2022-05-23T08:17:44-07:00 2021-03-31 660755792 Rodriguez Rivera & Toro PSC PO BOX 1080 MAYAGUEZ PR 006811080 990 2020-04-01 660428488 COSTA SALUD COMMUNITY HEALTH CENTERS INC COST 7878235555 PO Box 638 Rincon PR RQ 00677 Mrs Susana Perez Maldonado Executive Director 7878235555 2022-05-15 0 CPA Ivan Santiago Vega P01620794 7878343100 2022-05-15 1 11 1 AAL2 2020 2022-09-23 18:48:47Z MRS SUSANA PEREZ MALDONADO POBOX 638 RINCON PR 00677 30817969 0 X http://www.costasalud.com X 1977 PR To provide high quality primary health care services to low income individuals and families in Rincón, Puerto Rico and adjacent areas. 10 10 158 0 0 0 3320774 4912832 20744922 25037803 19136 43552 11131 823782 24095963 30817969 0 0 0 0 5072207 5655246 0 0 0 17188188 20299029 22260395 25954275 1835568 4863694 25310839 32143154 3927123 5172419 21383716 26970735 To provide high quality primary health care services to low income individuals and families in the area of Rincon, Puerto Rico and other adjacent areas. 0 0 21458369 0 24629561 To provide high quality primary health care services to low income individuals and families in the area of Rincon, Puerto Rico and other adjacent areas. 0 0 0 21458369 1 0 0 0 0 0 0 1 0 0 1 0 0 0 0 0 1 0 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 0 0 0 0 1 0 0 158 1 0 0 0 0 0 0 0 0 X 10 10 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 1 1 1 0 PR X CPA Evelyn Ortiz Espinosa 7878235555 PO Box 638 Rincon PR RQ 00677 Mrs Susana Perez Executive Director 37.5 0 X 201698 0 0 Mrs Carmen Cotto Chief Medical Officer 37.5 0 X 135447 0 0 Dr Edgar Rodriguez Nazario Medical Director 37.5 0 X 115435 0 0 Mrs Laura Quinones Torres Deputy Executive Director 37.5 0 X 95735 0 0 Mrs Bernice Perez Chief Innovation Officer 37.5 0 X 76414 0 0 CPA Evelyn Ortiz Espinosa Chief Finance Officer 37.5 0 X 66780 0 0 Mrs Yanira Valle Torres Institutional Program Director 37.5 0 X 62358 0 0 Mrs Omayra Sanchez Lasalle Compliance Officer 37.5 0 X 55012 0 0 808879 0 0 3 0 1 0 Laboratorio Clinico Toledo Calle Palma 51 Arecibo PR 00612 Laboratory 181948 Jani Clean Services PO Box 876 Mayaguez PR 00681 Maintenance 158159 Greenway PO Box 203658 Dallas TX 75320 Electronic Record 133616 US Security Associates Inc 200 Mansell Court Ste 500 Roswell GA TB 30076 Security 127965 CSCG inc PO Box 991 Aguada PR 00602 Construction 287311 7 0 0 0 0 4912832 0 0 4912832 CAPITATION INCOME 900099 16009895 16009895 0 0 CO-PAYMENT OF MEDICAL SERVICE 900099 186217 186217 0 0 MEDICAL INSURANCE INCOME 900099 5983723 5983723 0 0 WRAPAROUND PAYMENTS 900099 2449726 2449726 0 0 408242 408242 0 0 25037803 43552 43552 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Miscellaneous Income 900099 32582 32582 0 0 Gain on Extinguishment of Debt-PPP Loan 900099 791200 791200 0 0 0 0 0 0 823782 30817969 25905137 0 0 X 0 0 0 0 0 0 0 0 808879 0 808879 0 0 0 3891517 3364695 526822 0 0 0 0 0 438201 325747 112454 0 516649 369834 146815 0 0 0 0 0 187435 0 187435 0 33534 0 33534 0 0 0 0 0 0 0 0 0 0 0 16520118 15495594 1024524 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 424754 297328 127426 0 11444 0 11444 0 0 0 0 0 0 0 0 0 141401 0 141401 0 0 0 0 0 589716 481896 107820 0 158310 0 158310 0 Rental of Space and Equipment 100148 0 100148 0 Drugs and Medicines 651846 651846 0 0 Supplies Expense 604127 457226 146901 0 Repairs and Maintenance 103102 0 103102 0 773094 14203 758891 0 25954275 21458369 4495906 0 10038176 14756012 1863844 2054793 0 1488048 3168410 0 0 0 0 0 0 103252 113581 49155 92355 16043726 4402005 11461175 11641721 0 297189 301279 0 0 10000 15003 25310839 32143154 1343909 2954115 0 0 0 0 0 0 0 0 0 0 2583214 2218304 0 0 0 3927123 5172419 X 21383716 26970735 0 0 21383716 26970735 25310839 32143154 4863694 0 0 0 723325 0 X 0 1 1 1 1 X 19195720 20735205 23583653 24062326 29946119 117523023 0 0 0 0 0 0 0 0 0 0 19195720 20735205 23583653 24062326 29946119 117523023 117523023 32625 33472 10813 19136 43552 139598 0 0 0 0 8106 11300 6174 11131 823782 860493 118523114 0.99156 0.99839 X Schedule A, Part II, Line 10 Other Income items consist of miscellaneous income and gain on extinguishment of debt-PPP Loan 0 0 X Patient Relaxation Setting 0 1877249 0 1877249 10115647 0 1761592 8354055 428844 0 160817 268027 2554841 0 1870630 684211 1067145 0 608966 458179 11641721 30817969 0 0 0 0 0 30817969 0 0 0 30817969 25954275 0 0 0 0 0 25954275 0 0 0 25954275 Schedule D, Part III, Line 1 Costa Salud capitalized all property and equipment acquisitions in excess of $5,000 and an estimated useful life of one year or more. Donations of property and equipment are recorded as support at their estimated fair value at the date of donation. Such donations and property acquired are reported as support without donor restrictions unless the donor or grantor has restricted the asset to a specific purpose. Assets donated or acquired with explicit restrictions regarding their use and contributions of cash that must be used to acquire property and equipment are reported as support with donor restrictions. Costa Salud reports expiration of restrictions when the acquired or donated long-live assets are place in service. At the time net assets are reclassified from net assets with donor restrictions to net assets without donor restrictions. Repair and maintenance are expensed as incurred. Expenditures that increase the value or productive capacity of assets are also capitalized. Schedule D, Part III, Line 4 The artwork included on Costa Salud financial statements were recognized following the organization capitalization policy (property and equipment acquisitions in excess of $5,000 and an estimated useful life of one year or more are capitalized). These assets consist mostly of artwork located between the waiting room and emergency room hall. Its purpose is to create a setting to help patients calm down and relax during their visit. X 0 0 0 0 0 0 0 0 0 Mrs Susana Perez Executive Director 201698 0 0 0 0 0 0 0 0 0 201698 0 0 0 Form 990, Part VI, Section B, Line 11b The Form 990 is prepared by external auditors using the accounting records and other information and data used to prepare the audited financial statements. Once prepared, the form is given to the top management of the organization for the review and discussion with the external auditors. Once discussed with the external auditors, the Executive Director present and discuss the Form 990 with the Governing Board for approval. Once approved by the Board the form is submitted to the IRS. Form 990, Part VI, Section B, Line 12c The organization has a conflict of interest policy which is monitored by top management and the Governing Board. Top management of the organization and the Governing Board monitors the conflict of interest policy by analyzing sensitive transactions and contractual agreements and by requiring employees and board members to disclose any interest or relationship with a third party. The policy is also enforced throughout seminars and conferences to officers and key employees. Form 990, Part VI, Section B, Line 15 The compensation of the Executive Director is determined and approved by the Governing Board. The compensation is determined based on experience, qualifications, performance and comparable data of executive officers in Puerto Rico. Compensation of other officers and key employees such as the Chief Financial Officer, Medical Director, Chief Operating Officer and others is primarily determined based on experience, qualifications, performance and comparable or similar data for those positions in Puerto Rico. Compensation of officers and key employees is presented to the Governing Board for approval. Form 990, Part VI, Section C, Line 19 Governing documents, conflict of interest policy and financial statements are available for public inspection at the organization's administrative offices. They are delivered to the intended users (public) but under supervision of an official of the corporation. The availability of such documents may depend on the purposes and use of such information. Form 990, Part IX, Line 11g Other expenses on the Fees for Services (non-employees) category consist mainly of medical services paid to third party providers on behalf of the Organization as a part of capitation contracts with the Puerto Rico Government Health Care Reform. It also includes the cost of contracts for services provided by independent contractors. On August 10, 2021, the organization filed an extension request in order to have additional time for filing the Form 990. Unfortunately, the pandemic caused by Covid-19 has impacted our work environment, as recognized by OMB in Memorandum M-21-20 which provides extensions for filing single audits with the Federal Audit Clearinghouse, among other federal reports. Despite our efforts and commitment, we have not been able to gather on time the financial data to comply with filing the Form 990 before the date granted by extension request.