STRATEGY STUDIO / NONPROFIT PEOPLE SEARCH

COPPERTOWER FAMILY MEDICAL CENTER INC: Form 990, tax year 2018

View the entire original 990 at ProPublica ↗

Organization
COPPERTOWER FAMILY MEDICAL CENTER INC (EIN 68-0345901)
Tax period
2018-07-01 to 2019-06-30
Filed
2020-03-16
IRS object ID
202020769349301582
Schema version
2018v3.1
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 ReturnHeader

FieldValueIRS element (for citing)
Return2020-03-16T16:21:54-07:00ReturnTs
Tax Period End2019-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN455565460PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Goranson and Associates IncBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1717 College Avenue First FloorAddressLine1Txt
CitySanta RosaCityNm
State AbbreviationCAStateAbbreviationCd
ZIP95404ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2018-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN680345901EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1Coppertower Family Med Ctr IncBusinessNameLine1Txt
Business Name Line2dba Alexander Valley HealthcareBusinessNameLine2Txt
FieldValueIRS element (for citing)
Business Name ControlCOPPBusinessNameControlTxt
Phone7078944229PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1100 W Third StreetAddressLine1Txt
CityCloverdaleCityNm
State AbbreviationCAStateAbbreviationCd
ZIP95425ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonDebbie HowellPersonNm
Person TitleCEOPersonTitleTxt
Signature2020-03-11SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonSusan E GoransonPreparerPersonNm
PTINP00049464PTIN
Phone7075421256PhoneNum
FieldValueIRS element (for citing)
Tax2018TaxYr
Build TS2020-09-23 17:36:50ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerDebbie HowellPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1100 W Third StreetAddressLine1Txt
CityCloverdaleCityNm
State AbbreviationCAStateAbbreviationCd
ZIP95425ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$5,811,286GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
All Affiliates IncludedfalseAllAffiliatesIncludedInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresswww.alexandervalleyhealthcare.orgWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1994FormationYr
Legal Domicile StateCALegalDomicileStateCd
Activity Or MissionTo provide excellent and comprehensive primary care servicesActivityOrMissionDesc
Voting Members Governing Body11VotingMembersGoverningBodyCnt
Voting Members Independent11VotingMembersIndependentCnt
Total Employee74TotalEmployeeCnt
Total Volunteers16TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
PY Contributions Grants$1,362,826PYContributionsGrantsAmt
CY Contributions Grants$1,236,333CYContributionsGrantsAmt
PY Program Service Revenue$4,565,129PYProgramServiceRevenueAmt
CY Program Service Revenue$4,574,953CYProgramServiceRevenueAmt
CY Investment Income$0CYInvestmentIncomeAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$5,927,955PYTotalRevenueAmt
CY Total Revenue$5,811,286CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$3,984,683PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$4,018,580CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$1,385,342PYOtherExpensesAmt
CY Other Expenses$1,392,010CYOtherExpensesAmt
PY Total Expenses$5,370,025PYTotalExpensesAmt
CY Total Expenses$5,410,590CYTotalExpensesAmt
PY Revenues Less Expenses$557,930PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$400,696CYRevenuesLessExpensesAmt
Total Assets BOY$4,587,239TotalAssetsBOYAmt
Total Assets EOY$4,867,356TotalAssetsEOYAmt
Total Liabilities BOY$522,577TotalLiabilitiesBOYAmt
Total Liabilities EOY$401,998TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$4,064,662NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$4,465,358NetAssetsOrFundBalancesEOYAmt
MissionTo provide excellent and comprehensive primary care servicesMissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$3,989,565ExpenseAmt
DescWe 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$3,989,565TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesfalseReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (true)IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Invest Tax Exempt BondsfalseInvestTaxExemptBondsInd
Escrow AccountfalseEscrowAccountInd
On Behalf Of IssuerfalseOnBehalfOfIssuerInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document19IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee74EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Form990 T FiledfalseForm990TFiledInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Form8282 Filed0Form8282FiledCnt
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Form8899 FiledindfalseForm8899Filedind
Form1098 C FiledfalseForm1098CFiledInd
DAF Excess Business HoldingsfalseDAFExcessBusinessHoldingsInd
Taxable DistributionsfalseTaxableDistributionsInd
Distribution To DonorfalseDistributionToDonorInd
Org Filed In Lieu Of Form1041falseOrgFiledInLieuOfForm1041Ind
Licensed More Than One StatefalseLicensedMoreThanOneStateInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht PymtfalseSubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst IncfalseSubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members11GoverningBodyVotingMembersCnt
Independent Voting Member11IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
States Where Copy Of Return Is FldCAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonJenine SaundersPersonNm
Phone7078944229PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1100 W Third StreetAddressLine1Txt
CityCloverdaleCityNm
State AbbreviationCAStateAbbreviationCd
ZIP95425ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (18 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
Anna Felciano
Secretary2.000.00Yes (X)$0$0$0
Jack Dawson
Director2.000.00Yes (X)$0$0$0
Kirsten Tellez
Director2.000.00Yes (X)$0$0$0
Joel Hernandez
Director2.000.00Yes (X)$0$0$0
Paula Wrenn
Chairman2.000.00Yes (X)$0$0$0
Janet Anguiano
Vice Chairman2.000.00Yes (X)$0$0$0
Melonie Delsid
Director2.000.00Yes (X)$0$0$0
Larry Lossing
Director2.000.00Yes (X)$0$0$0
Jeanne Cox
Director2.000.00Yes (X)$0$0$0
Leonard Kuhi
Director2.000.00Yes (X)$0$0$0
James Novak
Director2.000.00Yes (X)$0$0$0
Jenine Saunders
CFO40.000.00$151,542$0$7,560Yes (X)
Debbie Howell
CEO40.000.00$204,037$0$19,649Yes (X)
Norr Hashem
Staff physician40.000.00$148,356$0$13,248Yes (X)
Shellie Burdick
Chief Medical Offi40.000.00$163,757$0$14,493Yes (X)
Cary Wheeler
Staff physician40.000.00$168,655$0$9,135Yes (X)
Samantha Guthman
coo40.000.00$110,753$0$5,142Yes (X)
Lea Queen
Psychologist40.000.00$103,443$0$12,810Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,050,543TotalReportableCompFromOrgAmt
Total Other Compensation$82,037TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K7IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Government Grants$1,201,123GovernmentGrantsAmt
All Other Contributions$35,210AllOtherContributionsAmt
Total Contributions$1,236,333TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt
Medical fees$4,275,542$4,275,542
Other revenue$299,411$299,411
FieldValueIRS element (for citing)
Total Program Service Revenue$4,574,953TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Other Revenue Total$0OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$5,811,286TotalRevenueColumnAmt
Related Or Exempt Func Income$4,574,953RelatedOrExemptFuncIncomeAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$382,788TotalAmt
Management And General$382,788ManagementAndGeneralAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$3,635,792TotalAmt
Program Services$2,843,284ProgramServicesAmt
Management And General$792,508ManagementAndGeneralAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$173,111TotalAmt
Program Services$118,969ProgramServicesAmt
Management And General$54,142ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$7,332TotalAmt
Management And General$7,332ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$46,198TotalAmt
Program Services$34,480ProgramServicesAmt
Management And General$11,718ManagementAndGeneralAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$170,615TotalAmt
Program Services$132,871ProgramServicesAmt
Management And General$37,744ManagementAndGeneralAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$4,239TotalAmt
Program Services$1,025ProgramServicesAmt
Management And General$3,214ManagementAndGeneralAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$2,142TotalAmt
Management And General$2,142ManagementAndGeneralAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$86,834TotalAmt
Program Services$61,303ProgramServicesAmt
Management And General$25,531ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$33,768TotalAmt
Program Services$29,641ProgramServicesAmt
Management And General$4,127ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
supplies$436,008$427,440$8,568
consultants and contractors$187,174$137,846$49,328
Laboratory Fees$69,941$69,941
staff development$47,408$41,281$6,127

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$127,240TotalAmt
Program Services$91,484ProgramServicesAmt
Management And General$35,756ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$5,410,590TotalAmt
Program Services$3,989,565ProgramServicesAmt
Management And General$1,421,025ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,471,718BOYAmt
EOY$879,488EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$1,938,448BOYAmt
EOY$1,988,431EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$24,887BOYAmt
EOY$57,328EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$875,974BOYAmt
EOY$1,279,520EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$52,677BOYAmt
EOY$73,326EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$94,065BOYAmt
EOY$142,525EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$887,898LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$441,160LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$129,470BOYAmt
EOY$446,738EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
EOY$0EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$4,587,239BOYAmt
EOY$4,867,356EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$485,855BOYAmt
EOY$383,774EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$36,722BOYAmt
EOY$18,224EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$522,577BOYAmt
EOY$401,998EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$4,064,662BOYAmt
EOY$4,465,358EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$4,064,662BOYAmt
EOY$4,465,358EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$4,587,239BOYAmt
EOY$4,867,356EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$400,696ReconcilationRevenueExpnssAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredYes (true)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (true)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$945,485CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,151,619CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,326,342CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,362,826CurrentTaxYearMinus1YearAmt
Current Tax Year$1,236,333CurrentTaxYearAmt
Total$6,022,605TotalAmt

Tax Rev Levied Orgnztnl Bnft170 TaxRevLeviedOrgnztnlBnft170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$945,485CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$1,151,619CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$1,326,342CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$1,362,826CurrentTaxYearMinus1YearAmt
Current Tax Year$1,236,333CurrentTaxYearAmt
Total$6,022,605TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$0SubstantialContributorsTotAmt
Public Support Total170$6,022,605PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Income170 OtherIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$4,131CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$62,887CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$306,665CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$345,501CurrentTaxYearMinus1YearAmt
Current Tax Year$299,411CurrentTaxYearAmt
Total$1,018,595TotalAmt
FieldValueIRS element (for citing)
Total Support$7,041,200TotalSupportAmt
Public Support CY1700.85530PublicSupportCY170Pct
Public Support PY1700.89360PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$496,642OtherCostOrOtherBasisAmt
Depreciation$441,160DepreciationAmt
Book Value$55,482BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$391,256OtherCostOrOtherBasisAmt
Book Value$391,256BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$446,738TotalBookValueLandBuildingsAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$5,811,286TotalRevEtcAuditedFinclStmtAmt
Revenue Subtotal$5,811,286RevenueSubtotalAmt
Total Revenue Per Form990$5,811,286TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$5,410,590TotExpnsEtcAuditedFinclStmtAmt
Expenses Subtotal$5,410,590ExpensesSubtotalAmt
Total Expenses Per Form990$5,410,590TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePart X : FIN48 FootnoteFormAndLineReferenceDesc
ExplanationThe 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

FieldValueIRS element (for citing)
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd
Rebuttable Presumption ProcfalseRebuttablePresumptionProcInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (5 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt
Cary Wheeler
Staff physician$168,655$9,135$177,790
Debbie Howell
CEO$204,037$10,180$223,686$9,469
Jenine Saunders
CFO$151,542$7,560$159,102
Norr Hashem
Staff physician$148,356$13,248$161,604
Shellie Burdick
Chief Medical Offi$163,757$14,493$178,250

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Form 990, Part VI, Line 11b: Form 990 Review ProcessThe 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 ConflictsThe 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 EmployeesBy 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 AvailableCopies 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.