2024-05-14T19:47:26-05:00 2023-06-30 910189318 MOSS ADAMS LLP 101 SECOND STREET SUITE 900 SAN FRANCISCO CA 94105 990 2022-07-01 237221695 OLE HEALTH OLEH 7072541770 1141 PEAR TREE LANE 100 NAPA CA 94558 ROSE MACISAAC CFO 7072541770 2024-05-14 1 ROSE MACISAAC 999009999 0 MICHAEL LUMSDEN P01262236 4159561500 2024-05-14 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z ALICIA HARDY 1141 PEAR TREE LANE 100 NAPA CA 94558 60761983 0 X WWW.OLEHEALTH.ORG X 1972 CA OLE HEALTH IS THE MEDICAL HOME FOR THE COMMUNITY'S UNDERSERVED PATIENTS. 14 14 419 18 0 0 13012362 16617011 31382690 38645918 984723 719712 177570 4610251 45557345 60592892 5000 0 0 0 31404945 34935954 0 0 0 13135018 14441278 44544963 49377232 1012382 11215660 56303054 65694919 15554803 13213326 40748251 52481593 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 23179583 0 28928320 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 28,000 PATIENTS PER YEAR. ALL OF THESE SERVICES ARE AVAILABLE AT LITTLE TO NO COST FOR PATIENTS THROUGH THE SLIDING FEE SCALE DISCOUNT PROGRAM. 3951169 0 5173932 THE DENTAL SERVICES PROGRAM AT OLE HEALTH PROVIDES AFFORDABLE DENTAL CARE TO APPROXIMATELY 3,500 PATIENTS PER YEAR. 2232612 0 2773247 THE MENTAL HEALTH PROGRAM AT OLE HEALTH PROVIDES AFFORDABLE MENTAL HEALTH CARE TO APPROXIMATELY 2,000 PATIENTS PER YEAR. 433635 0 1770419 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. 433635 0 1770419 29796999 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 1 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 42 0 1 419 1 0 0 0 0 0 0 0 0 0 0 0 0 X 14 14 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 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 THROUGH 12/2022 1.00 0.00 X 0 0 0 DEBORAH GOODIN BOARD MEMBER 1.00 0.00 X 0 0 0 RICHARD JONES BOARD MEMBER THROUGH 12/2022 1.00 3.00 X 0 0 0 BEATRICE LABASTIDA BOARD MEMBER 1.00 0.00 X 0 0 0 BRANDY LANE BOARD MEMBER THROUGH 12/2022 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 THROUGH 12/2022 1.00 0.00 X 0 0 0 LORI WILSON BOARD MEMBER 1.00 0.00 X 0 0 0 ALICIA HARDY CHIEF EXECUTIVE OFFICER 37.00 3.00 X 377325 0 13077 TERESA L SHINDER DO FAAP CHIEF MEDICAL OFFICER 40.00 0.00 X 343829 0 18155 HEMANTA MUNGUR CFO THROUGH 5/2023 30.00 10.00 X 229821 0 9419 ROSE MACISAAC CFO (THROUGH 2/2022; START 6/2023) 30.00 10.00 X 66536 0 5066 AISHA AMIN DMD MPH DENTAL DIRECTOR 26.00 0.00 X 130870 0 5952 ANDREW P TORGE CHIEF HUMAN RESOURCES OFFICER 40.00 0.00 X 314929 0 1325 GARY FEDLER CHIEF INFORMATION OFFICER 40.00 0.00 X 267030 0 13505 SONIA TOLBERT CHIEF DEVELOPMENT OFFICER 26.00 14.00 X 251733 0 9665 FLORA R ASUNCION CA&OO THROUGH 3/2022 40.00 0.00 X 206755 0 11485 JENNIFER ANN WILSON MD PHYSICIAN 37.00 0.00 X 272911 0 12445 HAMED ZAMANI MD PHYSICIAN 40.00 0.00 X 270466 0 20518 ALLISON CRISP DO MPH PEDIATRICIAN 40.00 0.00 X 269272 0 20470 MICHELLE MUNOZ MD PHYSICIAN 40.00 0.00 X 264365 0 10164 LYNETTE LEIGHTON MD PHSYCIAN 36.00 0.00 X 264000 0 11878 3529842 0 163124 86 0 1 0 COMPHEALTH PO BOX 972651 DALLAS TX 75397 CONTRACTED MEDICAL SERVICES 1959162 E CLINICAL WORKS LLC PO BOX 847950 BOSTON MA 02284 EHR SOFTWARE/IT SERVICES 653894 FALCON CLEANING & JANITORIAL SERVICES 675 HEGENBERGER RD 240 OAKLAND CA 94621 JANITORIAL SERVICES 593864 FONEMED LLC PO BOX 911599 DENVER CO 80291 TELEHEALTH SERVICES 299068 ALLIED UNIVERSAL SECURITY SERVICES PO BOX 31001 PASADENA CA 91110 SECURITY SERVICES 270397 11 1045033 13769640 1802338 16617011 NET PATIENT SERV REV 621400 24480394 24480394 340B PROGRAM REVENUE 621400 5722273 5722273 CAPITATION REVENUE 621400 4938516 4938516 PHC PROVIDER INCENTIVES 621400 3504735 3504735 38645918 661026 661026 227777 169091 58686 58686 58686 GAIN ON LEASE TERMINATION 900099 3922027 3922027 OTHER REVENUE 900099 688224 688224 4610251 60592892 38645918 0 5329963 2274312 597407 1676905 26649908 17188276 9461632 984503 604521 379982 3039801 1704457 1335344 1987430 1222608 764822 141367 141367 248180 4698 243482 74204 74204 4602840 3086146 1516694 172677 16758 155919 707261 138281 568980 534423 10785 523638 1771203 586787 1184416 48637 18106 30531 155634 66769 88865 106062 106062 620821 484855 135966 236360 236360 MEDICAL SUPPLIES 3657636 3588250 69386 EQUIPMENT COSTS 333409 228909 104500 DUES & SUBSCRIPTIONS 139673 17448 122225 STAFF APPRECIATION 123723 18103 105620 767168 107773 659395 49377232 29796999 19580233 0 4677200 3624482 1872828 38593 888922 410977 2685254 2951515 30000 14774610 14778610 661484 1001676 20124140 7267002 8559023 12857138 17168863 18222619 1671588 1671588 3343282 10107721 56303054 65694919 5941715 6172140 2522149 913810 2813372 2760839 4277567 3366537 15554803 13213326 X 40405273 52365035 342978 116558 40748251 52481593 56303054 65694919 11215660 527182 -9500 0 X 0 1 X 1 1 1 X 4783286 9502269 16551956 13012362 16617011 60466884 4783286 9502269 16551956 13012362 16617011 60466884 3328854 57138030 413870 430270 480969 604191 661026 2590326 10583 739428 60160 177570 4610251 5597992 68655202 150718201 0.83220 0.85600 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2018 AMOUNT: $ 10,583. 2019 AMOUNT: $ 739,428. 2020 AMOUNT: $ 60,160. 2021 AMOUNT: $ 177,570. 2022 AMOUNT: $ 688,224. GAIN ON LEASE TERMINATION - 2022 AMOUNT: $ 3,922,027. 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, 2023 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 213978 4646878 4613252 3623868 989384 3995285 2564895 1430390 5114747 864261 4250486 12857138 DUE FROM RELATED ORGANIZATIONS 1216980 QUALITY IMPROVEMENT PROGRAM RECEIVABLE 950000 DEPOSITS 28291 340B PROGRAM RECEIVABLE 666034 AMOUNTS DUE FROM THIRD-PARTY PAYORS 22063 OTHER ASSETS 681266 CASH HELD IN ESCROW 3777964 OPERATING LEASE RIGHT-OF-USE ASSET 2765123 10107721 DUE TO RELATED ORGANIZATIONS 515582 OPERATING LEASE LIABILITIES 2850955 3366537 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, 2023 AND 2022, 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 X 0 0 0 0 0 0 0 1 0 ALICIA HARDY CHIEF EXECUTIVE OFFICER 338640 0 35085 0 3600 0 10863 0 2214 0 390402 0 0 0 TERESA L SHINDER DO FAAP CHIEF MEDICAL OFFICER 300446 0 37351 0 6032 0 11099 0 7056 0 361984 0 0 0 ANDREW P TORGE CHIEF HUMAN RESOURCES OFFICER 281444 0 33485 0 0 0 1325 0 0 0 316254 0 0 0 HAMED ZAMANI MD PHYSICIAN 257357 0 1566 0 11543 0 11155 0 9363 0 290984 0 0 0 ALLISON CRISP DO MPH PEDIATRICIAN 263568 0 962 0 4742 0 11107 0 9363 0 289742 0 0 0 JENNIFER ANN WILSON MD PHYSICIAN 260057 0 874 0 11980 0 8032 0 4413 0 285356 0 0 0 GARY FEDLER CHIEF INFORMATION OFFICER 240045 0 26985 0 0 0 9268 0 4237 0 280535 0 0 0 LYNETTE LEIGHTON MD PHSYCIAN 255399 0 886 0 7715 0 10577 0 1301 0 275878 0 0 0 MICHELLE MUNOZ MD PHYSICIAN 244446 0 10265 0 9654 0 10164 0 0 0 274529 0 0 0 SONIA TOLBERT CHIEF DEVELOPMENT OFFICER 207803 0 43930 0 0 0 8364 0 1301 0 261398 0 0 0 HEMANTA MUNGUR CFO THROUGH 5/2023 221051 0 8770 0 0 0 0 0 9419 0 239240 0 0 0 FLORA R ASUNCION CA&OO THROUGH 3/2022 173982 0 26459 0 6314 0 5231 0 6254 0 218240 0 0 0 PART I, LINE 7 CERTAIN INDIVIDUALS APPEARING ON FORM 990, PART VII AND/OR SCHEDULE J, PART II RECEIVED A NON-FIXED PAYMENT IN THE FORM OF A BONUS; IN GENERAL, BONUSES FOR THESE INDIVIDUALS ARE NOT SPECIFIED BY A FIXED FORMULA AND REQUIRE THE USE OF DISCRETION (IN PART) TO DETERMINE WHETHER TO MAKE A BONUS PAYMENT AND/OR THE AMOUNT OF BONUS AWARDED. HAMAED ZAMANI MD TOP FIVE HIGHEST COMPENSATED EMPLOYEE PROVIDER RETENTION LOAN X 50000 30000 0 0 1 30000 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 NAPA VALLEY VINTNERS COMMUNITY HEALTH CENTER 1141 PEAR TREE LANE SUITE 100 NAPA CA 94558 680467715 LEASE OF HEALTHCARE FACILITIES TO OLE HEALTH 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 1045033 BOOK VALUE OLE HEALTH NMTC D 29651000 LOAN GUARANTEE AMOUNT OLE HEALTH NMTC K 597017 BOOK VALUE NAPA VALLEY VINTNERS COMMUNITY HEALTH CENTER K 120000 BOOK VALUE