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LA CLINICA TEPEYAC INC: Form 990, tax year 2022

View the entire original 990 at ProPublica ↗

Organization
LA CLINICA TEPEYAC INC (EIN 84-1285505)
Tax period
2022-01-01 to 2022-12-31
Filed
2023-11-10
IRS object ID
202343149349305739
Schema version
2022v5.0
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

FieldValueIRS element (for citing)
Return2023-11-10T17:03:20-06:00ReturnTs
Tax Period End2022-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN410746749PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1CLIFTONLARSONALLEN LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line18390 EAST CRESCENT PARKWAY SUITEAddressLine1Txt
Address Line2300AddressLine2Txt
CityGREENWOOD VILLAGECityNm
State AbbreviationCOStateAbbreviationCd
ZIP80111ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2022-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN841285505EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1LA CLINICA TEPEYACBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlLACLBusinessNameControlTxt
Phone7202742923PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line14725 HIGH STREETAddressLine1Txt
CityDENVERCityNm
State AbbreviationCOStateAbbreviationCd
ZIP80216ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJIM GARCIAPersonNm
Person TitleCEOPersonTitleTxt
Phone7202742923PhoneNum
Signature2023-11-10SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstJIMPersonFirstNm
Person LastGARCIAPersonLastNm
FieldValueIRS element (for citing)
SSNXXX-XX-XXXXSSN
FieldValueIRS element (for citing)
IRS Responsible Prty Info CurrYes (1)IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonBECKY DETTMANN CPAPreparerPersonNm
PTINP01408585PTIN
Phone3037795710PhoneNum
Preparation2023-11-08PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer2TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2022TaxYr
Build TS2023-04-26 12:10:37ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1TEPEYAC COMMUNITY HEALTH CENTERBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerJIM GARCIAPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line14725 HIGH STREETAddressLine1Txt
CityDENVERCityNm
State AbbreviationCOStateAbbreviationCd
ZIP80216ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$8,803,658GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.TEPEYACHEALTH.ORGWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1994FormationYr
Legal Domicile StateCOLegalDomicileStateCd
Activity Or MissionINSPIRE HEALTH, WELLBEING, AND HUMANITY IN OUR COMMUNITY, THROUGH ALL OF LIFE'S STAGES.ActivityOrMissionDesc
Voting Members Governing Body14VotingMembersGoverningBodyCnt
Voting Members Independent14VotingMembersIndependentCnt
Total Employee104TotalEmployeeCnt
Total Volunteers14TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$5,889,761PYContributionsGrantsAmt
CY Contributions Grants$7,104,184CYContributionsGrantsAmt
PY Program Service Revenue$1,399,528PYProgramServiceRevenueAmt
CY Program Service Revenue$1,490,517CYProgramServiceRevenueAmt
PY Investment Income$97,306PYInvestmentIncomeAmt
CY Investment Income$103,561CYInvestmentIncomeAmt
PY Other Revenue$3,160PYOtherRevenueAmt
CY Other Revenue-$17,868CYOtherRevenueAmt
PY Total Revenue$7,389,755PYTotalRevenueAmt
CY Total Revenue$8,680,394CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$60,000CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$3,969,706PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$4,355,080CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$49,076PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$34,099CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$404,862CYTotalFundraisingExpenseAmt
PY Other Expenses$2,531,823PYOtherExpensesAmt
CY Other Expenses$2,773,618CYOtherExpensesAmt
PY Total Expenses$6,550,605PYTotalExpensesAmt
CY Total Expenses$7,222,797CYTotalExpensesAmt
PY Revenues Less Expenses$839,150PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$1,457,597CYRevenuesLessExpensesAmt
Total Assets BOY$16,516,064TotalAssetsBOYAmt
Total Assets EOY$17,261,657TotalAssetsEOYAmt
Total Liabilities BOY$8,999,395TotalLiabilitiesBOYAmt
Total Liabilities EOY$8,297,509TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$7,516,669NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$8,964,148NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionINSPIRE HEALTH, WELLBEING, AND HUMANITY IN OUR COMMUNITY, THROUGH ALL OF LIFE'S STAGES. WE ENVISION A HEALTHY COMMUNITY WITH ACCESS TO REGULAR AND ONGOING HEALTH CARE. AS WE EXPAND OUR REACH AND BRING,(CONTINUED ON SCHEDULE O)CULTURAL RESPONSIVENESS INTO THE COMMUNITY WE STRIVE FOR EXCEPTIONAL, TRUSTWORTHY CARE THAT EMPOWERS OUR PATIENTS, DECREASES ROUTINE VISITS TO EMERGENCY ROOMS, AND CREATES HEALTHIER FAMILIES OVERALL.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$4,010,702ExpenseAmt
Grant$60,000GrantAmt
Revenue$1,490,517RevenueAmt
DescCLINIC: PROVIDE BASIC PRIMARY CARE SERVICES, BASIC WELLNESS, PHYSICAL EXAMS, BEHAVIORAL HEALTH AND HEALTH EDUCATION. THIS INCLUDES WOMEN'S HEALTH EXAMS, MAMMOGRAPHY, PRENATAL CARE, IMMUNIZATIONS, SCHOOL PHYSICALS, DIABETES MANAGEMENT, COLPOSCOPIES, PREVENTIVE HEALTH EDUCATION, WELLNESS CLASSES, AND ORAL HEALTH CARE.HEALTH PROMOTION: PROVIDES EDUCATION FOR THE LATINX COMMUNITY AND THEIR FAMILIES TO REDUCE THE RISK OF CHRONIC DISEASE THROUGH COMMUNITY OUTREACH AND PREVENTIVE HEALTH EDUCATION CONDUCTED BY THE PROMOTORAS DE SALUD (HEALTH PROMOTERS).Desc
Total Program Service Expenses$4,010,702TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B RequiredYes (1)ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi EndowmentsYes (1)DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional FundraisingYes (1)ProfessionalFundraisingInd
Fundraising ActivitiesYes (1)FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To OrganizationsYes (1)GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash ContriYes (1)DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl EntYes (1)RelatedOrganizationCtrlEntInd
Transaction With Control Ent0TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgYes (1)TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document40IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee104EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members14GoverningBodyVotingMembersCnt
Independent Voting Member14IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (1)DelegationOfMgmtDutiesInd
Change To Org DocumentsYes (1)ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEOYes (1)CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1LACY BRADLEYBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone7202742923PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line14725 HIGH STREETAddressLine1Txt
CityDENVERCityNm
State AbbreviationCOStateAbbreviationCd
ZIP80216ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (21 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeIndIndividual Trustee Or DirectorIndividualTrusteeOrDirectorInd
DR PAMELA VALENZA MD
CHO50.000.00Yes (X)$231,321$0$17,508
DR PATRICK HUFFER MD
PHYSICIAN40.000.00$184,165$0$19,726Yes (X)
JIM GARCIA
CEO60.001.00Yes (X)$171,410$0$14,524
SHANA MONTROSE
CAO40.000.00Yes (X)$121,862$0$10,626
ALISON QUINN BEITSCHER
ASSOCIATE MEDICAL DIRECTOR40.000.00$116,924$0$8,131Yes (X)
AMANDA SILK
CFO (THROUGH FEB. 2022)50.000.00Yes (X)$23,177$0$736
JOHANNA HELLER
INTERIM CFO40.000.00Yes (X)$0$0$0
JOHN BAUER MARTINEZ
PRESIDENT1.000.00Yes (X)$0$0$0Yes (X)
DR HARVEY BOGRAD MD
VICE PRESIDENT1.000.00Yes (X)$0$0$0Yes (X)
STEVE CHAVEZ
TREASURER1.000.00Yes (X)$0$0$0Yes (X)
LINDA OSTERLUND PHD
SECRETARY1.000.00Yes (X)$0$0$0Yes (X)
CAROLINE ACHA
CONSUMER MEMBER0.500.00$0$0$0Yes (X)
LUDY ESPERANZA CHACON
CONSUMER MEMBER0.500.00$0$0$0Yes (X)
CANDY HERNANDEZ
CONSUMER MEMBER0.500.00$0$0$0Yes (X)
JUANA MALDONADO
CONSUMER MEMBER0.500.00$0$0$0Yes (X)
GINA MILLAN
CONSUMER MEMBER0.500.00$0$0$0Yes (X)
JAQUELINE MORALES-LOZANO
CONSUMER MEMBER0.500.00$0$0$0Yes (X)
JESSE OGAS
DIRECTOR0.500.00$0$0$0Yes (X)
DR SAMIT SHAH MD
DIRECTOR0.500.00$0$0$0Yes (X)
RITA TORO
CONSUMER MEMBER0.500.00$0$0$0Yes (X)
DR GILBERT VIGIL PHD
DIRECTOR0.500.00$0$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$848,859TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$71,251TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K5IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (4 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
COMMUNITY LINK CONSULTING
PO BOX 276NEWMAN LAKEWA99025MANAGEMENT SERVICES$292,467
VIRSAGE SOLUTIONS
PO BOX 29650PHOENIXAZ85038CONTRACTED IT DEPARTMENT$219,781
ECLINICALWORKS LLC
PO BOX 847950BOSTONMA02284EHR SYSTEM$141,297
ROCHE BRAND ADVISORS
2890 GILPIN STDENVERCO80210BRAND CONSULTING$110,137
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K4CntrctRcvdGreaterThan100KCnt
Fundraising$161,932FundraisingAmt
Government Grants$5,021,919GovernmentGrantsAmt
All Other Contributions$1,920,333AllOtherContributionsAmt
Noncash Contributions$234,760NoncashContributionsAmt
Total Contributions$7,104,184TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescPATIENT FEESDesc
Business621110BusinessCd
Total Revenue Column$1,490,517TotalRevenueColumnAmt
Related Or Exempt Func Income$1,490,517RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$1,490,517TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$103,801TotalRevenueColumnAmt
Exclusion$103,801ExclusionAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$240SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities-$240SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column-$240TotalRevenueColumnAmt
Exclusion-$240ExclusionAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$54,099FundraisingGrossIncomeAmt
Contri Rpt Fundraising Event$161,932ContriRptFundraisingEventAmt
Fundraising Direct Expenses$123,024FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column-$68,925TotalRevenueColumnAmt
Exclusion-$68,925ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp

FieldValueIRS element (for citing)
DescMISCELLANEOUS INCOMEDesc
Business900099BusinessCd
Total Revenue Column$51,057TotalRevenueColumnAmt
Exclusion$51,057ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$51,057OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$8,680,394TotalRevenueColumnAmt
Related Or Exempt Func Income$1,490,517RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$85,693ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$60,000TotalAmt
Program Services$60,000ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$583,110TotalAmt
Program Services$228,560ProgramServicesAmt
Management And General$272,997ManagementAndGeneralAmt
Fundraising$81,553FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$3,194,636TotalAmt
Program Services$1,975,245ProgramServicesAmt
Management And General$1,048,052ManagementAndGeneralAmt
Fundraising$171,339FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$38,982TotalAmt
Program Services$20,580ProgramServicesAmt
Management And General$17,582ManagementAndGeneralAmt
Fundraising$820FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$248,636TotalAmt
Program Services$126,035ProgramServicesAmt
Management And General$110,260ManagementAndGeneralAmt
Fundraising$12,341FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$289,716TotalAmt
Program Services$144,527ProgramServicesAmt
Management And General$128,236ManagementAndGeneralAmt
Fundraising$16,953FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$25,098TotalAmt
Management And General$25,098ManagementAndGeneralAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$55,194TotalAmt
Management And General$55,194ManagementAndGeneralAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$34,099TotalAmt
Fundraising$34,099FundraisingAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$792,932TotalAmt
Program Services$125,195ProgramServicesAmt
Management And General$613,127ManagementAndGeneralAmt
Fundraising$54,610FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$40,393TotalAmt
Program Services$1,113ProgramServicesAmt
Management And General$27,774ManagementAndGeneralAmt
Fundraising$11,506FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$116,310TotalAmt
Program Services$52,237ProgramServicesAmt
Management And General$62,763ManagementAndGeneralAmt
Fundraising$1,310FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$459,375TotalAmt
Program Services$268,646ProgramServicesAmt
Management And General$186,612ManagementAndGeneralAmt
Fundraising$4,117FundraisingAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$163,388TotalAmt
Program Services$110,531ProgramServicesAmt
Management And General$51,982ManagementAndGeneralAmt
Fundraising$875FundraisingAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$19,201TotalAmt
Program Services$7,976ProgramServicesAmt
Management And General$11,225ManagementAndGeneralAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$18,859TotalAmt
Program Services$1,369ProgramServicesAmt
Management And General$17,488ManagementAndGeneralAmt
Fundraising$2FundraisingAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$363,547TotalAmt
Program Services$362,807ProgramServicesAmt
Management And General$740ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$89,736TotalAmt
Program Services$56,007ProgramServicesAmt
Management And General$33,729ManagementAndGeneralAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$42,559TotalAmt
Program Services$4,271ProgramServicesAmt
Management And General$38,288ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
MEDICAL SUPPLIES$300,356$298,016$2,340
CLINIC$117,898$116,968$930
DUES & MEMBERSHIPS$55,888$13,179$42,709
BAD DEBT$48,315$18,017$16,367$13,931

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$64,569TotalAmt
Program Services$19,423ProgramServicesAmt
Management And General$43,740ManagementAndGeneralAmt
Fundraising$1,406FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$7,222,797TotalAmt
Program Services$4,010,702ProgramServicesAmt
Management And General$2,807,233ManagementAndGeneralAmt
Fundraising$404,862FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$239,571BOYAmt
EOY$343,285EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$2,435,265BOYAmt
EOY$3,682,231EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$2,115,982BOYAmt
EOY$1,330,776EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$233,127BOYAmt
EOY$137,717EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$9,496,937BOYAmt
EOY$9,496,937EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$28,646BOYAmt
EOY$73,885EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$3,012,410LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$914,739LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$1,893,184BOYAmt
EOY$2,097,671EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$59,032BOYAmt
EOY$48,914EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$14,320BOYAmt
EOY$50,241EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$16,516,064BOYAmt
EOY$17,261,657EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$482,272BOYAmt
EOY$693,443EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$471,966BOYAmt
EOY$917,054EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$8,045,157BOYAmt
EOY$6,512,499EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$174,513EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$8,999,395BOYAmt
EOY$8,297,509EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$4,887,989BOYAmt
EOY$5,618,473EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$2,628,680BOYAmt
EOY$3,345,675EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$7,516,669BOYAmt
EOY$8,964,148EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$16,516,064BOYAmt
EOY$17,261,657EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss$1,457,597ReconcilationRevenueExpnssAmt
Other Changes In Net Assets-$10,118OtherChangesInNetAssetsAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit RequiredYes (1)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedYes (1)FederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Public Organization170Yes (X)PublicOrganization170Ind

Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$6,264,586CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$4,270,179CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$5,170,843CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$5,889,761CurrentTaxYearMinus1YearAmt
Current Tax Year$7,104,184CurrentTaxYearAmt
Total$28,699,553TotalAmt

Total Calendar Year170 TotalCalendarYear170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$6,264,586CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$4,270,179CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$5,170,843CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$5,889,761CurrentTaxYearMinus1YearAmt
Current Tax Year$7,104,184CurrentTaxYearAmt
Total$28,699,553TotalAmt
FieldValueIRS element (for citing)
Substantial Contributors Tot$988,741SubstantialContributorsTotAmt
Public Support Total170$27,710,812PublicSupportTotal170Amt

Gross Investment Income170 GrossInvestmentIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$8,730CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$15,186CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$8,375CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$96,090CurrentTaxYearMinus1YearAmt
Current Tax Year$103,801CurrentTaxYearAmt
Total$232,182TotalAmt

Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years$70,274CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$41,564CurrentTaxYearMinus2YearsAmt
Total$111,838TotalAmt

Other Income170 OtherIncome170Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$31,258CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$56,297CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$86,488CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$35,803CurrentTaxYearMinus1YearAmt
Current Tax Year$51,057CurrentTaxYearAmt
Total$260,903TotalAmt
FieldValueIRS element (for citing)
Total Support$29,304,476TotalSupportAmt
Gross Receipts Rltd Activities$6,024,232GrossReceiptsRltdActivitiesAmt
Public Support CY1700.94560PublicSupportCY170Pct
Public Support PY1700.97240PublicSupportPY170Pct
Thirty Thr Pct Suprt Tests CY170Yes (X)ThirtyThrPctSuprtTestsCY170Ind

Form990 Schedule A Part VI Form990ScheduleAPartVIGrp

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME:FormAndLineReferenceDesc
ExplanationOTHER INCOME - 2018 AMOUNT: $ 31,258. 2019 AMOUNT: $ 56,297. 2020 AMOUNT: $ 86,488. 2021 AMOUNT: $ 35,803. 2022 AMOUNT: $ 51,057.ExplanationTxt

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$59,032BeginningYearBalanceAmt
Investment Earnings Or Losses-$9,599InvestmentEarningsOrLossesAmt
Administrative Expenses-$519AdministrativeExpensesAmt
End Year Balance$48,914EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$54,195BeginningYearBalanceAmt
Investment Earnings Or Losses$5,404InvestmentEarningsOrLossesAmt
Administrative Expenses$567AdministrativeExpensesAmt
End Year Balance$59,032EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$48,268BeginningYearBalanceAmt
Investment Earnings Or Losses$6,406InvestmentEarningsOrLossesAmt
Administrative Expenses$479AdministrativeExpensesAmt
End Year Balance$54,195EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$41,663BeginningYearBalanceAmt
Investment Earnings Or Losses$7,057InvestmentEarningsOrLossesAmt
Administrative Expenses$452AdministrativeExpensesAmt
End Year Balance$48,268EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$44,285BeginningYearBalanceAmt
Investment Earnings Or Losses-$2,180InvestmentEarningsOrLossesAmt
Administrative Expenses$442AdministrativeExpensesAmt
End Year Balance$41,663EndYearBalanceAmt
FieldValueIRS element (for citing)
Board Designated Balance EOY0.00000BoardDesignatedBalanceEOYPct
Prmnnt Endowment Balance EOY1.00000PrmnntEndowmentBalanceEOYPct
Term Endowment Balance EOY0.00000TermEndowmentBalanceEOYPct
Endowments Held Unrelated OrgYes (1)EndowmentsHeldUnrelatedOrgInd
Endowments Held Related Org0EndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$22,500InvestmentCostOrOtherBasisAmt
Other Cost Or Other Basis$274,000OtherCostOrOtherBasisAmt
Book Value$296,500BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$1,905,509OtherCostOrOtherBasisAmt
Depreciation$528,861DepreciationAmt
Book Value$1,376,648BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$538,219OtherCostOrOtherBasisAmt
Depreciation$385,878DepreciationAmt
Book Value$152,341BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$272,182OtherCostOrOtherBasisAmt
Book Value$272,182BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$2,097,671TotalBookValueLandBuildingsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescDUE TO TEPEYAC, QALICB, INC.Desc
Amt$174,513Amt
FieldValueIRS element (for citing)
Total Liability$174,513TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$8,684,304TotalRevEtcAuditedFinclStmtAmt
Revenue Not Reported$0RevenueNotReportedAmt
Revenue Subtotal$8,684,304RevenueSubtotalAmt
Other Revenues Not Included-$3,910OtherRevenuesNotIncludedAmt
Revenue Not Reported Fincl Stmt-$3,910RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$8,680,394TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$7,421,827TotExpnsEtcAuditedFinclStmtAmt
Other Expenses Included$195,120OtherExpensesIncludedAmt
Expenses Not Reported$195,120ExpensesNotReportedAmt
Expenses Subtotal$7,226,707ExpensesSubtotalAmt
Other Expenses Not Included-$3,910OtherExpensesNotIncludedAmt
Expenses Not Rpt Fincl Stmt-$3,910ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$7,222,797TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail (5 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
PART V, LINE 4:THE PURPOSE OF THE ENDOWMENT FUND IS TO PAY FOR MEDICAL SERVICES FOR THE UNINSURED.
PART X, LINE 2:THE ORGANIZATION QUALIFIES AS A TAX-EXEMPT CORPORATION DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THE ORGANIZATION IS NOT A PRIVATE FOUNDATION, AND CONTRIBUTIONS TO THE ORGANIZATION QUALIFY AS CHARITABLE TAX DEDUCTIONS BY THE CONTRIBUTOR. THE ORGANIZATION FOLLOWS GUIDANCE IN THE INCOME TAX STANDARD REGARDING THE RECOGNITION AND MEASUREMENT OF UNCERTAIN TAX PROVISIONS. THE APPLICATION OF THIS STANDARD HAS NO EFFECT ON THE ORGANIZATIONS CONSOLIDATED FINANCIAL STATEMENTS. THE ORGANIZATION IS NOT AWARE OF ANY ACTIVITIES THAT WOULD JEOPARDIZE ITS TAX-EXEMPT STATUS OR AWARE OF ANY ACTIVITIES THAT ARE SUBJECT TO TAX ON UNRELATED BUSINESS INCOME OR EXCISE OR OTHER TAXES.
PART XI, LINE 4B - OTHER ADJUSTMENTS:ADDITIONAL FUNDRAISING EXPENSES REPORTED IN EXPENSE ON AUDITED F/S -3,910.
PART XII, LINE 2D - OTHER ADJUSTMENTS:CONSOLIDATED EXPENSES - TEPEYAC QALICB 255,120. ELIMINATION ON FINANCIAL STATEMENT -60,000.
PART XII, LINE 4B - OTHER ADJUSTMENTS:ADDITIONAL FUNDRAISING EXPENSES REPORTED IN EXPENSE ON AUDITED F/S -3,910.

Schedule G IRS990ScheduleG

FieldValueIRS element (for citing)
Mail SolicitationsYes (X)MailSolicitationsInd
Email SolicitationsYes (X)EmailSolicitationsInd
Phone SolicitationsYes (X)PhoneSolicitationsInd
In Person SolicitationsYes (X)InPersonSolicitationsInd
Solicitation Of Non Govt GrantsYes (X)SolicitationOfNonGovtGrantsInd
Solicitation Of Govt GrantsYes (X)SolicitationOfGovtGrantsInd
Special Fundraising EventsYes (X)SpecialFundraisingEventsInd
Agrmt Prof Fundraising Acty0AgrmtProfFundraisingActyInd

Fundraiser Activity Info FundraiserActivityInfoGrp (2 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdActivityActivityTxtFundraiser Control Of FundsFundraiserControlOfFundsIndGross ReceiptsGrossReceiptsAmtRetained By ContractorRetainedByContractorAmtNet To OrganizationNetToOrganizationAmt
RIPPLE AFFECT LLC
4000 LIPAN STREETDENVERCO80211CAPITAL CAMPAIGN CONSULTING0$0$26,099$0
EVENTFUL PRODUCTION
1427 LARIMER STREETDENVERCO80202EVENT MANAGEMENT0$0$8,000$0
FieldValueIRS element (for citing)
Total Retained By Contractors$34,099TotalRetainedByContractorsAmt
Licensed StatesCOLicensedStatesCd

Fundraising Event Information FundraisingEventInformationGrp

FieldValueIRS element (for citing)
Event1FIESTA ON THE PLAZAEvent1Nm
Gross Receipts Event1$140,875GrossReceiptsEvent1Amt
Charitable Contri Event1$104,395CharitableContriEvent1Amt
Gross Revenue Event1$36,480GrossRevenueEvent1Amt
Rent Facility Costs Event1$29,000RentFacilityCostsEvent1Amt
Food And Beverage Event1$36,480FoodAndBeverageEvent1Amt
Other Direct Expenses Event1$33,627OtherDirectExpensesEvent1Amt
Event2TORTILLAS FOR TEPEYACEvent2Nm
Gross Receipts Event2$75,156GrossReceiptsEvent2Amt
Charitable Contri Event2$57,537CharitableContriEvent2Amt
Gross Revenue Event2$17,619GrossRevenueEvent2Amt
Rent Facility Costs Event2$800RentFacilityCostsEvent2Amt
Food And Beverage Event2$17,619FoodAndBeverageEvent2Amt
Other Direct Expenses Event2$5,498OtherDirectExpensesEvent2Amt
Gross Receipts Total$216,031GrossReceiptsTotalAmt
Charitable Contributions Tot$161,932CharitableContributionsTotAmt
Gross Revenue Total Events$54,099GrossRevenueTotalEventsAmt
Rent Fclty Costs Total Events$29,800RentFcltyCostsTotalEventsAmt
Food And Beverage Total Events$54,099FoodAndBeverageTotalEventsAmt
Oth Direct Expnss Total Events$39,125OthDirectExpnssTotalEventsAmt
Direct Expense Summary Events$123,024DirectExpenseSummaryEventsAmt
Net Income Summary-$68,925NetIncomeSummaryAmt

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Recipient Table RecipientTable

Recipient Business Name RecipientBusinessName

FieldValueIRS element (for citing)
Business Name Line1TEPEYAC QALICB INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line14725 HIGH STREETAddressLine1Txt
CityDENVERCityNm
State AbbreviationCOStateAbbreviationCd
ZIP80216ZIPCd
FieldValueIRS element (for citing)
Recipient EIN851563851RecipientEIN
IRC Section501(C)(3)IRCSectionDesc
Cash Grant$60,000CashGrantAmt
Non Cash Assistance$0NonCashAssistanceAmt
Valuation Method UsedN/AValuationMethodUsedDesc
Non Cash AssistanceN/ANonCashAssistanceDesc
Purpose Of GrantGENERAL SUPPORTPurposeOfGrantTxt
FieldValueIRS element (for citing)
Total501c3 Org1Total501c3OrgCnt
Total Other Org0TotalOtherOrgCnt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 2:FormAndLineReferenceDesc
ExplanationTEPEYAC QALICB IS A RELATED CONTROLLED ORGANIZATION AND PROVIDES FINANCIAL REPORTS TO LA CLINICA TEPEYAC. THE CEO OF LA CLINICA TEPEYAC IS ALSO ON THE BOARD OF TEPEYAC QALICB.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Independent ConsultantYes (X)IndependentConsultantInd
Form990 Of Other OrganizationsYes (X)Form990OfOtherOrganizationsInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (3 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
DR PAMELA VALENZA MD
CHO$231,321$0$0$0$0$0$8,563$0$8,945$0$248,829$0$0$0
DR PATRICK HUFFER MD
PHYSICIAN$184,165$0$0$0$0$0$6,991$0$12,735$0$203,891$0$0$0
JIM GARCIA
CEO$171,410$0$0$0$0$0$5,814$0$8,710$0$185,934$0$0$0

Schedule M IRS990ScheduleM

Securities Publicly Traded SecuritiesPubliclyTradedGrp

FieldValueIRS element (for citing)
Non Cash CheckboxYes (X)NonCashCheckboxInd
Contribution8700ContributionCnt
Noncash Contributions Rpt F990$234,760NoncashContributionsRptF990Amt
Method Of Determining RevenuesFMVMethodOfDeterminingRevenuesTxt
FieldValueIRS element (for citing)
Form8283 Received0Form8283ReceivedCnt
Any Property That Must Be Held0AnyPropertyThatMustBeHeldInd
Review Process Unusual NC Gifts0ReviewProcessUnusualNCGiftsInd
Third Parties Used0ThirdPartiesUsedInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, COLUMN (B):FormAndLineReferenceDesc
ExplanationTHE NUMBER OF ITEMS CONTRIBUTED WAS USED IN PART I.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 1ATHE EXECUTIVE COMMITTEE IS COMPOSED OF THE PRESIDENT, VICE-PRESIDENT, SECRETARY, TREASURER, AND IMMEDIATE PAST-PRESIDENT OF THE BOARD OF DIRECTORS. WHEN THE BOARD IS NOT IN SESSION, THE EXECUTIVE COMMITTEE HAS THE POWER AND AUTHORITY OF THE BOARD TO TRANSACT ALL REGULAR BUSINESS OF THE CORPORATION, SUBJECT TO THE LIMITATIONS IMPOSED BY THE COLORADO NONPROFIT CORPORATION ACT AND TO ANY LIMITATIONS IMPOSED BY THE BOARD, INCLUDING, THAT SUCH COMMITTEE SHALL NOT: (1) ELECT, APPOINT, OR REMOVE ANY DIRECTOR; (2) AMEND ARTICLES OF INCORPORATION; (3) ADOPT, AMEND, OR REPEAL BYLAWS; (4) APPROVE A PLAN OF CONVERSION OR PLAN OF MERGER WITH ANOTHER ENTITY; OR (5) APPROVE A SALE, LEASE, EXCHANGE, OR OTHER DISPOSITION OF ALL, OR SUBSTANTIALLY ALL, OF ITS PROPERTY. THE EXECUTIVE COMMITTEE MUST REPORT ALL ACTIONS TAKEN INDEPENDENTLY AND ON BEHALF OF THE BOARD TO THE FULL GOVERNING BOARD, AND THE FULL GOVERNING BOARD MUST VOTE ON THESE ACTIONS AND REORD THEM IN THE BOARD MINUTES.
FORM 990, PART VI, SECTION A, LINE 3DURING 2022, THE ORGANIZATION PAID COMMUNITY LINK CONSULTING $167,640. FOR INTERIM FINANCIAL MANAGEMENT SERVICES, WHICH INCLUDED THE SERVICES PERFORMED BY JOHANNA HELLER, INTERIM CFO.
FORM 990, PART VI, SECTION A, LINE 4THE BYLAWS WERE AMENDED TO REFLECT THE FOLLOWING CHANGES: -NON-CONSUMER BOARD MEMBERS AT NO TIME MAY MORE THAN ONE-HALF OF THE NON-CONSUMER BOARD MEMBERS DERIVE MORE THAN 10% OF THEIR ANNUAL INCOME FROM THE HEALTH CARE INDUSTRY. -CLARIFIED RESPONSIBILITIES FOR BOARD OF DIRECTORS. -EACH DIRECTOR SHALL BE ENTITLED TO ONE VOTE ON ANY MATTER BEFORE THE BOARD. VOTING BY PROXY SHALL BE PERMITTED. A DIRECTOR MAY BE DEEMED TO BE PRESENT AT A MEETING AND TO VOTE IF THE DIRECTOR HAS GRANTED A SIGNED WRITTEN PROXY TO ANOTHER DIRECTOR WHO IS PRESENT AT THE MEETING, AUTHORIZING THE OTHER DIRECTOR TO CAST THE VOTE THAT IS DIRECTED TO CAST BY WRITTEN PROXY WITH RESPECT TO THE PARTICULAR PROPOSAL THAT IS DESCRIBED WITH REASONABLE SPECIFICITY IN THE PROXY. -ADDED POLICY FOR REMOVAL AND RESIGNATION OF CEO. -ANY VACANCY COUSED BY THE DEATH, RESIGNATION, REMOVAL, DISQUALIFICATION, OR OTHERWISE, OF THE CEO SHALL BE FILLED BY THE BOARD. VACANCIES OCCURRING IN THE OFFICES OF THE CEO APPOINTED AT THE DISCRETION OF THE BOARD MAY OR MAY NOT BE FILLED AS THE BOARD SHALL DETERMINE. -ADDED DUTIES OF CHIEF FINANCIAL OFFICER. -ADDED DUTIES OF CHIEF ADMINISTRATIVE OFFICER.
FORM 990, PART VI, SECTION B, LINE 11BTHE FORM 990 WAS PREPARED BY THE ORGANIZATION'S INDEPENDENT CPA WITH INFORMATION PROVIDED BY MANAGEMENT. A COPY OF THE FORM 990 WAS REVIEWED BY THE CFO AND THE CEO, THEN BY THE FINANCE COMMITTEE. THE 990 IS THEN DISTRIBUTED TO THE BOARD OF DIRECTORS PRIOR TO FILING.
FORM 990, PART VI, SECTION B, LINE 12CON AN ANNUAL BASIS, EACH BOARD MEMBER COMPLETES A CONFLICT OF INTEREST DISCLOSURE. IF A POTENTIAL CONFLICT OF INTEREST ARISES WITH A BOARD MEMBER, THE INDIVIDUAL PROVIDES WRITTEN NOTICE OF THE POTENTIAL CONFLICT OF INTEREST TO THE BOARD OF DIRECTORS AND REFRAINS FROM PARTICIPATION IN ANY DISCUSSION OR VOTING ON ANY MATTERS PERTAINING TO THE CONFLICT OF INTEREST. ANY DISCUSSION OF POTENTIAL CONFLICTS OF INTEREST ARE DOCUMENTED IN THE BOARD MINUTES.
FORM 990, PART VI, SECTION B, LINE 15ATHE BOARD OF DIRECTORS ANNUALLY REVIEWS THE CEO'S PERFORMANCE TO DETERMINE COMPENSATION. SALARY SURVEYS FROM THE COLORADO COMMUNITY HEALTH NETWORK AND THE COLORADO NONPROFIT ASSOCIATION ARE USED AS GUIDELINES. DISCUSSION RELATED TO THE DELIBERATION AND THE DECISION IS DOCUMENTED IN THE BOARD MINUTES. BASED ON COMPARABLE SALARY INFORMATION, THE CEO, CONTROLLER AND HR MANAGER REVIEW AND APPROVE THE COMPENSATION FOR THE OTHER OFFICERS OF THE ORGANIZATION. THE MOST RECENT COMPENSATION REVIEW WAS CONDUCTED IN 2022.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, AUDITED FINANCIAL STATEMENTS, AND CONFLICT OF INTEREST POLICY AVAILABLE TO THE GENERAL PUBLIC UPON REQUEST.
FORM 990, PART IX, LINE 11GOTHER SERVICES: PROGRAM SERVICE EXPENSES 125,195. MANAGEMENT AND GENERAL EXPENSES 613,127. FUNDRAISING EXPENSES 54,610. TOTAL EXPENSES 792,932.
FORM 990, PART XI, LINE 9:CHANGE IN BENEFICIAL INTEREST IN ASSETS HELD BY OTHERS -10,118.
PART XII, LINE 2CTHE PROCESS AND OVERSIGHT FOR SELECTION OF AN INDEPENDENT ACCOUNTANT HAS NOT CHANGED SINCE THE PRIOR YEAR.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp

Disregarded Entity Name DisregardedEntityName

FieldValueIRS element (for citing)
Business Name Line1TEPEYAC QALICB INCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line14725 HIGH STREETAddressLine1Txt
CityDENVERCityNm
State AbbreviationCOStateAbbreviationCd
ZIP80216ZIPCd
FieldValueIRS element (for citing)
EIN851563851EIN
Primary ActivitiesSUPPORT LA CLINICA TEPEYACPrimaryActivitiesTxt
Legal Domicile StateCOLegalDomicileStateCd
Exempt Code Section501(C)(3)ExemptCodeSectionTxt
Public Charity StatusLINE 12C, III-FIPublicCharityStatusTxt

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1LA CLINICA TEPEYACBusinessNameLine1Txt
FieldValueIRS element (for citing)
Controlled OrganizationYes (1)ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgYes (1)GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgYes (1)LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (1)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other OrgYes (1)PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees Sharing0PaidEmployeesSharingInd
Reimbursement Paid To Other Org0ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (2 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
TEPEYAC QALICB INC
B$60,000CASH PAID
TEPEYAC QALICB INC
D$174,514FAIR MARKET VALUE