CENTRAL NEIGHBORHOOD HEALTH FOUNDATION: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- CENTRAL NEIGHBORHOOD HEALTH FOUNDATION (EIN 75-2986675)
- Tax period
- 2020-07-01 to 2021-06-30
- Filed
- 2022-05-16
- IRS object ID
- 202241369349308559
- Schema version
- 2020v4.2
- 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 | 2022-05-16T12:56:46-05:00 | ReturnTs |
| Tax Period End | 2021-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 330700332 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | VASQUEZ & CO LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 655 N CENTRAL AVE STE 1550 | AddressLine1Txt |
| City | GLENDALE | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 91203 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 752986675 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CENTRAL NEIGHBORHOOD HEALTH FOUNDATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CENT | BusinessNameControlTxt |
| Phone | 3232345000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 714 WEST OLYMPIC BLVD NO 801 | AddressLine1Txt |
| City | LOS ANGELES | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 90015 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | KENNETH ORDUNA | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 3232345000 | PhoneNum |
| Signature | 2022-05-13 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | KENNETH | PersonFirstNm |
| Person Last | ORDUNA | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | REGINA PRINCE CPA | PreparerPersonNm |
| PTIN | P00576936 | PTIN |
| Phone | 2138731700 | PhoneNum |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | KENNETH ORDUNA | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 714 WEST OLYMPIC BLVD | AddressLine1Txt |
| City | LOS ANGELES | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 90015 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $24,201,200 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2004 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | ORGANIZATION'S MISSION IS TO MINIMIZE DISPARITIES IN HEALTH CARE ACCESS AND OUTCOMES BY PROVIDING SUPERIOR-QUALITY, PATIENT-CENTERED HEALTHCARE THROUGH AN INTEGRATED DELIVERY SYSTEM FOR UNDERSERVED AND VULNERABLE MULTI-ETHNIC COMMUNITIES IN OUR SERVICE ARES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 11 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $2,558,123 | PYContributionsGrantsAmt |
| CY Contributions Grants | $2,740,279 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $11,499,527 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $21,412,162 | CYProgramServiceRevenueAmt |
| PY Investment Income | $2,967 | PYInvestmentIncomeAmt |
| CY Investment Income | $5,502 | CYInvestmentIncomeAmt |
| PY Other Revenue | $177,303 | PYOtherRevenueAmt |
| CY Other Revenue | $43,257 | CYOtherRevenueAmt |
| PY Total Revenue | $14,237,920 | PYTotalRevenueAmt |
| CY Total Revenue | $24,201,200 | 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 | $6,904,794 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $9,079,340 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $5,268,101 | PYOtherExpensesAmt |
| CY Other Expenses | $8,459,350 | CYOtherExpensesAmt |
| PY Total Expenses | $12,172,895 | PYTotalExpensesAmt |
| CY Total Expenses | $17,538,690 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $2,065,025 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $6,662,510 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $10,566,158 | TotalAssetsBOYAmt |
| Total Assets EOY | $17,013,795 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $4,629,923 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $4,415,050 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $5,936,235 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $12,598,745 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE SPECIFIC PURPOSE OF THIS ORGANIZATION IS TO ADDRESS THE UNMET HEALTH CARE NEEDS IN THE UNDERSERVED POPULATIONS OF SOUTH LOS ANGELES, CALIFORNIA THROUGH THE PROVISION OF AFFORDABLE HEALTH CARE SERVICES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $13,938,589 | ExpenseAmt |
| Revenue | $21,412,162 | RevenueAmt |
| Desc | CENTRAL NEIGHBORHOOD HEALTH FOUNDATION (CNHF) IS ORGANIZED FOR THE PURPOSE OF OPERATING A COMPREHENSIVE COMMUNITY HEALTH CENTER. IT PROVIDES A FULL RANGE OF SERVICES, WHICH INCLUDE MEDICAL, DENTAL, VISION, MENTAL HEALTH, HEALTH EDUCATION, NUTRITION, SOCIAL SUPPORT, PHARMACY, LABORATORY, AND X-RAY. CNHF'S MISSION IS TO ADDRESS THE UNMET HEALTHCARE NEEDS OF THE UNDERSERVED POPULATIONS OF SOUTH LOS ANGELES, INGLEWOOD, FONTANA, AND SAN BERNARDINO, CALIFORNIA THROUGH THE PROVISION OF AFFORDABLE, CULTURALLY APPROPRIATE, HIGH-QUALITY, AND ACCESSIBLE HEALTH CARE SERVICES.LOCATED IN LOS ANGELES COUNTY, CALIFORNIA, CNHF SERVED APPROXIMATELY 16,973 PATIENTS DURING THE FISCAL YEARS ENDED. CNHF OPERATES CLINICS AT FOUR (4) SITES: SOUTH CENTRAL AVENUE, LOS ANGELES, CALIFORNIA; SOUTH GRAND AVENUE, LOS ANGELES, CALIFORNIA; EAST VIA WANDA AVENUE, LONG BEACH CALIFORNIA; AND MANCHESTER, INGLEWOOD, CALIFORNIA. | Desc |
| Total Program Service Expenses | $13,938,589 | 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 | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | 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 | Yes (1) | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | Yes (1) | 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 | Yes (1) | 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 | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 0 | EmployeeCnt |
| 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 | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | 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 | Yes (1) | LocalChaptersInd |
| Policies Reference Chapters | Yes (1) | PoliciesReferenceChaptersInd |
| 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 | 0 | WhistleblowerPolicyInd |
| Document Retention Policy | 0 | 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 | CHUKWUKA A CHIDI CPA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2135365815 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 714 WEST OLYMPIC BLVD STE 801 | AddressLine1Txt |
| City | LOS ANGELES | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 90015 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (22 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| WANDA THOMPSON | ||||||||
| BOARD SECRETARY | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| TYRONE DEVANCE | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| RASHID THOMPSON | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| JAMES MACKEY | ||||||||
| BOARD CHAIR | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| RICHARD MAYER | ||||||||
| BOARD TREASURER | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| VICTOR GARCIA | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| MARY WINNERS | ||||||||
| BOARD VICE CHAIR | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| OSCAR LOPEZ | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| CRYSTAL LAUTRUP | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| FRANK YBARRA | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| NANCY OCHOA | ||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| KENNETH M ORDUNA | ||||||||
| CEO | 40.00 | Yes (X) | $386,749 | $0 | $0 | |||
| CHUDWUKA CHIDI | ||||||||
| CFO | 40.00 | Yes (X) | $165,421 | $0 | $0 | |||
| ABDOULAYE DIOP | ||||||||
| CHIEF MEDICAL DIRECTOR | 40.00 | $320,577 | $0 | $328 | Yes (X) | |||
| KEULEYA R BLE | ||||||||
| CHIEF QUALITY OFFICER | 40.00 | $241,738 | $0 | $3,637 | Yes (X) | |||
| ELEANOR PEREZ | ||||||||
| CHIEF OPERATING OFFICER | 40.00 | $240,682 | $0 | $853 | Yes (X) | |||
| MARIA MEDINA | ||||||||
| CONTROLLER | 40.00 | $191,317 | $0 | $3,178 | Yes (X) | |||
| MEHRY GHARIB | ||||||||
| PHYSICIAN | 40.00 | $239,178 | $0 | $3,486 | Yes (X) | |||
| FREDERICK WILLIAMS | ||||||||
| PHYSICIAN | 40.00 | $220,616 | $0 | $0 | Yes (X) | |||
| DIAZ-GOMEZ MARIO | ||||||||
| PHYSICIAN | 40.00 | $210,700 | $0 | $150 | Yes (X) | |||
| FREDERICK N THOMAS | ||||||||
| PHYSICIAN | 40.00 | $204,119 | $0 | $41 | Yes (X) | |||
| SHAMIM FATEMA | ||||||||
| PHYSICIAN | 40.00 | $188,295 | $0 | $0 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,609,392 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $11,673 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 18 | 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 |
|---|---|---|---|---|---|
| JORGESEN LAW OFFICE APC | |||||
| 2328 W WHITTIER BLVD | MONTEBELLO | CA | 90640 | LEGAL SERVICE | $272,282 |
| FOUNTAIN SECURITY SERVICES INC | |||||
| 2930 W IMPERIAL HWY STE 510 | INGLEWOOD | CA | 90303 | SECURITY | $262,746 |
| HEALTH CARE FACILITIES MGMT | |||||
| 5198 PARK CLIFF COURT | RIVERSIDE | CA | 92504 | CONSULTING | $176,641 |
| ESG PERSONNEL LEASING INC | |||||
| 800 N HARBOR BLVD STE B | LA HABRA | CA | 90631 | HR CONSULTING | $115,256 |
| OCHIN INC | |||||
| 1881 SW NAITO PARKWAY | PORTLAND | OR | 97201 | EMR | $115,001 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 9 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $2,740,279 | AllOtherContributionsAmt |
| Total Contributions | $2,740,279 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 621110 | $19,383,641 | $19,383,641 |
| CAPITATION | 621110 | $1,560,666 | $1,560,666 |
| INCENTIVES | 621110 | $306,522 | $306,522 |
| 340B PHARMACY PROGRAM | 621110 | $161,333 | $161,333 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $21,412,162 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,502 | TotalRevenueColumnAmt |
| Exclusion | $5,502 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS INCOME | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $43,257 | TotalRevenueColumnAmt |
| Exclusion | $43,257 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $43,257 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $24,201,200 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $21,412,162 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $48,759 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,554,479 | TotalAmt |
| Program Services | $1,227,812 | ProgramServicesAmt |
| Management And General | $326,667 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,392,250 | TotalAmt |
| Program Services | $4,255,259 | ProgramServicesAmt |
| Management And General | $1,136,991 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,601,312 | TotalAmt |
| Program Services | $1,218,784 | ProgramServicesAmt |
| Management And General | $382,528 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $531,299 | TotalAmt |
| Program Services | $419,372 | ProgramServicesAmt |
| Management And General | $111,927 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,369,295 | TotalAmt |
| Program Services | $2,688,295 | ProgramServicesAmt |
| Management And General | $681,000 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $76,179 | TotalAmt |
| Program Services | $64,207 | ProgramServicesAmt |
| Management And General | $11,972 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $501,135 | TotalAmt |
| Program Services | $328,282 | ProgramServicesAmt |
| Management And General | $172,853 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $261,003 | TotalAmt |
| Program Services | $247,292 | ProgramServicesAmt |
| Management And General | $13,711 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,617,390 | TotalAmt |
| Program Services | $1,278,181 | ProgramServicesAmt |
| Management And General | $339,209 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $116,946 | TotalAmt |
| Program Services | $45,802 | ProgramServicesAmt |
| Management And General | $71,144 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,613 | TotalAmt |
| Program Services | $2,784 | ProgramServicesAmt |
| Management And General | $21,829 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $54,410 | TotalAmt |
| Management And General | $54,410 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $659,009 | TotalAmt |
| Program Services | $587,326 | ProgramServicesAmt |
| Management And General | $71,683 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $111,069 | TotalAmt |
| Program Services | $70,121 | ProgramServicesAmt |
| Management And General | $40,948 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL COST | $1,062,682 | $1,051,385 | $11,297 |
| EQUIPMENT MAINTENANCE & | $442,655 | $393,176 | $49,479 |
| PAYROLL PROCESSING FEE | $56,694 | $56,694 | |
| DUES & SUBSCRIPTION | $41,453 | $7,496 | $33,957 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $64,817 | TotalAmt |
| Program Services | $53,015 | ProgramServicesAmt |
| Management And General | $11,802 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,538,690 | TotalAmt |
| Program Services | $13,938,589 | ProgramServicesAmt |
| Management And General | $3,600,101 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $515,757 | BOYAmt |
| EOY | $433,682 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $927,675 | BOYAmt |
| EOY | $6,305,032 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $450,498 | BOYAmt |
| EOY | $310,648 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,870,872 | BOYAmt |
| EOY | $3,897,406 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $104,596 | BOYAmt |
| EOY | $200,132 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $3,181,492 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,290,932 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,268,118 | BOYAmt |
| EOY | $1,890,560 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $400,000 | BOYAmt |
| EOY | $400,000 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,655,800 | BOYAmt |
| EOY | $1,379,880 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,372,842 | BOYAmt |
| EOY | $2,196,455 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,566,158 | BOYAmt |
| EOY | $17,013,795 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,091,303 | BOYAmt |
| EOY | $1,274,394 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $335,473 | BOYAmt |
| EOY | $215,473 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,265,473 | BOYAmt |
| EOY | $352,170 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,937,674 | BOYAmt |
| EOY | $2,573,013 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,629,923 | BOYAmt |
| EOY | $4,415,050 | 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 | $5,936,235 | BOYAmt |
| EOY | $12,598,745 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,936,235 | BOYAmt |
| EOY | $12,598,745 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,566,158 | BOYAmt |
| EOY | $17,013,795 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $6,662,510 | ReconcilationRevenueExpnssAmt |
| 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) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| 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 | $2,372,263 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,858,039 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,423,487 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,640,323 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,740,279 | CurrentTaxYearAmt |
| Total | $15,034,391 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,372,263 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,858,039 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,423,487 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $3,640,323 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $2,740,279 | CurrentTaxYearAmt |
| Total | $15,034,391 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $3,218,930 | SubstantialContributorsTotAmt |
| Public Support Total170 | $11,815,461 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | $2,967 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $5,502 | CurrentTaxYearAmt |
| Total | $8,469 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $5,606 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $9,763 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $196,262 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $177,303 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $43,257 | CurrentTaxYearAmt |
| Total | $432,191 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $15,475,051 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $55,283,564 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.76350 | PublicSupportCY170Pct |
| Public Support PY170 | 0.70920 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: | FormAndLineReferenceDesc |
| Explanation | OTHER INCOME - 2016 AMOUNT: $ 5,606. 2017 AMOUNT: $ 9,763. 2018 AMOUNT: $ 196,262. 2019 AMOUNT: $ 177,303. 2020 AMOUNT: $ 43,257. | ExplanationTxt |
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
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,181,492 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,290,932 | DepreciationAmt |
| Book Value | $1,890,560 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,890,560 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| DEPOSIT | $53,223 |
| INTERCOMPANY RECEIVABLE | $2,143,232 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $2,196,455 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | THIRD PARTY SETTLEMENT PAYABLE | Desc |
| Amt | $2,573,013 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $2,573,013 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $28,835,256 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | $4,634,056 | OtherRevenueAmt |
| Revenue Not Reported | $4,634,056 | RevenueNotReportedAmt |
| Revenue Subtotal | $24,201,200 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $24,201,200 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $21,319,520 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $3,780,830 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $3,780,830 | ExpensesNotReportedAmt |
| Expenses Subtotal | $17,538,690 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $17,538,690 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | THE ORGANIZATION IS EXEMPT FROM TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND THE CALIFORNIA REVENUE AND TAXATION CODE SECTION 23701D. HOWEVER, THE ORGANIZATION IS SUBJECT TO INCOME TAXES ON ANY NET INCOME THAT IS DERIVED FROM A TRADE OR BUSINESS, REGULARLY CARRIED ON, AND NOT IN FURTHERANCE OF THE PURPOSES FOR WHICH IT WAS GRANTED EXEMPTION. NO INCOME TAX PROVISION HAS BEEN RECORDED AS THE NET INCOME, IF ANY, FROM ANY UNRELATED TRADE OR BUSINESS, IN THE OPINION OF MANAGEMENT, IS NOT MATERIAL TO THE FINANCIAL STATEMENTS TAKEN AS A WHOLE. GENERALLY ACCEPTED ACCOUNTING PRINCIPLES PRESCRIBE A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. IT REQUIRES THAT AN ORGANIZATION RECOGNIZE IN THE FINANCIAL STATEMENTS THE IMPACT OF THE TAX POSITION IF THAT POSITION WILL MORE LIKELY THAN NOT BE SUSTAINED ON AUDIT, BASED ON THE TECHNICAL MERITS OF THE POSITION. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | INCOME OF RELATED TAX=EXEMPT ENTITY 4,634,056. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | EXPENSES OF RELATED TAX-EXEMP ENTITY 3,780,830. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| KENNETH M ORDUNA | ||||||||||||||
| CEO | $292,299 | $0 | $51,152 | $0 | $43,298 | $0 | $0 | $0 | $0 | $0 | $386,749 | $0 | $0 | $0 |
| ABDOULAYE DIOP | ||||||||||||||
| CHIEF MEDICAL DIRECTOR | $253,125 | $0 | $46,971 | $0 | $20,481 | $0 | $0 | $0 | $328 | $0 | $320,905 | $0 | $0 | $0 |
| KEULEYA R BLE | ||||||||||||||
| CHIEF QUALITY OFFICER | $152,008 | $0 | $29,596 | $0 | $60,134 | $0 | $0 | $0 | $3,637 | $0 | $245,375 | $0 | $0 | $0 |
| MEHRY GHARIB | ||||||||||||||
| PHYSICIAN | $213,017 | $0 | $11,721 | $0 | $14,440 | $0 | $0 | $0 | $3,486 | $0 | $242,664 | $0 | $0 | $0 |
| ELEANOR PEREZ | ||||||||||||||
| CHIEF OPERATING OFFICER | $168,955 | $0 | $69,167 | $0 | $2,560 | $0 | $0 | $0 | $853 | $0 | $241,535 | $0 | $0 | $0 |
| FREDERICK WILLIAMS | ||||||||||||||
| PHYSICIAN | $183,048 | $0 | $7,153 | $0 | $30,415 | $0 | $0 | $0 | $0 | $0 | $220,616 | $0 | $0 | $0 |
| DIAZ-GOMEZ MARIO | ||||||||||||||
| PHYSICIAN | $188,800 | $0 | $3,500 | $0 | $18,400 | $0 | $0 | $0 | $150 | $0 | $210,850 | $0 | $0 | $0 |
| FREDERICK N THOMAS | ||||||||||||||
| PHYSICIAN | $163,519 | $0 | $10,360 | $0 | $30,240 | $0 | $0 | $0 | $41 | $0 | $204,160 | $0 | $0 | $0 |
| MARIA MEDINA | ||||||||||||||
| CONTROLLER | $111,937 | $0 | $13,369 | $0 | $66,011 | $0 | $0 | $0 | $3,178 | $0 | $194,495 | $0 | $0 | $0 |
| SHAMIM FATEMA | ||||||||||||||
| PHYSICIAN | $178,795 | $0 | $9,500 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $188,295 | $0 | $0 | $0 |
| CHUDWUKA CHIDI | ||||||||||||||
| CFO | $76,500 | $0 | $17,751 | $0 | $71,170 | $0 | $0 | $0 | $0 | $0 | $165,421 | $0 | $0 | $0 |
Schedule L IRS990ScheduleL
Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp (2 entries)
| Relationship With OrgRelationshipWithOrgTxt | Loan PurposeLoanPurposeTxt | Loan To OrganizationLoanToOrganizationInd | Original PrincipalOriginalPrincipalAmt | Balance DueBalanceDueAmt | DefaultDefaultInd | Board Or Committee ApprovalBoardOrCommitteeApprovalInd | Written AgreementWrittenAgreementInd |
|---|---|---|---|---|---|---|---|
| FATIMA JAHANGIR | |||||||
| FORMER COO | WORKING CAPITAL | Yes (X) | $140,000 | $105,473 | 0 | Yes (1) | Yes (1) |
| BASSET BROWN | |||||||
| FORMER CEO | WORKING CAPITAL | Yes (X) | $404,236 | $110,000 | 0 | Yes (1) | Yes (1) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | $215,473 | TotalBalanceDueAmt |
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ABDOULAYE DIOP MD | PersonNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | CHIEF MEDICAL DIRECTOR & KEY EMPLOYEE | RelationshipDescriptionTxt |
| Transaction | $247,294 | TransactionAmt |
| Transaction | RENTS. LEASE OF MEDICAL OFFICES. | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | CENTRAL NEIGHBORHOOD HEALTH FOUNDATION'S CFO AND CEO REVIEW THE FORM 990. SUBSEQUENTLY THE FORM 990, COMPLETE WITH SCHEDULES, IS PROVIDED TO THE FULL BOARD DURING SCHEDULED BOARD MEETING BEFORE FILING WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | CENTRAL NEIGHBORHOOD HEALTH FOUNDATION, INC. (CNHF) CONDUCTS ITS BUSINESS WITH THE HIGHEST DEGREE OF ETHICAL STANDARDS. MEMBERS OF THE BOARD OF DIRECTORS (BOARD), CNHF OFFICERS, AND EMPLOYEES ("COVERED PERSONS") ARE EXPECTED TO MODEL ETHICAL BEHAVIOR IN THEIR LEADERSHIP AND BUSINESS TRANSACTIONS ON BEHALF OF CNHF. CONFLICT OF INTEREST DISCLOSURE QUESTIONNAIRE IS DESIGNED TO ELICIT INFORMATION FROM BOARD MEMBERS, OFFICERS AND EMPLOYEES TO ASSURE THEY ARE ACTING IN THE BEST INTEREST OF CNHF AND TO IDENTIFY ANY CONFLICTS OF INTEREST THEY MAY HAVE. ALL DIRECTORS AND EMPLOYEES MUST ANNUALLY COMPLETE THE QUESTIONNAIRE, AND AGREE TO COMPLY WITH CNHF'S CONFLICT OF INTEREST POLICY. A CONFLICT OF INTEREST MAY OCCUR WHERE VOLUNTEERS OR EMPLOYEES HAVE A FINANCIAL, BUSINESS, OR PERSONAL INTEREST THAT IS IN CONFLICT OR APPEARS TO BE IN CONFLICT WITH THE INTERESTS OF CNHF. IMMEDIATE DISCLOSURE OF CONFLICTS OF INTEREST IS AN ESSENTIAL OBLIGATION. CNHF HAS A STRUCTURED CONFLICT OF INTEREST PROCESS WITH THE FOLLOWING STEPS: (1) BOARD MEMBERS OR MANAGERS MUST IDENTIFY OR RECOGNIZE THE FINANCIAL, BUSINESS, AND PERSONAL INTEREST IN CONFLICT WITH CNHF INTEREST; (2) THEY MUST NEXT DISCLOSE THE CONFLICT TO THE GENERAL COUNSEL, THE CHAIRMAN OF THE BOARD OR PRESIDENT AND CEO, RESPECTIVELY; (3) THE GENERAL COUNSEL WILL ASSESS ANY IMPACT OF THE CONFLICT ON CNHF; (4) THE GENERAL COUNSEL WILL DISCUSS POSSIBLE REMEDIAL ACTIONS WITH THE BOARD MEMBER OR MANAGER; AND (5) IF NECESSARY, THE GENERAL COUNSEL WILL DISCUSS THE CONFLICT AND PROPOSED REMEDIAL ACTION WITH THE CHAIRMAN OF THE BOARD OR PRESIDENT AND CEO. REMEDIAL ACTIONS MAY RANGE FROM FIREWALLS IN THE MANAGER'S WORK, TO RECUSAL FROM A BOARD VOTE, BUSINESS DECISION OR TRANSACTION INVOLVING CNHF OR THE OTHER ORGANIZATION, TO WITHDRAWAL FROM THE OTHER ORGANIZATION'S BUSINESS OR BOARD OF DIRECTORS, TO OTHER ACTIONS THAT ELIMINATE THE CONFLICT OF INTEREST OR APPEARANCE OF A CONFLICT. |
| FORM 990, PART VI, SECTION B, LINE 15 | EXECUTIVE COMPENSATION, INCLUDING PERFORMANCE BASED COMPENSATION, IS REVIEWED AND DETERMINED BY THE BOARD'S EXECUTIVE COMMITTEE, OR THE COMPENSATION SUBCOMMITTEE IN THE CASE OF THE CEO'S COMPENSATION. THE APPLICABLE COMMITTEE USED COMPARABILITY DATA OBTAINED FROM THE CALIFORNIA PRIMARY CARE ASSOCIATION WHICH IS PREPARED BY AN INDEPENDENT THIRD PARTY. THE DATA REPRESENTS WHAT 125 SIMILARLY SITUATED ORGANIZATIONS BASED ON LOCATION, BUDGET AND SIZE, PAY EXECUTIVES FOR FUNCTIONALLY COMPARABLE POSITIONS. THE APPLICABLE COMMITTEE COLLECTS THE COMPARABLE COMPENSATION DATA, DEBATES THE ISSUE, AND USES IT TOGETHER WITH THE ORGANIZATIONS STRATEGY AND THE EXECUTIVES QUALIFICATIONS TO MAKE COMPENSATION RECOMMENDATIONS TO THE FULL BOARD OF DIRECTORS FOR APPROVAL BY VOTING. THE FINDINGS OF THE APPLICABLE COMMITTEE, TOGETHER WITH THE BOARD'S CONSIDERATION AND APPROVAL, ARE RECORDED IN THE ORGANIZATION'S MEETING MINUTES. THIS PROCESS IS REPEATED ANNUALLY FOR THE PURPOSE OF MAKING ADJUSTMENTS TO COMPENSATION OR THE AWARD OF PERFORMANCE BASED COMPENSATION. |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE AT CORPORATE OFFICE UPON REQUEST DURING NORMAL BUSINESS HOURS. HOWEVER NEW TAX LAW DOES NOT REQUIRE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIALS BE PROVIDED TO THE PUBLIC. |
| FORM 990, PART IX, LINE 11G | CONSULTANTS: PROGRAM SERVICE EXPENSES 2,432,934. MANAGEMENT AND GENERAL EXPENSES 518,695. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,951,629. PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 255,361. MANAGEMENT AND GENERAL EXPENSES 162,305. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 417,666. |
| FORM 990, PART IX, LINE 24E | EDUCATION & AWARENESS: PROGRAM SERVICE EXPENSES 41,022. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 41,022. BUSINESS TAXES & LICENSES: PROGRAM SERVICE EXPENSES 8,862. MANAGEMENT AND GENERAL EXPENSES 3,253. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 12,115. BANK SERVICE CHARGE: PROGRAM SERVICE EXPENSES 3,131. MANAGEMENT AND GENERAL EXPENSES 8,549. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 11,680. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | H STREET CLINIC INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1329 NORTH H STREET | AddressLine1Txt |
| City | SAN BERNARDINO | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 92405 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 208191393 | EIN |
| Primary Activities | HEALTH CARE CLINIC | PrimaryActivitiesTxt |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Exempt Code Section | 501 (C) | ExemptCodeSectionTxt |
| Public Charity Status | LINE 3 | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CENTRAL NEIGHBORHOOD HEALTH FOUNDATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | Yes (1) | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | Yes (1) | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp
Other Organization Name OtherOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | H STREET CLINIC INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | R | TransactionTypeTxt |
| Involved | $1,180,339 | InvolvedAmt |
| Method Of Amount Determination | COST | MethodOfAmountDeterminationTxt |