2011-11-09T17:01:16-07:00 2011-06-30 DIAZ AND CANDELARIA PSC SUITE 112 PMB 294 100 GRAN BULEVAR PASEOS SAN JUAN PR 00926 990 2010-07-01 660329532 SALUD INTEGRAL EN LA MONTANA INC SALU 7878695900 PO BOX 515 NARANJITO PUERTO RICO RQ 00719 SANDRA GARCIA 7878695900 2011-11-08 1 CRISTINO ARIEL DIAZ-LOPEZ 7873994556 2011-11-07 2010 2016-02-24 21:20:13Z Salud Integral en la Montana Inc PO BOX 515 NARANJITO PR 00719 33146815 0 X WWW.SIMPR.COM X 1974 PR To provide excellent ambulatory and home health-care services in a safe environment, to procure the physical, mental, and social wellbeing of the residents of our community. SIM provides preventive, primary and home health services that include medical services, clinical laboratory, radiology, emergency room, immunization, pharmacy, dental services, social work among others. 11 0 453 0 6623370 7418601 24608887 25140688 54583 51959 553476 535567 31840316 33146815 0 0 0 0 10848002 10791165 0 0 0 20393397 21938593 31241399 32729758 598917 417057 25414900 26644108 15802278 16614429 9612622 10029679 To provide excellent ambulatory and home healthcare services in a safe environment, to procure the physical, mental and social wellbeing of the residents of our communities. 0 0 23353849 30656272 Community Health Center - a comprehensive primary health care program which provides services to low income families, agricultural migrants and seasonal farm workers as well as to their dependents in six municipalities located at the central and northern areas of Puerto Rico - Naranjito, Comerio, Corozal, Orocovis, Barranquitas y Toa Alta. 577153 931064 Hospice - The primary activities of the Hospice Program are to provide support services to patients with terminal diseases. 803186 1559479 Home Care - The objective of the Home Care Program is to provide nursing, therapeutic and other complementary services to elderly patients at their homes. 0 0 0 24734188 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 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 0 1 0 0 0 453 1 0 0 0 0 0 0 X 11 0 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 X Lillian Cruz Alvarez 7878695900 Carr 152 KM 12 2 Bo Cedro Arriba Naranjito PR 00719 Gerardo M Hernandez 1 X 0 0 0 Marcos A Melendez 1 X 0 0 0 Ignacio Febus 2 X 0 0 0 Maria A Rios 1 X 0 0 0 Maribel Concepcion 1 X 0 0 0 Antonio Moreno 1 X 0 0 0 Ignacio Padilla 1 X 0 0 0 Omayra Acevedo 1 X 0 0 0 Nereida Rodriguez 1 X 0 0 0 Sylma Maldonado 1 X 0 0 0 Arlin E Ramirez Vega 1 X 0 0 0 Sandra V Garcia Rodriguez 40 X X 127399 0 6000 Marien Vazquez 40 X 33328 0 0 Lillian Cruz 40 X 62058 0 1800 Jose S Rosado 40 X 34832 0 0 Ada T Torres 40 X 45509 0 0 Evin Vega Olivo 40 X 107304 0 0 Fernando Rivera Torres 40 X 111868 0 0 522298 0 7800 3 0 0 0 Quest Diagnostics 1st Floor Federal Building Road 2 KM 11 Bayamon PR 00956 Laboratory 316847 Jose Vilme PMB 138 Toa Alta PR 00953 Sonograms 170999 Bersa Group 497 Emilia San Juan PR 00926 Professional Services 230000 3 7418601 7418601 Premium Revenues (Capitation) 621400 14929380 14929380 0 NET PATIENT SERVICES 621400 10211308 10211308 0 0 0 0 25140688 51959 51959 0 403560 0 0 0 403560 0 403560 403560 0 0 0 0 Cafeteria & Vending 722210 132007 132007 0 0 0 0 0 132007 33146815 25728214 0 0 303126 33328 269798 0 7888028 5502206 2385822 43943 42496 1447 1497404 849077 648327 1058664 715439 343225 1021914 172273 849641 477568 170614 306954 51933 2709 49224 310696 310696 443676 17068 426608 130617 130617 HEAlTH SERVICE CLAIM 13578996 13578996 0 DRUGS AND MEDICINE 2559809 2559809 0 0 BAD DEBTS EXPENSES 490877 0 490877 SUPPLIES 1022157 694532 327625 OTHER EXPENSES 1850350 395641 1454709 0 32729758 24734188 7995570 0 6937115 8611157 602146 612253 1554397 603848 5705227 5053032 329667 320006 103735 128118 15190874 4046050 9981526 11144824 201087 170870 25414900 26644108 2087447 1936514 5778932 5446261 0 7935899 9231654 15802278 16614429 X 9372081 8240383 240541 1789296 0 0 9612622 10029679 25414900 26644108 417057 0 X 1 1 1 1 1 X 26784717 27091947 29577739 31232257 32559289 147245949 0 0 0 0 0 0 0 0 0 0 0 0 26784717 27091947 29577739 31232257 32559289 147245949 0 147245949 155829 95721 58840 54583 51959 416932 0 0 0 0 0 625392 768287 613959 553476 535567 3096681 150759562 0 0.97669 0.97041 X Other income corresponded to: Rental of Health Facilities $403,560 and Cafeteria and Vending Machines $132,007. 0 1959760 1959760 0 9302783 2156214 7146569 0 1579531 407371 1172160 0 2242976 1392647 850329 0 105824 89818 16006 11144824 0 INCURRED BUT NOT RECORDED (IBNR) 2443492 ACCTS. PAYABLE HUMANA - CONTRACT BALANCE 6788162 9231654 33146815 32729758 417057 0 0 0 0 0 0 417057 33146815 0 0 0 0 0 33146815 0 0 0 33146815 32729758 0 0 0 0 0 32729758 0 0 0 32729758 F990_P06_S0B_L11a Form 990, Part VI, Section B, Line 11a All questions related to governance, management & disclosure were asked to the Board members by the CPA Firm partner in charge. Form 990 was presented to the members of the Board of Directors on a regular meetting on October 26, 2011. The content of the form was reviewed and approved for filling by the Board. F990_P06_S0B_L12c Form 990, Part VI, Section B, Line 12c The Board of Directors are required to complete on an annual basis a certification of not conflict of interest. F990_P06_S0B_L15 Form 990, Part VI, Section B, Line 15 The salary of the Executive Director is determined and approved by the Board of Directors. It is determined based on performance and comparability data from other nonprofit organizations in Puerto Rico. The salaries of other key officers such as Medical Director, Finance Director, Director of Human Resources and Directors of Operations are determined and approved by the Executive Director on performance, comparability data provided by trade associations, benchmarking data, and the experience of the local labor market for positions with health professional shortages. F990_P06_S0C_L19 Form 990, Part VI, Section C, Line 19 The Accounting and Finance Policy and Procedures Manual of Salud Integral en la Montana, Inc. establishes that: ..." the Corporation will make the following forms available to the general public: a. Three most recent annual Return of Organization Exempt From Income Tax (990) b. The original tax exempt application (Form 1023 or 1024) filed with the IRS. It is the policy of the Corporation to follow the following rules to fulfill the requirements of the public statements mentioned above. a. A copy of the forms will be provided to any person that requests in person to inspect those forms during regular business hours The Finance Director is responsible for keeping a copy and for making it available to the public. b. For requests received bay mail, the Corporation will request payment in advance for the costs of copies and shipping charges. If the request does not include payment, the Corporation will notify the person by phone or by mail of its prepayments policy within the seven days after receiving the original request. c. The cost per copy will be $1.00 for the first copy and $.15 for each additional page. All copies will be sent to the person that requests them by priority mail within 30 days of receiving the request.