2022-02-16T16:18:58-06:00 2021-06-30 410746749 CLIFTONLARSONALLEN LLP 1301 WEST 22ND STREET SUITE 1100 OAK BROOK IL 60523 990 2020-07-01 320115907 ESPERANZA HEALTH CENTERS ESPE 7735846200 1940 S WESTERN NO 205 CHICAGO IL 60608 RYAN GADIA CFO 7735846200 2022-02-14 1 RYAN GADIA 999009999 CHRIS MANDERFIELD P01238973 6305738600 2022-02-14 2 AAL1 IAL1 2020 2022-03-31 18:45:55Z X RYAN GADIA 1940 S WESTERN NO 205 CHICAGO IL 60608 38597373 0 X WWW.ESPERANZACHICAGO.ORG X 2004 IL PRIMARY HEALTH CARE SERVICES 14 14 278 14 0 0 6506347 8629201 17982303 29020576 -73130 366840 516964 558837 24932484 38575454 0 0 0 0 15392718 23358068 0 0 653445 9192243 12635623 24584961 35993691 347523 2581763 24799898 28840414 12921376 14380129 11878522 14460285 TO DELIVER HEALTH AND HOPE TO CHICAGO'S UNDERSERVED COMMUNITIES 0 0 28221056 29562661 ESPERANZA HEALTH CENTERS SERVES AN AREA THAT IS IN GREAT NEED OF QUALITY HEALTHCARE. SERVICES INCLUDE; FAMILY MEDICINE, INTERNAL MEDICINE, PEDIATRICS, BEHAVIORAL HEALTH AND WOMEN'S HEALTH/OBSTETRICS. FAMILIES IN ESPERANZA'S SERVICE AREA EXPERIENCE SIGNIFICANT ECONOMIC, EDUCATIONAL, AND HEALTH DISPARITIES. MORE THAN 95 PERCENT OF RESIDENTS LIVE BELOW TWICE THE POVERTY LEVEL. LARGE PORTIONS OF ESPERANZA'S SERVICE AREA HAVE BEEN DESIGNATED AS A MEDICALLY UNDERSERVED AREA AND A HEALTH PROFESSIONAL SHORTAGE AREA BY THE HEALTH RESOURCES AND SERVICES ADMINISTRATION. ESPERANZA HEALTH CENTERS PROVIDE HIGH-QUALITY MEDICAL CARE TO ALL RESIDENTS OF OUR SOUTHWEST SIDE SERVICE AREA, REGARDLESS OF THEIR IMMIGRATION STATUS, RACE OR ETHNICITY, INCOME LEVEL OR INSURANCE STATUS. 28221056 1 1 0 0 0 0 0 0 0 0 1 0 1 0 1 1 0 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 0 1 1 1 0 0 1 23 0 278 1 0 0 0 0 0 0 0 0 0 0 0 0 X 14 14 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 IL X THE ORGANIZATION 7736405792 1940 S WESTERN NO 205 CHICAGO IL 60608 MICHAEL CHICO BOARD CHAIR 0.25 X X 0 0 0 LUIS GUTIERREZ VICE CHAIR 0.25 X X 0 0 0 NYLA DIAB SECRETARY 0.25 X X 0 0 0 BRIAN FREDERICKS TREASURER 0.25 X X 0 0 0 ELBA ARANDA-SUH DIRECTOR 0.25 X 0 0 0 JAIME ARTEAGA DIRECTOR 0.25 X 0 0 0 DAVID BERKEY DIRECTOR 0.25 X 0 0 0 MARISELA LAWSON DIRECTOR 0.25 X 0 0 0 GIA MAC DIRECTOR 0.25 X 0 0 0 RAFAEL ROBLES DIRECTOR 0.25 X 0 0 0 JODI PORTNOY DIRECTOR 0.25 X 0 0 0 JOEL RODARTE DIRECTOR 0.25 X 0 0 0 MELANIE TAN DIRECTOR 0.25 X 0 0 0 CHARLES WINTERSTEEN DIRECTOR 0.25 X 17160 0 0 DANIEL FULWILER CHIEF EXECUTIVE OFFICER 40.00 1.00 X 290725 0 9730 ANDREW J VAN WIEREN CHIEF MEDICAL OFFICER 40.00 X 281100 0 4852 CARMEN VERGARA CHIEF OPERATING OFFICER 40.00 X 161426 0 8269 RYAN D GADIA CHIEF FINANCIAL OFFICER 40.00 1.00 X 155322 0 20951 FREDERICO HERRERA MEDICAL DIRECTOR - LITTLE 40.00 X 234882 0 22223 KRISTINA N PONTARELLI PHYSICIAN 40.00 X 245515 0 9347 SYLVIA SHOKUNBI PHYSICIAN 40.00 X 243365 0 21498 CATHERINE LIU PHYSICIAN 40.00 X 252528 0 14757 ESTHER KIROV PHYSICIAN 40.00 X 226112 0 22240 OSCAR DIAZ PHYSICIAN 40.00 X 221281 0 17384 2329416 0 151251 42 0 1 0 ATHENAHEALTH INC 311 ARSENAL ST WATERTOWN MA 02472 EMR AND BILLING SERVICES 1203974 KMETZ-HAUSOUL INCORPORATE 917 RIDGE RD UNIT 3197 MUNSTER IN 46321 DESIGN AND CONSTRUCTION 318386 PCY GENERAL SERVICE INC 5911 W 88TH ST OAK LAWN IL 60453 JANITORIAL SERVICES 309646 BARTON ASSOCIATES INC 300 JUBILEE DR PEABODY MA 01960 LOCUMS, TEMPS 280331 SEQUOIA GENERAL CONTRACTING CORP 1585 BEVERLY COURT UNIT 108 AURORA IL 60502 DESIGN AND CONSTRUCTION 212919 10 60140 4968114 3600947 8629201 PATIENT FEES 621990 21685497 21685497 PHARMACY REVENUE 621990 7335079 7335079 29020576 366840 366840 38671 60140 21919 16752 16752 MISCELLANEOUS 900099 542085 542085 542085 38575454 29562661 0 383592 888575 706104 161956 20515 19361279 15385401 3528871 447007 355657 282622 64824 8211 1554030 1234907 283244 35879 1198527 952407 218449 27671 80592 48923 31669 141129 85672 55457 3149559 1911923 1237636 1691 1691 444751 195420 239535 9796 774599 648679 113098 12822 979701 641979 337722 535024 508168 26856 193922 178595 15327 176410 155638 20772 PHARMACY AND MEDICAL SU 4872112 4795977 76135 MISCELLANEOUS 527535 89050 358576 79909 REPAIRS AND MAINTENANCE 365033 265042 99991 STAFF TRAINING 271549 83670 185024 2855 122016 50879 64048 7089 35993691 28221056 7119190 653445 6062704 6603075 994507 1203533 2323604 3082067 11982000 11982000 353214 611004 2797360 371206 800405 2426154 2181453 2548292 199134 102011 185155 24799898 28840414 2360369 3181329 9256327 10872398 1304680 326402 12921376 14380129 X 11753522 14260285 125000 200000 11878522 14460285 24799898 28840414 2581763 0 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 1895344 94932 1800412 902016 276274 625742 2426154 MHN ACO, LLC 2548292 F 2548292 DEFERRED LIABILITIES 326402 326402 X PART X, LINE 2: THE CENTER IS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC). IN ADDITION, THE CENTER QUALIFIES FOR THE CHARITABLE CONTRIBUTION DEDUCTION UNDER SECTION 170(B)(1)(A)(III) AND HAS BEEN CLASSIFIED AS AN ORGANIZATION THAT IS NOT A PRIVATE FOUNDATION. THE CENTER WAS NOT REQUIRED TO RECORD A LIABILITY FOR UNCERTAIN TAX POSITIONS. ANNUAL GALA 60326 39695 20631 1500 645 GOLF OUTING 30340 20445 9895 220 3400 2687 1 8145 8145 547 6300 6620 98811 60140 38671 767 9700 2687 1500 7265 21919 16752 X X X X X 0 1 0 0 0 0 0 1 0 DANIEL FULWILER CHIEF EXECUTIVE OFFICER 243606 0 47119 0 0 0 3741 0 5989 0 300455 0 0 0 ANDREW J VAN WIEREN CHIEF MEDICAL OFFICER 246020 0 35080 0 0 0 3776 0 1076 0 285952 0 0 0 CATHERINE LIU PHYSICIAN 241733 0 10795 0 0 0 3384 0 11373 0 267285 0 0 0 SYLVIA SHOKUNBI PHYSICIAN 226489 0 16876 0 0 0 2920 0 18578 0 264863 0 0 0 FREDERICO HERRERA MEDICAL DIRECTOR - LITTLE 221980 0 12902 0 0 0 3358 0 18865 0 257105 0 0 0 KRISTINA N PONTARELLI PHYSICIAN 217769 0 27746 0 0 0 3313 0 6034 0 254862 0 0 0 ESTHER KIROV PHYSICIAN 215110 0 11002 0 0 0 3375 0 18865 0 248352 0 0 0 OSCAR DIAZ PHYSICIAN 219732 0 1549 0 0 0 3023 0 14361 0 238665 0 0 0 RYAN D GADIA CHIEF FINANCIAL OFFICER 135900 0 19422 0 0 0 2086 0 18865 0 176273 0 0 0 CARMEN VERGARA CHIEF OPERATING OFFICER 146069 0 15357 0 0 0 2235 0 6034 0 169695 0 0 0 PART I, LINE 3 THE CEO'S SALARY IS BASED ON A WRITTEN EMPLOYMENT CONTRACT. ANNUAL RAISES ARE BASED ON COMPENSATION STUDIES AND CONSULTATION SUBJECT TO APPROVAL BY THE BOARD OF DIRECTORS. PART I, LINE 4B THE ORGANIZATION SPONSORS AN EXECUTIVE 457(B) PLAN AND A 457(F) PLAN. THE 457(B) PLAN IS AVAILABLE TO SENIOR MANAGEMENT AND OTHER HIGHLY COMPENSATED EMPLOYEES. THE 457(F) PLAN IS CURRENTLY ONLY AVAILABLE TO THE CEO. PART I, LINE 7 THE CEO, CMO, COO, CFO AND MEDICAL DIRECTOR RECEIVE BONUSES IF THEY MEET CERTAIN ANNUAL PERFORMANCE GOALS SUCH AS MEETING/EXCEEDING BUDGETED NET INCOME, ACHIEVING CERTAIN QUALITY SCORES, OR ACHIEVING CERTAIN PROVIDER PRODUCTIVITY LEVELS. FORM 990, PART VI, SECTION B, LINE 11B FORM 990 IS REVIEWED IN DRAFT FORM BY THE ORGANIZATION'S FINANCE COMMITTEE, THEN SENT TO THE ENTIRE BOARD BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12C BOARD OF DIRECTORS COMPLETE COMPLIANCE DISCLOSURES UPON JOINING THE BOARD. FORM 990, PART VI, SECTION B, LINE 15A CEO'S COMPENSATION IS DETERMINED BY THE BOARD OF DIRECTORS AND IS INCLUDED IN THE BOARD MINUTES. THE DECISION WAS MADE USING COMPARISON TO ORGANIZATIONAL GOALS AND COMPARABILITY DATA OF OTHER SIMILAR SIZED ORGANIZATIONS. FORM 990, PART VI, SECTION C, LINE 19 UPON REQUEST FORM 990, PART XII, LINE 2C THE ORGANIZATION'S FINANCE COMMITTEE ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. HEALTHY BRIGHTON TITLE HOLDING CORPORATION NFP 2001 SOUTH CALIFORNIA AVENUE CHICAGO IL 60608 821949374 LEASING BUILDING SPACE IL 501(C)(3) LINE 12A, I ESPERANZA HEALTH CENTERS 1 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 HEALHTY BRIGHTON TITLE HOLDING CORPORATION NFP K 142000 RENTAL AGREEMENT