MENDOCINO COAST CLINICS INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- MENDOCINO COAST CLINICS INC (EIN 68-0262003)
- Tax period
- 2021-07-01 to 2022-06-30
- Filed
- 2023-05-03
- IRS object ID
- 202331239349300023
- Schema version
- 2021v4.2
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-05-03T08:14:25-05:00 | ReturnTs |
| Tax Period End | 2022-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 390758449 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WIPFLI LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 12237 | AddressLine1Txt |
| City | GREEN BAY | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 543072237 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 680262003 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MENDOCINO COAST CLINICS INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MEND | BusinessNameControlTxt |
| Phone | 7079641251 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 205 SOUTH STREET | AddressLine1Txt |
| City | FORT BRAGG | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95437 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | LUCRESHA RENTERIA | PersonNm |
| Person Title | EXECUTIVE DIRECTOR | PersonTitleTxt |
| Phone | 7079641251 | PhoneNum |
| Signature | 2023-05-02 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | LUCRESHA | PersonFirstNm |
| Person Last | RENTERIA | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | TERRI REXRODE CPA MST | PreparerPersonNm |
| PTIN | P00096513 | PTIN |
| Phone | 9206620016 | PhoneNum |
| Preparation | 2023-05-02 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | LUCRESHA RENTERIA | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 205 SOUTH STREET | AddressLine1Txt |
| City | FORT BRAGG | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95437 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $14,793,342 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.MENDOCINOCOASTCLINICS.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1994 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | MENDOCINO COAST CLINICS, INC. PROVIDES HEALTH CARE SERVICES TO ALL WITHOUT REGARD TO RACE, CREED, NATIONAL ORIGIN, PHYSICAL DISABILITY, SEXUAL ORIENTATION OR ABILITY TO PAY FOR SERVICES TO THE EXTENT THE SERVICES ARE AVAILABLE AT THESE FACILITIES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 179 | TotalEmployeeCnt |
| Total Volunteers | 10 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $4,220,799 | PYContributionsGrantsAmt |
| CY Contributions Grants | $4,082,614 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $8,857,849 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $10,607,434 | CYProgramServiceRevenueAmt |
| PY Investment Income | $6,522 | PYInvestmentIncomeAmt |
| CY Investment Income | $3,984 | CYInvestmentIncomeAmt |
| PY Other Revenue | $208,497 | PYOtherRevenueAmt |
| CY Other Revenue | $55,983 | CYOtherRevenueAmt |
| PY Total Revenue | $13,293,667 | PYTotalRevenueAmt |
| CY Total Revenue | $14,750,015 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $3,500 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $1,600 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $7,822,121 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $8,709,718 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $4,361,175 | PYOtherExpensesAmt |
| CY Other Expenses | $5,197,177 | CYOtherExpensesAmt |
| PY Total Expenses | $12,186,796 | PYTotalExpensesAmt |
| CY Total Expenses | $13,908,495 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,106,871 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $841,520 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $9,586,994 | TotalAssetsBOYAmt |
| Total Assets EOY | $10,156,019 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $3,030,536 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $2,251,398 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $6,556,458 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $7,904,621 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | MENDOCINO COAST CLINICS, INC. PROVIDES HEALTH CARE SERVICES TO ALL WITHOUT REGARD TO RACE, CREED, NATIONAL ORIGIN, PHYSICAL DISABILITY, SEXUAL ORIENTATION OR ABILITY TO PAY FOR SERVICES TO THE EXTENT THE SERVICES ARE AVAILABLE AT THESE FACILITIES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $4,983,722 | ExpenseAmt |
| Grant | $1,600 | GrantAmt |
| Revenue | $4,616,618 | RevenueAmt |
| Desc | MENDOCINO COAST CLINICS, INC. IS A PRIMARY CARE CLINIC PROVIDING MEDICAL SERVICES. DURING THE CURRENT FISCAL YEAR, MENDOCINO COAST CLINICS PROVIDED 17,015 MEDICAL VISITS. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,725,531 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $2,111,386 | RevenueAmt |
| Desc | MENDOCINO COAST CLINICS, INC. IS A PRIMARY CARE CLINIC PROVIDING DENTAL SERVICES. DURING THE CURRENT FISCAL YEAR, MENDOCINO COAST CLINICS PROVIDED 9,008 DENTAL VISITS. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,525,105 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $1,216,275 | RevenueAmt |
| Desc | MENDOCINO COAST CLINICS, INC. IS A PRIMARY CARE CLINIC PROVIDING PEDIATRICS SERVICES. DURING THE CURRENT FISCAL YEAR, MENDOCINO COAST CLINICS PROVIDED 5,673 PEDIATRIC VISITS. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp (3 entries)
| ExpenseExpenseAmt | GrantGrantAmt | RevenueRevenueAmt | DescDesc |
|---|---|---|---|
| $1,093,075 | $0 | $1,555,457 | MENDOCINO COAST CLINICS, INC. IS A PRIMARY CARE CLINIC PROVIDING BEHAVIORAL HEALTH SERVICES. DURING THE CURRENT FISCAL YEAR, MENDOCINO COAST CLINICS PROVIDED 6,690 BEHAVIORAL HEALTH VISITS. |
| $854,780 | $0 | $880,748 | MENDOCINO COAST CLINICS, INC. IS A PRIMARY CARE CLINIC PROVIDING OB/GYN SERVICES. DURING THE CURRENT FISCAL YEAR, MENDOCINO COAST CLINICS PROVIDED 3,023 OB/GYN VISITS. |
| $81,738 | $0 | $248,016 | MENDOCINO COAST CLINICS, INC. IS A PRIMARY CARE CLINIC PROVIDING WELLNESS CENTER SERVICES. DURING THE CURRENT FISCAL YEAR, MENDOCINO COAST CLINICS PROVIDED 856 WELLNESS CENTER HEALTH VISITS. |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $2,029,593 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Grant | $0 | TotalOtherProgSrvcGrantAmt |
| Total Other Prog Srvc Revenue | $2,684,221 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $10,263,951 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 58 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 179 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | CA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WIPFLI LLP | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7074631463 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 125 E MILL ST | AddressLine1Txt |
| City | UKIAH | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95482 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| MELISSA AZEVEDO | |||||||
| CHAIR | 4.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| KELLY GRIMES | |||||||
| VICE CHAIR | 4.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| DAPHNE HANEY | |||||||
| TREASURER | 4.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| TREVOR ORCHARD | |||||||
| SECRETARY | 4.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| CLAUDIA BOUDREAU | |||||||
| DIRECTOR (TERMED 8/10/21) | 4.00 | Yes (X) | $0 | $0 | $0 | ||
| JAMES KATZEL | |||||||
| DIRECTOR | 4.00 | Yes (X) | $0 | $0 | $0 | ||
| CHRISTINE KELLY | |||||||
| DIRECTOR (TERMED 1/7/22) | 4.00 | Yes (X) | $0 | $0 | $0 | ||
| CHRISTOPHER KNOERDEL | |||||||
| DIRECTOR (TERMED 8/10/21) | 4.00 | Yes (X) | $0 | $0 | $0 | ||
| MATT O'HALLORAN | |||||||
| DIRECTOR | 4.00 | Yes (X) | $0 | $0 | $0 | ||
| RIO PARFREY | |||||||
| DIRECTOR | 4.00 | Yes (X) | $0 | $0 | $0 | ||
| ARACELI RIVAS | |||||||
| DIRECTOR | 4.00 | Yes (X) | $0 | $0 | $0 | ||
| YADIRA SANCHEZ | |||||||
| DIRECTOR | 4.00 | Yes (X) | $0 | $0 | $0 | ||
| DEBORAH WYATT | |||||||
| DIRECTOR | 4.00 | Yes (X) | $0 | $0 | $0 | ||
| CLARE BERCOT ZWERLING | |||||||
| DIRECTOR (TERMED 6/14/22) | 4.00 | Yes (X) | $0 | $0 | $0 | ||
| LUCRESHA RENTERIA | |||||||
| EXECUTIVE DIRECTOR | 40.00 | Yes (X) | $170,315 | $0 | $32,941 | ||
| MERYL SCHLINGHEYDE | |||||||
| COO | 40.00 | Yes (X) | $83,110 | $0 | $12,568 | ||
| LAWRENCE GOLDYN | |||||||
| MEDICAL DIRECTOR | 40.00 | Yes (X) | $238,952 | $0 | $31,328 | ||
| AMY FAWCETT | |||||||
| CONTRACTED CFO | 3.00 | Yes (X) | $0 | $0 | $0 | ||
| CHRISTOPHER ROBSHAW | |||||||
| PEDIATRICIAN | 40.00 | $236,423 | $0 | $28,594 | Yes (X) | ||
| BRENT WRIGHT | |||||||
| OB/GYN PHYSICIAN | 40.00 | $230,294 | $0 | $27,160 | Yes (X) | ||
| JAE DO KIM | |||||||
| DENTIST | 40.00 | $150,450 | $0 | $12,777 | Yes (X) | ||
| JAMES THOMAS | |||||||
| PHYSICIANS ASSISTANT | 40.00 | $140,358 | $0 | $19,054 | Yes (X) | ||
| TADEUS ULATOWSKI | |||||||
| DENTIST | 40.00 | $155,464 | $0 | $15,942 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,405,366 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $180,364 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 7 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (4 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| MACMAN MANAGEMENT HEALTHCARE | |||||
| 1930 DEL PASO ROAD SUITE 120 | SACRAMENTO | CA | 95834 | BILLING SERVICE | $329,989 |
| WIPFLI LLP | |||||
| PO BOX 3160 | MILWAUKEE | WI | 532013160 | CONTRACTED PROVIDER | $260,563 |
| GABRIEL'S CLEANING SERVICE | |||||
| PO BOX 2221 | FORT BRAGG | CA | 95437 | CLEANING SERVICE | $175,388 |
| MEDICUS IT LLC | |||||
| 100 NORTH POINT CENTER EAST SUITE 1 | ALPHARETTA | GA | 30022 | FINANCIAL SERVICES | $156,979 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $3,440,450 | GovernmentGrantsAmt |
| All Other Contributions | $642,164 | AllOtherContributionsAmt |
| Total Contributions | $4,082,614 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT SERVICE FEES | Desc |
| Business | 621400 | BusinessCd |
| Total Revenue Column | $10,607,434 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $10,607,434 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $10,607,434 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,984 | TotalRevenueColumnAmt |
| Exclusion | $3,984 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $78,244 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $43,327 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $34,917 | TotalRevenueColumnAmt |
| Exclusion | $34,917 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OTHER INCOME | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $21,066 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $21,066 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $21,066 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $14,750,015 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $10,628,500 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $38,901 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,600 | TotalAmt |
| Program Services | $1,600 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $533,117 | TotalAmt |
| Program Services | $210,709 | ProgramServicesAmt |
| Management And General | $322,408 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,458,205 | TotalAmt |
| Program Services | $5,595,403 | ProgramServicesAmt |
| Management And General | $862,802 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $141,253 | TotalAmt |
| Program Services | $124,207 | ProgramServicesAmt |
| Management And General | $17,046 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,066,195 | TotalAmt |
| Program Services | $804,789 | ProgramServicesAmt |
| Management And General | $261,406 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $510,948 | TotalAmt |
| Program Services | $421,365 | ProgramServicesAmt |
| Management And General | $89,583 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,500 | TotalAmt |
| Management And General | $33,500 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,693 | TotalAmt |
| Program Services | $631 | ProgramServicesAmt |
| Management And General | $2,062 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $155,328 | TotalAmt |
| Management And General | $155,328 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,716,862 | TotalAmt |
| Program Services | $947,541 | ProgramServicesAmt |
| Management And General | $769,321 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $70,881 | TotalAmt |
| Program Services | $38,625 | ProgramServicesAmt |
| Management And General | $32,256 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $266,299 | TotalAmt |
| Program Services | $121,068 | ProgramServicesAmt |
| Management And General | $145,231 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $636,415 | TotalAmt |
| Program Services | $36,199 | ProgramServicesAmt |
| Management And General | $600,216 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $345,297 | TotalAmt |
| Program Services | $271,610 | ProgramServicesAmt |
| Management And General | $73,687 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,081 | TotalAmt |
| Program Services | $3,294 | ProgramServicesAmt |
| Management And General | $3,787 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $80,405 | TotalAmt |
| Program Services | $55,997 | ProgramServicesAmt |
| Management And General | $24,408 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $56,928 | TotalAmt |
| Program Services | $36,919 | ProgramServicesAmt |
| Management And General | $20,009 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $196,074 | TotalAmt |
| Program Services | $156,817 | ProgramServicesAmt |
| Management And General | $39,257 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $55,542 | TotalAmt |
| Program Services | $15,049 | ProgramServicesAmt |
| Management And General | $40,493 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| SUPPLIES-PHARM. 340B | $458,832 | $458,832 |
| SUPPLIES-PHARMACEUTICAL | $458,117 | $458,117 |
| SUPPLIES-CLINICAL | $406,350 | $406,350 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $250,573 | TotalAmt |
| Program Services | $98,829 | ProgramServicesAmt |
| Management And General | $151,744 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,908,495 | TotalAmt |
| Program Services | $10,263,951 | ProgramServicesAmt |
| Management And General | $3,644,544 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,861,177 | BOYAmt |
| EOY | $3,335,708 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,131 | BOYAmt |
| EOY | $10,136 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $100,547 | BOYAmt |
| EOY | $130,865 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,505,447 | BOYAmt |
| EOY | $1,854,403 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $696,949 | BOYAmt |
| EOY | $343,576 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $7,637,129 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $3,155,798 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,412,743 | BOYAmt |
| EOY | $4,481,331 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,586,994 | BOYAmt |
| EOY | $10,156,019 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,024,730 | BOYAmt |
| EOY | $1,013,039 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $687,239 | BOYAmt |
| EOY | $63,544 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,318,567 | BOYAmt |
| EOY | $1,174,815 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,030,536 | BOYAmt |
| EOY | $2,251,398 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,556,458 | BOYAmt |
| EOY | $7,904,621 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,556,458 | BOYAmt |
| EOY | $7,904,621 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,586,994 | BOYAmt |
| EOY | $10,156,019 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $841,520 | ReconcilationRevenueExpnssAmt |
| Prior Period Adjustments | $506,643 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART IV, SECTION A, LINE 3B: | FormAndLineReferenceDesc |
| Explanation | ALTHOUGH THIS ORGANIZATION IS CLASSIFIED AS A HOSPITAL FOR IRS PUBLIC CHARITY STATUS, IT IS NOT A LICENSED HOSPITAL AND THEREFORE, FORM 990, SCHEDULE H, HOSPITALS, IS NOT REQUIRED. | ExplanationTxt |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $433,924 | OtherCostOrOtherBasisAmt |
| Book Value | $433,924 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,615,817 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,977,181 | DepreciationAmt |
| Book Value | $3,638,636 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $38,590 | OtherCostOrOtherBasisAmt |
| Depreciation | $23,816 | DepreciationAmt |
| Book Value | $14,774 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,429,771 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,154,801 | DepreciationAmt |
| Book Value | $274,970 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $119,027 | OtherCostOrOtherBasisAmt |
| Book Value | $119,027 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $4,481,331 | TotalBookValueLandBuildingsAmt |
| Total Rev Etc Audited Fincl Stmt | $14,750,015 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $14,750,015 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $14,750,015 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $13,908,495 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $13,908,495 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $13,908,495 | TotalExpensesPerForm990Amt |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | CRAB FUNDRAISER | Event1Nm |
| Gross Receipts Event1 | $78,244 | GrossReceiptsEvent1Amt |
| Gross Revenue Event1 | $78,244 | GrossRevenueEvent1Amt |
| Rent Facility Costs Event1 | $1,200 | RentFacilityCostsEvent1Amt |
| Food And Beverage Event1 | $12,727 | FoodAndBeverageEvent1Amt |
| Other Direct Expenses Event1 | $29,400 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $78,244 | GrossReceiptsTotalAmt |
| Gross Revenue Total Events | $78,244 | GrossRevenueTotalEventsAmt |
| Rent Fclty Costs Total Events | $1,200 | RentFcltyCostsTotalEventsAmt |
| Food And Beverage Total Events | $12,727 | FoodAndBeverageTotalEventsAmt |
| Oth Direct Expnss Total Events | $29,400 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $43,327 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $34,917 | NetIncomeSummaryAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| LAWRENCE GOLDYN | ||||||||||||||
| MEDICAL DIRECTOR | $237,952 | $0 | $1,000 | $0 | $0 | $0 | $9,597 | $0 | $21,731 | $0 | $270,280 | $0 | $0 | $0 |
| CHRISTOPHER ROBSHAW | ||||||||||||||
| PEDIATRICIAN | $235,423 | $0 | $1,000 | $0 | $0 | $0 | $9,573 | $0 | $19,021 | $0 | $265,017 | $0 | $0 | $0 |
| BRENT WRIGHT | ||||||||||||||
| OB/GYN PHYSICIAN | $229,294 | $0 | $1,000 | $0 | $0 | $0 | $7,961 | $0 | $19,199 | $0 | $257,454 | $0 | $0 | $0 |
| LUCRESHA RENTERIA | ||||||||||||||
| EXECUTIVE DIRECTOR | $159,315 | $0 | $11,000 | $0 | $0 | $0 | $6,610 | $0 | $26,331 | $0 | $203,256 | $0 | $0 | $0 |
| TADEUS ULATOWSKI | ||||||||||||||
| DENTIST | $154,464 | $0 | $1,000 | $0 | $0 | $0 | $6,217 | $0 | $9,725 | $0 | $171,406 | $0 | $0 | $0 |
| JAE DO KIM | ||||||||||||||
| DENTIST | $149,450 | $0 | $1,000 | $0 | $0 | $0 | $3,053 | $0 | $9,724 | $0 | $163,227 | $0 | $0 | $0 |
| JAMES THOMAS | ||||||||||||||
| PHYSICIANS ASSISTANT | $139,358 | $0 | $1,000 | $0 | $0 | $0 | $0 | $0 | $19,054 | $0 | $159,412 | $0 | $0 | $0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 3 | WIPFLI LLP CONTRACTED CFO AMY FAWCETT $33,500 |
| FORM 990, PART VI, SECTION B, LINE 11B | A COPY OF THE FORM 990 AND ALL RELATED SCHEDULES AND STATEMENTS WAS PROVIDED TO THE BOARD BEFORE FILING FOR REVIEW AND COMMENT. |
| FORM 990, PART VI, SECTION B, LINE 12C | CONFLICT OF INTEREST STATEMENTS ARE UPDATED AND REVIEWED ANNUALLY. THE CONFLICT OF INTEREST POLICY APPLIES TO EMPLOYEES, OFFICERS AND THE BOARD OF DIRECTORS. THE GOVERNING BOARD OR COMMITTEE DETERMINES IF THERE IS A CONFLICT OF INTEREST. THE BOARD OR COMMITTEE REVIEWS THE CONFLICT. THE BOARD OF DIRECTORS OR OUTSIDE ADVISOR WILL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION IF NEEDED. |
| FORM 990, PART VI, SECTION B, LINE 15 | COMPENSATION OF KEY EMPLOYEES IS REVIEWED BY THE FULL BOARD OF DIRECTORS WHO ARE INDEPENDENT FROM THOSE IN WHICH COMPENSATION IS BEING REVIEWED. THE BOARD OF DIRECTORS APPROVE AND DOCUMENT ANY CHANGES TO COMPENSATION. |
| FORM 990, PART VI, SECTION C, LINE 19 | DOCUMENTS ARE MADE AVAILABLE UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | CONTRACTUAL MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 734,520. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 734,520. CONSULTING SERVICES: PROGRAM SERVICE EXPENSES 213,021. MANAGEMENT AND GENERAL EXPENSES 769,321. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 982,342. |