2023-05-12T14:44:04-05:00 2022-06-30 910189318 MOSS ADAMS LLP 101 SECOND STREET SUITE 900 SAN FRANCISCO CA 94105 990 2021-07-01 237221695 OLE HEALTH OLEH 7072541770 1141 PEAR TREE LANE 100 NAPA CA 94558 ALICIA HARDY CEO 7072541770 2023-05-11 1 ALICIA HARDY 999009999 MICHAEL LUMSDEN P01262236 4159561500 2023-05-11 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z ALICIA HARDY 1141 PEAR TREE LANE 100 NAPA CA 94558 45635552 0 X WWW.OLEHEALTH.ORG X 1972 CA OLE HEALTH IS THE MEDICAL HOME FOR THE COMMUNITY'S UNDERSERVED PATIENTS. 18 18 378 18 0 0 16551956 13012362 29402943 31382690 1733904 984723 60160 177570 47748963 45557345 0 5000 0 0 26047547 31404945 0 0 1386593 13440302 13135018 39487849 44544963 8261114 1012382 53712305 56303054 10759458 15554803 42952847 40748251 X OLE HEALTH BUILDS STRONGER COMMUNITIES BY ENSURING HIGH QUALITY, COMPREHENSIVE AND PERSONALIZED CARE FOR EVERYONE WHO LIVES AND WORKS IN THE PLACES WE CALL HOME. 0 0 20936074 0 25759193 OLE HEALTH IS A FEDERALLY QUALIFIED HEALTH CENTER (FQHC), SERVING BOTH NAPA AND SOLANO COUNTIES. WE PROVIDE PRIMARY MEDICAL CARE, INCLUDING PERINATAL AND NUTRITION SERVICES, TO OVER 30,000 PATIENTS PER YEAR. ALL OF THESE SERVICES ARE AVAILABLE AT LITTLE TO NO COST FOR PATIENTS THROUGH THE SLIDING FEE SCALE DISCOUNT PROGRAM. 3961077 0 3361870 THE DENTAL SERVICES PROGRAM AT OLE HEALTH PROVIDES AFFORDABLE DENTAL CARE TO APPROXIMATELY 6,000 PATIENTS PER YEAR. 1855398 0 1832990 THE MENTAL HEALTH PROGRAM AT OLE HEALTH PROVIDES AFFORDABLE MENTAL HEALTH CARE TO APPROXIMATELY 2,600 PATIENTS PER YEAR. 412078 5000 428637 OLE HEALTH'S COMPREHENSIVE OPTOMETRY SERVICES INCLUDE DIAGNOSIS AND TREATMENT OF THE EYE AND VISUAL SYSTEM, AND A MODERN OPTICAL DISPENSARY FEATURING THE LATEST DESIGNER EYEWEAR TECHNOLOGY. OPTOMETRY SERVICES INCLUDE: EYE AND VISION EXAMS; RED-EYE EXAMS; FRAME SELECTION; AND AN OPTICAL DEPARTMENT. 412078 5000 428637 27164627 1 1 0 1 0 0 0 0 0 0 1 0 0 1 1 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 42 0 1 378 1 0 0 0 0 0 0 0 0 0 0 0 0 X 18 18 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X CINDY JOHNSON 7072541770 2650 NAPA VALLEY CORPORATE DRIVE NAPA CA 94558 ALICIA HARDY CHIEF EXECUTIVE OFFICER 38.00 2.00 X 332978 0 24171 TERESA L SHINDER DO FAAP CHIEF MEDICAL OFFICER 40.00 0.00 X 310513 0 18092 GABRIELA BERMUDEZ MD MEDICAL DIRECTOR, UP VALLEY SITES 40.00 0.00 X 297754 0 20961 ROSE MACISAAC CFO/COO THROUGH 2/2022 31.00 9.00 X 275658 0 22373 JENNIFER ANN WILSON MD FAMILY MEDICINE PHYSICIAN 36.00 0.00 X 262273 0 18647 HAMED ZAMANI MD FAMILY MEDICINE PHYSICIAN 40.00 0.00 X 257525 0 18686 ALLISON CRISP DO MPH PEDIATRICIAN 40.00 0.00 X 261816 0 13365 LYNETTE LEIGHTON MD FAMILY MEDICINE PHYSICIAN 36.00 0.00 X 263188 0 10813 ANDREW TORGE CHIEF HUMAN RESOURCES OFFICER 40.00 0.00 X 271013 0 1258 VINCENT FILANOVA DDS CHIEF DENTAL OFFICER THROUGH 3/2022 40.00 0.00 X 253242 0 14242 GARY FEDLER CHIEF INFORMATION OFFICER 40.00 0.00 X 222864 0 22085 SONIA TOLBERT CHIEF DEVELOPMENT OFFICER 20.00 20.00 X 183150 0 5554 HEMANTA MUNGUR CHIEF FINANCIAL OFFICER START 2/2022 31.00 9.00 X 0 0 0 AISHA AMIN DMD MPH DENTAL DIRECTOR START 4/2022 40.00 0.00 X 0 0 0 PETE RICHMOND CHAIR 1.00 2.00 X X 0 0 0 ARTHUR ROOSA VICE CHAIR 1.00 0.00 X X 0 0 0 PATRICIA MCFARLAND TREASURER 1.00 0.00 X X 0 0 0 MADELINE HERNANDEZ SECRETARY 1.00 0.00 X X 0 0 0 MAIRA AYALA BOARD MEMBER 1.00 1.00 X 0 0 0 JOE CARRILLO BOARD MEMBER 1.00 0.00 X 0 0 0 DEBORAH GOODIN BOARD MEMBER 1.00 0.00 X 0 0 0 RICHARD JONES BOARD MEMBER 1.00 2.00 X 0 0 0 BEATRICE LABASTIDA BOARD MEMBER 1.00 0.00 X 0 0 0 BRANDY LANE BOARD MEMBER 1.00 0.00 X 0 0 0 CYNTHIA MACIAS BOARD MEMBER 1.00 0.00 X 0 0 0 MONIN MARTIN BOARD MEMBER 1.00 0.00 X 0 0 0 JO MOORE BOARD MEMBER 1.00 0.00 X 0 0 0 CEPHAS MUGERWA BOARD MEMBER 1.00 0.00 X 0 0 0 BRYAN NAZARIO BOARD MEMBER 1.00 0.00 X 0 0 0 ANNA ROTH BOARD MEMBER 1.00 0.00 X 0 0 0 DAWNIELLE THORNBURGH BOARD MEMBER 1.00 0.00 X 0 0 0 LORI WILSON BOARD MEMBER 1.00 0.00 X 0 0 0 3191974 0 190247 60 0 1 0 FALCON CLEANING & JANITORIAL SERVICES 675 HEGENBERGER RD 240 OAKLAND CA 94621 JANITORIAL SERVICES 283397 E CLINICAL WORKS LLC PO BOX 847950 BOSTON MA 02284 EHR SOFTWARE/IT SERVICES 261657 COMPHEALTH PO BOX 972651 DALLAS TX 75397 CONTRACTED MEDICAL SERVICES 236650 FONEMED LLC PO BOX 911599 DENVER CO 80291 TELEHEALTH SERVICES 235719 SVT GRUPPE PO BOX 270 NAPA CA 94558 SECURITY SERVICES 120534 5 2298619 6441893 4271850 13012362 NET PATIENT SERV REV 621400 19756874 19756874 340B PROGRAM REVENUE 621400 5465096 5465096 CAPITATION REVENUE 621400 4460720 4460720 PHC PROVIDER INCENTIVES 621400 1700000 1700000 31382690 604191 604191 458739 0 78207 458739 -78207 380532 380532 OTHER REVENUE 900099 177570 177570 177570 45557345 31382690 0 1162293 5000 5000 1974350 596090 1172401 205859 23943531 15100266 8406928 436337 803290 509082 278331 15877 2919243 1678750 1182712 57781 1764531 1064656 654209 45666 21410 17572 3838 206996 206996 76769 76769 3723148 2692004 934715 96429 89903 3358 69403 17142 578200 114800 404606 58794 491716 6467 477749 7500 2805431 1862574 921370 21487 28089 9709 18372 8 114105 92459 20034 1612 50950 42798 8152 542571 446312 85172 11087 163151 163151 MEDICAL SUPPLIES 2618231 2540668 77563 EQUIPMENT COSTS 377609 240153 135022 2434 DUES & SUBSCRIPTIONS 101629 16412 68155 17062 STAFF APPRECIATION 76101 31390 42496 2215 1069009 111679 571865 385465 44544963 27164627 15993743 1386593 3968314 4677200 2130064 1872828 911920 888922 2757895 2685254 90000 0 14621945 14774610 623356 661484 15385697 6826674 2849461 8559023 21032835 17168863 1671588 1671588 3054927 3343282 53712305 56303054 5590568 5941715 2416576 2522149 0 2813372 2752314 4277567 10759458 15554803 X 42441834 40405273 511013 342978 42952847 40748251 53712305 56303054 1012382 -3200478 -16500 0 X 0 1 X 1 1 1 X 6182508 4783286 9502269 16551956 13012362 50032381 6182508 4783286 9502269 16551956 13012362 50032381 4317558 45714823 386116 413870 430270 480969 604191 2315416 67528 10583 739428 60160 177570 1055269 53403066 136243443 0.85600 0.85010 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2017 AMOUNT: $ 67,528. 2018 AMOUNT: $ 10,583. 2019 AMOUNT: $ 739,428. 2020 AMOUNT: $ 60,160. 2021 AMOUNT: $ 177,570. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 7125 7125 0 PART II-B, LINE 1: DURING THE JUNE 30, 2022 TAX YEAR, THE ORGANIZATION PAID INDIRECT LOBBYING EXPENSES IN RELATION TO DUES PAID TO THE CALIFORNIA PRIMARY CARE ASSOCIATION ($28,500); 25% OF THOSE DUES ($7,125) WERE INDICATED AS UTILIZED FOR LOBBYING ACTIVITIES ASSOCIATED WITH HEALTH CARE RELATED LEGISLATION. 1540000 1540000 4860856 80885 4779971 4146786 3585062 561724 3465303 2468685 996618 1372752 692042 680710 8559023 DUE FROM RELATED ORGANIZATIONS 1678523 QUALITY IMPROVEMENT PROGRAM RECEIVABLE 500288 DEPOSITS 20011 340B PROGRAM RECEIVABLE 790101 AMOUNTS DUE FROM THIRD-PARTY PAYORS 22063 OTHER ASSETS 332296 3343282 DEFERRED RENT 3937985 DUE TO RELATED ORGANIZATIONS 339582 4277567 X 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, 2022 AND 2021, 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. X 1 1 X X 0 0 0 0 0 0 0 0 0 ALICIA HARDY CHIEF EXECUTIVE OFFICER 319390 0 1088 0 12500 0 11169 0 13002 0 357149 0 0 0 TERESA L SHINDER DO FAAP CHIEF MEDICAL OFFICER 304425 0 6088 0 0 0 11481 0 6611 0 328605 0 0 0 GABRIELA BERMUDEZ MD MEDICAL DIRECTOR, UP VALLEY SITES 265833 0 31921 0 0 0 10442 0 10519 0 318715 0 0 0 ROSE MACISAAC CFO/COO THROUGH 2/2022 274570 0 1088 0 0 0 9604 0 12769 0 298031 0 0 0 JENNIFER ANN WILSON MD FAMILY MEDICINE PHYSICIAN 255191 0 7082 0 0 0 7996 0 10651 0 280920 0 0 0 HAMED ZAMANI MD FAMILY MEDICINE PHYSICIAN 256437 0 1088 0 0 0 8602 0 10084 0 276211 0 0 0 ALLISON CRISP DO MPH PEDIATRICIAN 254595 0 7221 0 0 0 10528 0 2837 0 275181 0 0 0 LYNETTE LEIGHTON MD FAMILY MEDICINE PHYSICIAN 255906 0 7282 0 0 0 10490 0 323 0 274001 0 0 0 ANDREW TORGE CHIEF HUMAN RESOURCES OFFICER 261331 0 1088 0 8594 0 1154 0 104 0 272271 0 0 0 VINCENT FILANOVA DDS CHIEF DENTAL OFFICER THROUGH 3/2022 219154 0 1088 0 33000 0 8993 0 5249 0 267484 0 0 0 GARY FEDLER CHIEF INFORMATION OFFICER 216776 0 6088 0 0 0 8834 0 13251 0 244949 0 0 0 SONIA TOLBERT CHIEF DEVELOPMENT OFFICER 178150 0 5000 0 0 0 5231 0 323 0 188704 0 0 0 PART I, LINE 1A VINCENT FILANOVA, DDS (CHIEF DENTAL OFFICER), RECEIVED A TAXABLE HOUSING ALLOWANCE DURING THE 2021 CALENDAR YEAR, WHICH WAS REPORTED AS TAXABLE INCOME ON HIS 2021 FORM W-2. FORM 990, PART VI, SECTION B, LINE 11B TO PREPARE THE FORM 990, THE ORGANIZATION UTILIZED A PROFESSIONAL ACCOUNTING FIRM WHO WORKED IN CONJUNCTION WITH THE ORGANIZATION'S FINANCE AND ACCOUNTING TEAM TO GATHER THE REQUIRED INFORMATION. UPON REVIEW OF THE FORM 990 AMONGST THE ORGANIZATION'S MANAGEMENT TEAM, THE FORM 990 WAS THEN SENT TO THE AUDIT & BENEFITS COMMITTEE OF THE BOARD OF DIRECTORS FOR REVIEW AND APPROVAL. THE AUDIT & BENEFITS COMMITTEE ALSO PRESENTS THE RESULTS OF ITS REVIEW PROCESS TO THE BOARD OF DIRECTORS, WHO RECEIVES A COPY OF THE FORM 990 PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C ALL EMPLOYEES AND BOARD MEMBERS MUST COMPLETE AND SIGN A CONFLICT OF INTEREST DISCLOSURE STATEMENT ANNUALLY. IT IS ALSO THE CONTINUING RESPONSIBILITY OF THE BOARD, OFFICERS, AND MANAGEMENT EMPLOYEES TO SCRUTINIZE THEIR TRANSACTIONS, OUTSIDE BUSINESS INTERESTS, AND RELATIONSHIPS FOR POTENTIAL CONFLICTS AND TO IMMEDIATELY MAKE SUCH DISCLOSURES. TRANSACTIONS WITH PARTIES WITH WHOM A CONFLICTING INTEREST EXISTS MAY BE UNDERTAKEN ONLY IF ALL OF THE FOLLOWING ARE OBSERVED: (1) THE CONFLICTING INTEREST IS FULLY DISCLOSED; (2) THE PERSON WITH THE CONFLICT OF INTEREST IS EXCLUDED FROM THE DISCUSSION AND APPROVAL OF SUCH TRANSACTION; (3) A COMPETITIVE BID OR COMPARABLE VALUATION EXISTS; AND (4) THE BOARD HAS DETERMINED THAT THE TRANSACTION IS IN THE BEST INTEREST OF THE ORGANIZATION. DISCLOSURE FROM EMPLOYEES OF THE ORGANIZATION SHOULD BE MADE TO THE CHIEF EXECUTIVE OFFICER (OR IF HE/SHE IS THE ONE WITH THE CONFLICT, THEN TO THE BOARD CHAIR); DISCLOSURES INVOLVING DIRECTORS SHOULD BE MADE TO THE BOARD CHAIR (OR IF HE/SHE IS THE ONE WITH THE CONFLICT, THEN TO THE BOARD VICE CHAIR). CONFLICTED INDIVIDUALS ARE NOT ALLOWED TO PARTICIPATE IN THE DELIBERATION AND VOTE ON ANY MATTER. 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 HUMAN RESOURCES 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. OLE HEALTH FOUNDATION 1141 PEAR TREE LANE SUITE 100 NAPA CA 94558 680149424 FUNDRAISING CA 501(C)(3) LINE 7 OLE HEALTH 1 OLE HEALTH NMTC 1141 PEAR TREE LANE SUITE 100 NAPA CA 94558 815395044 NMTC FINANCING FOR EXEMPT ACTIVITIES CA 501(C)(3) LINE 12A, I OLE HEALTH 1 0 0 1 1 0 0 0 0 0 0 1 1 1 1 1 0 1 0 0 OLE HEALTH FOUNDATION C 2298619 BOOK VALUE OLE HEALTH NMTC D 29651000 LOAN GUARANTEE AMOUNT OLE HEALTH NMTC K 534408 BOOK VALUE