NORTHEASTERN RURAL HEALTH CLINICS: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- NORTHEASTERN RURAL HEALTH CLINICS (EIN 94-2492609)
- Tax period
- 2017-07-01 to 2018-06-30
- Filed
- 2019-05-15
- IRS object ID
- 201941359349312429
- Schema version
- 2017v2.3
- 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 | 2019-05-15T17:07:03-05:00 | ReturnTs |
| Tax Period End | 2018-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 910189318 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MOSS ADAMS LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3121 W MARCH LN STE 200 | AddressLine1Txt |
| City | STOCKTON | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 952192367 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 942492609 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | NORTHEASTERN RURAL HEALTH CLINICS INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | NORT | BusinessNameControlTxt |
| Phone | 5302515000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1850 SPRING RIDGE DRIVE | AddressLine1Txt |
| City | SUSANVILLE | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 96130 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | LYNN HUDGENS | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 5302515000 | PhoneNum |
| Signature | 2019-05-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | TRACY S PAGLIA | PreparerPersonNm |
| PTIN | P00366884 | PTIN |
| Phone | 2099556100 | PhoneNum |
| Preparation | 2019-05-15 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 12.129.7.100 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2019-05-15 | IPDt |
| IP Tm | 12:58:34 | IPTm |
| IP Timezone | PD | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | C8718CB9996E60864A3D8C801BA7929B0DAF3A04 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | C8718CB9996E60864A3D8C801BA7929B0DAF3A04 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | LYNN HUDGENS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1850 SPRING RIDGE DRIVE | AddressLine1Txt |
| City | SUSANVILLE | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 96130 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $11,985,679 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.NORTHEASTERNHEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1977 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | PROVIDE ACCESS TO QUALITY HEALTH CARE SERVICES TO SOCIALLY/ECONOMICALLY DEPRESSED IN LASSEN CTY, CA. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 144 | TotalEmployeeCnt |
| Total Volunteers | 8 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $2,323,742 | PYContributionsGrantsAmt |
| CY Contributions Grants | $2,516,916 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $9,945,306 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $9,393,052 | CYProgramServiceRevenueAmt |
| PY Investment Income | $665 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $521,506 | PYOtherRevenueAmt |
| CY Other Revenue | $62,596 | CYOtherRevenueAmt |
| PY Total Revenue | $12,791,219 | PYTotalRevenueAmt |
| CY Total Revenue | $11,972,564 | 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 | $7,739,478 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $7,197,050 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $6,578,755 | PYOtherExpensesAmt |
| CY Other Expenses | $5,215,256 | CYOtherExpensesAmt |
| PY Total Expenses | $14,318,233 | PYTotalExpensesAmt |
| CY Total Expenses | $12,412,306 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$1,527,014 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$439,742 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $6,370,562 | TotalAssetsBOYAmt |
| Total Assets EOY | $5,653,143 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $6,785,729 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $7,752,594 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$415,167 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$2,099,451 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO PROVIDE ACCESS TO QUALITY HEALTH CARE SERVICES TO SOCIALLY AND ECONOMICALLY DEPRESSED SECTORS OF LASSEN COUNTY IN NORTHEASTERN CALIFORNIA. THE CENTER IS COMMITTED TO ADDRESSING THE SPECIAL NEEDS OF THE COMMUNITY'S MEDICALLY UNDER SERVED. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $9,545,915 | ExpenseAmt |
| Revenue | $9,393,052 | RevenueAmt |
| Desc | PROVIDE QUALITY HEALTH CARE TO RURAL AND LOW INCOME POPULATION REGARDLESS OF ABILITY TO PAY SERVICES INCLUDE PRIMARY CARE, OB, DIAGNOSTIC LAB TESTING, PHARMACY SERVICES, EDUCATION AND BEHAVIORAL HEALTH 46,988 PATIENT VISITS ARE RECORDED FOR FISCAL YEAR ENDED JUNE 30, 2018. | Desc |
| Total Program Service Expenses | $9,545,915 | 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 |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| 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 | 0 | 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 With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| 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 | 43 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 144 | 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 |
| 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 | 0 | 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 |
| Own Website | Yes (X) | OwnWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LACEY SMITH | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5302515000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1850 SPRING RIDGE DRIVE | AddressLine1Txt |
| City | SUSANVILLE | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 96130 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (22 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| MARGE GARROD | |||||||
| CHAIR | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| EULA JOHNSON | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| SANDY RAFFLESON | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| ROSS STEVENSON | |||||||
| SECRETARY | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| MIKE O' KELLY | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| CARROL CURRY | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| SOPHIA WAGES | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| KATIE ANDERSON | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| SETH ANDERSON | |||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| MARIA NYE | |||||||
| TREASURER | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| DORI HOLMES | |||||||
| BOARD MEMBER (THRU 06/30/18) | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| NAOMI REA | |||||||
| MEDICAL DIRECTOR | 40.00 | Yes (X) | $185,687 | $0 | $9,007 | ||
| CHARLES GIDDINGS | |||||||
| DENTAL DIRECTOR (6/04/17) | 40.00 | Yes (X) | $118,720 | $0 | $0 | ||
| LYNN HUDGENS | |||||||
| CEO | 40.00 | Yes (X) | $80,382 | $0 | $3,919 | ||
| DANIEL KAZAKOS | |||||||
| CFO | 40.00 | Yes (X) | $22,568 | $0 | $1,306 | ||
| MIKE SCHWAB | |||||||
| COO | 40.00 | Yes (X) | $16,371 | $0 | $1,306 | ||
| MARYAM BAHADORI | |||||||
| DENTAL DIRECTOR | 40.00 | Yes (X) | $73,779 | $0 | $4,764 | ||
| JOHN DOZIER | |||||||
| PHYSICIAN | 40.00 | $262,191 | $0 | $16,993 | Yes (X) | ||
| RACHEL PETERSON | |||||||
| PHYSICIAN OB GYN | 40.00 | $190,635 | $0 | $18,409 | Yes (X) | ||
| STEVEN BRAATZ | |||||||
| PHYSICIAN OB GYN | 40.00 | $312,030 | $0 | $17,483 | Yes (X) | ||
| SAMUEL CARLTON | |||||||
| PHYSICIAN | 40.00 | $250,692 | $0 | $24,545 | Yes (X) | ||
| TIMOTHY ECKFORD | |||||||
| PHYSICIAN | 40.00 | $214,558 | $0 | $8,407 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,727,613 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $106,139 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 10 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| WEATHERBY LOCUMS INC | |||||
| PO BOX 972633 | DALLAS | TX | 75397 | LOCUM TENENS | $407,910 |
| MEDCADRE | |||||
| PO BOX 150290 | OGDEN | UT | 84415 | LOCUM TENENS | $356,306 |
| PROVIDER HEALTHCARE LLC | |||||
| 4252 SOUTH HIGHLAND DRIVE STE 104 | SALT LAKE CITY | UT | 84124 | LOCUM TENENS | $319,008 |
| BARTON ASSOCIATES INC | |||||
| PO BOX 417844 | BOSTON | MA | 02241 | LOCUM TENENS | $195,650 |
| HENDERSHOTT MANAGEMENT GROUP | |||||
| 290 RIVERVIEW DR | DOUGLAS | MI | 49406 | INTERIM CEO | $103,012 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $2,362,176 | GovernmentGrantsAmt |
| All Other Contributions | $154,740 | AllOtherContributionsAmt |
| Noncash Contributions | $12,636 | NoncashContributionsAmt |
| Total Contributions | $2,516,916 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 621400 | $6,715,674 | $6,715,674 |
| PHARMACY REVENUE | 621400 | $2,677,378 | $2,677,378 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $9,393,052 | TotalProgramServiceRevenueAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $10,550 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $13,115 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | -$2,565 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$2,565 | TotalRevenueColumnAmt |
| Exclusion | -$2,565 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS INCOME | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $65,161 | TotalRevenueColumnAmt |
| Exclusion | $65,161 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $65,161 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $11,972,564 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $9,393,052 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $62,596 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $813,407 | TotalAmt |
| Program Services | $140,007 | ProgramServicesAmt |
| Management And General | $673,400 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,145,278 | TotalAmt |
| Program Services | $4,709,513 | ProgramServicesAmt |
| Management And General | $435,765 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,991 | TotalAmt |
| Program Services | $15,760 | ProgramServicesAmt |
| Management And General | $3,231 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $766,206 | TotalAmt |
| Program Services | $655,545 | ProgramServicesAmt |
| Management And General | $110,661 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $453,168 | TotalAmt |
| Program Services | $339,730 | ProgramServicesAmt |
| Management And General | $113,438 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,560 | TotalAmt |
| Management And General | $5,560 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,444,753 | TotalAmt |
| Program Services | $1,713,564 | ProgramServicesAmt |
| Management And General | $731,189 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,296 | TotalAmt |
| Management And General | $28,296 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $220,961 | TotalAmt |
| Program Services | $49,797 | ProgramServicesAmt |
| Management And General | $171,164 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $212,771 | TotalAmt |
| Program Services | $137,821 | ProgramServicesAmt |
| Management And General | $74,950 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $37,279 | TotalAmt |
| Management And General | $37,279 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $43,234 | TotalAmt |
| Management And General | $43,234 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $173,912 | TotalAmt |
| Management And General | $173,912 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $367,803 | TotalAmt |
| Program Services | $240,770 | ProgramServicesAmt |
| Management And General | $127,033 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $59,859 | TotalAmt |
| Program Services | $48,629 | ProgramServicesAmt |
| Management And General | $11,230 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES & DRUG | $1,278,072 | $1,274,716 | $3,356 |
| COMMUNICATIONS | $165,052 | $105,633 | $59,419 |
| EQUIPMENT | $151,589 | $97,017 | $54,572 |
| LICENSES AND REGISTRATI | $25,027 | $17,413 | $7,614 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,088 | TotalAmt |
| Management And General | $1,088 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,412,306 | TotalAmt |
| Program Services | $9,545,915 | ProgramServicesAmt |
| Management And General | $2,866,391 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $790,479 | BOYAmt |
| EOY | $1,615,374 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $422,290 | BOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,453,934 | BOYAmt |
| EOY | $967,597 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $181,976 | BOYAmt |
| EOY | $146,552 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $7,969,520 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $5,045,900 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,286,990 | BOYAmt |
| EOY | $2,923,620 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $234,893 | BOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,370,562 | BOYAmt |
| EOY | $5,653,143 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,573,571 | BOYAmt |
| EOY | $911,758 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,822,471 | BOYAmt |
| EOY | $3,823,702 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,389,687 | BOYAmt |
| EOY | $3,017,134 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,785,729 | BOYAmt |
| EOY | $7,752,594 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$478,722 | BOYAmt |
| EOY | -$2,166,056 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $63,555 | BOYAmt |
| EOY | $66,605 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$415,167 | BOYAmt |
| EOY | -$2,099,451 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,370,562 | BOYAmt |
| EOY | $5,653,143 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$439,742 | ReconcilationRevenueExpnssAmt |
| Donated Services And Use Fclts | -$117 | DonatedServicesAndUseFcltsAmt |
| Prior Period Adjustments | -$1,244,425 | PriorPeriodAdjustmentsAmt |
| 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
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $249,132 | OtherCostOrOtherBasisAmt |
| Book Value | $249,132 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,435,514 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,164,394 | DepreciationAmt |
| Book Value | $2,271,120 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $358,842 | OtherCostOrOtherBasisAmt |
| Depreciation | $129,542 | DepreciationAmt |
| Book Value | $229,300 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $926,032 | OtherCostOrOtherBasisAmt |
| Depreciation | $751,964 | DepreciationAmt |
| Book Value | $174,068 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $2,923,620 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $11,985,680 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $11,985,680 | RevenueSubtotalAmt |
| Other Revenues Not Included | -$13,116 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | -$13,116 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $11,972,564 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $12,425,539 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $117 | DonatedServicesUseFcltsAmt |
| Other Expenses Included | $13,116 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $13,233 | ExpensesNotReportedAmt |
| Expenses Subtotal | $12,412,306 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $12,412,306 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | THE CENTER IS A NONPROFIT CORPORATION UNDER SECTION 501(C)(3) AND HAVE BEEN GRANTED TAX-EXEMPT STATUSES BY THE INTERNAL REVENUE SERVICE AND THE CALIFORNIA REVENUE AND TAXATION CODE. AS OF JUNE 30, 2018 THE CENTER HAD NO UNRECOGNIZED TAX POSITIONS OR UNCERTAIN TAX POSITIONS REQUIRING ACCRUAL. THEREFORE, NO PROVISION FOR INCOME TAXES HAS BEEN PROVIDED IN THE FINANCIAL STATEMENTS. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | RENTAL EXPENSES -13,116. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | RENTAL EXPENSES 13,116. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| 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 (6 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| NAOMI REA | ||||||||||||||
| MEDICAL DIRECTOR | $185,687 | $0 | $0 | $0 | $0 | $0 | $600 | $0 | $8,407 | $0 | $194,694 | $0 | $0 | $0 |
| JOHN DOZIER | ||||||||||||||
| PHYSICIAN | $262,191 | $0 | $0 | $0 | $0 | $0 | $125 | $0 | $16,868 | $0 | $279,184 | $0 | $0 | $0 |
| RACHEL PETERSON | ||||||||||||||
| PHYSICIAN OB GYN | $190,635 | $0 | $0 | $0 | $0 | $0 | $450 | $0 | $17,959 | $0 | $209,044 | $0 | $0 | $0 |
| STEVEN BRAATZ | ||||||||||||||
| PHYSICIAN OB GYN | $312,030 | $0 | $0 | $0 | $0 | $0 | $600 | $0 | $16,883 | $0 | $329,513 | $0 | $0 | $0 |
| SAMUEL CARLTON | ||||||||||||||
| PHYSICIAN | $250,692 | $0 | $0 | $0 | $0 | $0 | $600 | $0 | $23,945 | $0 | $275,237 | $0 | $0 | $0 |
| TIMOTHY ECKFORD | ||||||||||||||
| PHYSICIAN | $214,558 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $8,407 | $0 | $222,965 | $0 | $0 | $0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | THE CFO, WITH THE ASSISTANCE OF INDEPENDENT AUDIT FIRM, PREPARES AND PRESENTS THE 990 TO THE BOARD OR DIRECTORS AT MONTHLY MEETING. |
| FORM 990, PART VI, SECTION B, LINE 12C | DISCLOSURE COMPLETED ANNUALLY BY OFFICERS AND DIRECTORS. |
| FORM 990, PART VI, SECTION B, LINE 15 | WHEN A POSITION BECOMES AVAILABLE, SALARY AND COMPENSATION SCHEDULES OF SIMILAR ORGANIZATIONS ARE CONSULTED FOR COMPARABLE WAGE SCALES. CEO SALARY IS ESTABLISHED IN A WRITTEN CONTRACT SIGNED BY GOVERNING BOARD. |
| FORM 990, PART VI, SECTION C, LINE 19 | ALL OF THESE ITEMS ARE AVAILABLE UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | MEDICAL CONTRACTUAL SERVICES: PROGRAM SERVICE EXPENSES 1,713,564. MANAGEMENT AND GENERAL EXPENSES 729,040. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,442,604. RECRUITMENT & PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 2,149. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,149. |
| PART XI, LINE 8: | A REVIEW OF THE SUBSEQUENT CASH RECEIPTS FOR NET PATIENT ACCOUNTS RECEIVABLE OUTSTANDING AS OF JUNE 30, 2017 INDICATED THAT THE NET PATIENT ACCOUNTS RECEIVABLE AND NET PATIENT SERVICE REVENUES WERE OVERSTATED BY $724,419. ADDITIONALLY, THERE WERE DUPLICATE BILLINGS DURING THE YEAR ENDED JUNE 30, 2017, INDICATING THAT NET PATIENT REVENUES AND NET PATIENT ACCOUNTS RECEIVABLE WERE OVERSTATED BY $434,022 AND $71,497, RESPECTIVELY, AND THIRD-PARTY PAYOR SETTLEMENTS WAS UNDERSTATED BY $448,511. ACCORDINGLY, THE CENTER RESTATED THE BEGINNING BALANCE OF UNRESTRICTED NET ASSETS TO CORRECT THESE ERRORS. THE EFFECT OF THE RESTATEMENT INCREASES CHANGE IN NET ASSETS FOR 2017 BY $1,158,441; AND THE CUMULATIVE EFFECT INCREASES BEGINNING NET DEFICIT BY $1,244,425. |