2021-05-17T15:04:45-05:00 2020-06-30 680037990 GILBERT CPAS 2880 GATEWAY OAKS DR STE 100 SACRAMENTO CA 95833 990 2019-07-01 941713704 WELLSPACE HEALTH WELL 9163255556 777 12TH STREET NO 250 SACRAMENTO CA 95811 JONATHAN PORTEUS CEO 9163255556 2021-05-16 1 KEITH R GLEN P01317613 9166466464 2021-05-16 2019 2022-09-23 18:48:47Z JONATHAN PORTEUS 777 12TH STREET NO 250 SACRAMENTO CA 95811 77086034 0 X WWW.WELLSPACEHEALTH.ORG X 1970 CA ACHIEVING REGIONAL HEALTH THROUGH HIGH QUALITY COMPREHENSIVE CARE. 8 8 1051 55 104727 40272 10959833 8512204 55401069 68396508 1033 595 126391 176727 66488326 77086034 0 0 0 0 45277720 53430958 0 0 0 20662826 24094304 65940546 77525262 547780 -439228 27412698 37804786 18498490 29329880 8914208 8474906 X A FEDERALLY QUALIFIED HEALTH CENTER (FQHC) SINCE JUNE 2008, WELLSPACE HEALTH PROVIDES HEALTH CARE SERVICES INCLUDING PRIMARY & DENTAL CARE, BEHAVIORAL HEALTH, SUBSTANCE ABUSE TREATMENT, COUNSELING, PREVENTION AND CRISIS INTERVENTION SERVICES TO SOCIO-ECONOMICALLY DIVERSE FAMILIES AND THEIR CHILDREN. 0 0 69015728 68396508 WELLSPACE HEALTH IS A FEDERALLY QUALIFIED HEALTH CENTER (FQHC) AS WELL AS A BROAD RANGING BEHAVIORAL HEALTH AND SOCIAL SERVICE PROVIDER IN THE SACRAMENTO REGION. A NETWORK OF COMMUNITY HEALTH CENTERS ACROSS THREE COUNTIES (SACRAMENTO, PLACER, AND AMADOR) PROVIDES PRIMARY HEALTH AND INTEGRATED BEHAVIORAL HEALTH CARE FOR ALL AGES, WOMEN'S HEALTH (INCLUDING COMPREHENSIVE PERINATAL CARE THROUGHOUT AND AFTER PREGNANCY AND SPECIALIZED CULTURE-SPECIFIC INFANT MORTALITY PREVENTION SERVICES), AND ORAL HEALTH CARE FOR CHILDREN AND TEENS (CO-LOCATED IN 6 SITES). ADDITIONAL BEHAVIORAL HEALTH LOCATIONS EXTEND THE ORGANIZATION'S CLINICAL REACH THROUGH PREVENTION AND SPECIALTY MENTAL HEALTH AND SUBSTANCE USE DISORDERS TREATMENT, INCLUDING: A FULL CONTINUUM OF CO-OCCURRING MENTAL HEALTH AND SUBSTANCE USE DISORDERS TREATMENT PROGRAMS (OUTPATIENT, RESIDENTIAL REHABILITATION, MEDICALLY-MONITORED DETOXIFICATION, MEDICALLY ASSISTED TREATMENTS, CORRECTIONS-BASED AND DRUG COURT SERVICES); NORTHERN CALIFORNIA'S 24-HOUR PRIMARY SUICIDE PREVENTION HOTLINE AND CRISIS SUPPORT LINES; OUTPATIENT CHILDREN'S MENTAL HEALTH AND YOUTH VIOLENCE PREVENTION PROGRAMS; CHILD ABUSE PREVENTION AND HOME VISITATION SERVICES; AND MULTIPLE CARE TRANSITION PROGRAMS (FOR EXAMPLE WITHIN HOSPITAL EMERGENCY DEPARTMENTS, NAVIGATING SERVICES IN THE COMMUNITY, AND TRANSITIONING PATIENTS FROM INPATIENT SETTINGS). WELLSPACE HEALTH EMBRACES THE HIGHEST QUALITY STANDARDS ACROSS THE BREADTH OF ITS SERVICES AND IS ACCREDITED BY THE JOINT COMMISSION FOR BOTH AMBULATORY CARE AND BEHAVIORAL HEALTH. THE EXTENT TO WHICH THE ORGANIZATION INTEGRATES CARE WITHIN ITS HEALTH CENTERS AND BETWEEN ITS ADDITIONAL PROGRAM SITES IS ALSO DOCUMENTED BY ITS ADDITIONAL CERTIFICATIONS FROM THE JOINT COMMISSION FOR BOTH PATIENT CENTERED MEDICAL HOME (PCMH) AND BEHAVIORAL HEALTH HOME (BHH) - THEREBY MAXIMIZING THE ORGANIZATION'S COMMITMENT TO 'WHOLE PERSON CARE.' WELLSPACE HEALTH'S DIVERSE PATIENT POPULATION SPANS THE RICH CULTURAL DIVERSITY OF THE SACRAMENTO REGION, AS WELL AS ALL AGES AND PERSONS WHO ARE HOMELESS. 69015728 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 77 0 1 1051 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 8 8 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X JONATHAN PORTEUS CEO 9163138455 777 12TH STREET SUITE 250 SACRAMENTO CA 95814 LISA STEWART PRESIDENT/CONSUMER DIRECTO 1.00 X X 0 0 0 LARRY MAAS VICE PRESIDENT/NON-CONSUME 1.00 X X 0 0 0 RUZWA COOPER TREASURER/NON-CONSUMER DIR 1.00 X X 0 0 0 MARGIE MEZA SECRETARY/CONSUMER DIRECTO 1.00 X X 0 0 0 JIM TILTON NON-CONSUMER DIRECTOR 1.50 X 0 0 0 JODY GRAY CONSUMER DIRECTOR 1.00 X 0 0 0 TIMOTHY MARTIN CONSUMER DIRECTOR 1.00 X 0 0 0 TODD MURRAY CONSUMER DIRECTOR 1.00 X 0 0 0 NATHAN ALLEN MD-OB/GYNECOLOGIST 40.00 X 443148 0 6398 TROY SINGH MD-INTERNIST 40.00 X 485503 0 16785 OLGA THORNE OBGYNECOLOGIST 40.00 X 397083 0 20588 SUEJIN KIM MD-OB/GYNECOLOGIST 40.00 X 415696 0 5935 SALOME GOGOBERIDZE OBGYNECOLOGIST 40.00 X 393863 0 11443 KATHY WALKER CHIEF FINANCIAL OFFICER 40.00 X 105923 0 13204 JANINE BERA CHIEF MEDICAL OFFICER 40.00 X 350986 0 14846 BEN AVEY CHIEF PUBLIC AFFAIRS OFFICER 40.00 X 56785 0 492 ROBERT KAMRATH CHIEF HUMAN RESOURCES OFFICER 40.00 X 48454 0 4029 CORDIA LOSH II CHIEF STRATEGY OFFICER 40.00 X 0 0 0 DONA WEISSENFELS CHIEF QUALITY OFFICER 40.00 X 0 0 0 BRENDA SHIPP CHIEF OPERATIONS OFFICER 40.00 X 151465 0 21873 ALASDAIR JONATHAN PORTEUS CHIEF EXECUTIVE OFFICER 40.00 X 255499 0 6250 3104405 0 121843 81 0 1 0 PRUDENCIO GABRIEL SAMSON 2102 BROKEN RAIL LANE ROCKLIN CA 95765 PSYCHIATRIST SERVICES 226413 KENNETH FORSYTHE 3106 SCEPTRE DRIVE ROCKLIN CA 95765 PHYSICIAN SERVICES 116288 2 3408122 5104082 1022017 8512204 FEE FOR SERVICE 624100 66080435 66080435 OTHER PROGRAM REVENUE 624100 2255729 2255729 PHARMACY REVENUE 624100 47637 47637 CLIENT RESEARCH FEE 624100 12707 12707 68396508 595 595 176727 0 176727 176727 104727 72000 77086034 68396508 104727 72595 1088771 979444 109327 43508735 39137167 4371568 387954 354820 33134 5136861 4693411 443450 3308637 3006789 301848 424535 184846 239689 47550 20704 26846 4059800 3143906 915894 18155 12078 6077 1991097 1791413 199684 1998520 1448558 549962 6599347 6001585 597762 244846 188089 56757 268572 213117 55455 348397 166573 181824 1433974 1337412 96562 1278137 1118386 159751 UBI TAX 2916 0 2916 PATIENT SUPPLIES 3230967 3213838 17129 EQUIPMENT EXPENSE 826375 744847 81528 BAD DEBT EXPENSE 800000 800000 521116 458745 62371 77525262 69015728 8509534 0 3078164 1845094 2736 8382210 8363178 7941426 3159768 538108 305307 25388807 9240161 15408103 16148646 22409 22335 27412698 37804786 7694717 6634182 4907503 9433941 4896270 5134057 1000000 8127700 18498490 29329880 X 8891799 8452571 22409 22335 8914208 8474906 27412698 37804786 -439228 -74 0 X X 0 1 X 1 1 1 X 6454043 9715610 11102036 10959833 8512204 46743726 6454043 9715610 11102036 10959833 8512204 46743726 46743726 2394 4425 2274 127424 72595 209112 104727 104727 47057565 230950948 0.99330 0.99690 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 22409 -74 22335 21734 675 22409 20130 1604 21734 17764 2366 20130 18401 -637 17764 0.00000 1.00000 1 0 1228704 1228704 8659318 1741878 6917440 4209193 2407521 1801672 7865165 5090762 2774403 3426427 3426427 16148646 LINE OF CREDIT 200000 PPP LOAN 7927700 8127700 77223841 -74 137881 137807 77086034 0 77086034 77663143 137881 137881 77525262 0 77525262 X X X 0 0 0 0 0 0 0 0 0 NATHAN ALLEN MD-OB/GYNECOLOGIST 443148 0 0 0 0 0 6250 0 148 0 449546 0 0 0 TROY SINGH MD-INTERNIST 485503 0 0 0 0 0 0 0 16785 0 502288 0 0 0 OLGA THORNE OBGYNECOLOGIST 397083 0 0 0 0 0 4750 0 15838 0 417671 0 0 0 SUEJIN KIM MD-OB/GYNECOLOGIST 415696 0 0 0 0 0 0 0 5935 0 421631 0 0 0 SALOME GOGOBERIDZE OBGYNECOLOGIST 393863 0 0 0 0 0 4750 0 6693 0 405306 0 0 0 JANINE BERA CHIEF MEDICAL OFFICER 350986 0 0 0 0 0 5327 0 9519 0 365832 0 0 0 BRENDA SHIPP CHIEF OPERATIONS OFFICER 151465 0 0 0 0 0 6250 0 15623 0 173338 0 0 0 ALASDAIR JONATHAN PORTEUS CHIEF EXECUTIVE OFFICER 249499 0 0 0 6000 0 6250 0 0 0 261749 0 0 0 X 31164 FMV X 86 965853 FMV X FOOD 11 11278 FMV X OTHER 7 9811 FMV X ENTERTAINMENT 4 3912 FMV 0 0 0 PART I, COLUMN (B): WELLSPACE HEALTH USES A COMBINATION OF FMV, THRIFT STORE VALUE AND FACE VALUE DEPENDING ON THE ITEM AND CONDITION THAT THE ITEM IS IN. ALL METHODS ARE TAKEN INTO ACCOUNT WHEN ASSIGNING A VALUE TO EACH INDIVIDUAL DONATION. FORM 990, PART VI, SECTION B, LINE 11B THE AUDIT COMMITTEE REVIEWS FORM 990. AFTER ALL QUESTIONS AND COMMENTS ARE RESOLVED, FORM 990 IS REVIEWED AND APPROVED BY THE FULL BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 12C ALL BOARD OF DIRECTOR MEMBERS ARE REQUIRED TO DECLARE THEIR TYPE OF INDUSTRY, WHICH ARE EXCLUDED FROM ANY REQUESTS FOR PROPOSALS OR ANY SITUATION WHERE FUNDS COULD CHANGE HANDS, OR A SERVICE WOULD BE COMPROMISED. FORM 990, PART VI, SECTION B, LINE 15 WELLSPACE HEALTH USES MARKET COMPARISONS WITH REGIONAL NON-PROFITS AS A GUIDE. ALSO, WELLSPACE HEALTH USES THE PRIVATE MARKET, BASED ON EXPERIENCE, AND QUALIFICATIONS. THIS PROCESS WAS LAST UNDERTAKEN IN 2017. FORM 990, PART VI, SECTION C, LINE 19 DOCUMENTS ARE PROVIDED UPON REQUEST. THE DOCUMENTS ARE HOUSED AT THE 777 12TH STREET, SUITE 250, SACRAMENTO, CA 95814 FORM 990, PART XII, LINE 2C: THE PROCESS FOR OVERSIGHT OF THE FINANCIAL STATEMENT AUDIT AND THE PROCESS FOR SELECTION OF AN INDEPENDENT ACCOUNTANT HAS NOT CHANGED FROM THE PRIOR YEAR.