2019-05-15T17:07:03-05:00 2018-06-30 910189318 MOSS ADAMS LLP 3121 W MARCH LN STE 200 STOCKTON CA 952192367 990 2017-07-01 942492609 NORTHEASTERN RURAL HEALTH CLINICS INC NORT 5302515000 1850 SPRING RIDGE DRIVE SUSANVILLE CA 96130 LYNN HUDGENS CEO 5302515000 2019-05-15 1 TRACY S PAGLIA P00366884 2099556100 2019-05-15 12.129.7.100 2019-05-15 12:58:34 PD P C8718CB9996E60864A3D8C801BA7929B0DAF3A04 C8718CB9996E60864A3D8C801BA7929B0DAF3A04 2017 2019-02-21 02:37:17Z LYNN HUDGENS 1850 SPRING RIDGE DRIVE SUSANVILLE CA 96130 11985679 0 X WWW.NORTHEASTERNHEALTH.ORG X 1977 CA PROVIDE ACCESS TO QUALITY HEALTH CARE SERVICES TO SOCIALLY/ECONOMICALLY DEPRESSED IN LASSEN CTY, CA. 10 10 144 8 0 0 2323742 2516916 9945306 9393052 665 0 521506 62596 12791219 11972564 0 0 0 0 7739478 7197050 0 0 0 6578755 5215256 14318233 12412306 -1527014 -439742 6370562 5653143 6785729 7752594 -415167 -2099451 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. 0 0 9545915 9393052 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. 9545915 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 43 0 1 144 1 0 0 0 0 0 0 0 0 0 0 X 10 10 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 CA X X LACEY SMITH 5302515000 1850 SPRING RIDGE DRIVE SUSANVILLE CA 96130 MARGE GARROD CHAIR 2.00 X X 0 0 0 EULA JOHNSON BOARD MEMBER 2.00 X 0 0 0 SANDY RAFFLESON BOARD MEMBER 2.00 X 0 0 0 ROSS STEVENSON SECRETARY 2.00 X X 0 0 0 MIKE O' KELLY BOARD MEMBER 2.00 X 0 0 0 CARROL CURRY BOARD MEMBER 2.00 X 0 0 0 SOPHIA WAGES BOARD MEMBER 2.00 X 0 0 0 KATIE ANDERSON BOARD MEMBER 2.00 X 0 0 0 SETH ANDERSON BOARD MEMBER 2.00 X 0 0 0 MARIA NYE TREASURER 2.00 X X 0 0 0 DORI HOLMES BOARD MEMBER (THRU 06/30/18) 2.00 X 0 0 0 NAOMI REA MEDICAL DIRECTOR 40.00 X 185687 0 9007 CHARLES GIDDINGS DENTAL DIRECTOR (6/04/17) 40.00 X 118720 0 0 LYNN HUDGENS CEO 40.00 X 80382 0 3919 DANIEL KAZAKOS CFO 40.00 X 22568 0 1306 MIKE SCHWAB COO 40.00 X 16371 0 1306 MARYAM BAHADORI DENTAL DIRECTOR 40.00 X 73779 0 4764 JOHN DOZIER PHYSICIAN 40.00 X 262191 0 16993 RACHEL PETERSON PHYSICIAN OB GYN 40.00 X 190635 0 18409 STEVEN BRAATZ PHYSICIAN OB GYN 40.00 X 312030 0 17483 SAMUEL CARLTON PHYSICIAN 40.00 X 250692 0 24545 TIMOTHY ECKFORD PHYSICIAN 40.00 X 214558 0 8407 1727613 0 106139 10 0 1 0 WEATHERBY LOCUMS INC PO BOX 972633 DALLAS TX 75397 LOCUM TENENS 407910 MEDCADRE PO BOX 150290 OGDEN UT 84415 LOCUM TENENS 356306 PROVIDER HEALTHCARE LLC 4252 SOUTH HIGHLAND DRIVE STE 104 SALT LAKE CITY UT 84124 LOCUM TENENS 319008 BARTON ASSOCIATES INC PO BOX 417844 BOSTON MA 02241 LOCUM TENENS 195650 HENDERSHOTT MANAGEMENT GROUP 290 RIVERVIEW DR DOUGLAS MI 49406 INTERIM CEO 103012 5 2362176 154740 12636 2516916 NET PATIENT SERVICE REVENUE 621400 6715674 6715674 PHARMACY REVENUE 621400 2677378 2677378 9393052 10550 13115 -2565 -2565 -2565 MISCELLANEOUS INCOME 900099 65161 65161 65161 11972564 9393052 0 62596 X 813407 140007 673400 5145278 4709513 435765 18991 15760 3231 766206 655545 110661 453168 339730 113438 5560 5560 2444753 1713564 731189 28296 28296 220961 49797 171164 212771 137821 74950 37279 37279 43234 43234 173912 173912 367803 240770 127033 59859 48629 11230 MEDICAL SUPPLIES & DRUG 1278072 1274716 3356 COMMUNICATIONS 165052 105633 59419 EQUIPMENT 151589 97017 54572 LICENSES AND REGISTRATI 25027 17413 7614 1088 1088 12412306 9545915 2866391 0 790479 1615374 422290 1453934 967597 181976 146552 7969520 5045900 3286990 2923620 234893 6370562 5653143 1573571 911758 3822471 3823702 1389687 3017134 6785729 7752594 X -478722 -2166056 63555 66605 -415167 -2099451 6370562 5653143 X -439742 -117 -1244425 0 X 0 1 X 1 1 1 X 249132 249132 6435514 4164394 2271120 358842 129542 229300 926032 751964 174068 2923620 X 11985680 0 11985680 -13116 -13116 11972564 12425539 117 13116 13233 12412306 0 12412306 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. X 0 0 0 0 0 0 0 0 0 NAOMI REA MEDICAL DIRECTOR 185687 0 0 0 0 0 600 0 8407 0 194694 0 0 0 JOHN DOZIER PHYSICIAN 262191 0 0 0 0 0 125 0 16868 0 279184 0 0 0 RACHEL PETERSON PHYSICIAN OB GYN 190635 0 0 0 0 0 450 0 17959 0 209044 0 0 0 STEVEN BRAATZ PHYSICIAN OB GYN 312030 0 0 0 0 0 600 0 16883 0 329513 0 0 0 SAMUEL CARLTON PHYSICIAN 250692 0 0 0 0 0 600 0 23945 0 275237 0 0 0 TIMOTHY ECKFORD PHYSICIAN 214558 0 0 0 0 0 0 0 8407 0 222965 0 0 0 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.