2018-11-15T10:44:29-06:00 2017-12-31 910189318 MOSS ADAMS LLP 101 SECOND STREET SUITE 900 SAN FRANCISCO CA 94105 990 2017-01-01 264826604 MONTAGE MEDICAL GROUP MONT 8317189720 PO BOX HH MONTEREY CA 93942 MATT MORGAN VP FINANCE 8317189720 2018-11-14 1 RICHARD CROGHAN P00089862 4159561500 2018-11-14 216.1.190.98 2018-11-14 13:32:00 PS P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 49EFC680F81229405EF199BD73E62A476B2398BF 2017 2019-02-21 02:37:17Z STEVEN PACKER PO BOX HH MONTEREY CA 93942 16576485 0 X WWW.MONTAGEMEDICALGROUP.ORG X 2009 CA TO PROVIDE HEALTH CARE FOR THE GENERAL PUBLIC, CARRY ON ANY EDUCATIONAL ACTIVITIES RELATED TO RENDERING CARE TO THE SICK OR INJURED, AND TO PARTICIPATE IN SCIENTIFIC HEALTHCARE-RELATED RESEARCH TO PROMOTE THE GENERAL HEALTH OF THE COMMUNITY. 9 5 208 5 0 0 0 1500000 14076688 15076485 0 0 0 0 14076688 16576485 0 0 0 0 15310946 18258720 0 0 0 6553428 6821835 21864374 25080555 -7787686 -8504070 3070963 4180126 17730552 27343785 -14659589 -23163659 TO PROVIDE HEALTH CARE FOR THE GENERAL PUBLIC, CARRY ON ANY EDUCATIONAL ACTIVITIES RELATED TO RENDERING CARE TO THE SICK OR INJURED, AND TO PARTICIPATE IN SCIENTIFIC HEALTHCARE-RELATED RESEARCH TO PROMOTE THE GENERAL HEALTH OF THE COMMUNITY. 0 0 23592746 15076485 DIRECT CLINICAL SERVICES. 23592746 1 1 0 0 0 0 0 0 0 0 1 0 0 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 0 0 0 1 20 0 1 208 1 0 0 0 0 0 0 0 0 0 0 X 9 5 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 CA X SHIRLEY NORMAN 8312428605 PO BOX HH MONTEREY CA 93942 STAN MCKEE CHAIR 1.00 0.00 X X 0 0 0 MIKE LYON VICE CHAIR 1.00 2.00 X X 0 0 0 STEVEN PACKER MD PRESIDENT 1.00 54.00 X X 0 1086864 156284 ANTHONY CHAVIS SECRETARY 1.00 54.00 X X 0 603513 92563 DAVID STRAFACE MD DIRECTOR 40.00 0.00 X 297248 0 43221 JOHN MAHONEY MD DIRECTOR 1.00 0.00 X 0 0 0 GURU KHALSA MD DIRECTOR 40.00 0.00 X 0 73800 0 WAYNE MOON DIRECTOR 1.00 0.00 X 0 0 0 LANCELOT ALEXANDER MD DIRECTOR 1.00 0.00 X 0 0 0 LAURA ZEHM CFO 1.00 54.00 X 0 681609 105996 NUPUR SINHA MD PHYSICIAN 50.00 0.00 X 390625 0 35273 MICHAEL JACOBSON MD PHYSICIAN 50.00 0.00 X 421721 0 29271 STEVEN GOLDBERG MD PHYSICIAN 50.00 0.00 X 410452 0 10404 ANDREA CHAN MD PHYSICIAN 50.00 0.00 X 484853 0 30084 SHINKAI HAKIMA MD PHYSICIAN 50.00 0.00 X 398680 0 6654 2403579 2445786 509750 46 0 1 0 CYPRESS HEALTHCARE PARTNERS 100 WILSON RD STE 100 MONTEREY CA 93940 MANAGEMENT SERVICES 1601798 QUALITY SYSTEMS INC PO BOX 511449 LOS ANGELES CA 90051 SOFTWARE SYSTEMS SUPPORT 338641 COMPUTER TECHNICAL SPECIALISTS INC 7441 MATTERHORN PL PRUNEDALE CA 93907 COMPUTER SUPPORT 100578 3 1500000 1500000 PATIENT FEES 900099 15076485 15076485 15076485 16576485 15076485 0 0 340469 340469 15359565 15359565 446486 446486 1255437 1255437 856763 856763 1462809 1462809 1550381 1550381 69921 69921 170688 145688 25000 415464 415464 1320588 1320588 5997 5997 370971 370971 VACCINES AND MEDICINE 731122 731122 MEDICAL SUPPLIES 697844 697844 OTHER TAXES 16338 16338 REAL ESTATE TAXES 9712 9712 25080555 23592746 1487809 0 522714 1618993 1612068 1574701 122462 227521 2286019 1542780 792703 743239 21016 15672 3070963 4180126 1683997 1946522 16046555 25397263 17730552 27343785 X -14659589 -23163659 -14659589 -23163659 3070963 4180126 -8504070 0 X 0 1 X 1 0 X 168478 8222 160256 2117541 1534558 582983 743239 LOAN FROM CHOMP 25397083 PENSION LOAN EE 180 25397263 X PART X, LINE 2: MONTAGE, CHOMP, ASPIRE (EXCLUDING COASTAL), THE FOUNDATION, AND MMG HAVE BEEN DETERMINED TO BE EXEMPT ORGANIZATIONS BY THE INTERNAL REVENUE SERVICE AND THE CALIFORNIA FRANCHISE TAX BOARD AND GENERALLY ARE NOT SUBJECT TO TAXES ON INCOME PURSUANT TO SECTION 501(C)(3) AND SECTION 23701(D) OF THE INTERNAL REVENUE CODE AND CALIFORNIA REVENUE AND TAXATION CODE, RESPECTIVELY. CCCMIC AND COASTAL ARE TAXABLE ENTITIES AND INCOME TAXES ARE ACCOUNTED FOR USING AN ASSET AND LIABILITY APPROACH THAT REQUIRES THE RECOGNITION OF DEFERRED TAX ASSETS AND LIABILITIES FOR THE EXPECTED FUTURE TAX CONSEQUENCES OF EVENTS THAT HAVE BEEN INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS. UNDER THIS METHOD, DEFERRED TAX ASSETS AND LIABILITIES ARE DETERMINED BASED ON THE DIFFERENCES BETWEEN THE CONSOLIDATED FINANCIAL STATEMENT AND TAX BASIS OF ASSETS AND LIABILITIES USING ENACTED TAX RATES IN EFFECT FOR THE YEAR IN WHICH THE DIFFERENCES ARE EXPECTED TO REVERSE. CCCMIC AND COASTAL HAVE NET CUMULATIVE LOSSES AND THE DEFERRED TAX ASSETS ASSOCIATED WITH THESE LOSSES HAVE BEEN FULLY RESERVED. THERE WERE NO TAX PROVISIONS RECORDED FOR THE YEARS ENDED DECEMBER 31, 2017 AND 2016. THE ORGANIZATION ASSESSES UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH THE PROVISIONS OF THE FASB ASC TOPIC 740-10, INCOME TAXES. THE ORGANIZATION RECOGNIZES THE TAX BENEFIT FROM UNCERTAIN TAX POSITIONS ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITIONS WILL BE SUSTAINED ON EXAMINATION BY THE TAX AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFIT IS MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. THE ORGANIZATION RECOGNIZES INTEREST AND PENALTIES RELATED TO INCOME TAX MATTERS IN OPERATING EXPENSES. THERE WERE NO UNCERTAIN TAX POSITIONS AS OF DECEMBER 31, 2017 AND 2016. 0 0 0 0 0 0 0 0 0 STEVEN PACKER MD PRESIDENT 0 729060 0 318937 0 38867 0 129163 0 27121 0 1243148 0 0 ANTHONY CHAVIS SECRETARY 0 472585 0 106030 0 24898 0 65442 0 27121 0 696076 0 0 DAVID STRAFACE MD DIRECTOR 297023 0 0 0 225 0 23000 0 20221 0 340469 0 0 0 LAURA ZEHM CFO 0 518094 0 141400 0 22115 0 78875 0 27121 0 787605 0 0 NUPUR SINHA MD PHYSICIAN 390625 0 0 0 0 0 16200 0 19073 0 425898 0 0 0 MICHAEL JACOBSON MD PHYSICIAN 421721 0 0 0 0 0 17813 0 11458 0 450992 0 0 0 STEVEN GOLDBERG MD PHYSICIAN 410452 0 0 0 0 0 0 0 10404 0 420856 0 0 0 ANDREA CHAN MD PHYSICIAN 484853 0 0 0 0 0 18000 0 12084 0 514937 0 0 0 SHINKAI HAKIMA MD PHYSICIAN 398680 0 0 0 0 0 0 0 6654 0 405334 0 0 0 PART I, LINE 3 MMG RELIES ON A RELATED ORGANIZATION, COMMUNITY HOSPITAL OF THE MONTEREY PENINSULA, TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIALS USING ALL OF THE METHODS DESCRIBED ON LINE 3 EXCEPT "FORM 990 OF OTHER ORGANIZATIONS." FORM 990, PART VI, SECTION A, LINE 3 CYPRESS HEALTHCARE IS A PROFESSIONAL PHYSICIAN MANAGEMENT COMPANY. WHEN THE FORMER EXECUTIVE DIRECTOR LEFT, CYPRESS HEALTHCARE ASSUMED SOME OF THE RESPONSIBILITIES OF THE ED. FORM 990, PART VI, SECTION B, LINE 11B THE CFO AND VP FINANCE IS RESPONSIBLE FOR REVIEWING THE FORM 990 BEFORE FILING. ELECTRONIC COPIES ARE SENT TO ALL BOARD MEMBERS FOR REVIEW PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION USES SELF DISCLOSURE BY INTERESTED PERSONS AND MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC BY REQUEST. MONTAGE HEALTH PO BOX HH MONTEREY CA 93942 942789696 SUPPORT SERVICES CA 501(C)(3) LINE 10 N/A 0 COMMUNITY HOSPITAL OF THE MONTEREY PENINSULA PO BOX HH MONTEREY CA 93942 940760193 HEALTHCARE SERVICES CA 501(C)(3) LINE 3 MONTAGE HEALTH 0 ASPIRE HEALTH PLAN 10 RAGSDALE DRIVE SUITE 101 MONTEREY CA 93940 461567681 INSURANCE COMPANY CA 501(C)(4) MONTAGE HEALTH 0 MONTAGE HEALTH FOUNDATION PO BOX HH MONTEREY CA 93942 812889645 SUPPORT SERVICES CA 501(C)(3) LINE 7 MONTAGE HEALTH 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1