2023-05-03T08:14:25-05:00 2022-06-30 390758449 WIPFLI LLP PO BOX 12237 GREEN BAY WI 543072237 990 2021-07-01 680262003 MENDOCINO COAST CLINICS INC MEND 7079641251 205 SOUTH STREET FORT BRAGG CA 95437 LUCRESHA RENTERIA EXECUTIVE DIRECTOR 7079641251 2023-05-02 1 LUCRESHA RENTERIA 999009999 TERRI REXRODE CPA MST P00096513 9206620016 2023-05-02 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z LUCRESHA RENTERIA 205 SOUTH STREET FORT BRAGG CA 95437 14793342 0 X WWW.MENDOCINOCOASTCLINICS.ORG X 1994 CA 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. 10 10 179 10 0 0 4220799 4082614 8857849 10607434 6522 3984 208497 55983 13293667 14750015 3500 1600 0 0 7822121 8709718 0 0 0 4361175 5197177 12186796 13908495 1106871 841520 9586994 10156019 3030536 2251398 6556458 7904621 X 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. 0 0 4983722 1600 4616618 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. 1725531 0 2111386 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. 1525105 0 1216275 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. 1093075 0 1555457 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. 854780 0 880748 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. 81738 0 248016 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. 2029593 0 2684221 10263951 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 58 0 179 1 0 0 0 0 0 0 0 0 0 0 0 0 X 10 10 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X WIPFLI LLP 7074631463 125 E MILL ST UKIAH CA 95482 MELISSA AZEVEDO CHAIR 4.00 X X 0 0 0 KELLY GRIMES VICE CHAIR 4.00 X X 0 0 0 DAPHNE HANEY TREASURER 4.00 X X 0 0 0 TREVOR ORCHARD SECRETARY 4.00 X X 0 0 0 CLAUDIA BOUDREAU DIRECTOR (TERMED 8/10/21) 4.00 X 0 0 0 JAMES KATZEL DIRECTOR 4.00 X 0 0 0 CHRISTINE KELLY DIRECTOR (TERMED 1/7/22) 4.00 X 0 0 0 CHRISTOPHER KNOERDEL DIRECTOR (TERMED 8/10/21) 4.00 X 0 0 0 MATT O'HALLORAN DIRECTOR 4.00 X 0 0 0 RIO PARFREY DIRECTOR 4.00 X 0 0 0 ARACELI RIVAS DIRECTOR 4.00 X 0 0 0 YADIRA SANCHEZ DIRECTOR 4.00 X 0 0 0 DEBORAH WYATT DIRECTOR 4.00 X 0 0 0 CLARE BERCOT ZWERLING DIRECTOR (TERMED 6/14/22) 4.00 X 0 0 0 LUCRESHA RENTERIA EXECUTIVE DIRECTOR 40.00 X 170315 0 32941 MERYL SCHLINGHEYDE COO 40.00 X 83110 0 12568 LAWRENCE GOLDYN MEDICAL DIRECTOR 40.00 X 238952 0 31328 AMY FAWCETT CONTRACTED CFO 3.00 X 0 0 0 CHRISTOPHER ROBSHAW PEDIATRICIAN 40.00 X 236423 0 28594 BRENT WRIGHT OB/GYN PHYSICIAN 40.00 X 230294 0 27160 JAE DO KIM DENTIST 40.00 X 150450 0 12777 JAMES THOMAS PHYSICIANS ASSISTANT 40.00 X 140358 0 19054 TADEUS ULATOWSKI DENTIST 40.00 X 155464 0 15942 1405366 0 180364 7 0 1 0 MACMAN MANAGEMENT HEALTHCARE 1930 DEL PASO ROAD SUITE 120 SACRAMENTO CA 95834 BILLING SERVICE 329989 WIPFLI LLP PO BOX 3160 MILWAUKEE WI 532013160 CONTRACTED PROVIDER 260563 GABRIEL'S CLEANING SERVICE PO BOX 2221 FORT BRAGG CA 95437 CLEANING SERVICE 175388 MEDICUS IT LLC 100 NORTH POINT CENTER EAST SUITE 1 ALPHARETTA GA 30022 FINANCIAL SERVICES 156979 4 3440450 642164 4082614 PATIENT SERVICE FEES 621400 10607434 10607434 10607434 3984 3984 78244 43327 34917 34917 OTHER INCOME 900099 21066 21066 21066 14750015 10628500 0 38901 X 1600 1600 533117 210709 322408 6458205 5595403 862802 141253 124207 17046 1066195 804789 261406 510948 421365 89583 33500 33500 2693 631 2062 155328 155328 1716862 947541 769321 70881 38625 32256 266299 121068 145231 636415 36199 600216 345297 271610 73687 7081 3294 3787 80405 55997 24408 56928 36919 20009 196074 156817 39257 55542 15049 40493 SUPPLIES-PHARM. 340B 458832 458832 SUPPLIES-PHARMACEUTICAL 458117 458117 SUPPLIES-CLINICAL 406350 406350 250573 98829 151744 13908495 10263951 3644544 0 2861177 3335708 10131 10136 100547 130865 1505447 1854403 696949 343576 7637129 3155798 4412743 4481331 9586994 10156019 1024730 1013039 687239 63544 1318567 1174815 3030536 2251398 X 6556458 7904621 6556458 7904621 9586994 10156019 841520 506643 0 X 0 1 X 1 1 1 X PART IV, SECTION A, LINE 3B: 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. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 433924 433924 5615817 1977181 3638636 38590 23816 14774 1429771 1154801 274970 119027 119027 4481331 14750015 0 14750015 0 14750015 13908495 0 13908495 0 13908495 CRAB FUNDRAISER 78244 78244 1200 12727 29400 78244 78244 1200 12727 29400 43327 34917 X 0 0 0 0 0 0 0 0 0 LAWRENCE GOLDYN MEDICAL DIRECTOR 237952 0 1000 0 0 0 9597 0 21731 0 270280 0 0 0 CHRISTOPHER ROBSHAW PEDIATRICIAN 235423 0 1000 0 0 0 9573 0 19021 0 265017 0 0 0 BRENT WRIGHT OB/GYN PHYSICIAN 229294 0 1000 0 0 0 7961 0 19199 0 257454 0 0 0 LUCRESHA RENTERIA EXECUTIVE DIRECTOR 159315 0 11000 0 0 0 6610 0 26331 0 203256 0 0 0 TADEUS ULATOWSKI DENTIST 154464 0 1000 0 0 0 6217 0 9725 0 171406 0 0 0 JAE DO KIM DENTIST 149450 0 1000 0 0 0 3053 0 9724 0 163227 0 0 0 JAMES THOMAS PHYSICIANS ASSISTANT 139358 0 1000 0 0 0 0 0 19054 0 159412 0 0 0 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.