2018-01-10T08:12:58-08:00 2017-06-30 Ortega & Associates CPA 12526 High Bluff Drive Suite 300 San Diego CA 92130 990 2016-07-01 942210447 AMPLA HEALTH AMPL 5306744261 935 B MARKET STREET YUBA CITY CA 95991 BENJAMIN FLORES CEO 2018-01-10 true Mario G Ortega P00232069 8586232786 X 2016 2021-01-29 14:40:06Z 50254739 false false X WWW.AMPLAHEALTH.ORG X 1973 CA AMPLA HEALTH STRIVES TO PROVIDE HIGH QUALITY MEDICAL, DENTAL, SOCIAL AND EDUCATIONAL HEALTH SERVICES THAT MEET THE UNIQUE NEEDS OF ALL PATIENTS ESPECIALLY THOSE WHO ARE MEDICALLY UNDER SERVED INCLUDING FARM WORKERS AND OTHERS WITHOUT FINANCIAL RESOURCES. 17 17 483 0 9214813 9385427 37980887 40846138 2920 23174 0 47198620 50254739 0 0 34428674 36764346 0 0 12220609 13668250 46649283 50432596 549337 -177857 32970322 31333396 16934647 15475578 16035675 15857818 AMPLA HEALTH STRIVES TO PROVIDE HIGH QUALITY MEDICAL, DENTAL, SOCIAL AND EDUCATIONAL HEALTH SERVICES THAT MEET THE UNIQUE NEEDS OF ALL PATIENTS ESPECIALLY THOSE WHO ARE MEDICALLY UNDER SERVED INCLUDING FARM WORKERS AND OTHERS WITHOUT FINANCIAL RESOURCES. false false 39938814 AMPLA HEALTH PROVIDES MEDICAL SERVICES AND BASIC DENTAL SERVICES TO LOW-INCOME AND MIGRANT PATIENTS. IT ALSO PROVIDES HEALTH AND PRENATAL INFORMATION TO LOW-INCOME AND MIGRANT INDIVIDUALS, AS WELL AS, SUPPLEMENTAL FOOD TO ELIGIBLE LOW-INCOME WOMEN. SEE SCEHDULE O FOR MORE INFORMATION ON THE PROGRAMS OFFERED. FISCAL YEAR ENDED JUNE 30, 2012 HAD 288,090 PATIENT ENCOUNTERS. 39938814 true true false true false false false false false false true false false false false false true false false false false false false false false false false false false true false false false false false false false false false false false false false false false false false false false false false true 49 0 false 483 false false false false false false false false false 0 false false false false false false false false false false X 17 17 false false false false false false false true true false false true true true true true true true true false CA X VERONICA RICHTER 5306744261 935 MARKET STREET YUBA CITY CA 95991 KIM OWENS MEMBER 0.00 0.00 X 0 0 0 DEBBIE PORCAYO MEMEBER 0.00 0.00 X 0 0 0 ELIZABETH SKELLY Treasurer 0.00 0.00 X X 0 0 0 MARY JANE GRIEGO PARLIMENTARIAN 0.00 0.00 X X 0 0 0 WENCESLAO VASQUEZ MEMBER 0.00 0.00 X 0 0 0 ERNEST GARCIA MEMBER 0.00 0.00 X 0 0 0 CARLOS O PALACIOS MEMBER 0.00 0.00 X 0 0 0 MICHELE WALTERS Secretary 0.00 0.00 X X 0 0 0 ALEJANDRO LUQUIN MEMBER 0.00 0.00 X 0 0 0 MARK LUNDBERG MEMBER 0.00 0.00 X 0 0 0 J ANGEL CALDERON VICE CHAIR 0.00 0.00 X X 0 0 0 DANIEL CHAVEZ MEMBER 0.00 0.00 X 0 0 0 HORACIO PARAS CHAIR 0.00 0.00 X X 0 0 0 LILIA CHILDS MEMBER 0.00 0.00 X 0 0 0 MICHAEL D HARRISON MEMBER 0.00 0.00 X 0 0 0 THOMAS KELEM MEMBER 0.00 0.00 X 0 0 0 NEAL DENITA MEMBER 0.00 0.00 X 0 0 0 BENJAMIN FLORES CEO 40.00 0.00 X 296983 0 26116 CARLOS PERALTA CORRALES COO 40.00 0.00 X 128991 0 15402 TIFFANY ROBERTSON CFO 40.00 0.00 X 146055 0 13511 DANIEL SIRI CHIEF DENTAL OFFICER 40.00 0.00 X 203727 0 17368 MUSTAFA AMMAR CHIEF MEDICAL OFFICER 40.00 0.00 X 566760 0 22214 KANESHKA ALAMSHAHI PHYSICIAN 40.00 0.00 X 287504 0 18096 ARUN KUMAR PHYSICIAN 40.00 0.00 X 307252 0 19031 ALPINA MULLICK PHYSICIAN 40.00 0.00 X 288668 0 18528 NANAK BOPARAI PHYSICIAN 40.00 0.00 X 273960 0 18090 ABDULLAH AL-DWAIRI PHYSICIAN 40.00 0.00 X 271612 0 18914 2771512 187270 65 false true false BARTON ASSOCIATES INC PO BOX 417844 BOSTON MA 02241 CONTRACT PHYS 494140 ELITE UNIVERSAL SECURITY 5548 FEATHER RIVER BLVD OLIVEHURST CA 95961 SECURITY 179672 MENDOCINO MEDICAL 235 N PLUMAS ST WILLOWS CA 95988 PHYSICIAN 195756 PACIFIC COMPANIES INC 66 ENTERPRISE STE 250 ALISO VIEJO CA 92656 PHYSICIAN 242831 YUBA SUTTER HOSPITALIST GROUP 726 4TH STREET MARYSVILLE CA 95901 CONTRACT PHYSICIANS 293600 11 9374427 11000 9385427 340 B PROGRAM 621110 1319104 1319104 INSURANCE INCENTIVES 621110 5938944 5938944 OTHER 621110 316395 316395 PROGRAM SERVICE REVENUE 621110 33271695 33271695 40846138 23174 23174 0 0 0 0 0 0 0 0 50254739 40869312 0 0 0 0 1437127 1235929 201198 0 33242981 27713825 5529156 0 0 2084238 1750760 333478 72529 72529 100842 100842 51250 51250 0 0 0 4909468 3864594 1044874 0 0 0 0 513878 389617 124261 296994 141773 155221 0 0 380788 234305 146483 0 1626861 938532 688329 254973 76473 178500 SUPPLIES 2084607 1942467 142140 OTHER 744991 334315 410676 Utilities 627348 570659 56689 LOSS FROM BOND REFUNDING 484663 484663 1519058 745565 773493 50432596 39938814 10493782 0 626955 1642282 2933900 2415052 313632 471255 3584039 4888954 0 0 0 150443 125910 921436 1003203 37668649 17277561 21821323 20391088 1805082 0 0 0 0 813512 395652 32970322 31333396 5892301 5607461 5579799 5462547 9868117 16934647 15475578 X 15444494 15046947 591181 810871 16035675 15857818 32970322 31333396 -177857 X false true X true true true X 9695569 7945138 7477500 9214813 9385427 43718447 0 0 9695569 7945138 7477500 9214813 9385427 43718447 0 43718447 692 287 660 2920 23174 27733 0 234679 680627 4124736 4210422 7574444 16824908 60571088 152827672 0.72180 0.81630 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED false false false false false false false false false false true 43890 43890 false false Part II-B, Line 1i - Other Activities Description PART II-B, LINE 1(I), OTHER LOBBYING ACTIVITIES:THE ORGANIZATION PAID DUES TO THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS (NACHC),THE CALIFORNIA PRIMARY CARE ASSOCIATION (CPCA) AND CENTRAL VALLEY HEALTH NETWORK (CVHN). A PORTION OF THE DUES PAID MAY BE USED FOR LOBBYING. 2957194 2957194 23907372 9493246 14414126 196553 80105 116448 10607530 7704210 2903320 20391088 50254739 50254739 50254739 50432596 50432596 50432596 X X X false false false false false false false true false false ABDULLAH AL-DWAIRI PHYSICIAN 246062 25550 7382 11532 290526 ALPINA MULLICK PHYSICIAN 233178 55490 6996 11532 307196 ARUN KUMAR PHYSICIAN 249982 57270 7499 11532 326283 BENJAMIN FLORES CEO 291683 5300 14584 11532 323099 DANIEL SIRI CHIEF DENTAL OFFICER 194527 9200 5836 11532 221095 KANESHKA ALAMSHAHI PHYSICIAN 218784 68720 6564 11532 305600 MUSTAFA AMMAR CHIEF MEDICAL OFFICER 356060 210700 10682 11532 588974 NANAK BOPARAI PHYSICIAN 218600 55360 6558 11532 292050 TIFFANY ROBERTSON CFO 146055 4382 9129 159566 Part I, Line 7: Non-Fixed payments not listed above BONUS AND INCENTIVE PAYMENTS ARE BASED ON ENCOUNTER PRODUCTIVITY, WITH 400 ENCOUNTERS BEING THE STANDARD. Form 990, Part VI, Line 11b: Form 990 Review Process AN INDEPENDENT ACCOUNTING FIRM PREPARES THE FORM 990 WITH INFORMATION PROVIDED BY THE ORGANIZATION ACCOUNTING DEPARTMENT. THEN, THE COMPLETED 990 IS SENT TO THE CFO OF THE ORGANIZATION TO BE REVIEWED. THE CFO REVIEWED AND DISTRIBUTES THE 990 AMONG THE FINANCE COMMITTEE AND THE BOARD OF DIRECTORS FOR REVIEW AND QUESTIONS AT THE BOARD MEETING. UPON COMPLETION OF REVIEW AND APPROVAL, THE FORM 990 IS FILED. Form 990, Part VI, Line 19: Other Organization Documents Publicly Available THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY ARE AVAILABLE TO BE MAILED UPON WRITTEN REQUEST, HOWEVER, FINANCIAL STATEMENTS ARE NOT MADE PUBLIC.