2022-10-27T13:58:12-05:00 2021-12-31 910189318 MOSS ADAMS LLP 21700 OXNARD ST STE 300 WOODLAND HILLS CA 91367 990 2021-01-01 382453621 UNITED HOME HEALTH SERVICES INC UNIT 7344584649 6701 HARRISON GARDEN CITY MI 48135 DAVID KUNKLE VP OF FINANCE 7344584649 2022-10-06 1 DAVID KUNKLE 999009999 LAUREN A HAVERLOCK P00545829 8185771900 2022-10-06 3 AAL1 IAL1 2021 2022-09-23 18:48:47Z DAVID KUNKLE 6701 HARRISON GARDEN CITY MI 48135 1411968 0 X WWW.UHHS.ORG X 1983 MI PROVIDE QUALITY HOME HEALTH SERVICES WHICH ARE COMPREHENSIVE, WELL-COORDINATED AND COST EFFECTIVE THROUGH PATIENT MANAGEMENT, THERAPEUTIC SERVICES AND PERSONAL ASSISTANCE. 5 2 42 0 0 0 0 122235 1842980 1289733 0 0 0 0 1842980 1411968 0 0 0 0 1160755 1123000 0 0 0 271363 273363 1432118 1396363 410862 15605 812782 836391 1014193 1022197 -201411 -185806 PROVIDE QUALITY HOME HEALTH SERVICES WHICH ARE COMPREHENSIVE, WELL-COORDINATED AND COST EFFECTIVE THROUGH PATIENT MANAGEMENT, THERAPEUTIC SERVICES AND PERSONAL ASSISTANCE DELIVERED BY A CARING TEAM. 0 0 1212057 1289733 TO PROVIDE NECESSARY SKILLED SERVICES TO HOME BOUND PATIENTS IN THEIR PLACE OF RESIDENCE UNDER THE PLAN OF CARE OF A LICENSED PHYSICIAN IN MICHIGAN. SERVICES INCLUDE SKILLED NURSING, CERTIFIED HOME HEALTH AIDES, PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SPEECH THERAPY, MEDICAL SOCIAL WORK, REGISTERED DIETITIAN/NUTRITIONAL COUNSELING, WOUND AND OSTOMY THERAPY, CAREGIVERS AND COMPANIONS, AND GENERIC CARE MANAGEMENT. 1212057 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 2 0 1 42 1 0 0 0 0 0 0 0 0 0 0 0 0 X 5 2 1 0 0 0 1 1 1 1 1 0 0 0 1 1 1 1 1 1 1 0 X DAVID KUNKLE 7344584649 6701 HARRISON GARDEN CITY MI 48135 SAJU GEORGE CEO, PHS - GARDEN CITY 1.00 40.00 X X 0 500000 0 GINA BUTCHER THRU 022021 CFO, PHS - GARDEN CITY 1.00 40.00 X X 0 74384 0 DAVID KUNKLE AS OF 082021 VP OF FINANCE, PHS - GARDEN CITY 1.00 40.00 X X 0 52580 0 DR GARY SARAFA MEDICAL DIRECTOR / BOARD MEMBER 1.00 X 20000 0 0 SAM KENNEDY BOARD MEMBER 1.00 X 0 0 0 CHRIS FULKS INTERIM CFO / BOARD MEMBER 1.00 X X 0 0 0 20000 626964 0 0 0 1 0 0 122235 122235 PATIENT SERVICE 621610 1289733 1289733 1289733 1411968 1289733 0 0 X 946708 861515 85193 6211 5652 559 92075 83788 8287 78006 70985 7021 39900 39900 165798 165798 4030 4030 16764 16764 20404 20404 17258 17258 MISCELLANEOUS 5294 5294 MEDICAL SUPPLIES 3915 3915 1396363 1212057 184306 0 200 199 709651 668409 98729 162055 4202 5728 57438 57438 0 0 812782 836391 146301 113783 867892 908414 1014193 1022197 X -201411 -185806 -201411 -185806 812782 836391 15605 0 X 0 1 X 0 0 X 20000 122235 142235 1966247 1751042 1834189 1842980 1289733 8684191 1986247 1751042 1834189 1842980 1411968 8826426 20000 20000 0 20000 20000 8806426 89 89 89 89 1986247 1751131 1834189 1842980 1411968 8826515 0.99770 0.99750 0.00000 0.00000 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 57438 57438 0 0 DUE TO RELATED PARTIES 908414 908414 X PART X, LINE 2: THE LITERATURE RELATED TO UNCERTAIN TAX POSITIONS PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT PROCESS FOR ACCOUNTING FOR UNCERTAIN TAX POSITIONS AND ALSO PROVIDES GUIDANCE ON VARIOUS RELATED MANNERS SUCH AS DERECOGNITION, INTEREST, PENALTIES, AND DISCLOSURES REQUIRED. THE COMPANY DOES NOT HAVE ANY ENTITY-LEVEL UNCERTAIN TAX POSITIONS. THE COMPANY FILES INCOME TAX RETURNS, IN THE U.S. FEDERAL JURISDICTION AND VARIOUS STATE AND LOCAL JURISDICTIONS. GENERALLY, THE COMPANY IS SUBJECT TO EXAMINATION BY FEDERAL TAX AUTHORITIES FOR THREE YEARS FROM THE FILING OF A TAX RETURN AND STATE AND LOCAL TAX AUTHORITIES FOR FOUR YEARS FROM THE FILING OF THE STATE TAX RETURN. THE COMPANY IS CURRENTLY UNDER EXAMINATIONS BY THE INTERNAL REVENUE SERVICES FOR THE 2012-2013 TAX YEARS AND BY THE CALIFORNIA FRANCHISE TAX BOARD FOR TAX YEARS 2011 TO 2016. 0 0 0 0 0 0 0 0 0 SAJU GEORGE CEO, PHS - GARDEN CITY 0 440000 0 60000 0 0 0 0 0 0 0 500000 0 0 PART I, LINE 3 THE ORGANIZATION RELIED ON A RELATED ORGANIZATION THAT USED THE FOLLOWING METHODS TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION: INDEPENDENT COMPENSATION CONSULTANT, APPROVAL BY THE BOARD OF COMPENSATION COMMITTEE, AND COMPENSATION SURVEY OR STUDY FORM 990, PART VI, SECTION A, LINE 2 SAJU GEORGE AND CHRIS FOLKS HAVE A BUSINESS RELATIONSHIP. FORM 990, PART VI, SECTION A, LINE 6 PRIME HEALTHCARE SERVICES - GARDEN CITY, LLC IS THE SOLE MEMBER OF UNITED HOME HEALTH SERVICES, INC. FORM 990, PART VI, SECTION A, LINE 7A SAJU GEORGE MAINTAINS THE RIGHT TO APPOINT AND APPROVE NEW MEMBERS TO THE GOVERNING BOARD. FORM 990, PART VI, SECTION A, LINE 7B GARDEN CITY HOSPITAL, THE SOLE MEMBER OF UNITED HOME HEALTH SERVICES INC, HAS THE AUTHORITY OVER CERTAIN GOVERNANCE DECISIONS. FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION'S FINANCE DEPARTMENT ACCUMULATES INFORMATION AND DATA NECESSARY TO COMPLETE THE FEDERAL FORM 990. AUDITED FINANCIAL DATA AND BOARD APPROVED POLICIES AND PROCEDURES ARE USED AS INPUT TO COMPLETE THE FORM. A DRAFT RETURN IS PREPARED AND REVIEWED BY THE ORGANIZATION'S INDEPENDENT OUTSIDE TAX ACCOUNTANTS. AFTER THE REVIEW PROCESS IS COMPLETED BY THE INDEPENDENT OUTSIDE TAX ACCOUNTANTS, THE FINANCE STAFF REVIEWS THE FINAL FORM 990 AND PROVIDES A COPY TO EACH BOARD MEMBER. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION'S BOARD HAS ADOPTED THE CONFLICT OF INTEREST POLICY OF ITS PARENT ENTITY. ALL OFFICERS, DIRECTORS, AND EMPLOYEES ARE REQUIRED TO DISCLOSE ANY ACTUAL OR POTENTIAL CONFLICTS OF INTEREST. THIS IS MONITORED BY THE BOARD THROUGH QUARTERLY BOARD MEETING DISCUSSIONS. ALL POTENTIAL CONFLICTS ARE ADDRESSED BY THE BOARD. ANY ISSUES ARE DEALT WITH AS APPROPRIATE. FORM 990, PART VI, SECTION B, LINE 15 OFFICER COMPENSATION IS ESTABLISHED BY A RELATED ORGANIZATION. PRIME HEALTHCARE SERVIES - GARDEN CITY, LLC ENGAGES AN OUTSIDE CONSULTING FIRM TO SURVEY THE MARKET FOR APPROPRIATE PLANS AND LEVELS OF COMPENSATION. APPROPRIATE PLANS AND COMPENSATION ARE THEN NEGOTIATED WITH TOP MANAGEMENT PERSONNEL. ONCE THIS IS DONE, THE COMPENSATION PLAN IS SENT TO THE SOLE MEMBER OF PRIME HEALTHCARE SERVICES - GARDEN CITY, LLC FOR FINAL APPROVAL. ALL BOARD MEMBERS INVOLVED IN THIS PROCESS ARE INDEPENDENT MEMBERS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. GOVERNING DOCUMENTS AND THE CONFLICT OF INTEREST POLICY ARE NOT MADE AVAILABLE TO THE PUBLIC. FORM 990, PART IX, LINE 11G PURCHASED MEDICAL SERVICES: PROGRAM SERVICE EXPENSES 165,798. MANAGEMENT AND GENERAL EXPENSES 0. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 165,798. PULSE EMS LLC 6245 INKSTER ROAD GARDEN CITY MI 48135 300691829 AMBULANCE COMPANY MI N/A N/A 0 0 GCH ASSURANCE COMPANY LTD PO BOX 1159 KY-1102 CJ 980608598 OFFSHORE LIMITED LIABILITY CO. CJ N/A C 0 PRIME HEALTHCARE SERV - GARDEN CITY LLC 6245 INKSTER ROAD GARDEN CITY MI 48135 464719451 HOSPITAL MI N/A C 0 PRIME GARDEN CITY MEDICAL GROUP 6245 INKSTER ROAD GARDEN CITY MI 48135 383162092 PHYSICIAN OFFICES MI N/A C 0 PRIME HEALTHCARE HOLDINGS INC 3840 E GUASTI ROAD ONTARIO CA 917610000 272458309 MEDICAL SERVICES CA N/A S 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 1 0 0 1