2023-10-25T21:36:11-05:00 2022-12-31 946214841 ARMANINO LLP 2700 CAMINO RAMON STE 350 SAN RAMON CA 945835004 990 2022-01-01 941722562 NORTH EAST MEDICAL SERVICES NORT 4153919686 2171 JUNIPERO SERRA BLVD 260 DALY CITY CA 94014 JOHNSON WONG CFO 4153919686 2023-10-25 1 JOHNSON WONG 999009999 1 MATTHEW PETROSKI P00853132 9257902600 2023-10-19 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z EDDIE W CHAN 2171 JUNIPERO SERRA BLVD 260 DALY CITY CA 94014 242922850 0 X WWW.NEMS.ORG X 1971 CA NORTH EAST MEDICAL SERVICES (NEMS) IS A FAMILY-ORIENTED, COMPREHENSIVE HEALTH CENTER WHICH OFFERS A WIDE RANGE OF HEALTH SERVICES TO A PREDOMINANTLY ASIAN AMERICAN POPULATION. 10 10 971 10 1904 0 18709259 26499084 181568074 207527747 1434799 381030 11842828 8256758 213554960 242664619 0 0 0 0 84706384 98385032 0 0 0 71424073 85343733 156130457 183728765 57424503 58935854 369488279 416860860 65793382 54897565 303694897 361963295 X NORTH EAST MEDICAL SERVICES (NEMS) IS A FAMILY-ORIENTED, COMPREHENSIVE HEALTH CENTER WHICH OFFERS A WIDE RANGE OF HEALTH SERVICES TO A PREDOMINANTLY ASIAN AMERICAN POPULATION. 0 0 52149433 74639570 PRIMARY AND SPECIALTY MEDICAL SERVICES PROVIDED FOR 283,285 ENCOUNTERS. 41692681 74806858 MANAGED CARE SERVICES: NEMS MANAGEMENT SERVICES ORGANIZATION PROVIDES SKILL, SUPERVISION AND PERSONNEL IN THE OPERATION AND ADMINISTRATION OF CALIFORNIA PACIFIC MEDICAL CENTER'S AND NEMS MEDI-CAL MANAGED CARE BUSINESS. TOTAL MEMBER MONTHS WERE 702,630. 21113006 38903427 PHARMACY SERVED/FILLED 587,859 PRESCRIPTIONS. 6526100 9799454 DENTAL SERVICES PROVIDED FOR 38,662 ENCOUNTERS. 2989999 1427486 RADIOLOGY SERVICES: UNITS OF SERVICE PROVIDED WERE 15,496 3585501 1994199 LABORATORY SERVICES: UNITES OF SERVICE PROVIDED WERE 418,340. 1835040 1511219 HEATLH COUNSELING SERVICES: UNITS OF SERVICE PROVIDED WERE 6,582. 1178334 2610416 OPTOMETRY SERVICES: UNITS OF SERVICE PROVIDED WERE 10,772. 390853 482134 PHYSICAL THERAPY SERVICES: UNITS OF SERVICE PROVIDED WERE 19,395. 4604030 8300580 PACE: TOTAL MEMBER MONTHS WERE 829. 21109857 26125488 136064977 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 1 0 0 1 0 1 0 0 0 1 1 0 0 0 1 796 0 1 971 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 10 10 0 0 0 0 0 0 0 1 1 0 1 1 1 1 1 1 1 1 1 1 0 CA X JOHNSON WONG 4153919686 2171 JUNIPERO SERRA BLVD 260 DALY CITY CA 94014 ANNE D BRANDON JD CHAIR 1.00 1.00 X X 0 0 0 NANCY HUANG PHARM D VICE-CHAIR 1.00 1.00 X X 0 0 0 MIKE CHI SECRETARY/TREASURER 1.00 X X 0 0 0 CINDY W LAW BOARD MEMBER 1.00 X 0 0 0 SUZANNE S CHEUNG BOARD MEMBER 1.00 X 0 0 0 EUNICE HENDARY BOARD MEMBER 1.00 X 0 0 0 JOHN JIN LEE JD BOARD MEMBER 1.00 X 0 0 0 JEANY TAY MD BOARD MEMBER 1.00 X 0 0 0 EDWIN S WANG BOARD MEMBER 1.00 X 0 0 0 ALBERT Y YUE BOARD MEMBER 1.00 X 0 0 0 EDDIE W CHAN PRESIDENT & CEO 40.00 1.00 X 788126 0 41581 JOHNSON WONG VP, CFO 40.00 X 653030 0 195685 KENNETH B TAI VP, CHIEF HEALTH OFFICER 40.00 X 733830 0 56333 JERRY Y JEW VP, CHIEF STRATEGY OFFICER 40.00 X 470328 0 72739 DIANA KAWASAKI-YEE VP, CHIEF BUSINESS DEVELOPMENT OFFICER 12.75 X 459347 0 12241 PAUL E FOX CHIEF ADMINISTRATIVE OFFICER 40.00 X 337875 0 64257 RACHEL KOH CHIEF OPERATING OFFICER 40.00 X 418572 0 52141 MURALIMOHAN ATHULURI CHIEF INFORMATION OFFICER 40.00 X 354658 0 71946 DAI LIN TANG CHIEF MANAGED CARE OFFICER 40.00 X 429087 0 72647 LYNN XIAO LIU MEDICAL DIRECTOR 40.00 X 402635 0 45306 JAMES FREDERIC LEE MEDICAL DIRECTOR 26.15 X 433913 0 20058 HELEN M WONG MEDICAL DIRECTOR 40.00 X 399281 0 47347 WAI-HANG JACKIE LAM MEDICAL DIRECTOR 40.00 X 410064 0 27285 KATRINA ROSE LIU MSO MEDICAL DIRECTOR 40.00 X 406424 0 46005 6697170 0 825571 210 0 1 0 AM ONE CORPORATION 1601 GALVEZ AVENUE SAN FRANCISCO CA 94124 CONSTRUCTION 4713612 SUTTER BAY MEDICAL FOUNDATION PO BOX 276950 SACRAMENTO CA 95827 MEDICAL AND HEALTH CARE 4113947 TRANSWORLD CONSTRUCTION 1178 FOLSOM STREET SAN FRANCISCO CA 94103 CONSTRUCTION 2585025 PACIFIC HEMATOLOGY ONCOLOGY ASSOCIATES 2100 WEBSTER ST SUITE 225 SAN FRANCISCO CA 94115 MEDICAL AND HEALTH CARE 2291002 SAN FRANCISCO ONCOLOGY ASSOCIATES 2100 WEBSTER ST SUITE 326 SAN FRANCISCO CA 94115 MEDICAL AND HEALTH CARE 2154732 93 X 23659571 2839513 136700 26499084 MANGED CARE SERVICE 621300 81574880 81574880 MEDICAL SERVICE 621110 74639570 74639570 PHARMACY 621300 38903427 38903427 DENTAL 621300 9799454 9799454 OPTOMETRY SERVICES 621300 2610416 2610416 207527747 341550 341550 1561630 241686 1319944 1319944 1904 1318040 39480 0 39480 39480 39480 5763 16545 -10782 -10782 MISCELLANEOUS REVENUE 900099 3946041 3946041 ADMIN FEES 900099 3001555 3001555 6947596 242664619 214475343 1904 1688288 4603192 1693186 2910006 74611943 59102496 15509447 5257877 4016271 1241606 8741142 6575801 2165341 5170878 3862632 1308246 164648 164648 243369 243369 8115659 3592129 4523530 139436 50764 88672 963127 331824 631303 7793406 1828830 5964576 752559 94308 658251 254403 136837 117566 84226 84226 8394611 1430772 6963839 3694098 2804564 889534 MANAGED CARE CAPITATION 30870033 30870033 0 PHARMACEUTICALS AND IN- 15771512 15685835 85677 SUBSCRIPTIONS AND DUES 4815267 1180715 3634552 MEDICAL SUPPLIES 2733117 2587525 145592 554262 220455 333807 183728765 136064977 47663788 0 109217809 111052967 18235491 18246581 1408919 2212947 21999475 20686513 6375000 6502500 5866429 8006094 454584 642097 3018358 5334665 274689863 55678732 184046027 219011131 14563948 9799214 3621157 6805481 100000 100000 400000 400000 181082 8060670 369488279 416860860 17698504 23775298 61308 1591222 3700168 3604440 44333402 25926605 65793382 54897565 X 302509555 360771252 1185342 1192043 303694897 361963295 369488279 416860860 58935854 -667456 0 X 0 1 X 1 1 1 X 9046684 9161905 14358528 18709259 26499084 77775460 9046684 9161905 14358528 18709259 26499084 77775460 77775460 1740796 1728627 1672690 3017571 1903180 10062864 1904 1904 12641968 15701242 18403972 10495409 6947596 64190187 152030415 769173414 0.51160 0.42510 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 75960381 75960381 161054450 39419914 121634536 20278132 16258818 4019314 17396900 17396900 219011131 IBNR PAYABLE 3311871 MEDICARE & MEDI-CAL PAYABLE 21853796 DEPOSITS 144498 OPERATING LEASING LIABILITY 578713 DEFERRED RENT 37727 25926605 X 248264096 -667456 5430554 241686 5004784 243259312 -594693 -594693 242664619 190211736 5430554 1052417 6482971 183728765 0 183728765 PART X, LINE 2: NEMS HAS BEEN RECOGNIZED BY THE INTERNAL REVENUE SERVICE AS A NOT-FOR-PROFIT CORPORATION, AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC), AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE IRC AND 23701D OF THE CALIFORNIA REVENUE TAXATION CODE. NEMS HAS ADOPTED THE ACCOUNTING GUIDANCE RELATED TO UNCERTAIN TAX POSITIONS, AND HAS EVALUATED ITS TAX POSITIONS, AND BELIEVES THAT ALL OF THE POSITIONS TAKEN BY NEMS IN ITS FEDERAL AND STATE EXEMPT ORGANIZATION TAX RETURNS ARE MORE LIKELY THAN NOT TO BE SUSTAINED UPON EXAMINATION. NEMS' RETURNS ARE SUBJECT TO EXAMINATION BY FEDERAL AND STATE TAXING AUTHORITIES, GENERALLY FOR THREE YEARS AND FOUR YEARS RESPECTIVELY AFTER THEY ARE FILED. PART XI, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 241,686. PART XI, LINE 4B - OTHER ADJUSTMENTS: INTEREST EARNED FROM LOAN TO GBH 58,500. GBH INTEREST INCOME EXCLUDED -2,252. GBH NET PATIENT SERVICE REVENUE EXCLUDED -792,021. OTHER REVENUE EARNED FROM GBH 151,862. RAFFLE NET LOSS -10,782. PART XII, LINE 2D - OTHER ADJUSTMENTS: ADJUSTMENT TO EXCLUDE GBH 799,949. RENTAL EXPENSES 241,686. RAFFLE NET LOSS 10,782. X X 0 1 0 0 0 0 0 1 0 JOHNSON WONG VP, CFO 362178 0 67793 0 223059 0 179400 0 16285 0 848715 0 191844 0 EDDIE W CHAN PRESIDENT & CEO 588865 0 163817 0 35444 0 37802 0 3779 0 829707 0 0 0 KENNETH B TAI VP, CHIEF HEALTH OFFICER 441884 0 72793 0 219153 0 49400 0 6933 0 790163 0 176541 0 JERRY Y JEW VP, CHIEF STRATEGY OFFICER 411404 0 57793 0 1131 0 49400 0 23339 0 543067 0 0 0 DAI LIN TANG CHIEF MANAGED CARE OFFICER 340092 0 67793 0 21202 0 49400 0 23247 0 501734 0 0 0 DIANA KAWASAKI-YEE VP, CHIEF BUSINESS DEVELOPMENT OFFIC 104081 0 5000 0 350266 0 8329 0 3912 0 471588 0 289480 0 RACHEL KOH CHIEF OPERATING OFFICER 354923 0 57793 0 5856 0 49400 0 2741 0 470713 0 0 0 JAMES FREDERIC LEE MEDICAL DIRECTOR 229111 0 202258 0 2544 0 18329 0 1729 0 453971 0 0 0 KATRINA ROSE LIU MSO MEDICAL DIRECTOR 329848 0 51217 0 25359 0 24400 0 21605 0 452429 0 0 0 LYNN XIAO LIU MEDICAL DIRECTOR 334276 0 52561 0 15798 0 24400 0 20906 0 447941 0 0 0 HELEN M WONG MEDICAL DIRECTOR 325823 0 53793 0 19665 0 24400 0 22947 0 446628 0 0 0 WAI-HANG JACKIE LAM MEDICAL DIRECTOR 331361 0 49376 0 29327 0 24400 0 2885 0 437349 0 0 0 MURALIMOHAN ATHULURI CHIEF INFORMATION OFFICER 306865 0 47793 0 0 0 49400 0 22546 0 426604 0 0 0 PAUL E FOX CHIEF ADMINISTRATIVE OFFICER 295082 0 42793 0 0 0 48755 0 15502 0 402132 0 0 0 PART I, LINE 4B THE CEO ENTERED INTO A SPLIT-DOLLAR INSURANCE PLAN WITH NEMS IN 2021. NEMS FUNDED AN AMOUNT TO PAY PREMIUM ON A LIFE INSURANCE POLICY THAT THE CEO WILL OWN. THE LIFE INSURANCE POLICY HAS TWO COMPONENTS: ONE COMPONENT CREATES A FUND FROM WHICH THE CEO BORROWS TAX-FREE TO SUPPLEMENT RETIREMENT INCOME STARTING FROM 2027 AND THE OTHER COMPONENT PROVIDES DEATH PROCEEDS THAT: - REPAY NEMS'S PREMIUM PLUS INVESTMENT EARNINGS AND PROVIDE ADDITIONAL KEY PERSON COVERAGE. - PROVIDE A TAX-FREE DEATH BENEFIT TO CEO'S BENEFICIARY. THE ANNUAL TAX-FREE BENEFITS OVER 20 YEARS STARTS FROM 2027. NEMS ALSO MAINTAINS A DEFERRED COMPENSATION PLAN UNDER 457(F). THE ORGANIZATION ACCRUED CONTRIBUTIONS TO THE 457(F) PLAN FOR C-SUITE MEMBERS. THE AMOUNT ACCURED IS AS FOLLOWING: JOHNSON WONG, VICE PRESIDENT, CHIEF FINANCIAL OFFICER $155,000 KENNETH B TAI, VICE PRESIDENT, CHIEF HEALTH OFFICER $25,000 JERRY Y. JEW, VICE PRESIDENT, CHIEF STRATEGY OFFICER $25,000 PAUL E FOX, CHIEF ADMINISTRATIVE OFFICER $25,000 RACHEL KOH, CHIEF OPERATING OFFICER $25,000 MURALIMOHAN ATHULURI, CHIEF INFORMATION OFFICER $25,000 DAI LIN TANG, CHIEF MANAGED CARE OFFICER $25,000 IN 2022, THE ORGANIZATION ALSO MADE THE FOLLOWING 457(F) PLAN DISTRIBUTIONS REPORTED UNDER SCHEDULE J PART II COLUMN B(III): KENNETH B TAI $ 176,541 JOHNSON WONG $191,844 DIANA KAWASAKI-YEE $ 289,480 PART I, LINE 7 CEO'S BONUS WAS DETERMINED BY THE BOARD OF DIRECTORS ON A COMPLETELY DISCRETIONARY MANNER BASED UPON THE EMPLOYEE PERFORMANCE. OTHER EMPLOYEES' BONUSES WERE DETERMINED BY THE CEO AND THE BOARD OF DIRECTORS ON A COMPLETELY DISCRETIONARY MANNER BASED UPON THE EMPLOYEE PERFORMANCE. EDDIE W CHAN PRESIDENT & CEO SPLIT DOLLAR LIFE INSURANCE X 6375000 6502500 0 1 1 6502500 BEVERLEY CHAN DIRECTOR OF PHARMACY IS SPOUSE OF THE CEO 396549 COMPENSATION 0 X 1 13492 FMV X BOOKS AND OTHER SUPPLIES 6 123208 FMV 0 0 1 0 PART I, COLUMN (B): THIS NUMBER REPRESENTS THE NUMBER OF CONTRIBUTORS, NOT THE NUMBER OF ITEMS CONTRIBUTED. FORM 990, PART VI, SECTION B, LINE 11B THE NEMS MANAGEMENT SHALL HAVE THE RESPONSIBILITY FOR REVIEWING THE CLINIC'S FORM 990 (INCLUDING ALL PERTINENT SCHEDULES) BEFORE IT IS FILED WITH THE INTERNAL REVENUE SERVICE. AFTER THE DRAFT OF THE FORM 990 HAS BEEN OBTAINED BY THE NEMS MANAGEMENT, THEY WILL HAVE NO MORE THAN FOUR WEEKS TO COMPLETE THEIR REVIEW. ONCE THE NEMS MANAGEMENT HAS COMPLETED ITS INITIAL REVIEW OF THE FORM 990, A MEETING OR CONFERENCE CALL WILL BE SCHEDULED WITH THE PREPARER OF THE FORM 990 (REGARDLESS OF WHETHER THE FORM 990 IS EXTERNALLY OR INTERNALLY PREPARED) TO DISCUSS ANY QUESTIONS, COMMENTS, AND SUGGESTED REVISIONS IDENTIFIED BY THE NEMS MANAGEMENT. THE PREPARER OF THE FORM 990 SHOULD MAKE ANY REVISIONS TO THE FORM 990 AS SOON AS FEASIBLY POSSIBLE TO ENSURE THAT THE FORM 990 IS FILED WITH THE INTERNAL REVENUE SERVICE ON A TIMELY BASIS. ALL QUESTIONS, COMMENTS, AND SUGGESTED REVISIONS SET FORTH BY THE NEMS MANAGEMENT SHOULD BE DOCUMENTED, ALONG WITH ANY RESPONSES FROM THE PREPARER OF THE FORM 990, IF APPLICABLE. FORM 990, PART VI, SECTION B, LINE 12C BOARD OF DIRECTORS AND KEY MANAGEMENT STAFF WILL FILL OUT THE "ANNUAL CONFLICT DISCLOSURE QUESTIONNAIRE." THESE QUESTIONNAIRES WILL BE REVIEWED BY THE CHAIR OF THE BOARD OF DIRECTORS WHO WILL DETERMINE APPROPRIATE ACTION IF A CONFLICT OF INTEREST IS IDENTIFIED. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION OF THE ORGANIZATION'S CEO AND TOP MANAGEMENT OFFICER IS DETERMINED BY THE BOARD OF DIRECTORS WHO UTILIZE COMPARABILITY DATA PROVIDED ANNUALLY BY THE HOSPITAL AND HEALTHCARE COMPENSATION SERVICE FOR THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS. THE COMPENSATION OF THE ORGANIZATION'S OTHER OFFICERS AND KEY EMPLOYEES IS DETERMINED BY THE CEO WHO UTILIZES COMPARABILITY DATA FROM A COMPENSATION SPECIALIST. FORM 990, PART VI, SECTION C, LINE 19 THE CLINIC'S GOVERNING DOCUMENTS, POLICIES, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. FORM 990 PART VIII LINE 6 THE ORGANIZATION HAS BUSINESS RENTAL INCOME FROM VARIOUS PROPERTIES. ONLY TWO PROPERTIES ARE DEBT FINANCED. FOR THE DEBT FINANCED PROPERTIES, THE ORGANIZATION REPORTS RENTAL INCOME AS UNRELATED BUSINESS INCOME. GENERAL PROPERTY EXPENSES SUCH AS PROPERTY TAX, INSURANCE, INTEREST, AND DEPRECIATION ARE ALLOCATED TO NET WITH THE RENTAL INCOME BASED ON THE % OF PROPERTY USED FOR RENTAL AND ON DEBT/BASIS RATIO. 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