SAC HEALTH SYSTEM: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- SAC HEALTH SYSTEM (EIN 33-0664371)
- Tax period
- 2021-07-01 to 2022-06-30
- Filed
- 2023-09-12
- IRS object ID
- 202302559349301320
- Schema version
- 2021v4.2
- Note
- A later return for the same period supersedes this one.
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule G
- Schedule I
- Schedule J
- Schedule M
- Schedule O
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-09-12T12:03:09-05:00 | ReturnTs |
| Tax Period End | 2022-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 410746749 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10700 NORTHUP WAY SUITE 200 | AddressLine1Txt |
| City | BELLEVUE | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98004 | 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 | 330664371 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SAC HEALTH SYSTEM | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | SACH | BusinessNameControlTxt |
| Phone | 9092599113 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 250 S G STREET | AddressLine1Txt |
| City | SAN BERNARDINO | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 92410 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JORDAN URBAN | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 9092599113 | PhoneNum |
| Signature | 2023-09-09 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | JORDAN | PersonFirstNm |
| Person Last | URBAN | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KURT J BENNION CPA | PreparerPersonNm |
| PTIN | P01469618 | PTIN |
| Phone | 4252506100 | PhoneNum |
| Preparation | 2023-08-14 | 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) |
|---|---|---|
| Amended Return | Yes (X) | AmendedReturnInd |
| Principal Officer | JASON LOHR | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 250 S G STREET | AddressLine1Txt |
| City | SAN BERNARDINO | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 92410 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $128,405,105 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.SACHEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1995 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | PROVIDE COMMUNITIES WITH PRIMARY HEALTH CARE SERVICES, DENTAL CARE & BEHAVIORAL HEALTH SERVICES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 13 | VotingMembersIndependentCnt |
| Total Employee | 580 | TotalEmployeeCnt |
| Total Volunteers | 15 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $19,016,024 | PYContributionsGrantsAmt |
| CY Contributions Grants | $20,791,990 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $48,099,571 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $105,746,740 | CYProgramServiceRevenueAmt |
| PY Investment Income | $5,045 | PYInvestmentIncomeAmt |
| CY Investment Income | $8,040 | CYInvestmentIncomeAmt |
| PY Other Revenue | $2,822,568 | PYOtherRevenueAmt |
| CY Other Revenue | $1,858,335 | CYOtherRevenueAmt |
| PY Total Revenue | $69,943,208 | PYTotalRevenueAmt |
| CY Total Revenue | $128,405,105 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $5,250 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $61,362 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $34,566,036 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $39,391,126 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $104,160 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $153,135 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $153,135 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $34,227,327 | PYOtherExpensesAmt |
| CY Other Expenses | $43,121,420 | CYOtherExpensesAmt |
| PY Total Expenses | $68,902,773 | PYTotalExpensesAmt |
| CY Total Expenses | $82,727,043 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,040,435 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $45,678,062 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $20,750,511 | TotalAssetsBOYAmt |
| Total Assets EOY | $65,694,940 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $13,566,135 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $12,326,631 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $7,184,376 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $53,368,309 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO REFLECT THE HEALING MINISTRY AND LOVE OF JESUS CHRIST THROUGH HEALTHCARE, EDUCATION, AND PARTNERSHIPS THAT EMPOWER OUR COMMUNITIES TO FLOURISH. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $62,084,974 | ExpenseAmt |
| Grant | $61,362 | GrantAmt |
| Revenue | $97,705,630 | RevenueAmt |
| Desc | SACHS IS COMMITTED TO PROVIDING ACCESSIBLE INTEGRATED HEALTHCARE (I.E. MEDICAL, DENTAL & BEHAVIORAL HEALTH) TO ALL THOSE IN NEED IN THE SAN BERNARDINO COUNTY. SACHS EMPOWERS FAMILIES TO LIVE VIBRANT AND HEALTHY LIVES THROUGH THE DELIVERY OF CULTURALLY SENSITIVE AND HIGH QUALITY, COMPREHENSIVE SERVICES. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $4,105,152 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $0 | RevenueAmt |
| Desc | TEACHING HEALTH CENTER GRADUATE MEDICAL EDUCATION - HRSA FUNDED PRIMARY CARE RESIDENCY PROGRAMS WHICH INCLUDE FAMILY MEDICINE, INTERNAL MEDICINE, OB & GYN, PSYCHIATRY. IT HELPS BUILD HEALTHY COMMUNITIES BY SUPPORTING QUALIFIED HEALTHCARE PROVIDERS DEDICATED TO WORKING IN EDUCATION EXPENSES FOR TRAINING RESIDENTS IN NEW OR EXPANDING COMMUNITY BASED PRIMARY CARE RESIDENCY PROGRAMS. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $2,313,962 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $8,041,110 | RevenueAmt |
| Desc | IEHP'S BEHAVIORAL HEALTH INTEGRATION & COMPLEX CARE INITIATIVE GRANT - THE GRANT'S OBJECTIVE IS TO TRANSFORM PROVIDER'S CLINICAL PRACTICES IN 5 KEY AREAS WHICH INCLUDES ASSESSMENT PROCESSES, CARE PLANNING, SERVICE DELIVERY PRACTICES, POPULATION HEALTH CARE MANAGEMENT & HEALTH PROMOTION/PATIENT EXPERIENCE. IT SUPPORTS PRIMARY & BEHAVIORAL HEALTH CARE INTEGRATION (I.E. TEAM BASED CARE). THE GRANT PAYS FOR PERSONNEL INVOLVED IN THE OPERATION OF THE GRANT, AS WELL AS INDIRECT EXPENSES SUCH AS OFFICE SUPPLIES. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $2,878,251 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $0 | RevenueAmt |
| Desc | HRSA FULL 330 HEALTH CENTER PROGRAM GRANT. SACHS IS A FEDERALLY QUALIFIED HEALTH CENTER (FQHC) RECEIVING A GRANT UNDER SECTION 330 OF THE PUBLIC HEALTH SERVICE (PHS) ACT (42 UNITED STATES CODE SECTION 254A). FQHCS ARE PAID BASED ON THE FQHC PROSPECTIVE PAYMENT SYSTEM (PPS) FOR MEDICALLY-NECESSARY PRIMARY HEALTH SERVICES AND QUALIFIED PREVENTIVE HEALTH SERVICES FURNISHED BY AN FQHC PRACTITIONER. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $2,878,251 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Grant | $0 | TotalOtherProgSrvcGrantAmt |
| Total Other Prog Srvc Revenue | $0 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $71,382,339 | 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 | Yes (1) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | 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 | Yes (1) | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | Yes (1) | 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 | Yes (1) | 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 | 13 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 580 | 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 | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 13 | 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 | 0 | 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DEL DENISE MORENO | PersonNm |
| Phone | 9092599113 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 250 S G STREET | AddressLine1Txt |
| City | SAN BERNARDINO | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 92410 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (26 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|---|
| DR JASON LOHR | ||||||||
| PRESIDENT & CEO | 40.00 | Yes (X) | $379,475 | $0 | $67,966 | |||
| JUNE SULLIVAN | ||||||||
| CHIEF PEOPLE OFFICER (THROUGH SEP 2021) | 40.00 | $348,958 | $0 | $39,168 | Yes (X) | |||
| GERRARD GIER | ||||||||
| CIO | 40.00 | Yes (X) | $235,199 | $0 | $40,205 | |||
| LEE PODOLL | ||||||||
| CHIEF BUSINESS STRATEGY OFFICER | 40.00 | $202,738 | $0 | $59,637 | Yes (X) | |||
| DR MARYELLEN WESTERBERG | ||||||||
| COO | 40.00 | Yes (X) | $226,800 | $0 | $34,326 | |||
| JOHN SKELTON | ||||||||
| CFO | 40.00 | Yes (X) | $211,419 | $0 | $34,129 | |||
| YVETTE FELIPE | ||||||||
| DENTIST | 40.00 | $174,348 | $0 | $42,407 | Yes (X) | |||
| JOEL UMALI | ||||||||
| DIRECTOR DENTAL CLINIC | 40.00 | $157,133 | $0 | $52,056 | Yes (X) | |||
| MICHAEL CONRAD | ||||||||
| NURSE PRACTITIONER | 40.00 | $152,376 | $0 | $37,319 | Yes (X) | |||
| OSCAR LOPEZ | ||||||||
| DENTIST | 40.00 | $147,850 | $0 | $33,633 | Yes (X) | |||
| LADONNA OELSCHLAEGER | ||||||||
| CI PHARM CQ PRGRM MGR | 40.00 | $151,842 | $0 | $14,357 | Yes (X) | |||
| RODNEY NEAL | ||||||||
| BOARD CHAIR | 0.80 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| RAUL CASTILLO | ||||||||
| BOARD CO-CHAIR | 0.80 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| OLU TOMI DANIEL | ||||||||
| BOARD SECRETARY | 0.80 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| ANN ATKINSON | ||||||||
| BOARD MEMBER | 0.50 | $0 | $0 | $0 | Yes (X) | |||
| PETER BAKER | ||||||||
| BOARD MEMBER | 0.50 | $0 | $0 | $0 | Yes (X) | |||
| JESSICA GARCIA | ||||||||
| BOARD MEMBER | 0.50 | $0 | $0 | $0 | Yes (X) | |||
| DR RICHARD HART | ||||||||
| BOARD MEMBER | 0.50 | $0 | $0 | $0 | Yes (X) | |||
| DR MARILYN HERRMANN | ||||||||
| BOARD MEMBER | 0.50 | $0 | $0 | $0 | Yes (X) | |||
| MATT LIST | ||||||||
| BOARD MEMBER (THROUGH OCTOBER 2021) | 0.50 | $0 | $0 | $0 | Yes (X) | |||
| LUISA LOUBRIEL | ||||||||
| BOARD MEMBER | 0.50 | $0 | $0 | $0 | Yes (X) | |||
| PAT MORRIS | ||||||||
| BOARD MEMBER | 0.50 | $0 | $0 | $0 | Yes (X) | |||
| DR ERIC NGO | ||||||||
| BOARD MEMBER | 0.50 | $0 | $0 | $0 | Yes (X) | |||
| KEN RAMIREZ | ||||||||
| BOARD MEMBER | 0.50 | $0 | $0 | $0 | Yes (X) | |||
| MAGDALENA WIESNER | ||||||||
| BOARD MEMBER | 0.50 | $0 | $0 | $0 | Yes (X) | |||
| ELAINE ZUCCO | ||||||||
| BOARD MEMBER (THROUGH JULY 2021) | 0.50 | $0 | $0 | $0 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,388,138 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $455,203 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 39 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| FACULTY PHYSICIANS & SURGEONS OF LLUSM | |||||
| 350 E COMMERCIAL RD 101 | SAN BERNARDINO | CA | 92408 | PHYSICIAN SERVICES | $13,958,616 |
| LLU HEALTH EDUCATION CONSORTIUM | |||||
| 11165 MOUNTAIN VIEW AVE | LOMA LINDA | CA | 92350 | RESIDENTS CONTRACTOR | $3,718,751 |
| 518 MEDICAL PROFESSIONALS | |||||
| PO BOX 910569 | SAN DIEGO | CA | 921910569 | PROFESSIONAL STAFFING SERVICES | $1,058,119 |
| 7 LAYER IT SOLUTIONS INC | |||||
| 8921 FULLBRIGHT AVE | CHATSWORTH | CA | 91311 | TECH SUPPORT SERVICES | $1,039,123 |
| ALLIED UNIVERSAL SECURITY SERVICES | |||||
| PO BOX 31001-2374 | PASADENA | CA | 911102374 | SECURITY SERVICES | $606,165 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 23 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $15,766,408 | GovernmentGrantsAmt |
| All Other Contributions | $5,025,582 | AllOtherContributionsAmt |
| Noncash Contributions | $3,148,422 | NoncashContributionsAmt |
| Total Contributions | $20,791,990 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT CARE REVENUE | 621400 | $97,409,611 | $97,409,611 |
| CAPITATION REVENUE | 621400 | $8,337,129 | $8,337,129 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $105,746,740 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $8,040 | TotalRevenueColumnAmt |
| Exclusion | $8,040 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OTHER INCOME | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $1,858,335 | TotalRevenueColumnAmt |
| Exclusion | $1,858,335 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $1,858,335 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $128,405,105 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $105,746,740 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,866,375 | 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 | $61,362 | TotalAmt |
| Program Services | $61,362 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,328,814 | TotalAmt |
| Management And General | $2,328,814 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,110,069 | TotalAmt |
| Program Services | $14,252,877 | ProgramServicesAmt |
| Management And General | $12,857,192 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,653,005 | TotalAmt |
| Program Services | $956,557 | ProgramServicesAmt |
| Management And General | $696,448 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,070,072 | TotalAmt |
| Program Services | $3,149,518 | ProgramServicesAmt |
| Management And General | $2,920,554 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,229,166 | TotalAmt |
| Program Services | $1,120,567 | ProgramServicesAmt |
| Management And General | $1,108,599 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $482,204 | TotalAmt |
| Program Services | $13,500 | ProgramServicesAmt |
| Management And General | $468,704 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $37,660 | TotalAmt |
| Management And General | $37,660 | ManagementAndGeneralAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $153,135 | TotalAmt |
| Fundraising | $153,135 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,324,011 | TotalAmt |
| Program Services | $20,743,808 | ProgramServicesAmt |
| Management And General | $5,580,203 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,128,931 | TotalAmt |
| Program Services | $327,294 | ProgramServicesAmt |
| Management And General | $801,637 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,263,413 | TotalAmt |
| Program Services | $92,693 | ProgramServicesAmt |
| Management And General | $1,170,720 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,176,407 | TotalAmt |
| Program Services | $4,771,338 | ProgramServicesAmt |
| Management And General | $1,405,069 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $93,001 | TotalAmt |
| Program Services | $49,567 | ProgramServicesAmt |
| Management And General | $43,434 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $270,997 | TotalAmt |
| Program Services | $14,294 | ProgramServicesAmt |
| Management And General | $256,703 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $674,252 | TotalAmt |
| Program Services | $355,531 | ProgramServicesAmt |
| Management And General | $318,721 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $370,132 | TotalAmt |
| Program Services | $4,194 | ProgramServicesAmt |
| Management And General | $365,938 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $5,084,614 | $4,970,784 | $113,830 |
| EQUIPMENT | $475,157 | $124,345 | $350,812 |
| OTHER EXPENSES | $368,302 | $13,123 | $355,179 |
| DUES & SUBSCRIPTIONS | $132,468 | $27,755 | $104,713 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $239,871 | TotalAmt |
| Program Services | $20,333,232 | ProgramServicesAmt |
| Management And General | -$20,093,361 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $82,727,043 | TotalAmt |
| Program Services | $71,382,339 | ProgramServicesAmt |
| Management And General | $11,191,569 | ManagementAndGeneralAmt |
| Fundraising | $153,135 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,971,827 | BOYAmt |
| EOY | $12,281,308 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $642,159 | BOYAmt |
| EOY | $819,500 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,774,699 | BOYAmt |
| EOY | $3,423,943 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,544,094 | BOYAmt |
| EOY | $6,387,354 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $514,653 | BOYAmt |
| EOY | $586,930 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $58,366 | BOYAmt |
| EOY | $65,729 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $339,307 | BOYAmt |
| EOY | $617,837 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $10,755,370 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $4,893,680 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,315,318 | BOYAmt |
| EOY | $5,861,690 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $590,088 | BOYAmt |
| EOY | $35,650,649 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,750,511 | BOYAmt |
| EOY | $65,694,940 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,191,519 | BOYAmt |
| EOY | $5,335,713 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,132,080 | BOYAmt |
| EOY | $1,225,324 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $338,268 | BOYAmt |
| EOY | $211,760 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,903,668 | BOYAmt |
| EOY | $5,553,834 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $600 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,566,135 | BOYAmt |
| EOY | $12,326,631 | 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 | $6,786,674 | BOYAmt |
| EOY | $52,537,038 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $397,702 | BOYAmt |
| EOY | $831,271 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,184,376 | BOYAmt |
| EOY | $53,368,309 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $20,750,511 | BOYAmt |
| EOY | $65,694,940 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $45,678,062 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $58,130 | NetUnrlzdGainsLossesInvstAmt |
| Prior Period Adjustments | $447,741 | 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 |
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
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $134,372 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $12,620 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $146,992 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $127,906 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $6,466 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $134,372 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $122,643 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $5,263 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $127,906 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $74,782 | BeginningYearBalanceAmt |
| Contributions | $43,615 | ContributionsAmt |
| Investment Earnings Or Losses | $4,246 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $122,643 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $70,216 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $4,566 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $74,782 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.00000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.10000 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.90000 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $399,311 | OtherCostOrOtherBasisAmt |
| Book Value | $399,311 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,386,062 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,456,912 | DepreciationAmt |
| Book Value | $2,929,150 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $10,700 | OtherCostOrOtherBasisAmt |
| Depreciation | $10,700 | DepreciationAmt |
| Book Value | $0 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,997,584 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,426,068 | DepreciationAmt |
| Book Value | $1,571,516 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $961,713 | OtherCostOrOtherBasisAmt |
| Book Value | $961,713 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $5,861,690 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| ESTIMATED THIRD PARTY SETTLEMENT | $35,595,562 |
| DEPOSITS | $55,087 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $35,650,649 | TotalBookValueOtherAssetsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $129,309,666 | TotalRevEtcAuditedFinclStmtAmt |
| Donated Services And Use Fclts | $900,000 | DonatedServicesAndUseFcltsAmt |
| Other Revenue | $17,281 | OtherRevenueAmt |
| Revenue Not Reported | $917,281 | RevenueNotReportedAmt |
| Revenue Subtotal | $128,392,385 | RevenueSubtotalAmt |
| Other Revenues Not Included | $12,720 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $12,720 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $128,405,105 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $83,627,043 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $900,000 | DonatedServicesUseFcltsAmt |
| Expenses Not Reported | $900,000 | ExpensesNotReportedAmt |
| Expenses Subtotal | $82,727,043 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $82,727,043 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART V, LINE 4: | THE ENDOWMENT'S PRINCIPAL MAY NOT BE SPENT, BUT THE INCOME CAN BE EXPENDED AS OPERATING FUNDS FOR THE SACHS CLINICS. |
| PART X, LINE 2: | THE ORGANIZATION IS A PRIVATE NONPROFIT CORPORATION ORGANIZED UNDER THE LAWS OF THE STATE OF CALIFORNIA. THE ORGANIZATION HAS BEEN DETERMINED TO BE EXEMPT FROM INCOME TAXES UNDER SECTION 501(C) (3) OF THE INTERNAL REVENUE CODE AND SECTION 23701(D) OF THE STATE OF CALIFORNIA REVENUE AND TAXATION CODE BY THE IRS AND FRANCHISE TAX BOARD, RESPECTIVELY. ACCORDINGLY, NO PROVISION FOR INCOME TAXES IS INCLUDED IN THE ACCOMPANYING FINANCIAL STATEMENTS. THE ORGANIZATION FOLLOWS THE PROVISIONS OF FASB ASC 74010, INCOME TAXES, RELATING TO ACCOUNTING FOR UNCERTAIN TAX POSITIONS, WHICH HAS NO FINANCIAL STATEMENT IMPACT TO THE ORGANIZATION. THE ORGANIZATION RECOGNIZES THE TAX BENEFIT FROM UNCERTAIN TAX POSITIONS ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITIONS WILL BE SUSTAINED ON EXAMINATION BY THE TAX AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFIT IS MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. THERE WERE NO UNCERTAIN TAX POSITIONS AS OF JUNE 30, 2022 OR 2021. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | NET ASSETS RELEASED FROM RESTRICTIONS 17,281. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | CONTRIBUTIONS WITH DONOR RESTRICTIONS 12,720. |
Schedule G IRS990ScheduleG
| Field | Value | IRS element (for citing) |
|---|---|---|
| Solicitation Of Non Govt Grants | Yes (X) | SolicitationOfNonGovtGrantsInd |
| Solicitation Of Govt Grants | Yes (X) | SolicitationOfGovtGrantsInd |
| Agrmt Prof Fundraising Acty | Yes (1) | AgrmtProfFundraisingActyInd |
Fundraiser Activity Info FundraiserActivityInfoGrp
Organization Business Name OrganizationBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AM DEVELOPMENT GROUP | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10250 FARMINGTON STREET | AddressLine1Txt |
| City | OAK HILLS | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 92344 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Activity | CONSULTANT & GRANT WRITER | ActivityTxt |
| Fundraiser Control Of Funds | 0 | FundraiserControlOfFundsInd |
| Gross Receipts | $12,242,994 | GrossReceiptsAmt |
| Retained By Contractor | $153,135 | RetainedByContractorAmt |
| Net To Organization | $12,089,859 | NetToOrganizationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Gross Receipts | $12,242,994 | TotalGrossReceiptsAmt |
| Total Retained By Contractors | $153,135 | TotalRetainedByContractorsAmt |
| Total Net To Organization | $12,089,859 | TotalNetToOrganizationAmt |
| Licensed States | CA | LicensedStatesCd |
| Licensed States | MD | LicensedStatesCd |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Non Cash AssistanceNonCashAssistanceAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|---|
| LOMA LINDA CHILDREN'S HOSPITAL FOUNDATION | ||||||||
| 11234 ANDERSON STREET | LOMA LINDA | CA | 92354 | 330565591 | 501(C)(3) | $10,000 | $0 | DONATION TO 29TH ANNUAL FOUNDATION GALA |
| COACHELLA VALLEY RESCUE MISSION | ||||||||
| 47470 VAN BUREN | INDIO | CA | 92201 | 952684844 | 501(C)(3) | $33,962 | $0 | GENERAL OPERATING SUPPORT |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 2 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | PRIOR TO SPONSORING A LOCAL CHARITY, SAC HEALTH SYSTEM CONFIRMS THAT THE RECIPIENT IS A QUALIFIED CHARITABLE ORGANIZATION OR GOVERNMENTAL AGENCY. ALL SPONSORSHIPS ARE GIVEN FOR GENERAL OPERATING SUPPORT, SO NO FOLLOW-UP IS CONDUCTED. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Idemnification Gross Up Pmts | Yes (X) | IdemnificationGrossUpPmtsInd |
| Written Policy Ref T And E Expnss | Yes (1) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | 0 | SubstantiationRequiredInd |
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| 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 (11 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DR JASON LOHR | ||||||||||||||
| PRESIDENT & CEO | $377,875 | $0 | $1,600 | $0 | $0 | $0 | $30,698 | $0 | $37,268 | $0 | $447,441 | $0 | $0 | $0 |
| JUNE SULLIVAN | ||||||||||||||
| CHIEF PEOPLE OFFICER (THROUGH SEP 20 | $347,558 | $0 | $1,400 | $0 | $0 | $0 | $13,830 | $0 | $25,338 | $0 | $388,126 | $0 | $0 | $0 |
| GERRARD GIER | ||||||||||||||
| CIO | $233,799 | $0 | $1,400 | $0 | $0 | $0 | $18,054 | $0 | $22,151 | $0 | $275,404 | $0 | $0 | $0 |
| LEE PODOLL | ||||||||||||||
| CHIEF BUSINESS STRATEGY OFFICER | $201,138 | $0 | $1,600 | $0 | $0 | $0 | $16,493 | $0 | $43,144 | $0 | $262,375 | $0 | $0 | $0 |
| DR MARYELLEN WESTERBERG | ||||||||||||||
| COO | $225,200 | $0 | $1,600 | $0 | $0 | $0 | $18,263 | $0 | $16,063 | $0 | $261,126 | $0 | $0 | $0 |
| JOHN SKELTON | ||||||||||||||
| CFO | $209,819 | $0 | $1,600 | $0 | $0 | $0 | $17,083 | $0 | $17,046 | $0 | $245,548 | $0 | $0 | $0 |
| YVETTE FELIPE | ||||||||||||||
| DENTIST | $172,948 | $0 | $1,400 | $0 | $0 | $0 | $14,337 | $0 | $28,070 | $0 | $216,755 | $0 | $0 | $0 |
| JOEL UMALI | ||||||||||||||
| DIRECTOR DENTAL CLINIC | $155,733 | $0 | $1,400 | $0 | $0 | $0 | $11,409 | $0 | $40,647 | $0 | $209,189 | $0 | $0 | $0 |
| MICHAEL CONRAD | ||||||||||||||
| NURSE PRACTITIONER | $151,176 | $0 | $1,200 | $0 | $0 | $0 | $9,566 | $0 | $27,753 | $0 | $189,695 | $0 | $0 | $0 |
| OSCAR LOPEZ | ||||||||||||||
| DENTIST | $146,250 | $0 | $1,600 | $0 | $0 | $0 | $11,950 | $0 | $21,683 | $0 | $181,483 | $0 | $0 | $0 |
| LADONNA OELSCHLAEGER | ||||||||||||||
| CI PHARM CQ PRGRM MGR | $150,692 | $0 | $1,150 | $0 | $0 | $0 | $12,153 | $0 | $2,204 | $0 | $166,199 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 1A | FormAndLineReferenceDesc |
| Explanation | DURING 2021, THE ORGANIZATION GAVE HOLIDAY BONUSES OF $200 TO ALL EMPLOYEES AND THOSE BONUSES WERE GROSSED UP TO COVER TAXES. | ExplanationTxt |
Schedule M IRS990ScheduleM
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 52156 | ContributionCnt |
| Noncash Contributions Rpt F990 | $3,148,422 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | INVOICE PRICE | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8283 Received | 0 | Form8283ReceivedCnt |
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, COLUMN (B): | FormAndLineReferenceDesc |
| Explanation | THE NUMBER OF DONATED ITEMS RECEIVED DURING THE FISCAL YEAR IS REPORTED IN PART I, COLUMN B. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 1A | THE BOARD OF DIRECTORS HAS AN EXECUTIVE COMMITTEE CONSISTING OF THE BOARD'S CHAIR AND SECRETARY, AS WELL AS THE CHAIRS OF ALL STANDING COMMITTEES. THE AFFAIRS AND MANAGEMENT OF THE ORGANIZATION ARE SUPERVISED BY THE EXECUTIVE COMMITTEE, WHICH HAS POWER TO TRANSACT ALL REGULAR BUSINESS OF THE ORGANIZATION AND HAS THE FULL AUTHORITY OF THE BOARD DURING THE PERIOD BETWEEN MEETINGS OF THE BOARD, SUBJECT TO ANY PRIOR LIMITATIONS IMPOSED BY THE BOARD AND SUBJECT TO THE LIMITATIONS OF THE CALIFORNIA NONPROFIT PUBLIC BENEFIT CORPORATION LAW. ADDITIONALLY, EVERY TWO YEARS, THE EXECUTIVE COMMITTEE REVIEWS THE BYLAWS AND RECOMMENDS REVISIONS AS NECESSARY TO ENSURE COMPLIANCE WITH APPLICABLE STATUTES, REGULATIONS, LICENSING AND ACCREDITATION REQUIREMENTS. THE EXECUTIVE COMMITTEE ALSO RECOMMENDS TO THE BOARD NOMINEES FOR DIRECTORS AND MAY RECOMMEND NOMINEES FOR THE OFFICERS OF THE ORGANIZATION. THE ACTIONS OF THE EXECUTIVE COMMITTEE MUST NOT SUPERSEDE THE FULL HEALTH CENTER GOVERNING BOARD'S AUTHORITIES, FUNCTIONS AND RESPONSIBILITIES. |
| FORM 990, PART VI, SECTION A, LINE 3 | THE CHIEF OF ACADEMICS, CMO, AND ASSISTANT CMO ARE PROVIDED THROUGH A SERVICE AGREEMENT WITH FACULTY AND PHYSICIAN SERVICES OF LOMA LINDA UNIVERSITY, A SUBSIDIARY OF LOMA LINDA UNIVERSITY HEALTH. |
| FORM 990, PART VI, SECTION B, LINE 11B | PRIOR TO FILING THE IRS, THE FORM 990 WAS REVIEWED BY MANAGEMENT. A COPY WILL BE PROVIDED TO ANY BOARD MEMBER WHO REQUESTS IT. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE CHIEF PEOPLE OFFICER ANNUALLY OBTAINS STATEMENTS OF DISCLOSURE FROM BOARD MEMBERS, OFFICERS, ADMINISTRATORS, KEY EMPLOYEES AND OTHERS WHO MAKE OR AFFECT SIGNIFICANT DECISIONS AND REVIEWS THE FINDINGS WITH APPROPRIATE BOARDS AND COMMITTEES. THE BOARD MEMBERS MAKE THE DECISIONS REGARDING QUESTIONS WHICH HAVE NOT BEEN SATISFACTORILY ANSWERED AFTER ADMINISTRATIVE CONSIDERATION. AN INDIVIDUAL WITH A CONFLICT WOULD RECUSE THEM SELF FROM DISCUSSIONS, DECISION AND VOTE, ON ANY ISSUE FOR WHICH THE CONFLICT EXISTS. |
| FORM 990, PART VI, SECTION B, LINE 15 | SACHS HR DOES A COMPENSATION SURVEY FOR CEO, CFO, COO AND CIO PAY, AND BOARD APPROVES SALARY. DURING 2021, AN INDEPENDENT COMPENSATION CONSULTANT PROVIDED A COMPENSATION REVIEW FOR THE ORGANIZATION. THEY PROVIDED A MARKET RATE ANALYSIS OF EXECUTIVE PAY USING REGIONAL COMPARATIVE DATE AND RATES WERE RECOMMENDED FOR APPROVAL BY THE BOARD. |
| FORM 990, PART VI, SECTION C, LINE 19 | SAC HEALTH SYSTEM MAKES ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC UPON REQUEST AND IN ACCORDANCE WITH IRS GUIDELINES. THE CONFLICT OF INTEREST POLICY IS POSTED ON THE ORGANIZATION'S INTERNAL WEBSITE FOR EMPLOYEES. THE FINANCIAL INFORMATION IS INCLUDED IN THE IRS FORM 990 WHICH IS AVAILABLE TO THE PUBLIC ON THE GUIDESTAR WEBSITE. |
| FORM 990, PART IX, LINE 11G | OTHER SERVICES: PROGRAM SERVICE EXPENSES 20,743,808. MANAGEMENT AND GENERAL EXPENSES 5,580,203. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 26,324,011. |
| AMENDED FORM 990: | THE FORM 990 IS BEING AMENDED TO MATCH THE AUDITED FINANCIAL STATEMENTS, WHICH WERE ISSUED IN JULY 2023. THE FOLLOWING LINES, PARTS, SCHEDULES, ETC., ARE MODIFIED FROM THE ORIGINAL FILING: - FORM 990, PAGE 1, BOX G - FORM 990, PART I, LINES 9, 12, 19, 20, 22 - FORM 990, PART III, LINE 4A - FORM 990, PART VIII, LINES 2A, 2G, 12 - FORM 990, PART IX, LINES 22, 24C - FORM 990, PART X, LINES 1, 15, 16, 27, 28, 32, 33 - FORM 990, PART XI, LINES 1, 3, 10 - SCHEDULE D, PART IX - SCHEDULE D, PART XI, LINES 1, 3, 5 |