2022-05-13T14:28:11-05:00 2021-06-30 410746749 CLIFTONLARSONALLEN LLP 10700 NORTHUP WAY SUITE 200 BELLEVUE WA 98004 990 2020-07-01 330664371 SAC HEALTH SYSTEM SACH 9092599113 250 S G STREET SAN BERNARDINO CA 92410 JOHN SKELTON VICE PRESIDENT & CFO 9092599113 2022-05-13 1 JOHN SKELTON 999009999 KURT J BENNION CPA P01469618 4252506100 2022-05-13 3 AAL1 IAL1 2020 2022-09-23 18:48:47Z JASON LOHR 250 S G STREET SAN BERNARDINO CA 92410 69943208 0 X WWW.WEARESACHS.ORG X 1995 CA PROVIDE COMMUNITIES WITH PRIMARY HEALTH CARE SERVICES, DENTAL CARE & BEHAVIORAL MEDICINE SERVICES. 13 13 488 13 0 0 16648528 19016024 42094698 48099571 3887 5045 2946226 2822568 61693339 69943208 0 5250 0 0 28514401 34566036 125040 104160 104160 32354681 34227327 60994122 68902773 699217 1040435 21392983 20750511 15280917 13566135 6112066 7184376 X TO REFLECT THE HEALING MINISTRY AND LOVE OF JESUS CHRIST THROUGH HEALTHCARE, EDUCATION, AND PARTNERSHIPS THAT EMPOWER OUR COMMUNITIES TO FLOURISH. 0 0 52091084 5250 41776946 SACHS IS COMMITTED TO PROVIDING ACCESSIBLE INTEGRATED HEALTHCARE (I.E. MEDICAL, DENTAL & BEHAVIORAL HEALTH) TO ALL THOSE IN NEED IN THE SAN BERNARDINO COUNTY. SACHS EMPOWERS FAMILIES TO LIVE VIBRANT AND HEALTHY LIVES THROUGH THE DELIVERY OF CULTURALLY SENSITIVE AND HIGH QUALITY, COMPREHENSIVE SERVICES. 4189647 0 0 TEACHING HEALTH CENTER GRADUATE MEDICAL EDUCATION - HRSA FUNDED PRIMARY CARE RESIDENCY PROGRAMS WHICH INCLUDE FAMILY MEDICINE, INTERNAL MEDICINE, OB & GYN, PSYCHIATRY. IT HELPS BUILD HEALTHY COMMUNITIES BY SUPPORTING QUALIFIED HEALTHCARE PROVIDERS DEDICATED TO WORKING IN EDUCATION EXPENSES FOR TRAINING RESIDENTS IN NEW OR EXPANDING COMMUNITY BASED PRIMARY CARE RESIDENCY PROGRAMS. 2249214 0 6322625 IEHP'S BEHAVIORAL HEALTH INTEGRATION & COMPLEX CARE INITIATIVE GRANT - THE GRANT'S OBJECTIVE IS TO TRANSFORM PROVIDER'S CLINICAL PRACTICES IN 5 KEY AREAS WHICH INCLUDES ASSESSMENT PROCESSES, CARE PLANNING, SERVICE DELIVERY PRACTICES, POPULATION HEALTH CARE MANAGEMENT & HEALTH PROMOTION/PATIENT EXPERIENCE. IT SUPPORTS PRIMARY & BEHAVIORAL HEALTH CARE INTEGRATION (I.E. TEAM BASED CARE). THE GRANT PAYS FOR PERSONNEL INVOLVED IN THE OPERATION OF THE GRANT, AS WELL AS INDIRECT EXPENSES SUCH AS OFFICE SUPPLIES. 1928006 0 0 HRSA FULL 330 HEALTH CENTER PROGRAM GRANT. SACHS IS A FEDERALLY QUALIFIED HEALTH CENTER (FQHC) RECEIVING A GRANT UNDER SECTION 330 OF THE PUBLIC HEALTH SERVICE (PHS) ACT (42 UNITED STATES CODE SECTION 254A). FQHCS ARE PAID BASED ON THE FQHC PROSPECTIVE PAYMENT SYSTEM (PPS) FOR MEDICALLY-NECESSARY PRIMARY HEALTH SERVICES AND QUALIFIED PREVENTIVE HEALTH SERVICES FURNISHED BY AN FQHC PRACTITIONER. 1928006 0 0 60457951 1 1 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 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 0 0 0 0 0 1 29 0 1 488 1 0 0 0 0 0 0 0 0 0 0 0 0 X 13 13 0 1 1 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 CA X DEL DENISE MORENO 9092599113 250 S G STREET SAN BERNARDINO CA 92410 DR JASON LOHR PRESIDENT & CEO 40.00 X 365290 0 59021 LEE PODOLL CHIEF BUSINESS STRATEGY OFFICER 40.00 X 195008 0 56491 TAMARA BACHMAN FORMER OFFICER 0.00 X 239970 0 9158 GERRARD GIER VICE PRESIDENT & CIO 40.00 X 209315 0 37618 JOHN SKELTON VICE PRESIDENT & CFO 40.00 X 177693 0 33519 DR MARYELLEN WESTERBERG VICE PRESIDENT & COO 40.00 X 175157 0 32187 JOEL UMALI DIRECTOR, DENTAL CLINIC 40.00 X 151280 0 47653 YVETTE FELIPE DENTIST 40.00 X 146692 0 39894 JANE ATKINS FORMER KEY EMPLOYEE 40.00 X 132410 0 30464 EDELWEISS VON MAACK CHIEF NURSING OFFICER 40.00 X 135618 0 25127 RANDY STINNETT PROVIDER MANAGER INTERIM 40.00 X 132039 0 23647 OSCAR LOPEZ DENTIST 40.00 X 131106 0 10925 RODNEY NEAL BOARD CHAIR 0.80 X X 0 0 0 RAUL CASTILLO BOARD CO-CHAIR 0.80 X X 0 0 0 OLU TOMI DANIEL BOARD SECRETARY 0.50 X X 0 0 0 ANN ATKINSON BOARD MEMBER 0.50 X 0 0 0 DR RICHARD HART BOARD MEMBER 0.50 X 0 0 0 DR MARILYN HERRMANN BOARD MEMBER 0.50 X 0 0 0 MATT LIST BOARD MEMBER 0.50 X 0 0 0 PAT MORRIS BOARD MEMBER 0.50 X 0 0 0 DR ERIC NGO BOARD MEMBER 0.80 X 0 0 0 KEN RAMIREZ BOARD MEMBER 0.50 X 0 0 0 DEVONA ROBERTSON BOARD MEMBER 0.50 X 0 0 0 MAGDALENA WIESNER BOARD MEMBER 0.50 X 0 0 0 ELAINE ZUCCO BOARD MEMBER 0.50 X 0 0 0 2191578 0 405704 27 1 1 0 FACULTY PHYSICIANS & SURGEONS OF LLUSM 350 E COMMERCIAL RD 101 SAN BERNARDINO CA 92408 PHYSICIAN SERVICES 12561489 LLU HEALTH EDUCATION CONSORTIUM 11165 MOUNTAIN VIEW AVE LOMA LINDA CA 92350 RESIDENTS CONTRACTOR 4255210 LLU SHARED SERVICES 197 E CAROLINE ST SUITE 2100 SAN BERNARDINO CA 92408 VARIOUS SERVICES 2303324 518 MEDICAL PROFESSIONALS PO BOX 910569 SAN DIEGO CA 921910569 PROFESSIONAL STAFFING SERVICES 936058 KIMCO MEDQUEST DEPT 842023 LOS ANGELES CA 900842023 PROFESSIONAL STAFFING SERVICES 454263 13 11475945 7540079 19016024 PATIENT CARE REVENUE 621400 41583962 41583962 CAPITATION REVENUE 621400 6515609 6515609 48099571 5045 5045 OTHER INCOME 900099 2822568 2822568 2822568 69943208 48099571 0 2827613 X 5250 5250 1188401 1188401 22003353 11601465 10401888 1518416 847178 671238 7967556 4142155 3825401 1888310 968967 919343 374068 374068 48031 48031 104160 104160 22024292 18931573 3092719 969556 365919 603637 1205440 580560 624880 6456958 4898872 1558086 16660 8980 7680 17532 20690 -3158 495056 348084 146972 293345 8003 285342 MEDICAL SUPPLIES 1456407 1251630 204777 EQUIPMENT 334953 66754 268199 OTHER EXPENSES 192997 28572 164425 DUES & SUBSCRIPTIONS 114792 1566 113226 227240 16381733 -16154493 68902773 60457951 8340662 104160 9257167 5971827 780917 642159 3145603 4774699 4277484 4544094 496231 514653 86480 58366 234594 339307 7534746 4219428 2175139 3315318 939368 590088 21392983 20750511 8565932 8191519 4599190 2132080 458378 338268 1656817 2903668 600 600 15280917 13566135 X 5325876 6786674 786190 397702 6112066 7184376 21392983 20750511 1040435 31875 0 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 127906 6466 134372 122643 5263 127906 74782 43615 4246 122643 70216 4566 74782 66572 3644 70216 0.00000 0.10000 0.90000 0 0 3955993 2153964 1802029 10700 10700 0 3243331 2054764 1188567 324722 324722 3315318 DEPOSITS 600 600 X 71263571 900000 433873 1333873 69929698 13510 13510 69943208 69802773 900000 900000 68902773 0 68902773 PART V, LINE 4: THE ENDOWMENT'S PRINCIPAL MAY NOT BE SPENT, BUT THE INCOME CAN BE EXPENDED AS OPERATING FUNDS FOR THE SACHS CLINICS. PART X, LINE 2: THE ORGANIZATION IS A PRIVATE NONPROFIT CORPORATION ORGANIZED UNDER THE LAWS OF THE STATE OF CALIFORNIA. THE ORGANIZATION HAS BEEN DETERMINED TO BE EXEMPT FROM INCOME TAXES UNDER SECTION 501(C) (3) OF THE INTERNAL REVENUE CODE AND SECTION 23701(D) OF THE STATE OF CALIFORNIA REVENUE AND TAXATION CODE BY THE IRS AND FRANCHISE TAX BOARD, RESPECTIVELY. ACCORDINGLY, NO PROVISION FOR INCOME TAXES IS INCLUDED IN THE ACCOMPANYING FINANCIAL STATEMENTS. THE ORGANIZATION FOLLOWS THE PROVISIONS OF FASB ASC 74010, INCOME TAXES, RELATING TO ACCOUNTING FOR UNCERTAIN TAX POSITIONS, WHICH HAS NO FINANCIAL STATEMENT IMPACT TO THE ORGANIZATION. THE ORGANIZATION RECOGNIZES THE TAX BENEFIT FROM UNCERTAIN TAX POSITIONS ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITIONS WILL BE SUSTAINED ON EXAMINATION BY THE TAX AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFIT IS MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. THERE WERE NO UNCERTAIN TAX POSITIONS AS OF JUNE 30, 2021 OR 2020. PART XI, LINE 2D - OTHER ADJUSTMENTS: NET ASSETS RELEASED FROM RESTRICTIONS 433,873. PART XI, LINE 4B - OTHER ADJUSTMENTS: CONTRIBUTIONS WITH DONOR RESTRICTIONS 13,510. X X 1 AM DEVELOPMENT GROUP 10250 FARMINGTON STREET OAK HILLS CA 92344 CONSULTANT & GRANT WRITER 0 8241536 104160 8137376 8241536 104160 8137376 CA MD 1 PART I, LINE 2: PRIOR TO SPONSORING A LOCAL CHARITY, SAC HEALTH SYSTEM CONFIRMS THAT THE RECIPIENT IS A QUALIFIED CHARITABLE ORGANIZATION OR GOVERNMENTAL AGENCY. ALL SPONSORSHIPS ARE GIVEN FOR GENERAL OPERATING SUPPORT, SO NO FOLLOW-UP IS CONDUCTED. X X X X 0 0 0 0 0 0 0 0 0 DR JASON LOHR PRESIDENT & CEO 365065 0 225 0 0 0 22800 0 36221 0 424311 0 0 0 LEE PODOLL CHIEF BUSINESS STRATEGY OFFICER 194783 0 225 0 0 0 15879 0 40612 0 251499 0 0 0 TAMARA BACHMAN FORMER OFFICER 239782 0 0 0 188 0 2183 0 6975 0 249128 0 0 0 GERRARD GIER VICE PRESIDENT & CIO 209090 0 225 0 0 0 16615 0 21003 0 246933 0 0 0 JOHN SKELTON VICE PRESIDENT & CFO 177468 0 225 0 0 0 14372 0 19147 0 211212 0 0 0 DR MARYELLEN WESTERBERG VICE PRESIDENT & COO 174932 0 225 0 0 0 14361 0 17826 0 207344 0 0 0 JOEL UMALI DIRECTOR, DENTAL CLINIC 151055 0 225 0 0 0 9637 0 38016 0 198933 0 0 0 YVETTE FELIPE DENTIST 146467 0 225 0 0 0 12347 0 27547 0 186586 0 0 0 JANE ATKINS FORMER KEY EMPLOYEE 132410 0 0 0 0 0 10718 0 19746 0 162874 0 0 0 EDELWEISS VON MAACK CHIEF NURSING OFFICER 135393 0 225 0 0 0 10982 0 14145 0 160745 0 0 0 RANDY STINNETT PROVIDER MANAGER INTERIM 131814 0 225 0 0 0 10511 0 13136 0 155686 0 0 0 FORM 990, PART VI, SECTION A, LINE 1 THE BOARD OF DIRECTORS HAS AN EXECUTIVE COMMITTEE CONSISTING OF THE BOARD'S CHAIR AND SECRETARY, AS WELL AS THE CHAIRS OF ALL STANDING COMMITTEES. THE AFFAIRS AND MANAGEMENT OF THE ORGANIZATION ARE SUPERVISED BY THE EXECUTIVE COMMITTEE, WHICH HAS POWER TO TRANSACT ALL REGULAR BUSINESS OF THE ORGANIZATION AND HAS THE FULL AUTHORITY OF THE BOARD DURING THE PERIOD BETWEEN MEETINGS OF THE BOARD, SUBJECT TO ANY PRIOR LIMITATIONS IMPOSED BY THE BOARD AND SUBJECT TO THE LIMITATIONS OF THE CALIFORNIA NONPROFIT PUBLIC BENEFIT CORPORATION LAW. ADDITIONALLY, EVERY TWO YEARS, THE EXECUTIVE COMMITTEE REVIEWS THE BYLAWS AND RECOMMENDS REVISIONS AS NECESSARY TO ENSURE COMPLIANCE WITH APPLICABLE STATUTES, REGULATIONS, LICENSING AND ACCREDITATION REQUIREMENTS. THE EXECUTIVE COMMITTEE ALSO RECOMMENDS TO THE BOARD NOMINEES FOR DIRECTORS AND MAY RECOMMEND NOMINEES FOR THE OFFICERS OF THE ORGANIZATION. THE ACTIONS OF THE EXECUTIVE COMMITTEE MUST NOT SUPERSEDE THE FULL HEALTH CENTER GOVERNING BOARD'S AUTHORITIES, FUNCTIONS AND RESPONSIBILITIES. FORM 990, PART VI, SECTION A, LINE 3 CMO AND ASSISTANT CMO SERVICES ARE PROVIDED THROUGH A SERVICE AGREEMENT WITH FACULTY AND PHYSICIAN SERVICES OF LOMA LINDA UNIVERSITY, A SUBSIDIARY OF LOMA LINDA UNIVERSITY HEALTH. FORM 990, PART VI, SECTION A, LINE 4 ON NOVEMBER 5, 2020, THE ORGANIZATION FILED AMENDED AND RESTATED ARTICLES OF INCORPORATION IN ORDER TO RECLASSIFY ITSELF AS A RELIGIOUS CORPORATION ORGANIZED UNDER THE NONPROFIT RELIGIOUS CORPORATION LAW EXCLUSIVELY FOR RELIGIOUS PURPOSES. THE ORGANIZATION ALSO CHANGED ITS MISSION WHICH IS TO REFLECT THE HEALING MINISTRY AND LOVE OF JESUS CHRIST THROUGH HEALTHCARE, EDUCATION, AND PARTNERSHIPS THAT EMPOWER OUR COMMUNITIES TO FLOURISH. THE SPECIFIC PURPOSES OF THE ORGANIZATION WERE AMENDED TO REFLECT SUCH MISSION AND ARE: (1) TO PROVIDE LOW-COST HEALTH CARE TO RESIDENTS OF SAN BERNARDINO AND RIVERSIDE COUNTIES AND SURROUNDING AREAS; (2) TO PROVIDE PREVENTIVE CLINICAL SERVICES SUCH AS IMMUNIZATIONS, PRENATAL CARE, AND HEALTH PROMOTION TO THE RESIDENTS OF SAN BERNARDINO AND RIVERSIDE COUNTIES AND SURROUNDING AREAS; (3) TO ESTABLISH, OPERATE AND MAINTAIN MEDICAL CLINICS FOR THE PROVISION OF HEALTH CARE SERVICES THROUGH ITS AFFILIATION WITH LOMA LINDA UNIVERSITY HEALTH, A CALIFORNIA NONPROFIT RELIGIOUS CORPORATION, AND OTHER PARTNERS; AND (4) TO ENGAGE IN, SPONSOR, ADVANCE, ENCOURAGE AND PROMOTE HEALTH CARE, MEDICAL EDUCATION, MEDICAL RESEARCH AND RELATED ACTIVITIES. THE BYLAWS OF THE ORGANIZATION HAVE ALSO BEEN AMENDED TO REFLECT THE FOREGOING CHANGES. FORM 990, PART VI, SECTION B, LINE 11B PRIOR TO FILING THE IRS, THE FORM 990 WAS REVIEWED BY MANAGEMENT. A COPY WILL BE PROVIDED TO ANY BOARD MEMBER WHO REQUESTS IT. FORM 990, PART VI, SECTION B, LINE 12C GENERAL COUNSEL ANNUALLY OBTAINS STATEMENTS OF DISCLOSURE FROM BOARD MEMBERS, OFFICERS, ADMINISTRATORS, KEY EMPLOYEES AND OTHERS WHO MAKE OR AFFECT SIGNIFICANT DECISIONS AND REVIEWS THE FINDINGS WITH APPROPRIATE BOARDS AND COMMITTEES. THE BOARD MEMBERS MAKE THE DECISIONS REGARDING QUESTIONS WHICH HAVE NOT BEEN SATISFACTORILY ANSWERED AFTER ADMINISTRATIVE CONSIDERATION. AN INDIVIDUAL WITH A CONFLICT WOULD RECUSE THEM SELF FROM DISCUSSIONS, DECISION AND VOTE, ON ANY ISSUE FOR WHICH THE CONFLICT EXISTS. FORM 990, PART VI, SECTION B, LINE 15 SACHS HR DOES A COMPENSATION SURVEY FOR CEO, CFO, COO AND CIO PAY, AND BOARD APPROVES SALARY. DURING 2021, AN INDEPENDENT COMPENSATION CONSULTANT PROVIDED A COMPENSATION REVIEW FOR THE ORGANIZATION. THEY PROVIDED A MARKET RATE ANALYSIS OF EXECUTIVE PAY USING REGIONAL COMPARATIVE DATE AND RATES WERE RECOMMENDED FOR APPROVAL BY THE BOARD. FORM 990, PART VI, SECTION C, LINE 19 SAC HEALTH SYSTEM MAKES ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC UPON REQUEST AND IN ACCORDANCE WITH IRS GUIDELINES. THE CONFLICT OF INTEREST POLICY IS POSTED ON THE ORGANIZATION'S INTERNAL WEBSITE FOR EMPLOYEES. THE FINANCIAL INFORMATION IS INCLUDED IN THE IRS FORM 990 WHICH IS AVAILABLE TO THE PUBLIC ON THE GUIDESTAR WEBSITE. FORM 990, PART IX, LINE 11G OTHER SERVICES: PROGRAM SERVICE EXPENSES 18,931,573. MANAGEMENT AND GENERAL EXPENSES 3,092,719. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 22,024,292.