POMONA COMMUNITY HEALTH CENTER: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- POMONA COMMUNITY HEALTH CENTER (EIN 22-3914738)
- Tax period
- 2018-01-01 to 2018-12-31
- Filed
- 2019-09-06
- IRS object ID
- 201942499349300224
- 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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2019-09-06T11:18:28-05:00 | ReturnTs |
| Tax Period End | 2018-12-31 | 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 | 2210 EAST ROUTE 66 | AddressLine1Txt |
| City | GLENDORA | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 91740 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2018-01-01 | 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 | ELLEN SILVER | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 9098659501 | PhoneNum |
| Signature | 2019-08-23 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | TINA HENTON | PreparerPersonNm |
| PTIN | P00630282 | PTIN |
| Phone | 6268577300 | PhoneNum |
| Preparation | 2019-08-23 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 67.137.57.251 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2019-08-23 | IPDt |
| IP Tm | 12:44:15 | IPTm |
| IP Timezone | PD | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | FE364397F9AD7E3202A1F249EA4C481637B034D8 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 9A4A8B048A8B5CB9C3E0E0008FB24706BD561990 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | 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 | ELLEN SILVER | 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 | $11,363,397 | 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 | POMONA COMMUNITY HEALTH CENTER'S MISSION IS TO PROVIDE PREVENTIVE AND PRIMARY CARE SERVICES TO THE NEEDY IN THE COMMUNITY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 127 | TotalEmployeeCnt |
| Total Volunteers | 47 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $2,706,773 | PYContributionsGrantsAmt |
| CY Contributions Grants | $4,537,368 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $4,410,864 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $6,790,693 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $10,754 | PYOtherRevenueAmt |
| CY Other Revenue | $23,833 | CYOtherRevenueAmt |
| PY Total Revenue | $7,128,391 | PYTotalRevenueAmt |
| CY Total Revenue | $11,351,894 | 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 | $5,216,682 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $6,758,050 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,911,714 | PYOtherExpensesAmt |
| CY Other Expenses | $2,685,756 | CYOtherExpensesAmt |
| PY Total Expenses | $7,128,396 | PYTotalExpensesAmt |
| CY Total Expenses | $9,443,806 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$5 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,908,088 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $3,463,178 | TotalAssetsBOYAmt |
| Total Assets EOY | $6,752,993 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,745,021 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $4,704,663 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $718,157 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $2,048,330 | 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 | $7,933,321 | ExpenseAmt |
| Revenue | $6,814,526 | 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 | $7,933,321 | 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 | 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 | Yes (1) | 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 | 18 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 127 | 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 | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | 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 | ELLEN SILVER | 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 | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| FLOY BIGGS | ||||||||
| VICE-CHAIR | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| CHRIS ALDWORTH | ||||||||
| CHAIR | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| JENNIFER SANCEN | ||||||||
| SECRETARY | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| PEGGY SANCHEZ | ||||||||
| TREASURER | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| JAMES ALIG | ||||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| GWENDOLYN KEYS | ||||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| MICHAEL NELSON | ||||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| JE | ||||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| AUSA TUASINA | ||||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| ELVIA RIVAS | ||||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| SONIA BURNS | ||||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| ELLEN SILVER | ||||||||
| CEO | 40.00 | Yes (X) | $191,194 | $0 | $12,937 | |||
| ALFONSO AGUILERA | ||||||||
| CFO | 40.00 | Yes (X) | $119,974 | $0 | $18,318 | |||
| DAVID KADAR | ||||||||
| CHIEF DENTAL OFFICER | 40.00 | $187,772 | $0 | $12,344 | Yes (X) | |||
| ENRIQUE MELGOZA | ||||||||
| DENTIST | 40.00 | $143,069 | $0 | $11,285 | Yes (X) | |||
| RANJIT SHENOY | ||||||||
| INTERNAL MEDICINE PHYSICIAN | 40.00 | $276,602 | $0 | $6,552 | Yes (X) | |||
| DIANNE QUINTANA | ||||||||
| PHYSICIAN | 40.00 | $165,502 | $0 | $16,410 | Yes (X) | |||
| LORRAINE WALKER | ||||||||
| PHYSICIAN | 40.00 | $154,958 | $0 | $2,074 | Yes (X) | |||
| MARINA MARKOVA | ||||||||
| DENTIST | 40.00 | $145,280 | $0 | $6,630 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,384,351 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $86,550 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 8 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | INSPERITY | BusinessNameLine1Txt |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6 POINTE DR SUITE 150 | AddressLine1Txt |
| City | BREA | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 928216320 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | PROFESSIONAL EMPLOYER ORGANIZATION | ServicesDesc |
| Compensation | $195,471 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $4,097 | FundraisingAmt |
| Government Grants | $2,168,343 | GovernmentGrantsAmt |
| All Other Contributions | $2,364,928 | AllOtherContributionsAmt |
| Total Contributions | $4,537,368 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT REVENUE | 900099 | $6,714,193 | $6,714,193 |
| INCENTIVE PROGRAM REVENUE | 900099 | $76,500 | $76,500 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $6,790,693 | TotalProgramServiceRevenueAmt |
| Fundraising Gross Income | $11,503 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $4,097 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $11,503 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $23,833 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $23,833 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $23,833 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $11,351,894 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $6,814,526 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $542,539 | TotalAmt |
| Program Services | $200,116 | ProgramServicesAmt |
| Management And General | $342,423 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,690,856 | TotalAmt |
| Program Services | $4,865,093 | ProgramServicesAmt |
| Management And General | $825,763 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $69,128 | TotalAmt |
| Program Services | $69,128 | ProgramServicesAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,093 | TotalAmt |
| Program Services | $2,517 | ProgramServicesAmt |
| Management And General | $576 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $452,434 | TotalAmt |
| Program Services | $369,383 | ProgramServicesAmt |
| Management And General | $83,051 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $385 | TotalAmt |
| Program Services | $327 | ProgramServicesAmt |
| Management And General | $58 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,800 | TotalAmt |
| Program Services | $14,280 | ProgramServicesAmt |
| Management And General | $2,520 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $509,327 | TotalAmt |
| Program Services | $387,998 | ProgramServicesAmt |
| Management And General | $121,329 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,952 | TotalAmt |
| Program Services | $1,658 | ProgramServicesAmt |
| Management And General | $294 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $234,883 | TotalAmt |
| Program Services | $198,795 | ProgramServicesAmt |
| Management And General | $36,088 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $349,356 | TotalAmt |
| Program Services | $336,779 | ProgramServicesAmt |
| Management And General | $12,577 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,864 | TotalAmt |
| Program Services | $28,785 | ProgramServicesAmt |
| Management And General | $5,079 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,579 | TotalAmt |
| Program Services | $25,142 | ProgramServicesAmt |
| Management And General | $4,437 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $196,884 | TotalAmt |
| Program Services | $189,796 | ProgramServicesAmt |
| Management And General | $7,088 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $31,046 | TotalAmt |
| Program Services | $26,389 | ProgramServicesAmt |
| Management And General | $4,657 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $719,968 | $719,968 | |
| COMPUTERS AND MINOR EQU | $388,812 | $330,491 | $58,321 |
| REPAIRS AND MAINTENANCE | $172,900 | $166,676 | $6,224 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,443,806 | TotalAmt |
| Program Services | $7,933,321 | ProgramServicesAmt |
| Management And General | $1,510,485 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,908,727 | BOYAmt |
| EOY | $1,956,530 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $253,041 | BOYAmt |
| EOY | $895,834 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $44,766 | BOYAmt |
| EOY | $74,129 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $4,398,904 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $633,604 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,195,444 | BOYAmt |
| EOY | $3,765,300 | 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 | $3,463,178 | BOYAmt |
| EOY | $6,752,993 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,361,026 | BOYAmt |
| EOY | $1,952,114 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $424,475 | BOYAmt |
| EOY | $257,494 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $902,017 | BOYAmt |
| EOY | $2,402,017 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $57,503 | BOYAmt |
| EOY | $93,038 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,745,021 | BOYAmt |
| EOY | $4,704,663 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $718,157 | BOYAmt |
| EOY | $2,048,330 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $718,157 | BOYAmt |
| EOY | $2,048,330 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,463,178 | BOYAmt |
| EOY | $6,752,993 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $1,908,088 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$577,915 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| 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
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,613,195 | OtherCostOrOtherBasisAmt |
| Depreciation | $444,413 | DepreciationAmt |
| Book Value | $3,168,782 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $746,669 | OtherCostOrOtherBasisAmt |
| Depreciation | $164,141 | DepreciationAmt |
| Book Value | $582,528 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $39,040 | OtherCostOrOtherBasisAmt |
| Depreciation | $25,050 | DepreciationAmt |
| Book Value | $13,990 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $3,765,300 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DEFERRED LEASE LIABILITIES | Desc |
| Amt | $93,038 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $93,038 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $10,799,041 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | -$564,356 | OtherRevenueAmt |
| Revenue Not Reported | -$564,356 | RevenueNotReportedAmt |
| Revenue Subtotal | $11,363,397 | RevenueSubtotalAmt |
| Other Revenues Not Included | -$11,503 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | -$11,503 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $11,351,894 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $9,468,868 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $25,062 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $25,062 | ExpensesNotReportedAmt |
| Expenses Subtotal | $9,443,806 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $9,443,806 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 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 2D - OTHER ADJUSTMENTS: | REFUNDS AND ALLOWANCES -564,356. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | FUNDRAISING EXPENSES -11,503. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | BAD DEBT EXPENSE 13,559. FUNDRAISING EXPENSES 11,503. |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | ANNUAL EVENT | Event1Nm |
| Gross Receipts Event1 | $15,600 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $4,097 | CharitableContriEvent1Amt |
| Gross Revenue Event1 | $11,503 | GrossRevenueEvent1Amt |
| Food And Beverage Event1 | $10,070 | FoodAndBeverageEvent1Amt |
| Entertainment Event1 | $350 | EntertainmentEvent1Amt |
| Other Direct Expenses Event1 | $1,083 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $15,600 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $4,097 | CharitableContributionsTotAmt |
| Gross Revenue Total Events | $11,503 | GrossRevenueTotalEventsAmt |
| Food And Beverage Total Events | $10,070 | FoodAndBeverageTotalEventsAmt |
| Entertainment Total Events | $350 | EntertainmentTotalEventsAmt |
| Oth Direct Expnss Total Events | $1,083 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $11,503 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | $0 | NetIncomeSummaryAmt |
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 (7 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ELLEN SILVER | ||||||||||||||
| CEO | $191,194 | $0 | $0 | $0 | $0 | $0 | $3,876 | $0 | $9,061 | $0 | $204,131 | $0 | $0 | $0 |
| DAVID KADAR | ||||||||||||||
| CHIEF DENTAL OFFICER | $187,772 | $0 | $0 | $0 | $0 | $0 | $3,795 | $0 | $8,549 | $0 | $200,116 | $0 | $0 | $0 |
| ENRIQUE MELGOZA | ||||||||||||||
| DENTIST | $143,069 | $0 | $0 | $0 | $0 | $0 | $2,861 | $0 | $8,424 | $0 | $154,354 | $0 | $0 | $0 |
| RANJIT SHENOY | ||||||||||||||
| INTERNAL MEDICINE PHYSICIAN | $276,602 | $0 | $0 | $0 | $0 | $0 | $3,852 | $0 | $2,700 | $0 | $283,154 | $0 | $0 | $0 |
| DIANNE QUINTANA | ||||||||||||||
| PHYSICIAN | $165,502 | $0 | $0 | $0 | $0 | $0 | $2,111 | $0 | $14,299 | $0 | $181,912 | $0 | $0 | $0 |
| LORRAINE WALKER | ||||||||||||||
| PHYSICIAN | $154,958 | $0 | $0 | $0 | $0 | $0 | $1,572 | $0 | $502 | $0 | $157,032 | $0 | $0 | $0 |
| MARINA MARKOVA | ||||||||||||||
| DENTIST | $145,280 | $0 | $0 | $0 | $0 | $0 | $1,486 | $0 | $5,144 | $0 | $151,910 | $0 | $0 | $0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 1 | AS STATED IN THE BYLAWS OF THE ORGANIZATION, THE FINANCE COMMITTEE AND AUDIT COMMITTEE HAVE BEEN DELEGATED CERTAIN AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE CEO AND THE BOARD OF DIRECTORS REVIEW THE RETURN 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 REVIEWS COMPENSATION OF THE CEO AND CFO OF SIMILAR SIZED ORGANIZATIONS AND COMPARABLE DATA WHEN DETERMINING THEIR COMPENSATION. |
| FORM 990, PART VI, SECTION C, LINE 19 | COPIES OF DOCUMENTS WILL BE PROVIDED UPON WRITTEN REQUEST. |
| FORM 990, PART XI, LINE 9: | REFUNDS AND ALLOWANCES -564,356. BAD DEBT EXPENSE -13,559. |
| FORM 990, PART XII, LINE 2C: | NO CHANGES FROM PREVIOUS YEAR. |