2023-02-15T13:46:41-06:00 2022-03-31 FORVIS LLP 910 E ST LOUIS 200/PO BOX 1190 SPRINGFIELD MO 658062523 990 2021-04-01 952707101 CLINICA SIERRA VISTA % JOHN CHURCH CLIN 6616353050 1430 TRUXTUN AVENUE Suite 400 BAKERSFIELD CA 93301 JOHN CHURCH INTERIM CFO 6616353050 2023-02-15 true JOHN CHURCH XXX-XX-XXXX Krystal K Creach P01248198 4178658701 2023-02-15 2 2021 2023-03-07 01:45:13Z JOHN CHURCH 1430 TRUXTUN AVENUE 400 BAKERSFIELD CA 93301 180144899 false X WWW.CLINICASIERRAVISTA.ORG X 1971 CA THE MISSION OF CLINICA SIERRA VISTA IS TO PROVIDE QUALITY HEALTH CARE TO THE UNDERSERVED POPULATIONS OF KERN AND FRESNO COUNTIES. SEE SCHEDULE O FOR ADDITIONAL INFORMATION. 12 12 1236 15 0 0 66793750 74949772 79371715 91292901 718746 -511151 37250 7914 146921461 165739436 0 0 0 0 102860146 109753633 0 0 0 47711290 64041586 150571436 173795219 -3649975 -8055783 127234798 144486589 56666890 81974464 70567908 62512125 X THE MISSION OF CLINICA SIERRA VISTA IS TO PROVIDE QUALITY HEALTH CARE TO THE UNDERSERVED POPULATIONS OF KERN AND FRESNO COUNTIES. SEE SCHEDULE O FOR ADDITIONAL INFORMATION. false false 102235852 67101205 CLINICA SIERRA VISTA (CSV) PROVIDES ESSENTIAL MEDICAL SERVICES TO UNDERSERVED, LOW-INCOME, ISOLATED, HOMELESS AND OTHERWISE VULNERABLE PEOPLE IN KERN AND FRESNO COUNTIES. MEDICAL SPECIALTIES INCLUDE FULL SPECTRUM PRIMARY CARE THROUGH FAMILY MEDICINE, OB/GYN PEDIATRIC, AND OTHER SPECIALTY PHYSICIANS, PHYSICIAN ASSISTANTS, NURSE PRACTITIONERS AND OTHER ADVANCED PRACTICE PROVIDERS. CSV OFFERS ITS PATIENTS OUTREACH TRANSPORTATION, TRANSLATION, CASE MANAGEMENT, DISEASE MANAGEMENT REGISTRY AND OTHER ENABLING SERVICES TO PROMOTE ACCESS TO EFFECTIVE AND EFFICIENT MEDICAL CARE. CSV PROVIDED 458,000 MEDICAL AND OTHER ENCOUNTERS TO 129,000 PATIENTS IN FISCAL YEAR 2022. 18974690 12453797 CLINICA SIERRA VISTA PROVIDES ESSENTIAL BEHAVIORAL HEALTH SERVICES TO UNDERSERVED, LOW-INCOME, ISOLATED AND OTHERWISE VULNERABLE PEOPLE IN KERN AND FRESNO COUNTIES. BEHAVIORAL HEALTH SERVICES INCLUDE PSYCHIATRY, MEDICATION MANAGEMENT, THERAPY, AND INTEGRATED BEHAVIORAL HEALTH USING DISEASE MANAGEMENT REGISTRIES AND ALLIED HEALTH STAFF TO COORDINATE WITH PRIMARY CARE AND OTHER SPECIALTY MEDICAL PROVIDERS. CLINICA SIERRA VISTA PROVIDED 128,000 BEHAVIORAL HEALTH ENCOUNTERS TO 12,500 PATIENTS IN FISCAL YEAR 2022. 5660315 3715076 CLINICA SIERRA VISTA PROVIDES ESSENTIAL DENTAL HEALTH SERVICES TO UNDERSERVED, LOW-INCOME, ISOLATED AND OTHERWISE VULNERABLE PEOPLE IN KERN AND FRESNO COUNTIES. DENTAL HEALTH SERVICES INCLUDE FULL SPECTRUM PREVENTIVE AND RESTORATIVE CARE INCLUDING EXAMS, X-RAYS, CLEANINGS, FILLINGS, ROOT CANALS, CROWNS AND EXTRACTIONS. CLINICA SIERRA VISTA PROVIDED 63,500 DENTAL ENCOUNTERS TO 22,000 PATIENTS IN FISCAL YEAR 2022. 12223624 8022821 139094481 true true false false false false false false false false true false false true true false false true false false false false false false false false false false false true false false false false false false false false false false false false false false false false false true 268 0 true 1236 true false false false false false false false false false false false false X 12 12 false false false false false false false true true false false false true true true true true true false false CA X JOHN CHURCH 6616353050 1430 TRUXTUN AVENUE BAKERSFIELD CA 93301 RYAN JOHNSON PHYSICIAN 40.0 0.0 X 552263 0 40466 KAREN TAMMELA PHYSICIAN 40.0 0.0 X 523704 0 31626 AUTHER ADAMS PHYSICIAN 40.0 0.0 X 507038 0 31450 RHONDA ROBINSON PHYSICIAN 40.0 0.0 X 488159 0 38148 SONIA GHAI PHYSICIAN 40.0 0.0 X 501558 0 22789 STACY FERREIRA CEO 40.0 0.0 X 469980 0 40767 OLGA MEAVE CMO 40.0 0.0 X 361330 0 23768 STEPHEN LESLIE CFO 40.0 0.0 X 311000 0 30717 KRIS DELANO SECRETARY 1.0 0.0 X X 0 0 0 CLARIBEL GUTIERREZ PRESIDENT 1.0 0.0 X X 0 0 0 MICHAEL COSIMANO BOARD MEMBER 1.0 0.0 X 0 0 0 MARIO VALENZUELA INTERIM TREASURER BEG 9/21 1.0 0.0 X X 0 0 0 SOCORRO GAETA BOARD MEMBER 1.0 0.0 X 0 0 0 JUANITA BENAVIDEZ BOARD MEMBER 1.0 0.0 X 0 0 0 PHILLIP MELENDEZ BOARD MEMBER 1.0 0.0 X 0 0 0 JOSE J VALDOVINOS BOARD MEMBER 1.0 0.0 X 0 0 0 JORDAN DAVIS BOARD MEMBER BEG 11/21 1.0 0.0 X 0 0 0 ENRIQUE SAHAGUN BOARD MEMBER BEG 11/21 1.0 0.0 X 0 0 0 JANIE YADON BOARD MEMBER 1.0 0.0 X 0 0 0 PATRICIA MILLER BOARD MEMBER END 12/21 1.0 0.0 X 0 0 0 JERRY SHIPMAN TREASURER/MEMBER END 08/2021 1.0 0.0 X X 0 0 0 ROBERT GERDS BOARD MEMBER 1.0 0.0 X 0 0 0 ROBERTO RIVERA BOARD MEMBER END 10/21 1.0 0.0 X 0 0 0 3715032 0 259731 164 false true false PROVIDER HEALTHCARE LLC 2455 E PARLEYS WAY STE 130 SALT LAKE CITY UT 84109 LOCUM TENENS 1345779 KEN W SMITH 10721 RIO MESA DRIVE BAKERSFIELD CA 93308 CONSTRUCTION 931154 PHYSICIANS AUTOMATED LAB 2509 MOUNT VERNON AVENUE BAKERSFIELD CA 93306 LABORATORY 325087 MICROAGE 8160 S HARDY DR STE 101 TEMPE AZ 85284 IT SERVICES 306527 4 72759527 2190245 74949772 Net Patient Service Revenue 621400 86874830 86874830 INCENTIVE REVENUE 621400 3688954 3688954 Miscellanous Revenue 900099 729117 729117 91292901 769696 769696 0 0 47190 39276 7914 0 7914 7914 13078840 6500 14330842 35345 -1252002 -28845 -1280847 -1280847 0 0 0 0 0 0 0 0 0 0 165739436 91292901 0 -503237 X 0 0 0 0 1237562 1237562 0 85910269 74347934 11562335 3023591 2471716 551875 13040868 10572575 2468293 6541343 5280242 1261101 0 1151182 736 1150446 225890 136152 89738 0 0 144402 144402 21050750 18149992 2900758 775167 163879 611288 9459813 5217753 4242060 0 0 4604341 3390889 1213452 1141042 383478 757564 0 506227 303224 203003 951 951 0 3351951 774843 2577108 649684 261967 387717 0 MEDICAL SUPPLIES & DRUGS 9019756 9019756 LEGAL SETTLEMENT 8772221 6666888 2105333 REPAIRS & MAINTENANCE 1673221 698599 974622 RECRUITING & RETENTION 1331295 1144244 187051 183693 108663 75030 173795219 139094481 34700738 0 10203389 6290321 21082675 22516948 5512909 11895012 7555699 10692375 90000 0 0 0 3462750 3193635 165242 227931 414437 397636 81304304 25856996 41947767 55447308 24747630 20334029 0 0 0 0 50000 50000 12002300 13441394 127234798 144486589 15621180 27499720 0 0 1511817 960104 0 0 0 0 0 0 5157 0 1425949 36111 38102787 53478529 56666890 81974464 X 69914085 61214637 653823 1297488 70567908 62512125 127234798 144486589 -8055783 X false true X true true true X 53534463 52039309 60080313 66793750 74949772 307397607 0 0 53534463 52039309 60080313 66793750 74949772 307397607 0 307397607 797296 1456609 1678560 1129702 816886 5879053 0 0 313276660 397293649 0.98123 0.98030 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 4276690 4276690 57753752 16155325 41598427 4799629 843585 3956044 13120835 8858086 4262749 1353398 1353398 55447308 Est. due from third-party 13000083 Deposits 244700 Other Receivables 196611 13441394 0 EST. DUE TO THIRD PARTY 53478529 53478529 164990645 -134921 -134921 165125566 613870 613870 165739436 173690093 39276 39276 173650817 144402 144402 173795219 SCHEDULE D, PART X, LINE 2 UNCERTAIN TAX POSITIONS: MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIAL STATEMENTS. SCHEDULE D, PART XI, LINE 2D AMOUNTS INCLUDED ON LINE 1, BUT NOT FORM 990, PART VIII, LINE 12: $ (144,402) INVESTMENT MANAGEMENT FEES 9,481 NET ASSETS RELEASED FROM RESTRICTIONS --------- $ (134,921) SCHEDULE D, PART XI, LINE 4B AMOUNTS INCLUDED ON FORM 990, PART VIII, LINE 12, BUT NOT LINE 1: $ 653,146 TEMPORARILY RESTRICTED CONTRIBUTIONS (39,276) RENTAL EXPENSES --------- $ 613,870 SCHEDULE D, PART XII, LINE 2D AMOUNTS INCLUDED ON LINE 1, BUT NOT FORM 990, PART IX, LINE 25: $ 39,276 RENTAL EXPENSES X X X X X X false true false false false false false false false STEPHEN LESLIE CFO 310257 0 26 0 717 0 10103 0 20614 0 341717 0 0 0 OLGA MEAVE CMO 324854 0 7577 0 28899 0 11097 0 12671 0 385098 0 0 0 RYAN JOHNSON PHYSICIAN 411625 0 32114 0 108524 0 16411 0 24055 0 592729 0 0 0 KAREN TAMMELA PHYSICIAN 468363 0 7551 0 47790 0 11708 0 19918 0 555330 0 0 0 AUTHER ADAMS PHYSICIAN 361993 0 31551 0 113494 0 10846 0 20604 0 538488 0 0 0 SONIA GHAI PHYSICIAN 419003 0 7551 0 75004 0 11366 0 11423 0 524347 0 0 0 RHONDA ROBINSON PHYSICIAN 342673 0 31602 0 113884 0 14093 0 24055 0 526307 0 0 0 STACY FERREIRA CEO 294594 0 121468 0 53918 0 17255 0 23512 0 510747 0 0 0 FORM 990, PART III, LINE 1 ORGANIZATION'S MISSION: IT SHALL BE THE MISSION OF CLINICA SIERRA VISTA TO PROVIDE HIGH QUALITY AND COMPREHENSIVE PRIMARY AND PREVENTATIVE HEALTH CARE SERVICES AS THE MOST EFFICIENT COST TO UNDERSERVED POPULATIONS OF KERN, FRESNO AND INYO COUNTIES REGARDLESS OF ABILITY TO PAY AND TO SEEK NECESSARY RESOURCES TO MEET THE GROWING HEALTH CARE DEMANDS WHILE MAINTAINING THE CORPORATION'S FINANCIAL INTEGRITY. WE STRONGLY BELIEVE IN EVERYONE'S RIGHT TO QUALITY HEALTH CARE. THEREFORE, NO ONE IS DENIED SERVICES BASED ON RACE, RELIGION, ETHNICITY, SEX, AGE, DISABILITY OR ECONOMIC STATUS. FORM 990, PART III, LINE 4B BEHAVIORAL AND MENTAL HEALTH SERVICES: IN ADDITION, SEVERAL COMMUNITY HEALTH CENTERS THROUGHOUT BOTH COUNTIES ARE STAFFED WITH INTEGRATED SOCIAL WORK TO PROVIDE LIGHT THERAPY AND OTHER SOCIAL WORK SERVICES TO OUR PATIENTS. WE CAN ALSO BE FOUND ON MANY SCHOOL CAMPUSES. IN BOTH COUNTIES, OUR SPECIALTY BEHAVIORAL HEALTH CENTERS OFFER SPECIFIC TEAMS FOR CHILDREN (AGES 3-18) AND ADULTS (AGES 18+) WITH MENTAL/BEHAVIORAL HEALTH AND/OR SUBSTANCE USE PROBLEMS. ALL SERVICES ARE PROVIDED IN THE CLIENT'S PREFERRED LANGUAGE. FORM 990, PART III, LINE 4C DENTAL SERVICES: CLINICA SIERRA VISTA BELIEVES THAT EVERYONE IN THE COMMUNITIES WE SERVE SHOULD HAVE ACCESS TO QUALITY HEALTH CARE. WE HAVE TWO FULLY EQUIPPED, 40-FOOT MOBILE UNITS THAT TAKE OUR DENTAL AND MEDICAL PROFESSIONALS WHERE THEY ARE NEEDED MOST. OUR UNITS HAVE VISITED SCHOOLS, OFFERING FIRST-TIME CHECKUPS TO THOUSANDS OF CHILDREN, AS WELL AS THE HOMELESS ON THE STREETS AND FARM WORKERS IN THE FIELDS. FORM 990, PART III, LINE 4D ADDITIONAL PROGRAM SERVICES: CLINICA SIERRA VISTA PROVIDES NUTRITION EDUCATION AND SUPPLEMENTAL FOODS TO SAFEGUARD THE HEALTH OF LOW-INCOME PREGNANT, BREASTFEEDING, AND POSTPARTUM WOMEN, AND TO INFANTS AND CHILDREN. THIS PROGRAM IS FUNDED PRIMARILY THROUGH THE SPECIAL SUPPLEMENTAL NUTRITION PROGRAM FOR WOMEN, INFANTS AND CHILDREN (WIC). FORM 99O, PART VI, SECTION B, LINE 11B FORM 990 REVIEW PROCESS: THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENT AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. THE DIRECTOR OF FINANCE COMPILES AND VERIFIES 990 DATA. A FINAL DRAFT IS REVIEWED AND APPROVED BY THE LEADERSHIP TEAM PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY: CLINICA SIERRA VISTA HAS A CONFLICT OF INTEREST POLICY AND EMPLOYEE CONDUCT IN THE EMPLOYEE HANDBOOK. EACH EMPLOYEE IS GIVEN THE HANDBOOK AND THIS POLICY IS ALSO REVIEWED WITH EACH NEW HIRE. OUR POLICY REQUIRES EMPLOYEES TO REQUEST APPROVAL FOR OUTSIDE EMPLOYMENT. IT REQUIRES DISCLOSURE OF POTENTIAL PERSONAL AND PROFESSIONAL CONFLICTS, AND PROHIBITS EMPLOYEES FROM ENGAGING IN BUSINESS TRANSACTIONS THAT RESULT IN PERSONAL GAIN. THE HUMAN RESOURCES DEPARTMENT AND SUPERVISORS MONITOR THE ADHERENCE TO THIS POLICY. THE BOARD OF DIRECTORS, OFFICERS, AND KEY EMPLOYEES ARE REQUIRED TO DISCLOSE ANNUALLY ANY CONFLICT OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15A & 15B EXECUTIVE COMPENSATION POLICY: COMPENSATION FOR THE CEO IS DETERMINED AND APPROVED BY CLINICA SIERRA VISTA'S BOARD OF DIRECTORS. THE CEO DETERMINES AND APPROVES COMPENSATION FOR OFFICERS AND KEY EMPLOYEES BASED ON BOARD APPROVED SALARY SCHEDULE AND INDIVIDUALS' QUALIFICATIONS. FORM 990, PART VI, SECTION C, LINE 19 PUBLIC DISCLOSURE: ALL GOVERNING DOCUMENTS, FINANCIAL STATEMENTS AND FORM 990 ARE AVAILABLE TO THE PUBLIC UPON WRITTEN REQUEST. FORM 990 PART IX LINE 11G DESCRIPTION:OTHER FEES AND SERVICES TOTAL FEES:5310187 FORM 990 PART IX LINE 11G DESCRIPTION:PSYCHIATRIST FEES TOTAL FEES:2928038 FORM 990 PART IX LINE 11G DESCRIPTION:CUSTODIAL SERVICES TOTAL FEES:2300805 FORM 990 PART IX LINE 11G DESCRIPTION:PHYSICIAN FEES TOTAL FEES:2197450 FORM 990 PART IX LINE 11G DESCRIPTION:TEMP EMPLOYMENT SERVICES TOTAL FEES:2045642 FORM 990 PART IX LINE 11G DESCRIPTION:SECURITY TOTAL FEES:2040050 FORM 990 PART IX LINE 11G DESCRIPTION:INTERPRETING SERVICES TOTAL FEES:1581600 FORM 990 PART IX LINE 11G DESCRIPTION:PROFESSIONAL SERVICES FEES TOTAL FEES:1121283 FORM 990 PART IX LINE 11G DESCRIPTION:OUTSIDE LAB FEES TOTAL FEES:663200 FORM 990 PART IX LINE 11G DESCRIPTION:OTHER CONTRACTING TOTAL FEES:296104 FORM 990 PART IX LINE 11G DESCRIPTION:PAYROLL SERVICES TOTAL FEES:255966 FORM 990 PART IX LINE 11G DESCRIPTION:DENTAL FEES TOTAL FEES:191247 FORM 990 PART IX LINE 11G DESCRIPTION:PHARMACY TOTAL FEES:119178