2014-05-15T12:28:07-05:00 2013-06-30 910189318 MOSS ADAMS LLP 101 SECOND STREET 9TH FLOOR SAN FRANCISCO CA 94105 990 2012-07-01 237221695 COMMUNITY HEALTH CLINIC OLE COMM 7072541770 1141 PEAR TREE LN NO 100 NAPA CA 94558 TANIR AMI 7072541770 2014-05-14 1 RENIE BURBANK P00159653 4159561500 2012 2015-11-30 17:44:51Z TANIR AMI 1141 PEAR TREE LN NO 100 NAPA CA 94558 16360552 0 X WWW.CLINICOLE.ORG X 1972 CA 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. 13 13 198 15 0 0 3299118 3598468 12031315 11945835 2814 1885 303493 814364 15636740 16360552 0 0 0 0 11220199 11804000 0 0 0 3610105 3921860 14830304 15725860 806436 634692 9007467 9689824 2065647 2113312 6941820 7576512 X 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. 0 0 9457146 8713825 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. 1648192 2236248 THE DENTAL SERVICES PROGRAMS AT COMMUNITY HEALTH CLINIC OLE PROVIDE AFFORDABLE DENTAL CARE TO APPROXIMATELY 10,000 PATIENTS 337141 131253 THE MENTAL HEALTH PROGRAMS AT COMMUNITY HEALTH CLINIC OLE PROVIDE SERVICES TO THE COMMUNITY 444135 864509 COMMUNITY HEALTH CLINIC OLE PROVIDES HEALTH EDUCATION VIA OUTREACH PROGRAMS TO THE COUNTY'S LOW-INCOME, UNINSURED AND UNDERINSURED RESIDENTS. 444135 864509 11886614 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 30 0 1 198 1 0 0 0 0 0 0 0 0 X 13 13 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X MOLLY NELSON 7072541774 1141 PEAR TREE LN SUITE 100 NAPA CA 94558 KARYANNE DUNCAN 2.00 X X 0 0 0 JO MOORE 2.00 X X 0 0 0 DAN LYNCH 2.00 X X 0 0 0 ARJUNA ELKINS 2.00 X X 0 0 0 DAVID CARRASCO 1.00 X 0 0 0 VICTOR DAVIS 1.00 X 0 0 0 KEVIN FITZPATRICK 1.00 X 0 0 0 RICHARD JONES 1.00 X 0 0 0 CHARLES MATHEWSON 1.00 X 0 0 0 PETER MCCREA 1.00 X 0 0 0 DAWNIELLE THORNBURGH 1.00 X 0 0 0 PRISCILA UPTON 1.00 X 0 0 0 MARIANA URZUA 1.00 X 0 0 0 TANIR AMI 40.00 X 151593 0 13503 PATRICIA AGUILERA 40.00 X 139234 0 14140 COLLEEN TOWNSEND 40.00 X 163596 0 8958 JEROME SOLOMON 40.00 X 253284 0 6284 SITA SINGH 40.00 X 191264 0 8374 REBECCA LEVY 40.00 X 169064 0 5197 GABRIELA BERMUDEZ 40.00 X 161948 0 9065 SONIA HA 40.00 X 158880 0 10179 JENNIFER WILSON 40.00 X 152118 0 11854 1540981 0 87554 11 0 1 0 0 508350 1711142 1378976 3598468 PATIENT SERVICE REV. 621400 11945835 11945835 11945835 1885 1885 OTHER REV: PHC PROVIDER INCENTIVE 621400 449280 449280 OTHER REVENUE 900099 365084 365084 814364 16360552 11945835 0 816249 671504 537203 134301 9101491 7337561 1763930 122544 98865 23679 1016073 837828 178245 892388 722084 170304 298 298 72326 72326 546149 209173 336976 8611 1797 6814 1024363 579379 444984 454116 37035 417081 666495 613544 52951 40031 25673 14358 54732 26605 28127 13645 13645 385401 262304 123097 51440 27101 24339 PHARMACEUTICAL SUPPLIES 362988 362988 PROVISION FOR BAD DEBT 92956 92956 OTHER EXPENSES -34706 -34706 183015 114518 68497 15725860 11886614 3839246 0 3876219 4337907 1061816 1003155 52022 127096 1830136 1948946 190060 289098 4039221 2055599 1997214 1983622 9007467 9689824 1116451 1372341 434937 423395 514259 317576 2065647 2113312 X 6911965 7300975 29855 275537 6941820 7576512 9007467 9689824 634692 0 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2348825 882227 1466598 1365662 851687 513975 324734 321685 3049 1983622 X 16402212 134616 -92956 41660 16360552 0 16360552 15767520 134616 134616 15632904 92956 92956 15725860 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. X X X 0 0 0 0 0 0 0 0 0 TANIR AMI 151593 0 0 0 0 0 2753 0 10750 0 165096 0 0 0 PATRICIA AGUILERA 139234 0 0 0 0 0 2458 0 11682 0 153374 0 0 0 COLLEEN TOWNSEND 163596 0 0 0 0 0 3189 0 5769 0 172554 0 0 0 JEROME SOLOMON 253284 0 0 0 0 0 5279 0 1005 0 259568 0 0 0 SITA SINGH 191264 0 0 0 0 0 3981 0 4393 0 199638 0 0 0 REBECCA LEVY 169064 0 0 0 0 0 2892 0 2305 0 174261 0 0 0 GABRIELA BERMUDEZ 161948 0 0 0 0 0 0 0 9065 0 171013 0 0 0 SONIA HA 158880 0 0 0 0 0 3345 0 6834 0 169059 0 0 0 JENNIFER WILSON 152118 0 0 0 0 0 3059 0 8795 0 163972 0 0 0 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. CLINIC OLE FOUNDATION 1141 PEAR TREE LN STE 100 NAPA CA 94558 680149424 FUNDRAISING CA 501(C)(3) 11-I COMMUNITY HEALTH CLINIC OLE 1 0 0 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 0 CLINIC OLE FOUNDATION C 508350 BOOK/ACTUAL VALUE