2024-03-13T07:39:32-05:00 2023-06-30 390758449 WIPFLI LLP 1502 LONDON ROAD SUITE 200 DULUTH MN 55812 990 2022-07-01 952977147 CLINICAS DEL CAMINO REAL INC CLIN 8056591740 PO BOX 4566 VENTURA CA 93007 FARHAD FRED BENHARASH CFO 8056591740 2024-03-12 1 FARHAD FRED BENHARASH 999009999 0 MICHAEL J PETERSON CPA P01833529 2187224705 2024-03-12 3 AAL1 IAL1 2022 2023-04-26 12:10:37Z FARHAD FRED BENHARASH PO BOX 4566 VENTURA CA 93007 132313830 0 X WWW.CLINICAS.ORG X 1971 CA IT IS THE EXPLICIT MISSION OF CLINICAS DEL CAMINO REAL TO SAVE LIVES AND RESTORE GOOD HEALTH BY PROVIDING QUALITY COMPREHENSIVE AND PREVENTATIVE PERSONAL AND HUMANE HEALTH CARE SERVICES TO THE MEDICALLY UNDERSERVED POPULATION OF VENTURA COUNTY. THIS MISSION IS ACCOMPLISHED BY ELIMINATING THE BARRIERS OF LIMITED INCOME, RESOURCES, CULTURAL, AND LANGUAGE THROUGH THE USE OF OUTREACH PROGRAMS, BILINGUAL AND BICULTURAL STAFF MEMBERS, AND A SLIDING FEE PROGRAM BASED ON A PATIENT'S ABILITY TO PAY. 8 8 1064 8 0 0 24065683 18133336 87545032 101895947 568550 2213539 297023 173761 112476288 122416583 0 0 0 0 68660362 68946632 0 0 0 54193734 57023037 122854096 125969669 -10377808 -3553086 172085216 159336662 114537911 103229161 57547305 56107501 X IT IS THE EXPLICIT MISSION OF CLINICAS DEL CAMINO REAL TO SAVE LIVES AND RESTORE GOOD HEALTH BY PROVIDING QUALITY COMPREHENSIVE AND PREVENTATIVE PERSONAL AND HUMANE HEALTH CARE SERVICES TO THE MEDICALLY UNDERSERVED POPULATION OF VENTURA COUNTY. THIS MISSION IS ACCOMPLISHED BY ELIMINATING THE BARRIERS OF LIMITED INCOME, RESOURCES, CULTURAL, AND LANGUAGE THROUGH THE USE OF OUTREACH PROGRAMS, BILINGUAL AND BICULTURAL STAFF MEMBERS, AND A SLIDING FEE PROGRAM BASED ON A PATIENT'S ABILITY TO PAY. 0 0 98652383 0 101895947 IT IS THE EXPLICIT MISSION OF CLINICAS DEL CAMINO REAL TO SAVE LIVES AND RESTORE GOOD HEALTH BY PROVIDING QUALITY COMPREHENSIVE AND PREVENTATIVE PERSONAL AND HUMANE HEALTH CARE SERVICES TO THE MEDICALLY UNDERSERVED POPULATION OF VENTURA COUNTY. THIS MISSION IS ACCOMPLISHED BY ELIMINATING THE BARRIERS OF LIMITED INCOME, RESOURCES, CULTURAL, AND LANGUAGE THROUGH THE USE OF OUTREACH PROGRAMS, BILINGUAL AND BICULTURAL STAFF MEMBERS, AND A SLIDING FEE PROGRAM BASED ON A PATIENT'S ABILITY TO PAY. TOTAL PATIENT ENCOUNTERS FOR THE YEAR WERE 309,535. 98652383 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 452 0 1064 1 0 0 0 0 0 0 0 0 0 0 0 0 X 8 8 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 CA X FARHAD (FRED) BENHARASH 8056591740 1040 FLYNN RD CAMARILLO CA 93012 CHARLES HOOKSTRA PRESIDENT 1.00 X X 0 0 0 KRISTIN CADY VICE PRESIDENT 1.00 X X 0 0 0 DR ADOLFO MURILLO VICE PRESIDENT 1.00 X X 0 0 0 BARBARA A JOURNET TREASURER 1.00 X X 0 0 0 JAVIER M OCHOA PARLIAMENTARIAN 1.00 X X 0 0 0 ANGEL ARREOLA BOARD MEMBER 1.00 X 0 0 0 CANDELARIA FRANCO BOARD MEMBER 1.00 X 0 0 0 DANIEL GONZALEZ BOARD MEMBER 1.00 X 0 0 0 GAGAN PAWAR CEO 40.00 X 656658 0 19322 ROBERT C STREETER IV CMO 40.00 X 129285 0 1991 FARHAD FRED BENHARASH CFO 40.00 X 269641 0 0 ANWAR ALI ABBAS CIO 40.00 X 246134 0 10030 RAFAEL DIAZ DDIT 40.00 X 229758 0 8640 JASPREET BAL DD 40.00 X 173321 0 5581 TANISORN BOONYASETHA DABI 40.00 X 151834 0 8129 ALBA A CHACON HED 40.00 X 169448 0 2883 ANNA BELL MONROY COO 40.00 X 185554 0 8848 YASMIN SARAFZADEH PHYSICIAN 40.00 X 340662 0 20421 MENASHE EHRENBURG PHYSICIAN 40.00 X 469431 0 19810 TA THUC NGU DINH PHYSICIAN 40.00 X 423714 0 18902 TODD WAYNE MONROE PHYSICIAN 40.00 X 404994 0 16320 TIHELE L WALKOUSKY PHYSICIAN 40.00 X 402697 0 5551 ROBERTO S JUAREZ FORMER CEO 40.00 X 276250 0 2931 KELLY LYNN BENNETT FORMER HR DIRECTOR (THRU 03/22) 40.00 X 355862 0 5491 4885243 0 154850 123 1 1 0 TWO TREES PHYSICAL THERAPY & WELLNESS IN 3418 LOMA VISTA RD SUITE A VENTURA CA 93003 PHYSICAL THERAPY SERVICES 1630836 VENTURA COUNTY MEDICAL CENTER 800 S VICTORIA AVE VENTURA CA 93009 MEDICAL SERVICES 1529301 QUEST DIAGNOSTICS PO BOX 912411 PASADENA CA 91110 LAB SERVICES 1404232 PALMS IMAGING MEDICAL GROUP PO BOX 190 SIMI VALLEY CA 93062 RADIOLOGY SERVICES 1094396 BEVERLY RADIOLOGY MEDICAL GROUP PO BOX 101418 PASADENA CA 91189 RADIOLOGY SERVICES 849207 66 18126791 6545 18133336 PATIENT SERVICE REVENUE 621400 100125812 100125812 340(B) PHARMACY REVENUE 456110 1770135 1770135 101895947 744348 744348 11366438 9897247 1469191 1469191 1469191 173761 173761 173761 122416583 101895947 0 2387300 X 2347720 1090369 1257351 55505819 41734987 13770832 1156376 896019 260357 5482627 4270808 1211819 4454090 3451254 1002836 689780 689780 445540 445540 124069 124069 32463874 31302850 1161024 1294209 1275045 19164 2116531 1285224 831307 1146515 1077683 68832 1486387 1129947 356440 201819 147101 54718 167423 147072 20351 1625075 1475688 149387 3934084 630980 3303104 951087 761781 189306 SUPPLIES 6627007 6542027 84980 TAXES & LICENSES 1296458 663660 632798 REPAIRS & MAINTENANCE 950147 460895 489252 EQUIPMENT RENTALS 530560 308993 221567 972472 972472 125969669 98652383 27317286 0 16584 18267 39312567 23948018 341262 500460 9080358 12904634 734810 784671 121542892 42805364 85802960 78737528 24811375 27147895 1848060 1848060 10137240 13447129 172085216 159336662 31412772 18406119 295500 395500 70019683 67816394 246580 512099 12563376 16099049 114537911 103229161 X 57547305 56107501 57547305 56107501 172085216 159336662 -3553086 2113282 0 X 0 1 X 1 1 1 X 16216000 21701214 29985344 24065683 18133336 110101577 94362273 93038696 111412476 87842055 102069708 488725208 110578273 114739910 141397820 111907738 120203044 598826785 0 0 0 598826785 1155065 1450677 678314 568550 744348 4596954 1155065 1450677 678314 568550 744348 4596954 111733338 116190587 142076134 112476288 120947392 603423739 0.99240 0.99210 0.00760 0.00790 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 8429982 8429982 76486519 24155829 52330690 20378360 7320224 13058136 13058106 11005190 2052916 3189925 324121 2865804 78737528 ESTIMATED THIRD-PARTY PAYOR RECEIVABLES 5378451 SECURITY DEPOSITS 31785 RELATED PARTY NOTES RECEIVABLE 5642967 RIGHT OF USE ASSETS 2393926 13447129 ESTIMATED THIRD-PARTY PAYOR LIABILITIES 13705123 OBLIGATIONS UNDER CAPITAL LEASES 2393926 16099049 X X 1 0 0 0 0 0 0 0 0 GAGAN PAWAR CEO 464545 0 62500 0 129613 0 0 0 19322 0 675980 0 0 0 MENASHE EHRENBURG PHYSICIAN 448904 0 0 0 20527 0 0 0 19810 0 489241 0 0 0 TA THUC NGU DINH PHYSICIAN 398671 0 200 0 24843 0 0 0 18902 0 442616 0 0 0 TODD WAYNE MONROE PHYSICIAN 371183 0 0 0 33811 0 0 0 16320 0 421314 0 0 0 TIHELE L WALKOUSKY PHYSICIAN 384637 0 0 0 18060 0 0 0 5551 0 408248 0 0 0 KELLY LYNN BENNETT FORMER HR DIRECTOR (THRU 03/22) 64056 0 0 0 291806 0 0 0 5491 0 361353 0 0 0 YASMIN SARAFZADEH PHYSICIAN 333713 0 0 0 6949 0 0 0 20421 0 361083 0 0 0 ROBERTO S JUAREZ FORMER CEO 0 0 0 0 276250 0 0 0 2931 0 279181 0 0 0 FARHAD FRED BENHARASH CFO 236680 0 15000 0 17961 0 0 0 0 0 269641 0 0 0 ANWAR ALI ABBAS CIO 220942 0 0 0 25192 0 0 0 10030 0 256164 0 0 0 RAFAEL DIAZ DDIT 207438 0 0 0 22320 0 0 0 8640 0 238398 0 0 0 ANNA BELL MONROY COO 185554 0 0 0 0 0 0 0 8848 0 194402 0 0 0 JASPREET BAL DD 158831 0 0 0 14490 0 0 0 5581 0 178902 0 0 0 ALBA A CHACON HED 133952 0 0 0 35496 0 0 0 2883 0 172331 0 0 0 TANISORN BOONYASETHA DABI 125307 0 0 0 26527 0 0 0 8129 0 159963 0 0 0 PART I, LINE 4A DURING CALENDAR YEAR 2022, ROBERTO S. JUAREZ, FORMER CEO, RECEIVED A SEVERANCE PLAN PAYMENT IN THE AMOUNT OF $276,250 AND KELLY BENNETT, FORMER HR DIRECTOR, RECEIVED A SEVERANCE PLAN PAYMENT IN THE AMOUNT OF $225,000. A CALIFORNIA MUNICIPAL FINANCE AUTHORITY 201563466 13048VNU8 2020-03-19 71427330 REFINANCE DEBT & CONSTRUCTION 0 0 0 A 1195000 71427330 1250253 2233118 450437 41294160 2022 0 0 1 1 A 0 0 0 0 0 0 0 A 0 1 0 0 0 0 0 0 A 0 FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 IS PREPARED BY AN INDEPENDENT CPA AND THEN REVIEWED BY THE CFO. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION INVESTIGATES POTENTIAL CONFLICTS OF INTEREST WHEN THEY ARISE BY COMPLIANCE STAFF. ALL STAFF ARE COVERED UNDER THE CONFLICT OF INTEREST POLICIES. STAFF ARE REQUIRED TO SELF-REPORT ANY CONFLICT OF INTEREST AND DOCUMENT THE CONFLICT. CONFLICTS ARE REVIEWED BY COMPLIANCE AND SUPERVISING STAFF. DETERMINATIONS ARE MADE AS TO THE VIABILITY OF USING VENDORS/CONTRACTORS FOR COMPANY ACTIVITY AND WOULD PRECLUDE ANY CONFLICTED CDCR EMPLOYEE FROM BEING INVOLVED IN THE DECISION MAKING AND APPROVAL PROCESS. ANY VIOLATIONS ARE HANDLED IN ACCORDANCE WITH THE WRITTEN POLICIES AND PROCEDURES. FORM 990, PART VI, SECTION B, LINE 15 EVERY YEAR THE BOARD OF DIRECTORS FINANCE COMMITTEE EVALUATES THE CEO'S PERFORMANCE AND COMPENSATION. ANNUALLY THE CEO AND HR DIRECTOR WORK TOGETHER USING STATE AND NATIONALLY BASED SALARY SURVEYS TO COMPARE THE CORPORATION'S OFFICERS' SALARIES TO THOSE OF SIMILAR CORPORATIONS. COMPARISON SURVEYS ARE PERFORMED BY THE CEO AND HUMAN RESOURCES DIRECTOR USING STATE AND NATIONAL DATABASES. ANNUAL REVIEWS ARE PERFORMED BY THE BOARD OF DIRECTORS FOR ALL OFFICERS, KEY EMPLOYEES, AND OTHER HIGHLY COMPENSATED EMPLOYEES. FORM 990, PART VI, SECTION C, LINE 19 FORM 990 IS AVAILABLE FOR REVIEW AT THE ORGANIZATION'S ADMINISTRATIVE OFFICE DURING NORMAL BUSINESS HOURS. OTHER FORMS SUCH AS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE INTERNAL CORPORATE DOCUMENTS. FORM 990, PART IX, LINE 11G CLINICAL SERVICES: PROGRAM SERVICE EXPENSES 22,965,151. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 22,965,151. LAB SERVICES: PROGRAM SERVICE EXPENSES 1,950,440. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,950,440. OTHER PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 6,387,259. MANAGEMENT AND GENERAL EXPENSES 1,161,024. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 7,548,283. AMERICASHEALTH PLAN INC 1000 TOWN CENTER DRIVE SUITE 410 OXNARD CA 93036 271073990 MANAGED CARE HEALTH PLAN CA CLINICAS DEL CAMINO REAL INC C 34843816 6093508 1.00000 1 MEDPARTNERS MSO INCORPORATED 1040 FLYNN RD CAMARILLO CA 93012 814231443 INSURANCE BILLING CA CLINICAS DEL CAMINO REAL INC C 7648792 6004873 1.00000 1 1 0 0 1 0 0 0 0 0 0 0 1 1 0 0 0 1 0 0 AMERICASHEALTH PLAN INC A 24774 CASH AMERICASHEALTH PLAN INC D 1173001 CASH AMERICASHEALTH PLAN INC L 10263517 CASH MEDPARTNERS MSO INCORPORATED INC A 137465 CASH MEDPARTNERS MSO INCORPORATED INC M 6080095 CASH MEDPARTNERS MSO INCORPORATED INC D 4469966 CASH MEDPARTNERS MSO INCORPORATED INC Q 633129 CASH