2013-05-13T18:13:17-05:00 2012-06-30 910189318 MOSS ADAMS LLP 101 SECOND STREET 9TH FLOOR SAN FRANCISCO CA 94105 990 2011-07-01 237221695 COMMUNITY HEALTH CLINIC OLE COMM 7072541770 1141 PEAR TREE LN NAPA CA 94558 TANIR AMI 7072541770 2013-05-08 1 RICHARD CROGHAN P00089862 4159561500 2011 2016-02-24 21:20:13Z TANIR AMI 1141 PEAR TREE LN NAPA CA 94558 15636740 0 X WWW.CLINICOLE.ORG X 1972 CA COMMUNITY HEALTH CLINIC OLE IS THE MEDICAL AND DENTAL HOME FOR NAPA COUNTY'S UNDERSERVED, PROVIDING HIGH-QUALITY, AFFORDABLE, COMPASSIONATE AND CULTURALLY SENSITIVE PRIMARY HEALTH CARE. 11 11 195 15 0 0 4305186 3299118 10873313 12031315 6347 2814 0 303493 15184846 15636740 0 0 0 0 10128574 11220199 0 0 50475 3683508 3610105 13812082 14830304 1372764 806436 7162760 9007467 1027237 2065647 6135523 6941820 X COMMUNITY HEALTH CLINIC OLE IS THE MEDICAL AND DENTAL HOME FOR NAPA COUNTY'S UNDERSERVED, PROVIDING HIGH-QUALITY, AFFORDABLE, COMPASSIONATE AND CULTURALLY SENSITIVE PRIMARY HEALTH CARE. 0 0 9161866 9026097 COMMUNITY HEALTH CLINIC OLE IS A FEDERALLY QUALIFIED HEALTH CENTER (FQHC) AND THE ONLY NOT FOR PROFIT HEALTH CENTER IN NAPA COUNTY. THE CLINIC PROVIDES AFFORDABLE MEDICAL CARE TO NEARLY 20,000 PATIENTS. 1512101 2886542 THE DENTAL SERVICES PROGRAMS AT COMMUNITY HEALTH CLINIC OLE PROVIDE AFFORDABLE DENTAL CARE TO APPROXIMATELY 10,000 PATIENTS. 452410 268903 THE MENTAL HEALTH PROGRAMS AT COMMUNITY HEALTH CLINIC OLE PROVIDE SERVICES TO THE COMMUNITY. 1069676 143626 COMMUNITY HEALTH CLINIC OLE PROVIDES HEALTH EDUCATION VIA OUTREACH PROGRAMS TO THE COUNTY'S LOW-INCOME, UNINSURED AND UNDERINSURED RESIDENTS. 1069676 143626 12196053 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 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 1 1 1 0 0 1 0 0 195 1 0 0 0 0 0 0 0 0 0 0 X 11 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X PATRICIA AGUILERA 7072541776 1141 PEAR TREE LN NAPA CA 94558 X PRISCILA UPTON 2.00 X X 0 0 0 KARYNNE DUNCAN 2.00 X X 0 0 0 JO MOORE 2.00 X X 0 0 0 DAN LYNCH 2.00 X X 0 0 0 ARJUNA ELKINS 1.00 X 0 0 0 SUSAN PARKS 1.00 X 0 0 0 PETER MCCREA 1.00 X 0 0 0 CHARLES MATHEWSON 1.00 X 0 0 0 PATRICIA PERINI LONG 1.00 X 0 0 0 ERNEST HAMILTON 1.00 X 0 0 0 HORACIO GUERRERO 1.00 X 0 0 0 TANIR AMI 40.00 X 111294 0 23365 PATRICIA AGUILERA 40.00 X 36760 0 0 COLLEEN TOWNSEND 40.00 X 159949 0 23261 ROBERT MOORE 10.00 X 147776 0 23113 BEATRICE BOSTICK 10.00 X 125460 0 5328 JUDITH WATERMAN 10.00 X 313290 0 0 JEROME SOLOMON 40.00 X 252083 0 4356 REBCCA LEVY 40.00 X 173178 0 5847 GABRIELA BERMUDEZ 40.00 X 158015 0 34004 SONIA HA 40.00 X 158268 0 22960 ELIZABETH SHAW 40.00 X 150238 0 12275 1786311 0 154509 10 0 1 0 0 550000 1049903 1699215 3299118 PATIENT SERVICE REV. 621400 12031315 12031315 12031315 2814 2814 PHC PAYMENTS 900099 293853 293853 OTHER REVENUE 900099 9640 9640 303493 15636740 12325168 0 12454 1499732 1114728 385004 8223746 6793637 1397168 32941 124352 103140 21212 640633 531355 109278 731736 606918 124818 386357 296220 90137 164678 126259 38419 4712 3613 1099 292114 223964 68150 448980 344233 104747 651397 600164 48009 3224 40297 30896 9401 47560 36465 11095 22336 17125 5211 460814 353306 107508 52756 40448 12308 PHARMACEUTICAL SUPPLIES 303253 303253 TECHNICAL SUPPLIES 286298 286298 BAD DEBTS 219016 219016 229537 165015 50212 14310 14830304 12196053 2583776 50475 75398 3876219 733134 1061816 200960 52022 3550000 1830136 274540 190060 3721900 1724686 2258340 1997214 70388 7162760 9007467 858731 1116451 1604 434937 166902 514259 1027237 2065647 X 5495313 6911965 640210 29855 6135523 6941820 7162760 9007467 X 806436 -139 X X 0 1 1 X 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2302620 652047 1650573 1094546 754317 340229 324734 318322 6412 1997214 15636740 14830304 806436 -139 -139 806297 15771217 -139 134616 134477 15636740 0 15636740 14964920 134616 134616 14830304 0 14830304 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: THE ORGANIZATION IS A NONPROFIT CORPORATION UNDER INTERNAL REVENUE CODE SECTION 501(C)(3) AND HAS BEEN GRANTED TAX-EXEMPT STATUS BY THE INTERNAL REVENUE SERVICE AND THE CALIFORNIA REVENUE AND TAXATION CODE. AS OF JUNE 30, 2012, THE ORGANIZATION HAD NO UNRECOGNIZED TAX POSITIONS OR UNCERTAIN TAX POSITIONS REQUIRING ACCRUAL. THEREFORE, NO PROVISION FOR INCOME TAXES HAS BEEN PROVIDED IN THE CONSOLIDATED FINANCIAL STATEMENTS. X X X 1 0 0 0 0 0 0 0 0 COLLEEN TOWNSEND 159949 0 0 0 0 0 484 0 22777 0 183210 0 0 0 ROBERT MOORE 147776 0 0 0 0 0 375 0 22738 0 170889 0 0 0 JUDITH WATERMAN 313290 0 0 0 0 0 0 0 0 0 313290 0 0 0 JEROME SOLOMON 252083 0 0 0 0 0 660 0 3696 0 256439 0 0 0 REBCCA LEVY 173178 0 0 0 0 0 268 0 5579 0 179025 0 0 0 GABRIELA BERMUDEZ 158015 0 0 0 0 0 34004 0 0 0 192019 0 0 0 SONIA HA 158268 0 0 0 0 0 478 0 22482 0 181228 0 0 0 ELIZABETH SHAW 150238 0 0 0 0 0 447 0 11828 0 162513 0 0 0 PART I, LINE 4A BEATRICE BOSTICK RECEIVED SEVERANCE PAYMENT OF $115,667. FORM 990, PART VI, SECTION B, LINE 11 A COPY OF THE FORM 990 AND ALL RELATED SCHEDULES AND STATEMENTS WAS PROVIDED TO THE BOARD BEFORE FILING IN ORDER TO ALLOW SUFFICIENT TIME FOR REVIEW AND COMMENT. FORM 990, PART VI, SECTION B, LINE 12C CONFLICT OF INTEREST STATEMENTS ARE UPDATED AND REVIEWED PERIODICALLY. FORM 990, PART VI, SECTION B, LINE 15 THE CEO AND CFO SALARIES ARE APPROVED BY THE BOARD OF DIRECTORS AFTER PERFORMANCE REVIEWS AND COMPENSATION STUDIES. THE OTHER KEY LEADERSHIP POSITIONS ARE BASED ON A COMPENSATION STUDY DONE BY AN INDEPENDENT FIRM EVERY TWO TO THREE YEARS. IF NECESSARY TO EVALUATE OUTSIDE OF THAT TIME PERIOD, THE HR DEPARTMENT WILL EVALUATE BY SOLICITING EXTERNAL COMPENSATION DATA AND PLACE THE POSITION APPROPRIATELY WITHIN THE ORGANIZATIONAL STRUCTURE. FORM 990, PART VI, SECTION C, LINE 19 THE AUDITED FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY, AND GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST. BOUND COPIES OF AUDITED FINANCIAL STATEMENTS ARE AVAILABLE AT THE ADMINISTRATORS DESK FOR ANYONE WHO ASK FOR A COPY. ALSO WE PUBLISH A COMMUNITY REPORT WITH CONDENSED FINANCIAL INFORMATION INCLUDED. OFFICER HOURS DEVOTED TO RELATED ORGANIZATIONS 990, PART VII, SECTION A, COLUMN B PRISCILLA UPTON'S TIME IS DIVIDED AS FOLLOWS: COMMUNITY HEALTH CLINIC OLE 2.00 HOURS CLINIC OLE FOUNDATION 2.00 HOURS KARYNNE DUNCAN, MD'S TIME IS DIVIDED AS FOLLOWS: COMMUNITY HEALTH CLINIC OLE 2.00 HOURS CLINIC OLE FOUNDATION 2.00 HOURS DAN LYNCH'S TIME IS DIVIDED AS FOLLOWS: COMMUNITY HEALTH CLINIC OLE 2.00 HOUR CLINIC OLE FOUNDATION 2.00 HOURS PETER MCCREA'S TIME IS DIVIDED AS FOLLOWS: COMMUNITY HEALTH CLINIC OLE 1.00 HOUR CLINIC OLE FOUNDATION 2.00 HOURS PATRICIA PERINI LONG'S TIME IS DIVIDED AS FOLLOWS: COMMUNITY HEALTH CLINIC OLE 1.00 HOUR CLINIC OLE FOUNDATION 2.00 HOURS CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: NET UNREALIZED LOSSES ON INVESTMENTS: -139. AUDIT COMMITTEE AND OVERSIGHT 990, PART XII, LINE 2C THERE HAVE BEEN NO CHANGES TO THIS PROCESS FROM PRIOR YEAR. CLINIC OLE FOUNDATION 1141 PEAR TREE LN STE 260 NAPA CA 94558 680149424 FUNDRAISING CA 501(C)(3) 11-I COMMUNITY HEALTH CLINIC OLE 1 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 CLINIC OLE FOUNDATION C 550000 BOOK/ACTUAL VALUE