COPPERTOWER FAMILY MEDICAL CENTER INC: Form 990, tax year 2019

View the entire original 990 at ProPublica ↗

Organization: COPPERTOWER FAMILY MEDICAL CENTER INC (EIN 68-0345901)
Tax period: 2019-07-01 to 2020-06-30
Filed: 2021-05-17
IRS object ID: 202111379349306431
Schema version: 2019v5.0
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 D
Schedule J
Schedule O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2021-05-17T13:00:03-07:00	ReturnTs
Tax Period End	2020-06-30	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	455565460	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	Goranson and Associates	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	717 College Ave	AddressLine1Txt
City	Santa Rosa	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	95404	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	680345901	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	Coppertower Family Med Ctr Inc	BusinessNameLine1Txt
Business Name Line2	dba Alexander Valley Healthcare	BusinessNameLine2Txt

Field	Value	IRS element (for citing)
Business Name Control	COPP	BusinessNameControlTxt
Phone	7078944229	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	100 W Third Street	AddressLine1Txt
City	Cloverdale	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	95425	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	Debbie Howell	PersonNm
Person Title	CEO	PersonTitleTxt
Signature	2021-05-17	SignatureDt
Discuss With Paid Preparer	Yes (true)	DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	Sally Westgate	PreparerPersonNm
PTIN	P01739831	PTIN
Phone	7075421256	PhoneNum

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	Debbie Howell	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	100 W Third Street	AddressLine1Txt
City	Cloverdale	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	95425	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$5,424,874	GrossReceiptsAmt
Group Return For Affiliates	false	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	www.alexandervalleyhealthcare.org	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	1994	FormationYr
Legal Domicile State	CA	LegalDomicileStateCd
Activity Or Mission	To provide excellent and comprehensive primary care services	ActivityOrMissionDesc
Voting Members Governing Body	9	VotingMembersGoverningBodyCnt
Voting Members Independent	9	VotingMembersIndependentCnt
Total Employee	73	TotalEmployeeCnt
Total Volunteers	16	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
PY Contributions Grants	$1,236,333	PYContributionsGrantsAmt
CY Contributions Grants	$1,556,649	CYContributionsGrantsAmt
PY Program Service Revenue	$4,574,953	PYProgramServiceRevenueAmt
CY Program Service Revenue	$3,868,225	CYProgramServiceRevenueAmt
CY Investment Income	$0	CYInvestmentIncomeAmt
CY Other Revenue	$0	CYOtherRevenueAmt
PY Total Revenue	$5,811,286	PYTotalRevenueAmt
CY Total Revenue	$5,424,874	CYTotalRevenueAmt
CY Grants And Similar Paid	$0	CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members	$0	CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid	$4,018,580	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$4,270,811	CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$1,392,010	PYOtherExpensesAmt
CY Other Expenses	$1,433,864	CYOtherExpensesAmt
PY Total Expenses	$5,410,590	PYTotalExpensesAmt
CY Total Expenses	$5,704,675	CYTotalExpensesAmt
PY Revenues Less Expenses	$400,696	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	-$279,801	CYRevenuesLessExpensesAmt
Total Assets BOY	$4,867,356	TotalAssetsBOYAmt
Total Assets EOY	$5,554,670	TotalAssetsEOYAmt
Total Liabilities BOY	$401,998	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$1,369,113	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$4,465,358	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$4,185,557	NetAssetsOrFundBalancesEOYAmt
Mission	To provide excellent and comprehensive primary care services	MissionDesc
Significant New Program Srvc	false	SignificantNewProgramSrvcInd
Significant Change	false	SignificantChangeInd
Expense	$4,023,382	ExpenseAmt
Desc	We are the only medical provider in the community and provide care to people of all ages. A high percentage of our patient population is financially indigent.	Desc
Total Program Service Expenses	$4,023,382	TotalProgramServiceExpensesAmt
Described In Section501c3	Yes (true)	DescribedInSection501c3Ind
Schedule B Required	Yes (true)	ScheduleBRequiredInd
Political Campaign Acty	false	PoliticalCampaignActyInd
Lobbying Activities	false	LobbyingActivitiesInd
Subject To Proxy Tax	false	SubjectToProxyTaxInd
Donor Advised Fund	false	DonorAdvisedFundInd
Conservation Easements	false	ConservationEasementsInd
Collections Of Art	false	CollectionsOfArtInd
Credit Counseling	false	CreditCounselingInd
Donor Rstr Or Quasi Endowments	false	DonorRstrOrQuasiEndowmentsInd
Report Land Building Equipment	Yes (true)	ReportLandBuildingEquipmentInd
Report Investments Other Sec	false	ReportInvestmentsOtherSecInd
Report Program Related Invst	false	ReportProgramRelatedInvstInd
Report Other Assets	false	ReportOtherAssetsInd
Report Other Liabilities	false	ReportOtherLiabilitiesInd
Include FIN48 Footnote	Yes (true)	IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt	Yes (true)	IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt	false	ConsolidatedAuditFinclStmtInd
School Operating	false	SchoolOperatingInd
Foreign Office	false	ForeignOfficeInd
Foreign Activities	false	ForeignActivitiesInd
More Than5000 K To Org	false	MoreThan5000KToOrgInd
More Than5000 K To Individuals	false	MoreThan5000KToIndividualsInd
Professional Fundraising	false	ProfessionalFundraisingInd
Fundraising Activities	false	FundraisingActivitiesInd
Gaming Activities	false	GamingActivitiesInd
Operate Hospital	false	OperateHospitalInd
Grants To Organizations	false	GrantsToOrganizationsInd
Grants To Individuals	false	GrantsToIndividualsInd
Schedule J Required	Yes (true)	ScheduleJRequiredInd
Tax Exempt Bonds	false	TaxExemptBondsInd
Engaged In Excess Benefit Trans	false	EngagedInExcessBenefitTransInd
PY Excess Benefit Trans	false	PYExcessBenefitTransInd
Loan Outstanding	false	LoanOutstandingInd
Grant To Related Person	false	GrantToRelatedPersonInd
Business Rln With Org Mem	false	BusinessRlnWithOrgMemInd
Business Rln With Fam Mem	false	BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent	false	BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri	false	DeductibleNonCashContriInd
Deductible Art Contribution	false	DeductibleArtContributionInd
Terminate Operations	false	TerminateOperationsInd
Partial Liquidation	false	PartialLiquidationInd
Disregarded Entity	false	DisregardedEntityInd
Related Entity	false	RelatedEntityInd
Related Organization Ctrl Ent	false	RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org	false	TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp	false	ActivitiesConductedPrtshpInd
Schedule O Required	Yes (true)	ScheduleORequiredInd
IRP Document	13	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Backup Wthld Compliance	Yes (true)	BackupWthldComplianceInd
Employee	73	EmployeeCnt
Employment Tax Returns Filed	Yes (true)	EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit	false	UnrelatedBusIncmOverLimitInd
Foreign Financial Account	false	ForeignFinancialAccountInd
Prohibited Tax Shelter Trans	false	ProhibitedTaxShelterTransInd
Taxable Party Notification	false	TaxablePartyNotificationInd
Nondeductible Contributions	false	NondeductibleContributionsInd
Quid Pro Quo Contributions	false	QuidProQuoContributionsInd
Form8282 Property Disposed Of	false	Form8282PropertyDisposedOfInd
Form8282 Filed	0	Form8282FiledCnt
Rcv Fnds To Pay Prsnl Bnft Cntrct	false	RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct	false	PayPremiumsPrsnlBnftCntrctInd
Form8899 Filedind	false	Form8899Filedind
Form1098 C Filed	false	Form1098CFiledInd
Indoor Tanning Services	false	IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt	false	SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc	false	SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VI	Yes (X)	InfoInScheduleOPartVIInd
Governing Body Voting Members	9	GoverningBodyVotingMembersCnt
Independent Voting Member	9	IndependentVotingMemberCnt
Family Or Business Rln	false	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	false	DelegationOfMgmtDutiesInd
Change To Org Documents	false	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	false	MaterialDiversionOrMisuseInd
Members Or Stockholders	false	MembersOrStockholdersInd
Election Of Board Members	false	ElectionOfBoardMembersInd
Decisions Subject To Approva	false	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (true)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (true)	MinutesOfCommitteesInd
Officer Mailing Address	false	OfficerMailingAddressInd
Local Chapters	false	LocalChaptersInd
Form990 Provided To Gvrn Body	Yes (true)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (true)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (true)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (true)	RegularMonitoringEnfrcInd
Whistleblower Policy	Yes (true)	WhistleblowerPolicyInd
Document Retention Policy	Yes (true)	DocumentRetentionPolicyInd
Compensation Process CEO	Yes (true)	CompensationProcessCEOInd
Compensation Process Other	Yes (true)	CompensationProcessOtherInd
Investment In Joint Venture	false	InvestmentInJointVentureInd
States Where Copy Of Return Is Fld	CA	StatesWhereCopyOfReturnIsFldCd
Upon Request	Yes (X)	UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Field	Value	IRS element (for citing)
Person	Jenine Saunders	PersonNm
Phone	7078944229	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	100 W Third Street	AddressLine1Txt
City	Cloverdale	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	95425	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (14 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	OfficerOfficerInd	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd
Norr Hashem
Staff physician	40.00	0.00	$252,291	$0	$0
Debbie Howell
CEO	40.00	0.00	$203,720	$0	$0	Yes (X)
Cary Wheeler
Staff physician	40.00	0.00	$192,910	$0	$0
Shellie Burdick
Chief Medical Offi	40.00	0.00	$188,162	$0	$0
Jenine Saunders
CFO	40.00	0.00	$176,879	$0	$0	Yes (X)
Anna Felciano
Secretary	2.00	0.00	$0	$0	$0		Yes (X)
James Novak
Director	2.00	0.00	$0	$0	$0		Yes (X)
Kirsten Tellez
Director	2.00	0.00	$0	$0	$0		Yes (X)
Jackie Wiget
Director	2.00	0.00	$0	$0	$0		Yes (X)
Paula Wrenn
Chairman	2.00	0.00	$0	$0	$0		Yes (X)
Janet Anguiano
Vice Chairman	2.00	0.00	$0	$0	$0		Yes (X)
Melonie Delsid
Director	2.00	0.00	$0	$0	$0		Yes (X)
James Berry
Director	2.00	0.00	$0	$0	$0		Yes (X)
Jeanne Cox
Director	2.00	0.00	$0	$0	$0		Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$1,013,962	TotalReportableCompFromOrgAmt
Indiv Rcvd Greater Than100 K	5	IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed	false	FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K	Yes (true)	TotalCompGreaterThan150KInd
Compensation From Other Srcs	false	CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K	0	CntrctRcvdGreaterThan100KCnt
Government Grants	$1,539,795	GovernmentGrantsAmt
All Other Contributions	$16,854	AllOtherContributionsAmt
Total Contributions	$1,556,649	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDesc	Total Revenue ColumnTotalRevenueColumnAmt	Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Medical fees	$3,703,372	$3,703,372
Other revenue	$164,853	$164,853

Field	Value	IRS element (for citing)
Total Program Service Revenue	$3,868,225	TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Net Income From Gaming NetIncomeFromGamingGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Net Income Or Loss NetIncomeOrLossGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$0	TotalRevenueColumnAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$0	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$5,424,874	TotalRevenueColumnAmt
Related Or Exempt Func Income	$3,868,225	RelatedOrExemptFuncIncomeAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Foreign Grants ForeignGrantsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Benefits To Members BenefitsToMembersGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$380,599	TotalAmt
Management And General	$380,599	ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$3,890,212	TotalAmt
Program Services	$2,831,723	ProgramServicesAmt
Management And General	$1,058,489	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Management FeesForServicesManagementGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$111,577	TotalAmt
Program Services	$75,378	ProgramServicesAmt
Management And General	$36,199	ManagementAndGeneralAmt

Advertising AdvertisingGrp

Field	Value	IRS element (for citing)
Total	$8,165	TotalAmt
Management And General	$8,165	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$110,406	TotalAmt
Program Services	$85,477	ProgramServicesAmt
Management And General	$24,929	ManagementAndGeneralAmt

Royalties RoyaltiesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$184,235	TotalAmt
Program Services	$145,945	ProgramServicesAmt
Management And General	$38,290	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$14,915	TotalAmt
Program Services	$2,688	ProgramServicesAmt
Management And General	$12,227	ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$695	TotalAmt
Management And General	$695	ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$28,514	TotalAmt
Program Services	$24,135	ProgramServicesAmt
Management And General	$4,379	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$36,434	TotalAmt
Program Services	$18,681	ProgramServicesAmt
Management And General	$17,753	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
supplies	$428,995	$417,936	$11,059
consultants and contractors	$161,486	$161,486
Software support and fees	$119,643	$79,269	$40,374
communications	$46,259	$30,649	$15,610

All Other Expenses AllOtherExpensesGrp

Field	Value	IRS element (for citing)
Total	$182,540	TotalAmt
Program Services	$150,015	ProgramServicesAmt
Management And General	$32,525	ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$5,704,675	TotalAmt
Program Services	$4,023,382	ProgramServicesAmt
Management And General	$1,681,293	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$879,488	BOYAmt
EOY	$2,278,789	EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

Field	Value	IRS element (for citing)
BOY	$1,988,431	BOYAmt
EOY	$1,963,727	EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$57,328	BOYAmt
EOY	$228,381	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$1,279,520	BOYAmt
EOY	$327,000	EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

Field	Value	IRS element (for citing)
BOY	$73,326	BOYAmt
EOY	$74,120	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$142,525	BOYAmt
EOY	$102,051	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$997,382	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$416,780	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$446,738	BOYAmt
EOY	$580,602	EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Other Assets Total OtherAssetsTotalGrp

Field	Value	IRS element (for citing)
EOY	$0	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$4,867,356	BOYAmt
EOY	$5,554,670	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$383,774	BOYAmt
EOY	$467,150	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
EOY	$20,118	EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

Field	Value	IRS element (for citing)
BOY	$18,224	BOYAmt
EOY	$881,845	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$401,998	BOYAmt
EOY	$1,369,113	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	$4,465,358	BOYAmt
EOY	$4,185,557	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$4,465,358	BOYAmt
EOY	$4,185,557	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$4,867,356	BOYAmt
EOY	$5,554,670	EOYAmt

Field	Value	IRS element (for citing)
Reconcilation Revenue Expnss	-$279,801	ReconcilationRevenueExpnssAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	false	AccountantCompileOrReviewInd
FS Audited	Yes (true)	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 (true)	AuditCommitteeInd
Federal Grant Audit Required	Yes (true)	FederalGrantAuditRequiredInd
Federal Grant Audit Performed	Yes (true)	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	$1,151,619	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$1,326,342	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$1,362,826	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$1,236,333	CurrentTaxYearMinus1YearAmt
Current Tax Year	$1,556,649	CurrentTaxYearAmt
Total	$6,633,769	TotalAmt

Tax Rev Levied Orgnztnl Bnft170 TaxRevLeviedOrgnztnlBnft170Grp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$1,151,619	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$1,326,342	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$1,362,826	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$1,236,333	CurrentTaxYearMinus1YearAmt
Current Tax Year	$1,556,649	CurrentTaxYearAmt
Total	$6,633,769	TotalAmt

Field	Value	IRS element (for citing)
Substantial Contributors Tot	$0	SubstantialContributorsTotAmt
Public Support Total170	$6,633,769	PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp

Field	Value	IRS element (for citing)
Total	$0	TotalAmt

Other Income170 OtherIncome170Grp

Field	Value	IRS element (for citing)
Current Tax Year Minus4 Years	$62,887	CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years	$306,665	CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years	$345,501	CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year	$299,411	CurrentTaxYearMinus1YearAmt
Current Tax Year	$164,853	CurrentTaxYearAmt
Total	$1,179,317	TotalAmt

Field	Value	IRS element (for citing)
Total Support	$7,813,086	TotalSupportAmt
Public Support CY170	0.84910	PublicSupportCY170Pct
Public Support PY170	0.85530	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

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$448,779	OtherCostOrOtherBasisAmt
Depreciation	$416,780	DepreciationAmt
Book Value	$31,999	BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$548,603	OtherCostOrOtherBasisAmt
Book Value	$548,603	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$580,602	TotalBookValueLandBuildingsAmt
Footnote Text	Yes (X)	FootnoteTextInd
Total Rev Etc Audited Fincl Stmt	$5,424,874	TotalRevEtcAuditedFinclStmtAmt
Revenue Subtotal	$5,424,874	RevenueSubtotalAmt
Total Revenue Per Form990	$5,424,874	TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt	$5,704,675	TotExpnsEtcAuditedFinclStmtAmt
Expenses Subtotal	$5,704,675	ExpensesSubtotalAmt
Total Expenses Per Form990	$5,704,675	TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail

Field	Value	IRS element (for citing)
Form And Line Reference	Part X : FIN48 Footnote	FormAndLineReferenceDesc
Explanation	The Organization is exempt from Federal and State Income taxes under Internal Revenue Code Section 501(c)(3) and California Franchise Tax Board Code Section 23701(d). Therefore, no provision for income taxes has been made in the accompanying financial statements. In addition, the Internal Revenue Service has determined the Organization is not a private foundation within the meaning of Section 509(a) of the Internal Revenue Code.Management of the Organization considers the likelihood of changes by taxing authorities in its filed tax returns and recognizes a liability for or discloses potential significant changes if management believes it is more likely than not for a change to occur, including changes to the Organizations status as a not-for-profit entity. Management believes the Organization met the requirements to maintain its tax-exempt status and has not income subject to unrelated business income tax; therefore no provision for income taxes has been provided in these financial statements. The Organizations tax returns for the past three years are subject to examination by tax authorities, and may change upon examination.	ExplanationTxt

Schedule J IRS990ScheduleJ

Field	Value	IRS element (for citing)
Written Employment Contract	Yes (X)	WrittenEmploymentContractInd
Compensation Survey	Yes (X)	CompensationSurveyInd
Board Or Committee Approval	Yes (X)	BoardOrCommitteeApprovalInd
Severance Payment	false	SeverancePaymentInd
Supplemental Nonqual Rtr Plan	false	SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm	false	EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org	false	CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs	false	CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org	false	CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs	false	CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments	false	AnyNonFixedPaymentsInd
Initial Contract Exception	false	InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (5 entries)

TitleTitleTxt	Base Compensation Filing OrgBaseCompensationFilingOrgAmt	Total Compensation Filing OrgTotalCompensationFilingOrgAmt
Cary Wheeler
Staff physician	$192,910	$192,910
Debbie Howell
CEO	$203,720	$203,720
Jenine Saunders
CFO	$176,879	$176,879
Norr Hashem
Staff physician	$252,291	$252,291
Shellie Burdick
Chief Medical Offi	$188,162	$188,162

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
Form 990, Part VI, Line 11b: Form 990 Review Process	The form 990 will be made available to the board for review prior to submission in e-form if available or if not, it will be reviewed at the next regular board meeting.
Form 990, Part VI, Line 12c: Explanation of Monitoring and Enforcement of Conflicts	The Executive Director and CFO are responsible for fully disclosing to the board any potential conflicts of interest that may arise.
Form 990, Part VI, Line 15b: Compensation Review and Approval Process for Officers and Key Employees	By performance review and as comparable to peers as obtained through the California Primary Care Association annual salary survey results.
Form 990, Part VI, Line 19: Other Organization Documents Publicly Available	Copies of our financial audits are available upon request at our offices. The corporate bylaws and the conflict of interest policy contained within are not available for public inspection.