2016-05-16T10:47:14-05:00 2015-06-30 462978632 CHAVEZ SILVA & COMPANY 601 UNIVERSITY AVENUE SUITE 288 SACRAMENTO CA 95825 990 2014-07-01 680371679 PEACH TREE HEALTHCARE PEAC 5307493242 1114 YUBA STREET NO 144 MARYSVILLE CA 95901 KAY SIDHU CFO 5307493242 2016-05-13 1 DAVID R CHAVEZ P01059448 9162734808 2014 2016-08-17 19:52:53Z KAY SIDHU 1114 YUBA STREET NO 144 MARYSVILLE CA 95901 15405924 0 X WWW.PICKPEACH.ORG X 1995 CA PEACH TREE HEALTH IS COMMITTED TO PROVIDING PERSONALIZED, AFFORDABLE, HIGH-QUALITY HEALTH SERVICES. 10 10 120 0 0 0 1011302 1316934 8848275 11215437 2019 0 1963398 1292293 11824994 13824664 0 0 0 0 7439319 7372666 0 0 0 5084811 5124853 12524130 12497519 -699136 1327145 4200466 6035994 3104387 3612772 1096079 2423222 PEACH TREE HEALTH IS COMMITTED TO PROVIDING PERSONALIZED, AFFORDABLE, HIGH-QUALITY HEALTH SERVICES. 0 0 8737466 12507730 PROVIDED HEALTHCARE AND PHARMACEUTICAL SERVICES TO THE MEDICALLY UNDERSERVED POPULATION OF YUBA AND SUTTER COUNTY, CALIFORNIA, AND SURROUNDING COMMUNITIES. 8737466 1 0 0 0 0 0 0 0 0 0 1 0 0 0 1 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 37 0 0 120 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 1 1 1 1 0 CA X KAY SIDHU 5307493242 1114 YUBA ST ROOM 144 MARYSVILLE CA 95901 ANA ANDRADE DIRECTOR 1.00 X 0 0 0 BECKY DITTEMORE-ESCALANTE DIRECTOR 1.00 X 0 0 0 CYNTHIA PENA TREASURER 1.00 X 0 0 0 EDMUND SMITH PAST CHAIRMAN 1.00 X 0 0 0 JOHN NICOLETTI CHAIRMAN 1.00 X X 0 0 0 LIN LARSON DIRECTOR 1.00 X 0 0 0 MARCIA MYERS VICE-CHAIRMAN 1.00 X X 0 0 0 NARINDER DHALIWAL DIRECTOR 1.00 X 0 0 0 ROBERTA D'ARCY DIRECTOR 1.00 X 0 0 0 RUTH MIKKELSEN SECRETARY 1.00 X X 0 0 0 GREGORY STONE CEO 40.00 X 165254 0 2951 KAY SIDHU CFO 40.00 X 120168 0 12256 THEODORE FONG CHIEF DEVELOPMENT OFFICER 40.00 X 140000 0 20857 ROSALIE PENA-PRIDMORE MEDICAL DOCTOR 40.00 X 211435 0 28489 AZAD GAGANDEEP MEDICAL DOCTOR 40.00 X 186473 0 25279 MARIA ABORDO MEDICAL DOCTOR 40.00 X 200433 0 47179 PENNY LARSON MEDICAL DOCTOR 40.00 X 170257 0 3226 CHERRY ANN WY MEDICAL DOCTOR 40.00 X 223751 0 44750 TOMAS WY MEDICAL DOCTOR 40.00 X 176823 0 11017 1594594 0 196004 9 0 1 0 RIDGE EYE CARE 7056 SKYWAY PARADISE CA 95969 OPHTHALMOLOGISTS 403440 HEALTH INFORMATION TECHNOLOGY 775 BAYWOOD DRIVE SUITE 314 PETALUMA CA 94954 CONTRACTED IT SERVICES 308673 TITAN NURSE STAFFING 2110 S 169TH PLAZA 100 OMAHA NE 68130 STAFFING AGENCY 185027 YUBA SUTTER HOSPITALIST GROUP 726 4TH STREET MARYSVILLE CA 95901 HOSPITALIST SERVICES 162500 AMERICAN HEALTHCARE ENTERPRISES 701 SOUTH HAM LANE SUITE E LODI CA 95242 CONTRACTED PHYSICIAN 125170 5 1316934 1316934 PATIENT SERVICES 621400 11215437 11215437 11215437 2698178 1581260 1116918 1116918 MISCELLANEOUS INCOME 621400 175375 175375 175375 13824664 12507730 0 0 X 512590 350413 162177 5166849 3615761 1551088 158764 111103 47661 1082316 757405 324911 452147 316412 135735 15052 10533 4519 90308 63198 27110 2480047 1735537 744510 349259 244411 104848 335756 234962 100794 38062 26636 11426 349484 244569 104915 65706 45981 19725 PROVISION FOR BAD DEBT 301234 210804 90430 PURCHASED SERVICES 273023 191061 81962 LICENSES, TAXES, AND OT 272349 190590 81759 REPAIRS & MAINTENANCE 252627 176788 75839 301946 211302 90644 12497519 8737466 3760053 0 298500 836382 583448 878709 1356210 2664758 240258 229818 71783 118217 3218092 2032514 1359998 1185578 290269 122532 4200466 6035994 1205170 1339182 602985 1261233 594022 718680 702210 293677 3104387 3612772 X 1096079 2423222 1096079 2423222 4200466 6035994 1327145 0 X 0 1 X 1 1 1 X 716178 326982 389196 1945408 1440817 504591 556506 264715 291791 1185578 DEFERRED LEASE LIABILITY 121963 THIRD-PARTY SETTLEMENTS 171714 293677 13824665 0 13824665 0 13824665 12497519 0 12497519 0 12497519 X X X 0 0 0 0 0 0 0 0 0 GREGORY STONE CEO 165254 0 0 0 0 0 0 0 2951 0 168205 0 0 0 THEODORE FONG CHIEF DEVELOPMENT OFFICER 140000 0 0 0 0 0 16827 0 4030 0 160857 0 0 0 ROSALIE PENA-PRIDMORE MEDICAL DOCTOR 192145 0 4980 0 14310 0 24459 0 4030 0 239924 0 0 0 AZAD GAGANDEEP MEDICAL DOCTOR 176538 0 1845 0 8090 0 21229 0 4050 0 211752 0 0 0 MARIA ABORDO MEDICAL DOCTOR 188515 0 11918 0 0 0 44097 0 3082 0 247612 0 0 0 PENNY LARSON MEDICAL DOCTOR 169477 0 780 0 0 0 0 0 3226 0 173483 0 0 0 CHERRY ANN WY MEDICAL DOCTOR 186910 0 12047 0 24794 0 38867 0 5883 0 268501 0 0 0 TOMAS WY MEDICAL DOCTOR 176538 0 285 0 0 0 6987 0 4030 0 187840 0 0 0 PART I, LINE 3 CEO COMPENSATION IS APPROVED BY THE BOARD OF DIRECTORS ANNUALLY AND UPON HIRE. CEO COMPENSATION IS ESTABLISHED BY USING HISTORICAL BENCHMARKS FROM CEO'S, AS WELL AS THE SALARY GUIDE FROM THE CALIFORNIA PRIMARY CARE ASSOCIATION. WRITTEN EMPLOYEMENT CONTRACTS ARE OBTAINED FOR ALL CEO'S. FORM 990, PART VI, SECTION B, LINE 11 LINE 11A EXPLANATION - THE CLINIC ENGAGES A CPA FIRM TO PREPARE THE INFORMATION RETURN. A DRAFT OF THE RETURN IS REVIEWED AND APPROVED BY THE FINANCE COMMITTEE AND MANAGEMENT PRIOR TO SUBMISSION TO THE IRS. FORM 990, PART VI, SECTION B, LINE 12C CONFLICTS OF INTEREST FOR INDIVIDUALS SERVING AS PART OF ANY GOVERNING BODY ARE REVIEWED AT A MINIMUM ANNUALLY. FULL DISCLOSURE OF POTENTIAL CONFLICTS OF INTEREST FOR ALL INDIVIDUALS SERVING AS PART OF ANY GOVERNING BODY IS REQUIRED. FORM 990, PART VI, SECTION B, LINE 15 ALL COMPENSATION TO SENIOR MANAGEMENT AND KEY EMPLOYEES IS APPROVED BY THE BOARD OF DIRECTORS. SENIOR MANAGEMENT COMPENSATION IS ESTABLISHED BY USING HISTORICAL BENCHMARKS FROM PREVIOUS EMPLOYEES, AS WELL AS THE SALARY GUIDE FROM THE CALIFORNIA PRIMARY CARE ASSOCIATION. FORM 990, PART VI, SECTION C, LINE 19 UPON REQUEST, THE CLINIC WILL MAKE AVAILABLE ALL PUBLIC RECORDS. FORM 990, PART IX, LINE 11G CONTRACTED MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 1,241,392. MANAGEMENT AND GENERAL EXPENSES 532,532. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,773,924. CONSULTING: PROGRAM SERVICE EXPENSES 360,495. MANAGEMENT AND GENERAL EXPENSES 154,645. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 515,140. ADMINISTRATIVE SERVICES: PROGRAM SERVICE EXPENSES 110,726. MANAGEMENT AND GENERAL EXPENSES 47,499. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 158,225. IT SERVICES: PROGRAM SERVICE EXPENSES 22,924. MANAGEMENT AND GENERAL EXPENSES 9,834. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 32,758.