2016-08-26T11:21:30-07:00 2016-03-31 660755792 Rodriguez Rivera & Toro PSC PO BOX 1080 MAYAGUEZ PR 006811080 990 2015-04-01 660428488 COSTA SALUD COMMUNITY HEALTH CENTERS INC COST 7878235555 PO BOX 638 Rincon PR RQ 00677 Mrs Susana Perez Executive Director 7878235555 2016-08-15 0 CPA Ivan Santiago Vega P01620794 7878343100 2016-08-15 2015 2016-12-15 16:53:06Z Mrs Susana Perez PO Box 638 Rincon Puerto Rico RQ 00677 21087239 0 X X 1977 PR To provide high quality primary health care service to low income individuals and families in Rincon, Puerto Rico and adjacent areas. 11 11 75 0 0 0 1849035 2781098 10549922 18260154 31853 32127 7241 13860 12438051 21087239 0 0 0 0 2784721 3271614 0 0 0 10036291 14393748 12821012 17665362 -382961 3421877 18021550 18627991 7290723 4484722 10730827 14143269 To provide high quality primary health care services to low income individuals and families in the area of Rincon, Puerto Rico and other adjacent areas. 0 0 14754288 0 0 To provide high quality primary health care services to low income individuals and families in the area of Rincon, Puerto Rico and other adjacent areas. 0 0 0 14754288 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 75 1 0 0 0 0 0 0 X 11 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 1 1 1 0 PR X Mr Pedro Caro Finance Director 7878235555 PO BOX 638 Rincon PR RQ 00677 Mrs Susana Perez Executive Director 37.5 0 X 140777 0 0 Mr Pedro Caro Finance Director 37.5 0 X 48528 0 0 Dr Edgardo Rodriguez Medical Director 37.5 0 X 102267 0 0 Mrs Maria I Torres Chief Operational Officer 37.5 0 X 61845 0 0 353417 0 0 2 0 0 0 Jani Clean Guanajibo Industrial Park 1135 Mayagüez Puerto Rico RQ 00681 Maintenance services 103286 Kelly Services Inc PO Box 530437 Atlanta GA 303530437 Temporary Jobs 140291 US Security Associates Inc 200 Mansell Court Fifth Floor Roswell GA 30076 Security Services 143906 Feldesman Tucker Leifer Fidell LLP 1129 20th Street NW Suite 400 Washington DC 20036 Legal Service 100834 4 0 0 0 0 2764237 16861 0 2781098 Capitation Income 900099 11061734 11061734 0 0 Copayments of Medical Services 900099 403427 403427 0 0 Medical Insurance Income 900099 2945370 2945370 0 0 Wraparaound Income 900099 1103233 1103233 0 0 Recovery of excess of services provided over operating budget 900099 2630052 2630052 0 0 116338 116338 0 0 18260154 32127 32127 0 0 0 0 0 0 0 0 0 0 0 0 0 0 7350 0 0 7350 0 7350 Miscellaneous 900099 6510 6510 0 0 0 0 0 0 6510 21087239 18298791 0 7350 X 340962 340962 2240817 1870474 370343 387272 250172 137100 302563 218420 84143 123416 123416 37180 37180 11885387 10865216 1020171 62008 62008 350030 245021 105009 49207 435 48772 174331 174331 572270 425630 146640 39475 39475 Equipment & Space Rental 126860 93794 33066 0 Drugs & Medicines 513459 513459 0 0 Supplies Expense 297942 231660 66282 0 Repair and Maintenence 43395 0 43395 0 118788 40007 78781 17665362 14754288 2911074 0 1901387 2820505 1604352 1608149 0 693132 903788 0 0 0 0 0 0 69260 67069 19930 22447 14632921 1709396 13456485 12923525 0 0 277004 282508 0 0 0 0 0 0 18021550 18627991 3633356 1198727 200868 0 0 0 0 0 0 0 0 0 3456499 3285995 0 0 0 7290723 4484722 X 10730827 14143269 0 0 0 0 10730827 14143269 18021550 18627991 X 3421877 0 0 0 0 -9435 X 0 1 X 1 1 1 X 11013089 13953078 12482499 12398957 18411200 68258823 11013089 13953078 12482499 12398957 18411200 68258823 68258823 40086 35139 30739 31583 32127 169674 4427 3599 4765 7241 6510 26542 68455039 0.99713 0.99660 X Schedule A, Part II, Line 10 Miscellaneous income other than capital gain related to the principal activity of the organization. 1798249 0 1798249 9395153 0 587197 8807956 0 0 0 0 2226917 0 1004340 1222577 1212602 0 117859 1094743 12923525 21087239 0 0 0 0 0 21087239 0 0 0 21087239 17674797 0 0 0 0 0 17674797 0 -9435 -9435 17665362 Schedule D, Part XII, Line 4b Loss on disposition of assets. Form 990, Part VI, Section B, Line 11b The form 990 is prepared by the external auditors using the accounting records and other information and data used to prepare the audited Financial Statements. Once prepared, the form is given to the top management of the organization for the review and discussion with the external auditors. Once discussed with the external auditors, the Executive Director presents and discusses the form 990 with the Governing Board for approval. Once approved by the Board the form is submitted to the IRS. Form 990, Part VI, Section B, Line 12c The organization has a conflict of interest policy which is monitored by the top management and the Governing Board. Top Management of the organization and the Governing Board monitors the conflict of interest policy by analyzing sensitive transactions and contractual agreements and by requiring employees and board members to disclose any interest or relationship with a third party. The policy is also enforced throughout periodic seminars and conferences to officers and key employees. Form 990, Part VI, Section B, Line 15 The compensation of the Executive Director is determined and approved by the Governing Board. The compensation is determined based on experience, qualifications, performance and comparable or similar data of executive officers in Puerto Rico. Compensation of other officers and key employees such as the Chief Financial Officer, Medical Director, Chief Operating Officer and others is primarily determined based on experience, qualifications, performance and comparable or similar data for those positions in Puerto Rico. Compensation of officers and key employees is then presented to the Governing Board for approval. Form 990, Part VI, Section C, Line 19 Governing documents, conflict of interest policy and financial statements are available for public inspection at the administrative offices of the organization. They are delivered to the intended users (public) but under supervision of an official of the corporation. The availability of such documents may depend on the purposes and use of such information. Form 990, Part IX, Line 11g Other expenses on the Fees for Services (non-employees) category consists majorly of medical services paid to third party health providers on behalf of the Organization as part of capitation contracts with the Puerto Rico Government Health Care Reform. It also includes the costs of contracts for services provided by independent contractors. Form 990, Part XI, Line 9 Loss on disposition of assets. The accounting records are not updated with the necessary information for the preparation and e-file this informative return.