TY 2018 Form 990EZ

Form990EZ

Department of the Treasury
Internal Revenue Service

Short Form
Return of Organization Exempt From Income Tax

Under section 501(c), 527, or 4947(a)(1) of the Internal Revenue Code (except private foundations)

Do not enter social security numbers on this form as it may be made public.

Go to www.irs.gov/Form990EZ for instructions and the latest information.

OMB No. 1545-1150

2018

Open to Public
Inspection

Check if applicable:

Address change

Name change

Initial return

Final return/terminated

Amended return

Application pending

C Name of organization
Natividad Medical Staff
CO Terri Barroca

Number and street (or P. O. box, if mail is not delivered to street address)1441 Constitution Blvd
Room/suite

City or town, state or province, country, and ZIP or foreign postal code Salinas, CA93906

D Employer identification number

27-4033935

E Telephone number

F Group Exemption
Number bullet

Part ⅢStatement of Program Service Accomplishments (see the instructions for Part III) Check if the organization used Schedule O to respond to any question in this Part III . .	Expenses (Required for section 501(c)(3) and 501(c)(4) organizations; optional for others.)
What is the organization's primary exempt purpose? THE ORGANIZATION IS AN UNICORPORATED ASSOCIATION WHICH CONSTITUTES THE ORGANIZED MEDICAL STAFF OF NATIVIDAD MEDICAL CENTER. THE ORGANIZATION SERVES TO CREDENTIAL STAFF AND SUPERVISES THE MEDICAL SERVICES RENDERED BY ITS MEMBERS TO PATIENTS OF THE HOSPITAL.
Describe the organization’s program service accomplishments for each of its three largest program services, as measured by expenses. In a clear and concise manner, describe the services provided, the number of persons benefited, and other relevant information for each program title.
28 THE ORGANIZATION IS AN UNICORPORATED ASSOCIATION WHICH CONSTITUTES THE ORGANIZED MEDICAL STAFF OF NATIVIDAD MEDICAL CENTER. THE ORGANIZATION SERVES TO CREDENTIAL STAFF AND SUPERVISES THE MEDICAL SERVICES RENDERED BY ITS MEMBERS TO PATIENTS OF THE HOSPITAL. (Grants $ 22,221) If this amount includes foreign grants, check here ...			28a
29 (Grants $ ) If this amount includes foreign grants, check here ...			29a
30 (Grants $ ) If this amount includes foreign grants, check here ...			30a
31 Other program services (describe in Schedule O) ................ (Grants $ ) If this amount includes foreign grants, check here...	31a
32 Total program service expenses (add lines 28a through 31a)..........	32	22,221

(a) Name and title	(b) Average hours per week devoted to position	(c) Reportable compensation (Forms W-2/1099-MISC) (if not paid, enter -0-)
Charles Harris Director	2.00	15,000
Christopher Carpenter Director	2.00	0
Walter Mills Director	0	0
Craig Walls Director	0	0
Christina Zaro Director	0	0

Section 501(c)(3), 501(c)(4), and 501(c)(29) organizations. Did the organization engage in any section 4958 excess benefit transaction during the year, or did it engage in an excess benefit transaction in a prior year that has not been reported on any of its prior Forms 990 or 990-EZ? If “Yes," complete Schedule L, Part I

40b

Yes

Did the organization engage in lobbying activities or have a section 501(h) election in effect during the tax year? If "Yes," complete Schedule C, Part II .......................

Is the organization a school as described in section 170(b)(1)(A)(ii)? If "Yes," complete Schedule E ..

49a

Did the organization make any transfers to an exempt non-charitable related organization?......

49a

If "Yes," was the related organization a section 527 organization?................

49b

Complete this table for the organization's five highest compensated employees (other than officers, directors, trustees and key employees) who each received more than $100,000 of compensation from the organization. If there is none, enter "None."

(a) Name and title of each employee	(b) Average hours per week devoted to position	(c) Reportable compensation (Forms W-2/1099-MISC)	(d) Health benefits, contributions to employee benefit plans, and deferred compensation	(e) Estimated amount of other compensation
NONE

Total number of other employees paid over $100,000 ............. bullet

Complete this table for the organization's five highest compensated independent contractors who each received more than $100,000 of compensation from the organization. If there is none, enter "None."

(a) Name and business address of each independent contractor	(b) Type of service	(c) Compensation
NONE

Return Reference	Explanation
Grants and Similar Amounts Paid In Excess of $5,000.1	\| Donee's Name: NATIVIDAD MEDICAL CENTER \| Donee's Address: 1441 CONSTITUTION BLVD. SALINAS CA 93906 \| Relationship of Donee: NONE \| Cash Amount Given: $7000
Other Expenses.1002	Office Expenses $3466
Other Expenses.1007	Conferences, Conventions, and Meetings $35357
Other Expenses.1	CREDENTIALING COSTS $22221
Other Expenses.2	AWARDS $1309
Other Expenses.3	OTHER $1018

Return Reference

Explanation

Grants and Similar Amounts Paid In Excess of $5,000.1

| Donee's Name: NATIVIDAD MEDICAL CENTER | Donee's Address: 1441 CONSTITUTION BLVD. SALINAS CA 93906 | Relationship of Donee: NONE | Cash Amount Given: $7000

Other Expenses.1002

Office Expenses $3466

Other Expenses.1007

Conferences, Conventions, and Meetings $35357

Other Expenses.1

CREDENTIALING COSTS $22221

Other Expenses.2

AWARDS $1309

Other Expenses.3

OTHER $1018

1	Contributions, gifts, grants, and similar amounts received ....................	1	83,926
2	Program service revenue including government fees and contracts ...............	2
3	Membership dues and assessments ...........................	3
4	Investment income ...........................	4	81
5a	Gross amount from sale of assets other than inventory .....	5a
b	Less: cost or other basis and sales expenses .......	5b	0
c	Gain or (loss) from sale of assets other than inventory (Subtract line 5b from line 5a) ......	5c
6	Gaming and fundraising events
a	Gross income from gaming (attach Schedule G if greater than $15,000)	6a
b	Gross income from fundraising events (not including $ of contributions from fundraising events reported on line 1) (attach Schedule G if the			sum of such gross income and contributions exceeds $15,000) ..	6b	0
c	Less: direct expenses from gaming and fundraising events ...	6c	0
d	Net income or (loss) from gaming and fundraising events (add lines 6a and 6b and subtract line 6c)	6d
7a	Gross sales of inventory, less returns and allowances ......	7a
b	Less: cost of goods sold .............	7b	0
c	Gross profit or (loss) from sales of inventory (Subtract line 7b from line 7a) .........	7c
8	Other revenue (describe in Schedule O) ..........	8
9	Total revenue. Add lines 1, 2, 3, 4, 5c, 6d, 7c, and 8 ..............	9	84,007

10	Grants and similar amounts paid (list in Schedule O) ............	10	7,000
11	Benefits paid to or for members ................	11
12	Salaries, other compensation, and employee benefits ................	12	15,000
13	Professional fees and other payments to independent contractors ............	13	1,790
14	Occupancy, rent, utilities, and maintenance ...................	14
15	Printing, publications, postage, and shipping ..............	15
16	Other expenses (describe in Schedule O) ..............	16	63,371
17	Total expenses. Add lines 10 through 16 ..............	17	87,161

18	Excess or (deficit) for the year (Subtract line 17 from line 9) ............	18	-3,154
19	Net assets or fund balances at beginning of year (from line 27, column (A)) (must agree with
	end-of-year figure reported on prior year’s return) ............	19	134,859
20	Other changes in net assets or fund balances (explain in Schedule O) ..........	20
21	Net assets or fund balances at end of year. Combine lines 18 through 20 .......	21	131,705

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