2023-05-15T19:27:19-05:00 2022-06-30 464016990 THE PUN GROUP LLP 200 E SANDPOINTE AVENUE SUITE 600 SANTA ANA CA 92707 990 2021-07-01 942347424 ANDERSON VALLEY HEALTH CENTER INC ANDE 7078953477 13500 AIRPORT ROAD BOONVILLE CA 954150338 CHLOE GUAZZONE-RUGEBREGT EXECUTIVE DIRECTOR 7078953477 2023-05-15 CHLOE GUAZZONE-RUGEBREGT 999009999 KENNETH HPUN P01443751 9497778800 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z ERIN CHLOE GUAZZONE RUGEB 13500 AIRPORT ROAD BOONVILLE CA 95415 7221013 0 X WWW.AVHC.ORG X 1977 CA 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. 10 10 50 0 0 0 3442928 5052181 2030368 2142367 6707 -6741 22704 18952 5502707 7206759 0 0 0 0 2666132 2718369 30000 0 0 1576982 2011088 4273114 4729457 1229593 2477302 6859456 9652728 1269570 1610439 5589886 8042289 X 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. 0 0 1677228 1401955 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. 589659 384730 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. 333904 341428 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. 2600791 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 32 0 1 50 1 0 0 0 0 0 0 0 0 0 0 X 10 10 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X FABIOLA CORNEJO-PEREZ 7078953477 13500 AIRPORT ROAD BOONVILLE CA 95415 RICHARD C BONNER CHAIR PERSON 5.00 X X 0 0 0 ERIC LABOWITZ BOARD MEMBER 2.00 X 0 0 0 KATHLEEN COX BOARD MEMBER 2.00 X 0 0 0 HEIDI KNOTT GUNDLING BOARD MEMBER 2.00 X 0 0 0 ELISABETH VEGA BOARD MEMBER 2.00 X 0 0 0 CLAY EUBANK BOARD MEMBER 2.00 X 0 0 0 LUCY PLANCARTE BOARD MEMBER 2.00 X 0 0 0 AUTUMN EHNOW BOARD MEMBER 2.00 X 0 0 0 IVAN JIMENEZ BOARD MEMBER 2.00 X 0 0 0 XIMENA FLORES BOARD MEMBER 2.00 X 0 0 0 ERIN CHLOE GUAZZONE RUGEBREGT EXECUTIVE DIRECTOR 40.00 X 137741 0 0 CINDY NOVELLA MEDICAL DIRECTOR 40.00 X 129396 0 0 FABIOLA PEREZ OPERATIONS DIRECTOR 40.00 X 103803 0 0 DREW COLFAX VICE CHAIR 2.00 X 0 0 0 JAMES JR COLLINS TREASURER 2.00 X 0 0 0 MAUREEN HOCHBERG SECRETARY 2.00 X 0 0 0 JOHN A ROCHAT PHYSICIAN 40.00 X 158304 0 0 MARK APFEL FORMER PHYSICIAN 40.00 X 171556 0 0 JESSICA MCININCH FORMER PSYCHOLOGIST 40.00 X 129210 0 0 830010 0 0 6 1 1 0 WIPFLI LLP PO BOX 3160 MILWAUKEE WI 53201 ACCOUNTING SERVICES 239626 MEDICUS IT 100 NORTH POINT CENTER EAST STE 15 ALPHARETTA GA 30022 COMPUTER IT SUPPORT 116347 THE WRITE CHOICE NETWORK LLC 2205 LUNDY LANE BETTENDORF IA 52722 CONSULTING FEES 104837 3 3705285 1346896 10863 5052181 PATIENT SERVICE REVENU 624100 2142367 2142367 2142367 7513 7513 6000 0 6000 6000 6000 14254 -14254 -14254 -14254 REBATE 900099 10667 10667 OTHER INCOME 900099 2285 2285 12952 7206759 2128113 0 26465 137741 137741 2034727 1415982 618745 545901 348453 197448 251839 96 251743 104058 48267 55791 31022 515 30507 47990 28229 19761 169117 150745 18372 20377 5466 14911 PURCHASED SERVICES 848673 359333 489340 SUPPLIES 215086 176457 38629 OTHER 165574 47586 117988 THEFT 52564 52564 104788 19662 85126 4729457 2600791 2128666 0 2425689 2590986 669829 417663 211898 205048 400000 30085 58808 7848443 1868220 3521955 5980223 6859456 9652728 471466 824796 798104 785643 1269570 1610439 X 5555781 7936809 34105 105480 5589886 8042289 6859456 9652728 2477302 683 -25582 0 X X 0 1 X 1 1 1 X 1768537 1988841 2582280 3444955 5052181 14836794 1768537 1988841 2582280 3444955 5052181 14836794 14836794 82924 78729 28093 18492 7512 215750 15052544 4338147 0.98570 0.98040 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 242743 242743 4222980 1515408 2707572 11692 5162 6530 531098 347650 183448 2839930 2839930 5980223 X 7221698 683 14256 14939 7206759 0 7206759 4743713 14256 14256 4729457 0 4729457 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. X X 0 0 0 0 0 0 0 0 0 MARK APFEL FORMER PHYSICIAN 171556 0 0 0 0 0 0 0 0 0 171556 0 0 0 JOHN A ROCHAT PHYSICIAN 158304 0 0 0 0 0 0 0 0 0 158304 0 0 0 JESSICA MCININCH FORMER PSYCHOLOGIST 129210 0 0 0 0 0 0 0 0 0 129210 0 0 0 PART I, LINE 3 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 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.