UCSF HEALTH MEDICAL FOUNDATION: Form 990, tax year 2020
View the entire original 990 at ProPublica ↗
- Organization
- UCSF HEALTH MEDICAL FOUNDATION (EIN 86-1175591)
- Tax period
- 2020-07-01 to 2021-06-30
- Filed
- 2022-05-03
- IRS object ID
- 202201249349300700
- Schema version
- 2020v4.2
- 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 | 2022-05-03T23:03:20-05:00 | ReturnTs |
| Tax Period End | 2021-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 946214841 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ARMANINO LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 12657 ALCOSTA BLVD STE 500 | AddressLine1Txt |
| City | SAN RAMON | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 945834600 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2020-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 861175591 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BAYCHILDREN'S PHYSICIANS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | BAYC | BusinessNameControlTxt |
| Phone | 4154767220 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6475 CHRISTIE AVENUE NO 300 | AddressLine1Txt |
| City | EMERYVILLE | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 94608 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MITCHELL NEYHART | PersonNm |
| Person Title | CHIEF EXECUTIVE OFFICER | PersonTitleTxt |
| Phone | 4154767220 | PhoneNum |
| Signature | 2022-04-30 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | MITCHELL | PersonFirstNm |
| Person Last | NEYHART | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MATTHEW PETROSKI | PreparerPersonNm |
| PTIN | P00853132 | PTIN |
| Phone | 9257902600 | PhoneNum |
| Preparation | 2022-04-30 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2020 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | UCSF BENIOFF CHILDREN'S PHYSICIANS | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MITCHELL NEYHART | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6475 CHRISTIE AVENUE NO 300 | AddressLine1Txt |
| City | EMERYVILLE | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 94608 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $53,507,740 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2007 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | THE MISSION OF BAY CHILDREN'S PHYSICIANS IS THREEFOLD: TO ESTABLISH, OPERATE AND MAINTAIN MEDICAL CLINICS FOR THE PROVISION OF HEALTHCARE SERVICES IN CALIFORNIA; TO PROMOTE HEALTH BY PROVIDING, COORDINATING, INTEGRATING AND FACILITATING HEALTH CARE, MEDICAL AND WELLNESS SERVICES FOR CHILDREN AND FAMILIES; TO CONDUCT, SPONSOR AND SUPPORT MEDICAL RESEARCH, MEDICAL EDUCATION AND HEALTH EDUCATION. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 0 | VotingMembersIndependentCnt |
| Total Employee | 182 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $53,309,019 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $53,403,837 | CYProgramServiceRevenueAmt |
| PY Investment Income | $241,816 | PYInvestmentIncomeAmt |
| CY Investment Income | -$2,757 | CYInvestmentIncomeAmt |
| PY Other Revenue | $150,589 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $53,701,424 | PYTotalRevenueAmt |
| CY Total Revenue | $53,401,080 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $13,403,707 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $13,448,199 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $40,297,717 | PYOtherExpensesAmt |
| CY Other Expenses | $39,952,881 | CYOtherExpensesAmt |
| PY Total Expenses | $53,701,424 | PYTotalExpensesAmt |
| CY Total Expenses | $53,401,080 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $0 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $0 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $9,056,932 | TotalAssetsBOYAmt |
| Total Assets EOY | $9,899,523 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $9,056,932 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $9,899,523 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $0 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $0 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | SEE SCHEDULE OTHE MISSION OF BAY CHILDREN'S PHYSICIANS IS THREEFOLD: 1) TO ESTABLISH, OPERATE AND MAINTAIN MEDICAL CLINICS FOR THE PROVISION OF HEALTHCARE SERVICES IN CALIFORNIA; 2) TO PROMOTE HEALTH BY PROVIDING, COORDINATING, INTEGRATING AND FACILITATING HEALTH CARE, MEDICAL AND WELLNESS SERVICES FOR CHILDREN AND FAMILIES; AND 3) TO CONDUCT, SPONSOR AND SUPPORT MEDICAL RESEARCH, MEDICAL EDUCATION AND HEALTH EDUCATION. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $49,475,488 | ExpenseAmt |
| Revenue | $53,403,837 | RevenueAmt |
| Desc | THE FOUNDATION IS A MULTI-SPECIALTY PHYSICIAN FOUNDATION WITH A PRIMARY GOAL OF FOSTERING PHYSICIAN COLLABORATION TO DELIVER ADVANCED PEDIATRIC CARE. THE SPECIFIC AND PRIMARY PURPOSES OF THE FOUNDATION ARE TO PERFORM AND CARRY OUT CHARITABLE HEALTH FUNCTIONS AND PURPOSES BY CONDUCTING THE FOLLOWING ACTIVITIES: (1) ESTABLISHING, OPERATING AND MAINTAINING MEDICAL CLINICS FOR THE PROVISION OF HEALTHCARE SERVICES IN CALIFORNIA, PURSUANT TO THE PROVISION OF SECTION 1206(1) OF THE CALIFORNIA HEALTH AND SAFETY CODE; (2) PROMOTING HEALTH BY PROVIDING, COORDINATING, INTEGRATING, AND FACILITATING HEALTHCARE, MEDICAL AND WELLNESS SERVICES FOR CHILDREN; (3) CONDUCTING, SPONSORING AND SUPPORTING MEDICAL RESEARCH, MEDICAL EDUCATION, AND HEALTH EDUCATION; AND (4) ENGAGING IN ANY OTHER ACTIVITIES PERMITTED FOR A CORPORATION ORGANIZED UNDER THE NONPROFIT PUBLIC BENEFIT CORPORATION LAW.THE FOUNDATION CONTRACTS WITH PEDIATRIC MULTISPECIALTY MEDICAL GROUP ("PMMG") TO PROVIDE PHYSICIAN SERVICES. PMMG EMPLOYS APPROXIMATELY 68 PHYSICIANS WHO PRIMARILY WORK IN BCH-O CLINICS AND AT BCH-O. BEGINNING IN JANUARY 2015, THE FOUNDATION ESTABLISHED A PROFESSIONAL SERVICE AGREEMENT WITH BAY CHILDREN'S MEDICAL GROUP (BCMG). DURING THE YEAR ENDED JUNE 30, 2021, BCMG EMPLOYED 35 PHYSICIANS WHO SPLIT TIME BETWEEN BCH-O CLINICS AND COMMUNITYBASED OFFICES. | Desc |
| Total Program Service Expenses | $49,475,488 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | 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 | 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 | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | 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 | 0 | 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 | Yes (1) | 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 |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 24 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 182 | 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 | 9 | 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 | 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 | CA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LUAL LUALHATI ACCOUNTING MANAGER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 4154764977 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6475 CHRISTIE AVENUE NO 300 | AddressLine1Txt |
| City | EMERYVILLE | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 94608 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (16 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| MITCHELL NEYHART | ||||||||
| CHIEF EXECUTIVE OFFICER | 40.00 | Yes (X) | Yes (X) | $411,724 | $0 | $66,593 | ||
| MICHAEL ANDERSON MD | ||||||||
| DIRECTOR (THRU 08/20) | 1.00 | Yes (X) | $0 | $993,135 | $44,394 | 39.00 | ||
| RAJU IYER | ||||||||
| TREASURER | 1.00 | Yes (X) | Yes (X) | $0 | $909,675 | $38,209 | 39.00 | |
| JOSHUA ADLER MD | ||||||||
| CHAIRMAN | 1.00 | Yes (X) | Yes (X) | $0 | $798,051 | $54,528 | 39.00 | |
| AMY MURTHA | ||||||||
| DIRECTOR (AS OF 09/20) | 1.00 | Yes (X) | $0 | $778,980 | $62,262 | 39.00 | ||
| STEVE WILSON MD | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $578,085 | $57,959 | 39.00 | ||
| SABINA ALI | ||||||||
| DIRECTOR (AS OF 04/21) | 1.00 | Yes (X) | $0 | $233,879 | $34,758 | 39.00 | ||
| TED CHACONAS MD | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | 39.00 | ||
| SAM PEJHAM | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | 39.00 | ||
| MATTHEW COOK | ||||||||
| DIRECTOR (AS OF 01/21) | 1.00 | Yes (X) | $0 | $0 | $0 | 39.00 | ||
| LEANNE PASHKOV | ||||||||
| CHIEF OPERATING OFFICER | 40.00 | Yes (X) | $248,860 | $0 | $59,008 | |||
| MARY FAULKNER | ||||||||
| PRACTICE DIRECTOR | 40.00 | $200,091 | $0 | $37,073 | Yes (X) | |||
| KATIA MOUSSA | ||||||||
| PRACTICE DIRECTOR | 40.00 | $175,424 | $0 | $56,428 | Yes (X) | |||
| DENISE JIMENEZ | ||||||||
| HUMAN RESOURCES DIRECTOR | 40.00 | $169,864 | $0 | $55,397 | Yes (X) | |||
| AMANDA BERGLUND | ||||||||
| FINANCE DIRECTOR | 40.00 | $212,534 | $0 | $20,118 | Yes (X) | |||
| LUAL LUALHATI | ||||||||
| SR ACCOUNTING MANAGER | 40.00 | $161,666 | $0 | $42,332 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,580,163 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $4,291,805 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $629,059 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 8 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (4 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| CHANGE HEALTHCARE | |||||
| PO BOX 742526 | ATLANTA | GA | 30374 | BILLING SERVICES | $494,379 |
| COMPHEALTH | |||||
| PO BOX 972651 | DALLAS | TX | 75397 | PHYSICIAN SERVICES | $358,224 |
| PHYSICIAN'S COMPUTER CO INC | |||||
| 20 WINOOSKI FALLS WY SUITE 7 | WINOOSKE | VT | 05404 | BILLING SERVICES | $194,530 |
| B E SMITH | |||||
| PO BOX 219241 | KANSAS CITY | MO | 64121 | FINANCIAL CONSULTING | $105,787 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PHYSICIAN SERVICE REV | 541900 | $33,332,265 | $33,332,265 |
| NET PATIENT REVENUE | 541900 | $20,071,572 | $20,071,572 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $53,403,837 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $16,501 | TotalRevenueColumnAmt |
| Exclusion | $16,501 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $87,402 | OtherAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $106,660 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$19,258 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$19,258 | TotalRevenueColumnAmt |
| Exclusion | -$19,258 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $53,401,080 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $53,403,837 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$2,757 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $776,964 | TotalAmt |
| Management And General | $776,964 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,724,108 | TotalAmt |
| Program Services | $7,334,685 | ProgramServicesAmt |
| Management And General | $1,389,423 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $844,029 | TotalAmt |
| Program Services | $683,834 | ProgramServicesAmt |
| Management And General | $160,195 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,103,098 | TotalAmt |
| Program Services | $2,514,137 | ProgramServicesAmt |
| Management And General | $588,961 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $49,473 | TotalAmt |
| Management And General | $49,473 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $50,879 | TotalAmt |
| Management And General | $50,879 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $33,292,653 | TotalAmt |
| Program Services | $32,997,458 | ProgramServicesAmt |
| Management And General | $295,195 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,326 | TotalAmt |
| Program Services | $2,506 | ProgramServicesAmt |
| Management And General | $820 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $161,555 | TotalAmt |
| Program Services | $115,289 | ProgramServicesAmt |
| Management And General | $46,266 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,684,081 | TotalAmt |
| Program Services | $2,189,170 | ProgramServicesAmt |
| Management And General | $494,911 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,208 | TotalAmt |
| Program Services | $29,756 | ProgramServicesAmt |
| Management And General | $8,452 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,264,482 | TotalAmt |
| Program Services | $1,242,653 | ProgramServicesAmt |
| Management And General | $21,829 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $175,474 | TotalAmt |
| Program Services | $175,474 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| PHARMACEUTICALS | $1,504,968 | $1,504,968 | |
| SUPPLIES | $631,723 | $590,260 | $41,463 |
| ALL OTHER EXPENSES | $79,003 | $78,479 | $524 |
| RECRUITING | $9,658 | $9,421 | $237 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,398 | TotalAmt |
| Program Services | $7,398 | ProgramServicesAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $53,401,080 | TotalAmt |
| Program Services | $49,475,488 | ProgramServicesAmt |
| Management And General | $3,925,592 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,404,938 | BOYAmt |
| EOY | $4,419,945 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,210,874 | BOYAmt |
| EOY | $1,953,927 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $99,877 | BOYAmt |
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $381,036 | BOYAmt |
| EOY | $295,623 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $7,294,842 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $4,180,362 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,854,348 | BOYAmt |
| EOY | $3,114,480 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $105,859 | BOYAmt |
| EOY | $115,548 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,056,932 | BOYAmt |
| EOY | $9,899,523 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,599,760 | BOYAmt |
| EOY | $5,113,951 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,457,172 | BOYAmt |
| EOY | $4,785,572 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,056,932 | BOYAmt |
| EOY | $9,899,523 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,056,932 | BOYAmt |
| EOY | $9,899,523 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $0 | ReconcilationRevenueExpnssAmt |
| 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) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $57,964,863 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $59,500,048 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $57,266,702 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $53,459,608 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $53,403,837 | CurrentTaxYearAmt |
| Total | $281,595,058 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $57,964,863 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $59,500,048 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $57,266,702 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $53,459,608 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $53,403,837 | CurrentTaxYearAmt |
| Total | $281,595,058 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $281,595,058 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $33,553 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $26,696 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $19,040 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $14,210 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $16,501 | CurrentTaxYearAmt |
| Total | $110,000 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $33,553 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $26,696 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $19,040 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $14,210 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $16,501 | CurrentTaxYearAmt |
| Total | $110,000 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $57,998,416 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $59,526,744 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $57,285,742 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $53,473,818 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $53,420,338 | CurrentTaxYearAmt |
| Total | $281,705,058 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99960 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99970 | PublicSupportPY509Pct |
| Investment Income CY | 0.00040 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00030 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule D IRS990ScheduleD
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,552,627 | OtherCostOrOtherBasisAmt |
| Depreciation | $694,529 | DepreciationAmt |
| Book Value | $858,098 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $5,580,175 | OtherCostOrOtherBasisAmt |
| Depreciation | $3,323,793 | DepreciationAmt |
| Book Value | $2,256,382 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $162,040 | OtherCostOrOtherBasisAmt |
| Depreciation | $162,040 | DepreciationAmt |
| Book Value | $0 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $3,114,480 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| DUE TO PEDIATRIC MULTISPECIALTY MEDICAL GROUP | $349,895 |
| DUE TO RELATED PARTIES | $4,034,709 |
| PAYABLE TO BAY CHILDREN'S MEDICAL GROUP | $400,968 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $4,785,572 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $53,401,080 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $53,401,080 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $53,401,080 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $53,401,080 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $53,401,080 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $53,401,080 | TotalExpensesPerForm990Amt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| 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 (13 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MICHAEL ANDERSON MD | ||||||||||||||
| DIRECTOR (THRU 08/20) | $0 | $825,042 | $0 | $164,284 | $0 | $3,809 | $0 | $22,800 | $0 | $21,594 | $0 | $1,037,529 | $0 | $0 |
| RAJU IYER | ||||||||||||||
| TREASURER | $0 | $793,699 | $0 | $113,340 | $0 | $2,636 | $0 | $22,800 | $0 | $15,409 | $0 | $947,884 | $0 | $0 |
| JOSHUA ADLER MD | ||||||||||||||
| CHAIRMAN | $0 | $694,146 | $0 | $99,089 | $0 | $4,816 | $0 | $32,234 | $0 | $22,294 | $0 | $852,579 | $0 | $0 |
| AMY MURTHA | ||||||||||||||
| DIRECTOR (AS OF 09/20) | $0 | $778,895 | $0 | $0 | $0 | $85 | $0 | $30,858 | $0 | $31,404 | $0 | $841,242 | $0 | $0 |
| STEVE WILSON MD | ||||||||||||||
| DIRECTOR | $0 | $509,687 | $0 | $68,398 | $0 | $0 | $0 | $35,298 | $0 | $22,661 | $0 | $636,044 | $0 | $0 |
| MITCHELL NEYHART | ||||||||||||||
| CHIEF EXECUTIVE OFFICER | $411,724 | $0 | $0 | $0 | $0 | $0 | $28,500 | $0 | $38,093 | $0 | $478,317 | $0 | $0 | $0 |
| LEANNE PASHKOV | ||||||||||||||
| CHIEF OPERATING OFFICER | $248,860 | $0 | $0 | $0 | $0 | $0 | $25,252 | $0 | $33,756 | $0 | $307,868 | $0 | $0 | $0 |
| SABINA ALI | ||||||||||||||
| DIRECTOR (AS OF 04/21) | $0 | $232,718 | $0 | $971 | $0 | $190 | $0 | $12,323 | $0 | $22,435 | $0 | $268,637 | $0 | $0 |
| MARY FAULKNER | ||||||||||||||
| PRACTICE DIRECTOR | $200,091 | $0 | $0 | $0 | $0 | $0 | $20,527 | $0 | $16,546 | $0 | $237,164 | $0 | $0 | $0 |
| AMANDA BERGLUND | ||||||||||||||
| FINANCE DIRECTOR | $212,534 | $0 | $0 | $0 | $0 | $0 | $20,118 | $0 | $0 | $0 | $232,652 | $0 | $0 | $0 |
| KATIA MOUSSA | ||||||||||||||
| PRACTICE DIRECTOR | $175,424 | $0 | $0 | $0 | $0 | $0 | $17,726 | $0 | $38,702 | $0 | $231,852 | $0 | $0 | $0 |
| DENISE JIMENEZ | ||||||||||||||
| HUMAN RESOURCES DIRECTOR | $169,864 | $0 | $0 | $0 | $0 | $0 | $17,356 | $0 | $38,041 | $0 | $225,261 | $0 | $0 | $0 |
| LUAL LUALHATI | ||||||||||||||
| SR ACCOUNTING MANAGER | $161,666 | $0 | $0 | $0 | $0 | $0 | $16,287 | $0 | $26,045 | $0 | $203,998 | $0 | $0 | $0 |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| BAYCHILDREN'S MEDICAL GROUP | |||
| ENTITY MORE THAN 35% OWNED BY TED CHACONAS AND STEVE WILSON | $8,025,000 | PHYSICIAN SERVICES | 0 |
| TRI-VALLEY PEDIATRICS | |||
| ENTITY MORE THAN 35% OWNED BY SAM PEJHAM | $4,911,517 | PHYSICIAN SERVICES | 0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | BCP SHALL HAVE TWO MEMBERS: THE REGENTS OF THE UNIVERSITY OF CALIFORNIA, A CALIFORNIA CONSTITUTIONAL CORPORATION ACTING ON BEHALF OF THE UNIVERSITY OF CALIFORNIA, SAN FRANCISCO, AND CHILDREN'S HOSPITAL AND RESEARCH CENTER AT OAKLAND, A CALIFORNIA NONPROFIT PUBLIC BENEFIT CORPORATION. THEY SHALL HAVE ALL THE RIGHTS OF MEMBERS OF A CALIFORNIA NONPROFIT PUBLIC BENEFIT CORPORATION THAT ARE PROVIDED IN THE CALIFORNIA CORPORATIONS CODE AND THESE BYLAWS, INCLUDING THE RIGHT TO VOTE. THE MEMBERS MAY EXERCISE THEIR VOTES AND ATTEND MEMBERSHIP MEETINGS OF BCP BY RESOLUTIONS OF THE MEMBERS' RESPECTIVE GOVERNING BODIES OR THROUGH THE ACTION OF ANY PERSON EXPRESSLY AUTHORIZED BY THE MEMBERS' RESPECTIVE GOVERNING BODIES. MEMBERS WILL NOT HAVE ANY PROPERTY RIGHTS AND NO INDIVIDUAL LIABILITY. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE BOARD SHALL NOT WITHOUT PRIOR WRITTEN APPROVAL OF BOTH MEMBERS, WHICH APPROVAL MAY BE GIVEN, WITHHELD OR CONDITIONED BY EACH MEMBER IN ITS SOLE AND ABSOLUTE DISCRETION, PERFORM OR COMMIT OR AUTHORIZE OR DIRECT ANY OFFICER OF BCP TO PERFORM OR COMMIT THE ELECTION OR REMOVAL, WITH OR WITHOUT CAUSE, AFTER CONSULTATION WITH THE BOARD, OF THE CHAIR OF THE BOARD, THE VICE-CHAIR, THE SECRETARY, THE EXECUTIVE DIRECTOR, THE MEDICAL DIRECTOR OR THE TREASURER OF BCP. |
| FORM 990, PART VI, SECTION A, LINE 7B | MEMBERS SHALL ELECT THE FOLLOWING PERSONS TO THE BOARD: HALF OF THE NON-EX OFFICIO DIRECTORS CAN BE SELECTED BY UC IN ITS SOLE DISCRETION, SUBJECT ONLY TO THE RESTRICTIONS SET FORTH IN BCP'S BYLAWS. AS WELL AS HALF OF THE NON-EX OFFICIO DIRECTORS CAN BE SELECTED BY CHRCO IN ITS SOLE DISCRETION, SUBJECT ONLY TO THE RESTRICTIONS SET FORTH IN BCP'S BYLAWS. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE TAX PREPARERS FURNISH A DRAFT COPY OF THE FORM 990 TO THE ORGANIZATION. THE DRAFT OF THE FORM 990 WILL BE REVIEWED BY THE CHIEF EXECUTIVE OFFICER AND BOARD MEMBERS. FOLLOWING THIS REVIEW, ANY CHANGES WILL BE INCORPORATED AND THIS NEW DRAFT WILL BE SUBMITTED FOR FINAL APPROVAL. THE FINAL FORM 990 WILL BE DISTRIBUTED TO BOARD MEMBERS FOR REVIEW BEFORE FILING WITH THE INTERNAL REVENUE SERVICE. |
| FORM 990, PART VI, SECTION B, LINE 12C | ALL INTERESTED PERSONS ARE REQUIRED TO COMPLETE AN ANNUAL DISCLOSURE STATEMENT IN REGARDS TO POTENTIAL OR ACTUAL CONFLICTS OF INTERESTS. IF AN ACTUAL OR POTENTIAL CONFLICT OCCURS, THE BOARD SHALL APPOINT A COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION. THE BOARD SHALL EXERCISE DUE DILIGENCE IN DETERMINING WHETHER THE PROPOSED TRANSACTION IS FAIR AND REASONABLE. IN REGARDS TO A FAILED DISCLOSURE OF A CONFLICT OF INTEREST: THE BOARD SHALL ALLOW THE INTERESTED PERSON AN OPPORTUNITY TO EXPLAIN THE FAILURE TO DISCLOSE AND DETERMINE APPROPRIATE DISCIPLINARY AND CORRECTIVE ACTION. |
| FORM 990, PART VI, SECTION B, LINE 15 | COMPENSATION FOR THE EXECUTIVE DIRECTOR WAS REVIEWED AND APPROVED BY THE INDEPENDENT BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION C, LINE 19 | CALIFORNIA LAW REQUIRES THAT THE CORPORATION FILE ITS ARTICLES OF INCORPORATION (AND ANY AMENDMENTS OR RESTATEMENTS WITH RESPECT THERETO) WITH THE CALIFORNIA SECRETARY OF STATE. BAYCHILDREN'S PHYSICIANS HAS DONE SO. COPIES OF THE ARTICLES CAN BE OBTAINED BY MEMBERS OF THE PUBLIC THROUGH THE OFFICE OF THE CALIFORNIA SECRETARY OF STATE. THERE IS NO LEGAL REQUIREMENT THAT THE CORPORATION PROVIDE COPIES OF ITS GOVERNANCE DOCUMENTS DIRECTLY TO MEMBERS OF THE PUBLIC. TO OBTAIN A COPY OF THE GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS, ONE MUST SUBMIT A WRITTEN REQUEST TO THE RISK MANAGEMENT DEPARTMENT OF BAYCHILDREN'S PHYSICIANS AND A COPY WILL BE SENT TO THE RETURN ADDRESS. |
| FORM 990, PART IX, LINE 11G | PHYSICIAN SERVICES: PROGRAM SERVICE EXPENSES 29,637,901. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 29,637,901. PURCHASED SERVICES: PROGRAM SERVICE EXPENSES 3,359,557. MANAGEMENT AND GENERAL EXPENSES 295,195. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 3,654,752. |
| FORM 990, PART XII, LINE 2C | THE AUDIT COMMITTEE ASSUMES RESPONSIBILITY FOR FINANCIAL OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS. FURTHER, THE BOARD APPROVES THE AUDITED FINANCIAL STATEMENTS BASED ON RECOMMENDATION FROM THE AUDIT COMMITTEE. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| UCSF BENIOFF CHILDREN'S HOSPITAL OAKLAND | |||||||||||
| 747 52ND STREET | OAKLAND | CA | 94609 | 940382330 | HEALTHCARE | CA | 501(C)(3) | LINE 3 | N/A | 0 | |
| UCSF BENIOFF CHILDREN HOSPITAL FOUNDATION | |||||||||||
| 2201 BROADWAY STE 600 | OAKLAND | CA | 94609 | 941657474 | CHARITABLE FOUNDATION | CA | 501(C)(3) | LINE 7 | 0 | UCSF BENIOFF CHILDREN'S HOSPITAL OAKLAND | |
| CHILDREN'S HOSPITAL OAKLAND FAMILY HOUSE | |||||||||||
| 5222 DOVER STREET | OAKLAND | CA | 94609 | 942909976 | TEMPORARY LODGING FOR PATIENT FAMILIES | CA | 501(C)(3) | LINE 7 | 0 | UCSF BENIOFF CHILDREN'S HOSPITAL OAKLAND | |
| THE REGENTS OF THE UNIVERSITY OF CALIFORNIA | |||||||||||
| 1111 FRANKLIN STREET | OAKLAND | CA | 94607 | 946036493 | PUBLIC EDUCATIONAL INSTITUTION | CA | 501(C)(3) | LINE 6 | N/A | 0 | |
| FOUNDATION FOR CHILDREN'S CARE DBA FAMILY LEGACY FUND | |||||||||||
| 2201 BROADWAY STE 600 | OAKLAND | CA | 94612 | 912145422 | SUPPORT CHARITABLE ACTIVITIES OF CHILDREN'S FOUNDATION | CA | 501(C)(3) | LINE 12A, I | 0 | UCSF BENIOFF CHILDREN HOSPITAL FOUNDATION | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | 0 | 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 | Yes (1) | 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 | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |