2015-05-15T16:13:54-05:00 2014-06-30 910189318 MOSS ADAMS LLP 101 SECOND STREET SUITE 900 SAN FRANCISCO CA 94105 990 2013-07-01 941743078 GARDNER FAMILY HEALTH NETWORK INC GARD 4089353906 PO BOX 1240 ALVISO CA 95002 EFRAIN CONA COO/CFO 4089353906 2015-05-14 1 LINDSEY PARNELL P00546853 4159561500 2013 2016-02-25 16:41:14Z EFRAIN CORIA PO BOX 1240 ALVISO CA 95002 33963276 0 X WWW.GARDNERHEALTH.ORG X 1967 CA 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. 15 15 389 25 0 0 11370339 11674902 15761489 20635463 94958 624356 1118502 230331 28345288 33165052 0 0 0 0 27180680 24104916 0 0 219938 9075318 8855742 36255998 32960658 -7910710 204394 15372392 14443378 10947052 9813644 4425340 4629734 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. 0 0 25813685 20465504 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. 90570 169959 JOB CORPS PROVIDES PHYSICAL EXAMINATIONS AND MEDICAL SERVICES TO INDIVIDUALS PARTICIPATING IN THE JOB CORPS PROGRAM. 25904255 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 1 0 0 0 0 1 1 1 0 0 1 28 0 389 1 0 0 0 0 0 0 0 0 0 0 X 15 15 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 0 1 1 0 CA X EFRAIN CORIA 4082002291 PO BOX 1240 ALVISO CA 95002 KAHN D BUI CHAIRPERSON 2.00 2.00 X 0 0 0 LUCINDA HIRAHOKA-PISANO VICE CHAIR 2.00 2.00 X 0 0 0 INGRID HOLGUIN TREASURER 2.00 2.00 X 0 0 0 CONSUELO PONCE BOARD SECRETARY 2.00 2.00 X 0 0 0 ESTHER DURAN PA-C MEMBER-AT-LARGE 2.00 2.00 X 0 0 0 LLOYD ALVARADO BOARD MEMBER 2.00 2.00 X 0 0 0 HORACIO FIGARELLA CONSUMER BOARD MEMBER 2.00 2.00 X 0 0 0 NOE LOZANOM PHD PROFESIONAL BOARD MEMBER 2.00 2.00 X 0 0 0 RHONDA MASON CONSUMER BOARD MEMBER 2.00 2.00 X 0 0 0 TRACEY MASON CONSUMER BOARD MEMBER 2.00 2.00 X 0 0 0 ANGELICA M RUIZ MD CONSUMER BOARD MEMBER 2.00 2.00 X 0 0 0 ARMAND SANCHEZ PHD CONSUMER BOARD MEMBER 2.00 2.00 X 0 0 0 JAZMIN SEGURA PROFESIONAL BOARD MEMBER 2.00 2.00 X 0 0 0 FRANK SERRANO CONSUMER BOARD MEMBER 2.00 2.00 X 0 0 0 IRMA M TERRAZAS PROFESIONAL BOARD MEMBER 2.00 2.00 X 0 0 0 HENRY TOTAH CONSUMER BOARD MEMBER 2.00 2.00 X 0 0 0 LAURIE HALSEY DIRECTOR OF HUMAN RESOURCES 24.00 16.00 X 17250 0 373 REYMUNDO ESPINOZA CHIEF EXECUTIVE OFFICER 24.00 16.00 X 132641 119613 50904 EFRAIN CORIA CHIEF OPERATING OFFICER 24.00 16.00 X 134055 134412 42741 IGNACIO PEREZ CHIEF FINANCIAL OFFICER 36.00 4.00 X 172669 26459 17400 CONSTANCE TUCKER CHIEF MEDICAL OFFICER 40.00 0.00 X 194375 0 34411 WUNNA MINE CHIEF INFORMATION OFFICER 20.00 20.00 X 70000 72100 13776 NGHI KHUE LUU MD 40.00 0.00 X 162962 0 6658 EDGAR ORATE MD 40.00 0.00 X 163335 0 6666 BENJAMIN A HERNANDEZ-C MD 40.00 0.00 X 167021 0 26287 RANJANI CHANDRAMOULI MD 40.00 0.00 X 169883 0 33882 MADHUR BHATNAGAR MD 40.00 0.00 X 201993 0 30650 1586184 352584 263748 47 0 1 0 BLACH CONSTRUCTION 469 EL CAMINO REAL SUITE 100 SANTA CLARA CA 950504372 CONSTRUCTION 1701976 BRMS PO BOX 2140 FOLSOM CA 95763 HEALTH INSURANCE 559648 EXPRESS SCRIPTS INC 21653 NETWORK PLACE CHICAGO IL 606731216 HEALTH INSURNACE 508264 GARDNER FAMILY CARE CORPORATION 160 E VIRGINIA ST SAN JOSE CA 95112 RELATED PARTY 450000 AMERISOURCE BERGEN DRUG CORP PO BOX 100565 PASADENA CA 911890565 MEDICAL SUPPLIES 250470 10 11572306 102596 61436 11674902 MEDI-CAL AND MEDICARE 621110 18704464 18704464 PHARMACY REVENUE 621110 1070044 1070044 RISK POOL 621110 860955 860955 20635463 39852 39852 74325 74325 0 1308403 723899 584504 584504 584504 MISCELLANEOUS INCOME 900009 230331 230331 230331 33165052 20635463 0 854687 18266884 14475589 3694449 96846 407846 407846 5430186 4220111 1179279 30796 146685 146685 38624 38624 1696654 1136572 478255 81827 281405 16816 264265 324 1821000 1334626 480623 5751 104619 53727 50218 674 38895 3 38698 194 1209583 1142336 67247 155271 155271 MEDICAL SUPPLIES 1875446 1768089 107068 289 LUCILE PACKARD CHILDREN 1279065 1279065 208495 69475 135783 3237 32960658 25904255 6836465 219938 94979 367944 39697 39203 1201645 975955 3269983 2175342 254898 312792 371939 25435 27767578 17280225 8858939 10487353 1280312 59354 15372392 14443378 5944516 3993968 234211 1118276 3170000 4768325 1531400 10947052 9813644 X 4322021 4599869 103319 29865 4425340 4629734 15372392 14443378 204394 0 X X 0 1 X 1 1 1 X 9845912 9846137 11279371 11370339 11674902 54016661 9845912 9846137 11279371 11370339 11674902 54016661 54016661 94332 269500 207373 94958 39852 706015 365146 90593 228335 1118502 230331 2032907 56755583 80383906 0.95170 0.91150 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1506605 1506605 12522449 10500907 2021542 6536948 1101988 5434960 7019368 5677330 1342038 182208 182208 10487353 RESTRICTED ACCOUNTS PAYABLE 482183 LOAN PAYABLE-RELATED ORGANIZATION 30000 INCURRED BUT NOT REPORTED 708442 DUE TO AFFILIATE 23185 CONTIGENT LIABILITY 287590 1531400 X 33446840 207463 207463 33239377 -74325 -74325 33165052 33242446 207463 207463 33034983 -74325 -74325 32960658 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. X X X X 0 0 0 0 0 0 0 0 0 REYMUNDO ESPINOZA CHIEF EXECUTIVE OFFICER 132641 101360 0 0 0 18253 2865 21752 26287 0 161793 141365 0 0 EFRAIN CORIA CHIEF OPERATING OFFICER 134055 106541 0 0 0 27871 2896 2863 36982 0 173933 137275 0 0 IGNACIO PEREZ CHIEF FINANCIAL OFFICER 172669 26459 0 0 0 0 3730 572 13098 0 189497 27031 0 0 CONSTANCE TUCKER CHIEF MEDICAL OFFICER 194375 0 0 0 0 0 4198 0 30213 0 228786 0 0 0 WUNNA MINE CHIEF INFORMATION OFFICER 70000 72100 0 0 0 0 1512 1557 10707 0 82219 73657 0 0 NGHI KHUE LUU MD 162962 0 0 0 0 0 3520 0 3138 0 169620 0 0 0 EDGAR ORATE MD 163335 0 0 0 0 0 3528 0 3138 0 170001 0 0 0 BENJAMIN A HERNANDEZ-C MD 167021 0 0 0 0 0 0 0 26287 0 193308 0 0 0 RANJANI CHANDRAMOULI MD 169883 0 0 0 0 0 3669 0 30213 0 203765 0 0 0 MADHUR BHATNAGAR MD 201993 0 0 0 0 0 4363 0 26287 0 232643 0 0 0 X 201 61436 COST 2 0 0 0 PART I, LINE 33: TO THE BEST OF OUR KNOWLEDGE, ALL NON CASH RECEIVED ARE REPORTED. 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. GARDNER FAMILY CARE CORPORATION 160 EAST VIRGINIA STE 255 SAN JOSE CA 95112 231753068 HEALTH ORGANIZATION CA 501(C)(3) LINE 7 GFHN 1 0 0 0 1 1 0 0 0 0 1 1 0 0 0 0 1 0 0 0