2014-11-10T17:13:57-06:00 2013-12-31 910189318 MOSS ADAMS LLP 101 SECOND STREET 9TH FLOOR SAN FRANCISCO CA 94105 990 2013-01-01 264826604 PENINSULA PRIMARY CARE PENI 8317189720 275 THE CROSSROADS SUITE A CARMEL CA 93923 LAURA ZEHM VP/CFO 8317189720 2014-11-05 1 RICHARD CROGHAN P00089862 4159561500 2013 2015-11-30 17:44:51Z STEVEN PACKER 275 THE CROSSROADS SUITE A CARMEL CA 93923 4754854 0 X WWW.PENINSULAPRIMARYCARE.ORG X 2009 CA TO PROVIDE HEALTH CARE FOR THE GENERAL PUBLIC, CARRY ON ANY EDUCATIONAL ACTIVITIES RELATED TO RENDERING CARE TO THE SICK OR INJURED, AND TO PARTICIPATE IN SCIENTIFIC HEALTHCARE-RELATED RESEARCH TO PROMOTE THE GENERAL HEALTH OF THE COMMUNITY. 7 4 56 4 0 0 1000000 1000000 2265054 3544480 0 0 98852 210374 3363906 4754854 0 0 0 0 3129746 4023424 0 0 0 948497 1643075 4078243 5666499 -714337 -911645 1008589 1266991 778249 1948296 230340 -681305 TO PROVIDE HEALTH CARE FOR THE GENERAL PUBLIC, CARRY ON ANY EDUCATIONAL ACTIVITIES RELATED TO RENDERING CARE TO THE SICK OR INJURED, AND TO PARTICIPATE IN SCIENTIFIC HEALTHCARE-RELATED RESEARCH TO PROMOTE THE GENERAL HEALTH OF THE COMMUNITY. 0 0 5278097 3544480 DIRECT CLINICAL SERVICES. 5278097 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 13 0 1 56 1 0 0 0 0 0 0 0 0 0 0 X 7 4 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 CA X SHIRLEY NORMAN 8312428605 275 THE CROSSROADS STE A CARMEL CA 93923 MIKE LYON VICE CHAIR 1.00 0.00 X 0 0 0 TIM NYLEN BOARD MEMBER 0.00 55.00 X X 0 363444 33733 STEVEN PACKER MD PRESIDENT 1.00 54.00 X X 0 869342 146196 JILL SHEFFIELD DIRECTOR 1.00 0.00 X 0 0 0 BYRL SMITH SECRETARY 1.00 0.00 X 0 0 0 DAVID STRAFACE MD DIRECTOR 40.00 0.00 X 275664 0 40234 GERALDIN TAPLIN MD BOARD MEMBER 1.00 0.00 X 0 0 0 LAURA ZEHM CFO 1.00 54.00 X 0 513929 78006 PAULJOHN HAYNER EMPLOYEE 40.00 0.00 X 234787 0 15565 ANDREW JOHNSTON EMPLOYEE 40.00 0.00 X 221120 0 22250 AGNIESZKA LECH EMPLOYEE 40.00 0.00 X 213578 0 13688 JILL J TIONGCO EMPLOYEE 40.00 0.00 X 206895 0 21212 DANIEL J SON EMPLOYEE 40.00 0.00 X 174385 0 25539 1326429 1746715 396423 11 0 1 0 QUALITY SYSTEMS INC PO BOX 511449 LOS ANGELES CA 90051 AR BILLING MAINTENANCE 181385 1 1000000 1000000 PATIENT FEES 900099 3544480 3544480 3544480 INCENTIVE PAYMENTS 900099 210374 210374 210374 4754854 3544480 0 210374 315898 315898 3087616 3087616 215396 215396 181100 181100 223414 223414 363402 363402 501936 501936 13650 13650 64722 39722 25000 616292 616292 23265 23265 59790 59790 18 18 5666499 5278097 388402 0 199222 130150 302096 483241 44326 90427 723112 179955 442929 543157 20016 20016 1008589 1266991 252963 619957 525286 1328339 778249 1948296 X 230340 -681305 230340 -681305 1008589 1266991 -911645 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 25104 3902 21202 698008 176053 521955 543157 LOAN FROM CHOMP 1327909 PENSION LOAN EE 430 1328339 X PART X, LINE 2: CHF, CHOMP, CHE, CHP, AND PPC HAVE BEEN DETERMINED TO BE EXEMPT ORGANIZATIONS BY THE INTERNAL REVENUE SERVICE AND THE CALIFORNIA FRANCHISE TAX BOARD AND GENERALLY ARE NOT SUBJECT TO TAXES ON INCOME PURSUANT TO SECTION 501(C)(3) AND SECTION 23701(D) OF THE INTERNAL REVENUE CODE AND CALIFORNIA REVENUE AND TAXATION CODE, RESPECTIVELY. ASPIRE, CCCMIC, CMN, AND COASTAL ARE TAXABLE ENTITIES THAT HAVE NET CUMULATIVE LOSSES. THE DEFERRED TAX ASSETS ASSOCIATED WITH THESE LOSSES HAVE BEEN FULLY RESERVED. THERE WAS NO TAX PROVISION RECORDED FOR THE YEARS ENDED DECEMBER 31, 2013 AND 2012. THE ORGANIZATION ASSESSES UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH THE PROVISIONS OF THE FINANCIAL ACCOUNTING STANDARDS BOARD ("FASB") ACCOUNTING STANDARDS CODIFICATION ("ASC") TOPIC 740-10, INCOME TAXES. THE ORGANIZATION RECOGNIZES THE TAX BENEFIT FROM UNCERTAIN TAX POSITIONS ONLY IF IT IS MORE THAN LIKELY THAN NOT THAT THE TAX POSITIONS WILL BE SUSTAINED ON EXAMINATION BY THE TAX AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFIT IS MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. THE ORGANIZATION RECOGNIZES INTEREST AND PENALTIES RELATED TO INCOME TAX MATTERS IN OPERATING EXPENSES. THERE WERE NO UNCERTAIN TAX POSITIONS AS OF DECEMBER 31, 2013, AND 2012. 0 0 0 0 0 0 0 0 0 TIM NYLEN BOARD MEMBER 0 284744 0 60415 0 18285 0 21459 0 12274 0 397177 0 0 STEVEN PACKER MD PRESIDENT 0 593291 0 238911 0 37140 0 110209 0 35987 0 1015538 0 0 DAVID STRAFACE MD DIRECTOR 208014 0 44051 0 23599 0 22000 0 18234 0 315898 0 0 0 LAURA ZEHM CFO 0 429634 0 63422 0 20873 0 54788 0 23218 0 591935 0 0 PAULJOHN HAYNER EMPLOYEE 165185 0 48319 0 21283 0 5957 0 9608 0 250352 0 0 0 ANDREW JOHNSTON EMPLOYEE 168988 0 37459 0 14673 0 9636 0 12614 0 243370 0 0 0 AGNIESZKA LECH EMPLOYEE 197443 0 0 0 16135 0 6272 0 7416 0 227266 0 0 0 JILL J TIONGCO EMPLOYEE 131420 0 56449 0 19026 0 9003 0 12209 0 228107 0 0 0 DANIEL J SON EMPLOYEE 150601 0 3725 0 20059 0 14406 0 11133 0 199924 0 0 0 PART I, LINE 3 PPC RELIES ON A RELATED ORGANIZATION, COMMUNITY HOSPITAL OF THE MONTEREY PENINSULA, TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIALS USING ALL OF THE METHODS DESCRIBED ON LINE 3 EXCEPT "FORM 990 OF OTHER ORGANIZATIONS." FORM 990, PART VI, SECTION A, LINE 3 CYPRESS HEALTHCARE IS A PROFESSIONAL PHYSICIAN MANAGEMENT COMPANY. WHEN THE FORMER EXECUTIVE DIRECTOR LEFT IN MARCH, 2012, CYPRESS HEALTHCARE ASSUMED SOME OF THE RESPONSIBILITIES OF THE ED. FORM 990, PART VI, SECTION B, LINE 11 THE CFO IS RESPONSIBLE FOR REVIEWING THE FORM 990 BEFORE FILING. ELECTRONIC COPIES ARE SENT TO ALL BOARD MEMBERS FOR REVIEW PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION USES SELF DISCLOSURE BY INTERESTED PERSONS AND MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC BY REQUEST. COMMUNITY HOSPITAL FOUNDATION PO BOX HH MONTEREY CA 93942 942789696 SUPPORT SERVICES CA 501(C)(3) LINE 9 N/A 0 COMMUNITY HOSPITAL OF THE MONTEREY PENINSULA PO BOX HH MONTEREY CA 93942 940760193 HEALTHCARE SERVICES CA 501(C)(3) LINE 3 COMMUNITY HOSPITAL FOUNDATION 0 COMMUNITY HOSPITAL PROPERTIES PO BOX HH MONTEREY CA 93942 942795922 SUPPORT SERVICES CA 501(C)(3) LINE 11A, I COMMUNITY HOSPITAL FOUNDATION 0 COMMUNITY HOSPITAL ENDOWMENTS PO BOX HH MONTEREY CA 93942 942795423 SUPPORT SERVICES CA 501(C)(3) LINE 11A, I COMMUNITY HOSPITAL FOUNDATION 0 ASPIRE HEALTH PLAN 23625 HOLMAN HIGHWAY MONTEREY CA 93940 461567681 INSURANCE COMPANY CA N/A C 0 0 0 1 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 1