AVALON MEDICAL DEVELOPMENT CORPORATION: Form 990, tax year 2023
View the entire original 990 at ProPublica ↗
- Organization
- AVALON MEDICAL DEVELOPMENT CORPORATION (EIN 33-0222508)
- Tax period
- 2023-07-01 to 2024-06-30
- Filed
- 2025-05-15
- IRS object ID
- 202541359349311714
- 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 | 2025-05-15T14:50:06-05:00 | ReturnTs |
| Tax Period End | 2024-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 390758449 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | WIPFLI LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1502 LONDON ROAD SUITE 200 | AddressLine1Txt |
| City | DULUTH | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55812 | 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 | 330222508 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AVALON MEDICAL DEVELOPMENT CORPORATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | AVAL | BusinessNameControlTxt |
| Phone | 3105100700 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1563 | AddressLine1Txt |
| City | AVALON | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 90704 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JASON PARET | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 3105100700 | PhoneNum |
| Signature | 2025-05-13 | 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 | MICHAEL J PETERSON CPA | PreparerPersonNm |
| PTIN | P01833529 | PTIN |
| Phone | 2187224705 | PhoneNum |
| Preparation | 2025-05-08 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2023 | TaxYr |
| Build TS | 2025-03-06 01:10:19Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CATALINA ISLAND MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | JASON PARET | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1563 | AddressLine1Txt |
| City | AVALON | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 90704 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $19,083,765 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | CATALINAISLANDHEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1987 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | PROVIDE HEALTHCARE BENEFITS TO THE COMMUNITY OF CATALINA ISLAND AND MORE THAN 1 MILLION VISITORS EACH YEAR. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 135 | TotalEmployeeCnt |
| Total Volunteers | 9 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $2,914,990 | PYContributionsGrantsAmt |
| CY Contributions Grants | $5,086,457 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $19,140,299 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $13,979,635 | CYProgramServiceRevenueAmt |
| PY Investment Income | $13,642 | PYInvestmentIncomeAmt |
| CY Investment Income | -$14,226 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $22,068,931 | PYTotalRevenueAmt |
| CY Total Revenue | $19,051,866 | 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 | $8,927,344 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $9,712,311 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $10,327,883 | PYOtherExpensesAmt |
| CY Other Expenses | $9,238,221 | CYOtherExpensesAmt |
| PY Total Expenses | $19,255,227 | PYTotalExpensesAmt |
| CY Total Expenses | $18,950,532 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $2,813,704 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $101,334 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $11,876,797 | TotalAssetsBOYAmt |
| Total Assets EOY | $11,694,452 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,584,542 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $3,003,459 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $9,292,255 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $8,690,993 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO PROVIDE QUALITY HEALTHCARE TO EACH INDIVIDUAL AND IMPROVE THE OVERALL HEALTH OF OUR COMMUNITY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $13,162,299 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $13,979,635 | RevenueAmt |
| Desc | PROVIDE HEALTHCARE BENEFITS TO THE COMMUNITY. | Desc |
| Total Program Service Expenses | $13,162,299 | 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 | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | 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 | Yes (1) | OperateHospitalInd |
| Audited Financial Stmt Att | Yes (1) | AuditedFinancialStmtAttInd |
| 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 | 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 | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 70 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 135 | 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 | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (1) | 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 | 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 | CORY CLEAVENGER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3105100700 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1563 | AddressLine1Txt |
| City | AVALON | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 90704 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (17 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 |
|---|---|---|---|---|---|---|---|
| CATRINA AWALT | |||||||
| CHAIR | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| NICOLE HEHENSTEIN | |||||||
| VICE CHAIR | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| RENEE MACLEOD | |||||||
| TREASURER | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| JUDY GREER | |||||||
| SECRETARY | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| DR JOHN CHRISTIAN FOX | |||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| EHAB MADY | |||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| DENISE MOTTER | |||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| TRUDY SALDANA | |||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| PETE SAVAGE | |||||||
| MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JASON PARET | |||||||
| CEO | 40.00 | Yes (X) | $515,908 | $0 | $19,179 | ||
| ERIC CAMPBELL | |||||||
| CONTRACTED CFO (AS OF 04/24) | 40.00 | Yes (X) | $0 | $0 | $0 | ||
| JOHN LOVRICH | |||||||
| CONTRACTED CFO (THRU 02/24) | 40.00 | Yes (X) | $278,768 | $0 | $0 | ||
| NEIL MACREADY | |||||||
| CHIEF DEVELOPMENT OFFICER | 40.00 | $246,403 | $0 | $7,215 | Yes (X) | ||
| RONDA REIMBER | |||||||
| CNO | 40.00 | $232,929 | $0 | $15,834 | Yes (X) | ||
| SANTA DOMINQUEZ | |||||||
| NURSE PRACTITIONER | 40.00 | $212,839 | $0 | $19,820 | Yes (X) | ||
| KEILI HINIKER | |||||||
| RN | 40.00 | $165,138 | $0 | $8,469 | Yes (X) | ||
| ELIZABETH LOGAN | |||||||
| DIRECTOR OF OUTPATIENT SERVICES | 40.00 | $164,823 | $0 | $9,043 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,816,808 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $79,560 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 19 | 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 |
|---|---|---|---|---|---|
| UCI PHYSICIANS | |||||
| 101 ALDRICH HALL | IRVINE | CA | 92697 | EMERGENCY ROOM PHYSICIANS | $1,167,752 |
| MEDEFIS INC | |||||
| PO BOX 5068 | NEW YORK | NY | 100875068 | MEDICAL TRAVELER AGENCY | $1,154,424 |
| PM NAGLE CONSULTING LLC | |||||
| 3816 SALISH TRAIL | STEVENSVILLE | MT | 59870 | BILLING AND COLLECTION SERVICES | $383,500 |
| EDWIN MCGROARTY | |||||
| PO BOX 1255 | AVALON | CA | 907041255 | PHYSICIAN | $337,020 |
| ACCUDATA ADVISORS GROUP LLC | |||||
| 440 LOUISIANA ST STE 900 | HOUSTON | TX | 77002 | CONSULTANT | $249,182 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 17 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $775,000 | RelatedOrganizationsAmt |
| Government Grants | $4,237,957 | GovernmentGrantsAmt |
| All Other Contributions | $73,500 | AllOtherContributionsAmt |
| Total Contributions | $5,086,457 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT SERVICE REVENUE | Desc |
| Business | 621990 | BusinessCd |
| Total Revenue Column | $13,979,635 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $13,979,635 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $13,979,635 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $17,673 | TotalRevenueColumnAmt |
| Exclusion | $17,673 | ExclusionAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $31,899 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$31,899 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$31,899 | TotalRevenueColumnAmt |
| Exclusion | -$31,899 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $19,051,866 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $13,979,635 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$14,226 | 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 | $643,203 | TotalAmt |
| Management And General | $643,203 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,391,075 | TotalAmt |
| Program Services | $4,550,637 | ProgramServicesAmt |
| Management And General | $1,840,438 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,379 | TotalAmt |
| Program Services | $16,994 | ProgramServicesAmt |
| Management And General | $21,385 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,132,034 | TotalAmt |
| Program Services | $1,388,229 | ProgramServicesAmt |
| Management And General | $743,805 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $507,620 | TotalAmt |
| Program Services | $329,953 | ProgramServicesAmt |
| Management And General | $177,667 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $128,974 | TotalAmt |
| Management And General | $128,974 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $79,842 | TotalAmt |
| Management And General | $79,842 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,491,798 | TotalAmt |
| Program Services | $4,175,744 | ProgramServicesAmt |
| Management And General | $1,316,054 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $42,014 | TotalAmt |
| Program Services | $8,403 | ProgramServicesAmt |
| Management And General | $33,611 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $169,786 | TotalAmt |
| Program Services | $81,978 | ProgramServicesAmt |
| Management And General | $87,808 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,629 | TotalAmt |
| Program Services | $3,629 | ProgramServicesAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,202 | TotalAmt |
| Program Services | $1,546 | ProgramServicesAmt |
| Management And General | $1,656 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $74,042 | TotalAmt |
| Program Services | $74,042 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $794,855 | TotalAmt |
| Program Services | $634,695 | ProgramServicesAmt |
| Management And General | $160,160 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $370,254 | TotalAmt |
| Program Services | $370,254 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| SUPPLIES | $697,243 | $557,795 | $139,448 |
| BAD DEBT EXPENSE | $581,719 | $581,719 | |
| DUES AND SUBSCRIPTIONS | $140,064 | $67,627 | $72,437 |
| EQUIPMENT | $46,788 | $22,591 | $24,197 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $614,011 | TotalAmt |
| Program Services | $296,463 | ProgramServicesAmt |
| Management And General | $317,548 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $18,950,532 | TotalAmt |
| Program Services | $13,162,299 | ProgramServicesAmt |
| Management And General | $5,788,233 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $757,537 | BOYAmt |
| EOY | $349,547 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $441,058 | BOYAmt |
| EOY | $424,314 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,802,363 | BOYAmt |
| EOY | $4,382,138 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $196,466 | BOYAmt |
| EOY | $250,147 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $160,544 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $6,780,124 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $2,134,167 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,372,479 | BOYAmt |
| EOY | $4,645,957 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $184,355 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,122,539 | BOYAmt |
| EOY | $1,481,805 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,876,797 | BOYAmt |
| EOY | $11,694,452 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,103,522 | BOYAmt |
| EOY | $1,248,750 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $34,073 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $457,685 | BOYAmt |
| EOY | $942,162 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $989,262 | BOYAmt |
| EOY | $812,547 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,584,542 | BOYAmt |
| EOY | $3,003,459 | 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 | $9,292,255 | BOYAmt |
| EOY | $8,690,993 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,292,255 | BOYAmt |
| EOY | $8,690,993 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,876,797 | BOYAmt |
| EOY | $11,694,452 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $101,334 | ReconcilationRevenueExpnssAmt |
| Prior Period Adjustments | -$702,596 | PriorPeriodAdjustmentsAmt |
| 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 A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
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
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,665,168 | OtherCostOrOtherBasisAmt |
| Depreciation | $553,362 | DepreciationAmt |
| Book Value | $2,111,806 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $565,152 | OtherCostOrOtherBasisAmt |
| Depreciation | $113,031 | DepreciationAmt |
| Book Value | $452,121 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,778,691 | OtherCostOrOtherBasisAmt |
| Depreciation | $443,409 | DepreciationAmt |
| Book Value | $1,335,282 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,771,113 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,024,365 | DepreciationAmt |
| Book Value | $746,748 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $4,645,957 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| ESTIMATED THIRD-PARTY PAYOR SETTLEMENTS | $787,472 |
| INTERCOMPANY RECEIVABLES | $694,333 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $1,481,805 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | LEASE OBLIGATIONS | Desc |
| Amt | $812,547 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $812,547 | TotalLiabilityAmt |
Schedule H IRS990ScheduleH
| Field | Value | IRS element (for citing) |
|---|---|---|
| Financial Assistance Policy | Yes (1) | FinancialAssistancePolicyInd |
| Written Policy | Yes (1) | WrittenPolicyInd |
| FPG Reference Free Care | Yes (1) | FPGReferenceFreeCareInd |
| Percent200 | Yes (X) | Percent200Ind |
| FPG Reference Discounted Care | Yes (1) | FPGReferenceDiscountedCareInd |
| Percent400 | Yes (X) | Percent400Ind |
| Free Care Medically Indigent | Yes (1) | FreeCareMedicallyIndigentInd |
| Financial Assistance Budget | 0 | FinancialAssistanceBudgetInd |
| Annual Community Bnft Report | 0 | AnnualCommunityBnftReportInd |
Financial Assistance At Cost Typ FinancialAssistanceAtCostTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $17,825 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $17,825 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00100 | TotalExpensePct |
Unreimbursed Medicaid UnreimbursedMedicaidGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,546,696 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,660,288 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,886,408 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.15710 | TotalExpensePct |
Total Financial Assistance Typ TotalFinancialAssistanceTyp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,564,521 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,660,288 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $2,904,233 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.15810 | TotalExpensePct |
Community Health Services CommunityHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $10,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $10,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00050 | TotalExpensePct |
Health Professions Education HealthProfessionsEducationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $42,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $42,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00230 | TotalExpensePct |
Subsidized Health Services SubsidizedHealthServicesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,767,543 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,319,103 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,448,440 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.18770 | TotalExpensePct |
Cash And In Kind Contributions CashAndInKindContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $15,000 | TotalCommunityBenefitExpnsAmt |
| Net Community Benefit Expns | $15,000 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.00080 | TotalExpensePct |
Total Other Benefits TotalOtherBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $4,834,543 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $1,319,103 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $3,515,440 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.19130 | TotalExpensePct |
Total Community Benefits TotalCommunityBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Community Benefit Expns | $9,399,064 | TotalCommunityBenefitExpnsAmt |
| Direct Offsetting Revenue | $2,979,391 | DirectOffsettingRevenueAmt |
| Net Community Benefit Expns | $6,419,673 | NetCommunityBenefitExpnsAmt |
| Total Expense | 0.34940 | TotalExpensePct |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Bad Debt Expense Reported | Yes (1) | BadDebtExpenseReportedInd |
| Bad Debt Expense | $581,719 | BadDebtExpenseAmt |
| Bad Debt Expense Attributable | $36,890 | BadDebtExpenseAttributableAmt |
| Reimbursed By Medicare | $8,577,411 | ReimbursedByMedicareAmt |
| Cost Of Care Reimbursed By Medcr | $8,632,686 | CostOfCareReimbursedByMedcrAmt |
| Medicare Surplus Or Shortfall | -$55,275 | MedicareSurplusOrShortfallAmt |
Costing Methodology Used CostingMethodologyUsedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cost To Charge Ratio | Yes (X) | CostToChargeRatioInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Debt Collection Policy | Yes (1) | WrittenDebtCollectionPolicyInd |
| Financial Assistance Prvsn | Yes (1) | FinancialAssistancePrvsnInd |
| Hospital Facilities | 1 | HospitalFacilitiesCnt |
Hospital Facilities HospitalFacilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CATALINA ISLAND MEDICAL CENTER | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 1563 | AddressLine1Txt |
| City | AVALON | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 90704 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Website Address | CATALINAISLANDHEALTH.ORG | WebsiteAddressTxt |
| State License | 930000010 | StateLicenseNum |
| Licensed Hospital | Yes (X) | LicensedHospitalInd |
| Critical Access Hospital | Yes (X) | CriticalAccessHospitalInd |
| Emergency Room24 Hrs | Yes (X) | EmergencyRoom24HrsInd |
Hospital Fclty Policies Prctc HospitalFcltyPoliciesPrctcGrp
Hospital Facility Name HospitalFacilityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CATALINA ISLAND MEDICAL CENTER | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Facility | 1 | FacilityNum |
| First Licensed CY Or PY | 0 | FirstLicensedCYOrPYInd |
| Tax Exempt Hospital CY Or PY | 0 | TaxExemptHospitalCYOrPYInd |
| CHNA Conducted | Yes (1) | CHNAConductedInd |
| Community Definition | Yes (X) | CommunityDefinitionInd |
| Community Demographics | Yes (X) | CommunityDemographicsInd |
| Existing Resources | Yes (X) | ExistingResourcesInd |
| How Data Obtained | Yes (X) | HowDataObtainedInd |
| Community Health Needs | Yes (X) | CommunityHealthNeedsInd |
| Other Health Issues | Yes (X) | OtherHealthIssuesInd |
| Community Hlth Needs Id Process | Yes (X) | CommunityHlthNeedsIdProcessInd |
| Consulting Process | Yes (X) | ConsultingProcessInd |
| Prior CHNA Impact | Yes (X) | PriorCHNAImpactInd |
| CHNA Conducted | 22 | CHNAConductedYr |
| Take Into Account Others Input | Yes (1) | TakeIntoAccountOthersInputInd |
| CHNA Conducted With Other Fclts | 0 | CHNAConductedWithOtherFcltsInd |
| CHNA Conducted With Non Fclts | 0 | CHNAConductedWithNonFcltsInd |
| CHNA Report Widely Available | Yes (1) | CHNAReportWidelyAvailableInd |
| Rpt Available On Own Website | Yes (X) | RptAvailableOnOwnWebsiteInd |
| Own Website URL | SEE PART V, SECTION C, LINE 7D | OwnWebsiteURLTxt |
| Paper Copy Public Inspection | Yes (X) | PaperCopyPublicInspectionInd |
| Rpt Available Thru Other Method | Yes (X) | RptAvailableThruOtherMethodInd |
| Implementation Strategy Adopt | Yes (1) | ImplementationStrategyAdoptInd |
| Implementation Strategy Adpt | 22 | ImplementationStrategyAdptYr |
| Strategy Posted Website | Yes (1) | StrategyPostedWebsiteInd |
| Strategy Website URL | SEE PART V, SECTION C, LINE 7D | StrategyWebsiteURLTxt |
| Organization Incur Excise Tax | 0 | OrganizationIncurExciseTaxInd |
| Elig Criteria Explained | Yes (1) | EligCriteriaExplainedInd |
| FPG Family Incm Lmt Free Dscnt | Yes (X) | FPGFamilyIncmLmtFreeDscntInd |
| FPG Family Incm Lmt Free Care | 200.000000000000 | FPGFamilyIncmLmtFreeCarePct |
| FPG Family Incm Lmt Dscnt Care | 400.000000000000 | FPGFamilyIncmLmtDscntCarePct |
| Income Level Criteria | Yes (X) | IncomeLevelCriteriaInd |
| Asset Level Criteria | Yes (X) | AssetLevelCriteriaInd |
| Medical Indigency Criteria | Yes (X) | MedicalIndigencyCriteriaInd |
| Insurance Status Criteria | Yes (X) | InsuranceStatusCriteriaInd |
| Underinsurance Stat Criteria | Yes (X) | UnderinsuranceStatCriteriaInd |
| Explained Basis | 0 | ExplainedBasisInd |
| App Financial Asst Expln | Yes (1) | AppFinancialAsstExplnInd |
| Described Info | Yes (X) | DescribedInfoInd |
| Described Suprt Doc | Yes (X) | DescribedSuprtDocInd |
| Provided Hospital Contact | Yes (X) | ProvidedHospitalContactInd |
| Includes Publicity Measures | Yes (1) | IncludesPublicityMeasuresInd |
| FAP Available On Website | Yes (X) | FAPAvailableOnWebsiteInd |
| FAP Available On Website URL | HTTPS://CATALINAISLANDHEALTH.ORG/NEED-HELP-PAYING-YOUR-BILL/ | FAPAvailableOnWebsiteURLTxt |
| FAP App Available On Website | Yes (X) | FAPAppAvailableOnWebsiteInd |
| FAP App Available On Website URL | HTTPS://CATALINAISLANDHEALTH.ORG/NEED-HELP-PAYING-YOUR-BILL/ | FAPAppAvailableOnWebsiteURLTxt |
| FAP Summary On Website | Yes (X) | FAPSummaryOnWebsiteInd |
| FAP Summary On Website URL | HTTPS://CATALINAISLANDHEALTH.ORG/NEED-HELP-PAYING-YOUR-BILL/ | FAPSummaryOnWebsiteURLTxt |
| FAP Avlbl On Request No Charge | Yes (X) | FAPAvlblOnRequestNoChargeInd |
| FAP App Avlbl On Request No Chrg | Yes (X) | FAPAppAvlblOnRequestNoChrgInd |
| FAP Sum Avlbl On Request No Chrg | Yes (X) | FAPSumAvlblOnRequestNoChrgInd |
| Notified FAP Copy Bill Display | Yes (X) | NotifiedFAPCopyBillDisplayInd |
| FAP Translated | Yes (X) | FAPTranslatedInd |
| FAP Actions On Nonpayment | Yes (1) | FAPActionsOnNonpaymentInd |
| Permit No Actions | Yes (X) | PermitNoActionsInd |
| Collection Activities | 0 | CollectionActivitiesInd |
| Provided Written Notice | Yes (X) | ProvidedWrittenNoticeInd |
| Made Effort Orally Notify | Yes (X) | MadeEffortOrallyNotifyInd |
| Processed FAP Application | Yes (X) | ProcessedFAPApplicationInd |
| Made Presumptive Elig Determ | Yes (X) | MadePresumptiveEligDetermInd |
| Nondis Emergency Care Policy | Yes (1) | NondisEmergencyCarePolicyInd |
| Look Back Medicare | Yes (X) | LookBackMedicareInd |
| Amounts Generally Billed | 0 | AmountsGenerallyBilledInd |
| Gross Charges | 0 | GrossChargesInd |
Supplemental Information SupplementalInformationGrp (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| CATALINA ISLAND MEDICAL CENTER | PART V, SECTION B, LINE 5: WE INTERVIEWED 12 LOCAL HEALTH LEADERS, REPRESENTING A BROAD CROSS-SECTION OF CATALINA ISLAND, AND RECEIVED ONLINE SURVEY RESPONSES FROM 69 COMMUNITY MEMBERS. |
| CATALINA ISLAND MEDICAL CENTER | PART V, SECTION B, LINE 7D: PART V, SECTION B, LINE 7A & 10A:HTTPS://CATALINAISLANDHEALTH.ORG/WP-CONTENT/UPLOADS/2024/06/CIHEALTH_CHNA_FY2023.PDF |
| CATALINA ISLAND MEDICAL CENTER | PART V, SECTION B, LINE 11: IDENTIFIED HEALTH NEED 1: MENTAL HEALTHOBJECTIVE:1) ENSURE ADEQUATE SUPPLY OF PRIMARY CARE PROVIDERS TO MEET SERVICE NEEDS.STRATEGIES:1A) CONTINUE TO PROMOTE THE AVAILABILITY OF LICENSED SOCIAL WORKERS AND COLLABORATE WITH OTHER PROVIDERS TO PUBLICIZE MENTAL HEALTH SERVICES AVAILABLE ON CATALINA ISLAND. 1B) WORK TO BREAK DOWN CULTURAL BARRIERS TO INCREASE PATIENT ACCESS TO PROVIDER SERVICES. 1C) CONTINUE TO UTILIZE AND PROVIDE TELEPSYCH SERVICES.1D) EDUCATE COMMUNITY ON SERVICES AVAILABLE AND FINANCIAL OPTIONS AVAILABLE FOR SERVICES.IDENTIFIED HEALTH NEED 2: HOUSINGOBJECTIVES:1) CIMC TO BECOME EMPLOYER OF CHOICE IN AVALON.2) IMPROVE HEALTH EQUITY ACROSS THE ENTIRE SERVICE AREA.STRATEGIES:1) DEVELOP A HOUSING POLICY THAT MEETS THE NEEDS OF CIMC AND ITS EMPLOYEES.2A) COLLABORATE WITH COMMUNITY ORGANIZATIONS TO INCREASE AVAILABILITY OF LONG-TERM AFFORDABLE RENTALS.2B) COLLABORATE WITH ORGANIZATIONS TO INCREASE ASSISTED HOUSING UNITS ON CATALINA ISLANDIDENTIFIED HEALTH NEED 3: SPECIALTY ACCESSOBJECTIVES:1) EXPLORE, MAINTAIN AND EXPAND SERVICES TO INCREASE PATIENT VOLUME AND MARKET SHARE2) ASSESS SPECIALTY CARE NEEDS OF OUR SERVICE AREA AND FURTHER DEVELOP SPECIALTY CARE NETWORK TO MEET DEMANDS3) EXPLORE OPPORTUNITIES FOR MUTUALLY BENEFICIAL RELATIONSHIP WITH TERTIARY, REGIONAL AND PEER PROVIDERSSTRATEGIES:1A) IMPLEMENT HOSPITAL INFUSION SERVICES PROGRAM1B) EVALUATE FEASIBILITY OF DIALYSIS PROGRAM.1C) DEVELOP COMPREHENSIVE TELEHEALTH SERVICES1D) CREATE MARKETING CAMPAIGNS AROUND THE ADDITION OF NEW PROVIDERS AND SERVICES IN THE COMMUNITY IN BOTH SPANISH AND ENGLISH.2A) PROACTIVELY RECRUIT SPECIALISTS TO COME OUT PHYSICALLY AND VIRTUALLY TO CIMC.3A) EVALUATE OPPORTUNITIES WITH REGIONAL PROVIDERS TO DEVELOP HIGH VALUE, MUTUALLY BENEFICIAL RELATIONSHIPS THAT WOULD BENEFIT OUR SERVICE AREA, PROVIDE ADDITIONAL IN PERSON AND TELEMEDICINE SPECIALTY CONSULTATION/CLINIC OPPORTUNITIES WHILE MAINTAINING CIMC INDEPENDENCE AND FLEXIBILITY TO REFER PATIENTS WHERE APPROPRIATE.IDENTIFIED HEALTH NEED 4: CARE COORDINATION AND EDUCATIONOBJECTIVES:1) EXPLORE OPPORTUNITIES FOR MUTUALLY BENEFICIAL RELATIONSHIP WITH TERTIARY, REGIONAL, AND PEER PROVIDERS2) IMPROVE COMMUNITY HEALTHSTRATEGIES:1A) EVALUATE OPPORTUNITIES WITH REGIONAL PROVIDERS TO DEVELOP HIGH VALUE, MUTUALLY BENEFICIAL RELATIONSHIPS THAT WOULD BENEFIT OUR SERVICE AREA, PROVIDE ADDITIONAL IN PERSON AND TELEMEDICINE SPECIALTY CONSULTATION/CLINIC OPPORTUNITIES WHILE MAINTAINING CIMC INDEPENDENCE AND FLEXIBILITY TO REFER PATIENTS WHERE APPROPRIATE.2A) DEVELOP COMMUNITY OUTREACH PROGRAMS TO IMPROVE COMMUNITY HEALTH (I.E., EXERCISE PROGRAMS, FITNESS CENTER, YOGA, NUTRITION, ETC.)2B) LOOK AT OPPORTUNITIES FOR GREATER COORDINATION OF CARE FOR PATIENTS BETWEEN THE HOSPITAL, AND OTHER HEALTH ORGANIZATIONS IN THE COMMUNITY THAT CAN CONTRIBUTE SUBSTANCE ABUSE SUPPORT, MENTAL HEALTH SUPPORT, CONSISTENT FOLLOW UP TREATMENT, AND HOUSING.2C) FURTHER EDUCATION ON HEALTH SERVICES AVAILABLE AND HEALTHY EATING BEHAVIORS, SUCH AS NUTRITION SERVICES. PUBLICIZE SERVICES THROUGH PRIMARY CARE PHYSICIANS AND SOCIAL MEDIA. |
| CATALINA ISLAND MEDICAL CENTER | PART V, SECTION B, LINE 13B: PROPENSITY TO PAY |
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 7: | THE COSTING METHODOLOGY USED ON FORM 990 IS BASED ON A COST-TO-CHARGE RATIO WHICH IS DEVELOPED BASED ON THE HOSPITAL'S TOTAL OPERATING EXPENSES LESS THE PROVISION FOR BAD DEBT DIVIDED BY GROSS PATIENT SERVICE REVENUE. THIS COST-TO-CHARGE RATIO IS APPLIED AGAINST VARIOUS REVENUE AND EXPENSE CATEGORIES TO COMPUTE THE ESTIMATED COMMUNITY BENEFIT EXPENSE UNDER IRS SUGGESTED COSTING METHODS FOR THE FORM 990. |
| PART I, LINE 7, COLUMN (F): | THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 581,719. |
| PART III, LINE 2: | THE COSTING METHODOLOGY USED ON FORM 990 IS BASED ON A COST-TO-CHARGE RATIO, WHICH IS DEVELOPED BASED ON THE HOSPITAL'S TOTAL OPERATING EXPENSES, EXCLUDING THE PROVISION FOR BAD DEBT, DIVIDED BY GROSS PATIENT SERVICE REVENUE. THIS COST-TO-CHARGE RATIO IS APPLIED AGAINST THE TOTAL CHARGES THAT ARE WRITTEN OFF DURING THE YEAR TO ESTIMATE THE COST OF CARE OF PATIENTS WHO HAVE ACCOUNTS THAT ARE DEEMED TO BE BAD DEBTS TO THE HOSPITAL. THE HOSPITAL ALSO RECOGNIZES THAT IT ALSO PROVIDES A DISCOUNT TO SELF-PAY OR UNINSURED PATIENTS. THESE AMOUNTS ARE EXCLUDED FROM GROSS PATIENT SERVICE REVENUE ON THE CONSOLIDATED FINANCIAL STATEMENTS AND ARE NOT INCLUDED IN THE RATIO AS DESCRIBED ABOVE AND APPROVED BY THE IRS FOR USE ON FORM 990. IF CONSIDERED, THESE ADDITIONAL WRITE-OFF AMOUNTS TO UNINSURED ACCOUNTS WOULD ALSO INCREASE THE ESTIMATED BAD DEBT EXPENSE AMOUNT ASSOCIATED WITH THESE UNCOLLECTIBLE ACCOUNTS TO THE HOSPITAL. |
| PART III, LINE 3: | MANAGEMENT PROVIDES FOR PROBABLE UNCOLLECTIBLE AMOUNTS, PRIMARILY UNINSURED PATIENTS AND AMOUNTS PATIENTS ARE PERSONALLY RESPONSIBLE FOR, THROUGH A CHARGE TO OPERATIONS AND A CREDIT TO A VALUATION ALLOWANCE BASED ON ITS ASSESSMENT OF HISTORICAL COLLECTION LIKELIHOOD AND THE CURRENT STATUS OF INDIVIDUAL ACCOUNTS. BALANCES THAT ARE STILL OUTSTANDING AFTER THE HOSPITAL HAS USED REASONABLE COLLECTION EFFORTS ARE WRITTEN OFF THROUGH A CHARGE TO THE VALUATION ALLOWANCE AND CREDIT TO ACCOUNTS RECEIVABLE. MANY TIMES, PATIENTS DO NOT COMPLETE THE REQUIRED CHARITY CARE APPLICATION AND ARE TRANSFERRED TO COLLECTION SERVICES EVEN THOUGH THE HOSPITAL PROVIDES THIS INFORMATION TO ALL PATIENTS AND ASSISTS PATIENTS WITH THE APPLICATION. DUE TO NO RESPONSES FROM SOME PATIENTS, A PORTION OF BAD DEBTS COULD BE CONSIDERED AS CHARITY CARE. |
| PART III, LINE 8: | CATALINA ISLAND MEDICAL CENTER IS DESIGNATED AS A CRITICAL ACCESS HOSPITAL AND AS SUCH A PORTION OF ITS REVENUES ARE PAID UNDER A COST REIMBURSEMENT SYSTEM. BASED ON THE INSTRUCTIONS, THE TOTAL MEDICARE REVENUE SHOWN ON THIS FORM 990 INCLUDES ONLY A PORTION OF THE GROSS MEDICARE REVENUE THAT IS ACTUALLY RECEIVED BY THE HOSPITAL FROM THE MEDICARE PROGRAM. THE AMOUNTS LISTED FOR MEDICARE DO NOT INCLUDE PHYSICIAN AND MID-LEVEL PRACTITIONER SERVICES FOR THE COVERAGE OF THE EMERGENCY DEPARTMENT. PHYSICIAN COVERAGE IS REIMBURSED PRIMARILY ON A FEE SCHEDULE REIMBURSEMENT METHODOLOGY AT RATES THAT ARE OFTEN BELOW THE COSTS OF CARING FOR PATIENTS. EMERGENCY SERVICES PROVIDED TO MEDICARE PATIENTS ARE VITAL TO THE WELL-BEING OF THE COMMUNITY AND AS SUCH THESE COSTS AND SHORTFALLS SHOULD ALSO BE CONSIDERED AS AN ADDITIONAL BENEFIT THAT CATALINA ISLAND MEDICAL CENTER PROVIDES TO THE COMMUNITY AND SURROUNDING AREA. THE COSTING METHOD USED ABOVE FOR IRS FORM 990 COMPLIANCE REPORTING IS ALSO BASED ON AN OVERALL AVERAGE COST-TO-CHARGE RATIO AND DOES NOT CONSIDER MEDICARE NON-ALLOWABLE EXPENSES AS IT IS BASED ON TOTAL HOSPITAL PATIENT SERVICE REVENUES (IGNORING CONTRACTUAL ADJUSTMENTS ON FEE SCHEDULE REIMBURSED ITEMS AND NON-ALLOWABLE MEDICARE EXPENSES AS NOTED ABOVE) DIVIDED BY TOTAL OPERATING EXPENSES LESS THE PROVISION FOR BAD DEBT EXPENSE. THIS RATIO IS THEN MULTIPLIED BY THE TOTAL MEDICARE SERVICES WHICH ARE REIMBURSED ON A COST METHODOLOGY EXCLUDING THE FEE SCHEDULE ITEMS LIKE PHYSICIAN AND MID-LEVEL PRACTITIONER SERVICES WHICH THE HOSPITAL WOULD SHOW A LARGE LOSS ON THESE SERVICES.WHETHER THERE IS A SHORTFALL OR SURPLUS FROM SERVICES PROVIDED TO MEDICARE BENEFICIARIES, THESE PEOPLE, WHO ARE TYPICALLY ELDERLY MEMBERS OF THE COMMUNITY, ARE AN UNDERSERVED POPULATION WHO EXPERIENCE ISSUES WITH ACCESS TO HEALTHCARE SERVICES. WITHOUT TAX-EXEMPT HOSPITALS PROVIDING MEDICARE PATIENT SERVICES, THE CENTERS FOR MEDICARE AND MEDICAID (CMS) WOULD BEAR THE BURDEN OF DIRECTLY PROVIDING SERVICES TO THE ELDERLY AND DISABLED MEMBERS OF THE COMMUNITY. |
| PART III, LINE 9B: | IT IS THE POLICY OF CATALINA ISLAND HEALTH TO PURSUE COLLECTION OF PATIENT BALANCES FROM PATIENTS WHO HAVE THE ABILITY TO PAY FOR SERVICES. CATALINA ISLAND HEALTH WILL MAKE REASONABLE EFFORTS TO IDENTIFY PATIENTS WHO MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE.COLLECTION PROCEDURES WILL BE APPLIED CONSISTENTLY AND FAIRLY FOR ALL PATIENTS REGARDLESS OF INSURANCE STATUS. ALL COLLECTION PROCEDURES WILL COMPLY WITH APPLICABLE LAWS. FOR THOSE PATIENTS UNABLE TO PAY ALL OR A PORTION OF THEIR BILL, THE APPLICABLE FINANCIAL ASSISTANCE POLICY WILL BE FOLLOWED.PATIENTS WHO QUALIFY FOR CHARITY, I.E., WHOSE INCOME IS UP TO 200% OF FEDERAL POVERTY GUIDELINES (FPG) WILL BE ELIGIBLE FOR FULL CHARITY TOTAL FREE CARE.PATIENTS WHOSE INCOME EXCEEDS THE FPG BUT IS LESS THAN 400% OF FPG WILL BE ELIGIBLE FOR PARTIAL CHARITY CARE (SEE CHARITY CARE POLICY).COLLECTION AGENCIES AND LAW FIRMS MAY BE ENLISTED AFTER ALL REASONABLE COLLECTION AND PAYMENT OPTIONS HAVE BEEN EXHAUSTED. AGENCIES MAY HELP RESOLVE ACCOUNTS WHERE PATIENTS ARE UNCOOPERATIVE IN MAKING PAYMENT, HAVE NOT MADE APPROPRIATE PAYMENTS, OR HAVE BEEN UNWILLING TO PROVIDE REASONABLE FINANCIAL AND OTHER DATA TO SUPPORT THEIR REQUEST FOR FINANCIAL ASSISTANCE. SELF-PAY DISCOUNTS WILL BE AVAILABLE FOR PATIENTS THAT ARE UNINSURED, UNDER-INSURED OR WHERE COVERAGE IS NOT AVAILABLE FROM THEIR INSURANCE COMPANY FOR THE SERVICE BEING RENDERED. ALL SELF-PAY PATIENTS WILL BE SCREENED FOR LINKAGE TO ANY APPROPRIATE FORM OF ASSISTANCE, INCLUDING MEDI-CAL, COVERED CA, HEALTHY FAMILY PROGRAM, OR ANY THIRD-PARTY LIABILITY PROGRAM (AUTOMOBILE INSURANCE, WORKER'S COMPENSATION, ETC.). SELF-PAY PATIENTS WILL BE OFFERED A SELF-PAY DISCOUNT IN ACCORDANCE WITH THE HOSPITAL'S CURRENT DISCOUNT POLICY AND IN COMPLIANCE WITH THE STATE AND FEDERAL GUIDELINES. |
| PART VI, LINE 2: | THE HOSPITAL IS LOCATED IN A VERY PRECISE AND SMALL AREA. THE CHNA IS EFFECTIVE AT IDENTIFYING THE NEEDS OF THE COMMUNITY FORMALLY EVERY THREE YEARS AND THE HOSPITAL USES THEIR CARE FEEDBACK MECHANISMS AND THE BOARD, EMPLOYEES AND OTHER STAKEHOLDERS TO UNDERSTAND WHAT OTHER NEEDS MAY REQUIRE ATTENTION IN THE INTERIM. |
| PART VI, LINE 3: | WHEN A PATIENT CHECKS INTO THE HOSPITAL OR CLINIC, THE PATIENT (OR REPRESENTATIVE) WILL BE PROVIDED WITH THE SELF-PAY AND CHARITY CARE POLICY GUIDELINES ALONG WITH A CHARITY CARE APPLICATION.INFORMATION ABOUT FINANCIAL ASSISTANCE AVAILABLE FROM CIH SHALL BE DISTRIBUTED AS FOLLOWS: NOTICES IN PATIENT STATEMENTS AND OTHER CORRESPONDENCE DISTRIBUTION OF PATIENT NOTIFICATION AT TIME OF REGISTRATION FOR AN INPATIENT STAY, OUTPATIENT VISITS, EMERGENCY DEPARTMENT (ED) VISIT, RURAL HEALTH CLINIC (RHC) OR FAMILY HEALTH CLINIC (FHC) VISITS. POSTING NOTICES IN HIGH VOLUME AREAS SUCH AS THE: I. PATIENT ACCESS FOR INPATIENT OR OUTPATIENT SERVICES. 2. EMERGENCY DEPARTMENT. 3. PATIENT FINANCIAL SERVICES OFFICE. 4. OTHER PLACES AS CIH MAY ELECT. A. SUCH INFORMATION SHALL BE PROVIDED IN ENGLISH AND CAN BE TRANSLATED UPON REQUEST FOR PATIENTS/GUARANTORS WHO SPEAK OTHER LANGUAGES. 5. PATIENTS WHO ARE ADMITTED THROUGH THE ED SHALL BE NOTIFIED THAT THIS PROGRAM IS AVAILABLE TO THEM TO ALSO ASSIST WITH THE ED PROVIDER BILL UPON DISCHARGE AND THROUGH POSTING IN THE ED. |
| PART VI, LINE 4: | CATALINA ISLAND MEDICAL CENTER ("CIMC") SERVES THE POPULATION OF AVALON, CALIFORNIA. AVALON CURRENTLY REPRESENTS APPROXIMATELY 4,400 YEAR-ROUND RESIDENTS. CATALINA ISLAND CAN SEE ON AVERAGE 85,000 VISITORS PER MONTH. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Housing Allowance Or Residence | Yes (X) | HousingAllowanceOrResidenceInd |
| Written Policy Ref T And E Expnss | Yes (1) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (1) | SubstantiationRequiredInd |
| 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 (7 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JASON PARET | ||||||||||||||
| CEO | $515,908 | $0 | $0 | $0 | $0 | $0 | $15,477 | $0 | $3,702 | $0 | $535,087 | $0 | $0 | $0 |
| JOHN LOVRICH | ||||||||||||||
| CONTRACTED CFO (THRU 02/24) | $278,768 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $278,768 | $0 | $0 | $0 |
| NEIL MACREADY | ||||||||||||||
| CHIEF DEVELOPMENT OFFICER | $246,403 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $7,215 | $0 | $253,618 | $0 | $0 | $0 |
| RONDA REIMBER | ||||||||||||||
| CNO | $232,929 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $15,834 | $0 | $248,763 | $0 | $0 | $0 |
| SANTA DOMINQUEZ | ||||||||||||||
| NURSE PRACTITIONER | $212,839 | $0 | $0 | $0 | $0 | $0 | $6,415 | $0 | $13,405 | $0 | $232,659 | $0 | $0 | $0 |
| ELIZABETH LOGAN | ||||||||||||||
| DIRECTOR OF OUTPATIENT SERVICES | $164,823 | $0 | $0 | $0 | $0 | $0 | $4,064 | $0 | $4,979 | $0 | $173,866 | $0 | $0 | $0 |
| KEILI HINIKER | ||||||||||||||
| RN | $165,138 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $8,469 | $0 | $173,607 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 1A | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION PROVIDES A HOUSING ALLOWANCE TO THE FOLLOWING INTERESTED PERSONS: - JASON PARET, CEO THE HOUSING ALLOWANCE BENEFIT IS INCLUDED IN TAXABLE INCOME. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 3 | THE ORGANIZATION USED A MANAGEMENT COMPANY TO PERFORM MANAGEMENT DUTIES DURING THE YEAR. THE ORGANIZATION CONTRACTED CFO SERVICES FROM LOVRICH TAX AND BUSINESS SERVICES. JOHN LOVRICH, LISTED IN PART VII, SECTION A IS THE OWNER. THE ORGANIZATION PAID $278,678 FOR THESE SERVICES DURING CALENDAR YEAR 2023 AS LISTED IN PART VII, SECTION B. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE DRAFT FORM 990 IS PROVIDED TO THE BOARD EITHER AT THE BOARD MEETING OR ELECTRONICALLY IF ONE IS NOT SCHEDULED WITHIN A REASONABLE PERIOD BEFORE BEING FILED. |
| FORM 990, PART VI, SECTION B, LINE 12C | PRIOR TO CONDUCTING A BUSINESS SESSION AT A MEETING OF THE BOARD, BOARD MEMBERS SHALL DISCLOSE AND DISCUSS THEIR INDIVIDUAL CONFLICTS OR POTENTIAL CONFLICTS. IN THE EXERCISE OF VOTING RIGHTS BY MEMBERS OF THE BOARD, NO INDIVIDUAL SHALL VOTE ON ANY ISSUE, MOTION OR RESOLUTION WHICH DIRECTLY OR INDIRECTLY INURES TO HIS OR HER BENEFIT FINANCIALLY OR WITH RESPECT TO WHICH HE OR SHE HAS ANY OTHER CONFLICT OF INTEREST, EXCEPT THAT SUCH INDIVIDUAL MAY BE COUNTED IN ORDER TO QUALIFY A QUORUM AND, EXCEPT AS THE BOARD MAY OTHERWISE DIRECT, MAY PARTICIPATE IN THE DISCUSSION OF SUCH AN ISSUE, MOTION OR RESOLUTION IF HE OR SHE FIRST DISCLOSES THE NATURE OF HIS OR HER INTEREST. AFTER DISCLOSURE OF THE POSITION OR FINANCIAL INTEREST AND ALL MATERIAL FACTS, AND AFTER ANY DISCUSSION WITH THE INTERESTED PERSON, HE OR SHE WILL LEAVE THE BOARD MEETING WHILE THE DETERMINATION OF A CONFLICT OF INTEREST IS DISCUSSED AND VOTED UPON. THE REMAINING BOARD MEMBERS WILL DECIDE IF A CONFLICT OF INTEREST EXISTS. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE ORGANIZATION'S BOARD OF DIRECTORS WILL MAKE DETERMINATIONS REGARDING THE CEO'S COMPENSATION ANNUALLY. THE EXECUTIVE COMPENSATION COMMITTEE CONDUCTS NECESSARY RESEARCH AND DATA COLLECTION, AND BRINGS FORTH RECOMMENDATIONS, SUBJECT TO REVIEW AND ACTION BY THE INDEPENDENT BOARD MEMBERS. THE CEO ESTABLISHES SALARIES OF OTHER OFFICERS IN ACCORDANCE WITH THE ORGANIZATION'S CORPORATE POLICIES. CHANGES ARE SUBJECT TO REVIEW AND APPROVAL BY INDEPENDENT BOARD MEMBERS. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART IX, LINE 11G | PHYSICIAN FEES: PROGRAM SERVICE EXPENSES 1,893,835. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,893,835. CONSULTING FEES: PROGRAM SERVICE EXPENSES 377,794. MANAGEMENT AND GENERAL EXPENSES 217,887. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 595,681. REPAIRS AND MAINTENANCE SERVICES: PROGRAM SERVICE EXPENSES 135,169. MANAGEMENT AND GENERAL EXPENSES 77,956. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 213,125. OTHER PROFESSIONAL SERVICES: PROGRAM SERVICE EXPENSES 1,768,946. MANAGEMENT AND GENERAL EXPENSES 1,020,211. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 2,789,157. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CATALINA ISLAND MEDICAL CENTER FOUNDATION INC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 524 | AddressLine1Txt |
| City | AVALON | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 90704 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 330627293 | EIN |
| Primary Activities | FUNDRAISING FOR AVALON MEDICAL DEVELOPMENT CORPORATION | PrimaryActivitiesTxt |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Exempt Code Section | 501(C)(3) | ExemptCodeSectionTxt |
| Public Charity Status | LINE 7 | PublicCharityStatusTxt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AVALON MEDICAL DEVELOPMENT CORPORATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Organization | Yes (1) | ControlledOrganizationInd |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LEO'S CATALINA DRUG STORE | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 401 CRESCENT AVENUE | AddressLine1Txt |
| City | AVALON | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 90704 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 753152013 | EIN |
| Primary Activities | PHARMACY | PrimaryActivitiesTxt |
| Legal Domicile State | CA | LegalDomicileStateCd |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AVALON MEDICAL DEVELOPMENT CORPORATION | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Entity Type | C | EntityTypeTxt |
| Share Of Total Income | $1,371,507 | ShareOfTotalIncomeAmt |
| Share Of EOY Assets | $1,567,615 | ShareOfEOYAssetsAmt |
| Ownership | 1.00000 | OwnershipPct |
| Controlled Organization | Yes (1) | ControlledOrganizationInd |
| 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 | Yes (1) | 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 | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (2 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| CATALINA ISLAND MEDICAL CENTER FOUNDATION INC | ||
| C | $775,000 | CASH |
| LEO'S CATALINA DRUG STORE | ||
| Q | $635,457 | CASH |