COMMUNITY HEALTH ALLIANCE OF PASADENA: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- COMMUNITY HEALTH ALLIANCE OF PASADENA (EIN 95-4536824)
- Tax period
- 2019-07-01 to 2020-06-30
- Filed
- 2021-04-22
- IRS object ID
- 202111129349300231
- Schema version
- 2019v5.2
- 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 | 2021-04-22T15:43:58-05:00 | ReturnTs |
| Tax Period End | 2020-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 953001179 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WINDES INC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 87 | AddressLine1Txt |
| City | LONG BEACH | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 908010087 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2019-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 954536824 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COMMUNITY HEALTH ALLIANCE OF PASADENA | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | COMM | BusinessNameControlTxt |
| Phone | 6263986300 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 455 WEST MONTANA STREET | AddressLine1Txt |
| City | PASADENA | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 91103 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MARGARET B MARTINEZ | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 6263986300 | PhoneNum |
| Signature | 2021-03-30 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DONITA M JOSEPH | PreparerPersonNm |
| PTIN | P00286656 | PTIN |
| Phone | 5624351191 | PhoneNum |
| Preparation | 2021-03-27 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CHAPCARE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MARGARET B MARTINEZ | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 455 WEST MONTANA STREET | AddressLine1Txt |
| City | PASADENA | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 91103 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $21,887,051 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.CHAPCARE.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1995 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | PROVIDE MEDICAL, DENTAL, BEHAVORIAL HEALTH, AND OPTOMETRY SERVICES TO THE RESIDENTS OF THE SAN GABRIEL VALLEY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 14 | VotingMembersIndependentCnt |
| Total Employee | 551 | TotalEmployeeCnt |
| Total Volunteers | 14 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $10,110,128 | PYContributionsGrantsAmt |
| CY Contributions Grants | $8,820,620 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $12,864,107 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $13,038,391 | CYProgramServiceRevenueAmt |
| PY Investment Income | $138 | PYInvestmentIncomeAmt |
| CY Investment Income | $320 | CYInvestmentIncomeAmt |
| PY Other Revenue | $24,320 | PYOtherRevenueAmt |
| CY Other Revenue | $27,720 | CYOtherRevenueAmt |
| PY Total Revenue | $22,998,693 | PYTotalRevenueAmt |
| CY Total Revenue | $21,887,051 | 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 | $11,753,230 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $11,658,373 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $195,583 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $9,653,618 | PYOtherExpensesAmt |
| CY Other Expenses | $9,236,395 | CYOtherExpensesAmt |
| PY Total Expenses | $21,406,848 | PYTotalExpensesAmt |
| CY Total Expenses | $20,894,768 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,591,845 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $992,283 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $16,646,336 | TotalAssetsBOYAmt |
| Total Assets EOY | $17,756,043 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $11,308,451 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $11,425,875 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $5,337,885 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $6,330,168 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO PROVIDE EXCELLENT, COMPREHENSIVE, INNOVATIVE HEALTH CARE THAT IS ACCESSIBLE TO THE RESIDENTS OF THE SAN GABRIEL VALLEY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $13,647,883 | ExpenseAmt |
| Revenue | $11,585,431 | RevenueAmt |
| Desc | CHAPCARE OFFERS A FULL RANGE OF PRIMARY MEDICAL CARE SERVICES, PHYSICAL EXAMINATIONS FOR PEOPLE OF ALL AGES, CHOLESTEROL CHECKS, CANCER SCREENING, COMMUNICABLE DISEASE SCREENING, VISION AND HEARING TESTING, FAMILY PLANNING, BLOOD PRESSURE SCREENING, LAB AND RADIOLOGY, MEDICATIONS, PRESCRIPTIONS, AND CASE MANAGEMENT SERVICES. CHAPCARE PROVIDED OVER 47,000 MEDICAL VISITS TO OVER 14,000 UNDUPLICATED PATIENTS DURING THE FISCAL YEAR, JUNE 30, 2020. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $2,027,379 | ExpenseAmt |
| Revenue | $1,345,942 | RevenueAmt |
| Desc | CHAPCARE OFFERS DENTAL SERVICES FOR CHILDREN AND ADULTS. SERVICES INCLUDE ROUTINE CLEANING, EXAMINATION AND RESTORATIVE WORK. IN THE REPORTING YEAR, OVER 8,000 DENTAL VISITS WERE PROVIDED TO OVER 3,500 UNDUPLICATED PATIENTS. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $784,275 | ExpenseAmt |
| Revenue | $107,018 | RevenueAmt |
| Desc | CHAPCARE PROVIDES WELLNESS SERVICES AVAILABLE TO ALL THROUGH EXPERT PROFESSIONALS IN THE AREA OF DIABETES, WEIGHT MANAGEMENT, NUTRITION COUNSELING, SALSA COURSES, AS WELL AS PHARMACY CONSULTATION OUTREACH FOR DIRECT MEDICAL SERVICES AT SPECIFIC LOCATIONS FOR HOMELESS SERVICES AS WELL AS SCREENING AT HEALTH FAIRS. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $16,459,537 | 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 | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | 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 | 0 | TaxExemptBondsInd |
| 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 | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 20 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 551 | 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 | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 14 | 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 | Yes (1) | 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 | FRANCISCO BENAVIDES | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6263986300 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 455 WEST MONTANA STREET | AddressLine1Txt |
| City | PASADENA | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 91103 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (29 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 |
|---|---|---|---|---|---|---|---|---|
| SARAH SPYKSMA | ||||||||
| CHAIR | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| DEBORAH VILLAR | ||||||||
| VICE CHAIR | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| MIKE HERNANDEZ | ||||||||
| TREASURER | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| MAURICETTE MONTREDON | ||||||||
| SECRETARY | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| PORFIRIO FRAUSTO | ||||||||
| MEMBER | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| DAVID LEE | ||||||||
| MEMBER | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| THOMAS THORMAN | ||||||||
| MEMBER | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| HAKIM BAXTER | ||||||||
| MEMBER | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| JESSICAL RUIZ | ||||||||
| MEMBER | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| MICHAEL OLIVARES | ||||||||
| MEMBER | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| BETH SY HO | ||||||||
| MEMBER | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| PAM WALD | ||||||||
| MEMBER | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| CONNIE CASILLAS | ||||||||
| MEMBER | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| JAY LEE | ||||||||
| MEMBER | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| ARMANDO LUNA | ||||||||
| MEMBER | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| MARGARET B MARTINEZ | ||||||||
| CHIEF EXECUTIVE OFFICER | 40.00 | Yes (X) | $225,000 | $0 | $27,755 | |||
| SERGIO BAUTISTA | ||||||||
| CHIEF DEPUTY DIRECTOR | 40.00 | Yes (X) | $217,720 | $0 | $26,857 | |||
| VICTOR SUNGA MD | ||||||||
| CHIEF CARE OFFICER | 40.00 | Yes (X) | $156,124 | $0 | $19,259 | |||
| SCOTT YUNG KIM | ||||||||
| CHIEF CARE OFFICER | 40.00 | Yes (X) | $35,712 | $0 | $4,405 | |||
| FRANCISCO BENAVIDES | ||||||||
| CHIEF FINANCIAL OFFICER | 40.00 | Yes (X) | $163,534 | $0 | $20,173 | |||
| STEVEN IAN ABRAMSON | ||||||||
| CHIEF OPERATING OFFICER | 40.00 | Yes (X) | $163,441 | $0 | $20,161 | |||
| DEYNER ZAPATA | ||||||||
| CHIEF ADMINISTRATIVE OFFIC | 40.00 | Yes (X) | $163,534 | $0 | $20,173 | |||
| IRIS MARQUEZ PAISO | ||||||||
| DENTAL DIRECTOR | 40.00 | $182,773 | $0 | $22,546 | Yes (X) | |||
| KENNETH EDWARD ROTHSTEIN | ||||||||
| PHARMACY MANAGING DIRECTOR | 40.00 | $163,524 | $0 | $20,171 | Yes (X) | |||
| ENRIQUE HUGO VALLOTA | ||||||||
| PHYSICIAN | 40.00 | $202,078 | $0 | $24,927 | Yes (X) | |||
| DOROTHY JOAN MARQUEZ-MANEJA | ||||||||
| PHYSICIAN | 40.00 | $192,808 | $0 | $23,784 | Yes (X) | |||
| ONNIG JOHN PANOSIAN | ||||||||
| PHYSICIAN | 32.00 | $164,782 | $0 | $20,327 | Yes (X) | |||
| REX SAYO LAURENTE | ||||||||
| DENTIST | 40.00 | $135,188 | $0 | $16,676 | Yes (X) | |||
| CHARLES EVERETT BRADSHAW | ||||||||
| PHARMACIST | 40.00 | $129,150 | $0 | $15,931 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,295,368 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $283,145 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 21 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | 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 |
|---|---|---|---|---|---|
| AMERISOURCEBERGEN CHAP | |||||
| PO BOX 100565 | PASADENA | CA | 91189 | PHARMACEUTICALS | $1,027,867 |
| KAISER FOUNDATION HEALTH PLAN INC | |||||
| FILE 5915 | LOS ANGELES | CA | 90074 | MEDICAL HEALTH PLAN | $896,844 |
| CSI ELECTRICAL CONTRACTOR SERVICES INC | |||||
| 4195 CHINO HILLS PARKWAY 544 | CHINO HILLS | CA | 91709 | GENERAL CONTRACTOR | $693,732 |
| OCHIN | |||||
| 1881 SW NAITO PARKWAY | PORTLAND | CA | 97201 | ELECTRONIC HEALTH RECORD PROVIDER | $441,332 |
| 7 LAYER IT SOLUTIONS INC | |||||
| 8921 FULLBRIGHT AVE | CHATSWORTH | CA | 91311 | IT MANAGED SERVICE PROVIDER | $389,673 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 20 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $6,533,766 | GovernmentGrantsAmt |
| All Other Contributions | $2,286,854 | AllOtherContributionsAmt |
| Total Contributions | $8,820,620 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT FEES | 624100 | $8,417,820 | $8,417,820 |
| PHARMACY | 624100 | $3,920,941 | $3,920,941 |
| PROGRAM PARTICIPANT INCENTIVES | 624100 | $360,465 | $360,465 |
| OTHER PROGRAM INCOME | 624100 | $339,165 | $339,165 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $13,038,391 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $320 | TotalRevenueColumnAmt |
| Exclusion | $320 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $27,720 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $27,720 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $27,720 | TotalRevenueColumnAmt |
| Exclusion | $27,720 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $21,887,051 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $13,038,391 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $28,040 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,670,781 | TotalAmt |
| Program Services | $1,342,199 | ProgramServicesAmt |
| Management And General | $313,792 | ManagementAndGeneralAmt |
| Fundraising | $14,790 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,233,896 | TotalAmt |
| Program Services | $6,530,666 | ProgramServicesAmt |
| Management And General | $1,629,671 | ManagementAndGeneralAmt |
| Fundraising | $73,559 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,015,686 | TotalAmt |
| Program Services | $805,585 | ProgramServicesAmt |
| Management And General | $201,027 | ManagementAndGeneralAmt |
| Fundraising | $9,074 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $738,010 | TotalAmt |
| Program Services | $586,499 | ProgramServicesAmt |
| Management And General | $144,927 | ManagementAndGeneralAmt |
| Fundraising | $6,584 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $628,011 | TotalAmt |
| Program Services | $254,946 | ProgramServicesAmt |
| Management And General | $370,225 | ManagementAndGeneralAmt |
| Fundraising | $2,840 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $818,791 | TotalAmt |
| Program Services | $445,337 | ProgramServicesAmt |
| Management And General | $373,454 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $127,129 | TotalAmt |
| Program Services | $114,813 | ProgramServicesAmt |
| Management And General | $7,937 | ManagementAndGeneralAmt |
| Fundraising | $4,379 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $77,881 | TotalAmt |
| Program Services | $37,089 | ProgramServicesAmt |
| Management And General | $40,488 | ManagementAndGeneralAmt |
| Fundraising | $304 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $363,844 | TotalAmt |
| Program Services | $289,148 | ProgramServicesAmt |
| Management And General | $71,450 | ManagementAndGeneralAmt |
| Fundraising | $3,246 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $844,554 | TotalAmt |
| Program Services | $840,347 | ProgramServicesAmt |
| Management And General | $4,207 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $46,612 | TotalAmt |
| Program Services | $39,404 | ProgramServicesAmt |
| Management And General | $7,208 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $420,441 | TotalAmt |
| Program Services | $225,771 | ProgramServicesAmt |
| Management And General | $194,670 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,281,738 | TotalAmt |
| Program Services | $1,054,043 | ProgramServicesAmt |
| Management And General | $215,795 | ManagementAndGeneralAmt |
| Fundraising | $11,900 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $138,974 | TotalAmt |
| Program Services | $23,195 | ProgramServicesAmt |
| Management And General | $115,779 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| SUPPLIES - PHARMACY | $1,070,644 | $1,070,644 | |
| UTILITIES | $903,983 | $784,168 | $119,815 |
| SUPPLIES - CLINICAL | $577,349 | $577,349 | |
| ELECTRONIC HEALTH RECOR | $459,931 | $459,931 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,476,513 | TotalAmt |
| Program Services | $978,403 | ProgramServicesAmt |
| Management And General | $429,203 | ManagementAndGeneralAmt |
| Fundraising | $68,907 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,894,768 | TotalAmt |
| Program Services | $16,459,537 | ProgramServicesAmt |
| Management And General | $4,239,648 | ManagementAndGeneralAmt |
| Fundraising | $195,583 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $342,712 | BOYAmt |
| EOY | $1,159,230 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $367,397 | BOYAmt |
| EOY | $398,035 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $175,532 | BOYAmt |
| EOY | $65,946 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,687,473 | BOYAmt |
| EOY | $2,032,578 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $408,781 | BOYAmt |
| EOY | $410,161 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $56,841 | BOYAmt |
| EOY | $49,671 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $18,436,537 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $8,953,402 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,418,637 | BOYAmt |
| EOY | $9,483,135 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,188,963 | BOYAmt |
| EOY | $4,157,287 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,646,336 | BOYAmt |
| EOY | $17,756,043 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,398,086 | BOYAmt |
| EOY | $2,399,094 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,910,365 | BOYAmt |
| EOY | $9,026,781 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,308,451 | BOYAmt |
| EOY | $11,425,875 | 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 | $4,819,718 | BOYAmt |
| EOY | $5,769,284 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $518,167 | BOYAmt |
| EOY | $560,884 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,337,885 | BOYAmt |
| EOY | $6,330,168 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $16,646,336 | BOYAmt |
| EOY | $17,756,043 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $992,283 | ReconcilationRevenueExpnssAmt |
| 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) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| 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) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $7,707,375 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $7,774,080 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7,663,187 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $10,110,128 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $8,820,620 | CurrentTaxYearAmt |
| Total | $42,075,390 | TotalAmt |
Govt Furn Srvc Fclts Vl170 GovtFurnSrvcFcltsVl170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $392,487 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $536,887 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $617,935 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $630,483 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $587,902 | CurrentTaxYearAmt |
| Total | $2,765,694 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $8,099,862 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $8,310,967 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $8,281,122 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $10,740,611 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $9,408,522 | CurrentTaxYearAmt |
| Total | $44,841,084 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $44,841,084 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $27,423 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $23,221 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $23,246 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $24,458 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $28,040 | CurrentTaxYearAmt |
| Total | $126,388 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $44,967,472 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $58,527,662 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.99720 | PublicSupportCY170Pct |
| Public Support PY170 | 0.96520 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
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 | $1,268,878 | OtherCostOrOtherBasisAmt |
| Book Value | $1,268,878 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,252,199 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,674,961 | DepreciationAmt |
| Book Value | $1,577,238 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,040,312 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,521,655 | DepreciationAmt |
| Book Value | $3,518,657 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,875,148 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,756,786 | DepreciationAmt |
| Book Value | $3,118,362 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $9,483,135 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| ESTIMATED AMOUNTS DUE FROM THIRD-PARTY PAYERS | $4,018,340 |
| DEPOSITS | $138,947 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $4,157,287 | TotalBookValueOtherAssetsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $22,474,953 | TotalRevEtcAuditedFinclStmtAmt |
| Donated Services And Use Fclts | $587,902 | DonatedServicesAndUseFcltsAmt |
| Revenue Not Reported | $587,902 | RevenueNotReportedAmt |
| Revenue Subtotal | $21,887,051 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $21,887,051 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $21,482,670 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $587,902 | DonatedServicesUseFcltsAmt |
| Expenses Not Reported | $587,902 | ExpensesNotReportedAmt |
| Expenses Subtotal | $20,894,768 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $20,894,768 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION HAS BEEN DESIGNATED AS TAX-EXEMPT UNDER INTERNAL REVENUE CODE SECTION 501(C)(3), IS ALSO EXEMPT FROM STATE FRANCHISE TAXES UNDER SECTION 23701(D) OF THE CALIFORNIA REVENUE AND TAXATION CODE, AND IS NOT GENERALLY SUBJECT TO FEDERAL OR STATE INCOME TAXES. GENERALLY ACCEPTED ACCOUNTING PRINCIPLES PRESCRIBE A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. IT REQUIRES THAT AN ORGANIZATION RECOGNIZE IN THE FINANCIAL STATEMENTS THE IMPACT OF THE TAX POSITION IF THAT POSITION WILL MORE LIKELY THAN NOT BE SUSTAINED ON AUDIT, BASED ON THE TECHNICAL MERITS OF THE POSITION. AS OF AND FOR THE YEAR ENDED JUNE 30, 2020, THE ORGANIZATION HAD NO UNRECOGNIZED TAX BENEFITS, TAX PENALTIES, OR INTEREST. THE ORGANIZATION IS SUBJECT TO POTENTIAL INCOME TAX AUDITS ON OPEN TAX YEARS BY ANY TAXING JURISDICTION IN WHICH IT OPERATES. THE STATUTE OF LIMITATIONS FOR FEDERAL PURPOSES IS THREE YEARS AND FOR CALIFORNIA IS FOUR YEARS. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| 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 | 0 | 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MARGARET B MARTINEZ | ||||||||||||||
| CHIEF EXECUTIVE OFFICER | $225,000 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $27,755 | $0 | $252,755 | $0 | $0 | $0 |
| SERGIO BAUTISTA | ||||||||||||||
| CHIEF DEPUTY DIRECTOR | $217,720 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $26,857 | $0 | $244,577 | $0 | $0 | $0 |
| VICTOR SUNGA MD | ||||||||||||||
| CHIEF CARE OFFICER | $156,124 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $19,259 | $0 | $175,383 | $0 | $0 | $0 |
| FRANCISCO BENAVIDES | ||||||||||||||
| CHIEF FINANCIAL OFFICER | $163,534 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $20,173 | $0 | $183,707 | $0 | $0 | $0 |
| STEVEN IAN ABRAMSON | ||||||||||||||
| CHIEF OPERATING OFFICER | $163,441 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $20,161 | $0 | $183,602 | $0 | $0 | $0 |
| DEYNER ZAPATA | ||||||||||||||
| CHIEF ADMINISTRATIVE OFFIC | $163,534 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $20,173 | $0 | $183,707 | $0 | $0 | $0 |
| IRIS MARQUEZ PAISO | ||||||||||||||
| DENTAL DIRECTOR | $182,773 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $22,546 | $0 | $205,319 | $0 | $0 | $0 |
| KENNETH EDWARD ROTHSTEIN | ||||||||||||||
| PHARMACY MANAGING DIRECTOR | $163,524 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $20,171 | $0 | $183,695 | $0 | $0 | $0 |
| ENRIQUE HUGO VALLOTA | ||||||||||||||
| PHYSICIAN | $202,078 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $24,927 | $0 | $227,005 | $0 | $0 | $0 |
| DOROTHY JOAN MARQUEZ-MANEJA | ||||||||||||||
| PHYSICIAN | $192,808 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $23,784 | $0 | $216,592 | $0 | $0 | $0 |
| ONNIG JOHN PANOSIAN | ||||||||||||||
| PHYSICIAN | $164,782 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $20,327 | $0 | $185,109 | $0 | $0 | $0 |
| REX SAYO LAURENTE | ||||||||||||||
| DENTIST | $135,188 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $16,676 | $0 | $151,864 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 4A | FormAndLineReferenceDesc |
| Explanation | SERGIO BAUTISTA RECEIVED ONE MONTH SEVERANCE OF MEDICAL INSURANCE OF $571.32 FOR THE MONTH OF JUNE 2020. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | IT IS THE RESPONSIBILITY OF THE FINANCE COMMITTEE TO ACCEPT AND MAKE RECOMMENDATIONS TO THE BOARD OF DIRECTORS FOR APPROVAL. THE APPROVED 990 IS SIGNED BY THE CEO AND MAILED TO THE APPROPRIATE TAX AGENCY. |
| FORM 990, PART VI, SECTION B, LINE 12C | REVIEW OF POLICY IS PERFORMED BY THE BOARD OF DIRECTORS AND ANY POTENTIAL CONFLICTS ARE IDENTIFIED. EACH BOARD MEMBER SIGNS AN ETHICS AND CONFLICT OF INTEREST FORM ANNUALLY. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE BOARD USES A CPCA REPORT AND A LOCAL CLINIC SURVEY TO DETERMINE THE COMPENSATION PACKAGE FOR THE CEO. THE BOARD APPROVES THE COMPENSATION PACKAGE, WHICH IS DOCUMENTED IN THE MINUTES. THE FINANCE COMMITTEE PRESENTS TO THE BOARD A COMPREHENSIVE BUDGET, WHICH INCLUDES THE COMPENSATION OF ALL OTHER OFFICERS AND KEY EMPLOYEES. |
| FORM 990, PART VI, SECTION C, LINE 19 | ALL ITEMS ARE AVAILABLE UPON REQUEST. THE ITEMS SHOULD BE REQUESTED, IN WRITING, TO THE ATTENTION OF MARGARET B MARTINEZ, CEO. FORM 990 IS ALSO AVAILABLE ON WWW.GUIDESTAR.COM. |
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