 0 DAVID GORDON WREN 0.50 X 0 0 0 ANN ATKINSON 0.50 X 0 0 0 STEVEN LAWRENCE MOHR 0.50 X 0 0 0 EDELWEISS RAMAL 0.50 X 0 0 0 DAISY DELEON 0.50 X 0 0 0 CINTIA RAMIREZ 0.50 X 0 0 0 VERONICA REYES 0.50 X 0 0 0 KISHA NORRIS 0.50 X 0 0 0 ANITA ADORADOR 40.00 X 111181 0 28387 DANIEL GIANG MD 8.00 X 60637 0 0 NANCY YOUNG 40.00 X 197561 0 30579 HOLLY YONEMOTO 40.00 X 138237 0 30584 CYNTHIA KARYN ROLLINS 40.00 X 112058 0 13178 CAMILLE EUGENIO 40.00 X 126338 0 29770 746012 0 132498 5 0 1 0 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 2 12683 318936 4231715 4563334 PATIENT CARE REVENUE 621400 3076036 3076036 ALL OTHER PROGRAM REV 621940 163517 163517 3239553 1220 1220 33058 0 33058 33058 33058 7837165 3239553 0 34278 604969 604969 2435247 1300902 1134345 237981 100387 137594 1235687 509459 726228 288511 135943 152568 13934 13934 24367 24367 908357 872985 35372 515587 408195 107392 33600 33600 307556 192230 115326 3904 3496 408 46632 39509 7123 140588 3444 137144 99867 75506 24361 PURCHASED SERVICES 519434 312232 207202 PROV. UNCOLLECTIBLE ACC 194826 194826 DUES AND SUBSCRIPTIONS 2833 2833 41844 6592 35252 7655724 4158539 3497185 0 1151540 513868 579285 628569 180672 298971 198327 865681 115234 81508 14925 16363 1945979 1102948 596961 843031 0 293297 2836944 3541288 681139 908523 293297 77489 79711 758628 1281531 X 1499030 1631188 529137 578420 50149 50149 2078316 2259757 2836944 3541288 181441 0 X X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 57351 1220 58571 56331 1020 57351 55503 828 56331 54109 1394 55503 0.14600 0.85400 1 0 662956 527290 135666 1147057 575658 571399 135966 135966 843031 DUE FROM THIRD PARTY 293297 293297 DEPOSITS 600 PAYABLE TO LLUHS/LLU 79111 79711 7837165 7655724 181441 181441 8737165 900000 900000 7837165 0 7837165 8555723 900000 900000 7655723 1 1 7655724 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. X X X X X X 0 0 0 0 0 0 0 0 0 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 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 THIS ANNUAL AMOUNT TO AN UNRELATED ORGANIZATION (PROFESSIONAL MEDICAL GROUP) FOR THESE SERVICES. 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.