Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
| (A)
ALTAMED HEALTH SERVICES CORP |
952810095 | 3 | Yes | 1,338,564 | 0 | |
|
Total 1
|
1,338,564 | 0 | ||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | ||||||
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.... | ||||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 4 | Total. Add lines 1 through 3 | ||||||
| 5 | The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f) .. | ||||||
| 6 | Public support. Subtract line 5 from line 4. | ||||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | ||||||
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | ||||||
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | ||||||
| 11 | Total support. Add lines 7 through 10 | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | ||||||
| 2 | Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose | ||||||
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513 ..... | ||||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | ||||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge | ||||||
| 6 | Total. Add lines 1 through 5 | ||||||
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons | ||||||
| b | Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year. | ||||||
| c | Add lines 7a and 7b.. | ||||||
| 8 | Public support. (Subtract line 7c from line 6.) | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2018 | (b) 2019 | (c) 2020 | (d) 2021 | (e) 2022 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | ||||||
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | ||||||
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | ||||||
| 11 | Net income from unrelated business activities not included on line 10b, whether or not the business is regularly carried on. | ||||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | ||||||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | ||||||
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
||||
| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e |
Discount claimed for blockage or other factors (explain in detail in Part VI): |
|||||
| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 0.015 of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by 0.035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | 1 | |
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
2 | |
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | 3 | |
| 4 Amounts paid to acquire exempt-use assets | 4 | |
| 5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) | 5 | |
| 6 Other distributions (describe in Part VI). See instructions | 6 | |
| 7Total annual distributions. Add lines 1 through 6. | 7 | |
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
8 | |
| 9 Distributable amount for 2022 from Section C, line 6 | 9 | |
| 10 Line 8 amount divided by Line 9 amount | 10 | |
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2022 |
(iii) Distributable Amount for 2022 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2022 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2022 (reasonable cause required-- explain in Part VI).
See instructions. |
||||
| 3 Excess distributions carryover, if any, to 2022: | ||||
| a From 2017....... | ||||
| b From 2018....... | ||||
| c From 2019....... | ||||
| d From 2020....... | ||||
| e From 2021....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2022 distributable amount | ||||
|
i
Carryover from 2017 not applied (see instructions) |
||||
| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2022 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2022 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2022, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
||||
|
6
Remaining underdistributions for 2022. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
||||
|
7 Excess distributions carryover to 2023. Add lines 3j and 4c. |
||||
| 8 Breakdown of line 7: | ||||
| a Excess from 2018..... | ||||
| b Excess from 2019..... | ||||
| c Excess from 2020..... | ||||
| d Excess from 2021..... | ||||
| e Excess from 2022..... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|
| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | CASTULO DE LA ROCHA, BOARD MEMBER, AND ZOILA D. ESCOBAR, PRESIDENT, HAVE A FAMILY RELATIONSHIP. |
| FORM 990, PART VI, SECTION B, LINE 11B | ALTAMED FOUNDATION'S OUTSIDE CPA FIRM AND FINANCE STAFF PREPARE THE FORM 990. THE FORM IS THEN REVIEWED AND APPROVED BY THE ORGANIZATION'S PRESIDENT. THE FORM IS SUBSEQUENTLY PROVIDED TO THE FULL BOARD FOR REVIEW BEFORE FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | ALL OFFICERS, DIRECTORS AND KEY EMPLOYEES ARE COVERED PERSONS UNDER ALTAMED HEALTH FOUNDATION'S CONFLICT OF INTEREST POLICY. THE PURPOSE OF THE POLICY IS TO PROTECT THE CORPORATION'S INTERESTS WHEN IT IS CONTEMPLATING ENTERING INTO A TRANSACTION OR ARRANGEMENT THAT MIGHT BENEFIT THE PRIVATE INTERESTS OF A TRUSTEE, OFFICER OR OTHER PERSON IN A POSITION OF AUTHORITY WITHIN THE CORPORATION AND TO ENSURE COMPLIANCE WITH APPLICABLE LAW. AN INTERESTED PERSON IS REQUIRED TO MAKE AN APPROPRIATE DISCLOSURE OF ALL MATERIAL FACTS, INCLUDING THE EXISTENCE OF ANY FINANCIAL INTEREST, AT ANY TIME THAT ANY ACTUAL OR POTENTIAL CONFLICT OF INTEREST ARISES. THIS DISCLOSURE OBLIGATION INCLUDES INSTANCES IN WHICH AN INTERESTED PERSON WHO IS A TRUSTEE KNOWS OF THE POTENTIAL FOR A SELF-DEALING TRANSACTION AS DESCRIBED IN THE POLICY, OR A TRANSACTION INVOLVING COMMON DIRECTORSHIP AS DESCRIBED IN THE POLICY, INVOLVING HIM OR HER. IT ALSO INCLUDES INSTANCES IN WHICH THE INTERESTED PERSON PLANS NOT TO ATTEND A MEETING OF THE BOARD OR A BOARD COMMITTEE WITH GOVERNING BOARD-DELEGATED POWERS (A "COMMITTEE") AT WHICH HE OR SHE HAS REASON TO BELIEVE THAT THE BOARD OR COMMITTEE WILL ACT REGARDING A MATTER ABOUT WHICH HE OR SHE MAY HAVE A CONFLICT. DEPENDING ON THE CIRCUMSTANCES, THIS DISCLOSURE MAY BE MADE TO THE CHAIR OF THE BOARD, OR, IF THE POTENTIAL CONFLICT OF INTEREST FIRST ARISES IN THE CONTEXT OF A BOARD OR COMMITTEE MEETING, THE ENTIRE BOARD OR THE MEMBERS OF THE COMMITTEE CONSIDERING THE PROPOSED TRANSACTION OR ARRANGEMENT THAT RELATES TO THE ACTUAL OR POSSIBLE CONFLICT OF INTEREST. IN ADDITION, INTERESTED PERSONS ARE REQUIRED TO MAKE AN ANNUAL DISCLOSURE OF ONGOING RELATIONSHIPS AND INTERESTS THAT MAY PRESENT A CONFLICT OF INTEREST. IF AN INTERESTED PERSON BECOMES AWARE OF ANY POTENTIAL SELF-DEALING OR COMMON DIRECTORSHIP TRANSACTION OR OTHER CONFLICT OF INTEREST INVOLVING ANOTHER INTERESTED PERSON, HE OR SHE IS REQUIRED TO PROMPTLY REPORT IT CONSISTENTLY WITH THE REPORTING PROCEDURES AND REQUIREMENTS OF THE POLICY. FACTORS THE DECISION-MAKING BODY MAY CONSIDER WHEN DETERMINING WHETHER AN ACTUAL CONFLICT EXISTS INCLUDE: (I) THE PROXIMITY OF THE INTERESTED PERSON TO THE DECISION-MAKING AUTHORITY OF THE OTHER ENTITY INVOLVED IN THE TRANSACTION, (II) WHETHER THE AMOUNT OF THE FINANCIAL INTEREST OR INVESTMENT IS DE MINIMIS RELATIVE TO THE OVERALL FINANCIAL SITUATION OF THE CORPORATION, AND (III) THE DEGREE TO WHICH THE INTERESTED PERSON MIGHT BENEFIT PERSONALLY IF A PARTICULAR TRANSACTION WERE APPROVED. IF IT IS DETERMINED THAT AN ACTUAL CONFLICT OF INTEREST EXISTS WHICH ALSO CONSTITUTES A "SELF-DEALING" TRANSACTION AS DESCRIBED IN THE POLICY, THEN THE TRANSACTION OR MATTER IN QUESTION MAY BE AUTHORIZED ONLY IF APPROVED BY THE VOTE DESCRIBED IN THE POLICY AFTER THE CORPORATION HAS FOLLOWED THE PROCEDURES SET FORTH IN THE POLICY. THE INTERESTED PERSON OR A FAMILY MEMBER OF SUCH PERSON HAS FINANCIAL INTEREST, OR (III) AN ENTITY WITH WHICH THE INTERESTED PERSON HAS AN AGENCY RELATIONSHIP ON THE OTHER HAND, THEN THE MATTER IN QUESTION MAY BE AUTHORIZED ONLY IF APPROVED BY THE VOTE DESCRIBED IN THIS POLICY AFTER THE CORPORATION HAS FOLLOWED THE PROCEDURES SET FORTH IN THIS POLICY. IN ALL CIRCUMSTANCES WHERE IT IS DETERMINED THAT AN ACTUAL CONFLICT OF INTEREST EXISTS, THE DECISION-MAKING BODY SHALL RECOMMEND AN APPROPRIATE COURSE OF ACTION TO PROTECT THE INTERESTS OF THE CORPORATION. ALL DISCLOSURES AND THE OUTCOME OF THE DELIBERATION ABOUT WHETHER A CONFLICT OF INTEREST EXISTS SHALL BE RECORDED IN THE MINUTES OF THE APPROPRIATE DELIBERATIVE MEETING. PRIOR TO VOTING ON A CONTRACT, THE INTERESTED PERSON MAY MAKE A PRESENTATION AT THE BOARD OR COMMITTEE MEETING AT WHICH SUCH TRANSACTION IS BEING CONSIDERED, BUT FOLLOWING THE PRESENTATION, HE OR SHE MUST LEAVE THE MEETING PRIOR TO THE DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT INVOLVING THE CONFLICT OF INTEREST. THE CHAIR OF THE BOARD OR COMMITTEE, IF APPROPRIATE, WILL APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT. AFTER EXERCISING DUE DILIGENCE, THE BOARD OR COMMITTEE DETERMINES WHETHER THE CORPORATION COULD OBTAIN WITH REASONABLE EFFORTS A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT FROM A PERSON OR ENTITY THAT WOULD NOT GIVE RISE TO A CONFLICT OF INTEREST. IF THE BOARD OR COMMITTEE DETERMINES THAT A MORE ADVANTAGEOUS TRANSACTION OR ARRANGEMENT NOT PRODUCING A CONFLICT OF INTEREST IS NOT REASONABLY POSSIBLE UNDER CIRCUMSTANCES, THE BOARD OR COMMITTEE WILL DETERMINE WHETHER THE TRANSACTION OR ARRANGEMENT IS IN THE CORPORATION'S BEST INTERESTS, FOR ITS OWN BENEFIT, AND WHETHER IT IS FAIR AND REASONABLE TO THE CORPORATION. IN CONFORMITY WITH THE ABOVE DETERMINATION, THE BOARD OR COMMITTEE SHALL DETERMINE WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT BY THE VOTE DESCRIBED IN THE POLICY. IF THE BOARD HAS REASONABLE CAUSE TO BELIEVE THAT AN INTERESTED PERSON HAS FAILED TO DISCLOSE ACTUAL OR POSSIBLE CONFLICTS OF INTEREST, IT WILL INFORM THE INTERESTED PERSON OF THE BASIS FOR SUCH BELIEF AND AFFORD THE INTERESTED PERSON AN OPPORTUNITY TO EXPLAIN THE ALLEGED FAILURE TO DISCLOSE. IF, AFTER HEARING THE INTERESTED PERSON'S RESPONSE AND MAKING FURTHER INVESTIGATION AS WARRANTED BY THE CIRCUMSTANCES, THE BOARD DETERMINES THE INTERESTED PERSON HAS FAILED TO DISCLOSE AN ACTUAL OR POSSIBLE CONFLICT OF INTEREST, IT WILL TAKE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION. |
| FORM 990, PART VI, SECTION C, LINE 19 | GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. HOWEVER CURRENT TAX LAW DOES NOT REQUIRE THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY OR FINANCIALS BE PROVIDED TO THE PUBLIC. |
| Software ID: | |
| Software Version: |