LA CLINICA DEL VALLE FAMILY HEALTH CARE CENTER INC: Form 990, tax year 2010

View the entire original 990 at ProPublica ↗

Organization
LA CLINICA DEL VALLE FAMILY HEALTH CARE CENTER INC (EIN 94-3096772)
Tax period
2010-06-01 to 2011-05-31
Filed
2011-10-17
IRS object ID
201122909349300542
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)
Timestamp2011-10-17T11:38:59-07:00Timestamp
Tax Period End Date2011-05-31TaxPeriodEndDate

Preparer Firm PreparerFirm

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1MICHAEL L PIELS CPAs LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1940 TOWN CENTRE DRAddressLine1
CityMEDFORDCity
StateORState
ZIP Code975046100ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2010-06-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN943096772EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1LA CLINICA DEL VALLEBusinessNameLine1
Business Name Line2FAMILY HEALTH CARE CENTER INCBusinessNameLine2
FieldValueIRS element (for citing)
Name ControlLACLNameControl
Phone5415356239Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line13617 SOUTH PACIFIC HIGHWAYAddressLine1
CityMEDFORDCity
StateORState
ZIP Code97501ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameANGELICA RUPPEName
TitleCFOTitle
Date Signed2010-10-13DateSigned

Preparer Preparer

FieldValueIRS element (for citing)
NameSTEWART C PARMELE CPAName
Phone5417798261Phone
FieldValueIRS element (for citing)
Tax Year2010TaxYear
Build TS2016-03-07 17:11:31ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonANGELICA RUPPENameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line13617 S PACIFIC HWYAddressLine1
CityMEDFORDCity
StateORState
ZIP Code97501ZIPCode
FieldValueIRS element (for citing)
Gross Receipts13968416GrossReceipts
Group Return For AffiliatesfalseGroupReturnForAffiliates
All Affiliates IncludedfalseAllAffiliatesIncluded
Organization501c3XOrganization501c3
Web SiteWWW.LCDV.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1988YearFormation
State Legal DomicileORStateLegalDomicile
Activity Or Mission DescriptionTO PROVIDE QUALITY MEDICAL, DENTAL, AND SOCIAL SERVICES TO THE DIVERSE POPULATIONS WITHIN OUR COMMUNITIES, ESPECIALLY THOSE WHO FACE BARRIERS TO HEALTHCARE.ActivityOrMissionDescription
Nbr Voting Members Governing Body14NbrVotingMembersGoverningBody
Nbr Independent Voting Members14NbrIndependentVotingMembers
Total Nbr Employees236TotalNbrEmployees
Total Nbr Volunteers47TotalNbrVolunteers
Total Gross UBI0TotalGrossUBI
Contributions Grants Prior Year4990075ContributionsGrantsPriorYear
Contributions Grants Current Year4989639ContributionsGrantsCurrentYear
Program Service Revenue Prior Year7149864ProgramServiceRevenuePriorYear
Program Service Revenue CY8770420ProgramServiceRevenueCY
Investment Income Prior Year5579InvestmentIncomePriorYear
Investment Income Current Year14725InvestmentIncomeCurrentYear
Other Revenue Prior Year138886OtherRevenuePriorYear
Other Revenue Current Year178177OtherRevenueCurrentYear
Total Revenue Prior Year12284404TotalRevenuePriorYear
Total Revenue Current Year13952961TotalRevenueCurrentYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year9033151SalariesEtcPriorYear
Salaries Etc Current Year10430780SalariesEtcCurrentYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year43576TotalFundrsngExpCurrentYear
Other Expense Prior Year2794097OtherExpensePriorYear
Other Expenses Current Year3105929OtherExpensesCurrentYear
Total Expenses Prior Year11827248TotalExpensesPriorYear
Total Expenses Current Year13536709TotalExpensesCurrentYear
Revenues Less Expenses Prior Year457156RevenuesLessExpensesPriorYear
Revenues Less Expenses CY416252RevenuesLessExpensesCY
Total Assets BOY13518633TotalAssetsBOY
Total Assets EOY13639751TotalAssetsEOY
Total Liabilities BOY2874360TotalLiabilitiesBOY
Total Liabilities EOY2551010TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY10644273NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY11088741NetAssetsOrFundBalancesEOY
Mission DescriptionTO PROVIDE QUALITY MEDICAL, DENTAL, AND SOCIAL SERVICES TO THE DIVERSE POPULATIONS WITHIN OUR COMMUNITIES, ESPECIALLY THOSE WHO FACE BARRIERS TO HEALTHCARE.MissionDescription
Significant New Program ServicesfalseSignificantNewProgramServices
Significant ChangefalseSignificantChange
Expense12385743Expense
DescriptionHEALTH ENHANCEMENT FOR SEASONAL, MIGRATORY AGRICULTURAL WORKERS AND LOW INCOME PATIENTS.Description
Total Program Service Expense12385743TotalProgramServiceExpense
Described In501 C3trueDescribedIn501C3
Schedule B RequiredtrueScheduleBRequired
Political ActivitiesfalsePoliticalActivities
Lobbying ActivitiesfalseLobbyingActivities
Subject To Proxy TaxfalseSubjectToProxyTax
Donor Advised FundsfalseDonorAdvisedFunds
Conservation EasementsfalseConservationEasements
Collections Of ArtfalseCollectionsOfArt
Credit CounselingfalseCreditCounseling
Term Or Permanent EndowmentstrueTermOrPermanentEndowments
Report Land Bldg EquiptrueReportLandBldgEquip
Report Invest Oth SecuritiesfalseReportInvestOthSecurities
Report Prog Rel InvestfalseReportProgRelInvest
Report Other AssetsfalseReportOtherAssets
Report Other LiabilitiesfalseReportOtherLiabilities
Report Fin48 FootnotefalseReportFin48Footnote
Independent Audit Financial StmttrueIndependentAuditFinancialStmt
Consolidated Audit Financial StmtfalseConsolidatedAuditFinancialStmt
SchoolfalseSchool
Foreign OfficefalseForeignOffice
Foreign ActivitiesfalseForeignActivities
More Than5000 K To OrganizationsfalseMoreThan5000KToOrganizations
More Than5000 K To IndividualsfalseMoreThan5000KToIndividuals
Professional FundraisingfalseProfessionalFundraising
Fundraising ActivitiesfalseFundraisingActivities
GamingtrueGaming
HospitalfalseHospital
Grants To OrganizationsfalseGrantsToOrganizations
Grants To IndividualsfalseGrantsToIndividuals
Schedule J RequiredtrueScheduleJRequired
Tax Exempt BondsfalseTaxExemptBonds
Invest Tax Exempt BondsfalseInvestTaxExemptBonds
Escrow AccountfalseEscrowAccount
On Behalf Of IssuerfalseOnBehalfOfIssuer
Excess Benefit TransactionfalseExcessBenefitTransaction
Prior Excess Benefit TransactionfalsePriorExcessBenefitTransaction
Loan To Officer Or DQPfalseLoanToOfficerOrDQP
Grant To Related PersonfalseGrantToRelatedPerson
Bsnss Rltnshp With OrganizationfalseBsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family MemberfalseBsnssRltnshpThruFamilyMember
Officer Entity With Bsnss RltnshpfalseOfficerEntityWithBsnssRltnshp
Deductible Non Cash ContributionsfalseDeductibleNonCashContributions
Deductible Contributions Of ArtfalseDeductibleContributionsOfArt
TerminatedfalseTerminated
Partial LiquidationfalsePartialLiquidation
Disregarded EntityfalseDisregardedEntity
Related EntityfalseRelatedEntity
Related Org Controlled EntityfalseRelatedOrgControlledEntity
Transaction Related EntityfalseTransactionRelatedEntity
Transfers To Exempt Non Chrtbl OrgfalseTransfersToExemptNonChrtblOrg
Activities Conducted PartnershipfalseActivitiesConductedPartnership
Schedule O RequiredtrueScheduleORequired
Number Forms Transmitted With109622NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup WitholdingtrueComplianceWithBackupWitholding
Number Of Employees236NumberOfEmployees
Employment Tax Returns FiledtrueEmploymentTaxReturnsFiled
Unrelated Business IncomefalseUnrelatedBusinessIncome
Form990-T FiledfalseForm990-TFiled
Foreign Financial AccountfalseForeignFinancialAccount
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTrans
Taxable Party NotificationfalseTaxablePartyNotification
Form8886 T FiledfalseForm8886TFiled
Non Deductible ContributionsfalseNonDeductibleContributions
Non Deductible DisclosurefalseNonDeductibleDisclosure
Quid Pro Quo ContributionsfalseQuidProQuoContributions
Quid Pro Quo DisclosurefalseQuidProQuoDisclosure
Form8282 Property Disposed OffalseForm8282PropertyDisposedOf
Number Of8282 Filed0NumberOf8282Filed
Funds To Pay PremiumsfalseFundsToPayPremiums
Premiums PaidfalsePremiumsPaid
Form8899 FiledfalseForm8899Filed
Form1098 C FiledfalseForm1098CFiled
Excess Business HoldingsfalseExcessBusinessHoldings
Taxable DistributionsfalseTaxableDistributions
Distribution To DonorfalseDistributionToDonor
Filed Lieu1041falseFiledLieu1041
Licensed More Than One StatefalseLicensedMoreThanOneState
Indoor Tanning ServicesfalseIndoorTanningServices
Form720 FiledfalseForm720Filed
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members14NbrVotingGoverningBodyMembers
Number Independent Voting Members14NumberIndependentVotingMembers
Family Or Business RelationshipfalseFamilyOrBusinessRelationship
Delegation Of Management DutiesfalseDelegationOfManagementDuties
Changes To Organizing DocsfalseChangesToOrganizingDocs
Material Diversion Or MisusefalseMaterialDiversionOrMisuse
Members Or StockholdersfalseMembersOrStockholders
Election Of Board MemberstrueElectionOfBoardMembers
Decisions Subject To ApprovaltrueDecisionsSubjectToApproval
Minutes Of Governing BodytrueMinutesOfGoverningBody
Minutes Of CommitteestrueMinutesOfCommittees
Officer Mailing AddressfalseOfficerMailingAddress
Local ChaptersfalseLocalChapters
Policies Reference ChaptersfalsePoliciesReferenceChapters
Form990 Provided To Governing BodytrueForm990ProvidedToGoverningBody
Conflict Of Interest PolicytrueConflictOfInterestPolicy
Annual Disclosure Covered PersonsfalseAnnualDisclosureCoveredPersons
Regular Monitoring EnforcementtrueRegularMonitoringEnforcement
Whistleblower PolicytrueWhistleblowerPolicy
Document Retention PolicytrueDocumentRetentionPolicy
Compensation Process CEOtrueCompensationProcessCEO
Compensation Process OthertrueCompensationProcessOther
Investment In Joint VenturefalseInvestmentInJointVenture
Written Policy Or ProcedurefalseWrittenPolicyOrProcedure
States Where Copy Of Return Is FiledORStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonANGELICA RUPPENamePerson
Telephone Number5415356239TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line13617 S PACIFIC HWYAddressLine1
CityMEDFORDCity
StateORState
ZIP Code97501ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (20 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekHighest Compensated EmployeeHighestCompensatedEmployeeReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationIndividual Trustee Or DirectorIndividualTrusteeOrDirectorKey EmployeeKeyEmployee
WILLIAM H PALM
MEDICAL DOCTOR40.00X18917509791
RICHARD JULYAN
MEDICAL DOCTOR40.00X17890503382
PHILIP MICHAEL MD
President2.00000X
MOLLY MORISON
Secretary2.00000X
MICHAEL TOWERY
Vice President2.00000X
MARTIN RAMIREZ
BOARD MEMBER2.00000X
LISA GREIF
BOARD MEMBER2.00000X
LINDA HARRIS
OB/GYN40.00X12402905930
LILIA CABALLERO
BOARD MEMBER2.00000X
LEN HEBERT
BOARD MEMBER2.00000X
KEN RHEE
MEDICAL DOCTOR0.00X15700304166
JON ELLIOTT
BOARD MEMBER2.00000X
JOLIE JOHNSON
BOARD MEMBER2.00000X
JERRY TAYLOR
Treasurer2.00000X
FREDA CASILLAS
BOARD MEMBER2.00000X
EARL SHOWERMAN MD
BOARD MEMBER2.00000X
CHRISTIE VANAKEN
BOARD MEMBER2.00000X
CARL WHEELER
DENTIST40.00X12480603512
BRENDA JOHNSON RN MBA
CEO40.0013477407498X
ANGELICA RUPPE
CFO40.009249005767X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1001182TotalReportableCompFromOrg
Total Other Compensation40046TotalOtherCompensation
Number Individuals GT100 K6NumberIndividualsGT100K
Formers ListedfalseFormersListed
Total Comp GT150 KtrueTotalCompGT150K
Compensation From Other SourcesfalseCompensationFromOtherSources

Contractor Compensation ContractorCompensation (2 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
S & B JAMES CONSTRUCTION
8425 AGATE ROADWHITE CITYOR97503CONSTRUCTION113418
OCHIN-OREGON COMMUNITY HEALTH INFO NETWORK
707 SW WASHINGTON ST 1200PORTLANDOR97205MEDICAL BILLING203561
FieldValueIRS element (for citing)
Number Of Contractors GT100 K2NumberOfContractorsGT100K
Government Grants3974799GovernmentGrants
All Other Contributions1014840AllOtherContributions
Total Contributions4989639TotalContributions

Program Service Revenue ProgramServiceRevenue

FieldValueIRS element (for citing)
DescriptionNET PATIENT FEESDescription
Business Code621110BusinessCode
Total Revenue Column8770420TotalRevenueColumn
Exclusion$8,770,420ExclusionAmount
FieldValueIRS element (for citing)
Total Program Service Revenue8770420TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column10829TotalRevenueColumn
Exclusion$10,829ExclusionAmount

Income From Invest Bond Proceeds IncomeFromInvestBondProceeds

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Royalties Revenue RoyaltiesRevenue

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Gross Rents GrossRents

FieldValueIRS element (for citing)
Personal6393Personal

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Personal6393Personal

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column6393TotalRevenueColumn
Exclusion$6,393ExclusionAmount

Gross Amount Sales Assets GrossAmountSalesAssets

FieldValueIRS element (for citing)
Securities3896Securities

Gain Or Loss GainOrLoss

FieldValueIRS element (for citing)
Securities3896Securities

Net Gain Or Loss Investments NetGainOrLossInvestments

FieldValueIRS element (for citing)
Total Revenue Column3896TotalRevenueColumn
Exclusion$3,896ExclusionAmount

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn
FieldValueIRS element (for citing)
Gross Income Gaming101908GrossIncomeGaming
Gaming Direct Expenses15455GamingDirectExpenses

Net Income From Gaming NetIncomeFromGaming

FieldValueIRS element (for citing)
Total Revenue Column86453TotalRevenueColumn
Exclusion$86,453ExclusionAmount

Net Income Or Loss NetIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column0TotalRevenueColumn

Other Revenue Misc OtherRevenueMisc

FieldValueIRS element (for citing)
DescriptionMISC. INCOMEDescription
Business Code621110BusinessCode
Total Revenue Column85331TotalRevenueColumn
Exclusion$85,331ExclusionAmount
FieldValueIRS element (for citing)
Total Other Revenue85331TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column13952961TotalRevenueColumn
Exclusion$8,963,322ExclusionAmount

Grants To Domestic Orgs GrantsToDomesticOrgs

FieldValueIRS element (for citing)
Total0Total

Grants To Domestic Individuals GrantsToDomesticIndividuals

FieldValueIRS element (for citing)
Total0Total

Foreign Grants ForeignGrants

FieldValueIRS element (for citing)
Total0Total

Benefits To Members BenefitsToMembers

FieldValueIRS element (for citing)
Total0Total

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total1041228Total
Program Services800699ProgramServices
Management And General240529ManagementAndGeneral

Comp Disqual Persons CompDisqualPersons

FieldValueIRS element (for citing)
Total0Total

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total7573764Total
Program Services7419428ProgramServices
Management And General121502ManagementAndGeneral
Fundraising32834Fundraising

Pension Plan Contributions PensionPlanContributions

FieldValueIRS element (for citing)
Total0Total

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total1098676Total
Program Services1057207ProgramServices
Management And General40108ManagementAndGeneral
Fundraising1361Fundraising

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total717112Total
Program Services685396ProgramServices
Management And General28680ManagementAndGeneral
Fundraising3036Fundraising

Fees For Services Management FeesForServicesManagement

FieldValueIRS element (for citing)
Total0Total

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total0Total

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total0Total

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total0Total

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total0Total

Fees For Services Invst Mgmnt Fees FeesForServicesInvstMgmntFees

FieldValueIRS element (for citing)
Total0Total

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total0Total

Advertising Advertising

FieldValueIRS element (for citing)
Total0Total

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total0Total

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total0Total

Royalties Royalties

FieldValueIRS element (for citing)
Total0Total

Occupancy Occupancy

FieldValueIRS element (for citing)
Total322627Total
Program Services231421ProgramServices
Management And General91206ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total177964Total
Program Services108474ProgramServices
Management And General67672ManagementAndGeneral
Fundraising1818Fundraising

Travel Entrtnmnt Public Officials TravelEntrtnmntPublicOfficials

FieldValueIRS element (for citing)
Total0Total

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total0Total

Interest Interest

FieldValueIRS element (for citing)
Total101413Total
Program Services74015ProgramServices
Management And General27398ManagementAndGeneral

Payments To Affiliates PaymentsToAffiliates

FieldValueIRS element (for citing)
Total0Total

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total459787Total
Program Services302042ProgramServices
Management And General157745ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total42152Total
Program Services1423ProgramServices
Management And General40729ManagementAndGeneral

Other Expenses OtherExpenses (5 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneralFundraisingFundraising
SUPPLIES66799765609111568338
PROFESSIONAL FEES18345596971846321852
MISCELLANEOUS15130592881561682256
DUES, PUBLICATIONS & POSTAGE106288365126975323
CONTRACTUAL70328567538627899

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total189656Total
Program Services147797ProgramServices
Management And General41801ManagementAndGeneral
Fundraising58Fundraising

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total13536709Total
Program Services12385743ProgramServices
Management And General1107390ManagementAndGeneral
Fundraising43576Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY3166983BOY
EOY1757614EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
EOY0EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY374390BOY
EOY38444EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY1124036BOY
EOY1329608EOY

Receivables From Officers Etc ReceivablesFromOfficersEtc

FieldValueIRS element (for citing)
BOY50230BOY
EOY7517EOY

Receivables From Disqual Persons ReceivablesFromDisqualPersons

FieldValueIRS element (for citing)
EOY0EOY

Other Notes Loans Receivable Net OtherNotesLoansReceivableNet

FieldValueIRS element (for citing)
EOY0EOY

Inventories For Sale Or Use InventoriesForSaleOrUse

FieldValueIRS element (for citing)
BOY21243BOY
EOY28141EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY48788BOY
EOY40341EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis12357580LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec2523650LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY8536798BOY
EOY9833930EOY

Investments Pub Traded Securities InvestmentsPubTradedSecurities

FieldValueIRS element (for citing)
EOY0EOY

Investments Other Securities InvestmentsOtherSecurities

FieldValueIRS element (for citing)
BOY196165BOY
EOY604156EOY

Investments Program Related InvestmentsProgramRelated

FieldValueIRS element (for citing)
EOY0EOY

Intangible Assets IntangibleAssets

FieldValueIRS element (for citing)
EOY0EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
EOY0EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY13518633BOY
EOY13639751EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY818797BOY
EOY896956EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY425388BOY
EOY76452EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY1630175BOY
EOY1577602EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY2874360BOY
EOY2551010EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY10644273BOY
EOY11036661EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
EOY52080EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY10644273BOY
EOY11088741EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY13518633BOY
EOY13639751EOY
FieldValueIRS element (for citing)
Info In Schedule O Part XIXInfoInScheduleOPartXI
Reconcilation Revenue Expenses416252ReconcilationRevenueExpenses
Reconcilation Other Changes28216ReconcilationOtherChanges
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or ReviewfalseAccountantCompileOrReview
FS AuditedtrueFSAudited
Audit CommitteetrueAuditCommittee
Financial Statement SeparateXFinancialStatementSeparate
Federal Grant Audit RequiredtrueFederalGrantAuditRequired
Federal Grant Audit PerformedtrueFederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org170b1 AviXPubliclySupportedOrg170b1Avi

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years3077270CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years4558675CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years5303108CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year4317021CurrentTaxYearMinus1Year
Current Tax Year4180639CurrentTaxYear
Total21436713Total

Tax Rev Levied For Org Benefit170 TaxRevLeviedForOrgBenefit170

FieldValueIRS element (for citing)
Total0Total

Value Srvc Fclts Furnished By Govt ValueSrvcFcltsFurnishedByGovt

FieldValueIRS element (for citing)
Total0Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years3077270CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years4558675CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years5303108CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year4317021CurrentTaxYearMinus1Year
Current Tax Year4180639CurrentTaxYear
Total21436713Total
FieldValueIRS element (for citing)
Amounts Subst Contributors Total0AmountsSubstContributorsTotal
Public Support Total17021436713PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years141578CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years128454CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years61027CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year9583CurrentTaxYearMinus1Year
Current Tax Year10829CurrentTaxYear
Total351471Total

Net UBI NetUBI

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years7873CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years11744CurrentTaxYearMinus2Years
Current Tax Year6393CurrentTaxYear
Total26010Total

Other Income170 OtherIncome170

FieldValueIRS element (for citing)
Total0Total
FieldValueIRS element (for citing)
Total Support21814194TotalSupport
Public Support Pertcentage1700.98270PublicSupportPertcentage170
Public Support Pertcent Prior Year0.97770PublicSupportPertcentPriorYear
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 D IRS990ScheduleD

Current Year CurrentYear

FieldValueIRS element (for citing)
Beginning Of Year Balance196165BeginningOfYearBalance
Contributions375415Contributions
Investment Earnings Or Losses34615InvestmentEarningsOrLosses
Administrative Expenses2039AdministrativeExpenses
End Of Year Balance604156EndOfYearBalance

Current Year Minus1 Year CurrentYearMinus1Year

FieldValueIRS element (for citing)
Beginning Of Year Balance148799BeginningOfYearBalance
Investment Earnings Or Losses48895InvestmentEarningsOrLosses
Administrative Expenses1529AdministrativeExpenses
End Of Year Balance196165EndOfYearBalance

Current Year Minus2 Years CurrentYearMinus2Years

FieldValueIRS element (for citing)
Beginning Of Year Balance208547BeginningOfYearBalance
Investment Earnings Or Losses-58170InvestmentEarningsOrLosses
Administrative Expenses1578AdministrativeExpenses
End Of Year Balance148799EndOfYearBalance
FieldValueIRS element (for citing)
Board Designated EOY Balance1.00000BoardDesignatedEOYBalance
Endowments Held By Unrelated OrgstrueEndowmentsHeldByUnrelatedOrgs
Endowments Held By Related OrgsfalseEndowmentsHeldByRelatedOrgs
Are Related Orgs Listed Schedule RfalseAreRelatedOrgsListedScheduleR

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis1442898OtherCostOrOtherBasis
Book Value1442898BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis9220132OtherCostOrOtherBasis
Depreciation1493696Depreciation
Book Value7726436BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis1694550OtherCostOrOtherBasis
Depreciation1029954Depreciation
Book Value664596BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings9833930TotalOfBookValueLandBuildings
Total Revenue13952961TotalRevenue
Total Expenses13536709TotalExpenses
Excess Or Deficit For Year416252ExcessOrDeficitForYear
Net Unrealized GL On Investments28216NetUnrealizedGLOnInvestments
Total Adjustments28216TotalAdjustments
Excess Or Deficit Per FS444468ExcessOrDeficitPerFS
Tot Revenue Etc Audited Fincl Stmt14094889TotRevenueEtcAuditedFinclStmt
Net Unrealized Gains Investments28216NetUnrealizedGainsInvestments
Donated Srvc And Use Of Facilities98257DonatedSrvcAndUseOfFacilities
Other Revenues15455OtherRevenues
Revenue Not Rptd F990141928RevenueNotRptdF990
Revenue Subtotal13952961RevenueSubtotal
Total Revenue Per Form99013952961TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt13650421TotExpensesEtcAuditedFinclStmt
Donated Services Use Of Facilities98257DonatedServicesUseOfFacilities
Other Expenses Included15455OtherExpensesIncluded
Expenses Not Rptd F990113712ExpensesNotRptdF990
Expenses Subtotal13536709ExpensesSubtotal
Total Expenses Per Form99013536709TotalExpensesPerForm990

Form990 Schedule D Part XIV Form990ScheduleDPartXIV (2 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
Part XIII, Line 2dPart XIII, Line 2d: Other expenses and losses per audited F/SDIRECT FUNDRAISING EXPENSES $15455
Part XII, Line 2dPart XII, Line 2d: Other revenue amounts included in F/S but not included on form 990DIRECT FUNDRAISING EXPENSES $15455

Schedule G IRS990ScheduleG

FieldValueIRS element (for citing)
Agreement Ref FundraisingfalseAgreementRefFundraising

Gaming Information GamingInformation

FieldValueIRS element (for citing)
Volunteer Labor BingofalseVolunteerLaborBingo
Volunteer Labor Pull TabsfalseVolunteerLaborPullTabs
Gross Revenue Other Gaming101908GrossRevenueOtherGaming
Other Direct Expenses Other Gaming15455OtherDirectExpensesOtherGaming
Volunteer Labor Other GamingfalseVolunteerLaborOtherGaming
Gross Revenue Total Gaming101908GrossRevenueTotalGaming
Other Direct Expenses Total Gaming15455OtherDirectExpensesTotalGaming
Direct Expense Summary Gaming15455DirectExpenseSummaryGaming
Net Gaming Income Summary86453NetGamingIncomeSummary
FieldValueIRS element (for citing)
LicensedtrueLicensed
License Suspended EtcfalseLicenseSuspendedEtc
Gaming With NonmembersfalseGamingWithNonmembers
Member Of Other EntityfalseMemberOfOtherEntity
Percentage Of Gaming Othr Facility1.00000PercentageOfGamingOthrFacility
Contract With3rd Party For Gam RevfalseContractWith3rdPartyForGamRev
Charitable Distrib RequiredfalseCharitableDistribRequired

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Form990 Of Other OrganizationsXForm990OfOtherOrganizations
Written Employment ContractXWrittenEmploymentContract
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance PaymentfalseSeverancePayment
Supplemental Nonqual Retire PlantrueSupplementalNonqualRetirePlan
Equity Based Comp ArrangementfalseEquityBasedCompArrangement
Comp Based On Revenue Of Filing OrgfalseCompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related OrgsfalseCompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing OrgfalseCompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate OrgsfalseCompBasedNetEarningsRelateOrgs
Any Non Fixed PaymentsfalseAnyNonFixedPayments
Initial Contract ExceptionfalseInitialContractException
Rebuttable Presumption ProcedurefalseRebuttablePresumptionProcedure

Form990 Schedule J Part II Form990ScheduleJPartII (3 entries)

Base Compensation Filing OrgBaseCompensationFilingOrgOther Compensation Filing OrgOtherCompensationFilingOrgDeferred Comp Filing OrgDeferredCompFilingOrgTotal Compensation Filing OrgTotalCompensationFilingOrg
WILLIAM H PALM
18622629499791198966
RICHARD JULYAN
1789053382182287
KEN RHEE
1570034166161169

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (6 entries)

Return ReferenceReturnReferenceExplanationExplanationIdentifierIdentifier
FORM 990, PART I, LINE 1 - ORG. MISSIONTO ESTABLISH A COMPREHENSIVE FAMILY ORIENTED QUALITY HEALTH CARE CENTER WHICH PROVIDES FOR AGRICULTURAL WORKERS AND OTHER MEDICALLY UNDERSERVED IN JACKSON COUNTY. THE MISSION OF LA CLINICA IS TO PROVIDE QUALITY MEDICAL, DENTAL AND SOCIAL SERVICES TO THE DIVERSE POPULATIONS WITHIN OUR COMMUNITIES, ESPECIALLY THOSE WHO FACE BARRIERS TO HEALTHCARE.
Form 990, Part VI, Line 19: Other Organization Documents Publicly AvailableLA CLINICA DEL VALLE MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST AS PER THE FOLLOWING POLICY GUIDELINES:THE AUDITED FINANCIAL STATEMENTS WILL BE DISTRIBUTED TO THE BOARD OF DIRECTORS, TO REGULATORY AGENCIES AND TO ORGANIZATIONS ENTITLED TO RECEIVE A COPY DUE TO CONTRACTUAL AGREEMENT. THE AUTHORITY TO DISTRIBUTE THE STATEMENTS TO OTHER INDIVIDUALS OR FIRMS REQUESTING THEM WILL BE LEFT TO THE DISCRETION OF THE EXECUTIVE DIRECTOR AND THE FINANCE DIRECTOR.Form 990, Part VI, Line 19
Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key EmployeesEACH YEAR A MARKET REVIEW IS PERFORMED FOR A COMPETITIVE ANALYSIS OF SALARIES IN THE LOCAL AND REGIONAL AREAS FOR ALL POSITIONS IN THE ORGANIZATION. THE HUMAN RESOURCES COORDINATOR COMPILES THE INFORMATION AND IT IS GIVEN TO THE ACCOUNTANT WHO INPUTS THE DATA INTO THE FORECASTED BUDGET FOR THE NEXT FISCAL YEAR. INCREASES IN BASE PAY MAY BE INCLUDED FOR NEW BUDGET PERIODS (BEGINNING IN JUNE) IF THE FOLLOWING IS TRUE:1. FINANCIAL FORECAST FOR THE ORGANIZATION IS HEALTHY;2. IF THE SALARY FOR THE JOB POSITION HAS FALLEN BELOW THE AVERAGE MARKET RANGE AND PAY THRESHOLD FOR THE ORGANIZATION;3. THE BOARD OF DIRECTORS HAS REVIEWED AND APPROVED THE NEW BUDGET INCLUDING THE CHANGES TO SALARIES AND WAGES.Form 990, Part VI, Line 15b
Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of ConflictsCONFLICT OF INTEREST PROCEDURES: PERSONS CONCERNED: THIS STATEMENT IS DIRECTED NOT ONLY TO DIRECTORS AND OFFICERS, BUT ALSO TO ALL EMPLOYEES WHO CAN INFLUENCE THE ACTIONS OF LA CLINICA DEL VALLE. FOR EXAMPLE, THIS WOULD INCLUDE ALL WHO MAKE PURCHASING DECISIONS, ALL OTHER PERSONS WHO MIGHT BE DESCRIBED AS "MANAGEMENT PERSONNEL", AND ALL WHO HAVE PROPRIETARY INFORMATION CONCERNING LA CLINICA DEL VALLE.AREAS IN WHICH CONFLICT MAY ARISE: CONFLICTS OF INTEREST MAY ARISE IN THE RELATIONS OF DIRECTORS, OFFICERS, AND MANAGEMENT EMPLOYEES WITH ANY OF THE FOLLOWING THIRD PARTIES:1. PERSONS AND FIRMS SUPPLYING GOODS AND SERVICES TO LA CLINICA DEL VALLE.2. PERSONS AND FIRMS FROM WHOM LA CLINICA DEL VALLE LEASES PROPERTY AND EQUIPMENT.3. PERSONS AND FIRMS WITH WHOM LA CLINICA DEL VALLE IS DEALING OR PLANNING TO DEAL IN CONNECTION WITH THE GIFT, PURCHASE OR SALE OF REAL ESTATE, SECURITIES, OR OTHER PROPERTY.4. COMPETING OR AFFINITY ORGANIZATIONS.5. DONORS AND OTHERS SUPPORTING LA CLINICA DEL VALLE.6. AGENCIES, ORGANIZATIONS, AND ASSOCIATIONS, WHICH AFFECT THE OPERATIONS OF LA CLINICA DEL VALLE.7. FAMILY MEMBERS, FRIENDS, AND OTHER EMPLOYEES.DISCLOSURE PROCEDURE: DISCLOSURE SHOULD BE MADE ACCORDING TO LA CLINICA DEL VALLE'S STANDARDS. TRANSACTIONS WITH RELATED PARTIES MAY BE UNDERTAKEN ONLY IF ALL OF THE FOLLOWING ARE OBSERVED:1. A MATERIAL TRANSACTION IS FULLY DISCLOSED IN THE AUDITED FINANCIAL STATEMENTS OF THE OREGANIZATION;2. THE RELATED PARTY IS EXCLUDED FROM THE DISCUSSION AND APPROVAL OF SUCH TRANSACTIONS;3. A COMPETITVE BID OR COMPARABLE VALUATION EXISTS; AND4. THE ORGANIZATION'S BOARD HAS ACTED UPON AND DEMOSTRATED THAT THE TRANSACTION IS IN THE BEST INTEREST OF THE ORGANIZATION.DISCLOSURE IN THE ORGANIZATION SHOULD BE MADE TO THE EXECUTIVE DIRECTOR ( OR IF SHE OR HE IS THE ONE WITH THE CONFLICT, THEN TO THE BOARD CHAIR), WHO SHALL DETERMINE WHETHER A CONFLICT EXISTS AND IS MATERIAL, AND IF THE MATTERS ARE MATERIAL, BRING THEM TO THE ATTENTION OF THE BOARD CHAIR.DISCLOSURE INVOLVING DIRECTORS SHOULD BE MADE TO THE BOARD CHAIR, WHICH SHALL BRING THESE MATTERS, IF MATERIAL TO THE BOARD. THE BOARD SHALL DETERMINE WHETHER A CONFLICT EXISTS AND IS MATERIAL, AND IN THE PRESENCE OF AN EXISTING MATERIAL CONFLICT, WHETHER THE CONTEMPLATED TRANSACTION MAY BE AUTHORIZED AS JUST, FAIR, AND REASONABLE TO LA CLINICA DEL VALLE. THE DECISION OF THE BOARD ON THESE MATTERS WILL REST IN THEIR SOLE DISCRETION, AND THEIR CONCERN MUST BE THE WELFARE OF LA CLINICA DEL VALLE AND THE ADVANCEMENT OF ITS PURPOSE.Form 990, Part VI, Line 12c
Form 990, Part VI, Line 11: Form 990 Review ProcessTHE FORM 990 PREPARER PROVIDES A DRAFT COPY OF THE FORM 990 TO THE FINANCE DIRECTOR AND THE INTERNAL ACCOUNTANT FOR REVIEW. A COPY OF THE FORM 990 IS ALSO PROVIDED TO THE FINANCE/AUDIT COMMITTEE FOR REVIEW. AFTER REVIEW THE FORM 990 PREPARER IS NOTIFIED TO FILE THE FORM 990. A REPORT IS THEN PROVIDED TO THE FULL BOARD OF DIRECTORS ON THE RESULTS AND/OR FINDINGS OF THE FORM 990.Form 990, Part VI, Line 11
Form 990, Part VI, Line 7a: How Members or Shareholders Elect Governing BodyA NOMINATING COMMITTEE SHALL NOMINATE CANDIDATES FOR BOARD APPROVAL TO FILL BOARD MEMBER VACANCIES. THE NOMINATING COMMITTEE SHALL MAINTAIN A CURRENT PROFILE OF THE BOARD'S MEMBERSHIP COMPOSITION TO GUIDE THE SELECTION PROCESS. IT SHALL REVIEW THE PERFORMANCE OF INCUMBENT BOARD MEMBERS WHO ARE ELIGIBLE FOR RE-ELECTION, AND IF APPROPRIATE, RECOMMEND THEM TO THE BOARD OF DIRECTORS FOR NOMINATION AND RE-ELECTION. THE COMMITTEE SHALL, SUBJECT TO THE REQUIREMENTS SET FORTH IN THE BY-LAWS, ALSO NOMINATE MEMBERS-AT-LARGE. CANDIDATES NOMINATED TO FILL BOARD POSITIONS WILL BE ELECTED BY A MAJORITY VOTE OF THE MEMBERS AT A BOARD MEETING AT WHICH A QUORUM IS PRESENT.Form 990, Part VI, Line 7a

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