2022-01-31T10:46:03-06:00 2021-06-30 WITHUMSMITHBROWNPC 100 SPECTRUM CENTER DRIVE STE 1000 IRVINE CA 92618 990 2020-07-01 954492570 Central City Community Health Center Inc % DR ROSEMARY REYES CENT 3237240019 2019 Saturn Street Monterey Park CA 91755 DR ROSEMARY REYES CEO 3237240019 2022-01-20 true DR ROSEMARY REYES 999009999 TASHA J OTSUJI P00846495 9492612808 2020 2022-09-23 18:48:47Z X Dr Rosemary Reyes 2019 Saturn Street Monterey Park CA 91755 43383311 false X WWW.CENTRALCITYHEALTH.ORG X 1994 CA TO PROVIDE HEALTH CARE SERVICES TO UNDERSERVED COMMUNITIES. 9 9 354 9 0 6853982 6742234 34200874 36334716 64094 39052 50461 267309 41169411 43383311 0 0 0 0 18419591 17608746 0 0 0 16079483 17582673 34499074 35191419 6670337 8191892 27033417 35317348 30323000 31048286 -3289583 4269062 X TO PROVIDE HEALTH CARE SERVICES TO UNDERSERVED COMMUNITIES. false false 26955818 36602025 TO PROVIDE QUALITY HEALTH AND HUMAN SERVICES TO THE MEDICALLY UNDERSERVED AND LOW INCOME POPULATIONS IN A CULTURALLY SENSITIVE MANNER. CENTRAL CITY COMMUNITY HEALTH CENTER, INC. PROVIDES COMPREHENSIVE PRIMARY CARE, DENTAL, OBSTETRICS/GYNECOLOGY, FAMILY PLANNING, MENTAL HEALTH SERVICES, CHIROPRACTIC CARE, FAMILY PRACTICE, PEDIATRICS, PODIATRY, DRUG/HIV/STD TESTING, ONSITE MEDICAL ELIGIBILITY ASSISTANCE, CHRONIC DISEASE MANAGEMENT, AND HIV/AIDS CASE MANAGEMENT SERVICES. SERVICES ARE ALSO CONDUCTED THROUGH SITERUN PREVENTION PROGRAMS, INCLUDING THE COMPREHENSIVE PERINATAL SERVICES PROGRAM, VACCINE FOR CHILDREN PROGRAM, CHILD HEALTH AND DISABILITY PROGRAM, FAMILY PLANNING, ACCESS, CARE AND TREATMENT (FAMILY PACT), AND ITS SOUTH LOS ANGELESBASED MOBILE CLINIC PROVIDES THE SAME CARE TO AREA HOMELESS SHELTERS AND RESIDENTIAL FACILITIES FOR MENTALLY ILL ADULTS. IN 2020, 33750 PATIENTS WERE SERVED AND OVER 190,000 ENCOUNTERS WERE PROVIDED. 26955818 true true false false false false false false false false true false false false true true true false false false false false false false false false false false false true false false false false false true false false false false false false true false false false false true 120 0 true 354 true false false false false false false false false false false false false X 9 9 true false false false false false false true true false false false true true true true true true true false CA X DR ROSEMARY REYES 3237240019 2019 SATURN STREET Monterey Park CA 91755 Omar Moreno CEO & CFO (Through 5/20/21) 40.0 0.0 X 738487 0 31398 Michael Choi INTERNIST 40.0 0.0 X 297873 0 2182 Rosemary Reyes CMO/Interim CEO 40.0 0.0 X 265502 0 28158 Shafeeq Shamsid-Deen Lead Physician Residential 40.0 0.0 X 206525 0 57144 Michael Jordan Vizcarra OB-GYN 40.0 0.0 X 205069 0 24474 Nickolas L Lind Lead Physician 40.0 0.0 X 211174 0 3185 Charles Tuan Nguyen Psychiatrist 25.0 0.0 X 212240 0 0 Swati Purohit Pediatrician 40.0 0.0 X 183324 0 0 REGGIE PANIS CFO (through 2/16/21) 40.0 0.0 X 144825 0 0 Luis Marten Chairman 2.0 0.0 X X 0 0 0 Larry Landless Secretary 2.0 0.0 X X 0 0 0 Violi Wong Treasurer 2.0 0.0 X X 0 0 0 Stella Marten Board Member 2.0 0.0 X 0 0 0 Maria Duran Board Member 2.0 0.0 X 0 0 0 Melana Smith Board Member 2.0 0.0 X 0 0 0 Juan Duran Board Member 2.0 0.0 X 0 0 0 Dee M Libertine Board Member 2.0 0.0 X 0 0 0 Jacqueline Bravo Board Member 2.0 0.0 X 0 0 0 Javier Pulidao Board Member (Through 6/21/21) 2.0 0.0 X 0 0 0 Gilbert Varela INTERIM CEO 5/19/21 - 6/2/21 40.0 0.0 X 0 0 0 2465019 0 146541 37 false true false Creative Solutions at work 9234 Aero Drive PICO RIVERA CA 90660 Construction Service 1500000 Macman Management Healthcare Servic 1300 National Drive Ste 175 SACRAMENTO CA 95834 Billing Services 509531 KPG Healthcare LLC PO Box 840202 LOS ANGELES CA 900840202 Clinic Provider 479870 Dale J Brent MD 4955 Van Nuys Blvd Ste 411 SHERMAN OAKS CA 91403 Clinic Provider 405075 Varela Medical Group Inc 5233 E Beverly Blvd LOS ANGELES CA 90022 Clinic Provider 384000 26 150000 5670606 921628 24164 6742234 NET PATIENT SERVICE REVENUE 621110 32137238 32137238 PHARMACY REVENUE 621110 3398285 3398285 ADULT DAY CARE 621110 799193 799193 36334716 39052 39052 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 INSURANCE STOCK CONVERSION 909999 131143 131143 MEDI-CAL EHR INCENTIVE 909999 93500 93500 OTHER MISC INCOME 909999 42666 42666 267309 43383311 36602025 39052 X 0 0 0 0 1116275 862751 253524 0 13769646 10635945 3133701 98000 77612 20388 1475281 1168366 306915 1149544 910395 239149 0 186804 186804 0 0 0 0 7485480 5613849 1871631 5223 5223 1058290 799667 258623 663418 663418 0 2302474 1792986 509488 294369 227253 67116 0 89445 89445 494174 381502 112672 0 814537 628822 185715 297076 229343 67733 MEDICAL SUPPLIES 2473908 2473908 DUES AND SUBSCRIPTIONS 271331 209468 61863 REPAIRS AND MAINTENANCE 305796 236075 69721 EQUIPMENT RENTAL AND LEA 211200 163046 48154 629148 450162 178986 35191419 26955818 8235601 0 1000 1000 15691638 19752502 0 63628 2751033 2641368 0 0 0 0 0 0 0 0 263416 258601 15922685 5271716 7131823 10650969 0 0 0 0 0 0 1194507 987466 0 961814 27033417 35317348 1726174 2962976 0 0 296079 172954 0 0 0 0 0 0 2525739 2500000 0 0 25775008 25412356 30323000 31048286 X -3289583 4269062 0 0 -3289583 4269062 27033417 35317348 8191892 -633247 X false true X true true true X 4460941 5859060 5500119 6853982 6742234 29416336 0 0 4460941 5859060 5500119 6853982 6742234 29416336 0 29416336 173 47 1823 64094 39052 105189 0 0 29521525 161849423 0.99644 0.99760 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 2483339 2483339 10514279 3154000 7360279 1370305 1028174 342131 1554762 1089542 465220 10650969 0 STATE MEDI-CAL PAYABLE S/T 10099991 STATE MEDI-CAL PAYABLE L/T 15312365 25412356 X 43383311 43383311 43383311 35191419 35191419 35191419 SCHEDULE D: PART X LINE 2 - INCOME TAX FOOTNOTE THE HEALTH CENTER IS A NON-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE "CODE") AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(a)(1) OF THE CODE. THE HEALTH CENTER IS ALSO EXEMPT FROM STATE INCOME TAXES ON RELATED INCOME. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA PRESRIBE REQUIREMENTS FOR THE RECOGNITION OF INCOME TAXES IN FINANCIAL STATEMENTS, AND THE AMOUNTS RECOGNIZED ARE AFFECTED BY INCOME TAX POSITIONS TAKEN BY THE CENTER IN ITS TAX RETURNS. THE HEALTH CENTER'S STATUS AS AN EXEMPT CENTER IS DEFINED AS AN INCOME TAX POSITION UNDER THESE REQUIREMENTS. WHILE MANAGEMENT BELIEVES IT HAS COMPLIED WITH THE INTERNAL REVENUE CODE, THE SUSTAINABILITY OF SOME INCOME TAX POSITIONS TAKEN BY THE HEALTH CENTER IN ITS TAX RETURNS MAY BE UNCERTAIN. THERE ARE MINIMUM THRESHOLDS OF LIKELIHOOD THAT UNCERTAIN TAX POSITIONS ARE REQUIRED TO MEET BEFORE BEING RECOGNIZED IN THE FINANCIAL STATEMENTS. MANAGEMENT DOES NOT BELIEVE THAT THE HEALTH CENTER HAS ANY MATERIAL UNCERTAIN TAX POSTIIONS AS OF JUNE 30, 2021, OR 2020. IN THE EVENT INTEREST AND PENALTIES ARE DUE RELATING TO AN UNSUSTAINBALBLE TAX POSTION, THEY WOULD BE TREATED AS A COMPONENT OF INCOME TAX EXPENSE. DURING THE YEARS ENDED JUNE 30, 2021 AND 2020, THERE WERE NO INTEREST OR PENALTIES RELATING TO UNSUSTAINABLE TAX POSTIONS THAT WERE RECONGIZED IN THESE FINANCIAL STATEMENTS. X X X false false false false false false false false false Omar Moreno CEO & CFO (Through 5/20/21) 607398 0 131089 0 0 0 19500 0 11898 0 769885 0 Rosemary Reyes CMO/Interim CEO 265502 0 0 0 0 0 0 0 28158 0 293660 0 Michael Choi INTERNIST 297873 0 0 0 0 0 0 0 2182 0 300055 0 0 Charles Tuan Nguyen Psychiatrist 212240 0 0 0 0 0 0 0 0 0 212240 0 0 Nickolas L Lind Lead Physician 211174 0 0 0 0 0 0 0 3185 0 214359 0 Shafeeq Shamsid-Deen Lead Physician Residential 206525 0 0 0 0 0 0 0 57144 0 263669 0 Michael Jordan Vizcarra OB-GYN 205069 0 0 0 0 0 0 0 24474 0 229543 0 Swati Purohit Pediatrician 183324 0 0 0 0 0 0 0 0 0 183324 0 0 VARELA MEDICAL GROUP INC OWNED BY FORMER EXECUTIVE DIRECTOR, GILBERT VARELA 324000 see part v false ALLIANCE HEALTH SYSTEMS OWNED BY FORMER EXECUTIVE DIRECTOR, GILBERT VARELA 480628 SEE PART V false PART IV, LINE 1, COLUMN D: ORGANIZATION PAID VARELA MEDICAL GROUP FOR MEDICAL SERVICES PROVIDED TO THE ORGANIZATION. THE OWNER OF VARELA MEDICAL GROUP IS A FORMER CEO, GILBERT VARELA, WHO ALSO SERVED AS AN INTERIM CEO FOR LESS THAN A MONTH DURING THE CURRENT TAX YEAR while the Board selected a replacement. PART IV, LINE 2, COLUMN D ALLIANCE HEALTH SYSTEMS IS AN INDEPENDENT PRACTICE ASSOCIATION 100% OWNED BY THE FORMER CEO, GILBERT VARELA, who ALSO served AS AN INTERIM CEO FOR less than a month DURING THE CURRENT TAX YEAR while the Board selected a replacement. THE ORGANIZATION RECEIVES A CAPITATED PAYMENT ON A PER MEMBER PER MONTH BASIS FOR PRIMARY CARE SERVICES PROVIDED BY THE ORGANIZATION. FORM 990, PART VI, SECTION A, LINE 2 MARIA AND JUAN DURAN HAVE A FAMILY RELATIONSHIP. LUIS AND STELLA MARTEN HAVE A FAMILY RELATIONSHIP. FORM 990, PART VI, SECTION B, LINE 11B A DRAFT COPY OF IRS FORM 990 WAS DISTRIBUTED TO THE FULL BOARD OF DIRECTORS AS WELL AS CEO AND FISCAL DIRECTOR OF THE ORGANIZATION FOR REVIEW AND APPROVAL PRIOR TO SUBMISSION. FORM 990, PART VI, SECTION B, LINE 12C: ONCE A YEAR DURING A BOARD MEETING, EACH BOARD MEMBER IS GIVEN A STATEMENT TO SIGN STATING THERE ARE NO CONFLICTS OF INTEREST THAT HAVE OCCURRED OR WILL OCCUR DURING THE PAST AND SUBSEQUENT TIME REMAINING AS A BOARD MEMBER. FORM 990, PART VI, SECTION B, LINE 15 FOR ALL KEY POSITIONS OF THE ORGANIZATION, THE BOARD OF DIRECTORS OBTAIN AND DOCUMENT THE SALARY SURVEYS THAT HAVE BEEN PREPARED BY INDEPENDENT ORGANIZATIONS. IN ADDITION, THE BOARD OF DIRECTORS OBTAIN SALARY INFORMATION FROM COMPARABLE ORGANIZATIONS TO PROVIDE GUIDANCE IN SETTING THE COMPENSATION OF EACH OF THE POSITIONS. TAKEN INTO CONSIDERATION IN MAKING THE PROPER COMPARISONS ARE THE SIZE AND REVENUES OF THE ORGANIZATIONS. UPON COMPLETE SATISFACTION OF THE COMPARISONS AND SALARY RANGES, THE BOARD MOTIONS TO APPROVE THE COMPENSATION AT THEIR MEETING. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY, AND AUDITED FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST VIA PHONE OR WRITTEN REQUEST. THESE DOCUMENTS ARE MADE AVAILABLE AT THE ORGANIZATION'S OFFICE BY APPOINTMENT. FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACTUAL - FINANCIAL TOTAL FEES:79120 FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACTUAL - ADMINISTRATIVE TOTAL FEES:597396 FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACTUAL - FACILITY TOTAL FEES:171900 FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACTUAL - MEDICAL/MENTAL TOTAL FEES:5115181 FORM 990 PART IX LINE 11G DESCRIPTION:CONTRACTUAL - DENTAL TOTAL FEES:5500 FORM 990 PART IX LINE 11G DESCRIPTION:CONSULTANTS - OTHERS TOTAL FEES:982250 FORM 990 PART IX LINE 11G DESCRIPTION:BILLING SERVICES TOTAL FEES:534133 HEALTH GUARD INLAND LLC 268 MCARTHUR WAY UPLAND CA 91786 263522465 ADULT DAYCARE CA 799193 CCCHC INC