BROWN MEDICINE: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- BROWN MEDICINE (EIN 05-0450410)
- Tax period
- 2018-10-01 to 2019-09-30
- Filed
- 2020-08-10
- IRS object ID
- 202042239349300444
- Schema version
- 2018v3.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2020-08-10T11:02:15-05:00 | ReturnTs |
| Tax Period End | 2019-09-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 050409384 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KAHN LITWIN RENZA & CO LTD | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 951 NORTH MAIN STREET | AddressLine1Txt |
| City | PROVIDENCE | CityNm |
| State Abbreviation | RI | StateAbbreviationCd |
| ZIP | 02904 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2018-10-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 050450410 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BROWN MEDICINE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | BROW | BusinessNameControlTxt |
| Phone | 4014445135 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 110 ELM STREET 2ND FLOOR | AddressLine1Txt |
| City | PROVIDENCE | CityNm |
| State Abbreviation | RI | StateAbbreviationCd |
| ZIP | 02903 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ANN KASHMANIAN | PersonNm |
| Person Title | CHIEF EXECUTIVE OFFICER | PersonTitleTxt |
| Phone | 4014445135 | PhoneNum |
| Signature | 2020-08-10 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | SANDY ROSS | PreparerPersonNm |
| PTIN | P01399337 | PTIN |
| Phone | 4012742001 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 38.111.239.2 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2020-08-10 | IPDt |
| IP Tm | 10:11:19 | IPTm |
| IP Timezone | ED | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 0DE9224A7ECA9E89698B996EC4621D764FA0EBF9 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | F28E2B4EAD4C8CD2ABB1BD5859C0E522F0D5B131 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2020-09-23 17:36:50Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | LOUIS RICE MD | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 110 ELM STREET 2ND FLOOR | AddressLine1Txt |
| City | PROVIDENCE | CityNm |
| State Abbreviation | RI | StateAbbreviationCd |
| ZIP | 02903 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $87,730,656 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | HTTP://WWW.BROWNMED.ORG/ | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2000 | FormationYr |
| Legal Domicile State | RI | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE HIGH-LEVEL PATIENT CARE, ADVANCE MEDICAL KNOWLEDGE AND SCIENCE AND DEVELOP CURES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 3 | VotingMembersIndependentCnt |
| Total Employee | 505 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $85,274,605 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $85,878,287 | CYProgramServiceRevenueAmt |
| PY Investment Income | $447,250 | PYInvestmentIncomeAmt |
| CY Investment Income | $799,097 | CYInvestmentIncomeAmt |
| PY Other Revenue | $143,683 | PYOtherRevenueAmt |
| CY Other Revenue | $285,002 | CYOtherRevenueAmt |
| PY Total Revenue | $85,865,538 | PYTotalRevenueAmt |
| CY Total Revenue | $86,962,386 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $22,500 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $27,780 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $68,837,280 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $70,348,717 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $14,787,596 | PYOtherExpensesAmt |
| CY Other Expenses | $15,196,263 | CYOtherExpensesAmt |
| PY Total Expenses | $83,647,376 | PYTotalExpensesAmt |
| CY Total Expenses | $85,572,760 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $2,218,162 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,389,626 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $71,273,542 | TotalAssetsBOYAmt |
| Total Assets EOY | $71,121,299 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $32,994,101 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $31,440,954 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $38,279,441 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $39,680,345 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | BROWN MEDICINE IS A NON-PROFIT, ACADEMIC, MULTI-SPECIALTY MEDICAL GROUP WITH PRACTICE LOCATIONS IN PROVIDENCE, RI AND SURROUNDING COMMUNITIES. OUR THREE-PART MISSION COMBINES PATIENT CARE, TEACHING, AND RESEARCH, ENABLING US TO PROVIDE EXCEPTIONAL CARE LOCALLY, NATIONALLY, AND GLOBALLY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $75,581,098 | ExpenseAmt |
| Grant | $27,780 | GrantAmt |
| Revenue | $85,878,287 | RevenueAmt |
| Desc | BROWN MEDICINE PROVIDED PRIMARY CARE AND SPECIALTY CARE AT NUMEROUS SITES THROUGHOUT RHODE ISLAND AS WELL AS OUTPATIENT AND INPATIENT CARE THROUGH NINE SUBSPECIALTY DIVISIONS AT RHODE ISLAND HOSPITAL, MIRIAM HOSPITAL AND THE PROVIDENCE VETERAN'S ADMINISTRATION HOSPITAL. BROWN MEDICINE PHYSICIANS RAN THE HOSPITALISTS PROGRAMS AT BOTH THE RHODE ISLAND AND MIRIAM HOSPITALS. IN ADDITION, BROWN MEDICINE OFFERED MEDICAL CARE AT ALL SEVEN OF RHODE ISLAND'S INPATIENT KIDNEY DIALYSIS CENTERS AND TWO STAND ALONE OUTPATIENT DIALYSIS CENTERS, AND BROWN MEDICINE OFFERED A TRAVEL CLINIC AT MIRIAM HOSPITAL. | Desc |
| Total Program Service Expenses | $75,581,098 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | 0 | 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 |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| 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 | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | Yes (1) | 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 | Yes (1) | 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 With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 69 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 505 | 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 | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 3 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (1) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 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 | 0 | 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 | RI | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HERMINEH OHARONIAN | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 4017844909 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 110 ELM STREET 2ND FLOOR | AddressLine1Txt |
| City | PROVIDENCE | CityNm |
| State Abbreviation | RI | StateAbbreviationCd |
| ZIP | 02903 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (23 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|
| LOUIS RICE MD | ||||||||
| PRESIDENT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| ANGELA CALIENDO MD | ||||||||
| VICE PRESIDENT | 40.00 | Yes (X) | Yes (X) | $541,336 | $0 | $44,784 | ||
| PETER HOLLMANN MD | ||||||||
| CMO/TREASURER/SECRETARY | 40.00 | Yes (X) | Yes (X) | $224,796 | $0 | $37,039 | ||
| THOMAS BLEDSOE MD | ||||||||
| DIRECTOR | 40.00 | Yes (X) | $230,486 | $0 | $44,339 | |||
| MICHAEL BLUNDIN MD | ||||||||
| DIRECTOR | 40.00 | Yes (X) | $242,356 | $0 | $48,712 | |||
| DEEPAN DALAL MD | ||||||||
| DIRECTOR (AS OF 1/19) | 40.00 | Yes (X) | $146,076 | $0 | $38,186 | |||
| SUSIE HU MD | ||||||||
| DIRECTOR | 40.00 | Yes (X) | $197,313 | $0 | $28,659 | |||
| KELLY MCGARRY MD | ||||||||
| DIRECTOR | 40.00 | Yes (X) | $202,293 | $0 | $43,226 | |||
| LYNN MCNICOLL MD | ||||||||
| DIRECTOR | 40.00 | Yes (X) | $57,695 | $0 | $29,083 | |||
| JOHN O'BELL | ||||||||
| DIRECTOR (UP TO 1/19) | 40.00 | Yes (X) | $193,017 | $0 | $42,686 | |||
| HARLAN RICH MD | ||||||||
| DIRECTOR | 40.00 | Yes (X) | $348,177 | $0 | $49,674 | |||
| SHARON ROUNDS MD | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| ANGELA TABER MD | ||||||||
| DIRECTOR | 40.00 | Yes (X) | $283,646 | $0 | $36,117 | |||
| MARGARET VAN BREE | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| COREY VENTETUOLO MD | ||||||||
| DIRECTOR | 40.00 | Yes (X) | $242,892 | $0 | $45,924 | |||
| TAMMY LEDERER | ||||||||
| CHIEF HUMAN RESOURCES OFFI | 40.00 | Yes (X) | $181,249 | $0 | $26,481 | |||
| ANN KASHMANIAN | ||||||||
| CHIEF EXECUTIVE OFFICER | 40.00 | Yes (X) | $333,771 | $0 | $44,115 | |||
| KWAME DAPAAH-AFRIYIE MD | ||||||||
| PHYSICIAN | 40.00 | $522,800 | $0 | $50,689 | Yes (X) | |||
| HOWARD P SAFRAN | ||||||||
| PHYSICIAN | 40.00 | $491,965 | $0 | $53,100 | Yes (X) | |||
| MITCHELL LEVY MD | ||||||||
| PHYSICIAN | 40.00 | $398,201 | $0 | $45,008 | Yes (X) | |||
| ANTHONY MEGA MD | ||||||||
| PHYSICIAN | 40.00 | $405,661 | $0 | $36,326 | Yes (X) | |||
| BENEDITO CARNEIRO FILHO MD | ||||||||
| PHYSICIAN | 40.00 | $401,982 | $0 | $35,520 | Yes (X) | |||
| MARY JANE ZIMMER | ||||||||
| FORMER COO (UP TO 8/18) | 40.00 | $227,376 | $0 | $14,305 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $5,873,088 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $793,973 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 202 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (1) | 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 |
|---|---|---|---|---|---|
| ECLINICALWORKS | |||||
| PO BOX 847950 | BOSTON | MA | 02284 | ELECTRONIC MEDICAL RECORDS | $932,750 |
| RHODE ISLAND HOSPITAL | |||||
| 593 EDDY STREET | PROVIDENCE | RI | 02903 | PHYSICIAN SERVICES, STAFFING | $713,904 |
| OPTUM 360 LLC | |||||
| 3436 MOMENTUM PLACE | CHICAGO | IL | 60689 | MEDICAL BILLING | $456,806 |
| LIFESPAN | |||||
| PO BOX 414546 | BOSTON | MA | 02241 | PHYSICIAN SERVICES, STAFFING | $392,507 |
| NAVICURE INC | |||||
| 1311 SOLUTIONS CENTER | CHICAGO | IL | 60677 | MEDICAL BILLING | $389,392 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 8 | CntrctRcvdGreaterThan100KCnt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| MEDICAL SERVICE FEES | 621491 | $66,331,874 | $66,331,874 |
| CONTRACT SERVICE REV. | 621491 | $9,788,725 | $9,788,725 |
| SUPPORT FROM RIH, TMH | 621491 | $8,505,313 | $8,505,313 |
| MISCELLANEOUS | 621491 | $1,252,375 | $1,252,375 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $85,878,287 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $484,234 | TotalRevenueColumnAmt |
| Exclusion | $484,234 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $1,083,133 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $762,056 | SecuritiesAmt |
| Other | $6,214 | OtherAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $321,077 | SecuritiesAmt |
| Other | -$6,214 | OtherAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $314,863 | TotalRevenueColumnAmt |
| Exclusion | $314,863 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OTHER REVENUE | Desc |
| Business | 621491 | BusinessCd |
| Total Revenue Column | $285,002 | TotalRevenueColumnAmt |
| Exclusion | $285,002 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $285,002 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $86,962,386 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $85,878,287 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $1,084,099 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $27,780 | TotalAmt |
| Program Services | $27,780 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,856,256 | TotalAmt |
| Program Services | $3,274,187 | ProgramServicesAmt |
| Management And General | $582,069 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $53,658,336 | TotalAmt |
| Program Services | $49,364,869 | ProgramServicesAmt |
| Management And General | $4,293,467 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,282,863 | TotalAmt |
| Program Services | $3,977,607 | ProgramServicesAmt |
| Management And General | $305,256 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,025,460 | TotalAmt |
| Program Services | $4,114,593 | ProgramServicesAmt |
| Management And General | $910,867 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,525,802 | TotalAmt |
| Program Services | $3,235,601 | ProgramServicesAmt |
| Management And General | $290,201 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $127,474 | TotalAmt |
| Program Services | $62,430 | ProgramServicesAmt |
| Management And General | $65,044 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $84,000 | TotalAmt |
| Management And General | $84,000 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $28,330 | TotalAmt |
| Management And General | $28,330 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,646,127 | TotalAmt |
| Program Services | $1,518,009 | ProgramServicesAmt |
| Management And General | $2,128,118 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $513,494 | TotalAmt |
| Program Services | $356,242 | ProgramServicesAmt |
| Management And General | $157,252 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $402,203 | TotalAmt |
| Program Services | $171,496 | ProgramServicesAmt |
| Management And General | $230,707 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,035,393 | TotalAmt |
| Program Services | $2,816,770 | ProgramServicesAmt |
| Management And General | $218,623 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $206,010 | TotalAmt |
| Management And General | $206,010 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,309,044 | TotalAmt |
| Program Services | $1,055,511 | ProgramServicesAmt |
| Management And General | $253,533 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,728,752 | TotalAmt |
| Program Services | $1,630,969 | ProgramServicesAmt |
| Management And General | $97,783 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| MEDICAL SUPPLIES | $1,268,399 | $1,265,943 | $2,456 |
| CARDIOLOGY EXPENSES-AEF | $1,134,276 | $1,134,276 | |
| ASSESSMENT EXPENSE | $503,936 | $503,936 | |
| OTHER EXPENSES | $473,047 | $335,101 | $137,946 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $735,778 | TotalAmt |
| Program Services | $735,778 | ProgramServicesAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $85,572,760 | TotalAmt |
| Program Services | $75,581,098 | ProgramServicesAmt |
| Management And General | $9,991,662 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $9,453,895 | BOYAmt |
| EOY | $7,767,514 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,602,495 | BOYAmt |
| EOY | $9,160,123 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,356,966 | BOYAmt |
| EOY | $3,582,979 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,609,012 | BOYAmt |
| EOY | $2,192,440 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $13,315,255 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $5,348,586 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,547,097 | BOYAmt |
| EOY | $7,966,669 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,759,972 | BOYAmt |
| EOY | $16,394,281 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $24,944,105 | BOYAmt |
| EOY | $24,057,293 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $71,273,542 | BOYAmt |
| EOY | $71,121,299 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $6,113,974 | BOYAmt |
| EOY | $6,550,476 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,472,222 | BOYAmt |
| EOY | $4,138,889 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,407,905 | BOYAmt |
| EOY | $20,751,589 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $32,994,101 | BOYAmt |
| EOY | $31,440,954 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $38,243,129 | BOYAmt |
| EOY | $39,680,345 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $36,312 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $38,279,441 | BOYAmt |
| EOY | $39,680,345 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $71,273,542 | BOYAmt |
| EOY | $71,121,299 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $1,389,626 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $11,278 | NetUnrlzdGainsLossesInvstAmt |
| 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) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Medical Research Organization | Yes (X) | MedicalResearchOrganizationInd |
Hospital Name And Address HospitalNameAndAddressGrp (5 entries)
| CityCityNm | State AbbreviationStateAbbreviationCd |
|---|---|
| RHODE ISLAND HOSPITAL | |
| PROVIDENCE | RI |
| MIRIAM HOSPITAL | |
| PROVIDENCE | RI |
| NEWPORT HOSPITAL | |
| NEWPORT | RI |
| WOMEN AND INFANTS HOSPITAL | |
| PROVIDENCE | RI |
| PROVIDENCE VETERANS ADMINISTRATION HOSPITAL | |
| PROVIDENCE | RI |
Schedule D IRS990ScheduleD
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,117,606 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,128,829 | DepreciationAmt |
| Book Value | $5,988,777 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $6,197,649 | OtherCostOrOtherBasisAmt |
| Depreciation | $4,219,757 | DepreciationAmt |
| Book Value | $1,977,892 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $7,966,669 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp (6 entries)
| DescDesc | Book ValueBookValueAmt |
|---|---|
| OTHER RECEIVABLES | $6,240,251 |
| CONSTRUCTION IN PROGRESS | $217,626 |
| RIGHT-OF-USE ASSETS - OPERATING LEASES | $17,067,183 |
| RIGHT-OF-USE ASSETS - FINANCING LEASES | $471,001 |
| INTEREST RATE CAP | $4,159 |
| DEFERRED FINANCING COSTS | $57,073 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $24,057,293 | TotalBookValueOtherAssetsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (3 entries)
| DescDesc | AmtAmt |
|---|---|
| DEFERRED COMPENSATION PLAN | $2,210,309 |
| OPERATING LEASES PAYABLE | $18,058,497 |
| FINANCING LEASES PAYABLE | $482,783 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $20,751,589 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $86,945,334 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $11,278 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | $11,278 | RevenueNotReportedAmt |
| Revenue Subtotal | $86,934,056 | RevenueSubtotalAmt |
| Investment Expenses Not Incld | $28,330 | InvestmentExpensesNotIncldAmt |
| Revenue Not Reported Fincl Stmt | $28,330 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $86,962,386 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $85,544,430 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $85,544,430 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $28,330 | InvestmentExpensesNotIncld2Amt |
| Expenses Not Rpt Fincl Stmt | $28,330 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $85,572,760 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION IS EXEMPT FROM FEDERAL INCOME TAX UNDER THE PROVISIONS OF SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. MANAGEMENT BELIEVES THAT THE ORGANIZATION OPERATES IN A MANNER CONSISTENT WITH ITS TAX-EXEMPT STATUS AT BOTH THE STATE AND FEDERAL LEVEL. THE ORGANIZATION ANNUALLY FILES IRS FORM 990 - RETURN OF ORGANIZATION EXEMPT FROM INCOME TAX, REPORTING VARIOUS INFORMATION THAT THE IRS USES TO MONITOR THE ACTIVITIES OF TAX-EXEMPT ENTITIES. THESE TAX RETURNS ARE SUBJECT TO REVIEW BY THE TAXING AUTHORITIES, AND THE FEDERAL INCOME TAX RETURNS ARE SUBJECT TO EXAMINATION BY THE IRS, GENERALLY FOR THREE YEARS AFTER THEY WERE FILED. THE ORGANIZATION CURRENTLY HAS NO TAX EXAMINATIONS IN PROGRESS. | ExplanationTxt |
Schedule F IRS990ScheduleF
Account Activities Outside US AccountActivitiesOutsideUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Region | CENTRAL AMERICA AND THE CARIBBEAN - | RegionTxt |
| Offices | 0 | OfficesCnt |
| Employee | 0 | EmployeeCnt |
| Type Of Activities Conducted | DOCTORS TRAVEL TO DOMINICAN REPUBLIC FOR A FEW WEEKS TO TRAIN RESIDENT MDS | TypeOfActivitiesConductedTxt |
| Specific Services Provided | INTERNATIONAL HEALTH PROGRAM | SpecificServicesProvidedTxt |
| Region Total Expenditures | $18,270 | RegionTotalExpendituresAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Subtotal Offices | 0 | SubtotalOfficesCnt |
| Subtotal Employees | 0 | SubtotalEmployeesCnt |
| Continuation Total Office | 0 | ContinuationTotalOfficeCnt |
| Continuation Total Employee | 0 | ContinuationTotalEmployeeCnt |
| Total Office | 0 | TotalOfficeCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Subtotal Spent | $18,270 | SubtotalSpentAmt |
| Continuation Spent | $0 | ContinuationSpentAmt |
| Total Spent | $18,270 | TotalSpentAmt |
| Transfer To Foreign Corp | 0 | TransferToForeignCorpInd |
| Interest In Foreign Trust | 0 | InterestInForeignTrustInd |
| Foreign Corp Ownership | 0 | ForeignCorpOwnershipInd |
| Passive Foreign Investmest Co | 0 | PassiveForeignInvestmestCoInd |
| Foreign Partnership | 0 | ForeignPartnershipInd |
| Boycott Countries | 0 | BoycottCountriesInd |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | 0 | GrantRecordsMaintainedInd |
Recipient Table RecipientTable (8 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | Recipient EINRecipientEIN | IRC SectionIRCSectionDesc | Cash GrantCashGrantAmt | Purpose Of GrantPurposeOfGrantTxt |
|---|---|---|---|---|---|---|---|
| HOPE HEALTH | |||||||
| 1085 NORTH MAIN STREET | PROVIDENCE | RI | 02904 | 510192422 | 501(C)(3) | $4,000 | TO SPONSOR GOLF INVITATIONAL TOURNAMENT |
| EAST PROVIDENCE ROTARY | |||||||
| PO BOX 14303 | EAST PROVIDENCE | RI | 02914 | 056015710 | 501(C)(3) | $1,280 | TO SPONSOR GOLF INVITATIONAL TOURNAMENT |
| RHODE ISLAND HOSPITAL | |||||||
| 593 EDDY STREET | PROVIDENCE | RI | 02903 | 050258954 | 501(C)(3) | $6,000 | TO SPONSOR GOLF INVITATIONAL TOURNAMENT |
| RI MS FOUNDATION | |||||||
| 405 PROMENADE STREET SUITE A | PROVIDENCE | RI | 02908 | 050401176 | 501(C)(3) | $5,000 | PHYSICIANS HEALTH FUND |
| GLAD RI | |||||||
| 18 TREMONT STREET STE 800 | BOSTON | MA | 02108 | 042660498 | 501(C)(3) | $2,000 | TO SPONSOR ANNUAL FUNDRAISER EVENT |
| LIFESPAN CANCER INSTITUTE | |||||||
| 593 EDDY STREET | PROVIDENCE | RI | 02903 | 050258954 | 501(C)(3) | $5,000 | TO SPONSOR GOLF INVITATIONAL TOURNAMENT |
| RHODE ISLAND FREE CLINIC | |||||||
| 655 BROAD STREET STE 301 | PROVIDENCE | RI | 029071444 | 050501276 | 501(C)(3) | $1,500 | TO SPONSOR ANNUAL FUNDRAISER EVENT |
| TOMORROW FUND | |||||||
| 593 EDDY STREET | PROVIDENCE | RI | 02903 | 050450569 | 501(C)(3) | $3,000 | TO SUPPORT ANNUAL BALL |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total501c3 Org | 7 | Total501c3OrgCnt |
| Total Other Org | 0 | TotalOtherOrgCnt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| 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 (19 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ANGELA CALIENDO MD | ||||||||||||||
| VICE PRESIDENT | $536,980 | $0 | $0 | $0 | $4,356 | $0 | $27,500 | $0 | $17,284 | $0 | $586,120 | $0 | $0 | $0 |
| PETER HOLLMANN MD | ||||||||||||||
| CMO/TREASURER/SECRETARY | $221,509 | $0 | $0 | $0 | $3,287 | $0 | $23,053 | $0 | $13,986 | $0 | $261,835 | $0 | $0 | $0 |
| THOMAS BLEDSOE MD | ||||||||||||||
| DIRECTOR | $228,226 | $0 | $0 | $0 | $2,260 | $0 | $23,262 | $0 | $21,077 | $0 | $274,825 | $0 | $0 | $0 |
| MICHAEL BLUNDIN MD | ||||||||||||||
| DIRECTOR | $241,891 | $0 | $0 | $0 | $465 | $0 | $24,837 | $0 | $23,875 | $0 | $291,068 | $0 | $0 | $0 |
| DEEPAN DALAL MD | ||||||||||||||
| DIRECTOR (AS OF 1/19) | $145,794 | $0 | $0 | $0 | $282 | $0 | $15,500 | $0 | $22,686 | $0 | $184,262 | $0 | $0 | $0 |
| SUSIE HU MD | ||||||||||||||
| DIRECTOR | $196,698 | $0 | $0 | $0 | $615 | $0 | $19,475 | $0 | $9,184 | $0 | $225,972 | $0 | $0 | $0 |
| KELLY MCGARRY MD | ||||||||||||||
| DIRECTOR | $201,225 | $0 | $0 | $0 | $1,068 | $0 | $20,803 | $0 | $22,423 | $0 | $245,519 | $0 | $0 | $0 |
| JOHN O'BELL | ||||||||||||||
| DIRECTOR (UP TO 1/19) | $192,417 | $0 | $0 | $0 | $600 | $0 | $20,000 | $0 | $22,686 | $0 | $235,703 | $0 | $0 | $0 |
| HARLAN RICH MD | ||||||||||||||
| DIRECTOR | $345,339 | $0 | $0 | $0 | $2,838 | $0 | $27,500 | $0 | $22,174 | $0 | $397,851 | $0 | $0 | $0 |
| ANGELA TABER MD | ||||||||||||||
| DIRECTOR | $283,027 | $0 | $0 | $0 | $619 | $0 | $27,500 | $0 | $8,617 | $0 | $319,763 | $0 | $0 | $0 |
| COREY VENTETUOLO MD | ||||||||||||||
| DIRECTOR | $242,428 | $0 | $0 | $0 | $464 | $0 | $25,088 | $0 | $20,836 | $0 | $288,816 | $0 | $0 | $0 |
| TAMMY LEDERER | ||||||||||||||
| CHIEF HUMAN RESOURCES OFFI | $178,851 | $0 | $0 | $0 | $2,398 | $0 | $18,302 | $0 | $8,179 | $0 | $207,730 | $0 | $0 | $0 |
| ANN KASHMANIAN | ||||||||||||||
| CHIEF EXECUTIVE OFFICER | $331,191 | $0 | $0 | $0 | $2,580 | $0 | $27,500 | $0 | $16,615 | $0 | $377,886 | $0 | $0 | $0 |
| KWAME DAPAAH-AFRIYIE MD | ||||||||||||||
| PHYSICIAN | $521,282 | $0 | $0 | $0 | $1,518 | $0 | $27,500 | $0 | $23,189 | $0 | $573,489 | $0 | $0 | $0 |
| HOWARD P SAFRAN | ||||||||||||||
| PHYSICIAN | $489,127 | $0 | $0 | $0 | $2,838 | $0 | $27,500 | $0 | $25,600 | $0 | $545,065 | $0 | $0 | $0 |
| MITCHELL LEVY MD | ||||||||||||||
| PHYSICIAN | $393,019 | $0 | $0 | $0 | $5,182 | $0 | $27,500 | $0 | $17,508 | $0 | $443,209 | $0 | $0 | $0 |
| ANTHONY MEGA MD | ||||||||||||||
| PHYSICIAN | $402,823 | $0 | $0 | $0 | $2,838 | $0 | $27,500 | $0 | $8,826 | $0 | $441,987 | $0 | $0 | $0 |
| BENEDITO CARNEIRO FILHO MD | ||||||||||||||
| PHYSICIAN | $401,322 | $0 | $0 | $0 | $660 | $0 | $10,533 | $0 | $24,987 | $0 | $437,502 | $0 | $0 | $0 |
| MARY JANE ZIMMER | ||||||||||||||
| FORMER COO (UP TO 8/18) | $225,069 | $0 | $0 | $0 | $2,307 | $0 | $14,305 | $0 | $0 | $0 | $241,681 | $0 | $0 | $0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | ALL PHYSICIANS ARE MEMBERS UPON JOINING THE ORGANIZATION. |
| FORM 990, PART VI, SECTION A, LINE 7A | ALL BOARD MEMBERS ARE ELECTED BY THE MEMBERS, EXCEPT THE FOUR WHO SERVE AS EX OFFICIO. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE PRESIDENT'S VETO OF ANY ACTION CAN BE OVERRIDDEN BY A MEMBERSHIP VOTE OF 75%. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE 990 IS NOT PROVIDED TO THE ORGANIZATION'S FULL BOARD OF DIRECTORS BEFORE IT IS FILED. THE 990 IS REVIEWED BY THE FINANCE OFFICE AND THE PRESIDENT. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION'S CONFLICT OF INTEREST FORMS ARE REQUIRED TO BE FILLED OUT ANNUALLY. THE RESPONSES ARE COMPILED BY THE CEO'S OFFICE AND FOLLOWED UP IF THE FORMS INDICATE POTENTIAL CONFLICTS. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE COMPENSATION OF THE BOARD MEMBERS THAT ARE EMPLOYEES OF THE ORGANIZATION IS DETERMINED BY THE DIVISION DIRECTOR. THE COMPENSATION OF THE CEO AND OTHER KEY EMPLOYEES IS DETERMINED BY THE PRESIDENT OF THE ORGANIZATION. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S ARTICLES OF INCORPORATION ARE AVAILABLE AT THE SECRETARY OF STATE'S OFFICE AND ON THE RELATED WEBSITE. THE ORGANIZATION DOES NOT MAKE ITS FINANCIAL STATEMENTS, BY-LAWS OR ITS CONFLICT OF INTEREST POLICY AVAILABLE TO THE PUBLIC AS IT DOES NOT BELIEVE THAT A PUBLIC PURPOSE WOULD BE SERVED BY DOING SO. |