2023-04-26T15:21:57-05:00 2022-06-30 410746749 CLIFTONLARSONALLEN LLP 1301 WEST 22ND STREET SUITE 1100 OAK BROOK IL 60523 990 2021-07-01 320115907 ESPERANZA HEALTH CENTERS ESPE 7735846200 1940 S WESTERN 205 CHICAGO IL 60608 RYAN GADIA CFO 7736405792 2023-04-17 1 RYAN GADIA 999009999 CHRIS MANDERFIELD P01238973 6305738600 2023-04-17 3 AAL1 IAL1 2021 2023-04-26 12:10:37Z DAN FULWILER 1940 S WESTERN 205 CHICAGO IL 60608 48335689 0 X WWW.ESPERANZACHICAGO.ORG X 2004 IL PRIMARY HEALTH CARE SERVICES 16 16 437 16 0 0 8629201 11607121 29020576 35868956 366840 293185 558837 505024 38575454 48274286 0 0 0 0 23358068 28757810 0 0 860246 12635623 15892634 35993691 44650444 2581763 3623842 28840414 32262882 14380129 15490688 14460285 16772194 TO DELIVER HEALTH AND HOPE TO CHICAGO'S UNDERSERVED COMMUNITIES 0 0 36440333 36381302 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. 36440333 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 1 0 0 0 0 0 0 0 1 1 1 0 0 1 42 0 1 437 1 0 0 0 0 0 0 0 0 0 0 0 0 X 16 16 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 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 0 0 0 ERIKA MARTINEZ DIRECTOR 0.25 X 0 0 0 DESTINY ORTEGA DIRECTOR 0.25 X 0 0 0 DANIEL FULWILER CHIEF EXECUTIVE OFFICER 40.00 1.00 X 326408 0 16795 ANDREW J VAN WIEREN CHIEF MEDICAL OFFICER 40.00 X 293074 0 7964 CARMEN VERGARA CHIEF OPERATING OFFICER 40.00 X 180672 0 14010 RYAN D GADIA CHIEF FINANCIAL OFFICER 40.00 1.00 X 161570 0 27549 FREDERICO HERRERA MEDICAL DIRECTOR - LITTLE 40.00 X 226793 0 31043 KRISTINA N PONTARELLI PHYSICIAN 40.00 X 227922 0 11280 SYLVIA SHOKUNBI PHYSICIAN 40.00 X 228855 0 30544 KAREN ESCOBAR PHYSICIAN 40.00 X 223713 0 14047 DHARA BHAKTA PHYSICIAN 40.00 X 228118 0 23085 OSCAR DIAZ PHYSICIAN 40.00 X 245048 0 24572 2342173 0 200889 51 0 1 0 ATHENAHEALTH INC 311 ARSENAL ST WATERTOWN MA 02472 EMR AND BILLING SERVICES 2077175 343 LLC 23120 FLORALWOOD LN BOCA RATON FL 33433 LOCUMS, TEMPS 1203504 BARTON ASSOCIATES INC 300 JUBILEE DR PEABODY MA 01960 LOCUMS, TEMPS 563430 SEQUOIA GENERAL CONTRACTING CORP 1585 BEVERLY COURT UNIT 108 AURORA IL 60502 DESIGN AND CONSTRUCTION 523855 PCY GENERAL SERVICE INC 5911 W 88TH ST OAK LAWN IL 60453 JANITORIAL SERVICES 499574 32 145409 8889517 2572195 11607121 PATIENT FEES 621990 26031605 26031605 PHARMACY REVENUE 621990 9837351 9837351 35868956 293185 293185 54081 145409 61403 -7322 -7322 MISCELLANEOUS 900099 512346 512346 512346 48274286 36381302 0 285863 1111978 951778 134297 25903 23046444 19726203 2783384 536857 774116 662591 93492 18033 2169751 1857161 262047 50543 1655521 1417014 199942 38565 27759 16638 11121 108714 65160 43554 4094440 2454085 1640355 54047 54047 553259 225268 263889 64102 626739 476354 129458 20927 1232499 938585 293914 567346 293132 274214 385612 318704 66908 211241 166979 44262 PHARMACY AND MEDICAL SU 6407831 6322481 85350 STAFF TRAINING 588738 197613 383792 7333 REPAIRS AND MAINTENANCE 281898 144947 136951 MEMBERSHIP DUES AND SUB 117749 35579 72858 9312 634762 170061 430077 34624 44650444 36440333 7349865 860246 6603075 6581056 1203533 2100810 3082067 3642153 11982000 11982000 611004 697499 4780737 728444 2426154 4052293 2548292 2841477 199134 178534 185155 187060 28840414 32262882 3181329 4232046 10872398 10929547 326402 329095 14380129 15490688 X 14260285 16272194 200000 500000 14460285 16772194 28840414 32262882 X 3623842 -1311933 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 3109498 287346 2822152 1003858 441098 562760 667381 667381 4052293 MHN ACO, LLC 2841477 F 2841477 DEFERRED LIABILITIES 329095 329095 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 126939 98709 28230 11329 21016 2375 1361 GOLF OUTING 62631 46700 15931 112 4282 6230 2537 1 9920 9920 718 702 6162 500 4079 199490 145409 54081 718 814 15611 33408 2875 7977 61403 -7322 X X X X X 0 1 0 0 0 0 0 1 0 DANIEL FULWILER CHIEF EXECUTIVE OFFICER 260383 0 66025 0 0 0 9802 0 6993 0 343203 0 0 0 ANDREW J VAN WIEREN CHIEF MEDICAL OFFICER 255151 0 37923 0 0 0 7831 0 133 0 301038 0 0 0 OSCAR DIAZ PHYSICIAN 235593 0 9455 0 0 0 9802 0 14770 0 269620 0 0 0 SYLVIA SHOKUNBI PHYSICIAN 211663 0 17192 0 0 0 8860 0 21684 0 259399 0 0 0 FREDERICO HERRERA MEDICAL DIRECTOR - LITTLE 209866 0 16927 0 0 0 9072 0 21971 0 257836 0 0 0 DHARA BHAKTA PHYSICIAN 206731 0 21387 0 0 0 8803 0 14282 0 251203 0 0 0 KRISTINA N PONTARELLI PHYSICIAN 204537 0 23385 0 0 0 4512 0 6768 0 239202 0 0 0 KAREN ESCOBAR PHYSICIAN 216134 0 7579 0 0 0 8946 0 5101 0 237760 0 0 0 CARMEN VERGARA CHIEF OPERATING OFFICER 157251 0 23421 0 0 0 6972 0 7038 0 194682 0 0 0 RYAN D GADIA CHIEF FINANCIAL OFFICER 140622 0 20948 0 0 0 5578 0 21971 0 189119 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, AND CFO ARE ELIGIBLE TO 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. CHARLES WINTERSTEEN MEMBER OF BOARD OF DIRECTORS 11773 LEGAL SERVICES 0 SCHEDULE L, PART IV ESPERANZA HEALTH CENTER UTILIZES THE SERVICES OF WINTERSTEEN PATEL LAW GROUP FOR LEGAL SERVICES RELATED TO IMMEGRATION MATTERS. CHARLES WINTERSTEEN IS THE FOUNDING PARTNER AND ALSO A MEMBER OF ESPERANZA HEALTH CENTER'S BOARD OF DIRECTORS. 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 XI, LINE 9: TRANSFER OF NET ASSETS BETWEEN AFFILATES -1,311,933. 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 129500 RENTAL AGREEMENT