GARDNER FAMILY HEALTH NETWORK INC: Form 990, tax year 2013
View the entire original 990 at ProPublica ↗
- Organization
- GARDNER FAMILY HEALTH NETWORK INC (EIN 94-1743078)
- Tax period
- 2013-07-01 to 2014-06-30
- Filed
- 2015-05-15
- IRS object ID
- 201521359349307422
- Schema version
- 2013v4.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2015-05-15T16:13:54-05:00 | ReturnTs |
| Tax Period End | 2014-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 910189318 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MOSS ADAMS LLP | BusinessNameLine1 |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 SECOND STREET SUITE 900 | AddressLine1 |
| City | SAN FRANCISCO | City |
| State | CA | State |
| ZIP Code | 94105 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2013-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 941743078 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GARDNER FAMILY HEALTH NETWORK INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | GARD | BusinessNameControlTxt |
| Phone | 4089353906 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1240 | AddressLine1 |
| City | ALVISO | City |
| State | CA | State |
| ZIP Code | 95002 | ZIPCode |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | EFRAIN CONA | PersonNm |
| Person Title | COO/CFO | PersonTitleTxt |
| Phone | 4089353906 | PhoneNum |
| Signature | 2015-05-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | LINDSEY PARNELL | PreparerPersonNm |
| PTIN | P00546853 | PTIN |
| Phone | 4159561500 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2013 | TaxYr |
| Build TS | 2016-02-25 16:41:14Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | EFRAIN CORIA | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1240 | AddressLine1 |
| City | ALVISO | City |
| State | CA | State |
| ZIP Code | 95002 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $33,963,276 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.GARDNERHEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1967 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | TO IMPROVE THE HEALTH STATUS OF THE COMMUNITIES WE SERVE, ESPECIALLY THE DISENFRANCHISED, POOR & MOST VULNERABLE MEMBERS BY PROVIDING HIGH QUALITY, COMPREHENSIVE CARE, WHICH IS AFFORDABLE, RESPECTFUL, CULTURALLY, LINGUISTICALLY & AGE APPROPRIATE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 15 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 15 | VotingMembersIndependentCnt |
| Total Employee | 389 | TotalEmployeeCnt |
| Total Volunteers | 25 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $11,370,339 | PYContributionsGrantsAmt |
| CY Contributions Grants | $11,674,902 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $15,761,489 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $20,635,463 | CYProgramServiceRevenueAmt |
| PY Investment Income | $94,958 | PYInvestmentIncomeAmt |
| CY Investment Income | $624,356 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,118,502 | PYOtherRevenueAmt |
| CY Other Revenue | $230,331 | CYOtherRevenueAmt |
| PY Total Revenue | $28,345,288 | PYTotalRevenueAmt |
| CY Total Revenue | $33,165,052 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $27,180,680 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $24,104,916 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $219,938 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $9,075,318 | PYOtherExpensesAmt |
| CY Other Expenses | $8,855,742 | CYOtherExpensesAmt |
| PY Total Expenses | $36,255,998 | PYTotalExpensesAmt |
| CY Total Expenses | $32,960,658 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$7,910,710 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $204,394 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $15,372,392 | TotalAssetsBOYAmt |
| Total Assets EOY | $14,443,378 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $10,947,052 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $9,813,644 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $4,425,340 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $4,629,734 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO IMPROVE THE HEALTH STATUS OF THE COMMUNITIES WE SERVE, ESPECIALLY THE DISENFRANCHISED, POOR & MOST VULNERABLE MEMBERS BY PROVIDING HIGH QUALITY, COMPREHENSIVE CARE, WHICH IS AFFORDABLE, RESPECTFUL, CULTURALLY, LINGUISTICALLY & AGE APPROPRIATE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $25,813,685 | ExpenseAmt |
| Revenue | $20,465,504 | RevenueAmt |
| Desc | PRIMARY CARE PROGRAM PROVIDES MEDICAL, DENTAL, OPTOMETRY, PHARMACEUTICAL, PODIATRY AND ANCILLARY SERVICES TO LOW 1NCOME RESIDENTS OF SANTA CLARA COUNTY. PROVIDED 160,654 VISITS TO 41,106 PATIENTS. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $90,570 | ExpenseAmt |
| Revenue | $169,959 | RevenueAmt |
| Desc | JOB CORPS PROVIDES PHYSICAL EXAMINATIONS AND MEDICAL SERVICES TO INDIVIDUALS PARTICIPATING IN THE JOB CORPS PROGRAM. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $25,904,255 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | Yes (1) | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 28 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 389 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 15 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 15 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | 0 | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | 0 | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | CA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EFRAIN CORIA | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 4082002291 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1240 | AddressLine1 |
| City | ALVISO | City |
| State | CA | State |
| ZIP Code | 95002 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionAGrp (27 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| KAHN D BUI | ||||||||
| CHAIRPERSON | 2.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| LUCINDA HIRAHOKA-PISANO | ||||||||
| VICE CHAIR | 2.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| INGRID HOLGUIN | ||||||||
| TREASURER | 2.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| CONSUELO PONCE | ||||||||
| BOARD SECRETARY | 2.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| ESTHER DURAN PA-C | ||||||||
| MEMBER-AT-LARGE | 2.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| LLOYD ALVARADO | ||||||||
| BOARD MEMBER | 2.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| HORACIO FIGARELLA | ||||||||
| CONSUMER BOARD MEMBER | 2.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| NOE LOZANOM PHD | ||||||||
| PROFESIONAL BOARD MEMBER | 2.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| RHONDA MASON | ||||||||
| CONSUMER BOARD MEMBER | 2.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| TRACEY MASON | ||||||||
| CONSUMER BOARD MEMBER | 2.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| ANGELICA M RUIZ MD | ||||||||
| CONSUMER BOARD MEMBER | 2.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| ARMAND SANCHEZ PHD | ||||||||
| CONSUMER BOARD MEMBER | 2.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| JAZMIN SEGURA | ||||||||
| PROFESIONAL BOARD MEMBER | 2.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| FRANK SERRANO | ||||||||
| CONSUMER BOARD MEMBER | 2.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| IRMA M TERRAZAS | ||||||||
| PROFESIONAL BOARD MEMBER | 2.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| HENRY TOTAH | ||||||||
| CONSUMER BOARD MEMBER | 2.00 | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| LAURIE HALSEY | ||||||||
| DIRECTOR OF HUMAN RESOURCES | 24.00 | 16.00 | $17,250 | $0 | $373 | Yes (X) | ||
| REYMUNDO ESPINOZA | ||||||||
| CHIEF EXECUTIVE OFFICER | 24.00 | 16.00 | $132,641 | $119,613 | $50,904 | Yes (X) | ||
| EFRAIN CORIA | ||||||||
| CHIEF OPERATING OFFICER | 24.00 | 16.00 | $134,055 | $134,412 | $42,741 | Yes (X) | ||
| IGNACIO PEREZ | ||||||||
| CHIEF FINANCIAL OFFICER | 36.00 | 4.00 | $172,669 | $26,459 | $17,400 | Yes (X) | ||
| CONSTANCE TUCKER | ||||||||
| CHIEF MEDICAL OFFICER | 40.00 | 0.00 | $194,375 | $0 | $34,411 | Yes (X) | ||
| WUNNA MINE | ||||||||
| CHIEF INFORMATION OFFICER | 20.00 | 20.00 | $70,000 | $72,100 | $13,776 | Yes (X) | ||
| NGHI KHUE LUU | ||||||||
| MD | 40.00 | 0.00 | $162,962 | $0 | $6,658 | Yes (X) | ||
| EDGAR ORATE | ||||||||
| MD | 40.00 | 0.00 | $163,335 | $0 | $6,666 | Yes (X) | ||
| BENJAMIN A HERNANDEZ-C | ||||||||
| MD | 40.00 | 0.00 | $167,021 | $0 | $26,287 | Yes (X) | ||
| RANJANI CHANDRAMOULI | ||||||||
| MD | 40.00 | 0.00 | $169,883 | $0 | $33,882 | Yes (X) | ||
| MADHUR BHATNAGAR | ||||||||
| MD | 40.00 | 0.00 | $201,993 | $0 | $30,650 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,586,184 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $352,584 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $263,748 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 47 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1 | CityContractorAddress/USAddress/City | StateContractorAddress/USAddress/State | ZIP CodeContractorAddress/USAddress/ZIPCode | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| BLACH CONSTRUCTION | |||||
| 469 EL CAMINO REAL SUITE 100 | SANTA CLARA | CA | 950504372 | CONSTRUCTION | $1,701,976 |
| BRMS | |||||
| PO BOX 2140 | FOLSOM | CA | 95763 | HEALTH INSURANCE | $559,648 |
| EXPRESS SCRIPTS INC | |||||
| 21653 NETWORK PLACE | CHICAGO | IL | 606731216 | HEALTH INSURNACE | $508,264 |
| GARDNER FAMILY CARE CORPORATION | |||||
| 160 E VIRGINIA ST | SAN JOSE | CA | 95112 | RELATED PARTY | $450,000 |
| AMERISOURCE BERGEN DRUG CORP | |||||
| PO BOX 100565 | PASADENA | CA | 911890565 | MEDICAL SUPPLIES | $250,470 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 10 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $11,572,306 | GovernmentGrantsAmt |
| All Other Contributions | $102,596 | AllOtherContributionsAmt |
| Noncash Contributions | $61,436 | NoncashContributionsAmt |
| Total Contributions | $11,674,902 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| MEDI-CAL AND MEDICARE | 621110 | $18,704,464 | $18,704,464 |
| PHARMACY REVENUE | 621110 | $1,070,044 | $1,070,044 |
| RISK POOL | 621110 | $860,955 | $860,955 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $20,635,463 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $39,852 | TotalRevenueColumnAmt |
| Exclusion | $39,852 | ExclusionAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $74,325 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $74,325 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $1,308,403 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $723,899 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $584,504 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $584,504 | TotalRevenueColumnAmt |
| Exclusion | $584,504 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS INCOME | Desc |
| Business | 900009 | BusinessCd |
| Total Revenue Column | $230,331 | TotalRevenueColumnAmt |
| Exclusion | $230,331 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $230,331 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $33,165,052 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $20,635,463 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $854,687 | ExclusionAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,266,884 | TotalAmt |
| Program Services | $14,475,589 | ProgramServicesAmt |
| Management And General | $3,694,449 | ManagementAndGeneralAmt |
| Fundraising | $96,846 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $407,846 | TotalAmt |
| Program Services | $407,846 | ProgramServicesAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,430,186 | TotalAmt |
| Program Services | $4,220,111 | ProgramServicesAmt |
| Management And General | $1,179,279 | ManagementAndGeneralAmt |
| Fundraising | $30,796 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $146,685 | TotalAmt |
| Management And General | $146,685 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,624 | TotalAmt |
| Management And General | $38,624 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,696,654 | TotalAmt |
| Program Services | $1,136,572 | ProgramServicesAmt |
| Management And General | $478,255 | ManagementAndGeneralAmt |
| Fundraising | $81,827 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $281,405 | TotalAmt |
| Program Services | $16,816 | ProgramServicesAmt |
| Management And General | $264,265 | ManagementAndGeneralAmt |
| Fundraising | $324 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,821,000 | TotalAmt |
| Program Services | $1,334,626 | ProgramServicesAmt |
| Management And General | $480,623 | ManagementAndGeneralAmt |
| Fundraising | $5,751 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $104,619 | TotalAmt |
| Program Services | $53,727 | ProgramServicesAmt |
| Management And General | $50,218 | ManagementAndGeneralAmt |
| Fundraising | $674 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,895 | TotalAmt |
| Program Services | $3 | ProgramServicesAmt |
| Management And General | $38,698 | ManagementAndGeneralAmt |
| Fundraising | $194 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,209,583 | TotalAmt |
| Program Services | $1,142,336 | ProgramServicesAmt |
| Management And General | $67,247 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $155,271 | TotalAmt |
| Management And General | $155,271 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (2 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| MEDICAL SUPPLIES | $1,875,446 | $1,768,089 | $107,068 | $289 |
| LUCILE PACKARD CHILDREN | $1,279,065 | $1,279,065 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $208,495 | TotalAmt |
| Program Services | $69,475 | ProgramServicesAmt |
| Management And General | $135,783 | ManagementAndGeneralAmt |
| Fundraising | $3,237 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $32,960,658 | TotalAmt |
| Program Services | $25,904,255 | ProgramServicesAmt |
| Management And General | $6,836,465 | ManagementAndGeneralAmt |
| Fundraising | $219,938 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $94,979 | BOYAmt |
| EOY | $367,944 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $39,697 | BOYAmt |
| EOY | $39,203 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,201,645 | BOYAmt |
| EOY | $975,955 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,269,983 | BOYAmt |
| EOY | $2,175,342 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $254,898 | BOYAmt |
| EOY | $312,792 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $371,939 | BOYAmt |
| EOY | $25,435 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $27,767,578 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $17,280,225 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,858,939 | BOYAmt |
| EOY | $10,487,353 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,280,312 | BOYAmt |
| EOY | $59,354 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,372,392 | BOYAmt |
| EOY | $14,443,378 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,944,516 | BOYAmt |
| EOY | $3,993,968 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $234,211 | BOYAmt |
| EOY | $1,118,276 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $3,170,000 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,768,325 | BOYAmt |
| EOY | $1,531,400 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,947,052 | BOYAmt |
| EOY | $9,813,644 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,322,021 | BOYAmt |
| EOY | $4,599,869 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $103,319 | BOYAmt |
| EOY | $29,865 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,425,340 | BOYAmt |
| EOY | $4,629,734 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,372,392 | BOYAmt |
| EOY | $14,443,378 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $204,394 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $9,845,912 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $9,846,137 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $11,279,371 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $11,370,339 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $11,674,902 | CurrentTaxYearAmt |
| Total | $54,016,661 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $9,845,912 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $9,846,137 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $11,279,371 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $11,370,339 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $11,674,902 | CurrentTaxYearAmt |
| Total | $54,016,661 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $54,016,661 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $94,332 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $269,500 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $207,373 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $94,958 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $39,852 | CurrentTaxYearAmt |
| Total | $706,015 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $365,146 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $90,593 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $228,335 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,118,502 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $230,331 | CurrentTaxYearAmt |
| Total | $2,032,907 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $56,755,583 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $80,383,906 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.95170 | PublicSupportCY170Pct |
| Public Support PY170 | 0.91150 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,506,605 | OtherCostOrOtherBasisAmt |
| Book Value | $1,506,605 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $12,522,449 | OtherCostOrOtherBasisAmt |
| Depreciation | $10,500,907 | DepreciationAmt |
| Book Value | $2,021,542 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,536,948 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,101,988 | DepreciationAmt |
| Book Value | $5,434,960 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,019,368 | OtherCostOrOtherBasisAmt |
| Depreciation | $5,677,330 | DepreciationAmt |
| Book Value | $1,342,038 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $182,208 | OtherCostOrOtherBasisAmt |
| Book Value | $182,208 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $10,487,353 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)
| DescDesc | AmtAmt |
|---|---|
| RESTRICTED ACCOUNTS PAYABLE | $482,183 |
| LOAN PAYABLE-RELATED ORGANIZATION | $30,000 |
| INCURRED BUT NOT REPORTED | $708,442 |
| DUE TO AFFILIATE | $23,185 |
| CONTIGENT LIABILITY | $287,590 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $1,531,400 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $33,446,840 | TotalRevEtcAuditedFinclStmtAmt |
| Donated Services And Use Fclts | $207,463 | DonatedServicesAndUseFcltsAmt |
| Revenue Not Reported | $207,463 | RevenueNotReportedAmt |
| Revenue Subtotal | $33,239,377 | RevenueSubtotalAmt |
| Other Revenues Not Included | -$74,325 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | -$74,325 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $33,165,052 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $33,242,446 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $207,463 | DonatedServicesUseFcltsAmt |
| Expenses Not Reported | $207,463 | ExpensesNotReportedAmt |
| Expenses Subtotal | $33,034,983 | ExpensesSubtotalAmt |
| Other Expenses Not Included | -$74,325 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | -$74,325 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $32,960,658 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | THE ORGANIZATION IS A NONPROFIT CORPORATION UNDER INTERNAL REVENUE CODE SECTION 501(C)(3) AND HAS BEEN GRANTED TAXEXEMPT STATUS BY THE INTERNAL REVENUE SERVICE AND THE CALIFORNIA REVENUE AND TAXATION CODE. AS OF JUNE 30, 2014, THE ORGANIZATION HAD NO UNRECOGNIZED TAX POSITIONS OR UNCERTAIN TAX POSITIONS REQUIRING ACCRUAL. THEREFORE, NO PROVISION FOR INCOME TAXES HAS BEEN PROVIDED IN THE CONSOLIDATED FINANCIAL STATEMENTS. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | RENT EXPENSE RECLASSIFICATION -74,325. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | RENT EXPENSE RECLASSIFICATION -74,325. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (10 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| REYMUNDO ESPINOZA | ||||||||||||||
| CHIEF EXECUTIVE OFFICER | $132,641 | $101,360 | $0 | $0 | $0 | $18,253 | $2,865 | $21,752 | $26,287 | $0 | $161,793 | $141,365 | $0 | $0 |
| EFRAIN CORIA | ||||||||||||||
| CHIEF OPERATING OFFICER | $134,055 | $106,541 | $0 | $0 | $0 | $27,871 | $2,896 | $2,863 | $36,982 | $0 | $173,933 | $137,275 | $0 | $0 |
| IGNACIO PEREZ | ||||||||||||||
| CHIEF FINANCIAL OFFICER | $172,669 | $26,459 | $0 | $0 | $0 | $0 | $3,730 | $572 | $13,098 | $0 | $189,497 | $27,031 | $0 | $0 |
| CONSTANCE TUCKER | ||||||||||||||
| CHIEF MEDICAL OFFICER | $194,375 | $0 | $0 | $0 | $0 | $0 | $4,198 | $0 | $30,213 | $0 | $228,786 | $0 | $0 | $0 |
| WUNNA MINE | ||||||||||||||
| CHIEF INFORMATION OFFICER | $70,000 | $72,100 | $0 | $0 | $0 | $0 | $1,512 | $1,557 | $10,707 | $0 | $82,219 | $73,657 | $0 | $0 |
| NGHI KHUE LUU | ||||||||||||||
| MD | $162,962 | $0 | $0 | $0 | $0 | $0 | $3,520 | $0 | $3,138 | $0 | $169,620 | $0 | $0 | $0 |
| EDGAR ORATE | ||||||||||||||
| MD | $163,335 | $0 | $0 | $0 | $0 | $0 | $3,528 | $0 | $3,138 | $0 | $170,001 | $0 | $0 | $0 |
| BENJAMIN A HERNANDEZ-C | ||||||||||||||
| MD | $167,021 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $26,287 | $0 | $193,308 | $0 | $0 | $0 |
| RANJANI CHANDRAMOULI | ||||||||||||||
| MD | $169,883 | $0 | $0 | $0 | $0 | $0 | $3,669 | $0 | $30,213 | $0 | $203,765 | $0 | $0 | $0 |
| MADHUR BHATNAGAR | ||||||||||||||
| MD | $201,993 | $0 | $0 | $0 | $0 | $0 | $4,363 | $0 | $26,287 | $0 | $232,643 | $0 | $0 | $0 |
Schedule M IRS990ScheduleM
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 201 | ContributionCnt |
| Noncash Contributions Rpt F990 | $61,436 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | COST | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form8283 Received | 2 | Form8283ReceivedCnt |
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 33: | FormAndLineReferenceDesc |
| Explanation | TO THE BEST OF OUR KNOWLEDGE, ALL NON CASH RECEIVED ARE REPORTED. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | THE FORM 990 AND RELATED SCHEDULES ARE REVIEWED BY THE CFO AND CONTROLLER OF THE ORGANIZATION. ADDITIONALLY, THE FORM 990 IS SUBSEQUENTLY DISTRIBUTED TO THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION HAS A COMPLIANCE OFFICER WHO OVERSEES THE CONFLICT OF INTEREST POLICY AND PROVIDES ANNUAL ONGOING TRAINING TO THE BOARD OF DIRECTORS AND STAFF. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE CEO COMPENSATION IS DETERMINED AND APPROVED BY THE BOARD EXECUTIVE COMMITTEE THROUGH SALARY COMPENSATION SURVEYS 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. |
| FORM 990, PART XII, LINE 2C | THE ORGANIZATION HAS MADE A CHANGE FOR THE CURRENT YEAR FINANCIAL STATEMENTS. WE ARE CONSOLIDATING OUR STATEMENTS TO REPORT GFCC AND GFHN AS ONE CONSOLIDATED COMPANY ON THE GFHN BOOKS. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GARDNER FAMILY CARE CORPORATION | BusinessNameLine1 |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 160 EAST VIRGINIA STE 255 | AddressLine1 |
| City | SAN JOSE | City |
| State | CA | State |
| ZIP Code | 95112 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 231753068 | EIN |
| Primary Activities | HEALTH ORGANIZATION | PrimaryActivitiesTxt |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | LINE 7 | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GFHN | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | Yes (1) | ControlledOrganizationInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | 0 | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | Yes (1) | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | Yes (1) | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | Yes (1) | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (1) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |