SAN DIEGO AMERICAN INDIAN HEALTH CENTER: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- SAN DIEGO AMERICAN INDIAN HEALTH CENTER (EIN 95-3397369)
- Tax period
- 2019-07-01 to 2020-06-30
- Filed
- 2021-05-14
- IRS object ID
- 202101349349303255
- Schema version
- 2019v5.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2021-05-14T10:50:33-05:00 | ReturnTs |
| Tax Period End | 2020-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 390758449 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WIPFLI LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1502 LONDON ROAD SUITE 200 | AddressLine1Txt |
| City | DULUTH | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55812 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2019-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 953397369 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SAN DIEGO AMERICAN INDIAN HEALTH CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | SAND | BusinessNameControlTxt |
| Phone | 6192342158 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2602 FIRST AVENUE NO 105 | AddressLine1Txt |
| City | SAN DIEGO | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 92103 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | KEVIN M LACHAPELLE | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 6192342158 | PhoneNum |
| Signature | 2021-05-12 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MICHAEL J PETERSON CPA | PreparerPersonNm |
| PTIN | P01833529 | PTIN |
| Phone | 2187224705 | PhoneNum |
| Preparation | 2021-05-06 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | KEVIN M LACHAPELLE | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2602 FIRST AVENUE NO 105 | AddressLine1Txt |
| City | SAN DIEGO | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 92103 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $8,009,307 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.SDAIHC.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1980 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | TO PROMOTE EXCELLENCE IN HEALTH CARE, WITH RESPECT FOR CUSTOM AND TRADITION TO SAN DIEGO'S URBAN AMERICAN INDIAN POPULATION. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 126 | TotalEmployeeCnt |
| Total Volunteers | 11 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $4,441,663 | PYContributionsGrantsAmt |
| CY Contributions Grants | $5,156,880 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $2,578,925 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $2,606,610 | CYProgramServiceRevenueAmt |
| PY Investment Income | $344 | PYInvestmentIncomeAmt |
| CY Investment Income | -$22,170 | CYInvestmentIncomeAmt |
| PY Other Revenue | $92,290 | PYOtherRevenueAmt |
| CY Other Revenue | $223,079 | CYOtherRevenueAmt |
| PY Total Revenue | $7,113,222 | PYTotalRevenueAmt |
| CY Total Revenue | $7,964,399 | 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 | $5,148,519 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $5,177,915 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $2,017,889 | PYOtherExpensesAmt |
| CY Other Expenses | $2,021,237 | CYOtherExpensesAmt |
| PY Total Expenses | $7,166,408 | PYTotalExpensesAmt |
| CY Total Expenses | $7,199,152 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$53,186 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $765,247 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $9,539,644 | TotalAssetsBOYAmt |
| Total Assets EOY | $12,842,539 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $5,354,544 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $7,892,192 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $4,185,100 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $4,950,347 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO REDUCE THE SIGNIFICANT HEALTH DISPARITIES IN THE SAN DIEGO URBAN AMERICAN INDIAN POPULATION BY INCREASING ACCESS TO CARE AND IMPROVING THE QUALITY OF CARE, RESULTING IN INCREASED LIFE EXPECTANCY AND IMPROVED QUALITY OF LIFE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $4,463,476 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $2,606,610 | RevenueAmt |
| Desc | THE HEALTH CENTER IS ORGANIZED AS AN URBAN INDIAN HEALTH ORGANIZATION (UIHO) UNDER TITLE V OF THE INDIAN HEALTH CARE IMPROVEMENT ACT, AND WE PROVIDE SERVICES WITHOUT CHARGE TO URBAN AIAN POPULATIONS WHO MEET THE ELIGIBILITY REQUIREMENTS ESTABLISHED BY THE INDIAN HEALTH SERVICES (IHS), AS WELL AS OTHER INSURED INDIVIDUALS REGARDLESS OF RACE, COLOR, GENDER, AGE, OR NATIONAL ORIGIN. THE ORGANIZATION PROVIDES A RANGE OF HEALTH RELATED SERVICES TO THE NATIVE AMERICAN POPULATION IN THE SAN DIEGO AREA. PROVIDERS INCLUDE PHYSICIANS, DENTISTS, PSYCHIATRISTS, AND NURSES WITH AN UNDERSTANDING AND APPRECIATION FOR THE UNIQUE CULTURAL NEEDS OF NATIVE AMERICANS. DUE TO INCREASED FUNDING FROM VARIOUS SOURCES, INCLUDING 330 FUNDING, THE CENTER WAS ABLE TO ADD STAFFING AND EXPAND SERVICE AREAS SUCH AS TALKING CIRCLES, CULTURAL ARTS WORKSHOPS, COMMUNITY HEALTH EDUCATION CLASSES DESIGNED TO PROMOTE HEALTHY EATING AND ACTIVE LIVING (HEAL), YOUTH SUBSTANCE ABUSE PREVENTION COUNSELING AND EARLY INTERVENTION PROGRAMMING. OTHER COMMUNITY ENGAGEMENT ACTIVITIES INCLUDE PARTICIPATING IN HEALTH FAIRS, POW WOWS, OUTREACH EVENTS AND HOSTING REGULAR FAMILY & COMMUNITY EVENTS INTENDED TO STRENGTHEN THE CULTURAL COLLABORATION BETWEEN THE HEALTH CENTER AND THE LOCAL URBAN INDIAN COMMUNITY. THESE PROGRAMS ARE AS FOLLOWS:1. URBAN INDIAN YOUTH CENTER, A PREVENTION AND EARLY INTERVENTION PROGRAM FOR NATIVE YOUTH BETWEEN THE AGES OF 10-24, OFFERING A VARIETY OF THERAPEUTIC, CULTURAL EDUCATION, AND ACADEMIC SUPPORT ACTIVITIES WHICH INCLUDE DRUG AND ALCOHOL PREVENTION, HEALTH AND FITNESS EDUCATION, CURRENT EVENTS DISCUSSION, HEALTHY COOKING CLASSES, ACADEMIC TUTORING AND INDIVIDUAL COUNSELING. 2. SPIRITUAL SOLUTIONS TALKING CIRCLE, A TRADITIONAL NATIVE AMERICAN TALKING CIRCLE THAT MEETS WEEKLY AS IS FACILITATED BY A NAVAJO HEALER, OFFERING PRAYER, DRUMMING, AND TRADITIONAL CEREMONY AND HEALING PRACTICES TO PROMOTE COMMUNITY WELLNESS AND LONG-TERM RECOVERY. 3. WELLBRIETY SUPPORT GROUP, WEEKLY PEER-LED SOBRIETY SUPPORT GROUPS BASED ON THE WHITE BISON RED ROAD TO RECOVERY MODEL AND DESIGNED TO SUPPORT INDIVIDUALS IN RECOVERY FROM ALCOHOL AND SUBSTANCE ABUSE. 4. ELDERS TALKING CIRCLE, A WEEKLY INTERGENERATIONAL GROUP EMPHASIZING THE TRADITIONAL ROLE OF ELDERS WITHIN THE COMMUNITY, FACILITATED BY A CHEROKEE HEALER, USING TRADITIONAL CULTURAL PRACTICES DESIGNED TO PROMOTE COMMUNITY WELLNESS. | Desc |
| Total Program Service Expenses | $4,463,476 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | 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 | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | 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 | 21 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 126 | 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 | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 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 | TIM NGUYEN | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6192342158 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2602 FIRST AVENUE NO 105 | AddressLine1Txt |
| City | SAN DIEGO | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 92103 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|
| MELISSA DEER | |||||||
| MEDICAL DIRECTOR | 40.00 | Yes (X) | $278,852 | $0 | $6,902 | ||
| CHELSEA RICHARDSON | |||||||
| DENTAL DIRECTOR | 40.00 | Yes (X) | $165,091 | $0 | $7,419 | ||
| SEAN AYERSMAN | |||||||
| IT DIRECTOR | 40.00 | Yes (X) | $137,038 | $0 | $6,580 | ||
| KEVIN M LACHAPELLE | |||||||
| CEO | 40.00 | $18,450 | $0 | $1,780 | Yes (X) | ||
| TIM NGUYEN | |||||||
| CFO | 40.00 | $167,652 | $0 | $11,323 | Yes (X) | ||
| DONA JAMES | |||||||
| CAO, INTERIM CEO | 40.00 | $165,286 | $0 | $12,613 | Yes (X) | ||
| PAULA BRIM | |||||||
| CHAIR | 1.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | |
| DALE SQUIRES | |||||||
| VICE CHAIR | 1.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | |
| JILL SHEMAN-WARNE | |||||||
| SECRETARY | 1.00 | $0 | $0 | $0 | Yes (X) | Yes (X) | |
| ELKE CHENEVY | |||||||
| BOARD MEMBER | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| EVANS CRAIG | |||||||
| BOARD MEMBER | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| DARIN CRAW | |||||||
| BOARD MEMBER | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| DAVID GLORIA | |||||||
| BOARD MEMBER | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| KEREN HILGER MD | |||||||
| BOARD MEMBER (THRU MAY) | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| RUBEN LEYVA | |||||||
| BOARD MEMBER | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| RICK NEEDHAM | |||||||
| BOARD MEMBER | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| YVETTE THAYER | |||||||
| BOARD MEMBER | 1.00 | $0 | $0 | $0 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $932,369 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $46,617 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 5 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (3 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| DT TRAK CONSULTING INC | |||||
| 210 NORTH BROADWAY | MILLER | SD | 57362 | PATIENT BILLING & COLLECTIONS | $188,445 |
| HENRY SCHEIN INC | |||||
| PO BOX 7156 | PASADENA | CA | 91109 | DENTAL SUPPLIES & SERVICES | $138,685 |
| ADVANCED DENTAL ARTS INC | |||||
| 185 W MADISON AVE | EL CAJON | CA | 92020 | DENTAL LABORATORY | $102,741 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 3 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $4,939,448 | GovernmentGrantsAmt |
| All Other Contributions | $217,432 | AllOtherContributionsAmt |
| Total Contributions | $5,156,880 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICES REVEN | 621400 | $2,114,711 | $2,114,711 |
| CAPITATION REVENUE | 621400 | $319,001 | $319,001 |
Total Oth Program Service Rev TotalOthProgramServiceRevGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $172,898 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $172,898 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $2,606,610 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $299 | TotalRevenueColumnAmt |
| Exclusion | $299 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $245,518 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $22,439 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $223,079 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $223,079 | TotalRevenueColumnAmt |
| Exclusion | $223,079 | ExclusionAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $22,469 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$22,469 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$22,469 | TotalRevenueColumnAmt |
| Exclusion | -$22,469 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $7,964,399 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $2,606,610 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $200,909 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $394,664 | TotalAmt |
| Management And General | $394,664 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,851,559 | TotalAmt |
| Program Services | $2,618,114 | ProgramServicesAmt |
| Management And General | $1,233,445 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $411,234 | TotalAmt |
| Program Services | $269,510 | ProgramServicesAmt |
| Management And General | $141,724 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $520,458 | TotalAmt |
| Program Services | $322,684 | ProgramServicesAmt |
| Management And General | $197,774 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,426 | TotalAmt |
| Program Services | $5,844 | ProgramServicesAmt |
| Management And General | $3,582 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $32,802 | TotalAmt |
| Program Services | $20,337 | ProgramServicesAmt |
| Management And General | $12,465 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $671,505 | TotalAmt |
| Program Services | $416,333 | ProgramServicesAmt |
| Management And General | $255,172 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $874 | TotalAmt |
| Program Services | $542 | ProgramServicesAmt |
| Management And General | $332 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $136,228 | TotalAmt |
| Program Services | $84,461 | ProgramServicesAmt |
| Management And General | $51,767 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $88,140 | TotalAmt |
| Program Services | $54,647 | ProgramServicesAmt |
| Management And General | $33,493 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $173,786 | TotalAmt |
| Program Services | $107,747 | ProgramServicesAmt |
| Management And General | $66,039 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,391 | TotalAmt |
| Program Services | $16,982 | ProgramServicesAmt |
| Management And General | $10,409 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $26,450 | TotalAmt |
| Program Services | $16,399 | ProgramServicesAmt |
| Management And General | $10,051 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $178,091 | TotalAmt |
| Program Services | $110,416 | ProgramServicesAmt |
| Management And General | $67,675 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $171,884 | TotalAmt |
| Program Services | $106,568 | ProgramServicesAmt |
| Management And General | $65,316 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $44,953 | TotalAmt |
| Program Services | $27,871 | ProgramServicesAmt |
| Management And General | $17,082 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| REPAIRS AND MAINTENANCE | $168,009 | $104,166 | $63,843 |
| MEDICAL AND OTHER SUPPL | $123,433 | $76,528 | $46,905 |
| EQUIP, PARKING, STORAGE | $94,643 | $58,679 | $35,964 |
| DUES AND SUBSCRIPTIONS | $60,888 | $37,751 | $23,137 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,734 | TotalAmt |
| Program Services | $7,897 | ProgramServicesAmt |
| Management And General | $4,837 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,199,152 | TotalAmt |
| Program Services | $4,463,476 | ProgramServicesAmt |
| Management And General | $2,735,676 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,469,664 | BOYAmt |
| EOY | $4,045,643 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $564,684 | BOYAmt |
| EOY | $1,282,516 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $484,507 | BOYAmt |
| EOY | $378,903 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $317,309 | BOYAmt |
| EOY | $402,734 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $200,000 | BOYAmt |
| EOY | $200,000 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,580 | BOYAmt |
| EOY | $12,580 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $56,721 | BOYAmt |
| EOY | $54,809 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $7,383,559 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $918,205 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,434,179 | BOYAmt |
| EOY | $6,465,354 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,539,644 | BOYAmt |
| EOY | $12,842,539 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $790,321 | BOYAmt |
| EOY | $771,893 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $146,460 | BOYAmt |
| EOY | $1,978,811 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,417,763 | BOYAmt |
| EOY | $4,295,488 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $846,000 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,354,544 | BOYAmt |
| EOY | $7,892,192 | 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 | $4,185,100 | BOYAmt |
| EOY | $4,950,347 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,185,100 | BOYAmt |
| EOY | $4,950,347 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,539,644 | BOYAmt |
| EOY | $12,842,539 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $765,247 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Cash | Yes (X) | MethodOfAccountingCashInd |
| 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 | $2,693,739 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,343,851 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,737,924 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $4,441,663 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $5,156,880 | CurrentTaxYearAmt |
| Total | $20,374,057 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,693,739 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $4,343,851 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,737,924 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $4,441,663 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $5,156,880 | CurrentTaxYearAmt |
| Total | $20,374,057 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $20,374,057 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $244 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,230 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $192,538 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $258,542 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $245,817 | CurrentTaxYearAmt |
| Total | $698,371 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $21,072,428 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $13,876,616 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.96690 | PublicSupportCY170Pct |
| Public Support PY170 | 0.97440 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,400,000 | OtherCostOrOtherBasisAmt |
| Book Value | $3,400,000 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,367,645 | OtherCostOrOtherBasisAmt |
| Depreciation | $588,645 | DepreciationAmt |
| Book Value | $2,779,000 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $615,914 | OtherCostOrOtherBasisAmt |
| Depreciation | $329,560 | DepreciationAmt |
| Book Value | $286,354 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $6,465,354 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PAYCHECK PROTECTION PROGRAM LOAN PAYABLE | Desc |
| Amt | $846,000 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $846,000 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $7,986,838 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | $22,439 | OtherRevenueAmt |
| Revenue Not Reported | $22,439 | RevenueNotReportedAmt |
| Revenue Subtotal | $7,964,399 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $7,964,399 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $7,221,591 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $22,439 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $22,439 | ExpensesNotReportedAmt |
| Expenses Subtotal | $7,199,152 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $7,199,152 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | IN ORDER TO ACCOUNT FOR ANY UNCERTAIN TAX POSITIONS, THE HEALTH CENTER DETERMINES WHETHER IT IS MORE LIKELY THAN NOT THAT A TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY THE TAXING AUTHORITIES BASED ON THE TECHNICAL MERITS OF THE POSITION, ASSUMING THE TAXING AUTHORITY HAS FULL KNOWLEDGE OF ALL INFORMATION. IF THE TAX POSITION DOES NOT MEET THE MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD, THE BENEFIT OF THE TAX POSITION IS NOT RECOGNIZED IN THE FINANCIAL STATEMENTS. MANAGEMENT DOES NOT BELIEVE THE HEALTH CENTER HAS ANY MATERIAL UNCERTAIN TAX POSITIONS OR UNRECOGNIZED TAX BENEFITS. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | RENTAL EXPENSES 22,439. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | RENTAL EXPENSES 22,439. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (4 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MELISSA DEER | ||||||||||||||
| MEDICAL DIRECTOR | $273,852 | $0 | $5,000 | $0 | $0 | $0 | $0 | $0 | $6,902 | $0 | $285,754 | $0 | $0 | $0 |
| CHELSEA RICHARDSON | ||||||||||||||
| DENTAL DIRECTOR | $165,091 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $7,419 | $0 | $172,510 | $0 | $0 | $0 |
| TIM NGUYEN | ||||||||||||||
| CFO | $167,652 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $11,323 | $0 | $178,975 | $0 | $0 | $0 |
| DONA JAMES | ||||||||||||||
| CAO, INTERIM CEO | $165,286 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $12,613 | $0 | $177,899 | $0 | $0 | $0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | THE 990 IS DISTRIBUTED TO BOARD MEMBERS AND REVIEWED DURING A MONTHLY BOARD MEETING, WHICH TAKES PLACE AFTER RECEIVING DRAFT COPIES FROM OUR INDEPENDENT AUDITOR/CPA FIRM. |
| FORM 990, PART VI, SECTION B, LINE 12C | ALL BOARD MEMBERS, WHEN ELECTED, ARE REQUIRED TO FILE WRITTEN DECLARATIONS OF POTENTIAL CONFLICTS OF INTEREST WITH THE CHAIR OF THE BOARD. ALL SUBMITTED DECLARATIONS ARE SWORN FOR TRUTH AND ACCURACY FOR THE PRECEDING CALENDAR YEAR. IF IN DOUBT, ALL POTENTIAL CONFLICTS SHALL BE DISCLOSED. FOLLOWING THE DISCLOSURE THE OTHER BOARD MEMBERS SHALL VOTE ON WHETHER TO ALLOW THE MEMBER IN QUESTION TO PARTICIPATE IN THE PROPOSED BOARD ACTIVITIES. ALL BOARD MEMBERS ARE PROHIBITED FROM DELIBERATIONS, VOTING, OR ATTEMPTING TO INFLUENCE OTHER BOARD MEMBERS ON ACTIVITIES IN WHICH THEY HAVE A POSSIBLE CONFLICT OF INTEREST. |
| FORM 990, PART VI, SECTION B, LINE 15 | COMPENSATION OF OFFICERS AND KEY EMPLOYEES IS REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS, AND IS KEPT CONSISTENT WITH COMPENSATION FOR SIMILAR POSITIONS IN THE HEALTH CARE INDUSTRY. THE CEO'S SALARY IS DETERMINED BY THE BOARD OF DIRECTORS, WHILE THE CEO IS RESPONSIBLE FOR REVIEW AND APPROVAL OF ALL OTHER REQUESTS FOR WAGES IN CONJUNCTION WITH OTHER MEMBERS OF THE KEY STAFF. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY, AND AUDITED FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |