POMONA COMMUNITY HEALTH CENTER: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization: POMONA COMMUNITY HEALTH CENTER (EIN 22-3914738)
Tax period: 2020-01-01 to 2020-12-31
Filed: 2021-11-05
IRS object ID: 202143099349304354
Schema version: 2020v4.1
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 M
Schedule O

Return header ReturnHeader

Field	Value	IRS element (for citing)
Return	2021-11-05T15:19:42-05:00	ReturnTs
Tax Period End	2020-12-31	TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Field	Value	IRS element (for citing)
Preparer Firm EIN	410746749	PreparerFirmEIN

Preparer Firm Name PreparerFirmName

Field	Value	IRS element (for citing)
Business Name Line1	CLIFTONLARSONALLEN LLP	BusinessNameLine1Txt

Preparer US Address PreparerUSAddress

Field	Value	IRS element (for citing)
Address Line1	10700 NORTHUP WAY SUITE 200	AddressLine1Txt
City	BELLEVUE	CityNm
State Abbreviation	WA	StateAbbreviationCd
ZIP	98004	ZIPCd

Field	Value	IRS element (for citing)
Return Type	990	ReturnTypeCd
Tax Period Begin	2020-01-01	TaxPeriodBeginDt

Filer Filer

Field	Value	IRS element (for citing)
EIN	223914738	EIN

Business Name BusinessName

Field	Value	IRS element (for citing)
Business Name Line1	POMONA COMMUNITY HEALTH CENTER	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Business Name Control	POMO	BusinessNameControlTxt
Phone	9098659501	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1450 HOLT AVENUE	AddressLine1Txt
City	POMONA	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	91767	ZIPCd

Business Officer BusinessOfficerGrp

Field	Value	IRS element (for citing)
Person	DAVID KADAR	PersonNm
Person Title	CEO	PersonTitleTxt
Phone	9098659501	PhoneNum
Signature	2021-11-03	SignatureDt
Discuss With Paid Preparer	Yes (1)	DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

Field	Value	IRS element (for citing)
Person First	DAVID	PersonFirstNm
Person Last	KADAR	PersonLastNm

Field	Value	IRS element (for citing)
SSN	999009999	SSN

Preparer Person PreparerPersonGrp

Field	Value	IRS element (for citing)
Preparer Person	KURT BENNION CPA	PreparerPersonNm
PTIN	P01469618	PTIN
Phone	4252506100	PhoneNum
Preparation	2021-11-03	PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

Field	Value	IRS element (for citing)
Trusted Customer	2	TrustedCustomerCd
Authentication Assurance Level	AAL1	AuthenticationAssuranceLevelCd
Identity Assurance Level	IAL1	IdentityAssuranceLevelCd

Field	Value	IRS element (for citing)
Tax	2020	TaxYr
Build TS	2022-09-23 18:48:47Z	BuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

Field	Value	IRS element (for citing)
Business Name Line1	PARKTREE COMMUNITY HEALTH CENTER	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Principal Officer	DAVID KADAR	PrincipalOfficerNm

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1450 HOLT AVENUE	AddressLine1Txt
City	POMONA	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	91767	ZIPCd

Field	Value	IRS element (for citing)
Gross Receipts	$14,691,282	GrossReceiptsAmt
Group Return For Affiliates	0	GroupReturnForAffiliatesInd
Organization501c3	Yes (X)	Organization501c3Ind
Website Address	WWW.PARKTREECHC.ORG	WebsiteAddressTxt
Type Of Organization Corp	Yes (X)	TypeOfOrganizationCorpInd
Formation	2005	FormationYr
Legal Domicile State	CA	LegalDomicileStateCd
Activity Or Mission	TO PROVIDE PREVENTIVE AND PRIMARY CARE SERVICES TO THE NEEDY IN THE COMMUNITY.	ActivityOrMissionDesc
Voting Members Governing Body	9	VotingMembersGoverningBodyCnt
Voting Members Independent	9	VotingMembersIndependentCnt
Total Employee	171	TotalEmployeeCnt
Total Volunteers	21	TotalVolunteersCnt
Total Gross UBI	$0	TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm	$0	NetUnrelatedBusTxblIncmAmt
PY Contributions Grants	$3,475,857	PYContributionsGrantsAmt
CY Contributions Grants	$6,765,205	CYContributionsGrantsAmt
PY Program Service Revenue	$6,310,509	PYProgramServiceRevenueAmt
CY Program Service Revenue	$7,898,633	CYProgramServiceRevenueAmt
PY Investment Income	$0	PYInvestmentIncomeAmt
CY Investment Income	$0	CYInvestmentIncomeAmt
PY Other Revenue	$34,015	PYOtherRevenueAmt
CY Other Revenue	$27,444	CYOtherRevenueAmt
PY Total Revenue	$9,820,381	PYTotalRevenueAmt
CY Total Revenue	$14,691,282	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	$7,973,484	PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid	$10,072,924	CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns	$0	PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns	$0	CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense	$0	CYTotalFundraisingExpenseAmt
PY Other Expenses	$3,039,154	PYOtherExpensesAmt
CY Other Expenses	$4,006,205	CYOtherExpensesAmt
PY Total Expenses	$11,012,638	PYTotalExpensesAmt
CY Total Expenses	$14,079,129	CYTotalExpensesAmt
PY Revenues Less Expenses	-$1,192,257	PYRevenuesLessExpensesAmt
CY Revenues Less Expenses	$612,153	CYRevenuesLessExpensesAmt
Total Assets BOY	$6,665,463	TotalAssetsBOYAmt
Total Assets EOY	$8,366,631	TotalAssetsEOYAmt
Total Liabilities BOY	$5,809,390	TotalLiabilitiesBOYAmt
Total Liabilities EOY	$6,898,405	TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY	$856,073	NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY	$1,468,226	NetAssetsOrFundBalancesEOYAmt
Mission	POMONA COMMUNITY HEALTH CENTER'S MISSION IS TO SERVE THE MEDICALLY UNDERSERVED AREA (MUA) PROVIDING A SAFETY NET OF MEDICAL AND DENTAL CARE REGARDLESS OF THE PATIENTS' ABILITY TO PAY.	MissionDesc
Significant New Program Srvc	0	SignificantNewProgramSrvcInd
Significant Change	0	SignificantChangeInd
Expense	$11,044,400	ExpenseAmt
Grant	$0	GrantAmt
Revenue	$7,898,633	RevenueAmt
Desc	POMONA COMMUNITY HEALTH CENTER IS A COMPREHENSIVE PRIMARY MEDICAL AND DENTAL CLINIC PROVIDING MEDICAL AND DENTAL SERVICES AND MEDICINE AT NO OR LOW COST TO LOW INCOME INDIVIDUALS AND FAMILIES (NO COST, LOW FEE OR MEDI-CAL / MEDI-CARE ACCEPTED BASED ON INCOME).	Desc
Total Program Service Expenses	$11,044,400	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	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	22	IRPDocumentCnt
IRP Document W2 G	0	IRPDocumentW2GCnt
Employee	171	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	9	GoverningBodyVotingMembersCnt
Independent Voting Member	9	IndependentVotingMemberCnt
Family Or Business Rln	0	FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties	0	DelegationOfMgmtDutiesInd
Change To Org Documents	0	ChangeToOrgDocumentsInd
Material Diversion Or Misuse	0	MaterialDiversionOrMisuseInd
Members Or Stockholders	0	MembersOrStockholdersInd
Election Of Board Members	0	ElectionOfBoardMembersInd
Decisions Subject To Approva	0	DecisionsSubjectToApprovaInd
Minutes Of Governing Body	Yes (1)	MinutesOfGoverningBodyInd
Minutes Of Committees	Yes (1)	MinutesOfCommitteesInd
Officer Mailing Address	0	OfficerMailingAddressInd
Local Chapters	Yes (1)	LocalChaptersInd
Policies Reference Chapters	Yes (1)	PoliciesReferenceChaptersInd
Form990 Provided To Gvrn Body	Yes (1)	Form990ProvidedToGvrnBodyInd
Conflict Of Interest Policy	Yes (1)	ConflictOfInterestPolicyInd
Annual Disclosure Covered Prsn	Yes (1)	AnnualDisclosureCoveredPrsnInd
Regular Monitoring Enfrc	Yes (1)	RegularMonitoringEnfrcInd
Whistleblower Policy	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	ALFONSO AGUILERA	BusinessNameLine1Txt

Field	Value	IRS element (for citing)
Phone	9098659501	PhoneNum

US Address USAddress

Field	Value	IRS element (for citing)
Address Line1	1450 HOLT AVENUE	AddressLine1Txt
City	POMONA	CityNm
State Abbreviation	CA	StateAbbreviationCd
ZIP	91767	ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)

TitleTitleTxt	Average Hours Per WeekAverageHoursPerWeekRt	Highest Compensated EmployeeHighestCompensatedEmployeeInd	Reportable Comp From OrgReportableCompFromOrgAmt	Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt	Other CompensationOtherCompensationAmt	Key EmployeeKeyEmployeeInd	OfficerOfficerInd	Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd
RANJIT SHENOY
PHYSICIAN	40.00	Yes (X)	$245,078	$0	$10,943
SRINIVASU SUNKARA
CMO	40.00		$240,923	$0	$1,423	Yes (X)
DAVID KADAR
CEO	40.00		$201,996	$0	$14,035		Yes (X)
RAKHI SINHA
PHYSICIAN	40.00	Yes (X)	$186,161	$0	$13,457
DIANNE QUINTANA
PHYSICIAN	40.00	Yes (X)	$172,299	$0	$20,256
LORRAINE WALKER
PHYSICIAN	40.00	Yes (X)	$179,154	$0	$4,085
ENRIQUE MELGOZA
CDO	40.00		$165,654	$0	$12,780	Yes (X)
MARINA MARKOVA
DENTIST	40.00	Yes (X)	$154,232	$0	$8,925
ALFONSO AGUILERA
CFO	40.00		$141,179	$0	$20,827		Yes (X)
ELVIA SANCHEZ
COO	40.00		$91,725	$0	$10,123		Yes (X)
CHRIS ALDWORTH
CHAIR	2.00		$0	$0	$0		Yes (X)	Yes (X)
FLOY BIGGS
VICE-CHAIR	2.00		$0	$0	$0		Yes (X)	Yes (X)
AVA PHILLIPS
SECRETARY	2.00		$0	$0	$0		Yes (X)	Yes (X)
PEGGY SANCHEZ
TREASURER	2.00		$0	$0	$0		Yes (X)	Yes (X)
JAMES ALIG
BOARD MEMBER	2.00		$0	$0	$0			Yes (X)
SONIA BURNS
BOARD MEMBER	2.00		$0	$0	$0			Yes (X)
GWENDOLYN KEYS
BOARD MEMBER	2.00		$0	$0	$0			Yes (X)
MICHAEL NELSON
BOARD MEMBER	2.00		$0	$0	$0			Yes (X)
ELVIA RIVAS
BOARD MEMBER	2.00		$0	$0	$0			Yes (X)

Field	Value	IRS element (for citing)
Total Reportable Comp From Org	$1,778,401	TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org	$0	TotReportableCompRltdOrgAmt
Total Other Compensation	$116,854	TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K	21	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
OHIO SHARED INFORMATION SERVICES
8790 GOVERNORS HILL DR 202	CINCINNATI	OH	45249	CLOUD-BASED SITE HOSTING	$289,846
INSPERITY
6 POINTE DRIVE SUITE 150	BREA	CA	928216320	PROFESSIONAL EMPLOYER ORGANIZATION	$273,020
OFER B HO INC
6520 PLATT AVENUE 625	WEST HILLS	CA	91307	CONSULTANT	$184,162

Field	Value	IRS element (for citing)
Cntrct Rcvd Greater Than100 K	3	CntrctRcvdGreaterThan100KCnt
Government Grants	$3,440,660	GovernmentGrantsAmt
All Other Contributions	$3,324,545	AllOtherContributionsAmt
Noncash Contributions	$436,012	NoncashContributionsAmt
Total Contributions	$6,765,205	TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

Field	Value	IRS element (for citing)
Desc	PATIENT REVENUE	Desc
Business	621110	BusinessCd
Total Revenue Column	$7,898,633	TotalRevenueColumnAmt
Related Or Exempt Func Income	$7,898,633	RelatedOrExemptFuncIncomeAmt

Field	Value	IRS element (for citing)
Total Program Service Revenue	$7,898,633	TotalProgramServiceRevenueAmt

Other Revenue Misc OtherRevenueMiscGrp

Field	Value	IRS element (for citing)
Desc	MISCELLANEOUS	Desc
Business	900099	BusinessCd
Total Revenue Column	$27,444	TotalRevenueColumnAmt
Exclusion	$27,444	ExclusionAmt

Field	Value	IRS element (for citing)
Other Revenue Total	$27,444	OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

Field	Value	IRS element (for citing)
Total Revenue Column	$14,691,282	TotalRevenueColumnAmt
Related Or Exempt Func Income	$7,898,633	RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue	$0	UnrelatedBusinessRevenueAmt
Exclusion	$27,444	ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

Field	Value	IRS element (for citing)
Total	$900,663	TotalAmt
Program Services	$738,657	ProgramServicesAmt
Management And General	$162,006	ManagementAndGeneralAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

Field	Value	IRS element (for citing)
Total	$7,325,069	TotalAmt
Program Services	$5,472,692	ProgramServicesAmt
Management And General	$1,852,377	ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

Field	Value	IRS element (for citing)
Total	$59,728	TotalAmt
Program Services	$51,545	ProgramServicesAmt
Management And General	$8,183	ManagementAndGeneralAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

Field	Value	IRS element (for citing)
Total	$1,624	TotalAmt
Program Services	$1,527	ProgramServicesAmt
Management And General	$97	ManagementAndGeneralAmt

Payroll Taxes PayrollTaxesGrp

Field	Value	IRS element (for citing)
Total	$1,785,840	TotalAmt
Program Services	$1,349,894	ProgramServicesAmt
Management And General	$435,946	ManagementAndGeneralAmt

Fees For Services Legal FeesForServicesLegalGrp

Field	Value	IRS element (for citing)
Total	$200	TotalAmt
Management And General	$200	ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

Field	Value	IRS element (for citing)
Total	$35,700	TotalAmt
Management And General	$35,700	ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

Field	Value	IRS element (for citing)
Total	$454,991	TotalAmt
Program Services	$249,230	ProgramServicesAmt
Management And General	$205,761	ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

Field	Value	IRS element (for citing)
Total	$207,604	TotalAmt
Program Services	$161,920	ProgramServicesAmt
Management And General	$45,684	ManagementAndGeneralAmt

Information Technology InformationTechnologyGrp

Field	Value	IRS element (for citing)
Total	$602,812	TotalAmt
Program Services	$469,839	ProgramServicesAmt
Management And General	$132,973	ManagementAndGeneralAmt

Occupancy OccupancyGrp

Field	Value	IRS element (for citing)
Total	$415,017	TotalAmt
Program Services	$389,915	ProgramServicesAmt
Management And General	$25,102	ManagementAndGeneralAmt

Travel TravelGrp

Field	Value	IRS element (for citing)
Total	$14,976	TotalAmt
Program Services	$11,672	ProgramServicesAmt
Management And General	$3,304	ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

Field	Value	IRS element (for citing)
Total	$28,022	TotalAmt
Program Services	$21,841	ProgramServicesAmt
Management And General	$6,181	ManagementAndGeneralAmt

Interest InterestGrp

Field	Value	IRS element (for citing)
Total	$70,024	TotalAmt
Program Services	$30,504	ProgramServicesAmt
Management And General	$39,520	ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

Field	Value	IRS element (for citing)
Total	$429,052	TotalAmt
Program Services	$403,101	ProgramServicesAmt
Management And General	$25,951	ManagementAndGeneralAmt

Insurance InsuranceGrp

Field	Value	IRS element (for citing)
Total	$82,661	TotalAmt
Program Services	$64,775	ProgramServicesAmt
Management And General	$17,886	ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDesc	TotalTotalAmt	Program ServicesProgramServicesAmt	Management And GeneralManagementAndGeneralAmt
MEDICAL SUPPLIES	$1,321,028	$1,321,028
REPAIRS AND MAINTENANCE	$235,952	$221,680	$14,272
LICENSES & PERMITS	$65,002	$50,937	$14,065
DUES & SUBSCRIPTIONS	$43,164	$33,643	$9,521

Total Functional Expenses TotalFunctionalExpensesGrp

Field	Value	IRS element (for citing)
Total	$14,079,129	TotalAmt
Program Services	$11,044,400	ProgramServicesAmt
Management And General	$3,034,729	ManagementAndGeneralAmt
Fundraising	$0	FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

Field	Value	IRS element (for citing)
BOY	$1,656,654	BOYAmt
EOY	$3,407,338	EOYAmt

Accounts Receivable AccountsReceivableGrp

Field	Value	IRS element (for citing)
BOY	$1,390,183	BOYAmt
EOY	$1,625,000	EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

Field	Value	IRS element (for citing)
BOY	$91,748	BOYAmt
EOY	$129,807	EOYAmt

Field	Value	IRS element (for citing)
Land Bldg Equip Cost Or Other Bss	$4,588,486	LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec	$1,445,200	LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

Field	Value	IRS element (for citing)
BOY	$3,465,678	BOYAmt
EOY	$3,143,286	EOYAmt

Intangible Assets IntangibleAssetsGrp

Field	Value	IRS element (for citing)
BOY	$61,200	BOYAmt
EOY	$61,200	EOYAmt

Total Assets TotalAssetsGrp

Field	Value	IRS element (for citing)
BOY	$6,665,463	BOYAmt
EOY	$8,366,631	EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

Field	Value	IRS element (for citing)
BOY	$3,298,846	BOYAmt
EOY	$4,183,133	EOYAmt

Deferred Revenue DeferredRevenueGrp

Field	Value	IRS element (for citing)
BOY	$5,539	BOYAmt
EOY	$205,777	EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

Field	Value	IRS element (for citing)
BOY	$2,402,017	BOYAmt
EOY	$2,402,017	EOYAmt

Other Liabilities OtherLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$102,988	BOYAmt
EOY	$107,478	EOYAmt

Total Liabilities TotalLiabilitiesGrp

Field	Value	IRS element (for citing)
BOY	$5,809,390	BOYAmt
EOY	$6,898,405	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	$856,073	BOYAmt
EOY	$1,381,506	EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

Field	Value	IRS element (for citing)
BOY	$0	BOYAmt
EOY	$86,720	EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$856,073	BOYAmt
EOY	$1,468,226	EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

Field	Value	IRS element (for citing)
BOY	$6,665,463	BOYAmt
EOY	$8,366,631	EOYAmt

Field	Value	IRS element (for citing)
Reconcilation Revenue Expnss	$612,153	ReconcilationRevenueExpnssAmt
Other Changes In Net Assets	$0	OtherChangesInNetAssetsAmt
Method Of Accounting Accrual	Yes (X)	MethodOfAccountingAccrualInd
Accountant Compile Or Review	0	AccountantCompileOrReviewInd
FS Audited	Yes (1)	FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

Field	Value	IRS element (for citing)
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)
Hospital	Yes (X)	HospitalInd

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

Buildings BuildingsGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$3,158,827	OtherCostOrOtherBasisAmt
Depreciation	$994,911	DepreciationAmt
Book Value	$2,163,916	BookValueAmt

Equipment EquipmentGrp

Field	Value	IRS element (for citing)
Other Cost Or Other Basis	$1,429,659	OtherCostOrOtherBasisAmt
Depreciation	$450,289	DepreciationAmt
Book Value	$979,370	BookValueAmt

Field	Value	IRS element (for citing)
Total Book Value Land Buildings	$3,143,286	TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

Field	Value	IRS element (for citing)
Desc	DEFERRED LEASE LIABILITIES	Desc
Amt	$107,478	Amt

Field	Value	IRS element (for citing)
Total Liability	$107,478	TotalLiabilityAmt
Footnote Text	Yes (X)	FootnoteTextInd
Total Rev Etc Audited Fincl Stmt	$14,604,562	TotalRevEtcAuditedFinclStmtAmt
Revenue Not Reported	$0	RevenueNotReportedAmt
Revenue Subtotal	$14,604,562	RevenueSubtotalAmt
Other Revenues Not Included	$86,720	OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt	$86,720	RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990	$14,691,282	TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt	$14,079,129	TotExpnsEtcAuditedFinclStmtAmt
Expenses Not Reported	$0	ExpensesNotReportedAmt
Expenses Subtotal	$14,079,129	ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt	$0	ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990	$14,079,129	TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (2 entries)

Form And Line ReferenceFormAndLineReferenceDesc

ExplanationExplanationTxt

PART X, LINE 2:

PCHC IS EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE IRC AND BY THE CALIFORNIA REVENUE AND TAXATION CODE SECTION 23701D. PCHC'S REVENUE COMES FROM PROVIDING OUTPATIENT PRIMARY MEDICAL CARE TO LOW-INCOME UNINSURED MEMBERS OF THE COMMUNITY AND IS NOT SUBJECT TO FEDERAL OR STATE INCOME TAXES. PCHC HAS EVALUATED ITS TAX POSITIONS AND THE CERTAINTY AS TO WHETHER THOSE POSITIONS WILL BE SUSTAINED IN THE EVENT OF AN AUDIT BY TAXING AUTHORITIES AT THE FEDERAL AND STATE LEVELS. THE PRIMARY TAX POSITIONS EVALUATED ARE RELATED TO PCHC'S CONTINUED QUALIFICATION AS A TAX-EXEMPT ORGANIZATION AND WHETHER THERE ARE UNRELATED BUSINESS INCOME ACTIVITIES CONDUCTED THAT WOULD BE TAXABLE. MANAGEMENT HAS DETERMINED THAT ALL INCOME TAX POSITIONS ARE MORE LIKELY THAN NOT OF BEING SUSTAINED UPON POTENTIAL AUDIT OR EXAMINATION; THEREFORE, NO DISCLOSURES OF UNCERTAIN INCOME TAX POSITIONS ARE REQUIRED. PCHC FILES INFORMATIONAL RETURNS IN THE U.S. FEDERAL JURISDICTION, AND THE STATE OF CALIFORNIA. THE STATUTE OF LIMITATIONS FOR FEDERAL AND CALIFORNIA STATE PURPOSES IS GENERALLY THREE AND FOUR YEARS, RESPECTIVELY.

PART XI, LINE 4B - OTHER ADJUSTMENTS:

CONTRIBUTIONS WITH DONOR RESTRICTIONS 86,720.

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 (9 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
RANJIT SHENOY
PHYSICIAN	$245,078	$0	$0	$0	$0	$0	$6,041	$0	$4,902	$0	$256,021	$0	$0	$0
SRINIVASU SUNKARA
CMO	$240,923	$0	$0	$0	$0	$0	$1,423	$0	$0	$0	$242,346	$0	$0	$0
DAVID KADAR
CEO	$201,996	$0	$0	$0	$0	$0	$9,941	$0	$4,094	$0	$216,031	$0	$0	$0
RAKHI SINHA
PHYSICIAN	$186,161	$0	$0	$0	$0	$0	$9,648	$0	$3,809	$0	$199,618	$0	$0	$0
DIANNE QUINTANA
PHYSICIAN	$172,299	$0	$0	$0	$0	$0	$16,655	$0	$3,601	$0	$192,555	$0	$0	$0
LORRAINE WALKER
PHYSICIAN	$179,154	$0	$0	$0	$0	$0	$502	$0	$3,583	$0	$183,239	$0	$0	$0
ENRIQUE MELGOZA
CDO	$165,654	$0	$0	$0	$0	$0	$9,467	$0	$3,313	$0	$178,434	$0	$0	$0
MARINA MARKOVA
DENTIST	$154,232	$0	$0	$0	$0	$0	$5,840	$0	$3,085	$0	$163,157	$0	$0	$0
ALFONSO AGUILERA
CFO	$141,179	$0	$0	$0	$0	$0	$17,835	$0	$2,992	$0	$162,006	$0	$0	$0

Schedule M IRS990ScheduleM

Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp

Field	Value	IRS element (for citing)
Non Cash Checkbox	Yes (X)	NonCashCheckboxInd
Contribution	116	ContributionCnt
Noncash Contributions Rpt F990	$436,012	NoncashContributionsRptF990Amt
Method Of Determining Revenues	INVOICE PRICE	MethodOfDeterminingRevenuesTxt

Field	Value	IRS element (for citing)
Form8283 Received	0	Form8283ReceivedCnt
Any Property That Must Be Held	0	AnyPropertyThatMustBeHeldInd
Review Process Unusual NC Gifts	Yes (1)	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 NUMBER OF CONTRIBUTIONS REPRESENTS THE NUMBER OF SHIPMENTS RECEIVED.	ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDesc	ExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 1	THE OFFICERS OF THE BOARD CONSTITUTE AN EXECUTIVE COMMITTEE. THE BOARD OF DIRECTORS MAY DELEGATE TO THE EXECUTIVE COMMITTEE ANY OF THE BOARD'S POWERS AND AUTHORITY IN THE MANAGEMENT OF THE ORGANIZATION'S BUSINESS AND AFFAIRS BETWEEN MEETINGS OF THE BOARD, EXCEPT THE POWER TO ADOPT, AMEND OR REPEAL THE BYLAWS. THE FINANCE COMMITTEE AND AUDIT COMMITTEE HAVE ALSO BEEN DELEGATED CERTAIN AUTHORITY TO ACT ON BEHALF OF THE BOARD.
FORM 990, PART VI, SECTION B, LINE 11B	THE FORM 990 WAS REVIEWED BY THE CEO, CFO AND THE BOARD OF DIRECTORS PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12C	BOARD MEMBERS AND ALL EMPLOYEES ARE COVERED AND SIGN A CONFLICT OF INTEREST STATEMENT ANNUALLY. DETERMINATIONS AND RESTRICTIONS ARE ASSESSED ON A CASE BY CASE SCENARIO. ALL FORMS WILL BE AVAILABLE FOR REVIEW UPON REQUEST.
FORM 990, PART VI, SECTION B, LINE 15	THE BOARD ANNUALLY APPROVES A SALARY SCALE FOR ALL POSITIONS IN THE ORGANIZATION. THE SALARY SCALE IS PREPARED USING THE CALIFORNIA PRIMARY CARE ASSOCIATION'S SALARY SCALE. THE BOARD REVIEWS AND APPROVES THE CEO'S COMPENSATION. THE CEO REVIEWS AND APPROVES OTHER EXECUTIVES' COMPENSATION IN CONJUNCTION WITH H.R. THIS PROCESS WAS LAST COMPLETED IN 2020.
FORM 990, PART VI, SECTION C, LINE 19	THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON WRITTEN REQUEST.