HEALTHLINC INC: Form 990, tax year 2019
View the entire original 990 at ProPublica ↗
- Organization
- HEALTHLINC INC (EIN 35-2147791)
- Tax period
- 2019-01-01 to 2019-12-31
- Filed
- 2020-11-11
- IRS object ID
- 202033169349302138
- Schema version
- 2019v5.1
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule J
- Schedule L
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2020-11-11T11:10:15-06:00 | ReturnTs |
| Tax Period End | 2019-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 352102008 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CNA TAX PROFESSIONALS INC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 10475 CROSSPOINT BOULEVARD SUITE | AddressLine1Txt |
| Address Line2 | 200 | AddressLine2Txt |
| City | INDIANAPOLIS | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46256 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2019-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 352147791 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HEALTHLINC INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | HEAL | BusinessNameControlTxt |
| Phone | 2194627173 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2401 VALLEY DRIVE | AddressLine1Txt |
| City | VALPARAISO | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46383 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | BETH WROBEL | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 2194627173 | PhoneNum |
| Signature | 2020-11-11 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | SHAWN D DREIMAN CPA | PreparerPersonNm |
| PTIN | P00380913 | PTIN |
| Phone | 3178413393 | PhoneNum |
| Preparation | 2020-10-23 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 96.90.28.109 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2020-11-11 | IPDt |
| IP Tm | 12:10:06 | IPTm |
| IP Timezone | ES | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 69954AB7B88365E85264179B0021FE71187A4A62 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 69954AB7B88365E85264179B0021FE71187A4A62 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2019 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | BETH WROBEL | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2401 VALLEY DRIVE | AddressLine1Txt |
| City | VALPARAISO | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46383 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $39,811,658 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.HEALTHLINCCHC.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2001 | FormationYr |
| Legal Domicile State | IN | LegalDomicileStateCd |
| Activity Or Mission | THE ORGANIZATION PROVIDES A FULL SPECTRUM OF COMPREHENSIVE HEALTH CARE SERVICES THROUGHOUT THE LIFE CYCLE, AND MAKES THOSE SERVICES AVAILABLE TO INDIVIDUALS REGARDLESS OF A PATIENT'S ABILITY TO PAY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 14 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 14 | VotingMembersIndependentCnt |
| Total Employee | 477 | TotalEmployeeCnt |
| Total Volunteers | 60 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $5,621,073 | PYContributionsGrantsAmt |
| CY Contributions Grants | $9,014,198 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $11,927,690 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $18,528,344 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | -$106 | CYInvestmentIncomeAmt |
| PY Other Revenue | $11,899,854 | PYOtherRevenueAmt |
| CY Other Revenue | $12,265,619 | CYOtherRevenueAmt |
| PY Total Revenue | $29,448,617 | PYTotalRevenueAmt |
| CY Total Revenue | $39,808,055 | 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 | $20,352,711 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $24,830,967 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $8,530,855 | PYOtherExpensesAmt |
| CY Other Expenses | $13,636,876 | CYOtherExpensesAmt |
| PY Total Expenses | $28,883,566 | PYTotalExpensesAmt |
| CY Total Expenses | $38,467,843 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $565,051 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,340,212 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $24,694,864 | TotalAssetsBOYAmt |
| Total Assets EOY | $27,146,705 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $6,953,728 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $8,011,354 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $17,741,136 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $19,135,351 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE ORGANIZATION PROVIDES A FULL SPECTRUM OF COMPREHENSIVE HEALTH CARE SERVICES THROUGHOUT THE LIFE CYCLE, AND MAKES THOSE SERVICES AVAILABLE TO INDIVIDUALS REGARDLESS OF A PATIENT'S ABILITY TO PAY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $32,477,416 | ExpenseAmt |
| Revenue | $30,793,963 | RevenueAmt |
| Desc | THE ORGANIZATION PROVIDES A FULL SPECTRUM OF COMPREHENSIVE HEALTH CARE SERVICES THROUGHOUT THE LIFE CYCLE, AND MAKES THOSE SERVICES AVAILABLE REGARDLESS OF A PATIENT'S ABILITY TO PAY. ITS SERVICES ARE CULTURALLY AND LINGUISTICALLY APPROPRIATE FOR THE TARGET POPULATION. INCLUDED IN THE ORGANIZATION'S APPROACH TO PRIMARY CARE ARE ON-SITE DISEASE SCREENING, DIAGNOSTIC LABORATORY SERVICES, PREVENTIVE SERVICES, IMMUNIZATIONS, SOCIAL SERVICES AND SUPPORTIVE COUNSELING, FAMILY PLANNING, HEALTH EDUCATION, CASE MANAGEMENT, TRANSPORTATION SERVICES, ASTHMA PREVENTION, AND CHILD DEVELOPMENT PROGRAMS. IN ADDITION, THE CENTER PROVIDES PREVENTIVE DENTAL SERVICES INCLUDING PROPHYLAXIS, X-RAYS, FILLINGS, EXTRACTIONS, AND DENTURE FITTINGS. DIAGNOSTIC LABORATORY, RADIOLOGY SERVICES, EMERGENCY SERVICES, AND INPATIENT CARE ARE PROVIDED BY ST. JOSEPHS, ST CATHERINES, PORTER REGIONAL, ST ANTHONYS AND IU HOSPITALS. SPECIALTY CARE IS PROVIDED BY A NETWORK OF OVER 130 SPECIALISTS THAT HAVE ENTERED INTO AGREEMENTS WITH THE ORGANIZATION TO ACCEPT THEIR REFERRALS AND CHARGE UNINSURED PATIENTS ON A SLIDING FEE SCALE. SINCE ITS INCEPTION, HEALTHLINC, INC. HAS PROVIDED PRIMARY MEDICAL, DENTAL AND MENTAL HEALTH SERVICES TO OVER 32,000 UNINSURED AND UNDERINSURED PATIENTS. | Desc |
| Total Program Service Expenses | $32,477,416 | 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 | 0 | 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 | Yes (1) | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | Yes (1) | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | Yes (1) | DisregardedEntityInd |
| Related Entity | 0 | 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 |
| IRP Document | 44 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 477 | 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 |
| 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 | 14 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 14 | 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 | 0 | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | IN | StatesWhereCopyOfReturnIsFldCd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | JOAN BONDI CFO | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2194627173 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2401 VALLEY DRIVE | AddressLine1Txt |
| City | VALPARAISO | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46383 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (19 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| PAT TERREL | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| LISA KIZER | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| DONNITA SCULLY | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| DEBRA WILLIAMS | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| CHRISTINE GRAEBER | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| ROBERT FRANKO | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| DONALD RAMIREZ | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| STEPHEN MASSA | |||||||
| DIRECTOR | 2.00 | Yes (X) | $0 | $0 | $0 | ||
| CHRIS ATHERTON | |||||||
| SECRETARY | 2.00 | $0 | $0 | $0 | Yes (X) | ||
| BETH WROBEL | |||||||
| CEO | 40.00 | $347,073 | $0 | $33,000 | Yes (X) | ||
| JOHN D GORNTO | |||||||
| BOARD CHAIR | 2.00 | $0 | $0 | $0 | Yes (X) | ||
| KRISTI FIGG | |||||||
| TREASURER | 2.00 | $0 | $0 | $0 | Yes (X) | ||
| CLARENCE GEHRKE | |||||||
| VICE CHAIR | 2.00 | $0 | $0 | $0 | Yes (X) | ||
| JOAN BONDI | |||||||
| CFO | 40.00 | $183,965 | $0 | $26,000 | Yes (X) | ||
| PRAVEEN SINGH | |||||||
| PHYSICIAN | 40.00 | $236,985 | $0 | $17,938 | Yes (X) | ||
| SONYA WILLIAMS | |||||||
| PHYSICIAN | 40.00 | $290,922 | $0 | $22,400 | Yes (X) | ||
| REBECCA BAUER | |||||||
| PHYSICIAN | 40.00 | $217,152 | $0 | $17,858 | Yes (X) | ||
| CARL TOREN | |||||||
| CMO | 40.00 | $305,625 | $0 | $32,773 | Yes (X) | ||
| KATHERINE LISONI | |||||||
| PHYSICIAN | 40.00 | $226,720 | $0 | $25,750 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,808,442 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $175,719 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 7 | 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 |
|---|---|---|---|---|---|
| BEACON MEDICAL GROUP INC | |||||
| 710 N NILES AVE | SOUTH BEND | IN | 46617 | LEASED DOCTORS AND RENT | $1,373,068 |
| CARDINAL HEALTH | |||||
| 7000 CARDINAL PLACE | DUBLIN | OH | 43017 | HEALTHCARE SUPPLIES | $978,354 |
| MCKESSON MEDICAL SURGICAL | |||||
| 1995 MCKESSON ST STE 101 | AURORA | IL | 60502 | HEALTHCARE SUPPLIES | $922,119 |
| MCKESSON DRUGS | |||||
| 1995 MCKESSON ST STE 101 | AURORA | IL | 60502 | PHARMACEUTICAL SUPPL | $701,193 |
| GREENWAY | |||||
| PO BOX 203658 | DALLAS | TX | 75320 | TECHNOLOGY COMPANY | $623,597 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 26 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $8,666,494 | GovernmentGrantsAmt |
| All Other Contributions | $347,704 | AllOtherContributionsAmt |
| Noncash Contributions | $211,495 | NoncashContributionsAmt |
| Total Contributions | $9,014,198 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| FEES & CONTRACTS GOV AGEN | 621400 | $14,519,405 | $14,519,405 |
| PATIENT FEES | 621400 | $3,987,761 | $3,987,761 |
| SERVICE INCOME | 621400 | $21,178 | $21,178 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $18,528,344 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $3,497 | TotalRevenueColumnAmt |
| Exclusion | $3,497 | ExclusionAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | $3,603 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other | -$3,603 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$3,603 | TotalRevenueColumnAmt |
| Exclusion | -$3,603 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OTHER INCOME | Desc |
| Business | 621400 | BusinessCd |
| Total Revenue Column | $12,265,619 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $12,265,619 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $12,265,619 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $39,808,055 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $30,793,963 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$106 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,984,162 | TotalAmt |
| Program Services | $1,693,230 | ProgramServicesAmt |
| Management And General | $290,932 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,846,805 | TotalAmt |
| Program Services | $19,496,847 | ProgramServicesAmt |
| Management And General | $3,349,958 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $50,693 | TotalAmt |
| Management And General | $50,693 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $47,187 | TotalAmt |
| Management And General | $47,187 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,641,362 | TotalAmt |
| Program Services | $3,516,494 | ProgramServicesAmt |
| Management And General | $124,868 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $554,743 | TotalAmt |
| Program Services | $128,494 | ProgramServicesAmt |
| Management And General | $426,249 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,393,905 | TotalAmt |
| Program Services | $1,080,102 | ProgramServicesAmt |
| Management And General | $313,803 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $551,279 | TotalAmt |
| Program Services | $287,153 | ProgramServicesAmt |
| Management And General | $264,126 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,896 | TotalAmt |
| Management And General | $2,896 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $172,642 | TotalAmt |
| Management And General | $172,642 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $958,158 | TotalAmt |
| Program Services | $892,812 | ProgramServicesAmt |
| Management And General | $65,346 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $128,775 | TotalAmt |
| Program Services | $108,271 | ProgramServicesAmt |
| Management And General | $20,504 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL AND DENTAL SUPP | $3,484,086 | $3,469,156 | $14,930 |
| SOFTWARE EXPENSES | $1,467,702 | $1,120,330 | $347,372 |
| OTHER EXPENSES | $417,174 | $73,863 | $343,311 |
| BAD DEBT | $306,917 | $306,917 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $459,357 | TotalAmt |
| Program Services | $303,747 | ProgramServicesAmt |
| Management And General | $155,610 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,467,843 | TotalAmt |
| Program Services | $32,477,416 | ProgramServicesAmt |
| Management And General | $5,990,427 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,997,816 | BOYAmt |
| EOY | $5,600,360 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,757 | BOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,027,414 | BOYAmt |
| EOY | $3,822,169 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $6,487 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $350,441 | BOYAmt |
| EOY | $196,433 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $17,958,770 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $4,269,904 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,983,998 | BOYAmt |
| EOY | $13,688,866 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,317,438 | BOYAmt |
| EOY | $3,832,390 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,694,864 | BOYAmt |
| EOY | $27,146,705 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,866,635 | BOYAmt |
| EOY | $3,991,834 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $171,880 | BOYAmt |
| EOY | $231,500 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,915,213 | BOYAmt |
| EOY | $3,788,020 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,953,728 | BOYAmt |
| EOY | $8,011,354 | 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 | $17,723,379 | BOYAmt |
| EOY | $19,114,096 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,757 | BOYAmt |
| EOY | $21,255 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $17,741,136 | BOYAmt |
| EOY | $19,135,351 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,694,864 | BOYAmt |
| EOY | $27,146,705 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $1,340,212 | ReconcilationRevenueExpnssAmt |
| Donated Services And Use Fclts | $54,003 | DonatedServicesAndUseFcltsAmt |
| Other Changes In Net Assets | $0 | 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 | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,790,388 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $5,520,431 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $5,950,769 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $5,621,073 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $9,014,198 | CurrentTaxYearAmt |
| Total | $30,896,859 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $4,790,388 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $5,520,431 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $5,950,769 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $5,621,073 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $9,014,198 | CurrentTaxYearAmt |
| Total | $30,896,859 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $30,896,859 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | $388,523 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year | $3,497 | CurrentTaxYearAmt |
| Total | $392,020 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $6,336,235 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $7,418,794 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $8,530,982 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $11,899,854 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $12,265,619 | CurrentTaxYearAmt |
| Total | $46,451,484 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $77,740,363 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $62,940,549 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.39740 | PublicSupportCY170Pct |
| Public Support PY170 | 0.40630 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
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 | $12,976,054 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,551,218 | DepreciationAmt |
| Book Value | $11,424,836 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,879,049 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,145,570 | DepreciationAmt |
| Book Value | $733,479 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,029,680 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,040,461 | DepreciationAmt |
| Book Value | $989,219 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,073,987 | OtherCostOrOtherBasisAmt |
| Depreciation | $532,655 | DepreciationAmt |
| Book Value | $541,332 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $13,688,866 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (2 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| OTHER INVESTMENTS | $3,810,636 |
| BENEFICIAL INTEREST IN COMMUNITY FOUNDATION | $21,754 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $3,832,390 | TotalBookValueOtherAssetsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $39,862,058 | TotalRevEtcAuditedFinclStmtAmt |
| Donated Services And Use Fclts | $54,003 | DonatedServicesAndUseFcltsAmt |
| Revenue Not Reported | $54,003 | RevenueNotReportedAmt |
| Revenue Subtotal | $39,808,055 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $39,808,055 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $38,467,843 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $38,467,843 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $38,467,843 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION HAS ADOPTED FASB STANDARD FOR ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES. UPON ADOPTION OF THIS STANDARD, THE ORGANIZATION WILL RECOGNIZE A TAX BENEFIT ONLY IF IT IS MORE LIKELY THAN NOT THE TAX POSITION WOULD BE SUSTAINED IN A TAX EXAMINATION, WITH A TAX EXAMINATION BEING PRESUMED TO OCCUR. THE AMOUNT RECOGNIZED WILL BE THE LARGEST AMOUNT OF TAX BENEFIT THAT IS GREATER THAN 50% LIKELY OF BEING REALIZED ON EXAMINATION. FOR TAX POSITIONS NOT MEETING THE MORE-LIKELY-THAN-NOT TEST, NO TAX BENEFIT WILL BE RECORDED. CURRENTLY, THE ORGANIZATION ACCOUNTS FOR CONTINGENCIES ASSOCIATED WITH CERTAIN TAX POSITIONS IN ACCORDANCE WITH THE FASB STANDARD ACCOUNTING FOR CONTINGENCIES, WHICH PROVIDES THE RECORDING OF A CONTINGENCY BASED ON THE PROBABILITY OF CERTAIN EVENTS TO TRANSPIRE THAT RANGE FROM PROBABLE TO REMOTE AS OPPOSED TO APPLYING A MORE LIKELY THAN NOT RECOGNITION THRESHOLD. THE ORGANIZATION HAS EXAMINED THIS ISSUE AND HAS DETERMINED THERE ARE NO MATERIAL CONTINGENT TAX LIABILITIES. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (7 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| BETH WROBEL | ||||||||||||||
| CEO | $347,073 | $0 | $0 | $0 | $0 | $0 | $25,000 | $0 | $8,000 | $0 | $380,073 | $0 | $0 | $0 |
| JOAN BONDI | ||||||||||||||
| CFO | $183,965 | $0 | $0 | $0 | $0 | $0 | $25,000 | $0 | $1,000 | $0 | $209,965 | $0 | $0 | $0 |
| PRAVEEN SINGH | ||||||||||||||
| PHYSICIAN | $236,985 | $0 | $0 | $0 | $0 | $0 | $14,219 | $0 | $3,719 | $0 | $254,923 | $0 | $0 | $0 |
| SONYA WILLIAMS | ||||||||||||||
| PHYSICIAN | $290,922 | $0 | $0 | $0 | $0 | $0 | $19,000 | $0 | $3,400 | $0 | $313,322 | $0 | $0 | $0 |
| REBECCA BAUER | ||||||||||||||
| PHYSICIAN | $217,152 | $0 | $0 | $0 | $0 | $0 | $10,858 | $0 | $7,000 | $0 | $235,010 | $0 | $0 | $0 |
| CARL TOREN | ||||||||||||||
| CMO | $305,625 | $0 | $0 | $0 | $0 | $0 | $24,773 | $0 | $8,000 | $0 | $338,398 | $0 | $0 | $0 |
| KATHERINE LISONI | ||||||||||||||
| PHYSICIAN | $226,720 | $0 | $0 | $0 | $0 | $0 | $19,000 | $0 | $6,750 | $0 | $252,470 | $0 | $0 | $0 |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SEE BELOW | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | SEE BELOW | RelationshipDescriptionTxt |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART IV | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION CONTRACTED WITH A LOCAL GENERAL CONSTRUCTION CONTRACTOR WITH WHOM ONE OF ITS PROJECT MANAGERS IS A MEMBER OF THE BOARD. IN ADDITION, THE ORGANIZATION PURCHASES COMPUTER TECHNOLOGY SERVICES OF $383,917 FROM A COMPANY IN WHICH A BOARD MEMBER IS A PARTNER. ANOTHER BOARD MEMBER IS A DIRECTOR AT THE LAPORTE HOSPITAL. IN 2019, THE ORGANIZATION TOOK OVER THELAPORTE HOSPITAL FREE CLINIC AND RECEIVED CASH, IN-KIND ASSETS AND CLINIC SPACE TOTALING $172,737. | ExplanationTxt |
Schedule M IRS990ScheduleM
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $73,734 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenuesTxt |
Other Non Cash Contri Table OtherNonCashContriTableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Desc | MISC INVENTORY | Desc |
| Contribution | 1 | ContributionCnt |
| Noncash Contributions Rpt F990 | $137,762 | NoncashContributionsRptF990Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 7A | LINE 7A EXPLANATION - THE BOARD OF DIRECTORS APPOINTS MEMBERS OF THE ORGANIZATION'S BOARD OF DIRECTORS. |
| FORM 990, PART VI, SECTION B, LINE 11B | LINE 11B EXPLANATION - THE EXECUTIVE COMMITTEE AND THE FINANCE COMMITTEE OF THE BOARD OF DIRECTORS REVIEWS THE FORM 990 WITH MANAGEMENT BEFORE IT IS SIGNED AND FILED. THE BOARD OF DIRECTORS ARE GIVEN A COPY OF THE RETURN PRIOR TO IT BEING FILED. |
| FORM 990, PART VI, SECTION B, LINE 12C | A CONFLICT OF INTEREST POLICY AND QUESTIONNAIRE IS DISTRIBUTED ANNUALLY TO MEMBERS OF THE BOARD OF DIRECTORS AND EMPLOYEES. INDIVIDUALS MUST ACKNOWLEDGE THROUGH SIGNATURE THEY HAVE READ AND UNDERSTAND THE POLICY AND INDICATE ON THE QUESTIONNAIRE IF THERE IS ANY CONFLICT OR POTENTIAL CONFLICT OF INTEREST. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS ANNUALLY COLLECTS AND ANALYZES COMPENSATION DATA FOR COMPARABLE POSITIONS TO THE ORGANIZATION'S C.E.O. THIS DATA IS PRESENTED TO THE FULL BOARD AS A BASIS FOR SETTING THE COMPENSATION FOR C.E.O. ALL INFORMATION USED IN MAKING THE DECISION AND THE SUBSTANCE OF THE DELIBERATION WILL BE DOCUMENTED IN THE BOARD MINUTES. THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS ANNUALLY COLLECTS AND ANALYZES COMPENSATION DATA FOR COMPARABLE POSITIONS TO THE ORGANIZATION'S C.E.O. THIS DATA IS PRESENTED TO THE FULL BOARD AS A BASIS FOR SETTING THE COMPENSATION FOR C.E.O. ALL INFORMATION USED IN MAKING THE DECISION AND THE SUBSTANCE OF THE DELIBERATION WILL BE DOCUMENTED IN THE BOARD MINUTES. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S GOVERNING DOCUMENTS, POLICIES, FINANCIAL INFORMATION AND TAX RETURNS ARE MADE AVAILABLE UPON RECEIPT OF REASONABLE REQUEST. |
Schedule R IRS990ScheduleR
Id Disregarded Entities IdDisregardedEntitiesGrp
Disregarded Entity Name DisregardedEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HEALTHLINC PHARMACY LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 2401 VALLEY DRIVE | AddressLine1Txt |
| City | VALPARAISO | CityNm |
| State Abbreviation | IN | StateAbbreviationCd |
| ZIP | 46383 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 842839214 | EIN |
| Primary Activities | PHARMACY | PrimaryActivitiesTxt |
| Legal Domicile State | IN | LegalDomicileStateCd |
| Total Income | $21,178 | TotalIncomeAmt |
| End Of Year Assets | $82,871 | EndOfYearAssetsAmt |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HEALTHLINC INC | BusinessNameLine1Txt |