AMPLA HEALTH: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- AMPLA HEALTH (EIN 94-2210447)
- Tax period
- 2021-07-01 to 2022-06-30
- Filed
- 2023-05-12
- IRS object ID
- 202331329349301313
- Schema version
- 2021v4.2
- 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) |
|---|---|---|
| Return | 2023-05-12T07:37:31-05:00 | ReturnTs |
| Tax Period End | 2022-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 390758449 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WIPFLI LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 12237 | AddressLine1Txt |
| City | GREEN BAY | CityNm |
| State Abbreviation | WI | StateAbbreviationCd |
| ZIP | 543072237 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 942210447 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AMPLA HEALTH | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | AMPL | BusinessNameControlTxt |
| Phone | 5306744261 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 935 MARKET STREET | AddressLine1Txt |
| City | YUBA CITY | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95991 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | BENJAMIN H FLORES MPH | PersonNm |
| Person Title | PRESIDENT & CEO | PersonTitleTxt |
| Phone | 5306744261 | PhoneNum |
| Signature | 2023-05-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | BENJAMIN | PersonFirstNm |
| Person Last | FLORES MPH | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | TERRI REXRODE CPA MST | PreparerPersonNm |
| PTIN | P00096513 | PTIN |
| Phone | 9206620016 | PhoneNum |
| Preparation | 2023-05-11 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 0 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | BENJAMIN H FLORES MPH | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 935 MARKET STREET | AddressLine1Txt |
| City | YUBA CITY | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95991 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $93,373,369 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | HTTPS://WWW.AMPLAHEALTH.ORG/ | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1973 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | AMPLA HEALTH STRIVES TO PROVIDE HIGH QUALITY MEDICAL, DENTAL, SOCIAL AND EDUCATIONAL HEALTH SERVICES THAT MEET THE UNIQUE NEEDS OF ALL PATIENTS ESPECIALLY THOSE WHO ARE MEDICALLY UNDER SERVED INCLUDING FARM WORKERS AND OTHERS WITHOUT FINANCIAL RESOURCES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 14 | VotingMembersIndependentCnt |
| Total Employee | 783 | TotalEmployeeCnt |
| Total Volunteers | 14 | TotalVolunteersCnt |
| Total Gross UBI | $37,543 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $20,669 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $17,549,015 | PYContributionsGrantsAmt |
| CY Contributions Grants | $20,400,235 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $62,856,430 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $68,513,297 | CYProgramServiceRevenueAmt |
| PY Investment Income | $72,475 | PYInvestmentIncomeAmt |
| CY Investment Income | $31,339 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $4,376,319 | CYOtherRevenueAmt |
| PY Total Revenue | $80,477,920 | PYTotalRevenueAmt |
| CY Total Revenue | $93,321,190 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $56,257,040 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $61,853,191 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $23,179,821 | PYOtherExpensesAmt |
| CY Other Expenses | $24,219,602 | CYOtherExpensesAmt |
| PY Total Expenses | $79,436,861 | PYTotalExpensesAmt |
| CY Total Expenses | $86,072,793 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $1,041,059 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $7,248,397 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $44,466,635 | TotalAssetsBOYAmt |
| Total Assets EOY | $58,961,636 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $19,261,726 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $26,508,190 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $25,204,909 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $32,453,446 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | AMPLA HEALTH STRIVES TO PROVIDE HIGH QUALITY MEDICAL, DENTAL, SOCIAL AND EDUCATIONAL HEALTH SERVICES THAT MEET THE UNIQUE NEEDS OF ALL PATIENTS ESPECIALLY THOSE WHO ARE MEDICALLY UNDER SERVED INCLUDING FARM WORKERS AND OTHERS WITHOUT FINANCIAL RESOURCES. | MissionDesc |
| Significant New Program Srvc | Yes (1) | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $64,020,160 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $68,513,297 | RevenueAmt |
| Desc | AMPLA HEALTH PROVIDES MEDICAL SERVICES AND BASIC DENTAL SERVICES TO LOW-INCOME AND MIGRANT PATIENTS. IT ALSO PROVIDES HEALTH AND PRENATAL INFORMATION TO LOW-INCOME AND MIGRANT INDIVIDUALS, AS WELL AS, SUPPLEMENTAL FOOD TO ELIGIBLE LOW-INCOME WOMEN. FISCAL YEAR ENDED JUNE 30, 2022 HAD 355,237 PATIENT ENCOUNTERS.AMPLA HEALTH PROVIDES PHARMACY SERVICES THAT SPECIALIZE IN PROVIDING AFFORDABLE PRESCRIPTIONS TO OUR PATIENTS. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant | $0 | GrantAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $64,020,160 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 52 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 783 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (1) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (1) | Form990TFiledInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 14 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | CA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | VERONICA RICHTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5306744261 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 935 MARKET STREET | AddressLine1Txt |
| City | YUBA CITY | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95991 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (25 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Key EmployeeKeyEmployeeInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd |
|---|---|---|---|---|---|---|---|---|
| MUSTAFA AMMAR | ||||||||
| MEDICAL DIRECTOR | 40.00 | Yes (X) | $659,465 | $0 | $38,165 | |||
| BENJAMIN FLORES | ||||||||
| CEO | 40.00 | $447,844 | $0 | $36,883 | Yes (X) | |||
| KANESHKA ALAMSHAHI | ||||||||
| MEDICAL DIRECTOR | 40.00 | $405,072 | $0 | $24,568 | Yes (X) | |||
| NANAK BOPARAI | ||||||||
| MEDICAL DIRECTOR | 40.00 | $364,077 | $0 | $35,450 | Yes (X) | |||
| KANWAR MULTANI | ||||||||
| MEDICAL DIRECTOR | 40.00 | $277,338 | $0 | $28,834 | Yes (X) | |||
| AMITABH SINGH | ||||||||
| MEDICAL DIRECTOR | 40.00 | $281,512 | $0 | $19,607 | Yes (X) | |||
| DANIEL SIRI | ||||||||
| DENTAL DIRECTOR | 40.00 | Yes (X) | $278,981 | $0 | $2,879 | |||
| KATHY WALKER | ||||||||
| CFO | 40.00 | $211,202 | $0 | $34,706 | Yes (X) | Yes (X) | ||
| CARLOS PERALTA CORRALES | ||||||||
| COO | 40.00 | $209,299 | $0 | $34,197 | Yes (X) | Yes (X) | ||
| CINDY SNELGROVE | ||||||||
| NURSING DIRECTOR | 40.00 | Yes (X) | $205,265 | $0 | $13,996 | |||
| JOHN FLEMING | ||||||||
| PLANNING & DEVELOPMENT DIRECTOR | 40.00 | $149,585 | $0 | $29,912 | Yes (X) | |||
| HORACIO PARAS | ||||||||
| BOARD CHAIR | 0.69 | $0 | $0 | $0 | Yes (X) | Yes (X) | ||
| KIM OWENS | ||||||||
| VICE CHAIR | 0.69 | $0 | $0 | $0 | Yes (X) | Yes (X) | ||
| DEBBIE PORCAYO | ||||||||
| SECRETARY | 0.69 | $0 | $0 | $0 | Yes (X) | Yes (X) | ||
| WENCESLAO VASQUEZ | ||||||||
| TREASURER | 0.69 | $0 | $0 | $0 | Yes (X) | Yes (X) | ||
| MARK LUNDBERG | ||||||||
| PARLIAMENTARIAN | 0.69 | $0 | $0 | $0 | Yes (X) | Yes (X) | ||
| VAISHALI AUSTIN | ||||||||
| BOARD MEMBER | 0.69 | $0 | $0 | $0 | Yes (X) | |||
| DIVINDER K BAINS | ||||||||
| BOARD MEMBER | 0.69 | $0 | $0 | $0 | Yes (X) | |||
| J ANGEL CALDERON | ||||||||
| BOARD MEMBER | 0.69 | $0 | $0 | $0 | Yes (X) | |||
| ERNEST L GARCIA DDS | ||||||||
| BOARD MEMBER | 0.69 | $0 | $0 | $0 | Yes (X) | |||
| ROBERTO GONZALEZ | ||||||||
| BOARD MEMBER | 0.69 | $0 | $0 | $0 | Yes (X) | |||
| CARLOS O PALACIOS | ||||||||
| BOARD MEMBER | 0.69 | $0 | $0 | $0 | Yes (X) | |||
| JOYCE POPE | ||||||||
| BOARD MEMBER | 0.69 | $0 | $0 | $0 | Yes (X) | |||
| LORENZO VALDOVINOS | ||||||||
| BOARD MEMBER | 0.69 | $0 | $0 | $0 | Yes (X) | |||
| TENG VANG | ||||||||
| BOARD MEMBER | 0.69 | $0 | $0 | $0 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $3,489,640 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $299,197 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 100 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| ECLINICAL | |||||
| PO BOX 847950 | BOSTON | MA | 02284 | CONTRACTUAL DATA SERVICES | $960,150 |
| COMCAST | |||||
| PO BOX 37601 | PHILADELPHIA | PA | 19101 | CONTRACTUAL DATA SERVICES | $452,953 |
| LANGUAGE LINE SERVICES | |||||
| PO BOX 202564 | DALLAS | TX | 75320 | CONTRACTUAL HEALTH SERVICE CONSUL | $363,023 |
| ELITE UNIVERSAL SECURITY | |||||
| 5548 FEATHER RIVER BLVD | OLIVEHURST | CA | 95961 | CONTRACTUAL STAFFING /TEM SRV | $357,717 |
| MALWA DOCTOR'S INC | |||||
| 1420 E ROSEVILLE PKWY 140-217 | ROSEVILLE | CA | 95661 | CONTRACTUAL PHYSICIAN | $244,400 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 16 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $20,388,635 | GovernmentGrantsAmt |
| All Other Contributions | $11,600 | AllOtherContributionsAmt |
| Total Contributions | $20,400,235 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENUE | 621110 | $44,751,590 | $44,751,590 |
| PHARMACY REVENUE | 621110 | $18,056,812 | $18,056,812 |
| CAPITATION REVENUE | 900099 | $5,704,895 | $5,704,895 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $68,513,297 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $31,339 | TotalRevenueColumnAmt |
| Exclusion | $31,339 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $89,722 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $52,179 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $37,543 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $37,543 | TotalRevenueColumnAmt |
| Unrelated Business Revenue | $37,543 | UnrelatedBusinessRevenueAmt |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,338,776 | TotalRevenueColumnAmt |
| Exclusion | $4,338,776 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $4,338,776 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $93,321,190 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $68,513,297 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $37,543 | UnrelatedBusinessRevenueAmt |
| Exclusion | $4,370,115 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,074,840 | TotalAmt |
| Management And General | $1,074,840 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $50,254,829 | TotalAmt |
| Program Services | $39,342,523 | ProgramServicesAmt |
| Management And General | $10,912,306 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,525,635 | TotalAmt |
| Program Services | $1,188,918 | ProgramServicesAmt |
| Management And General | $336,717 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,627,782 | TotalAmt |
| Program Services | $4,347,691 | ProgramServicesAmt |
| Management And General | $1,280,091 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,370,105 | TotalAmt |
| Program Services | $2,586,173 | ProgramServicesAmt |
| Management And General | $783,932 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $149,254 | TotalAmt |
| Management And General | $149,254 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $74,075 | TotalAmt |
| Management And General | $74,075 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,803,721 | TotalAmt |
| Program Services | $10,268,928 | ProgramServicesAmt |
| Management And General | $3,534,793 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $651,606 | TotalAmt |
| Program Services | $121,496 | ProgramServicesAmt |
| Management And General | $530,110 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $344,124 | TotalAmt |
| Program Services | $64,164 | ProgramServicesAmt |
| Management And General | $279,960 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,755,369 | TotalAmt |
| Program Services | $1,478,387 | ProgramServicesAmt |
| Management And General | $276,982 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $245,132 | TotalAmt |
| Program Services | $60,413 | ProgramServicesAmt |
| Management And General | $184,719 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $174,923 | TotalAmt |
| Program Services | $32,615 | ProgramServicesAmt |
| Management And General | $142,308 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $495,242 | TotalAmt |
| Program Services | $33,606 | ProgramServicesAmt |
| Management And General | $461,636 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,800,603 | TotalAmt |
| Program Services | $1,022,956 | ProgramServicesAmt |
| Management And General | $777,647 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $378,232 | TotalAmt |
| Program Services | $38,838 | ProgramServicesAmt |
| Management And General | $339,394 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (2 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $3,648,454 | $3,046,714 | $601,740 |
| REPAIRS AND MAINTENANCE | $462,991 | $342,757 | $120,234 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $235,876 | TotalAmt |
| Program Services | $43,981 | ProgramServicesAmt |
| Management And General | $191,895 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $86,072,793 | TotalAmt |
| Program Services | $64,020,160 | ProgramServicesAmt |
| Management And General | $22,052,633 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,642,982 | BOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $463,828 | BOYAmt |
| EOY | $13,844,331 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,833,584 | BOYAmt |
| EOY | $1,892,259 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,545,120 | BOYAmt |
| EOY | $10,709,438 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $132,904 | BOYAmt |
| EOY | $366,115 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $903,009 | BOYAmt |
| EOY | $1,131,784 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $55,952,006 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $25,140,082 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,945,208 | BOYAmt |
| EOY | $30,811,924 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $205,785 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $44,466,635 | BOYAmt |
| EOY | $58,961,636 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,378,419 | BOYAmt |
| EOY | $9,908,270 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $244,772 | BOYAmt |
| EOY | $14,236 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,638,535 | BOYAmt |
| EOY | $14,590,106 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $1,995,578 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $19,261,726 | BOYAmt |
| EOY | $26,508,190 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,204,909 | BOYAmt |
| EOY | $32,453,446 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,204,909 | BOYAmt |
| EOY | $32,453,446 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $44,466,635 | BOYAmt |
| EOY | $58,961,636 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $7,248,397 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $140 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $503,018 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $9,835,212 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $11,223,871 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $17,549,015 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $20,400,235 | CurrentTaxYearAmt |
| Total | $59,511,351 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $503,018 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $9,835,212 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $11,223,871 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $17,549,015 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $20,400,235 | CurrentTaxYearAmt |
| Total | $59,511,351 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $59,511,351 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $39,928 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $43,515 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $127,293 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $72,475 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $31,339 | CurrentTaxYearAmt |
| Total | $314,550 | TotalAmt |
Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | $37,543 | CurrentTaxYearAmt |
| Total | $37,543 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $59,863,444 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $311,265,942 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.99410 | PublicSupportCY170Pct |
| Public Support PY170 | 0.86190 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| 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) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,749,794 | OtherCostOrOtherBasisAmt |
| Book Value | $3,749,794 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $35,392,926 | OtherCostOrOtherBasisAmt |
| Depreciation | $13,766,754 | DepreciationAmt |
| Book Value | $21,626,172 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $12,608,591 | OtherCostOrOtherBasisAmt |
| Depreciation | $10,961,361 | DepreciationAmt |
| Book Value | $1,647,230 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,200,695 | OtherCostOrOtherBasisAmt |
| Depreciation | $411,967 | DepreciationAmt |
| Book Value | $3,788,728 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $30,811,924 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| 3RD PARTY REIMBURSEMENT PAYABLE | $1,951,358 |
| OPERATING LEASE LIABILITY | $44,220 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,995,578 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $93,373,509 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $140 | NetUnrealizedGainsInvstAmt |
| Other Revenue | $52,179 | OtherRevenueAmt |
| Revenue Not Reported | $52,319 | RevenueNotReportedAmt |
| Revenue Subtotal | $93,321,190 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $93,321,190 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $86,124,972 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $52,179 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $52,179 | ExpensesNotReportedAmt |
| Expenses Subtotal | $86,072,793 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $86,072,793 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | RENTAL EXPENSES |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | RENTAL EXPENSES |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (11 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MUSTAFA AMMAR | ||||||||||||||
| MEDICAL DIRECTOR | $461,300 | $0 | $150,087 | $0 | $48,078 | $0 | $7,433 | $0 | $30,732 | $0 | $697,630 | $0 | $0 | $0 |
| BENJAMIN FLORES | ||||||||||||||
| CEO | $443,272 | $0 | $0 | $0 | $4,572 | $0 | $15,250 | $0 | $21,633 | $0 | $484,727 | $0 | $0 | $0 |
| KANESHKA ALAMSHAHI | ||||||||||||||
| MEDICAL DIRECTOR | $351,690 | $0 | $53,058 | $0 | $324 | $0 | $5,837 | $0 | $18,731 | $0 | $429,640 | $0 | $0 | $0 |
| NANAK BOPARAI | ||||||||||||||
| MEDICAL DIRECTOR | $303,356 | $0 | $49,000 | $0 | $11,721 | $0 | $5,439 | $0 | $30,011 | $0 | $399,527 | $0 | $0 | $0 |
| KANWAR MULTANI | ||||||||||||||
| MEDICAL DIRECTOR | $236,040 | $0 | $41,041 | $0 | $257 | $0 | $3,205 | $0 | $25,629 | $0 | $306,172 | $0 | $0 | $0 |
| AMITABH SINGH | ||||||||||||||
| MEDICAL DIRECTOR | $251,679 | $0 | $29,545 | $0 | $288 | $0 | $4,591 | $0 | $15,016 | $0 | $301,119 | $0 | $0 | $0 |
| DANIEL SIRI | ||||||||||||||
| DENTAL DIRECTOR | $254,214 | $0 | $15,531 | $0 | $9,236 | $0 | $1,022 | $0 | $1,857 | $0 | $281,860 | $0 | $0 | $0 |
| KATHY WALKER | ||||||||||||||
| CFO | $210,650 | $0 | $0 | $0 | $552 | $0 | $4,237 | $0 | $30,469 | $0 | $245,908 | $0 | $0 | $0 |
| CARLOS PERALTA CORRALES | ||||||||||||||
| COO | $192,610 | $0 | $7,418 | $0 | $9,271 | $0 | $4,186 | $0 | $30,011 | $0 | $243,496 | $0 | $0 | $0 |
| CINDY SNELGROVE | ||||||||||||||
| NURSING DIRECTOR | $184,622 | $0 | $16,196 | $0 | $4,447 | $0 | $3,466 | $0 | $10,530 | $0 | $219,261 | $0 | $0 | $0 |
| JOHN FLEMING | ||||||||||||||
| PLANNING & DEVELOPMENT DIRECTOR | $136,922 | $0 | $1,849 | $0 | $10,814 | $0 | $2,794 | $0 | $27,118 | $0 | $179,497 | $0 | $0 | $0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART III, LINE 2 | AMPLA HEALTH STARTED OFFERING PHARMACY SERVICES THAT SPECIALIZE IN PROVIDING AFFORDABLE PRESCRIPTIONS TO OUR PATIENTS. |
| FORM 990, PART VI, SECTION B, LINE 11B | AN INDEPENDENT ACCOUNTING FIRM PREPARES THE FORM 990 WITH THE INFORMATION PROVIDED BY THE ORGANIZATION ACCOUNTING DEPARTMENT. THEN THE COMPLETED 990 IS SENT TO THE CFO OF THE ORGANIZATION TO BE REVIEWED. THE CFO REVIEWS AND DISTRIBUTES THE 990 AMONG THE FINANCE COMMITTEE AND THE BOARD OF DIRECTORS FOR REVIEW AND QUESTIONS AT THE BOARD MEETING. UPON COMPLETION OF REVIEW AND APPROVAL, THE FORM 990 IS FILED. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE TO BE MAILED UPON WRITTEN REQUEST. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE COMPENSATION IS DETERMINED FOR THE CEO BY HIRING A CONSULTANT WHO GATHERS INFORMATION OF OTHER CEO'S PAY. THE CONSULTANT THEN PRESENTS THE SALARY RANGES TO THE BOARD OF DIRECTORS WHO THEN WILL DECIDE ON THE COMPENSATION FOR THE CEO. ANNUAL REVIEWS AND ANNUAL SALARY SURVEYS ARE DONE TO MAKE SURE THE CEO IS COMPENSATED FAIRLY. THE ANNUAL REVIEW AND ANNUAL SALARY SURVEY IS DONE YEARLY AROUND MARCH OR APRIL. THE COMPENSATION IS DETERMINED FOR THE KEY EMPLOYEES IS DETERMINED BY HIRING A CONSULTANT WHO GATHERS INFORMATION OF OTHER KEY EMPLOYEES PAY. THE CONSULTANT THEN PRESENTS THE SALARY RANGES TO THE CEO WHO THEN WILL DECIDE ON THE COMPENSATION FOR THE KEY EMPLOYEE. ANNUAL REVIEWS AND ANNUAL SALARY SURVEYS ARE DONE TO MAKE SURE THE KEY EMPLOYEES ARE COMPENSATED FAIRLY. THE ANNUAL REVIEW AND ANNUAL SALARY SURVEY IS DONE YEARLY AROUND MARCH OR APRIL. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE TO BE MAILED UPON REQUEST. HOWEVER, FINANCIAL STATEMENTS ARE NOT MADE PUBLIC. |
| FORM 990, PART IX, LINE 11G | CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 10,268,928. MANAGEMENT AND GENERAL EXPENSES 3,534,793. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 13,803,721. |