2020-07-15T09:11:55-05:00 2019-06-30 946214841 ARMANINO LLP 12657 ALCOSTA BLVD STE 500 SAN RAMON CA 945834600 990 2018-07-01 237118361 TIBURCIO VASQUEZ HEALTH CENTER INC TIBU 5104715880 22331 MISSION BLVD HAYWARD CA 945413911 LUCIEN FREEMAN CFO 5104715880 2020-07-14 1 MATTHEW PETROSKI P00853132 9257902600 2020-07-13 34.100.94.80 2020-07-14 16:00:36 MD P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 7777A0160DD75CFDDC16105D0C842EB02EF403B0 2018 2021-01-29 14:40:06Z LUCIEN FREEMAN 22331 MISSION BLVD HAYWARD CA 945413911 32562757 0 X WWW.TVHC.ORG X 1971 CA TIBURCIO VASQUEZ HEALTH CENTER, INC. IS A PRIVATE NONPROFIT ORGANIZATION FORMED TO SPONSOR, PROMOTE, AND PROVIDE COMPREHENSIVE COMMUNITY HEALTH SERVICES THAT APPROPRIATELY MEET THE PHYSICAL, MENTAL, AND SOCIAL NEEDS OF SOUTHERN ALAMEDA COUNTY. 9 9 389 39 0 0 12312514 11265371 21929038 20509548 71103 63986 191942 723852 34504597 32562757 4125 2400 0 0 23304617 23001708 0 0 0 8971166 9093682 32279908 32097790 2224689 464967 20549058 20414325 8939194 8339494 11609864 12074831 PROVIDE COMPREHENSIVE COMMUNITY HEALTH SERVICES TO SOUTHERN ALAMEDA COUNTY. 0 0 3533167 2400 3533167 HEALTHPAC: PROVIDES MEDICALLY NECESSARY SERVICES TO LOW-INCOME UNINSURED INDIVIDUALS ENROLLED IN THE COUNTY MEDICALLY INDIGENT SERVICES PLAN. 3284797 3284797 PRIMARY CARE OUTPATIENT: THE MEDICAL CLINIC PROVIDES BASIC HEALTH CARE FOR THE PEOPLE OF ALL AGES FAMILY MEDICINE, INTERNAL MEDICINE, PEDIATRICS AND OBSTETRICS-GYNOCOLOGY. THE DENTAL DEPARTMENT OFFERS A VARIETY OF DENTAL CARE FOR CHILDREN AND ADULTS, INCLUDING DENTAL EXAMS, FILLINGS, CROWNS, ROOT CANALS, EXTRACTIONS, SPACE MAINTAINERS, AND EMERGENCY SERVICES. 19699190 14409436 19699190 14409436 26517154 1 1 0 0 0 0 0 0 0 0 1 0 1 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 51 0 1 389 1 0 0 0 0 0 0 0 0 0 0 0 0 X 9 9 1 0 0 0 0 0 0 1 1 0 1 1 1 1 1 1 1 1 1 1 0 CA X LUCIEN FREEMAN 5104715880 22331 MISSION BLVD HAYWARD CA 945413911 NANCY SOTO PRESIDENT 3.00 X X 0 0 0 MINYON CORCUCHIA-GARDE VICE PRESIDENT 1.50 X X 0 0 0 JOSUE A HERNANDEZ SECRETARY 1.50 X X 0 0 0 JAIME PATINO TREASURER 1.50 X X 0 0 0 AHMAD ASIR BOARD MEMBER 1.50 X 0 0 0 JENNIE REYES BOARD MEMBER 1.50 X 0 0 0 JESSE ROBLES BOARD MEMBER 1.50 X 0 0 0 DIANA SUAREZ BOARD MEMBER 1.50 X 0 0 0 CARLA RAMIREZ BOARD MEMBER 1.50 X 0 0 0 DAVID B VLIET CHIEF EXECUTIVE OFFICER 40.00 3.00 X 297352 0 28213 ANDREA SCHWAB-GALINDO CHIEF ADMIN. OFFICER 40.00 X 181245 0 12174 BRENT COPEN CFO (THRU 1/19) 40.00 3.00 X 202684 0 12174 CALEB J SANDFORD CHIEF OPERATIONS OFFICER 40.00 X 181472 0 12563 LUCIEN FREEMAN CFO (START 2/19) 40.00 X 0 0 0 PORSHIA MACK CHIEF MEDICAL OFFICER 40.00 X 273019 0 11694 SRIDEVI PONNALA CHIEF DENTAL OFFICER 40.00 X 221510 0 2746 JAMES H KRAVETZ PHYSICIAN 40.00 X 227055 0 2427 PARVEEN KAUR PHYSICIAN 40.00 X 211759 0 11694 ANKITA SHRIVASTAVA PHYSICIAN 40.00 X 205798 0 2466 ROXANA E STANCESCU-POPESCU PHYSICIAN 40.00 X 186508 0 6541 OLGA KASHLINSKAYA PHYSICIAN 40.00 X 183549 0 11694 2371951 0 114386 32 0 1 0 PRIORITY MANAGEMENT GROUP 700 SCHOOL STREET PAWTUCKET RI 02860 BILLING 751502 BAY CHILDREN'S PHYSICIANS 6475 CHRISTIE AVENUE SUITE 300 EMERYVILLE CA 94608 PHYSICIAN SERVICES 497870 OAKLAND PARMACY INC 333 9TH STREET OAKLAND CA 94607 PHARMACY SERVICES 367983 QUEST DIAGNOSTICS PO BOX 50368 LOS ANGELES CA 900740368 LABORATORY SERVICES 352668 CATO'S PAVING 22302 HATHAWAY AVE HAYWARD CA 94541 PARKING LOT REPAIRS 202920 14 10034386 1230985 11265371 PATIENT & THIRD PARTY 621300 17463297 17463297 CAPITATION REVENUE 621300 2845480 2845480 OTHER PROGRAM REVENUE 621300 200771 200771 20509548 63986 63986 6000 0 6000 6000 6000 OTHER INCOME 900099 717852 717852 717852 32562757 21227400 0 69986 2400 2400 1540913 551101 989812 17017170 14846609 2170561 307221 283722 23499 2746621 2384148 362473 1389783 1160050 229733 63869 3150 60719 201306 5000 196306 2828233 2743771 84462 57720 31050 26670 355533 229114 126419 281859 108760 173099 1921903 1613379 308524 65501 38774 26727 97545 53522 44023 200158 194251 5907 318356 160235 158121 160053 15635 144418 PROGRAM SUPPLIES 1197227 1193380 3847 EQUIPMENT & MAINTENANCE 450651 346224 104427 LICENSES & FEES 279302 107774 171528 PHARMACY 243053 243053 371413 202052 169361 32097790 26517154 5580636 0 4089810 4201675 2017121 2348791 2644212 2039750 1504030 1479421 392833 184011 9892452 7614940 2099142 2277512 7003000 7003000 798910 880165 20549058 20414325 2802638 3400007 49941 142895 4586355 4158895 1500260 637697 8939194 8339494 X 11604834 12069801 5030 5030 11609864 12074831 20549058 20414325 464967 0 X X 0 1 X 1 1 1 X 10576830 10452791 12158494 12312514 11265371 56766000 10576830 10452791 12158494 12312514 11265371 56766000 56766000 77526 76145 76226 77103 69986 376986 498113 455546 14951 185942 717852 1872404 59015390 91278553 0.96190 0.96650 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 20317 20317 3790070 2469451 1320619 5978238 5145489 832749 103827 103827 2277512 INVESTMENT IN NMTC TVHC FUND 7003000 F 7003000 PPS SETTLEMENTS 637697 637697 X PART X, LINE 2: TVHC IS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND FROM STATE INCOME TAX UNDER SECTION 23701(D) OF THE REVENUE AND TAXATION CODE OF THE STATE OF CALIFORNIA. ACCORDINGLY, CONTRIBUTIONS TO TVHC ARE QUALIFIED CHARITABLE CONTRIBUTION DEDUCTIONS. TVHC HAS EVALUATED ITS CURRENT TAX POSITIONS AND HAS CONCLUDED THAT AS OF JUNE 30, 2019, IT DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS FOR WHICH A RESERVE WOULD BE NECESSARY. TVHC FILES U.S. FEDERAL AND STATE RETURNS, AND IS GENERALLY NO LONGER SUBJECT TO TAX EXAMINATIONS FOR YEARS PRIOR TO 2015 AND 2014, RESPECTIVELY. TVHC FACILITIES, INC. AND TVHC FACILITIES II, INC. ARE QUALIFIED AS TAX EXEMPT ORGANIZATIONS. X 0 0 0 0 0 0 0 0 0 DAVID B VLIET CHIEF EXECUTIVE OFFICER 277707 0 19645 0 0 0 15440 0 12773 0 325565 0 0 0 ANDREA SCHWAB-GALINDO CHIEF ADMIN. OFFICER 181245 0 0 0 0 0 1040 0 11134 0 193419 0 0 0 BRENT COPEN CFO (THRU 1/19) 202684 0 0 0 0 0 1040 0 11134 0 214858 0 0 0 CALEB J SANDFORD CHIEF OPERATIONS OFFICER 171472 0 10000 0 0 0 1040 0 11523 0 194035 0 0 0 PORSHIA MACK CHIEF MEDICAL OFFICER 263019 0 10000 0 0 0 1040 0 10654 0 284713 0 0 0 SRIDEVI PONNALA CHIEF DENTAL OFFICER 221510 0 0 0 0 0 1040 0 1706 0 224256 0 0 0 JAMES H KRAVETZ PHYSICIAN 222055 0 5000 0 0 0 1040 0 1387 0 229482 0 0 0 PARVEEN KAUR PHYSICIAN 206759 0 5000 0 0 0 1040 0 10654 0 223453 0 0 0 ANKITA SHRIVASTAVA PHYSICIAN 200798 0 5000 0 0 0 1040 0 1426 0 208264 0 0 0 ROXANA E STANCESCU-POPESCU PHYSICIAN 186508 0 0 0 0 0 1032 0 5509 0 193049 0 0 0 OLGA KASHLINSKAYA PHYSICIAN 183549 0 0 0 0 0 1040 0 10654 0 195243 0 0 0 FORM 990, PART VI, SECTION A, LINE 2 NANCY SOTO AND JESSE ROBLES HAVE A FAMILY RELATIONSHIP. FORM 990, PART VI, SECTION B, LINE 11B THE TAX RETURN IS REVIEWED BY THE FINANCE COMMITTEE AND MADE AVAILABLE TO THE BOARD BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12C ALL EMPLOYEES SIGN A FORM THAT SIGNIFIES RECEIPT AND UNDERSTANDING OF THE CONFLICT OF INTEREST POLICY UPON HIRE. THE HR DEPARTMENT MAKES SURE THAT NEW CONSULTANTS, VENDORS, & FUTURE EMPLOYEES ARE NOT RELATED TO ANY OF THE EMPLOYEES THAT HAVE A DIRECT BUSINESS RELATIONSHIP/TRANSACTION WITH ANY RELATIVE OF AN OFFICER, BOARD MEMBER OR EMPLOYEE IN A MANAGEMENT POSITION THAT WILL HAVE A DIRECT BENEFIT FROM THE TRANSACTION. THE CONFLICT OF INTEREST POLICY MONITORED BY A COMBINATION OF MANAGEMENT, SUPERVISORS, AND THE HUMAN RESOURCES DEPARTMENT. IF ANY INTERESTED PERSON HAS A CONFLICT OF INTEREST, IT IS THE DUTY OF THE INTERESTED PERSON TO REPORT IT. IF THE INTERESTED PERSON IS NOT ABLE TO MITIGATE THE CONFLICT OF INTEREST, MANAGEMENT WILL DETERMINE THE APPROPRIATE COURSE OF ACTION IN EITHER MITIGATING THE CONFLICT OF INTEREST OR DISMISSING THE INTERESTED PERSON. FORM 990, PART VI, SECTION B, LINE 15 THE HR OFFICER COMPARES THE COMPENSATIONS OF TVHC'S TOP MANAGEMENT OFFICIALS, DIRECTORS, AND STAFF TO THE STATE PRIMARY CARE ASSOCIATION TO MAKE SURE TVHC'S COMPENSATIONS ARE CLOSE TO MARKET. FORM 990, PART VI, SECTION C, LINE 19 THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XII, LINE 2C: THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR TVHC FACILITIES INC 22331 MISSION BLVD HAYWARD CA 945413911 270250766 SUPPORT TVHC'S DIRECT CHARITABLE & EDUCATIONAL ACTIVITIES CA 509(A)(3) LINE 12B, II TIBURCIO VASQUEZ HEALTH CENTER INC 1 TVHC FACILITIES II INC 22331 MISSION BLVD HAYWARD CA 945413911 463821919 SUPPORT TVHC'S DIRECT CHARITABLE & EDUCATIONAL ACTIVITIES CA 509(A)(3) LINE 12B, II TIBURCIO VASQUEZ HEALTH CENTER INC 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 1 0 TVHC FACILITIES II INC R 150000 PER TAX AMOUNT