GRAPHITE HEALTH INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- GRAPHITE HEALTH INC (EIN 87-0933859)
- Tax period
- 2021-05-25 to 2021-12-31
- Filed
- 2022-11-15
- IRS object ID
- 202243199349306354
- Schema version
- 2021v4.2
- 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 | 2022-11-15T10:24:25-06:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 850436347 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PELTIER GUSTAFSON & MILLER P A | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7020 PROSPECT PLACE NE | AddressLine1Txt |
| City | ALBUQUERQUE | CityNm |
| State Abbreviation | NM | StateAbbreviationCd |
| ZIP | 87110 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-05-25 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 870933859 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GRAPHITE HEALTH INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | GRAP | BusinessNameControlTxt |
| Phone | 5052643122 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7601 JEFFERSON STREET NE 380 | AddressLine1Txt |
| City | ALBUQUERQUE | CityNm |
| State Abbreviation | NM | StateAbbreviationCd |
| ZIP | 87109 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | JENNIFER BROWN | PersonNm |
| Person Title | CAO & GENERAL COUNSEL | PersonTitleTxt |
| Phone | 5052643122 | PhoneNum |
| Signature | 2022-11-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | JENNIFER | PersonFirstNm |
| Person Last | BROWN | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | DONALD H MILLER | PreparerPersonNm |
| PTIN | P00024321 | PTIN |
| Phone | 5058813953 | PhoneNum |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 0 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Initial Return | Yes (X) | InitialReturnInd |
| Application Pending | Yes (X) | ApplicationPendingInd |
| Principal Officer | JENNIFER BROWN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7601 JEFFERSON STREET NE 380 | AddressLine1Txt |
| City | ALBUQUERQUE | CityNm |
| State Abbreviation | NM | StateAbbreviationCd |
| ZIP | 87109 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $4,000,139 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c | Yes (X) | Organization501cInd |
| Website Address | GRAPHITEHEALTH.IO | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2021 | FormationYr |
| Legal Domicile State | DE | LegalDomicileStateCd |
| Activity Or Mission | SEE SCHEDULE O. | ActivityOrMissionDesc |
| Voting Members Governing Body | 4 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 3 | VotingMembersIndependentCnt |
| Total Employee | 9 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| CY Contributions Grants | $4,000,000 | CYContributionsGrantsAmt |
| CY Program Service Revenue | $0 | CYProgramServiceRevenueAmt |
| CY Investment Income | $139 | CYInvestmentIncomeAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| CY Total Revenue | $4,000,139 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| CY Salaries Comp Emp Bnft Paid | $1,031,511 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| CY Other Expenses | $1,996,356 | CYOtherExpensesAmt |
| CY Total Expenses | $3,027,867 | CYTotalExpensesAmt |
| CY Revenues Less Expenses | $972,272 | CYRevenuesLessExpensesAmt |
| Total Assets EOY | $4,479,148 | TotalAssetsEOYAmt |
| Total Liabilities EOY | $3,506,876 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances EOY | $972,272 | NetAssetsOrFundBalancesEOYAmt |
| Mission | GRAPHITE HEALTH OPERATES AS A NON-PROFIT COMPANY WITH A MISSION TO ESTABLISH A TRUSTED DIGITAL ECOSYSTEM, COMPOSED OF AN INTEROPERABILITY DATA PLATFORM AND AN APPLICATION MARKETPLACE THAT WILL DRIVE THE ADVANCEMENT OF HEALTHCARE FOR ALL PATIENTS. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Desc | IN 2021, THE ORGANIZATION WAS IN ITS INITIAL STAGES, PROGRAMS HAD NOT BEEN ESTABLISHED AND ALL COSTS WERE CONSIDERED ADMINISTRATIVE AND GENERAL IN NATURE. | Desc |
| Described In Section501c3 | 0 | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 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 | Yes (1) | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | Yes (1) | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 18 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 9 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | Yes (1) | NondeductibleContributionsInd |
| Nondeductible Contri Discl | Yes (1) | NondeductibleContriDisclInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 4 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 3 | 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 | 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 | 0 | 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 |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LYNNE HUNT | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5058813953 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 7601 JEFFERSON STREET NE STE 380 | AddressLine1Txt |
| City | ALBUQUERQUE | CityNm |
| State Abbreviation | NM | StateAbbreviationCd |
| ZIP | 87109 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (8 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 |
|---|---|---|---|---|---|---|---|
| MARK RIES ROBINSON | |||||||
| PRESIDENT/CEO | 50.00 | Yes (X) | Yes (X) | $209,805 | $41,667 | $13,170 | |
| DAN LILJENQUIST | |||||||
| CHAIRMEN OF THE BOARD | 5.00 | Yes (X) | $0 | $0 | $0 | ||
| CARTER DREDGE | |||||||
| MEMBER OF THE BOARD | 5.00 | Yes (X) | $0 | $0 | $0 | ||
| DALE MAXWELL | |||||||
| MEMBER OF THE BOARD | 5.00 | Yes (X) | $0 | $0 | $0 | ||
| JESSICA LIN | |||||||
| SECRETARY/CHIEF OF STAFF | 45.00 | Yes (X) | $122,352 | $0 | $5,435 | ||
| LYNNE HUNT | |||||||
| VP FINANCE | 50.00 | Yes (X) | $120,519 | $0 | $8,144 | ||
| JENNIFER COREY SCHMID | |||||||
| COO LABS | 40.00 | $157,087 | $0 | $10,257 | Yes (X) | ||
| MATT ABRAMS | |||||||
| VP INDUSTRY DEVELOPMENTS | 40.00 | $168,455 | $0 | $13,162 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $778,218 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $41,667 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $50,168 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 5 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | Yes (1) | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| SSI INC | |||||
| PO BOX 98991 | CHICAGO | IL | 60693 | EXECUTIVE RECRUITING | $605,000 |
| WYATT SPECIALISTS | |||||
| 2552 EL ALBA WAY | CHANDLER | AZ | 85224 | ENGINEERING CONSULTING | $178,425 |
| CROSSCUT STRATEGIES LLC | |||||
| 1200 18TH STREET NW 7TH FLOOR | WASHINGTON | DC | 20036 | MARKETING | $173,250 |
| THOMPSON COBURN | |||||
| ONE US BANK PLAZA | ST LOUIS | MO | 63101 | LEGAL SERVICES | $106,379 |
| SYMBOTIX LLC | |||||
| 7517 EVERTON WAY | WAKE FOREST | NC | 27587 | ENGINEERING CONSULTING | $105,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 5 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $4,000,000 | AllOtherContributionsAmt |
| Total Contributions | $4,000,000 | TotalContributionsAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $139 | TotalRevenueColumnAmt |
| Exclusion | $139 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $4,000,139 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $139 | 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 | $747,501 | TotalAmt |
| Management And General | $747,501 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $190,440 | TotalAmt |
| Management And General | $190,440 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,420 | TotalAmt |
| Management And General | $5,420 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,546 | TotalAmt |
| Management And General | $11,546 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $76,604 | TotalAmt |
| Management And General | $76,604 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $215,869 | TotalAmt |
| Management And General | $215,869 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $152,199 | TotalAmt |
| Management And General | $152,199 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,493 | TotalAmt |
| Management And General | $11,493 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,090,498 | TotalAmt |
| Management And General | $1,090,498 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $179,693 | TotalAmt |
| Management And General | $179,693 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,162 | TotalAmt |
| Management And General | $4,162 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,140 | TotalAmt |
| Management And General | $20,140 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $34,969 | TotalAmt |
| Management And General | $34,969 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $43,601 | TotalAmt |
| Management And General | $43,601 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,897 | TotalAmt |
| Management And General | $15,897 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $177,194 | TotalAmt |
| Management And General | $177,194 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $367 | TotalAmt |
| Management And General | $367 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,466 | TotalAmt |
| Management And General | $11,466 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|
| DUES & SUBSCRIPTIONS | $21,243 | $21,243 |
| PROFESSIONAL DUES | $16,000 | $16,000 |
| DONATIONS | $1,520 | $1,520 |
| TAXES, LICENSES AND FEE | $45 | $45 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,027,867 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $3,027,867 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $463,708 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $3,000,139 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $1,000,000 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $8,331 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $7,337 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $367 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $6,970 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $4,479,148 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $178,961 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $3,177,194 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $150,721 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $3,506,876 | 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) |
|---|---|---|
| EOY | $972,272 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $972,272 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $4,479,148 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $972,272 | 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 B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,337 | OtherCostOrOtherBasisAmt |
| Depreciation | $367 | DepreciationAmt |
| Book Value | $6,970 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $6,970 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DUE TO PRESBYTERIAN HEALTHCARE SERVICES | Desc |
| Amt | $150,721 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $150,721 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $4,000,139 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $4,000,139 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $4,000,139 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $3,027,867 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $3,027,867 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $3,027,867 | TotalExpensesPerForm990Amt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| 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 (5 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| MARK RIES ROBINSON | ||||||||||||||
| PRESIDENT/CEO | $209,805 | $41,667 | $0 | $0 | $0 | $0 | $11,103 | $0 | $2,067 | $0 | $222,975 | $41,667 | $0 | $0 |
| MATT ABRAMS | ||||||||||||||
| VP INDUSTRY DEVELOPMENTS | $168,455 | $0 | $0 | $0 | $0 | $0 | $4,682 | $0 | $8,480 | $0 | $181,617 | $0 | $0 | $0 |
| JENNIFER COREY SCHMID | ||||||||||||||
| COO LABS | $157,087 | $0 | $0 | $0 | $0 | $0 | $10,257 | $0 | $0 | $0 | $167,344 | $0 | $0 | $0 |
| LYNNE HUNT | ||||||||||||||
| VP FINANCE | $120,519 | $0 | $0 | $0 | $0 | $0 | $4,252 | $0 | $3,892 | $0 | $128,663 | $0 | $0 | $0 |
| JESSICA LIN | ||||||||||||||
| SECRETARY/CHIEF OF STAFF | $122,352 | $0 | $0 | $0 | $0 | $0 | $1,505 | $0 | $3,930 | $0 | $127,787 | $0 | $0 | $0 |
Schedule L IRS990ScheduleL
Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp (3 entries)
| Relationship With OrgRelationshipWithOrgTxt | Loan PurposeLoanPurposeTxt | Loan To OrganizationLoanToOrganizationInd | Original PrincipalOriginalPrincipalAmt | Balance DueBalanceDueAmt | DefaultDefaultInd | Board Or Committee ApprovalBoardOrCommitteeApprovalInd | Written AgreementWrittenAgreementInd |
|---|---|---|---|---|---|---|---|
| IHC HEALTH SERVICES | |||||||
| MEMBER | OPERATIONAL | Yes (X) | $1,000,000 | $1,059,065 | 0 | Yes (1) | Yes (1) |
| SSM HEALTHCARE | |||||||
| MEMBER | OPERATIONAL | Yes (X) | $1,000,000 | $1,059,065 | 0 | Yes (1) | Yes (1) |
| PRESBYTERIAN HEATH CARE SERVICES | |||||||
| MEMBER | OPERATIONAL | Yes (X) | $1,000,000 | $1,059,064 | 0 | Yes (1) | Yes (1) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Balance Due | $3,177,194 | TotalBalanceDueAmt |
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PRESBYTERIAN HEATHCARE SERVICES | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | MEMBER | RelationshipDescriptionTxt |
| Transaction | $150,721 | TransactionAmt |
| Transaction | PART IV - PRESBYTERIAN HEALTHCARE SERVICES PAID OPERATING EXPENSES FOR GRAPHITE HEALTH UNTIL GRAPHITE HEALTH RECEIVED DEBT FINANCING FROM ITS MEMBERS. THIS AMOUNT WAS REPAID IN 2022. | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (11 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART 1 SUMMARY: MISSION STATEMENT | GRAPHITE HEALTH OPERATES AS A NON-PROFIT COMPANY WITH A MISSION TO ESTABLISH A TRUSTED DIGITAL ECOSYSTEM, COMPOSED OF AN INTEROPERABILITY DATA PLATFORM AND AN APPLICATION MARKETPLACE THAT WILL DRIVE THE ADVANCEMENT OF HEALTHCARE FOR ALL PATIENTS. |
| FORM 990, PART VI, SECTION A, LINE 6 | GRAPHITE HEALTH'S GOVERNING DOCUMENTS ALLOW FOR THREE CLASSES OF MEMBERS: GOVERNING, FOUNDING AND SUBSCRIBING. EACH CLASS HAS DISTINCT RIGHTS AND PRIVALEDGES. |
| FORM 990, PART VI, SECTION A, LINE 7A | EACH GOVERNING MEMBER HAS THE RIGHT TO NOMINATE ONE INDIVIDUAL TO SERVE ON GRAPHITE HEALTH'S BOARD OF DIRECTORS. GOVERNING MEMBERS ALSO HAVE THE RIGHT TO SELECT ONE INDIVIDUAL TO SIT ON EACH OF ITS ADVISORY COMMITTEES. FOUNDING MEMBERS HAVE NO VOTING RIGHTS AS THOSE ARE CONFERRED UPON THE GOVERNING MEMBERS. FOUNDING MEMBERS HAVE THE RIGHT TO DESIGNATE INDIVIDUALS TO SERVE ON THE THREE ADVISORY COMMITTEES. |
| FORM 990, PART VI, SECTION B, LINE 11B | A COMPLETE COPY OF FORM 990 WAS SENT TO ALL BOARD MEMBERS FOR REVIEW AND COMMENTS PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | DIRECTORS, OFFICERS AND OTHER SENIOR LEADERS HAVE BEEN PROVIDED TRAINING ON THE CONFLICT OF INTEREST POLICY, ARE SURVEYED FOR POSSIBLE CONFLICTS OF INTEREST AND REQUIRED TO DISCLOSE ANNUALLY. |
| FORM 990, PART VI, SECTION B, LINE 15 | GRAPHITE HEALTH RETAINS INDEPENDENT COMPENSATION CONSULTANTS TO DEVELOP COMPENSATION RANGES AND REBUTTABLE PRESUMPTION OF REASONABLENESS OPINIONS FOR ALL SENIOR EXECUTIVES. IT ALSO EMPLOYS INDEPENDENT CONSULTANTS, COMPENSATION SURVEYS AND OFFERS FROM SIMILAR INSTITUTIONS TO DETERMINE THE COMPENSATION FOR ALL OTHER OFFICERS AND KEY EMPLOYEES. OFFERS TO THESE LEVELS OF EMPLOYEES MUST BE APPROVED BY THE BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION DID NOT MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC DURING THE SHORT TAX PERIOD ENDING DECEMBER 31, 2021 BECAUSE THEY WERE BEING DEVELOPED DURING THIS PERIOD. THEY ARE NOW AVAILABLE. |
| FORM 990, PART VI, LINE 18 | THE ORGANIZATION WAS INCORPORATED ON 5/25/2021. IT HAS NOT MADE ITS 501(C)(4) APPLICATION AS OF THE DATE OF THIS FILING. ADDITIONALLY, NO F990 HAS YET BEEN FILED. |
| FORM 990, PART VI, LINE 13 | BECAUSE THE ORGANIZATION IS IN ITS INITIAL STAGES AND HAD ONLY 9 EMPLOYEES BY YEAR-END, IT HAD NOT YET ESTABLISEHD A WHISTLE BLOWER POLICY. SUCH POLICY WAS ESTABLISHED IN 2022. |
| FORM 990, PART IX, LINE 11G | EXECUTIVE RECRUITING AND COMPENSATION ANALYSIS - $678,580, ENGINEERING AND OTHER PRE-DEVELOPMENT - $361,136, ADMINISTRATIVE SERVICES - $50,782. |
| FORM 990, PART IX | BECAUSE THE ORGANIZATION IS IN ITS INITIAL STAGES, PROGRAMS HAVE NOT BEEN ESTABLISHED AND ALL COSTS ARE CONSIDERED ADMINISTRATIVE AND GENERAL IN NATURE. |