BARTZ-ALTADONNA COMMUNITY HEALTH CENTER: Form 990, tax year 2024
View the entire original 990 at ProPublica ↗
- Organization
- BARTZ-ALTADONNA COMMUNITY HEALTH CENTER (EIN 27-3261289)
- Tax period
- 2024-01-01 to 2024-12-31
- Filed
- 2025-11-14
- IRS object ID
- 202523189349314547
- Schema version
- 2024v5.2
- 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 | 2025-11-14T17:11:52-06:00 | ReturnTs |
| Tax Period End | 2024-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 330700332 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | VASQUEZ COMPANY LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 655 N CENTRAL AVE STE 1550 | AddressLine1Txt |
| City | GLENDALE | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 91203 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2024-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 273261289 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BARTZ-ALTADONNA COMMUNITY HEALTH CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | BART | BusinessNameControlTxt |
| Phone | 6618744050 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 43322 GINGHAM AVENUE | AddressLine1Txt |
| City | LANCASTER | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 93535 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MARY CUMMINGS | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 6618744050 | PhoneNum |
| Signature | 2025-11-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | Yes (1) | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | REGINA L PRINCE CPA | PreparerPersonNm |
| PTIN | P00576936 | PTIN |
| Phone | 2138731700 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2024 | TaxYr |
| Build TS | 2025-03-06 01:10:19Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MARY CUMMINGS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 43322 GINGHAM AVENUE | AddressLine1Txt |
| City | LANCASTER | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 93535 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $27,802,844 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.BACHC.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2010 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | A STATE-LICENSED CLINIC THAT PROVIDES COMPREHENSIVE PRIMARY MEDICAL CARE, INCLUDING WOMEN'S CARE, FOR LOW-INCOME, UNINSURED, UNDERINSURED, AND HOMELESS PERSONS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 201 | TotalEmployeeCnt |
| Total Volunteers | 9 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $3,870,986 | PYContributionsGrantsAmt |
| CY Contributions Grants | $4,623,283 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $22,219,264 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $22,783,849 | CYProgramServiceRevenueAmt |
| PY Investment Income | $360,826 | PYInvestmentIncomeAmt |
| CY Investment Income | $334,093 | CYInvestmentIncomeAmt |
| PY Other Revenue | $29,248 | PYOtherRevenueAmt |
| CY Other Revenue | $61,314 | CYOtherRevenueAmt |
| PY Total Revenue | $26,480,324 | PYTotalRevenueAmt |
| CY Total Revenue | $27,802,539 | 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 | $14,756,469 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $15,925,007 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $6,471,013 | PYOtherExpensesAmt |
| CY Other Expenses | $8,437,879 | CYOtherExpensesAmt |
| PY Total Expenses | $21,227,482 | PYTotalExpensesAmt |
| CY Total Expenses | $24,362,886 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $5,252,842 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $3,439,653 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $35,281,822 | TotalAssetsBOYAmt |
| Total Assets EOY | $41,409,533 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $14,268,967 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $16,957,025 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $21,012,855 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $24,452,508 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO PROVIDE PATIENT-CENTERED HIGH-QUALITY, TRAUMA-INFORMED HEALTH CARE SERVICES TO ALL RESIDENTS WITH INTESIVE OUTREACH TO THE HOMELESS OF THE ANTELOPE VALLEY WITHOUT REGARD TO SOCIAL BARRIERS OR ABILITY TO PAY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $21,620,734 | ExpenseAmt |
| Revenue | $22,783,849 | RevenueAmt |
| Desc | BARTZ-ALTADONNA COMMUNITY HEALTH CENTER (BACHC) IS THE ANTELOPE VALLEY'S FIRST FEDERALLY QUALIFIED HEALTH CENTER (FQHC) AND IS COMMITTED TO PROVIDING PATIENT-CENTERED TRAUMA-INFORMED PRIMARY CARE SERVICES TO ALL ITS PATIENTS. BACHC'S CLINICS IN LANCASTER, PALMDALE, CAL-CITY AND BORON AND ITS FOUR MOBILE UNITS PROVIDED OUTPATIENT MEDICAL CARE; SPECIALTY CARE FOR HIV/AIDS AND HIV RELATED ILLNESS AND URGENT CARE FOR WALK-INS; REFERRALS FOR SPECIALTY CARE, MENTAL HEALTH, BEHAVIORAL, AND PSYCHIATRIC SERVICES; AND SUBSTANCE ABUSE DISORDER ASSESSMENTS AND COUNSELING SERVICES. BACHC ALSO PROVIDED LIMITED PROCEDURES FOR HEALTH CARE SUCH AS IM INJECTIONS, TB TESTS, EAR LAVAGE, EKG(S), AND HEALTH PHYSICALS. OTHER SERVICES INCLUDE FEMALE EXAMINATIONS AND CARE, LIMITED LABORATORY SERVICES AND GENERAL EXAMINATIONS THAT INCLUDE NUTRITIONAL SERVICES. BEGINNING JANUARY 2021, BACHC PROVIDED A HYBRID MODEL OF CARE TO ALL ITS PATIENTS. THIS HYBRID MODEL ALLOWED US TO DECREASE NO-SHOW RATES, INCREASE PROVIDER PRODUCTIVITY, IMPROVE PATIENT OUTCOMES, AND IMPROVE PATIENT SATISFACTION. DURING 2024, BACHC SERVICED 20,503 UNDUPLICATED PATIENTS; PROVIDING 54,286 CLINIC VISITS AND 39,802 VIRTUAL VISITS. THIS INCLUDES 3,763 MENTAL HEALTH CLINIC VISITS AND 3,055 MENTAL HEALTH VIRTUAL VISITS. | Desc |
| Total Program Service Expenses | $21,620,734 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | Yes (1) | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 46 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 201 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| 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 | ERLINDA MAGALONA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6618744050 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 43322 GINGHAM AVENUE | AddressLine1Txt |
| City | LANCASTER | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 93535 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (21 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 |
|---|---|---|---|---|---|---|---|---|
| ROBERT WEBB | ||||||||
| CHAIRPERSON | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| ISMENE HERNANDEZ | ||||||||
| VICE CHAIR | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| DAN ANGEL | ||||||||
| TREASURER | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| TAMARA BINNS | ||||||||
| SECRETARY | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| RICCARDO MANSON | ||||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| SUSAN GUTIERREZ | ||||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| ALBERTINA THORNTON | ||||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| SONIA HICKS | ||||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| SHELLY KELLER-GAGE | ||||||||
| BOARD MEMBER | 2.00 | Yes (X) | $0 | $0 | $0 | |||
| MARY CUMMINGS | ||||||||
| CHIEF EXECUTIVE OFFICER | 40.00 | Yes (X) | $753,262 | $0 | $26,912 | |||
| JO VASQUEZ | ||||||||
| CFO UNTIL 09/2024 | 40.00 | Yes (X) | $235,568 | $0 | $15,419 | |||
| ERLINDA O MAGALONA | ||||||||
| CFO AS OF 10/2024 | 40.00 | Yes (X) | $104,945 | $0 | $5,717 | |||
| SILVIA SOLOMON | ||||||||
| CHIEF OF COMPLIANCE | 40.00 | $203,279 | $0 | $15,434 | Yes (X) | |||
| PAMELA GRIFFIN | ||||||||
| COS | 40.00 | $297,751 | $0 | $15,754 | Yes (X) | |||
| TABBA LARAIB | ||||||||
| CMO | 40.00 | $475,928 | $0 | $30,901 | Yes (X) | |||
| CARLOS COYUKIAT | ||||||||
| HR DIRECTOR | 40.00 | $186,769 | $0 | $20,586 | Yes (X) | |||
| CARL HAYES | ||||||||
| PROVIDER | 40.00 | $284,208 | $0 | $15,542 | Yes (X) | |||
| RYAN GORJI | ||||||||
| PROVIDER | 40.00 | $300,884 | $0 | $22,028 | Yes (X) | |||
| AYESHA OGLE | ||||||||
| PROVIDER | 40.00 | $303,030 | $0 | $16,499 | Yes (X) | |||
| ASHRUTA PATEL | ||||||||
| PROVIDER | 40.00 | $347,586 | $0 | $24,801 | Yes (X) | |||
| SIMONA MYERS | ||||||||
| PROVIDER | 40.00 | $272,400 | $0 | $71 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $3,765,610 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $209,664 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 27 | 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 |
|---|---|---|---|---|---|
| MAC URBAN CONSTRUCTION | |||||
| 357 E CARSON STREET STE 211 | CARSON | CA | 90745 | CONSTRUCTION SERVICES | $1,176,290 |
| ANDERSON CONSTRUCTION | |||||
| 49440 ELISE ST | LANCASTER | CA | 93536 | CONSTRUCTION SERVICES | $450,500 |
| CROSS COUNTRY STAFFING | |||||
| PO BOX 404691 | ATLANTA | GA | 30384 | MEDICAL SERVICE WORKFORCE | $271,489 |
| OLIVER NEIL REFUGIO | |||||
| 330 N WESTLAKE AVE APT 717 | LOS ANGELES | CA | 90026 | MEDICAL SERVICE WORKFORCE | $216,576 |
| MEHRNAZ KOUHKAN | |||||
| 11690 MONTANA AVE APT105 | LOS ANGELES | CA | 90049 | MEDICAL SERVICE PROVIDER | $210,940 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 7 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $2,815,817 | GovernmentGrantsAmt |
| All Other Contributions | $1,807,466 | AllOtherContributionsAmt |
| Noncash Contributions | $164,821 | NoncashContributionsAmt |
| Total Contributions | $4,623,283 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICES | 621400 | $20,548,278 | $20,548,278 |
| CAPITATION REVENUE | 621400 | $1,287,993 | $1,287,993 |
| PHARMACY REVENUE | 621400 | $947,578 | $947,578 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $22,783,849 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $334,093 | TotalRevenueColumnAmt |
| Exclusion | $334,093 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $57,249 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $57,249 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $57,249 | TotalRevenueColumnAmt |
| Exclusion | $57,249 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $1,266 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $305 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $961 | TotalRevenueColumnAmt |
| Exclusion | $961 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OTHER INCOME | Desc |
| Business | 621400 | BusinessCd |
| Total Revenue Column | $3,104 | TotalRevenueColumnAmt |
| Exclusion | $3,104 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $3,104 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $27,802,539 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $22,783,849 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $395,407 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,388,224 | TotalAmt |
| Program Services | $2,053,849 | ProgramServicesAmt |
| Management And General | $334,375 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,243,796 | TotalAmt |
| Program Services | $9,669,554 | ProgramServicesAmt |
| Management And General | $1,574,242 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $293,713 | TotalAmt |
| Program Services | $252,590 | ProgramServicesAmt |
| Management And General | $41,123 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $748,770 | TotalAmt |
| Program Services | $643,935 | ProgramServicesAmt |
| Management And General | $104,835 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,250,504 | TotalAmt |
| Program Services | $1,075,421 | ProgramServicesAmt |
| Management And General | $175,083 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $89,580 | TotalAmt |
| Program Services | $79,734 | ProgramServicesAmt |
| Management And General | $9,846 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $371,169 | TotalAmt |
| Program Services | $327,391 | ProgramServicesAmt |
| Management And General | $43,778 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $29,269 | TotalAmt |
| Program Services | $28,524 | ProgramServicesAmt |
| Management And General | $745 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $490,070 | TotalAmt |
| Program Services | $379,038 | ProgramServicesAmt |
| Management And General | $111,032 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $721,588 | TotalAmt |
| Program Services | $712,821 | ProgramServicesAmt |
| Management And General | $8,767 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $618,336 | TotalAmt |
| Program Services | $451,364 | ProgramServicesAmt |
| Management And General | $166,972 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,441 | TotalAmt |
| Program Services | $29,226 | ProgramServicesAmt |
| Management And General | $1,215 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $65,365 | TotalAmt |
| Program Services | $62,755 | ProgramServicesAmt |
| Management And General | $2,610 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $821,136 | TotalAmt |
| Program Services | $821,136 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $998,568 | TotalAmt |
| Program Services | $961,132 | ProgramServicesAmt |
| Management And General | $37,436 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $244,609 | TotalAmt |
| Program Services | $236,793 | ProgramServicesAmt |
| Management And General | $7,816 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| PROGRAM EXPENSES | $2,730,964 | $2,720,498 | $10,466 |
| SETTLEMENT COSTS | $694,266 | $617,955 | $76,311 |
| REPAIRS & MAINTENANCE | $238,430 | $219,438 | $18,992 |
| DUES AND LICENSING | $156,212 | $154,464 | $1,748 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $137,876 | TotalAmt |
| Program Services | $123,116 | ProgramServicesAmt |
| Management And General | $14,760 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,362,886 | TotalAmt |
| Program Services | $21,620,734 | ProgramServicesAmt |
| Management And General | $2,742,152 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,125,062 | BOYAmt |
| EOY | $324,330 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,403,874 | BOYAmt |
| EOY | $6,572,925 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $217,364 | BOYAmt |
| EOY | $305,407 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,146,280 | BOYAmt |
| EOY | $3,232,094 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $31,914 | BOYAmt |
| EOY | $22,395 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $124,743 | BOYAmt |
| EOY | $134,146 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $34,136,049 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $3,909,363 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,485,363 | BOYAmt |
| EOY | $30,226,686 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $747,222 | BOYAmt |
| EOY | $591,550 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $35,281,822 | BOYAmt |
| EOY | $41,409,533 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,595,769 | BOYAmt |
| EOY | $3,519,045 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,857,101 | BOYAmt |
| EOY | $13,295,084 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $816,097 | BOYAmt |
| EOY | $142,896 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,268,967 | BOYAmt |
| EOY | $16,957,025 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,012,855 | BOYAmt |
| EOY | $24,452,508 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,012,855 | BOYAmt |
| EOY | $24,452,508 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $35,281,822 | BOYAmt |
| EOY | $41,409,533 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $3,439,653 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,869,478 | OtherCostOrOtherBasisAmt |
| Book Value | $5,869,478 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $16,633,466 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,216,541 | DepreciationAmt |
| Book Value | $15,416,925 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,249,198 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,115,955 | DepreciationAmt |
| Book Value | $2,133,243 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,531,413 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,576,867 | DepreciationAmt |
| Book Value | $954,546 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,852,494 | OtherCostOrOtherBasisAmt |
| Book Value | $5,852,494 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $30,226,686 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| LEASE LIABILITY | $87,875 |
| ESTIMATED SETTLEMENT AMOUNTS DUE TO THIRD PARTY PAYERS | $55,021 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $142,896 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $27,802,539 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $27,802,539 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $27,802,539 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $24,362,886 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $24,362,886 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $24,362,886 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION IS EXEMPT FROM TAXATION UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND SECTION 23701D OF THE CALIFORNIA REVENUE AND TAXATION CODE AND IS GENERALLY NOT SUBJECT TO FEDERAL OR STATE INCOME TAXES. HOWEVER, THE ORGANIZATION IS SUBJECT TO INCOME TAXES ON ANY NET INCOME THAT IS DERIVED FROM A TRADE OR BUSINESS, REGULARLY CARRIED ON, AND NOT IN FURTHERANCE OF THE PURPOSES FOR WHICH IT WAS GRANTED AN EXEMPTION. NO INCOME TAX PROVISION HAS BEEN RECORDED AS THE NET INCOME, IF ANY, FROM ANY UNRELATED TRADE OR BUSINESS, IN THE OPINION OF MANAGEMENT, IS NOT MATERIAL TO THE FINANCIAL STATEMENTS TAKEN AS A WHOLE. U.S. GAAP PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. THE ORGANIZATION 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 RELATE TO THE ORGANIZATION'S CONTINUED QUALIFICATION AS A TAX-EXEMPT ORGANIZATION AND WHETHER THERE IS A MATERIAL UNRELATED TRADE OR BUSINESS INCOME TAX LIABILITY. MANAGEMENT HAS DETERMINED THAT ALL INCOME TAX POSITIONS, BASED ON THE TECHNICAL MERITS OF THE POSITION, WILL MORE-LIKELY-THAN-NOT BE SUSTAINED UPON POTENTIAL AUDIT OR EXAMINATION. THEREFORE, NO DISCLOSURES OF UNCERTAIN INCOME TAX POSITIONS ARE REQUIRED. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | Yes (1) | 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 (12 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MARY CUMMINGS | ||||||||||||||
| CHIEF EXECUTIVE OFFICER | $537,190 | $0 | $87,567 | $0 | $128,505 | $0 | $19,387 | $0 | $7,525 | $0 | $780,174 | $0 | $0 | $0 |
| TABBA LARAIB | ||||||||||||||
| CMO | $315,967 | $0 | $98,120 | $0 | $61,841 | $0 | $19,730 | $0 | $11,171 | $0 | $506,829 | $0 | $0 | $0 |
| ASHRUTA PATEL | ||||||||||||||
| PROVIDER | $190,119 | $0 | $102,180 | $0 | $55,287 | $0 | $16,196 | $0 | $8,605 | $0 | $372,387 | $0 | $0 | $0 |
| RYAN GORJI | ||||||||||||||
| PROVIDER | $263,847 | $0 | $12,682 | $0 | $24,355 | $0 | $17,645 | $0 | $4,383 | $0 | $322,912 | $0 | $0 | $0 |
| AYESHA OGLE | ||||||||||||||
| PROVIDER | $162,360 | $0 | $115,830 | $0 | $24,840 | $0 | $11,843 | $0 | $4,656 | $0 | $319,529 | $0 | $0 | $0 |
| PAMELA GRIFFIN | ||||||||||||||
| COS | $224,522 | $0 | $27,363 | $0 | $45,866 | $0 | $15,471 | $0 | $283 | $0 | $313,505 | $0 | $0 | $0 |
| CARL HAYES | ||||||||||||||
| PROVIDER | $242,010 | $0 | $5,230 | $0 | $36,968 | $0 | $15,471 | $0 | $71 | $0 | $299,750 | $0 | $0 | $0 |
| SIMONA MYERS | ||||||||||||||
| PROVIDER | $239,200 | $0 | $2,000 | $0 | $31,200 | $0 | $0 | $0 | $71 | $0 | $272,471 | $0 | $0 | $0 |
| JO VASQUEZ | ||||||||||||||
| CFO UNTIL 09/2024 | $115,694 | $0 | $0 | $0 | $119,874 | $0 | $9,792 | $0 | $5,627 | $0 | $250,987 | $0 | $0 | $0 |
| SILVIA SOLOMON | ||||||||||||||
| CHIEF OF COMPLIANCE | $147,378 | $0 | $23,653 | $0 | $32,248 | $0 | $10,778 | $0 | $4,656 | $0 | $218,713 | $0 | $0 | $0 |
| CARLOS COYUKIAT | ||||||||||||||
| HR DIRECTOR | $151,539 | $0 | $15,452 | $0 | $19,778 | $0 | $9,362 | $0 | $11,224 | $0 | $207,355 | $0 | $0 | $0 |
| ERLINDA O MAGALONA | ||||||||||||||
| CFO AS OF 10/2024 | $97,740 | $0 | $522 | $0 | $6,683 | $0 | $5,717 | $0 | $0 | $0 | $110,662 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 4A | FormAndLineReferenceDesc |
| Explanation | IN 2024, JO VASQUEZ, WHO SERVED AS CHIEF FINANCIAL OFFICER, RECEIVED SEVERANCE COMPENSATION TOTALING $61,509. | ExplanationTxt |
Schedule M IRS990ScheduleM
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 3 | ContributionCnt |
| Noncash Contributions Rpt F990 | $163,649 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | COMPARABLE SALES | MethodOfDeterminingRevenuesTxt |
Other Non Cash Contri Table OtherNonCashContriTableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Desc | FURNITURE | Desc |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $1,172 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | THRIFT SHOP VALUE | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I COLUMN B | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION IS REPORTING IN PART I, COLUMN (B), THE NUMBER OF CONTRIBUTIONS RECEIVED. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | THE FINANCE COMMITTEE MEETS TO REVIEW THE FORM BEFORE IT IS FILED WITH THE IRS. A COMPLETE COPY OF FORM 990, INCLUDING ALL SCHEDULES, IS PROVIDED TO THE ENTIRE VOTING BOARD BEFORE IT IS E-FILED WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE INTERESTED PERSONS COVERED UNDER THE ORGANIZATION'S CONFLICT OF INTEREST POLICY IS ANY PERSON SERVING AS AN OFFICER, EMPLOYEE, MEMBER OF THE BOARD OF DIRECTORS, MAJOR DONOR, OR ANYONE ELSE WHO IS IN A POSITION OF CONTROL OVER BARTZ-ALTADONNA COMMUNITY HEALTH CENTER WHO HAS A PERSONAL INTEREST THAT CONFLICTS WITH THE INTERESTS OF BARTZ-ALTADONNA COMMUNITY HEALTH CENTER. ANNUALLY, EACH EMPLOYEE, OFFICER, OR BOARD MEMBER IS REQUIRED TO SUBMIT A CONFLICT OF INTEREST ATTESTATION AND DISCLOSURE FORM. PROCEDURE. PRIOR TO BOARD OR COMMITTEE ACTION ON A CONTRACT OR TRANSACTION INVOLVING A CONFLICT OF INTEREST, A DIRECTOR OR COMMITTEE MEMBER HAVING A CONFLICT OF INTEREST WHO ATTENDS THE MEETING MUST DISCLOSE ALL FACTS IN WRITING MATERIAL TO THE CONFLICT OF INTEREST. SUCH PROCEDURE IS REFLECTED IN THE MINUTES OF THE MEETING. A PERSON WHO HAS A CONFLICT OF INTEREST MUST NOT PARTICIPATE IN OR BE PERMITTED TO HEAR THE BOARD'S OR COMMITTEE'S DISCUSSION OF THE MATTER EXCEPT TO DISCLOSE MATERIAL FACTS AND TO RESPOND TO QUESTIONS. SUCH PERSON MUST NOT ATTEMPT TO EXERT HIS OR HER PERSONAL INFLUENCE WITH RESPECT TO THE MATTER, EITHER AT OR OUTSIDE THE MEETING. INTERESTED PERSONS WHO ARE NOT MEMBERS OF THE BOARD OF DIRECTORS MUST DISCLOSE IN WRITING TO THEIR SUPERVISOR, OR THE CHAIR, OR THE CHAIR'S DESIGNEE, ANY CONFLICT OF INTEREST THAT SUCH PERSON HAS WITH RESPECT TO A CONTRACT OR TRANSACTION. SUCH DISCLOSURE MUST BE MADE AS SOON AS THE CONFLICT OF INTEREST IS KNOWN TO THE INTERESTED PERSON. THE INTERESTED PERSON SHALL REFRAIN FROM ANY ACTION THAT MAY AFFECT BARTZ-ALTADONNA COMMUNITY HEALTH CENTER'S PARTICIPATION IN SUCH CONTRACT OR TRANSACTION. IN THE EVENT IT IS NOT ENTIRELY CLEAR THAT A CONFLICT OF INTEREST EXISTS, THE INDIVIDUAL WITH THE POTENTIAL CONFLICT MUST DISCLOSE IN WRITING THE CIRCUMSTANCES TO HER OR HER SUPERVISOR OR THE CHAIR OR THE CHAIR'S DESIGNEE, WHO MUST DETERMINE WHETHER FULL BOARD DISCUSSION IS WARRANTED OR WHETHER THERE EXISTS A CONFLICT OF INTEREST THAT IS SUBJECT TO THE POLICY. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE ORGANIZATION'S BOARD OF DIRECTORS HAS A PROCESS FOR REVIEWING AND APPROVING THE COMPENSATION OF THE CHIEF EXECUTIVE OFFICER AND OTHER OFFICERS AND KEY EMPLOYEES ON A REGULAR BASIS TO DETERMINE IT IS FAIR AND REASONABLE WITH THE GOAL OF RETAINING EMPLOYEES AT COMPENSATION LEVELS WITHIN APPROPRIATE MARKET RANGE. THE PROCESS FOR DETERMINING THE COMPENSATION PAID TO THE CHIEF EXECUTIVE OFFICER AND OTHER OFFICERS AND KEY EMPLOYEES INCLUDES THE APPROVAL OF THE COMPENSATION ARRANGEMENT IN ADVANCE, WITH ALL PERSONS WITH A CONFLICT OF INTEREST ABSTAINING FROM THE DELIBERATION AND DISCUSSION OF THE TRANSACTION. THE BOARD OF DIRECTORS REVIEWS DATA OF COMPARABLE COMPENSATION FOR SIMILARLY QUALIFIED NONPROFIT EXECUTIVES AT SIMILARLY SITUATED ENTITIES. THE DOCUMENTATION IN THE BOARD MINUTES INCLUDES THE TERMS OF THE TRANSACTION AND THE DATE OF APPROVAL, THE MEMBERS WHO WERE PRESENT DURING THE DEBATE AND VOTE ON THE TRANSACTION, A DESCRIPTION OF THE COMPARABLE DATA AND HOW IT WAS OBTAINED, AND DOCUMENTATION OF THE BASIS FOR THE DETERMINATION. |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENTS, THE CONFLICT-OFINTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. HOWEVER, CURRENT TAX LAW DOES NOT REQUIRE THESE DOCUMENTS TO BE PROVIDED TO THE PUBLIC. |