CLINICAS DEL CAMINO REAL INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- CLINICAS DEL CAMINO REAL INC (EIN 95-2977147)
- Tax period
- 2021-07-01 to 2022-06-30
- Filed
- 2023-05-01
- IRS object ID
- 202331219349301328
- Schema version
- 2021v4.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-05-01T10:35:05-05:00 | ReturnTs |
| Tax Period End | 2022-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 390758449 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WIPFLI LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 12237 | AddressLine1Txt |
| City | GREEN BAY | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 543072237 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 952977147 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLINICAS DEL CAMINO REAL INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CLIN | BusinessNameControlTxt |
| Phone | 8056591740 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 4566 | AddressLine1Txt |
| City | VENTURA | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 93007 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | FRED BENHARASH | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 8056591740 | PhoneNum |
| Signature | 2023-04-28 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | FRED | PersonFirstNm |
| Person Last | BENHARASH | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | TERRI REXRODE CPA MST | PreparerPersonNm |
| PTIN | P00096513 | PTIN |
| Phone | 9206620016 | PhoneNum |
| Preparation | 2023-04-24 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 0 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | FRED BENHARASH | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 4566 | AddressLine1Txt |
| City | VENTURA | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 93007 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $112,476,288 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.CLINICAS.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1971 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | IT IS THE EXPLICIT MISSION OF CLINICAS DEL CAMINO REAL TO SAVE LIVES AND RESTORE GOOD HEALTH BY PROVIDING QUALITY COMPREHENSIVE AND PREVENTATIVE PERSONAL AND HUMANE HEALTH CARE SERVICES TO THE MEDICALLY UNDERSERVED POPULATION OF VENTURA COUNTY. THIS MISSION IS ACCOMPLISHED BY ELIMINATING THE BARRIERS OF LIMITED INCOME, RESOURCES, CULTURAL, AND LANGUAGE THROUGH THE USE OF OUTREACH PROGRAMS, BILINGUAL AND BICULTURAL STAFF MEMBERS, AND A SLIDING FEE PROGRAM BASED ON A PATIENT'S ABILITY TO PAY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 8 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 1045 | TotalEmployeeCnt |
| Total Volunteers | 10 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $29,985,344 | PYContributionsGrantsAmt |
| CY Contributions Grants | $24,065,683 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $95,060,281 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $87,545,032 | CYProgramServiceRevenueAmt |
| PY Investment Income | $678,314 | PYInvestmentIncomeAmt |
| CY Investment Income | $568,550 | CYInvestmentIncomeAmt |
| PY Other Revenue | $16,352,195 | PYOtherRevenueAmt |
| CY Other Revenue | $297,023 | CYOtherRevenueAmt |
| PY Total Revenue | $142,076,134 | PYTotalRevenueAmt |
| CY Total Revenue | $112,476,288 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $69,172,505 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $68,660,362 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $74,361,449 | PYOtherExpensesAmt |
| CY Other Expenses | $54,193,734 | CYOtherExpensesAmt |
| PY Total Expenses | $143,533,954 | PYTotalExpensesAmt |
| CY Total Expenses | $122,854,096 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$1,457,820 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$10,377,808 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $207,265,824 | TotalAssetsBOYAmt |
| Total Assets EOY | $172,085,216 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $111,979,707 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $114,537,911 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $95,286,117 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $57,547,305 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | IT IS THE EXPLICIT MISSION OF CLINIAS DEL CAMINO REAL TO SAVE LIVES AND RESTORE GOOD HEALTH BY PROVIDING QUALITY COMPREHENSIVE AND PREVENTATIVE PERSONAL AND HUMANE HEALTH CARE SERVICES TO THE MEDICALLY UNDERSERVED POPULATION OF VENTURA COUNTY. THIS MISSION IS ACCOMPLISHED BY ELIMINATING THE BARRIERS OF LIMITED INCOME, RESOURCES, CULTURAL, AND LANGUAGE THROUGH THE USE OF OUTREACH PROGRAMS, BILINGUAL AND BICULTURAL STAFF MEMBERS, AND A SLIDING FEE PROGRAM BASED ON A PATIENT'S ABILITY TO PAY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $94,280,693 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $87,545,032 | RevenueAmt |
| Desc | IT IS THE EXPLICIT MISSION OF CLINICAS DEL CAMINO REAL TO SAVE LIVES AND RESTORE GOOD HEALTH BY PROVIDING QUALITY COMPREHENSIVE AND PREVENTATIVE PERSONAL AND HUMANE HEALTH CARE SERVICES TO THE MEDICALLY UNDERSERVED POPULATION OF VENTURA COUNTY. THIS MISSION IS ACCOMPLISHED BY ELIMINATING THE BARRIERS OF LIMITED INCOME, RESOURCES, CULTURAL, AND LANGUAGE THROUGH THE USE OF OUTREACH PROGRAMS, BILINGUAL AND BICULTURAL STAFF MEMBERS, AND A SLIDING FEE PROGRAM BASED ON A PATIENT'S ABILITY TO PAY. TOTAL PATIENT ENCOUNTERS FOR THE YEAR WERE 300,974. | Desc |
| Total Program Service Expenses | $94,280,693 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | Yes (1) | TaxExemptBondsInd |
| Invest Tax Exempt Bonds | 0 | InvestTaxExemptBondsInd |
| Escrow Account | 0 | EscrowAccountInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 454 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 1045 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 8 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 8 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | 0 | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | CA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | FRED BENHARASH | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 8056591740 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1040 FLYNN RD | AddressLine1Txt |
| City | CAMARILLO | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 93012 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| CHARLES HOOKSTRA | |||||||||
| PRESIDENT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| DR ADOLFO MURILLO | |||||||||
| VICE PRESIDENT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| KRISTIN CADY | |||||||||
| VICE PRESIDENT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| BARBARA A JOURNET | |||||||||
| TREASURER | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| JAVIER M OCHOA | |||||||||
| PARLIAMENTARIAN | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |||
| ANGEL ARREOLA | |||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| DR NANCY CARROLL | |||||||||
| BOARD MEMBER (THRU MAY 2022) | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| CANDELARIA FRANCO | |||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| EDER GAONA-MACEDO | |||||||||
| BOARD MEMBER (THRU APRIL 2022) | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| DANIEL GONZALEZ | |||||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||||
| GAGAN PAWAR | |||||||||
| CEO | 40.00 | Yes (X) | $436,442 | $0 | $32,334 | ||||
| CHRISTINA M VELASCO | |||||||||
| CFO (THRU SEPTEMBER 2021) | 40.00 | Yes (X) | $502,413 | $0 | $18,810 | ||||
| FRED BENHARASH | |||||||||
| CFO (BEGIN MARCH 2022) | 40.00 | Yes (X) | $0 | $0 | $0 | ||||
| ANTONIO ALATORRE | |||||||||
| CBDO | 40.00 | $369,529 | $0 | $18,765 | Yes (X) | ||||
| ANWAR ALI ABBAS | |||||||||
| CIO | 40.00 | $218,551 | $0 | $14,512 | Yes (X) | ||||
| KELLY LYNN BENNETT | |||||||||
| HR DIRECTOR | 40.00 | $261,756 | $0 | $24,471 | Yes (X) | ||||
| ANNA BELL MONROY | |||||||||
| COO | 40.00 | $186,179 | $0 | $8,848 | Yes (X) | ||||
| MENASHE EHRENBURG | |||||||||
| PHYSICIAN | 40.00 | $427,858 | $0 | $38,812 | Yes (X) | ||||
| TA THUC NGU DINH | |||||||||
| PHYSICIAN | 40.00 | $402,781 | $0 | $37,442 | Yes (X) | ||||
| TODD WAYNE MONROE | |||||||||
| PHYSICIAN | 40.00 | $406,919 | $0 | $23,208 | Yes (X) | ||||
| HEIDI LEE MILLER | |||||||||
| PHYSICIAN | 40.00 | $350,547 | $0 | $5,551 | Yes (X) | ||||
| TIHELE L WALKOUSKY | |||||||||
| PHYSICIAN | 40.00 | $381,554 | $0 | $15,549 | Yes (X) | ||||
| ROBERTO S JUAREZ | |||||||||
| FORMER CEO (THRU JUNE 2021) | 40.00 | $639,489 | $0 | $25,573 | Yes (X) | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $4,584,018 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $263,875 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 114 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| VENTURA COUNTY MEDICAL CENTER | |||||
| 800 S VICTORIA AVE | VENTURA | CA | 93009 | HEALTHCARE PROVIDER | $1,730,723 |
| QUEST DIAGNOSTICS INCORPORATED | |||||
| PO BOX 912411 | PASADENA | CA | 91110 | MEDICAL LAB SERVICES | $1,579,326 |
| PALMS IMAGING MEDICAL GROUP INC | |||||
| PO BOX 190 | SIMI VALLEY | CA | 93062 | DIAGNOSTIC IMAGING PROVIDER | $1,197,763 |
| TWO TREES PHYSICAL THERAPY | |||||
| 3418 LOMA VISTA RD | VENTURA | CA | 93033 | HEALTHCARE PROVIDER | $1,170,985 |
| BEVERLY RADIOLOGY MEDICAL GROUP | |||||
| PO BOX 101418 | PASADENA | CA | 91189 | DIAGNOSTIC IMAGING PROVIDER | $815,741 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 72 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $24,041,788 | GovernmentGrantsAmt |
| All Other Contributions | $23,895 | AllOtherContributionsAmt |
| Total Contributions | $24,065,683 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENUE | 621400 | $85,524,012 | $85,524,012 |
| 340(B) PHARMACY REVENUE | 446110 | $2,021,020 | $2,021,020 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $87,545,032 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $568,550 | TotalRevenueColumnAmt |
| Exclusion | $568,550 | ExclusionAmt |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $297,023 | TotalRevenueColumnAmt |
| Exclusion | $297,023 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $297,023 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $112,476,288 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $87,545,032 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $865,573 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,911,110 | TotalAmt |
| Management And General | $1,911,110 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $52,628,809 | TotalAmt |
| Program Services | $40,983,685 | ProgramServicesAmt |
| Management And General | $11,645,124 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,068,898 | TotalAmt |
| Program Services | $830,384 | ProgramServicesAmt |
| Management And General | $238,514 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,352,150 | TotalAmt |
| Program Services | $6,676,834 | ProgramServicesAmt |
| Management And General | $2,675,316 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,699,395 | TotalAmt |
| Program Services | $2,622,220 | ProgramServicesAmt |
| Management And General | $1,077,175 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $617,772 | TotalAmt |
| Management And General | $617,772 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,063,622 | TotalAmt |
| Management And General | $3,063,622 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $136,065 | TotalAmt |
| Management And General | $136,065 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,210,316 | TotalAmt |
| Program Services | $29,342,214 | ProgramServicesAmt |
| Management And General | $868,102 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,484,051 | TotalAmt |
| Program Services | $1,473,645 | ProgramServicesAmt |
| Management And General | $10,406 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,134,116 | TotalAmt |
| Program Services | $1,343,925 | ProgramServicesAmt |
| Management And General | $790,191 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $924,519 | TotalAmt |
| Program Services | $877,754 | ProgramServicesAmt |
| Management And General | $46,765 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,337,366 | TotalAmt |
| Program Services | $965,995 | ProgramServicesAmt |
| Management And General | $371,371 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $172,270 | TotalAmt |
| Program Services | $103,057 | ProgramServicesAmt |
| Management And General | $69,213 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $282,855 | TotalAmt |
| Program Services | $150,136 | ProgramServicesAmt |
| Management And General | $132,719 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $548,420 | TotalAmt |
| Program Services | $518,634 | ProgramServicesAmt |
| Management And General | $29,786 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,009,365 | TotalAmt |
| Program Services | $492,186 | ProgramServicesAmt |
| Management And General | $2,517,179 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $994,246 | TotalAmt |
| Program Services | $819,971 | ProgramServicesAmt |
| Management And General | $174,275 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| SUPPLIES | $5,724,933 | $5,660,283 | $64,650 |
| TAXES & LICENSES | $1,122,755 | $542,416 | $580,339 |
| REPAIRS & MAINTENANCE | $926,762 | $360,290 | $566,472 |
| EQUIPMENT RENTALS | $796,628 | $474,321 | $322,307 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $707,673 | TotalAmt |
| Program Services | $42,743 | ProgramServicesAmt |
| Management And General | $664,930 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $122,854,096 | TotalAmt |
| Program Services | $94,280,693 | ProgramServicesAmt |
| Management And General | $28,573,403 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,268,900 | BOYAmt |
| EOY | $16,584 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $68,131,276 | BOYAmt |
| EOY | $39,312,567 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,277,087 | BOYAmt |
| EOY | $341,262 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,623,407 | BOYAmt |
| EOY | $9,080,358 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,340,881 | BOYAmt |
| EOY | $734,810 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $125,355,677 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $39,552,717 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $69,040,564 | BOYAmt |
| EOY | $85,802,960 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $27,503,589 | BOYAmt |
| EOY | $24,811,375 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,848,060 | BOYAmt |
| EOY | $1,848,060 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,232,060 | BOYAmt |
| EOY | $10,137,240 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $207,265,824 | BOYAmt |
| EOY | $172,085,216 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $30,955,498 | BOYAmt |
| EOY | $31,412,772 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $100,000 | BOYAmt |
| EOY | $295,500 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $69,579,498 | BOYAmt |
| EOY | $70,019,683 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $276,695 | BOYAmt |
| EOY | $246,580 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,068,016 | BOYAmt |
| EOY | $12,563,376 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $111,979,707 | BOYAmt |
| EOY | $114,537,911 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $73,286,495 | BOYAmt |
| EOY | $57,547,305 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,999,622 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $95,286,117 | BOYAmt |
| EOY | $57,547,305 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $207,265,824 | BOYAmt |
| EOY | $172,085,216 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$10,377,808 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$5,783,201 | NetUnrlzdGainsLossesInvstAmt |
| Prior Period Adjustments | -$21,577,803 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $15,486,150 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $16,216,000 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $21,701,214 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $29,985,344 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $24,065,683 | CurrentTaxYearAmt |
| Total | $107,454,391 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $84,938,153 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $94,362,273 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $93,038,696 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $111,412,476 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $87,842,055 | CurrentTaxYearAmt |
| Total | $471,593,653 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $100,424,303 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $110,578,273 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $114,739,910 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $141,397,820 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $111,907,738 | CurrentTaxYearAmt |
| Total | $579,048,044 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $579,048,044 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $773,649 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,155,065 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,450,677 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $678,314 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $568,550 | CurrentTaxYearAmt |
| Total | $4,626,255 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $773,649 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $1,155,065 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $1,450,677 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $678,314 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $568,550 | CurrentTaxYearAmt |
| Total | $4,626,255 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $101,197,952 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $111,733,338 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $116,190,587 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $142,076,134 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $112,476,288 | CurrentTaxYearAmt |
| Total | $583,674,299 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99210 | PublicSupportCY509Pct |
| Investment Income CY | 0.00790 | InvestmentIncomeCYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $10,679,982 | OtherCostOrOtherBasisAmt |
| Book Value | $10,679,982 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $53,823,399 | OtherCostOrOtherBasisAmt |
| Depreciation | $21,834,481 | DepreciationAmt |
| Book Value | $31,988,918 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $20,255,014 | OtherCostOrOtherBasisAmt |
| Depreciation | $7,087,657 | DepreciationAmt |
| Book Value | $13,167,357 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $11,304,892 | OtherCostOrOtherBasisAmt |
| Depreciation | $10,346,158 | DepreciationAmt |
| Book Value | $958,734 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $29,292,390 | OtherCostOrOtherBasisAmt |
| Depreciation | $284,421 | DepreciationAmt |
| Book Value | $29,007,969 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $85,802,960 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (3 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| ESTIMATED THIRD-PARTY PAYOR RECEIVABLES | $5,597,196 |
| SECURITY DEPOSITS | $31,785 |
| RELATED PARTY NOTES RECEIVABLE | $4,508,259 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $10,137,240 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | ESTIMATED THIRD-PARTY PAYOR LIABILITIES | Desc |
| Amt | $12,563,376 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $12,563,376 | TotalLiabilityAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (12 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ROBERTO S JUAREZ | ||||||||||||||
| FORMER CEO (THRU JUNE 2021) | $326,570 | $0 | $0 | $0 | $312,919 | $0 | $17,575 | $0 | $7,998 | $0 | $665,062 | $0 | $0 | $0 |
| CHRISTINA M VELASCO | ||||||||||||||
| CFO (THRU SEPTEMBER 2021) | $307,171 | $0 | $52,247 | $0 | $142,995 | $0 | $6,450 | $0 | $12,360 | $0 | $521,223 | $0 | $0 | $0 |
| GAGAN PAWAR | ||||||||||||||
| CEO | $382,695 | $0 | $53,747 | $0 | $0 | $0 | $15,362 | $0 | $16,972 | $0 | $468,776 | $0 | $0 | $0 |
| MENASHE EHRENBURG | ||||||||||||||
| PHYSICIAN | $426,358 | $0 | $1,500 | $0 | $0 | $0 | $11,781 | $0 | $27,031 | $0 | $466,670 | $0 | $0 | $0 |
| TA THUC NGU DINH | ||||||||||||||
| PHYSICIAN | $401,281 | $0 | $1,500 | $0 | $0 | $0 | $12,000 | $0 | $25,442 | $0 | $440,223 | $0 | $0 | $0 |
| TODD WAYNE MONROE | ||||||||||||||
| PHYSICIAN | $405,419 | $0 | $1,500 | $0 | $0 | $0 | $0 | $0 | $23,208 | $0 | $430,127 | $0 | $0 | $0 |
| TIHELE L WALKOUSKY | ||||||||||||||
| PHYSICIAN | $379,054 | $0 | $2,500 | $0 | $0 | $0 | $9,998 | $0 | $5,551 | $0 | $397,103 | $0 | $0 | $0 |
| ANTONIO ALATORRE | ||||||||||||||
| CBDO | $349,099 | $0 | $1,750 | $0 | $18,680 | $0 | $2,445 | $0 | $16,320 | $0 | $388,294 | $0 | $0 | $0 |
| HEIDI LEE MILLER | ||||||||||||||
| PHYSICIAN | $349,047 | $0 | $1,500 | $0 | $0 | $0 | $0 | $0 | $5,551 | $0 | $356,098 | $0 | $0 | $0 |
| KELLY LYNN BENNETT | ||||||||||||||
| HR DIRECTOR | $217,041 | $0 | $44,715 | $0 | $0 | $0 | $5,850 | $0 | $18,621 | $0 | $286,227 | $0 | $0 | $0 |
| ANWAR ALI ABBAS | ||||||||||||||
| CIO | $217,551 | $0 | $1,000 | $0 | $0 | $0 | $0 | $0 | $14,512 | $0 | $233,063 | $0 | $0 | $0 |
| ANNA BELL MONROY | ||||||||||||||
| COO | $184,679 | $0 | $1,500 | $0 | $0 | $0 | $0 | $0 | $8,848 | $0 | $195,027 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 4A | DURING CALENDAR YEAR 2021, ROBERTO S. JUAREZ, THE FORMER CEO, RECEIVED A SEVERANCE PLAN PAYMENT IN THE AMOUNT OF $233,750. |
| PART I, LINE 7 | NONFIXED PAYMENTS INCLUDE HOLIDAY AND OTHER BONUSES. HOLIDAY BONUSES ARE GIVEN BASED ON TIME WORKED AT THE COMPANY. AT YEAR END, THE CEO WILL PROPOSE TO THE BOARD OF DIRECTORS ADDITIONAL BONUSES FOR MANAGEMENT BASED ON VARIOUS COMPANY PERFORMANCE MEASURES. THE BOARD APPROVES THE AMOUNTS TO AWARD. |
Schedule K IRS990ScheduleK
Tax Exempt Bonds Issues TaxExemptBondsIssuesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
Issuer Name IssuerName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CALIFORNIA MUNICIPAL FINANCE AUTHORITY | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Issuer EIN | 201563466 | BondIssuerEIN |
| CUSIP | 13048VNU8 | CUSIPNum |
| Bond Issued | 2020-03-19 | BondIssuedDt |
| Issue Price | $71,427,330 | IssuePriceAmt |
| Purpose | REFINANCE DEBT & CONSTRUCTION | PurposeDesc |
| Defeased | 0 | DefeasedInd |
| On Behalf Of Issuer | 0 | OnBehalfOfIssuerInd |
| Pool Financing | 0 | PoolFinancingInd |
Tax Exempt Bonds Proceeds TaxExemptBondsProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Retired | $965,000 | RetiredAmt |
| Total Proceeds | $71,427,330 | TotalProceedsAmt |
| In Reserve Fund | $1,250,253 | InReserveFundAmt |
| Capitalized Interest | $1,982,868 | CapitalizedInterestAmt |
| Issuance Costs From Proceeds | $927,699 | IssuanceCostsFromProceedsAmt |
| Capital Expenditures | $36,634,941 | CapitalExpendituresAmt |
| Other Spent Proceeds | $28,432,480 | OtherSpentProceedsAmt |
| Unspent | $4,181,957 | UnspentAmt |
| Refunding Tax Exempt Bonds | 0 | RefundingTaxExemptBondsInd |
| Refunding Taxable Bonds | 0 | RefundingTaxableBondsInd |
| Final Allocation Made | Yes (1) | FinalAllocationMadeInd |
| Adequate Books And Rec Maint | Yes (1) | AdequateBooksAndRecMaintInd |
Tax Exempt Bonds Private Bus Use TaxExemptBondsPrivateBusUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Owning Bond Financed Property | 0 | OwningBondFinancedPropertyInd |
| Any Lease Arrangements | 0 | AnyLeaseArrangementsInd |
| Mgmt Contract Bond Fincd Prop | 0 | MgmtContractBondFincdPropInd |
| Any Research Agreements | 0 | AnyResearchAgreementsInd |
| Bond Iss Meet Prvt Sec Pymt Test | 0 | BondIssMeetPrvtSecPymtTestInd |
| Change In Use Bond Financed Prop | 0 | ChangeInUseBondFinancedPropInd |
| Procs Nonqualified Bond Remdtd | 0 | ProcsNonqualifiedBondRemdtdInd |
Tax Exempt Bonds Arbitrage TaxExemptBondsArbitrageGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Form8038 T Filed | 0 | Form8038TFiledInd |
| Rebate Not Due Yet | 0 | RebateNotDueYetInd |
| Exception To Rebate | 0 | ExceptionToRebateInd |
| No Rebate Due | 0 | NoRebateDueInd |
| Variable Rate Issue | 0 | VariableRateIssueInd |
| Hedge Identified In Bks And Rec | 0 | HedgeIdentifiedInBksAndRecInd |
| Gross Proceeds Invested In GIC | 0 | GrossProceedsInvestedInGICInd |
| Written Proc To Monitor Reqs | 0 | WrittenProcToMonitorReqsInd |
Procedures Corrective Action ProceduresCorrectiveActionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bond Reference | A | BondReferenceCd |
| Procedures Corrective Action | 0 | ProceduresCorrectiveActionInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 IS PREAPRED BY AN INDEPENDENT CPA AND THEN REVIEWED BY THE CFO. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION INVESTIGATES POTENTIAL CONFLICTS OF INTEREST WHEN THEY ARISE BY COMPLIANCE STAFF. ALL STAFF ARE COVERED UNDER THE CONFLICT OF INTEREST POLICIES. STAFF ARE REQUIRED TO SELF-REPORT ANY CONFLICT OF INTEREST AND DOCUMENT THE CONFLICT. CONFLICTS ARE REVIEWED BY COMPLIANCE AND SUPERVISING STAFF. DETERMINATIONS ARE MADE AS TO THE VIABILITY OF USING VENDORS/CONTRACTORS FOR COMPANY ACTIVITY AND WOULD PRECLUDE ANY CONFLICTED CDCR EMPLOYEE FROM BEING INVOLVED IN THE DECISION MAKING AND APPROVAL PROCESS. ANY VIOLATIONS ARE HANDLED IN ACCORDANCE WITH THE WRITTEN POLICIES AND PROCEDURES. |
| FORM 990, PART VI, SECTION B, LINE 15 | EVERY YEAR THE BOARD OF DIRECTORS FINANCE COMMITTEE EVALUATES THE CEO'S PERFORMANCE AND COMPENSATION. ANNUALLY THE CEO AND HR DIRECTOR WORK TOGETHER USING STATE AND NATIONALLY BASED SALARY SURVEYS TO COMPARE THE CORPORATION'S OFFICERS' SALARIES TO THOSE OF SIMILAR CORPORATIONS. COMPARISON SURVEYS ARE PERFORMED BY THE CEO AND HUMAN RESOURCES DIRECTOR USING STATE AND NATIONAL DATABASES. ANNUAL REVIEWS ARE PERFORMED BY THE BOARD OF DIRECTORS FOR ALL OFFICERS, KEY EMPLOYEES, AND OTHER HIGHLY COMPENSATED EMPLOYEES. |
| FORM 990, PART VI, SECTION C, LINE 19 | FORM 990 IS AVAILABLE FOR REVIEW AT THE ORGANIZATIONS ADMINISTRATIVE OFFICE DURING NORMAL BUSINESS HOURS. OTHER FORMS SUCH AS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE INTERNAL CORPORATE DOCUMENTS. |
| FORM 990, PART IX, LINE 11G | CLINICAL SERVICES: PROGRAM SERVICE EXPENSES 21,420,385. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 21,420,385. LAB SERVICES: PROGRAM SERVICE EXPENSES 2,522,787. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,522,787. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 5,399,042. MANAGEMENT AND GENERAL EXPENSES 868,102. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,267,144. |
Schedule R IRS990ScheduleR
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | OwnershipOwnershipPct | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| AMERICASHEALTH PLAN INC | ||||||||||||
| 1000 TOWN CENTER DRIVE SUITE 410 | OXNARD | CA | 93036 | 271073990 | MANAGED CARE HEALTH PLAN | CA | CLINICAS DEL CAMINO REAL INC | C | $25,428,898 | $8,169,218 | 1.00000 | Yes (1) |
| MEDPARTNERS MSO INCORPORATED | ||||||||||||
| 1040 FLYNN RD | CAMARILLO | CA | 93012 | 814231443 | INSURANCE BILLING | CA | CLINICAS DEL CAMINO REAL INC | C | $6,016,238 | $4,590,723 | 1.00000 | Yes (1) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | Yes (1) | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (1) | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (5 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| AMERICASHEALTH PLAN INC | ||
| A | $25,921 | CASH |
| AMERICASHEALTH PLAN INC | ||
| D | $1,235,000 | CASH |
| AMERICASHEALTH PLAN INC | ||
| L | $1,261,088 | CASH |
| MEDPARTNERS MSO INCORPORATED INC | ||
| A | $99,936 | CASH |
| MEDPARTNERS MSO INCORPORATED INC | ||
| M | $6,373,363 | CASH |
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