STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

NORTHBAY HEALTHCARE CORPORATION: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization
NORTHBAY HEALTHCARE CORPORATION (EIN 68-0046750)
Tax period
2021-01-01 to 2021-12-31
Filed
2022-11-15
IRS object ID
202203199349327370
Schema version
2021v4.2
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2022-11-15T17:17:15-06:00ReturnTs
Tax Period End2021-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN910189318PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1MOSS ADAMS LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1101 SECOND STREET SUITE 900AddressLine1Txt
CitySAN FRANCISCOCityNm
State AbbreviationCAStateAbbreviationCd
ZIP94105ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2021-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN680046750EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1NORTHBAY HEALTHCARE CORPORATIONBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlNORTBusinessNameControlTxt
Phone7076463400PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line14500 BUSINESS CENTER DRIVEAddressLine1Txt
CityFAIRFIELDCityNm
State AbbreviationCAStateAbbreviationCd
ZIP94534ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonMICHELE BOUITPersonNm
Person TitleVP, FINANCE/CFOPersonTitleTxt
Phone7076463400PhoneNum
Signature2022-11-13SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstMICHELEPersonFirstNm
Person LastBOUITPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonMICHAEL LUMSDENPreparerPersonNm
PTINP01262236PTIN
Phone4159561500PhoneNum
Preparation2022-11-13PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer3TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2021TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerB KONARD JONESPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line14500 BUSINESS CENTER DRIVEAddressLine1Txt
CityFAIRFIELDCityNm
State AbbreviationCAStateAbbreviationCd
ZIP94534ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$91,132,100GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.NORTHBAY.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1984FormationYr
Legal Domicile StateCALegalDomicileStateCd
Activity Or MissionMANAGEMENT AND OTHER SUPPORT SERVICES FOR NORTHBAY HEALTHCARE AFFILIATED ORGANIZATIONS.ActivityOrMissionDesc
Voting Members Governing Body8VotingMembersGoverningBodyCnt
Voting Members Independent7VotingMembersIndependentCnt
Total Employee3114TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$74,450,451PYProgramServiceRevenueAmt
CY Program Service Revenue$91,080,061CYProgramServiceRevenueAmt
PY Investment Income$2,945PYInvestmentIncomeAmt
CY Investment Income$3,571CYInvestmentIncomeAmt
PY Other Revenue$50,200PYOtherRevenueAmt
CY Other Revenue$46,506CYOtherRevenueAmt
PY Total Revenue$74,503,596PYTotalRevenueAmt
CY Total Revenue$91,130,138CYTotalRevenueAmt
PY Grants And Similar Paid$79,109PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$72,609CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$42,419,588PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$33,478,218CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$32,011,265PYOtherExpensesAmt
CY Other Expenses$57,579,311CYOtherExpensesAmt
PY Total Expenses$74,509,962PYTotalExpensesAmt
CY Total Expenses$91,130,138CYTotalExpensesAmt
PY Revenues Less Expenses-$6,366PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$0CYRevenuesLessExpensesAmt
Total Assets BOY$21,427,121TotalAssetsBOYAmt
Total Assets EOY$22,992,689TotalAssetsEOYAmt
Total Liabilities BOY$22,397,201TotalLiabilitiesBOYAmt
Total Liabilities EOY$49,686,106TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY-$970,080NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY-$26,693,417NetAssetsOrFundBalancesEOYAmt
MissionCOMPASSIONATE CARE, ADVANCED MEDICINE, CLOSE TO HOME.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$67,974,581ExpenseAmt
Grant$72,609GrantAmt
Revenue$91,080,061RevenueAmt
DescNORTHBAY HEALTHCARE CORPORATION (NBHC) IS THE PARENT ORGANIZATION OF THREE CALIFORNIA NON-PROFIT PUBLIC BENEFIT CORPORATIONS; ONE OF THOSE CORPORATIONS, NORTHBAY HEALTHCARE GROUP, OWNS AND OPERATES NON-PROFIT COMMUNITY HOSPITALS IN FAIRFIELD AND VACAVILLE. THE PURPOSE OF NBHC IS TO SUPPORT AND HELP CARRY OUT THE PURPOSES AND FUNCTIONS OF NORTHBAY HEALTHCARE GROUP, NORTHBAY HEALTH ADVANTAGE, AND NORTHBAY HEALTHCARE FOUNDATION. THIS IS ACCOMPLISHED THROUGH PROVIDING COORDINATION, MANAGEMENT, AND OTHER SUPPORT SERVICES TO THE NON-PROFIT HOSPITALS AND OTHER RELATED COMMUNITY HEALTHCARE PROGRAMS. THESE SERVICES INCLUDE MARKETING, RESEARCH OF NEW CLINICAL SERVICE AREAS, MANAGING CONTRACTS BETWEEN PROVIDERS AND PAYORS, AND FINANCING.Desc

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$0ExpenseAmt
Grant$0GrantAmt
Revenue$0RevenueAmt
DescNORTHBAY GUILD IS THE VOLUNTEER GROUP FOR NORTHBAY HEALTHCARE GROUP. THE PURPOSE OF THE NORTHBAY GUILD IS TO SUPPORT AND HELP CARRY OUT THE PURPOSE AND FUNCTIONS OF NORTHBAY HEALTHCARE GROUP IN PROMOTING THE HEALTH OF THE COMMUNITY. THIS IS ACCOMPLISHED THROUGH PROVIDING FUNDRAISING SUPPORT TO THE NORTHBAY HEALTHCARE FOUNDATION, AS WELL AS SCHOLARSHIPS TO MEMBERS OF THE COMMUNITY. OPERATIONS OF NORTHBAY GUILD WERE TEMPORARILY SUSPENDED DURING THE 2021 TAX YEAR DUE TO THE COVID-19 PANDEMIC.Desc
FieldValueIRS element (for citing)
Total Program Service Expenses$67,974,581TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying ActivitiesYes (1)LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi EndowmentsYes (1)DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 Footnote0IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (1)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
Info In Schedule O Part VYes (X)InfoInScheduleOPartVInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Employee3114EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtYes (1)SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members8GoverningBodyVotingMembersCnt
Independent Voting Member7IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process OtherYes (1)CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldCAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MICHELE BOUITBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone7076463400PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line14500 BUSINESS CENTER DRIVEAddressLine1Txt
CityFAIRFIELDCityNm
State AbbreviationCAStateAbbreviationCd
ZIP94534ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (24 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
MARK SIEVERS
CHAIR1.001.00Yes (X)Yes (X)$0$16,850$0
STEPHEN J POWER
VICE CHAIR1.000.00Yes (X)Yes (X)$0$16,850$0
MARY MANCINI MD
SECRETARY - TREASURER1.000.00Yes (X)Yes (X)$0$24,939$0
GARY FALATI
DIRECTOR1.001.00Yes (X)$0$9,032$0
ARCHIE HUMPHREY
DIRECTOR1.001.00Yes (X)$0$16,887$0
CHRIS SWEENEY
DIRECTOR1.000.00Yes (X)$0$16,864$0
MURRAY WOOLF MD
DIRECTOR1.000.00Yes (X)$0$16,828$0
B KONARD JONES
DIRECTOR / PRESIDENT & CEO30.0020.00Yes (X)Yes (X)$1,712,261$0$408,955
AIMEE BREWER
PRES NBHG / ASST SECR (THRU 9/2021)5.0045.00Yes (X)$684,178$0$109,617
WAYNE GIETZ
PRES NBHG / ASST SECR (START 9/2021)5.0045.00Yes (X)$623,438$0$82,421
MICHELE BOUIT
VP, FINANCE & CFO / ASST SECR8.0042.00Yes (X)$512,144$0$88,016
CHRISTOPHER TIMBERS
VP, CHIEF INFORMATION OFFICER10.0040.00$484,597$0$126,816Yes (X)
STEVE HUDDLESTON
VP, PUBLIC AFFAIRS5.0045.00$418,468$0$50,130Yes (X)
SCOTT DAVIS
VP, CHIEF STRATEGY OFFICER/PRES NBHA10.0040.00$509,139$0$75,631Yes (X)
JIM ANDERSEN
VP, HUMAN RESOURCES5.0045.00$558,805$0$72,262Yes (X)
SETH KAUFMAN MD
CHIEF MEDICAL OFFICER0.0050.00$456,289$0$64,713Yes (X)
TRACI DUNCAN
VP, CHIEF NURSING OFFICER0.0050.00$477,669$0$35,931Yes (X)
ROBERT COSCIONE
VP, PAYER STRATEGY (THRU 8/2021)0.0050.00$418,462$0$57,077Yes (X)
NICOLE BROCATO
VP, OPERATIONS / CQO (THRU 8/2021)0.0050.00$308,498$0$75,687Yes (X)
THERESA BARTOLI
CLINICAL COORDINATOR0.0040.00$336,318$0$65,987Yes (X)
AROLD NELSON
CLINICAL NURSE SUPERVISOR0.0040.00$339,281$0$56,680Yes (X)
THEO RALLIS
ASSISTANT VP, FINANCE / CONTROLLER8.0042.00$336,033$0$49,391Yes (X)
DUSTIN DATOC
REGISTERED NURSE FIRST ASSISTANT0.0040.00$315,833$0$56,957Yes (X)
JOANNE JACOB
CLINICAL COORDINATOR0.0040.00$321,492$0$14,784Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$8,812,905TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$118,250TotReportableCompRltdOrgAmt
Total Other Compensation$1,491,055TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K137IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
OPTUM360 LLC
PO BOX 88050CHICAGOIL606801050REVENUE SERVICES$13,720,514
RECEIVABLE SOLUTIONS LLC
800 DUTCH SQUARE BLVD 100COLUMBIASC29210COLLECTIONS SERVICES$2,089,222
CERNER CORPORATION
PO BOX 959156ST LOUISMO631959156IT SERVICES$1,123,431
PRAXIS HEALHTCARE SOLUTIONS
PO BOX 208272DALLASTX753208272COLLECTIONS SERVICES$839,925
MAYO COLLABORATIVE SERVICES INC
PO BOX 9146MINNEAPOLISMN554809146LABORATORY SERVICES$743,112
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K36CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
MANAGEMENT & ADMIN FEES541900$90,780,570$90,780,570
REBATES & REFUNDS900099$299,491$299,491
FieldValueIRS element (for citing)
Total Program Service Revenue$91,080,061TotalProgramServiceRevenueAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$46,506RealAmt

Less Rental Expenses LessRentalExpensesGrp

FieldValueIRS element (for citing)
Real$0RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$46,506RealAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$46,506TotalRevenueColumnAmt
Exclusion$46,506ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$5,533SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$0SecuritiesAmt
Other$1,962OtherAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$5,533SecuritiesAmt
Other-$1,962OtherAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$3,571TotalRevenueColumnAmt
Exclusion$3,571ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$91,130,138TotalRevenueColumnAmt
Related Or Exempt Func Income$91,080,061RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$50,077ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$72,609TotalAmt
Program Services$72,609ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$7,560,012TotalAmt
Program Services$3,010,164ProgramServicesAmt
Management And General$4,549,848ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$19,742,976TotalAmt
Program Services$16,359,280ProgramServicesAmt
Management And General$3,383,696ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$863,624TotalAmt
Program Services$709,748ProgramServicesAmt
Management And General$153,876ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$3,648,846TotalAmt
Program Services$2,859,149ProgramServicesAmt
Management And General$789,697ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$1,662,760TotalAmt
Program Services$1,224,456ProgramServicesAmt
Management And General$438,304ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$9,021,258TotalAmt
Program Services$86,247ProgramServicesAmt
Management And General$8,935,011ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$113,959TotalAmt
Management And General$113,959ManagementAndGeneralAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$71,895TotalAmt
Management And General$71,895ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$31,161,786TotalAmt
Program Services$27,596,177ProgramServicesAmt
Management And General$3,565,609ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$343,305TotalAmt
Management And General$343,305ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$1,102,336TotalAmt
Program Services$1,013,442ProgramServicesAmt
Management And General$88,894ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$7,636,950TotalAmt
Program Services$7,636,271ProgramServicesAmt
Management And General$679ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$3,552,194TotalAmt
Program Services$3,372,312ProgramServicesAmt
Management And General$179,882ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$115,330TotalAmt
Program Services$69,495ProgramServicesAmt
Management And General$45,835ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$55,454TotalAmt
Program Services$51,880ProgramServicesAmt
Management And General$3,574ManagementAndGeneralAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$4,995TotalAmt
Program Services$4,267ProgramServicesAmt
Management And General$728ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$3,209,037TotalAmt
Program Services$3,175,183ProgramServicesAmt
Management And General$33,854ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$270,048TotalAmt
Program Services$270,048ProgramServicesAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
DUES & SUBSCRIPTIONS$399,755$275,647$124,108
RECRUITING$251,467$61,291$190,176
TAXES/LICENSES$59,017$1,555$57,462
PUBLIC RELATIONS$35,256$32,256$3,000

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$175,269TotalAmt
Program Services$93,104ProgramServicesAmt
Management And General$82,165ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$91,130,138TotalAmt
Program Services$67,974,581ProgramServicesAmt
Management And General$23,155,557ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$313,747BOYAmt
EOY-$195,924EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$57,404BOYAmt
EOY$752,302EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$177,537BOYAmt
EOY$177,537EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$3,466,990BOYAmt
EOY$3,369,235EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$54,379,444LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$44,798,683LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$5,707,236BOYAmt
EOY$9,580,761EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$3,349,494BOYAmt
EOY$3,173,819EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$100BOYAmt
EOY$100EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$8,354,613BOYAmt
EOY$6,134,859EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$21,427,121BOYAmt
EOY$22,992,689EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$11,055,865BOYAmt
EOY$36,776,611EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$11,329BOYAmt
EOY$16,605EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$171,003BOYAmt
EOY$103,719EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$11,159,004BOYAmt
EOY$12,789,171EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$22,397,201BOYAmt
EOY$49,686,106EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY-$963,734BOYAmt
EOY-$26,687,071EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY-$6,346BOYAmt
EOY-$6,346EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY-$970,080BOYAmt
EOY-$26,693,417EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$21,427,121BOYAmt
EOY$22,992,689EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$0ReconcilationRevenueExpnssAmt
Other Changes In Net Assets-$25,723,337OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Supporting Organization509a3Yes (X)SupportingOrganization509a3Ind
Supporting Org Type2Yes (X)SupportingOrgType2Ind
Supported Organizations1SupportedOrganizationsCnt

Supported Org Information SupportedOrgInformationGrp

Supported Organization Name SupportedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1NORTHBAY HEALTHCARE GROUPBusinessNameLine1Txt
FieldValueIRS element (for citing)
EIN941458282EIN
Organization Type3OrganizationTypeCd
Governing Document ListedYes (1)GoverningDocumentListedInd
Support$0SupportAmt
Other Support$0OtherSupportAmt
FieldValueIRS element (for citing)
Supported Organizations Total1SupportedOrganizationsTotalCnt
Support Sum$0SupportSumAmt
Other Support Sum$0OtherSupportSumAmt

Form990 Sch A Supporting Org Form990SchASupportingOrgGrp

FieldValueIRS element (for citing)
Listed By Name Governing DocYes (1)ListedByNameGoverningDocInd
Suprt Org No IRS Determination0SuprtOrgNoIRSDeterminationInd
Supported Org Section C4560SupportedOrgSectionC456Ind
Supported Org Not Organized US0SupportedOrgNotOrganizedUSInd
Organization Change Suprt Org0OrganizationChangeSuprtOrgInd
Support Non Supported Org0SupportNonSupportedOrgInd
Payment Substantial Contribtr0PaymentSubstantialContribtrInd
Loan Disqualified Person0LoanDisqualifiedPersonInd
Controlled Disqualified Prsn0ControlledDisqualifiedPrsnInd
Disqualified Prsn Controll Int0DisqualifiedPrsnControllIntInd
Disqualified Prsn Ownr Int0DisqualifiedPrsnOwnrIntInd
Excess Business Holdings Rules0ExcessBusinessHoldingsRulesInd
Contribution Controller0ContributionControllerInd
Contribution Family0ContributionFamilyInd
Contribution35 Controlled0Contribution35ControlledInd
FieldValueIRS element (for citing)
Majority Dir Trst Supported Org0MajorityDirTrstSupportedOrgInd

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, SECTION A, LINE 12G, COLUMN (VI):THE ORGANIZATION PROVIDES COORDINATION, MANAGEMENT, AND OTHER SUPPORT SERVICES TO NORTHBAY HEALTHCARE GROUP. THESE SERVICES INCLUDE MARKETING, RESEARCH OF NEW CLINICAL SERVICE AREAS, MANAGING CONTRACTS BETWEEN PROVIDERS AND PAYORS, AND FINANCING.
PART IV, SECTION C, LINE 1:NORTHBAY HEALTHCARE CORPORATION (NBHC) IS THE SOLE CORPORATE MEMBER OF NORTHBAY HEALTHCARE GROUP (NBHG), AS WELL AS NBHG'S OTHER SUPPORTING ORGANIZATIONS (NORTHBAY HEALTH ADVANTAGE AND NORTHBAY HEALTHCARE FOUNDATION). NBHC SERVES AS THE PARENT AND SUPPORTS AND CARRIES OUT THE PURPOSES AND FUNCTIONS OF NBHG. NBHC, A TYPE II SUPPORTING ORGANIZATION, HAS A HISTORICAL AND CONTINUOUS WORKING RELATIONSHIP WITH ITS SUPPORTED ORGANIZATION, NBHG, IN THAT TWO MEMBERS OF NBHC'S BOARD AND THE CEO OF NBHC SERVE AS VOTING DIRECTORS OF NBHG, THUS ENSURING NBHC WILL BE RESPONSIVE TO THE NEEDS OF NBHG.

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0VolunteersInd
Paid Staff Or Management0PaidStaffOrManagementInd
Media Advertisements0MediaAdvertisementsInd
Mailings Members0MailingsMembersInd
Publications Or Broadcast0PublicationsOrBroadcastInd
Grants Other Organizations0GrantsOtherOrganizationsInd
Direct Contact Legislators0DirectContactLegislatorsInd
Rallies Demonstrations0RalliesDemonstrationsInd
Other ActivitiesYes (1)OtherActivitiesInd
Other Activities$15,668OtherActivitiesAmt
Total Lobbying Expenditures$15,668TotalLobbyingExpendituresAmt
Not Described Section501c30NotDescribedSection501c3Ind

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART II-B, LINE 1:FormAndLineReferenceDesc
ExplanationNORTHBAY HEALTHCARE CORPORATION SUPPORTS CERTAIN INITIATIVES AND ISSUES THAT ARE HEALTHCARE RELATED AND CONSISTENT WITH ITS MISSION OF PROMOTING HEALTHCARE IN ITS COMMUNITY. EXPENDITURES INCURRED TO SUPPORT THESE INITIATIVES MAY BE CONSIDERED TO BE LOBBYING EXPENDITURES. DURING 2021, AN INDIRECT EXPENDITURE IN RELATION TO A PORTION OF MEMBERSHIP DUES PAID TO THE CALIFORNIA ASSOCIATION OF HOSPITALS AND HEALTH SYSTEMS WAS INDICATED AS USED FOR LOBBYING EXPENDITURES.ExplanationTxt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$20BeginningYearBalanceAmt
End Year Balance$20EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$20BeginningYearBalanceAmt
End Year Balance$20EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$20BeginningYearBalanceAmt
End Year Balance$20EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$20BeginningYearBalanceAmt
End Year Balance$20EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$20BeginningYearBalanceAmt
End Year Balance$20EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.00000BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY0.00000PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY1.00000TermEndowmentBalanceEOYPct
Endowments Held Unrelated Org0EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$710,938OtherCostOrOtherBasisAmt
Depreciation$710,938DepreciationAmt
Book Value$0BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,409,201OtherCostOrOtherBasisAmt
Depreciation$1,141,384DepreciationAmt
Book Value$267,817BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$44,543,719OtherCostOrOtherBasisAmt
Depreciation$42,144,343DepreciationAmt
Book Value$2,399,376BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$7,715,586OtherCostOrOtherBasisAmt
Depreciation$802,018DepreciationAmt
Book Value$6,913,568BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$9,580,761TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp

FieldValueIRS element (for citing)
DescOPERATING LEASE RIGHT-OF-USE ASSETSDesc
Book Value$6,134,859BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Other Assets$6,134,859TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)

DescDescAmtAmt
WORKERS COMP RESERVE$4,970,492
OPERATING LEASE LIABILITIES$7,210,436
DEFERRED EMPLOYER SOCIAL SECURITY TAX LIABILITY$608,243
FieldValueIRS element (for citing)
Total Liability$12,789,171TotalLiabilityAmt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART V, LINE 4:FormAndLineReferenceDesc
ExplanationTHE ENDOWMENT FUNDS ARE USED TO SUPPORT THE CERNER USER GROUP ANNUAL TRAINING AND EDUCATION CONFERENCE.ExplanationTxt

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable (5 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdRecipient EINRecipientEINIRC SectionIRCSectionDescCash GrantCashGrantAmtNon Cash AssistanceNonCashAssistanceAmtPurpose Of GrantPurposeOfGrantTxt
SOLANO EDC GOLD CLASSIC
360 CAMPUS LANE SUITE 102FAIRFIELDCA94534942912759501(C)(3)$25,000$0GENERAL SUPPORT
TOURO UNIVERSITY OF CALIFORNIA
1310 CLUB DRIVEVALLEJOCA94592133838740501(C)(3)$17,500$0SPONSORSHIP AND GENERAL SUPPORT
VACAVILLE CHAMBER OF COMMERCE
300 MAIN STREETVACAVILLECA95688941111162501(C)(6)$11,109$0SPONSORSHIP AND GENERAL SUPPORT
FAIRFIELD-SUISUN CHAMBER OF COMMERCE
1111 WEBSTER STREETFAIRFIELDCA94533941059185501(C)(6)$10,500$0SPONSORSHIP AND GENERAL SUPPORT
SOLANO COUNTY LIBRARY FOUNDATION
601 KENTUCKY STREETFAIRFIELDCA94533680342423501(C)(3)$8,500$0SPONSORSHIP OF REACH OUT AND READ
FieldValueIRS element (for citing)
Total501c3 Org3Total501c3OrgCnt
Total Other Org2TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationNBHC GRANTS FUNDS TO OTHER LOCAL NON-PROFITS AND COMMUNITY ORGANIZATIONS KNOWN TO NBHC TO ASSIST WITH THEIR FUNDRAISING ENDEAVORS. NBHC DOES NOT MONITOR USE OF THESE GRANT FUNDS, AS GRANT FUNDS ARE UNRESTRICTED.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr PlanYes (1)SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsYes (1)AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (17 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
B KONARD JONES
DIRECTOR / PRESIDENT & CEO$721,606$0$946,747$0$43,908$0$372,149$0$36,806$0$2,121,216$0$0$0
AIMEE BREWER
PRES NBHG / ASST SECR (THRU 9/2021)$418,381$0$156,975$0$108,822$0$68,598$0$41,019$0$793,795$0$0$0
WAYNE GIETZ
PRES NBHG / ASST SECR (START 9/2021)$391,227$0$222,897$0$9,314$0$56,396$0$26,025$0$705,859$0$0$0
JIM ANDERSEN
VP, HUMAN RESOURCES$452,158$0$86,112$0$20,535$0$58,091$0$14,171$0$631,067$0$0$0
CHRISTOPHER TIMBERS
VP, CHIEF INFORMATION OFFICER$390,355$0$80,499$0$13,743$0$65,082$0$61,734$0$611,413$0$0$0
MICHELE BOUIT
VP, FINANCE & CFO / ASST SECR$449,101$0$43,126$0$19,917$0$80,770$0$7,246$0$600,160$0$0$0
SCOTT DAVIS
VP, CHIEF STRATEGY OFFICER/PRES NBHA$414,897$0$80,499$0$13,743$0$24,669$0$50,962$0$584,770$0$0$0
SETH KAUFMAN MD
CHIEF MEDICAL OFFICER$403,348$0$45,989$0$6,952$0$5,811$0$58,902$0$521,002$0$0$0
TRACI DUNCAN
VP, CHIEF NURSING OFFICER$348,150$0$80,075$0$49,444$0$19,191$0$16,740$0$513,600$0$27,852$0
ROBERT COSCIONE
VP, PAYER STRATEGY (THRU 8/2021)$230,179$0$80,500$0$107,783$0$49,035$0$8,042$0$475,539$0$0$0
STEVE HUDDLESTON
VP, PUBLIC AFFAIRS$173,117$0$73,913$0$171,438$0$28,150$0$21,980$0$468,598$0$24,331$0
THERESA BARTOLI
CLINICAL COORDINATOR$334,520$0$1,798$0$0$0$15,032$0$50,955$0$402,305$0$0$0
AROLD NELSON
CLINICAL NURSE SUPERVISOR$329,495$0$2,478$0$7,308$0$7,289$0$49,391$0$395,961$0$0$0
THEO RALLIS
ASSISTANT VP, FINANCE / CONTROLLER$236,133$0$98,670$0$1,230$0$17,395$0$31,996$0$385,424$0$0$0
NICOLE BROCATO
VP, OPERATIONS / CQO (THRU 8/2021)$214,768$0$79,333$0$14,397$0$27,865$0$47,822$0$384,185$0$0$0
DUSTIN DATOC
REGISTERED NURSE FIRST ASSISTANT$315,596$0$237$0$0$0$5,647$0$51,310$0$372,790$0$0$0
JOANNE JACOB
CLINICAL COORDINATOR$319,385$0$2,107$0$0$0$14,356$0$428$0$336,276$0$0$0

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART I, LINE 4BTHE FOLLOWING INDIVIDUALS PARTICIPATED IN THE ORGANIZATION'S SUPPLEMENTAL 457(F) RETIREMENT PLAN. EMPLOYER CONTRIBUTIONS TO THE PLAN DURING THE 2021 CALENDAR YEAR ARE AS FOLLOWS, WHICH HAS BEEN REPORTED AS "RETIREMENT AND OTHER DEFERRED COMPENSATION" ON SCHEDULE J, PART II, COLUMN (C): B. KONARD JONES - $361,640 AIMEE BREWER - $57,838 WAYNE GIETZ - $45,292 JIM ANDERSEN - $48,777 CHRISTOPHER TIMBERS - $54,058 MICHELE BOUIT - $78,001 SCOTT DAVIS - $19,500 TRACI DUNCAN - $8,127 ROBERT COSCIONE - $43,495 STEVE HUDDLESTON - $7,277 NICOLE BROCATO - $19,413 ADDITIONALLY, DUE TO VESTING OF THE 457(F) RETIREMENT PLAN, THE FOLLOWING INDIVIDUALS RECOGNIZED TAXABLE COMPENSATION IN THE FOLLOWING AMOUNTS, WHICH HAS BEEN REPORTED AS "OTHER REPORTABLE COMPENSATION" IN SCHEDULE J, PART II, COLUMN (B)(III) AND "COMPENSATION IN COLUMN (B) REPORTED AS DEFERRED ON PRIOR FORM 990" IN SCHEDULE J, PART II, COLUMN (F). TRACI DUNCAN - $27,852 STEVE HUDDLESTON - $24,331
PART I, LINE 7THE SENIOR MANAGEMENT INCENTIVE PROGRAM INCLUDES SPECIFIC CRITERIA WHICH MUST BE MET IN ORDER FOR SUCH INDIVIDUALS TO RECEIVE ADDITIONAL COMPENSATION; SOME OF THIS CRITERIA REQUIRES SUPERVISORS TO EXERCISE DISCRETION WHEN CALCULATING THE AMOUNT OF PAYMENT OR DECIDING WHETHER TO MAKE SUCH A PAYMENT.

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART V, LINES 1A AND 2A:ALL FORM 1099S FOR NORTHBAY HEALTHCARE CORPORATION WERE FILED BY NORTHBAY HEALTHCARE GROUP, A RELATED ORGANIZATION. ACCORDINGLY, THE AMOUNT REPORTED ON FORM 990, PART V, LINE 1A (IN REGARDS TO THE AMOUNT REPORTED ON THE 2021 FORM 1096, BOX 3) REFLECTS ZERO. ADDITIONALLY, ALL FORM W-2S FOR NORTHBAY HEALTHCARE SYSTEM WERE FILED BY NORTHBAY HEALTHCARE CORPORATION, WHICH IS THE BASIS FOR THE NUMBER OF EMPLOYEES REPORTED ON FORM 990, PART V, LINE 2A.
FORM 990, PART VI, SECTION B, LINE 11BTHE FORM 990 IS REVIEWED BY THE VICE PRESIDENT/CHIEF FINANCIAL OFFICER; ADJUSTMENTS ARE MADE, AS NECESSARY. A COMPLETE COPY OF THE FORM 990 IS PROVIDED TO ALL VOTING MEMBERS OF THE GOVERNING BODY FOR REVIEW AND COMMENT PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE.
FORM 990, PART VI, SECTION B, LINE 12CTHE ORGANIZATION REQUESTS ALL OFFICERS, DIRECTORS, KEY EMPLOYEES AND MEMBERS OF COMMITTEES APPOINTED BY THE BOARD OF DIRECTORS TO SELF-MONITOR COMPLIANCE WITH THE ORGANIZATION'S CONFLICT OF INTEREST POLICY; IN ADDITION, EACH OFFICER AND BOARD MEMBERS MUST ANNUALLY COMPLETE A CONFLICT OF INTEREST STATEMENT. THE CONFLICT OF INTEREST STATEMENTS ARE REVIEWED AND ALL RESPONSES FILED. IF A POTENTIAL CONFLICT ARISES, BOARD MEMBERS AND EMPLOYEES ARE REQUIRED TO SELF-DISCLOSE THE CONFLICT TO THE CORPORATE COMPLIANCE OFFICER. PROCESSES AND PROCEDURES ARE IN PLACE TO EVALUATE AND DETERMINE IF A POSSIBLE CONFLICT OF INTEREST EXISTS. IF A CONFLICT OF INTEREST EXISTS, THE INDIVIDUAL WILL PRESENT RELEVANT INFORMATION TO THE BOARD. AFTER SUCH PRESENTATION, THE INDIVIDUAL SHALL LEAVE THE MEETING DURING THE DISCUSSION OF, AND VOTE ON, THE TRANSACTION OR ARRANGEMENT INVOLVING THE POSSIBLE CONFLICT.
FORM 990, PART VI, SECTION B, LINE 15AN AD HOC COMPENSATION COMMITTEE OF THE HEALTH SYSTEM BOARD REVIEWS EXECUTIVE COMPENSATION, INCLUDING THAT OF THE ORGANIZATION'S CEO, OTHER OFFICERS, AND KEY EMPLOYEES; THEY ARE ASSISTED BY INDEPENDENT CONSULTANTS. THE ORGANIZATION USES INDEPENDENT LOCAL SURVEYS AS A MEANS TO SUBSTANTIATE COMPENSATION DECISIONS.
FORM 990, PART VI, SECTION C, LINE 19THE FINANCIAL STATEMENTS ARE AVAILABLE ON THE DIGITAL ASSURANCE CORPORATION WEBSITE. THE GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE PUBLIC.
FORM 990, PART IX, LINE 11GTEMPORARY LABOR: PROGRAM SERVICE EXPENSES 947,331. MANAGEMENT AND GENERAL EXPENSES 107,412. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,054,743. PROFESSIONAL FEES - MEDICAL: PROGRAM SERVICE EXPENSES -24,948. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES -24,948. CONSULTING FEES: PROGRAM SERVICE EXPENSES 1,120,182. MANAGEMENT AND GENERAL EXPENSES 1,135,279. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,255,461. OTHER PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 2,697. MANAGEMENT AND GENERAL EXPENSES 133,527. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 136,224. PURCHASED SERVICES - OTHER: PROGRAM SERVICE EXPENSES 25,550,915. MANAGEMENT AND GENERAL EXPENSES 2,189,391. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 27,740,306.
FORM 990, PART XI, LINE 9:RELIEF OF DUE TO/DUE FROM RELATED ORGANIZATIONS -25,723,337.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
NORTHBAY HEALTH ADVANTAGE
4500 BUSINESS CENTER DRIVEFAIRFIELDCA94534942495998MANAGES REAL ESTATE FOR NORTHBAY HEALTHCARE GROUP & AFFILIATESCA501(C)(3)LINE 12B, IINORTHBAY HEALTHCARE CORPORATIONYes (1)
NORTHBAY HEALTHCARE GROUP
1200 B GALE WILSON BOULEVARDFAIRFIELDCA94533941458282OPERATES TWO NONPROFIT HOSPITALSCA501(C)(3)LINE 3NORTHBAY HEALTHCARE CORPORATIONYes (1)
NORTHBAY HEALTHCARE FOUNDATION
4500 BUSINESS CENTER DRIVEFAIRFIELDCA94534942995085PROVIDES FUNDRAISING FOR NORTHBAY HEALTHCARE GROUP & AFFILIATESCA501(C)(3)LINE 12B, IINORTHBAY HEALTHCARE CORPORATIONYes (1)

Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1SOLANO DIAGNOSTIC PARTNERSBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line11101 B GALE WILSON BLVDAddressLine1Txt
CityFAIRFIELDCityNm
State AbbreviationCAStateAbbreviationCd
ZIP94533ZIPCd
FieldValueIRS element (for citing)
EIN931013774EIN
Primary ActivitiesDIAGNOSTIC IMAGINGPrimaryActivitiesTxt
Legal Domicile StateCALegalDomicileStateCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1NORTHBAY HEALTH ADVANTAGEBusinessNameLine1Txt
FieldValueIRS element (for citing)
Predominant Income TypeRELATEDPredominantIncomeTypeTxt
Share Of Total Income$2,475ShareOfTotalIncomeAmt
Share Of EOY Assets$178,234ShareOfEOYAssetsAmt
Disproportionate Allocations0DisproportionateAllocationsInd
General Or Managing Partner0GeneralOrManagingPartnerInd
Ownership0.05000OwnershipPct
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgYes (1)PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgYes (1)ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (3 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
NORTHBAY HEALTH ADVANTAGE
L$144,182BOOK VALUE
NORTHBAY HEALTHCARE GROUP
L$89,981,791BOOK VALUE
SOLANO DIAGNOSTIC PARTNERS
L$631,931BOOK VALUE