BRISTOL HOSPITAL MULTI-SPECIALTY GROUP: Form 990, tax year 2023
View the entire original 990 at ProPublica ↗
- Organization
- BRISTOL HOSPITAL MULTI-SPECIALTY GROUP (EIN 06-1466555)
- Tax period
- 2023-10-01 to 2024-09-30
- Filed
- 2025-09-09
- IRS object ID
- 202522529349300417
- 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 | 2025-09-09T08:33:31-05:00 | ReturnTs |
| Tax Period End | 2024-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 390859910 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BAKER TILLY ADVISORY GROUP LP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1570 FRUITVILLE PIKE SUITE 400 | AddressLine1Txt |
| City | LANCASTER | CityNm |
| State Abbreviation | PA | StateAbbreviationCd |
| ZIP | 17601 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2023-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 061466555 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BRISTOL HOSPITAL MULTI-SPECIALTY GROUP | BusinessNameLine1Txt |
| Business Name Line2 | INC | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | BRIS | BusinessNameControlTxt |
| Phone | 8605853469 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 2828 | AddressLine1Txt |
| City | BRISTOL | CityNm |
| State Abbreviation | CT | StateAbbreviationCd |
| ZIP | 060112828 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TIMOTHY AJAYI | PersonNm |
| Person Title | VP & CFO | PersonTitleTxt |
| Phone | 8605853469 | PhoneNum |
| Signature | 2025-09-02 | 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 | KERRI N BOGDA | PreparerPersonNm |
| PTIN | P00760402 | PTIN |
| Phone | 7177404863 | PhoneNum |
| Preparation | 2025-09-02 | 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 | KURT BARWIS | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 2828 | AddressLine1Txt |
| City | BRISTOL | CityNm |
| State Abbreviation | CT | StateAbbreviationCd |
| ZIP | 060112828 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $38,345,445 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.BRISTOLHOSPITAL.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2011 | FormationYr |
| Legal Domicile State | CT | LegalDomicileStateCd |
| Activity Or Mission | HIGH QUALITY PATIENT-CENTERED HEALTH CARE THAT RESPONDS TO EVOLVING PATIENT HEALTH CARE NEEDS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 2 | VotingMembersIndependentCnt |
| Total Employee | 352 | TotalEmployeeCnt |
| Total Volunteers | 3 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $10,485,583 | PYContributionsGrantsAmt |
| CY Contributions Grants | $9,460,303 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $28,474,525 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $27,574,766 | CYProgramServiceRevenueAmt |
| PY Investment Income | -$24,321 | PYInvestmentIncomeAmt |
| CY Investment Income | -$22,512 | CYInvestmentIncomeAmt |
| PY Other Revenue | $149,666 | PYOtherRevenueAmt |
| CY Other Revenue | $1,310,376 | CYOtherRevenueAmt |
| PY Total Revenue | $39,085,453 | PYTotalRevenueAmt |
| CY Total Revenue | $38,322,933 | 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 | $38,815,540 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $38,753,167 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $17,535,319 | PYOtherExpensesAmt |
| CY Other Expenses | $17,394,425 | CYOtherExpensesAmt |
| PY Total Expenses | $56,350,859 | PYTotalExpensesAmt |
| CY Total Expenses | $56,147,592 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$17,265,406 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$17,824,659 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $15,526,638 | TotalAssetsBOYAmt |
| Total Assets EOY | $13,995,466 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $18,654,508 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $17,288,792 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$3,127,870 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$3,293,326 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO PROVIDE ACCESSIBLE, HIGH QUALITY, SUSTAINABLE, PATIENT-CENTERED HEALTH CARE IN THE COMMUNITY, AND TO RESPOND TO THE EVOLVING HEALTH CARE NEEDS OF THE COMMUNITY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $47,917,003 | ExpenseAmt |
| Revenue | $27,574,766 | RevenueAmt |
| Desc | THE BRISTOL HOSPITAL MULTISPECIALTY GROUP WAS FORMED TO DELIVER A FULL RANGE OF HEALTH AND SPECIALTY CARE SERVICES AT CONVENIENT LOCATIONS THROUGHOUT BRISTOL, CONNECTICUT, AND THE SURROUNDING TOWNS. THEY PROVIDE ACCESSIBLE, HIGH QUALITY, EVIDENCE-BASED, STATE-OF-THE-ART, COST-EFFECTIVE, COMPASSIONATE AND PATIENT-CENTERED HEALTH CARE IN THE COMMUNITIES SERVED BY BRISTOL HOSPITAL. THEY RESPOND APPROPRIATELY TO EVOLVING COMMUNITY HEALTH CARE NEEDS AND TO CHANGES IN TECHNOLOGY AND THE HEALTH CARE SYSTEM; AND THEY ASSURE A SUSTAINABLE LEGACY OF HEALTH CARE SERVICE EXCELLENCE IN THOSE COMMUNITIES. THESE SERVICES ARE AVAILABLE TO ALL PERSONS, WITHOUT REGARD TO THEIR ABILITY TO PAY FOR SUCH SERVICES, AND ARE OPERATIONAL AT ALL TIMES IN FURTHERANCE OF THE TAX-EXEMPT CHARITABLE MISSIONS OF BRISTOL HOSPITAL AND HEALTH CARE GROUP, INC. THE ORGANIZATION'S PHYSICIANS PROVIDE FREQUENT COMMUNITY-WIDE EDUCATION SUCH AS SEMINARS, ARTICLES IN THE LOCAL NEWSPAPERS, AND SESSIONS AT THE SENIOR CENTERS AND SCHOOLS. THESE COMMUNITY EVENTS ALSO PROVIDE THE PUBLIC THE OPPORTUNITY TO INTERACT WITH THE PHYSICIANS AT NO COST. | Desc |
| Total Program Service Expenses | $47,917,003 | 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 | Yes (1) | 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 | 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 | 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 | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| IRP Document | 39 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 352 | 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 | 2 | 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 | Yes (1) | 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 | 0 | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TIM AJAYI | PersonNm |
| Phone | 8605853024 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 41 BREWSTER ROAD | AddressLine1Txt |
| City | BRISTOL | CityNm |
| State Abbreviation | CT | StateAbbreviationCd |
| ZIP | 06010 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|---|
| CHRIS ANN MEANEY | |||||||||
| PRESIDENT OF BHMG | 5.00 | 35.00 | Yes (X) | Yes (X) | $0 | $330,377 | $1,230 | ||
| KURT BARWIS | |||||||||
| PRESIDENT, CEO & CFO | 2.00 | 38.00 | Yes (X) | Yes (X) | $0 | $650,032 | $37,738 | ||
| RUPALINI RAWAL-DHINGRA MD | |||||||||
| CHAIR OF THE BOARD | 40.00 | 8.00 | Yes (X) | Yes (X) | $370,527 | $0 | $28,912 | ||
| MARGARITA REYES MD | |||||||||
| VICE CHAIR (UNTIL 5/23) | 40.00 | 0.00 | Yes (X) | Yes (X) | $324,208 | $0 | $15,583 | ||
| JOHN LODOVICO JR | |||||||||
| SECRETARY/TREASURER | 2.00 | 10.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| GLENN HEISER | |||||||||
| DIRECTOR (UNTIL 4/24) | 2.00 | 0.00 | Yes (X) | $0 | $0 | $0 | |||
| LIRAN BLUM MD | |||||||||
| DIRECTOR / PHYSICIAN | 40.00 | 8.00 | Yes (X) | $447,429 | $0 | $28,912 | |||
| TOSHITA KUMAR MD | |||||||||
| DIRECTOR (UNTIL 11/23) / PHYSICIAN | 40.00 | 0.00 | Yes (X) | $390,644 | $0 | $147 | |||
| KEONA DAWSON-CAMEROTA APRN | |||||||||
| DIRECTOR (UNTIL 1/24) | 40.00 | 0.00 | Yes (X) | $149,492 | $0 | $139 | |||
| ROBERT BLACK MD | |||||||||
| VICE CHAIR OF THE BOARD | 2.00 | 0.00 | Yes (X) | $434,871 | $0 | $148 | |||
| MATTHEW HUNT APRN | |||||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $110,383 | $0 | $5,852 | |||
| LOUIS AULETTA JR | |||||||||
| DIRECTOR | 2.00 | 10.00 | Yes (X) | $0 | $0 | $0 | |||
| SAIMA PASHA | |||||||||
| DIRECTOR | 2.00 | 0.00 | Yes (X) | $381,904 | $0 | $148 | |||
| HENRY EDWARD VINCENT | |||||||||
| EXECUTIVE DIRECTOR | 30.00 | 10.00 | Yes (X) | $0 | $205,085 | $14,197 | |||
| ANDREW LIM MD | |||||||||
| MEDICAL DIRECTOR | 40.00 | 0.00 | $435,923 | $0 | $382 | Yes (X) | |||
| KAI HANS HAMMERICH | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $1,242,323 | $0 | $2,905 | Yes (X) | |||
| THOMAS O'SHEA | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $712,193 | $0 | $22,483 | Yes (X) | |||
| KYLE LAVERY | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $585,596 | $0 | $31,737 | Yes (X) | |||
| MORENIKEJI AYODELE BURAIMOH | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $659,409 | $0 | $28,912 | Yes (X) | |||
| VANESSA MALIT | |||||||||
| PHYSICIAN | 40.00 | 0.00 | $694,169 | $0 | $32,303 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $6,939,071 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,185,494 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $251,728 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 94 | 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 |
|---|---|---|---|---|---|
| COMPHEALTH | |||||
| 7529 S BINGHAM JUNCTION BLVD | MIDVALE | UT | 84047 | PHYSICIAN SERVICES | $503,169 |
| CHARTER ANESTHESIOLOGY LLC | |||||
| 151 MAIN STREET | BRISTOL | CT | 06010 | ANESTHESIOLOGY SERVICES | $457,291 |
| CHALEEL LLC | |||||
| 9 HILLDALE ROAD | WEST HARTFORD | CT | 06117 | PHYSICIAN SERVICES | $397,580 |
| MEDCARE BUSINESS SOLUTIONS LLC | |||||
| 59 PLEASANT STREET APT 2 | BOSTON | MA | 02125 | BILLING SERVICES | $177,973 |
| MARLENE MURPHY SETZKO | |||||
| 15 RIVERSIDE AVENUE UROLOGY | BRISTOL | CT | 06010 | PHYSICIAN SERVICES | $174,488 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 7 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $9,460,303 | RelatedOrganizationsAmt |
| Total Contributions | $9,460,303 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT SERVICE REVENUE | Desc |
| Business | 621110 | BusinessCd |
| Total Revenue Column | $27,574,766 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $27,574,766 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $27,574,766 | TotalProgramServiceRevenueAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $20,700 | RealAmt |
Less Rental Expenses LessRentalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $20,700 | RealAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $20,700 | TotalRevenueColumnAmt |
| Exclusion | $20,700 | ExclusionAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $22,512 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$22,512 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$22,512 | TotalRevenueColumnAmt |
| Exclusion | -$22,512 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| INCENTIVE BONUS | 900099 | $1,215,097 | $1,215,097 |
| SLEEP CENTER MANAGEMENT FEE | 900099 | $54,000 | $54,000 |
| MEDICAL STUDENT TRAINING | 900099 | $16,950 | $16,950 |
Miscellaneous Revenue MiscellaneousRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,629 | TotalRevenueColumnAmt |
| Exclusion | $3,629 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $1,289,676 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $38,322,933 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $27,574,766 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,287,864 | ExclusionAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $36,111,685 | TotalAmt |
| Program Services | $33,692,456 | ProgramServicesAmt |
| Management And General | $2,419,229 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $203,777 | TotalAmt |
| Program Services | $153,786 | ProgramServicesAmt |
| Management And General | $49,991 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $448,552 | TotalAmt |
| Program Services | $173,124 | ProgramServicesAmt |
| Management And General | $275,428 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,989,153 | TotalAmt |
| Program Services | $1,810,819 | ProgramServicesAmt |
| Management And General | $178,334 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $46,224 | TotalAmt |
| Program Services | $41,766 | ProgramServicesAmt |
| Management And General | $4,458 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,538,388 | TotalAmt |
| Program Services | $4,538,388 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $949,577 | TotalAmt |
| Program Services | $737,727 | ProgramServicesAmt |
| Management And General | $211,850 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,104,764 | TotalAmt |
| Program Services | $1,104,764 | ProgramServicesAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $258,691 | TotalAmt |
| Program Services | $258,691 | ProgramServicesAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,305,701 | TotalAmt |
| Program Services | $2,297,345 | ProgramServicesAmt |
| Management And General | $8,356 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,409,891 | TotalAmt |
| Program Services | $1,409,891 | ProgramServicesAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| SHARED SERVICES | $5,077,603 | $5,400 | $5,072,203 |
| MEDICAL SUPPLIES | $937,192 | $937,192 | |
| DRUGS | $755,624 | $755,624 | |
| MISCELLANEOUS EXPENSES | $10,770 | $30 | $10,740 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $56,147,592 | TotalAmt |
| Program Services | $47,917,003 | ProgramServicesAmt |
| Management And General | $8,230,589 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,068,646 | BOYAmt |
| EOY | $4,468,425 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $101,135 | BOYAmt |
| EOY | $170,367 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $421,541 | BOYAmt |
| EOY | $629,856 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $5,758,925 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $3,773,924 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,222,851 | BOYAmt |
| EOY | $1,985,001 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,712,465 | BOYAmt |
| EOY | $6,741,817 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,526,638 | BOYAmt |
| EOY | $13,995,466 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,990,665 | BOYAmt |
| EOY | $9,675,637 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $546,590 | BOYAmt |
| EOY | $434,591 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,117,253 | BOYAmt |
| EOY | $7,178,564 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,654,508 | BOYAmt |
| EOY | $17,288,792 | 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 | -$3,127,870 | BOYAmt |
| EOY | -$3,293,326 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$3,127,870 | BOYAmt |
| EOY | -$3,293,326 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,526,638 | BOYAmt |
| EOY | $13,995,466 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$17,824,659 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $17,659,203 | 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) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $10,144,772 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $12,065,632 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $11,915,034 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $10,485,583 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $9,460,303 | CurrentTaxYearAmt |
| Total | $54,071,324 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $25,777,769 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $25,617,975 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $26,447,030 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $28,474,525 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $27,574,766 | CurrentTaxYearAmt |
| Total | $133,892,065 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $35,922,541 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $37,683,607 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $38,362,064 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $38,960,108 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $37,035,069 | CurrentTaxYearAmt |
| Total | $187,963,389 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $187,963,389 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $11,289 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $21,446 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $23,665 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $19,200 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $20,700 | CurrentTaxYearAmt |
| Total | $96,300 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $11,289 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $21,446 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $23,665 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $19,200 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $20,700 | CurrentTaxYearAmt |
| Total | $96,300 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $42,855 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $7,788 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $7,327 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $130,466 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,289,676 | CurrentTaxYearAmt |
| Total | $1,478,112 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $35,976,685 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $37,712,841 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $38,393,056 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $39,109,774 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $38,345,445 | CurrentTaxYearAmt |
| Total | $189,537,801 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99170 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99840 | PublicSupportPY509Pct |
| Investment Income CY | 0.00050 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00050 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: | FormAndLineReferenceDesc |
| Explanation | MEDICAL STUDENT TRAINING - 2019 AMOUNT: $ 7,804. 2020 AMOUNT: $ 7,788. 2021 AMOUNT: $ 6,875. 2022 AMOUNT: $ 127,787. 2023 AMOUNT: $ 16,950. INSURANCE CLAIM PROCEEDS - 2019 AMOUNT: $ 9,299. MISC REFUND - 2019 AMOUNT: $ 42. 2021 AMOUNT: $ 452. 2022 AMOUNT: $ 2,679. 2023 AMOUNT: $ 3,629. INSURANCE DISTRIBUTION - 2019 AMOUNT: $ 25,710. SLEEP CENTER MANAGEMENT FEE - 2023 AMOUNT: $ 54,000. INCENTIVE BONUS - 2023 AMOUNT: $ 1,215,097. | ExplanationTxt |
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 | $33,057 | OtherCostOrOtherBasisAmt |
| Depreciation | $33,057 | DepreciationAmt |
| Book Value | $0 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,376,375 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,014,352 | DepreciationAmt |
| Book Value | $1,362,023 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $3,240,581 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,726,515 | DepreciationAmt |
| Book Value | $514,066 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $108,912 | OtherCostOrOtherBasisAmt |
| Book Value | $108,912 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $1,985,001 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (3 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| DUE FROM AFFILIATE | $2,042 |
| RIGHT-OF-USE ASSETS, FINANCE LEASES | $5,199,155 |
| RIGHT-OF-USE ASSETS, OPERATING LEASES | $1,540,620 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $6,741,817 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| CASH OVERDRAFT | $76,683 |
| RIGHT-OF-USE ASSETS, FINANCE LEASES | $5,538,135 |
| RIGHT-OF-USE ASSETS, OPERATING LEASES | $1,563,746 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $7,178,564 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $55,982,136 | TotalRevEtcAuditedFinclStmtAmt |
| Other Revenue | $17,659,203 | OtherRevenueAmt |
| Revenue Not Reported | $17,659,203 | RevenueNotReportedAmt |
| Revenue Subtotal | $38,322,933 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $38,322,933 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $56,147,592 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $56,147,592 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $56,147,592 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | THE CORPORATION ACCOUNTS FOR UNCERTAIN TAX POSITIONS WITH PROVISIONS OF FASB ASC 740, INCOME TAXES, WHICH PROVIDES A FRAMEWORK FOR HOW COMPANIES SHOULD RECOGNIZE, MEASURE, PRESENT AND DISCLOSE UNCERTAIN TAX POSITIONS IN THEIR CONSOLIDATED FINANCIAL STATEMENTS. THE CORPORATION MAY RECOGNIZE THE TAX BENEFIT FROM AN UNCERTAIN TAX POSITION ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY THE TAXING AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE CORPORATION DOES NOT HAVE ANY UNCERTAIN TAX POSITIONS AS OF SEPTEMBER 30, 2024 AND 2023. IT IS THE CORPORATION'S POLICY TO RECORD PENALTIES AND INTEREST ASSOCIATED WITH UNCERTAIN TAX PROVISIONS AS A COMPONENT OF OPERATING EXPENSES. AS OF SEPTEMBER 30, 2024 AND 2023, THE CORPORATION DID NOT RECORD ANY PENALTIES OR INTEREST ASSOCIATED WITH UNCERTAIN TAX POSITIONS. THE CORPORATION'S PRIOR THREE TAX YEARS ARE OPEN AND SUBJECT TO EXAMINATION BY THE INTERNAL REVENUE SERVICE. THE CORPORATION DOES NOT EXPECT THE TOTAL AMOUNT OF UNRECOGNIZED TAX BENEFITS TO SIGNIFICANTLY CHANGE IN THE NEXT 12 MONTHS. |
| PART XI, LINE 2D - OTHER ADJUSTMENTS: | TRANSFER FROM AFFILIATES 17,659,143. OTHER CHANGES IN NET ASSETS 60. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | 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 | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (15 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| KAI HANS HAMMERICH | ||||||||||||||
| PHYSICIAN | $821,054 | $0 | $421,269 | $0 | $0 | $0 | $0 | $0 | $2,905 | $0 | $1,245,228 | $0 | $0 | $0 |
| THOMAS O'SHEA | ||||||||||||||
| PHYSICIAN | $693,693 | $0 | $18,500 | $0 | $0 | $0 | $0 | $0 | $22,483 | $0 | $734,676 | $0 | $0 | $0 |
| VANESSA MALIT | ||||||||||||||
| PHYSICIAN | $676,044 | $0 | $18,125 | $0 | $0 | $0 | $0 | $0 | $32,303 | $0 | $726,472 | $0 | $0 | $0 |
| MORENIKEJI AYODELE BURAIMOH | ||||||||||||||
| PHYSICIAN | $650,076 | $0 | $9,333 | $0 | $0 | $0 | $0 | $0 | $28,912 | $0 | $688,321 | $0 | $0 | $0 |
| KURT BARWIS | ||||||||||||||
| PRESIDENT, CEO & CFO | $0 | $650,032 | $0 | $0 | $0 | $0 | $0 | $24,314 | $0 | $13,424 | $0 | $687,770 | $0 | $0 |
| KYLE LAVERY | ||||||||||||||
| PHYSICIAN | $577,263 | $0 | $8,333 | $0 | $0 | $0 | $0 | $0 | $31,737 | $0 | $617,333 | $0 | $0 | $0 |
| LIRAN BLUM MD | ||||||||||||||
| DIRECTOR / PHYSICIAN | $356,617 | $0 | $90,812 | $0 | $0 | $0 | $0 | $0 | $28,912 | $0 | $476,341 | $0 | $0 | $0 |
| ANDREW LIM MD | ||||||||||||||
| MEDICAL DIRECTOR | $435,923 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $382 | $0 | $436,305 | $0 | $0 | $0 |
| ROBERT BLACK MD | ||||||||||||||
| VICE CHAIR OF THE BOARD | $434,871 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $148 | $0 | $435,019 | $0 | $0 | $0 |
| RUPALINI RAWAL-DHINGRA MD | ||||||||||||||
| CHAIR OF THE BOARD | $353,239 | $0 | $17,288 | $0 | $0 | $0 | $0 | $0 | $28,912 | $0 | $399,439 | $0 | $0 | $0 |
| TOSHITA KUMAR MD | ||||||||||||||
| DIRECTOR (UNTIL 11/23) / PHYSICIAN | $361,394 | $0 | $29,250 | $0 | $0 | $0 | $0 | $0 | $147 | $0 | $390,791 | $0 | $0 | $0 |
| SAIMA PASHA | ||||||||||||||
| DIRECTOR | $303,212 | $0 | $78,692 | $0 | $0 | $0 | $0 | $0 | $148 | $0 | $382,052 | $0 | $0 | $0 |
| MARGARITA REYES MD | ||||||||||||||
| VICE CHAIR (UNTIL 5/23) | $287,301 | $0 | $36,907 | $0 | $0 | $0 | $0 | $0 | $15,583 | $0 | $339,791 | $0 | $0 | $0 |
| CHRIS ANN MEANEY | ||||||||||||||
| PRESIDENT OF BHMG | $0 | $330,377 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $1,230 | $0 | $331,607 | $0 | $0 |
| HENRY EDWARD VINCENT | ||||||||||||||
| EXECUTIVE DIRECTOR | $0 | $5,842 | $0 | $82,389 | $0 | $116,854 | $0 | $3,450 | $0 | $10,747 | $0 | $219,282 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | KURT BARWIS, THE ORGANIZATION'S PRESIDENT, CEO AND CFO, IS COMPENSATED BY A RELATED ORGANIZATION, BRISTOL HOSPITAL, INC., WHICH USES THE FOLLOWING METHODS TO ESTABLISH HIS COMPENSATION: COMPENSATION COMMITTEE, INDEPENDENT COMPENSATION CONSULTANT, COMPENSATION SURVEY OR STUDY, AND APPROVAL BY THE BOARD OR COMPENSATION COMMITTEE. |
| PART I, LINE 4B | BRISTOL HOSPITAL PROVIDES SUPPLEMENTAL RETIREMENT BENEFITS TO ITS CHIEF EXECUTIVE OFFICER ("CEO") THROUGH AN ALTERNATIVE FUNDING ARRANGEMENT THE IRS CALLS "LOAN-REGIME SPLIT-DOLLAR" ("LRSD"). ALTHOUGH THE IRS REQUIRES LRSD TO COMPLY WITH THE TAX PRINCIPLES OF A LOAN FOR FEDERAL INCOME TAX PURPOSES (IRC 7872), LRSD IS NOT AN ACTUAL LOAN. NO FUNDS ARE TRANSFERRED TO THE EXECUTIVE. RATHER, THE "LOAN" TREATMENT APPLIES BECAUSE AFTER THE EXECUTIVE HAS RECEIVED RETIREMENT BENEFITS (SUBJECT TO VESTING REQUIREMENTS AND POLICY INVESTMENT PERFORMANCE), BRISTOL HOSPITAL RECOVERS ALL ITS OUTLAYS PLUS A MARKET RATE OF INTEREST. AS WITH AN EMPLOYER-EMPLOYEE LOAN, AND CONSISTENT WITH THE 2003 FINAL REGULATIONS AND IRC 7872, THE PLAN IS NON-COMPENSATORY TO THE PARTICIPATING EXECUTIVE, AS THE LOAN IS REPAID PLUS INTEREST UPON THE DEATH OF THE EXECUTIVE. UNDER THE REGULATIONS, THERE IS NO COMPENSATION IMPUTED TO THE EXECUTIVE. THE BRISTOL HOSPITAL LRSD PLAN WORKS AS FOLLOWS. BRISTOL HOSPITAL DEPOSITED FUNDS DIRECTLY INTO CASH VALUE LIFE INSURANCE POLICIES ON THE CEO'S LIFE. DURING LIFE, TO THE EXTENT THE CEO FULFILLS SERVICE AND VESTING REQUIREMENTS, THE CEO CAN BORROW AGAINST VALUES IN THE POLICIES TO SUPPLEMENT RETIREMENT INCOME. POLICY PERFORMANCE IS CLOSELY MONITORED. IF POLICY PERFORMANCE LAGS, THE CEO'S BORROWING RIGHTS COULD BE REDUCED TO PROTECT BRISTOL HOSPITAL'S RECOVERY RIGHTS. AT THE CEO'S DEATH, THE POLICY DEATH PROCEEDS ARE FIRST USED TO REPAY BRISTOL HOSPITAL'S DEPOSITS PLUS COMPOUNDED INTEREST (AT THE IRS LONG-TERM APPLICABLE FEDERAL RATE). THE CEO'S BENEFICIARY THEN RECEIVES ANY PROJECTED RETIREMENT BORROWING NOT ACCESSED DURING LIFE. SEVERAL EXECUTIVES PARTICIPATE IN THE HOSPITAL'S 457(F) DEFINED CONTRIBUTION PLAN, HOWEVER, NO CONTRIBUTIONS WERE MADE BY THE ORGANIZATION DURING THE YEAR. THE FOLLOWING INDIVIDUALS MAY RECEIVE CONTRIBUTIONS BY THE ORGANIZATION UNDER THE PLAN: EDWARD HENRY AND CHRIS ANN MEANEY. |
| PART I, LINE 7 | CERTAIN EXECUTIVES ARE PAID VARIABLE COMPENSATION BASED ON PRE-APPROVED QUALITY, SAFETY AND FINANCIAL GOALS. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PAGE 5, PART V, LINE 2A | THE FILING ENTITY IS AN AFFILIATE IN A GROUP OF WHICH BRISTOL HOSPITAL, INC. (EIN 06-0646559) IS CONSIDERED A COMMON PAY AGENT FOR W-2 REPORTING. BRISTOL HOSPITAL REPORTS ALL EMPLOYEES ON ITS FORM W-3, HOWEVER, EACH AFFILIATE HAS EMPLOYEES ALLOCATED TO THAT ENTITY. PER IRS INSTRUCTIONS, EMPLOYEES LISTED ON PART V, LINE 2A ARE THOSE WHO HAVE BEEN DEEMED TO BE EMPLOYEES OF THIS ORGANIZATION. BRISTOL HOSPITAL MULTI-SPECIALTY GROUP, INC. DOES NOT, HOWEVER, REPORT THESE EMPLOYEES ON A SEPARATE W-3 UNDER ITS OWN EIN. |
| FORM 990, PART VI, SECTION A, LINE 6 | THE ORGANIZATION HAS A SOLE MEMBER, WHICH IS BRISTOL HOSPITAL AND HEALTH CARE GROUP, INC. |
| FORM 990, PART VI, SECTION A, LINE 7A | THE ORGANIZATION HAS A SOLE MEMBER, WHICH IS BRISTOL HOSPITAL AND HEALTH CARE GROUP, INC. THE MEMBER HAS THE RIGHT TO ELECT THE MEMBERS OF THE GOVERNING BODY. |
| FORM 990, PART VI, SECTION A, LINE 7B | CERTAIN DECISIONS, CONSIDERED "MAJOR ACTIONS," REQUIRE THE APPROVAL OF THE SOLE MEMBER, BRISTOL HOSPITAL AND HEALTH CARE GROUP, INC. THESE ACTIONS INCLUDE THE ADOPTION OF THE ORGANIZATION'S ANNUAL BUDGET AS WELL AS OTHER MAJOR ACTIONS. THE SOLE MEMBER HAS FULL VOTING RIGHTS. |
| FORM 990, PART VI, SECTION B, LINE 11B | A COMPLETED 990 IS PROVIDED TO EACH BOARD MEMBER BEFORE THE RETURN IS FILED. THIS PROVIDES AN OPPORTUNITY FOR MEMBERS TO ASK QUESTIONS AND FOLLOW UP WITH THE FINANCE TEAM REGARDING ANY ISSUES OR CONCERNS. THE 990 IS ALSO REVIEWED INTERNALLY BY MEMBERS OF THE FINANCE AND MANAGEMENT TEAMS. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE PARENT ORGANIZATION, BRISTOL HOSPITAL AND HEALTH CARE GROUP, HAS THREE CONFLICT OF INTEREST POLICIES - ONE FOR THE BOARD OF DIRECTORS AND COMMITTEE MEMBERS, ONE FOR NON-MEDICAL STAFF EMPLOYEES, AND ONE FOR MEDICAL STAFF MEMBERS. BOARD OF DIRECTORS AND COMMITTEE MEMBERS EACH OF THE ABOVE LISTED PERSONS RECEIVES, READS AND SIGNS A STATEMENT ONCE ANNUALLY AGREEING TO COMPLY WITH THE CONFLICT OF INTEREST POLICY. IF ANY ACTUAL, APPARENT OR POTENTIAL CONFLICT OF INTEREST ARISES, THE PERSON SHALL MAKE FULL DISCLOSURE OF SUCH ACTUAL, APPARENT OR POTENTIAL CONFLICT OF INTEREST, WITHIN FIFTEEN (15) DAYS OF THE TIME THAT SUCH CONFLICT IS DISCOVERED, OR AT LEAST ONCE ANNUALLY AT THE COMMENCEMENT OF EACH CALENDAR YEAR, WITH REGULAR WRITTEN UPDATES TO ACCORD WITH ANY CHANGE IN CIRCUMSTANCES. THE GOVERNANCE COMMITTEE REVIEWS ALL SUCH DISCLOSURES TO DETERMINE WHETHER AN ACTUAL, APPARENT OR POTENTIAL CONFLICT OF INTEREST EXISTS. DECISIONS PERTAINING TO ACTUAL, APPARENT OR POTENTIAL CONFLICTS OF INTEREST SHALL BE MADE BY THE GOVERNANCE COMMITTEE. THE CORPORATE COMPLIANCE OFFICER (CCO) SHALL BE AVAILABLE TO THE GOVERNANCE COMMITTEE UPON REQUEST. IN THE EVENT THAT IT DETERMINES THAT AN APPARENT OR POTENTIAL CONFLICT OF INTEREST EXISTS, THE GOVERNANCE COMMITTEE SHALL INSTITUTE A REASONABLE COMPLIANCE MANAGEMENT PLAN INCLUDING PERIODIC REVIEWS OF RELATIONSHIPS OR ACTIVITIES OF ANY PERSON OR RELATIVE. ANY CHANGES OR MODIFICATIONS IN SUCH RELATIONSHIPS OR ACTIVITIES SHALL BE PERIODICALLY REVIEWED AND EVALUATED BY THE GOVERNANCE COMMITTEE. NON-MEDICAL STAFF EMPLOYEES SAME PROCESS AS OUTLINED ABOVE WITH ONE EXCEPTION: THE OVERSIGHT, REVIEW AND DETERMINATIONS OF DISCLOSURES ARE MADE BY THE CCO. THE BRISTOL HEALTH EXECUTIVE LEADERSHIP GROUP (ELG) SHALL BE AVAILABLE TO THE CCO UPON REQUEST. MEDICAL STAFF MEMBERS MEDICAL STAFF MEMBERS COMPLETE CONFLICT OF INTEREST DISCLOSURE STATEMENTS DURING THE INITIAL CREDENTIALING PROCESS AND SUBSEQUENTLY EVERY TWO YEARS DURING THE RECREDENTIALING PROCESS. ANY NEW RELATIONSHIPS THAT ARISE IN THE INTERIM DEEMED TO BE A POTENTIAL CONFLICT MUST BE DISCLOSED IN A TIMELY MANNER. DISCLOSURES ARE REVIEWED AND DETERMINATIONS ARE MADE BY THE EXECUTIVE COMMITTEE OF THE MEDICAL STAFF (ECMS). THE CCO IS A MEMBER OF THIS COMMITTEE. IN THE EVENT THAT THE ECMS DETERMINES THAT AN APPARENT OR POTENTIAL CONFLICT OF INTEREST EXISTS, A REASONABLE COMPLIANCE MANAGEMENT PLAN INCLUDING PERIODIC REVIEWS OF RELATIONSHIPS OR ACTIVITIES OF ANY PERSON OR RELATIVE WILL BE INSTITUTED. ANY CHANGES OR MODIFICATIONS IN SUCH RELATIONSHIPS OR ACTIVITIES SHALL BE PERIODICALLY REVIEWED AND EVALUATED BY THE ECMS. |
| FORM 990, PART VI, SECTION B, LINE 15B | THE ORGANIZATION'S CEO/CFO, KURT BARWIS, AND THE ORGANIZATION'S EXECUTIVE DIRECTOR, EDWARD HENRY, ARE COMPENSATED BY A RELATED ORGANIZATION, BRISTOL HOSPITAL, INC. IN ACCORDANCE WITH IRS INSTRUCTIONS, PART VI, LINE 15A IS THEREFORE MARKED NO. OFFICERS OF THE ORGANIZATION, RUPALINI RAWAL-DHINGRA, CHAIR OF THE BOARD, AND MARGARITA REYES, VICE CHAIR, RECEIVE COMPENSATION FROM THE ORGANIZATION FOR THEIR SERVICES AS PHYSICIANS. THEIR COMPENSATION IS BASED UPON FAIR MARKET VALUE FOR PHYSICIAN SERVICES IN THEIR GEOGRAPHICAL AREA. |
| 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 XI, LINE 9: | TRANSFER FROM AFFILIATES 17,659,143. OTHER CHANGES 60. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (5 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd | Direct Controlling NADirectControllingNACd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| BRISTOL HOSPITAL INC | |||||||||||
| 41 BREWSTER RD | BRISTOL | CT | 06010 | 060646559 | SHORT-TERM ACUTE CARE COMMUNITY HOSPITAL | CT | 501(C)(3) | LINE 3 | BRISTOL HOSPITAL AND HEALTH CARE GROUP | 0 | |
| BRISTOL HOSPITAL AND HEALTH CARE GROUP INC | |||||||||||
| 41 BREWSTER RD | BRISTOL | CT | 06010 | 222577726 | HEALTHCARE PARENT COMPANY | CT | 501(C)(3) | LINE 12B, II | 0 | N/A | |
| BRISTOL HOSPITAL DEVELOPMENT FOUNDATION INC | |||||||||||
| 41 BREWSTER RD | BRISTOL | CT | 06010 | 222577740 | FUNDRAISING | CT | 501(C)(3) | LINE 7 | BRISTOL HOSPITAL AND HEALTH CARE GROUP | 0 | |
| BRISTOL HEALTH CARE INC | |||||||||||
| 41 BREWSTER RD | BRISTOL | CT | 06010 | 222577731 | NURSING HOME | CT | 501(C)(3) | LINE 10 | BRISTOL HOSPITAL AND HEALTH CARE GROUP | 0 | |
| BRISTOL HOME CARE AND HOSPICE AGENCY INC | |||||||||||
| 41 BREWSTER RD | BRISTOL | CT | 06010 | 821663577 | HOME CARE AND HOSPICE | CT | 501(C)(3) | LINE 10 | BRISTOL HOSPITAL AND HEALTH CARE GROUP | 0 | |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp
Related Organization Name RelatedOrganizationName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BRISTOL HOSPITAL EMS LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 41 BREWSTER RD | AddressLine1Txt |
| City | BRISTOL | CityNm |
| State Abbreviation | CT | StateAbbreviationCd |
| ZIP | 06010 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 061547648 | EIN |
| Primary Activities | EMERGENCY MEDICAL SERVICES | PrimaryActivitiesTxt |
| Legal Domicile State | CT | LegalDomicileStateCd |
| Direct Controlling NA | N/A | DirectControllingNACd |
| Entity Type | C | EntityTypeTxt |
| Controlled Organization | 0 | 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 | Yes (1) | 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 | Yes (1) | 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 | Yes (1) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | Yes (1) | TransferFromOtherOrgInd |