2012-04-26T15:30:08-05:00 2011-06-30 GORELICK & USLANER CPAS A PROF CORP 11620 WILSHIRE BLVD SUITE 800 LOS ANGELES CA 90025 990 2010-07-01 952374185 WILSHIRE HEALTH AND COMMUNITY SERVICES INC WILS 8055477025 285 SOUTH STREET NO J SAN LUIS OBISPO CA 93401 TRICIA RITCHIE 8055477025 2012-04-24 1 BRUCE G BURG 3104441889 2010 2016-02-24 21:20:13Z TRICIA RITCHIE 285 SOUTH STREET NO J SAN LUIS OBISPO CA 93401 14633083 0 X WWW.WILSHIREHCS.ORG X 1960 CA PROVIDING A BROAD RANGE OF HEALTH AND COMMUNITY SERVICES TO ENHANCE THE LIVES OF OUR PATIENTS. 9 7 208 0 1446 0 2035 144156 13263272 12845189 7176 3818 1490186 1638900 14762669 14632063 35450 48500 0 0 10196724 10606354 0 0 0 3762211 3676537 13994385 14331391 768284 300672 10211911 10206056 3777415 3499356 6434496 6706700 TO ENHANCE THE LIVES OF OUR PATIENTS, CLIENTS AND THEIR FAMILIES BY PROVIDING A BROAD RANGE OF HEALTH AND COMMUNITY SERVICES THROUGH OUR DEDICATED TEAM. 0 0 12983434 14481623 OPERATION OF HOME HEALTH AGENCIES, HOSPICES, AND AN INVESTMENT IN A HEALTH CARE JOINT VENTURE - ALL OF WHICH PROVIDE HEALTH CARE SERVICES TO THE PUBLIC. 12983434 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 1 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 53 0 208 1 1 1 0 0 0 0 0 0 0 0 0 X 9 7 0 0 0 0 0 0 0 1 1 0 1 1 1 1 1 1 1 1 1 1 1 1 CA X TRICIA RITCHIE 8055477025 285 SOUTH STREET SUITE J SAN LUIS OBISPO CA 93401 IRA R ALPERT 8.00 X 1200 0 0 TED J GREENBERG 28.00 X X 81279 0 7162 TRICIA RITCHIE 25.00 X X 258639 0 11450 TOM GORDON 1.00 X 600 0 0 ABBE LAND 1.00 X 600 0 0 CLARE RICHARDSON 1.00 X 1200 0 0 ANTHONY HARRIS 1.00 X 900 0 0 STEPHEN GROSSMAN 1.00 X 900 0 0 GARY HARKINS 1.00 X 1200 0 0 SAM STODDARD 24.00 X 104875 0 6276 CAROLE WETMORE 10.00 X 104875 0 6967 LAURIE SMITH 40.00 X 135629 0 8347 KERRY CHAPUT 40.00 X 133519 0 6470 JIM DORF 40.00 X 135672 0 10786 ANDREA BRADFIELD 40.00 X 141147 0 14477 HELEN ROWEN 40.00 X 122532 0 8228 1224767 0 80163 16 0 1 0 CNC ASSOCIATES 641 E FARGO AVENUE HANFORD CA 93230 NETWORK ADMINISTRATOR 179103 ALLSCRIPTS 24630 NETWORK PLACE CHICAGO IL 60673 SOFTWARE SUPPORT SERVICES 165231 SHC SERVICES PO BOX 27124 SALT LAKE CITY UT 84127 CONTRACTED RNS & LVNS 126109 COMPHEALTH MEDICAL STAFFING PO BOX 872670 DALLAS TX 75397 CONTRACTED RNS & LVNS 125217 GORELICK & USLANER CPAS 11620 WILSHIRE BLVD SUITE 800 LOS ANGELES CA 90025 ACCOUNTING SERVICES 119722 5 144156 144156 PATIENT REVENUE 621610 12845189 12845189 12845189 4838 4838 1020 -1020 -1020 -1020 MANAGEMENT FEE INCOME 561000 825163 825163 INC FROM SUB THRU K-1 623000 812291 812291 MEDICAL RECORDS 624100 1446 1446 1638900 14632063 14481623 1446 4838 48500 48500 583805 313020 270785 8093826 7539941 553885 235423 129078 106345 1024401 911435 112966 668899 605331 63568 27805 23575 4230 139500 139500 186321 186297 24 641614 630382 11232 412754 409188 3566 19080 18308 772 1206 1146 60 230917 228733 2184 78202 6563 71639 OUTSIDE SERVICES 530178 527293 2885 SUPPLIES 286816 286111 705 OUTSIDE SERVICES - PHYS 272103 272103 REPAIRS & MAINTENANCE 211874 211190 684 OUTSIDE SERVICES - OCCU 139456 139456 498711 495784 2927 14331391 12983434 1347957 0 614222 867060 12000 2584762 1935897 604834 3667364 25564 27730 162877 222368 1981272 1495680 508815 485592 42535 72555 5656302 2927490 10211911 10206056 1470758 1527465 45900 45400 2260757 1926491 3777415 3499356 X 6240265 6493035 137506 156940 56725 56725 6434496 6706700 10211911 10206056 X 300672 -28468 X X 0 1 1 X 0 X 51309 4625 3820 2035 144156 205945 12943595 11706668 11499376 13263272 12845189 62258100 12994904 11711293 11503196 13265307 12989345 62464045 0 0 0 62464045 205352 183598 61041 7176 3818 460985 205352 183598 61041 7176 3818 460985 19115 23381 3578 588 1446 48108 930393 915944 917485 1489598 1637454 5890874 14149764 12834216 12485300 14762669 14632063 68864012 0.90710 0.91470 0.00670 0.00800 X SCHEDULE A, PART II, LINE 12, EXPLANATION OF OTHER INCOME: INCOME FROM SUB THRU K-1 MANAGEMENT FEE INCOME RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 290128 102801 187327 1691144 1392879 298265 485592 DEPOSITS 94215 GOODWILL - NET OF AMORTIZATION 658667 INVESTMENT IN AFFILIATES 2174608 2927490 DEFERRED RETIREMENT BENEFITS 1421847 DUE TO MEDICARE FOR OVERPAYMENT 61123 DEFERRED REVENUE 443521 1926491 14632063 14331391 300672 -28468 -28468 272204 27553085 14562132 14562132 12990953 1641110 1641110 14632063 27280881 12981790 12981790 14299091 32300 32300 14331391 DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: PART X: MANAGEMENT HAS CONSIDERED ITS TAX POSITIONS AND BELIEVES THAT ALL OF THE POSITIONS TAKEN IN ITS FEDERAL AND STATE EXEMPT ORGANIZATION TAX RETURNS ARE MORE LIKELY THAN NOT TO BE SUSTAINED UPON EXAMINATION. PART XI, LINE 8 - OTHER ADJUSTMENTS: ADJUST INCOME FROM INVESTMENT IN LLC PER K-1 328,821. NET LOSS OF SUBSIDIARIES REPORTED ON SEPARATE RETURNS -389,589. AMORTIZATION OF GOODWILL 32,300. PART XII, LINE 2D - OTHER ADJUSTMENTS: INVESTMENT INCOME NOT REPORTED ON THIS RETURN - COASTAL LLC 1,144,768. SUBSIDIARY INCOME REPORTED ON A SEPARATE RETURN - HOSPICE PARTNERS, INC. 12,935,256. SUBSIDIARY INCOME REPORTED ON A SEPARATE RETURN -WILSHIRE COMMUNITY SERVICES 482,108. PART XII, LINE 4B - OTHER ADJUSTMENTS: ORDINARY INCOME FROM SUBSIDIARY THRU K-1 - COASTAL LLC 812,291. INTEREST INCOME FROM SUBSIDIARY THRU K-1 - COASTAL LLC 3,656. MANAGEMENT FEE FROM SUBSIDIARY REPORTED AS INCOME FOR TAX RETURN PURPOSES 825,163. PART XIII, LINE 2D - OTHER ADJUSTMENTS: SUBSIDIARY EXPENSE REPORTED ON A SEPARATE RETURN - HOSPICE PARTNERS, INC. 12,408,709. SUBSIDIARY EXPENSE REPORTED ON A SEPARATE RETURN - WILSHIRE MGMT SERVICES 4,113. SUBSIDIARY EXPENSE REPORTED ON A SEPARATE RETURN-WILSHIRE COMMUNITY SERVICES 568,968. PART XIII, LINE 4B - OTHER ADJUSTMENTS: AMORTIZATION OF GOODWILL 32,300. 1 UCLA FOUNDATION - SCHOOL OF PUBLIC HEALTH PO BOX 951772 LOS ANGELES CA 90095 952250801 501(C)(3) 5000 EDUCATIONAL PROGRAM CEDARS SINAI MEDICAL CARE FOUNDATION 200 N ROBERTSON BLVD 101 LOS ANGELES CA 90211 951644600 501(C)(3) 5000 MEDICAL SERVICES YMCA OF SAN LUIS OBISPO 1020 SOUTHWOOD DRIVE SAN LUIS OBISPO CA 93401 952147727 501(C)(3) 2000 SOCIAL SERVICES CUESTA COLLEGE FOUNDATION PO BOX 8106 SAN LUIS OBISPO CA 93403 237225601 501(C)(3) 10000 EDUCATIONAL PROGRAM FOOD BANK COALITION OF SLO COUNTY PO BOX 2070 PASO ROBLES CA 93447 770338513 501(C)(3) 1000 SOCIAL SERVICES SANTA BARBARA NEIGBORHOOD CLINICS 970 EMBARCADERO DEL MAR ISLA VISTA CA 93117 770496382 501(C)(3) 5000 MEDICAL SERVICES VALLEY CAREGIVERS RESOURCE CENTER 3845 N CLARK STREET FRESNO CA 93726 770370104 501(C)(3) 5000 SOCIAL SERVICES SABAN FREE CLINIC 8405 BEVERLY BOULEVARD LOS ANGELES CA 90048 952539105 501(C)(3) 10000 MEDICAL SERVICES ACCRUED CURRENTLY UNSPENT 5500 ACCRUED, CURRENTLY UNSPENT PROCEDURE FOR MONITORING GRANTS IN THE U.S.: PART I, LINE 2: SCHEDULE I, PART I, LINE 2: GRANTS ARE MADE TO 501(C)(3) ORGANIZATIONS WITHOUT RESTRICTIONS. THERE IS NO FORMAL MONITORING OF THE USE OF FUNDS. X X X X 0 1 0 0 0 0 0 1 0 TRICIA RITCHIE 258639 0 0 0 0 0 6200 0 5250 0 270089 0 0 0 ANDREA BRADFIELD 141147 0 0 0 0 0 5793 0 8684 0 155624 0 0 0 PART I, LINE 4B EMPLOYEES PARTICIPATING IN THE NONQUALIFIED 457(B) PLAN, AND THE CONTRIBUTIONS ACCRUED FOR THE YEAR ENDING JUNE 30, 2011: TRICIA RITCHIE - $6,200 ANDREA BRADFIELD - $5,793 JIM DORF - $5,140 PART I, LINE 7 THE CEO/PRESIDENT'S COMPENSATION IS SET BY THE BOARD OF DIRECTORS. 10% OF COMPENSATION IS BASED UPON A PRE-DETERMINED SET OF GOALS AND OBJECTIVES. FOLLOWING THE END OF THE FISCAL YEAR, THE BOARD OF DIRECTORS REVIEWS THESE GOALS AND OBJECTIVES TO SEE IF THEY HAVE BEEN MET AND TO DETERMINE INCENTIVE COMPENSATION, IF ANY. FORM 990, PART VI, SECTION B, LINE 11 A COPY OF THE RETURNS IS PROVIDED TO ALL BOARD MEMBERS. THE BOARD MEMBERS REVIEW THE RETURNS AND ARE ENCOURAGED TO ASK THE PREPARER ANY QUESTIONS THEY MIGHT HAVE. ABSENT ANY OBJECTIONS, THE RETURNS ARE FILED. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY THROUGH THEIR CONFLICT OF INTEREST QUESTIONNAIRES PROVIDED TO ALL BOARD MEMBERS. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD HAS A SEPARATE COMPENSATION COMMITTEE MADE UP OF ALL EXTERNAL AND NON-INTERESTED PARTIES. THIS COMMITTEE OBTAINS INDUSTRY AVERAGE COMPENSATION DATA FOR THE OFFICERS' POSITIONS FROM AN INDEPENDENT CONSULTANT. THIS DATA IS THEN USED IN THE DECISION MAKING PROCESS OF THE COMPENSATION COMMITTEE TO SET OFFICERS' SALARIES. OTHER FACTORS ARE ALSO CONSIDERED INCLUDING RESULTS OF OPERATIONS AND ACHIEVEMENT OF OTHER ORGANIZATION GOALS. FORM 990, PART VI, SECTION C, LINE 19 UPON REQUEST. CHANGES IN NET ASSETS OR FUND BALANCES: FORM 990, PART XI, LINE 5: ADJUST INCOME FROM INVESTMENT IN LLC PER K-1 328,821. NET LOSS OF SUBSIDIARIES REPORTED ON SEPARATE RETURNS -389,589. AMORTIZATION OF GOODWILL 32,300. TOTAL TO FORM 990, PART XI, LINE 5: -28,468. FORM 990, PART XI, LINE 2C: THE PROCESS OF THE OVERSIGHT OF THE AUDIT AND THE SELECTION OF THE INDEPENDENT ACCOUNTANTS HAS NOT CHANGED. FORM 990, PART VII - ESTIMATED HOURS OF OFFICERS TO RELATED ENTITIES: TRICIA RITCHIE - AS PRESIDENT OF HOSPICE PARTNERS, INC. - ESTIMATED 13 HOURS PER WEEK TRICIA RITCHIE - AS PRESIDENT OF WILSHIRE COMMUNITY SERVICES, INC. - ESTIMATED 2 HOURS PER WEEK SAM STODDARD - AS CO-CFO OF HOSPICE PARTNERS, INC. - ESTIMATED 8 HOURS PER WEEK SAM STODDARD - AS CO-CFO OF WILSHIRE COMMUNITY SERVICES, INC. - ESTIMATED 8 HOURS PER WEEK CAROLE WETMORE - AS CO-CFO OF HOSPICE PARTNERS, INC. - ESTIMATED 30 HOURS PER WEEK CAROLE WETMORE - AS CO-CFO OF WILSHIRE COMMUNITY SERVICES, INC. - ESTIMATED 0 HOURS PER WEEK TED GREENBERG - AS SECRETARY OF HOSPICE PARTNERS, INC, - ESTIMATED 2 HOURS PER WEEK IRA ALPERT - AS DIRECTOR OF HOSPICE PARTNERS, INC. - ESTIMATED 4 HOURS PER WEEK HOSPICE PARTNERS INC 285 SOUTH STREET SUITE J SAN LUIS OBISPO CA 93401 770475425 OPERATES HOSPICE AGENCIES, A HOSPICE INPATIENT UNIT & A THRIFT STORE CA 501(C)(3) 9 N/A 0 WILSHIRE COMMUNITY SERVICES 285 SOUTH STREET SUITE J SAN LUIS OBISPO CA 93401 205885093 SENIOR SERVICE PROGRAMS, MEDIATION, FACILITATION & TRAINING SERVICES CA 501(C)(3) 9 N/A 0 COASTAL LLC 200 S 13TH ST 205 GROVER BEACH CA 93433 770411900 OPERATES SKILLED NURSING FACILITIES CA N/A RELATED 1144768 4551009 0 1 0.50000 WILSHIRE MANAGEMENT SERVICES INC 285 SOUTH ST SUITE J SAN LUIS OBISPO CA 93401 954570093 BACK OFFICE SUPPORT FOR HEALTCHARE ORGANIZATIONS CA N/A C -4113 387 1.00000 0 0 0 1 0 0 0 1 0 0 0 0 1 1 0 1 0 1 HOSPICE PARTNERS INC P 254383 HOSPICE PARTNERS INC R 2143 WILSHIRE MANAGEMENT SERVICES INC P 4513 WILSHIRE COMMUNITY SERVICES P 358453 WILSHIRE COMMUNITY SERVICES R 262675 COASTAL LLC D 2869601 WILSHIRE COMMUNITY SERVICES M 60058 HOSPICE PARTNERS INC N 161814 WILSHIRE COMMUNITY SERVICES N 284004