MOSAIC HEALTH INC: Form 990, tax year 2023
View the entire original 990 at ProPublica ↗
- Organization
- MOSAIC HEALTH INC (EIN 16-1293681)
- Tax period
- 2023-01-01 to 2023-12-31
- Filed
- 2024-11-12
- IRS object ID
- 202403179349305600
- Schema version
- 2023v5.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2024-11-12T13:03:39-06:00 | ReturnTs |
| Tax Period End | 2023-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 161131146 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BONADIO & CO LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 171 SULLYS TRAIL | AddressLine1Txt |
| City | PITTSFORD | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 14534 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2023-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 161293681 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MOSAIC HEALTH INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | MOSA | BusinessNameControlTxt |
| Phone | 5853252280 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | ONE SOUTH WASHINGTON STREET | AddressLine1Txt |
| City | ROCHESTER | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 14614 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MICHAEL LEARY | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 5853252280 | PhoneNum |
| Signature | 2024-11-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | Yes (1) | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KELSEY DEMPSEY | PreparerPersonNm |
| PTIN | P02013906 | PTIN |
| Phone | 5853811000 | PhoneNum |
| Preparation | 2024-11-07 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2023 | TaxYr |
| Build TS | 2024-10-15 13:58:12Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MICHAEL LEARY | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | ONE SOUTH WASHINGTON STREET | AddressLine1Txt |
| City | ROCHESTER | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 14614 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $40,004,268 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.MOSAICHEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1986 | FormationYr |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Activity Or Mission | MOSAIC HEALTH IS A UNIQUE NETWORK OF COMMUNITY BASED HEALTH CENTERS THAT PROVIDES ACCESS TO QUALITY PRIMARY MEDICAL AND DENTAL CARE FOR ALL, BUT ESPECIALLY FOR THOSE WHO EXPERIENCE FINANCIAL, CULTURAL, OR SOCIAL BARRIERS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 13 | VotingMembersIndependentCnt |
| Total Employee | 186 | TotalEmployeeCnt |
| Total Volunteers | 13 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $16,774,922 | PYContributionsGrantsAmt |
| CY Contributions Grants | $15,381,423 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $24,040,745 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $24,117,722 | CYProgramServiceRevenueAmt |
| PY Investment Income | $13,287 | PYInvestmentIncomeAmt |
| CY Investment Income | $188,294 | CYInvestmentIncomeAmt |
| PY Other Revenue | $176,234 | PYOtherRevenueAmt |
| CY Other Revenue | $316,829 | CYOtherRevenueAmt |
| PY Total Revenue | $41,005,188 | PYTotalRevenueAmt |
| CY Total Revenue | $40,004,268 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $8,078,232 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $5,529,466 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $12,183,541 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $12,718,857 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $19,743,585 | PYOtherExpensesAmt |
| CY Other Expenses | $21,222,029 | CYOtherExpensesAmt |
| PY Total Expenses | $40,005,358 | PYTotalExpensesAmt |
| CY Total Expenses | $39,470,352 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $999,830 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $533,916 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $26,037,639 | TotalAssetsBOYAmt |
| Total Assets EOY | $22,339,408 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $13,015,852 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $8,735,348 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $13,021,787 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $13,604,060 | NetAssetsOrFundBalancesEOYAmt |
| Mission | IMPROVE THE HEALTH STATUS OF THOSE WHO EXPERIENCE FINANCIAL AND OTHER BARRIERS TO ACCESSING HEALTH CARE THROUGH DIRECT PATIENT CARE, COLLABORATION, ADVOCACY, AND DIRECT FUNDING. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $34,105,753 | ExpenseAmt |
| Grant | $5,529,466 | GrantAmt |
| Revenue | $24,434,551 | RevenueAmt |
| Desc | MOSAIC HEALTH IS A FEDERALLY QUALIFIED HEALTH CENTER THAT TAKES A PROACTIVE APPROACH TO ENSURE POSITIVE RESULTS FOR THE MOST VULNERABLE, UNDERSERVED AND UNINSURED POPULATIONS BY PROVIDING PRIMARY CARE SERVICES AND ENGAGING IN OUTREACH, DISEASE PREVENTION, PATIENT EDUCATION AND SELF-CARE MANAGEMENT ACTIVITIES IN URBAN AND RURAL COMMUNITIES. MOSAIC HEALTH ACCOMPLISHES THIS THROUGH SIX OWNED HEALTH CENTERS LOCATED IN RUSHVILLE, UTICA, LYONS, MT. MORRIS AND ILION, NY, A COMMUNITY DENTISTRY PROGRAM, AND CONTRACTUALLY THROUGH MOSAIC HEALTH'S SUBRECIPIENTS AT ELEVEN ADDITIONAL PUBLIC LOCATIONS AROUND THE ROCHESTER AREA AND AT FIVE SCHOOL-BASED HEALTH CENTERS LOCATED WITHIN SCHOOLS IN THE ROCHESTER CITY SCHOOL DISTRICT. ASSISTANCE PROVIDED AT THE HEALTH CENTERS IN 2023 WAS FOR 103,675 PATIENTS. | Desc |
| Total Program Service Expenses | $34,105,753 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | Yes (1) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | Yes (1) | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 48 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 186 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 13 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | NY | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LISA OLSCAMP | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5853252280 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1 SOUTH WASHINGTON STREET | AddressLine1Txt |
| City | ROCHESTER | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 14614 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (25 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| LYDIA RIVERA-WARR | |||||||
| CHAIR | 4.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| JAMES WATERS | |||||||
| DIRECTOR | 3.00 | Yes (X) | $0 | $0 | $0 | ||
| FREDDIE CALDWELL | |||||||
| DIRECTOR | 3.00 | Yes (X) | $0 | $0 | $0 | ||
| DOMINIC GALANTE MD | |||||||
| DIRECTOR | 4.00 | Yes (X) | $0 | $0 | $0 | ||
| GEORGE HAZLIP | |||||||
| SECRETARY | 4.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| JERRY GIUDICI | |||||||
| DIRECTOR | 3.00 | Yes (X) | $0 | $0 | $0 | ||
| KEVIN LOUGHRAN | |||||||
| TREASURER | 3.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| DONALD GINSBERG | |||||||
| DIRECTOR | 4.00 | Yes (X) | $0 | $0 | $0 | ||
| SUSAN HUSTLEBY | |||||||
| DIRECTOR | 4.00 | Yes (X) | $0 | $0 | $0 | ||
| SHANA DAHLIN | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| JOHN GLEASON | |||||||
| CHAIR ELECT | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| DANIEL SCOTT | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| CAITLIN ADAMS | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| MICHAEL J LEARY | |||||||
| CEO/PRESIDENT | 40.00 | Yes (X) | $206,745 | $0 | $27,065 | ||
| DENISE BURGEN | |||||||
| COO | 40.00 | Yes (X) | $155,899 | $0 | $5,085 | ||
| LISA M OLSCAMP | |||||||
| CFO | 40.00 | Yes (X) | $155,905 | $0 | $14,364 | ||
| MELISSA S COPELLA DDS | |||||||
| CHIEF DENTAL OFFIDER | 40.00 | Yes (X) | $189,319 | $0 | $19,871 | ||
| CYNTHIA L JONES MD | |||||||
| CHIEF MEDICAL OFFICER | 40.00 | Yes (X) | $294,001 | $0 | $29,861 | ||
| G MARTIN HOTALING | |||||||
| CIO | 40.00 | Yes (X) | $120,934 | $0 | $15,138 | ||
| HANNAH MONK | |||||||
| CHIEF BEHAVIORIAL HEALTH O | 40.00 | Yes (X) | $134,595 | $0 | $13,832 | ||
| SAMANTHA M GLARNER | |||||||
| FAMILY NURSE PRACTITIONER | 36.00 | $125,023 | $0 | $23,146 | Yes (X) | ||
| ERIC M HOLMES DDS | |||||||
| DENTIST | 40.00 | $161,443 | $0 | $12,988 | Yes (X) | ||
| MICHELLE WINSIEWSKI DDS | |||||||
| DENTIST | 40.00 | $147,001 | $0 | $14,097 | Yes (X) | ||
| STEPHEN J MIKLETHUN | |||||||
| DENTIST | 32.00 | $144,836 | $0 | $13,963 | Yes (X) | ||
| JULIAN J KILIAN | |||||||
| PHYSICIANS ASSISTANT | 36.00 | $121,021 | $0 | $45 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,956,722 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $189,455 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 17 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| JAVEN CONSTRUCTION CO INC | |||||
| 2575 BAIRD RD | PENFIELD | NY | 14526 | CONSTRUCTION SERVICES | $988,125 |
| SECURITAS | |||||
| 502 COURT STREETM SUITE 205 | UTICA | NY | 13502 | SECURITY GUARD SERVICES | $176,337 |
| ECLINICAL WORKS LLC | |||||
| 2 TECHNOLOGY DR | WESTBOROUGH | MA | 01581 | COMPUTER SOFTWARE USEAGE AND MONTHLY MAI | $156,236 |
| HERKIMER ARC | |||||
| 30 S WASHINGTON ST | HERKIMER | NY | 13350 | RENT AND CLEANING SERVICES | $151,457 |
| WJM PROPERTIES LLC | |||||
| 259 ALEXANDER ST | ROCHESTER | NY | 14607 | RENT | $150,928 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 10 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $14,369,463 | GovernmentGrantsAmt |
| All Other Contributions | $1,011,960 | AllOtherContributionsAmt |
| Total Contributions | $15,381,423 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| 340B PHARMACY INCOME | 900099 | $16,250,727 | $16,250,727 |
| PATIENT SERVICE REVENUE NET | 621110 | $7,866,995 | $7,866,995 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $24,117,722 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $188,294 | TotalRevenueColumnAmt |
| Exclusion | $188,294 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| CONTRIBUTED NON FINANCIAL ASSET | 900099 | $174,101 | $174,101 |
| OTHER | 900099 | $142,728 | $142,728 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $316,829 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $40,004,268 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $24,434,551 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $188,294 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,529,466 | TotalAmt |
| Program Services | $5,529,466 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,382,426 | TotalAmt |
| Program Services | $393,585 | ProgramServicesAmt |
| Management And General | $988,841 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,840,874 | TotalAmt |
| Program Services | $6,939,692 | ProgramServicesAmt |
| Management And General | $1,901,182 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $253,067 | TotalAmt |
| Program Services | $199,323 | ProgramServicesAmt |
| Management And General | $53,744 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,504,880 | TotalAmt |
| Program Services | $1,172,367 | ProgramServicesAmt |
| Management And General | $332,513 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $737,610 | TotalAmt |
| Program Services | $531,176 | ProgramServicesAmt |
| Management And General | $206,434 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $67,354 | TotalAmt |
| Program Services | $62,639 | ProgramServicesAmt |
| Management And General | $4,715 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $169,328 | TotalAmt |
| Program Services | $114,767 | ProgramServicesAmt |
| Management And General | $54,561 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $397,612 | TotalAmt |
| Program Services | $200,895 | ProgramServicesAmt |
| Management And General | $196,717 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $705,566 | TotalAmt |
| Program Services | $429,109 | ProgramServicesAmt |
| Management And General | $276,457 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $57,917 | TotalAmt |
| Program Services | $53,184 | ProgramServicesAmt |
| Management And General | $4,733 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $167,346 | TotalAmt |
| Program Services | $60,613 | ProgramServicesAmt |
| Management And General | $106,733 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $646,472 | TotalAmt |
| Program Services | $302,586 | ProgramServicesAmt |
| Management And General | $343,886 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,184,838 | TotalAmt |
| Program Services | $1,062,430 | ProgramServicesAmt |
| Management And General | $122,408 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $134,515 | TotalAmt |
| Program Services | $89,114 | ProgramServicesAmt |
| Management And General | $45,401 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,574 | TotalAmt |
| Program Services | $17,660 | ProgramServicesAmt |
| Management And General | $914 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $826,325 | TotalAmt |
| Program Services | $219,325 | ProgramServicesAmt |
| Management And General | $607,000 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $126,391 | TotalAmt |
| Program Services | $82,228 | ProgramServicesAmt |
| Management And General | $44,163 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt |
|---|---|---|
| PHARMACY INCOME SHARING | $8,185,751 | $8,185,751 |
| PRESCRIPTION DRUGS | $4,905,701 | $4,905,701 |
| PHARMACY ADMIN | $2,150,744 | $2,150,744 |
| PROGRAM SUPPLIES | $742,842 | $742,842 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $734,753 | TotalAmt |
| Program Services | $660,556 | ProgramServicesAmt |
| Management And General | $74,197 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $39,470,352 | TotalAmt |
| Program Services | $34,105,753 | ProgramServicesAmt |
| Management And General | $5,364,599 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,355,494 | BOYAmt |
| EOY | $3,822,021 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,245,508 | BOYAmt |
| EOY | $2,252,072 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,457,014 | BOYAmt |
| EOY | $4,269,052 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $689,708 | BOYAmt |
| EOY | $894,044 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $231,009 | BOYAmt |
| EOY | $212,409 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $13,331,719 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $7,718,916 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,619,030 | BOYAmt |
| EOY | $5,612,803 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $250,222 | BOYAmt |
| EOY | $4,449,893 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,189,654 | BOYAmt |
| EOY | $827,114 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,037,639 | BOYAmt |
| EOY | $22,339,408 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,610,729 | BOYAmt |
| EOY | $1,776,456 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,392,610 | BOYAmt |
| EOY | $5,516,121 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $369,526 | BOYAmt |
| EOY | $189,426 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $446,074 | BOYAmt |
| EOY | $417,236 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,196,913 | BOYAmt |
| EOY | $836,109 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,015,852 | BOYAmt |
| EOY | $8,735,348 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,768,562 | BOYAmt |
| EOY | $13,297,309 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $253,225 | BOYAmt |
| EOY | $306,751 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,021,787 | BOYAmt |
| EOY | $13,604,060 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $26,037,639 | BOYAmt |
| EOY | $22,339,408 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $533,916 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $48,357 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $10,122,763 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $12,853,717 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $11,986,223 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $16,774,922 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $15,381,423 | CurrentTaxYearAmt |
| Total | $67,119,048 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $10,122,763 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $12,853,717 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $11,986,223 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $16,774,922 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $15,381,423 | CurrentTaxYearAmt |
| Total | $67,119,048 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $67,119,048 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $50,403 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $41,192 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $8,245 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $13,287 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $188,294 | CurrentTaxYearAmt |
| Total | $301,421 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $151,931 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $143,842 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $124,120 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $176,234 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $316,829 | CurrentTaxYearAmt |
| Total | $912,956 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $68,333,425 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $63,543,552 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.98220 | PublicSupportCY170Pct |
| Public Support PY170 | 0.98260 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $241,743 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $53,526 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $295,269 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $286,384 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | -$44,641 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $241,743 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $231,313 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $55,071 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $286,384 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $201,187 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $30,126 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $231,313 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $161,621 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $39,566 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $201,187 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Prmnnt Endowment Balance EOY | 0.37500 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.62500 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $75,018 | InvestmentCostOrOtherBasisAmt |
| Book Value | $75,018 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $1,856,320 | InvestmentCostOrOtherBasisAmt |
| Depreciation | $7,718,916 | DepreciationAmt |
| Book Value | -$5,862,596 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $5,501,087 | InvestmentCostOrOtherBasisAmt |
| Book Value | $5,501,087 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $4,485,441 | InvestmentCostOrOtherBasisAmt |
| Book Value | $4,485,441 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Investment Cost Or Other Basis | $1,413,853 | InvestmentCostOrOtherBasisAmt |
| Book Value | $1,413,853 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $5,612,803 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| CURRENT PORTION OF OPERATING LEASE LIABILITIES | $382,903 |
| OPERATING LEASE LIABILITIES, NET CURRENT PORTION | $453,206 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $836,109 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $40,052,625 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $48,357 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | $48,357 | RevenueNotReportedAmt |
| Revenue Subtotal | $40,004,268 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $40,004,268 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $39,470,352 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $39,470,352 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $39,470,352 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART V, LINE 4: | FormAndLineReferenceDesc |
| Explanation | MOASIC HEALTH'S ENDOWMENT CONSISTS OF A DONOR-RESTRICTED FUND TO SUPPORT THE OPERATIONS AT THE RUSHVILLE COMMUNITY HEALTH CENTER. | ExplanationTxt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Non Cash AssistanceNonCashAssistanceAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|---|
| ROCHESTER GENERAL HOSPITAL | ||||||||
| 1425 PORTLAND AVENUE | ROCHESTER | NY | 14621 | 160743134 | 501(C)3 | $0 | $4,594,409 | FOR USE AS PERMISSIBLE BY THE GRANTS EXCLUDING CAPITAL OUTLAYS. |
| UNITY HEALTH SYSTEM | ||||||||
| 89 GENESEE STREET | ROCHESTER | NY | 14611 | 227221763 | 501(C)3 | $0 | $935,057 | FOR USE AS PERMISSIBLE BY THE GRANTS EXCLUDING CAPITAL OUTLAYS. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| CYNTHIA L JONES MD | ||||||||||||||
| CHIEF MEDICAL OFFICER | $294,001 | $0 | $0 | $0 | $0 | $0 | $11,529 | $0 | $18,332 | $0 | $323,862 | $0 | $0 | $0 |
| MICHAEL J LEARY | ||||||||||||||
| CEO/PRESIDENT | $202,685 | $0 | $0 | $0 | $4,060 | $0 | $7,699 | $0 | $19,366 | $0 | $233,810 | $0 | $0 | $0 |
| MELISSA S COPELLA DDS | ||||||||||||||
| CHIEF DENTAL OFFIDER | $182,622 | $0 | $0 | $0 | $6,697 | $0 | $5,888 | $0 | $13,983 | $0 | $209,190 | $0 | $0 | $0 |
| ERIC M HOLMES DDS | ||||||||||||||
| DENTIST | $160,693 | $0 | $750 | $0 | $0 | $0 | $7,277 | $0 | $5,711 | $0 | $174,431 | $0 | $0 | $0 |
| LISA M OLSCAMP | ||||||||||||||
| CFO | $151,164 | $0 | $0 | $0 | $4,741 | $0 | $8,951 | $0 | $5,413 | $0 | $170,269 | $0 | $0 | $0 |
| MICHELLE WINSIEWSKI DDS | ||||||||||||||
| DENTIST | $147,001 | $0 | $0 | $0 | $0 | $0 | $5,765 | $0 | $8,332 | $0 | $161,098 | $0 | $0 | $0 |
| DENISE BURGEN | ||||||||||||||
| COO | $151,113 | $0 | $0 | $0 | $4,786 | $0 | $5,040 | $0 | $45 | $0 | $160,984 | $0 | $0 | $0 |
| STEPHEN J MIKLETHUN | ||||||||||||||
| DENTIST | $144,836 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $13,963 | $0 | $158,799 | $0 | $0 | $0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | ONCE THE FINAL DRAFT OF THE 990 IS COMPLETED BY THE AUDIT FIRM, IT IS REVIEWED BY THE CFO. IF ALL FOUND CORRECT, IT IS SENT TO THE BOARD FOR REVIEW BEFORE IT IS FILED. |
| FORM 990, PART VI, SECTION B, LINE 12C | ANNUALLY THE BOARD MEMBERS ARE REQUIRED TO COMPLETE THE CONFLICT OF INTEREST FORMS. THE CEO REVIEWS ALL FORMS AND ADDRESSES ANY POSSIBLE CONFLICT. |
| FORM 990, PART VI, SECTION B, LINE 15 | EXECUTIVE AND MANAGEMENT COMPENSATION IS DETERMINED BY REVIEWING SALARY SURVEYS FROM THE NATIONAL ASSOCIATION OF COMMUNITY HEALTH CENTERS AND/OR THE ROCHESTER BUSINESS ALLIANCE FOR COMPARABLE POSITIONS AT SIMILAR SIZED HEALTH CENTERS. SALARIES ARE ALSO COMPARED TO OTHER FQHC'S. IN ADDITION, INFORMATION IS OBTAINED FROM THE NYS DEPARTMENT OF LABOR WEBSITE ALONG WITH PROFESSIONAL RESOURCES SUCH AS HR BUSINESS LEGAL RESOURCES AND COMMONLY USED WEB BASED PROGRAMS. THE CEO'S SALARY IS REVIEWED ANNUALLY BY THE EXECUTIVE COMMITTEE AND RECOMMENDED TO THE BOARD. |
| FORM 990, PART VI, SECTION C, LINE 19 | MOSAIC HEALTH MAKES THE REQUIRED DOCUMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART VII, LINE 2C: | NO CHANGES IN THE CURRENT YEAR. |