2019-05-15T12:39:33-05:00 2018-06-30 946214841 ARMANINO LLP 12657 ALCOSTA BLVD STE 500 SAN RAMON CA 945834600 990 2017-07-01 237118361 TIBURCIO VASQUEZ HEALTH CENTER INC TIBU 5104715880 22331 MISSION BLVD HAYWARD CA 945413911 LUCIEN FREEMAN CFO 5104715880 2019-05-15 1 KATY BROWN P00650274 9257902600 2019-05-13 38.111.205.16 2019-05-15 10:19:01 PD P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 A2E24C1476FD8CDFD41A098AE2F632677580B14E 2017 2019-02-21 02:37:17Z LUCIEN FREEMAN 22331 MISSION BLVD HAYWARD CA 945413911 34504597 0 X WWW.TVHC.ORG X 1971 CA 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. 8 8 361 15 0 0 12158494 12312514 18343633 21929038 70726 71103 488650 191942 31061503 34504597 1000 4125 0 0 20911022 23304617 0 0 0 8119217 8971166 29031239 32279908 2030264 2224689 18037104 20549058 8651929 8939194 9385175 11609864 PROVIDE COMPREHENSIVE COMMUNITY HEALTH SERVICES TO SOUTHERN ALAMEDA COUNTY. 0 0 3419273 3419273 HEALTHPAC: PROVIDES MEDICALLY NECESSARY SERVICES TO LOW-INCOME UNINSURED INDIVIDUALS ENROLLED IN THE COUNTY MEDICALLY INDIGENT SERVICES PLAN. 2050000 2050000 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. 1893304 1565501 EPSDT: PROVIDES MENTAL HEALTH SERVICES, CASE MANAGEMENT, CRISIS INTERVENTION, AND MEDICATION SUPPORT SERVICES TO TEEN PARENTS, ADULT PARENTS AND THEIR CHILDREN. 19485365 4125 14894264 19485365 4125 14894264 26847942 1 1 0 0 0 0 0 0 0 0 1 0 1 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 44 0 1 361 1 0 0 0 0 0 0 0 0 0 0 X 8 8 1 0 0 0 0 0 0 1 1 0 1 1 1 1 1 1 1 1 1 1 0 CA X LUCIEN FREEMAN 5104715880 22331 MISSION BLVD HAYWARD CA 945413911 NANCY SOTO PRESIDENT 3.00 X X 0 0 0 MINYON CORCUCHIA-GARDE VICE PRESIDENT 1.50 X X 0 0 0 JOSUE A HERNANDEZ SECRETARY 1.50 X X 0 0 0 JAIME PATINO TREASURER 1.50 X X 0 0 0 JESSE ROBLES BOARD MEMBER 1.50 X 0 0 0 AHMAD ASIR BOARD MEMBER 1.50 X 0 0 0 DIANA SUAREZ BOARD MEMBER 1.50 X 0 0 0 JENNIE REYES BOARD MEMBER 1.50 X 0 0 0 DAVID B VLIET CHIEF EXECUTIVE OFFICER 40.00 X 267230 0 25244 ANDREA SCHWAB-GALINDO CHIEF ANALYTICS OFFICER 40.00 X 166249 0 11419 BRENT COPEN CHIEF FINANCIAL OFFICER 40.00 X 191819 0 11856 CALEB J SANDFORD CHIEF OPERATIONS OFFICER 40.00 X 153008 0 12987 PORSHIA MACK CHIEF MEDICAL OFFICER 40.00 X 163885 0 4836 SRIDEVI PONNALA CHIEF DENTAL OFFICER 40.00 X 215539 0 2437 JAMES H KRAVETZ PHYSICIAN 40.00 X 211039 0 2152 PARVEEN KAUR PHYSICIAN 40.00 X 201760 0 10799 ANKITA SHRIVASTAVA PHYSICIAN 40.00 X 190250 0 2043 ROBERTO DIAZ PHYSICIAN 40.00 X 180077 0 1999 MADHUR BHATNAGAR PHYSICIAN 40.00 X 178283 0 11073 2119139 0 96845 29 0 1 0 PRIORITY MANAGEMENT GROUP 700 SCHOOL STREET PAWTUCKET RI 02860 BILLING 662310 MCKESSON MEDICAL SURGICIAL PO BOX 634404 CINCINNATI OH 452634404 MEDICAL SUPPLIES 576937 BAY CHILDREN'S PHYSICIANS 6475 CHRISTIE AVENUE SUITE 300 EMERYVILLE CA 94608 PHYSICIAN SERVICES 500419 QUEST DIAGNOSTICS PO BOX 50368 LOS ANGELES CA 900740368 LABORATORY SERVICES 405741 HENRY SCHEIN INC PO BOX 7156 PASADENA CA 911097156 DENTAL SUPPLIES 238250 14 10876894 1435620 12312514 PATIENT & THIRD PARTY 621300 18828876 18828876 CAPITATION REVENUE 621300 2877231 2877231 OTHER PROGRAM REVENUE 621300 222931 222931 21929038 71103 71103 6000 0 6000 6000 6000 OTHER INCOME 900099 185942 185942 185942 34504597 21929038 0 263045 X 4125 4125 1410876 494060 916816 17368276 15332202 2036074 335460 310738 24722 2712395 2456621 255774 1477610 1254342 223268 50768 1850 48918 183102 1050 182052 2422203 2349909 72294 24963 4435 20528 369393 283631 85762 607109 553408 53701 1467699 1188935 278764 71149 53679 17470 107398 64694 42704 228695 205394 23301 294293 142920 151373 131550 131550 PROGRAM SUPPLIES 1346931 1346931 EQUIPMENT & MAINTENANCE 414517 338395 76122 PHARMACY 215759 215759 LICENSES & FEES 196930 106760 90170 838707 138104 700603 32279908 26847942 5431966 0 3968756 4089810 12186 2017121 2395152 2644212 1706250 1504030 150880 392833 9439583 7340441 2038514 2099142 7003000 7003000 762366 798910 18037104 20549058 2859681 2802638 142823 49941 5395650 4586355 253775 1500260 8651929 8939194 X 9326729 11604834 58446 5030 9385175 11609864 18037104 20549058 2224689 0 X X 0 1 X 1 1 1 X 11461538 10576830 10452791 12158494 12312514 56962167 11461538 10576830 10452791 12158494 12312514 56962167 111016 56851151 28005 77526 76145 76226 77103 335005 369885 498113 455546 14951 185942 1524437 58821609 82640483 0.96650 0.96780 X 20317 20317 3778286 2372696 1405590 5640980 4967745 673235 2099142 INVESTMENT IN NMTC TVHC FUND 7003000 F 7003000 PPS SETTLEMENTS 1500260 1500260 X PART X, LINE 2: 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. X 0 1 0 0 0 0 0 0 0 DAVID B VLIET CHIEF EXECUTIVE OFFICER 267230 0 0 0 0 0 13040 0 12204 0 292474 0 0 0 ANDREA SCHWAB-GALINDO CHIEF ANALYTICS OFFICER 166249 0 0 0 0 0 1040 0 10379 0 177668 0 0 0 BRENT COPEN CHIEF FINANCIAL OFFICER 191819 0 0 0 0 0 607 0 11249 0 203675 0 0 0 CALEB J SANDFORD CHIEF OPERATIONS OFFICER 145008 0 8000 0 0 0 693 0 12294 0 165995 0 0 0 PORSHIA MACK CHIEF MEDICAL OFFICER 143885 0 20000 0 0 0 0 0 4836 0 168721 0 0 0 SRIDEVI PONNALA CHIEF DENTAL OFFICER 215539 0 0 0 0 0 1040 0 1397 0 217976 0 0 0 JAMES H KRAVETZ PHYSICIAN 211039 0 0 0 0 0 1040 0 1112 0 213191 0 0 0 PARVEEN KAUR PHYSICIAN 201510 0 250 0 0 0 780 0 10019 0 212559 0 0 0 ANKITA SHRIVASTAVA PHYSICIAN 190000 0 250 0 0 0 1040 0 1003 0 192293 0 0 0 ROBERTO DIAZ PHYSICIAN 179827 0 250 0 0 0 960 0 1039 0 182076 0 0 0 MADHUR BHATNAGAR PHYSICIAN 178033 0 250 0 0 0 1040 0 10033 0 189356 0 0 0 PART I, LINE 4B DURING FYE 06/30/18, DAVID B. VLIET PARTICIPATED IN AND CONTRIBUTED $12,000 TO A 457(B) CONTRIBUTION PLAN. 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 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 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 1 1 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0