CONCERN EMPLOYEE ASSISTANCE PROGRAM: Form 990, tax year 2023
View the entire original 990 at ProPublica ↗
- Organization
- CONCERN EMPLOYEE ASSISTANCE PROGRAM (EIN 77-0528349)
- Tax period
- 2023-07-01 to 2024-06-30
- Filed
- 2025-05-14
- IRS object ID
- 202531349349311348
- Schema version
- 2023v6.0
- 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 | 2025-05-14T17:54:58-05:00 | ReturnTs |
| Tax Period End | 2024-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 910189318 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MOSS ADAMS LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 101 SECOND STREET SUITE 900 | AddressLine1Txt |
| City | SAN FRANCISCO | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 94105 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2023-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 770528349 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CONCERN EMPLOYEE ASSISTANCE PROGRAM | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CONC | BusinessNameControlTxt |
| Phone | 8003444222 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2500 GRANT ROAD | AddressLine1Txt |
| City | MOUNTAIN VIEW | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 94040 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MICHAEL WALSH | PersonNm |
| Person Title | CONTROLLER | PersonTitleTxt |
| Phone | 6509407240 | PhoneNum |
| Signature | 2025-05-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | 0 | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MICHAEL LUMSDEN | PreparerPersonNm |
| PTIN | P01262236 | PTIN |
| Phone | 4159561500 | PhoneNum |
| Preparation | 2025-05-14 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2023 | TaxYr |
| Build TS | 2025-03-06 01:10:19Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | CECILE CURRIER | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2500 GRANT ROAD | AddressLine1Txt |
| City | MOUNTAIN VIEW | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 94040 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $13,134,800 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c | Yes (X) | Organization501cInd |
| Website Address | WWW.CONCERNHEALTH.COM | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1999 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE AND PROMOTE AFFORDABLE HEALTH CARE TO RESIDENTS OF CALIFORNIA. CONCERN IS LICENSED BY THE CALIFORNIA DEPARTMENT OF MANAGED HEALTH CARE AND OFFERS LIMITED MENTAL HEALTH CARE ON A PREPAID BASIS TO EMPLOYEES OF SMALL, MEDIUM, AND LARGE EMPLOYER GROUPS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 3 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 0 | VotingMembersIndependentCnt |
| Total Employee | 32 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,422,339 | PYContributionsGrantsAmt |
| CY Contributions Grants | $1,185,715 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $8,418,792 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $11,386,751 | CYProgramServiceRevenueAmt |
| PY Investment Income | $476,822 | PYInvestmentIncomeAmt |
| CY Investment Income | $562,334 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $10,317,953 | PYTotalRevenueAmt |
| CY Total Revenue | $13,134,800 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $454,441 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $357,597 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $3,674,543 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $3,751,525 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $5,278,815 | PYOtherExpensesAmt |
| CY Other Expenses | $7,582,273 | CYOtherExpensesAmt |
| PY Total Expenses | $9,407,799 | PYTotalExpensesAmt |
| CY Total Expenses | $11,691,395 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $910,154 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,443,405 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $18,315,720 | TotalAssetsBOYAmt |
| Total Assets EOY | $19,570,706 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $3,660,474 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $3,662,813 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $14,655,246 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $15,907,893 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO PROVIDE TIMELY ACCESS TO MENTAL HEALTH AND WELLBEING RESOURCES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $9,962,583 | ExpenseAmt |
| Grant | $357,597 | GrantAmt |
| Revenue | $11,386,751 | RevenueAmt |
| Desc | CONCERN'S EXEMPT PURPOSE IS TO PROVIDE AND PROMOTE AFFORDABLE HEALTH CARE TO RESIDENTS WHO LIVE WITHIN CALIFORNIA. CONCERN IS LICENSED BY THE CALIFORNIA DEPARTMENT OF MANAGED HEALTH CARE AND OFFERS LIMITED MENTAL HEALTH CARE ON A PREPAID BASIS TO EMPLOYEES OF SMALL, MEDIUM, AND LARGE EMPLOYER GROUPS.CURRENTLY, CONCERN CONTRACTS WITH OVER 400 PROVIDERS WHO HAVE OFFICES THROUGHOUT CALIFORNIA AND HAVE AGREED TO PROVIDE SHORT-TERM COUNSELING TO CLIENTS OF SMALL, MEDIUM AND LARGE EMPLOYER GROUPS. CONCERN'S INTENDED FOCUS IS TO PROVIDE MENTAL HEALTH CARE SERVICES TO EMPLOYEES IN THE BAY AREA.EMPLOYERS HAVE TOLD CONCERN THEY HAVE SELECTED THE SERVICES PROVIDED BY THE ORGANIZATION: (I) TO INCREASE PRODUCTIVITY, ENHANCE PERFORMANCE, AND PROMOTE THE OVERALL QUALITY OF LIFE OF EMPLOYEES AND THEIR FAMILIES; (II) TO PROVIDE SUPPORT AND CONSULTATION TO CORPORATE MANAGEMENT IN RESOLVING COMPLEX EMPLOYEE RELATION PROBLEMS; AND (III) TO DECREASE EMPLOYER COSTS BY REDUCING ABSENTEEISM AND TURNOVER. CONCERN BELIEVES THAT THE HEALTH CARE COVERAGE IT PROVIDES STRENGTHENS THE MENTAL HEALTH CARE RESOURCES AVAILABLE TO CLIENTS WHO DESIRE SUCH CARE. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $188,588 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $0 | RevenueAmt |
| Desc | IN ORDER TO PROVIDE OUT-PATIENT HEALTH CARE TO LOW-INCOME FAMILIES IN THE SAN FRANCISCO BAY AREA, CONCERN HAS ASSUMED THE MANAGEMENT AND OPERATION OF FOUR PROGRAMS FORMERLY ADMINISTERED BY EL CAMINO HOSPITAL, CONCERN'S SOLE MEMBER. THESE PROGRAMS ARE: (I) HEALTH LIBRARY AND RESOURCE CENTER; (II) ROADRUNNERS TRANSPORTATION SERVICE; (III) SOUTH ASIAN HEART CENTER; AND (IV) CHINESE HEALTH INITIATIVE.THE HEALTH LIBRARY AND RESOURCE CENTER, ESTABLISHED IN 1986, IS DEDICATED TO HELPING SENIORS, COMMUNITY MEMBERS, PATIENTS, AND THEIR FAMILIES FIND THE RESOURCES AND INFORMATION THEY NEED TO MAKE INFORMED DECISIONS ABOUT THEIR HEALTH. THE CENTER IS AVAILABLE TO THE COMMUNITY AND IS STAFFED BY A PROFESSIONAL MEDICAL LIBRARIAN. IT PROVIDES A WIDE RANGE OF FREE PROGRAMS AND SERVICES INCLUDING ELDERCARE CONSULTATION SERVICES, MEDICARE COUNSELING, SUPPORT GROUPS, ASSISTANCE COMPLETING AN ADVANCED HEALTH CARE DIRECTIVE, AS WELL AS DIETITIAN AND PHARMACY CONSULTATIONS. A FREE MEMBERSHIP PROGRAM IS ALSO OFFERED TO ANYONE WHO WANTS TO RECEIVE HOME ACCESS TO MEDICAL AND CONSUMER HEALTH JOURNALS, MEDICAL TEXTBOOKS ONLINE, FREE ARTICLES, AND LIBRARY CHECK-OUT PRIVILEGES. THE HEALTH LIBRARY AND RESOURCE CENTER SERVED 8,349 INDIVIDUALS DURING FY2024.THE ROADRUNNERS TRANSPORTATION SERVICE, ESTABLISHED IN 1976, FILLS A CRITICAL GAP IN NORTHERN SANTA CLARA COUNTY'S SENIOR SERVICES BY PROVIDING PERSONALIZED, DOOR-TO-DOOR TRANSPORTATION TO MEDICAL AND OTHER ESSENTIAL APPOINTMENTS. DURING FY2024, 6,650 RIDES WERE PROVIDED.THE SOUTH ASIAN HEART CENTER, ESTABLISHED IN JUNE 2006, IS A RESPONSE TO THE EPIDEMIC OF HEART DISEASE IN THE SOUTH ASIAN COMMUNITY. SOUTH ASIANS, OR PEOPLE WHO ORIGINATE FROM THE INDIAN SUB-CONTINENT (FROM COUNTRIES SUCH AS BANGLADESH, INDIA, NEPAL, PAKISTAN, AND SRI LANKA) FACE A FOUR-FOLD INCREASED RISK OF CORONARY ARTERY DISEASE (CAD) DESPITE BEING PREDOMINANTLY VEGETARIAN, NON-SMOKERS, AND NON-OBESE. THE CENTER SCREENS INDIVIDUAL PARTICIPANTS FOR THEIR RISK FACTORS, EDUCATES AND COUNSELS THEM ON THE IMPACT OF THOSE RISKS, AND CUSTOMIZES A PLAN TO HELP MITIGATE THESE RISKS. THE CENTER PROVIDES LIFESTYLE MANAGEMENT INCLUDING NUTRITION COUNSELING, AND ON-GOING HEART HEALTH COACHING. THE SOUTH ASIAN HEART CENTER ADDRESSES AN UNMET NEED TO MORE COMPREHENSIVELY AND AGGRESSIVELY SCREEN SOUTH ASIANS FOR THIS INCREASED RISK OF CAD AND HELP PREVENT HEART ATTACKS IN A YOUNGER POPULATION. DURING FY2024, THE CENTER SERVED 2,344 INDIVIDUALS.THE CHINESE HEALTH INITIATIVE (CHI), ESTABLISHED AT EL CAMINO HOSPITAL IN MARCH 2010, PROVIDES SCREENING AND COMMUNITY EDUCATION TO ADDRESS THE HEALTH NEEDS OF THE CHINESE COMMUNITY, AND SEEKS TO PROVIDE A CULTURALLY APPROPRIATE EXPERIENCE FOR CHINESE PATIENTS AND THEIR FAMILY/CAREGIVERS. THE CHINESE HEALTH INITIATIVE ALSO WORKS WITH CHINESE PHYSICIANS AND THE CHINESE MEDIA TO PROMOTE HEALTH LITERACY IN THE COMMUNITY. DURING FY2024, THE CHINESE HEALTH INITIATIVE SERVED 1,945 INDIVIDUALS. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $10,151,171 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | 0 | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| 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 | 0 | 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 | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 32 | 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 | Yes (1) | NondeductibleContributionsInd |
| Nondeductible Contri Discl | Yes (1) | NondeductibleContriDisclInd |
| 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 | 3 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 0 | 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 | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | 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 | 0 | 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 | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | CA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MICHAEL WALSH | PersonNm |
| Phone | 6509407240 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2500 GRANT ROAD | AddressLine1Txt |
| City | MOUNTAIN VIEW | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 94040 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (8 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| DEANNA DUDLEY | ||||||||
| BOARD MEMBER / VP OF HR, ECH | 1.00 | 40.00 | Yes (X) | $0 | $517,377 | $31,801 | ||
| CECILE CURRIER | ||||||||
| BOARD MEMBER / CEO | 20.00 | 20.00 | Yes (X) | $444,312 | $0 | $88,312 | Yes (X) | |
| ANDREW COPE | ||||||||
| BOARD MEMBER / PRESIDENT OF ECHF | 1.00 | 40.00 | Yes (X) | $0 | $376,253 | $70,868 | ||
| PRIYA DHARAN | ||||||||
| MANAGER, BUSINESS DEVELOPMENT | 40.00 | 0.00 | $202,662 | $0 | $25,123 | Yes (X) | ||
| DIKSHYA ADHIKARI | ||||||||
| DIRECTOR OF OPERATIONS & CLIENT EXP | 40.00 | 0.00 | $168,918 | $0 | $20,566 | Yes (X) | ||
| ASHISH MATHUR | ||||||||
| EXECUTIVE DIRECTOR, SAHC | 40.00 | 0.00 | $163,955 | $0 | $51,929 | Yes (X) | ||
| MARGOT BROWN | ||||||||
| SUPERVISOR, EAP CLINICAL SERVICES | 40.00 | 0.00 | $154,940 | $0 | $28,363 | Yes (X) | ||
| ANN WAGNER | ||||||||
| ACCOUNT EXECUTIVE | 40.00 | 0.00 | $137,069 | $0 | $45,549 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,271,856 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $893,630 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $362,511 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 10 | 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 | Address Line1ContractorAddress/ForeignAddress/AddressLine1Txt | CityContractorAddress/ForeignAddress/CityNm | CountryContractorAddress/ForeignAddress/CountryCd | Foreign PostalContractorAddress/ForeignAddress/ForeignPostalCd |
|---|---|---|---|---|---|---|---|---|---|
| BETTERHELP | |||||||||
| 990 VILLA STREET | MOUNTAIN VIEW | CA | 94041 | DIGITAL HEALTH SERVICES | $754,105 | ||||
| ZS ASSOCIATES | |||||||||
| 611 GATEWAY BOULEVARD | SOUTH SAN FRANCISCO | CA | 94080 | MANAGEMENT & TECH CONSULTING | $693,733 | ||||
| RIGHTSOURCING INC | |||||||||
| 990 STEWART AVE SUITE 100 | BETHPAGE | IL | 11714 | TEMPORARY LABOR | $373,063 | ||||
| ENDAVA | |||||||||
| SOFTWARE DESIGN SERVICES | $328,281 | 125 OLD BROAD STREET | LONDON | UK | EC2N 1DW | ||||
| PERSPECTIVE LTD | |||||||||
| PO BOX 75501 | CHICAGO | IL | 60675 | CALL CENTER SERVICES | $249,781 | ||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 11 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $1,185,715 | RelatedOrganizationsAmt |
| Total Contributions | $1,185,715 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| COUNSELING SERVICES | 624100 | $10,842,013 | $10,842,013 |
| OTHER OPERATING REVENUE | 624100 | $544,738 | $544,738 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $11,386,751 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $562,334 | TotalRevenueColumnAmt |
| Exclusion | $562,334 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $13,134,800 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $11,386,751 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $562,334 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $357,597 | TotalAmt |
| Program Services | $357,597 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $266,312 | TotalAmt |
| Management And General | $266,312 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,776,954 | TotalAmt |
| Program Services | $2,265,977 | ProgramServicesAmt |
| Management And General | $510,977 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $107,604 | TotalAmt |
| Program Services | $103,002 | ProgramServicesAmt |
| Management And General | $4,602 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $401,095 | TotalAmt |
| Program Services | $314,708 | ProgramServicesAmt |
| Management And General | $86,387 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $199,560 | TotalAmt |
| Program Services | $150,778 | ProgramServicesAmt |
| Management And General | $48,782 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $106,327 | TotalAmt |
| Management And General | $106,327 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $63,224 | TotalAmt |
| Management And General | $63,224 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $216,552 | TotalAmt |
| Management And General | $216,552 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,515,626 | TotalAmt |
| Program Services | $6,418,241 | ProgramServicesAmt |
| Management And General | $97,385 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $76,404 | TotalAmt |
| Program Services | $61,123 | ProgramServicesAmt |
| Management And General | $15,281 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $37,012 | TotalAmt |
| Program Services | $29,610 | ProgramServicesAmt |
| Management And General | $7,402 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $34 | TotalAmt |
| Program Services | $34 | ProgramServicesAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $17,991 | TotalAmt |
| Program Services | $14,395 | ProgramServicesAmt |
| Management And General | $3,596 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $254,384 | TotalAmt |
| Program Services | $203,508 | ProgramServicesAmt |
| Management And General | $50,876 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $49,882 | TotalAmt |
| Management And General | $49,882 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| PATIENT SUPPORT EXPENSE | $34,698 | $34,698 | |
| DUES & SUBSCRIPTIONS | $10,051 | $10,051 | |
| REPAIRS & MAINTENANCE | $6,375 | $6,375 | |
| LICENSES & TAXES | $4,819 | $4,819 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $188,894 | TotalAmt |
| Program Services | $187,449 | ProgramServicesAmt |
| Management And General | $1,445 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,691,395 | TotalAmt |
| Program Services | $10,151,171 | ProgramServicesAmt |
| Management And General | $1,540,224 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,494,639 | BOYAmt |
| EOY | $4,065,887 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $150,000 | BOYAmt |
| EOY | $150,000 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $584,507 | BOYAmt |
| EOY | $812,004 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $155,983 | BOYAmt |
| EOY | $120,154 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $3,337,339 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,970,080 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,243,760 | BOYAmt |
| EOY | $1,367,259 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,686,831 | BOYAmt |
| EOY | $13,055,402 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,315,720 | BOYAmt |
| EOY | $19,570,706 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $349,521 | BOYAmt |
| EOY | $383,581 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $358,053 | BOYAmt |
| EOY | $357,933 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,952,900 | BOYAmt |
| EOY | $2,921,299 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,660,474 | BOYAmt |
| EOY | $3,662,813 | 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 | $14,505,246 | BOYAmt |
| EOY | $15,757,893 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $150,000 | BOYAmt |
| EOY | $150,000 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,655,246 | BOYAmt |
| EOY | $15,907,893 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,315,720 | BOYAmt |
| EOY | $19,570,706 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $1,443,405 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$190,758 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| 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 | 0 | FederalGrantAuditRequiredInd |
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
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,337,339 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,970,080 | DepreciationAmt |
| Book Value | $1,367,259 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,367,259 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| DUE TO RELATED ORGANIZATIONS | $2,718,968 |
| CLAIMS LIABILITY | $202,331 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $2,921,299 | TotalLiabilityAmt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | EL CAMINO HOSPITAL | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2500 GRANT ROAD | AddressLine1Txt |
| City | MOUNTAIN VIEW | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 94040 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 943167314 | RecipientEIN |
| IRC Section | STATE OF CA | IRCSectionDesc |
| Cash Grant | $357,597 | CashGrantAmt |
| Non Cash Assistance | $0 | NonCashAssistanceAmt |
| Purpose Of Grant | TRANSFER FOR COMMUNITY BENEFIT | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 1 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2: | FormAndLineReferenceDesc |
| Explanation | CONCERN PROVIDES GRANTS SOLELY TO EL CAMINO HOSPITAL, CONCERN'S SOLE MEMBER. MONITORING USE OF GRANTS FUNDS IS ACHIEVED THROUGH OVERLAPPING BOARD MEMBERS OF CONCERN WHO ALSO SERVE AS EXECUTIVES OF EL CAMINO HOSPITAL. PERIODIC REPORTS OUTLINING HOW GRANT FUNDS ARE EXPENDED MAY ALSO BE REQUIRED. | ExplanationTxt |
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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DEANNA DUDLEY | ||||||||||||||
| BOARD MEMBER / VP OF HR, ECH | $0 | $517,377 | $0 | $0 | $0 | $0 | $0 | $16,758 | $0 | $15,043 | $0 | $549,178 | $0 | $0 |
| CECILE CURRIER | ||||||||||||||
| BOARD MEMBER / CEO | $444,312 | $0 | $0 | $0 | $0 | $0 | $57,446 | $0 | $30,866 | $0 | $532,624 | $0 | $0 | $0 |
| ANDREW COPE | ||||||||||||||
| BOARD MEMBER / PRESIDENT OF ECHF | $0 | $376,253 | $0 | $0 | $0 | $0 | $0 | $31,123 | $0 | $39,745 | $0 | $447,121 | $0 | $0 |
| PRIYA DHARAN | ||||||||||||||
| MANAGER, BUSINESS DEVELOPMENT | $202,662 | $0 | $0 | $0 | $0 | $0 | $12,016 | $0 | $13,107 | $0 | $227,785 | $0 | $0 | $0 |
| ASHISH MATHUR | ||||||||||||||
| EXECUTIVE DIRECTOR, SAHC | $163,955 | $0 | $0 | $0 | $0 | $0 | $21,143 | $0 | $30,786 | $0 | $215,884 | $0 | $0 | $0 |
| DIKSHYA ADHIKARI | ||||||||||||||
| DIRECTOR OF OPERATIONS & CLIENT EXP | $168,918 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $20,566 | $0 | $189,484 | $0 | $0 | $0 |
| MARGOT BROWN | ||||||||||||||
| SUPERVISOR, EAP CLINICAL SERVICES | $154,940 | $0 | $0 | $0 | $0 | $0 | $14,148 | $0 | $14,215 | $0 | $183,303 | $0 | $0 | $0 |
| ANN WAGNER | ||||||||||||||
| ACCOUNT EXECUTIVE | $137,069 | $0 | $0 | $0 | $0 | $0 | $14,362 | $0 | $31,187 | $0 | $182,618 | $0 | $0 | $0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THE ORGANIZATION HAS ONE SOLE MEMBER: EL CAMINO HOSPITAL. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE BOARD OF DIRECTORS OF EL CAMINO HOSPITAL ELECTS ALL MEMBERS OF THE GOVERNING BODY OF CONCERN. |
| FORM 990, PART VI, SECTION A, LINE 7B | EL CAMINO HOSPITAL SHALL HAVE THE RIGHT TO VOTE ON: (I) THE DISPOSITION OF ALL OR SUBSTANTIALLY ALL OF CONCERN'S ASSETS; (II) ON ANY MERGER AND ITS PRINCIPAL TERMS AND ANY AMENDMENT OF THOSE TERMS, AND (III) ON ANY ELECTION TO DISSOLVE THE CORPORATION. EL CAMINO HOSPITAL ALSO HAS THE RIGHT TO APPROVE THE ADOPTION OF AMENDMENTS TO THE BYLAWS AND TO THE ARTICLES OF INCORPORATION OF CONCERN. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 IS PREPARED BY AN INDEPENDENT ACCOUNT IN CONJUNCTION WITH THE ACCOUNTING AND FINANCE DEPARTMENT OF EL CAMINO HOSPITAL, CONCERN'S SOLE MEMBER. THE CONTROLLER OF EL CAMINO HOSPITAL THEN REVIEWS A DRAFT OF THE FORM 990 PRIOR TO FILING WITH THE INTERNAL REVENUE SERVICE. |
| FORM 990, PART VI, SECTION B, LINE 12C | CONCERN IS COVERED BY THE CONFLICT OF INTEREST POLICY OF EL CAMINO HOSPITAL (ECH), ITS SOLE MEMBER. UNDER THE CONFLICT OF INTEREST POLICY, ALL EMPLOYEES AND GOVERNING BOARD MEMBERS ARE REQUIRED TO DISCLOSE POTENTIAL CONFLICTS OF INTEREST AS SOON AS POSSIBLE TO THE PERSON THEY REPORT TO; GOVERNING BOARD MEMBERS AND EXECUTIVES ARE ALSO REQUIRED TO COMPLETE A CONFLICT OF INTEREST DISCLOSURE STATEMENT ON AN ANNUAL BASIS AND SUBMIT TO CORPORATE COMPLIANCE OFFICER. FOR POTENTIAL CONFLICTS OF INTERESTS INVOLVING EMPLOYEES, THE INDIVIDUAL MUST DISCLOSE THE FACTS GIVING RISE TO THE INTEREST TO THE CORPORATE COMPLIANCE OFFICER, CEO, OR IMMEDIATE SUPERVISOR (AS APPROPRIATE). AFTER DISCLOSURE, THE IMMEDIATE SUPERVISOR OF THE PERSON MAKING THE DISCLOSURE, THE KEY MANAGER IN CHARGE OF THE TRANSACTION, OR THE CORPORATE COMPLIANCE OFFICER SHALL DETERMINE WHETHER THE INTEREST CREATES A POTENTIAL CONFLICT OF INTEREST AND IF SO, TAKE APPROPRIATE STEPS TO MITIGATE OR ELIMINATE THE EFFECT OF THE POTENTIAL CONFLICT OF INTEREST ON THE PROPOSED TRANSACTION (INCLUDING EXCLUSION OF THE PERSON WITH THE CONFLICT OF INTEREST FROM NEGOTIATING OR EVALUATING THE TRANSACTION OR ARRANGEMENT, EXCLUSION OF THE ENTITY OR INDIVIDUAL IN WHICH THE PERSON HAS A CONFLICT OF INTEREST FROM THE NEGOTIATION OR SELECTION PROCESS, AND APPROPRIATE DISCLOSURE TO THE BOARD). FOR POTENTIAL CONFLICTS OF INTEREST INVOLVING BOARD MEMBERS, THE MATTER SHALL BE REPORTED TO THE CEO AND REFERRED TO ECH'S AD HOC INTERESTS COMMITTEE FOR DETERMINATION AS TO WHETHER A POTENTIAL CONFLICT OF INTEREST EXISTS. IF THE AD HOC INTERESTS COMMITTEE DETERMINES A DISCLOSABLE CONFLICT EXISTS, THE MATTER IS REFERRED TO THE BOARD. A REPORT IS SUBMITTED TO THE CHAIRPERSON OF THE BOARD CONTAINING RECOMMENDATIONS FOR MITIGATION OF THE CONFLICT OF INTEREST, WHICH INCLUDE REQUESTING SUCH BOARD MEMBER: (I) LEAVE THE ROOM DURING ALL OR PART OF THE RELATED PRESENTATIONS AND DISCUSSIONS; (II) REFRAIN FROM PARTICIPATING IN ALL OR PART OF THE RELATED PRESENTATION DISCUSSIONS; AND (III) REFRAIN FROM VOTING ON ANY MATTERS RELATED TO THE ACTUAL OR POTENTIAL CONFLICT OF INTEREST. |
| FORM 990, PART VI, SECTION B, LINE 15A | COMPENSATION FOR THE CEO AND OTHER KEY EMPLOYEES IS ESTABLISHED BY INDEPENDENT MEMBERS OF THE BOARD OF DIRECTORS, WHO UTILIZE MARKET SURVEY INFORMATION OF SIMILARLY SITUATED ORGANIZATIONS IN SIMILAR GEOGRAPHIC REGIONS TO DETERMINE REASONABLE COMPENSATION. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 2,287,088. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,287,088. MEDICAL OUTSIDE SERVICES: PROGRAM SERVICE EXPENSES 4,005,174. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 4,005,174. PATIENT TRANSPORATION: PROGRAM SERVICE EXPENSES 125,979. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 125,979. CONSULTING AND MANAGEMENT FEES: PROGRAM SERVICE EXPENSES 0. MANAGEMENT AND GENERAL EXPENSES 97,385. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 97,385. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| EL CAMINO HEALTHCARE DISTRICT | |||||||||||
| 2500 GRANT ROAD | MOUNTAIN VIEW | CA | 94040 | 946033890 | ESTABLISH, MAINTAIN AND OPERATE, AND PROVIDE ASSISTANCE IN HEALTH FACILITIES | CA | N/A | 0 | |||
| EL CAMINO HOSPITAL | |||||||||||
| 2500 GRANT ROAD | MOUNTAIN VIEW | CA | 94040 | 943167314 | PROVISION OF HEALTH CARE SERVICES | CA | 0 | EL CAMINO HEALTHCARE DISTRICT | |||
| EL CAMINO HOSPITAL FOUNDATION | |||||||||||
| 2500 GRANT ROAD | MOUNTAIN VIEW | CA | 94040 | 942823235 | FUNDRAISING ACTIVITIES ON BEHALF OF EL CAMINO HOSPITAL | CA | 0 | EL CAMINO HOSPITAL | 501(C)(3) | LINE 7 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | 0 | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | Yes (1) | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (1) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |