MANIFEST MEDEX: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
MANIFEST MEDEX (EIN 27-2367522)
Tax period
2010-01-01 to 2010-12-31
Filed
2011-05-16
IRS object ID
201121369349302142
Schema version
2010v3.2
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)
Timestamp2011-05-16T10:49:40-05:00Timestamp
Tax Period End Date2010-12-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1MACHER & CLARK CPA'SBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line13689 ARLINGTON AVENUEAddressLine1
CityRIVERSIDECity
StateCAState
ZIP Code925063938ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-01-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN272367522EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1INLAND EMPIRE EHR RESOURCE CENTERBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlINLANameControl
Phone9516863343Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line13993 JURUPA AVENUEAddressLine1
CityRIVERSIDECity
StateCAState
ZIP Code92506ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameD GREENName
TitleCHAIRMAN OF THE BOARDTitle
Phone9516863343Phone
Date Signed2011-05-16DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
NameDAVID C MACHER CPAName
Phone9517870330Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-02-24 21:20:13ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonJOSEPH JC LEE MDNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line13993 JURUPA AVENUEAddressLine1
CityRIVERSIDECity
StateCAState
ZIP Code92506ZIPCode
FieldValueIRS element (for citing)
Gross Receipts175034GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteN/AWebSite
Type Of Organization OtherXTypeOfOrganizationOther
Type Of Org Other DescriptionELECTRONIC HEALTH RECORD RESOURCE CTRTypeOfOrgOtherDescription
Year Formation2010YearFormation
State Legal DomicileCAStateLegalDomicile
Activity Or Mission DescriptionTHE SPECIFIC PURPOSE OF THIS CORPORATION IS TO RECEIVE AND ADMINISTER FUNDS AND OTHER PROPERTY TO ADVANCE AND SUPPORT THE ACCESSIBILITY AND USAGE OF ELECTRONIC HEALTH RECORDS THROUGHTOUT THE INLAND EMPIRE REGION OF CALIFORNIA, TO ADVANCE AND SUPPORT THE SUCCESSFUL IMPLEMENTATION OF ELECTRONIC HEALTH RECORDS IN THE MEDICAL COMMUNITY, AND TO DO ALL THINGS APPROPRIATE TO FURTHER SUCH PURPOSE.ActivityOrMissionDescription
Nbr Voting Members Governing Body9NbrVotingMembersGoverningBody
Nbr Independent Voting Members0NbrIndependentVotingMembers
Total Nbr Employees0TotalNbrEmployees
Total Nbr Volunteers0TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Net Unrelated Business Txbl Income0NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year0ContributionsGrantsPriorYear
Contributions Grants Current Year173288ContributionsGrantsCurrentYear
Program Service Revenue Prior Year0ProgramServiceRevenuePriorYear
Program Service Revenue CY1746ProgramServiceRevenueCY
Investment Income Prior Year0InvestmentIncomePriorYear
Investment Income Current Year0InvestmentIncomeCurrentYear
Other Revenue Prior Year0OtherRevenuePriorYear
Other Revenue Current Year0OtherRevenueCurrentYear
Total Revenue Prior Year0TotalRevenuePriorYear
Total Revenue Current Year175034TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year0SalariesEtcPriorYear
Salaries Etc Current Year39928SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year6779TotalFundrsngExpCurrentYear
Other Expense Prior Year0OtherExpensePriorYear
Other Expenses Current Year36907OtherExpensesCurrentYear
Total Expenses Prior Year0TotalExpensesPriorYear
Total Expenses Current Year76835TotalExpensesCurrentYear
Revenues Less Expenses Prior Year0RevenuesLessExpensesPriorYear
Revenues Less Expenses CY98199RevenuesLessExpensesCY
Total Assets BOY0TotalAssetsBOY
Total Assets EOY115510TotalAssetsEOY
Total Liabilities BOY0TotalLiabilitiesBOY
Total Liabilities EOY17311TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY0NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY98199NetAssetsOrFundBalancesEOY
Mission DescriptionTO ADMINISTER FUNDS FROM GOVERNMENTAL AGENCIES THAT WILL BE USED FOR THE SUCCESSFUL IMPLIMENTATION OF ELECTRONIC HEALTH RECORDS PROCEDURES.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense70056Expense
Grants73288Grants
Revenue0Revenue
DescriptionCALHIPSO AWARD, SACRAMENTO, CALIFORNIA.Description
Total Program Service Expense70056TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities0LobbyingActivities
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip0ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities0ReportOtherLiabilities
Report Fin48 Footnote0ReportFin48Footnote
Independent Audit Financial Stmt0IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities0FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required0ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions0DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity0RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transaction Related Entity0TransactionRelatedEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With10960NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Number Of Employees0NumberOfEmployees
Unrelated Business Income0UnrelatedBusinessIncome
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members9NbrVotingGoverningBodyMembers
Number Independent Voting Members0NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties1DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO0CompensationProcessCEO
Compensation Process Other0CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledCAStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

Name Business NameBusiness

FieldValueIRS element (for citing)
Business Name Line1INLAND EMPIRE EHR RESOURCE CENTERBusinessNameLine1
FieldValueIRS element (for citing)
Telephone Number9516863343TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line13993 JURUPA AVENUEAddressLine1
CityRIVERSIDECity
StateCAState
ZIP Code92506ZIPCode
FieldValueIRS element (for citing)
No Listed Persons CompensatedXNoListedPersonsCompensated

Form990 Part VII Section A Form990PartVIISectionA (9 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorOfficerOfficerReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensation
JOSEPH JC LEE MD
CHAIRMAN OF THE BOARD2.50XX000
LEROY L OUNANIAN MD
SECRETARY/TREASURER2.50XX000
DOLORES L GREEN
EXECUTIVE DIRECTOR2.50XX000
PHILLIP BRANSTETTER
MEMBER1.00X000
BRADLEY GILBERT MD
MEMBER1.00X000
WILLIAM HENNING DO
MEMBER1.00X000
TAREK MAHDI MD
MEMBER1.00X000
C PAUL SINKHORN MD
MEMBER1.00X000
LINDA STRATTON
MEMBER1.00X000
FieldValueIRS element (for citing)
Total Reportable Comp From Org0TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation0TotalOtherCompensation
Number Individuals GT100 K0NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K0TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources
Number Of Contractors GT100 K0NumberOfContractorsGT100K
Government Grants73288GovernmentGrants
All Other Contributions100000AllOtherContributions
Total Contributions173288TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionREIMBURSED MEETINGSDescription
Business Code561000BusinessCode
Total Revenue Column1746TotalRevenueColumn
Related Or Exempt Function Income1746RelatedOrExemptFunctionIncome
FieldValueIRS element (for citing)
Total Program Service Revenue1746TotalProgramServiceRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column175034TotalRevenueColumn
Related Or Exempt Function Income1746RelatedOrExemptFunctionIncome
Unrelated Business Revenue0UnrelatedBusinessRevenue
Exclusion$0ExclusionAmount

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total38639Total
Program Services38639ProgramServices

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total1289Total
Program Services1289ProgramServices

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total2819Total
Program Services2819ProgramServices

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total6779Total
Fundraising6779Fundraising

Advertising Advertising

FieldValueIRS element (for citing)
Total606Total
Program Services606ProgramServices

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total4330Total
Program Services4330ProgramServices

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total906Total
Program Services906ProgramServices

Occupancy Occupancy

FieldValueIRS element (for citing)
Total6750Total
Program Services6750ProgramServices

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total3442Total
Program Services3442ProgramServices

Insurance Insurance

FieldValueIRS element (for citing)
Total2801Total
Program Services2801ProgramServices

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServices
EDUCATION & OUTREACH SE78747874
TELEPHONE496496
MISCELLANEOUS6868
POSTAGE3636

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total76835Total
Program Services70056ProgramServices
Management And General0ManagementAndGeneral
Fundraising6779Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
EOY92194EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
EOY18941EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
EOY4375EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY0BOY
EOY115510EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
EOY17311EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY0BOY
EOY17311EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
EOY98199EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY0BOY
EOY98199EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY0BOY
EOY115510EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses98199ReconcilationRevenueExpenses
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited0FSAudited
Federal Grant Audit Required0FederalGrantAuditRequired

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org170b1 AviXPubliclySupportedOrg170b1Avi

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

FieldValueIRS element (for citing)
Current Tax Year175034CurrentTaxYear
Total175034Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year175034CurrentTaxYear
Total175034Total
FieldValueIRS element (for citing)
Public Support Total170175034PublicSupportTotal170
Total Support175034TotalSupport
Public Support Pertcentage1701.00000PublicSupportPertcentage170
Thirty Three Percnt Tests CY170XThirtyThreePercntTestsCY170

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

IdentifierIdentifierExplanationExplanationReturn ReferenceReturnReference
FORM 990, PART VI, SECTION A, LINE 3THE ORGANIZATION'S MANAGEMENT DUTIES ARE PERFORMED BY THE MANAGEMENT OF THE RELATED PARTY, RIVERSIDE COUNTY MEDICAL ASSOCIATION (RCMA) MANAGEMENT PERSONNEL. THE ORGANIZATION REIMBURSES THE RCMA, OR ITS DESIGNEE, FOR THE SERVICES OF ADMINISTRATION AND PROGRAM SERVICE PERSONNEL.
FORM 990, PART VI, SECTION B, LINE 11COPY OF FORM 990 IS SENT TO THE EXECUTIVE DIRECTOR WHO REVIEWS IT AND GIVES IT TO A BOARD MEMBER FOR REVIEW AND APPROVAL BEFORE IT IS FILED.
ANNUALLY OFFICERS/DIRECTORS ARE REQUIRED TO COMPLETE NEW DISCLOSURE DOCUMENTS.FORM 990, PART VI, SECTION B, LINE 12C
FORM 990 IS AVAILABLE AT THE CENTER'S OFFICE IN RIVERSIDE, CALIFORNIA UPON REQUESTFORM 990, PART VI, SECTION C, LINE 18
GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC AT THE CENTER'S OFFICE IN RIVERSIDE, CALIFORNIA UPON REQUESTFORM 990, PART VI, SECTION C, LINE 19

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