TIBURCIO VASQUEZ HEALTH CENTER INC: Form 990, tax year 2017
View the entire original 990 at ProPublica ↗
- Organization
- TIBURCIO VASQUEZ HEALTH CENTER INC (EIN 23-7118361)
- Tax period
- 2017-07-01 to 2018-06-30
- Filed
- 2019-05-15
- IRS object ID
- 201901359349306715
- Schema version
- 2017v2.3
- 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 | 2019-05-15T12:39:33-05:00 | ReturnTs |
| Tax Period End | 2018-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 946214841 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ARMANINO LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 12657 ALCOSTA BLVD STE 500 | AddressLine1Txt |
| City | SAN RAMON | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 945834600 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2017-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 237118361 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TIBURCIO VASQUEZ HEALTH CENTER INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | TIBU | BusinessNameControlTxt |
| Phone | 5104715880 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 22331 MISSION BLVD | AddressLine1Txt |
| City | HAYWARD | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 945413911 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | LUCIEN FREEMAN | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 5104715880 | PhoneNum |
| Signature | 2019-05-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KATY BROWN | PreparerPersonNm |
| PTIN | P00650274 | PTIN |
| Phone | 9257902600 | PhoneNum |
| Preparation | 2019-05-13 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 38.111.205.16 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2019-05-15 | IPDt |
| IP Tm | 10:19:01 | IPTm |
| IP Timezone | PD | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | A2E24C1476FD8CDFD41A098AE2F632677580B14E | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2017 | TaxYr |
| Build TS | 2019-02-21 02:37:17Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | LUCIEN FREEMAN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 22331 MISSION BLVD | AddressLine1Txt |
| City | HAYWARD | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 945413911 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $34,504,597 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.TVHC.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1971 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | TIBURCIO VASQUEZ HEALTH CENTER, INC. IS A PRIVATE NONPROFIT ORGANIZATION FORMED TO SPONSOR, PROMOTE, AND PROVIDE COMPREHENSIVE COMMUNITY HEALTH SERVICES THAT APPROPRIATELY MEET THE PHYSICAL, MENTAL, AND SOCIAL NEEDS OF SOUTHERN ALAMEDA COUNTY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 8 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 8 | VotingMembersIndependentCnt |
| Total Employee | 361 | TotalEmployeeCnt |
| Total Volunteers | 15 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $12,158,494 | PYContributionsGrantsAmt |
| CY Contributions Grants | $12,312,514 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $18,343,633 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $21,929,038 | CYProgramServiceRevenueAmt |
| PY Investment Income | $70,726 | PYInvestmentIncomeAmt |
| CY Investment Income | $71,103 | CYInvestmentIncomeAmt |
| PY Other Revenue | $488,650 | PYOtherRevenueAmt |
| CY Other Revenue | $191,942 | CYOtherRevenueAmt |
| PY Total Revenue | $31,061,503 | PYTotalRevenueAmt |
| CY Total Revenue | $34,504,597 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $1,000 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $4,125 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $20,911,022 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $23,304,617 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $8,119,217 | PYOtherExpensesAmt |
| CY Other Expenses | $8,971,166 | CYOtherExpensesAmt |
| PY Total Expenses | $29,031,239 | PYTotalExpensesAmt |
| CY Total Expenses | $32,279,908 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $2,030,264 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $2,224,689 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $18,037,104 | TotalAssetsBOYAmt |
| Total Assets EOY | $20,549,058 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $8,651,929 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $8,939,194 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $9,385,175 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $11,609,864 | NetAssetsOrFundBalancesEOYAmt |
| Mission | PROVIDE COMPREHENSIVE COMMUNITY HEALTH SERVICES TO SOUTHERN ALAMEDA COUNTY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $3,419,273 | ExpenseAmt |
| Revenue | $3,419,273 | RevenueAmt |
| Desc | HEALTHPAC: PROVIDES MEDICALLY NECESSARY SERVICES TO LOW-INCOME UNINSURED INDIVIDUALS ENROLLED IN THE COUNTY MEDICALLY INDIGENT SERVICES PLAN. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $2,050,000 | ExpenseAmt |
| Revenue | $2,050,000 | RevenueAmt |
| Desc | PRIMARY CARE OUTPATIENT: THE MEDICAL CLINIC PROVIDES BASIC HEALTH CARE FOR THE PEOPLE OF ALL AGES FAMILY MEDICINE, INTERNAL MEDICINE, PEDIATRICS AND OBSTETRICS-GYNOCOLOGY. THE DENTAL DEPARTMENT OFFERS A VARIETY OF DENTAL CARE FOR CHILDREN AND ADULTS, INCLUDING DENTAL EXAMS, FILLINGS, CROWNS, ROOT CANALS, EXTRACTIONS, SPACE MAINTAINERS, AND EMERGENCY SERVICES. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,893,304 | ExpenseAmt |
| Revenue | $1,565,501 | RevenueAmt |
| Desc | EPSDT: PROVIDES MENTAL HEALTH SERVICES, CASE MANAGEMENT, CRISIS INTERVENTION, AND MEDICATION SUPPORT SERVICES TO TEEN PARENTS, ADULT PARENTS AND THEIR CHILDREN. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $19,485,365 | ExpenseAmt |
| Grant | $4,125 | GrantAmt |
| Revenue | $14,894,264 | RevenueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $19,485,365 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Grant | $4,125 | TotalOtherProgSrvcGrantAmt |
| Total Other Prog Srvc Revenue | $14,894,264 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $26,847,942 | 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 |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | Yes (1) | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | 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 With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| 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 | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | 0 | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 44 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 361 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| 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 |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 8 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 8 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | 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 | Yes (1) | LocalChaptersInd |
| Policies Reference Chapters | Yes (1) | PoliciesReferenceChaptersInd |
| 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 | LUCIEN FREEMAN | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5104715880 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 22331 MISSION BLVD | AddressLine1Txt |
| City | HAYWARD | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 945413911 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| NANCY SOTO | ||||||||
| PRESIDENT | 3.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| MINYON CORCUCHIA-GARDE | ||||||||
| VICE PRESIDENT | 1.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| JOSUE A HERNANDEZ | ||||||||
| SECRETARY | 1.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| JAIME PATINO | ||||||||
| TREASURER | 1.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| JESSE ROBLES | ||||||||
| BOARD MEMBER | 1.50 | Yes (X) | $0 | $0 | $0 | |||
| AHMAD ASIR | ||||||||
| BOARD MEMBER | 1.50 | Yes (X) | $0 | $0 | $0 | |||
| DIANA SUAREZ | ||||||||
| BOARD MEMBER | 1.50 | Yes (X) | $0 | $0 | $0 | |||
| JENNIE REYES | ||||||||
| BOARD MEMBER | 1.50 | Yes (X) | $0 | $0 | $0 | |||
| DAVID B VLIET | ||||||||
| CHIEF EXECUTIVE OFFICER | 40.00 | Yes (X) | $267,230 | $0 | $25,244 | |||
| ANDREA SCHWAB-GALINDO | ||||||||
| CHIEF ANALYTICS OFFICER | 40.00 | Yes (X) | $166,249 | $0 | $11,419 | |||
| BRENT COPEN | ||||||||
| CHIEF FINANCIAL OFFICER | 40.00 | Yes (X) | $191,819 | $0 | $11,856 | |||
| CALEB J SANDFORD | ||||||||
| CHIEF OPERATIONS OFFICER | 40.00 | Yes (X) | $153,008 | $0 | $12,987 | |||
| PORSHIA MACK | ||||||||
| CHIEF MEDICAL OFFICER | 40.00 | $163,885 | $0 | $4,836 | Yes (X) | |||
| SRIDEVI PONNALA | ||||||||
| CHIEF DENTAL OFFICER | 40.00 | $215,539 | $0 | $2,437 | Yes (X) | |||
| JAMES H KRAVETZ | ||||||||
| PHYSICIAN | 40.00 | $211,039 | $0 | $2,152 | Yes (X) | |||
| PARVEEN KAUR | ||||||||
| PHYSICIAN | 40.00 | $201,760 | $0 | $10,799 | Yes (X) | |||
| ANKITA SHRIVASTAVA | ||||||||
| PHYSICIAN | 40.00 | $190,250 | $0 | $2,043 | Yes (X) | |||
| ROBERTO DIAZ | ||||||||
| PHYSICIAN | 40.00 | $180,077 | $0 | $1,999 | Yes (X) | |||
| MADHUR BHATNAGAR | ||||||||
| PHYSICIAN | 40.00 | $178,283 | $0 | $11,073 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $2,119,139 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $96,845 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 29 | 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 |
|---|---|---|---|---|---|
| PRIORITY MANAGEMENT GROUP | |||||
| 700 SCHOOL STREET | PAWTUCKET | RI | 02860 | BILLING | $662,310 |
| MCKESSON MEDICAL SURGICIAL | |||||
| PO BOX 634404 | CINCINNATI | OH | 452634404 | MEDICAL SUPPLIES | $576,937 |
| BAY CHILDREN'S PHYSICIANS | |||||
| 6475 CHRISTIE AVENUE SUITE 300 | EMERYVILLE | CA | 94608 | PHYSICIAN SERVICES | $500,419 |
| QUEST DIAGNOSTICS | |||||
| PO BOX 50368 | LOS ANGELES | CA | 900740368 | LABORATORY SERVICES | $405,741 |
| HENRY SCHEIN INC | |||||
| PO BOX 7156 | PASADENA | CA | 911097156 | DENTAL SUPPLIES | $238,250 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 14 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $10,876,894 | GovernmentGrantsAmt |
| All Other Contributions | $1,435,620 | AllOtherContributionsAmt |
| Total Contributions | $12,312,514 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT & THIRD PARTY | 621300 | $18,828,876 | $18,828,876 |
| CAPITATION REVENUE | 621300 | $2,877,231 | $2,877,231 |
| OTHER PROGRAM REVENUE | 621300 | $222,931 | $222,931 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $21,929,038 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $71,103 | TotalRevenueColumnAmt |
| Exclusion | $71,103 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $6,000 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $6,000 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $6,000 | TotalRevenueColumnAmt |
| Exclusion | $6,000 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OTHER INCOME | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $185,942 | TotalRevenueColumnAmt |
| Exclusion | $185,942 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $185,942 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $34,504,597 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $21,929,038 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $263,045 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,125 | TotalAmt |
| Program Services | $4,125 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,410,876 | TotalAmt |
| Program Services | $494,060 | ProgramServicesAmt |
| Management And General | $916,816 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,368,276 | TotalAmt |
| Program Services | $15,332,202 | ProgramServicesAmt |
| Management And General | $2,036,074 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $335,460 | TotalAmt |
| Program Services | $310,738 | ProgramServicesAmt |
| Management And General | $24,722 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,712,395 | TotalAmt |
| Program Services | $2,456,621 | ProgramServicesAmt |
| Management And General | $255,774 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,477,610 | TotalAmt |
| Program Services | $1,254,342 | ProgramServicesAmt |
| Management And General | $223,268 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $50,768 | TotalAmt |
| Program Services | $1,850 | ProgramServicesAmt |
| Management And General | $48,918 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $183,102 | TotalAmt |
| Program Services | $1,050 | ProgramServicesAmt |
| Management And General | $182,052 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,422,203 | TotalAmt |
| Program Services | $2,349,909 | ProgramServicesAmt |
| Management And General | $72,294 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,963 | TotalAmt |
| Program Services | $4,435 | ProgramServicesAmt |
| Management And General | $20,528 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $369,393 | TotalAmt |
| Program Services | $283,631 | ProgramServicesAmt |
| Management And General | $85,762 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $607,109 | TotalAmt |
| Program Services | $553,408 | ProgramServicesAmt |
| Management And General | $53,701 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,467,699 | TotalAmt |
| Program Services | $1,188,935 | ProgramServicesAmt |
| Management And General | $278,764 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $71,149 | TotalAmt |
| Program Services | $53,679 | ProgramServicesAmt |
| Management And General | $17,470 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $107,398 | TotalAmt |
| Program Services | $64,694 | ProgramServicesAmt |
| Management And General | $42,704 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $228,695 | TotalAmt |
| Program Services | $205,394 | ProgramServicesAmt |
| Management And General | $23,301 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $294,293 | TotalAmt |
| Program Services | $142,920 | ProgramServicesAmt |
| Management And General | $151,373 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $131,550 | TotalAmt |
| Management And General | $131,550 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| PROGRAM SUPPLIES | $1,346,931 | $1,346,931 | |
| EQUIPMENT & MAINTENANCE | $414,517 | $338,395 | $76,122 |
| PHARMACY | $215,759 | $215,759 | |
| LICENSES & FEES | $196,930 | $106,760 | $90,170 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $838,707 | TotalAmt |
| Program Services | $138,104 | ProgramServicesAmt |
| Management And General | $700,603 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $32,279,908 | TotalAmt |
| Program Services | $26,847,942 | ProgramServicesAmt |
| Management And General | $5,431,966 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,968,756 | BOYAmt |
| EOY | $4,089,810 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,186 | BOYAmt |
| EOY | $2,017,121 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,395,152 | BOYAmt |
| EOY | $2,644,212 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,706,250 | BOYAmt |
| EOY | $1,504,030 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $150,880 | BOYAmt |
| EOY | $392,833 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $9,439,583 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $7,340,441 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,038,514 | BOYAmt |
| EOY | $2,099,142 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,003,000 | BOYAmt |
| EOY | $7,003,000 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $762,366 | BOYAmt |
| EOY | $798,910 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,037,104 | BOYAmt |
| EOY | $20,549,058 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,859,681 | BOYAmt |
| EOY | $2,802,638 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $142,823 | BOYAmt |
| EOY | $49,941 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,395,650 | BOYAmt |
| EOY | $4,586,355 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $253,775 | BOYAmt |
| EOY | $1,500,260 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,651,929 | BOYAmt |
| EOY | $8,939,194 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,326,729 | BOYAmt |
| EOY | $11,604,834 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $58,446 | BOYAmt |
| EOY | $5,030 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,385,175 | BOYAmt |
| EOY | $11,609,864 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,037,104 | BOYAmt |
| EOY | $20,549,058 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $2,224,689 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| 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) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| 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 | $11,461,538 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $10,576,830 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $10,452,791 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $12,158,494 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $12,312,514 | CurrentTaxYearAmt |
| Total | $56,962,167 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $11,461,538 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $10,576,830 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $10,452,791 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $12,158,494 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $12,312,514 | CurrentTaxYearAmt |
| Total | $56,962,167 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Substantial Contributors Tot | $111,016 | SubstantialContributorsTotAmt |
| Public Support Total170 | $56,851,151 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $28,005 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $77,526 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $76,145 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $76,226 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $77,103 | CurrentTaxYearAmt |
| Total | $335,005 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $369,885 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $498,113 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $455,546 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $14,951 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $185,942 | CurrentTaxYearAmt |
| Total | $1,524,437 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $58,821,609 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $82,640,483 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.96650 | PublicSupportCY170Pct |
| Public Support PY170 | 0.96780 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Schedule B IRS990ScheduleB
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $20,317 | OtherCostOrOtherBasisAmt |
| Book Value | $20,317 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,778,286 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,372,696 | DepreciationAmt |
| Book Value | $1,405,590 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,640,980 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,967,745 | DepreciationAmt |
| Book Value | $673,235 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $2,099,142 | TotalBookValueLandBuildingsAmt |
Invst Program Related Org InvstProgramRelatedOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | INVESTMENT IN NMTC TVHC FUND | Desc |
| Book Value | $7,003,000 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Program Rltd | $7,003,000 | TotalBookValueProgramRltdAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PPS SETTLEMENTS | Desc |
| Amt | $1,500,260 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,500,260 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | TVHC IS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE AND FROM STATE INCOME TAX UNDER SECTION 23701(D) OF THE REVENUE AND TAXATION CODE OF THE STATE OF CALIFORNIA. ACCORDINGLY, CONTRIBUTIONS TO TVHC ARE QUALIFIED CHARITABLE CONTRIBUTION DEDUCTIONS. TVHC HAS EVALUATED ITS CURRENT TAX POSITIONS AND HAS CONCLUDED THAT AS OF JUNE 30, 2018, IT DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS FOR WHICH A RESERVE WOULD BE NECESSARY. TVHC FILES U.S. FEDERAL AND STATE RETURNS, AND IS GENERALLY NO LONGER SUBJECT TO TAX EXAMINATIONS FOR YEARS PRIOR TO 2014 AND 2013, RESPECTIVELY. TVHC FACILITIES, INC. AND TVHC FACILITIES II, INC. ARE QUALIFIED AS TAX EXEMPT ORGANIZATIONS. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DAVID B VLIET | ||||||||||||||
| CHIEF EXECUTIVE OFFICER | $267,230 | $0 | $0 | $0 | $0 | $0 | $13,040 | $0 | $12,204 | $0 | $292,474 | $0 | $0 | $0 |
| ANDREA SCHWAB-GALINDO | ||||||||||||||
| CHIEF ANALYTICS OFFICER | $166,249 | $0 | $0 | $0 | $0 | $0 | $1,040 | $0 | $10,379 | $0 | $177,668 | $0 | $0 | $0 |
| BRENT COPEN | ||||||||||||||
| CHIEF FINANCIAL OFFICER | $191,819 | $0 | $0 | $0 | $0 | $0 | $607 | $0 | $11,249 | $0 | $203,675 | $0 | $0 | $0 |
| CALEB J SANDFORD | ||||||||||||||
| CHIEF OPERATIONS OFFICER | $145,008 | $0 | $8,000 | $0 | $0 | $0 | $693 | $0 | $12,294 | $0 | $165,995 | $0 | $0 | $0 |
| PORSHIA MACK | ||||||||||||||
| CHIEF MEDICAL OFFICER | $143,885 | $0 | $20,000 | $0 | $0 | $0 | $0 | $0 | $4,836 | $0 | $168,721 | $0 | $0 | $0 |
| SRIDEVI PONNALA | ||||||||||||||
| CHIEF DENTAL OFFICER | $215,539 | $0 | $0 | $0 | $0 | $0 | $1,040 | $0 | $1,397 | $0 | $217,976 | $0 | $0 | $0 |
| JAMES H KRAVETZ | ||||||||||||||
| PHYSICIAN | $211,039 | $0 | $0 | $0 | $0 | $0 | $1,040 | $0 | $1,112 | $0 | $213,191 | $0 | $0 | $0 |
| PARVEEN KAUR | ||||||||||||||
| PHYSICIAN | $201,510 | $0 | $250 | $0 | $0 | $0 | $780 | $0 | $10,019 | $0 | $212,559 | $0 | $0 | $0 |
| ANKITA SHRIVASTAVA | ||||||||||||||
| PHYSICIAN | $190,000 | $0 | $250 | $0 | $0 | $0 | $1,040 | $0 | $1,003 | $0 | $192,293 | $0 | $0 | $0 |
| ROBERTO DIAZ | ||||||||||||||
| PHYSICIAN | $179,827 | $0 | $250 | $0 | $0 | $0 | $960 | $0 | $1,039 | $0 | $182,076 | $0 | $0 | $0 |
| MADHUR BHATNAGAR | ||||||||||||||
| PHYSICIAN | $178,033 | $0 | $250 | $0 | $0 | $0 | $1,040 | $0 | $10,033 | $0 | $189,356 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 4B | FormAndLineReferenceDesc |
| Explanation | DURING FYE 06/30/18, DAVID B. VLIET PARTICIPATED IN AND CONTRIBUTED $12,000 TO A 457(B) CONTRIBUTION PLAN. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | NANCY SOTO AND JESSE ROBLES HAVE A FAMILY RELATIONSHIP. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE TAX RETURN IS REVIEWED BY THE FINANCE COMMITTEE AND MADE AVAILABLE TO THE BOARD BEFORE FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | ALL EMPLOYEES SIGN A FORM THAT SIGNIFIES RECEIPT AND UNDERSTANDING OF THE CONFLICT OF INTEREST POLICY UPON HIRE. THE HR DEPARTMENT MAKES SURE THAT NEW CONSULTANTS, VENDORS, & FUTURE EMPLOYEES ARE NOT RELATED TO ANY OF THE EMPLOYEES THAT HAVE A DIRECT BUSINESS RELATIONSHIP/TRANSACTION WITH ANY RELATIVE OF AN OFFICER, BOARD MEMBER OR EMPLOYEE IN A MANAGEMENT POSITION THAT WILL HAVE A DIRECT BENEFIT FROM THE TRANSACTION. THE CONFLICT OF INTEREST POLICY MONITORED BY A COMBINATION OF MANAGEMENT, SUPERVISORS, AND THE HUMAN RESOURCES DEPARTMENT. IF ANY INTERESTED PERSON HAS A CONFLICT OF INTEREST, IT IS THE DUTY OF THE INTERESTED PERSON TO REPORT IT. IF THE INTERESTED PERSON IS NOT ABLE TO MITIGATE THE CONFLICT OF INTEREST, MANAGEMENT WILL DETERMINE THE APPROPRIATE COURSE OF ACTION IN EITHER MITIGATING THE CONFLICT OF INTEREST OR DISMISSING THE INTERESTED PERSON. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE HR OFFICER COMPARES THE COMPENSATIONS OF TVHC'S TOP MANAGEMENT OFFICIALS, DIRECTORS, AND STAFF TO THE STATE PRIMARY CARE ASSOCIATION TO MAKE SURE TVHC'S COMPENSATIONS ARE CLOSE TO MARKET. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | OTHER PROFESSIONAL FEES: PROGRAM SERVICE EXPENSES 2,349,909. MANAGEMENT AND GENERAL EXPENSES 72,294. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,422,203. |
| FORM 990, PART XII, LINE 2C: | THE PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| TVHC FACILITIES INC | ||||||||||
| 22331 MISSION BLVD | HAYWARD | CA | 945413911 | 270250766 | SUPPORT TVHC'S DIRECT CHARITABLE & EDUCATIONAL ACTIVITIES | CA | 509(A)(3) | LINE 12B, II | TIBURCIO VASQUEZ HEALTH CENTER INC | Yes (1) |
| TVHC FACILITIES II INC | ||||||||||
| 22331 MISSION BLVD | HAYWARD | CA | 945413911 | 463821919 | SUPPORT TVHC'S DIRECT CHARITABLE & EDUCATIONAL ACTIVITIES | CA | 509(A)(3) | LINE 12B, II | TIBURCIO VASQUEZ HEALTH CENTER INC | Yes (1) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | Yes (1) | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |