OLE HEALTH: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- OLE HEALTH (EIN 23-7221695)
- Tax period
- 2012-07-01 to 2013-06-30
- Filed
- 2014-05-15
- IRS object ID
- 201411359349305526
- Schema version
- 2012v2.1
- 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) |
|---|---|---|
| Timestamp | 2014-05-15T12:28:07-05:00 | Timestamp |
| Tax Period End Date | 2013-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 910189318 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MOSS ADAMS LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 SECOND STREET 9TH FLOOR | AddressLine1 |
| City | SAN FRANCISCO | City |
| State | CA | State |
| ZIP Code | 94105 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 237221695 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY HEALTH CLINIC OLE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | COMM | NameControl |
| Phone | 7072541770 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1141 PEAR TREE LN NO 100 | AddressLine1 |
| City | NAPA | City |
| State | CA | State |
| ZIP Code | 94558 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | TANIR AMI | Name |
| Title | CEO | Title |
| Phone | 7072541770 | Phone |
| Date Signed | 2014-05-14 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | RENIE BURBANK | Name |
| PTIN | P00159653 | PTIN |
| Phone | 4159561500 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | TANIR AMI | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1141 PEAR TREE LN NO 100 | AddressLine1 |
| City | NAPA | City |
| State | CA | State |
| ZIP Code | 94558 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 16360552 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.CLINICOLE.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1972 | YearFormation |
| State Legal Domicile | CA | StateLegalDomicile |
| Activity Or Mission Description | COMMUNITY HEALTH CLINIC OLE IS THE MEDICAL AND DENTAL HOME FOR NAPA COUNTY'S UNDERSERVED, PROVIDING HIGH-QUALITY, AFFORDABLE, COMPASSIONATE AND CULTURALLY SENSITIVE PRIMARY HEALTH CARE. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 13 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 13 | NbrIndependentVotingMembers |
| Total Nbr Employees | 198 | TotalNbrEmployees |
| Total Nbr Volunteers | 15 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 3299118 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 3598468 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 12031315 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 11945835 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 2814 | InvestmentIncomePriorYear |
| Investment Income Current Year | 1885 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 303493 | OtherRevenuePriorYear |
| Other Revenue Current Year | 814364 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 15636740 | TotalRevenuePriorYear |
| Total Revenue Current Year | 16360552 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 11220199 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 11804000 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 3610105 | OtherExpensePriorYear |
| Other Expenses Current Year | 3921860 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 14830304 | TotalExpensesPriorYear |
| Total Expenses Current Year | 15725860 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 806436 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 634692 | RevenuesLessExpensesCY |
| Total Assets BOY | 9007467 | TotalAssetsBOY |
| Total Assets EOY | 9689824 | TotalAssetsEOY |
| Total Liabilities BOY | 2065647 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 2113312 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 6941820 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 7576512 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | COMMUNITY HEALTH CLINIC OLE IS THE MEDICAL AND DENTAL HOME FOR NAPA COUNTY'S UNDERSERVED, PROVIDING HIGH-QUALITY, AFFORDABLE, COMPASSIONATE AND CULTURALLY SENSITIVE PRIMARY HEALTH CARE. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 9457146 | Expense |
| Revenue | 8713825 | Revenue |
| Description | COMMUNITY HEALTH CLINIC OLE IS A FEDERALLY QUALIFIED HEALTH CENTER(FQHC) AND THE ONLY NOT FOR PROFIT HEALTH CENTER IN NAPA COUNTY. THE CLINIC PROVIDES AFFORDABLE MEDICAL CARE TO NEARLY 20,000 PATIENTS. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 1648192 | Expense |
| Revenue | 2236248 | Revenue |
| Description | THE DENTAL SERVICES PROGRAMS AT COMMUNITY HEALTH CLINIC OLE PROVIDE AFFORDABLE DENTAL CARE TO APPROXIMATELY 10,000 PATIENTS | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 337141 | Expense |
| Revenue | 131253 | Revenue |
| Description | THE MENTAL HEALTH PROGRAMS AT COMMUNITY HEALTH CLINIC OLE PROVIDE SERVICES TO THE COMMUNITY | Description |
Activity Other ActivityOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 444135 | Expense |
| Revenue | 864509 | Revenue |
| Description | COMMUNITY HEALTH CLINIC OLE PROVIDES HEALTH EDUCATION VIA OUTREACH PROGRAMS TO THE COUNTY'S LOW-INCOME, UNINSURED AND UNDERINSURED RESIDENTS. | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Other Program Service Exp | 444135 | TotalOfOtherProgramServiceExp |
| Total Of Other Program Service Rev | 864509 | TotalOfOtherProgramServiceRev |
| Total Program Service Expense | 11886614 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 0 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 0 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 1 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 1 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 30 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 198 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 13 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 13 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | CA | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | MOLLY NELSON | NamePerson |
| Telephone Number | 7072541774 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1141 PEAR TREE LN SUITE 100 | AddressLine1 |
| City | NAPA | City |
| State | CA | State |
| ZIP Code | 94558 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (22 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| KARYANNE DUNCAN | ||||||||
| CHAIRMAN | 2.00 | X | X | 0 | 0 | 0 | ||
| JO MOORE | ||||||||
| VICE CHAIRMAN | 2.00 | X | X | 0 | 0 | 0 | ||
| DAN LYNCH | ||||||||
| TREASURER | 2.00 | X | X | 0 | 0 | 0 | ||
| ARJUNA ELKINS | ||||||||
| SECRETARY | 2.00 | X | X | 0 | 0 | 0 | ||
| DAVID CARRASCO | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| VICTOR DAVIS | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| KEVIN FITZPATRICK | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| RICHARD JONES | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| CHARLES MATHEWSON | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| PETER MCCREA | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| DAWNIELLE THORNBURGH | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| PRISCILA UPTON | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| MARIANA URZUA | ||||||||
| DIRECTOR | 1.00 | X | 0 | 0 | 0 | |||
| TANIR AMI | ||||||||
| CHIEF EXECUTIVE OFFICER | 40.00 | X | 151593 | 0 | 13503 | |||
| PATRICIA AGUILERA | ||||||||
| CHIEF FINANCIAL OFFICER | 40.00 | X | 139234 | 0 | 14140 | |||
| COLLEEN TOWNSEND | ||||||||
| CHIEF MEDICAL OFFICER | 40.00 | X | 163596 | 0 | 8958 | |||
| JEROME SOLOMON | ||||||||
| PHYSICIAN | 40.00 | 253284 | 0 | 6284 | X | |||
| SITA SINGH | ||||||||
| OB/GYN | 40.00 | 191264 | 0 | 8374 | X | |||
| REBECCA LEVY | ||||||||
| PHYSICIAN | 40.00 | 169064 | 0 | 5197 | X | |||
| GABRIELA BERMUDEZ | ||||||||
| PHYSICIAN | 40.00 | 161948 | 0 | 9065 | X | |||
| SONIA HA | ||||||||
| PHYSICIAN | 40.00 | 158880 | 0 | 10179 | X | |||
| JENNIFER WILSON | ||||||||
| PHYSICIAN | 40.00 | 152118 | 0 | 11854 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1540981 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 87554 | TotalOtherCompensation |
| Number Individuals GT100 K | 11 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
| Number Of Contractors GT100 K | 0 | NumberOfContractorsGT100K |
| Related Organizations | 508350 | RelatedOrganizations |
| Government Grants | 1711142 | GovernmentGrants |
| All Other Contributions | 1378976 | AllOtherContributions |
| Total Contributions | 3598468 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | PATIENT SERVICE REV. | Description |
| Business Code | 621400 | BusinessCode |
| Total Revenue Column | 11945835 | TotalRevenueColumn |
| Related Or Exempt Function Income | 11945835 | RelatedOrExemptFunctionIncome |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 11945835 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 1885 | TotalRevenueColumn |
| Exclusion | $1,885 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | ExclusionExclusionAmount |
|---|---|---|---|
| OTHER REV: PHC PROVIDER INCENTIVE | 621400 | 449280 | $449,280 |
| OTHER REVENUE | 900099 | 365084 | $365,084 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 814364 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 16360552 | TotalRevenueColumn |
| Related Or Exempt Function Income | 11945835 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $816,249 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 671504 | Total |
| Program Services | 537203 | ProgramServices |
| Management And General | 134301 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 9101491 | Total |
| Program Services | 7337561 | ProgramServices |
| Management And General | 1763930 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 122544 | Total |
| Program Services | 98865 | ProgramServices |
| Management And General | 23679 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1016073 | Total |
| Program Services | 837828 | ProgramServices |
| Management And General | 178245 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 892388 | Total |
| Program Services | 722084 | ProgramServices |
| Management And General | 170304 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 298 | Total |
| Management And General | 298 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 72326 | Total |
| Management And General | 72326 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 546149 | Total |
| Program Services | 209173 | ProgramServices |
| Management And General | 336976 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8611 | Total |
| Program Services | 1797 | ProgramServices |
| Management And General | 6814 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1024363 | Total |
| Program Services | 579379 | ProgramServices |
| Management And General | 444984 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 454116 | Total |
| Program Services | 37035 | ProgramServices |
| Management And General | 417081 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 666495 | Total |
| Program Services | 613544 | ProgramServices |
| Management And General | 52951 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 40031 | Total |
| Program Services | 25673 | ProgramServices |
| Management And General | 14358 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 54732 | Total |
| Program Services | 26605 | ProgramServices |
| Management And General | 28127 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13645 | Total |
| Management And General | 13645 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 385401 | Total |
| Program Services | 262304 | ProgramServices |
| Management And General | 123097 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 51440 | Total |
| Program Services | 27101 | ProgramServices |
| Management And General | 24339 | ManagementAndGeneral |
Other Expenses OtherExpenses (3 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| PHARMACEUTICAL SUPPLIES | 362988 | 362988 | |
| PROVISION FOR BAD DEBT | 92956 | 92956 | |
| OTHER EXPENSES | -34706 | -34706 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 183015 | Total |
| Program Services | 114518 | ProgramServices |
| Management And General | 68497 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 15725860 | Total |
| Program Services | 11886614 | ProgramServices |
| Management And General | 3839246 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3876219 | BOY |
| EOY | 4337907 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1061816 | BOY |
| EOY | 1003155 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 52022 | BOY |
| EOY | 127096 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1830136 | BOY |
| EOY | 1948946 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 190060 | BOY |
| EOY | 289098 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 4039221 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 2055599 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1997214 | BOY |
| EOY | 1983622 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9007467 | BOY |
| EOY | 9689824 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1116451 | BOY |
| EOY | 1372341 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 434937 | BOY |
| EOY | 423395 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 514259 | BOY |
| EOY | 317576 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2065647 | BOY |
| EOY | 2113312 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6911965 | BOY |
| EOY | 7300975 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 29855 | BOY |
| EOY | 275537 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6941820 | BOY |
| EOY | 7576512 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9007467 | BOY |
| EOY | 9689824 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 634692 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Consolidated | X | FinancialStatementConsolidated |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 1 | FederalGrantAuditRequired |
| Federal Grant Audit Performed | 1 | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| 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) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2348825 | OtherCostOrOtherBasis |
| Depreciation | 882227 | Depreciation |
| Book Value | 1466598 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1365662 | OtherCostOrOtherBasis |
| Depreciation | 851687 | Depreciation |
| Book Value | 513975 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 324734 | OtherCostOrOtherBasis |
| Depreciation | 321685 | Depreciation |
| Book Value | 3049 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 1983622 | TotalOfBookValueLandBuildings |
| Footnote In Part XIII | X | FootnoteInPartXIII |
| Tot Revenue Etc Audited Fincl Stmt | 16402212 | TotRevenueEtcAuditedFinclStmt |
| Donated Srvc And Use Of Facilities | 134616 | DonatedSrvcAndUseOfFacilities |
| Other Revenues | -92956 | OtherRevenues |
| Revenue Not Rptd F990 | 41660 | RevenueNotRptdF990 |
| Revenue Subtotal | 16360552 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 16360552 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 15767520 | TotExpensesEtcAuditedFinclStmt |
| Donated Services Use Of Facilities | 134616 | DonatedServicesUseOfFacilities |
| Expenses Not Rptd F990 | 134616 | ExpensesNotRptdF990 |
| Expenses Subtotal | 15632904 | ExpensesSubtotal |
| Other Expenses Not Included | 92956 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 92956 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 15725860 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII (3 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X, LINE 2: | THE ORGANIZATION IS A NONPROFIT CORPORATION UNDER INTERNAL REVENUE CODE SECTION 501(C)(3) AND HAS BEEN GRANTED TAX-EXEMPT STATUS BY THE INTERNAL REVENUE SERVICE AND THE CALIFORNIA REVENUE AND TAXATION CODE. AS OF JUNE 30, 2013 AND 2012, THE ORGANIZATION HAD NO UNRECOGNIZED TAX POSITIONS OR UNCERTAIN TAX POSITIONS REQUIRING ACCRUAL. THEREFORE, NO PROVISION FOR INCOME TAXES HAS BEEN PROVIDED IN THE CONSOLIDATED FINANCIAL STATEMENTS. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | RECLASSIFICATION OF PROVISION FOR BAD DEBT EXPENSE -92,956. | |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | RECLASSIFICATION OF PROVISION FOR BAD DEBT EXPENSE 92,956. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (9 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| TANIR AMI | ||||||||||||||
| CHIEF EXECUTIVE OFFICER | 151593 | 0 | 0 | 0 | 0 | 0 | 2753 | 0 | 10750 | 0 | 165096 | 0 | 0 | 0 |
| PATRICIA AGUILERA | ||||||||||||||
| CHIEF FINANCIAL OFFICER | 139234 | 0 | 0 | 0 | 0 | 0 | 2458 | 0 | 11682 | 0 | 153374 | 0 | 0 | 0 |
| COLLEEN TOWNSEND | ||||||||||||||
| CHIEF MEDICAL OFFICER | 163596 | 0 | 0 | 0 | 0 | 0 | 3189 | 0 | 5769 | 0 | 172554 | 0 | 0 | 0 |
| JEROME SOLOMON | ||||||||||||||
| PHYSICIAN | 253284 | 0 | 0 | 0 | 0 | 0 | 5279 | 0 | 1005 | 0 | 259568 | 0 | 0 | 0 |
| SITA SINGH | ||||||||||||||
| OB/GYN | 191264 | 0 | 0 | 0 | 0 | 0 | 3981 | 0 | 4393 | 0 | 199638 | 0 | 0 | 0 |
| REBECCA LEVY | ||||||||||||||
| PHYSICIAN | 169064 | 0 | 0 | 0 | 0 | 0 | 2892 | 0 | 2305 | 0 | 174261 | 0 | 0 | 0 |
| GABRIELA BERMUDEZ | ||||||||||||||
| PHYSICIAN | 161948 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 9065 | 0 | 171013 | 0 | 0 | 0 |
| SONIA HA | ||||||||||||||
| PHYSICIAN | 158880 | 0 | 0 | 0 | 0 | 0 | 3345 | 0 | 6834 | 0 | 169059 | 0 | 0 | 0 |
| JENNIFER WILSON | ||||||||||||||
| PHYSICIAN | 152118 | 0 | 0 | 0 | 0 | 0 | 3059 | 0 | 8795 | 0 | 163972 | 0 | 0 | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (5 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | A COPY OF THE FORM 990 AND ALL RELATED SCHEDULES AND STATEMENTS WAS PROVIDED TO THE BOARD BEFORE FILING IN ORDER TO ALLOW SUFFICIENT TIME FOR REVIEW AND COMMENT. |
| FORM 990, PART VI, SECTION B, LINE 12C | CONFLICT OF INTEREST STATEMENTS ARE UPDATED AND REVIEWED PERIODICALLY. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE CEO AND CFO SALARIES ARE APPROVED BY THE BOARD OF DIRECTORS AFTER PERFORMANCE REVIEWS AND COMPENSATION STUDIES. THE OTHER KEY LEADERSHIP POSITIONS ARE BASED ON A COMPENSATION STUDY DONE BY AN INDEPENDENT FIRM EVERY TWO TO THREE YEARS. IF NECESSARY TO EVALUATE OUTSIDE OF THAT TIME PERIOD, THE HR DEPARTMENT WILL EVALUATE BY SOLICITING EXTERNAL COMPENSATION DATA AND PLACE THE POSITION APPROPRIATELY WITHIN THE ORGANIZATIONAL STRUCTURE. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE AUDITED FINANCIAL STATEMENTS, CONFLICT OF INTEREST POLICY, AND GOVERNING DOCUMENTS ARE AVAILABLE UPON REQUEST. BOUND COPIES OF AUDITED FINANCIAL STATEMENTS ARE AVAILABLE AT THE ADMINISTRATORS DESK FOR ANYONE WHO ASKS FOR A COPY. ALSO WE PUBLISH A COMMUNITY REPORT WITH CONDENSED FINANCIAL INFORMATION INCLUDED. |
| FORM 990, PART XII, LINE 2C | THERE HAVE BEEN NO CHANGES TO THIS PROCESS FROM PRIOR YEAR. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLINIC OLE FOUNDATION | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1141 PEAR TREE LN STE 100 | AddressLine1 |
| City | NAPA | City |
| State | CA | State |
| ZIP Code | 94558 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 680149424 | EIN |
| Primary Activities | FUNDRAISING | PrimaryActivities |
| Legal Domicile State | CA | LegalDomicileState |
| Exempt Code Section | 501(C)(3) | ExemptCodeSection |
| Public Charity Status | 11-I | PublicCharityStatus |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY HEALTH CLINIC OLE | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Org | 1 | ControlledOrg |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 1 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Dividends Related Organization | 0 | DividendsRelatedOrganization |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 0 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 1 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 0 | SharingOfFacilities |
| Sharing Of Paid Employees | 0 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 1 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 0 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable
Name Of Other Organization NameOfOtherOrganization
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLINIC OLE FOUNDATION | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Transaction Type | C | TransactionType |
| Amount Involved | 508350 | AmountInvolved |
| Method Of Amt Determination | BOOK/ACTUAL VALUE | MethodOfAmtDetermination |