2023-11-15T15:38:12-06:00 2022-12-31 910189318 MOSS ADAMS LLP 101 SECOND STREET SUITE 900 SAN FRANCISCO CA 94105 990 2022-01-01 264826604 MONTAGE MEDICAL GROUP MONT 8317189720 PO BOX HH MONTEREY CA 93942 MATT MORGAN VP, CFO 8317189720 2023-11-14 1 MATT MORGAN 999009999 0 LESLIE VAN P01294411 4159561500 2023-11-14 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z STEVEN PACKER PO BOX HH MONTEREY CA 93942 35998443 0 X WWW.MONTAGEMEDICALGROUP.ORG X 2009 CA TO PROVIDE HEALTH CARE FOR THE GENERAL PUBLIC, CARRY ON ANY EDUCATIONAL ACTIVITIES RELATED TO RENDERING CARE TO THE SICK OR INJURED, AND TO PARTICIPATE IN SCIENTIFIC HEALTHCARE-RELATED RESEARCH TO PROMOTE THE GENERAL HEALTH OF THE COMMUNITY. 8 4 357 4 0 0 18481600 3298140 32286089 27405966 0 0 4102529 5294337 54870218 35998443 0 0 0 0 39926949 45726301 0 0 0 18485756 15449441 58412705 61175742 -3542487 -25177299 6246074 4884874 56073519 79889618 -49827445 -75004744 TO PROVIDE HEALTH CARE FOR THE GENERAL PUBLIC, CARRY ON ANY EDUCATIONAL ACTIVITIES RELATED TO RENDERING CARE TO THE SICK OR INJURED, AND TO PARTICIPATE IN SCIENTIFIC HEALTHCARE-RELATED RESEARCH TO PROMOTE THE GENERAL HEALTH OF THE COMMUNITY. 0 0 56978270 27405966 DIRECT CLINICAL SERVICES. 56978270 1 1 0 0 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 0 0 0 1 41 0 1 357 1 0 0 0 0 0 0 0 0 0 0 0 0 X 8 4 0 1 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 CA X SHIRLEY NORMAN 8312428605 PO BOX HH MONTEREY CA 93942 STEVEN PACKER MD DIRECTOR & PRESIDENT 10.00 45.00 X X 0 1274632 1321268 LAURA ZEHM DIRECTOR (THRU 7/22) 1.00 54.00 X 0 922761 148744 KATHLEEN CHASE MD DIRECTOR 55.00 X 409920 0 12200 THOMAS CUNNINGHAM MD DIRECTOR 55.00 X 366946 0 12200 GURU KHALSA MD DIRECTOR 5.00 6.00 X 0 99324 0 STAN MCKEE CHAIR 9.00 2.00 X X 0 0 0 RANDALL CHARLES VICE CHAIR 2.00 5.00 X X 0 0 0 JACK JEWETT DIRECTOR 2.00 X 0 0 0 WAYNE MOON DIRECTOR 2.00 X 0 0 0 MARK CARVALHO MD CEO 45.00 10.00 X 0 734097 108924 MATTHEW MORGAN VP, CFO 2.00 53.00 X 0 670563 129446 STEVEN LOME DO PHYSICIAN 55.00 X 978698 0 22315 MARK VIERRA MD PHYSICIAN 55.00 X 905620 0 20287 STEVEN CHANG MD PHYSICIAN 55.00 X 896214 0 21974 GREGORY SPOWART MD PHYSICIAN 55.00 X 844921 0 8087 AMBREEN LAEEQ MD PHYSICIAN 55.00 X 822500 0 1926 5224819 3701377 1807371 85 0 1 0 CYPRESS HEALTHCARE PARTNERS 100 WILSON ROAD SUITE 100 MONTEREY CA 93940 MANAGEMENT SERVICES 2897652 EXECUTIVE CONSULTING GROUP 11512 EL CAMINO REAL SUITE 20 SAN DIEGO CA 92130 CONSULTING SERVICES 281339 TRINITY MAINTENANCE SERVICES 820 PARK ROW SUITE 463 SALINAS CA 93901 MAINTENANCE SERVICES 113580 3 3298140 3298140 NET PATIENT REVENUE 621110 27392386 27392386 CAPITATION 900099 13580 13580 27405966 OTHER REVENUE 900099 5294337 5294337 5294337 35998443 27405966 0 5294337 801266 801266 37898931 35304485 2594446 462919 324043 138876 4646534 4549085 97449 1916651 1724986 191665 2949943 2507452 442491 5954797 5399608 555189 542539 515412 27127 3309000 3287883 21117 533511 506835 26676 MEDICAL SUPPLIES 2150695 2048981 101714 CAPITATION EXPENSE 8956 8234 722 61175742 56978270 4197472 0 1452251 1340331 2543694 2452155 109298 58043 5357904 4344575 1219853 1013329 920978 21016 6246074 4884874 4831526 4186103 51241993 75703515 56073519 79889618 X -49827445 -75004744 -49827445 -75004744 6246074 4884874 -25177299 0 X 0 1 X 1 0 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 279883 226949 52934 5078021 4117626 960395 1013329 INTERCOMPANY PAYABLES 75703515 75703515 X PART X, LINE 2: THE ORGANIZATION ASSESSES UNCERTAIN TAX POSITIONS IN ACCORDANCE WITH THE PROVISIONS OF THE FASB ASC TOPIC 740-10, INCOME TAXES. THE ORGANIZATION RECOGNIZES THE TAX BENEFIT FROM UNCERTAIN TAX POSITIONS ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITIONS WILL BE SUSTAINED ON EXAMINATION BY THE TAX AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFIT IS MEASURED BASED ON THE LARGEST BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. THE ORGANIZATION RECOGNIZES INTEREST AND PENALTIES RELATED TO INCOME TAX MATTERS IN OPERATING EXPENSES. THERE WERE NO UNCERTAIN TAX POSITIONS AS OF DECEMBER 31, 2022 AND 2021. 0 1 0 0 0 1 1 1 0 STEVEN PACKER MD DIRECTOR & PRESIDENT 0 901101 0 314500 0 59031 0 1289098 0 32170 0 2595900 0 0 LAURA ZEHM DIRECTOR (THRU 7/22) 0 307200 0 186885 0 428676 0 131289 0 17455 0 1071505 0 0 STEVEN LOME DO PHYSICIAN 400000 0 578698 0 0 0 12200 0 10115 0 1001013 0 0 0 MARK VIERRA MD PHYSICIAN 848682 0 56938 0 0 0 12200 0 8087 0 925907 0 0 0 STEVEN CHANG MD PHYSICIAN 705142 0 191072 0 0 0 12200 0 9774 0 918188 0 0 0 GREGORY SPOWART MD PHYSICIAN 710000 0 134921 0 0 0 0 0 8087 0 853008 0 0 0 MARK CARVALHO MD CEO 0 528344 0 144935 0 60818 0 61244 0 47680 0 843021 0 0 AMBREEN LAEEQ MD PHYSICIAN 750000 0 72500 0 0 0 0 0 1926 0 824426 0 0 0 MATTHEW MORGAN VP, CFO 0 494044 0 142065 0 34454 0 79417 0 50029 0 800009 0 0 KATHLEEN CHASE MD DIRECTOR 343417 0 66503 0 0 0 12200 0 0 0 422120 0 0 0 THOMAS CUNNINGHAM MD DIRECTOR 340000 0 26946 0 0 0 12200 0 0 0 379146 0 0 0 PART I, LINE 3 A RELATED ORGANIZATION HAS A COMPENSATION COMMITTEE OF THE BOARD OF TRUSTEES THAT REVIEWS AND APPROVES THE OFFICERS' COMPENSATION. A CONSULTING FIRM IS ENGAGED TO PROVIDE COMPARABLE DATA. PART I, LINE 4B STEVEN PACKER PARTICIPATED IN A 457(F) PLAN AND NO PAYMENT WAS RECEIVED IN 2022. PART I, LINE 6 MANAGEMENT INCENTIVE PLANS HAVE A PERCENTAGE OF THE INCENTIVE PACKAGE THAT ARE BASED ON THE FINANCIAL RESULTS OF THE FILING ORGANIZATION AND RELATED ORGANIZATIONS. PART I, LINE 7 PART OF THE INCENTIVE PACKAGES FOR MANAGEMENT ARE BASED ON MEETING PERFORMANCE GOALS DURING THE YEAR. FORM 990, PART VI, SECTION A, LINE 3 CYPRESS HEALTHCARE IS A PROFESSIONAL PHYSICIAN MANAGEMENT COMPANY. WHEN THE FORMER EXECUTIVE DIRECTOR LEFT, CYPRESS HEALTHCARE ASSUMED SOME OF THE RESPONSIBILITIES OF THE ED. FORM 990, PART VI, SECTION A, LINE 6 MONTAGE HEALTH IS THE SOLE CORPORATE MEMBER OF MONTAGE MEDICAL GROUP. FORM 990, PART VI, SECTION A, LINE 7A MONTAGE HEALTH HAS THE RIGHT TO ELECT AND APPOINT THE DIRECTORS OF MONTAGE MEDICAL GROUP. FORM 990, PART VI, SECTION A, LINE 7B THE FOLLOWING GOVERNANCE DECISIONS ARE RESERVED FOR MONTAGE HEALTH: (A) THE MERGER, CONSOLIDATION OR DISSOLUTION OF THE CORPORATION; (B) THE AMENDMENT OR RESTATEMENT OF THE ARTICLES OF INCORPORATION OR THE BYLAWS OF THE CORPORATION; (C) THE AGGREGATE BORROWING FOR ANY PURPOSE OF AN AMOUNT IN EXCESS OF A DOLLAR AMOUNT TO BE ESTABLISHED BY MONTAGE HEALTH FROM TIME TO TIME. FOR PURPOSES OF THIS SUBSECTION, AGGREGATE BORROWING INCLUDES, BUT IS NOT LIMITED TO, LEASE AGREEMENTS AND CONTRACTS OF SALE OR PURCHASE; (D) THE PURCHASE, SALE, LEASE, DISPOSITION, EXCHANGE, GIFT, PLEDGE OR ENCUMBRANCE OF ANY ASSET, REAL OR PERSONAL, OF THE CORPORATION WITH A VALUE IN EXCESS OF A DOLLAR AMOUNT TO BE ESTABLISHED BY MONTAGE HEALTH FROM TIME TO TIME; (E) THE APPROVAL OF ANY TRANSACTION OF THE CORPORATION IN WHICH A DIRECTOR OR OFFICER OF THE CORPORATION HAS A MATERIAL FINANCIAL INTEREST; (F) THE APPOINTMENT OF LEGAL COUNSEL AND AUDITORS FOR THE CORPORATION; (G) THE APPOINTMENT OF THE AUDIT COMMITTEE FOR THE CORPORATION; (H) THE ESTABLISHMENT OF LONG RANGE GOALS, PLANS AND STRATEGIES FOR THE CORPORATION; (I) THE APPOINTMENT OR REMOVAL OF THE PRESIDENT/CHIEF EXECUTIVE OFFICER OF THE CORPORATION; (J) THE APPROVAL OF THE EXACT NUMBER OF AUTHORIZED DIRECTORS WITHIN THE VARIABLE RANGE ESTABLISHED PURSUANT TO SECTION 2 OF ARTICLE IV OF THESE BYLAWS; AND (K) THE FILLING OF ANY VACANCY ON THE BOARD OF DIRECTORS, INCLUDING, WITHOUT LIMITATION, ANY VACANCY CREATED BY THE REMOVAL OF A DIRECTOR. FORM 990, PART VI, SECTION B, LINE 11B THE CFO AND VP FINANCE IS RESPONSIBLE FOR REVIEWING THE FORM 990 BEFORE FILING. ELECTRONIC COPIES ARE SENT TO ALL BOARD MEMBERS FOR REVIEW PRIOR TO FILING. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION USES SELF DISCLOSURE BY INTERESTED PERSONS AND MONITORS AND ENFORCES COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC BY REQUEST. MONTAGE HEALTH PO BOX HH MONTEREY CA 93942 942789696 SUPPORT SERVICES CA 501(C)(3) LINE 7 N/A 0 COMMUNITY HOSPITAL OF THE MONTEREY PENINSULA PO BOX HH MONTEREY CA 93942 940760193 HEALTHCARE SERVICES CA 501(C)(3) LINE 3 MONTAGE HEALTH 0 ASPIRE HEALTH PLAN 10 RAGSDALE DRIVE SUITE 101 MONTEREY CA 93940 461567681 INSURANCE COMPANY CA 501(C)(4) N/A MONTAGE HEALTH 0 MONTAGE HEALTH FOUNDATION PO BOX HH MONTEREY CA 93942 812889645 SUPPORT SERVICES CA 501(C)(3) LINE 7 MONTAGE HEALTH 0 MOGO URGENT CARE PO BOX HH MONTEREY CA 93942 832329260 MEDICAL SERVICES CA 501(C)(3) LINE 3 MONTAGE HEALTH 0 CENTRAL COAST HEALTH CONNECT LLC 10 RAGSDALE DRIVE SUITE 102 MONTEREY CA 93940 611759835 HEALTH SERVICES CA N/A 0 0 SAN CARLOS & 7TH LLC 23625 HOLMAN HIGHWAY MONTEREY CA 93940 274672809 REAL ESTATE CA N/A 0 0 MONTEREY BAY ENDOSCOPY CENTER LLC 23625 HOLMAN HIGHWAY MONTEREY CA 93940 770324855 ENDOSCOPY CENTER CA N/A 0 0 CYPRESS MEDICAL NETWORK INC PO BOX HH MONTEREY CA 93942 770438780 INACTIVE CA N/A C 0 CENTRAL COAST COMMUNITY MUTUAL INSURANCE COMPANY 40 MAIN STREET SUITE 200 BURLINGTON VT 05401 454016797 INSURANCE VT N/A C 0 COASTAL TPA INC PO BOX 80308 SALINAS CA 93912 770523382 MEDICAL CLAIMS PROCESSING CA N/A C 0 COASTAL HEALTHCARE ADMINISTRATORS PO BOX 80308 SALINAS CA 93912 770311413 MEDICAL CLAIMS PROCESSING CA N/A C 0 BAY SERVICES INC PO BOX 80308 SALINAS CA 93912 942250761 SERVICES CA N/A C 0 CHARITABLE REMAINDER TRUSTS (6) PO BOX HH MONTEREY CA 93942 HOLDING COMPANY CA N/A T 0 0 0 1 0 1 0 0 0 0 0 1 0 0 0 1 0 0 0 1