WEST COUNTY HEALTH CENTERS INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- WEST COUNTY HEALTH CENTERS INC (EIN 23-7310613)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-11-11
- IRS object ID
- 202213159349304831
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule J
- Schedule K
- Schedule M
- Schedule O
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-11-11T13:19:22-06:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 910189318 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MOSS ADAMS LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 SECOND STREET SUITE 900 | AddressLine1Txt |
| City | SAN FRANCISCO | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 94105 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 237310613 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WEST COUNTY HEALTH CENTERS INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | WEST | BusinessNameControlTxt |
| Phone | 7078695977 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1449 | AddressLine1Txt |
| City | GUERNEVILLE | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95446 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JASON CUNNINGHAM DO | PersonNm |
| Person Title | CHIEF EXECUTIVE OFFICER | PersonTitleTxt |
| Phone | 7078695977 | PhoneNum |
| Signature | 2022-11-09 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | JASON | PersonFirstNm |
| Person Last | CUNNINGHAM DO | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MICHAEL LUMSDEN | PreparerPersonNm |
| PTIN | P01262236 | PTIN |
| Phone | 4159561500 | PhoneNum |
| Preparation | 2022-11-09 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 0 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JASON CUNNINGHAM DO | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1449 | AddressLine1Txt |
| City | GUERNEVILLE | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95446 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $26,462,696 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.WCHEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1973 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | WEST COUNTY HEALTH CENTERS INC. IS A PRIVATE, NON-PROFIT FEDERALLY QUALIFIED HEALTH CENTER PROVIDING QUALITY HEALTH SERVICES TO THE WHOLE COMMUNITY REGARDLESS OF ABILITY TO PAY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 13 | VotingMembersIndependentCnt |
| Total Employee | 263 | TotalEmployeeCnt |
| Total Volunteers | 100 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $9,712,542 | PYContributionsGrantsAmt |
| CY Contributions Grants | $10,808,632 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $10,736,144 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $15,617,759 | CYProgramServiceRevenueAmt |
| PY Investment Income | $27,536 | PYInvestmentIncomeAmt |
| CY Investment Income | $7,145 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $29,160 | CYOtherRevenueAmt |
| PY Total Revenue | $20,476,222 | PYTotalRevenueAmt |
| CY Total Revenue | $26,462,696 | 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 | $14,579,838 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $15,346,118 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $94,076 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $4,782,826 | PYOtherExpensesAmt |
| CY Other Expenses | $9,243,435 | CYOtherExpensesAmt |
| PY Total Expenses | $19,362,664 | PYTotalExpensesAmt |
| CY Total Expenses | $24,589,553 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,113,558 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,873,143 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $27,875,608 | TotalAssetsBOYAmt |
| Total Assets EOY | $28,615,022 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $16,307,211 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $15,119,095 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $11,568,397 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $13,495,927 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO PROVIDE COMPREHENSIVE, QUALITY, AND ACCESSIBLE HEALTH CARE SERVICES TO THE COMMUNITIES OF WESTERN SONOMA COUNTY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $16,342,482 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $15,617,759 | RevenueAmt |
| Desc | WEST COUNTY HEALTH CENTER OFFERS A FULL SCOPE OF PRIMARY MEDICAL, DENTAL CARE, AND MENTAL HEALTH SERVICES WITHIN WESTERN SONOMA COUNTY. OUR HIGHLY QUALIFIED HEALTH CARE TEAM CONSISTS OF PHYSICIANS, MID-LEVEL PROVIDERS (FAMILY NURSE PRACTITIONERS AND PHYSICIAN ASSISTANTS), DENTISTS, PSYCHOTHERAPISTS, AND NURSES, AND ARE SUPPORTED BY MEDICAL AND DENTAL ASSISTANTS, OUTREACH WORKERS, AND ADMINISTRATIVE STAFF. ALL OF OUR EMPLOYEES ARE COMMITTED TO PROVIDING COMPASSIONATE AND ACCESSIBLE CARE FOR ALL MEMBERS OF OUR DIVERSE COMMUNITY. MANY OF OUR STAFF MEMBERS ARE BILINGUAL IN SEVERAL LANGUAGES, INCLUDING SPANISH AND VIETNAMESE. WEST COUNTY HEALTH CENTERS DELIVERS HEALTH CARE TO AN IMPORTANT CROSS-SECTION OF OUR COMMUNITY, INCLUDING ELEMENTARY AGE CHILDREN WHOSE PARENTS CANNOT OTHERWISE AFFORD THE MEDICAL CARE NEEDED TO KEEP THEM HEALTHY AND ACTIVE IN SCHOOLS; THOSE WHO ARE NOT ACCEPTED ELSEWHERE DUE TO HIV/AIDS, HOMELESSNESS, MENTAL ILLNESS OR ADDICTION; THOSE IN THE COMMUNITY WHO LACK THE FINANCIAL RESOURCES TO PAY FOR QUALITY HEALTH CARE; AS WELL AS MANY OTHERS. NO PATIENT IS TURNED AWAY FROM WEST COUNTY HEALTH CENTER FOR LACK OF FUNDS. | Desc |
| Total Program Service Expenses | $16,342,482 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | 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 | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 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 | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | Yes (1) | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 35 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 263 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 13 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | 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 | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | CA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GRETCHEN ERDMANN | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7078695977 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1449 | AddressLine1Txt |
| City | GUERNEVILLE | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95446 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (24 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|---|
| JASON CUNNINGHAM DO | ||||||||
| CHIEF EXECUTIVE OFFICER | 40.00 | Yes (X) | $233,625 | $0 | $28,491 | |||
| RAIN MOORE MD | ||||||||
| CMO - COMMUNITY HEALTH & ADVOCACY | 40.00 | $217,340 | $0 | $25,834 | Yes (X) | |||
| CONSTANCE EARL DO | ||||||||
| CMO - INNOVATIONS & OPERATIONS | 40.00 | $210,748 | $0 | $29,450 | Yes (X) | |||
| DEETTE DEVILLE MD | ||||||||
| CMO - PROVIDER SUSTAINABILITY | 40.00 | $189,399 | $0 | $30,550 | Yes (X) | |||
| MICHAEL KOZART MD | ||||||||
| PSYCHIATRIST | 40.00 | $199,953 | $0 | $4,951 | Yes (X) | |||
| JARED GARRISON-JAKEL MD | ||||||||
| PHYSICIAN | 40.00 | $184,059 | $0 | $14,311 | Yes (X) | |||
| STEVEN BROMER MD | ||||||||
| PHYSICIAN | 40.00 | $181,880 | $0 | $3,581 | Yes (X) | |||
| ELLEN BAUER PHD | ||||||||
| CHIEF ADMINISTRATIVE OFFICER | 40.00 | $165,028 | $0 | $12,283 | Yes (X) | |||
| MICHELLE DAVEY DO | ||||||||
| HIV PROGRAM MEDICAL DIRECTOR | 40.00 | $161,628 | $0 | $12,919 | Yes (X) | |||
| ANDREA SEIFFERTT DO | ||||||||
| PHYSICIAN | 40.00 | $160,998 | $0 | $13,290 | Yes (X) | |||
| ROBERT HEINEMEIER | ||||||||
| CHIEF FINANCIAL OFFICER | 40.00 | Yes (X) | $0 | $0 | $0 | |||
| JOHN KORNFELD PHD | ||||||||
| PRESIDENT | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| DEBRA JOHNSON | ||||||||
| VICE PRESIDENT | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| MARY FELTON RN MSN | ||||||||
| SECRETARY | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| DWIGHT CARY | ||||||||
| TREASURER | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| ANGELES DAVID | ||||||||
| BOARD MEMBER | 1.00 | $0 | $0 | $0 | Yes (X) | |||
| ELIOT ENRIQUEZ | ||||||||
| BOARD MEMBER | 1.00 | $0 | $0 | $0 | Yes (X) | |||
| PAULETTE HALL | ||||||||
| BOARD MEMBER | 1.00 | $0 | $0 | $0 | Yes (X) | |||
| HENRY JAKE HAMLIN | ||||||||
| BOARD MEMBER | 1.00 | $0 | $0 | $0 | Yes (X) | |||
| JENNIFER NICHOLS | ||||||||
| BOARD MEMBER | 1.00 | $0 | $0 | $0 | Yes (X) | |||
| KATHLEEN SHERIDAN | ||||||||
| BOARD MEMBER | 1.00 | $0 | $0 | $0 | Yes (X) | |||
| ALAN SIEGLE | ||||||||
| BOARD MEMBER | 1.00 | $0 | $0 | $0 | Yes (X) | |||
| DIANE SPAIN | ||||||||
| BOARD MEMBER | 1.00 | $0 | $0 | $0 | Yes (X) | |||
| MERI HARDING STORINO | ||||||||
| BOARD MEMBER | 1.00 | $0 | $0 | $0 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,904,658 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $175,660 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 22 | 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 |
|---|---|---|---|---|---|
| GMH BUILDERS INC | |||||
| PO BOX 1773 | SONOMA | CA | 95476 | CONSTRUCTION SERVICES | $6,775,751 |
| MAXIMON VENTURES LLC | |||||
| 900 PACIFIC COAST HWY 105 | HUNTINGTON BEACH | CA | 92648 | CONSULTANTS - CFO / COO/CSO/IT/CASE MGMT | $653,363 |
| KLH CONSULTING INC | |||||
| 2324 BETHARDS DRIVE | SANTA ROSA | CA | 95405 | CONSULTING - IT SERVICES | $615,830 |
| WEATHERBY LOCUMS INC | |||||
| PO BOX 972633 | DALLAS | TX | 75397 | CONTRACTED MEDICAL PROVIDERS | $412,550 |
| MINDFUL SPECIALTY ASSOCIATES | |||||
| 24040 CAMINO DEL AVION STE E196 | DANA POINT | CA | 92629 | CONTRACTED MEDICAL PROVIDERS | $262,416 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 6 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $8,205,309 | GovernmentGrantsAmt |
| All Other Contributions | $2,603,323 | AllOtherContributionsAmt |
| Noncash Contributions | $48,441 | NoncashContributionsAmt |
| Total Contributions | $10,808,632 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 621400 | $10,828,189 | $10,828,189 |
| 340B PHARMACY REVENUE | 446110 | $4,429,644 | $4,429,644 |
| CAPITATION REVENUE | 621400 | $359,866 | $359,866 |
| OTHER REVENUE | 523000 | $60 | $60 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $15,617,759 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $6,214 | TotalRevenueColumnAmt |
| Exclusion | $6,214 | ExclusionAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $931 | TotalRevenueColumnAmt |
| Exclusion | $931 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $29,160 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $29,160 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $29,160 | TotalRevenueColumnAmt |
| Exclusion | $29,160 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $26,462,696 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $15,617,759 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $36,305 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,142,748 | TotalAmt |
| Program Services | $703,321 | ProgramServicesAmt |
| Management And General | $439,427 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,695,085 | TotalAmt |
| Program Services | $9,443,683 | ProgramServicesAmt |
| Management And General | $2,176,978 | ManagementAndGeneralAmt |
| Fundraising | $74,424 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $74,912 | TotalAmt |
| Program Services | $63,092 | ProgramServicesAmt |
| Management And General | $11,258 | ManagementAndGeneralAmt |
| Fundraising | $562 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,529,998 | TotalAmt |
| Program Services | $1,221,602 | ProgramServicesAmt |
| Management And General | $298,820 | ManagementAndGeneralAmt |
| Fundraising | $9,576 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $903,375 | TotalAmt |
| Program Services | $715,038 | ProgramServicesAmt |
| Management And General | $183,048 | ManagementAndGeneralAmt |
| Fundraising | $5,289 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,325 | TotalAmt |
| Program Services | $413 | ProgramServicesAmt |
| Management And General | $7,912 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $50,708 | TotalAmt |
| Management And General | $50,708 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,963,535 | TotalAmt |
| Program Services | $111,992 | ProgramServicesAmt |
| Management And General | $1,851,361 | ManagementAndGeneralAmt |
| Fundraising | $182 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $440,351 | TotalAmt |
| Program Services | $86,204 | ProgramServicesAmt |
| Management And General | $354,147 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $141,167 | TotalAmt |
| Program Services | $59,172 | ProgramServicesAmt |
| Management And General | $81,995 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,051,001 | TotalAmt |
| Program Services | $10,765 | ProgramServicesAmt |
| Management And General | $1,040,062 | ManagementAndGeneralAmt |
| Fundraising | $174 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,136,203 | TotalAmt |
| Program Services | $1,010,603 | ProgramServicesAmt |
| Management And General | $125,600 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $60,222 | TotalAmt |
| Program Services | $4,320 | ProgramServicesAmt |
| Management And General | $55,902 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $345,439 | TotalAmt |
| Program Services | $83 | ProgramServicesAmt |
| Management And General | $345,356 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $253,035 | TotalAmt |
| Program Services | $145,278 | ProgramServicesAmt |
| Management And General | $107,757 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $390,482 | TotalAmt |
| Program Services | $23,438 | ProgramServicesAmt |
| Management And General | $367,044 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| MEDICAL SUPPLIES/DRUGS | $2,789,825 | $2,684,182 | $105,643 | |
| LOSS - ASSET IMPAIRMENT | $457,642 | $457,642 | ||
| DUES, FEES, MEMBERSHIPS | $111,703 | $33,390 | $74,894 | $3,419 |
| STAFF DEV & EDUCATION | $18,071 | $4,451 | $13,170 | $450 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $25,726 | TotalAmt |
| Program Services | $21,455 | ProgramServicesAmt |
| Management And General | $4,271 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,589,553 | TotalAmt |
| Program Services | $16,342,482 | ProgramServicesAmt |
| Management And General | $8,152,995 | ManagementAndGeneralAmt |
| Fundraising | $94,076 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $706,602 | BOYAmt |
| EOY | $912,582 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,860,688 | BOYAmt |
| EOY | $8,676,859 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,710,855 | BOYAmt |
| EOY | $1,637,748 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,000,930 | BOYAmt |
| EOY | $709,738 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $316,432 | BOYAmt |
| EOY | $316,431 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $301,154 | BOYAmt |
| EOY | $268,927 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $16,531,968 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $2,529,854 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,426,076 | BOYAmt |
| EOY | $14,002,114 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $117,326 | BOYAmt |
| EOY | $222,169 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,435,545 | BOYAmt |
| EOY | $1,868,454 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,875,608 | BOYAmt |
| EOY | $28,615,022 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,585,789 | BOYAmt |
| EOY | $2,462,833 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $655,398 | BOYAmt |
| EOY | $872,671 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,774,144 | BOYAmt |
| EOY | $9,676,848 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $540,499 | BOYAmt |
| EOY | $452,448 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,040,672 | BOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $710,709 | BOYAmt |
| EOY | $1,654,295 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,307,211 | BOYAmt |
| EOY | $15,119,095 | 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 | $9,870,837 | BOYAmt |
| EOY | $13,264,409 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,697,560 | BOYAmt |
| EOY | $231,518 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,568,397 | BOYAmt |
| EOY | $13,495,927 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,875,608 | BOYAmt |
| EOY | $28,615,022 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $1,873,143 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $54,387 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $7,106,109 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $10,304,877 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $8,441,909 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $9,712,542 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $10,808,632 | CurrentTaxYearAmt |
| Total | $46,374,069 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $7,106,109 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $10,304,877 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $8,441,909 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $9,712,542 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $10,808,632 | CurrentTaxYearAmt |
| Total | $46,374,069 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $78,314 | SubstantialContributorsTotAmt |
| Public Support Total170 | $46,295,755 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $5,080 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $17,200 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $52,088 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $27,536 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $36,305 | CurrentTaxYearAmt |
| Total | $138,209 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $320,082 | CurrentTaxYearMinus4YearsAmt |
| Total | $320,082 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $46,832,360 | TotalSupportAmt |
| Public Support CY170 | 0.98850 | PublicSupportCY170Pct |
| 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 | MISCELLANEOUS REVENUE - 2017 AMOUNT: $ 320,082. 2018 AMOUNT: $ 0. 2019 AMOUNT: $ 0. 2020 AMOUNT: $ 0. 2021 AMOUNT: $ 0. | 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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Volunteers | 0 | VolunteersInd |
| Paid Staff Or Management | 0 | PaidStaffOrManagementInd |
| Media Advertisements | 0 | MediaAdvertisementsInd |
| Mailings Members | 0 | MailingsMembersInd |
| Publications Or Broadcast | 0 | PublicationsOrBroadcastInd |
| Grants Other Organizations | 0 | GrantsOtherOrganizationsInd |
| Direct Contact Legislators | 0 | DirectContactLegislatorsInd |
| Rallies Demonstrations | 0 | RalliesDemonstrationsInd |
| Other Activities | Yes (1) | OtherActivitiesInd |
| Other Activities | $7,024 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $7,024 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | 0 | NotDescribedSection501c3Ind |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART II-B, LINE 1: | FormAndLineReferenceDesc |
| Explanation | DURING 2021, THE ORGANIZATION PAID DUES THE CALIFORNIA PRIMARY CARE ASSOCIATION; A PORTION OF THOSE DUES ($7,024) HAVE BEEN INDICATED AS USED FOR LOBBYING ACTIVITIES PERTAINING TO THE HEALTHCARE INDUSTRY. | ExplanationTxt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,095,744 | OtherCostOrOtherBasisAmt |
| Book Value | $1,095,744 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,323,458 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,440,548 | DepreciationAmt |
| Book Value | $882,910 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,421,704 | OtherCostOrOtherBasisAmt |
| Depreciation | $624,666 | DepreciationAmt |
| Book Value | $797,038 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $863,685 | OtherCostOrOtherBasisAmt |
| Depreciation | $464,640 | DepreciationAmt |
| Book Value | $399,045 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $10,827,377 | OtherCostOrOtherBasisAmt |
| Book Value | $10,827,377 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $14,002,114 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (3 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| DEPOSITS | $32,688 |
| ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS | $375,589 |
| RIGHT-OF-USE ASSETS | $1,460,177 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $1,868,454 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS | $194,118 |
| OPERATING LEASE LIABILITIES | $1,460,177 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,654,295 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $26,517,083 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $54,387 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | $54,387 | RevenueNotReportedAmt |
| Revenue Subtotal | $26,462,696 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $26,462,696 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $24,589,553 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $24,589,553 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $24,589,553 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE CENTER IS A NONPROFIT CORPORATION UNDER INTERNAL REVENUE CODE SECTION 501(C)(3) AND HAS BEEN GRANTED TAX-EXEMPT STATUSES BY THE INTERNAL REVENUE SERVICE AND THE CALIFORNIA REVENUE AND TAXATION CODE. AS OF DECEMBER 31, 2021, THE CENTER HAD NO UNRECOGNIZED TAX POSITIONS OR UNCERTAIN TAX POSITIONS REQUIRING ACCRUAL. THEREFORE, NO PROVISION FOR INCOME TAXES HAS BEEN PROVIDED IN THE FINANCIAL STATEMENTS. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| 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 (10 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JASON CUNNINGHAM DO | ||||||||||||||
| CHIEF EXECUTIVE OFFICER | $233,113 | $0 | $512 | $0 | $0 | $0 | $4,896 | $0 | $23,595 | $0 | $262,116 | $0 | $0 | $0 |
| RAIN MOORE MD | ||||||||||||||
| CMO - COMMUNITY HEALTH & ADVOCACY | $188,774 | $0 | $26,991 | $0 | $1,575 | $0 | $4,445 | $0 | $21,389 | $0 | $243,174 | $0 | $0 | $0 |
| CONSTANCE EARL DO | ||||||||||||||
| CMO - INNOVATIONS & OPERATIONS | $184,493 | $0 | $11,948 | $0 | $14,307 | $0 | $4,462 | $0 | $24,988 | $0 | $240,198 | $0 | $0 | $0 |
| DEETTE DEVILLE MD | ||||||||||||||
| CMO - PROVIDER SUSTAINABILITY | $162,996 | $0 | $23,853 | $0 | $2,550 | $0 | $3,991 | $0 | $26,559 | $0 | $219,949 | $0 | $0 | $0 |
| MICHAEL KOZART MD | ||||||||||||||
| PSYCHIATRIST | $199,396 | $0 | $507 | $0 | $50 | $0 | $3,989 | $0 | $962 | $0 | $204,904 | $0 | $0 | $0 |
| JARED GARRISON-JAKEL MD | ||||||||||||||
| PHYSICIAN | $162,781 | $0 | $19,328 | $0 | $1,950 | $0 | $3,605 | $0 | $10,706 | $0 | $198,370 | $0 | $0 | $0 |
| STEVEN BROMER MD | ||||||||||||||
| PHYSICIAN | $158,736 | $0 | $21,044 | $0 | $2,100 | $0 | $2,835 | $0 | $746 | $0 | $185,461 | $0 | $0 | $0 |
| ELLEN BAUER PHD | ||||||||||||||
| CHIEF ADMINISTRATIVE OFFICER | $164,521 | $0 | $507 | $0 | $0 | $0 | $3,300 | $0 | $8,983 | $0 | $177,311 | $0 | $0 | $0 |
| MICHELLE DAVEY DO | ||||||||||||||
| HIV PROGRAM MEDICAL DIRECTOR | $147,989 | $0 | $9,189 | $0 | $4,450 | $0 | $3,211 | $0 | $9,708 | $0 | $174,547 | $0 | $0 | $0 |
| ANDREA SEIFFERTT DO | ||||||||||||||
| PHYSICIAN | $149,678 | $0 | $9,009 | $0 | $2,311 | $0 | $3,210 | $0 | $10,080 | $0 | $174,288 | $0 | $0 | $0 |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CALIFORNIA MUNICIPAL FINANCE AUTHORITY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 201563466 | BondIssuerEIN |
| CUSIP | 13048VQH4 | CUSIPNum |
| Bond Issued | 2020-10-14 | BondIssuedDt |
| Issue Price | $10,519,473 | IssuePriceAmt |
| Purpose | CONSTRUCTION OF NEW HEALTH CENTER BUILDING | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Total Proceeds | $10,519,473 | TotalProceedsAmt |
| In Reserve Fund | $275,614 | InReserveFundAmt |
| Issuance Costs From Proceeds | $210,389 | IssuanceCostsFromProceedsAmt |
| Credit Enhancement | $519,600 | CreditEnhancementAmt |
| Capital Expenditures | $5,619,618 | CapitalExpendituresAmt |
| Unspent | $3,894,252 | UnspentAmt |
| Refunding Tax Exempt Bonds | 0 | RefundingTaxExemptBondsInd |
| Refunding Taxable Bonds | 0 | RefundingTaxableBondsInd |
| Final Allocation Made | Yes (1) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | 0 | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | 0 | MgmtContractBondFincdPropInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Private Bus Use By Others | 0.00000 | PrivateBusUseByOthersPct |
| Private Bus Concerning UBI | 0.00000 | PrivateBusConcerningUBIPct |
| Total Private Business Use | 0.00000 | TotalPrivateBusinessUsePct |
| Bond Iss Meet Prvt Sec Pymt Test | 0 | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | Yes (1) | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | Yes (1) | RebateNotDueYetInd |
| Exception To Rebate | 0 | ExceptionToRebateInd |
| No Rebate Due | 0 | NoRebateDueInd |
| Variable Rate Issue | 0 | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | 0 | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Gross Proceeds Invested | 0 | GrossProceedsInvestedInd |
| Written Proc To Monitor Reqs | Yes (1) | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | Yes (1) | ProceduresCorrectiveActionInd |
Schedule M IRS990ScheduleM
Securities Publicly Traded SecuritiesPubliclyTradedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $48,441 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FAIR MARKET VALUE | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8283 Received | 0 | Form8283ReceivedCnt |
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, COLUMN (B): | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION IS REPORTING THE NUMBER OF CONTRIBUTIONS RECEIVED (DEFINED AS EACH SEPARATE GIFT) IN SCHEDULE M, PART I, COLUMN (B). | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 3 | THE ORGANIZATION'S CHIEF FINANCIAL OFFICER AND CHIEF OPERATIONS & STRATEGY OFFICER ARE CONSULTANTS EMPLOYED BY MAXIMON VENTURES, LLC. TOTAL COMPENSATION PAID TO MAXIMON VENTURES, LLC IN EXCHANGE FOR THESE SERVICES (AS WELL AS VARIOUS IT AND CASE MANAGEMENT SERVICES) TOTALED $653,363 DURING THE 2021 TAX YEAR. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 IS PREPARED BY AN INDEPENDENT TAX ACCOUNTANT IN CONJUNCTION WITH THE ORGANIZATION'S FINANCE AND ACCOUNTING STAFF. A DRAFT FORM 990 IS PREPARED AND REVIEWED BY THE CFO; ADJUSTMENTS ARE MADE (AS NECESSARY). A COMPLETE COPY OF THE FORM 990 IS THEN MADE AVAILABLE TO THE ENTIRE BOARD FOR REVIEW AND COMMENT PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION HAS A WRITTEN CONFLICT OF INTEREST POLICY WHICH COVERS ALL BOARD MEMBERS, OFFICERS, AND KEY EMPLOYEES. UNDER THE POLICY, EACH BOARD MEMBERS IS REQUIRED TO COMPLETE AN ANNUAL CONFLICT-OF-INTEREST DISCLOSURE STATEMENT; ADDITIONAL, EACH OFFICER AND KEY EMPLOYEE IS REQUIRED TO PROVIDE A WRITTEN DISCLOSURE OF REAL OR APPARENT CONFLICTS WHEN THEY ARISE. THE COMPLETED STATEMENTS ARE PROVIDED TO THE CHIEF EXECUTIVE OFFICER AND BOARD CHAIR FOR THEIR REVIEW AND ARE MAINTAINED IN THE BOARD RECORDS. SHOULD AN ACTUAL OR POTENTIAL CONFLICT OF INTEREST BE IDENTIFIED, THE CEO (IN THE CASE OF AN EMPLOYEE) OR THE BOARD CHAIR (IN THE CASE OF BOARD MEMBERS AND/OR THE CEO) SHALL VOTE ON WHETHER TO PROCEED WITH THE POTENTIAL TRANSACTION OR ARRANGEMENT. CONFLICTED INDIVIDUALS ARE NOT ALLOWED TO PARTICIPATE IN THE DELIBERATION OR DECISION IN REGARDS TO THE POTENTIAL OR ACTUAL CONFLICT. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE BOARD OF DIRECTORS REVIEWS THE CEO'S COMPENSATION ANNUALLY, UTILIZING PUBLICLY AVAILABLE COMPENSATION INFORMATION OF SIMILARLY SITUATED EMPLOYEES IN SIMILAR ORGANIZATIONS TO SUBSTANTIATE ITS DECISION. SALARIES FOR ALL REMAINING OFFICERS AND KEY EMPLOYEES ARE DETERMINED BY THE CEO, WHO UTILIZES PUBLICLY AVAILABLE COMPENSATION INFORMATION OF SIMILARLY SITUATED EMPLOYEES. IN ADDITION, THE BOARD APPROVES ANNUAL SALARY INCREASES FOR ALL STAFF DURING THE BUDGETING PROCESS. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |