2022-11-15T10:24:25-06:00 2021-12-31 850436347 PELTIER GUSTAFSON & MILLER P A 7020 PROSPECT PLACE NE ALBUQUERQUE NM 87110 990 2021-05-25 870933859 GRAPHITE HEALTH INC GRAP 5052643122 7601 JEFFERSON STREET NE 380 ALBUQUERQUE NM 87109 JENNIFER BROWN CAO & GENERAL COUNSEL 5052643122 2022-11-11 1 JENNIFER BROWN 999009999 DONALD H MILLER P00024321 5058813953 0 AAL1 IAL1 2021 2022-09-23 18:48:47Z X X JENNIFER BROWN 7601 JEFFERSON STREET NE 380 ALBUQUERQUE NM 87109 4000139 0 X GRAPHITEHEALTH.IO X 2021 DE SEE SCHEDULE O. 4 3 9 0 0 0 4000000 0 139 0 4000139 0 0 1031511 0 0 1996356 3027867 972272 4479148 3506876 972272 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. 0 0 IN 2021, THE ORGANIZATION WAS IN ITS INITIAL STAGES, PROGRAMS HAD NOT BEEN ESTABLISHED AND ALL COSTS WERE CONSIDERED ADMINISTRATIVE AND GENERAL IN NATURE. 0 1 0 0 0 0 0 0 0 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 1 18 0 1 9 1 0 0 0 0 1 1 0 0 0 X 4 3 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 0 1 1 1 0 X LYNNE HUNT 5058813953 7601 JEFFERSON STREET NE STE 380 ALBUQUERQUE NM 87109 MARK RIES ROBINSON PRESIDENT/CEO 50.00 X X 209805 41667 13170 DAN LILJENQUIST CHAIRMEN OF THE BOARD 5.00 X 0 0 0 CARTER DREDGE MEMBER OF THE BOARD 5.00 X 0 0 0 DALE MAXWELL MEMBER OF THE BOARD 5.00 X 0 0 0 JESSICA LIN SECRETARY/CHIEF OF STAFF 45.00 X 122352 0 5435 LYNNE HUNT VP FINANCE 50.00 X 120519 0 8144 JENNIFER COREY SCHMID COO LABS 40.00 X 157087 0 10257 MATT ABRAMS VP INDUSTRY DEVELOPMENTS 40.00 X 168455 0 13162 778218 41667 50168 5 0 1 1 SSI INC PO BOX 98991 CHICAGO IL 60693 EXECUTIVE RECRUITING 605000 WYATT SPECIALISTS 2552 EL ALBA WAY CHANDLER AZ 85224 ENGINEERING CONSULTING 178425 CROSSCUT STRATEGIES LLC 1200 18TH STREET NW 7TH FLOOR WASHINGTON DC 20036 MARKETING 173250 THOMPSON COBURN ONE US BANK PLAZA ST LOUIS MO 63101 LEGAL SERVICES 106379 SYMBOTIX LLC 7517 EVERTON WAY WAKE FOREST NC 27587 ENGINEERING CONSULTING 105000 5 4000000 4000000 139 139 4000139 0 0 139 X 747501 747501 190440 190440 5420 5420 11546 11546 76604 76604 215869 215869 152199 152199 11493 11493 1090498 1090498 179693 179693 4162 4162 20140 20140 34969 34969 43601 43601 15897 15897 177194 177194 367 367 11466 11466 DUES & SUBSCRIPTIONS 21243 21243 PROFESSIONAL DUES 16000 16000 DONATIONS 1520 1520 TAXES, LICENSES AND FEE 45 45 3027867 0 3027867 0 0 463708 0 3000139 0 1000000 0 8331 7337 367 0 6970 0 4479148 0 178961 3177194 0 150721 0 3506876 X 972272 0 972272 0 4479148 972272 0 X X 0 1 X 1 0 RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 7337 367 6970 6970 DUE TO PRESBYTERIAN HEALTHCARE SERVICES 150721 150721 4000139 0 4000139 0 4000139 3027867 0 3027867 0 3027867 X X X X 0 0 0 0 0 0 0 0 0 MARK RIES ROBINSON PRESIDENT/CEO 209805 41667 0 0 0 0 11103 0 2067 0 222975 41667 0 0 MATT ABRAMS VP INDUSTRY DEVELOPMENTS 168455 0 0 0 0 0 4682 0 8480 0 181617 0 0 0 JENNIFER COREY SCHMID COO LABS 157087 0 0 0 0 0 10257 0 0 0 167344 0 0 0 LYNNE HUNT VP FINANCE 120519 0 0 0 0 0 4252 0 3892 0 128663 0 0 0 JESSICA LIN SECRETARY/CHIEF OF STAFF 122352 0 0 0 0 0 1505 0 3930 0 127787 0 0 0 IHC HEALTH SERVICES MEMBER OPERATIONAL X 1000000 1059065 0 1 1 SSM HEALTHCARE MEMBER OPERATIONAL X 1000000 1059065 0 1 1 PRESBYTERIAN HEATH CARE SERVICES MEMBER OPERATIONAL X 1000000 1059064 0 1 1 3177194 PRESBYTERIAN HEATHCARE SERVICES MEMBER 150721 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. 0 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.