2018-05-14T16:01:25-05:00 2017-06-30 910189318 Moss Adams LLP 101 Second Street Suite 900 San Francisco CA 94105 990 2016-07-01 941743078 Gardner Family Health Network Inc GARD 4082002291 PO Box 1240 Alviso CA 95002 Efrain Coria COO/CFO 4082002291 2018-05-14 1 Michael Lumsden P01262236 4159561500 2018-05-11 12.129.7.100 2018-05-14 15:42:30 PD P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 5029E8FD9FE66385FA59B177B15FCADA276E8E0F 2016 2021-01-29 14:40:06Z Reymundo Espinoza PO Box 1240 Alviso CA 95002 35246868 0 X www.gardnerhealth.org X 1967 CA Gardner is dedicated to improving the health status of the communities we serve, especially the disenfranchised, disadvantaged and most vulnerable members. Our mission is to provide high quality, comprehensive health care, including prevention and education, early intervention, treatment and advocacy services which are affordable, respectful, culturally, linguistically and age appropriate. 11 11 423 25 0 0 11724581 13828621 23890467 21195869 -236 -222 143442 222377 35758254 35246645 64764 0 0 0 25368445 25006192 0 0 122294 9737066 9358540 35170275 34364732 587979 881913 16023983 16593205 8969662 8656971 7054321 7936234 X Gardner is dedicated to improving the health status of the communities we serve, especially the disenfranchised, disadvantaged, and most vulnerable members. Our mission is to provide high quality, comprehensive health care, including prevention and education, early intervention, treatment, and advocacy services which are affordable, respectful, culturally, linguistically and age appropriate. 0 0 28353219 21195869 During the fiscal year ended June 30, 2017, the organization provided outpatient primary care services to approximately 40,155 unduplicated clients (2,942 homeless clients). Over 92% of the indivdiuals were at or below 200% of the federal poverty level. The medical department provided 73,103 visits, the dental department provided 32,755 visits, the optometry department provided 13,299 visits, and the homeless department provided 6,196 visits. 28353219 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 0 0 1 62 0 1 423 1 0 0 0 0 0 0 0 0 0 0 X 11 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X Efrain Coria 4082002291 PO Box 1240 Alviso CA 95002 Noe P Lozano PhD Consumer Board Chair 2.00 2.00 X X 0 0 0 Joann K Zimmerman Prof Vice Chair start 1/1/2017 2.00 2.00 X X 0 0 0 Jose Raul Alcantar Consumer Board Treasurer 2.00 2.00 X X 0 0 0 Allison L Pitt Professional Board Secretary 2.00 2.00 X X 0 0 0 William Roth Professional Board Member-at-Large 2.00 2.00 X X 0 0 0 Frank V Serrano MSW EdD Prof Vice Chair / Board Member 2.00 2.00 X X 0 0 0 Irma Terrazas Professional Board Member 2.00 2.00 X 0 0 0 Adolfo Gomez Consumer Board Member 2.00 2.00 X 0 0 0 Guillermo Viveros Professional Board Member 2.00 2.00 X 0 0 0 Horacio Figarella Consumer Board Member 2.00 2.00 X 0 0 0 Patricia Gutierrez Consumer Board Member 2.00 2.00 X 0 0 0 Henry Totah Consumer Board Member thru 9/2016 2.00 2.00 X 0 0 0 Reymundo Espinoza MPH Chief Executive Officer 24.00 16.00 X 157500 112082 66881 Efrain Coria COO & CFO 28.00 12.00 X 186370 94657 59310 Ranjani Chandramouli MD Medical Director 40.00 0.00 X 245249 0 37343 Laurie Halsey Chief Admin/HR Officer thru 10/2016 24.00 16.00 X 96731 58356 17254 Francisco Camaclang Carpio MD Doctor 40.00 0.00 X 159500 0 3445 Nayyar Khan MD Doctor 40.00 0.00 X 166575 0 3598 Tzvetanka Zlatanova MD Doctor 40.00 0.00 X 175058 0 16879 Carl Hayes MD Doctor 40.00 0.00 X 189700 0 1041 George Barghouth MD Doctor 40.00 0.00 X 198131 0 45631 1574814 265095 251382 36 0 1 0 Lucile Packard Children's Hospital 725 Welch Road Palo Alto CA 94304 Outside Provider Services 681124 BRMS PO Box 2140 Folsom CA 95763 Health Insurance Consultant 559530 WellDyneRX PO Box 4517 Englewood CO 80155 Pharmacy Benefit Manager 548885 CompHealth 7259 S Bingham Jct Blvd Midvale UT 84047 Outside Staffing 306098 Quality Systems Inc 18111 Von Karman Ave Suite 700 Irvine CA 92612 IT Maintenance Services 291876 16 12241760 1586861 86551 13828621 Net patient revenue 621400 18465338 18465338 Pharmacy revenue 446110 1400959 1400959 Risk pool - Medi-Cal 621400 1329572 1329572 21195869 1 1 65652 0 65652 65652 65652 223 -223 -223 -223 Other revenue 900099 156725 156725 156725 35246645 19794910 0 1623114 770404 282592 487812 18599897 15618666 2911539 69692 461019 390193 70826 3934962 3246613 667978 20371 1239910 1006063 233847 31853 31853 39313 39313 1824459 1444090 380369 7105 154 6951 1246948 956007 267440 23501 2425413 2137218 288195 159866 85613 74253 57709 8283 49426 1202243 982104 219168 971 179901 143921 35980 Medical Supplies 1849459 1849459 Dues and Subscriptions 94998 47499 47499 239273 154744 76770 7759 34364732 28353219 5889219 122294 3101211 4116867 38726 38504 1056887 1870024 2171641 1648210 296233 394822 71661 197753 27593249 20199958 8194052 7393291 1093572 933734 16023983 16593205 2913045 2745949 200000 170117 3050000 2930000 2806617 2810905 8969662 8656971 X 7030589 7914979 23732 21255 7054321 7936234 16023983 16593205 881913 0 X 0 1 X 1 1 1 X 11370339 11674902 11974040 11724581 13828621 60572483 11370339 11674902 11974040 11724581 13828621 60572483 60572483 94958 39852 59689 60170 65653 320322 1118502 230331 52688 83274 156725 1641520 62534325 105560562 0.96860 0.96390 X Schedule A, Part II, Line 10, Explanation of Other Income: Other Income - 2012 Amount: $ 1,118,502. 2013 Amount: $ 230,331. 2014 Amount: $ 52,688. 2015 Amount: $ 83,274. 2016 Amount: $ 156,725. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1506605 1506605 12806876 11720907 1085969 6521686 2812040 3709646 6575874 5557686 1018188 182208 109325 72883 7393291 Security Deposits 120898 Due From GFCC 51753 Estimated Third-Party Payor Settlements 761083 933734 Self Insurance Payable 813408 Estimated Third-Party Payor Settlements 675381 Due to GFCC 25120 Deferred Rent 1296996 2810905 X Part X, Line 2: The Organization is exempt from Federal Taxes under Section 501(c)(3) of the Internal Revenue Code as amended and Section 23701(d) of the Revenue and Taxation Code of the State of California. Accordingly, no provision for Federal and Franchise taxes has been recognized in the consolidated financial statements. The Organization has adopted the accounting guidance related to uncertain tax positions, and has evaluated its tax positions and believes that all of the positions taken by the Organization in its federal and state exempt organization tax returns are more likely than not to be sustained upon examination. The Organization's returns are subject to examination by federal and state taxing authorities generally for three years after they are filed. X X X 0 0 0 0 0 0 0 0 0 Reymundo Espinoza MPH Chief Executive Officer 153461 100697 0 0 4039 11385 12512 28082 26287 0 196299 140164 0 0 Efrain Coria COO & CFO 185813 75057 0 3000 557 16600 8866 13462 36982 0 232218 108119 0 0 Ranjani Chandramouli MD Medical Director 242527 0 0 0 2722 0 11056 0 26287 0 282592 0 0 0 Laurie Halsey Chief Admin/HR Officer thru 10/2016 80671 58356 0 0 16060 0 2170 1260 13824 0 112725 59616 0 0 Francisco Camaclang Carpio MD Doctor 158760 0 0 0 740 0 3445 0 0 0 162945 0 0 0 Nayyar Khan MD Doctor 164348 0 0 0 2227 0 3598 0 0 0 170173 0 0 0 Tzvetanka Zlatanova MD Doctor 173531 0 0 0 1527 0 3781 0 13098 0 191937 0 0 0 Carl Hayes MD Doctor 187963 0 0 0 1737 0 1041 0 0 0 190741 0 0 0 George Barghouth MD Doctor 195996 0 0 0 2135 0 8649 0 36982 0 243762 0 0 0 X 161 86551 Fair Market Value 0 0 0 0 Part I, Column (b): The organization is reporting the numer of items contributed in Schedule M, Part I, Column (b) Form 990, Part VI, Section B, line 11b The Form 990 is prepared by an independent accountant in conjunction with the organization's finance and accounting department. The Form 990 and related schedules are then reviewed by the CFO and Controller of the organization. Upon approval by the CFO and Controller, the Form 990 is made available to the Board of Directors prior to filing with the Internal Revenue Service. Form 990, Part VI, Section B, line 12c The organization has a compliance program in place, along with a compliance officer who oversees the conflict of interest policy and provides annual ongoing training to the board of directors and staff. Any staff member or member of the Board of Directors is required to recuse himself/herself from participating in a board deliberation and/or decisions involving a transaction that creates a potential or actual conflict of interest. Failure to do so can result in disciplinary action of the staff member or Director of the Board, including termination. Form 990, Part VI, Section B, line 15 The CEO's compensation is determined and approved by the Board Executive Committee through salary compensation surveys of organizations in the same industry and comparable budgets. Compensation for other officers and key employees of the organization is determined by the CEO, who utilizes salary surveys and other comparability data of organizations in the same industry and comparable budgets. Form 990, Part VI, Section C, line 19 The organization's governing documents, policies and financial statements are made available to the public upon request. Gardner Family Care Corporation 160 East Virginia Suite 255 San Jose CA 95112 237153068 Outpatient Drug/Alcohol, Maternal and Childcare, and Mental Health Services CA 501(c)(3) Line 7 GFHN 1 0 0 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 0 0 Gardner Family Care Corporation J 65702 Book Value Gardner Family Care Corporation K 332928 Book Value Gardner Family Care Corporation Q 363976 Book Value