Liabilities / Assets
25th percentile
Higher debt load relative to assets than 25% of similar nonprofits.
EIN 94-2583156 • 501(c)3 • Auburn, CA
Profile
Provides comprehensive health care and ancillary services to the Native-American population of Sierra, Placer, and Nevada Counties of California.
Precomputed percentiles relative to similar nonprofits. These scores are descriptive rather than judgmental.
Liabilities / Assets
25th percentile
Higher debt load relative to assets than 25% of similar nonprofits.
Liabilities / Revenue
35th percentile
Higher debt load relative to revenue than 35% of similar nonprofits.
Net Margin
85th percentile
Higher net margin than 85% of similar nonprofits.
Top Officer Pay
55th percentile
Higher top officer pay than 55% of similar nonprofits.
Top officer pay equals 0.7% of source-year revenue.
Asset Growth
86th percentile
Faster asset growth than 86% of similar nonprofits.
Revenue Growth
70th percentile
Faster revenue growth than 70% of similar nonprofits.
Assets
Up$208,048,447
Up $29,351,221 (+16%) from 2022
Liabilities
Up$16,022,081
Up $2,082,424 (+15%) from 2022
Net Assets
Up$192,026,366
Up $27,268,797 (+17%) from 2022
Revenue
Up$66,598,010
Up $1,575,594 (+2.4%) from 2022
Expenses
Up$44,920,233
Up $5,447,849 (+14%) from 2022
Net Income
Down$21,677,777
Down $3,872,255 (-15%) from 2022
Most recent year
2023 • Form 990Summary only. Only limited summary data is available for this year.
The latest 2023 filing currently has summary financial data only. Showing the latest detailed filing from 2021 below.
Provides comprehensive health care and ancillary services to the Native-American population of Sierra, Placer, and Nevada Counties of California.
Provides comprehensive health care and ancillary services to the native-american population of sierra, placer and nevada counties of california.
| Line | Beginning | End | Change |
|---|---|---|---|
| Assets | |||
| Investments Other Securities | $71,011,835 | $100,592,350 | ▲ $29,580,515 |
| Savings and Temporary Cash Investments | $34,761,691 | $35,279,557 | ▲ $517,866 |
| Land, Buildings, and Equipment, Net | $24,084,084 | $29,620,139 | ▲ $5,536,055 |
| Accounts Receivable | $2,007,769 | $3,312,912 | ▲ $1,305,143 |
| Pledges and Grants Receivable | $287,067 | $2,160,222 | ▲ $1,873,155 |
| Inventories for Sale or Use | $214,395 | $175,432 | ▼ $38,963 |
| Cash and Non-Interest-Bearing Accounts | $6,800 | $6,400 | ▼ $400 |
| Total Assets | $132,597,049 | $171,407,470 | ▲ $38,810,421 |
| Other Assets Total | $223,408 | $260,458 | ▲ $37,050 |
| Liabilities | |||
| Deferred Revenue | $6,893,197 | $15,205,987 | ▲ $8,312,790 |
| Other Liabilities | $4,296,400 | $0 | ▼ $4,296,400 |
| Accounts Payable and Accrued Expenses | $3,180,254 | $4,175,320 | ▲ $995,066 |
| Total Liabilities | $14,369,851 | $19,381,307 | ▲ $5,011,456 |
| Net Assets / Fund Balance | |||
| Net Assets Without Donor Restrictions | $118,227,198 | $152,026,163 | ▲ $33,798,965 |
| Net Assets With Donor Restrictions | $0 | $0 | → $0 |
| Total Net Assets Fund Balance | $118,227,198 | $152,026,163 | ▲ $33,798,965 |
| Total Liabilities and Net Assets / Fund Balance | $132,597,049 | $171,407,470 | ▲ $38,810,421 |
| Asset | Book Value | Depreciation | Basis |
|---|---|---|---|
| Buildings | $18,896,425 | $15,496,150 | $34,392,575 |
| Other Land Buildings | $5,046,771 | - | $5,046,771 |
| Land | $4,961,827 | - | $4,961,827 |
| Equipment | $715,116 | $3,437,971 | $4,153,087 |
| Other Securities | $100,592,350 | - | - |
| Name | Title | Full / Part Time | Base | Other | Total |
|---|---|---|---|---|---|
| Lisa Davies | CEO | FT | $296,706 | $70,008 | $366,714 |
| Alinea Stevens | Medical Director | PT | $210,864 | $71,927 | $282,791 |
| William Jornlin | Physician | FT | $224,486 | $51,615 | $276,101 |
| Michael Quion | Lead Physician | FT | $215,897 | $46,398 | $262,295 |
| Richard Malek | Psychiatrist | FT | $251,600 | $6,543 | $258,143 |
| Sierk Haitsma | CFO | FT | $208,217 | $46,025 | $254,242 |
| Pauline Karunakaran | Dental Director | FT | $206,027 | $41,895 | $247,922 |
| Karina Gookin | Lead Physician | FT | $199,795 | $46,724 | $246,519 |
| Darla Clark | COO | FT | $191,103 | $52,067 | $243,170 |
| Adam Borruso | Family Nurse Practitioner/clinical Informatics Lea | FT | $178,530 | $26,811 | $205,341 |
| Adam Borruso | Family Nurse Practitioner/clinical I | - | $171,461 | $33,880 | $205,341 |
| Eric Osborn | Chief Information Officer | FT | $178,565 | $25,865 | $204,430 |
| Anthony Reyes | Chief Administrative Officer | FT | $159,289 | $42,741 | $202,030 |
| Julie Garchow | Physician | PT | $166,436 | $33,516 | $199,952 |
| Jashanjot Bajwa | Dentist | FT | $160,182 | $21,895 | $182,077 |
| Name | Title |
|---|---|
| Brenda Adams | Chair |
| David Keyser | Vice-chair |
| Jason Camp | Board Member |
| John L Williams | Board Member |
| Gene Whitehouse | Secretary |
| Contractor | Services | Location | Compensation |
|---|---|---|---|
| Effort Pharmacy Services INC | Pharmacy Services | 3215 PENNINGTON ROAD, Live Oak, CA 95953 | $1,904,807 |
| Descor Builders INC | Building Contractor | 3164 GOLD CAMP DRIVE 250, Rancho Cordova, CA 95670 | $1,816,251 |
| Deacon Construction LLC | Building Contractor | 7745 GREENBACK LANE 250, Citrus Heights, CA 95610 | $1,810,126 |
| Keker Van Nest & Peters LLP | Professional Service | 633 BATTERY STREET, San Francisco, CA 94111 | $1,084,110 |
| Rcp Construction INC | Building Contractor | 5180 GOLDEN FOOTHILLS PKWY 110, El Dorado Hills, CA 95762 | $905,493 |
| Line Item | Amount |
|---|---|
| Salaries, Compensation, and Employee Benefits | $23,705,459 |
| Other Expenses | $11,825,705 |
| Grants and Similar Amounts Paid | $0 |
| Professional Fundraising Fees | $0 |
| Total Fundraising Expense | $0 |
| Line Item | Program | Management | Fundraising | Total |
|---|---|---|---|---|
| Other Salaries and Wages | $12,543,730 | $4,041,551 | - | $16,585,281 |
| Other Employee Benefits | $2,518,372 | $995,176 | - | $3,513,548 |
| Fees for Services Other | $2,615,356 | $697,239 | - | $3,312,595 |
| Current Officers, Directors, Trustees, and Key Employees | $1,673,629 | $553,813 | - | $2,227,442 |
| Depreciation Depletion | $183,464 | $1,300,844 | - | $1,484,308 |
| Payroll Taxes | $988,547 | $390,641 | - | $1,379,188 |
| Occupancy | $961 | $1,006,917 | - | $1,007,878 |
| Information Technology | $114,568 | $457,196 | - | $571,764 |
| All Other Expenses | $192,952 | $247,911 | - | $440,863 |
| Other Expenses | $239,770 | $29,158 | - | $268,928 |
| Fees for Services Legal | $176,556 | $46,932 | - | $223,488 |
| Office Expenses | $6,398 | $152,139 | - | $158,537 |
| Fees for Service Investment Mgmnt Fees | - | $136,706 | - | $136,706 |
| Insurance | - | $124,084 | - | $124,084 |
| Fees for Services Accounting | $55,467 | $14,744 | - | $70,211 |
| Travel | $47,231 | $6,737 | - | $53,968 |
| Interest | - | $24,719 | - | $24,719 |
| Total Functional Expenses | $24,743,242 | $10,787,922 | $0 | $35,531,164 |
| Line Item | Amount |
|---|---|
| Total Expenses per Form 990 | $35,531,164 |
| Expenses per Audited Statements | $35,394,458 |
| Total Expenses per Audited Statements | $35,394,458 |
| Expenses Not Reported on Financial Statements | $136,706 |
| Expenses Not Reported on Form 990 | $0 |
| Line Item | Amount |
|---|---|
| Professional Fundraising Fees | $0 |
“The board of directors hires all officers of the organization. The compensation amount is based on prevailing salaries in the area and the experience and qualifications of the officer.”
“The form 990 is presented by the cfo to the full board of directors and is approved for filing. The chairperson is authorized to sign the form 990 after the approval by the full board of directors.”
“The organization performs an annual evaluation of all potential conflict of interest situations.”
“The board of directors hires ceo and top management of the organization. The compensation amount is based on prevailing salaries in the area and the experience and qualifications of the employee. This process was last undertaken in 2020.”
“Documents are available upon request from the general public.”
“The process has not changed from the prior period.”
This appendix keeps the raw XML leaves available for debugging and edge-case review. The human report above is the primary experience.
| Path | # | Value |
|---|---|---|
| IRS990/AccountantCompileOrReviewInd | 0 | 0 |
| IRS990/AccountsPayableAccrExpnssGrp/BOYAmt | 0 | 3180254 |
| IRS990/AccountsPayableAccrExpnssGrp/EOYAmt | 0 | 4175320 |
| IRS990/AccountsReceivableGrp/BOYAmt | 0 | 2007769 |
| IRS990/AccountsReceivableGrp/EOYAmt | 0 | 3312912 |
| IRS990/ActivitiesConductedPrtshpInd | 0 | 0 |
| IRS990/ActivityOrMissionDesc | 0 | PROVIDES COMPREHENSIVE HEALTH CARE AND ANCILLARY SERVICES TO THE NATIVE-AMERICAN POPULATION OF SIERRA, PLACER AND NEVADA COUNTIES OF CALIFORNIA. |
| IRS990/AllOtherContributionsAmt | 0 | 4137 |
| IRS990/AllOtherExpensesGrp/ManagementAndGeneralAmt | 0 | 247911 |
| IRS990/AllOtherExpensesGrp/ProgramServicesAmt | 0 | 192952 |
| IRS990/AllOtherExpensesGrp/TotalAmt | 0 | 440863 |
| IRS990/AnnualDisclosureCoveredPrsnInd | 0 | 1 |
| IRS990/AuditCommitteeInd | 0 | 1 |
| IRS990/BackupWthldComplianceInd | 0 | 1 |
| IRS990/BooksInCareOfDetail/BusinessName/BusinessNameLine1Txt | 0 | SIERK HAITSMA |
| IRS990/BooksInCareOfDetail/PhoneNum | 0 | 5308872800 |
| IRS990/BooksInCareOfDetail/USAddress/AddressLine1Txt | 0 | 11670 ATWOOD ROAD |
| IRS990/BooksInCareOfDetail/USAddress/CityNm | 0 | AUBURN |
| IRS990/BooksInCareOfDetail/USAddress/StateAbbreviationCd | 0 | CA |
| IRS990/BooksInCareOfDetail/USAddress/ZIPCd | 0 | 95603 |
| IRS990/BusinessRlnWith35CtrlEntInd | 0 | 0 |
| IRS990/BusinessRlnWithFamMemInd | 0 | 0 |
| IRS990/BusinessRlnWithOrgMemInd | 0 | 0 |
| IRS990/CashNonInterestBearingGrp/BOYAmt | 0 | 6800 |
| IRS990/CashNonInterestBearingGrp/EOYAmt | 0 | 6400 |
| IRS990/ChangeToOrgDocumentsInd | 0 | 0 |
| IRS990/CntrctRcvdGreaterThan100KCnt | 0 | 31 |
| IRS990/CollectionsOfArtInd | 0 | 0 |
| IRS990/CompCurrentOfcrDirectorsGrp/ManagementAndGeneralAmt | 0 | 553813 |
| IRS990/CompCurrentOfcrDirectorsGrp/ProgramServicesAmt | 0 | 1673629 |
| IRS990/CompCurrentOfcrDirectorsGrp/TotalAmt | 0 | 2227442 |
| IRS990/CompensationFromOtherSrcsInd | 0 | 0 |
| IRS990/CompensationProcessCEOInd | 0 | 1 |
| IRS990/CompensationProcessOtherInd | 0 | 1 |
| IRS990/ConflictOfInterestPolicyInd | 0 | 1 |
| IRS990/ConservationEasementsInd | 0 | 0 |
| IRS990/ConsolidatedAuditFinclStmtInd | 0 | 0 |
| IRS990/ContractorCompensationGrp/CompensationAmt | 0 | 1904807 |
| IRS990/ContractorCompensationGrp/CompensationAmt | 1 | 1816251 |
| IRS990/ContractorCompensationGrp/CompensationAmt | 2 | 1810126 |
| IRS990/ContractorCompensationGrp/CompensationAmt | 3 | 1084110 |
| IRS990/ContractorCompensationGrp/CompensationAmt | 4 | 905493 |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/AddressLine1Txt | 0 | 3215 PENNINGTON ROAD |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/AddressLine1Txt | 1 | 3164 GOLD CAMP DRIVE 250 |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/AddressLine1Txt | 2 | 7745 GREENBACK LANE 250 |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/AddressLine1Txt | 3 | 633 BATTERY STREET |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/AddressLine1Txt | 4 | 5180 GOLDEN FOOTHILLS PKWY 110 |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/CityNm | 0 | LIVE OAK |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/CityNm | 1 | RANCHO CORDOVA |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/CityNm | 2 | CITRUS HEIGHTS |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/CityNm | 3 | SAN FRANCISCO |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/CityNm | 4 | EL DORADO HILLS |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/StateAbbreviationCd | 0 | CA |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/StateAbbreviationCd | 1 | CA |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/StateAbbreviationCd | 2 | CA |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/StateAbbreviationCd | 3 | CA |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/StateAbbreviationCd | 4 | CA |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/ZIPCd | 0 | 95953 |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/ZIPCd | 1 | 95670 |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/ZIPCd | 2 | 95610 |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/ZIPCd | 3 | 94111 |
| IRS990/ContractorCompensationGrp/ContractorAddress/USAddress/ZIPCd | 4 | 95762 |
| IRS990/ContractorCompensationGrp/ContractorName/BusinessName/BusinessNameLine1Txt | 0 | EFFORT PHARMACY SERVICES INC |
| IRS990/ContractorCompensationGrp/ContractorName/BusinessName/BusinessNameLine1Txt | 1 | DESCOR BUILDERS INC |
| IRS990/ContractorCompensationGrp/ContractorName/BusinessName/BusinessNameLine1Txt | 2 | DEACON CONSTRUCTION LLC |
| IRS990/ContractorCompensationGrp/ContractorName/BusinessName/BusinessNameLine1Txt | 3 | KEKER VAN NEST & PETERS LLP |
| IRS990/ContractorCompensationGrp/ContractorName/BusinessName/BusinessNameLine1Txt | 4 | RCP CONSTRUCTION INC |
| IRS990/ContractorCompensationGrp/ServicesDesc | 0 | PHARMACY SERVICES |
| IRS990/ContractorCompensationGrp/ServicesDesc | 1 | BUILDING CONTRACTOR |
| IRS990/ContractorCompensationGrp/ServicesDesc | 2 | BUILDING CONTRACTOR |
| IRS990/ContractorCompensationGrp/ServicesDesc | 3 | PROFESSIONAL SERVICE |
| IRS990/ContractorCompensationGrp/ServicesDesc | 4 | BUILDING CONTRACTOR |
| IRS990/CreditCounselingInd | 0 | 0 |
| IRS990/CYBenefitsPaidToMembersAmt | 0 | 0 |
| IRS990/CYContributionsGrantsAmt | 0 | 17847918 |
| IRS990/CYGrantsAndSimilarPaidAmt | 0 | 0 |
| IRS990/CYInvestmentIncomeAmt | 0 | 1962180 |
| IRS990/CYOtherExpensesAmt | 0 | 11825705 |
| IRS990/CYOtherRevenueAmt | 0 | 0 |
| IRS990/CYProgramServiceRevenueAmt | 0 | 38852079 |
| IRS990/CYRevenuesLessExpensesAmt | 0 | 23131013 |
| IRS990/CYSalariesCompEmpBnftPaidAmt | 0 | 23705459 |
| IRS990/CYTotalExpensesAmt | 0 | 35531164 |
| IRS990/CYTotalFundraisingExpenseAmt | 0 | 0 |
| IRS990/CYTotalProfFndrsngExpnsAmt | 0 | 0 |
| IRS990/CYTotalRevenueAmt | 0 | 58662177 |
| IRS990/DecisionsSubjectToApprovaInd | 0 | 0 |
| IRS990/DeductibleArtContributionInd | 0 | 0 |
| IRS990/DeductibleNonCashContriInd | 0 | 0 |
| IRS990/DeferredRevenueGrp/BOYAmt | 0 | 6893197 |
| IRS990/DeferredRevenueGrp/EOYAmt | 0 | 15205987 |
| IRS990/DelegationOfMgmtDutiesInd | 0 | 0 |
| IRS990/DepreciationDepletionGrp/ManagementAndGeneralAmt | 0 | 1300844 |
| IRS990/DepreciationDepletionGrp/ProgramServicesAmt | 0 | 183464 |
| IRS990/DepreciationDepletionGrp/TotalAmt | 0 | 1484308 |
| IRS990/Desc | 0 | PRIMARY HEALTH CARE PROGRAM- CHAPA-DE INDIAN PROGRAM, INC PROVIDED COMPREHENSIVE HEALTH SERVICES TO THE NATIVE-AMERICAN POPULATION AND OTHER RESIDENTS OF SIERRA, PLACER, AND NEVADA COUNTIES OF CALIFORNIA. COMPREHENSIVE HEALTH SERVICES INCLUDE DIRECT PATIENT CARE, IMMUNIZATIONS, HEALTH PROMOTION AND DISEASE PREVENTION, DRUG ABUSE AND EDUCATION/PREVENTION PROGRAMS, AND DENTAL CARE. |
| IRS990/DescribedInSection501c3Ind | 0 | 1 |
| IRS990/DisregardedEntityInd | 0 | 0 |
| IRS990/DocumentRetentionPolicyInd | 0 | 1 |
| IRS990/DonorAdvisedFundInd | 0 | 0 |
| IRS990/DonorRestrictionNetAssetsGrp/BOYAmt | 0 | 0 |
| IRS990/DonorRestrictionNetAssetsGrp/EOYAmt | 0 | 0 |
| IRS990/DonorRstrOrQuasiEndowmentsInd | 0 | 0 |
| IRS990/ElectionOfBoardMembersInd | 0 | 0 |
| IRS990/EmployeeCnt | 0 | 297 |
| IRS990/EmploymentTaxReturnsFiledInd | 0 | 1 |
| IRS990/EngagedInExcessBenefitTransInd | 0 | 0 |
| IRS990/ExpenseAmt | 0 | 23106597 |
| IRS990/FamilyOrBusinessRlnInd | 0 | 0 |
| IRS990/FederalGrantAuditPerformedInd | 0 | 1 |
| IRS990/FederalGrantAuditRequiredInd | 0 | 1 |
| IRS990/FeesForServicesAccountingGrp/ManagementAndGeneralAmt | 0 | 14744 |
| IRS990/FeesForServicesAccountingGrp/ProgramServicesAmt | 0 | 55467 |
| IRS990/FeesForServicesAccountingGrp/TotalAmt | 0 | 70211 |
| IRS990/FeesForServicesLegalGrp/ManagementAndGeneralAmt | 0 | 46932 |
| IRS990/FeesForServicesLegalGrp/ProgramServicesAmt | 0 | 176556 |
| IRS990/FeesForServicesLegalGrp/TotalAmt | 0 | 223488 |
| IRS990/FeesForServicesOtherGrp/ManagementAndGeneralAmt | 0 | 697239 |
| IRS990/FeesForServicesOtherGrp/ProgramServicesAmt | 0 | 2615356 |
| IRS990/FeesForServicesOtherGrp/TotalAmt | 0 | 3312595 |
| IRS990/FeesForSrvcInvstMgmntFeesGrp/ManagementAndGeneralAmt | 0 | 136706 |
| IRS990/FeesForSrvcInvstMgmntFeesGrp/TotalAmt | 0 | 136706 |
| IRS990/ForeignActivitiesInd | 0 | 0 |
| IRS990/ForeignFinancialAccountInd | 0 | 0 |
| IRS990/ForeignOfficeInd | 0 | 0 |
| IRS990/Form8282PropertyDisposedOfInd | 0 | 0 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 0 | 2.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 1 | 2.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 2 | 2.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 3 | 2.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 4 | 2.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 5 | 40.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 6 | 40.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 7 | 40.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 8 | 32.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 9 | 40.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 10 | 40.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 11 | 36.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 12 | 36.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 13 | 40.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 14 | 40.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 15 | 40.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 16 | 32.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 17 | 40.00 |
| IRS990/Form990PartVIISectionAGrp/AverageHoursPerWeekRt | 18 | 40.00 |
| IRS990/Form990PartVIISectionAGrp/HighestCompensatedEmployeeInd | 0 | X |
| IRS990/Form990PartVIISectionAGrp/HighestCompensatedEmployeeInd | 1 | X |
| IRS990/Form990PartVIISectionAGrp/HighestCompensatedEmployeeInd | 2 | X |
| IRS990/Form990PartVIISectionAGrp/HighestCompensatedEmployeeInd | 3 | X |
| IRS990/Form990PartVIISectionAGrp/HighestCompensatedEmployeeInd | 4 | X |
| IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd | 0 | X |
| IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd | 1 | X |
| IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd | 2 | X |
| IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd | 3 | X |
| IRS990/Form990PartVIISectionAGrp/IndividualTrusteeOrDirectorInd | 4 | X |
| IRS990/Form990PartVIISectionAGrp/KeyEmployeeInd | 0 | X |
| IRS990/Form990PartVIISectionAGrp/KeyEmployeeInd | 1 | X |
| IRS990/Form990PartVIISectionAGrp/KeyEmployeeInd | 2 | X |
| IRS990/Form990PartVIISectionAGrp/KeyEmployeeInd | 3 | X |
| IRS990/Form990PartVIISectionAGrp/KeyEmployeeInd | 4 | X |
| IRS990/Form990PartVIISectionAGrp/KeyEmployeeInd | 5 | X |
| IRS990/Form990PartVIISectionAGrp/OfficerInd | 0 | X |
| IRS990/Form990PartVIISectionAGrp/OfficerInd | 1 | X |
| IRS990/Form990PartVIISectionAGrp/OfficerInd | 2 | X |
| IRS990/Form990PartVIISectionAGrp/OfficerInd | 3 | X |
| IRS990/Form990PartVIISectionAGrp/OfficerInd | 4 | X |
| IRS990/Form990PartVIISectionAGrp/OfficerInd | 5 | X |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 0 | 0 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 1 | 0 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 2 | 0 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 3 | 0 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 4 | 0 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 5 | 31167 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 6 | 38008 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 7 | 22665 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 8 | 46481 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 9 | 28365 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 10 | 13365 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 11 | 42608 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 12 | 39870 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 13 | 24450 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 14 | 26811 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 15 | 17469 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 16 | 28823 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 17 | 645 |
| IRS990/Form990PartVIISectionAGrp/OtherCompensationAmt | 18 | 44283 |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 0 | BRENDA ADAMS |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 1 | DAVID KEYSER |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 2 | GENE WHITEHOUSE |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 3 | JASON CAMP |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 4 | JOHN L WILLIAMS |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 5 | DARLA CLARK |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 6 | LISA DAVIES |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 7 | SIERK HAITSMA |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 8 | ALINEA STEVENS |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 9 | ANTHONY REYES |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 10 | ERIC OSBORN |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 11 | KARINA GOOKIN |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 12 | MICHAEL QUION |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 13 | PAULINE KARUNAKARAN |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 14 | ADAM BORRUSO |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 15 | JASHANJOT BAJWA |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 16 | JULIE GARCHOW |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 17 | RICHARD MALEK |
| IRS990/Form990PartVIISectionAGrp/PersonNm | 18 | WILLIAM JORNLIN |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 0 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 1 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 2 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 3 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 4 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 5 | 212003 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 6 | 328706 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 7 | 231577 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 8 | 236310 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 9 | 173665 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 10 | 191065 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 11 | 203911 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 12 | 222425 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 13 | 223472 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 14 | 178530 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 15 | 164608 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 16 | 171129 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 17 | 257498 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromOrgAmt | 18 | 231818 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 0 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 1 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 2 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 3 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 4 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 5 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 6 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 7 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 8 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 9 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 10 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 11 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 12 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 13 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 14 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 15 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 16 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 17 | 0 |
| IRS990/Form990PartVIISectionAGrp/ReportableCompFromRltdOrgAmt | 18 | 0 |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 0 | CHAIR |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 1 | VICE-CHAIR |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 2 | SECRETARY |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 3 | BOARD MEMBER |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 4 | BOARD MEMBER |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 5 | COO |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 6 | CEO |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 7 | CFO |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 8 | MEDICAL DIRECTOR |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 9 | CHIEF ADMINISTRATIVE OFFICER |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 10 | CHIEF INFORMATION OFFICER |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 11 | LEAD PHYSICIAN |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 12 | LEAD PHYSICIAN |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 13 | DENTAL DIRECTOR |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 14 | FAMILY NURSE PRACTITIONER/CLINICAL INFORMATICS LEA |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 15 | DENTIST |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 16 | PHYSICIAN |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 17 | PSYCHIATRIST |
| IRS990/Form990PartVIISectionAGrp/TitleTxt | 18 | PHYSICIAN |
| IRS990/Form990ProvidedToGvrnBodyInd | 0 | 1 |
| IRS990/FormationYr | 0 | 1979 |
| IRS990/FormerOfcrEmployeesListedInd | 0 | 0 |
| IRS990/FSAuditedBasisGrp/SeparateBasisFinclStmtInd | 0 | X |
| IRS990/FSAuditedInd | 0 | 1 |
| IRS990/FundraisingActivitiesInd | 0 | 0 |
| IRS990/GainOrLossGrp/SecuritiesAmt | 0 | 2664 |
| IRS990/GamingActivitiesInd | 0 | 0 |
| IRS990/GoverningBodyVotingMembersCnt | 0 | 5 |
| IRS990/GovernmentGrantsAmt | 0 | 17843781 |
| IRS990/GrantsToIndividualsInd | 0 | 0 |
| IRS990/GrantsToOrganizationsInd | 0 | 0 |
| IRS990/GrantToRelatedPersonInd | 0 | 0 |
| IRS990/GrossAmountSalesAssetsGrp/SecuritiesAmt | 0 | 2664 |
| IRS990/GrossReceiptsAmt | 0 | 58662177 |
| IRS990/GroupReturnForAffiliatesInd | 0 | 0 |
| IRS990/IncludeFIN48FootnoteInd | 0 | 0 |
| IRS990/IndependentAuditFinclStmtInd | 0 | 1 |
| IRS990/IndependentVotingMemberCnt | 0 | 5 |
| IRS990/IndivRcvdGreaterThan100KCnt | 0 | 42 |
| IRS990/IndoorTanningServicesInd | 0 | 0 |
| IRS990/InfoInScheduleOPartVIInd | 0 | X |
| IRS990/InfoInScheduleOPartXIIInd | 0 | X |
| IRS990/InformationTechnologyGrp/ManagementAndGeneralAmt | 0 | 457196 |
| IRS990/InformationTechnologyGrp/ProgramServicesAmt | 0 | 114568 |
| IRS990/InformationTechnologyGrp/TotalAmt | 0 | 571764 |
| IRS990/InsuranceGrp/ManagementAndGeneralAmt | 0 | 124084 |
| IRS990/InsuranceGrp/TotalAmt | 0 | 124084 |
| IRS990/InterestGrp/ManagementAndGeneralAmt | 0 | 24719 |
| IRS990/InterestGrp/TotalAmt | 0 | 24719 |
| IRS990/InventoriesForSaleOrUseGrp/BOYAmt | 0 | 214395 |
| IRS990/InventoriesForSaleOrUseGrp/EOYAmt | 0 | 175432 |
| IRS990/InvestmentIncomeGrp/ExclusionAmt | 0 | 1959516 |
| IRS990/InvestmentIncomeGrp/TotalRevenueColumnAmt | 0 | 1959516 |
| IRS990/InvestmentInJointVentureInd | 0 | 0 |
| IRS990/InvestmentsOtherSecuritiesGrp/BOYAmt | 0 | 71011835 |
| IRS990/InvestmentsOtherSecuritiesGrp/EOYAmt | 0 | 100592350 |
| IRS990/IRPDocumentCnt | 0 | 94 |
| IRS990/IRPDocumentW2GCnt | 0 | 0 |
| IRS990/LandBldgEquipAccumDeprecAmt | 0 | 18934121 |
| IRS990/LandBldgEquipBasisNetGrp/BOYAmt | 0 | 24084084 |
| IRS990/LandBldgEquipBasisNetGrp/EOYAmt | 0 | 29620139 |
| IRS990/LandBldgEquipCostOrOtherBssAmt | 0 | 48554260 |
| IRS990/LegalDomicileStateCd | 0 | CA |
| IRS990/LessCostOthBasisSalesExpnssGrp/SecuritiesAmt | 0 | 0 |
| IRS990/LoanOutstandingInd | 0 | 0 |
| IRS990/LobbyingActivitiesInd | 0 | 0 |
| IRS990/LocalChaptersInd | 0 | 0 |
| IRS990/MaterialDiversionOrMisuseInd | 0 | 0 |
| IRS990/MembersOrStockholdersInd | 0 | 0 |
| IRS990/MethodOfAccountingAccrualInd | 0 | X |
| IRS990/MinutesOfCommitteesInd | 0 | 1 |
| IRS990/MinutesOfGoverningBodyInd | 0 | 1 |
| IRS990/MissionDesc | 0 | PROVIDES COMPREHENSIVE HEALTH CARE AND ANCILLARY SERVICES TO THE NATIVE-AMERICAN POPULATION OF SIERRA, PLACER AND NEVADA COUNTIES OF CALIFORNIA. |
| IRS990/MoreThan5000KToIndividualsInd | 0 | 0 |
| IRS990/MoreThan5000KToOrgInd | 0 | 0 |
| IRS990/NetAssetsOrFundBalancesBOYAmt | 0 | 118227198 |
| IRS990/NetAssetsOrFundBalancesEOYAmt | 0 | 152026163 |
| IRS990/NetGainOrLossInvestmentsGrp/ExclusionAmt | 0 | 2664 |
| IRS990/NetGainOrLossInvestmentsGrp/TotalRevenueColumnAmt | 0 | 2664 |
| IRS990/NetUnrelatedBusTxblIncmAmt | 0 | 0 |
| IRS990/NetUnrlzdGainsLossesInvstAmt | 0 | 10667952 |
| IRS990/NoDonorRestrictionNetAssetsGrp/BOYAmt | 0 | 118227198 |
| IRS990/NoDonorRestrictionNetAssetsGrp/EOYAmt | 0 | 152026163 |
| IRS990/NondeductibleContributionsInd | 0 | 0 |
| IRS990/OccupancyGrp/ManagementAndGeneralAmt | 0 | 1006917 |
| IRS990/OccupancyGrp/ProgramServicesAmt | 0 | 961 |
| IRS990/OccupancyGrp/TotalAmt | 0 | 1007878 |
| IRS990/OfficeExpensesGrp/ManagementAndGeneralAmt | 0 | 152139 |
| IRS990/OfficeExpensesGrp/ProgramServicesAmt | 0 | 6398 |
| IRS990/OfficeExpensesGrp/TotalAmt | 0 | 158537 |
| IRS990/OfficerMailingAddressInd | 0 | 0 |
| IRS990/OperateHospitalInd | 0 | 0 |
| IRS990/Organization501c3Ind | 0 | X |
| IRS990/OrganizationFollowsFASB117Ind | 0 | X |
| IRS990/OtherAssetsTotalGrp/BOYAmt | 0 | 223408 |
| IRS990/OtherAssetsTotalGrp/EOYAmt | 0 | 260458 |
| IRS990/OtherChangesInNetAssetsAmt | 0 | 0 |
| IRS990/OtherEmployeeBenefitsGrp/ManagementAndGeneralAmt | 0 | 995176 |
| IRS990/OtherEmployeeBenefitsGrp/ProgramServicesAmt | 0 | 2518372 |
| IRS990/OtherEmployeeBenefitsGrp/TotalAmt | 0 | 3513548 |
| IRS990/OtherExpensesGrp/Desc | 0 | MEDICAL SUPPLIES |
| IRS990/OtherExpensesGrp/Desc | 1 | BUILDING AND EQUIPMENT |
| IRS990/OtherExpensesGrp/Desc | 2 | PATIENT RELATED COSTS |
| IRS990/OtherExpensesGrp/Desc | 3 | EXPENSED EQUIPMENT |
| IRS990/OtherExpensesGrp/ManagementAndGeneralAmt | 0 | 21926 |
| IRS990/OtherExpensesGrp/ManagementAndGeneralAmt | 1 | 517442 |
| IRS990/OtherExpensesGrp/ManagementAndGeneralAmt | 2 | 22047 |
| IRS990/OtherExpensesGrp/ManagementAndGeneralAmt | 3 | 29158 |
| IRS990/OtherExpensesGrp/ProgramServicesAmt | 0 | 2748687 |
| IRS990/OtherExpensesGrp/ProgramServicesAmt | 1 | 188528 |
| IRS990/OtherExpensesGrp/ProgramServicesAmt | 2 | 449026 |
| IRS990/OtherExpensesGrp/ProgramServicesAmt | 3 | 239770 |
| IRS990/OtherExpensesGrp/TotalAmt | 0 | 2770613 |
| IRS990/OtherExpensesGrp/TotalAmt | 1 | 705970 |
| IRS990/OtherExpensesGrp/TotalAmt | 2 | 471073 |
| IRS990/OtherExpensesGrp/TotalAmt | 3 | 268928 |
| IRS990/OtherLiabilitiesGrp/BOYAmt | 0 | 4296400 |
| IRS990/OtherLiabilitiesGrp/EOYAmt | 0 | 0 |
| IRS990/OtherSalariesAndWagesGrp/ManagementAndGeneralAmt | 0 | 4041551 |
| IRS990/OtherSalariesAndWagesGrp/ProgramServicesAmt | 0 | 12543730 |
| IRS990/OtherSalariesAndWagesGrp/TotalAmt | 0 | 16585281 |
| IRS990/PartialLiquidationInd | 0 | 0 |
| IRS990/PayPremiumsPrsnlBnftCntrctInd | 0 | 0 |
| IRS990/PayrollTaxesGrp/ManagementAndGeneralAmt | 0 | 390641 |
| IRS990/PayrollTaxesGrp/ProgramServicesAmt | 0 | 988547 |
| IRS990/PayrollTaxesGrp/TotalAmt | 0 | 1379188 |
| IRS990/PledgesAndGrantsReceivableGrp/BOYAmt | 0 | 287067 |
| IRS990/PledgesAndGrantsReceivableGrp/EOYAmt | 0 | 2160222 |
| IRS990/PoliticalCampaignActyInd | 0 | 0 |
| IRS990/PrincipalOfficerNm | 0 | LISA DAVIES |
| IRS990/ProfessionalFundraisingInd | 0 | 0 |
| IRS990/ProgramServiceRevenueGrp/BusinessCd | 0 | 621400 |
| IRS990/ProgramServiceRevenueGrp/Desc | 0 | HEALTH SERVICES |
| IRS990/ProgramServiceRevenueGrp/RelatedOrExemptFuncIncomeAmt | 0 | 38852079 |
| IRS990/ProgramServiceRevenueGrp/TotalRevenueColumnAmt | 0 | 38852079 |
| IRS990/ProgSrvcAccomActy2Grp/Desc | 0 | DIABETES PREVENTION PROGRAM-THIS PROGRAM PROVIDES DIABETES PREVENTION, MANAGEMENT AND LIFESTYLE EDUCATION, AND TESTING SERVICES TO NATIVE- AMERICAN PATIENTS DURING THE FISCAL YEAR. THESE PATIENTS LIVE PRIMARILY IN SIERRA, PLACER, AND NEVADA COUNTIES OF CALIFORNIA. |
| IRS990/ProgSrvcAccomActy2Grp/ExpenseAmt | 0 | 290481 |
| IRS990/ProgSrvcAccomActyOtherGrp/ExpenseAmt | 0 | 1346164 |
| IRS990/ProhibitedTaxShelterTransInd | 0 | 0 |
| IRS990/PYBenefitsPaidToMembersAmt | 0 | 0 |
| IRS990/PYContributionsGrantsAmt | 0 | 25916727 |
| IRS990/PYExcessBenefitTransInd | 0 | 0 |
| IRS990/PYGrantsAndSimilarPaidAmt | 0 | 0 |
| IRS990/PYInvestmentIncomeAmt | 0 | 1693657 |
| IRS990/PYOtherExpensesAmt | 0 | 12005073 |
| IRS990/PYOtherRevenueAmt | 0 | 0 |
| IRS990/PYProgramServiceRevenueAmt | 0 | 33291642 |
| IRS990/PYRevenuesLessExpensesAmt | 0 | 28400700 |
| IRS990/PYSalariesCompEmpBnftPaidAmt | 0 | 20496253 |
| IRS990/PYTotalExpensesAmt | 0 | 32501326 |
| IRS990/PYTotalProfFndrsngExpnsAmt | 0 | 0 |
| IRS990/PYTotalRevenueAmt | 0 | 60902026 |
| IRS990/QuidProQuoContributionsInd | 0 | 0 |
| IRS990/RcvFndsToPayPrsnlBnftCntrctInd | 0 | 0 |
| IRS990/ReconcilationRevenueExpnssAmt | 0 | 23131013 |
| IRS990/RegularMonitoringEnfrcInd | 0 | 1 |
| IRS990/RelatedEntityInd | 0 | 0 |
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