2023-09-28T16:49:09-07:00 2022-12-31 990 2022-01-01 770425496 AVENAL COMMUNITY HEALTH CENTER AVEN 5599258800 PO Box 580 Lemoore CA 93245 Andrew Miller Controller 5592422108 2023-09-23 1 1 11 0 AAL2 X 2022 2023-04-26 12:10:37Z Johan Blaine 360 Hanover Avenue Lemoore CA 93245 47593721 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 9 609 0 28887 0 6604232 7791662 43560400 39685226 1824 6976 45884 28887 50212340 47512751 0 0 0 0 22046447 26036436 0 0 0 13861165 16433991 35907612 42470427 14304728 5042324 42667528 50781377 10860436 13931961 31807092 36849416 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 33762673 0 39685226 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 33762673 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 0 0 1 609 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 Jean Olvier 5596704902 555 E Street Lemoore CA 93245 John Blaine CEO 60 0 X 448500 0 26000 Jose R Salas Physician 40 0 X 418113 0 0 Jonathan F Mathews Dentist 40 0 X 388860 0 20500 Ayesha Walden Certified Nurse Midwife 40 0 X 278474 0 20500 Sartaj K Dhillon Physician 40 0 X 271751 0 16782 Derrick J Gruen Chief Operations Officer 40 0 X 259921 0 6938 Monica Gonzalez Nurse Practitioner 40 0 X 244018 0 7217 Andrew J Miller Controller 40 0 X 213808 0 14423 Amy Y Grigore Physician Assistant 40 0 X 202419 0 20500 Harpreet K Badhesha Nurse Practitioner 40 0 X 182027 0 20500 Emilian Grigore Physician Assistant 40 0 X 178571 0 20500 Roblen G Nieblas Dental Director 40 0 X 173866 0 20500 Paul Broussard Director of Pharmacy 40 0 X 164335 0 16446 Thanhan T Mathews Nurse Practitioner 40 0 X 159994 0 20500 Karen M Christensen Nurse Practitioner 40 0 X 155498 0 20500 Parul Gupta Physician 24 0 X 173427 0 0 Wendy Arzaga Physician Assistant 40 0 X 152345 0 20500 Jenelle Mason Chief Compliance Officer 40 0 X 155220 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 Bezabih Buz Felleke Director 2 0 X 0 0 0 Briana Mora Director 2 0 X 0 0 0 Paul Gonzales Director 2 0 X 0 0 0 Sean Simplicio 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 4221147 0 272306 32 1 1 0 SurgiTek Outpatient Center Inc 833 Greenfield Ave Ste 105 Hanford CA 93230 Dentistry 377916 CompHealth PO Box 972651 Dallas TX 753972651 Medical 474727 Carlos Santivanez MD Inc 855 Garner Avenue Hanford CA 93230 Medical 393375 Ramon Resa MD 569 W Putnam Ave Porterville CA 93257 MD 393870 PRACTICALMED Inc 4322 W Oriole CT Visalia CA 93291 Medical Physician 335054 11 0 0 0 0 7744462 47200 0 7791662 Healthcare Services FQHC 621400 39685226 39685226 0 0 0 0 0 0 39685226 6976 6976 0 0 0 0 0 0 0 0 0 0 109857 0 80970 0 28887 0 28887 0 28887 0 0 0 0 0 0 0 0 0 47512751 39692202 28887 0 X 0 0 0 0 0 0 0 0 1077449 0 1077449 0 0 0 0 0 20966323 16563395 4402928 0 384117 303452 80665 0 1894665 1496785 397880 0 1713882 1353967 359915 0 0 0 0 0 67689 0 67689 0 179622 0 179622 0 0 0 0 0 0 0 0 0 0 0 4705484 3685526 1019958 0 0 0 0 0 1227740 1043579 184161 0 713356 563551 149805 0 0 0 0 0 2221115 1923677 297438 0 474178 403051 71127 0 0 0 0 0 72645 0 72645 0 11317 8940 2377 0 0 0 0 0 1102517 984113 118404 0 197341 129897 67444 0 Minor Equipment 252262 226941 25321 0 Supplies 5024772 5024772 0 0 183953 51027 132926 0 42470427 33762673 8707754 0 6805 7005 20256075 17835010 572081 52175 7047343 14202960 0 0 0 0 2717064 2863349 404213 367440 131262 265075 19419922 4681845 11362895 14738077 0 0 0 0 0 0 0 0 169790 450286 42667528 50781377 2620833 2685209 0 0 997609 35394 0 0 0 0 0 0 3616393 6558220 3299358 153676 326243 4499462 10860436 13931961 X 31807092 36849416 0 0 31807092 36849416 42667528 50781377 5042324 0 0 0 0 0 X 0 1 X 1 1 1 X 3852159 3817584 3920441 6604232 7791662 25986078 18662947 25895186 28851516 43560400 39685226 156655275 75646 4576 114457 109857 109857 414393 0 0 0 0 0 0 0 0 0 0 0 0 22590752 29717346 32886414 50274489 47586745 183055746 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 183055746 5063 8475 2586 1824 6976 24924 63046 0 30389 43189 28887 165511 68109 8475 32975 45013 35863 190435 0 0 0 0 0 0 575 955 640 195 0 2365 22659436 29726776 32920029 50319697 47622608 183248546 0.99895 0.99870 0.00104 0.00128 X Schedule A, Part III, Line 12 No Other income to report. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 2062871 2062871 0 10080601 1775328 8305273 0 366480 319668 46812 0 3022767 2120184 902583 0 3887203 466665 3420538 14738077 Tenant Deposit 8338 457B Liability 341488 Synergy 365 651206 Current Portion Lease Commitment AC842 387811 Current Portion Lease Commitment AC842 3110619 4499462 X X X 0 0 0 0 0 0 0 0 0 John Blaine CEO 298000 0 150500 0 0 0 26000 0 0 0 474500 0 0 0 Jose R Salas Physician 226500 0 191613 0 0 0 0 0 0 0 418113 0 0 0 Jonathan F Mathews Dentist 153704 0 235156 0 0 0 20500 0 0 0 409360 0 0 0 Ayesha Walden Certified Nurse Midwife 185000 0 93474 0 0 0 20500 0 0 0 298974 0 0 0 Sartaj K Dhillon Physician 260112 0 11639 0 0 0 16782 0 0 0 288533 0 0 0 Derrick J Gruen Chief Operations Officer 197100 0 62821 0 0 0 6938 0 0 0 266859 0 0 0 Monica Gonzalez Nurse Practitioner 123225 0 120793 0 0 0 7217 0 0 0 251235 0 0 Andrew J Miller Controller 213308 0 500 0 0 0 14423 0 0 0 228231 0 0 0 Amy Y Grigore Physician Assistant 139879 0 62540 0 0 0 20500 0 0 0 222919 0 0 0 Harpreet K Badhesha Nurse Practitioner 128172 0 53855 0 0 0 20500 0 0 0 202527 0 0 0 Emilian Grigore Physician Assistant 132003 0 46568 0 0 0 20500 0 0 0 199071 0 0 Roblen G Nieblas Dental Director 170577 0 3289 0 0 0 20500 0 0 0 194366 0 0 0 Parul Gupta Physician 133921 0 39506 0 0 0 0 0 0 0 173427 0 0 Wendy Arzaga Physician Assistant 116500 0 35935 0 0 0 20500 0 0 0 172935 0 0 0 Paul Broussard Director of Pharmacy 163835 0 500 0 0 0 16446 0 0 0 180781 0 0 0 Thanhan T Mathews Nurse Practitioner 113923 0 46071 0 0 0 20500 0 0 0 180494 0 0 0 Karen M Christensen Nurse Practitioner 109554 0 45944 0 0 0 20500 0 0 0 175998 0 0 0 Jenelle Mason Chief Compliance Officer 154000 0 1220 0 0 0 0 0 0 0 155220 0 0 0 Schedule J, Part II 403B and 457B Deferred Compensation 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 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 make the following documents available for inspection at its primary location by appointment with an officer or director. Most recent form 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, 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 0 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 net was based on an estimate of the market rate per square foot leased.