2022-01-28T15:44:29-06:00 2021-06-30 910189318 MOSS ADAMS LLP 3121 W MARCH LN STE 200 STOCKTON CA 952192367 990 2020-07-01 942492609 NORTHEASTERN RURAL HEALTH CLINICS INC NORT 5302515000 1850 SPRING RIDGE DRIVE SUSANVILLE CA 96130 MICHAEL SCHAUB CEO 5302515000 2022-01-25 1 MICHAEL SCHAUB 999009999 TRACY S PAGLIA P00366884 2099556100 2022-01-25 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z MICHAEL SCHAUB 1850 SPRING RIDGE DRIVE SUSANVILLE CA 96130 15176412 0 X WWW.NORTHEASTERNHEALTH.ORG X 1977 CA PROVIDE ACCESS TO QUALITY HEALTH CARE SERVICES TO SOCIALLY/ECONOMICALLY DEPRESSED IN LASSEN CTY, CA. 8 8 149 9 0 0 3452038 5960057 8065075 9011658 0 -4677 -2739 186391 11514374 15153429 0 0 0 0 8039183 8379449 0 0 0 5611307 5107259 13650490 13486708 -2136116 1666721 5641880 6010387 10647127 9348913 -5005247 -3338526 OUR MISSION IS TO PROVIDE QUALITY, COMPREHENSIVE, PREVENTIVE, AND ACCESSIBLE HEALTH CARE SERVICES, REGARDLESS OF ABILITY TO PAY; AND TO MEET THE CHANGING NEEDS OF OUR COMMUNITIES WITH CREATIVITY AND INNOVATION. 0 0 9985857 0 9011658 PROVIDE QUALITY HEALTH CARE TO RURAL AND LOW INCOME POPULATION REGARDLESS OF ABILITY TO PAY SERVICES INCLUDE PRIMARY CARE, OB, DIAGNOSTIC LAB TESTING, PHARMACY SERVICES, EDUCATION AND BEHAVIORAL HEALTH 44,192 PATIENT VISITS ARE RECORDED FOR FISCAL YEAR ENDED JUNE 30, 2021. 9985857 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 17 0 1 149 1 0 0 0 0 0 0 0 0 0 0 0 0 X 8 8 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X X LACEY LIVELY 5302515000 1850 SPRING RIDGE DRIVE SUSANVILLE CA 96130 STEVEN BRAATZ PROVIDER 40.00 X 328900 0 21108 KIMBERLY CLINITE PROVIDER 40.00 X 264876 0 29329 RACHEL PETERSON PROVIDER 40.00 X 261156 0 30569 SAMUEL CARLTON PROVIDER 40.00 X 217782 0 29946 MICHAEL SCHAUB CEO 40.00 X 174743 0 15584 DAVID MCCANN DENTIST 40.00 X 158770 0 29554 NAOMI REA CMO 40.00 X 175309 0 10414 LACEY LIVELY CFO 40.00 X 100224 0 10456 MARGE GARROD CHAIRMAN OF BOARD 2.00 X X 0 0 0 EULA JOHNSON VICE CHAIR 2.00 X X 0 0 0 CARROL CURRY SECRETARY 2.00 X X 0 0 0 KATIE ANDERSON TREASURER 2.00 X X 0 0 0 LINDSEY MARTIN BOARD MEMBER 2.00 X 0 0 0 MARK SOLOMON BOARD MEMBER 2.00 X 0 0 0 ERIKA TOMLINSON BOARD MEMBER 2.00 X 0 0 0 FRANKIE LUALLEN BOARD MEMBER 2.00 X 0 0 0 SANDY RAFFLESON BOARD MEMBER (THRU 5/1/21) 2.00 X 0 0 0 1681760 0 176960 11 0 1 0 NORTH AMERICAN MENTAL HEALTH SERVICES 2165 LAKSPUR LANE REDDING CA 96002 EMPLOYEE HEALTH BENEFITS 691526 THE MEDCOR GROUP INC 1801 W OLYMPIC BLVD PASADENA CA 911992259 CONTRACTED BILLING 342880 MK HOLDINGS INC 4581 AZALEA DR NAPLES FL 34119 INTERIM CIO 299113 BARTON ASSOCIATES INC PO BOX 417844 BOSTON MA 02241 LOCUM PROVIDERS 231697 COMPHEALTH MEDICAL STAFFING PO BOX 972651 DALLAS TX 753972651 LOCUM PROVIDERS 185805 9 5459288 500769 5960057 NET PATIENT SERVICE REVENUE 621400 7677875 7677875 PHARMACY REVENUE 621400 1333783 1333783 9011658 3000 13006 -10006 -10006 -10006 5300 9977 -4677 -4677 -4677 MISCELLANEOUS INCOME 900099 196397 196397 196397 15153429 9011658 0 181714 X 556090 142535 413555 6376697 5356178 1020519 1446662 991010 455652 62853 62853 69168 69168 2257197 1548506 708691 12147 11320 827 621437 553419 68018 26427 26427 462272 251435 210837 1903 1181 722 22241 2719 19522 138606 138606 234985 215384 19601 59681 30323 29358 340B PROGRAMS 554955 554955 WIC PROGRAMS 93696 93696 LICENSES & REGISTRATION 42793 28228 14565 MEDICAL SUPPLIES & LAB 31277 31277 415621 267387 148234 13486708 9985857 3500851 0 1802025 2104207 1195542 1055708 12608 131492 126337 8694095 5982568 2432235 2711527 80586 0 5641880 6010387 2004608 1333809 1984943 1397900 3319463 3487442 3338113 3129762 10647127 9348913 X -5026110 -3361189 20863 22663 -5005247 -3338526 5641880 6010387 1666721 0 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 288555 288555 6396868 4769420 1627448 367719 231724 135995 1640953 981424 659529 2711527 X 15166435 13006 13006 15153429 0 15153429 13499714 13006 13006 13486708 0 13486708 PART X, LINE 2: THE CENTER IS A NONPROFIT CORPORATION UNDER SECTION 501(C)(3) AND HAVE BEEN GRANTED TAX-EXEMPT STATUSES BY THE INTERNAL REVENUE SERVICE AND THE CALIFORNIA REVENUE AND TAXATION CODE. AS OF JUNE 30, 2021 AND 2020, THE CENTER HAD NO UNRECOGNIZED TAX POSITIONS OR UNCERTAIN TAX POSITIONS REQUIRING ACCRUAL. THEREFORE, NO PROVISION FOR INCOME TAXES HAS BEEN PROVIDED IN THE FINANCIAL STATEMENTS. PART XI, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 13,006. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 13,006. X X 0 0 0 0 0 0 0 1 0 STEVEN BRAATZ PROVIDER 245000 0 83900 0 0 0 600 0 20508 0 350008 0 0 0 KIMBERLY CLINITE PROVIDER 230000 0 34876 0 0 0 25 0 29304 0 294205 0 0 0 RACHEL PETERSON PROVIDER 240000 0 21156 0 0 0 0 0 30569 0 291725 0 0 0 SAMUEL CARLTON PROVIDER 215500 0 2282 0 0 0 600 0 29346 0 247728 0 0 0 MICHAEL SCHAUB CEO 174743 0 0 0 0 0 0 0 15584 0 190327 0 0 0 DAVID MCCANN DENTIST 158770 0 0 0 0 0 250 0 29304 0 188324 0 0 0 NAOMI REA CMO 146078 0 29231 0 0 0 600 0 9814 0 185723 0 0 0 PART I, LINE 7 BONUSES ARE NOT A REGULAR EVENT. IF THE CLINIC IS AWARDED UNRESTRICTED FUNDS, THE BOARD OF DIRECTORS WILL DETERMINE IF BONUSES ARE PAID OUT ALONG WITH THE AMOUNTS. FORM 990, PART VI, SECTION B, LINE 11B ONCE THE FORMS ARE COMPLETED, THE CHIEF FINANCIAL OFFICER WILL PRESENT THE DOCUMENTS TO THE BOARD OF DIRECTORS. THE BOARD WILL THEN ACCEPT THE DOCUMENTS THROUGH A RECORDED VOTE. FORM 990 WILL THEN BE SUBMITTED TO THE IRS. FORM 990, PART VI, SECTION B, LINE 12C DUTY TO DISCLOSE - IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICT OF INTEREST, AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF THE FINANCIAL INTEREST AND BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE BOARD OR EXECUTIVE COMMITTEE. RECUSAL TO SELF - ANY DIRECTOR MAY RECUSE HIM OR HER AT ANY TIME FROM INVOLVEMENT IN ANY DECISION OR DISCUSSION IN WHICH THE DIRECTOR BELIEVES HE OR SHE HAS OR MAY HAVE A CONFLICT OF INTEREST, WITHOUT GOING THROUGH THE PROCESS FOR DETERMINING WHETHER A CONFLICT OF INTEREST EXISTS. DETERMINING WHETHER A CONFLICT OF INTEREST EXISTS - AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, HE/SHE SHALL LEAVE THE BOARD OR EXECUTIVE COMMITTEE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING BOARD OR EXECUTIVE COMMITTEE MEMBERS SHALL DECIDE IF A CONFLICT OF INTEREST EXISTS. ADDRESSING THE CONFLICT OF INTEREST A. AN INTERESTED PERSON MAY MAKE A PRESENTATION AT THE BOARD OR EXECUTIVE COMMITTEE MEETING, BUT AFTER THE PRESENTATION, HE/SHE SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT INVOLVING THE POSSIBLE CONFLICT OF INTEREST. B. THE CHAIRPERSON OF THE BOARD OR EXECUTIVE COMMITTEE SHALL, IF APPROPRIATE, APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT. C. AFTER EXERCISING DUE DILIGENCE, THE BOARD OR EXECUTIVE COMMITTEE SHALL DETERMINE WHETHER NRHC CAN OBTAIN WITH REASONABLE EFFORTS A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. D. IF A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT IS NOT REASONABLY POSSIBLE UNDER CIRCUMSTANCES NOT PRODUCING A CONFLICT OF INTEREST, THE BOARD OR EXECUTIVE COMMITTEE SHALL DETERMINE BY A MAJORITY VOTE OF THE DISINTERESTED DIRECTORS WHETHER THE TRANSACTION OR ARRANGEMENT IS IN NRHC'S BEST INTEREST, FOR ITS OWN BENEFIT, AND WHETHER IT IS FAIR AND REASONABLE. IN CONFORMITY WITH THE ABOVE DETERMINATION, IT SHALL MAKE ITS DECISION AS TO WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT. FORM 990, PART VI, SECTION B, LINE 15 COMPENSATION FOR CEO IS DETERMINED BY THE BOARD OF DIRECTORS. THE BOARD USES COMPARISON DATA CATALOGS RELATED TO THE FQHC INDUSTRY. THESE CATALOGS ARE ISSUED ANNUALLY BY MULTIPLE INDUSTRY LEADERS SUCH AS NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS (NATIONAL OVERVIEW), CALIFORNIA PRIMARY CARE ASSOCIATION (STATE OVERVIEW), HEALTH ALLIANCE OF NORTHERN CALIFORNIA, (REGIONAL OVERVIEW). GEOGRAPHICAL LOCATION AND COMPETITIVE LOCAL MARKET RATES ARE ALSO CONSIDERED AS WELL AS RELATED JOB EXPERIENCE OF THE SELECTED PERSON. THIS INFORMATION IS DISCUSSED DURING CLOSED SESSION AT THE BOARD OF DIRECTORS MEETING AND IS VOTED ON. ONCE PASSED IT IS THEN RECORDED IN BOARD MINUTES AND IS MEMORIALIZED IN THE EMPLOYMENT CONTRACT BETWEEN NORTHEASTERN'S BOD AND SELECTED PERSON. THE BOD ANNUALLY REVIEWS AND APPROVES A SALARY SCALE FOR ALL EMPLOYMENT POSITIONS AT THE CLINIC. THE POSITION OF CEO IS ALSO INCLUDED IN THE SCALE. THE SAME DATA CATALOGS LISTED ABOVE ARE USED TO CREATE, ADJUST AND APPROVE THE SALARY SCALE. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION DOES NOT MAKE AVAILABLE TO THE PUBLIC ANY OF THEIR GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY OR FINANCIAL STATEMENTS. FORM 990, PART IX, LINE 11G RECRUITMENT & PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 15,889. MANAGEMENT AND GENERAL EXPENSES 26,340. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 42,229. LOCUM TENANS: PROGRAM SERVICE EXPENSES 332,186. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 332,186. MEDCOR BILLING CONTRACTOR: PROGRAM SERVICE EXPENSES 363,698. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 363,698. MEDICAL CONTRACTUAL SERVICES: PROGRAM SERVICE EXPENSES 137,170. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 137,170. CONTRACT SERVICES/PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 699,563. MANAGEMENT AND GENERAL EXPENSES 682,351. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,381,914.