2019-05-14T11:40:19-05:00 2018-06-30 464016990 THE PUN GROUP LLP 200 EAST SANDPOINTE AVENUE SUITE 600 SANTA ANA CA 92707 990 2017-07-01 952833205 FAMILY HEALTH CENTERS OF SAN DIEGO INC FAMI 6195152300 823 GATEWAY CENTER WAY SAN DIEGO CA 92102 RICARDO ROMAN CFO 6195152300 2019-05-14 1 FRANCES KUO P02057020 9497778800 173.254.195.178 2019-05-14 09:42:19 PD P 19D86D94D03DA3213986CFF9BD0A1C6D9557E984 19D86D94D03DA3213986CFF9BD0A1C6D9557E984 2017 2019-02-21 02:37:17Z RICARDO ROMAN 823 GATEWAY CENTER WAY SAN DIEGO CA 92102 199849222 0 X WWW.FHCSD.ORG X 1970 CA PROVIDING QUALITY HEALTH CARE SERVICES TO THE UNINSURED AND UNDERINSURED 13 13 2045 345 140310 160902 39195768 40398537 147345207 157382094 68117 714133 1813996 1203804 188423088 199698568 0 0 0 0 111190887 125240993 0 0 127362 50598011 52698340 161788898 177939333 26634190 21759235 257822632 278227242 66569486 65051930 191253146 213175312 FHCSD'S PRIMARY MISSION IS TO PROVIDE COMPREHENSIVE, ACCESSIBLE AND QUALITY HEALTH CARE SERVICES TO ALL INCOME LEVELS WITH A SPECIAL COMMITTMENT TO LOW INCOME MEDICALLY UNDERSERVED INDIVIDUALS. 0 0 138934053 159159721 PRIMARY AND DENTAL CARE SERVICES AND AIDS PREVENTION -THROUGH US HEALTH AND HUMAN SERVICES WITH THE ASSISTANCE OF GRANT FUNDING. PRIMARY CARE AND DENTAL CARE ARE PROVIDED TO THE SOCIALLY DISADVANTAGED. ALSO, THROUGH US HEALTH AND HUMAN SERVICES, AIDS EDUCATION AND INSTRUCTION ON PREVENTATIVE MEASURES ARE PROVIDED. 138934053 1 1 0 0 0 0 0 0 0 0 1 0 0 0 0 1 1 1 0 0 0 0 0 0 1 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 1 0 0 1 32 0 1 2045 1 1 1 0 0 0 0 0 0 0 X 13 13 0 0 0 0 0 0 0 1 1 0 1 1 1 1 1 1 1 1 1 1 0 CA X RICARDO ROMAN CFO 6199064603 823 GATEWAY CENTER WAY SAN DIEGO CA 92102 BARBARA CARR BOARD CHAIRPERSON 2.00 X 0 0 0 WALTER SCOTT BOARD VICE CHAIR 2.00 X 0 0 0 VENUS THOMAS BOARD SECRETARY/TREASURER/ 2.00 X 0 0 0 DANIEL GUILLEN AUDIT COMMITTEE CHAIR 2.00 X 0 0 0 MARGARITA I CARMONA MARKET PLANNING COMMITTEE 2.00 X 0 0 0 BERTHA GARCIA MARKET PLANNING COMMITTEE 2.00 X 0 0 0 WAYNE R ANDERSON MD CHAIR, CLINICAL REVIEW COMMITTEE 2.00 X 0 0 0 JOSE R DE LA GARZA AUDIT COMMITTEE MEMBER 2.00 X 0 0 0 MARTHA EUGENIA ESCOBAR BOARD MEMBER 2.00 X 0 0 0 FRANK ESPINOZA BOARD MEMBER 2.00 X 0 0 0 SEAN MATHEWS CHAIR, MARKET PLANNING COMMITTEE 2.00 X 0 0 0 STEPHANIE PEREZ MARKET PLANNING COMMITTEE MEMBER 2.00 X 0 0 0 THE HONORABLE MAYOR MARY SESSOM BOARD MEMBER 2.00 X 0 0 0 FRAN BUTLER-COHEN PRESIDENT/CEO 40.00 X 694980 0 57754 RICARDO ROMAN CHIEF FINANCIAL OFFICER 40.00 X 347792 0 30678 ANDRES GUTIERREZ CHIEF INFORMATION OFFICER 40.00 X 268870 0 27269 IBRAHIM SAWAYA DENTAL DIRECTOR 40.00 X 312858 0 27533 FACIKA TAFARA LAB DIRECTOR 40.00 X 226186 0 28643 ALAN ZIEG PHYSICIAN - CHIEF OF OB GY 40.00 X 435167 0 46269 JANET ADAMIAN VP OF PROGRAMS AND SYSTEM 40.00 X 181245 0 30149 CHRISTOPHER GORDON CHIEF MEDICAL OFFICER & CO 40.00 X 344483 0 19981 DONNA BAKER SRVP - ADMINISTRATION 40.00 X 267117 0 64187 KHAWLA SULEIMAN-QAFITI CHIEF OF PEDIATRICS 40.00 X 237884 0 21569 CLAUDIO CABREJOS MED DIR-ASST-PSYCHIATRY 40.00 X 367643 0 57800 BAHGHI KEFLEZIGHI MEDICAL DIRECTOR ASSISTANT 40.00 X 235659 0 34800 CHRISTIAN RAMERS MEDICAL DIR-ASST-RESEARCH 40.00 X 258639 0 18000 JEFFREY GERING VP OF PLANNING & SUPPORT S 40.00 X 232789 0 22269 CHARLES SMOOT ASSISTANT MEDICAL DIRECTOR 40.00 X 225871 0 44239 DAVID WHISENHUNT VP - PHYSICAL FACILITIES 40.00 X 181026 0 41189 MARSHA SPITZER ASSISTANT MEDICAL DIRECTOR 40.00 X 197223 0 18000 GARRICK TONG MED DIR-ASST-CHILD PSYCHI 40.00 X 327619 0 52800 SANDRA CERVANTES MED DIR-ASST-OBGYN 40.00 X 303186 0 16497 UYEN-THAO TRAN ASSOCIATE DIR-FM RESIDENCY 40.00 X 252698 0 49178 DEXTER ANTHONY JENSEN ASSISTANT MEDICAL DIRECTOR 40.00 X 293106 0 29644 NARAYANADAS C VAKAMUDI CHIEF TECHNOLOGY OFFICER 40.00 X 184843 0 22572 MARK KNIGHT PSYCHIATRIST 40.00 X 307109 0 23633 JOE SEPULVEDA PSYCHIATRIST 40.00 X 373196 0 39645 CHARLENE BUECHNER PHYSICIAN - OB/GYN 40.00 X 270587 0 35254 ALLISON LOEFFLER PHYSICIAN - OB/GYN 40.00 X 285249 0 17254 DEBORAH ANNE BIRNBAUM PSYCHIATRIST 40.00 X 315817 0 30906 7928842 0 907712 172 0 1 0 JAMES BYRNES DBA BRYNES CONSTRUCTION PO BOX 4024 CARLSBAD CA 92108 CONSTRUCTION 132545 CERTIFIED LANGUAGES INTERNATIONAL 4800 SW MACADAM SUITE 400 PORTLAND OR 97239 TEACHING & SUPERVISION 105400 2 122474 35785124 4490939 40398537 PATIENT SERVICE REVENUE 621110 135451995 135451995 PHARMACY INCOME 621110 21930099 21930099 157382094 714133 714133 263158 122848 140310 140310 140310 27806 122474 27806 0 OTHER REVENUE 624100 1063494 1063494 1063494 199698568 159159721 140310 0 7137904 5710561 1427343 118026507 91596359 26430148 76582 76582 7793648 5486738 2306910 995473 153106 842367 5016797 824993 4191804 924152 924152 6042155 631912 5410243 586677 586677 TAXES ON UNRELATED BUSI 59096 59096 MEDICAL AND PHARM SUPPL 22745431 22744627 804 OTHER EXPENSES 4828991 9572475 -4793122 49638 MINOR EQUIPMENT 2232991 1335294 897650 47 1472929 877988 593846 1095 177939333 138934053 38877918 127362 82872279 97515532 3375348 3101030 19535049 20803833 28256456 28323684 703930 348796 1443421 1527716 163671186 38261466 120756397 125409720 612075 817001 267677 379930 257822632 278227242 14121983 15842641 3848279 2436904 48599224 46772385 66569486 65051930 X 190495504 211996211 757642 1179101 191253146 213175312 257822632 278227242 21759235 162931 0 X X 0 1 X 1 1 1 X 36002460 32760750 33848830 39195768 40398537 182206345 36002460 32760750 33848830 39195768 40398537 182206345 182206345 99713 123889 321597 252440 140310 937949 1150667 1158716 2991976 1561318 1362607 8225284 191369578 0.95210 0.95220 X 38394908 38394908 103924784 23931491 79993293 4298879 1839658 2459221 11081467 8004614 3076853 5971148 4485703 1485445 125409720 X 199861499 162931 162931 199698568 0 199698568 0 0 0 0 0 PART X, LINE 2: THE HEALTH CENTER HAS BEEN RECOGNIZED AS A NOT-FOR-PROFIT ORGANIZATION UNDER INTERNAL REVENUE CODE SECTION 501(C)3 AND CALIFORNIA REVENUE CODE SECTION 23701(D) AND IS EXEMPT FROM FEDERAL AND CALIFORNIA INCOME TAXES ON RELATED INCOME. FOR THE YEARS ENDED JUNE 30, 2018 AND 2017, THE HEALTH CENTER GENERATED REVENUE FROM AN UNRELATED BUSINESS ACTIVITY AND WAS TAXED ACCORDINGLY. EFFECTIVE JULY 1, 2009, THE HEALTH CENTER ADOPTED NEWLY ISSUED GUIDANCE ON ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES. UNDER THIS NEW GUIDANCE, THE HEALTH CENTER UTILIZED A TWO-STEP APPROACH TO RECOGNIZING AND MEASURING UNCERTAIN TAX POSITIONS (TAX CONTINGENCIES). THE FIRST STEP IS TO EVALUATE THE TAX POSITION FOR RECOGNITION BY DETERMINING IF THE WEIGHT OF AVAILABLE EVIDENCE INDICATES IT IS MORE LIKELY THAN NOT THAT THE POSITION WILL BE SUSTAINED ON AUDIT, INCLUDING RESOLUTION OF RELATED APPEALS OR LITIGATION PROCESSES. THE SECOND STEP IS TO MEASURE THE TAX BENEFIT AS THE LARGEST AMOUNT, WHICH IS MORE THAN 50% LIKELY OF BEING REALIZED UPON ULTIMATE SETTLEMENT. AS A RESULT OF THE ADOPTION OF ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES, THE HEALTH CENTER DID NOT RECOGNIZE AN INCREASE OR DECREASE IN THE LIABILITY FOR UNRECOGNIZED TAX BENEFITS RELATED TO TAX POSITIONS TAKEN IN PRIOR PERIODS; THEREFORE, THERE WAS NOT CORRESPONDING ADJUSTMENT TO UNRESTRICTED NET ASSETS. ADDITIONALLY, FOR THE YEAR ENDED JUNE 30, 2018, THERE WERE NO ADDITIONAL LIABILITIES RECORDED FOR UNRECOGNIZED TAX BENEFITS RELATED TO TAX POSITIONS TAKEN IN THE CURRENT YEAR. THE HEALTH CENTER CONSIDERS MANY FACTORS WHEN EVALUATING AND ESTIMATING IT'S TAX POSITIONS AND TAX BENEFITS, WHICH MAY REQUIRE PERIODIC ADJUSTMENTS AND WHICH MAY NOT ACCURATELY FORECAST ACTUAL OUTCOMES. THERE WERE NO ACCRUALS FOR INTEREST AND PENALTIES RELATED TO UNCERTAIN TAX POSITIONS AT THE INCEPTION DATE OR FOR THE YEAR ENDED JUNE 30, 2018. THE HEALTH CENTER HAS DETERMINED THAT IT'S MAJOR TAX JURISDICTIONS ARE THE STATE OF CALIFORNIA AND ALL OTHER STATES WITHIN THE UNITED STATES OF AMERICA. THE TAX YEARS OF 2016, 2017, AND 2018 REMAIN OPEN AND SUBJECT TO EXAMINATION BY THE APPROPRIATE GOVERNMENTAL AGENCIES IN THE UNITED STATES. SPIRIT OF THE BARRIO 150280 122474 27806 10973 12238 4595 150280 122474 27806 10973 12238 4595 27806 0 X 0 0 0 0 0 0 0 0 0 FRAN BUTLER-COHEN PRESIDENT/CEO 539677 0 140303 0 15000 0 40500 0 17254 0 752734 0 0 0 RICARDO ROMAN CHIEF FINANCIAL OFFICER 335947 0 11845 0 0 0 17500 0 13178 0 378470 0 0 0 ANDRES GUTIERREZ CHIEF INFORMATION OFFICER 268870 0 0 0 0 0 23000 0 4269 0 296139 0 0 0 IBRAHIM SAWAYA DENTAL DIRECTOR 312858 0 0 0 0 0 18000 0 9533 0 340391 0 0 0 FACIKA TAFARA LAB DIRECTOR 226186 0 0 0 0 0 17801 0 10842 0 254829 0 0 0 ALAN ZIEG PHYSICIAN - CHIEF OF OB GY 405413 0 29754 0 0 0 42000 0 4269 0 481436 0 0 0 JANET ADAMIAN VP OF PROGRAMS AND SYSTEM 181245 0 0 0 0 0 18000 0 12149 0 211394 0 0 0 CHRISTOPHER GORDON CHIEF MEDICAL OFFICER & CO 326563 0 17920 0 0 0 15712 0 4269 0 364464 0 0 0 DONNA BAKER SRVP - ADMINISTRATION 266617 0 500 0 0 0 41282 0 22905 0 331304 0 0 0 KHAWLA SULEIMAN-QAFITI CHIEF OF PEDIATRICS 221839 0 16045 0 0 0 21569 0 0 0 259453 0 0 0 CLAUDIO CABREJOS MED DIR-ASST-PSYCHIATRY 355798 0 11845 0 0 0 41000 0 16800 0 425443 0 0 0 BAHGHI KEFLEZIGHI MEDICAL DIRECTOR ASSISTANT 223564 0 12095 0 0 0 18000 0 16800 0 270459 0 0 0 CHRISTIAN RAMERS MEDICAL DIR-ASST-RESEARCH 236994 0 21645 0 0 0 18000 0 0 0 276639 0 0 0 JEFFREY GERING VP OF PLANNING & SUPPORT S 232789 0 0 0 0 0 18000 0 4269 0 255058 0 0 0 CHARLES SMOOT ASSISTANT MEDICAL DIRECTOR 205518 0 20353 0 0 0 34706 0 9533 0 270110 0 0 0 DAVID WHISENHUNT VP - PHYSICAL FACILITIES 181026 0 0 0 0 0 23935 0 17254 0 222215 0 0 0 MARSHA SPITZER ASSISTANT MEDICAL DIRECTOR 171577 0 25646 0 0 0 18000 0 0 0 215223 0 0 0 GARRICK TONG MED DIR-ASST-CHILD PSYCHI 315774 0 11845 0 0 0 36000 0 16800 0 380419 0 0 0 SANDRA CERVANTES MED DIR-ASST-OBGYN 263341 0 39845 0 0 0 10835 0 5662 0 319683 0 0 0 UYEN-THAO TRAN ASSOCIATE DIR-FM RESIDENCY 233778 0 18920 0 0 0 36000 0 13178 0 301876 0 0 0 DEXTER ANTHONY JENSEN ASSISTANT MEDICAL DIRECTOR 280761 0 12345 0 0 0 21244 0 8400 0 322750 0 0 0 NARAYANADAS C VAKAMUDI CHIEF TECHNOLOGY OFFICER 184343 0 500 0 0 0 16910 0 5662 0 207415 0 0 0 MARK KNIGHT PSYCHIATRIST 295264 0 11845 0 0 0 0 0 23633 0 330742 0 0 0 JOE SEPULVEDA PSYCHIATRIST 361351 0 11845 0 0 0 16740 0 22905 0 412841 0 0 0 CHARLENE BUECHNER PHYSICIAN - OB/GYN 234824 0 25035 0 10728 0 18000 0 17254 0 305841 0 0 0 ALLISON LOEFFLER PHYSICIAN - OB/GYN 249222 0 36027 0 0 0 0 0 17254 0 302503 0 0 0 DEBORAH ANNE BIRNBAUM PSYCHIATRIST 303972 0 11845 0 0 0 17728 0 13178 0 346723 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS SUBMITTED TO THE BOARD OF DIRECTORS AND MANAGEMENT FOR REVIEW. UPON FINAL APPROVAL, THE FORM IS FINALIZED AND SUBMITTED TO THE INTERNAL REVENUE SERVICE. FORM 990, PART VI, SECTION B, LINE 12C FHCSD MONITORS AND ENFORCES COMPLIANCE WITH THE FHCSD'S CONFLICT OF INTEREST POLICY BY HAVING A CORPORATE COMPLIANCE COMMITTEE ACTIVELY AND PERIODICALLY PERFORMING AUDITS TO ENSURE COMPLIANCE. STAFF ARE TRAINED ANNUALLY TO REMIND THEM OF THEIR ONGOING OBLIGATION TO REPORT ANY INCIDENT OF FRAUD OR CONFLICT OF INTEREST. THERE IS A HOTLINE TO CALL WHERE THEY CAN REMAIN ANONYMOUS. FORM 990, PART VI, SECTION B, LINE 15 THE PROCESS OF DETERMING COMPENSATION FOR THE FHCSD'S TOP MANAGEMENT AND KEY EMPLOYEES INVOLVES OUR HUMAN RESOURCES DEPARTMENT. IT IS BASED ON A NUMBER OF CONSIDERATIONS SUCH AS THE NATURE AND SCOPE OF INDIVIDUAL DUTIES, BACKGROUND, EXPERTISE, SIZE, COMPLEXITY OF ORGANIZATION, AND AMOUNT PAID BY SIMILAR ORGANIZATIONS OF SIMILAR SIZE AND TYPE. HUMAN RESOURCES ROUTINELY CONDUCTS SALARY SURVEYS AND PERFORMS ASSESSMENTS OF THE JOB MARKET. THE FINAL DECISION RESTS WITH THE GOVERNING BOARD WHEN THE ANNUAL CORPORATE BUDGET IS REVIEWED AND APPROVED FOR ADOPTION. FORM 990, PART VI, SECTION C, LINE 19 FAMILY HEALTH CENTERS OF SAN DIEGO'S GOVERNING DOCUMENTS, POLICIES AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990, PART XII, LINE 1C: ALL REVIEW AND PROCESS FOR THE OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT AUDITOR REMAINS CONSISTENT BETWEEN YEARS. FHCSD HITEC LLC 823 GATEWAY CENTER WAY SAN DIEGO CA 92102 471993025 TO ACQUIRE AND CONSTRUCT PROPERTY TO BE USE AS TRAINING FACILITY AND FQHC CA 14670496 FAMILY HEATH CENTERS OF SAN DIEGO INC FHCSD FCC2 LLC 823 GATEWAY CENTER WAY SAN DIEGO CA 92102 813946372 TO FACILITATE FINANCING, DEVELOPMENT, AND CONSTRUCTION OF HEALTH CENTER CA 7479753 FAMILY HEATH CENTERS OF SAN DIEGO INC FHCSD EL CAJON LLC 823 GATEWAY CENTER WAY SAN DIEGO CA 92102 813684543 TO FACILITATE FINANCING, DEVELOPMENT, AND CONSTRUCTION OF HEALTH CENTER CA 9912882 FAMILY HEATH CENTERS OF SAN DIEGO INC FHCSD COMMUNITY SERVICES INC 823 GATEWAY CENTER WAY SAN DIEGO CA 92102 461579623 SUPPORT THE CHARITABLE & EDUCATIONAL ACTIVITIES OF FHCSD CA 501 ACTIVE (GOOD STANDIN FAMILY HEATH CENTERS OF SAN DIEGO INC 1 FHCSD GROWTH FUND INC 823 GATEWAY CENTER WAY SAN DIEGO CA 92102 300841451 SUPPORT THE CHARITABLE & EDUCATIONAL ACTIVITIES OF FHCSD CA 501 ACTIVE (GOOD STANDIN FAMILY HEATH CENTERS OF SAN DIEGO INC 1 0 1 0 0 0 0 0 0 0 0 1 1 0 1 1 0 0 0 0 FHCSD GROWTH FUND INC B 42 AUDITED FINANCIAL STATEMENTS FHCSD HITEC LLC B 189719 AUDITED FINANCIAL STATEMENTS FHCSD COMMUNITY SERVICES INC O 1129254 AUDITED FINANCIAL STATEMENTS FHCSD GROWTH FUND INC O 1129254 AUDITED FINANCIAL STATEMENTS FHCSD FCC2 LLC O 1129254 AUDITED FINANCIAL STATEMENTS FHCSD EL CAJON LLC O 1129254 AUDITED FINANCIAL STATEMENTS FHCSD HITEC LLC O 1129254 AUDITED FINANCIAL STATEMENTS FHCSD COMMUNITY SERVICES INC K 329359 AGREEMENT FHCSD HITEC LLC K 707716 AGREEMENT FHCSD FCC2 LLC K 174847 AGREEMENT FHCSD EL CAJON LLC K 362912 AGREEMENT