2017-03-14T15:06:21-05:00 2016-04-30 330700332 VASQUEZ & COMPANY LLP 801 S GRAND AVE SUITE 400 LOS ANGELES CA 90017 990 2015-05-01 952810095 ALTAMED HEALTH SERVICES CORPORATION ALTA 3237258751 2040 CAMFIELD AVENUE LOS ANGELES CA 90040 JOSE ESPARZA SR. VP OF FINANCE AND CFO 3237258751 2017-03-13 1 GILBERT R VASQUEZ P00743144 2138731700 2015 2021-01-29 14:40:06Z JOSE ESPARZA 2040 CAMFIELD AVENUE LOS ANGELES CA 90040 542836840 0 X HTTP://WWW.ALTAMED.ORG X 1970 CA SEE SCHEDULE O : TO ELIMINATE DISPARITIES IN HEALTH CARE ACCESS AND OUTCOMES BY PROVIDING SUPERIOR QUALITY HEALTH AND HUMAN SERVICES THROUGH AN INTEGRATED WORLD-CLASS DELIVERY SYSTEM FOR LATINO , MULTI-ETHNIC AND UNDERSERVED COMUNITIES IN SOUTHERN CALIFORNIA.VISION: TO BE THE LEADING COMMUNITY-BASED PROVIDER OF QUALITY HEALTH CARE AND HUMAN SERVICES 9 9 3144 0 0 0 4421200 2810073 399737230 500053552 2786489 2711972 3583256 3205128 410528175 508780725 0 0 0 0 156216689 186390220 0 0 1325026 208762424 236701337 364979113 423091557 45549062 85689168 307729125 496702569 92433475 198177303 215295650 298525266 X TO ELIMINATE DISPARITIES IN HEALTH CARE ACCESS AND OUTCOMES BY PROVIDING SUPERIOR QUALITY HEALTH AND HUMAN SERVICES THROUGH AN INTEGRATED WORLD-CLASS DELIVERY SYSTEM FOR LATINO, MULTI-ETHNIC AND UNDERSERVED COMMUNITIES IN SOUTHERN CALIFORNIA. 0 0 285542519 335461880 ALTAMED OPERATES A TOTAL OF 23 PRIMARY CARE CLINICS IN THE GREATER LOS ANGELES AREA, EIGHT OF WHICH ALSO INCLUDE DENTAL CLINICS. ADDITIONALLY, THREE MOBILE UNITS OFFER MEDICAL, DENTAL, HIV SERVICES, AND OUTREACH. THE 7 CLINICS IN ORANGE COUNTY AND 16 CLINICS IN LOS ANGELES COUNTY SEE OVER 150,000 PATIENTS PER YEAR. THE DENTAL CLINICS, MOBILE UNIT, AND 5 PORTABLE DENTAL UNITS PROVIDE ORAL HEALTH CARE TO OVER 55,000 CHILDREN AND ADULTS ANNUALLY. ALTAMED PROVIDES INTEGRATED SERVICES ALONG A CONTINUUM OF CARE THAT INCLUDES PERINATAL SERVICES, PEDIATRIC AND ADOLESCENT CARE, WOMEN'S HEALTH, AND GERIATRIC MEDICINE AND HEALTH FOR THE FRAIL AND NON-FRAIL ELDERLY. ALONG WITH ITS PREVENTIVE AND PRIMARY CARE SERVICES, ALTAMED SPECIALIZES IN SERVICES THAT INCLUDE A PEDIATRIC AND ADOLESCENT OBESITY PROGRAM, A BEHAVIORAL HEALTH PROGRAM AND A CHRONIC DISEASE MANAGEMENT PROGRAM. OTHER SERVICES INCLUDE LABORATORY TESTING, RADIOLOGIC SCREENING, PHARMACY SERVICES, INCLUDING MEDICATION MANAGEMENT AND RECONCILIATION. HEALTH SERVICES ARE ALSO SUPPORTED BY A COMMUNITY OUTREACH AND HEALTH EDUCATION TEAM PROMOTING HEALTHY BEHAVIORS AND ADVANCING THE OVERALL HEALTH AND WELL-BEING AMONG THOSE LIVING IN MEDICALLY-UNDERSERVED COMMUNITIES. 119077665 148365326 LONG TERM CARE. EACH YEAR, OVER 3,500 FRAIL AND ELDERLY SENIORS AND DISABLED ADULTS ARE SUPPORTED BY AN ARRAY OF SERVICES THROUGH ALTAMED'S 8 PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) SITES. SERVICES INCLUDE PRIMARY CARE/GERIATRIC MEDICINE NURSING CARE, REHABILITATION THERAPY, FAMILY SUPPORT INTERVENTIONS, COUNSELING, MEDICATION MANAGEMENT, NUTRITION EDUCATION, SOCIAL ACTIVITIES, AND DOOR TO DOOR TRANSPORTATION SERVICES BOTH TO PARTICIPANTS HOMES AND SPECIALTY CARE MEDICAL APPOINTMENTS. ALTAMED ALSO PROVIDES SPECIALIZED IN-HOME SUPPORTIVE PROGRAMS AND SERVICES THAT ENHANCE THE LIVES OF NEARLY 4,500 SENIORS LIVING INDEPENDENTLY IN THE COMMUNITY OR WHO ARE AT-RISK OF INSTITUTIONALIZED CARE. 9738718 6243255 HIV SERVICES. AS THE ONLY PROVIDER THAT OFFERS A COMPREHENSIVE MEDICAL HOME SPECIALIZING IN HIV CARE FOR LATINOS IN LOS ANGELES, ALTAMED OPERATES A TOTAL OF FIVE HIV PRIMARY CARE CLINICS - FOUR (4) IN LOS ANGELES COUNTY AND ONE (1) IN ORANGE COUNTY. IN RESPONSE TO THE AIDS EPIDEMIC, ALTAMED LAUNCHED HIV SERVICES IN 1986 TO PROVIDE CULTURALLY-COMPETENT ACCESS TO CARE TO COMBAT THE DISEASE IN ITS PREDOMINANTLY URBAN LATINO SERVICE COMMUNITIES. SINCE THEN, ALTAMED HAS GROWN TO BECOME THE LARGEST PROVIDER OF BILINGUAL HIV MEDICAL SERVICES IN LA, SERVING OVER 1700 HIV PATIENTS EACH YEAR, AND A NATIONAL LEADER IN HIV PREVENTION SERVICES TARGETING LATINO MEN WHO HAVE SEX WITH MEN. ALTAMED OFFERS A FULL CONTINUUM OF CARE THAT INCLUDES: HIV TESTING & COUNSELING; LINKAGE TO CARE/ PATIENT NAVIGATION; MEDICAL OUTPATIENT; MEDICAL CARE COORDINATION; TREATMENT EDUCATION; BENEFITS ASSISTANCE; MENTAL HEALTH SERVICES AND INTERVENTIONS; NUTRITION COUNSELING; MEDICATION ADHERENCE; ANAL CANCER DETECTION/TREATMENT; DENTAL CARE; HOME-BASED CARE; AND SUPPORT GROUPS. ALTAMED ALSO IS AN ESTABLISHED LEADER IN HIV BIOMEDICAL PREVENTION SERVICES AS A PROVIDER OF PRE-EXPOSURE PROPHYLAXIS (PREP) MEDICATION TO REDUCE THE RISK OF CONTRACTING HIV. ALTAMED'S USE OF INNOVATIVE, CULTURALLY-TAILORED OUTREACH CAMPAIGNS HAS SOLIDIFIED ITS STANDING AS A PREFERRED LATINO, GAY- AND YOUTH-FRIENDLY HIV SERVICES PROVIDER. 5545235 3487245 (I) YOUTH SERVICES. ALTAMED PROVIDES AN ARRAY OF YOUTH SERVICES TO OVER 1,500 AT-RISK TEENS AND YOUNG ADULTS IN MEDICALLY-UNDERSERVED COMMUNITIES EACH YEAR. SERVICES INCLUDE: PREGNANCY AND STD PREVENTION PROGRAMS, FAMILY PLANNING, HEALTH EDUCATION AND INFORMATION WORKSHOPS, LINKAGES TO CLINICAL SERVICES, CASE MANAGEMENT FOR PREGNANT/PARENTING TEENS; PARENTING EDUCATION; SUPPORT FOR PARENTING TEENS TO HELP THEM STAY IN SCHOOL; AND LIFE-SKILLS DEVELOPMENT. 5545235 3487245 419904137 1 1 0 1 0 0 0 1 0 0 1 0 0 1 1 1 1 1 0 0 0 0 0 0 1 0 0 0 0 1 1 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 1 0 0 0 1 2664 0 1 3144 1 0 0 0 0 0 1 1 0 0 0 0 X 9 9 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X X JOSE ESPARZA SR VP OF FINANCE AND CFO 3237258751 2040 CAMFIELD AVENUE LOS ANGELES CA 90040 FERNANDO DE NECOCHEA BOARD CHAIRMAN 1.60 X X 0 0 0 EFRAIN TALAMANTES BOARD MEMBER 1.60 X 0 0 0 MARIA GRIMALDO CONSUMER BOARD MEMBER 1.20 X 0 0 0 GREG VALENZUELA CONSUMER BOARD MEMBER 1.60 X 0 0 0 DON NAKANISHI PHD SECRETARY 1.60 X X 0 0 0 GLORIA CARRILLO ZAMORA CONSUMER BOARD MEMBER 1.20 X 0 0 0 SHIRLEY DETTLOFF VICE CHAIRPERSON 1.60 X X 0 0 0 RICARDO ROBLES TREASURER 1.60 X X 0 0 0 LILIANA RAMIREZ CONSUMER BOARD MEMBER 1.20 X 0 0 0 CASTULO DELA ROCHA JD PRESIDENT & CEO 40.00 X 934844 0 139601 MARTIN LEE SEROTA MD SVP, CHIEF MEDICAL OFFICER 40.00 X 523197 0 10400 JOSE U ESPARZA SR. VP OF FINANCE & CFO 40.00 X 424196 0 10400 MARIE TORRES SR.VP OF GOV'T RELATIONS 40.00 X 346969 0 10400 ZOILA ESCOBAR SR.VP STRATEGIC DEV & COMM SUPPORT 40.00 X 349969 0 10400 JENNIFER SPALDING SR.VP CHIEF OPERATION OFFICER 40.00 X 344522 0 9533 ANGELA ROBERTS SR.VP FACILITY DEVELOPMENT & MGT. 40.00 X 328650 0 10400 ESIQUIO CASILLAS VP, MEDICAL DIRECTOR MEDICAL MGMT 40.00 X 339352 0 10400 CRISTIAN RICO MD VP,MEDICAL GROUP MEDICAL DIRECTOR 40.00 X 330491 0 10400 FELIX CARPIO MD DIR., MEDICAL-CLINICAL INFORMATICS 40.00 X 310701 0 9501 DONALD MALDONADO DIRECTOR, SITE MEDICAL 40.00 X 300883 0 8545 4533774 0 239980 296 0 1 0 CHILDRENS HOSPITAL LA MED GRP INC PO BOX 12021 BELFAST ME 04915 MEDICAL SERVICES 15102451 WHITE MEMORIAL MEDICAL CENTER PO BOX 842176 LOS ANGELES CA 90084 MEDICAL SERVICES 7706225 TOTAL CORPORATE SOLUTIONS 20335 SOUTH WESTERN AVENUE TORRANCE CA 90501 FACILITY SUPPLIES 5691050 CLINICA DEL DR CASTILLOY DR SILVA INC 212 NORTH BAILEY ST STE 204 LOS ANGELES CA 90033 MEDICAL SERVICES 3422018 UNITED MEDICAL IMAGING HEALTH INC PO BOX 491149 LOS ANGELES CA 90049 LAB SERVICES 3109223 249 387022 2423051 52795 2810073 MANAGED CARE SERVICES 624100 331712244 331712244 PATIENT FEES 624100 140721916 140721916 CONTRACTUAL SERVICES 624100 27619392 27619392 500053552 2711972 2711972 305760 387022 1325024 -1019264 -1019264 33759235 32731091 1028144 1028144 OTHER CONTRACT SERVICES 624100 2348109 2348109 INTERCOMPANY REVENUE 900099 500563 500563 REFUND/REIMBURSEMENT/DEPOSIT 900099 358768 358768 -11192 -11192 3196248 508780725 504277944 0 1692708 4533774 4533774 141859285 141801806 57479 3504184 3503014 1170 25295337 25286890 8447 11197640 11193900 3740 1296129 1296129 5164122 5163527 595 2896664 2889300 7364 7241792 7197959 43833 1518619 1518619 10168139 10161578 6561 3007698 3002881 4817 SPECIALTY SERVICES 104742673 104742673 MEDICAL SERVICES 42128379 42127563 816 ADMINISTRATIVE SERVICES 17210009 16152424 566265 491320 MEDICAL SUPPLIES 8736144 8735190 954 32590969 31893039 697930 423091557 419904137 1862394 1325026 10622509 18478933 25914833 64748528 4819401 4349629 41904639 39794233 16116265 20602056 34943456 13172744 555053 1017954 2706124 3425541 193553677 58237105 77258924 135316572 84203973 144003880 4006819 5131380 4677129 46661119 307729125 496702569 26273718 78626440 2019223 6216912 8072076 109512688 3017826 2749063 53050632 1072200 92433475 198177303 X 212519590 295873182 2776060 2652084 215295650 298525266 307729125 496702569 85689168 -2459552 0 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1 1 0 1 321 0 0 1 36167 0 1 378717 415205 0 PART II-B, LINE 1: AMOUNTS WERE PAID TO LEGISLATIVE CONSULTANTS FOR LOBBYING ACTIVITIES. 1222779 X X X 0 27540369 27540369 56073970 8750097 47323873 56607659 13029171 43578488 53331679 36457837 16873842 135316572 ASSETS LIMITED AS TO USE 41251519 CONTRIBUTION RECEIVABLES 2445342 DEPOSITS 2449445 DUE FROM RELATED PARTIES 514813 46661119 INTEREST RATE SWAP 1072200 1072200 X 537756135 -2499290 32770829 30271539 507484596 1296129 1296129 508780725 454526519 32731091 32731091 421795428 1296129 1296129 423091557 PART III, LINE 4: ALTAMED HEALTH SERVICES IS A NON-PROFIT ORGANIZATION THAT PROVIDES QUALITY HEALTHCARE AND HUMAN SERVICES TO THE UNDERSERVED COMMUNITIES OF SOUTHERN CALIFORNIA. THE ORGANIZATION RECOGNIZES THE THERAPEUTIC EFFECT OF CULTURALLY RELEVANT WORKS OF ART AND THEIR EFFECT ON PATIENTS, DONORS AND MEMBERS OF THE PUBLIC. AS PART OF ITS HOLISTIC APPROACH TO HEALTHCARE, THE ORGANIZATION HOLDS A SIGNIFICANT COLLECTION OF ART BY A DIVERSE RANGE OF EMERGING, MID-CAREER AND ESTABLISHED ARTISTS BASED IN LOS ANGELES, AS WELL AS CHICANO/A ARTISTS, AND INTERNATIONALLY RECOGNIZED ARTISTS FROM MEXICO, LATIN AMERICA, ASIA , AND THE UNITED STATES FOR THE PURPOSE OF EXHIBITION AND PRESENTATION THROUGHOUT ITS CLINICS AND OTHER OF ITS HEALTH SERVICES CENTERS. THIS APPROACH HAS BEEN INSTRUMENTAL IN GIVING ALTAMED PATIENTS A CALM, CURATIVE ENVIRONMENT ALLEVIATING STRESSES ASSOCIATED WITH BEING IN A CLINICAL SETTING. ALTAMED BELIEVES THAT EVERYONE, REGARDLESS OF AGE, RACE, GENDER, OR SOCIAL STANDING, HAS THE RIGHT TO EXPERIENCE ART IN THEIR EVERYDAY LIFE. PART X, LINE 2: THE CORPORATION QUALIFIES AS A TAX EXEMPT ORGANIZATION UNDER THE INTERNAL REVENUE CODE SECTION 501(C)(3) AND CALIFORNIA REVENUE AND TAXATION CODE 23701D. THE CORPORATION HAS EVALUATED ITS TAX POSITIONS AND THE CERTAINTY AS TO WHETHER THOSE POSITIONS WILL BE SUSTAINED IN THE EVENT OF AN AUDIT BY TAXING AUTHORITIES AT THE FEDERAL AND STATE LEVELS. THE PRIMARY TAX POSITIONS EVALUATED RELATE TO THE CORPORATION CONTINUED QUALIFICATION AS A TAX-EXEMPT ORGANIZATION AND WHETHER THERE ARE UNRELATED BUSINESS INCOME ACTIVITIES THAT WOULD BE TAXABLE. MANAGEMENT HAS DETERMINED THAT ALL INCOME TAX POSITIONS WILL MORE LIKELY THAN NOT (>50%) BE SUSTAINED UPON POTENTIAL AUDIT OR EXAMINATION; THEREFORE, NO DISCLOSURE OF UNCERTAIN INCOME TAX POSITIONS ARE REQUIRED. THE CORPORATION FILES INFORMATION RETURNS IN THE US FEDERAL JURISDICTION AND THE STATE OF CALIFORNIA. WITH FEW EXCEPTIONS, THE CORPORATION IS NO LONGER SUBJECT TO U.S. FEDERAL AND STATE EXAMINATIONS BY TAX AUTHORITIES FOR YEARS BEFORE 2011. PART XI, LINE 2D - OTHER ADJUSTMENTS: CHANGE IN FAIR VALUE OF INTEREST RATE SWAP 39,738. COST OF GOOD SOLD-PHARMACY 32,731,091. PART XI, LINE 4B - OTHER ADJUSTMENTS: INVESTMENT MANAGEMENT FEES 1,296,129. PART XII, LINE 2D - OTHER ADJUSTMENTS: PHARMACY COST 32,731,091. PART XII, LINE 4B - OTHER ADJUSTMENTS: INVESTMENT MANAGEMENT FEES 1,296,129. X X X X X X 0 FOOD & WINE TASTING 337947 141807 196140 115796 28810 282820 187629 ANNIVERSARY GALA 89190 9220 79970 5829 6794 25634 263429 6 265645 235995 29650 33721 6561 118070 249931 692782 387022 305760 155346 42165 426524 700989 1325024 -1019264 X X 1 1 X X X X X X 0 1 0 0 0 0 0 1 0 CASTULO DELA ROCHA JD PRESIDENT & CEO 663998 0 222000 0 48846 0 139601 0 0 0 1074445 0 0 0 MARTIN LEE SEROTA MD SVP, CHIEF MEDICAL OFFICER 439687 0 56650 0 26860 0 10400 0 0 0 533597 0 0 0 JOSE U ESPARZA SR. VP OF FINANCE & CFO 356111 0 53375 0 14710 0 10400 0 0 0 434596 0 0 0 MARIE TORRES SR.VP OF GOV'T RELATIONS 289129 0 43130 0 14710 0 10400 0 0 0 357369 0 0 0 ZOILA ESCOBAR SR.VP STRATEGIC DEV & COMM SUPPORT 290792 0 44177 0 15000 0 10400 0 0 0 360369 0 0 0 JENNIFER SPALDING SR.VP CHIEF OPERATION OFFICER 279241 0 50421 0 14860 0 9533 0 0 0 354055 0 0 0 ANGELA ROBERTS SR.VP FACILITY DEVELOPMENT & MGT. 272633 0 41307 0 14710 0 10400 0 0 0 339050 0 0 0 ESIQUIO CASILLAS VP, MEDICAL DIRECTOR MEDICAL MGMT 298031 0 35863 0 5458 0 10400 0 0 0 349752 0 0 0 CRISTIAN RICO MD VP,MEDICAL GROUP MEDICAL DIRECTOR 282144 0 39905 0 8442 0 10400 0 0 0 340891 0 0 0 FELIX CARPIO MD DIR., MEDICAL-CLINICAL INFORMATICS 271678 0 29531 0 9492 0 9501 0 0 0 320202 0 0 0 DONALD MALDONADO DIRECTOR, SITE MEDICAL 213617 0 87266 0 0 0 8545 0 0 0 309428 0 0 0 PART I, LINE 1A ALTAMED MAINTAINS A DISCRETIONARY SPENDING ACCOUNT FOR OFFICERS, KEY EMPLOYEES AND OTHERS WHERE THE COMPANY ALLOWS A CERTAIN AMOUNT TO BE USED AT THE DISCRETION OF THE PAYEE FOR BUSINESS EXPENSES SUCH AS AUTOMOBILE EXPENSES . ANY AMOUNTS USED FROM THE DISCRETIONARY ACCOUNT ARE TAXED TO THE RECIPIENT AS PART OF THEIR COMPENSATION. IN ADDITION, ALTAMED PROVIDES A HOUSING SUBSIDY OF $12,000 FOR THE CHIEF MEDICAL OFFICER. PART I, LINE 4B SCHEDULE J:AT THE PRESENT TIME THE PRESIDENT AND CEO ARE ELIGIBLE FOR THE ORGANIZATION'S SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN ( SERP) ; FUNDING OF THIS PLAN IS DISCRETIONARY AND ASSETS OF THE PLAN ARE SUBJECT TO THE CLAIMS OF CREDITORS . RETIREMENT AND OTHER DEFERRED COMPENSATION INCLUDES $129,201 PAID TO THE SERP IN CALENDAR YEAR 2015. PART I, LINE 7 SCHEDULE J :ALTAMED MAINTAINS A DISCRETIONARY EXECUTIVE AND DIRECTOR LEVEL BONUS PROGRAM THAT AWARDS INCENTIVE COMPENSATION BASED ON ACHIEVEMENT OF CERTAIN ORGANIZATIONAL OBJECTIVES INCLUDING FINANCIAL, OPERATIONAL, QUALITY AND MISSION OBJECTIVES DURING THE FISCAL YEAR. MEMBERS OF THE EXECUTIVE AND DIRECTOR LEADERSHIP TEAM ARE EVALUATED ANNUALLY FOR THEIR ABILITY TO MEET THOSE ORGANIZATIONAL OBJECTIVES TO ARRIVE AT THE INCENTIVE AMOUNT, IF ANY, FOR THE FISCAL YEAR. OVERALL ALTAMED MUST ACHIEVE SPECIFIC FINANCIAL GOALS BEFORE ANY INCENTIVES CAN BE EARNED AND PAID. A CALIFORNIA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY 2007-12-01 7012000 FINANCE THE COST OF ACQ,CONSTRUCTION,IMPROVEMENT & EQUIPPING OF FACILITIES 0 0 0 B CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY 521643828 2015-10-01 118760000 SEE SUPPLEMENTAL INFORMATION 0 0 0 A 197151 0 0 1 1 B 2246766 118805362 1719003 63365955 3500000 50220404 1 0 0 1 A 0 0 0 0 0 0 0 B 0 1 1 1 1 1 0 0 1 A 0 0 0 0 1 1 BANK OF THE WEST 15.000000000000 0 0 0 0 0 B 0 1 1 0 1 0 0 0 1 A 0 B 1 PART 1 LINE B (F) TO FINANCE THE ACQUISITION, CONSTRUCTION, RENOVATION, AND EQUIPPING OF CAPITAL PROJECTS AND REFINANCE A PRIOR LOAN. PART 1, LINE B, COLUMN (D) & (E): THE ISSUER HAS FILED TWO 8038S FOR THIS ISSUE. THE ISSUE PRICE OF THE NOTES (DATED SEPTEMBER 29, 2015) IS $17,200,000, THE ISSUE PRICE OF THE BONDS (DATED OCTOBER 1, 2015) IS $101,560,000. PART 1, LINE B(F): THE PRIOR LOAN WAS ISSUED ON FEBRUARY 14, 2011. PART 1, LINE B COLUMN E, AND PART II, COLUMN B, LINE 3 DIFFERENCE BETWEEN PART 1 LINE B (E) AND PART II, COLUMN B, LINE 3 IS DUE TO INTEREST EARNINGS ON BOND PROCEEDS. PART III, COLUMN B, LINE 7: AS PROVIDED IN TREASURY REGULATION SECTION 1.141-4(C)(2)(I)(B), THE AMOUNT OF PRIVATE PAYMENTS TAKEN INTO ACCOUNT UNDER THE PRIVATE PAYMENT TEST MAY NOT EXCEED THE AMOUNT OF PRIVATE BUSINESS USE AND/OR UNRELATED TRADE OR BUSINESS USE. ACCORDINGLY, THE AMOUNT OF PRIVATE PAYMENTS FOR THE REPORTING PERIOD DOES NOT EXCEED THE AMOUNT STATED IN PART III COLUMN B LINE 6. THE ORGANIZATION HAS NOT UNDERTAKEN AN ANALYSIS OF THE PRIVATE SECURITY TEST WITH RESPECT TO THE BONDS, AS THE LEVEL OF PRIVATE BUSINESS USE AND/OR UNRELATED TRADE OR BUSINESS REPORTED IN PART III COLUMN B, LINE 6, IS NOT IN EXCESS OF AMOUNT PERMITTED UNDER SECTION 145 OF THE CODE. PART IV, COLUMN B, LINE 2(B): THE REFUNDING PORTION OF THE OBLIGATIONS MET THE 6-MONTHS SPENDING EXCEPTION TO REBATE. CASTULO DE LA ROCHA SPLIT DOLLAR LIFE INSURANCE X 9243695 9863240 0 1 1 ZOILA D ESCOBAR SPLIT DOLLAR LIFE INSURANCE X 2225000 2374127 0 1 1 JOSE U ESPARZA SPLIT DOLLAR LIFE INSURANCE X 2226500 2375728 0 1 1 MARIE S TORRES SPLIT DOLLAR LIFE INSURANCE X 2537065 2717810 0 1 1 MARTIN SEROTA SPLIT DOLLAR LIFE INSURANCE X 3080000 3271151 0 1 1 20602056 FORM 990 PART X LINE 5 IN 2011 ALTAMED ADOPTED A SPLIT DOLLAR RETENTION AND LOAN PLAN ( THE PLAN) DESIGNED TO ASSIST ALTAMED IN RECRUITING AND RETAINING KEY EXECUTIVES AND REWARD FUTURE SERVICE. THE PLAN IS DESIGNED TO SATISFY THE FINAL REGULATIONS DEALING WITH LOANS MADE TO EXECUTIVES TO PAY PREMIUMS ON LIFE INSURANCE POLICIES THEY OWN. REPAYMENT OF THE LOANS IS SECURED BY THE CASH VALUES AND DEATH BENEFITS IN ACCORDANCE WITH TAX AND CALIFORNIA LEGAL REQUIREMENTS. IN ADDITION, THE LOANS BEAR INTEREST AND BECAUSE OF THE PLAN'S DESIGN , ALTAMED IS EXPECTED TO BE REPAID FULLY WITH THE APPLICABLE FEDERAL RATE OF INTEREST . THE LOANS ARE REPORTED ON PART X AND SCHEDULE L. X FOR SPECIAL EVENTS 0 43344 FAIR MARKET VALUE X PRINTING 0 5758 FAIR MARKET VALUE X BAGS OF GROCERY 0 2500 FAIR MARKET VALUE X PARTY RENTALS 0 813 FAIR MARKET VALUE X GRAPHIC DESIGN 0 380 FAIR MARKET VALUE 0 1 0 FORM 990, PART VI, SECTION A, LINE 2 THE PRESIDENT AND CEO ARE RELATED BY MARRIAGE TO THE VP OF STRATEGIC DEVELOPMENT AND COMMUNITY SUPPORT. FORM 990, PART VI, SECTION B, LINE 11 ALTA MED HEALTH SERVICES CORPORATION OUTSIDE CPA FIRM AND FINANCE STAFF PREPARE FORM 990. THE FORM IS THEN REVIEWED AND APPROVED BY THE ORGANIZATION PRESIDENT AND SR. VP OF FINANCE AND CFO. THE FORM IS THEN PROVIDED TO THE FULL BOARD FOR ACCEPTANCE BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12C ALTAMED HEALTH SERVICES CORP. (ALTAMED) REQUIRES ALL EMPLOYEES TO DISCLOSE, AT LEAST ANNUALLY, ALL SOURCES OF INCOME FROM COMPENSATION OR FROM OWNERSHIP OF EVERY OUTSIDE ENTITY THAT (A) SOLD, SUPPLIED OR PROVIDED SERVICES (B) OPERATED A COMPETING ENTERPRISE OR (C) PROVIDED GOODS OR SERVICES TO ALTAMED IN THE LAST SIX MONTHS. ALTAMED ALSO REQUIRES ALL DIRECTORS TO ANNUALLY SIGN A STATEMENT AFFIRMING (A) RECEIPT OF ALTAMED CONFLICT OF INTEREST POLICY (B) UNDERSTANDING OF THE POLICY AND (C) AGREEMENT WITH THE POLICY. THE CONFLICT OF INTEREST POLICY DESCRIBES HOW ALTAMED WILL RESOLVE POSSIBLE CONFLICTS OF INTEREST. BOARD MEMBERS RESUBMIT CONFLICT OF INTEREST STATEMENTS AS PART OF THE ANNUAL REVIEW OF THE BYLAWS AND MEMBERSHIP. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF DIRECTORS COMPENSATION COMMITTEE HAS ENGAGED A NATIONALLY RECOGNIZED INDEPENDENT COMPENSATION CONSULTANT FIRM TO REVIEW ITS EXECUTIVE AND NON-EXECUTIVE SALARIES. THE FIRM UNDERTAKES SPECIFIC PROTOCOLS AND OBTAIN VAST ORGANIZATIONAL DATA FROM NUMEROUS COMPANIES AND PEER GROUPS AND THEN RENDERS A "REASONABLENESS" OPINION TO THE BOARD OF DIRECTORS. THE FIRM'S PROCESS INCLUDES A REVIEW OF COMPENSATION OF SIMILARLY CONSTITUTED COMPANIES, TRENDS, THE ORGANIZATION'S PRESENT COMPENSATION PACKAGES INCLUDING CASH AND NON-CASH BENEFITS , THE METHODOLOGY AND PHILOSOPHY USED FOR THE ASSESSMENT AND THE TOTAL COMPENSATION ANALYSIS. ADDITIONALLY, MARKET BENEFIT AND RECRUITMENT AND RETENTION TRENDS ARE CONSIDERED AND EVALUATED. THE OPINIONS ARE PROVIDED TO THE BOARD'S COMPENSATION COMMITTEE, WHICH IS COMPRISED OF INDEPENDENT DIRECTORS. THE COMPENSATION COMMITTEE IS PROVIDED WITH A REGIONAL PEER GROUP THAT INCLUDES MOST COMPARABLY SIZED CALIFORNIA NON PROFIT AND SOME FOR PROFIT HEALTHCARE ORGANIZATIONS. THE OPINIONS ARE BASED ON COMPARABILITY DATA FROM NATIONAL AND REGIONAL DATA BASES, FROM WHICH COMPARISONS OF THE ORGANIZATION'S EXECUTIVE COMPENSATION WITH PEER GROUP COMPENSATION LEVELS CAN BE MADE, WHICH IS PROVIDED TO THE COMPENSATION COMMITTEE IN ITS REPORT. THE COMPENSATION COMMITTEE IS PRESENTED WITH DATA THAT COMPARES THE ORGANIZATION'S COMPENSATION PACKAGES TO THE LEVEL TARGETED IN THE COMPENSATION PHILOSOPHY. BASED UPON THE TOTALITY OF THE DATA GARNERED BY THE COMPENSATION CONSULTING FIRM, THE COMPENSATION COMMITTEE IS PROVIDED WITH RECOMMENDED BASE SALARY AND BENEFIT RANGES FOR THE PERIOD ASSESSED. THE COMPENSATION COMMITTEE DELIBERATES ON THE DATA TO ASSESS WHETHER IT IS APPROPRIATE IN REPRESENTING COMPENSATION LEVELS WITH SIMILAR ORGANIZATIONS, POSITIONS AND CIRCUMSTANCES AND THAT IT REPRESENTS FAIR MARKET VALUE FOR SERVICES RENDERED ON A REALISTIC BASIS. THE COMPENSATION COMMITTEE THEN PROVIDES ITS RECOMMENDATIONS TO THE BOARD OF DIRECTORS. THE BOARD OF DIRECTORS IS PROVIDED WITH ALL AVAILABLE INFORMATION AND THE OPINIONS OF THE EXPERTS AND DELIBERATES AND DISCUSSES THE RECOMMENDATIONS AS IT DEEMS NECESSARY TO PROPERLY ASSESS THE COMPENSATION LEVELS OF ITS EXECUTIVES AND OTHER EMPLOYEES. FORM 990, PART VI, SECTION C, LINE 19 SOME OR ALL OF THESE ITEMS MAY BE AVAILABLE UPON REQUEST. ALTAMED MANAGEMENT SERVICES LLC 2040 CAMFIELD AVENUE LOS ANGELES CA 90040 810785877 MANAGED CARE CA 105659 105659 ALTAMED HEALTH SERVICES CORPORATION ALTAMED HEALTH NETWORK INC 2040 CAMFIELD AVE LOS ANGELES CA 90040 460635843 MANAGED CARE CA 501(C)(3) SECTION 509(A)(1) ALTAMED HEALTH SERVICES CORPORATION 1 ALTAMED FOUNDATION 2040 CAMFIELD AVE LOS ANGELES CA 90040 954090420 FUNDRAISING CA 501(C)(3) SECTION 509(A)(1) ALTAMED HEALTH SERVICES CORPORATION 0 ALTAMED ACTION FUND 777 S FIGUEROA ST STE 4050 LOS ANGELES CA 90017 465650824 SOCIAL WELFARE ACTIVITIES CA 501(C)(4) N/A 0 0 1 0 1 0 0 0 0 0 0 0 1 1 1 0 0 0 0 0 ALTAMED HEALTH NETWORK INC N 7309 ACTUAL AMOUNT PAID ALTAMED ACTION FUND B 235000 ACTUAL AMOUNT PAID PART II LINE 3