2025-02-04T16:25:09-06:00 2024-03-31 952302617 SINGERLEWAK LLP 10960 WILSHIRE BLVD SUITE 1100 LOS ANGELES CA 90024 990 2023-04-01 953514918 ARROYO VISTA FAMILY HEALTH FOUNDATION ARRO 3232545291 6000 N FIGUEROA STREET LOS ANGELES CA 90042 JLORRAINE ESTRADAS CEO 3232545291 2025-01-24 1 1 LIOR TEMKIN P00748170 3104773924 2025-01-24 2023 2025-03-06 01:10:19Z JLORRAINE ESTRADAS 6000 N FIGUEROA STREET LOS ANGELES CA 90042 23481067 0 X WWW.ARROYOVISTA.ORG X 1980 CA TO MEET THE CURRENT AND FUTURE HEALTH NEEDS OF GREATER NORTHEAST LOS ANGELES BY PROVIDING HIGH QUALITY, COMPREHENSIVE AND AFFORDABLE HEALTH SERVICES IN A COMPASSIONATE AND FINANCIALLY RESPONSIBLE MANNER. 9 9 224 9 0 0 9270643 7060794 16279246 15520348 155355 434772 318521 465153 26023765 23481067 0 0 0 0 16431529 17361171 0 0 9271 6954384 7885961 23385913 25247132 2637852 -1766065 42306882 37777798 16074755 13625780 26232127 24152018 X TO MEET THE CURRENT AND FUTURE HEALTH NEEDS OF GREATER NORTHEAST LOS ANGELES BY PROVIDING HIGH QUALITY, COMPREHENSIVE AND AFFORDABLE HEALTH SERVICES IN A COMPASSIONATE AND FINANCIALLY RESPONSIBLE MANNER. 0 0 21400503 15964501 SEE SCHEDULE O 21400503 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 27 0 1 224 1 0 0 0 0 0 1 1 0 0 0 0 0 0 X 9 9 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X X JOHN L ANSALDO CFO 3232545291 6000 N FIGUEROA STREET LOS ANGELES CA 90042 PETER FERNANDEZ BOARD MEMBER 2.50 X 0 0 0 ARMANDO HERNANDEZ BOARD MEMBER 2.50 X 0 0 0 MARIA DEL ROSARIO MARTINEZ BOARD MEMBER 2.50 X 0 0 0 TERESITA MEZA BOARD MEMBER 2.50 X 0 0 0 NATO FLORES BOARD MEMBER 2.50 X 0 0 0 SERGIO TEJADILLA BOARD TREASURER / MEMBER 2.50 X X 0 0 0 ROGER ESTRADA BOARD PRESIDENT / MEMBER 2.50 X X 0 0 0 RACHAEL LOPEZ-KINNEY BOARD SECRETARY / MEMBER 2.50 X X 0 0 0 CARLOS ZARAGOZA ESQ BOARD VICE-PRESIDENT / MEM 2.50 X X 0 0 0 JOHN L ANSALDO CHIEF FINANCIAL OFFICER 40.00 X 256913 0 17178 J LORRAINE ESTRADAS RN CHIEF EXECUTIVE OFFICER 40.00 X 345692 0 26094 THUY Q PHAM MD CHIEF MEDICAL OFFICER 40.00 X 309187 0 26457 HASSAN HALAWI MD PHYSICIAN 40.00 X 222293 0 9712 FRANKLIN NGUYEN MD PHYSICIAN 40.00 X 259756 0 24358 JESSICA WONG MD PHYSICIAN 32.00 X 214867 0 5372 DARYOUSH YEROSHALMI MD PHYSICIAN 32.00 X 214166 0 17217 ERIN KIMBERLY HERNDON MD PHYSICIAN 40.00 X 224045 0 22192 2046919 0 148580 8 0 1 0 HUNTINGTON EL SERENO LLC 1180 S BEVERLY DR SUITE 300 LOS ANGELES CA 90035 FACILITY RENT 625657 LOAN ADMINISTRATION NETWORK INC 2082 BUSINESS CENTER DRIVE SUITE 2 IRVINE CA 92612 TEMPORARY SERVICES 444728 LATARA ENTERPRISE INC 1716 W HOLT AVENUE POMONA CA 91768 CLINICAL LABORATORY & PATHOLOGY SERVICES 326787 THOMAS MILAM MD INC (IRIS TELEHEALTH) POBOX 25732 PASADENA CA 91185 BEHAVIORAL SERVICES PROVIDERS 117247 TERESA HOANG 565 EAST SAN JOSE AVENUE APT304 BUBANK CA 91501 CONSULTANT 116487 7 5510348 1550446 1316363 7060794 PATIENT FEES 621400 13194282 13194282 INCENTIVE-BASED REVENUE 621400 1878492 1878492 PRESCRIPTION DRUG PROGRAM 621400 447574 447574 15520348 434772 434772 21000 0 21000 21000 21000 OTHER INCOME 900099 444153 444153 444153 23481067 15964501 0 455772 1051299 290493 760385 421 13488739 12135398 1350464 2877 1765220 1548936 215897 387 1055913 904996 150678 239 120 120 84121 84121 1570645 1364902 200396 5347 429228 81476 347752 1410621 1036267 374354 17178 14909 2269 374638 306949 67689 187337 72000 115337 SUPPLIES 2655675 2642549 13126 UTILITIES 531107 402786 128321 LABORATORY 425226 425226 REPAIRS AND MAINTENANCE 173545 157208 16337 26520 16408 10112 25247132 21400503 3837358 9271 X 550717 230130 18881007 17101905 780809 2438 903190 949908 3591075 2888376 11607541 7330562 4441788 4276979 13158296 12328062 42306882 37777798 3041790 2390509 13032965 11235271 16074755 13625780 X 22879472 21240630 3352655 2911388 26232127 24152018 42306882 37777798 X -1766065 97185 -411227 -2 X 0 1 X 1 1 1 X 5483823 7589627 10507696 9270643 7060794 39912583 5483823 7589627 10507696 9270643 7060794 39912583 39912583 188190 48039 24928 155355 455772 872284 544428 1471060 693753 297521 444153 3450915 44235782 67562999 0.90230 0.90360 X SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: 2017 OTHER INCOME 537358 2018 OTHER INCOME 423043 2019 OTHER INCOME 544428 2020 OTHER INCOME 1471060 2021 OTHER INCOME 693753 2022 OTHER INCOME 297521 2023 OTHER INCOME 444153 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 529084 529084 5096443 2385247 2711196 1510563 1044630 465933 4034527 3516997 517530 436924 383688 53236 4276979 CONTRIBUTION RECEIVABLE 2880981 RIGHT-OF-USE ASSET 9447081 12328062 DUE TO THIRD PARTY PAYERS 1508733 OPERATING LEASE 9726538 11235271 X 23578252 97185 97185 23481067 0 23481067 25658359 411227 411227 25247132 0 25247132 PART X, LINE 2: THE FOUNDATION HAS BEEN DESIGNATED AS TAX EXEMPT UNDER INTERNAL REVENUE CODE SECTION 501(C)(3), IS ALSO EXEMPT FROM STATE FRANCHISE TAXES UNDER SECTION 23701(D) OF THE CALIFORNIA REVENUE AND TAXATION CODE, AND IS NOT GENERALLY SUBJECT TO FEDERAL OR STATE INCOME TAXES. HOWEVER, THE FOUNDATION IS SUBJECT TO INCOME TAXES ON ANY NET INCOME THAT IS DERIVED FROM A TRADE OR BUSINESS, REGULARLY CARRIED ON, AND NOT IN FURTHERANCE OF, THE PURPOSES FOR WHICH IT WAS GRANTED EXEMPTION. NO INCOME TAX PROVISION HAS BEEN RECORDED AS THE NET INCOME, IF ANY, FROM ANY UNRELATED TRADE OR BUSINESS, AND IN THE OPINION OF MANAGEMENT, IS NOT MATERIAL TO THE BASIC FINANCIAL STATEMENTS TAKEN AS A WHOLE. THE FOUNDATION RECOGNIZES THE IMPACT OF TAX POSITIONS IN THE FINANCIAL STATEMENTS IF THAT POSITION IS MORE LIKELY THAN NOT TO BE SUSTAINED ON AUDIT, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE FOUNDATION HAS DETERMINED THAT THERE ARE NO UNRECOGNIZED TAX BENEFITS. X 0 0 0 0 0 0 0 0 0 J LORRAINE ESTRADAS RN CHIEF EXECUTIVE OFFICER 345692 0 0 0 0 0 12200 0 13894 0 371786 0 0 0 THUY Q PHAM MD CHIEF MEDICAL OFFICER 309187 0 0 0 0 0 12200 0 14257 0 335644 0 0 0 FRANKLIN NGUYEN MD PHYSICIAN 258756 0 1000 0 0 0 10609 0 13749 0 284114 0 0 0 JOHN L ANSALDO CHIEF FINANCIAL OFFICER 256913 0 0 0 0 0 8300 0 8878 0 274091 0 0 0 ERIN KIMBERLY HERNDON MD PHYSICIAN 223045 0 1000 0 0 0 9249 0 12943 0 246237 0 0 0 HASSAN HALAWI MD PHYSICIAN 221293 0 1000 0 0 0 9251 0 461 0 232005 0 0 0 DARYOUSH YEROSHALMI MD PHYSICIAN 213166 0 1000 0 0 0 8335 0 8882 0 231383 0 0 0 JESSICA WONG MD PHYSICIAN 213867 0 1000 0 0 0 5372 0 0 0 220239 0 0 0 X 1 1316363 COST 0 0 0 FORM 990, PART I, LINE 8, CONTRIBUTIONS AND GRANTS THE DECLINE OF MORE THAN 10% OF THE CONTRIBUTIONS AND GRANTS THIS YEAR COMPARED TO PRIOR YEAR WAS DUE TO THE EXPIRATION OF PANDEMIC RELATED FUNDING MAINLY THE HRSA-ARPA GRANT. FORM 990, PART I, LINE 10, INVESTMENT INCOME THE INCREASE IN INVESTMENT INCOME THIS YEAR COMPARED TO PRIOR YEAR WAS DUE MAINLY TO THE HIGH YIELDS ON BANK DEPOSITS AND INVESTMENTS. PART FORM 990, PART I, LINE 11, OTHER REVENUE THE INCREASE OF MORE THAN 10% OF THE OTHER REVENUE THIS YEAR COMPARED TO PRIOR YEAR WAS DUE TO HIGHER THAN ANTICIPATED PAY FOR PERFORMANCE INCENTIVES FROM HEALTH PLANS. FORM 990, PART III, LINE 4A, PROGRAM SERVICE ACCOMPLISHMENTS: MADE FOR THE COMMUNITY, BY THE COMMUNITY, ARROYO VISTA FAMILY HEALTH CENTER IS A NON-PROFIT COMMUNITY HEALTH CENTER GOVERNED BY A CONSUMER BOARD OF DIRECTORS WITH A TRUSTED TEAM OF HEALTHCARE PROFESSIONALS SERVING THE GREATER NORTHEAST LOS ANGELES SINCE 1981. WE ARE LICENSED BY THE STATE OF CALIFORNIA DEPARTMENT OF HEALTH SERVICES. AS A FEDERALLY QUALIFIED HEALTH CENTER, FUNDING IS PROVIDED THROUGH PUBLIC HEALTH SERVICES ACT, SECTION 330, WITH ADDITIONAL FUNDING FROM LOS ANGELES COUNTY AND PRIVATE SOURCES. WE ARE ACCREDITED BY THE JOINT COMMISSION, WHICH MEANS THAT ARROYO VISTA HAS BEEN RIGOROUSLY INSPECTED, TESTED AND EVALUATED. WE ARE NATIONALLY RECOGNIZED FOR THE HIGHEST LEVEL OF PATIENT SAFETY AND QUALITY OF CARE. AS A CERTIFIED PRIMARY CARE MEDICAL HOME BY THE JOINT COMMISSION, WE FOLLOW CARE COORDINATION AND INTERDISCIPLINARY TEAM CARE MODEL FOR THE PROVISION OF SERVICES. FROM OUR HUMBLE BEGINNING IN 1981 AS A SMALL STOREFRONT CLINIC, WE HAVE GROWN TO A NETWORK OF FOUR HEALTH CENTERS AND A MOBILE CLINIC SERVING EVERY MEMBER OF THE COMMUNITY, WITH OVER 102,000 PATIENT VISITS IN 2023. ARROYO VISTA PROVIDES A COMPREHENSIVE RANGE OF MEDICAL, DENTAL, OPTOMETRY, BEHAVIORAL HEALTH, IMAGING, ENHANCED CARE MANAGEMENT AND PHARMACEUTICAL SERVICES. OUR SERVICES ARE DESIGNED FOR ALL AGES, FROM INFANTS AND CHILDREN, TO TEENS, ADULTS, AND THE ELDERLY. MANY SERVICES ARE PROVIDED AT NO COST, INCLUDING HEALTH EDUCATION, ANNUAL FLU VACCINE CLINICS, IMMUNIZATION FOR CHILDREN, ANNUAL HEALTH FAIR SCREENINGS, AS WELL AS COVID-19 TESTS AND VACCINES. WE ALSO PROVIDE TRANSPORTATION ASSISTANCE AND APPLICATION SUPPORT FOR MEDI-CAL, MEDICARE, AND COVERED CA. SERVICES ARE PROVIDED TO OUR VALUED PATIENTS REGARDLESS OF ABILITY TO PAY. PATIENTS WHO ARE ELIGIBLE FOR SLIDING SCALE DISCOUNTS WILL RECEIVE DISCOUNTS ON PROFESSIONAL AND IMAGING SERVICES. PATIENTS WITH OR WITHOUT INSURANCE, MEDI-CAL AND MEDICARE.....EVERYONE IS WELCOME AT ARROYO VISTA. OUR SERVICES ARE PROVIDED IN A CULTURALLY SENSITIVE, LINGUISTICALLY APPROPRIATE AND COMPASSIONATE MANNER. MANY OF OUR DOCTORS, NURSES, AND ADMINISTRATIVE STAFF COME FROM THE LOCAL COMMUNITY, AND MANY OF US INCLUDING OUR BOARD MEMBERS ARE ALSO PATIENTS OF ARROYO VISTA. FORM 990, PART VI, SECTION B, LINE 11B EXPLANATION: THE INFORMATIONAL RETURN IS PREPARED BY AN OUTSIDE ACCOUNTANT. IT IS THEN REVIEWED BY THE CFO. ONCE APPROVED, THE RETURN IS PROVIDED TO THE BOARD OF DIRECTORS BEFORE IT IS E-FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C EXPLANATION: ARROYO VISTA BOARD MEMBERS SHALL COMPLETE A DIRECTOR QUESTIONNAIRE ANNUALLY CONFIRMING THEIR INDEPENDENT STATUS AND COMPLIANCE WITH THE AGENCY'S CONFLICT OF INTEREST POLICY. FORM 990, PART VI, SECTION B, LINE 15 EXPLANATION: ARROYO VISTA'S PERSONNEL COMMITTEE HAS RESPONSIBILITY FOR THE REVIEW OF PERSONNEL POLICIES AND PROCEDURES INCLUDING COMPENSATION AND BENEFIT PROGRAMS. ARROYO VISTA EXECUTIVE COMMITTEE'S RESPONSIBILITIES INCLUDE YEARLY EVALUATION OF THE CHIEF EXECUTIVE OFFICER'S PERFORMANCE AND COMPENSATION, WHICH IS THEN PRESENTED TO THE FULL BOARD OF DIRECTORS FOR FINAL REVIEW AND APPROVAL. OTHER OFFICERS AND KEY EMPLOYEES UNDERGO AN ANNUAL APPRAISAL REVIEW TO DETERMINE PROMOTION TO A HIGHER PAY LEVEL OR FOR MERIT INCREASES. THE CEO WILL MAKE THE DECISION ON MERIT INCREASES BASED ON THE SUPERVISOR'S AND/OR EXECUTIVE'S RECOMMENDATION AND EMPLOYEE PERFORMANCE AT THE TIME OF THE APPRAISAL REVIEW. FORM 990, PART VI, SECTION C, LINE 19 EXPLANATION: ARROYO VISTA MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST, AND TO INDEPENDENT AUDITORS DURING THEIR ANNUAL INDEPENDENT FINANCIAL AUDIT. FORM 990, PART X, LINE 15, OTHER ASSETS AT MARCH 31, 2018, THE FOUNDATION HAD A RECEIVABLE THAT REPRESENTED UNCONDITIONAL PROMISES TO USE THE FACILITY LOCATED AT 6000 NORTH FIGUEROA STREET, LOS ANGELES, CA 90042, FROM THE CITY OF LOS ANGELES, DEPARTMENT OF GENERAL SERVICES (THE "CITY"). THE INITIAL TERM OF THE AGREEMENT WAS FOR THE RENT-FREE USE OF THE BUILDING FOR 20 YEARS STARTING IN JUNE 1987. THE AGREEMENT WAS AMENDED IN OCTOBER 2014, AND THE LEASE WAS RENEWED FOR ANOTHER 15 YEARS AT A NOMINAL RENT OF $1 PER YEAR. THE FOUNDATION USES THE PREMISES FOR THE PRIMARY OBJECTIVE OF PROVIDING HEALTH CARE SERVICES TO THE COMMUNITY. AS OF MARCH 31, 2024, THE BALANCE FOR THE RECEIVABLE IS $2,880,981. FORM 990, PART XI, LINE 9: ROUNDING -2.