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Nonprofiteer
← H STREET CLINIC INC

Form 990 for tax year 2022

Filed by H STREET CLINIC INC.

Totals

Total revenue
$5,638,728
Total expenses
$5,231,847
Contributions and grants received
$1,479,693
Grants paid
$0
Program service revenue
$4,159,035
Investment income
$0
Other revenue
$0
Total assets, end of year
$2,547,027
Total liabilities, end of year
$3,888,761
Net assets or fund balances, end of year
-$1,341,734
Program services expenses (Part IX)
$5,184,550
Management and general expenses
$47,297
Fundraising expenses
$0
Program service expenses (Part III)
$5,184,550

Program services were 99.1% of total expenses calculated — Part IX's program-services column over total expenses, both as filed.

Line items

Every line the filer filed in Parts VIII, IX and X, as filed and in filed order. Blank columns are left out, and the lines are not forced to add up to the totals above.

Revenue

Part VIII, the statement of revenue.

  • 1f · All other contributions, gifts and grants

    $1,479,693

  • 2a · Program service revenue: PATIENT REVENUE, NET

    total $2,290,865 · related or exempt $2,290,865

  • 2b · Program service revenue: CAPITATION

    total $1,216,388 · related or exempt $1,216,388

  • 2c · Program service revenue: INCENTIVES

    total $651,782 · related or exempt $651,782

Functional expenses

Part IX, the statement of functional expenses.

  • 7 · Other salaries and wages

    total $2,758,180 · program services $2,731,999 · management and general $26,181

  • 9 · Other employee benefits

    total $212,591 · program services $210,714 · management and general $1,877

  • 10 · Payroll taxes

    total $208,881 · program services $206,898 · management and general $1,983

  • 11g · Fees: other

    total $349,139 · program services $349,139

  • 13 · Office expenses

    total $194,713 · program services $184,213 · management and general $10,500

  • 16 · Occupancy

    total $785,981 · program services $785,981

  • 17 · Travel

    total $46,930 · program services $46,930

  • 19 · Conferences, conventions and meetings

    total $100 · program services $100

  • 20 · Interest

    total $6,756 · management and general $6,756

  • 22 · Depreciation, depletion and amortization

    total $111,097 · program services $111,097

  • 23 · Insurance

    total $52,213 · program services $52,213

  • 24a · Other expenses: MEDICAL COSTS

    total $443,507 · program services $443,507

  • 24b · Other expenses: EDUCATION & AWARENESS

    total $36,114 · program services $36,114

  • 24c · Other expenses: BUSINESS TAXES & LICENS

    total $13,517 · program services $13,517

  • 24d · Other expenses: DUES & SUBSCRIPTIONS

    total $12,128 · program services $12,128

Balance sheet

Part X, book values.

  • 1 · Cash, non-interest-bearing

    beginning of year $120,914 · end of year $109,640

  • 2 · Savings and temporary cash investments

    beginning of year $7,188 · end of year $6,903

  • 4 · Accounts receivable

    beginning of year $642,932 · end of year $1,176,921

  • 9 · Prepaid expenses and deferred charges

    beginning of year $5,000 · end of year $4,996

  • 10a · Land, buildings and equipment: cost or other basis

    $438,036

  • 10b · Land, buildings and equipment: accumulated depreciation

    $169,060

  • 10c · Land, buildings and equipment, net

    beginning of year $207,182 · end of year $268,976

  • 15 · Other assets

    beginning of year $20,588 · end of year $979,591

  • 17 · Accounts payable and accrued expenses

    beginning of year $377,620 · end of year $221,707

  • 25 · Other liabilities

    beginning of year $2,374,799 · end of year $3,667,054

  • 27 · Net assets without donor restrictions

    beginning of year -$1,748,615 · end of year -$1,341,734

Mission and programs · 2022

Mission

THE ROLE AND MISSION OF H STREET CLINIC, INC. ("CORPORATION") IS TO PROVIDE:A. HIGH-QUALITY, COST-EFFECTIVE, ACCESSIBLE AND EFFICIENT HEALTH CARE SERVICES TO LOCAL AND SURROUNDING MEDICALLY UNDERSERVED POPULATIONS;B. A MEDICAL STAFF AND PERSONNEL CONSISTING OF CULTURALLY SENSITIVE AND MULTI-LINGUAL INDIVIDUALS FOR COMPREHENSIVE PATIENT COMMUNICATION;C. A SETTING WHICH UTILIZES ADVANCED FACILITIES AND MEDICAL TECHNOLOGIES IN PROVIDING OPTIMUM CARE; ANDD. AN ENVIRONMENT WHICH ASPIRES TO ACHIEVE SIGNIFICANT, MEASURABLE IMPROVEMENTS IN THE MORBIDITY AND MORTALITY STATISTICS OF ITS PATIENT POPULATION BY MEANS OF PREVENTIVE CARE SERVICES AND APPROPRIATE HEALTH INTERVENTIONS.

Activities or mission (Part I)

H STREET'S MISSION IS TO ADDRESS THE UNMET HEALTHCARE NEEDS OF UNDERSERVED AND HOMELESS POPULATIONS IN SAN BERNARDINO AND RIVERSIDE COUNTIES THROUGH THE PROVISION OF AFFORDABLE, CULTURALLY APPROPRIATE, HIGH-QUALITY, ANDACCESSIBLE HEALTH CARE SERVICES.

  • THE CLINIC PROVIDED A FULL RANGE OF SERVICES WHICH INCLUDE MEDICAL, DENTAL, VISION, MENTAL HEALTH, WOMEN'S HEALTH, OBSTETRICS AND GYNECOLOGY SERVICES, NUTRITION, HEALTH EDUCATION, SOCIAL SUPPORT, PHARMACY, LABORATORY, AND X-RAY SERVICES. THE CLINIC ADDRESSED THE UNMET HEALTHCARE NEEDS OF UNDERSERVED AND HOMELESS POPULATIONS IN SAN BERNARDINO AND RIVERSIDE COUNTIES AND SERVED APPROXIMATELY 7,211 PATIENTS DURING THE FISCAL YEAR.

    Expenses $5,184,550 · Revenue $4,159,035

As filed on the 2022 return. The filer continues this part on Schedule O, which is not shown here.

Listed in Part VII

  • CRYSTAL LAUTRUP

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    2 + 1 related

  • JAMES MACKEY

    BOARD CHAIR

    Total calculated
    $0
    Hours/week
    2 + 1 related

  • RICHARD MAYER

    BOARD TREASURER

    Total calculated
    $0
    Hours/week
    2 + 1 related

  • WANDA THOMPSON

    BOARD SECRETARY

    Total calculated
    $0
    Hours/week
    2 + 1 related

  • MARY WINNERS

    BOARD VICE CHAIR

    Total calculated
    $0
    Hours/week
    2 + 1 related

  • KAYRETHA HALE WILLIS

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    2 + 1 related

  • VICTOR GARCIA

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    2 + 1 related

  • OSCAR LOPEZ

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    2 + 1 related

  • FRANK YBARRA

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    2 + 1 related

  • NANCY OCHOA

    BOARD MEMBER

    Total calculated
    $0
    Hours/week
    2 + 1 related

  • KENNETH M ORDUNA

    CHIEF EXECUTIVE OFFICER

    Total calculated
    $469,505
    From this org
    $0
    From related orgs
    $468,578
    Other
    $927
    Hours/week
    2 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $340,502 related
    Bonus
    $0 + $128,076 related
    Other
    $0
    Deferred
    $0
    Nontaxable benefits
    $0 + $927 related
    Filer's total
    $0 + $469,505 related

  • CHUDWUKA CHIDI A

    CHIEF FINANCIAL OFFICER

    Total calculated
    $284,222
    From this org
    $0
    From related orgs
    $284,222
    Other
    $0
    Hours/week
    2 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $224,940 related
    Bonus
    $0 + $59,282 related
    Other
    $0
    Deferred
    $0
    Nontaxable benefits
    $0
    Filer's total
    $0 + $284,222 related

  • ABDOULAYE DIOP

    CHIEF MEDICAL OFFICER

    Total calculated
    $363,487
    From this org
    $0
    From related orgs
    $363,381
    Other
    $106
    Hours/week
    2 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $305,881 related
    Bonus
    $0 + $57,500 related
    Other
    $0
    Deferred
    $0
    Nontaxable benefits
    $0 + $106 related
    Filer's total
    $0 + $363,487 related

  • ELEANOR PEREZ

    CHIEF OPERATING OFFICER

    Total calculated
    $244,164
    From this org
    $0
    From related orgs
    $236,971
    Other
    $7,193
    Hours/week
    2 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $235,971 related
    Bonus
    $0 + $1,000 related
    Other
    $0
    Deferred
    $0
    Nontaxable benefits
    $0 + $7,193 related
    Filer's total
    $0 + $244,164 related

  • FAREEHA ASIF SIAL

    PHYSICIAN ASSISTANT

    Total calculated
    $132,584
    From this org
    $129,525
    From related orgs
    $0
    Other
    $3,059
    Hours/week
    40

  • MARIA MEDINA

    CONTROLLER

    Total calculated
    $205,122
    From this org
    $0
    From related orgs
    $203,529
    Other
    $1,593
    Hours/week
    2 + 40 related

    Schedule J breakdown matched by us

    Base
    $0 + $132,937 related
    Bonus
    $0 + $70,592 related
    Other
    $0
    Deferred
    $0
    Nontaxable benefits
    $0 + $1,593 related
    Filer's total
    $0 + $205,122 related

  • SEJAD ZAID AL-TAHAN

    INTERNIST PHYSICIAN

    Total calculated
    $279,621
    From this org
    $275,500
    From related orgs
    $0
    Other
    $4,121
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $275,000
    Bonus
    $500
    Other
    $0
    Deferred
    $0
    Nontaxable benefits
    $4,121
    Filer's total
    $279,621

  • VANESSA CHARMEIN OLTON

    FAMILY PRACTICE PHYSICIAN

    Total calculated
    $250,876
    From this org
    $245,940
    From related orgs
    $0
    Other
    $4,936
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $245,440
    Bonus
    $500
    Other
    $0
    Deferred
    $0
    Nontaxable benefits
    $4,936
    Filer's total
    $250,876

  • LUCIAN OPREA

    INTERNIST PHYSICIAN

    Total calculated
    $224,128
    From this org
    $220,500
    From related orgs
    $0
    Other
    $3,628
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $220,000
    Bonus
    $500
    Other
    $0
    Deferred
    $0
    Nontaxable benefits
    $3,628
    Filer's total
    $224,128

  • RAVISHANKAR NEHRU KOPPADA

    PHYSICIAN PEDIATRICS

    Total calculated
    $178,020
    From this org
    $178,000
    From related orgs
    $0
    Other
    $20
    Hours/week
    40

    Schedule J breakdown matched by us

    Base
    $172,500
    Bonus
    $5,500
    Other
    $0
    Deferred
    $0
    Nontaxable benefits
    $20
    Filer's total
    $178,020

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

None.

Answered no

  • 4a · Severance or change-of-control payment
  • 4b · Supplemental nonqualified retirement plan
  • 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
EXECUTIVE COMPENSATION, INCLUDING PERFORMANCE BASED COMPENSATION, IS REVIEWED AND DETERMINED BY THE RELATED ORGANIZATION'S EXECUTIVE COMMITTEE OF THE BOARD, OR THE COMPENSATION SUBCOMMITTEE IN THE CASE OF THE CEO'S COMPENSATION. THE APPLICABLE COMMITTEE USED COMPARABILITY DATA OBTAINED FROM THE CALIFORNIA PRIMARY CARE ASSOCIATION WHICH IS PREPARED BY AN INDEPENDENT THIRD PARTY. THE DATA REPRESENTS WHAT 125 SIMILARLY SITUATED ORGANIZATIONS BASED ON LOCATION, BUDGET AND SIZE, PAY EXECUTIVES FOR FUNCTIONALLY COMPARABLE POSITIONS. THE APPLICABLE COMMITTEE COLLECTS THE COMPARABLE COMPENSATION DATA, DEBATES THE ISSUE, AND USES IT TOGETHER WITH THE ORGANIZATIONS STRATEGY AND THE EXECUTIVES QUALIFICATIONS TO MAKE COMPENSATION RECOMMENDATIONS TO THE FULL BOARD OF DIRECTORS FOR APPROVAL BY VOTING. THE FINDINGS OF THE APPLICABLE COMMITTEE, TOGETHER WITH THE RELATED ORGANIZATION'S BOARD'S CONSIDERATION AND APPROVAL AND RECORDED IN THE RELATED ORGANIZATION'S MEETING MINUTES. THIS PROCESS IS REPEATED ANNUALLY FOR THE PURPOSE OF MAKING ADJUSTMENTS TO COMPENSATION OR THE AWARD OF PERFORMANCE BASED COMPENSATION.

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.

Provenance

Return type
form_990
Tax year
2022
Filed
9 May 2024
IRS schema version
2022v5.0
Source object
202441319349304334

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