2012-05-15T18:39:34-05:00 2011-06-30 MOSS ADAMS LLP 101 SECOND STREET 9TH FLOOR SAN FRANCISCO CA 94105 990 2010-07-01 330664371 SAC HEALTH SYSTEM SACH 9093827110 1454 E 2ND ST SAN BERNARDINO CA 94208 HOLLY YONEMOTO 9093827110 2012-05-15 1 RENIE BURBANK 4159561500 2010 2016-02-24 21:20:13Z HOLLY YONEMOTO 1454 E 2ND ST SAN BERNARDINO CA 94208 7036003 0 1071 X N/A X 1995 CA PROVIDE OUR COMMUNITIES WITH PRIMARY HEALTH CARE SERVICES, DENTAL CARE, & BEHAVIORAL MEDICINE SERVICES. 15 6 65 7 0 0 1781357 4384496 2827902 2613399 13599 1020 35592 37088 4658450 7036003 0 0 0 0 2892867 4787889 0 0 0 1375763 2195953 4268630 6983842 389820 52161 2616532 2836944 590376 758628 2026156 2078316 TO PROVIDE OUR COMMUNITIES WITH PRIMARY HEALTH CARE SERVICE WHICH INCORPORATES THE PREPARATION OF HEALTH PROFESSIONALS, WHILE RESPECTING CULTURAL DIVERSITY, RESPONDING TO INDIVIDUAL NEEDS, PROMOTING FAMILY STRENGTH, AND EMPOWERING PEOPLE TO MAKE THEIR LIVES WHOLE. 0 0 3894742 2613399 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, 2010 THRU JUNE 30, 2011, SACHS PROVIDED PRIMARY CARE SERVICES TO 21,596 PATIENTS, DENTAL CARE TO 7,826 PATIENTS, AND BEHAVIORAL MEDICINE SERVICES TO 2,691 PATIENTS. 3894742 1 1 0 0 0 0 0 0 0 1 1 0 0 0 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 1 0 0 0 0 1 16 0 1 65 1 0 0 0 0 0 0 0 0 0 0 X 15 6 0 0 1 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 X HOLLY YONEMOTO 9093827110 1455 E 3RD STREET SAN BERNARDINO CA 92410 X STEVEN LAWRENCE MOHR 0.50 X 0 408080 68281 LESLIE NELSON POLLARD 0.50 X 0 172986 11933 DAVID GORDON WREN 0.50 X 0 253775 40246 MARILYN HERMANN 0.50 X X 0 159325 27413 JUAN BELLIARD 0.50 X X 0 89558 19835 EDELWEISS RAMAL 0.50 X 0 79298 18152 DAISY DELEON 0.50 X 0 128526 24572 DANIEL GIANG MD 0.50 X 0 243384 65919 CARLTON LOFGREN MD 0.50 X X 0 0 0 ERIC NGO MD 0.50 X 0 0 0 ANN ATKINSON 0.50 X 0 0 0 VERONICA REYES 0.50 X 0 0 0 CINTHIA RAMIREZ 0.50 X 0 0 0 KISHA R NORRIS 0.50 X 0 0 0 KENNETH HART MD 40.00 X 0 119613 45025 NANCY YOUNG 40.00 X 83563 117045 7901 HOLLY YONEMOTO 40.00 X 32885 80328 6391 CYNTHIA ROLLINS 40.00 X 59665 75038 4442 CAMILLE EUGENIO 40.00 X 52622 52133 9629 ANITA ADORADOR 40.00 X 39826 62554 9011 DONNA SMITH-BURGESS 40.00 X 89547 0 4442 RITA PRIETO-GARCIA 40.00 X 90345 0 7275 MESEGA THOMAS 40.00 X 80669 0 6123 268561 2041643 358750 0 0 1 0 0 22500 3915056 300350 146590 4384496 PATIENT CARE REVENUE 621400 2467267 2467267 ALL OTHER PROGRAM REV 621940 146132 146132 2613399 1020 1020 37088 37088 37088 37088 7036003 2613399 0 38108 477584 477584 2472457 1406512 1065945 191829 92046 99783 1359753 593780 765973 286266 150365 135901 8381 8381 26402 26402 711252 710377 875 468130 358716 109414 37009 37009 294365 195859 98506 20810 19164 1646 78834 3444 75390 73505 51440 22065 PURCHASED SERVICES 411714 257711 154003 PROVISION FOR UNCOLLECT 22321 22321 DUES & SUBSCRIPTIONS 220 220 43010 33007 10003 6983842 3894742 3089100 0 457107 1151540 515109 579285 846212 180672 324501 198327 110944 115234 2777 14925 1559322 962361 359882 596961 2616532 2836944 589776 681139 600 77489 590376 758628 X 1460584 1499030 515423 529137 50149 50149 2026156 2078316 2616532 2836944 X 52161 -1 X X 0 1 1 X 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 56331 1020 57351 55503 828 56331 54109 1394 55503 1.00000 0 0 654586 479743 174843 904736 482618 422118 596961 DEPOSITS 600 PAYABLE TO LLUHS/LLU 76889 77489 7036003 6983842 52161 -1 -1 52160 7936003 900000 900000 7036003 0 7036003 7883843 900000 900000 6983843 -1 -1 6983842 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 XI, LINE 8 - OTHER ADJUSTMENTS: ROUNDING -1. PART XIII, LINE 4B - OTHER ADJUSTMENTS: ROUNDING -1. X X X X X X 0 0 0 0 0 0 0 0 0 STEVEN LAWRENCE MOHR 0 344000 0 0 0 64080 0 12052 0 56229 0 476361 0 0 LESLIE NELSON POLLARD 0 137041 0 0 0 35945 0 6606 0 5327 0 184919 0 0 DAVID GORDON WREN 0 220874 0 0 0 32901 0 15014 0 25232 0 294021 0 0 MARILYN HERMANN 0 159224 0 0 0 101 0 11942 0 15471 0 186738 0 0 DAISY DELEON 0 128315 0 0 0 211 0 9624 0 14948 0 153098 0 0 DANIEL GIANG MD 0 188267 0 50117 0 5000 0 46119 0 19800 0 309303 0 0 KENNETH HART MD 0 111000 0 4613 0 4000 0 37525 0 7500 0 164638 0 0 NANCY YOUNG 83563 117045 0 0 0 0 2299 0 5602 0 91464 117045 0 0 FORM 990, PART VI, SECTION A, LINE 4 EFFECTIVE JULY 15, 2010, THE ORGANIZATION MADE A CHANGE TO HAVE NO CORPORATE MEMBERS. FORM 990, PART VI, SECTION A, LINE 6 THE CORPORATE MEMBERS ("MEMBERS") OF THIS CORPORATION PURSUANT TO THE CORPORATIONS CODE SECTION 5056(A) ARE LOMA LINDA UNIVERSITY, A CALIFORNIA NONPROFIT RELIGIOUS CORPORATION AND LOMA LINDA UNIVERSITY MEDICAL CENTER, A CALIFORNIA NONPROFIT RELIGIOUS CORPORATION. EFFECTIVE JULY 15, 2010, SAC HEALTH SYSTEM MADE A CHANGE TO HAVE NO CORPORATE MEMBERS AND BECAME AN INDEPENDENT 501(C)(3) NOT-FOR-PROFIT ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 7A PURSUANT TO THE GOVERNING DOCUMENTS UNTIL THEY CHANGED IN JULY 2010 AND NOTWITHSTANDING ANY OTHER PROVISION OF THESE BYLAWS, THE MEMBERS SHALL HAVE THE FOLLOWING POWERS, WHICH THEY MAY EXERCISE WITHOUT APPROVAL FROM THIS CORPORATION: A. APPROVE THE MEMBERS OF THIS CORPORATION'S BOARD B. REMOVE THIS CORPORATION'S BOARD, IN WHOLE BUT NOT IN PART, IF DUE CAUSE FOR SUCH REMOVAL IS DETERMINED IN GOOD FAITH BY THE MEMBERS, UPON A VOTE OF TWO-THIRDS (2/3) OF THE AUTHORIZED TRUSTEES OF THE MEMBERS' BOARD OF TRUSTEES. FORM 990, PART VI, SECTION A, LINE 7B SUBJECT TO THE PROVISIONS AND LIMITATIONS OF THE CALIFORNIA NONPROFIT PUBLIC BENEFIT CORPORATION LAW AND ANY OTHER APPLICABLE LAWS, AND SUBJECT TO LIMITATIONS OF THE ARTICLES OF INCORPORATION AND ARTICLE IV OF THE BYLAWS, THE CORPORATION'S ACTIVITIES AND AFFAIRS SHALL BE MANAGED, AND ALL CORPORATE POWERS SHALL BE EXERCISED, BY OR UNDER THE DIRECTION OF THE BOARD. 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. 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, LINE 1A FORM 990, PART VII, LINE 1A: LLUAHSC, AS THE PARENT ORGANIZATION, EMPLOYS THE SENIOR EXECUTIVES OF ITS RELATED ORGANIZATIONS. THE AVERAGE HOURS PER WEEK REPORTED FOR OFFICERS ON PART VII, LINE 1A, COLUMN B, REPRESENT TOTAL AVERAGE HOURS (AT LEAST 50 HOURS PER WEEK) DEVOTED BY EACH OFFICER TO LLUAHSC AND RELATED ORGANIZATIONS AS ALLOCATED TO THE APPLICABLE RELATED ORGANIZATIONS AS FOLLOWS: MOHR, STEVEN L. 45.00 HOURS/WEEK DEVOTED TO LOMA LINDA UNIVERSITY MEDICAL CENTER 04.50 HOURS/WEEK DEVOTED TO LOMA LINDA UNIVERSITY BEHAVIORAL MEDICINE CENTER 00.50 HOURS/WEEK DEVOTED TO SAC HEALTH SYSTEM POLLARD, LESLIE 50 HOURS/WEEK DEVOTED TO LOMA LINDA UNIVERSITY HEALTH SERVICES 00.50 HOURS/WEEK DEVOTED TO SAC HEALTH SYSTEM WREN, DAVID G. 49.50 HOURS/WEEK DEVOTED TO LOMA LINDA UNIVERSITY HEALTH CARE 00.50 HOURS/WEEK DEVOTED TO SAC HEALTH SYSTEM CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: ROUNDING -1. TOTAL TO FORM 990, PART XI, LINE 5: -1. 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 ASSUME 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. LOMA LINDA UNIVERSITY ADVENTIST HEALTH SCIENCES CENTER 11175 CAMPUS ST LOMA LINDA CA 92354 953804495 PARENT COMPANY CA 501(C)(3) 1 N/A 0 LOMA LINDA UNIVERSITY 11145 ANDERSON ST LOMA LINDA CA 92354 951816009 UNIVERSITY CA 501(C)(3) 2 LOMA LINDA UNIVERSITY ADVENTIST HEALTH SCIENCES CENTER 0 LOMA LINDA UNIVERSITY MEDICAL CENTER 11234 ANDERSON ST LOMA LINDA CA 92354 953522679 HOSPITAL CA 501(C)(3) 3 LOMA LINDA UNIVERSITY ADVENTIST HEALTH SCIENCES CENTER 0 LOMA LINDA MERCANTILE 24887 TAYLOR ST LOMA LINDA CA 92354 953858272 PURCHASING COMPANY CA 501(C)(3) 1 LOMA LINDA UNIVERSITY ADVENTIST HEALTH SCIENCES CENTER 0 LOMA LINDA UNIVERSITY MEDICAL ENTERPRISES PO BOX 2000 LOMA LINDA CA 92354 330873998 OUTPATIENT PHARMACY CA 501(C)(3) 1 LOMA LINDA UNIVERSITY ADVENTIST HEALTH SCIENCES CENTER 0 LOMA LINDA UNIVERSITY FACULTY PHARMACY PO BOX 2000 LOMA LINDA CA 92354 330873998 OUTPATIENT PHARMACY CA 501(C)(3) 1 LOMA LINDA UNIVERSITY ADVENTIST HEALTH SCIENCES CENTER 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 1 0 0 0