2023-01-10T14:43:02-07:00 2021-12-31 990 2021-01-01 770425496 AVENAL COMMUNITY HEALTH CENTER AVEN 5599258800 PO Box 580 Lemoore CA 93245 Andrew Miller Controller 5592422108 2023-01-03 1 11 0 AAL2 2021 2023-03-07 01:45:13Z John Blaine 360 Hanover Ave Lemoore CA 93245 50279008 0 X https://ariachc.org/ X 1996 CA Our mission is to improve the health of the communities we serve, by addressing the individual needs of each patient with respect, courtesy and quality service. As a community health center, our significant activities include primary medical care, general dental care, primary behavioral and substance abuse counseling, nutrition, health education and other specialty and enabling services. 9 9 559 0 43189 43189 7733656 6604232 28851516 43560400 7326 1824 30389 45884 36622887 50212340 0 0 0 0 21473264 22046447 0 0 0 8853359 13861165 30326623 35907612 6296264 14304728 28742135 42667528 11239771 10860436 17502364 31807092 To improve the health and wellness of our patients and communities by addressing the individual's needs with respect, courtesy and quality service. 0 0 35907612 0 43564919 Providing preventive and primary health care services to a medically under-served area. Rendering encounters with patients in the areas of medicine, dentistry, behavioral health, enabling and a variety of specialties. More than 80% of the patients that are served are on public assistance or uninsured. Services are provided regardless of ability to pay. 0 0 0 35907612 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 0 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 1 1 1 0 1 X 56 56 1 559 1 1 0 0 0 0 0 0 0 0 X 9 9 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 CA X Andrew Miller 5592422108 555 E Street Lemoore CA 93245 John Blaine CEO 60 0 X 466026 0 0 Jonathan F Mathews Dentist 40 0 X 394933 0 0 Hemanta Mungur CFO 40 0 X 363496 0 0 Daphine Kaniaru Medical Director 40 0 X 291251 0 0 Ayesha Walden Certified Nurse Midwife 40 0 X 274543 0 0 Jonathan W Ruminson Dentist 40 0 X 262834 0 0 Mario Celaya Physician Assistant 40 0 X 218752 0 0 Andrew J Miller Controller 40 0 X 205394 0 0 Patel Girishchandra Physician 40 0 X 193406 0 0 Namrata Arora Dentist 40 0 X 193044 0 0 Derrick J Gruen Chief Operations Officer 40 0 X 190817 0 0 Roblen G Nieblas Dental Director 40 0 X 189548 0 0 Monica Gonzalez Nurse Practitioner 40 0 X 165604 0 0 Amy Y Grigore Physician Assistant 40 0 X 165396 0 0 Paul Broussard Director of Pharmacy 40 0 X 162659 0 0 Charles W Smith Nurse Practitioner 40 0 X 161847 0 0 Ashley L Netrow Nurse Practitioner 40 0 X 153821 0 0 Nicasio Sarabia Dentist 40 0 X 153268 0 0 Jenelle Mason Chief Compliance Officer 40 0 X 131167 0 0 Lissette Padilla Secretary 2 0 X 0 0 0 Domenica Sanchez Director 2 0 X 0 0 0 Delia Vigil Director 2 0 X 0 0 0 Elizabeth Campos-Jaramillo Chair 2 0 X 0 0 0 Carolina Jurado Director 2 0 X 0 0 0 Randy Beddoe Director 2 0 X 0 0 0 Sean Simplicio Director 1 0 X 0 0 0 Bezabih Buz Felleke Director 2 0 X 0 0 0 Briana Mora Director 2 0 X 0 0 0 Steven Bickner Director 2 0 X 0 0 0 Sofia Jiminez Director 2 0 X 0 0 0 4337806 0 0 37 1 1 0 SurgiTek Outpatient Center Inc 833 Greenfield Ave Ste 105 Hanford CA 93230 Dentistry 310800 CompHealth PO Box 972651 Dallas TX 753972651 Medical 513006 Carlos Santivanez MD Inc 855 Garner Avenue Hanford CA 93230 Medical 331650 Ramon Resa MD 569 W Putnam Ave Porterville CA 93257 MD 323825 Jatinder Chopra MD 858 N Cherry St Suite E Tulare CA CA 932742243 Medical Physician 340292 10 0 0 0 0 6550242 53990 0 6604232 Healthcare Services FQHC 621400 43560400 43560400 0 0 0 0 0 0 43560400 1824 1824 0 0 0 0 0 0 0 0 0 0 109857 0 66668 0 43189 0 43189 0 43189 0 0 0 0 2695 2695 0 0 2695 50212340 43564919 43189 0 X 0 0 0 0 0 0 0 0 1120773 1120773 0 0 0 0 0 0 17711895 17711895 0 0 364389 364389 0 0 1273483 1273483 0 0 1575907 1575907 0 0 140363 140363 0 0 58454 58454 0 0 70337 70337 0 0 0 0 0 0 0 0 0 0 0 0 3859936 3859936 0 0 0 0 0 0 1114596 1114596 0 0 639699 639699 0 0 0 0 0 0 1327664 1327664 0 0 134929 134929 0 0 0 0 0 0 48880 48880 0 0 0 0 0 0 0 0 0 0 653264 653264 0 0 221804 221804 0 0 Minor Equipment 266979 266979 0 0 Supplies 4538087 4538087 0 0 Repairs & Maintenance 499051 499051 0 0 287122 287122 0 0 35907612 35907612 0 0 7105 6805 8804446 20256075 0 572081 5847797 7047343 0 0 0 0 607923 2717064 312000 404213 592108 131262 14903286 3540391 12007772 11362895 0 0 0 0 0 0 0 0 562984 169790 28742135 42667528 3383082 2620833 0 0 84384 997609 0 0 0 0 0 0 3991494 3616393 3300000 3299358 480811 326243 11239771 10860436 X 17502364 31807092 0 0 17502364 31807092 28742135 42667528 14304728 0 0 0 0 0 X 0 1 X 1 1 1 X 3838822 3852159 3817584 3920441 6604232 22033238 13685384 18662947 25895186 28851516 43560400 130655433 162402 75646 4576 114457 109857 466938 0 0 0 0 0 0 0 0 0 0 0 0 17686608 22590752 29717346 32886414 50274489 153155609 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 153155609 154 5063 8475 2586 1824 18102 41066 63046 0 30389 43189 177690 41220 68109 8475 32975 45013 195792 0 0 0 0 0 0 480 575 955 640 195 2845 17728308 22659436 29726776 32920029 50319697 153354246 0.99870 0.99865 0.00128 0.00132 X Schedule A, Part III, Line 12 Fees Charged to provide copies of medical records to patients' attorneys. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 2062871 2062871 0 9038770 1109611 7929159 0 366480 290102 76378 0 3435165 2140678 1294487 0 0 0 0 11362895 0 357B Liability 317906 Tenant Deposits 8337 326243 X X X 0 0 0 0 0 0 0 0 0 John Blaine CEO 284000 0 156026 0 0 0 26000 0 0 0 466026 0 0 0 Jonathan F Mathews Dentist 175628 0 199805 0 0 0 19500 0 0 0 394933 0 0 0 Hemanta Mungur CFO 358246 0 0 0 0 0 5250 0 180 0 363676 0 0 0 Jonathan W Ruminson Dentist 168987 0 86347 0 0 0 7500 0 0 0 262834 0 0 0 Ayesha Walden Certified Nurse Midwife 171310 0 62353 0 0 0 19500 0 720 0 253883 0 0 0 Daphine Kaniaru Medical Director 249994 0 32527 0 0 0 8730 0 699 0 291950 0 0 0 Mario Celaya Physician Assistant 132073 0 86679 0 0 0 0 0 0 0 218752 0 0 0 Andrew J Miller Controller 185637 0 257 0 0 0 19500 0 0 0 205394 0 0 0 Patel Girishchandra Physician 193149 0 257 0 0 0 0 0 0 0 193406 0 0 0 Namrata Arora Dentist 134433 0 55509 0 0 0 3102 0 0 0 193044 0 0 0 Derrick J Gruen Chief Operations Officer 146476 0 40367 0 0 0 3974 0 0 0 190817 0 0 0 Roblen G Nieblas Dental Director 121189 0 52769 0 0 0 15590 0 0 0 189548 0 0 0 Monica Gonzalez Nurse Practitioner 125950 0 39154 0 0 0 0 0 500 0 165604 0 0 0 Amy Y Grigore Physician Assistant 140840 0 4306 0 0 0 19500 0 750 0 165396 0 0 0 Paul Broussard Director of Pharmacy 153332 0 274 0 0 0 9053 0 0 0 162659 0 0 0 Charles W Smith Nurse Practitioner 87714 0 47488 0 0 0 26000 0 645 0 161847 0 0 0 Ashley L Netrow Nurse Practitioner 104213 0 37714 0 0 0 11144 0 750 0 153821 0 0 0 Nicasio Sarabia Dentist 134742 0 18526 0 0 0 0 0 0 0 153268 0 0 0 Schedule J, Part II 403B and 457B Deferred Compensation Form 990, Part V, Line 3b Form 990, Part V, Line 3b - we are in the process of preparing a Form 990-T. Form 990, Part VI, Section B, Line 11b The draft copy of the Form 990 is reviewed by the CFO/CEO before the final copy is submitted to the Board of directors prior to filling if time permits otherwise after the filing is completed. Form 990, Part VI, Section B, Line 12c The conflict-of-interest policy is reviewed annually, and a signed statement is submitted by each director and officer. Form 990, Part VI, Section B, Line 15 All Compensation is determined by market review, including national, state and private sources and documents. The CEO's compensation was established by the independent Board of Directors upon review, including Form 990 from other similar organizations and compensation surveys. (CPCA / NACHC) Form 990, Part VI, Section C, Line 19 As required by law, the organization makes the following documents available for inspection at its primary location by appointment with an officer or director: Most recent for 990, application for exemption, articles of incorporation to bylaws and conflict of interest policy. Form 990, Part IX, Line 11g Contractor Services - Practitioner fees, 340B TPA, Billing and Collection Services, Lab Services and Quality Testing. Synergy 365 555 E Street Lemoore CA 93245 833287663 Holding title to property, collecting rental income and turning it over to ACHC CA 501(c)(2) Avenal Community Health Center 1 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 Synergy 365 k 329278 Rent specified in lease agreement. The rent per lease was based on an estimate of the market rate per square foot leased. Synergy 365 b 2109141 Book Value of property contributed (Original cost price plus improvements less depreciation) The Covid pandemic overwhelmed our staff and put a great strain on our organization. We fell behind in our record keeping but have made every effort to catch up with our delinquent fillings.