CAMARENA HEALTH: Form 990, tax year 2012
View the entire original 990 at ProPublica ↗
- Organization
- CAMARENA HEALTH (EIN 94-2503904)
- Tax period
- 2012-01-01 to 2012-12-31
- Filed
- 2013-04-29
- IRS object ID
- 201301209349300770
- Schema version
- 2012v2.0
- 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) |
|---|---|---|
| Timestamp | 2013-04-29T16:32:15-07:00 | Timestamp |
| Tax Period End Date | 2012-12-31 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 202707086 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TCA Partners LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1111 E Herndon Avenue Suite 211 | AddressLine1 |
| City | Fresno | City |
| State | CA | State |
| ZIP Code | 93720 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2012-01-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 942503904 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Camarena Health | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | CAMA | NameControl |
| Phone | 5596644000 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 299 | AddressLine1 |
| City | Madera | City |
| State | CA | State |
| ZIP Code | 93639 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Paulo Soares | Name |
| Title | Chief Executive Officer | Title |
| Phone | 5596644000 | Phone |
| Date Signed | 2013-04-09 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | Jeremy Ware | Name |
| PTIN | P00642659 | PTIN |
| Phone | 5594317708 | Phone |
| Date Prepared | 2013-04-09 | DatePrepared |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2012 | TaxYear |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | Paulo A Soares | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO Box 299 | AddressLine1 |
| City | Madera | City |
| State | CA | State |
| ZIP Code | 93639 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 16887854 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | www.camarenahealth.org | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1978 | YearFormation |
| State Legal Domicile | CA | StateLegalDomicile |
| Activity Or Mission Description | To provide the highest quality healthcare to the communities we are privileged to serve, in a caring and compassionate manner. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 11 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 11 | NbrIndependentVotingMembers |
| Total Nbr Employees | 208 | TotalNbrEmployees |
| Total Nbr Volunteers | 0 | TotalNbrVolunteers |
| Total Gross UBI | 0 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 2735638 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 3014873 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 11161452 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 13393901 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 103 | InvestmentIncomePriorYear |
| Investment Income Current Year | 109 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | 730816 | OtherRevenuePriorYear |
| Other Revenue Current Year | 478971 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 14628009 | TotalRevenuePriorYear |
| Total Revenue Current Year | 16887854 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 9613875 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 10925681 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 0 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 4172003 | OtherExpensePriorYear |
| Other Expenses Current Year | 5082152 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 13785878 | TotalExpensesPriorYear |
| Total Expenses Current Year | 16007833 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 842131 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 880021 | RevenuesLessExpensesCY |
| Total Assets BOY | 7785731 | TotalAssetsBOY |
| Total Assets EOY | 8881696 | TotalAssetsEOY |
| Total Liabilities BOY | 4039188 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 4255132 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 3746543 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 4626564 | NetAssetsOrFundBalancesEOY |
| Mission Description | To provide the highest quality healthcare to the communities we are privileged to serve, in a caring and compassionate manner. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 14004664 | Expense |
| Grants | 0 | Grants |
| Revenue | 16882106 | Revenue |
| Description | The Organization provides both medical and dental care to patients regardless of ability to pay. During the year, Camarena Health provided over 90,106 encounters; 69,486 medical and 20,620 dental. | Description |
| Total Of Other Program Service Exp | 0 | TotalOfOtherProgramServiceExp |
| Total Of Other Program Service Grnt | 0 | TotalOfOtherProgramServiceGrnt |
| Total Of Other Program Service Rev | 0 | TotalOfOtherProgramServiceRev |
| Total Program Service Expense | 14004664 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 0 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 0 | ReportOtherLiabilities |
| Report Fin48 Footnote | 0 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 0 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 0 | RelatedEntity |
| Related Org Controlled Entity | 0 | RelatedOrgControlledEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 57 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 208 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 0 | UnrelatedBusinessIncome |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 11 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 11 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | CA | StatesWhereCopyOfReturnIsFiled |
| Own Website | X | OwnWebsite |
| Other Website | X | OtherWebsite |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | Margarita Medina | NamePerson |
| Telephone Number | 5596444000 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 344 E 6th Street | AddressLine1 |
| City | Madera | City |
| State | CA | State |
| ZIP Code | 93639 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (20 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Average Hours Per Week RelatedAverageHoursPerWeekRelated | OfficerOfficer | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| Patty Thompson | ||||||||
| Board Member | 2 | X | 0 | 0 | 0 | |||
| Jutta Webb | ||||||||
| Board Member | 2 | X | 0 | 0 | 0 | |||
| Cal Crane | ||||||||
| Board Member | 2 | X | 0 | 0 | 0 | |||
| Ross Thorton | ||||||||
| Board Member | 2 | X | 0 | 0 | 0 | |||
| Walter Grisby | ||||||||
| Board Member | 2 | X | 0 | 0 | 0 | |||
| Patty Pistoresi | ||||||||
| Board Member | 2 | X | 0 | 0 | 0 | |||
| Monic Asenjo Wilhite | ||||||||
| Board Member | 2 | X | 0 | 0 | 0 | |||
| Cecilia Massetti | ||||||||
| Board Member | 2 | X | 0 | 0 | 0 | |||
| Muriel Fore | ||||||||
| Board Member | 2 | X | 0 | 0 | 0 | |||
| Melissa Nassar | ||||||||
| Board Member | 2 | X | 0 | 0 | 0 | |||
| Abimail Vargas | ||||||||
| Board Member | 2 | X | 0 | 0 | 0 | |||
| Paulo Soares | ||||||||
| CEO | 40 | 191598 | 0 | 4872 | 0 | X | ||
| Christine Nicole Howland | ||||||||
| Chief Operations Officer | 40 | 113110 | 0 | 2725 | 0 | X | ||
| Jonathon Forncrook | ||||||||
| Chief Medical Officer | 40 | 133952 | 0 | 918 | 0 | X | ||
| Michael Lee Gaskin | ||||||||
| Chief Information Officer | 40 | 104914 | 0 | 825 | 0 | X | ||
| Kenneth Bernstein | ||||||||
| Staff Physician | 40 | 183446 | 0 | 4900 | 0 | X | ||
| Kirandeep Panatch | ||||||||
| Dentist | 40 | 181271 | 0 | 3567 | 0 | X | ||
| Phillip Kim | ||||||||
| Staff Physician | 40 | 176122 | 0 | 7400 | 0 | X | ||
| Guillermo Sandoval | ||||||||
| Staff Physician | 40 | 139372 | 0 | 1361 | 0 | X | ||
| Joseph McFarland | ||||||||
| Dentist | 40 | 136786 | 0 | 4900 | 0 | X | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1360571 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 31468 | TotalOtherCompensation |
| Number Individuals GT100 K | 10 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (4 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| McCombs Claude and Rose | |||||
| 250 San Juan Avenue | Santa Cruz | CA | 95062 | Rent | 165546 |
| Oscar Young | |||||
| 363 E Almond Avenue 101 | Madera | CA | 93637 | OB | 106575 |
| Bronco Professional Park LLC | |||||
| 20 Via Cerioni | Madera | CA | 93637 | Rent | 104757 |
| Quest Diagnostics | |||||
| PO Box 515002 | Sacramento | CA | 95851 | Lab | 146169 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 4 | NumberOfContractorsGT100K |
| Federated Campaigns | 0 | FederatedCampaigns |
| Membership Dues | 0 | MembershipDues |
| Fundraising Events | 0 | FundraisingEvents |
| Related Organizations | 0 | RelatedOrganizations |
| Government Grants | 2997225 | GovernmentGrants |
| All Other Contributions | 17648 | AllOtherContributions |
| Noncash Contributions | 0 | NoncashContributions |
| Total Contributions | 3014873 | TotalContributions |
Program Service Revenue ProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Net Patient Service Revenue | Description |
| Business Code | 621400 | BusinessCode |
| Total Revenue Column | 13393901 | TotalRevenueColumn |
| Related Or Exempt Function Income | 13393901 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
Total Oth Program Service Revenue TotalOthProgramServiceRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 13393901 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 109 | TotalRevenueColumn |
| Related Or Exempt Function Income | 109 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
Income From Invest Bond Proceeds IncomeFromInvestBondProceeds
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
Royalties Revenue RoyaltiesRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 0 | TotalRevenueColumn |
| Related Or Exempt Function Income | 0 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 0 | Real |
| Personal | 0 | Personal |
Gain Or Loss GainOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | 0 | Securities |
| Other | 0 | Other |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrbtns Rprtd Fundraising Events | 0 | CntrbtnsRprtdFundraisingEvents |
Other Revenue Misc OtherRevenueMisc
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Meaningful Use Revenue | Description |
| Business Code | 621400 | BusinessCode |
| Total Revenue Column | 345313 | TotalRevenueColumn |
| Related Or Exempt Function Income | 345313 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
Miscellaneous Revenue MiscellaneousRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 133658 | TotalRevenueColumn |
| Related Or Exempt Function Income | 133658 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 478971 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 16887854 | TotalRevenueColumn |
| Related Or Exempt Function Income | 13872981 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 0 | UnrelatedBusinessRevenue |
| Exclusion | $0 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1360571 | Total |
| Program Services | 1088457 | ProgramServices |
| Management And General | 272114 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 6828894 | Total |
| Program Services | 6146005 | ProgramServices |
| Management And General | 682889 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 2736216 | Total |
| Program Services | 2462594 | ProgramServices |
| Management And General | 273622 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1695783 | Total |
| Program Services | 1356626 | ProgramServices |
| Management And General | 339157 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 658227 | Total |
| Program Services | 526582 | ProgramServices |
| Management And General | 131645 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 151791 | Total |
| Program Services | 121433 | ProgramServices |
| Management And General | 30358 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 81388 | Total |
| Program Services | 65110 | ProgramServices |
| Management And General | 16278 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 196997 | Total |
| Program Services | 157598 | ProgramServices |
| Management And General | 39399 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 480740 | Total |
| Program Services | 480740 | ProgramServices |
Insurance Insurance
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 61430 | Total |
| Program Services | 49144 | ProgramServices |
| Management And General | 12286 | ManagementAndGeneral |
Other Expenses OtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Description | Medical Supplies | Description |
| Total | 1327517 | Total |
| Program Services | 1327517 | ProgramServices |
| Management And General | 0 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 428279 | Total |
| Program Services | 222858 | ProgramServices |
| Management And General | 205421 | ManagementAndGeneral |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 16007833 | Total |
| Program Services | 14004664 | ProgramServices |
| Management And General | 2003169 | ManagementAndGeneral |
| Fundraising | 0 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1453283 | BOY |
| EOY | 1688291 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 50637 | BOY |
| EOY | 56384 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 23019 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 686267 | BOY |
| EOY | 963981 | EOY |
Receivables From Officers Etc ReceivablesFromOfficersEtc
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 298798 | BOY |
| EOY | 244620 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 11053694 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 5196932 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 5296746 | BOY |
| EOY | 5856762 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | 48639 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7785731 | BOY |
| EOY | 8881696 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 757749 | BOY |
| EOY | 874108 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 194327 | BOY |
| EOY | 85830 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3087112 | BOY |
| EOY | 3295194 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4039188 | BOY |
| EOY | 4255132 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3695906 | BOY |
| EOY | 4570179 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 50637 | BOY |
| EOY | 56385 | EOY |
Permanently Restricted Net Assets PermanentlyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 0 | BOY |
| EOY | 0 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 3746543 | BOY |
| EOY | 4626564 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 7785731 | BOY |
| EOY | 8881696 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expenses | 880021 | ReconcilationRevenueExpenses |
| Reconciliation Unrealized Invest | 0 | ReconciliationUnrealizedInvest |
| Reconcilation Donated Services | 0 | ReconcilationDonatedServices |
| Reconcilation Invest Expenses | 0 | ReconcilationInvestExpenses |
| Reconcilation Prior Adjustment | 0 | ReconcilationPriorAdjustment |
| Reconcilation Other Changes | 0 | ReconcilationOtherChanges |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
FS Audited Basis FSAuditedBasis
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Statement Separate | X | FinancialStatementSeparate |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | 1 | AuditCommittee |
| Federal Grant Audit Required | 1 | FederalGrantAuditRequired |
| Federal Grant Audit Performed | 1 | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital170b1 Aiii | X | Hospital170b1Aiii |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 446446 | OtherCostOrOtherBasis |
| Book Value | 446446 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 6862065 | OtherCostOrOtherBasis |
| Depreciation | 2374323 | Depreciation |
| Book Value | 4487742 | BookValue |
Leasehold Improvements LeaseholdImprovements
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 0 | OtherCostOrOtherBasis |
| Depreciation | 0 | Depreciation |
| Book Value | 0 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 3661934 | OtherCostOrOtherBasis |
| Depreciation | 2822609 | Depreciation |
| Book Value | 839325 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | 0 | InvestmentCostOrOtherBasis |
| Other Cost Or Other Basis | 83249 | OtherCostOrOtherBasis |
| Depreciation | 0 | Depreciation |
| Book Value | 83249 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 5856762 | TotalOfBookValueLandBuildings |
| Tot Revenue Etc Audited Fincl Stmt | 16887854 | TotRevenueEtcAuditedFinclStmt |
| Net Unrealized Gains Investments | 0 | NetUnrealizedGainsInvestments |
| Donated Srvc And Use Of Facilities | 0 | DonatedSrvcAndUseOfFacilities |
| Recoveries Of Prior Year Grants | 0 | RecoveriesOfPriorYearGrants |
| Other Revenues | 0 | OtherRevenues |
| Revenue Not Rptd F990 | 0 | RevenueNotRptdF990 |
| Revenue Subtotal | 16887854 | RevenueSubtotal |
| Investment Expenses Not Included | 0 | InvestmentExpensesNotIncluded |
| Other Revenues Not Included | 0 | OtherRevenuesNotIncluded |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 16887854 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 16007833 | TotExpensesEtcAuditedFinclStmt |
| Donated Services Use Of Facilities | 0 | DonatedServicesUseOfFacilities |
| Prior Year Adjustments | 0 | PriorYearAdjustments |
| Losses Reported | 0 | LossesReported |
| Other Expenses Included | 0 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 0 | ExpensesNotRptdF990 |
| Expenses Subtotal | 16007833 | ExpensesSubtotal |
| Investment Expenses Not Included2 | 0 | InvestmentExpensesNotIncluded2 |
| Other Expenses Not Included | 0 | OtherExpensesNotIncluded |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 16007833 | TotalExpensesPerForm990 |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | X | WrittenEmploymentContract |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 0 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (4 entries)
| TitleTitle | Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Paulo Soares | ||||||||||||||
| CEO | 169727 | 0 | 0 | 0 | 0 | 0 | 17000 | 0 | 4872 | 0 | 191599 | 0 | 0 | 0 |
| Kenneth Bernstein | ||||||||||||||
| Staff Physician | 154696 | 0 | 1350 | 0 | 0 | 0 | 22500 | 0 | 4900 | 0 | 183446 | 0 | 0 | 0 |
| Kirandeep Panatch | ||||||||||||||
| Dentist | 148960 | 0 | 15810 | 0 | 0 | 0 | 12934 | 0 | 3567 | 0 | 181271 | 0 | 0 | 0 |
| Phillip Kim | ||||||||||||||
| Staff Physician | 150728 | 0 | 1350 | 0 | 0 | 0 | 16643 | 0 | 7400 | 0 | 176121 | 0 | 0 | 0 |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (4 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| F990_P06_S0B_L11b | Form 990, Part VI, Section B, Line 11b | The Form 990 is reviewed and approved by the finance committee. |
| F990_P06_S0B_L12c | Form 990, Part VI, Section B, Line 12c | Achieved through annual evaluation of both board and employees. Annual review and signing of conflict of interest policy. |
| F990_P06_S0B_L15 | Form 990, Part VI, Section B, Line 15 | Survey of comparable Chief Executive Officer positions in local regional area. |
| F990_P06_S0C_L19 | Form 990, Part VI, Section C, Line 19 | Available upon request. |