Totals
- Total revenue
- $9,410,092
- Total expenses
- $4,559,503
- Contributions and grants received
- $0
- Grants paid
- $0
- Program services expenses (Part IX)
- $1,621,433
- Management and general expenses
- $2,938,070
- Fundraising expenses
- $0
- Program service expenses (Part III)
- $1,621,433
Program services were 35.6% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.
Listed in Part VII
-
BEVERLY DORSETT
CHAIR
- Total calculated
- $0
- Hours/week
- 1
-
DEBORAH SUGIYAMA
SECRETARY-TREASURER
- Total calculated
- $16,718
- From this org
- $0
- From related orgs
- $16,718
- Other
- $0
- Hours/week
- 1
-
GARY FALATI
DIRECTOR
- Total calculated
- $9,032
- From this org
- $0
- From related orgs
- $9,032
- Other
- $0
- Hours/week
- 1 + 1 related
-
B KONARD JONES
DIRECTOR / NBHC CEO
- Total calculated
- $1,663,586
- From this org
- $0
- From related orgs
- $1,241,415
- Other
- $422,171
- Hours/week
- 5 + 45 related
Schedule J breakdown matched by us
- Base
- $0 + $955,902 related
- Bonus
- $0
- Other
- $0 + $285,513 related
- Deferred
- $0 + $380,198 related
- Nontaxable benefits
- $0 + $41,973 related
- Filer's total
- $0 + $1,663,586 related
-
HERKANWAL KHAIRA MD
DIRECTOR
- Total calculated
- $25,221
- From this org
- $0
- From related orgs
- $25,221
- Other
- $0
- Hours/week
- 1
-
CLAYBORN LEA JR PHD
DIRECTOR
- Total calculated
- $0
- Hours/week
- 1
-
SANDY PERSON
DIRECTOR
- Total calculated
- $16,636
- From this org
- $0
- From related orgs
- $16,636
- Other
- $0
- Hours/week
- 1 + 1 related
-
SEAN QUINN
DIRECTOR
- Total calculated
- $0
- Hours/week
- 1
-
SCOTT DAVIS
PRES NBHA / VP, CSO THRU 8/2022
- Total calculated
- $898,232
- From this org
- $0
- From related orgs
- $803,881
- Other
- $94,351
- Hours/week
- 40 + 10 related
Schedule J breakdown matched by us
- Base
- $0 + $286,192 related
- Bonus
- $0
- Other
- $0 + $517,689 related
- Deferred
- $0 + $50,656 related
- Nontaxable benefits
- $0 + $43,695 related
- Filer's total
- $0 + $898,232 related
-
MICHELE BOUIT
VP, FINANCE & CFO THRU 11/2022
- Total calculated
- $603,188
- From this org
- $0
- From related orgs
- $519,394
- Other
- $83,794
- Hours/week
- 5 + 45 related
Schedule J breakdown matched by us
- Base
- $0 + $451,818 related
- Bonus
- $0
- Other
- $0 + $67,576 related
- Deferred
- $0 + $66,506 related
- Nontaxable benefits
- $0 + $17,288 related
- Filer's total
- $0 + $603,188 related
-
TIMOTHY MAURICE
INT VP, FINANCE & CFO START 11/2022
- Total calculated
- $145,396
- From this org
- $0
- From related orgs
- $145,386
- Other
- $10
- Hours/week
- 5 + 45 related
Compensation is as filed in Part VII: reportable pay from this organization and from related organizations, other compensation, and hours per week. The total, marked calculated, is our sum of the three dollar columns, with a blank column counted as $0; the form itself has no total. On a Form 990-EZ the columns are Part IV's instead — compensation, contributions to benefit plans, and expense account — and the total sums those. A Schedule J breakdown is as filed: base pay, bonus, other, deferred compensation and nontaxable benefits from this organization, with any from related organizations beside each, and the filer's own total. It is shown with the Part VII listing of the same name on the same return. The form gives no key between the two, so that pairing is ours, and is marked matched by us.
Schedule J
Answered yes
- 4a · Severance or change-of-control payment
- 4b · Supplemental nonqualified retirement plan
Answered no
- 4c · Equity-based compensation arrangement
- 5a · Pay contingent on this organization's revenues
- 5b · Pay contingent on a related organization's revenues
- 6a · Pay contingent on this organization's net earnings
- 6b · Pay contingent on a related organization's net earnings
- 7 · Other non-fixed payments
- 8 · Paid under the initial-contract exception
The filer's explanations (Part III)
- PART I, LINE 3
- THE PRESIDENT OF NORTHBAY HEALTH ADVANTAGE IS A PAID EMPLOYEE OF NORTHBAY HEALTHCARE CORPORATION, A RELATED ORGANIZATION. NORTHBAY HEALTHCARE CORPORATION UTILIZES THE FOLLOWING METHODS TO DETERMINE THE COMPENSATION OF THE PRESIDENT: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE.
- PART I, LINES 4A-B
- DURING THE 2022 CALENDAR YEAR, SCOTT DAVIS RECEIVED A $433,000 SEVERANCE PAYMENT FROM A RELATED ORGANIZATION. THIS PAYMENT WAS TAXABLE COMPENSATION TO MR. DAVIS AND REPORTED WITHIN SCHEDULE J, PART II, COLUMN (B)(III). THE FOLLOWING INDIVIDUALS PARTICIPATED IN A RELATED ORGANIZATION'S SUPPLEMENTAL 457(F) RETIREMENT PLAN. EMPLOYER CONTRIBUTIONS TO THE PLAN DURING THE 2022 CALENDAR YEAR ARE AS FOLLOWS, WHICH HAS BEEN REPORTED AS "RETIREMENT AND OTHER DEFERRED COMPENSATION" FROM A RELATED ORGANIZATION ON SCHEDULE J, PART II, COLUMN (C): B. KONARD JONES - $ 367,998 SCOTT DAVIS - $41,991 MICHELE BOUIT - $ 60,406
Part I's answers as filed. A line not listed was left unanswered; on lines 1a and 3 that means the box was not checked.
Grants on this return
No itemized grants to organizations on this return.
Related organizations on this return
Schedule R Part II: tax-exempt organizations related to the filer by control. It does not record shared board members or money.
-
NORTHBAY HEALTHCARE CORPORATION
501(C)(3) · TO SUPPORT THE OPERATION OF NORTHBAY HEALTHCARE GROUP & AFFILIATES · CA
-
501(C)(3) · OPERATES TWO NONPROFIT HOSPITALS · CA
Directly controlled by NORTHBAY HEALTHCARE CORPORATION
-
NORTHBAY HEALTHCARE FOUNDATION
501(C)(3) · PROVIDES FUNDRAISING FOR NORTHBAY HEALTHCARE GROUP & AFFILIATES · CA
Directly controlled by NORTHBAY HEALTHCARE CORPORATION
Provenance
- Return type
- form_990
- Tax year
- 2022
- Filed
- 14 November 2023
- IRS schema version
- 2022v5.0
- Source object
- 202303189349308730
Check it against the return as filed: the GivingTuesday Data Lake hosts a public copy of the original XML.
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