LONG ISLAND SELECT HEALTHCARE INC: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- LONG ISLAND SELECT HEALTHCARE INC (EIN 47-1001464)
- Tax period
- 2018-01-01 to 2018-12-31
- Filed
- 2019-11-12
- IRS object ID
- 201943169349302009
- Schema version
- 2018v3.1
- 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 ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2019-11-12T09:43:15-06:00 | ReturnTs |
| Tax Period End | 2018-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BDO USA LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 PARK AVENUE | AddressLine1Txt |
| City | NEW YORK | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 100175001 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2018-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 471001464 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LONG ISLAND SELECT HEALTHCARE INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % EDGARDO UY | InCareOfNm |
| Business Name Control | LONG | BusinessNameControlTxt |
| Phone | 6316502510 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 159 Carleton Avenue | AddressLine1Txt |
| City | Central Islip | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 11722 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | PEDRO L RIVERA | PersonNm |
| Person Title | cfo | PersonTitleTxt |
| Phone | 6316502160 | PhoneNum |
| Signature | 2019-11-12 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Paul Hammerschmidt | PreparerPersonNm |
| PTIN | P01384178 | PTIN |
| Phone | 2128858000 | PhoneNum |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 24.98.146.212 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Federal Original Submission Id | 26308920193165000000 | FederalOriginalSubmissionId |
| Federal Original Submission Id | 2019-11-12 | FederalOriginalSubmissionIdDt |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 7A09D87DFB4197FECD83FF23FA2E591689F028E1 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 7650403D266B766C333176AE000A8E3E9E2A92DE | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2020-04-17 16:48:07Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LISH INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | PEDRO L RIVERA | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 159 Carleton Avenue | AddressLine1Txt |
| City | Central Islip | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 11722 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $15,948,796 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.lishcare.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2014 | FormationYr |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE PRIMARY AND PREVENTATIVE HEALTHCARE SRVCS TO RESIDENTS OF SPECIFIC AREAS OF SUFFOLK COUNTY WITH A FOCUS ON LOW INCOME, MEDICALLY UNSERVED & UNDERSERVED INDIVIDUALS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 125 | TotalEmployeeCnt |
| Total Volunteers | 11 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $13,971 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $0 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $15,280,652 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $15,947,146 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $1,650 | CYOtherRevenueAmt |
| PY Total Revenue | $15,280,652 | PYTotalRevenueAmt |
| CY Total Revenue | $15,948,796 | 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 | $8,707,485 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $8,461,262 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $6,464,709 | PYOtherExpensesAmt |
| CY Other Expenses | $5,814,253 | CYOtherExpensesAmt |
| PY Total Expenses | $15,172,194 | PYTotalExpensesAmt |
| CY Total Expenses | $14,275,515 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $108,458 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,673,281 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $4,789,987 | TotalAssetsBOYAmt |
| Total Assets EOY | $4,098,001 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $5,681,922 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $3,316,655 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$891,935 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $781,346 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO PROVIDE PRIMARY AND PREVENTIVE HEALTHCARE SERVICES FOCUSING ON LOW INCOME, MEDICALLY UNSERVED AND UNDERSERVED INDIVIDUALS WHILE HELPING IMPROVE ACCESS TO CARE AND ENSURING THAT INABILITY TO PAY IS NOT A BARRIER. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $10,448,107 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $14,148,188 | RevenueAmt |
| Desc | ARTICLE 28 - LONG ISLAND SELECT HEALTHCARE PROVIDES DIAGNOSTIC AND TREATMENT SERVICES INCLUDING COMPREHENSIVE PRIMARY CARE, DENTAL, BEHAVIORAL HEALTH, MEDICAL SPECIALTIES, THERAPEUTIC SPECIALTIES, AND CHRONIC CARE MANAGEMENT SERVICES. TOTAL NUMBER OF PATIENTS: 6,745. LISH PARTICIPATES IN THE 340B PROGRAM WHICH REQUIRES DRUG MANUFACTURERS PARTICIPATING IN MEDICAID DRUG REPORTS PROGRAM TO SIGN A PHARMACEUTICAL PRICE AGREEMENT WITH THE SECRETARY OF HEALTH AND HUMAN SERVICES. THIS AGREEMENT LIMITS THE PRICE THAT MANUFACTURERS MAY CHARGE CERTAIN "COVERED ENTITIES" FOR COVERED OUTPATIENT DRUGS. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,891,111 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $1,425,146 | RevenueAmt |
| Desc | ARTICLE 16 - THROUGH THE NEW YORK STATE OFFICE OF PEOPLE WITH DEVELOPMENTAL DISABILITIES, LONG ISLAND SELECT HEALTHCARE PROVIDES SPEECH THERAPY, OCCUPATIONAL THERAPY AND PHYSICAL THERAPY SERVICES. TOTAL NUMBER OF PATIENTS: 680 | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $245,551 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $373,812 | RevenueAmt |
| Desc | OTHER SERVICES - THE ORGANIZATION IS A FEDERALLY QUALIFIED HEALTH CENTER SUBRECIPIENT OF HUDSON RIVER HEALTH CARE, INC. FEDERAL AWARD UNDER HEALTH RESOURCES AND SERVICES ADMNISTRATION (HRSA). SCOPE OF SERVICES INCLUDE COMPREHENSIVE PRIMARY AND PREVENTIVE HEALTHCARE SERVICES TO RESIDENTS OF SPECIFIC AREAS OF SUFFOLK COUNTY WITH A PARTICULAR FOCUS ON LOW INCOME, MEDICALLY UNSERVED AND UNDERSERVED INDIVIDUALS; AND SUBRECIPIENT OF SUFFOLK CARE COLLABORATIVE/DELIVERY SYSTEM REFORM INCENTIVE PROGRAM (DSRIP) - TO IMPROVE THE EFFECTIVENESS AND EFFICIENCY OF HEALTH CARE DELIVERY FOR MEDICAID BENEFICIARIES AND UNINSURED INDIVIDUALS IN SUFFOLK COUNTY. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $12,584,769 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | false | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (true) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | false | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | false | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| Info In Schedule O Part V | Yes (X) | InfoInScheduleOPartVInd |
| IRP Document | 73 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 125 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | Yes (true) | UnrelatedBusIncmOverLimitInd |
| Form990 T Filed | Yes (true) | Form990TFiledInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | false | MembersOrStockholdersInd |
| Election Of Board Members | false | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | NY | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | EDGARDO UY | PersonNm |
| Phone | 6316502160 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 159 CARLETON AVENUE | AddressLine1Txt |
| City | Central Islip | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 11722 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (19 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 |
|---|---|---|---|---|---|---|---|---|---|
| JOHN LESSARD | |||||||||
| PRESIDENT | 3.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| STEPHEN FRIEDMAN | |||||||||
| TREASURER | 3.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| ROBERT BUDD | |||||||||
| SECRETARY | 3.0 | 0.0 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| TINA ACEVEDO | |||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| DOREEN BIONDOLILLO | |||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| ROCCO CIRIGLIANO | |||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| JUDY EISMAN | |||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| LISA MEYER-FERTAL | |||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| ROY PROBEYAHN | |||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| DAVID SISKIND MD | |||||||||
| DIRECTOR | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| ADRIENNE WASHINGTON | |||||||||
| DIRECTOR (11/18-12/31/18) | 1.0 | 0.0 | Yes (X) | $0 | $0 | $0 | |||
| TRACY G MCDANIEL THRU 1118 | |||||||||
| CHIEF EXECUTIVE OFFICER | 37.5 | 0.0 | Yes (X) | $177,480 | $0 | $16,901 | |||
| PEDRO L RIVERA | |||||||||
| CHIEF FINANCIAL OFFICER | 37.5 | 0.0 | Yes (X) | $142,900 | $0 | $33,720 | |||
| JAMES R POWELL MD | |||||||||
| CHIEF MEDICAL OFFICER | 37.5 | 0.0 | $280,890 | $0 | $33,300 | Yes (X) | |||
| PARIS ARIANAS MD | |||||||||
| PSYCHIATRIST | 24.0 | 0.0 | $281,486 | $0 | $0 | Yes (X) | |||
| SPIRO THEOHARAKIS MD | |||||||||
| PSYCHIATRIST | 25.0 | 0.0 | $213,448 | $0 | $20,502 | Yes (X) | |||
| MAGERY SATISH MD | |||||||||
| PSYCHIATRIST | 16.0 | 0.0 | $204,657 | $0 | $0 | Yes (X) | |||
| GAIL FRASER-FARMER MD | |||||||||
| PHYSICIAN | 37.5 | 0.0 | $169,729 | $0 | $33,603 | Yes (X) | |||
| JEFFREY ROMANO PSYD | |||||||||
| PSYCHOLOGIST | 37.5 | 0.0 | $146,068 | $0 | $23,690 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,616,658 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $161,716 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 17 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (4 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| SOLUTIONS 4 COMMUNITY HEALTH | |||||
| 1200 BROWN STREET | PEEKSKILL | NY | 10566 | MEDICAL BILLING SVCS | $823,966 |
| FLEXIBLE BUSINESS SYSTEMS | |||||
| 290 MOTOR PARKWAY | HAUPPAUGE | NY | 11788 | I.T. SUPPORT | $168,059 |
| ECLINICAL WORKS LLC | |||||
| PO BOX 847950 | BOSTON | MA | 02284 | CLINICAL INFO. SVCS. | $125,223 |
| MODERN CLEANING SYSTEMS | |||||
| PO BOX 37 | WEST ISLIP | NY | 11795 | OFFICE CLEANING SVCS | $101,220 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 4 | CntrctRcvdGreaterThan100KCnt |
| Total Contributions | $0 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| NET PATIENT SERVICE REVENUE | 624200 | $14,205,554 | $14,205,554 |
| 340B PHARMACY REVENUE | 624200 | $1,454,225 | $1,454,225 |
| GOVERNMENT CONTRACT REVENUE | 624200 | $280,916 | $280,916 |
| OTHER REVENUE | 624200 | $6,451 | $6,451 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $15,947,146 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Gross Rents GrossRentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $1,650 | RealAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $1,650 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $1,650 | TotalRevenueColumnAmt |
| Exclusion | $1,650 | ExclusionAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $0 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $0 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $0 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $0 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $15,948,796 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $15,947,146 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $1,650 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part IX | Yes (X) | InfoInScheduleOPartIXInd |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $685,191 | TotalAmt |
| Management And General | $685,191 | ManagementAndGeneralAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,399,455 | TotalAmt |
| Program Services | $5,975,032 | ProgramServicesAmt |
| Management And General | $424,423 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $730,516 | TotalAmt |
| Program Services | $670,113 | ProgramServicesAmt |
| Management And General | $60,403 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $646,100 | TotalAmt |
| Program Services | $539,256 | ProgramServicesAmt |
| Management And General | $106,844 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $75,662 | TotalAmt |
| Program Services | $27,784 | ProgramServicesAmt |
| Management And General | $47,878 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $113,526 | TotalAmt |
| Program Services | $104,117 | ProgramServicesAmt |
| Management And General | $9,409 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,655,839 | TotalAmt |
| Program Services | $1,630,694 | ProgramServicesAmt |
| Management And General | $25,145 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $732,239 | TotalAmt |
| Program Services | $688,793 | ProgramServicesAmt |
| Management And General | $43,446 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $153,901 | TotalAmt |
| Program Services | $136,719 | ProgramServicesAmt |
| Management And General | $17,182 | ManagementAndGeneralAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,475,670 | TotalAmt |
| Program Services | $2,289,057 | ProgramServicesAmt |
| Management And General | $186,613 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,955 | TotalAmt |
| Program Services | $6,139 | ProgramServicesAmt |
| Management And General | $15,816 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,265 | TotalAmt |
| Management And General | $10,265 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $134,555 | TotalAmt |
| Program Services | $123,838 | ProgramServicesAmt |
| Management And General | $10,717 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $201,029 | TotalAmt |
| Program Services | $182,818 | ProgramServicesAmt |
| Management And General | $18,211 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| EQUIPMENT REPAIR/MAINTENANCE | $183,980 | $172,987 | $10,993 |
| DUES AND SUBSCRIPTIONS | $40,726 | $23,092 | $17,634 |
| MISCELLANEOUS | $14,906 | $14,330 | $576 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $14,275,515 | TotalAmt |
| Program Services | $12,584,769 | ProgramServicesAmt |
| Management And General | $1,690,746 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,035,374 | BOYAmt |
| EOY | $1,299,877 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $443,269 | BOYAmt |
| EOY | $340,015 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,486,507 | BOYAmt |
| EOY | $1,848,731 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $61,992 | BOYAmt |
| EOY | $50,975 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $774,159 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $332,160 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $565,203 | BOYAmt |
| EOY | $441,999 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $197,642 | BOYAmt |
| EOY | $116,404 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,789,987 | BOYAmt |
| EOY | $4,098,001 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,059,206 | BOYAmt |
| EOY | $867,239 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $272,992 | BOYAmt |
| EOY | $172,992 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,349,724 | BOYAmt |
| EOY | $2,276,424 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,681,922 | BOYAmt |
| EOY | $3,316,655 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$891,935 | BOYAmt |
| EOY | $781,346 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$891,935 | BOYAmt |
| EOY | $781,346 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,789,987 | BOYAmt |
| EOY | $4,098,001 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $1,673,281 | ReconcilationRevenueExpnssAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Schedule D IRS990ScheduleD
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp | |
| Land | LandGrp | |
| Buildings | BuildingsGrp |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $14,306 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,431 | DepreciationAmt |
| Book Value | $12,875 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $371,085 | OtherCostOrOtherBasisAmt |
| Depreciation | $179,788 | DepreciationAmt |
| Book Value | $191,297 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $388,768 | OtherCostOrOtherBasisAmt |
| Depreciation | $150,941 | DepreciationAmt |
| Book Value | $237,827 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $441,999 | TotalBookValueLandBuildingsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DUE TO LEGACY AGENCIES | Desc |
| Amt | $2,276,424 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $2,276,424 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $15,948,796 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Subtotal | $15,948,796 | RevenueSubtotalAmt |
| Total Revenue Per Form990 | $15,948,796 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $14,275,515 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Subtotal | $14,275,515 | ExpensesSubtotalAmt |
| Total Expenses Per Form990 | $14,275,515 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | Long Island Select Healthcare, Inc. adopted the provisions of Accounting Standards Codification (ASC) 740, "Accounting for Uncertainty in Income Taxes." Under ASC 740, an organization must recognize the tax benefit associated with tax positions taken for tax return purposes when it is more likely than not that the position will not be sustained. The implementation of ASC 740 had no impact on the organizations financial statements. The organization does not believe there are any material uncertain tax positions and, accordingly, it will recognize any liability for unrecognized tax benefits. The organization has filed for and received income tax exemptions in the jurisdictions where it is required to do so. For the year ended December 31, 2018, there was no interest or penalties recorded or included in the statement of activities. For the year ended December 31, 2018, The organization had no unrelated business income. The organization is subject to routine audits by taxing authorities. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Independent Consultant | Yes (X) | IndependentConsultantInd |
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| TRACY G MCDANIEL THRU 1118 | ||||||||||||||
| CHIEF EXECUTIVE OFFICER | $177,480 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $16,901 | $0 | $194,381 | $0 | $0 | $0 |
| PEDRO L RIVERA | ||||||||||||||
| CHIEF FINANCIAL OFFICER | $142,900 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $33,720 | $0 | $176,620 | $0 | $0 | $0 |
| JAMES R POWELL MD | ||||||||||||||
| CHIEF MEDICAL OFFICER | $280,890 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $33,300 | $0 | $314,190 | $0 | $0 | $0 |
| PARIS ARIANAS MD | ||||||||||||||
| PSYCHIATRIST | $281,486 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $281,486 | $0 | $0 | $0 |
| SPIRO THEOHARAKIS MD | ||||||||||||||
| PSYCHIATRIST | $213,448 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $20,502 | $0 | $233,950 | $0 | $0 | $0 |
| MAGERY SATISH MD | ||||||||||||||
| PSYCHIATRIST | $204,657 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $204,657 | $0 | $0 | $0 |
| GAIL FRASER-FARMER MD | ||||||||||||||
| PHYSICIAN | $169,729 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $33,603 | $0 | $203,332 | $0 | $0 | $0 |
| JEFFREY ROMANO PSYD | ||||||||||||||
| PSYCHOLOGIST | $146,068 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $23,690 | $0 | $169,758 | $0 | $0 | $0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (8 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART I, LINE 7B AND PART V, LINE 3A: | FORM 990-T WAS FILED EXCLUSIVELY TO REPORT QUALIFIED TRANSPORTATION AND PARKING FRINGE BENEFITS, AND ANY ON-PREMISES ATHLETIC FACILITIES UNDER SECTION 512(A)(7). |
| FORM 990, PART VI, SECTION B, LINE 11B: | FORM 990 WAS PREPARED BY A NATIONALLY RENOWNED ACCOUNTING FIRM IN CONJUNCTION WITH THE ORGANIZATION'S FINANCIAL DEPARTMENT. DRAFT FORM 990 WAS REVIEWED AND PROVIDED TO ALL MEMBERS OF THE BOARD OF DIRECTORS IN DRAFT VIA ELECTRONIC MAIL, WITH AN OPPORTUNITY FOR THEM TO COMMENT OR MAKE INQUIRY BEFORE IT WAS FILED WITH THE INTERNAL REVENUE SERVICE. |
| FORM 990, PART VI, SECTION B, LINE 12: | Officers, directors and key employees are provided with a copy of the organizations Conflict of Interest Policy and are required to submit an annual conflict of interest disclosure form to report situations that pose or may give the appearance of conflict of interest. In addition, this process is performed with other staff as the CEO deems appropriate. |
| FORM 990, PART VI, SECTION B, LINES 15A AND 15B: | The organization utilizes a compensation review process that includes independent people evaluating key statistics including but not limited to performance and market compensation data. |
| 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 VII: | Solutions 4 Community Health provided the reporting organization with practice management and medical billing services including an interim CEO (not a common law employee) for the period 12/02/2018 through 05/29/2019. |
| FORM 990 PART IX LINE 11G | DESCRIPTION:CONTRACTED HEALTHCARE SERVICES TOTAL FEES:1546832 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:OTHER PROFESSIONAL FEES TOTAL FEES:109007 |