2015-01-21T11:21:26-08:00 2014-06-30 Ortega & Associates CPA 5151 Shoreham Pl Suite 100 San Diego CA 92122 990 2013-07-01 942210447 AMPLA HEALTH AMPL 5306744261 935 B MARKET STREET YUBA CITY CA 95991 BENJAMIN FLORES CEO 2015-01-21 true Mario G Ortega P00232069 8586232786 X 2013 2016-02-25 16:41:14Z 35676690 false false X WWW.AMPLAHEALTH.ORG X 1973 CA AMPLA HEALTH STRIVES TO PROVIDE HIGH QUALITY MEDICAL, DENTAL, SOCIAL AND EDUCATIONAL HEALTH SERVICES THAT MEET THE UNIQUE NEEDS OF ALL PATIENTS ESPECIALLY THOSE WHO ARE MEDICALLY UNDER SERVED INCLUDING FARM WORKERS AND OTHERS WITHOUT FINANCIAL RESOURCES. 14 14 501 0 9695569 7945138 27110395 27731265 692 287 0 36806656 35676690 0 0 25948313 28918615 0 0 8085804 9251497 34034117 38170112 2772539 -2493422 29166601 30148908 13678193 17153922 15488408 12994986 AMPLA HEALTH STRIVES TO PROVIDE HIGH QUALITY MEDICAL, DENTAL, SOCIAL AND EDUCATIONAL HEALTH SERVICES THAT MEET THE UNIQUE NEEDS OF ALL PATIENTS ESPECIALLY THOSE WHO ARE MEDICALLY UNDER SERVED INCLUDING FARM WORKERS AND OTHERS WITHOUT FINANCIAL RESOURCES. false false 31001402 AMPLA HEALTH PROVIDES MEDICAL SERVICES AND BASIC DENTAL SERVICES TO LOW-INCOME AND MIGRANT PATIENTS. IT ALSO PROVIDES HEALTH AND PRENATAL INFORMATION TO LOW-INCOME AND MIGRANT INDIVIDUALS, AS WELL AS, SUPPLEMENTAL FOOD TO ELIGIBLE LOW-INCOME WOMEN. SEE SCEHDULE O FOR MORE INFORMATION ON THE PROGRAMS OFFERED. FISCAL YEAR ENDED JUNE 30, 2012 HAD 288,090 PATIENT ENCOUNTERS. 31001402 true true false true false false false false false false true false false false false false true false false false false false false false false false false false false true true false false false false false false false false false false false false false false false false false false false false true 31 0 false 501 false false false false false false false false false 0 false false false false false false false false false false X 14 14 false false false false false false false true true false false true true true true true true true true false X VERONICA RICHTER 5306744261 935 MARKET STREET YUBA CITY CA 95991 KIM OWENS MEMBER 0.00 0.00 X 0 0 0 DEBBIE PORCAYO MEMEBER 0.00 0.00 X 0 0 0 ELIZABETH SKELLY Treasurer 0.00 0.00 X X 0 0 0 MARSHA HENDERSON Chairman 0.00 0.00 X X 0 0 0 WENCESLAO VASQUEZ PARLIAMENTARIAN 0.00 0.00 X X 0 0 0 LILIAN DELATORRE MEMBER 0.00 0.00 X 0 0 0 ROBERTO GONZALEZ MEMBER 0.00 0.00 X 0 0 0 MICHELE WALTERS MEMBER 0.00 0.00 X 0 0 0 ALEJANDRO LUQUIN MEMBER 0.00 0.00 X 0 0 0 SURINDER CHAHAL MEMBER 0.00 0.00 X 0 0 0 J ANGEL CALDERON Secretary 0.00 0.00 X X 0 0 0 HORACIO PARAS VICE CHAIR 0.00 0.00 X X 0 0 0 PETRA CASTRO MEMBER 0.00 0.00 X 0 0 0 DARA ALI MEMBER 0.00 0.00 X 0 0 0 BENJAMIN FLORES CEO 40.00 0.00 X 230562 0 39242 KENNETH TESAR CFO 40.00 0.00 X 33925 0 2546 HILTON PEREZ COO 40.00 0.00 X 129734 0 13901 DALE JOHNSON CFO 40.00 0.00 X 81118 0 4667 DANIEL SIRI CHIEF DENTAL OFFICER 40.00 0.00 X 194768 0 14909 MUSTAFA AMMAR CHIEF MEDICAL OFFICER 40.00 0.00 X 422164 0 17473 CINDY SNELGROVE NURSING DIRECTOR 40.00 0.00 X 109495 0 13393 ELJAZ AHMED PHYSICIAN 40.00 0.00 X 218887 0 16346 ARUN KUMAR PHYSICIAN 40.00 0.00 X 216387 0 15849 JOHL HARPREET PHYSICIAN 40.00 0.00 X 223312 0 15420 THIN THIN AUNG PHYSICIAN 40.00 0.00 X 208355 0 12330 ALPNA MULLICK PHYSICIAN 40.00 0.00 X 208457 0 15517 2277164 181593 54 false true false GRYPON DENTAL LAB 3249 FOOTHILLS BLVD ORVILLE CA 95966 DENTAL LAB 203107 MED3000 INC 680 ANDERSEN DRIVE FOSTER PLZ 10 PITSBURGH PA 15220 E.H.R. SUPPORT 264407 GE HEALTHCARE IITS USA CORP 15724 COLLECTIONS CNTR DRIVE CHICACO IL 60693 PM SYSTEM 155653 COMCAST PO BOX 34227 SEATTLE WA 98124 INTERNET SERV 154266 YUBA SUTTER HOSPITALIST GROUP 726 4TH STREET MARYSVILLE CA 95901 CONTRACT PHYSICIANS 258200 6 7918138 27000 7945138 MEDI-CAL EHR INCENTIVE 621110 412250 412250 OTHER 621110 268376 268376 PROGRAM SERVICE REVENUE 621110 27050639 27050639 27731265 287 287 0 0 0 0 0 0 0 0 35676690 27731552 0 0 0 0 1307897 1124792 183105 0 22030997 18660828 3370169 531859 450431 81428 3475851 2923387 552464 1572011 1331336 240675 17965 17965 66471 66471 41700 41700 0 0 0 2705996 2247552 458444 0 0 0 0 419959 373903 46056 253813 111565 142248 0 0 500607 352293 148314 0 1099294 787031 312263 219893 44735 175158 SUPPLIES 1622127 1423762 198365 Utilities 499063 445932 53131 COMMUNICATIONS 410156 262175 147981 OTHER 300529 67472 233057 1093924 394208 699716 38170112 31001402 7168710 0 383191 418743 2688848 29031 829657 410753 3058009 4440823 0 0 0 213096 175961 874659 996209 34799356 12655805 19224446 22143551 1006022 1014405 0 0 0 888673 519432 29166601 30148908 5427766 5328296 6458294 6175462 1792133 5650164 13678193 17153922 X 15065469 12478948 422939 516038 15488408 12994986 29166601 30148908 -2493422 X false true X true true true X 7398487 7833567 6800043 9695569 7945138 39672804 0 0 7398487 7833567 6800043 9695569 7945138 39672804 0 39672804 36833 12653 618 692 287 51083 0 0 39723887 136216983 0.99870 0.99770 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false false false true 64971 64971 false false Part II-B, Line 1i - Other Activities Description PART II-B, LINE 1(I), OTHER LOBBYING ACTIVITIES:THE ORGANIZATION PAID DUES TO THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS (NACHC),THE CALIFORNIA PRIMARY CARE ASSOCIATION (CPCA) AND CENTRAL VALLEY HEALTH NETWORK (CVHN). A PORTION OF THE DUES PAID MAY BE USED FOR LOBBYING. 2187234 2187234 23754435 7118683 16635752 196553 41554 154999 8563726 5495568 3068158 97408 97408 22143551 35676690 35676690 35676690 38170112 38170112 38170112 X X X false false false false false false false true false false ALPNA MULLICK PHYSICIAN 183017 25440 5335 10182 223974 ARUN KUMAR PHYSICIAN 194617 21770 5667 10182 232236 BENJAMIN FLORES CEO 226962 3600 11279 27963 269804 DANIEL SIRI CHIEF DENTAL OFFICER 163082 31686 4721 10188 209677 ELJAZ AHMED PHYSICIAN 218887 6163 10183 235233 JOHL HARPREET PHYSICIAN 180086 43226 5238 10182 238732 MUSTAFA AMMAR CHIEF MEDICAL OFFICER 256172 165992 7290 10183 439637 THIN THIN AUNG PHYSICIAN 182315 26040 2148 10182 220685 Part I, Line 7: Non-Fixed payments not listed above BONUS AND INCENTIVE PAYMENTS ARE BASED ON ENCOUNTER PRODUCTIVITY, WITH 400 ENCOUNTERS BEING THE STANDARD. A US BANK - SER 2003-CSCDA 521598225 130911TT7 2003-12-01 8795000 BUILDING PURCHASES false false false A 8795000 603169 false false false true A false false false false A false false false false false A true Form 990, Part VI, Line 11b: Form 990 Review Process AN INDEPENDENT ACCOUNTING FIRM PREPARES THE FORM 990 WITH INFORMATION PROVIDED BY THE ORGANIZATION ACCOUNTING DEPARTMENT. THEN, THE COMPLETED 990 IS SENT TO THE CFO OF THE ORGANIZATION TO BE REVIEWED. THE CFO REVIEWED AND DISTRIBUTES THE 990 AMONG THE FINANCE COMMITTEE AND THE BOARD OF DIRECTORS FOR REVIEW AND QUESTIONS AT THE BOARD MEETING. UPON COMPLETION OF REVIEW AND APPROVAL, THE FORM 990 IS FILED. Form 990, Part VI, Line 19: Other Organization Documents Publicly Available THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE TO BE MAILED UPON WRITTEN REQUEST, HOWEVER, FINANCIAL STATEMENTS ARE NOT MADE PUBLIC.