2024-05-14T11:51:31-05:00 2023-06-30 910189318 MOSS ADAMS LLP 4747 EXECUTIVE DR SUITE 1300 SAN DIEGO CA 92121 990 2022-07-01 271332228 ARCH HEALTH PARTNERS INC ARCH 8586732502 15611 POMERADO ROAD 400 POWAY CA 92064 HEATHER PUNAK CHIEF FINANCIAL OFFICER 8586732502 2024-05-13 1 HEATHER PUNAK 999009999 0 JANE COLEMAN P01391236 8586271400 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z HARVEY HERSHKOWITZ 15611 POMERADO ROAD 400 POWAY CA 92064 195956952 0 X WWW.ARCHHEALTH.ORG X 2009 CA TO PROVIDE COMPREHENSIVE HEALTHCARE SERVICES OF EXCEPTIONAL QUALITY. 10 10 944 11 0 0 34729573 37222631 128781533 158734084 96151 -444960 0 0 163607257 195511755 0 0 0 0 48854486 57835023 0 0 0 115510927 139146471 164365413 196981494 -758156 -1469739 65698174 101235709 64972900 101435471 725274 -199762 TO PERFORM AND CARRY OUT CHARITABLE HEALTHCARE FUNCTIONS AND PURPOSES BY ESTABLISHING, OPERATING AND MAINTAINING A MULTI-SPECIALTY MEDICAL CLINICS FOR THE PROVISION OF HEALTHCARE SERVICES. 0 0 191470628 158734084 THE SPECIFIC AND PRIMARY PURPOSES OF THE ORGANIZATION ARE TO PERFORM AND CARRY OUT CHARITABLE HEALTHCARE FUNCTIONS AND PURPOSES BY ESTABLISHING, OPERATING AND MAINTAINING A MULTI-SPECIALTY MEDICAL CLINIC. 191470628 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 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 0 1 154 0 1 944 1 0 0 0 0 0 0 0 0 0 0 0 0 X 10 10 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X MANUELA LUPU 8586732552 15611 POMERADO ROAD 400 POWAY CA 92064 POREMBA MICHAEL BOARD SECRETARY/TREASURER 0.50 X X 0 0 0 HERSHKOWITZ HARVEY BOARD CHAIR 0.50 X X 0 0 0 MAFFEI REBECCA BOARD MEMBER (THRU 07/22) 0.50 X 0 0 0 MALEK MD MIKHAIL BOARD MEMBER 0.50 X 0 0 0 MCGHEE KIMBERLY BOARD MEMBER 0.50 X 0 0 0 RICKEY DAVE BOARD MEMBER 0.50 X 0 0 0 PETERS MD VANESSA BOARD MEMBER 0.50 X 0 0 0 HANSEN DIANE BOARD MEMBER/PH PRESIDENT & CEO 0.50 X 0 0 0 PUTNAM MD RICHARD BOARD MEMBER 0.50 X 0 0 0 RODRIGUEZ MD GEORGE BOARD MEMBER 0.50 X 0 0 0 SMITH WILLIAM BILL BOARD MEMBER 0.50 X 0 0 0 OLSEN RYAN PHMG CEO 40.00 X 0 274780 76938 MOURNING KELLY ASSOCIATE GENERAL COUNSEL 40.00 X 0 194259 54393 PUNAK HEATHER AS OF 1122 PHMG CHIEF FINANCIAL OFFICER 40.00 X 0 30007 8402 PAPE AMANDA THRU 1122 PHMG ACTING CFO/PH VP OF FINANCE 40.00 X 0 101346 28377 LEE JOON PHMG CHIEF POPULATION HEALTH OFFICER 40.00 X 0 191527 53628 HOLT STACI PHMG CHIEF OPERATING OFFICER 40.00 X 0 278206 77898 FITZGERALD APRIL THRU 0722 ARCH CHIEF OPERATING OFFICER 40.00 X 0 384190 107573 PAYNE MARY KAY PHMG DIRECTOR OF REVENUE CYCLE 40.00 X 222465 0 55610 REDDICK JAMIE A PHMG REGIONAL DIRECTOR-MULTISPECIALTY OPERATIONS 40.00 X 158025 0 4719 HUSTOSKY DAVID PHMG PHYSICIAN ASSISTANT 40.00 X 235643 0 37262 KROCHMAL RACHEL E PHMG NURSE PRACTIONER/PHYSICIANS ASSISTANT 40.00 X 175220 0 36009 MUNDERLOH BJ PHMG DIRECTOR OF UTILIZATION MANAGEMENT 40.00 X 238411 0 16818 STEEN CARL PHMG DIR OF CLINICAL SERVICES AND QM & INTERIM DIR 40.00 X 183584 0 32932 STOKES TROY THRU 0822 PHMG DIRECTOR OF INFORMATION TECHNOLOGY 40.00 X 0 235487 65936 1213348 1689802 656495 49 0 1 0 GRAYBILL MEDICAL GROUP 332 S JUNIPER ST STE 112 ESCONDIDO CA 92025 MEDICAL SERVICES 27698192 ANESTHESIA CONSULTANTS OF 11440 W BERNARDO CT STE 300 SAN DIEGO CA 92127 MEDICAL SERVICES 13254308 PIMG A PROFESSIONAL MEDICAL CORP 15611 POMERADO RD STE 400 POWAY CA 92064 MEDICAL SERVICES 13068242 ORTHOPEDIC SURGERY ASSOCS 15611 POMERADO RD STE 575 POWAY CA 92064 MEDICAL SERVICES 9961846 ESCONDIDO CARDIOLOGY ASSOCINC 1955 CITRACADO PKWY STE 300 ESCONDIDO CA 92029 MEDICAL SERVICES 6107737 50 37222631 37222631 PATIENT REVENUE 621990 86777772 86777772 NET PREMIUM REVENUE 621990 48679938 48679938 PPH PROGRAM REVENUE 621990 12229804 12229804 11046570 11046570 158734084 237 237 445197 -445197 -445197 -445197 195511755 158734084 0 -444960 X 462630 462630 46968932 46968932 943690 943690 5715351 5715351 3744420 3744420 9628844 9628844 330401 330401 1912785 1912785 90830052 90830052 100094 100094 2914934 2914934 4027880 4027880 13206134 13206134 521262 521262 58512 58512 243883 243883 4051512 4051512 3267680 3267680 PHARMACEUTICAL AND MEDI 7616331 7616331 436167 436167 196981494 191470628 5510866 0 866316 5231068 29948563 46309307 283125 458204 1109977 1588941 19758029 13658744 5119692 6099285 6106617 4986891 22263884 36562013 65698174 101235709 38667901 59666346 3976988 4497702 22328011 37271423 64972900 101435471 X 725274 -199762 725274 -199762 65698174 101235709 X -1469739 544703 X 0 1 X 1 0 X SCHEDULE A, PART I: ARCH HEALTH PARTNERS WAS RECOGNIZED AS A HEALTHCARE ORGANIZATION DESCRIBED IN SECTION 170(B)(1)(A)(III) OF THE INTERNAL REVENUE CODE. THIS ORGANIZATION DOES NOT OPERATE A FACILITY THAT IS OR IS REQUIRED TO BE LICENSED AS A HOSPITAL. THEREFORE, ARCH HEALTH PARTNERS IS NOT REQUIRED TO FILE FORM 990, SCHEDULE H. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 6098485 4850156 1248329 12842647 8287685 4554962 816897 520903 295994 6099285 ROU ASSET 35976999 DEPOSITS 585014 36562013 ROU LIABILITY 37228217 DEFERRED RENT 43206 37271423 X X X 1 0 0 0 0 0 0 0 0 FITZGERALD APRIL THRU 0722 ARCH CHIEF OPERATING OFFICER 0 170885 0 0 0 213305 0 0 0 107573 0 491763 0 0 HOLT STACI PHMG CHIEF OPERATING OFFICER 0 278206 0 0 0 0 0 0 0 77898 0 356104 0 0 OLSEN RYAN PHMG CEO 0 274780 0 0 0 0 0 0 0 76938 0 351718 0 0 STOKES TROY THRU 0822 PHMG DIRECTOR OF INFORMATION TECHNOL 0 139087 0 0 0 96400 0 0 0 65936 0 301423 0 0 PAYNE MARY KAY PHMG DIRECTOR OF REVENUE CYCLE 198274 0 23986 0 205 0 6005 0 49605 0 278075 0 0 0 HUSTOSKY DAVID PHMG PHYSICIAN ASSISTANT 226182 0 9389 0 72 0 6750 0 30512 0 272905 0 0 0 MUNDERLOH BJ PHMG DIRECTOR OF UTILIZATION MANAGEM 217378 0 20000 0 1033 0 6750 0 10068 0 255229 0 0 0 MOURNING KELLY ASSOCIATE GENERAL COUNSEL 0 194259 0 0 0 0 0 0 0 54393 0 248652 0 0 LEE JOON PHMG CHIEF POPULATION HEALTH OFFICER 0 191527 0 0 0 0 0 0 0 53628 0 245155 0 0 STEEN CARL PHMG DIR OF CLINICAL SERVICES AND QM 183463 0 0 0 121 0 2416 0 30516 0 216516 0 0 0 KROCHMAL RACHEL E PHMG NURSE PRACTIONER/PHYSICIANS ASS 175142 0 0 0 78 0 5493 0 30516 0 211229 0 0 0 REDDICK JAMIE A PHMG REGIONAL DIRECTOR-MULTISPECIALT 138615 0 19398 0 12 0 3117 0 1602 0 162744 0 0 0 PART I, LINE 4A APRIL FITZGERALD, OFFICER, RECEIVED SEVERANCE IN THE AMOUNT OF $213,305. TROY STOKES, HIGHEST COMPENSATED EMPLOYEE, RECEIVED SEVERANCE IN THE AMOUNT OF $96,400. FORM 990, PART VI, SECTION A, LINE 3 AS OF JULY 1, 2017, ARCH HEALTH ("AHMG") CONTRACTED WITH PACIFIC ACCOUNTABLE MANAGEMENT ("PAM") TO PROVIDE MANAGEMENT SERVICES. IT WAS A RELATED COMPANY, AND THE CHIEF OFFICERS OF AHMG BECAME EMPLOYED BY PAM AT THAT TIME, MAINTAINING THEIR RESPECTIVE ROLES. ALL OFFICERS RESIGNED PRIOR TO JULY 01, 2018. FORM 990, PART VI, SECTION A, LINE 6 THE SOLE MEMBER OF THE CORPORATION IS PALOMAR POMERADO HEALTH, A CALIFORNIA HEALTH DISTRICT ORGANIZED UNDER DIVISION 23 OF THE HEALTH AND SAFETY CODE (PPH). FORM 990, PART VI, SECTION A, LINE 7A PPH PRESIDENT/CHIEF EXECUTIVE OFFICER SHALL SERVE ON THE BOARD OF ARCH HEALTH PARTNERS, INC. FOR AS LONG AS HE/SHE HOLD HIS/HER ASSOCIATED TITLE AT PPH. FORM 990, PART VI, SECTION A, LINE 7B THE APPROVAL BY THE BOARD OF THE OPERATING AND CAPITAL BUDGETS OF THE CORPORATION, AND ANY ADDITION, MODIFICATION OR DELETION TO THE OPERATING AND CAPITAL BUDGETS IN EXCESS OF $250,000, SHALL BE SUBJECT TO THE APPROVAL OF PPH. PPH MEMBERS OF THE COMMUNITY WILL BE APPOINTED TO THE BOARD UPON THE APPROVAL OF A MAJORITY OF THE BOARD, FOLLOWING NOMINATION BY ANY CURRENT MEMBER OF THE BOARD (EACH A "COMMUNITY MEMBER"), AND THE APPROVAL OF THE MEMBER. PPH MAY REMOVE ANY OR ALL DIRECTOR WITHOUT CAUSE AT ANY TIME UPON WRITTEN NOTICE TO THE BOARD. THE APPOINTMENT OR REMOVAL OF THE CEO AND THE CFO SHALL BE SUBJECT TO THE APPROVAL OF PPH. FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WAS PREPARED BY OUTSIDE ACCOUNTANTS AND IS REVIEWED BY THE EXECUTIVE DIRECTOR, PH CHIEF FINANCIAL OFFICER, AND FINANCE COMMITTEE OF THE ORGANIZATION. ONCE APPROVED, THE INFORMATIONAL RETURN IS THEN PROVIDED FOR THE REST OF THE BOARD PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REQUIRES ANNUAL DISCLOSURE OF ANY CONFLICT OF INTEREST. IF A TRANSACTION ARISES WHERE THERE IS A CONFLICT OF INTEREST, THE PERSON WITH SUCH CONFLICT IS NOT ALLOWED TO VOTE ON THE TRANSACTION. FORM 990, PART VI, SECTION B, LINE 15 CONDUCT THOROUGH JOB ANALYSIS, UPDATE JOB DESCRIPTIONS AS NEEDED, CONDUCT SALARY SURVEYS FOR RELEVANT LABOR MARKET, COMPARE DATA WITH SIMILAR EMPLOYERS IN AREA, DATA REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS, UTILIZE WRITTEN EMPLOYMENT CONTRACT OR OFFER LETTER. THIS PROCESS IS DOCUMENTED AND WAS LAST COMPLETED ON 3/1/17. FORM 990, PART VI, SECTION C, LINE 18 THE FORMS 1023 AND 990 OF THE ORGANIZATION WILL BE AVAILABLE UPON REQUEST (FOR INSPECTION OR COPYING) AT THE ORGANIZATION'S MAIN OFFICE DURING NORMAL BUSINESS HOURS. THE DOCUMENTS CAN ALSO BE FOUND AT WWW.GUIDESTAR.ORG FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATIONAL DOCUMENTS, GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS OF THE ORGANIZATION WILL BE AVAILABLE UPON REQUEST (FOR INSPECTION OR COPYING) AT THE ORGANIZATION'S MAIN OFFICE DURING NORMAL BUSINESS HOURS. FORM 990, PART IX, LINE 11G CONTRACT PHYSICIANS AND MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 84,819,983. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 84,819,983. CONSULTING FEE/PURCHASE SERVICES: PROGRAM SERVICE EXPENSES 6,010,069. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 6,010,069. FORM 990, PART XI, LINE 9: GAGAS CONSOLIDATED ADJUSTMENT 544,703. PACIFIC ACCOUNTABLE CARE LLC 15611 POMERADO ROAD NO 400 POWAY CA 92064 HEALTH CARE CA 3937640 4031423 ARCH HEALTH PARTNERS INC PACIFIC ACCOUNTABLE MANAGEMENT LLC 15611 POMERADO ROAD NO 400 POWAY CA 92064 HEALTH CARE CA SOUTH COAST INVESTMENTS INC FKA ESCONDIDO HEALTH INC RELATED 0 0 1.00000 PACIFIC ACCOUNTABLE MANAGEMENT SAN DIEGO LLC 15611 POMERADO ROAD NO 400 POWAY CA 92064 HEALTH CARE CA SOUTH COAST INVESTMENTS INC FKA ESCONDIDO HEALTH INC RELATED 0 0 1.00000 PACIFIC ACCOUNTABLE MANAGEMENT SAN FRANCISCO LLC 15611 POMERADO ROAD NO 400 POWAY CA 92064 HEALTH CARE CA PACIFIC ACCOUNTABLE MANAGEMENT LLC RELATED 0 0 1.00000 PACIFIC REGIONAL IMAGING LLC 15611 POMERADO ROAD NO 400 POWAY CA 92064 HEALTH CARE CA ARCH HEALTH PARTNERS RELATED 0 0 0.50000 SOUTH COAST INVESTMENTS INC FKA ESCONDIDO HEALTH INC 15611 POMERADO ROAD NO 400 POWAY CA 92064 HEALTH CARE CA ARCH HEALTH PARTNERS C 1.00000 1 PHS-PAM HOLDINGS INC (PHS-PAM) 15611 POMERADO ROAD NO 400 POWAY CA 92064 HEALTH CARE CA ARCH HEALTH PARTNERS C 1.00000 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0