TY 2014 Form 990

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(1) JOHN PAVONI........................................................................ BOARD CHAIR	4.0 .......................0.0	X	X		0
(2) JIM MARRILL........................................................................ VICE-CHAIR	4.0 .......................0.0	X	X		0
(3) GERALD CHANEY........................................................................ SECRETARY/TREASURER BEG 6/15	8.0 .......................0.0	X	X		0
(4) WAYNE MENGER........................................................................ DIRECTOR	2.0 .......................0.0	X			0
(5) TOM JORDAN........................................................................ DIRECTOR BEGINNING 12/14	2.0 .......................0.0	X			0
(6) BILL MERGENER........................................................................ DIRECTOR	2.0 .......................0.0	X			0
(7) CARLOS FRAUSTO........................................................................ DIRECTOR	2.0 .......................0.0	X			0
(8) JACQUELINE WILLIAMS........................................................................ DIRECTOR	1.0 .......................0.0	X			0
(9) JANE BERRY........................................................................ DIRECTOR	2.0 .......................0.0	X			0
(10) BARBARA NEWELL........................................................................ SECRETARY/TREASURER END 02/15	2.0 .......................0.0	X	X		0
(11) CAROLE PRESS........................................................................ COO TO 5/15,INTER CEO BEG 6/15	40.0 .......................0.0		X		154,772
(12) JEFF WIEDENFELD........................................................................ CHIEF INFORMATION OFFICER	40.0 .......................0.0		X		157,853
(13) TIMOTHY J DOLAN........................................................................ CHIEF FINANCIAL OFFICER	40.0 .......................0.0		X		136,550
(14) LINNEA HUNTER........................................................................ CEO ENDING 05/2015	40.0 .......................0.0		X		234,073
(15) JILL DAMIAN........................................................................ COO BEGINNING 06/15	40.0 .......................0.0		X		101,529
(16) KAREN CRABTREE........................................................................ DIRECTOR CARE FOR HER	40.0 .......................0.0			X	362,942
(17) DOUG LEWIS........................................................................ DIRECTOR DENTAL OPERATIONS	40.0 .......................0.0			X	175,818

Do not include amounts reported on lines 6b, 7b, 8b, 9b, and 10b of Part VIII.	(A) Total expenses	(B) Program service expenses	(C) Management and general expenses	(D) Fundraising expenses
1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....	69,090	69,090
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ....	0
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16 ............	0
4	Benefits paid to or for members ....	0
5	Compensation of current officers, directors, trustees, and key employees ....	1,579,990	795,213	784,777
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) ....	0
7	Other salaries and wages ....	16,378,091	12,591,371	3,786,720
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	299,988	223,622	76,366
9	Other employee benefits .......	2,770,919	2,065,540	705,379
10	Payroll taxes ...........	1,259,377	938,784	320,593
11	Fees for services (non-employees):
a	Management ......	0
b	Legal .........	25,367		25,367
c	Accounting ...........	180,928		180,928
d	Lobbying ...........	0
e	Professional fundraising services. See Part IV, line 17	0
f	Investment management fees ......	0
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O) ....	1,506,717	987,026	519,691
12	Advertising and promotion ....	172,626	22,727	149,899
13	Office expenses .......	1,871,940	1,305,625	566,315
14	Information technology ......	593,684	114,883	478,801
15	Royalties ..	0
16	Occupancy ...........	558,499	417,276	141,223
17	Travel ............	141,626	51,427	90,199
18	Payments of travel or entertainment expenses for any federal, state, or local public officials ......	0
19	Conferences, conventions, and meetings ....	325,371	180,104	145,267
20	Interest ...........	191,996	11,715	180,281
21	Payments to affiliates .......	0
22	Depreciation, depletion, and amortization .....	930,353	580,265	350,088
23	Insurance ..............	166,854	84,561	82,293
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	MEDICAL SUPPLIES & DRUGS	1,450,664	1,450,664
b	BAD DEBT	389,826	389,826
c	LICENSES, DUES, SUBSCRIPTIONS	123,481	45,779	77,702
d	RECRUITING & RETENTION	112,479	93,022	19,457
e	All other expenses
25	Total functional expenses. Add lines 1 through 24e	31,099,866	22,418,520	8,681,346	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

Part X Balance Sheet Check if Schedule O contains a response or note to any line in this Part X ..............
	1	Cash–non-interest-bearing .............	5,295	1	42,718
2	Savings and temporary cash investments .........	1,179,707	2	2,386,862
3	Pledges and grants receivable, net ...........	243,037	3	16,977
4	Accounts receivable, net .............	2,537,431	4	2,448,865
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
		0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
		0	6	0
7	Notes and loans receivable, net .............	0	7	0
8	Inventories for sale or use ..............	53,836	8	67,384
9	Prepaid expenses and deferred charges ..........	310,650	9	284,060
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	16,663,868
b	Less: accumulated depreciation .....	10b	6,877,715	10,019,624	10c	9,786,153
11	Investments—publicly traded securities ..........	0	11	0
12	Investments—other securities. See Part IV, line 11 .....	0	12	0
13	Investments—program-related. See Part IV, line 11 .....	0	13	0
14	Intangible assets ...............	0	14	0
15	Other assets. See Part IV, line 11 ...........	106,621	15	723,963
16	Total assets. Add lines 1 through 15 (must equal line 34)......	14,456,201	16	15,756,982
	17	Accounts payable and accrued expenses .........	2,266,113	17	2,947,155
18	Grants payable .................	0	18	0
19	Deferred revenue ................	0	19	0
20	Tax-exempt bond liabilities .............	0	20	0
21	Escrow or custodial account liability. Complete Part IV of Schedule D..	0	21	0
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........	0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..	4,195,912	23	3,959,724
24	Unsecured notes and loans payable to unrelated third parties ....	0	24	0
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D....................	0	25	1,000,000
26	Total liabilities. Add lines 17 through 25.........	6,462,025	26	7,906,879
		Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............	7,919,176	27	7,845,103
28	Temporarily restricted net assets ...........	75,000	28	5,000
29	Permanently restricted net assets ...........	0	29	0
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds ........		30
31	Paid-in or capital surplus, or land, building or equipment fund .....		31
32	Retained earnings, endowment, accumulated income, or other funds		32
33	Total net assets or fund balances ...........	7,994,176	33	7,850,103
34	Total liabilities and net assets/fund balances ........	14,456,201	34	15,756,982

- TIN:

SCHEDULE A
(Form 990 or 990EZ)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
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Attach to Form 990 or Form 990-EZ.
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Information about Schedule A (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public
Inspection

Name of the organization

MENDOCINO COMMUNITY HEALTH CLINIC INC

Employer identification number

68-0259045

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 11, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E.)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in

section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An organization that normally receives: (1) more than 331/3% of its support from contributions, membership fees, and gross

receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 331/3% of

its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses

acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

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). See section 509(a)(3). Check the box in lines 11a through 11d that describes the type of supporting organization and complete lines 11e, 11f, and 11g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations .............................

Provide the following information about the supported organization(s).

(i)Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i)Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990EZ.

Cat. No. 11285F

Schedule A (Form 990 or 990-EZ) 2014

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization fails to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2010	(b) 2011	(c) 2012	(d) 2013	(e) 2014	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") ....
2	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.......
3	The value of services or facilities furnished by a governmental unit to the organization without charge..
4	Total. Add lines 1 through 3
5	The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f)..
6	Public support. Subtract line 5 from line 4.

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2010	(b) 2011	(c) 2012	(d) 2013	(e) 2014	(f) Total
7	Amounts from line 4..
8	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources...
9	Net income from unrelated business activities, whether or not the business is regularly carried on..
10	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.)..
11	Total support Add lines 7 through 10.

Gross receipts from related activities, etc. (see instructions) ..................

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2014 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2013 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2014. If the organization did not check the box on line 13, and line 14 is 33 1/3% or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2013. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2014. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2013. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990 or 990-EZ) 2014

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 9 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

Calendar year (or fiscal year beginning in)		(a) 2010	(b) 2011	(c) 2012	(d) 2013	(e) 2014	(f) Total
1	Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") .	5,414,703	4,748,689	6,171,536	4,880,287	4,497,087	25,712,302
2	Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose......	18,316,988	20,363,146	21,423,195	23,564,237	26,457,238	110,124,804
3	Gross receipts from activities that are not an unrelated trade or business under section 513..						0
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...						0
5	The value of services or facilities furnished by a governmental unit to the organization without charge..						0
6	Total. Add lines 1 through 5.	23,731,691	25,111,835	27,594,731	28,444,524	30,954,325	135,837,106
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons...						0
b	Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year.						0
c	Add lines 7a and 7b..						0
8	Public support (Subtract line 7c from line 6.)						135,837,106

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2010	(b) 2011	(c) 2012	(d) 2013	(e) 2014	(f) Total
9	Amounts from line 6...	23,731,691	25,111,835	27,594,731	28,444,524	30,954,325	135,837,106
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..	1,111	706	1,514	2,288	1,468	7,087
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.						0
c	Add lines 10a and 10b.	1,111	706	1,514	2,288	1,468	7,087
11	Net income from unrelated business activities not included in line 10b, whether or not the business is regularly carried on.						0
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..						0
13	Total support. (Add lines 9, 10c, 11, and 12.)..	23,732,802	25,112,541	27,596,245	28,446,812	30,955,793	135,844,193

First five years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2014 (line 8, column (f) divided by line 13, column (f)) .........

99.995 %

Public support percentage from 2013 Schedule A, Part III, line 15 ...............

99.990 %

Section D. Computation of Investment Income Percentage

Investment income percentage for 2014 (line 10c, column (f) divided by line 13, column (f)) ......

0.005 %

Investment income percentage from 2013 Schedule A, Part III, line 17 .............

0.010 %

19a

33 1/3% support tests—2014. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2013. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990 or 990-EZ) 2014

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 11 of Part I. If you checked 11a of Part I, complete Sections A and B. If you checked 11b of Part I, complete Sections A and C. If you checked 11c of Part I, complete Sections A, D, and E. If you checked 11d of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer (b) and (c) below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked 11a or 11b in Part I, answer (b) and (c) below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations....

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer (b) and (c) below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed, (ii) the reasons for each such action, (iii) the authority under the organization's organizing document authorizing such action, and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (a) its supported organizations; (b) individuals that are part of the charitable class benefited by one or more of its supported organizations; or (c) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in IRC 4958(c)(3)(C)), a family member of a substantial contributor, or a 35-percent controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described in line 7? If “Yes,” complete Part II of Schedule L (Form 990).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined in line 9(a)) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined in line 9(a)) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of IRC 4943 because of IRC 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described in (b) and (c) below, the governing body of a supported organization?

11a

A family member of a person described in (a) above?

11b

A 35% controlled entity of a person described in (a) or (b) above? If “Yes” to a, b, or c, provide detail in Part VI.

11c

Schedule A (Form 990 or 990-EZ) 2014

Page 5

Part IV

Supporting Organizations (continued)

Section B. Type I Supporting Organizations

Yes

Did the directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (1) a written notice describing the type and amount of support provided during the prior tax year, (2) a copy of the Form 990 that was most recently filed as of the date of notification, and (3) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in (2), did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer (a) and (b) below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described in (a) constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer (a) and (b) below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations? Provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI the role played by the organization in this regard.

Schedule A (Form 990 or 990-EZ) 2014

Page 6

Part V – Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

1. Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970. See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
1	Net short-term capital gain	1
2	Recoveries of prior-year distributions	2
3	Other gross income (see instructions)	3
4	Add lines 1 through 3	4
5	Depreciation and depletion	5
6	Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions)	6
7	Other expenses (see instructions)	7
8	Adjusted Net Income (subtract lines 5, 6 and 7 from line 4)	8

	Section B - Minimum Asset Amount		(A) Prior Year	(B) Current Year (optional)
1	Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year):	1
a	Average monthly value of securities	1a
b	Average monthly cash balances	1b
c	Fair market value of other non-exempt-use assets	1c
d	Total (add lines 1a, 1b, and 1c)	1d
e	Discount claimed for blockage or other factors (explain in detail in Part VI):
2	Acquisition indebtedness applicable to non-exempt use assets	2
3	Subtract line 2 from line 1d	3
4	Cash deemed held for exempt use. Enter 1-1/2% of line 3 (for greater amount, see instructions).	4
5	Net value of non-exempt-use assets (subtract line 4 from line 3)	5
6	Multiply line 5 by .035	6
7	Recoveries of prior-year distributions	7
8	Minimum Asset Amount (add line 7 to line 6)	8

	Section C - Distributable Amount		Current Year
1	Adjusted net income for prior year (from Section A, line 8, Column A)	1
2	Enter 85% of line 1	2
3	Minimum asset amount for prior year (from Section B, line 8, Column A)	3
4	Enter greater of line 2 or line 3	4
5	Income tax imposed in prior year	5
6	Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions)	6
7	Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990 or 990-EZ) 2014

Page 7

Section D - Distributions		Current Year
1 Amounts paid to supported organizations to accomplish exempt purposes
2 Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity
3 Administrative expenses paid to accomplish exempt purposes of supported organizations
4 Amounts paid to acquire exempt-use assets
5 Qualified set-aside amounts (prior IRS approval required)
6 Other distributions (describe in Part VI). See instructions
7Total annual distributions. Add lines 1 through 6.
8 Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions
9 Distributable amount for 2014 from Section C, line 6
10 Line 8 amount divided by Line 9 amount

Section E - Distribution Allocations (see instructions)		(i) Excess Distributions	(ii) Underdistributions Pre-2014	(iii) Distributable Amount for 2014
1 Distributable amount for 2014 from Section C, line 6
2 Underdistributions, if any, for years prior to 2014 (reasonable cause required--see instructions)
3 Excess distributions carryover, if any, to 2014:
a From 2009.......X
b From 2010.......X
c From 2011.......X
d From 2012.......X
e From 2013.......
fTotal of lines 3a through e
g Applied to underdistributions of prior years
h Applied to 2014 distributable amount
i Carryover from 2009 not applied (see instructions)
j Remainder. Subtract lines 3g, 3h, and 3i from 3f.
4Distributions for 2014 from Section D, line 7:
$
a Applied to underdistributions of prior years
b Applied to 2014 distributable amount
c Remainder. Subtract lines 4a and 4b from 4.
5 Remaining underdistributions for years prior to 2014, if any. Subtract lines 3g and 4a from line 2 (if amount greater than zero, see instructions)
6 Remaining underdistributions for 2014. Subtract lines 3h and 4b from line 1 (if amount greater than zero, see instructions)
7 Excess distributions carryover to 2015. Add lines 3j and 4c.
8 Breakdown of line 7:
a From 2010.......X
b From 2011.......X
c From 2012.......X
d From 2013.......
e From 2014.......

Schedule A (Form 990 or 990-EZ) (2014)

Schedule A (Form 990 or 990-EZ) 2014

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990 or 990-EZ) 2014

Additional Data

Software ID:
Software Version:

- TIN:

Schedule B
(Form 990, 990-EZ,
or 990-PF)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Information about Schedule B (Form 990, 990-EZ, or 990-PF) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Name of the organization

MENDOCINO COMMUNITY HEALTH CLINIC INC

Employer identification number

68-0259045

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note. Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or
property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Do not complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution. An organization that is not covered by the General Rule and/or the Special Rules does not file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its
Form 990-EZ or on its Form 990PF, Part I, line 2, to certify that it does not meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990, 990-EZ, or 990-PF) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Page 2

Name of organization MENDOCINO COMMUNITY HEALTH CLINIC INC

Part I	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Page 3

Name of organization MENDOCINO COMMUNITY HEALTH CLINIC INC

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (see instructions)	(d) Date received
		$
Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Page 4

Name of organization
MENDOCINO COMMUNITY HEALTH CLINIC INC

Employer identification number

68-0259045

Part III

Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10)
that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) Arrow Bullet

$
Use duplicate copies of Part III if additional space is needed.

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a) No.
from
Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990, 990-EZ, or 990-PF) (2014)

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE C
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Political Campaign and Lobbying Activities

For Organizations Exempt From Income Tax Under section 501(c) and section 527
SchCMd Bullet

Complete if the organization is described below. SchCMd Bullet

Attach to Form 990 or Form 990-EZ.
SchCMd Bullet

Information about Schedule C (Form 990 or 990-EZ) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public
Inspection

If the organization answered "Yes" to Form 990, Part IV, Line 3, or Form 990-EZ, Part V, line 46 (Political Campaign Activities), then
Round Bullet

Section 501(c)(3) organizations: Complete Parts I-A and B. Do not complete Part I-C.
Round Bullet

Section 501(c) (other than section 501(c)(3)) organizations: Complete Parts I-A and C below. Do not complete Part I-B.
Round Bullet

Section 527 organizations: Complete Part I-A only.
If the organization answered "Yes" to Form 990, Part IV, Line 4, or Form 990-EZ, Part VI, line 47 (Lobbying Activities), then
Round Bullet

Section 501(c)(3) organizations that have filed Form 5768 (election under section 501(h)): Complete Part II-A. Do not complete Part II-B.
Round Bullet

Section 501(c)(3) organizations that have NOT filed Form 5768 (election under section 501(h)): Complete Part II-B. Do not complete Part II-A.
If the organization answered "Yes" to Form 990, Part IV, Line 5 (Proxy Tax) (see separate instructions) or Form 990-EZ, Part V, line 35c (Proxy Tax) (see separate instructions), then
Round Bullet

Section 501(c)(4), (5), or (6) organizations: Complete Part III.

Name of the organization

MENDOCINO COMMUNITY HEALTH CLINIC INC

Employer identification number

68-0259045

Part I-A

Complete if the organization is exempt under section 501(c) or is a section 527 organization.

Provide a description of the organization’s direct and indirect political campaign activities in Part IV.

Political expenditures .................................... SchCMd Bullet

Volunteer hours ........................................

Part I-B

Complete if the organization is exempt under section 501(c)(3).

Enter the amount of any excise tax incurred by the organization under section 4955 ......... SchCMd Bullet

Enter the amount of any excise tax incurred by organization managers under section 4955 ...... SchCMd Bullet

If the organization incurred a section 4955 tax, did it file Form 4720 for this year? ..............

Yes No

Was a correction made? .........................................

Yes No

If "Yes," describe in Part IV.

Part I-C

Complete if the organization is exempt under section 501(c), except section 501(c)(3).

Enter the amount directly expended by the filing organization for section 527 exempt function activities SchCMd Bullet

Enter the amount of the filing organization's funds contributed to other organizations for section 527 exempt function activities ................................... SchCMd Bullet

Total exempt function expenditures. Add lines 1 and 2. Enter here and on Form 1120-POL, line 17b.. SchCMd Bullet

Did the filing organization file Form 1120-POL for this year? ..........................

Yes No

Enter the names, addresses and employer identification number (EIN) of all section 527 political organizations to which the filing
organization made payments. For each organization listed, enter the amount paid from the filing organization’s funds. Also enter the amount of political contributions received that were promptly and directly delivered to a separate political organization, such as a separate segregated fund or a political action committee (PAC). If additional space is needed, provide information in Part IV.

(a) Name	(b) Address	(c) EIN	(d) Amount paid from filing organization's funds. If none, enter -0-.	(e) Amount of political contributions received and promptly and directly delivered to a separate political organization. If none, enter -0-.

For Paperwork Reduction Act Notice, see the instructions for Form 990 or 990-EZ.

Cat. No. 50084S

Schedule C (Form 990 or 990-EZ) 2014

Page 2

Part II-A

Complete if the organization is exempt under section 501(c)(3) and filed Form 5768 (election under section 501(h)).

A Check SchCMd Bullet

if the filing organization belongs to an affiliated group (and list in Part IV each affiliated group member's name, address, EIN, expenses, and share of excess lobbying expenditures).
B Check SchCMd Bullet

if the filing organization checked box A and "limited control" provisions apply.

Limits on Lobbying Expenditures (The term "expenditures" means amounts paid or incurred.)		(b) Affiliated group totals
1a	Total lobbying expenditures to influence public opinion (grass roots lobbying) ......
b	Total lobbying expenditures to influence a legislative body (direct lobbying) .......
c	Total lobbying expenditures (add lines 1a and 1b) ...................
d	Other exempt purpose expenditures ........................
e	Total exempt purpose expenditures (add lines 1c and 1d) ...............
f	Lobbying nontaxable amount. Enter the amount from the following table in both columns.
	If the amount on line 1e, column (a) or (b) is:The lobbying nontaxable amount is:
	Not over $500,00020% of the amount on line 1e.
	Over $500,000 but not over $1,000,000$100,000 plus 15% of the excess over $500,000.
	Over $1,000,000 but not over $1,500,000$175,000 plus 10% of the excess over $1,000,000.
	Over $1,500,000 but not over $17,000,000$225,000 plus 5% of the excess over $1,500,000.
	Over $17,000,000$1,000,000.

g	Grassroots nontaxable amount (enter 25% of line 1f) .................
h	Subtract line 1g from line 1a. If zero or less, enter -0-. ................
i	Subtract line 1f from line 1c. If zero or less, enter -0-. ................
j	If there is an amount other than zero on either line 1h or line 1i, did the organization file Form 4720 reporting section 4911 tax for this year? ......................................	Yes No

4-Year Averaging Period Under section 501(h) (Some organizations that made a section 501(h) election do not have to complete all of the five columns below. See the separate instructions for lines 2a through 2f.)
Lobbying Expenditures During 4-Year Averaging Period
	Calendar year (or fiscal year beginning in)	(a) 2011	(b) 2012	(c) 2013	(d) 2014	(e) Total

2a	Lobbying nontaxable amount

b	Lobbying ceiling amount (150% of line 2a, column(e))

c	Total lobbying expenditures

d	Grassroots nontaxable amount

e	Grassroots ceiling amount (150% of line 2d, column (e))

f	Grassroots lobbying expenditures

Schedule C (Form 990 or 990-EZ) 2014

Page 3

Part II-B

Complete if the organization is exempt under section 501(c)(3) and has NOT filed Form 5768 (election under section 501(h)).

For each "Yes" response to lines 1a through 1i below, provide in Part IV a detailed description of the lobbying activity.

(a)

Yes

(b)

Amount

During the year, did the filing organization attempt to influence foreign, national, state or local legislation, including any attempt to influence public opinion on a legislative matter or referendum, through the use of:

Volunteers? .........................................

Paid staff or management (include compensation in expenses reported on lines 1c through 1i)? ....

Media advertisements? ....................................

Mailings to members, legislators, or the public? .........................

Publications, or published or broadcast statements? .......................

Grants to other organizations for lobbying purposes? .......................

Direct contact with legislators, their staffs, government officials, or a legislative body? ........

Rallies, demonstrations, seminars, conventions, speeches, lectures, or any similar means? ......

Other activities? ..........................

Yes

16,400

Total. Add lines 1c through 1i ...............................

16,400

Did the activities in line 1 cause the organization to be not described in section 501(c)(3)? .....

If "Yes," enter the amount of any tax incurred under section 4912 .................

If "Yes," enter the amount of any tax incurred by organization managers under section 4912 .....

If the filing organization incurred a section 4912 tax, did it file Form 4720 for this year? .......

Part III-A

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6).

Yes

Were substantially all (90% or more) dues received nondeductible by members? ................

Did the organization make only in-house lobbying expenditures of $2,000 or less? ................

Did the organization agree to carry over lobbying and political expenditures from the prior year? ..........

Part III-B

Complete if the organization is exempt under section 501(c)(4), section 501(c)(5), or section 501(c)(6) and if either (a) BOTH Part III-A, lines 1 and 2, are answered "No" OR (b) Part III-A, line 3, is answered “Yes."

Dues, assessments and similar amounts from members .....................

Section 162(e) nondeductible lobbying and political expenditures (do not include amounts of political
expenses for which the section 527(f) tax was paid).

Current year .........................................

Carryover from last year ....................................

Total ............................................

Aggregate amount reported in section 6033(e)(1)(A) notices of nondeductible section 162(e) dues .

If notices were sent and the amount on line 2c exceeds the amount on line 3, what portion of the excess does the organization agree to carryover to the reasonable estimate of nondeductible lobbying and political expenditure next year? ................................

Taxable amount of lobbying and political expenditures (see instructions) ..............

Part IV

Supplemental Information

Provide the descriptions required for Part l-A, line 1; Part l-B, line 4; Part l-C, line 5; Part II-A (affiliated group list); Part II-A, lines 1 and 2 (see instructions), and Part ll-B, line 1. Also, complete this part for any additional information.

Return Reference	Explanation
SCHEDULE C, PART II-B, LINE 1(I)	OTHER LOBBYING ACTIVITIES: THE ORGANIZATION PAYS DUES TO THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS (NACHC) AND THE CALIFORNIA PRIMARY CARE ASSOCIATION (CPCA). A PORTION OF THESE DUES MAY BE USED FOR LOBBYING PURPOSES.

Schedule C (Form 990 or 990EZ) 2014

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," to Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet

Attach to Form 990.
Information about Schedule D (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public Inspection

Name of the organization

MENDOCINO COMMUNITY HEALTH CLINIC INC

Employer identification number

68-0259045

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" to Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised
funds are the organization's property, subject to the organization's exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be
used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................

Yes No

Part II

Conservation Easements. Complete if the organization answered "Yes" to Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements .......................	2a
b	Total acreage restricted by conservation easements ..................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 8/17/06, and not on a historic structure listed in the National Register ....................	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during
the tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and
enforcement of the conservation easements it holds? .............................

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, and enforcing conservation easements during the year
SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .......................................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" to Form 990, Part IV, line 8.

If the organization elected, as permitted under SFAS 116 (ASC 958), not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under SFAS 116 (ASC 958), to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenue included in Form 990, Part VIII, line 1 ........................ SchDMd Bullet

(ii)

Assets included in Form 990, Part X .............................. SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under SFAS 116 (ASC 958) relating to these items:

Revenue included in Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2014

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?........

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" to Form 990,
Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No

If "Yes," explain the arrangement in Part XIII and complete the following table:


c	Beginning balance .................................	1c
d	Additions during the year ..............................	1d
e	Distributions during the year .............................	1e
f	Ending balance ...................................	1f

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability?

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII .......

Part V

Endowment Funds. Complete if the organization answered "Yes" to Form 990, Part IV, line 10.

		(a)Current year	(b)Prior year	b (c)Two years back	(d)Three years back	(e)Four years back
1a	Beginning of year balance ....
b	Contributions ........
c	Net investment earnings, gains, and losses
d	Grants or scholarships .....
e	Other expenditures for facilities and programs ........
f	Administrative expenses ....
g	End of year balance ......

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

Temporarily restricted endowment SchDMd Bullet

The percentages in lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) unrelated organizations ........................

3a(i)

(ii) related organizations ........................

3a(ii)

If "Yes" to 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(b)Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value
1a	Land .................	792,155		792,155
b	Buildings ................	11,452,016	3,625,990	7,826,026
c	Leasehold improvements ............
d	Equipment ................	3,284,979	2,641,970	643,009
e	Other .................	1,134,718	609,755	524,963
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).).......				9,786,153

Schedule D (Form 990) 2014

Page 3

Part VII

InvestmentsOther Securities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)		(b)Book value	(c) Method of valuation: Cost or end-of-year market value
(1)Financial derivatives
(2)Closely-held equity interests
Other








Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

InvestmentsProgram Related. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment		(b) Book value	(c) Method of valuation: Cost or end-of-year market value









Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value









Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........

Part X

Other Liabilities. Complete if the organization answered 'Yes' to Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability		(b) Book value
Federal income taxes		0
ESTIMATED AMOUNT DUE TO 3RD PARTIES		1,000,000








Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)		1,000,000
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2014

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......			1	30,635,967
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d	-299,826
e	Add lines 2a through 2d .....................			2e	-299,826
3	Subtract line 2e from line 1.....................			3	30,935,793
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b	20,000
c	Add lines 4a and 4b.......................			4c	20,000
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......			5	30,955,793

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' to Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........			1	30,710,040
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities ..........	2a
b	Prior year adjustments ..............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d......................			2e
3	Subtract line 2e from line 1.....................			3	30,710,040
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b	389,826
c	Add lines 4a and 4b.......................			4c	389,826
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......			5	31,099,866

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b;
Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference	Explanation
SCHEDULE D, PART X, LINE 2	MANAGEMENT HAS EVALUATED THEIR INCOME TAX POSITIONS UNDER THE GUIDANCE INCLUDED IN ASC 740. BASED ON THEIR REVIEW, MANAGEMENT HAS NOT IDENTIFIED ANY MATERIAL UNCERTAIN TAX POSITIONS TO BE RECORDED OR DISCLOSED IN THE FINANCIALS STATEMENTS.
SCHEDULE D, PART XI, LINE 2D	OTHER REVENUE ON LINE 1, BUT NOT ON FORM 990, PART VIII, LINE 12: $ (389,826) BAD DEBT 90,000 NET ASSETS RELEASED FROM RESTRICTION ---------- $ (299,826)
SCHEDULE D, PART XI, LINE 4B	OTHER REVENUE ON FORM 990, PART VIII, LINE 12, BUT NOT ON LINE 1: $ 20,000 TEMPORARILY RESTRICTED CONTRIBUTIONS
SCHEDULE D, PART XII, LINE 4B	OTHER EXPENSES ON FORM 990, PART XI, LINE 25, BUT NOT ON LINE 1: $ 389,826 BAD DEBT EXPENSE

Schedule D (Form 990) 2014

Additional Data

Software ID:
Software Version:

- TIN:

Schedule I
(Form 990)

Department of the Treasury
Internal Revenue Service

Grants and Other Assistance to Organizations,
Governments and Individuals in the United States

Complete if the organization answered "Yes," to Form 990, Part IV, line 21 or 22.
lBullet

Attach to Form 990.
lBullet

Information about Schedule I (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public
Inspection

Name of the organization
MENDOCINO COMMUNITY HEALTH CLINIC INC

Employer identification number
68-0259045

Part I

General Information on Grants and Assistance

Does the organization maintain records to substantiate the amount of the grants or assistance, the grantees' eligibility for the grants or assistance, and
the selection criteria used to award the grants or assistance? ....................................

Yes No

Describe in Part IV the organization's procedures for monitoring the use of grant funds in the United States.

Part II

Grants and Other Assistance to Domestic Organizations and Domestic Governments. Complete if the organization answered "Yes" to
Form 990, Part IV, line 21, for any recipient that received more than $5,000. Part II can be duplicated if additional space is needed.

(a) Name and address of organization or government	(b) EIN	(c) IRC section if applicable	(d) Amount of cash grant	(h) Purpose of grant or assistance
(1) MENDOCINO COAST CLINIC 205 SOUTH STREET FORT BRAGG,CA95437	68-0262003	501(C)(3)	69,090	SUPPORT

Enter total number of section 501(c)(3) and government organizations listed in the line 1 table ................ Bullet Image

Enter total number of other organizations listed in the line 1 table ........................ . Bullet Image

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50055P

Schedule I (Form 990) 2014

Page 2

Part III

Grants and Other Assistance to Domestic Individuals. Complete if the organization answered "Yes" to Form 990, Part IV, line 22.
Part III can be duplicated if additional space is needed.

(a)Type of grant or assistance	(b)Number of recipients	(c)Amount of cash grant	(d)Amount of non-cash assistance	(e)Method of valuation (book, FMV, appraisal, other)	(f)Description of non-cash assistance

Part IV

Supplemental Information. Provide the information required in Part I, line 2, Part III, column (b), and any other additional information.

Return Reference	Explanation
SCHEDULE I, PART I, LINE 2	GRANT MONITORING PROCEDURES: THE GRANT TO MENDOCINO COAST CLINIC IS SPECIFICALLY TO SUPPORT OUTPATIENT EARLY INTERVENTION SERVICES WITH RESPECT TO HIV DISEASE. A MENDOCINO COMMUNITY HEALTH CLINIC EMPLOYEE, WHO IS DIRECTOR OF THE RYAN WHITE PROGRAM, MONITORS THE USE OF GRANT FUNDS TO ENSURE THEY ARE USED FOR THE INTENDED PURPOSE.

Schedule I (Form 990) 2014

Additional Data

Software ID:
Software Version:

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" to Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

Information about Schedule J (Form 990) and its instructions is at www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public Inspection

Name of the organization

MENDOCINO COMMUNITY HEALTH CLINIC INC

Employer identification number

68-0259045

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed in Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes in line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain....

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked in line 1a? ..

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed in Form 990, Part VII, Section A, line 1a with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? ................

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Participate in, or receive payment from, an equity-based compensation arrangement? .........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 5a or 5b, describe in Part III.

For persons listed in Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ...........................

Any related organization? .........................

If "Yes," to line 6a or 6b, describe in Part III.

For persons listed in Form 990, Part VII, Section A, line 1a, did the organization provide any non-fixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Were any amounts reported in Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III .............................

If "Yes" to line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2014

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported in Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2 and/or 1099-MISC compensation			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column(B) reported as deferred in prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1KAREN CRABTREEDIRECTOR CARE FOR HER	(i) (ii)	362,942 ............................... 0	0 ............................... 0	0 ............................... 0	0 ............................... 0	0 ............................... 0	362,942 ............................... 0	0 ............................... 0
2ADWOA CHRISTYPHYSICIAN	(i) (ii)	320,748 ............................... 0	0 ............................... 0	0 ............................... 0	0 ............................... 0	0 ............................... 0	320,748 ............................... 0	0 ............................... 0
3GUY TERANPHYSICIAN	(i) (ii)	156,467 ............................... 0	124,011 ............................... 0	0 ............................... 0	0 ............................... 0	0 ............................... 0	280,478 ............................... 0	0 ............................... 0
4STEVEN WIRTHPHYSICIAN	(i) (ii)	217,303 ............................... 0	78,527 ............................... 0	0 ............................... 0	0 ............................... 0	0 ............................... 0	295,830 ............................... 0	0 ............................... 0
5CAROLE PRESSCOO TO 5/15,INTER CEO BEG 6/15	(i) (ii)	154,772 ............................... 0	0 ............................... 0	0 ............................... 0	0 ............................... 0	0 ............................... 0	154,772 ............................... 0	0 ............................... 0
6JEFF WIEDENFELDCHIEF INFORMATION OFFICER	(i) (ii)	157,853 ............................... 0	0 ............................... 0	0 ............................... 0	0 ............................... 0	0 ............................... 0	157,853 ............................... 0	0 ............................... 0
7DOUG LEWISDIRECTOR DENTAL OPERATIONS	(i) (ii)	175,818 ............................... 0	0 ............................... 0	0 ............................... 0	0 ............................... 0	0 ............................... 0	175,818 ............................... 0	0 ............................... 0
8REBECCA TIMMEDIRECTOR PSYCHIATRIC OPERATION	(i) (ii)	185,953 ............................... 0	70,500 ............................... 0	0 ............................... 0	0 ............................... 0	0 ............................... 0	256,453 ............................... 0	0 ............................... 0
9LINNEA HUNTERCEO ENDING 05/2015	(i) (ii)	234,073 ............................... 0	0 ............................... 0	0 ............................... 0	0 ............................... 0	0 ............................... 0	234,073 ............................... 0	0 ............................... 0
10JOANN ROSENFELDPHYSICIAN	(i) (ii)	232,499 ............................... 0	0 ............................... 0	0 ............................... 0	0 ............................... 0	0 ............................... 0	232,499 ............................... 0	0 ............................... 0
11SARA ALVORDPHYSICIAN	(i) (ii)	220,891 ............................... 0	0 ............................... 0	0 ............................... 0	0 ............................... 0	0 ............................... 0	220,891 ............................... 0	0 ............................... 0

Schedule J (Form 990) 2014

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II.
Also complete this part for any additional information.

Return Reference	Explanation
SCHEDULE J, PART II, COLUMN B	BONUSES: ALL BONUSES REPORTED ON SCHEDULE J ARE INCENTIVE BONUSES BASED ON THE PROVIDERS PRODUCTIVITY. ALL ARE CALCULATED BASED ON FIXED FORMULAS SPECIFIED IN THE PROVIDERS' CONTRACTS.

Schedule J (Form 990) 2014

Additional Data

Software ID:
Software Version:

- TIN:

SCHEDULE O
(Form 990 or 990-EZ)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Information about Schedule O (Form 990 or 990-EZ) and its instructions is at
www.irs.gov/form990.

OMB No. 1545-0047

2014

Open to Public
Inspection

Name of the organization

MENDOCINO COMMUNITY HEALTH CLINIC INC

Employer identification number

68-0259045

Return Reference	Explanation
FORM 990, PART I, LINE 1	ORGANIZATION'S MISSION: OUR VISION: WE ENSURE THAT THERE ARE NO CLOSED DOORS FOR THOSE SEEKING PRIMARY HEALTH CARE AT MENDOCINO COMMUNITY HEALTH CLINIC ("MCHC") IN LAKE AND MENDOCINO COUNTIES. EXCELLENCE, ACCESS, COMMUNITY AND COMPASSION ARE THE VALUES OF OUR ORGANIZATION. OUR GOALS: OUR PATIENTS ARE AS HEALTHY AS POSSIBLE: - THEY HAVE ACCESS TO SERVICES REGARDLESS OF THEIR ABILITY TO PAY. - THEY ARE WELL-INFORMED. - THEY HAVE A SIGNIFICANT VOICE IN THEIR HEALTHCARE CHOICES. - THEY RECOGNIZE THEIR ABILITY TO IMPACT THEIR OWN HEALTH. MCHC IS AN EXTRAORDINARILY POSITIVE PLACE TO WORK: - WE ARE COMMITTED TO OUR MISSION AND VISION. - WE PRODUCE EXCEPTIONAL CLINICAL RESULTS THROUGH IMPLEMENTATION OF BEST MEDICAL PRACTICES. - WE ARE HIGHLY PROFESSIONAL AND SEEK CAREER DEVELOPMENT OPPORTUNITIES. - WE DEMONSTRATE OUR CUSTOMER SERVICE PHILOSOPHY WHEN INTERACTING WITH PATIENTS AND EACH OTHER. - WE WORK TOGETHER TO GENERATE SUSTAINABLE FINANCIAL RESULTS. THE COMMUNITY LOOKS TO MCHC FOR HEALTH CARE LEADERSHIP: - MCHC IS RECOGNIZED AND SUPPORTED AS A VALUABLE COMMUNITY RESOURCE. - MCHC COLLABORATES WITH OTHER HEALTH PRACTITIONERS TO IMPROVE THE HEALTH OF OUR COMMUNITY. - MCHC IS CONSULTED REGARDING HEALTH POLICY ISSUES ON A LOCAL, STATE AND NATIONAL LEVEL. - MCHC'S BOARD OF DIRECTORS ARE ACTIVELY INVOLVED IN THEIR COMMUNITIES. OUR CORE OPERATING PRINCIPLES: - WE BELIEVE THAT HEALTH CARE IS A RIGHT AND A RESPONSIBILITY. - WE DELIVER PRIMARY HEALTH CARE IN A SUPPORTIVE, SAFE AND NONJUDGMENTAL MANNER, STRESSING PATIENT INVOLVEMENT. - WE ENSURE THAT LIMITED FUNDS ARE USED EFFECTIVELY. - WE BELIEVE IT IS THE RESPONSIBILITY OF MANAGEMENT TO CREATE A PRODUCTIVE AND POSITIVE WORKING ENVIRONMENT FOR ALL STAFF BY MODELING EFFECTIVE COLLABORATION AND COMMUNICATION AT ALL LEVELS. - WE ACCEPT RESPONSIBILITY FOR OURSELVES. - WE BELIEVE THAT TRUST IS EARNED. - WE EMPHASIZE PROFESSIONAL TRAINING AND DEVELOPMENT OF ALL STAFF. - WE BELIEVE THAT HAPPY PEOPLE TREAT EACH OTHER WELL AND THAT FUN LEADS TO CREATIVITY.
FORM 990, PART I, LINE 6	VOLUNTEERS: THE ORGANIZATION'S BOARD OF DIRECTORS IS A VOLUNTEER BOARD.
FORM 990, PART III, LINE 4A	MEDICAL CARE: THE ORGANIZATION IS INVOLVED IN ONGOING STRATEGIC ASSESSMENT OF OUR COUNTIES' HEALTH CARE NEEDS AND IT RESPONDS WITH AGILITY BY INSTITUTING INNOVATIVE HEALTH PROGRAMS. OUR PATIENTS ARE OFFERED COMPREHENSIVE PRIMARY CARE MEDICAL SERVICES, INCLUDING PHYSICAL EXAMS, CHRONIC DISEASE MANAGEMENT SERVICES, HEALTH MAINTENANCE SUPPORT, VACCINES, IMMUNIZATIONS, INCISION/DRAINAGE OF CYSTS, OUTPATIENT HIV TESTING AND CARE, WELL-CHILD CARE, CHILD HEALTH AND DISABILITY PROGRAM EXAMS, ADDICTION MEDICINE, SCREENINGS FOR ANEMIA, LEAD, VISION, HEARING AND TUBERCULOSIS. SERVICES ARE OFFERED IN BOTH ENGLISH AND SPANISH. OTHER SPECIAL CLINICAL INITIATIVES INCLUDE OFFSITE SERVICES TO POPULATIONS WITH SPECIAL BARRIERS TO CARE INCLUDING SENIORS IN SKILLED NURSING FACILITIES AND THE HOMELESS; AN ORGANIZATION-WIDE PURSUIT OF SOLUTIONS TO MANAGEMENT OF DIABETES, HIV AND EARLY CANCER DETECTION; AND THE DEVELOPMENT OF COLLABORATIVE RESPONSES TO WIDE-RANGING HEALTH THREATS SUCH AS MRSA. WE HAVE DEVELOPED STRONG ALLIANCES WITH SPECIALTY CARE PROVIDERS IN ALL OUR COMMUNITIES, GIVING OUR PATIENTS THE ABILITY TO HAVE CARE FOR THEIR UNIQUE HEALTH CHALLENGES. CURRENT SPECIALTIES INCLUDE CHIROPRACTIC, DERMATOLOGY, NUTRITION EDUCATION, GASTROINTESTINAL MEDICINE, ORTHOPEDICS, PEDIATRICS, PODIATRY, PSYCHIATRY AND SURGERY. CHRONIC DISEASE MANAGEMENT DIABETES, CANCER AND HIV/AIDS ARE THE KINDS OF SERIOUS ILLNESSES AFFECTING OUR PATIENTS. IN A VARIETY OF WAYS WE GRAPPLE WITH MEETING SHORT-TERM AND LONG-TERM TREATMENT NEEDS OF THESE MORE FRAGILE PATIENTS. MCHC HAS ACTIVELY PARTICIPATED IN IMPLEMENTING THE HEALTH DISPARITIES COLLABORATIVE MODEL OF CARE. WE CURRENTLY PARTICIPATE IN DIABETES, CANCER SCREENING, AND HIV COLLABORATIVES. THESE PROJECTS USE PATIENT REGISTRIES AND CLINICAL GUIDELINES TO IMPROVE OUR PROVISION OF CARE. ON A DAY-TO-DAY BASIS, WE EXTEND SUPPORT TO OUR PATIENTS THROUGH OUR CASE MANAGERS. CASE MANAGERS WORK WITH THE CLINICAL TEAM TO HELP FORMULATE COST EFFECTIVE CARE PLANS. THESE CARE COORDINATING STAFF MEMBERS ALSO TAKE ON THE TASK OF IDENTIFYING A PATIENT'S UNIQUE NEEDS AND THEN HELP CONNECT THEM TO COMMUNITY SERVICES THAT MAY FILL IMMEDIATE NEEDS FOR NUTRITION, SHELTER AND TRANSPORTATION. MCHC IS PROUD THAT ITS CARE FOR ITS PATIENTS DOES NOT END AT THE DOOR, AND THAT OUR YEARS OF COMMUNITY COLLABORATION HAVE STRENGTHENED THE COMMUNITY'S SAFETY NET SO IT EFFICIENTLY PROTECTS ITS MOST VULNERABLE POPULATIONS. WOMEN'S HEALTH SERVICES CARE FOR HER, AN INNOVATIVE, BY-WOMEN, FOR-WOMEN HEALTH UNIT, WAS ESTABLISHED IN 2002. IT PROVIDES COMPREHENSIVE WOMEN'S HEALTH SERVICES IN A SENSITIVE AND SUPPORTIVE ENVIRONMENT. THE PROGRAM'S STAFFING MODEL RELIES ON CERTIFIED NURSE-MIDWIVES AND FAMILY NURSE-PRACTITIONERS WHO HAVE ACCESS TO A BROAD ARRAY OF SUPPORT STAFF, INCLUDING WOMEN'S HEALTH SPECIALISTS, NURSES, HEALTH EDUCATORS, NUTRITIONISTS, BREASTFEEDING SPECIALISTS, CANCER SPECIALISTS AND LAB TECHNICIANS. CARE FOR HER PROVIDES WOMEN WITH FULL-SCOPE GYNECOLOGY SERVICES, PAP SMEARS, FOLLOW UP FOR ABNORMAL PAPS AND COLPOSCOPIES; INFORMATION AND EDUCATION ABOUT SEXUALLY-TRANSMITTED INFECTIONS, NUTRITION AND SMOKING CESSATION; GENETIC SCREENING AND COUNSELING; BLOOD TESTS, INCLUDING THYROID, DIABETES, CHOLESTEROL AND HORMONAL EVALUATIONS; URINALYSIS; BONE DENSITY/DEXASCAN; MAMMOGRAMS; CANCER SCREENINGS. MCHC IS PROUD OF OUR PREGNANCY CARE PROGRAM. A SEAMLESSLY BILINGUAL STAFF OF PROFESSIONAL WOMEN HAVE CREATED A HOMELIKE ENVIRONMENT WHERE WOMEN MAY COME TO PREPARE FOR THE BIRTH OF THEIR CHILD. PRENATAL EDUCATION CLASSES CREATE A LEARNING ENVIRONMENT THAT ALLOWS FAMILIES TO FURTHER DEVELOP CHILD-REARING SKILLS. CARE FOR HER OFFERS HANDS-ON INDIVIDUALIZED EDUCATION FOR THE PREGNANT MOTHERS ENTERING OUR PRACTICE. IN OUR EXPERIENCE, EXPECTANT MOTHERS WELCOME THE OPPORTUNITY TO IMPROVE THEIR SKILLS. WE KNOW THIS ONE-ON-ONE EDUCATION SUPPORTS THE GROWING FAMILIES IN OUR COMMUNITIES. CLASSES INCLUDE PREGNANCY EDUCATION, PARENTING SKILLS, NUTRITION, FAMILY PLANNING, DIABETES, INFANT CARE, BREAST-FEEDING AND EARLY CHILDHOOD DEVELOPMENT.
FORM 990, PART III, LINE 4B	DENTAL CARE: AT ALL THREE SITES, MCHC OFFERS COMPREHENSIVE DENTAL SERVICES TO ITS PATIENTS. IN ADDITION TO EXAMS, PATIENTS ARE OFFERED ACCESS TO GUM TREATMENT, SEALANTS, TOOTH-COLORED FILLINGS, DENTURES AND EMERGENCY CARE. SPECIAL PROGRAMS INCLUDE HIV DENTAL CARE, A NURSING FACILITY DENTAL OUTREACH PROGRAM, ORAL HEALTH CARE FOR PREGNANT WOMEN AND A COMMITMENT TO COMMUNITY OUTREACH THAT ALLOWS MCHC TO IMPLEMENT SHORT-TERM, COMMUNITY BASED SERVICE PROJECTS INCLUDING ON-SITE SCREENINGS AT MIGRANT EDUCATION SCHOOLS. WE ARE ONE OF THE FEW HEALTH FACILITIES IN NORTHERN CALIFORNIA THAT SPECIALIZES IN ORAL CARE FOR THE DEVELOPMENTALLY DISABLED. ADDITIONALLY, WE REFER PATIENTS IN NEED OF ORAL SURGERY TO A NETWORK OF SPECIALISTS IN THE NORTHERN CALIFORNIA REGION. WE CONTINUE TO PURSUE, AND RECEIVE, GRANT FUNDING TO FOCUS ON THIS PROBLEM. CONSEQUENTLY, WE ARE ACTIVELY RECRUITING DENTISTS COMMITTED TO SERVICE WHO WISH TO WORK IN A FAST-PACED TEAM ENVIRONMENT.
FORM 990, PART III, LINE 4C	MENTAL HEALTH CARE: IN OUR PRACTICE, MANY OF OUR PATIENTS ARE BESET BY MULTIPLE CONDITIONS. FOR EXAMPLE, A SENIOR STRUGGLING WITH THE EFFECTS OF DIABETES MAY SUFFER FROM CHRONIC DEPRESSION OR A MOTHER SEEKING CARE AT OUR WOMEN'S HEALTH UNIT MAY BE A VICTIM OF ABUSE. AT MCHC, WE SEEK TO TREAT THE WHOLE PERSON. PRIMARY CARE CONSULTATION (PCC) PCC IS AN INTEGRATED PRIMARY CARE/BEHAVIORAL HEALTH PROGRAM DESIGNED TO SERVE PATIENTS WHOSE HEALTH IS AFFECTED BY STRESS, WHO HAVE PROBLEMS MAINTAINING HEALTHY LIFESTYLES AND/OR THOSE AFFECTED BY PSYCHOLOGICAL DISORDERS. THE PCC MODEL ENCOURAGES MEDICAL AND MENTAL HEALTH PROVIDERS TO COLLABORATE AND UNDERSTAND THE PATIENT HOLISTICALLY, AN APPROACH THAT IS BROADLY ADVOCATED WITHIN THE DISCIPLINES OF FAMILY MEDICINE, SOCIAL WORK AND PSYCHIATRY. PSYCHOTHERAPY MCHC'S PSYCHOTHERAPY DEPARTMENT PROVIDES OUTPATIENT PSYCHOTHERAPY AND COUNSELING SERVICES. ELIGIBLE PATIENTS ARE REFERRED TO ONE OF OUR PSYCHIATRISTS, LICENSED PSYCHOLOGISTS OR LICENSED CLINICAL SOCIAL WORKERS WHO PROVIDE SERVICES AT OUR CENTERS.
FORM 990, PART III, LINE 4D	OTHER PROGRAM SERVICES: PEOPLE IN GREATEST NEED CANNOT CONSISTENTLY ACCESS AFFORDABLE MEDICATIONS. THOSE WHO ARE LOW INCOME, UNINSURED AND/OR HAVE CHRONIC CONDITIONS ARE MOST SEVERELY IMPACTED BY LACK OF ACCESS TO AFFORDABLE MEDICATIONS. BECAUSE OF ITS ORGANIZATIONAL COMMITMENT TO ACCESS, MCHC HAS A FULL-TIME, LICENSED, BILINGUAL PHARMACIST AT HILLSIDE HEALTH CENTER. BY MAINTAINING A FULL-SERVICE PHARMACY, MCHC CAN MAKE LIFE-SAVING MEDICATIONS AVAILABLE TO LOW-INCOME PATIENTS AT REDUCED FEES. MCHC ALSO PARTICIPATES IN THE 340B DISCOUNTED DRUG PROGRAM AND OTHER PROGRAMS THAT PROVIDE FREE MEDICATIONS TO ELIGIBLE USERS. PATIENT FINANCIAL SERVICES (PFS) BECAUSE WE KNOW THAT ACCESSING SUPPORT FOR HEALTH CARE CAN BE DIFFICULT, WE HAVE A STRONG PATIENT FINANCIAL SERVICES STAFF TRAINED TO HELP PATIENTS NAVIGATE PUBLIC INSURANCE PROGRAM APPLICATIONS. THEY ARE KNOWLEDGEABLE ADVOCATES WHO ASSIST OUR PATIENTS IN ACCESSING AFFORDABLE HEALTH CARE. IN ADDITION TO PFS REPRESENTATIVES, MCHC OFFERS ACCESS TO A FAMILY ASSISTANCE REPRESENTATIVE (FAR) FROM COUNTY SOCIAL SERVICES. THIS COLLABORATIVE SERVICE IS AVAILABLE TO OUR PATIENTS AT EACH OF OUR CENTERS, EXPEDITING PROCESSING OF PROGRAM APPLICATIONS AND ENSURING THAT ELIGIBLE PATIENTS MAY OBTAIN HEALTHCARE BENEFITS IN A TIMELY MANNER. CENTERS, EXPEDITING PROCESSING OF PROGRAM APPLICATIONS AND ENSURING THAT ELIGIBLE PATIENTS MAY OBTAIN HEALTHCARE BENEFITS IN A TIMELY MANNER. ADDITIONALLY, THE ORGANIZATION PROVIDES GRANTS AND ASSISTANCE TO OTHER ORGANIZATIONS.
FORM 990, PART VI, SECTION B, LINE 11B	PROCESS TO REVIEW THE FORM 990: THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNTING FIRM BASED ON THE AUDITED FINANCIAL STATEMENTS AND INFORMATION PROVIDED BY THE ACCOUNTING DEPARTMENT OF THE ORGANIZATION. PRIOR TO BEING FILED THE FORM 990 IS REVIEWED BY THE CEO AND CFO, THE FULL BOARD WILL RECEIVE A COPY OF THE 990 PRIOR TO IT BEING FILED WITH THE IRS.
FORM 990 PART VI, SECTION B, LINE 12C	MONITORING COMPLIANCE WITH CONFLICT OF INTEREST POLICY: THE ORGANIZATION HAS A COMPLIANCE OFFICER IN PLACE WHO MONITORS THE ADHERENCE TO THE POLICY RELATED TO CONFLICTS OF INTEREST. THIS POLICY IS INCLUDED IN THE EMPLOYEE HANDBOOK AND COVER ALL EMPLOYEES AND BOARD MEMBERS. IF A CONFLICT OF INTEREST IS IDENTIFIED WITHIN THE BOARD, THE INTERESTED PARTY WOULD RECUSE HIMSELF OR HERSELF FROM ANY MATTER UNDER WHICH THE CONFLICT OPERATES. TO THE ORGANIZATION'S KNOWLEDGE, THERE ARE NO SUCH CONFLICTS AT THIS TIME.
FORM 990, PART VI, SECTION B, LINES 15A & 15B	COMPENSATION REVIEW: THE CEO AND CFO'S COMPENSATION REVIEWED BY THE ORGANIZATION'S BOARD OF DIRECTORS ANNUALLY. THE REVIEW INCLUDES AN ANALYSIS BY THE AUDIT COMMITTEE OF THE BOARD UTILIZING COMPARABILITY DATA FROM MACHC SURVEYS. THE ANALYSIS AND RECOMMENDATION WAS PRESENTED TO THE FULL BOARD AND APPROVED. THIS APPROVAL WAS DOCUMENTED IN THE BOARD MINUTES.
FORM 990, PART VI, SECTION C, LINE 19	DOCUMENT DISCLOSURE: FINANCIALS STATEMENTS, GOVERNING DOCUMENTS, AND CONFLICT OF INTEREST POLICY ARE MADE AVAILABLE TO BE MAILED UPON REQUEST.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990 or 990-EZ) 2014

Additional Data

Software ID:
Software Version:

1	Briefly describe the organization’s mission or most significant activities: THE ORGANIZATION IS A FEDERALLY QUALIFIED HEALTH CENTER THAT PROVIDES HEALTH CARE AND EDUCATION SERVICES THROUGH CLINICS LOCATED IN UKIAH,WILLITS, AND LAKEPORT, CA. SEE SCH O
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	9
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	9
5	Total number of individuals employed in calendar year 2014 (Part V, line 2a) ......	5	390
6	Total number of volunteers (estimate if necessary) .............	6	12
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, line 34 .........	7b	0

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 15,043,366 including grants of $ ) (Revenue $ 17,597,239 )
	PRIMARY MEDICAL SERVICES OUR HEALTH CENTERS GRAPPLE WITH THE MOST FUNDAMENTAL HEALTH PROBLEMS BESETTING OUR COMMUNITIES. ALMOST ONE-THIRD OF OUR PATIENTS HAVE SOME FORM OF CHRONIC ILLNESS, AND THE OVERWHELMING NUMBERS OF THESE INDIVIDUALS HAVE MULTIPLE DISORDERS. THE ORGANIZATION IS INVOLVED IN ONGOING STRATEGIC ASSESSMENT OF OUR COUNTIES HEALTH CARE NEEDS AND IT RESPONDS WITH AGILITY BY INSTITUTING INNOVATIVE HEALTH PROGRAMS. DURING THE FISCAL YEAR, THE ORGANIZATION HAD 101,162 PATIENT ENCOUNTERS RELATED TO MEDICAL CARE. SEE SCHEDULE O FOR MORE INFORMATION.

4b	(Code: ) (Expenses $ 4,760,033 including grants of $ ) (Revenue $ 5,968,307 )
	DENTAL CARE THE UNINSURED AND UNDERINSURED OF MENDOCINO AND LAKE COUNTIES CONTINUE TO HAVE SERIOUS ACCESS PROBLEMS FOR THEIR ORAL HEALTH NEEDS. OUR DENTAL DEPARTMENT IS ONE OF OUR FASTEST GROWING SERVICES. DURING THE FISCAL YEAR, THE ORGANIZATION HAD 37,138 PATIENT ENCOUNTERS RELATED TO DENTAL CARE. SEE SCHEDULE O FOR MORE INFORMATION.

4c	(Code: ) (Expenses $ 2,237,865 including grants of $ ) (Revenue $ 2,667,697 )
	MENTAL HEALTH CARE MENDOCINO PROVIDES MENTAL HEALTH CARE SERVICES, INCLUDING PRIMARY CARE CONSULTATIONS, COUNSELING AND PSYCHOTHERAPY. DURING THE FISCAL YEAR, THE ORGANIZATION HAD 16,282 PATIENT ENCOUNTERS RELATED TO MENTAL HEALTH CARE. SEE SCHEDULE O FOR MORE INFORMATION.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ 377,256 including grants of $ 69,090 ) (Revenue $ 223,995 )
4e	Total program service expenses22,418,520

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)............	2,930,436	0	0

(A) Name and business address	(B) Description of services	(C) Compensation





2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	4,880,287	4,497,087
9	Program service revenue (Part VIII, line 2g) .........	23,564,237	26,457,238
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....	-68,393	1,468
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	0	0
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)...................	28,376,131	30,955,793
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...	65,353	69,090
14	Benefits paid to or for members (Part IX, column (A), line 4).....	0	0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	19,741,502	22,288,365
16a	Professional fundraising fees (Part IX, column (A), line 11e).....	0	0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	7,609,425	8,742,411
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	27,416,280	31,099,866
19	Revenue less expenses. Subtract line 18 from line 12.......	959,851	-144,073
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	14,456,201	15,756,982
21	Total liabilities (Part X, line 26).............	6,462,025	7,906,879
22	Net assets or fund balances. Subtract line 21 from line 20.....	7,994,176	7,850,103

(A) Name and Title	(B) Average hours per week (list any hours for related organizations below dotted line)			(D) Reportable compensation from the organization (W- 2/1099-MISC)	(E) Reportable compensation from related organizations (W- 2/1099-MISC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and Title
(18) REBECCA TIMME........................................................................ DIRECTOR PSYCHIATRIC OPERATION	40.0 .......................0.0	X		256,453	0	0
(19) ADWOA CHRISTY........................................................................ PHYSICIAN	40.0 .......................0.0		X	320,748	0	0
(20) GUY TERAN........................................................................ PHYSICIAN	40.0 .......................0.0		X	280,478	0	0
(21) STEVEN WIRTH........................................................................ PHYSICIAN	40.0 .......................0.0		X	295,830	0	0
(22) JOANN ROSENFELD........................................................................ PHYSICIAN	40.0 .......................0.0		X	232,499	0	0
(23) SARA ALVORD........................................................................ PHYSICIAN	40.0 .......................0.0		X	220,891	0	0

				(A) Total revenue	(B) Related or exempt function revenue	(C) Unrelated business revenue	(D) Revenue excluded from tax under sections 512-514
1a	Federated campaigns..1a
b	Membership dues....1b
c	Fundraising events....1c
d	Related organizations...1d
e	Government grants (contributions)1e		4,301,320

f	All other contributions, gifts, grants, and similar amounts not included above1f		195,767

g	Noncash contributions included in lines 1a-1f:$
h	Total. Add lines 1a-1f.......			4,497,087
			Business Code
2a	PATIENT SERVICE		624100	24,787,497	24,787,497
b	EHR INCENTIVE REVENUE		624100	255,000	255,000
c	CONTRACTED MEDICAL SERVICES		624100	97,800	97,800
d	OTHER		624100	1,316,941	1,316,941
e
f	All other program service revenue .
g	Total. Add lines 2a–2f........			26,457,238
3	Investment income (including dividends, interest, and other similar amounts).......			1,468			1,468
4	Income from investment of tax-exempt bond proceeds..			0
5	Royalties...........			0
		(i) Real	(ii) Personal
6a	Gross rents
b	Less: rental expenses
c	Rental income or (loss)	0	0
d	Net rental income or (loss).......			0
		(i) Securities	(ii) Other
7a	Gross amount from sales of assets other than inventory
b	Less: cost or other basis and sales expenses
c	Gain or (loss)
d	Net gain or (loss)..........			0
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ..
	a
b	Less: direct expenses ...b
c	Net income or (loss) from fundraising events..			0
9a	Gross income from gaming activities. See Part IV, line 19 ...
	a
b	Less: direct expenses ...b
c	Net income or (loss) from gaming activities...			0
10a	Gross sales of inventory, less returns and allowances .
	a
b	Less: cost of goods sold ..b
c	Net income or (loss) from sales of inventory..			0
Miscellaneous Revenue			Business Code
11a
b
c
d	All other revenue ....
e	Total. Add lines 11a–11d ......			0
12	Total revenue. See Instructions......			30,955,793	26,457,238		1,468


				(A) Beginning of year		(B) End of year
1	Cash–non-interest-bearing .............			5,295	1	42,718
2	Savings and temporary cash investments .........			1,179,707	2	2,386,862
3	Pledges and grants receivable, net ...........			243,037	3	16,977
4	Accounts receivable, net .............			2,537,431	4	2,448,865
5	Loans and other receivables from current and former officers, directors, trustees, key employees, and highest compensated employees. Complete Part II of Schedule L ..................
				0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), persons described in section 4958(c)(3)(B), and contributing employers and sponsoring organizations of section 501(c)(9) voluntary employees' beneficiary organizations (see instructions) Complete Part II of Schedule L
				0	6	0
7	Notes and loans receivable, net .............			0	7	0
8	Inventories for sale or use ..............			53,836	8	67,384
9	Prepaid expenses and deferred charges ..........			310,650	9	284,060
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	16,663,868
b	Less: accumulated depreciation .....	10b	6,877,715	10,019,624	10c	9,786,153
11	Investments—publicly traded securities ..........			0	11	0
12	Investments—other securities. See Part IV, line 11 .....			0	12	0
13	Investments—program-related. See Part IV, line 11 .....			0	13	0
14	Intangible assets ...............			0	14	0
15	Other assets. See Part IV, line 11 ...........			106,621	15	723,963
16	Total assets. Add lines 1 through 15 (must equal line 34)......			14,456,201	16	15,756,982
17	Accounts payable and accrued expenses .........			2,266,113	17	2,947,155
18	Grants payable .................			0	18	0
19	Deferred revenue ................			0	19	0
20	Tax-exempt bond liabilities .............			0	20	0
21	Escrow or custodial account liability. Complete Part IV of Schedule D..			0	21	0
22	Loans and other payables to current and former officers, directors, trustees, key employees, highest compensated employees, and disqualified
	persons. Complete Part II of Schedule L..........			0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..			4,195,912	23	3,959,724
24	Unsecured notes and loans payable to unrelated third parties ....			0	24	0
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17-24). Complete Part X of Schedule D....................			0	25	1,000,000
26	Total liabilities. Add lines 17 through 25.........			6,462,025	26	7,906,879
	Organizations that follow SFAS 117 (ASC 958), check here and complete lines 27 through 29, and lines 33 and 34.
27	Unrestricted net assets ..............			7,919,176	27	7,845,103
28	Temporarily restricted net assets ...........			75,000	28	5,000
29	Permanently restricted net assets ...........			0	29	0
	Organizations that do not follow SFAS 117 (ASC 958), check here and complete lines 30 through 34.
30	Capital stock or trust principal, or current funds ........				30
31	Paid-in or capital surplus, or land, building or equipment fund .....				31
32	Retained earnings, endowment, accumulated income, or other funds				32
33	Total net assets or fund balances ...........			7,994,176	33	7,850,103
34	Total liabilities and net assets/fund balances ........			14,456,201	34	15,756,982