2024-05-15T20:38:48-05:00 2023-06-30 946214841 ARMANINO LLP 2700 CAMINO RAMON STE 350 SAN RAMON CA 945835004 990 2022-07-01 943123446 CENTER FOR ELDERS' INDEPENDENCE INC CENT 5104331150 510 17TH STREET 3RD FL OAKLAND CA 94612 LAURA HOLDEN CHIEF FINANCIAL OFFICER 5104331150 2024-05-13 1 LAURA HOLDEN 999009999 1 MATTHEW PETROSKI P00853132 9257902600 2024-05-13 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z LAURA HOLDEN 510 17TH STREET 3RD FL OAKLAND CA 94612 128953406 0 X CEI.ELDERS.ORG X 1989 CA PROVIDE HIGH QUALITY, AFFORDABLE, INTEGRATED HEALTH SERVICES (CONTINUED ON SCHEDULE O)TO THE ELDERLY, WHICH PROMOTE AUTONOMY, QUALITY OF LIFE AND THE ABILITY OF INDIVIDUALS TO LIVE IN THEIR COMMUNITIES. 13 12 454 15 0 0 654932 23794 108759506 126899722 1194866 1050454 272341 -6015 110881645 127967955 0 0 0 0 36823770 38903216 0 0 366740 51180961 64610739 88004731 103513955 22876914 24454000 163334060 204699204 15368812 26697798 147965248 178001406 X PROVIDE HIGH QUALITY, AFFORDABLE, INTEGRATED HEALTH SERVICES TO THE ELDERLY, WHICH PROMOTE AUTONOMY, QUALITY OF LIFE AND THE ABILITY OF INDIVIDUALS TO LIVE IN THEIR COMMUNITIES. 0 1 97260517 126899722 THE ELDERLY CARE SERVICES PROVIDED ARE IN ACCORDANCE WITH THE PACE REGULATIONS, A FEDERAL PROGRAM AND AN OPTIONAL MEDI-CAL BENEFIT. PACE IS AN ACRONYM FOR 'PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY. CEI ASSUMES FULL RISK FOR AND DIRECTLY PROVIDES OR CONTRACTS TO PROVIDE THE FULL BENEFITS TO WHICH INDIVIDUAL ARE ENTITLED UNDER MEDICARE AND MEDI-CAL PROGRAMS, INCLUDING BUT NOT LIMITED TO PRIMARY CARE, SPECIALTY CARE, ACUTE AND SKILLED NURSING FACILITY CARE, DAY CARE, SKILLED NURSING HOME HEALTH VISITS, NON-NURSING HOME CARE, TRANSPORTATION, MEALS, SOCIAL AND PSYCHOSOCIAL SERVICES. DURING THE YEAR ENDING JUNE 30TH, 2023, CEI SERVED AN AVERAGE OF 1,067 ENROLLED MEMBERS. 97260517 1 0 0 1 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 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1 391 0 1 454 1 0 0 0 0 0 0 0 0 0 0 0 0 X 13 12 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 CA X LAURA HOLDEN 5104331150 510 17TH STREET 3RD FL OAKLAND CA 94612 MARIA ELENA ZAMORA PRESIDENT/CEO 40.00 X 457246 0 41805 JAMES MITTELBERGER CHIEF MEDICAL OFFICER 40.00 X 430601 0 22816 LAURA HOLDEN CHIEF FINANCIAL OFFICER 40.00 X 326048 0 32767 LINCOLN SISON MEDICAL DIR., GERIATRIC PROCESS EXCELLENCE 40.00 X 307967 0 35091 RAYMOND ROQUE MEDICAL DIRECTOR, CARE MANAGEMENT 40.00 X 297108 0 2961 FAITH CRUMPLER PRIMARY CARE PHYSICIAN 40.00 X 248825 0 29742 TERESA JANE KING SENIOR VICE PRESIDENT OPERATIONS 40.00 X 232910 0 10539 JUSTIN LOLA VICE PRESIDENT, IS & CLOUD SRVCS 40.00 X 191101 0 31762 THOMAS HYLAND EXECUTIVE DIRECTOR FOUNDATION 20.00 20.00 X 76966 76966 15816 FLORENCE RASKIN BOARD CHAIR 6.00 3.00 X X 0 0 0 MICHAEL HARRIS VICE CHAIR 1.00 1.00 X X 0 0 0 MICHAEL SMART PAST CHAIR 1.00 X X 0 0 0 CHIP CONRADI TREASURER 4.00 X X 0 0 0 MARTY LYNCH SECRETARY 1.00 2.00 X X 0 0 0 CAITLIN CHAN DIRECTOR 1.00 X 0 0 0 SHARON CORNU DIRECTOR 1.00 X 0 0 0 AMY KIMMEL DIRECTOR 1.00 X 0 0 0 JOANNA KIM-SELBY DIRECTOR (THRU 12/23) 1.00 X 0 0 0 DAVID LINDEMAN DIRECTOR 1.00 X 0 0 0 ANCEL ROMERO DIRECTOR 1.00 X 0 0 0 MALAIKA STOLL DIRECTOR 1.00 X 0 0 0 WILLIAM WEBSTER DIRECTOR (THRU 7/23) 1.00 X 0 0 0 2568772 76966 223299 83 0 1 0 BELLAKEN GARDEN 2780 26TH AVE OAKLAND CA 94601 SKILLED NURSING FACILITY CARE 1113602 VALE OPERATING COMPANY LP 13484 SAN PABLO AVE SAN PABLO CA 94806 SKILLED NURSING FACILITY CARE 916408 DIMOND CARE LLC 3003 FRUITVALE AVENUE OAKLAND CA 94602 SKILLED NURSING FACILITY CARE 833915 FRUITVALE HEALTHCARE CENTER 3020 E 15TH STREET OAKLAND CA 94601 SKILLED NURSING FACILITY CARE 705771 CHAPARRAL FDN HOUSE 1309 ALLSTON WAY BERKELEY CA 94702 SKILLED NURSING FACILITY CARE 641700 57 23794 23794 PREMIUMS- MEDI-CAL 623990 86387621 86387621 PREMIUMS- MEDICARE 623990 37234037 37234037 OTHER PROGRAM SERVICE 623990 2487702 2487702 SELF-PAY REVENUE 623990 790362 790362 126899722 1572218 1572218 308067 314082 -6015 -6015 -6015 149605 0 671369 149605 -671369 -521764 -521764 127967955 126899722 0 1044439 2926526 2390334 492671 43521 29163054 27627608 1378872 156574 1296643 1221346 70548 4749 3842178 3615477 209903 16798 1674815 1572120 94672 8023 115090 115090 23923 23923 39000 39000 165804 165804 4987527 4520856 420687 45984 4800202 2894882 1822936 82384 418218 411187 6225 806 3336527 2797576 538951 362297 314053 40343 7901 4395 4395 3256947 2794269 462678 1390720 1390720 CLAIMS & MEDICAL COST 39969052 39969052 PARTICIPANT EXPENSE 5399784 5399784 LOSS ON PPP LOAN 227500 227500 BAD DEBT EXPENSE 113753 113753 103513955 97260517 5886698 366740 32694126 159979 5501710 59500814 9883754 9012629 1138973 1680554 63970674 23726165 34738409 40244509 78808897 84374858 264310 0 303881 9725861 163334060 204699204 14689115 16548613 617701 0 61996 10149185 15368812 26697798 X 107496000 178001406 40469248 0 147965248 178001406 163334060 204699204 24454000 5582158 0 X 0 1 X 1 0 X 510577 958817 326338 654932 23794 2474458 79001872 85125453 95334605 108759506 126899722 495121158 333136 333136 79845585 86084270 95660943 109414438 126923516 497928752 97530 47530 70000 215060 0 97530 47530 70000 215060 497713692 9394 285338 253034 297032 1880285 2725083 9394 285338 253034 297032 1880285 2725083 79854979 86369608 95913977 109711470 128803801 500653835 0.99410 0.99600 0.00540 0.00190 X 0 0 0 0 0 0 0 0 1 39000 39000 0 PART II-B, LINE 1: HURST BROOKS ESPINOSA (HBE) PROVIDES STRATEGIC ADVICE AND ANALYSIS ON VARIOUS STATE AND LOCAL ISSUES THAT MAY IMPACT HOW CEI MANAGES THE PACE SENIOR CARE PROGRAM. HBE MAY ALSO ADVOCATE FOR MAINTAINING CEI PACE PROGRAM FINANCIAL SUPPORT DURING PERIODS OF STATE BUDGET DEFICITS. 3125104 3125104 48857297 14799288 34058009 8979046 6762029 2217017 3009227 2164848 844379 40244509 DEPOSITS PAYABLE 27660 OPERATING LEASE LIABILITIES 10066911 FINANCE LEASE LIABILITIES 54614 10149185 X 133698393 5582160 5582160 128116233 165804 -314082 -148278 127967955 103662233 314082 314082 103348151 165804 165804 103513955 PART X, LINE 2: CEI IS EXEMPT FROM INCOME TAXES UNDER SECTION 501(A) SUBSECTION (C)(3) OF THE INTERNAL REVENUE CODE AND SECTION 23701(D) OF THE CALIFORNIA REVENUE AND TAXATION CODE WHEREBY ONLY UNRELATED BUSINESS INCOME, AS DEFINED BY SECTION 512(A)(1) OF THE INTERNAL REVENUE CODE AND SIMILAR CODE SECTIONS OF THE CALIFORNIA REVENUE AND TAXATION CODE IS SUBJECT TO INCOME TAX. ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN PROVIDED FOR IN THE ACCOMPANYING FINANCIAL STATEMENTS. CEI IS REQUIRED TO FILE ANNUAL INFORMATIONAL RETURNS WITH THE INTERNAL REVENUE SERVICE AND THE CALIFORNIA FRANCHISE TAX BOARD. MANAGEMENT HAS EVALUATED ITS CURRENT TAX POSITIONS AND HAS CONCLUDED AS OF JUNE 30, 2023 AND 2022, THAT CEI DOES NOT HAVE ANY SIGNIFICANT UNCERTAIN TAX POSITIONS FOR WHICH A RESERVE WOULD BE NECESSARY. PART XI, LINE 4B - OTHER ADJUSTMENTS: RENTAL EXPENSES -314,082. PART XII, LINE 2D - OTHER ADJUSTMENTS: RENTAL EXPENSES 314,082. X X X 0 0 0 0 0 0 0 1 0 MARIA ELENA ZAMORA PRESIDENT/CEO 382246 0 75000 0 0 0 34207 0 7598 0 499051 0 0 0 JAMES MITTELBERGER CHIEF MEDICAL OFFICER 333769 0 96832 0 0 0 22816 0 0 0 453417 0 0 0 LAURA HOLDEN CHIEF FINANCIAL OFFICER 271092 0 54956 0 0 0 15899 0 16868 0 358815 0 0 0 LINCOLN SISON MEDICAL DIR., GERIATRIC PROCESS EXCE 274914 0 33053 0 0 0 28063 0 7028 0 343058 0 0 0 RAYMOND ROQUE MEDICAL DIRECTOR, CARE MANAGEMENT 273951 0 23157 0 0 0 2961 0 0 0 300069 0 0 0 FAITH CRUMPLER PRIMARY CARE PHYSICIAN 230702 0 18123 0 0 0 12874 0 16868 0 278567 0 0 0 TERESA JANE KING SENIOR VICE PRESIDENT OPERATIONS 209591 0 23319 0 0 0 10539 0 0 0 243449 0 0 0 JUSTIN LOLA VICE PRESIDENT, IS & CLOUD SRVCS 174241 0 16860 0 0 0 10317 0 21445 0 222863 0 0 0 THOMAS HYLAND EXECUTIVE DIRECTOR FOUNDATION 70923 70923 6043 6043 0 0 3661 3661 4247 4247 84874 84874 0 0 PART I, LINE 3 THE BOARD OF DIRECTORS APPROVES THE SALARY FOR THE EXECUTIVES. FOR NEW EXECUTIVE EMPLOYEES, GENERALLY, A WAGE AND SALARY SURVEY IS CONDUCTED TO IDENTIFY COMPETITIVE RATES OF COMPENSATION PAID TO EMPLOYEES PERFORMING SIMILAR DUTIES AND HAVING SIMILAR RESPONSIBILITIES IN A SIMILAR ORGANIZATION. SIMILAR REFERS TO SUCH THINGS AS THE LEVEL OF THE POSITION WITHIN THE ORGANIZATION, OVERALL BUDGET OF THE ORGANIZATION, AND AN ANALYSIS OF THE LEVEL DEFINING CHARACTERISTICS OF THE JOB. THE BOARD CONSIDERS ALL THE FACTORS (INCLUDING THE POTENTIAL EMPLOYEES' CURRENT LEVEL OF COMPENSATION, LOCATION, AND OTHER RELEVANT FACTORS) AND AFTER NEGOTIATION WITH THE POTENTIAL EXECUTIVE EMPLOYEE, ARRIVES AT THE COMPENSATION TO BE PAID. INCREASES ARE PERIODICALLY CONSIDERED BY THE BOARD AND, IF REQUESTED, ADDITIONAL WAGE AND SALARY INFORMATION IS OBTAINED. PART I, LINE 7 ALL CORPORATE DISCRETIONARY BONUSES ARE NON-FIXED PAYMENTS. THERE IS NO CONTRACT FOR ANY EMPLOYEE TO RECEIVE A BONUS IN EXCHANGE FOR PROVIDING SERVICES. FORM 990, PART III, LINE 3 IN FEB 2023, CEI CLOSED THE GUARDIAN ADULT DAY HEALTH CENTER FACILITY. FORM 990, PART VI, SECTION B, LINE 11B A DRAFT COPY OF THE 990 PROVIDED TO BOARD MEMBERS FOR REVIEW PRIOR TO FILING. ALL QUESTIONS AND COMMENTS ARE ADDRESSED PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C ALL CEI OFFICERS, DIRECTORS, TRUSTEES, AND KEY EMPLOYEES ARE COVERED UNDER THE CEI CONFLICT OF INTEREST POLICY. FOR POTENTIAL CONFLICTS OF INTEREST INVOLVING STAFF EMPLOYEES AND RELATIVES, EITHER THE HR DIRECTOR OR THE CEO WILL REVIEW. FOR POTENTIAL CONFLICTS OF INTEREST INVOLVING SENIOR MANAGEMENT OR A BOARD MEMBER, THE CHAIRPERSON OF THE GOVERNING BOARD OR COMMITTEE SHALL, IF APPROPRIATE, APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT. A BOARD MEMBER HAS A DUTY TO DISCLOSE ANY POTENTIAL CONFLICT OF INTEREST TO HIS/HER GOVERNING BOARD OR COMMITTEE. AFTER DISCLOSURE OF THE FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, HE/SHE SHALL LEAVE THE GOVERNING BOARD OR COMMITTEE MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. ALL CEI OFFICERS, DIRECTORS, TRUSTEES, AND KEY EMPLOYEES ARE REQUIRED TO DISCLOSE OR UPDATE ANNUALLY VIA A QUESTIONNAIRE, INFORMATION REGARDING THEIR INTERESTS AND THOSE OF THEIR FAMILY MEMBERS THAT COULD GIVE RISE TO CONFLICTS OF INTEREST, SUCH AS A LIST OF FAMILY MEMBERS, SUBSTANTIAL BUSINESS OR INVESTMENT HOLDINGS, AND OTHER TRANSACTIONS OR AFFILIATIONS WITH BUSINESSES AND OTHER ORGANIZATIONS AND THOSE OF FAMILY MEMBERS. IN ADDITION, ALL TRANSACTIONS, INCLUDING LEASING ARRANGEMENTS AND CONTRACTUAL AGREEMENTS, ARE SUBJECT TO REVIEW BY THE DIRECTOR OF COMPLIANCE AND CONTRACTS AND/OR THE BOARD OF DIRECTORS OF CEI. CONFLICTS OF INTEREST SHOULD BE DISCOVERED BEFORE THE TRANSACTION HAS OCCURRED. FORM 990, PART VI, SECTION B, LINE 15 THE BOARD OF DIRECTORS APPROVES THE SALARY FOR THE EXECUTIVES. FOR NEW EXECUTIVE EMPLOYEES, GENERALLY, A WAGE AND SALARY SURVEY IS CONDUCTED TO IDENTIFY COMPETITIVE RATES OF COMPENSATION PAID TO EMPLOYEES PERFORMING SIMILAR DUTIES AND HAVING SIMILAR RESPONSIBILITIES IN A SIMILAR ORGANIZATION. SIMILAR REFERS TO SUCH THINGS AS THE LEVEL OF THE POSITION WITHIN THE ORGANIZATION, OVERALL BUDGET OF THE ORGANIZATION, AND AN ANALYSIS OF THE LEVEL DEFINING CHARACTERISTICS OF THE JOB. THE BOARD CONSIDERS ALL THE FACTORS (INCLUDING THE POTENTIAL EMPLOYEES' CURRENT LEVEL OF COMPENSATION, LOCATION, AND OTHER RELEVANT FACTORS) AND AFTER NEGOTIATION WITH THE POTENTIAL EXECUTIVE EMPLOYEE, ARRIVES AT THE COMPENSATION TO BE PAID. INCREASES ARE PERIODICALLY CONSIDERED BY THE BOARD AND, IF REQUESTED, ADDITIONAL WAGE AND SALARY INFORMATION IS OBTAINED. FORM 990, PART VI, SECTION C, LINE 19 FORM 990, GOVERNING DOCUMENTS, POLICIES, AND ANNUAL FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. CEI FOUNDATION 510 17TH STREET OAKLAND CA 94612 611655955 HEALTH SERVICES CA 501(C)(3) LINE 12B, II CENTER FOR ELDERS' INDEPENDENCE INC 1 OVER 60CEI INC PO BOX 11247 BERKELEY CA 94712 943305198 HEALTH SERVICES CA 501(C)(3) LINE 12A, I CENTER FOR ELDERS' INDEPENDENCE INC 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 OVER60CEI INC A 97210 PREPAID RENT AMORT. SCHEDULE CEI FOUNDATION Q 1408560 PER SERVICE LEVEL AGREEMENT