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← CENTRAL CALIFORNIA HEALTH CENTERS

Form 990 for tax year 2022

Filed by CENTRAL CALIFORNIA HEALTH CENTERS.

Totals

Total revenue
$0
Total expenses
$1,965
Contributions and grants received
$0
Grants paid
$0
Program service revenue
$0
Investment income
$0
Other revenue
$0
Total assets, end of year
$0
Total liabilities, end of year
$3,262,749
Net assets or fund balances, end of year
-$3,262,749
Program services expenses (Part IX)
$0
Management and general expenses
$1,965
Fundraising expenses
$0
Program service expenses (Part III)
not reported

Program services were 0.0% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Listed in Part VII

  • JON VAN BOENING

    FORMER OFFICER (PRESIDENT/CEO)

    Total calculated
    $1,550,352
    From this org
    $0
    From related orgs
    $1,145,156
    Other
    $405,196
    Hours/week
    0 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $553,349 related
    Bonus
    $0 + $387,113 related
    Other
    $0 + $204,694 related
    Deferred
    $0 + $385,192 related
    Nontaxable benefits
    $0 + $20,005 related
    Filer's total
    $0 + $1,550,353 related

  • DAVID YEAGER

    DIVISION CFO, SOCAL

    Total calculated
    $642,820
    From this org
    $0
    From related orgs
    $581,090
    Other
    $61,730
    Hours/week
    1 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $491,313 related
    Bonus
    $0 + $89,777 related
    Other
    $0
    Deferred
    $0 + $39,132 related
    Nontaxable benefits
    $0 + $22,598 related
    Filer's total
    $0 + $642,820 related

  • SCOTT ROBERTSON MD

    PRESIDENT/CEO

    Total calculated
    $629,950
    From this org
    $0
    From related orgs
    $571,479
    Other
    $58,471
    Hours/week
    0.1 + 50 related

    Schedule J breakdown matched by us

    Base
    $0 + $486,822 related
    Bonus
    $0 + $81,812 related
    Other
    $0 + $2,845 related
    Deferred
    $0 + $29,648 related
    Nontaxable benefits
    $0 + $28,823 related
    Filer's total
    $0 + $629,950 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, and on a Form 990-PF Part VIII's — 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

  • 4b · Supplemental nonqualified retirement plan

Answered no

  • 4a · Severance or change-of-control payment
  • 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 ORGANIZATION RELIED ON A RELATED ORGANIZATION, COMMONSPIRIT, THAT USED ONE OR MORE OF THE METHODS DESCRIBED IN SCHEDULE J, PART I, LINE 3, TO ESTABLISH THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL'S COMPENSATION: (1) HUMAN RESOURCES AND COMPENSATION COMMITTEE OF THE COMMONSPIRIT BOARD OF STEWARDSHIP TRUSTEES ("BOARD"); (2) INDEPENDENT COMPENSATION CONSULTANT; (3) COMPENSATION SURVEY OR STUDY; AND (4) APPROVAL BY THE BOARD OR HUMAN RESOURCES AND COMPENSATION COMMITTEE. SEE SCHEDULE O DISCLOSURE FOR FORM 990, PART VI, SECTION B, LINE 15 FOR ADDITIONAL INFORMATION. PART I, LINE 4A: CERTAIN LISTED PERSONS ARE COVERED BY AN EXECUTIVE SEVERANCE POLICY THAT PROVIDES MARKET-STANDARD COMPENSATION, RANGING FROM PAYMENTS OF 9 TO 24 MONTHS OF BASE COMPENSATION, DEPENDING ON THE EXECUTIVE'S POSITION, IN THE EVENT OF A POSITION ELIMINATION OR OTHER INVOLUNTARY TERMINATION, IN ACCORDANCE WITH THE GUIDELINES OF THE POLICY. NO PAYMENTS WERE MADE DURING 2022 PURSUANT TO THIS PLAN.
PART I, LINE 4B
CERTAIN LISTED PERSONS PARTICIPATE IN THE DIGNITY HEALTH EXCESS BENEFIT PLAN, A NONQUALIFIED SUPPLEMENTAL BENEFIT PLAN LIMITED TO PARTICIPANTS IN THE DIGNITY HEALTH RETIREMENT PLAN WHOSE BENEFITS ARE AFFECTED BY THE LIMITATIONS IMPOSED BY SECTIONS 401(A)(17) AND 415 OF THE INTERNAL REVENUE CODE. BENEFIT SERVICE UNDER THIS PLAN WAS FROZEN AS OF JANUARY 1, 2008. NO PAYMENTS WERE MADE TO ANY LISTED PERSONS DURING 2022 PURSUANT TO THIS PLAN. CERTAIN LISTED PERSONS ARE ELIGIBLE TO PARTICIPATE IN NONQUALIFIED 457(F) PLANS THAT ARE SUBJECT TO SUBSTANTIAL RISK OF FORFEITURE, AS REQUIRED BY THE IRS. THE 2007 EXECUTIVE DEFERRED COMPENSATION PLAN IS FOR EXECUTIVES HIRED PRIOR TO JUNE 30, 2006. THE BENEFIT IS INTENDED TO BRIDGE THE DIFFERENCE, IF ANY, BETWEEN THE BENEFIT PROVIDED UNDER THE DIGNITY HEALTH EXCESS BENEFIT PLAN HAD BENEFIT SERVICE NOT BEEN FROZEN AT JANUARY 1, 2008, AND THE BENEFITS PROVIDED FROM ALL OTHER QUALIFIED AND NONQUALIFIED PLANS. BENEFITS VEST UNDER THIS 457(F) PLAN AT THE LATER OF THE DATE THE PARTICIPANT ATTAINS AGE 62 OR IS CREDITED WITH 15 YEARS OF SERVICE. THE 2010 EXECUTIVE DEFERRED COMPENSATION PLAN IS FOR CERTAIN OFFICERS AND KEY EMPLOYEES, PRIMARILY THOSE WHO ARE NOT ELIGIBLE TO PARTICIPATE IN THE DIGNITY HEALTH EXCESS BENEFIT PLAN OR THE 2007 EXECUTIVE DEFERRED COMPENSATION PLAN DESCRIBED ABOVE. THIS BENEFIT PROVIDES AN ANNUAL ACCRUAL OF 10% OF TOTAL COMPENSATION AND IS PAYABLE ANNUALLY ON JULY 1 ONCE VESTED, WHICH IS AGE 62 WITH 5 YEARS OF SERVICE; THE PLAN ALSO ALLOWS FOR SPECIAL AWARDS. A PAYMENT WAS MADE DURING 2022 TO J. VAN BOENING, $186,694. COMPENSATION AMOUNTS FOR THE SUPPLEMENTAL NONQUALIFIED RETIREMENT PLANS DISCUSSED ABOVE ARE REPORTED AS DEFERRED COMPENSATION IN THE YEAR ACCRUED (SCHEDULE J, PART II, COLUMN C) AND ARE REFLECTED AGAIN AS OTHER REPORTABLE COMPENSATION IN THE YEAR PAID (SCHEDULE J, PART II, COLUMN B(III)).
SCHEDULE J, PART II - SUPPLEMENTAL DISCLOSURES
THE ORGANIZATION FOLLOWS COMMONSPIRIT'S EXECUTIVE COMPENSATION PHILOSOPHY. COMMONSPIRIT'S EXECUTIVE COMPENSATION PHILOSOPHY IS DESIGNED TO ASSIST THE ORGANIZATION IN ATTRACTING AND RETAINING THE CALIBER OF EXECUTIVES REQUIRED TO ENABLE THE ORGANIZATION TO FULFILL ITS MISSION OF PROVIDING HIGH QUALITY HEALTH CARE FOR ALL PERSONS REGARDLESS OF THEIR ABILITY TO PAY FOR SERVICES, IMPROVING THE QUALITY OF LIFE IN THE COMMUNITIES THE ORGANIZATION SERVES, PROMOTING EMPLOYEE SATISFACTION, AND ENSURING FINANCIAL STABILITY. A SUBSTANTIAL PORTION OF EXECUTIVE COMPENSATION IS PERFORMANCE BASED AND IS LINKED TO ORGANIZATIONAL GOALS APPROVED IN ADVANCE BY THE HUMAN RESOURCES AND COMPENSATION COMMITTEE. THESE GOALS INCLUDE ATTAINMENT OF ANNUAL AND LONG-TERM FINANCIAL PERFORMANCE, CERTAIN HEALTHCARE QUALITY STANDARDS AND ITS COMMITMENT TO SERVING THE POOR AND DISENFRANCHISED IN THE COMMUNITIES IT SERVES. TOTAL COMPENSATION, WHICH INCLUDES BASE SALARY, ANNUAL AND LONGTERM INCENTIVE COMPENSATION, IS ESTABLISHED TO APPROXIMATE THE PREVAILING MARKET CONDITIONS FOR EXECUTIVES OF COMPANIES OF SIMILAR SIZE, REVENUES AND COMPLEXITY. PAYMENTS PURSUANT TO A LONG-TERM FINANCIAL PERFORMANCE GOAL WERE PAID IN CALENDAR YEAR 2022.

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.

Taxable family on this return

Schedule R Parts I, III and IV, as filed. These record ownership and control, not shared board members or money moved.

Related partnerships

Part III: related organizations taxable as a partnership, with the filer's share.

Related corporations and trusts

Part IV: related organizations taxable as a corporation or trust.

Provenance

Return type
form_990
Tax year
2022
Filed
2 May 2024
IRS schema version
2022v5.0
Source object
202411239349300301

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