2024-05-08T10:25:11-07:00 2023-06-30 472251777 CHW LLP 7797 N First Street Suite 15 Fresno CA 93720 990 2022-07-01 942476242 INDIAN HEALTH CENTER OF SANTA CLARA VALLEY INDI 4084453400 1333 Meridian Avenue San Jose CA 95125 Sonya Tetnowski CEO 4084453400 2024-03-19 1 Sonya Tetnowski 999009999 1 Jeremy Ware P00642659 5595495400 2024-03-27 1 11 1 AAL2 2022 2023-04-26 12:10:37Z Sonya Tetnowski 1333 Meridian Avenue San Jose CA 95125 36081204 0 X X 1977 CA To help ensure the survival and healing of American Indians and Alaskan Natives and our community. 9 9 331 16 0 0 16614546 16152290 20194211 18530797 10675 42126 1708432 1355991 38527864 36081204 0 0 0 0 24900456 27473948 0 0 0 12771412 14105413 37671868 41579361 855996 -5498157 45668547 40383078 17665720 17878408 28002827 22504670 To help ensure the survival and healing of American Indians and Alaskan Natives and our community. 0 0 34426345 0 0 A FULL RANGE OF PRIMARY MEDICAL, DENTAL, NUTRITION, MENTAL HEALTH, COUNSELING AND COMMUNITY SERVICES FOR LOW-INCOME CHILDREN FAMILIES AND ADULTS INCLUDING GENERAL MEDICAL CARE, IMMUNIZATION, COMPREHENSIVE PRENATAL AND POSTNATAL CARE, CANCER PREVENTION AND SCREENING, CHRONIC DISEASE MANAGEMENT, AND GERIATRIC HEALTH SERVICES. DURING THE YEAR, PROVIDED SERVICES TO OVER 19,840 PATIENTS. 0 0 0 34426345 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 59 0 1 331 1 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X Sonya Tetnowski 4084453400 1333 Meridian Avenue San Jose CA 95125 Sonya Tetnowski CEO 40 0 X 389786 0 37577 Sonia Raheja Psychiatrist 40 0 X 377000 0 11656 Anupama Balakrishnan CMO 40 0 X 300584 0 15814 Richard Grooms CFO 40 0 X 259108 0 39419 Elizabeth McCraven Physician 40 0 X 272228 0 22168 Ira Singh COO 40 0 X 252751 0 32584 Sonya Lobana Physician 40 0 X 265833 0 11537 Amit Bhakhir Psychiatrist 24 0 X 258268 0 18568 My Phuc Le Physician 40 0 X 230215 0 11726 Paulette Pico Board Treasurer 1 0 X 0 0 0 Lisa Aguirre Board Secretary 1 0 X 0 0 0 Soma de Bourbon Board Member 1 0 X 0 0 0 PJ Brien Board Member 1 0 X 0 0 0 Rene Samayoa Board Member 1 0 X 0 0 0 Charlene Eigen Vasquez Board Vice Chair 1 0 X 0 0 0 Pablo Viramontes Board Chair 1 0 X 0 0 0 Simone Yeager Board member 1 0 X 0 0 0 Yvette Brown Shirley Board Member 1 0 X 0 0 0 2605773 0 201049 45 0 1 0 FTG Builders 2975 Scott Blvd Santa Clara CA 95054 Clinic Renovation 355976 University Healthcare Alliance 7999 Gateway Blvd Newark CA 94560 Residency Program 1088303 CARE Consulting Group 4579 Laclede Avenue St Louis MO 63108 Consulting 267297 Tadco Supply PO Box 6917 San Jose CA 95150 Janitorial Services 898616 United Security Specialists 2010 El Camino Real Santa Clara CA 95050 Security Services 416702 8 0 0 0 0 12321034 3831256 1053151 16152290 Net patient service revenue 621400 16597953 16597953 0 0 1932844 1932844 0 0 18530797 42126 0 0 42126 0 0 0 0 0 0 0 0 0 0 0 0 0 1355991 1355991 0 0 1355991 36081204 19886788 0 42126 X 27473948 23131288 4342660 4321917 3847513 474404 2287757 2054478 233279 327871 192798 135073 2298704 1959181 339523 133375 49844 83531 1245583 1120598 124985 177973 131673 46300 3312233 1938972 1373261 41579361 34426345 7153016 0 22768416 4924261 935117 937468 2710238 12157969 1812959 2113278 153757 595372 530796 28357972 10512601 16846445 17845371 1720178 45668547 40383078 3589637 3925861 3055135 2007904 4408720 6133923 6612228 5810720 17665720 17878408 X 26362860 21964583 1639967 540087 28002827 22504670 45668547 40383078 -5498157 X 0 1 X 1 1 1 X 10321339 13521285 19255679 16614546 16152290 75865139 10321339 13521285 19255679 16614546 16152290 75865139 75865139 7989 19778 9539 10675 42126 90107 75955246 0.99881 0.99923 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 6485126 6485126 0 6532127 0 6532127 0 9946683 0 9946683 0 3758684 0 3758684 0 1635352 10512601 -8877249 17845371 Estimated third party settlements 5810720 5810720 X 36081204 0 0 0 0 0 36081204 0 0 0 36081204 41579361 0 0 0 0 0 41579361 0 0 0 41579361 Schedule D, Part X, Line 2 IHCSCV is exempt from Federal income taxes under Section 501(c)(3) of the Internal Revenue Code and from California franchise taxes under Section 23701(d) of the Revenue and Taxation Code. It is only required to submit annual federal and state information returns and no provision for Federal and State income taxes is required. IHCSCV has adopted the accounting guidance related to uncertain tax positions, and has evaluated its tax positions and believes that all of the positions taken by IHCSCV in its federal and state exempt organization tax returns are more likely than not to be sustained upon examination. IHCSCV's returns are subject to examination by federal and state taxing authorities generally for three years (federal) and four years (state) after they are filed. X 0 0 0 0 0 0 0 0 0 Sonya Tetnowski CEO 374520 0 14024 0 1242 0 6786 0 30791 0 427363 0 0 0 Sonia Raheja Psychiatrist 374750 0 1709 0 540 0 10576 0 1080 0 388655 0 0 0 Anupama Balakrishnan CMO 285426 0 14320 0 838 0 4256 0 11558 0 316398 0 0 0 Elizabeth McCraven Physician 253326 0 6467 0 12434 0 9765 0 12403 0 294395 0 0 0 Richard Grooms CFO 219529 0 38886 0 693 0 8895 0 30524 0 298527 0 0 0 Ira Singh COO 235581 0 16657 0 512 0 1921 0 30663 0 285334 0 0 0 Sonya Lobana Physician 256352 0 8314 0 1167 0 8398 0 3139 0 277370 0 0 0 Amit Bhakhir Psychiatrist 256012 0 1717 0 539 0 7709 0 10859 0 276836 0 0 0 My Phuc Le Physician 227981 0 1771 0 463 0 3567 0 8158 0 241940 0 0 0 X 1 1053151 FMV 0 0 1 0 Form 990, Part VI, Section B, Line 11b A copy of the Form 990 is provided to the governing board before it is filed. Form 990, Part VI, Section B, Line 12c THE ORGANIZATION'S CONFLICT OF INTEREST POLICY WAS UPDATED ON 10/24/2018. ANY DIRECTOR, PRINCIPAL OFFICER, MEMBER OF A COMMITTEE WITH BOARD DELEGATED POWERS, EMPLOYEE, OR AGENT WHO HAS A DIRECT OR INDIRECT FINANCIAL INTEREST, AS DEFINED BELOW, IS AN INTERESTED PERSON. IF A PERSON IS AN INTERESTED PERSON WITH RESPECT TO ANY ENTITY OF WHICH THE HEALTH CENTER IS AFFILIATED, HE OR SHE IS AN INTERESTED PERSON WITH RESPECT TO ALL ENTITIES IN THE HEALTHCARE SYSTEM. AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF HIS OR HER PERSONAL OR BUSINESS FINANCIAL INTEREST AND ALL MATERIAL FACTS TO THE BOARD AND MEMBERS OF COMMITTEES WITH BOARD-DELEGATED POWERS CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT. AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, HE OR SHE SHALL LEAVE THE BOARD OR COMMITTEE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING BOARD OR COMMITTEE MEMBERS SHALL DECIDE IF A CONFLICT OF INTEREST EXISTS. THE CHIEF EXECUTIVE OFFICER IS RESPONSIBLE FOR THE IMPLEMENTATION AND MAINTENANCE OF THIS POLICY. Form 990, Part VI, Section B, Line 15 IN 2018 HR STARTED A SUBSCRIPTION TO 2 SURVEYS, CPCA AND FAIR PAY FOR NORTHERN CALIFORNIA NONPROFITS, TO DO A COMPENSATION ANALYSIS OF ALL EMPLOYEES. IN 2019, THE ORGANIZATION'S BOARD MEMBERS REVIEWED AND APPROVED THE COMPENSATION FOR THE CEO BASED UPON COMPARABILITY DATA FROM THESE TWO SURVEYS. Form 990, Part VI, Section C, Line 19 Available upon request. Form 990, Part IX, Line 11g Purchased and professional fees.