2017-01-11T08:48:05-06:00 2016-06-30 410746749 CLIFTONLARSONALLEN LLP 1301 W 22ND ST STE 1100 OAK BROOK IL 60523 990 2015-07-01 320115907 ESPERANZA HEALTH CENTERS ESPE 7735846200 2001 SOUTH CALIFORNIA AVENUE NO 100 CHICAGO IL 60608 WAYNE SOTTILE CFO 7735846200 2017-01-10 1 GREGORY S ADAMS P00095597 6305738600 2015 2021-01-29 14:40:06Z WAYNE SOTTILE 2001 SOUTH CALIFORNIA AVENUE NO 100 CHICAGO IL 60608 14620878 0 X WWW.ESPERANZACHICAGO.ORG X 2004 IL PRIMARY HEALTH CARE SERVICES 10 10 123 12 0 0 2337041 3367169 7347422 9940347 0 986963 537078 276036 10221541 14570515 0 0 0 0 5226580 6791019 0 0 0 3289456 4872181 8516036 11663200 1705505 2907315 4007995 6739917 1087071 911678 2920924 5828239 TO PROMOTE HEALTHY LIFESTYLES & IMPROVE OUR PATIENTS' HEALTH THROUGH THE PROVISION OF HIGH QUALITY HEALTH CARE AND WELLNESS SERVICES IN THE COMMUNITIES OF CHICAGO'S SOUTHWEST SIDE. 0 0 9787254 10149317 ESPERANZA HEALTH CENTERS SERVES AN AREA THAT IS IN GREAT NEED OF QUALITY HEALTHCARE. SERVICES INCLUDE; FAMILY MEDICINE, INTERNAL MEDICINE, PEDIATRICS, BEHAVIORAL HEALTH AND WOMEN'S HEALTH/OBSTETRICS. FAMILIES IN ESPERANZA'S SERVICE AREA EXPERIENCE SIGNIFICANT ECONOMIC, EDUCATIONAL, AND HEALTH DISPARITIES. MORE THAN 53 PERCENT OF RESIDENTS LIVE BELOW TWICE THE POVERTY LEVEL. LARGE PORTIONS OF ESPERANZA'S SERVICE AREA HAVE BEEN DESIGNATED AS A MEDICALLY UNDERSERVED AREA AND A HEALTH PROFESSIONAL SHORTAGE AREA BY THE HEALTH RESOURCES AND SERVICES ADMINISTRATION. ESPERANZA HEALTH CENTERS PROVIDE HIGH-QUALITY MEDICAL CARE TO ALL RESIDENTS OF OUR SOUTHWEST SIDE SERVICE AREA, REGARDLESS OF THEIR IMMIGRATION STATUS, RACE OR ETHNICITY, INCOME LEVEL OR INSURANCE STATUS. 9787254 1 1 0 0 0 0 0 0 0 0 1 0 1 0 0 1 1 0 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 12 0 1 123 1 0 0 0 0 0 1 1 0 0 0 0 X 10 10 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 1 1 IL X WAYNE SOTTILE 7735846154 2001 SOUTH CALIFORNIA AVE SUITE 100 CHICAGO IL 60608 RICK GUTIERREZ VICE CHAIR 0.25 X X 0 0 0 PAUL BETLINSKI TREASURER 0.25 X X 0 0 0 CARA GOLDSBERRY SECRETARY 0.25 X X 0 0 0 ADRIANA DE LA MORA DIRECTOR 0.25 X 0 0 0 NYLA DIAB PRESIDENT 0.25 X X 0 0 0 DEBBIE GONZALEZ DIRECTOR 0.25 X 0 0 0 MILTON MORA DIRECTOR 0.25 X 0 0 0 JODI PORTNOY DIRECTOR 0.25 X 0 0 0 ANEL RUIZ DIRECTOR 0.25 X 0 0 0 ANDREW TINAJERO DIRECTOR 0.25 X 0 0 0 DANIEL FULWILER CEO 40.00 X 202731 0 3492 WAYNE SOTTILE CFO 40.00 X 140796 0 5914 ANDREW J VAN WIEREN MEDICAL DIRECTOR 40.00 X 175948 0 8609 CATHERINE CHIA AI LIU PHYSICIAN 40.00 X 232227 0 9156 SARAH HOQUE PHYSICIAN 40.00 X 216189 0 2965 MARIA SILVA PHYSICIAN 40.00 X 160036 0 18254 1127927 0 48390 6 0 1 0 SAINT ANTHONY HOSPITAL - FINANCE DEPARTM 2875 W 19TH STREET CHICAGO IL 60623 OUTSIDE MEDICAL PROVIDER, RENT AND OTHER 406976 PRACTICE MANAGEMENT SUPPORT SERVICES IN 415 W GOLF ROAD STE 16 ARLINGTON HEIGHTS IL 60005 BILLING SERVICES 218230 PILSEN WELLNESS CENTER INC 2319 S DAMEN AVENUE CHICAGO IL 60608 RENT 201330 OHIO SHARED INFORMATION SERVICES 8790 GOVERNORS HILL DRIVE SUITE 2 CINCINNATI OH 45249 EHR HOSTING 186600 MD TECHNOLOGY SERVICES 2030 E ALGONQUIN ROAD SCHAUMBURG IL 60173 IT SUPPORT 158926 7 69112 2159039 1139018 3367169 PATIENT FEES 621990 7749555 7749555 PHARMACY REVENUE 621990 2190792 2190792 9940347 986963 986963 28229 69112 50363 -22134 -22134 MISCELLANEOUS 900099 208970 208970 DEBT FORGIVENESS 900099 89200 89200 298170 14570515 10149317 0 1054029 544315 96248 448067 5220676 4844322 376354 133651 112574 21077 419499 353344 66155 472878 398305 74573 1046726 706183 340543 33881 2876 31005 107968 53893 54075 420061 369576 50485 463780 443710 20070 53866 11812 42054 2190 2041 149 94553 6465 88088 310212 310212 PHARMACY AND MEDICAL SU 1856180 1855791 389 MISCELLANEOUS 161024 83103 77921 REPAIRS AND MAINTENANCE 151466 93185 58281 MEMBERSHIP DUES AND SUB 102232 18308 83924 68042 25306 42736 11663200 9787254 1875946 0 1962343 2560431 511212 991130 899966 1570135 184586 135414 633049 337205 249888 295844 200000 1186963 4007995 6739917 669479 886678 417592 25000 1087071 911678 X 2473252 5340576 447672 487663 2920924 5828239 4007995 6739917 2907315 0 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 19122 11954 7168 472522 325251 147271 141405 141405 295844 MHN ACO, LLC 1186963 C 1186963 X 14570515 0 14570515 0 14570515 11663200 0 11663200 0 11663200 PART X, LINE 2: THE CENTER IS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC). IN ADDITION, THE CENTER QUALIFIES FOR THE CHARITABLE CONTRIBUTION DEDUCTION UNDER SECTION 170(B)(1)(A) AND HAS BEEN CLASSIFIED AS AN ORGANIZATION THAT IS NOT A PRIVATE FOUNDATION. THE CENTER WAS NOT REQUIRED TO RECORD A LIABILITY FOR UNRECOGNIZED TAX BENEFITS FOR THE YEARS ENDED JUNE 30, 2016 OR 2015. ANNUAL GALA 86385 66963 19422 8164 14141 850 22596 10956 2149 8807 1948 250 2414 97341 69112 28229 8164 16089 1100 25010 50363 -22134 X X X X X 0 0 0 0 0 1 0 1 0 DANIEL FULWILER CEO 169731 0 33000 0 0 0 3492 0 0 0 206223 0 0 0 ANDREW J VAN WIEREN MEDICAL DIRECTOR 174615 0 1333 0 0 0 3738 0 4871 0 184557 0 0 0 CATHERINE CHIA AI LIU PHYSICIAN 215394 0 16833 0 0 0 3431 0 5725 0 241383 0 0 0 SARAH HOQUE PHYSICIAN 210289 0 5900 0 0 0 2965 0 0 0 219154 0 0 0 MARIA SILVA PHYSICIAN 158703 0 1333 0 0 0 2683 0 15571 0 178290 0 0 0 PART I, LINE 6 THE CEO, CFO AND MEDICAL DIRECTOR ARE ELIGIBLE FOR BONUSES IF ESPERANZA HEALTH CENTER MEETS OR EXCEEDS ITS ANNUAL BUDGETED NET INCOME. PART I, LINE 7 THE CEO, CFO AND MEDICAL DIRECTOR RECEIVE BONUSES IF THEY MEET CERTAIN ANNUAL PERFORMANCE GOALS SUCH AS MEETING/EXCEEDING BUDGETED NET INCOME, ACHIEVING CERTAIN QUALITY SCORES, OR ACHIEVING CERTAIN PROVIDER PRODUCTIVITY LEVELS. FORM 990, PART VI, SECTION B, LINE 11 FORM 990 IS REVIEWED IN DRAFT FORM BY THE ORGANIZATION'S FINANCE COMMITTEE, THEN SENT THE ENTIRE BOARD BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12C BOARD OF DIRECTORS COMPLETE COMPLIANCE DISCLOSURES UPON JOINING THE BOARD. FORM 990, PART VI, SECTION B, LINE 15A CEO'S COMPENSATION IS DETERMINED BY THE BOARD OF DIRECTORS AND IS INCLUDED IN THE BOARD MINUTES. THE DECISION WAS MADE USING COMPARISON TO ORGANIZATIONAL GOALS AND COMPARABILITY DATA OF OTHER SIMILAR SIZED ORGANIZATIONS. FORM 990, PART VI, SECTION C, LINE 19 UPON REQUEST FORM 990, PART XII, LINE 2C THE ORGANIZATION'S AUDIT COMMITTEE ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.