CLINICA MSR OSCAR A ROMERO: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- CLINICA MSR OSCAR A ROMERO (EIN 95-3881333)
- Tax period
- 2012-07-01 to 2013-06-30
- Filed
- 2014-05-15
- IRS object ID
- 201411359349306271
- Schema version
- 2012v2.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Timestamp | 2014-05-15T13:32:31-05:00 | Timestamp |
| Tax Period End Date | 2013-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 410746749 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLIFTONLARSONALLEN LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 20 E THOMAS RD STE 2300 | AddressLine1 |
| City | PHOENIX | City |
| State | AZ | State |
| ZIP Code | 85012 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 953881333 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CLINICA MSR OSCAR A ROMERO | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | CLIN | NameControl |
| Phone | 3239871401 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 123 S ALVARADO ST | AddressLine1 |
| City | LOS ANGELES | City |
| State | CA | State |
| ZIP Code | 90057 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | SANDRA ROSSATO | Name |
| Title | EXECUTIVE DIRECTOR | Title |
| Phone | 3239871401 | Phone |
| Date Signed | 2014-05-15 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | KACIE MCEWEN | Name |
| PTIN | P01599614 | PTIN |
| Phone | 6022662248 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2015-11-30 17:44:51Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Change | X | AddressChange |
| Name Of Principal Officer Person | SANDRA ROSSATO | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 123 S ALVARADO ST | AddressLine1 |
| City | LOS ANGELES | City |
| State | CA | State |
| ZIP Code | 90057 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 9134182 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.CLINICAROMERO.COM | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1983 | YearFormation |
| State Legal Domicile | CA | StateLegalDomicile |
| Activity Or Mission Description | TO PROVIDE QUALITY, AFFORDABLE AND CULTURALLY SENSITIVE HEALTH CARE AND OTHER SERVICES TO THE UNINSURED, INSURED AND UNDERSERVED COMMUNITIES OF GREATER LOS ANGELES REGARDLESS OF THEIR ABILITY TO PAY BY UPHOLDING THE LEGACY AND TRADITION OF MONSENOR OSCAR ROMERO AND EDUCATING AND EMPOWERING SALVADORAN AND OTHER COMMUNITY MEMBERS THROUGH COMMUNITY ORGANIZING, HEALTH EDUCATION AND SOCIAL JUSTICE AND EXCHANGE PROGRAMS IN EL SALVADOR. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 9 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 9 | NbrIndependentVotingMembers |
| Total Nbr Employees | 137 | TotalNbrEmployees |
| Total Nbr Volunteers | 16 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 3855566 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 2762794 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 4594191 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 6248371 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 343 | InvestmentIncomePriorYear |
| Investment Income Current Year | 370 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 179823 | OtherRevenuePriorYear |
| Other Revenue Current Year | 112825 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 8629923 | TotalRevenuePriorYear |
| Total Revenue Current Year | 9124360 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 150 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 5782287 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 5934065 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 26257 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 3370377 | OtherExpensePriorYear |
| Other Expenses Current Year | 2789525 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 9152664 | TotalExpensesPriorYear |
| Total Expenses Current Year | 8723740 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | -522741 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 400620 | RevenuesLessExpensesCY |
| Total Assets BOY | 9194194 | TotalAssetsBOY |
| Total Assets EOY | 8828654 | TotalAssetsEOY |
| Total Liabilities BOY | 5927156 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 5355257 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 3267038 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 3473397 | NetAssetsOrFundBalancesEOY |
| Info In Schedule O Part III | X | InfoInScheduleOPartIII |
| Mission Description | OUR MISSION IS TO PROVIDE QUALITY, AFFORDABLE AND CULTURALLY SENSITIVE HEALTH CARE AND OTHER SERVICES TO THE UNINSURED, INSURED AND UNDERSERVED COMMUNITIES OF GREATER LOS ANGELES REGARDLESS OF THEIR ABILITY TO PAY BY UPHOLDING THE LEGACY AND TRADITION OF MONSENOR OSCAR ROMERO AND EDUCATING AND EMPOWERING SALVADORAN AND OTHER COMMUNITY MEMBERS THROUGH COMMUNITY ORGANIZING, HEALTH EDUCATION AND SOCIAL JUSTICE AND EXCHANGE PROGRAMS IN EL SALVADOR. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 5631748 | Expense |
| Grants | 150 | Grants |
| Revenue | 5544202 | Revenue |
| Description | CLINICA ROMERO PROVIDES LOW-COST COMPREHENSIVE PRIMARY CARE AND DISEASE PREVENTION SERVICES FOR MEN, WOMEN AND CHILDREN OF ALL AGES. OUR DOCTORS STRIVE TO PROVIDE THE BEST LEVEL OF CARE IN ORDER TO IMPROVE THE QUALITY OF LIFE OF ALL PATIENTS. SERVICES INCLUDE: EXAMS: COMPLETE MEDICAL EXAMINATIONS.CANCER SCREENINGS: LAB TESTS, ULTRASOUNDS.CHRONIC DISEASE MANAGEMENT: MEDICATIONS AND LIFESTYLE REGIMENS FOR AVOIDING COMPLICATIONS ASSOCIATED WITH ASTHMA, HEART DISEASE, HYPERTENSION, HIGH BLOOD PRESSURE AND DIABETES.FAMILY PLANNING: PROGRAMS TO ASSIST YOUNG AND BEGINNING FAMILIES.PRENATAL CARE: PRENATAL CLASSES AND NUTRITIONAL GUIDANCE.PEDIATRICS: WELL-CHILD VISITS FOR HEALTHY GROWTH AND DEVELOPMENT.VACCINATIONS: PEDIATRIC IMMUNIZATIONS AND ADULT VACCINES. | Description |
Activity2 Activity2
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 625553 | Expense |
| Grants | 0 | Grants |
| Revenue | 588034 | Revenue |
| Description | CLINICA ROMERO PROVIDES A LOW-COST DENTAL SERVICES FOR ADULTS AND CHILDREN IN A FRIENDLY ENVIRONMENT THAT PUTS OUR PATIENTS AT EASE. GOOD ORAL HEALTH REQUIRES REGULAR DENTAL EXAMINATION AND MAINTENANCE TO HELP PREVENT AND MANAGE DISEASE. OUR TEAM SPECIALIZES IN PREVENTATIVE CARE AND PROVIDES THE FOLLOWING SERVICES:SERVICES FOR ADULTS:COMPLETE ORAL EXAMINATIONS INCLUDING X-RAYS.PREVENTATIVE SERVICES AND PERIODIC PERIODONTAL MAINTENANCE TREATMENT:PROPHYLAXIS (CLEANINGS) AND NON-SURGICAL PERIODONTAL TREATMENT (SCALING AND ROOT PLANING), ORAL HYGIENE EDUCATIONRESTORATIVE SERVICES:RESTORATION FILLINGS, CANAL TREATMENT LIMITED TO ANTERIOR TEETH, SIMPLE EXTRACTIONSSERVICES FOR CHILDREN:COMPLETE ORAL EXAMINATIONS AND X-RAYSPREVENTATIVE SERVICES:PROPHYLAXIS (CLEANINGS), FLUORIDE VARNISH APPLICATIONS, SEALANTS, ORAL HYGIENE EDUCATIONRESTORATIVE SERVICES:RESTORATION FILLINGS, PULPOTOMIES, STAINLESS STEEL CROWNS, SPACE MAINTAINERS, SIMPLE EXTRACTIONS | Description |
Activity3 Activity3
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | 672761 | Expense |
| Grants | 0 | Grants |
| Revenue | 116135 | Revenue |
| Description | CLINICA ROMERO'S MENTAL HEALTH DEPARTMENT WORKS WITH A PATIENT'S PRIMARY CARE PROVIDER TO ENSURE A COORDINATED PAN OF CARE. WE PROVIDE AN ARRAY OF SERVICES THAT MEETS THE PATIENT WHERE THEY ARE IN THEIR ABILITY TO MANAGE THEIR DIAGNOSIS. SERVICES INCLUDE:INDIVIDUAL COUNSELINGCHILD & ADOLESCENT COUNSELINGCOUPLE'S COUNSELINGFAMILY COUNSELINGGROUP COUNSELING:"HEALING IS A CHOICE" SUPPORT GROUP IN ENGLISH AND SPANISH | Description |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expense | 6930062 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 0 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 0 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 0 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 22 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 0 | ComplianceWithBackupWitholding |
| Number Of Employees | 137 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 9 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 9 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 0 | WhistleblowerPolicy |
| Document Retention Policy | 0 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 0 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | CA | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
| Other Explain In Sch O | X | OtherExplainInSchO |
The Books Are In Care Of TheBooksAreInCareOf
Name Business NameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SANDRA ROSSATO | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Telephone Number | 2132015745 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 123 S ALVARADO ST | AddressLine1 |
| City | LOS ANGELES | City |
| State | CA | State |
| ZIP Code | 90057 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (15 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation |
|---|---|---|---|---|---|---|
| CARLOS VAQUERANO | ||||||
| PRESIDENT | 1.00 | X | X | 0 | 0 | 0 |
| MARCELO VILLAGOMEZ | ||||||
| VICE PRESIDENT | 1.00 | X | X | 0 | 0 | 0 |
| PABLO LOPEZ | ||||||
| TREASURER | 1.00 | X | X | 0 | 0 | 0 |
| JONATHAN CANAS | ||||||
| SECRETARY | 1.00 | X | X | 0 | 0 | 0 |
| ANA MARTINEZ | ||||||
| MEMBER | 1.00 | X | 0 | 0 | 0 | |
| MARIA ELENA GARCIA | ||||||
| MEMBER | 1.00 | X | 0 | 0 | 0 | |
| IVONNENANETTE MACHADO | ||||||
| MEMBER | 1.00 | X | 0 | 0 | 0 | |
| ADALY UGALDE | ||||||
| MEMBER | 1.00 | X | 0 | 0 | 0 | |
| RODNEY SAMAAN | ||||||
| MEMBER | 1.00 | X | 0 | 0 | 0 | |
| JOSE ARTURO RUVALCABA | ||||||
| MEMBER (FORMER) | 1.00 | X | 0 | 0 | 0 | |
| LESLIE LAMBERT | ||||||
| MEMBER (FORMER) | 1.00 | X | 0 | 0 | 0 | |
| CHRISTINA BUGARIN | ||||||
| FINANCE DIRECTOR | 40.00 | X | 43549 | 0 | 0 | |
| SANDRA ROSSATO | ||||||
| EXECUTIVE DIRECTOR | 40.00 | X | 61742 | 0 | 0 | |
| CHRISTINA RECINOS | ||||||
| INTERIM MEDICAL DIRECTOR | 40.00 | X | 122786 | 0 | 0 | |
| ALBERT PACHECO | ||||||
| EXECUTIVE DIRECTOR (FORMER) | 40.00 | X | 30544 | 0 | 0 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 258621 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 0 | TotalOtherCompensation |
| Number Individuals GT100 K | 1 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 0 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
| Number Of Contractors GT100 K | 0 | NumberOfContractorsGT100K |
| Government Grants | 2532785 | GovernmentGrants |
| All Other Contributions | 230009 | AllOtherContributions |
| Total Contributions | 2762794 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (3 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| MEDICAL SERVICES | 621110 | 5544202 | 5544202 |
| DENTAL SERVICES | 621110 | 588034 | 588034 |
| HEALTH SERVICES | 621110 | 116135 | 116135 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 6248371 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 370 | TotalRevenueColumn |
| Exclusion | $370 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 74700 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 9822 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 64878 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 64878 | TotalRevenueColumn |
| Exclusion | $64,878 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | OTHER INCOME | Description |
| Business Code | 900099 | BusinessCode |
| Total Revenue Column | 47947 | TotalRevenueColumn |
| Exclusion | $47,947 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 47947 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 9124360 | TotalRevenueColumn |
| Related Or Exempt Function Income | 6248371 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $113,195 | ExclusionAmount |
Grants To Domestic Orgs GrantsToDomesticOrgs
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 150 | Total |
| Program Services | 150 | ProgramServices |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 326497 | Total |
| Program Services | 147535 | ProgramServices |
| Management And General | 178962 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 4165458 | Total |
| Program Services | 3670627 | ProgramServices |
| Management And General | 479589 | ManagementAndGeneral |
| Fundraising | 15242 | Fundraising |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1053306 | Total |
| Program Services | 895310 | ProgramServices |
| Management And General | 154422 | ManagementAndGeneral |
| Fundraising | 3574 | Fundraising |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 388804 | Total |
| Program Services | 330484 | ProgramServices |
| Management And General | 57001 | ManagementAndGeneral |
| Fundraising | 1319 | Fundraising |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 18000 | Total |
| Program Services | 8720 | ProgramServices |
| Management And General | 9011 | ManagementAndGeneral |
| Fundraising | 269 | Fundraising |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 164859 | Total |
| Program Services | 79864 | ProgramServices |
| Management And General | 82530 | ManagementAndGeneral |
| Fundraising | 2465 | Fundraising |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 716363 | Total |
| Program Services | 633893 | ProgramServices |
| Management And General | 82470 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 250 | Total |
| Program Services | 100 | ProgramServices |
| Management And General | 150 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 221862 | Total |
| Program Services | 104891 | ProgramServices |
| Management And General | 115487 | ManagementAndGeneral |
| Fundraising | 1484 | Fundraising |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 80376 | Total |
| Program Services | 38807 | ProgramServices |
| Management And General | 40249 | ManagementAndGeneral |
| Fundraising | 1320 | Fundraising |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 378691 | Total |
| Program Services | 199841 | ProgramServices |
| Management And General | 178266 | ManagementAndGeneral |
| Fundraising | 584 | Fundraising |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 27217 | Total |
| Program Services | 11485 | ProgramServices |
| Management And General | 15732 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 5261 | Total |
| Program Services | 922 | ProgramServices |
| Management And General | 4339 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 93466 | Total |
| Program Services | 40392 | ProgramServices |
| Management And General | 53074 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 478466 | Total |
| Program Services | 286239 | ProgramServices |
| Management And General | 192227 | ManagementAndGeneral |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 44730 | Total |
| Program Services | 26838 | ProgramServices |
| Management And General | 17892 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| MEDICAL SUPPLIES | 285908 | 285908 | |
| HAZARDOUS WASTE DISPOSA | 146300 | 146300 | |
| MAINTENANCE AND REPAIRS | 81020 | 15985 | 65035 |
| EDUCATION AND TRAINING | 24284 | 24284 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 22472 | Total |
| Program Services | 5771 | ProgramServices |
| Management And General | 16701 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 8723740 | Total |
| Program Services | 6930062 | ProgramServices |
| Management And General | 1767421 | ManagementAndGeneral |
| Fundraising | 26257 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 267824 | BOY |
| EOY | 510062 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1624517 | BOY |
| EOY | 1186667 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1425697 | BOY |
| EOY | 1474734 | EOY |
Inventories For Sale Or Use InventoriesForSaleOrUse
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9188 | BOY |
| EOY | 10784 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 13582 | BOY |
| EOY | 17188 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 9115354 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 3535565 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5826127 | BOY |
| EOY | 5579789 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 27259 | BOY |
| EOY | 49430 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9194194 | BOY |
| EOY | 8828654 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1750816 | BOY |
| EOY | 658046 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 231844 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4176340 | BOY |
| EOY | 4465367 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5927156 | BOY |
| EOY | 5355257 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1915376 | BOY |
| EOY | 2069291 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1351662 | BOY |
| EOY | 1404106 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3267038 | BOY |
| EOY | 3473397 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9194194 | BOY |
| EOY | 8828654 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 400620 | ReconcilationRevenueExpenses |
| Reconcilation Prior Adjustment | -194261 | ReconcilationPriorAdjustment |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Separate | X | FinancialStatementSeparate |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 0 | AuditCommittee |
| Federal Grant Audit Required | 1 | FederalGrantAuditRequired |
| Federal Grant Audit Performed | 1 | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org170b1 Avi | X | PubliclySupportedOrg170b1Avi |
Gifts Grants Contrib Received170 GiftsGrantsContribReceived170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 5532603 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 5732065 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 4822159 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 3855566 | CurrentTaxYearMinus1Year |
| Current Tax Year | 2762794 | CurrentTaxYear |
| Total | 22705187 | Total |
Total170 Total170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 5532603 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 5732065 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 4822159 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 3855566 | CurrentTaxYearMinus1Year |
| Current Tax Year | 2762794 | CurrentTaxYear |
| Total | 22705187 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | 22705187 | PublicSupportTotal170 |
Gross Investment Income170 GrossInvestmentIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 5408 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 5017 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 1413 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 84921 | CurrentTaxYearMinus1Year |
| Current Tax Year | 75069 | CurrentTaxYear |
| Total | 171828 | Total |
Other Income170 OtherIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 122524 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 108625 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 122868 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 95245 | CurrentTaxYearMinus1Year |
| Current Tax Year | 47949 | CurrentTaxYear |
| Total | 497211 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | 23374226 | TotalSupport |
| Gross Receipts From Admissions Etc | 22309259 | GrossReceiptsFromAdmissionsEtc |
| Public Support Pertcentage170 | 0.97140 | PublicSupportPertcentage170 |
| Public Support Pertcent Prior Year | 0.98850 | PublicSupportPertcentPriorYear |
| Thirty Three Percnt Tests CY170 | X | ThirtyThreePercntTestsCY170 |
| General Explanation | SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: OTHER INCOME - 2008 AMOUNT: $ 122,524. 2009 AMOUNT: $ 108,625. 2010 AMOUNT: $ 122,868. 2011 AMOUNT: $ 95,245. 2012 AMOUNT: $ 47,949. | GeneralExplanation |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 1618324 | OtherCostOrOtherBasis |
| Book Value | 1618324 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 4345616 | OtherCostOrOtherBasis |
| Depreciation | 1376127 | Depreciation |
| Book Value | 2969489 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 763083 | OtherCostOrOtherBasis |
| Depreciation | 558647 | Depreciation |
| Book Value | 204436 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 2388331 | OtherCostOrOtherBasis |
| Depreciation | 1600791 | Depreciation |
| Book Value | 787540 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 5579789 | TotalOfBookValueLandBuildings |
| Footnote In Part XIII | X | FootnoteInPartXIII |
| Tot Revenue Etc Audited Fincl Stmt | 9134182 | TotRevenueEtcAuditedFinclStmt |
| Revenue Not Rptd F990 | 0 | RevenueNotRptdF990 |
| Revenue Subtotal | 9134182 | RevenueSubtotal |
| Other Revenues Not Included | -9822 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | -9822 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 9124360 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 8733562 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 9822 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 9822 | ExpensesNotRptdF990 |
| Expenses Subtotal | 8723740 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 8723740 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIII Form990ScheduleDPartXIII (3 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X, LINE 2: | CLINICA IS A NONPROFIT CORPORATION EXEMPT FROM THE PAYMENT OF INCOME TAXES UNDER INTERNAL REVENUE CODE SECTION 501(C)(3) AND CALIFORNIA REVENUE AND TAXATION CODE SECTION 23701(D). ACCORDINGLY, NO PROVISION HAS BEEN MADE FOR INCOME TAXES. HOWEVER, CLINICA IS SUBJECT TO INCOME TAXES ON ANY NET INCOME THAT IS DERIVED FROM A TRADE OR BUSINESS NOT IN FURTHERANCE OF THE PURPOSES FOR WHICH IT WAS GRANTED EXEMPTION. NO INCOME TAX PROVISION HAS BEEN RECORDED AS THE NET INCOME, IF ANY, FROM ANY UNRELATED TRADE OR BUSINESS IN THE OPINION OF MANAGEMENT, IS NOT MATERIAL TO THE FINANCIAL STATEMENTS TAKEN AS A WHOLE. CLINICA FOLLOWS THE ACCOUNTING STANDARDS FOR CONTINGENCIES IN EVALUATING UNCERTAIN TAX POSITIONS. CLINICA FILES INFORMATION RETURNS AS A TAX EXEMPT ORGANIZATION. SHOULD THAT STATUS BE CHALLENGED IN THE FUTURE, ALL YEARS SINCE INCEPTION COULD BE SUBJECT TO REVIEW BY THE INTERNAL REVENUE SERVICE. THE TAX RETURNS FOR THE YEARS 2009 TO 2011 ARE OPEN TO EXAMINATION BY FEDERAL, STATE AND LOCAL AUTHORITIES. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | OFFSETTING EXPENSES RELATED TO RENTAL REVENUE -9,822. | |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | RENTAL EXPENSES TO OFFSET RENTAL REVENUE 9,822. |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (5 entries)
| Return ReferenceReturnReference | ExplanationExplanation |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 1 | THE EXECUTIVE COMMITTEE SHALL: A) CONSIST OF FOUR (4) OFFICERS AND THE IMMEDIATE PAST PRESIDENT OF THE BOARD. IF THERE IS NO IMMEDIATE PAST PRESIDENT OF THE BOARD THEN SERVING AS A DIRECTOR, THE PRESIDENT MAY, IN HIS OR HER DISCRETION, APPOINT AN ADDITIONAL MEMBER TO THE COMMITTEE FROM AMONG THE OTHER DIRECTORS THEN IN OFFICE. IN ADDITION, THE EXECUTIVE DIRECTOR AND SUCH OTHER NON-DIRECTORS AS ARE DESIGNATED FROM TIME TO TIME BY THE BOARD OF DIRECTORS, MAY BE NON- VOTING ADVISORS TO THE EXECUTIVE COMMITTEE. B) HAVE AND EXERCISE SUCH AUTHORITY AS MAY BE DELEGATED TO IT BY THE BOARD AND ACT IN ITS ABSENCE DURING AN EMERGENCY IF THE FULL BOARD IS UNABLE TO MEET. C) HAVE OVERSIGHT OVER STRATEGIC PLANNING FOR CLINICA. D) WORK WITH THE EXECUTIVE DIRECTOR AND DEVELOPMENT DEPARTMENT TO OBTAIN FUNDS FROM A BROAD RANGE OF SOURCES IN BOTH THE PUBLIC AND PRIVATE SECTORS INCLUDING: INDIVIDUALS, CORPORATIONS, FOUNDATIONS AND GOVERNMENT. E) MEET MONTHLY AT A TIME AND PLACE DETERMINED BY THE COMMITTEE. SPECIAL MEETINGS SHALL BE CALLED BY THE PRESIDENT, OR AT THE WRITTEN REQUEST OF AT LEAST TWO COMMITTEE MEMBERS. T) A MAJORITY OF THE MEMBERS SHALL CONSTITUTE A QUORUM. |
| FORM 990, PART VI, SECTION B, LINE 11 | CLINICA MSR OSCAR A ROMERO OUTSIDE AUDITORS AND FINANCIAL STAFF PREPARE THE FORM 990. THE FORM IS THEN REVIEWED AND APPROVED BY THE ORGANIZATION'S CONTROLLER OR CHIEF FINANCIAL OFFICER AND CHIEF EXECUTIVE OFFICER. THE FORM IS THEN SENT TO THE FULL BOARD BEFORE FILING WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | CLINICA MSR OSCAR A ROMERO (CMOAR) 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 CMOAR IN THE LAST SIX MONTHS. CMOAR ALSO REQUIRES ALL DIRECTORS TO ANNUALLY SIGN A STATEMENT AFFIRMING (A) RECEIPT OF CMOAR CONFLICT OF INTEREST POLICY (B) UNDERSTANDING OF THE POLICY AND (C) AGREEMENT WITH THE POLICY. CMOAR CONFLICT OF INTEREST POLICY DESCRIBES HOW CMOAR WILL RESOLVE POSSIBLE CONFLICTS OF INTEREST. |
| FORM 990, PART VI, SECTION B, LINE 15A | THE BOARD REVIEWED CLINICA MSR OSCAR A ROMERO CEO'S COMPENSATION. THE BOARD REVIEWED DATA OF COMPARABLE COMPENSATION FOR SIMILARLY QUALIFIED NONPROFIT EXECUTIVES. THE OCCURRENCE OF THESE DELIBERATION ARE NOTED IN THE BOARD MINUTES. |
| FORM 990, PART VI, SECTION C, LINE 19 | ALL DOCUMENTS ARE AVAILABLE UPON REQUEST. IN ADDITION TO BEING AVAILABLE UPON REQUEST, THE ORGANIZATION'S FORM 990 IS AVAILABLE AT WWW.GUIDESTAR.ORG. |
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