ANDERSON VALLEY HEALTH CENTER INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- ANDERSON VALLEY HEALTH CENTER INC (EIN 94-2347424)
- Tax period
- 2021-07-01 to 2022-06-30
- Filed
- 2023-05-15
- IRS object ID
- 202331359349319503
- 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 | 2023-05-15T19:27:19-05:00 | ReturnTs |
| Tax Period End | 2022-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 464016990 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | THE PUN GROUP LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 E SANDPOINTE AVENUE SUITE 600 | AddressLine1Txt |
| City | SANTA ANA | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 92707 | 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 | 942347424 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ANDERSON VALLEY HEALTH CENTER INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | ANDE | BusinessNameControlTxt |
| Phone | 7078953477 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 13500 AIRPORT ROAD | AddressLine1Txt |
| City | BOONVILLE | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 954150338 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | CHLOE GUAZZONE-RUGEBREGT | PersonNm |
| Person Title | EXECUTIVE DIRECTOR | PersonTitleTxt |
| Phone | 7078953477 | PhoneNum |
| Signature | 2023-05-15 | SignatureDt |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | CHLOE | PersonFirstNm |
| Person Last | GUAZZONE-RUGEBREGT | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KENNETH HPUN | PreparerPersonNm |
| PTIN | P01443751 | PTIN |
| Phone | 9497778800 | PhoneNum |
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 | ERIN CHLOE GUAZZONE RUGEB | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 13500 AIRPORT ROAD | AddressLine1Txt |
| City | BOONVILLE | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95415 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $7,221,013 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.AVHC.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1977 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | PROVIDE COMPREHENSIVE AND LOW COST MEDICAL, PSYCHIATRIC AND HEALTH RELATED SERVICES, REGARDLESS OF RACE, COLOR, CREED, NATIONAL ORIGIN, AGE, SEX, SOCIAL OR POLITICAL BELIEFS, HANDICAPPED STATUS OR ABILITY TO PAY; PROVIDE PREVENTATIVE HEALTH EDUCATION IN THE SCHOOLS AND COMMUNITY OF ANDERSON VALLEY, MENDOCINO COUNTY, CALIFORNIA AND ITS ENVIRONS; EDUCATE AND TRAIN PARAMEDICS AND CITIZENRY IN EMERGENCY FIRST AID; ACT AS A COMMUNITY RESOURCE AND AS A CENTER OF HEALTH CARE INFORMATION. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 50 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $3,442,928 | PYContributionsGrantsAmt |
| CY Contributions Grants | $5,052,181 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $2,030,368 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $2,142,367 | CYProgramServiceRevenueAmt |
| PY Investment Income | $6,707 | PYInvestmentIncomeAmt |
| CY Investment Income | -$6,741 | CYInvestmentIncomeAmt |
| PY Other Revenue | $22,704 | PYOtherRevenueAmt |
| CY Other Revenue | $18,952 | CYOtherRevenueAmt |
| PY Total Revenue | $5,502,707 | PYTotalRevenueAmt |
| CY Total Revenue | $7,206,759 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $2,666,132 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $2,718,369 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $30,000 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,576,982 | PYOtherExpensesAmt |
| CY Other Expenses | $2,011,088 | CYOtherExpensesAmt |
| PY Total Expenses | $4,273,114 | PYTotalExpensesAmt |
| CY Total Expenses | $4,729,457 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,229,593 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $2,477,302 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $6,859,456 | TotalAssetsBOYAmt |
| Total Assets EOY | $9,652,728 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,269,570 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,610,439 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $5,589,886 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $8,042,289 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | ANDERSON VALLEY HEALTH CENTER, INC.(AVHC), A CALIFORNIA NOT-FOR-PROFIT ORGANIZATION WAS INCORPORATED IN 1977 FOR THE PURPOSE OF RENDERING PROFESSIONAL MEDICAL AND HEALTH SERVICES TO THE RURAL AREA OF ANDERSON VALLEY. AVHC IS A FEDERALLY QUALIFIED HEALTH CENTER AND, AS THE SOLE PROVIDER OF HEALTH CARE SERVICES IN THE AREA, OFFERS PRIMARY MEDICAL, DENTAL AND BEHAVIORAL HEALTH SERVICES. AVHC DERIVES SUPPORT THROUGH GRANTS AND CONTRACTS WITH THE U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES AND THE CALIFORNIA HEALTH AND HUMAN SERVICES AGENCY. THE MAJORITY OF THE REVENUE IS DERIVED FROM PATIENT SERVICES AND THE REMAINDER FROM THE AFOREMENTIONED GRANTS AND CONTRACTS AS WELL AS OTHER STATE AND LOCAL GRANTS.AS A NOT-FOR-PROFIT ORGANIZATION RECEIVING PUBLIC FUNDS, AVHC PROVIDES SERVICES TO QUALIFIED INDIVIDUALS ON A SLIDING FEE SCALE AS WELL AS TO PATIENTS WITH MEDICAL AND MEDICARE COVERAGE, PRIVATE INSURANCE AND SELF-PAY STATUS. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $1,677,228 | ExpenseAmt |
| Revenue | $1,401,955 | RevenueAmt |
| Desc | PRIMARY CARE - COMPREHENSIVE PRIMARY CARE FOR ALL AGES WITH AN EMPHASIS ON HEALTH EDUCATION, FAMILY PLANNING, WOMEN'S HEALTH, PHYSICAL EXAMINATIONS FOR SPORTS, DMV, CAMP, SCHOOL AND CHDP, TEEN HEALTH, URGENT CARE, EFERRALS, AND WORKER'S COMPENSATION & SPECIALTY CLINICS. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $589,659 | ExpenseAmt |
| Revenue | $384,730 | RevenueAmt |
| Desc | DENTAL SERVICES - ANDERSON VALLEY HEALTH CENTER OFFERS COMPREHENSIVE DENTAL SERVICES. ON STAFF DENTISTRY OFFERS A FULL SCOPE OF DENTAL SERVICES TO PATIENTS OF ALL AGES. CUSTOMARY ORAL CARE SERVICES, PATIENTS REQUIRING SPECIALTY SERVICES ARE OFTEN REFERRED TO OUT OF NETWORK TO PROFESSIONAL PARTNERS. AVHC IS FOCUSED ON THE PREVENTION AND DENTAL SCREENING TO THE COMMUNITY.PREVENTIVE DENTAL SERVICES INCLUDE COMPLETE ORAL EXAMINATIONS, DIGITAL X-RAYS, ROUTINE CLEANING, BASIC PERIODONTAL SERVICES, SEALANT APPLICATION, MERCURY FREE RESTORATIONS, CROWNS/BRIDGES, ROOT CANALS, EXTRACTIONS, COMPLETE AND PARTIAL DENTURES, EMERGENCY TREATMENT, AND SPECIALTY REFERAL.PREVENTIVE PROGRAMS INCLUDE MAJOR DENTAL INSURANCE, DENTI-CAL/MEDICAL, COUNTY MEDICAL SERVIES PROGRAM (CMSP), HEALTH FAMILIES DELTA DENTAL/PREMIER ACCESS, AND SLIDING FEE SCALE. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $333,904 | ExpenseAmt |
| Revenue | $341,428 | RevenueAmt |
| Desc | BEHAVIORAL HEALTH - STAFF CLINICAL PSYCHOLOGISTS ARE DEDICATED TO IMPROVING THE OVERALL QUALITY OF LIFE FOR CHILDREN, ADULTS AND FAMILIES BY PROVIDING TIME-TESTED AND SKILLS BASED TREATMENTS. QUALIFIED TECHNIQUES ARE USED TO FOSTER A GREATER SENSE OF PEACE AND WELL-BEING.BEHAVIORAL HEALTH SERVICES OF THE HUMAN CONDITION TO INCLUDE BUT NOT LIMITED TO - DEPRESSION, ANXIETY, ADHD, SUBSTANCE USE, COUPLE'S THERAPY, AND TRAUMA RESOLUTION. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $2,600,791 | 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 | Yes (1) | 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 | 0 | 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 | 32 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 50 | 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 |
| 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 | 0 | 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 | FABIOLA CORNEJO-PEREZ | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7078953477 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 13500 AIRPORT ROAD | AddressLine1Txt |
| City | BOONVILLE | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95415 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|
| RICHARD C BONNER | ||||||||
| CHAIR PERSON | 5.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| ERIC LABOWITZ | ||||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| KATHLEEN COX | ||||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| HEIDI KNOTT GUNDLING | ||||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| ELISABETH VEGA | ||||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| CLAY EUBANK | ||||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| LUCY PLANCARTE | ||||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| AUTUMN EHNOW | ||||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| IVAN JIMENEZ | ||||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| XIMENA FLORES | ||||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| ERIN CHLOE GUAZZONE RUGEBREGT | ||||||||
| EXECUTIVE DIRECTOR | 40.00 | Yes (X) | $137,741 | $0 | $0 | |||
| CINDY NOVELLA | ||||||||
| MEDICAL DIRECTOR | 40.00 | Yes (X) | $129,396 | $0 | $0 | |||
| FABIOLA PEREZ | ||||||||
| OPERATIONS DIRECTOR | 40.00 | Yes (X) | $103,803 | $0 | $0 | |||
| DREW COLFAX | ||||||||
| VICE CHAIR | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| JAMES JR COLLINS | ||||||||
| TREASURER | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| MAUREEN HOCHBERG | ||||||||
| SECRETARY | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| JOHN A ROCHAT | ||||||||
| PHYSICIAN | 40.00 | $158,304 | $0 | $0 | Yes (X) | |||
| MARK APFEL | ||||||||
| FORMER PHYSICIAN | 40.00 | $171,556 | $0 | $0 | Yes (X) | |||
| JESSICA MCININCH | ||||||||
| FORMER PSYCHOLOGIST | 40.00 | $129,210 | $0 | $0 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $830,010 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $0 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 6 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (3 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| WIPFLI LLP | |||||
| PO BOX 3160 | MILWAUKEE | WI | 53201 | ACCOUNTING SERVICES | $239,626 |
| MEDICUS IT | |||||
| 100 NORTH POINT CENTER EAST STE 15 | ALPHARETTA | GA | 30022 | COMPUTER IT SUPPORT | $116,347 |
| THE WRITE CHOICE NETWORK LLC | |||||
| 2205 LUNDY LANE | BETTENDORF | IA | 52722 | CONSULTING FEES | $104,837 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 3 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $3,705,285 | GovernmentGrantsAmt |
| All Other Contributions | $1,346,896 | AllOtherContributionsAmt |
| Noncash Contributions | $10,863 | NoncashContributionsAmt |
| Total Contributions | $5,052,181 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT SERVICE REVENU | Desc |
| Business | 624100 | BusinessCd |
| Total Revenue Column | $2,142,367 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $2,142,367 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $2,142,367 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $7,513 | TotalRevenueColumnAmt |
| Exclusion | $7,513 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $6,000 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $6,000 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $6,000 | TotalRevenueColumnAmt |
| Exclusion | $6,000 | ExclusionAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $14,254 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$14,254 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$14,254 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | -$14,254 | RelatedOrExemptFuncIncomeAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| REBATE | 900099 | $10,667 | $10,667 |
| OTHER INCOME | 900099 | $2,285 | $2,285 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $12,952 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $7,206,759 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $2,128,113 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $26,465 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $137,741 | TotalAmt |
| Management And General | $137,741 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,034,727 | TotalAmt |
| Program Services | $1,415,982 | ProgramServicesAmt |
| Management And General | $618,745 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $545,901 | TotalAmt |
| Program Services | $348,453 | ProgramServicesAmt |
| Management And General | $197,448 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $251,839 | TotalAmt |
| Program Services | $96 | ProgramServicesAmt |
| Management And General | $251,743 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $104,058 | TotalAmt |
| Program Services | $48,267 | ProgramServicesAmt |
| Management And General | $55,791 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $31,022 | TotalAmt |
| Program Services | $515 | ProgramServicesAmt |
| Management And General | $30,507 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $47,990 | TotalAmt |
| Program Services | $28,229 | ProgramServicesAmt |
| Management And General | $19,761 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $169,117 | TotalAmt |
| Program Services | $150,745 | ProgramServicesAmt |
| Management And General | $18,372 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,377 | TotalAmt |
| Program Services | $5,466 | ProgramServicesAmt |
| Management And General | $14,911 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| PURCHASED SERVICES | $848,673 | $359,333 | $489,340 |
| SUPPLIES | $215,086 | $176,457 | $38,629 |
| OTHER | $165,574 | $47,586 | $117,988 |
| THEFT | $52,564 | $52,564 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $104,788 | TotalAmt |
| Program Services | $19,662 | ProgramServicesAmt |
| Management And General | $85,126 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,729,457 | TotalAmt |
| Program Services | $2,600,791 | ProgramServicesAmt |
| Management And General | $2,128,666 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,425,689 | BOYAmt |
| EOY | $2,590,986 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $669,829 | BOYAmt |
| EOY | $417,663 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $211,898 | BOYAmt |
| EOY | $205,048 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $400,000 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,085 | BOYAmt |
| EOY | $58,808 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $7,848,443 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,868,220 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,521,955 | BOYAmt |
| EOY | $5,980,223 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,859,456 | BOYAmt |
| EOY | $9,652,728 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $471,466 | BOYAmt |
| EOY | $824,796 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $798,104 | BOYAmt |
| EOY | $785,643 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,269,570 | BOYAmt |
| EOY | $1,610,439 | 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 | $5,555,781 | BOYAmt |
| EOY | $7,936,809 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $34,105 | BOYAmt |
| EOY | $105,480 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,589,886 | BOYAmt |
| EOY | $8,042,289 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,859,456 | BOYAmt |
| EOY | $9,652,728 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $2,477,302 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $683 | NetUnrlzdGainsLossesInvstAmt |
| Prior Period Adjustments | -$25,582 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| 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) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,768,537 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,988,841 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,582,280 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,444,955 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $5,052,181 | CurrentTaxYearAmt |
| Total | $14,836,794 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $1,768,537 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,988,841 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $2,582,280 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,444,955 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $5,052,181 | CurrentTaxYearAmt |
| Total | $14,836,794 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $14,836,794 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $82,924 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $78,729 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $28,093 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $18,492 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $7,512 | CurrentTaxYearAmt |
| Total | $215,750 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $15,052,544 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $4,338,147 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.98570 | PublicSupportCY170Pct |
| Public Support PY170 | 0.98040 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
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 | $242,743 | OtherCostOrOtherBasisAmt |
| Book Value | $242,743 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,222,980 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,515,408 | DepreciationAmt |
| Book Value | $2,707,572 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $11,692 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,162 | DepreciationAmt |
| Book Value | $6,530 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $531,098 | OtherCostOrOtherBasisAmt |
| Depreciation | $347,650 | DepreciationAmt |
| Book Value | $183,448 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,839,930 | OtherCostOrOtherBasisAmt |
| Book Value | $2,839,930 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $5,980,223 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $7,221,698 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $683 | NetUnrealizedGainsInvstAmt |
| Other Revenue | $14,256 | OtherRevenueAmt |
| Revenue Not Reported | $14,939 | RevenueNotReportedAmt |
| Revenue Subtotal | $7,206,759 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $7,206,759 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $4,743,713 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $14,256 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $14,256 | ExpensesNotReportedAmt |
| Expenses Subtotal | $4,729,457 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $4,729,457 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | THE HEALTH CENTER HAS BEEN RECOGNIZED AS A NOT-FOR-PROFIT ORGANIZATION UNDER INTERNAL REVENUE CODE SECTION 501(C)3 AND CALIFORNIA REVENUE CODE SECTION 23701(D) AND IS EXEMPT FROM FEDERAL AND CALIFORNIA INCOME TAXES ON RELATED INCOME FOR THE YEARS ENDED JUNE 30, 2022 AND 2021. EFFECTIVE JULY 1, 2009, THE CENTER ADOPTED NEWLY ISSUED GUIDANCE ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES. UNDER THIS NEW GUIDANCE, THE CENTER UTILIZES A TWO-STEP APPROACH TO RECOGNIZING AND MEASURING UNCERTAIN TAX POSITIONS. THE FIRST STEP IS TO EVALUATE THE TAX POSITION FOR RECOGNITION BY DETERMINING IF THE WEIGHT OF AVAILABLE EVIDENCE INDICATES IT IS MORE LIKELY THAN NOT THAT, THE POSITION WILL BE SUSTAINED ON AUDIT, INCLUDING RESOLUTION OF RELATED APPEALS OR LITIGATION PROCESSES. THE SECOND STEP IS TO MEASURE THE TAX BENEFIT AS THE LARGEST AMOUNT, WHICH IS MORE THAN 50% LIKELY OF BEING REALIZED UPON ULTIMATE SETTLEMENT. ADOPTION OF SUCH GUIDANCE DID NOT HAVE A MATERIAL EFFECT TO THE FINANCIAL STATEMENTS. AT JUNE 30, 2022 AND 2021, THERE WERE NO UNCERTAIN TAX POSITIONS. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | LOSS ON DISPOSAL OF ASSETS 14,256. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | LOSS ON DISPOSAL OF ASSETS 14,256. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| 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 (3 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MARK APFEL | ||||||||||||||
| FORMER PHYSICIAN | $171,556 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $171,556 | $0 | $0 | $0 |
| JOHN A ROCHAT | ||||||||||||||
| PHYSICIAN | $158,304 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $158,304 | $0 | $0 | $0 |
| JESSICA MCININCH | ||||||||||||||
| FORMER PSYCHOLOGIST | $129,210 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $129,210 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 3 | FormAndLineReferenceDesc |
| Explanation | THE PROCESS OF DETERMING COMPENSATION FOR ANDERSON VALLEY HEALTH CENTER'S TOP MANAGEMENT AND KEY EMPLOYEES INVOLVES OUR HUMAN RESOURCES DEPARTMENT. IT IS BASED ON A NUMBER OF CONSIDERATIONS SUCH AS THE NATURE AND SCOPE OF INDIVIDUAL DUTIES, BACKGROUND, EXPERTISE, SIZE, COMPLEXITY OF ORGANIZATION, AND AMOUNT PAID BY SIMILAR ORGANIZATIONS OF SIMILAR SIZE AND TYPE. HUMAN RESOURCES ROUTINELY CONDUCTS SALARY SURVEYS AND PERFORMS ASSESSMENTS OF THE JOB MARKET. THE FINAL DECISION RESTS WITH THE GOVERNING BOARD WHEN THE ANNUAL CORPORATE BUDGET IS REVIEWED AND APPROVED FOR ADOPTION. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 IS SUBMITTED TO THE BOARD OF DIRECTORS AND MANAGEMENT FOR REVIEW. UPON FINAL APPROVAL, THE FORM IS FINALIZED AND SUBMITTED TO THE INTERNAL REVENUE SERVICE. |
| FORM 990, PART VI, SECTION B, LINE 12C | ANDERSON VALLEY HEALTH CENTER MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY BY HAVING A CORPORATE COMPLIANCE COMMITTEE ACTIVELY AND PERIODICALLY PERFORMING AUDITS TO ENSURE COMPLIANCE. STAFF ARE TRAINED ANNUALLY TO REMIND THEM OF THEIR ONGOING OBLIGATION TO REPORT ANY INCIDENT OF FRAUD OR CONFLICT OF INTEREST. THERE IS A HOTLINE TO CALL WHERE THEY CAN REMAIN ANONYMOUS. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE PROCESS OF DETERMING COMPENSATION FOR ANDERSON VALLEY HEALTH CENTER'S TOP MANAGEMENT AND KEY EMPLOYEES INVOLVES OUR HUMAN RESOURCES DEPARTMENT. IT IS BASED ON A NUMBER OF CONSIDERATIONS SUCH AS THE NATURE AND SCOPE OF INDIVIDUAL DUTIES, BACKGROUND, EXPERTISE, SIZE, COMPLEXITY OF ORGANIZATION, AND AMOUNT PAID BY SIMILAR ORGANIZATIONS OF SIMILAR SIZE AND TYPE. HUMAN RESOURCES ROUTINELY CONDUCTS SALARY SURVEYS AND PERFORMS ASSESSMENTS OF THE JOB MARKET. THE FINAL DECISION RESTS WITH THE GOVERNING BOARD WHEN THE ANNUAL CORPORATE BUDGET IS REVIEWED AND APPROVED FOR ADOPTION. |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENTS, POLICIES AND FINANCIAL STATEMENTS ARE FURNISHED UPON REQUEST. |
| FORM 990, PART XII, LINE 2C: | ALL REVIEW AND PROCESS FOR THE OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT AUDITOR REMAINS CONSISTENT BETWEEN YEARS. |