Adventist Health California Medical Foundation in Roseville, California (CA)

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Adventist Health California Medical Foundation
Employer Identification Number (EIN)680357690
Name of OrganizationAdventist Health California Medical Foundation
In Care of NameStanley Adams
Address2100 Douglas Blvd, Roseville, CA 95661
ActivitiesHealth clinic, Other medical research, Group medical practice association
SubsectionCharitable Organization
Ruling Date07/1997
DeductibilityContributions are deductible
FoundationOrganizations operated solely for the benefit of and in conjunction with organizations described in 10 through 16 above
OrganizationCorporation
Exempt Organization StatusUnconditional Exemption
Tax Period2009
Assets$10,000,000 to $49,999,999
Income$50,000,000 to greater
Filing Requirement990 (all other) or 990EZ return
Asset Amount$23,865,927
Amount of Income$53,229,536
Form 990 Revenue Amount$53,229,536
National Taxonomy of Exempt Entities (NTEE)Health - General and Rehabilitative: Ambulatory Health Center, Community Clinic


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Amount of income in 2009: $53,229,536 (it was $53,229,536 in 2013)
This organization: 

 $53,229,536
Other organizations performing similar types of work: 

 $3,354,681

Assets in 2009: $23,865,927 (it was $23,865,927 in 2013)
Adventist Health California Medical Foundation: 

 $23,865,927
Other organizations performing similar types of work: 

 $2,201,764

Expenses in 2013: $53,105,170
This organization: 

 $53,105,170
Other organizations performing similar types of work: 

 $3,381,198

Income to expenses ratio in 2013: 1.0
This organization: 

 1.0
Other organizations performing similar types of work: 

 1.0

Grants share in income in 2013: 0.2%
Adventist Health California Medical Foundation: 

 0.2%
Other organizations performing similar types of work: 

 6.7%

Financial snapshot ($)

Revenue for 2013

Assets at the end of 2013

Functional expenses for 2013

Checklist
2013
Is the organization described in section 501(c)(3) or 4947(a)(1) (other than a private foundation)?Yes
Is the organization required to complete Schedule B, Schedule of Contributors?No
Did the organization engage in direct or indirect political campaign activities on behalf of or in opposition to candidates for public office?No
Did the organization engage in lobbying activities, or have a section 501(h) election in effect during the tax year?No
Is the organization a section 501(c)(4), 501(c)(5), or 501(c)(6) organization that receives membership dues, assessments, or similar amounts as defined in Revenue Procedure 98-19?No
Did the organization maintain any donor advised funds or any similar funds or accounts for which donors have the right to provide advice on the distribution or investment of amounts in such funds or accounts?No
Did the organization receive or hold a conservation easement, including easements to preserve open space, the environment, historic land areas, or historic structures?No
Did the organization maintain collections of works of art, historical treasures, or other similar assets?No
Did the organization report an amount for escrow or custodial account liability; serve as a custodian or provide credit counseling, debt management, credit repair, or debt negotiation services?No
Did the organization, directly or through a related organization, hold assets in temporarily restricted endowments, permanent endowments, or quasi-endowments?No
Did the organization report an amount for land, buildings, and equipment?No
Did the organization report an amount for investments-other securities that is 5% or more of its total assets?No
Did the organization report an amount for investments-program related that is 5% or more of its total assets?No
Did the organization report an amount for other assets that is 5% or more of its total assets?Yes
Did the organization report an amount for other liabilities?Yes
Did the organization's separate or consolidated financial statements for the tax year include a footnote that addresses the organization's liability for uncertain tax positions under FIN 48 (ASC 740)?No
Did the organization obtain separate, independent audited financial statements for the tax year?No
Was the organization included in consolidated, independent audited financial statements for the tax year?Yes
Is the organization a school described in section 170(b)(1)(A)(ii)?No
Did the organization maintain an office, employees, or agents outside of the United States?No
Did the organization have aggregate revenues or expenses of more than $10,000 from grantmaking, fundraising, business, investment, and program service activities outside the United States, or aggregate foreign investments valued at $100,000 or more?No
Did the organization report more than $5,000 of grants or other assistance to or for any foreign organization?No
Did the organization report more than $5,000 of aggregate grants or other assistance to or for foreign individuals?No
Did the organization report a total of more than $15,000 of expenses for professional fundraising services?No
Did the organization report more than $15,000 total of fundraising event gross income and contributions?No
Did the organization report more than $15,000 of gross income from gaming activities?No
Did the organization operate one or more hospital facilities?No
Did the organization attach a copy of its audited financial statements?No
Did the organization report more than $5,000 of grants or other assistance to any domestic organization or domestic government?No
Did the organization report more than $5,000 of grants or other assistance to or for domestic individuals?No
Did the organization answer 'Yes' about compensation of the organization's current and former officers, directors, trustees, key employees, and highest compensated employees?Yes
Did the organization have a tax-exempt bond issue with an outstanding principal amount of more than $100,000 as of the last day of the year, that was issued after December 31, 2002?No
Did the organization invest any proceeds of tax-exempt bonds beyond a temporary period exception?No
Did the organization maintain an escrow account other than a refunding escrow at any time during the year to defease any tax-exempt bonds?No
Did the organization act as an 'on behalf of' issuer for bonds outstanding at any time during the year?No
Did the organization engage in an excess benefit transaction with a disqualified person during the year?No
Is the organization aware that it engaged in an excess benefit transaction with a disqualified person in a prior year, and that the transaction has not been reported on any of the organization's prior Forms 990 or 990-EZ?No
Did the organization report any amount for receivables from or payables to any current or former officers, directors, trustees, key employees, highest compensated employees, or disqualified persons?No
Did the organization provide a grant or other assistance to an officer, director, trustee, key employee, substantial contributor or employee thereof, a grant selection committee member, or to a 35% controlled entity or family member of any of these persons?No
Was the organization a party to a business transaction with one of the following parties
A current or former officer, director, trustee, or key employee?No
A family member of a current or former officer, director, trustee, or key employee?No
An entity of which a current or former officer, director, trustee, or key employee (or a family member thereof) was an officer, director, trustee, or direct or indirect owner?No
Did the organization receive more than $25,000 in non-cash contributions?No
Did the organization receive contributions of art, historical treasures, or other similar assets, or qualified conservation contributions?No
Did the organization liquidate, terminate, or dissolve and cease operations?No
Did the organization sell, exchange, dispose of, or transfer more than 25% of its net assets?No
Did the organization own 100% of an entity disregarded as separate from the organization under Regulations sections 301.7701-2 and 301.7701-3?No
Was the organization related to any tax-exempt or taxable entity?Yes
Did the organization have a controlled entity within the meaning of section 512(b)(13)?No
Did the organization make any transfers to an exempt non-charitable related organization?No
Did the organization conduct more than 5% of its activities through an entity that is not a related organization and that is treated as a partnership for federal income tax purposes?No
Statements Regarding Other IRS Filings and Tax Compliance
20112013
The number reported in Box 3 of Form 10960
The number of Forms W-2G0
Did the organization comply with backup withholding rules for reportable payments to vendors and reportable gaming (gambling) winnings to prize winners?No
The number of employees reported on Form W-3, Transmittal of Wage and Tax Statements, filed for the calendar year ending with or within the year covered by this return0
Did the organization file all required federal employment tax returns?No
Did the organization have unrelated business gross income of $1,000 or more during the year?NoNo
Has it filed a Form 990-T for this year?No
At any time during the calendar year, did the organization have an interest in, or a signature or other authority over, a financial account in a foreign country (such as a bank account, securities account, or other financial account)?No
Was the organization a party to a prohibited tax shelter transaction at any time during the tax year?No
Did any taxable party notify the organization that it was or is a party to a prohibited tax shelter transaction?No
Did the organization file Form 8886-T?No
Does the organization have annual gross receipts that are normally greater than $100,000, and did the organization solicit any contributions that were not tax deductible as charitable contributions?No
Did the organization include with every solicitation an express statement that such contributions or gifts were not tax deductible?No
Did the organization receive a payment in excess of $75 made partly as a contribution and partly for goods and services provided to the payor?No
Did the organization notify the donor of the value of the goods or services provided?No
Did the organization sell, exchange, or otherwise dispose of tangible personal property for which it was required to file Form 8282?No
Did the organization receive any funds, directly or indirectly, to pay premiums on a personal benefit contract?No
Did the organization, during the year, pay premiums, directly or indirectly, on a personal benefit contract?No
If the organization received a contribution of qualified intellectual property, did the organization file Form 8899 as required?No
If the organization received a contribution of cars, boats, airplanes, or other vehicles, did the organization file a Form 1098-C?No
Did a donor advised fund maintained by the sponsoring organization have excess business holdings at any time during the year?No
Did the sponsoring organization make any taxable distributions under section 4966?No
Did the sponsoring organization make a distribution to a donor, donor advisor, or related person?No
Initiation fees and capital contributions$0$0
Gross receipts for public use of club facilities $0$0
Gross income from members or shareholders$0$0
Gross income from other sources$0$0
Is the organization filing Form 990 in lieu of Form 1041?No
The amount of tax-exempt interest received or accrued during the year$0
Is the organization licensed to issue qualified health plans in more than one state?No
The amount of reserves the organization is required to maintain by the states in which the organization is licensed to issue qualified health plans$0
The amount of reserves on hand$0
Did the organization receive any payments for indoor tanning services during the tax year?No
Has it filed a Form 720 to report these payments?No
Compensation of Officers, Directors, Trustees, Key Employees, Highest Compensated Employees, and Independent Contractors
2013
Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees
Total reportable compensation from the organization$240,000
Total reportable compensation from related organizations$6,780,141
Total estimated amount of other compensation from the organization and related organizations$1,096,750
Total number of individuals who received more than $100,000 of reportable compensation from the organization1
Total number of independent contractors who received more than $100,000 of compensation from the organization0
Statement of Revenue
20112013
Total revenue$26,194,118$53,229,536
Contributions, Gifts, Grants and Other Similar Amounts$0$127,200
Program Service Revenue$16,504,204$31,865,662
621110$31,784,474
Lessors of Nonresidential Buildings (except Miniwarehouses) $81,188
All other program service revenue$0
Other Revenue
Investment income (including dividends, interest, and other similar amounts)$30,682$177,773
Income from investment of tax-exempt bond proceeds$0$0
Royalties$0$0
Net rental income$0$0
Net gain/loss from sales of assets other than inventory$0$0
Net income/loss from fundraising events$0$0
Net income/loss from gaming activities$0$0
Net income/loss from sales of inventory$0$0
Miscellaneous Revenue$9,659,232$21,058,901
900099$18,176,115
900099$2,882,786
All other revenue$0
Statement of Functional Expenses
20112013
Total functional expenses$26,164,094$53,105,170
Grants and other assistance to domestic organizations and domestic governments$0
Grants and other assistance to domestic individuals$0
Grants and other assistance to foreign organizations, foreign governments, and foreign individuals$0
Benefits paid to or for members$0
Compensation of current officers, directors, trustees, and key employees$0$258,779
Compensation not included above, to disqualified persons$0
Other salaries and wages$5,457,844$10,969,167
Pension plan accruals and contributions$136,770
Other employee benefits$2,385,023
Payroll taxes$405,480$855,864
Fees for services (non-employees)
Management$0
Legal$291,243
Accounting$0
Lobbying$0
Professional fundraising services$0$0
Investment management fees$0
Other$24,921,124
Advertising and promotion$8,156
Office expenses$892,936
Information technology$393,692
Royalties$0
Occupancy$4,816,925
Travel$61,530
Payments of travel or entertainment expenses for any federal, state, or local public officials$0
Conferences, conventions, and meetings$10,691
Interest$0
Payments to affiliates$0
Depreciation, depletion, and amortization$1,002,993
Insurance$56,845
Other expenses$3,103,108
Other expenses$2,284,965
Other expenses$491,442
Other expenses$163,917
Balance Sheet
20112013
Total assets$4,837,533$23,865,927
Cash - non-interest-bearing$844,290
Savings and temporary cash investments$3,732,894
Pledges and grants receivable, net$0
Accounts receivable, net$6,369,527
Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees$0
Loans and other receivables from other disqualified persons, persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations$0
Notes and loans receivable, net$0
Inventories for sale or use$0
Prepaid expenses and deferred charges$141,777
Land, buildings, and equipment: cost or other basis$0
Investments - publicly traded securities$0
Investments - other securities$0
Investments - program-related$0
Intangible assets$0
Other assets$12,777,439
Total liabilities$4,582,424$23,342,197
Accounts payable and accrued expenses$1,396,239
Grants payable$0
Deferred revenue$4,886,675
Tax-exempt bond liabilities$0$0
Escrow or custodial account liability$0
Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified persons$0
Secured mortgages and notes payable to unrelated third parties$0$0
Unsecured notes and loans payable to unrelated third parties$0$0
Other liabilities (including federal income tax, payables to related third parties, and other liabilities)$17,059,283
Total net assets or fund balances$255,109$523,730
Unrestricted net assets$523,730
Temporarily restricted net assets$0
Permanently restricted net assets$0
Capital stock or trust principal, or current funds$0
Paid-in or capital surplus, or land, building, or equipment fund$0
Retained earnings, endowment, accumulated income, or other funds$0$0
Reason for Public Charity Status (for 2013)
The organization is not a private foundation because it is:An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2)
Number of organizations supported9
Sum of amounts of support$0
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Organizations performing similar types of work
IdNameAddressStateEstablishedTotal Income
1John Muir Physician Network1400 Treat Blvd, Walnut Creek, CA 94597-2142CA1998-02$234,283,517
2Centro De Salud La Comunidad De San Ysidro Inc1275 30th St 2nd Fl, San Diego, CA 92154-3476CA1973-09$87,355,817
3Adventist Health California Medical Foundation2100 Douglas Blvd, Roseville, CA 95661CA1997-07$53,229,536
4Santa Rosa Community Health Centers3569 Round Barn Circle, Santa Rosa, CA 95403-5781CA1996-02$43,330,468
5Shasta Community Health Center1035 Placer St, Redding, CA 96001-1125CA1992-10$35,761,700
6South Central Family Health Center4425 S Central Ave, Los Angeles, CA 90011-3629CA1984-03$14,518,204
7Valley Community Healthcare6801 Coldwater Cyn Ave Ste 1b, North Hollywood, CA 91605-5164CA1970-05$14,051,348
8San Jose Foothill Family Community Clinic Inc2670 S White Rd Ste 200, San Jose, CA 95148-2073CA1997-04$12,420,388
9Siskiyou Family HealthcarePO BOX 1608, Yreka, CA 96097CA1991-11$1,025,057
10Westside Neighborhood Clinic2125 Santa Fe Ave, Long Beach, CA 90810-3547CA1976-05$584,670
11Sutter Roseville Auxiliary1 Medical Plaza Dr, Roseville, CA 95661-3037CA1972-04$339,724
12American Civil Rights Defense Foundation1095 N Main St Ste C, Orange, CA 92867-5459CA1995-05$0
13Clinica Del Valle Del Pajaro45 Neilson St, Watsonville, CA 95076-2468CA1995-09$0
14Happy Camp Health Services IncPo Box 1065, Happy Camp, CA 96039CA1975-12$0
15Harbor Community Health Center10722 S Broadway, Los Angeles, CA 90061-2018CA1996-05$0
16Health And Environment International1151 Lisa Ln, Los Altos, CA 94024-6038CA1995-09$0
17International Health Medical Group Inc2500 Wilshire Blvd Ste 108, Los Angeles, CA 90057-4319CA1998-03$0
18Metabolic Clinic Whittier Inst For Diabetes & Endocinology4275 Campus Point Ct Cp 111, San Diego, CA 92121-1513CA1989-01$0
19Prescription For Healing Medical Practice Inc1760 Termino Ave Ste 307, Long Beach, CA 90804-2157CA1995-09$0
20Rural Community Health CentersPO BOX 580, Lemoore, CA 93245-0580CA1996-05$0
Number of organizations performing similar types of work
Alaska1
Alabama5
Arkansas6
Arizona3
California44
Colorado9
Connecticut3
District of Columbia2
Florida28
Georgia12
Hawaii2
Iowa5
Idaho3
Illinois15
Indiana13
Kansas5
Kentucky3
Louisiana7
Massachusetts10
Maryland13
Maine6
Michigan7
Minnesota6
Missouri5
Mississippi7
Montana4
North Carolina14
North Dakota1
Nebraska4
New Hampshire2
New Jersey10
New Mexico6
New York24
Ohio24
Oklahoma7
Oregon6
Pennsylvania14
South Carolina6
South Dakota2
Tennessee11
Texas29
Utah3
Virginia21
Vermont6
Washington5
Wisconsin4
West Virginia7
International4
Total434

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