2022-11-08T21:12:52-06:00 2021-12-31 330700332 VASQUEZ COMPANY LLP 655 N CENTRAL AVENUE STE 1550 GLENDALE CA 91203 990 2021-01-01 952810095 ALTAMED HEALTH SERVICES CORPORATION ALTA 3237258751 2040 CAMFIELD AVENUE LOS ANGELES CA 90040 JOSE ESPARZA EVP OF FINANCE/CFO 3237258751 2022-11-04 1 JOSE ESPARZA 999009999 REGINA L PRINCE CPA P00576936 2138731700 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z JOSE U ESPARZA 2040 CAMFIELD AVENUE LOS ANGELES CA 90040 1084685338 0 X HTTP://WWW.ALTAMED.ORG X 1970 CA SEE SCHEDULE O : TO ELIMINATE DISPARITIES IN HEALTH CARE ACCESS AND OUTCOMES BY PROVIDING SUPERIOR QUALITY HEALTH AND HUMAN SERVICES THROUGH AN INTEGRATED WORLD-CLASS DELIVERY SYSTEM FOR LATINO, MULTI-ETHNIC AND UNDERSERVED COMMUNITIES IN SOUTHERN CALIFORNIA.VISION: TO BE THE LEADING COMMUNITY-BASED PROVIDER OF QUALITY HEALTH CARE AND HUMAN SERVICES. 9 9 4200 11 170649 129754 59831177 54978241 742904849 849228193 17174106 44007910 51322691 105922017 871232823 1054136361 318750 50247750 0 0 324155477 344326453 0 0 3752037 476014808 608279203 800489035 1002853406 70743788 51282955 1022946635 1171212102 338030612 419128933 684916023 752083169 X TO ELIMINATE DISPARITIES IN HEALTH CARE ACCESS AND OUTCOMES BY PROVIDING SUPERIOR QUALITY HEALTH AND HUMAN SERVICES THROUGH AN INTEGRATED WORLD-CLASS DELIVERY SYSTEM FOR LATINO, MULTI-ETHNIC UNDERSERVED COMMUNITIES IN SOUTHERN CALIFORNIA. 0 0 589410156 50247750 546954570 CLINICS - ALTAMED OPERATES A TOTAL OF 30 PRIMARY CARE AND DENTAL CLINICS IN LOS ANGELES AND ORANGE COUNTIES. ADDITIONALLY, 1 MOBILE UNITS OFFER MEDICAL, DENTAL, AND COMMUNITY OUTREACH. IN 2021, THE 7 CLINICS IN ORANGE COUNTY AND 23 CLINICS IN LOS ANGELES COUNTY SAW OVER 238,000 PATIENTS. IN 2021 THE DENTAL CLINICS, MOBILE UNIT, AND 6 PORTABLE ORAL HEALTH UNITS PROVIDED DENTAL CARE TO OVER 44,400 CHILDREN AND ADULTS. ALTAMED PROVIDES INTEGRATED SERVICES THAT INCLUDE PERINATAL SERVICES, PEDIATRIC AND ADOLESCENT CARE, FAMILY HEALTH, BEHAVIORAL HEALTH, WOMEN'S HEALTH, AND GERIATRIC CARE. THROUGH ITS EDUCATION DEPARTMENT, ALTAMED PROVIDES PROGRAMMING FOR PATIENTS WITH OBESITY AND OTHER CHRONIC CARE CONDITIONS. OTHER SERVICES INCLUDE LAB TESTING, RADIOLOGY, TRANSPORTATION, TRANSLATION, AND OTHER ENABLING SERVICES.IN THE YEARS OF THE PANDEMIC, ALTAMED HAD TO PIVOT HEALTH CARE DELIVERY TO INCLUDE A VIRTUAL FORMAT, INTRODUCE COVID SCREENINGS, ADMINISTER COVID VACCINATIONS, AND CHANGE MANY CLINIC PROCESS FLOWS TO MAINTAIN SAFETY FOR PATIENTS AND STAFF. PARTNERSHIPS WITH THE DEPT. OF PUBLIC HEALTH, CITIES, GOVERNMENT, AND MEDIA INSURED WE KEPT THE COMMUNITY EDUCATED ABOUT MAINTAINING THEIR HEALTH AND PROTECTION THROUGH THE PANDEMIC.THE MANAGED CARE TEAM IS COMPOSED OF OVER 360 STAFF MEMBERS DEDICATED TO MANAGING DELEGATED RISK FROM HEALTH PLANS. THIS TEAM CURRENTLY SERVICES OVER 328,000 UNIQUE CAPITATED LIVES IN LOS ANGELES AND ORANGE COUNTIES CALIFORNIA. THE MAJOR TEAMS INVOLVED WITH THESE OPERATIONS COVER: UTILIZATION MANAGEMENT, CASE MANAGEMENT, CLAIMS ADMINISTRATION, ELIGIBILITY, ACCOUNTING, INFORMATION TECHNOLOGIES, CONTRACTING, PROVIDER SERVICES, CREDENTIALING, CUSTOMER SERVICE, AND CONFIGURATION. FUNCTIONING AS A COHESIVE TEAM, THESE DEPARTMENTS GOAL IS TO PROVIDE HIGH QUALITY AND LOW COST CARE TO MEMBERS ENROLLED WITH ALTAMED. 229033031 300363833 LONG TERM CARE - EACH YEAR 3,000 FRAIL AND ELDERLY SENIORS AND DISABLED ADULTS ARE SUPPORTED BY AN ARRAY OF SERVICES THROUGH ALTAMED'S 11 PROGRAMS OF ALL-INCLUSIVE CARE FOR THE ELDERLY (PACE) SITES. SERVICES INCLUDE PRIMARY CARE/GERIATRIC MEDICINE, NURSING CARE, REHABILITATION THERAPY, FAMILY SUPPORT INTERVENTIONS, COUNSELING, MEDICATION MANAGEMENT, NUTRITION EDUCATION, SOCIAL ACTIVITIES, AND "DOOR THROUGH DOOR" TRANSPORTATION SERVICES BOTH TO PARTICIPANTS' HOMES AND SPECIALTY CARE MEDICAL APPOINTMENTS. ALTAMED ALSO PROVIDES SPECIALIZED IN-HOME SUPPORTIVE PROGRAMS AND SERVICES THAT ENHANCE THE LIVES OF NEARLY 4,500 SENIORS LIVING INDEPENDENTLY IN THE COMMUNITY OR WHO ARE AT-RISK OF INSTITUTIONALIZED CARE. 13089693 1909790 HIV SERVICES - WITH TWO DECADES OF EXPERIENCE AS A RYAN WHITE PART C PROVIDER, ALTAMED SERVES 2,000 CLIENTS ANNUALLY THROUGH HIV MEDICAL CARE SERVICES, AND 3,000 CLIENTS THROUGH HIV PREVENTION PROGRAMS. ALTAMED OPERATES ONE (1) HIV MEDICAL OUTPATIENT CLINICS IN LOS ANGELES COUNTY. ALTAMED'S HIV SERVICES DIVISION INCLUDES TRADITIONAL AND BIOMEDICAL HIV PREVENTION, MEDICAL CARE, MENTAL HEALTH, NUTRITION COUNSELING, ORAL HEALTH, CASE MANAGEMENT, AND SOCIAL SUPPORT SERVICES IN A ONE-STOP MODEL TO LATINX AND OTHER UNDERSERVED POPULATIONS. 8982828 YOUTH SERVICES - ALTAMED PROVIDES AN ARRAY OF YOUTH SERVICES TO OVER 1,200 AT-RISK TEENS AND YOUNG ADULTS IN MEDICALLY-UNDERSERVED COMMUNITIES EACH YEAR. SERVICES INCLUDE: PREGNANCY AND STD PREVENTION PROGRAMS, FAMILY PLANNING, HEALTH EDUCATION AND INFORMATION WORKSHOPS, LINKAGES TO CLINICAL SERVICES, CASE MANAGEMENT FOR PREGNANT/PARENTING TEENS, PARENTING EDUCATION, SUPPORT FOR PARENTING TEENS TO HELP THEM STAY IN SCHOOL AND LIFE-SKILLS DEVELOPMENT. ALTAMED ALSO PROVIDES INTENSIVE TUTORING FOR HIGH SCHOOL STUDENTS, MENTORSHIP, GUIDANCE INTO COLLEGE AND TECHNICAL SCHOOLS, AND WORKFORCE DEVELOPMENT WITH CAREER PIPELINES IN THE MEDICAL FIELD.THE ALTAMED INSTITUTE FOR HEALTH EQUITY (AIHE). THROUGH INNOVATION AND COMMUNITY ENGAGEMENT, THE WORK OF THE INSTITUTE IS TO ADDRESS A WIDE ARRAY OF HEALTH INEQUITIES THAT DISPROPORTIONATELY AFFECT RACIAL AND ETHNIC GROUPS, INCLUDING ADDRESSING THE MULTIPLE SOCIAL DETERMINANTS OF HEALTH WHICH LEAD TO DISPARITIES IN CLINICAL OUTCOMES. ALTAMED'S PATIENT POPULATION IS OVERWHELMINGLY FROM RACIAL/ETHNIC MINORITIES INCLUDING INDIVIDUALS WITH LIMITED ENGLISH PROFICIENCY THAT SUFFER DISPROPORTIONATELY FROM HEALTH DISPARITIES. THROUGH TRANSLATIONAL RESEARCH, GRANTS, AND STRATEGIC PARTNERSHIPS, THE INSTITUTE IS DEVELOPING EVIDENCE-BASED STRATEGIES TO IMPROVE PATIENT CARE. THE INSTITUTE REPRESENTS THE ESTABLISHMENT OF CRITICAL RESOURCES TO ADVISE ALTAMED HEALTH SERVICES ON SYSTEMATICALLY ADDRESSING KEY ISSUES IN HEALTH EQUITY BY DEVELOPING AND ADVANCING CONSENSUS STRATEGIES THAT ARE EFFECTIVE, SUSTAINABLE AND THAT CAN BE IMPLEMENTED LOCALLY.ALTAMED OFFERS 9 SPECIALTY CARE SERVICES TO REMOVE THE BARRIERS TO CARE MANY WERE EXPERIENCING WHEN TRYING TO ACCESS THESE MUCH NEEDED SERVICES. EXPANSION OF THE WORKFORCE PIPELINES CONTINUE TO EDUCATE AND TRAIN COMMUNITY MEMBERS IN MA, LVN, AND NURSE CAREER PATHWAYS. ALTAMED HAS GROWN THE NEWLY FORMED CIVIC ENGAGEMENT DEPARTMENT TO ADDRESS SOCIAL DETERMINANTS OF HEALTH AND TRAIN COMMUNITY MEMBERS ON HOW TO ADVOCATE AT THE GRASSROOTS LEVEL FOR INCREASED AND PARTICULAR HEALTH ACCESS AND REFORMS, AND ENCOURAGE COMMUNITY TO GET INVOLVED WITH LOCAL ISSUES AND VOTE. 8982828 840515708 1 1 0 1 0 0 0 1 0 0 1 0 0 0 1 1 0 1 0 1 1 0 0 0 1 0 0 1 0 1 1 0 0 0 0 0 1 0 0 0 0 1 0 0 0 1 1 1 0 0 0 1 709 0 1 4200 1 1 1 0 0 0 0 1 1 0 0 0 0 1 0 X 9 9 1 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X JOSE U ESPARZA EVP OF FINANCECFO 3237258751 2040 CAMFIELD AVENUE LOS ANGELES CA 90040 HECTOR BARRETO-RESIGNED 092321 BOARD CHAIRPERSON 1.60 X X 0 0 0 RICARDO ROBLES BOARD SECRETARY 1.60 X X 0 0 0 MARIA GRIMALDO CONSUMER BOARD MEMBER 1.20 X 0 0 0 JOSEPH GOMEZ CONSUMER BOARD MEMBER 1.60 X 0 0 0 ADOLFO CHANEZ BOARD MEMBER 1.60 X 0 0 0 NADIA ALVAREZ CONSUMER BOARD MEMBER 1.20 X 0 0 0 MARC VICTOR BOARD TREASURER 1.60 X X 0 0 0 JOSE AVALOS MD BOARD VICE-CHAIR 1.60 X X 0 0 0 LUCY HERRERA CONSUMER BOARD MEMBER 1.20 X 0 0 0 SARKIS KARAKESISOGLU-RESIGN 111821 CONSUMER BOARD MEMBER 1.20 X 0 0 0 VICTOR OLMOS BOARD MEMBER 1.20 X 0 0 0 CASTULO DELA ROCHA JD PRESIDENT & CEO 40.00 3.00 X 1351160 0 209149 JOSE U ESPARZA SVP FINANCE & CFO 40.00 1.00 X 626108 0 51664 ZOILA ESCOBAR SVP, CHIEF ADMIN OFFICER 40.00 1.00 X 640278 0 37715 ANNA TRAN SR.STRATEGY EXECUTIVE 40.00 X 766040 0 22511 EFRAIN TALAMANTES SVP, HS CHIEF OPERATING OF 40.00 X 634183 0 69686 ESIQUIO CASILLAS VP, MEDICAL DIRECTOR, PACE 40.00 X 536267 0 93515 RICO CRISTIAN INTERIM CMO 40.00 2.00 X 636437 0 68561 PARHAM NAGHDECHI HOSPITALIST 40.00 X 434677 0 69607 DARREN MCLACHLAN VP, IPA OPERATION 40.00 X 488110 0 69686 HENRY HOLGUIN SVP, GENERAL COUNSEL 40.00 1.00 X 512551 0 52333 RAYMOND LOWE SVP & CHIEF INFORMATION OFFICER 40.00 X 450604 0 68011 MELANIE LIN MEDICAL DIRECTOR 40.00 X 460062 0 22752 7536477 0 835190 12 0 1 0 HEALTH TALENT 2 26090 TOWNE CENTER DIVE FOOTHILL RANCH CA 92610 STAFFING AGENCY 34993123 FIRST AMERICAN TITLE INSURANCE COMPANY 101 MISSION STREET SUITE 1600 SAN FRANCISCO CA 94105 INSURANCE SERVICES 30165158 ANTHEM BLUE CROSS 120 MONUMENT CIRCLE INDIANAPOLIS IN 46204 HEALTH INSURANCE 29241811 CHILDRENS HOSPITAL LA MEDICAL GROUP 3701 WILSHIRE BLVD LOS ANGELES CA 90010 MEDICAL SERVICES 16646774 VINCOR CONSTRUCTION INC 2651 SATURN STREET BREA CA 92821 CONSTRUCTION SERVICES 8717949 5 74292 35672779 19231170 1555032 54978241 MANAGED CARE CONTRACTS 624100 595798084 595798084 NET PATIENT SERVICES 624100 195991891 195991891 PHARMACY REVENNUE 624100 56596200 56596200 WELLNESS INCENTIVES 624100 842018 842018 849228193 31065932 170649 30895283 43218788 30276810 12941978 12941978 12941978 240327 74292 272167 -31840 -31840 ADMINISTRATIVE SUPPORT 541900 53682077 53682077 MANAGEMENT SERVICES 541610 49411216 49411216 CONTRACT SERVICES 531110 2860564 2860564 105953857 1054136361 849228193 170649 149759278 X 50247750 50247750 5743274 5047477 652882 42915 275674408 242195345 31400475 2078588 5849804 5157264 652536 40004 37748351 33279448 4210769 258134 19310616 17024496 2154069 132051 75722115 61170938 13748706 802471 1514424 1223404 274971 16049 515470 515470 913853 913853 312393059 308788877 3586710 17472 6560858 3511992 3048866 13133150 7374075 5611706 147369 12384806 2573838 9750902 60066 15807992 11895784 3904110 8098 6091680 3659219 2432461 26134871 13408547 12716806 9518 7364622 6169938 1173093 21591 MANAGEMENT SERVICES 51179374 51179374 PHARMACEUTICALS 46766476 46766476 MEDICAL SUPPLIES 14681851 14340894 291184 49773 PATIENT TRANSPORTATION 3974548 3963807 10741 13140054 2200669 10871447 67938 1002853406 840515708 158585661 3752037 50891319 51502208 15614526 4817124 4137654 5485541 24576945 36726677 33146360 33477717 13258223 11911927 1594396 2922443 9069495 5672519 482600506 153365735 303970558 329234771 523153071 622735021 20469821 25192747 7000000 23064267 34533407 1022946635 1171212102 132293289 153555264 16973103 18726160 167032147 97869378 21373911 98609131 358162 50369000 338030612 419128933 X 677136459 742203815 7779564 9879354 684916023 752083169 1022946635 1171212102 51282955 15884191 0 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 0 0 0 1 515470 515470 0 PART II-B, LINE 1: AMOUNTS WERE PAID TO LEGISLATIVE CONSULTANTS FOR LOBBYING ACTIVITIES. 3461234 X X X 0 74758848 74758848 16435715 8750097 7685618 230770939 52603924 178167015 150191507 92011714 58179793 10443497 10443497 329234771 INTEREST RATE SWAP 156606 DUE TO RELATRED PARTIES 50212394 50369000 X 1020292649 15884191 325000 272166 16481357 1003811292 913853 49411216 50325069 1054136361 951357345 325000 272166 597166 950760179 913853 51179374 52093227 1002853406 PART III, LINE 4: ALTAMED HEALTH SERVICES IS A NON-PROFIT ORGANIZATION THAT PROVIDES QUALITY HEALTHCARE AND HUMAN SERVICES TO THE UNDERSERVED COMMUNITIES OF SOUTHERN CALIFORNIA. THE ORGANIZATION RECOGNIZES THE THERAPEUTIC EFFECT OF CULTURALLY RELEVANT WORKS OF ART AND THEIR EFFECT ON PATIENTS, DONORS AND MEMBERS OF THE PUBLIC. AS PART OF ITS HOLISTIC APPROACH TO HEALTHCARE, THE ORGANIZATION HOLDS A SIGNIFICANT COLLECTION OF ART BY A DIVERSE RANGE OF EMERGING, MID-CAREER AND ESTABLISHED ARTISTS BASED IN LOS ANGELES, AS WELL AS CHICANX ARTISTS, AND INTERNATIONALLY RECOGNIZED ARTISTS FROM MEXICO, LATIN AMERICA, ASIA, AND THE UNITED STATES FOR THE PURPOSE OF EXHIBITION AND PRESENTATION THROUGHOUT ITS CLINICS AND OTHER OF ITS HEALTH SERVICES CENTERS. THIS APPROACH HAS BEEN INSTRUMENTAL IN GIVING ALTAMED PATIENTS A CALM, CURATIVE ENVIRONMENT ALLEVIATING STRESSES ASSOCIATED WITH BEING IN A CLINICAL SETTING. ALTAMED BELIEVES THAT EVERYONE, REGARDLESS OF AGE, RACE, GENDER, OR SOCIAL STANDING, HAS THE RIGHT TO EXPERIENCE ART IN THEIR EVERYDAY LIFE. PART X, LINE 2: ALTAMED IS A NONPROFIT CORPORATION EXEMPT FROM THE PAYMENT OF INCOME TAXES UNDER INTERNAL REVENUE CODE SECTION 501(C)(3) AND CALIFORNIA REVENUE AND TAXATION CODE SECTION 23701D. ALTAMED HAS EVALUATED ITS TAX POSITIONS AND THE CERTAINTY AS TO WHETHER THOSE POSITIONS WILL BE SUSTAINED IN THE EVENT OF AN AUDIT BY TAXING AUTHORITIES AT THE FEDERAL AND STATE LEVELS. THE PRIMARY TAX POSITIONS EVALUATED RELATE TO ALTAMED'S CONTINUED QUALIFICATION AS A TAX-EXEMPT ORGANIZATION AND WHETHER THERE ARE UNRELATED BUSINESS INCOME ACTIVITIES THAT WOULD BE TAXABLE. MANAGEMENT HAS DETERMINED THAT ALL INCOME TAX POSITIONS WILL MORE LIKELY THAN NOT BE SUSTAINED UPON POTENTIAL AUDIT OR EXAMINATION; THEREFORE, NO DISCLOSURES OF UNCERTAIN INCOME TAX POSITIONS ARE REQUIRED. ALTAMED'S INCOME TAX RETURNS REMAIN SUBJECT TO EXAMINATION FOR ALL TAX YEARS ENDED ON OR AFTER DECEMBER 31, 2017 WITH REGARD TO ALL TAX POSITIONS AND RESULTS REPORTED. PART XI, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EXPENSES 272,166. PART XI, LINE 4B - OTHER ADJUSTMENTS: GROSS REVENUE FROM ALTURA MGMT SERVICES LLC 49,411,216. PART XII, LINE 2D - OTHER ADJUSTMENTS: FUNDRAISING EXPENSES 272,166. PART XII, LINE 4B - OTHER ADJUSTMENTS: EXPENSES FROM ALTURA MANAGEMENT SERVICES LLC 51,179,374. NORTH AMERICA - CANADA AND MEXICO, BUT NOT THE UNITED STATES 0 3 PURCHASE OF ARTWORK & DESIGN EDIT SERVICES/ART EXHIBITION ART AS A HOLISTIC APPROACH TO HEALTHCARE 35753 0 3 0 0 0 3 35753 0 35753 0 0 0 0 0 0 PART III ACCOUNTING METHOD: FOOD & WINE TASTING 220901 13569 207332 35895 2561 8750 182632 GOLF TOURNAMENT 93718 60723 32995 18720 18047 200 5362 314619 74292 240327 54615 20608 8950 187994 272167 -31840 1 ALTAMED FOUNDATION 2040 CAMFIELD AVE LOS ANGELES CA 90040 954090420 501(C)(3) 50000000 0 BOOK REDUCE HEALTH DISPARITY IN UNDERSERVED COMMUNITIES. ANDRES Y MARIA CARDENAS FAMILY FOUNDATION 13700 FOOTHILL BLVD SYLMAR CA 90392 954625314 501(C)(3) 25000 0 BOOK REDUCE HEALTH DISPARITY IN UNDERSERVED COMMUNITIES. GARFIELD ALUMNI FOUNDATION PO BOX 3308 MONTEBELLO CA 90640 450621701 501(C)(3) 15000 0 BOOK REDUCE HEALTH DISPARITY IN UNDERSERVED COMMUNITIES. JOHN BENSON SCHOLARSHIP FOUNDATION INC 3915 S FORECASTLE AVE WEST COVINA CA 91792 461299728 501(C)(3) 10000 0 BOOK REDUCE HEALTH DISPARITY IN UNDERSERVED COMMUNITIES. LA PLAZA DE CULTURA Y ARTES 501 N MAIN ST LOS ANGELES CA 90012 753059288 501(C)(3) 10000 0 BOOK REDUCE HEALTH DISPARITY IN UNDERSERVED COMMUNITIES. LATINO FILM INSTITUTE YOUTH CINEMA PROJECT 143 S GLENDALE AVE SUITE 204 GLENDALE CA 91205 475010246 501(C)(3) 25000 0 BOOK REDUCE HEALTH DISPARITY IN UNDERSERVED COMMUNITIES. MUSEUM OF LATIN AMERICAN ART 628 ALAMITOS AVE LONG BEACH CA 90802 330786070 501(C)(3) 35000 0 BOOK REDUCE HEALTH DISPARITY IN UNDERSERVED COMMUNITIES. NATIONAL MEDICAL FELLOWSHIPS 12 E 46TH STREET SUITE 5E NEW YORK NY 10017 010963657 501(C)(3) 25750 0 BOOK REDUCE HEALTH DISPARITY IN UNDERSERVED COMMUNITIES. PARTNERS IN CARE FOUNDATION 732 MOTT STREETSUITE 150 SAN FERNANDO CA 91340 953954057 501(C)(3) 25000 0 BOOK REDUCE HEALTH DISPARITY IN UNDERSERVED COMMUNITIES. SOUTHWEST VOTER REGISTRATION EDUCATION PROJECT 320 EL PASO STREET SAN ANTONIO TX 78207 237380570 501(C)(3) 25000 0 BOOK REDUCE HEALTH DISPARITY IN UNDERSERVED COMMUNITIES. THE CALIFORNIA MEXICO STUDIES CENTER 1551 N STUDEBAKER RD LONG BEACH CA 90815 274994817 501(C)(3) 7000 0 BOOK REDUCE HEALTH DISPARITY IN UNDERSERVED COMMUNITIES. TIDES CENTER 1012 TORNEY AVENUE SAN FRANCISCO CA 94129 943213100 501(C)(3) 10000 0 BOOK REDUCE HEALTH DISPARITY IN UNDERSERVED COMMUNITIES. UNIVERSITY OF SOUTHERN CALIFORNIA UNIVERSITY GARDENS BLDG SUITE 205 LOS ANGELES CA 90089 951642394 501(C)(3) 20000 0 BOOK REDUCE HEALTH DISPARITY IN UNDERSERVED COMMUNITIES. 13 PART I, LINE 2: THE ORGANIZATION MONITORS THE USE OF THE GRANT FUNDS BY REQUIRING FULL AND COMPLETE REPORTS FROM THE GRANTEE ORGANIZATION ON HOW FUNDS ARE SPENT TO ACCOMPLISH CHARITABLE PURPOSES. X 1 1 X X X X X 0 1 0 0 0 0 0 1 0 CASTULO DELA ROCHA JD PRESIDENT & CEO 900060 0 363200 0 87900 0 197434 0 11715 0 1560309 0 0 0 ANNA TRAN SR.STRATEGY EXECUTIVE 583523 0 169954 0 12563 0 0 0 22511 0 788551 0 0 0 RICO CRISTIAN INTERIM CMO 432862 0 132616 0 70959 0 37875 0 30686 0 704998 0 0 0 EFRAIN TALAMANTES SVP, HS CHIEF OPERATING OF 463507 0 138840 0 31836 0 39000 0 30686 0 703869 0 0 0 ZOILA ESCOBAR SVP, CHIEF ADMIN OFFICER 485950 0 141538 0 12790 0 26000 0 11715 0 677993 0 0 0 JOSE U ESPARZA SVP FINANCE & CFO 442183 0 150087 0 33838 0 45500 0 6164 0 677772 0 0 0 ESIQUIO CASILLAS VP, MEDICAL DIRECTOR, PACE 399675 0 104621 0 31971 0 76748 0 16767 0 629782 0 0 0 HENRY HOLGUIN SVP, GENERAL COUNSEL 393695 0 95607 0 23249 0 45500 0 6833 0 564884 0 0 0 DARREN MCLACHLAN VP, IPA OPERATION 389692 0 81603 0 16815 0 39000 0 30686 0 557796 0 0 0 RAYMOND LOWE SVP & CHIEF INFORMATION OFFICER 352810 0 85788 0 12006 0 45500 0 22511 0 518615 0 0 0 PARHAM NAGHDECHI HOSPITALIST 331120 0 29047 0 74510 0 38921 0 30686 0 504284 0 0 0 MELANIE LIN MEDICAL DIRECTOR 412841 0 44613 0 2608 0 16753 0 5999 0 482814 0 0 0 PART I, LINE 1A ALTAMED MAINTAINS A DISCRETIONARY SPENDING ACCOUNT FOR OFFICERS, KEY EMPLOYEES AND OTHERS WHERE THE COMPANY ALLOWS A CERTAIN AMOUNT TO BE USED AT THE DISCRETION OF THE PAYEE FOR BUSINESS EXPENSES SUCH AS AUTOMOBILE EXPENSES. ANY AMOUNTS USED FROM THE DISCRETIONARY ACCOUNT ARE TAXED TO THE RECIPIENT AS PART OF THEIR COMPENSATION. PART I, LINE 4B 4B; AT THE PRESENT TIME THE PRESIDENT AND CEO IS ELIGIBLE FOR THE ORGANIZATION'S SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP); FUNDING OF THIS PLAN IS DISCRETIONARY AND ASSETS OF THE PLAN ARE SUBJECT TO THE CLAIMS OF CREDITORS. THE ORGANIZATION MADE A CONTRIBUTION IN THE AMOUNT OF $171,434 ON BEHALF OF CASTULO DELA ROCHA, J.D., PRESIDENT & CEO, DURING THE TAX YEAR. ALTAMED HAS ESTABLISHED A NON-QUALIFIED PLAN PURSUANT TO 457(F) OF THE INTERNAL REVENUE CODE. THE PURPOSE OF THIS PLAN IS TO INCENTIVIZE THE ORGANIZATION'S OFFICERS AND SENIOR MANAGEMENT IN RECOGNITION OF THE FACT THEY ARE REQUIRED TO DEVOTE SIGNIFICANT AMOUNTS OF TIME, SKILL, AND ENERGY TO THE ORGANIZATION. THE AMOUNTS DEFERRED ARE SUBJECT TO SUBSTANTIAL RISK OF FORFEITURE. ONCE VESTED THE AMOUNTS UNDER THIS PLAN ARE REPORTED ON FORM W-2 AS TAXABLE COMPENSATION TO THE INDIVIDUAL. NO AMOUNTS WERE PAID OR DEFERRED DURING THE TAX YEAR. PART I, LINE 7 ALTAMED MAINTAINS A DISCRETIONARY EXECUTIVE AND DIRECTOR LEVEL BONUS PROGRAM THAT AWARDS INCENTIVE COMPENSATION BASED ON ACHIEVEMENT OF CERTAIN ORGANIZATIONAL OBJECTIVES INCLUDING FINANCIAL, OPERATIONAL, QUALITY AND MISSION OBJECTIVES DURING THE FISCAL YEAR. MEMBERS OF THE EXECUTIVE AND DIRECTOR LEADERSHIP TEAM ARE EVALUATED ANNUALLY FOR THEIR ABILITY TO MEET THOSE ORGANIZATIONAL OBJECTIVES TO ARRIVE AT THE INCENTIVE AMOUNT, IF ANY, FOR THE FISCAL YEAR. OVERALL ALTAMED MUST ACHIEVE SPECIFIC FINANCIAL GOALS BEFORE ANY INCENTIVES CAN BE EARNED AND PAID. A CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY 521643828 2015-10-01 118760000 FINANCE ACQ,CONST,RENOVATION & EQUIPPING OF CAP. PROJ.& REFI A PRIOR LOAN 0 0 0 B CALIFORNIA STATEWIDE COMMUNITIES DEVELOPMENT AUTHORITY 2007-12-14 7012000 FINANCE THE COST OF ACQ,CONSTRUCTION,IMPROVEMENT & EQUIPPING OF FACILITIES 0 0 0 C CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY 521643828 2018-10-30 20000000 FINANCE CAPITAL PROJECTS AND PAY COSTS OF INSURANCE. 0 0 0 A 32906400 119507118 1707227 114299890 3500000 1 2020 1 0 1 1 B 7012500 7012500 2008 0 0 1 1 C 12295228 20299968 127748 20172221 0 0 0 1 A 0 0 1 1 0 0 0 1 B 0 0 0 0 0 0 0 C 0 1 0 0 0 0 1 A 0 0 1 1 1 0 0 1 1 B 0 0 0 0 1 1 BANK OF THE WEST 15.000000000000 0 0 0 0 1 C 0 1 0 0 0 0 0 0 1 A 1 B 0 C 1 SCHEDULE K PART 1-A (D) & (E) THE ISSUER HAS FILED TWO 8038S FOR THIS ISSUE. THE ISSUE PRICE FOR THE NOTES (DATED SEPTEMBER 29, 2015) IS $17,200,000; THE ISSUE PRICE FOR THE BONDS (DATED OCTOBER 1, 2015) IS $101,560,000. SCHEDULE K PART 1-A (F) THE PRIOR LOAN WAS ISSUED ON FEBRUARY 14, 2011. SCHEDULE K PART 1-A (E) & PART II LINE 3 DIFFERENCE BETWEEN PART 1 (E) AND PART II, LINE 3 IS DUE TO INTEREST EARNINGS ON BOND PROCEEDS. SCHEDULE K PART III-A, LINE 7 AS PROVIDED IN TREASURY REGULATION SECTION 1.141-4(C)(2)(I)(B), THE AMOUNT OF PRIVATE PAYMENTS TAKEN INTO ACCOUNT UNDER THE PRIVATE PAYMENT TEST MAY NOT EXCEED THE AMOUNT OF PRIVATE BUSINESS USE AND/OR UNRELATED TRADE OR BUSINESS USE. ACCORDINGLY, THE AMOUNT OF PRIVATE PAYMENTS FOR THE REPORTING PERIOD DOES NOT EXCEED THE AMOUNT STATED IN PART III-A, LINE 6. THE ORGANIZATION HAS NOT UNDERTAKEN AN ANALYSIS OF THE PRIVATE SECURITY TEST WITH RESPECT TO THE BONDS, AS THE LEVEL OF PRIVATE BUSINESS USE AND/OR UNRELATED TRADE OR BUSINESS REPORTED IN PART III-A, LINE 6 IS NOT IN EXCESS OF AMOUNTS PERMITTED UNDER SECTION 145 OF THE CODE. SCHEDULE K PATY IV-A, LINE 2(B) THE REFUNDING PORTION OF THE BONDS HAS MET THE 6-MONTH SPENDING EXCEPTION TO REBATE. SCHEDULE K PART II-C LINE 3 DIFFERENCE BETWEEN PART 1-C (E) AND PART II-C, LINE 3 IS DUE TO INTEREST EARNINGS ON NOTE PROCEEDS. SCHEDULE K PART III-C LINE 7 AS PROVIDED IN TREASURY REGULATION SECTION 1.141-4(C)(2)(I)(B), THE AMOUNT OF PRIVATE PAYMENTS TAKEN INTO ACCOUNT UNDER THE PRIVATE PAYMENT TEST MAY NOT EXCEED THE AMOUNT OF PRIVATE BUSINESS USE AND/OR UNRELATED TRADE OR BUSINESS USE. ACCORDINGLY, THE AMOUNT OF PRIVATE PAYMENTS FOR THE REPORTING PERIOD DOES NOT EXCEED THE AMOUNT STATED IN PART III-C, LINE 6. THE ORGANIZATION HAS NOT UNDERTAKEN AN ANALYSIS OF THE PRIVATE SECURITY TEST WITH RESPECT TO THE BONDS, AS THE LEVEL OF PRIVATE BUSINESS USE AND/OR UNRELATED TRADE OR BUSINESS REPORTED IN PART III-C, LINE 6 IS NOT IN EXCESS OF AMOUNTS PERMITTED UNDER SECTION 145 OF THE CODE. CASTULO DE LA ROCHA OFFICER SPLIT DOLLAR LIFE INSURANCE X 14789912 16829619 0 1 1 ZOILA D ESCOBAR OFFICER SPLIT DOLLAR LIFE INSURANCE X 3560000 4050967 0 1 1 JOSE U ESPARZA OFFICER SPLIT DOLLAR LIFE INSURANCE X 3562400 4053698 0 1 1 MARIE S TORRES OFFICER SPLIT DOLLAR LIFE INSURANCE X 4059304 4619131 0 1 1 MARTIN SEROTA OFFICER SPLIT DOLLAR LIFE INSURANCE X 3405795 3924302 0 1 1 33477717 FORM 990 PART X LINE 5 IN 2011 ALTAMED ADOPTED A SPLIT DOLLAR RETENTION AND LOAN PLAN (THE PLAN) DESIGNED TO ASSIST ALTAMED IN RECRUITING AND RETAINING KEY EXECUTIVES AND REWARD FUTURE SERVICE. THE PLAN IS DESIGNED TO SATISFY THE FINAL REGULATIONS DEALING WITH LOANS MADE TO EXECUTIVES TO PAY PREMIUMS ON LIFE INSURANCE POLICIES THEY OWN. REPAYMENT OF THE LOANS ARE SECURED BY THE CASH VALUES AND DEATH BENEFITS IN ACCORDANCE WITH TAX AND CALIFORNIA LEGAL REQUIREMENTS. IN ADDITION, THE LOANS BEAR INTEREST AND BECAUSE OF THE PLAN'S DESIGN, ALTAMED IS EXPECTED TO BE REPAID FULLY WITH THE APPLICABLE FEDERAL RATE OF INTEREST. THE LOANS ARE REPORTED ON PART X AND SCHEDULE L. X 306486 COMPARABLE SALE X 7 1249578 COMPARABLE SALE X MARKETING MATERIALS 1 14435 COMPARABLE SALE X FOOD SUPPLIES 6 10617 COMPARABLE SALE X NINTENDO 1 441 REPLACEMENT COST 0 1 0 FORM 990, PART VI, SECTION A, LINE 2 THE PRESIDENT AND CEO IS RELATED BY MARRIAGE TO THE SENIOR VICE PRESIDENT & CHIEF ADMINISTRATIVE OFFICER. FORM 990, PART VI, SECTION B, LINE 11B ALTAMED HEALTH SERVICES CORPORATION'S OUTSIDE CPA FIRM AND FINANCE STAFF PREPARE FORM 990. THE FORM IS THEN REVIEWED AND APPROVED BY BOTH THE ORGANIZATION'S PRESIDENT AND CEO, AND THE SR. VP OF FINANCE AND CFO. THE FORM IS THEN PROVIDED TO THE FULL BOARD FOR ACCEPTANCE BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12C ALTAMED HEALTH SERVICES CORPORATION ("ALTAMED") MAINTAINS POLICIES THAT REQUIRE ANNUAL ACKNOWLEDGMENT OF ALTAMED'S CONFLICT OF INTEREST POLICIES AND THE SUBSEQUENT DISCLOSURE OF ANY SUCH CONFLICTS, AS NECESSARY, BY ALL BOARD MEMBERS, EMPLOYEES AND AGENTS ("DISCLOSING PARTIES") WHO: A) HAVE THE AUTHORITY TO NEGOTIATE OR APPROVE BUSINESS DECISIONS AND/OR REFERRALS TO ENTITIES PAID DIRECTLY OR INDIRECTLY BY MEDICARE AND/OR MEDICAID SERVICES AND B) HAVE PERSONAL, FINANCIAL, AND/OR OTHER INTEREST. DISCLOSING PARTIES MUST NOTIFY AND DISCLOSE ANY SUSPECTED OR KNOWN CONFLICTS OF INTEREST TO THE OFFICE OF COMPLIANCE AND RISK MANAGEMENT ("OCRM"). ALTAMED'S POLICIES ARE REVIEWED WITH DISCLOSING PARTIES ANNUALLY THROUGH TRAINING VIDEOS AND IN-PERSON PRESENTATIONS, WITH SIGNED ACKNOWLEDGMENTS OBTAINED WHERE POSSIBLE AND APPROPRIATE. ALTAMED MAINTAINS A DETAILED REVIEW PROCESS FOR ANY POTENTIAL CONFLICTS IDENTIFIED BY ANY DISCLOSING PARTIES. THIS PROCESS INCLUDES FACT GATHERING, REVIEW OF THE CIRCUMSTANCES, A DETERMINATION OF ANY ACTUAL CONFLICTS, AND REMEDIATION STEPS TO ADDRESS SUCH ACTUAL CONFLICTS. FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS SERVES AS THE COMPENSATION COMMITTEE AND REVIEWS THE PRESIDENT & CEO'S COMPENSATION. ADDITIONALLY, A NATIONALLY RECOGNIZED INDEPENDENT COMPENSATION CONSULTANT FIRM IS ENGAGED TO REVIEW THE PRESIDENT & CEO'S COMPENSATION. THE FIRM UNDERTAKES SPECIFIC PROTOCOLS AND OBTAINS ORGANIZATIONAL DATA FROM NUMEROUS COMPANIES AND PEER GROUPS AND THEN RENDERS A "REASONABLENESS" OPINION THAT IS PRESENTED TO THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS. THE FIRM'S PROCESS INCLUDES A REVIEW OF COMPENSATION DATA OF SIMILARLY CONSTITUTED COMPANIES, MARKET TRENDS, THE ORGANIZATION'S PRESENT COMPENSATION PACKAGE FOR THE PRESIDENT & CEO, INCLUDING CASH AND NON-CASH BENEFITS, AND THE METHODOLOGY AND PHILOSOPHY USED FOR THE ASSESSMENT AND TOTAL COMPENSATION ANALYSIS. ADDITIONALLY, MARKET BENEFIT AND RECRUITMENT AND RETENTION TRENDS ARE CONSIDERED AND EVALUATED. THE FIRM'S REPORT, INCLUDING OPINIONS ARE PROVIDED TO THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS, WHICH IS COMPRISED OF FOUR INDEPENDENT DIRECTORS. THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS IS PROVIDED WITH EXTERNAL PEER GROUP DATA THAT INCLUDES EXECUTIVE COMPENSATION (IN U.S. DOLLARS AND MARKET PERCENTILES) OF COMPARABLY SIZED CALIFORNIA NON-PROFIT AND SOME FOR-PROFIT HEALTHCARE ORGANIZATIONS. THE FIRM'S OPINIONS ARE BASED ON COMPARABILITY DATA FROM NATIONAL AND REGIONAL DATA BASES, FROM WHICH COMPARISONS OF THE ORGANIZATION'S PRESIDENT & CEO COMPENSATION WITH EXTERNAL PEER GROUP COMPENSATION LEVELS CAN BE MADE, WHICH IS PROVIDED TO THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS IN ITS REPORT. THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS IS ALSO PRESENTED WITH DATA THAT COMPARES THE ORGANIZATION'S COMPENSATION PACKAGE FOR THE PRESIDENT & CEO TO THE LEVEL GENERALLY TARGETED IN THE ORGANIZATION'S COMPENSATION PHILOSOPHY. BASED UPON THE TOTALITY OF THE DATA GARNERED BY THE COMPENSATION CONSULTING FIRM, THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS IS PROVIDED WITH THE FIRM'S OPINION AS TO THE "REASONABLENESS" OF THE PRESIDENT & CEO'S COMPENSATION. THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS DELIBERATES ON THE DATA TO ASSESS WHETHER IT IS APPROPRIATE IN REPRESENTING COMPENSATION LEVELS WITH SIMILAR ORGANIZATIONS, POSITIONS AND CIRCUMSTANCES AND THAT IT REPRESENTS FAIR MARKET VALUE FOR SERVICES RENDERED ON A REALISTIC BASIS. THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS ALSO INTERVIEWS THE PRESIDENT & CEO AND CONSIDERS THE PRESIDENT & CEO'S SELF-EVALUATION AND OTHER INFORMATION RELEVANT TO ASSESSING THE PRESIDENT & CEO'S COMPENSATION. THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS THEN PROVIDES ITS RECOMMENDATIONS TO THE BOARD OF DIRECTORS FOR THE PRESIDENT & CEO'S COMPENSATION. THE BOARD OF DIRECTORS IS PROVIDED WITH AVAILABLE INFORMATION AND THE OPINIONS OF THE EXPERTS AND DELIBERATES AND DISCUSSESS SUCH INFORMATION AND OPINIONS AS IT DEEMS NECESSARY TO PROPERLY ASSESS THE COMPENSATION LEVELS OF THE ORGANIZATION'S PRESIDENT & CEO. ALL PERSONS WITH A CONFLICT OF INTEREST ABSTAIN FROM DELIBERATION AND DISCUSSION. THE EXECUTIVE GROUP LEADERSHIP TEAM OF ALTAMED PERIODICALLY RECEIVES A REPORT FROM A NATIONALLY RECOGNIZED AND INDEPENDENT COMPENSATION CONSULTING FIRM THAT COMPILES COMPENSATION BENCHMARKS AND COMPARES THE COMPENSATION ARRANGEMENTS OF SIMILAR EXECUTIVES ACROSS THE COUNTRY IN SIMILAR INDUSTRIES FOR OTHER EXECUTIVES. THE EXECUTIVE GROUP LEADERSHIP TEAM ANNUALLY REVIEWS THE FIXED AND VARIABLE COMPENSATION OF "OTHER OFFICERS OR KEY EMPLOYEES" OF ALTAMED. THIS REVIEW AND ASSESSMENT INCLUDES THE FOLLOWING: AN EMPLOYEE'S CURRENT FIXED AND VARIABLE COMPENSATION PACKAGE; MARKET COMPENSATION DATA, NATIONAL AND/OR LOCAL, OF SIMILARLY CONSTITUTED COMPANIES AND EXECUTIVES AS PROVIDED BY MERCER; MARKET TRENDS, NATIONAL AND/OR LOCAL; AN EVALUATION OF THE EMPLOYEE'S PERFORMANCE LEVELS FOR THE RELEVANT PERFORMANCE CYCLE INCLUDING AN EMPLOYEE SELF-REVIEW; AN EVALUATION OF ALTAMED'S PERFORMANCE LEVELS FOR THE RELEVANT PERFORMANCE CYCLE; COMPENSATION DATA OF INTERNAL PEERS; THE METHODOLOGY AND/OR COMPENSATION PHILOSOPHY USED FOR THE RELEVANT PERFORMANCE CYCLE; INPUT FROM HUMAN RESOURCES; AND, OTHER RELEVANT AND LAWFUL INFORMATION, AS APPROPRIATE. AFTER REVIEW AND ASSESSMENT, THE EXECUTIVE GROUP LEADERSHIP TEAM WILL DETERMINE WHETHER THE COMPENSATION PROVIDED TO THE EMPLOYEE APPROPRIATELY REPRESENTS: (1) COMPENSATION LEVELS WITH SIMILAR ORGANIZATIONS, POSITIONS AND CIRCUMSTANCES, AND (2) FAIR MARKET VALUE FOR THE SERVICES RENDERED BY THE EMPLOYEE ON A REALISTIC BASIS. THE EXECUTIVE GROUP LEADERSHIP TEAM THEN DETERMINES COMPENSATION ADJUSTMENTS, AS APPROPRIATE. FORM 990, PART VI, SECTION C, LINE 19 SOME OR ALL OF THESE ITEMS MAY BE AVAILABLE UPON REQUEST. FORM 990, PART IX, LINE 11G CONTRACT LABOR: PROGRAM SERVICE EXPENSES 7,538,326. MANAGEMENT AND GENERAL EXPENSES 1,321,668. FUNDRAISING EXPENSES 17,472. TOTAL EXPENSES 8,877,466. SPECIALTY SERVICES: PROGRAM SERVICE EXPENSES 224,736,660. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 224,736,660. MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 73,936,296. MANAGEMENT AND GENERAL EXPENSES 2,238,968. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 76,175,264. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 2,461,049. MANAGEMENT AND GENERAL EXPENSES 26,074. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,487,123. THERAPEUTIC SERVICES: PROGRAM SERVICE EXPENSES 116,546. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 116,546. 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