2015-11-11T10:15:07-06:00 2014-12-31 910189318 MOSS ADAMS LLP 101 SECOND STREET SUITE 900 SAN FRANCISCO CA 94105 990 2014-01-01 264826604 PENINSULA PRIMARY CARE PENI 8317189720 PO BOX HH MONTEREY CA 93942 LAURA ZEHM VP/CFO 8317189720 2015-11-10 1 RICHARD CROGHAN P00089862 4159561500 2014 2016-02-25 16:41:14Z X STEVEN PACKER PO BOX HH MONTEREY CA 93942 8266725 0 X WWW.PENINSULAPRIMARYCARE.ORG X 2009 CA TO PROVIDE HEALTH CARE FOR THE GENERAL PUBLIC, CARRY ON ANY EDUCATIONAL ACTIVITIES RELATED TO RENDERING CARE TO THE SICK OR INJURED, AND TO PARTICIPATE IN SCIENTIFIC HEALTHCARE-RELATED RESEARCH TO PROMOTE THE GENERAL HEALTH OF THE COMMUNITY. 7 4 132 4 0 0 1000000 665996 3544480 6905555 0 0 210374 695174 4754854 8266725 0 0 0 0 4023424 8641453 0 0 0 1643075 2882033 5666499 11523486 -911645 -3256761 1266991 2154968 1948296 6093034 -681305 -3938066 TO PROVIDE HEALTH CARE FOR THE GENERAL PUBLIC, CARRY ON ANY EDUCATIONAL ACTIVITIES RELATED TO RENDERING CARE TO THE SICK OR INJURED, AND TO PARTICIPATE IN SCIENTIFIC HEALTHCARE-RELATED RESEARCH TO PROMOTE THE GENERAL HEALTH OF THE COMMUNITY. 0 0 10690649 6905555 DIRECT CLINICAL SERVICES. 10690649 1 1 0 0 0 0 0 0 0 0 1 0 0 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 0 0 0 1 15 0 1 132 1 0 0 0 0 0 0 0 0 0 0 X 7 4 0 1 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 0 0 0 CA X SHIRLEY NORMAN 8312428605 PO BOX HH MONTEREY CA 93942 MIKE LYON VICE CHAIR 1.00 2.00 X 0 0 0 TIM NYLEN BOARD MEMBER 0.00 55.00 X X 0 357807 35085 STEVEN PACKER MD PRESIDENT 1.00 54.00 X X 0 901419 299579 JILL SHEFFIELD CHAIR 1.00 0.00 X 0 0 0 BYRL SMITH SECRETARY (THROUGH 12/2014) 1.00 0.00 X 0 0 0 DAVID STRAFACE MD DIRECTOR (THROUGH 12/2014) 40.00 0.00 X 310361 1275 42736 GERALDIN TAPLIN MD BOARD MEMBER 1.00 0.00 X 0 0 0 LAURA ZEHM CFO 1.00 54.00 X 0 588774 82874 ALEXANDER IZMAILOV MD EMPLOYEE 40.00 0.00 X 312860 75000 4932 JIHAD JAFFER MD EMPLOYEE 40.00 0.00 X 298992 20525 13627 VANESSA GULLA MD EMPLOYEE 40.00 0.00 X 277083 50000 2859 HARRY NERVINO MD EMPLOYEE 40.00 0.00 X 272532 0 11384 LANCELOT ALEXANDER MD EMPLOYEE 40.00 0.00 X 272205 1650 10901 1744033 1996450 503977 24 0 1 0 CYPRESS HEALTHCARE PARTNERS PO BOX HH MONTEREY CA 93942 MEDICAL SERVICES 789969 QUALITY SYSTEMS INC PO BOX 511449 LOS ANGELES CA 90051 AR BILLING MAINTENANCE 264748 MCKESSON MEDICAL SURGICAL 130-10711 CAMBIE ROAD RICHMOND BRITISH COLUMBIA CA MEDICAL 252348 COMPUTER TECHNICAL SPECIALISTS 7441 MATTERHORN PL SALINAS CA 93907 COMPUTER SUPPORT 153047 EN POINT TECHNOLOGIES 155 NE 100TH STREET SEATTLE WA 98125 IT SERVICES 128235 5 665996 665996 PATIENT FEES 900099 6905555 6905555 6905555 INCENTIVE PAYMENTS 900099 695174 695174 695174 8266725 6905555 0 695174 X 353097 353097 7143823 7143823 295492 295492 389524 389524 459517 459517 90000 90000 1556268 838431 717837 156839 131839 25000 95928 95928 903920 903920 66585 66585 12493 12493 11523486 10690649 832837 0 130150 28131 483241 754077 90427 95360 1502924 246540 543157 1256384 20016 21016 1266991 2154968 619957 1115984 1328339 4977050 1948296 6093034 X -681305 -3938066 -681305 -3938066 1266991 2154968 -3256761 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 66554 5609 60945 1436370 240931 1195439 1256384 LOAN FROM CHOMP 4976993 PENSION LOAN EE 57 4977050 X PART X, LINE 2: CHF, CHOMP, CHE, CHP, AND PPC HAVE BEEN DETERMINED TO BE EXEMPT ORGANIZATIONS BY THE INTERNAL REVENUE SERVICE AND THE CALIFORNIA FRANCHISE TAX BOARD AND GENERALLY ARE NOT SUBJECT TO TAXES ON INCOME PURSUANT TO SECTION 501(C)(3) AND SECTION 23701(D) OF THE INTERNAL REVENUE CODE AND CALIFORNIA REVENUE AND TAXATION CODE, RESPECTIVELY. ASPIRE, CCCMIC, CMN, AND COASTAL ARE TAXABLE ENTITIES AND INCOME TAXES ARE ACCOUNTED FOR USING AN ASSET AND LIABILITY APPROACH THAT REQUIRES THE RECOGNITION OF DEFERRED TAX ASSETS AND LIABILITIES FOR THE EXPECTED FUTURE TAX CONSEQUENCES OF EVENTS THAT HAVE BEEN INCLUDED IN THE CONSOLIDATED FINANCIAL STATEMENTS. UNDER THIS METHOD, DEFERRED TAX ASSETS AND LIABILITIES ARE DETERMINED BASED ON THE DIFFERENCES BETWEEN THE CONSOLIDATED FINANCIAL STATEMENT AND TAX BASIS OF ASSETS AND LIABILITIES USING ENACTED TAX RATES IN EFFECT FOR THE YEAR IN WHICH THE DIFFERENCES ARE EXPECTED TO REVERSE. ASPIRE, CCCMIC, CMN, AND COASTAL HAVE NET CUMULATIVE LOSSES AND THE DEFERRED TAX ASSETS ASSOCIATED WITH THESE LOSSES HAVE BEEN FULLY RESERVED. THERE WERE NO TAX PROVISIONS RECORDED FOR THE YEARS ENDED DECEMBER 31, 2014 AND 2013. THE ORGANIZATION ASSESSES UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH THE PROVISIONS OF THE FINANCIAL ACCOUNTING STANDARDS BOARD ("FASB") ACCOUNTING STANDARDS CODIFICATION ("ASC") TOPIC 740-10, INCOME TAXES. THE ORGANIZATION RECOGNIZES THE TAX BENEFIT FROM UNCERTAIN TAX POSITIONS ONLY IF IT IS MORE THAN LIKELY THAN NOT THAT THE TAX POSITIONS WILL BE SUSTAINED ON EXAMINATION BY THE TAX AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFIT IS MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. THE ORGANIZATION RECOGNIZES INTEREST AND PENALTIES RELATED TO INCOME TAX MATTERS IN OPERATING EXPENSES. THERE WERE NO UNCERTAIN TAX POSITIONS AS OF DECEMBER 31, 2014, AND 2013. 0 0 0 0 0 0 0 0 0 TIM NYLEN BOARD MEMBER 0 275664 0 44655 0 37488 0 23083 0 12002 0 392892 0 0 STEVEN PACKER MD PRESIDENT 0 642806 0 226965 0 31648 0 268373 0 31206 0 1200998 0 0 DAVID STRAFACE MD DIRECTOR (THROUGH 12/2014) 189670 1275 74361 0 46330 0 23000 0 19736 0 353097 1275 0 0 LAURA ZEHM CFO 0 466773 0 102539 0 19462 0 58870 0 24004 0 671648 0 0 ALEXANDER IZMAILOV MD EMPLOYEE 243270 75000 37860 0 31730 0 1146 0 3786 0 317792 75000 0 0 JIHAD JAFFER MD EMPLOYEE 228601 4575 44992 0 25399 15950 0 0 13627 0 312619 20525 0 0 VANESSA GULLA MD EMPLOYEE 258238 20000 18845 30000 0 0 0 0 2859 0 279942 50000 0 0 HARRY NERVINO MD EMPLOYEE 201252 0 58234 0 13046 0 0 0 11384 0 283916 0 0 0 LANCELOT ALEXANDER MD EMPLOYEE 240752 1650 0 0 31453 0 1469 0 9432 0 283106 1650 0 0 PART I, LINE 3 PPC RELIES ON A RELATED ORGANIZATION, COMMUNITY HOSPITAL OF THE MONTEREY PENINSULA, TO ESTABLISH THE COMPENSATION OF THE ORGANIZATION'S TOP MANAGEMENT OFFICIALS USING ALL OF THE METHODS DESCRIBED ON LINE 3 EXCEPT "FORM 990 OF OTHER ORGANIZATIONS." FORM 990, PART VI, SECTION A, LINE 3 CYPRESS HEALTHCARE IS A PROFESSIONAL PHYSICIAN MANAGEMENT COMPANY. WHEN THE FORMER EXECUTIVE DIRECTOR LEFT IN MARCH, 2012, CYPRESS HEALTHCARE ASSUMED SOME OF THE RESPONSIBILITIES OF THE ED. FORM 990, PART VI, SECTION B, LINE 11 THE CFO IS RESPONSIBLE FOR REVIEWING THE FORM 990 BEFORE FILING. ELECTRONIC COPIES ARE SENT TO ALL BOARD MEMBERS FOR REVIEW PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION USES SELF DISCLOSURE BY INTERESTED PERSONS AND MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC BY REQUEST. FORM 990, PART IX, LINE 11G OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 838,431. MANAGEMENT AND GENERAL EXPENSES 717,837. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,556,268. COMMUNITY HOSPITAL FOUNDATION PO BOX HH MONTEREY CA 93942 942789696 SUPPORT SERVICES CA 501(C)(3) LINE 9 N/A 0 COMMUNITY HOSPITAL OF THE MONTEREY PENINSULA PO BOX HH MONTEREY CA 93942 940760193 HEALTHCARE SERVICES CA 501(C)(3) LINE 3 COMMUNITY HOSPITAL FOUNDATION 0 COMMUNITY HOSPITAL PROPERTIES PO BOX HH MONTEREY CA 93942 942795922 SUPPORT SERVICES CA 501(C)(3) LINE 11A, I COMMUNITY HOSPITAL FOUNDATION 0 COMMUNITY HOSPITAL ENDOWMENTS PO BOX HH MONTEREY CA 93942 942795423 SUPPORT SERVICES CA 501(C)(3) LINE 11A, I COMMUNITY HOSPITAL FOUNDATION 0 ASPIRE HEALTH PLAN 23625 HOLMAN HIGHWAY MONTEREY CA 93940 461567681 INSURANCE COMPANY CA N/A C 0 0 0 1 0 1 0 0 0 0 0 1 0 0 0 0 0 0 0 1