PACKARD HEALTH INC: Form 990, tax year 2023
View the entire original 990 at ProPublica ↗
- Organization
- PACKARD HEALTH INC (EIN 38-2269817)
- Tax period
- 2023-09-01 to 2024-08-31
- Filed
- 2025-02-05
- IRS object ID
- 202510369349300536
- 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 | 2025-02-05T15:54:10-05:00 | ReturnTs |
| Tax Period End | 2024-08-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 382706146 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | YEO & YEO PC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1450 EISENHOWER PLACE | AddressLine1Txt |
| City | ANN ARBOR | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 481083283 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2023-09-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 382269817 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PACKARD HEALTH INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PACK | BusinessNameControlTxt |
| Phone | 7349711073 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5200 VENTURE DRIVE | AddressLine1Txt |
| City | ANN ARBOR | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48108 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | RAYMOND RION | PersonNm |
| Person Title | EXECUTIVE DIRECTOR | PersonTitleTxt |
| Phone | 7349711073 | PhoneNum |
| Signature | 2025-01-22 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | false | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | BRIAN R DIXON | PreparerPersonNm |
| PTIN | P01321580 | PTIN |
| Phone | 7347691331 | PhoneNum |
| Preparation | 2025-02-03 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2023 | TaxYr |
| Build TS | 2025-03-06 01:10:19Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | RAYMOND RION | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5200 VENTURE PARK DRIVE | AddressLine1Txt |
| City | ANN ARBOR | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48108 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $15,266,634 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.PACKARDHEALTH.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1973 | FormationYr |
| Legal Domicile State | MI | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE THE BEST POSSIBLE CARE TO OUR PATIENTS AND COMMUNITY, INCLUDING PEOPLE WHOSE ECONOMIC, SOCIAL OR CULTURAL CONDITIONS MIGHT OTHERWISE PREVENT THEM FROM ACCESSING HEALTH CARE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 15 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 15 | VotingMembersIndependentCnt |
| Total Employee | 143 | TotalEmployeeCnt |
| Total Volunteers | 21 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $3,955,787 | PYContributionsGrantsAmt |
| CY Contributions Grants | $2,789,669 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $8,554,470 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $12,291,405 | CYProgramServiceRevenueAmt |
| PY Investment Income | $91,220 | PYInvestmentIncomeAmt |
| CY Investment Income | $140,021 | CYInvestmentIncomeAmt |
| PY Other Revenue | $170 | PYOtherRevenueAmt |
| CY Other Revenue | $45,539 | CYOtherRevenueAmt |
| PY Total Revenue | $12,601,647 | PYTotalRevenueAmt |
| CY Total Revenue | $15,266,634 | CYTotalRevenueAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $8,475,556 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $9,844,397 | CYSalariesCompEmpBnftPaidAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $293,159 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $4,095,314 | PYOtherExpensesAmt |
| CY Other Expenses | $6,099,602 | CYOtherExpensesAmt |
| PY Total Expenses | $12,570,870 | PYTotalExpensesAmt |
| CY Total Expenses | $15,943,999 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $30,777 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$677,365 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $18,440,917 | TotalAssetsBOYAmt |
| Total Assets EOY | $18,061,803 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $3,254,462 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $3,401,034 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $15,186,455 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $14,660,769 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO PROVIDE THE BEST POSSIBLE CARE TO OUR PATIENTS AND COMMUNITY, INCLUDING PEOPLE WHOSE ECONOMIC, SOCIAL OR CULTURAL CONDITIONS MIGHT OTHERWISE PREVENT THEM FROM ACCESSING HEALTH CARE. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $11,762,440 | ExpenseAmt |
| Revenue | $12,291,405 | RevenueAmt |
| Desc | PRIMARY HEALTH SERVICES, INCLUDING MENTAL HEALTH CARE, PHARMACEUTICAL SERVICES, AND HEALTH PROMOTION TO PATIENTS IN THE WASHTENAW COUNTY AREA. | Desc |
| Total Program Service Expenses | $11,762,440 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | Yes (true) | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 3 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 143 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 15 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 15 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | MI | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DAVID HOFFMAN | PersonNm |
| Phone | 7349711073 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5200 VENTURE PARK DRIVE | AddressLine1Txt |
| City | ANN ARBOR | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48108 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (24 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| RAYMOND RION | ||||||||
| EXECUTIVE DI | 40.00 | Yes (X) | $260,944 | $0 | $17,068 | |||
| DR ANKOOR SONI | ||||||||
| MEDICAL DIRE | 40.00 | $207,218 | $0 | $24,009 | Yes (X) | |||
| DAVID HOFFMAN | ||||||||
| CFO | 40.00 | Yes (X) | $133,054 | $0 | $1,416 | |||
| NEIL B KIRST | ||||||||
| CMO | 40.00 | $251,817 | $0 | $25,791 | Yes (X) | |||
| RANA SMITH | ||||||||
| BOARD CHAIR | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| MOLLY WELCH-MARAHAR | ||||||||
| VICE CHAIR | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| CHUCK HOFFMAN | ||||||||
| TREASURER | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| NORA MALOY PHD | ||||||||
| SECRETARY | 1.00 | Yes (X) | $0 | $0 | $0 | Yes (X) | ||
| GARY BOREN | ||||||||
| TRUSTEE | 1.00 | $0 | $0 | $0 | Yes (X) | |||
| MARGARET CALARCO | ||||||||
| TRUSTEE | 1.00 | $0 | $0 | $0 | Yes (X) | |||
| DEBORAH VANDENBROEK | ||||||||
| TRUSTEE | 1.00 | $0 | $0 | $0 | Yes (X) | |||
| SHARON MOORE | ||||||||
| TRUSTEE | 1.00 | $0 | $0 | $0 | Yes (X) | |||
| EDD SNYDER | ||||||||
| TRUSTEE | 1.00 | $0 | $0 | $0 | Yes (X) | |||
| DOUG STRONG | ||||||||
| TRUSTEE | 1.00 | $0 | $0 | $0 | Yes (X) | |||
| BRYAN WAGONER | ||||||||
| TRUSTEE | 1.00 | $0 | $0 | $0 | Yes (X) | |||
| PAULA LANTZ | ||||||||
| TRUSTEE | 1.00 | $0 | $0 | $0 | Yes (X) | |||
| JUAN MARQUEZ MD MPH | ||||||||
| TRUSTEE | 1.00 | $0 | $0 | $0 | Yes (X) | |||
| RUTH CASSIDY | ||||||||
| TRUSTEE | 1.00 | $0 | $0 | $0 | Yes (X) | |||
| JOSEPH KAPLAN | ||||||||
| TRUSTEE | 1.00 | $0 | $0 | $0 | Yes (X) | |||
| RAVI VADLAMUDI | ||||||||
| PHYSICIAN | 40.00 | $226,206 | $0 | $23,070 | Yes (X) | |||
| LINDSEY KOTAGAL | ||||||||
| PHYSICIAN | 40.00 | $199,585 | $0 | $9,930 | Yes (X) | |||
| RONALD ROMERO | ||||||||
| PHYSICIAN | 40.00 | $166,051 | $0 | $22,362 | Yes (X) | |||
| DANIEL ORAM | ||||||||
| PHYSICIAN | 40.00 | $160,680 | $0 | $21,753 | Yes (X) | |||
| HOLLY ROSS | ||||||||
| COMPLIANCE O | 40.00 | $157,284 | $0 | $25,415 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,762,839 | TotalReportableCompFromOrgAmt |
| Total Other Compensation | $170,814 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 18 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| ATHENAHEALTH INC | |||||
| 315 MADISON AVE STE 1804 | NEW YORK | NY | 10017 | BILLING AND AR | $417,238 |
| 340BASICS | |||||
| 311 ARSENAL STREET | WATERTOWN | MA | 02472 | 340B SERVICES | $273,185 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $1,529,967 | GovernmentGrantsAmt |
| All Other Contributions | $1,259,702 | AllOtherContributionsAmt |
| Noncash Contributions | $473,787 | NoncashContributionsAmt |
| Total Contributions | $2,789,669 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT FEES | 624100 | $7,005,683 | $7,005,683 |
| PHARMACY | 624100 | $2,488,987 | $2,488,987 |
| CONTRACT SERVICE FEES | 624100 | $2,480,305 | $2,480,305 |
| CAPITATION FEES | 624100 | $316,430 | $316,430 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $12,291,405 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $140,021 | TotalRevenueColumnAmt |
| Exclusion | $140,021 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OTHER | Desc |
| Business | 624100 | BusinessCd |
| Total Revenue Column | $45,539 | TotalRevenueColumnAmt |
| Exclusion | $45,539 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $45,539 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $15,266,634 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $12,291,405 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $185,560 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,009,025 | TotalAmt |
| Program Services | $408,437 | ProgramServicesAmt |
| Management And General | $600,588 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,069,126 | TotalAmt |
| Program Services | $5,209,044 | ProgramServicesAmt |
| Management And General | $1,713,467 | ManagementAndGeneralAmt |
| Fundraising | $146,615 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $137,315 | TotalAmt |
| Program Services | $105,216 | ProgramServicesAmt |
| Management And General | $28,971 | ManagementAndGeneralAmt |
| Fundraising | $3,128 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,019,449 | TotalAmt |
| Program Services | $720,533 | ProgramServicesAmt |
| Management And General | $279,248 | ManagementAndGeneralAmt |
| Fundraising | $19,668 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $609,482 | TotalAmt |
| Program Services | $425,237 | ProgramServicesAmt |
| Management And General | $173,064 | ManagementAndGeneralAmt |
| Fundraising | $11,181 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $84,919 | TotalAmt |
| Program Services | $16,984 | ProgramServicesAmt |
| Management And General | $67,935 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,548,931 | TotalAmt |
| Program Services | $949,653 | ProgramServicesAmt |
| Management And General | $597,544 | ManagementAndGeneralAmt |
| Fundraising | $1,734 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $103,617 | TotalAmt |
| Fundraising | $103,617 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $190,146 | TotalAmt |
| Program Services | $131,201 | ProgramServicesAmt |
| Management And General | $57,044 | ManagementAndGeneralAmt |
| Fundraising | $1,901 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $389,415 | TotalAmt |
| Program Services | $339,530 | ProgramServicesAmt |
| Management And General | $48,291 | ManagementAndGeneralAmt |
| Fundraising | $1,594 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $65,765 | TotalAmt |
| Program Services | $64,002 | ProgramServicesAmt |
| Management And General | $1,706 | ManagementAndGeneralAmt |
| Fundraising | $57 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $269,081 | TotalAmt |
| Program Services | $145,304 | ProgramServicesAmt |
| Management And General | $121,086 | ManagementAndGeneralAmt |
| Fundraising | $2,691 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,595 | TotalAmt |
| Management And General | $36,595 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| MEDICAL SUPPLIES | $3,041,142 | $3,041,142 | ||
| DUES, LICENSES & SUBSCRIP | $104,408 | $76,723 | $27,685 | |
| REPAIRS & MAINTENANCE | $97,294 | $67,133 | $29,188 | $973 |
| INTEREST | $91,449 | $91,449 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $76,840 | TotalAmt |
| Program Services | $62,301 | ProgramServicesAmt |
| Management And General | $14,539 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,943,999 | TotalAmt |
| Program Services | $11,762,440 | ProgramServicesAmt |
| Management And General | $3,888,400 | ManagementAndGeneralAmt |
| Fundraising | $293,159 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,067 | BOYAmt |
| EOY | $975 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,057,462 | BOYAmt |
| EOY | $673,251 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $195,328 | BOYAmt |
| EOY | $192,516 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,346,311 | BOYAmt |
| EOY | $2,084,453 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $125,434 | BOYAmt |
| EOY | $331,248 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $197,349 | BOYAmt |
| EOY | $235,779 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $9,972,559 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $976,404 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,991,054 | BOYAmt |
| EOY | $8,996,155 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,904,367 | BOYAmt |
| EOY | $5,086,187 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $619,545 | BOYAmt |
| EOY | $461,239 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,440,917 | BOYAmt |
| EOY | $18,061,803 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $617,225 | BOYAmt |
| EOY | $844,158 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $50,000 | BOYAmt |
| EOY | $200,000 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,960,313 | BOYAmt |
| EOY | $1,885,287 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $626,924 | BOYAmt |
| EOY | $471,589 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,254,462 | BOYAmt |
| EOY | $3,401,034 | 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 | $14,704,108 | BOYAmt |
| EOY | $14,278,859 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $482,347 | BOYAmt |
| EOY | $381,910 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,186,455 | BOYAmt |
| EOY | $14,660,769 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,440,917 | BOYAmt |
| EOY | $18,061,803 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$677,365 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $151,679 | NetUnrlzdGainsLossesInvstAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | 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 (true) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (true) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (true) | FederalGrantAuditPerformedInd |
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
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,295,809 | OtherCostOrOtherBasisAmt |
| Book Value | $1,295,809 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,382,535 | OtherCostOrOtherBasisAmt |
| Depreciation | $671,015 | DepreciationAmt |
| Book Value | $6,711,520 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $258,383 | OtherCostOrOtherBasisAmt |
| Depreciation | $157,583 | DepreciationAmt |
| Book Value | $100,800 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $337,025 | OtherCostOrOtherBasisAmt |
| Depreciation | $147,806 | DepreciationAmt |
| Book Value | $189,219 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $698,807 | OtherCostOrOtherBasisAmt |
| Book Value | $698,807 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $8,996,155 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OPERATING LEASE | Desc |
| Amt | $471,589 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $471,589 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $15,418,313 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $151,679 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | $151,679 | RevenueNotReportedAmt |
| Revenue Subtotal | $15,266,634 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $15,266,634 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $15,943,999 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $15,943,999 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $15,943,999 | TotalExpensesPerForm990Amt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt |
|---|---|---|---|---|
| RAYMOND RION | ||||
| EXECUTIVE DIRECTOR | $260,944 | $10,454 | $6,614 | $278,012 |
| DR ANKOOR SONI | ||||
| MEDICAL DIRECTOR | $207,218 | $6,976 | $17,033 | $231,227 |
| NEIL B KIRST | ||||
| CMO | $251,817 | $10,075 | $15,716 | $277,608 |
| RAVI VADLAMUDI | ||||
| PHYSICIAN | $226,206 | $7,962 | $15,108 | $249,276 |
| LINDSEY KOTAGAL | ||||
| PHYSICIAN | $199,585 | $7,983 | $1,947 | $209,515 |
| RONALD ROMERO | ||||
| PHYSICIAN | $166,051 | $6,646 | $15,716 | $188,413 |
| DANIEL ORAM | ||||
| PHYSICIAN | $160,680 | $6,126 | $15,627 | $182,433 |
| HOLLY ROSS | ||||
| COMPLIANCE OFFICER | $157,284 | $6,291 | $19,124 | $182,699 |
Schedule M IRS990ScheduleM
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 1166 | ContributionCnt |
| Noncash Contributions Rpt F990 | $473,787 | NoncashContributionsRptF990Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | false | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | Yes (true) | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | false | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 6, PART VI, LINE 11B | THE 990 IS REVIEWED BY THE CFO IN DETAIL, THE 990 IS ALSO PROVIDED TO THE EXECUTIVE DIRECTOR, TREASURER AND THE BOARD FOR REVIEW PRIOR TO FILING. |
| FORM 990, PAGE 6, PART VI, LINE 12C | THE BOARD REVISITS THE CONFLICTS OF INTEREST POLICY ANNUALLY. |
| FORM 990, PAGE 6, PART VI, LINE 15A | THE BOARD DETERMINES THE COMPENSATION OF THE EXECUTIVE DIRECTOR BASED ON PERFORMANCE AND OTHER FACTORS. |
| FORM 990, PAGE 6, PART VI, LINE 15B | THE EXECUTIVE DIRECTOR DETERMINES THE COMPENSATION FOR OFFICERS & KEY EMPLOYEES. |
| FORM 990, PAGE 6, PART VI, LINE 19 | DOCUMENTS ARE AVAILABLE UPON REQUEST. |