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STAMFORD HEALTH MEDICAL GROUP INC: Form 990, tax year 2017

View the entire original 990 at ProPublica ↗

Organization
STAMFORD HEALTH MEDICAL GROUP INC (EIN 27-1648289)
Tax period
2017-10-01 to 2018-09-30
Filed
2019-08-12
IRS object ID
201932249349301513
Schema version
2017v2.3
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

FieldValueIRS element (for citing)
Return2019-08-12T13:00:59-05:00ReturnTs
Tax Period End2018-09-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1ERNST & YOUNG US LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line15 TIMES SQUAREAddressLine1Txt
CityNEW YORKCityNm
State AbbreviationNYStateAbbreviationCd
ZIP10036ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2017-10-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN271648289EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1STAMFORD HEALTH MEDICAL GROUPBusinessNameLine1Txt
FieldValueIRS element (for citing)
In Care Of% Rodrigo AcostaInCareOfNm
Business Name ControlSTAMBusinessNameControlTxt
Phone2032767447PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1One Hospital Plaza PO Box 9317AddressLine1Txt
CitySTAMFORDCityNm
State AbbreviationCTStateAbbreviationCd
ZIP06904ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonRODRIGO ACOSTA MDPersonNm
Person TitlePRESIDENT/CEOPersonTitleTxt
Phone2032761000PhoneNum
Signature2019-08-12SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonNICOLE M SOKOLOWSKIPreparerPersonNm
PTINP01683199PTIN
Phone2127733000PhoneNum

Filing Security Information FilingSecurityInformation

IP Address IPAddress

FieldValueIRS element (for citing)
I Pv4 Address108.206.163.59IPv4AddressTxt
FieldValueIRS element (for citing)
Federal Original Submission Id56103920192245000001FederalOriginalSubmissionId
Federal Original Submission Id2019-08-12FederalOriginalSubmissionIdDt
Filing License TypePFilingLicenseTypeCd
At Submission Creation Device Id47CCE9F19DA6832300AFC0DC75FEB109EC0143B4AtSubmissionCreationDeviceId
At Submission Filing Device Id770194AAF055F9EA87E64CA02E08FE540289067FAtSubmissionFilingDeviceId
FieldValueIRS element (for citing)
Tax2017TaxYr
Build TS2019-02-21 02:37:17ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerRodrigo Acosta MDPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1Same as aboveAddressLine1Txt
CityStamfordCityNm
State AbbreviationCTStateAbbreviationCd
ZIP06905ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$73,634,000GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website Addresshttps://www.stamfordhealth.org/shmg/WebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2009FormationYr
Legal Domicile StateCTLegalDomicileStateCd
Activity Or MissionSUPPORTS THE PROVISION OF PHYSICIAN serVICES AND OTHER HEALTH PRACTITIONER SERVICES TO THE RESIDENTS OF the COMMUNITIES SERVED BY STAMFORD HOSPITAL AFFILIATED ORGANIZATIONS.ActivityOrMissionDesc
Voting Members Governing Body9VotingMembersGoverningBodyCnt
Voting Members Independent0VotingMembersIndependentCnt
Total Employee624TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$55,604,030PYProgramServiceRevenueAmt
CY Program Service Revenue$61,638,667CYProgramServiceRevenueAmt
PY Investment Income$0PYInvestmentIncomeAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue$7,774,539PYOtherRevenueAmt
CY Other Revenue$11,995,333CYOtherRevenueAmt
PY Total Revenue$63,378,569PYTotalRevenueAmt
CY Total Revenue$73,634,000CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$74,017,322PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$82,121,758CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$32,209,835PYOtherExpensesAmt
CY Other Expenses$32,681,242CYOtherExpensesAmt
PY Total Expenses$106,227,157PYTotalExpensesAmt
CY Total Expenses$114,803,000CYTotalExpensesAmt
PY Revenues Less Expenses-$42,848,588PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$41,169,000CYRevenuesLessExpensesAmt
Total Assets BOY$36,439,945TotalAssetsBOYAmt
Total Assets EOY$36,249,838TotalAssetsEOYAmt
Total Liabilities BOY$26,643,709TotalLiabilitiesBOYAmt
Total Liabilities EOY$26,833,468TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$9,796,236NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$9,416,370NetAssetsOrFundBalancesEOYAmt
MissionSUPPORTS THE PROVISION OF PHYSICIAN SERVICES AND OTHER HEALTH PRACTITIONER SERVICES TO THE RESIDENTS OF THE COMMUNITIES SERVED BY STAMFORD HOSPITAL AND AFFILIATED ORGANIZATIONS.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$91,140,441ExpenseAmt
Revenue$72,486,233RevenueAmt
DescSTAMFORD HEALTH MEDICAL GROUP INC. PROVIDES A COMPREHENSIVE ARRAY OF MANAGEMENT SERVICES IN SUPPORT OF PHYSICIAN PRACTICES.Desc
Total Program Service Expenses$91,140,441TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredfalseScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Temp Or Permanent EndowmentsfalseTempOrPermanentEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstfalseReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnotefalseIncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (true)ConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With Officer EntfalseBusinessRlnWithOfficerEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityYes (true)RelatedEntityInd
Related Organization Ctrl EntYes (true)RelatedOrganizationCtrlEntInd
Transaction With Control EntYes (true)TransactionWithControlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpfalseActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document73IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee624EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsfalseQuidProQuoContributionsInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members9GoverningBodyVotingMembersCnt
Independent Voting Member0IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersYes (true)MembersOrStockholdersInd
Election Of Board MembersYes (true)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (true)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyYes (true)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VenturefalseInvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonRodrigo AcostaPersonNm
Phone2032761000PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1One Omega Drive 2nd FloorAddressLine1Txt
CityStamfordCityNm
State AbbreviationCTStateAbbreviationCd
ZIP06907ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (17 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtHighest Compensated EmployeeHighestCompensatedEmployeeInd
Rodrigo Acosta MD
President & Chairman40.00.0Yes (X)Yes (X)$714,359$0$56,957
Craig Olin MD
Director/Physician40.00.0Yes (X)$750,941$0$49,190
Michael Ebright MD
Director/Physician40.00.0Yes (X)$669,351$0$37,522
David Gruen MD
Director/Physician40.00.0Yes (X)$616,190$0$57,190
Joseph Costanzo MD
Physician/Treasurer40.00.0Yes (X)Yes (X)$300,736$0$56,522
John Dowdle MD
Director/Physician40.00.0Yes (X)$687,496$0$54,492
Allison Ostroff
Director/Physician40.00.0Yes (X)$284,327$0$40,246
Ann Williams
Director/Physician40.00.0Yes (X)$253,012$0$37,323
Gerald Rakos MD
Director/Physician0.040.0Yes (X)$0$522,935$25,853
Elizabeth Longmore
Chief Operating Officer40.00.0Yes (X)$215,761$0$35,348
William Hines MD
Chief Medical Officer40.00.0Yes (X)$459,891$0$43,022
Fortrella Cummings
CHIEF FINANCIAL OFFICER40.00.0Yes (X)$275,746$0$15,447
Arghiris Barbadimos MD
PHYSICIAN40.00.0$814,924$0$25,308Yes (X)
Charles Rosenstein MD
PHYSICIAN40.00.0$757,117$0$37,308Yes (X)
RUSSELL CAVALLO MD
PHYSICIAN40.00.0$656,251$0$36,179Yes (X)
JEFFREY GREEN MD
PHYSICIAN40.00.0$667,181$0$56,968Yes (X)
SCOTT WEISS MD
PHYSICIAN40.00.0$633,929$0$37,242Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$8,757,212TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$522,935TotReportableCompRltdOrgAmt
Total Other Compensation$702,117TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K153IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp (5 entries)

Address Line1ContractorAddress/USAddress/AddressLine1TxtCityContractorAddress/USAddress/CityNmState AbbreviationContractorAddress/USAddress/StateAbbreviationCdZIPContractorAddress/USAddress/ZIPCdServicesServicesDescCompensationCompensationAmt
CALDWELL WALSH BUILDING
17 BERKSHIRE RDSANDY HOOKCT06482Construction SVCS$564,998
NAVICURE INC
2055 SUGARLOAF CIRCLE SUITE 600DULTHGA30097BILLING CONSULTANT$315,109
ECLINICALWORKS LLC
PO BOX 847950BOSTONMA02284CAP/SYSTEM & SUPPORT$1,854,319
PULMONARY ASSOCIATES OF STAMFORD
29 HOSPITAL PLAZA SUITE 505STAMFORDCT06902PHYSICIAN FEES$3,284,978
EXECUTIVE CONSULTING GROUP LLC
1111 THIRD AVE SUITE 2500SEATTLEWA98101IS CONSULTING SVCS$329,580
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K19CntrctRcvdGreaterThan100KCnt
Fundraising$0FundraisingAmt
Noncash Contributions$0NoncashContributionsAmt
Total Contributions$0TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmtExclusionExclusionAmt
MEDICARE621110$22,582,885$22,582,885$0$0
PHYSICIAN BILLING621110$39,055,782$39,055,782$0$0
FieldValueIRS element (for citing)
Total Program Service Revenue$61,638,667TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Royalties Revenue RoyaltiesRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Gross Rents GrossRentsGrp

FieldValueIRS element (for citing)
Real$1,147,767RealAmt

Rental Income Or Loss RentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Real$1,147,767RealAmt
Personal$0PersonalAmt

Net Rental Income Or Loss NetRentalIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,147,767TotalRevenueColumnAmt
Exclusion$1,147,767ExclusionAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Fundraising Gross Income$0FundraisingGrossIncomeAmt
Fundraising Direct Expenses$0FundraisingDirectExpensesAmt

Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gaming Gross Income$0GamingGrossIncomeAmt
Gaming Direct Expenses$0GamingDirectExpensesAmt

Net Income From Gaming NetIncomeFromGamingGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt
FieldValueIRS element (for citing)
Gross Sales Of Inventory$0GrossSalesOfInventoryAmt
Cost Of Goods Sold$0CostOfGoodsSoldAmt

Net Income Or Loss NetIncomeOrLossGrp

FieldValueIRS element (for citing)
Total Revenue Column$0TotalRevenueColumnAmt

Other Revenue Misc OtherRevenueMiscGrp (3 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmtExclusionExclusionAmt
INTERCOMPANY STAFFING REIMBURSEMENTS900099$10,561,705$10,561,705$0$0
ABSTRACTS900099$210,555$210,555$0$0
OTHER RETAIL SALES900099$73,353$73,353$0$0

Miscellaneous Revenue MiscellaneousRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$1,953TotalRevenueColumnAmt
Related Or Exempt Func Income$1,953RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Other Revenue Total$10,847,566OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$73,634,000TotalRevenueColumnAmt
Related Or Exempt Func Income$72,486,233RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$1,147,767ExclusionAmt

Grants To Domestic Orgs GrantsToDomesticOrgsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt

Foreign Grants ForeignGrantsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt

Benefits To Members BenefitsToMembersGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$6,988,753TotalAmt
Program Services$5,607,640ProgramServicesAmt
Management And General$1,381,113ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Comp Disqual Persons CompDisqualPersonsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$65,371,998TotalAmt
Program Services$54,837,863ProgramServicesAmt
Management And General$10,534,135ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$6,142,882TotalAmt
Program Services$5,191,277ProgramServicesAmt
Management And General$951,605ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$3,618,125TotalAmt
Program Services$3,091,575ProgramServicesAmt
Management And General$526,550ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Management FeesForServicesManagementGrp

FieldValueIRS element (for citing)
Total$164,775TotalAmt
Management And General$164,775ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$345,633TotalAmt
Management And General$345,633ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$73,647TotalAmt
Management And General$73,647ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Lobbying FeesForServicesLobbyingGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Prof Fundraising FeesForServicesProfFundraising

FieldValueIRS element (for citing)
Total$0TotalAmt
Fundraising$0FundraisingAmt

Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$8,666,327TotalAmt
Program Services$6,315,297ProgramServicesAmt
Management And General$2,351,030ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$704,984TotalAmt
Program Services$4,659ProgramServicesAmt
Management And General$700,325ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$5,056,092TotalAmt
Program Services$3,563,899ProgramServicesAmt
Management And General$1,492,193ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$40,875TotalAmt
Program Services$4,492ProgramServicesAmt
Management And General$36,383ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Royalties RoyaltiesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$9,360,753TotalAmt
Program Services$7,700,805ProgramServicesAmt
Management And General$1,659,948ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$73,085TotalAmt
Program Services$30,412ProgramServicesAmt
Management And General$42,673ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Conferences Meetings ConferencesMeetingsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Payments To Affiliates PaymentsToAffiliatesGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
Program Services$0ProgramServicesAmt
Management And General$0ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$2,984,861TotalAmt
Program Services$2,116,543ProgramServicesAmt
Management And General$868,318ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$2,261,106TotalAmt
Program Services$2,249,787ProgramServicesAmt
Management And General$11,319ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
SERVICE CONTRACTS$2,443,994$44,423$2,399,571$0
NON COLLEGE EDUCATION$424,296$332,500$91,796$0
DUES AND MEMBERSHIPS$17,404$2,245$15,159$0
LICENSES AND FEES$7,044$800$6,244$0

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$56,366TotalAmt
Program Services$46,224ProgramServicesAmt
Management And General$10,142ManagementAndGeneralAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$114,803,000TotalAmt
Program Services$91,140,441ProgramServicesAmt
Management And General$23,662,559ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Total Joint Costs TotalJointCostsGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$4,136,429BOYAmt
EOY$3,494,259EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$7,602,563BOYAmt
EOY$7,644,158EOYAmt

Receivables From Officers Etc ReceivablesFromOfficersEtcGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$327,341BOYAmt
EOY$311,222EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$33,968,992LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$9,688,487LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$23,782,240BOYAmt
EOY$24,280,505EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Other Securities InvestmentsOtherSecuritiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Intangible Assets IntangibleAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$591,372BOYAmt
EOY$519,694EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$36,439,945BOYAmt
EOY$36,249,838EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$16,204,033BOYAmt
EOY$16,111,438EOYAmt

Grants Payable GrantsPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Deferred Revenue DeferredRevenueGrp

FieldValueIRS element (for citing)
BOY$4,173,299BOYAmt
EOY$3,753,966EOYAmt

Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Escrow Account Liability EscrowAccountLiabilityGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$6,266,377BOYAmt
EOY$6,968,064EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$26,643,709BOYAmt
EOY$26,833,468EOYAmt
FieldValueIRS element (for citing)
Organization Follows SFAS117Yes (X)OrganizationFollowsSFAS117Ind

Unrestricted Net Assets UnrestrictedNetAssetsGrp

FieldValueIRS element (for citing)
BOY$9,796,236BOYAmt
EOY$9,416,370EOYAmt

Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$9,796,236BOYAmt
EOY$9,416,370EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$36,439,945BOYAmt
EOY$36,249,838EOYAmt
FieldValueIRS element (for citing)
Info In Schedule O Part XIYes (X)InfoInScheduleOPartXIInd
Reconcilation Revenue Expnss-$41,169,000ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$0NetUnrlzdGainsLossesInvstAmt
Donated Services And Use Fclts$0DonatedServicesAndUseFcltsAmt
Investment Expense$0InvestmentExpenseAmt
Prior Period Adjustments$0PriorPeriodAdjustmentsAmt
Other Changes In Net Assets$40,789,134OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedYes (true)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (true)AuditCommitteeInd
Federal Grant Audit RequiredfalseFederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$0CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$0CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$0CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$0CurrentTaxYearMinus1YearAmt
Current Tax Year$0CurrentTaxYearAmt
Total$0TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$43,626,293CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$50,922,529CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$57,926,345CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$62,529,436CurrentTaxYearMinus1YearAmt
Current Tax Year$72,410,927CurrentTaxYearAmt
Total$287,415,530TotalAmt

Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Tax Rev Levied Orgnztnl Bnft509 TaxRevLeviedOrgnztnlBnft509Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Govt Furn Srvc Fclts Vl509 GovtFurnSrvcFcltsVl509Grp

FieldValueIRS element (for citing)
Total$0TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$43,626,293CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$50,922,529CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$57,926,345CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$62,529,436CurrentTaxYearMinus1YearAmt
Current Tax Year$72,410,927CurrentTaxYearAmt
Total$287,415,530TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$287,415,530PublicSupportTotal509Amt

Gross Investment Income509 GrossInvestmentIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$32,631CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$122,914CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$468,558CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$737,161CurrentTaxYearMinus1YearAmt
Current Tax Year$1,147,767CurrentTaxYearAmt
Total$2,509,031TotalAmt

Post1975 UBTI Post1975UBTIGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Investment Income And UBTI InvestmentIncomeAndUBTIGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$32,631CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$122,914CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$468,558CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$737,161CurrentTaxYearMinus1YearAmt
Current Tax Year$1,147,767CurrentTaxYearAmt
Total$2,509,031TotalAmt

Net Income From Other UBI NetIncomeFromOtherUBIGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Other Income509 OtherIncome509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$124,496CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$133,280CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$78,077CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$111,972CurrentTaxYearMinus1YearAmt
Current Tax Year$75,306CurrentTaxYearAmt
Total$523,131TotalAmt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years$43,783,420CurrentTaxYearMinus4YearsAmt
Current Tax Year Minus3 Years$51,178,723CurrentTaxYearMinus3YearsAmt
Current Tax Year Minus2 Years$58,472,980CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$63,378,569CurrentTaxYearMinus1YearAmt
Current Tax Year$73,634,000CurrentTaxYearAmt
Total$290,447,692TotalAmt
FieldValueIRS element (for citing)
Public Support CY5090.98956PublicSupportCY509Pct
Public Support PY5090.99232PublicSupportPY509Pct
Investment Income CY0.00864InvestmentIncomeCYPct
Investment Income PY0.00571InvestmentIncomePYPct
Thirty Thr Pct Suprt Tests CY509Yes (X)ThirtyThrPctSuprtTestsCY509Ind

Schedule D IRS990ScheduleD

FieldValueIRS element (for citing)
Art Public Exhibition AmountsArtPublicExhibitionAmountsGrp
Held Works ArtHeldWorksArtGrp
CY Minus3 Yr Endwmt FundCYMinus3YrEndwmtFundGrp
CY Minus4 Yr Endwmt FundCYMinus4YrEndwmtFundGrp

Land LandGrp

FieldValueIRS element (for citing)
Book Value$0BookValueAmt
FieldValueIRS element (for citing)
BuildingsBuildingsGrp

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$22,775,489OtherCostOrOtherBasisAmt
Depreciation$4,954,850DepreciationAmt
Book Value$17,820,639BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$10,884,390OtherCostOrOtherBasisAmt
Depreciation$4,733,637DepreciationAmt
Book Value$6,150,753BookValueAmt

Other Land Buildings OtherLandBuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$309,113OtherCostOrOtherBasisAmt
Book Value$309,113BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$24,280,505TotalBookValueLandBuildingsAmt
Federal Income Tax Liability$0FederalIncomeTaxLiabilityAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescDUE TO AFFILIATES - SHIDesc
Amt$6,968,064Amt
FieldValueIRS element (for citing)
Total Liability$6,968,064TotalLiabilityAmt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Idemnification Gross Up PmtsYes (X)IdemnificationGrossUpPmtsInd
Written Policy Ref T And E ExpnssYes (true)WrittenPolicyRefTAndEExpnssInd
Substantiation RequiredYes (true)SubstantiationRequiredInd
Compensation CommitteeYes (X)CompensationCommitteeInd
Independent ConsultantYes (X)IndependentConsultantInd
Written Employment ContractYes (X)WrittenEmploymentContractInd
Compensation SurveyYes (X)CompensationSurveyInd
Board Or Committee ApprovalYes (X)BoardOrCommitteeApprovalInd
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (17 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
Rodrigo Acosta MD
President & Chairman$597,488$0$0$0$116,871$0$18,000$0$38,957$0$771,316$0$0$0
Arghiris Barbadimos MD
PHYSICIAN$719,775$0$87,625$0$7,524$0$0$0$25,308$0$840,232$0$0$0
Charles Rosenstein MD
PHYSICIAN$751,573$0$0$0$5,544$0$0$0$37,308$0$794,425$0$0$0
Craig Olin MD
Director/Physician$555,032$0$193,977$0$1,932$0$10,000$0$39,190$0$800,131$0$0$0
Michael Ebright MD
Director/Physician$583,708$0$84,383$0$1,260$0$0$0$37,522$0$706,873$0$0$0
David Gruen MD
Director/Physician$554,258$0$60,000$0$1,932$0$18,000$0$39,190$0$673,380$0$0$0
Elizabeth Longmore
Chief Operating Officer$200,115$0$15,000$0$646$0$0$0$35,348$0$251,109$0$0$0
Joseph Costanzo MD
Physician/Treasurer$296,816$0$3,920$0$0$0$5,200$0$51,322$0$357,258$0$0$0
John Dowdle MD
Director/Physician$682,594$0$0$0$4,902$0$18,000$0$36,492$0$741,988$0$0$0
Allison Ostroff
Director/Physician$273,098$0$10,634$0$595$0$0$0$40,246$0$324,573$0$0$0
Ann Williams
Director/Physician$247,683$0$3,532$0$1,797$0$0$0$37,323$0$290,335$0$0$0
Gerald Rakos MD
Director/Physician$0$477,722$0$45,000$0$213$0$0$0$25,853$0$548,788$0$0
William Hines MD
Chief Medical Officer$429,157$0$25,190$0$5,544$0$18,000$0$25,022$0$502,913$0$0$0
Fortrella Cummings
CHIEF FINANCIAL OFFICER$249,486$0$25,000$0$1,260$0$0$0$15,447$0$291,193$0$0$0
RUSSELL CAVALLO MD
PHYSICIAN$630,285$0$25,000$0$966$0$0$0$36,179$0$692,430$0$0$0
JEFFREY GREEN MD
PHYSICIAN$665,471$0$0$0$1,710$0$18,000$0$38,968$0$724,149$0$0$0
SCOTT WEISS MD
PHYSICIAN$617,798$0$15,344$0$787$0$0$0$37,242$0$671,171$0$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferenceSCHEDULE J, PART I, LINE 1AFormAndLineReferenceDesc
ExplanationPresident & Chairman - RODRIGO ACOSTA Taxable Gross Up Payment $18,162 GROSS-UP PAYMENTS, PER POLICY, ARE PROCESSED ON ALL TAXABLE BENEFITS. TUITION IS PAID FOR RODRIGO ACOSTA, PRESIDENT AND CEO.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, LINE 6STAMFORD HEALTH MEDICAL GROUP ('SHMG') IS A CONNECTICUT NONSTOCK CORPORATION. SHMG HAS TWO CLASSES OF MEMBERS. CLASS A MEMBERS ARE THE PHYSICIANS EMPLOYED BY SHMG. THE CLASS B MEMBER IS THE STAMFORD HOSPITAL. FORM 990, PART VI, LINE 7A THE BOARD OF DIRECTORS SHALL TOTAL NINE MEMBERS. THE INITIAL BOARD WAS SELECTED BY THE INCORPORATOR, AND THEREAFTER THE BOARD WILL BE ELECTED AS FOLLOWS: (A) EIGHT MEMBERS OF THE BOARD OF DIRECTORS SHALL BE ELECTED BY THE CLASS A MEMBERS, SUBJECT TO THE APPROVAL OF THE CLASS B MEMBER, AND (B) ONE MEMBER OF THE BOARD OF DIRECTORS SHALL BE APPOINTED BY THE CLASS B MEMBER.
FORM 990, PART VI, LINE 7BALL POWERS OF SHMG SHALL BE EXERCISED BY AND UNDER THE AUTHORITY OF THE BOARD OF DIRECTORS, EXCEPT THAT THE CLASS B MEMBER SHALL HAVE THE SOLE AUTHORITY TO AMEND THE BYLAWS OF SHMG AND SELECT THE AUDITORS OF SHMG.
FORM 990, PART VI, LINE 11BSTAMFORD HEALTH MEDICAL GROUP (SHMG) HAS A COMPREHENSIVE REVIEW PROCESS IN PLACE RELATING TO THE REVIEW OF FORM 990. PRIOR TO FINALIZATION OF THE 990, MANAGEMENT PROVIDES THE DRAFT OF THE FORM 990 TO THE BOARD OF DIRECTORS. SHMG'S EXTERNAL TAX ACCOUNTANTS ADDRESS ANY SPECIFIC CONCERNS OR QUESTIONS WITH MANAGEMENT AND THE BOARD. THIS REVIEW PROCEDURE HELPS TO ASSURE SOUND REPORTING AND COMPLIANCE WITH TAX LAW.
FORM 990, PART VI, LINE 12CSHMG, AS A WHOLLY OWNED SUBSIDIARY OF THE STAMFORD HOSPITAL, FOLLOWS THE HOSPITAL'S CONFLICT OF INTEREST POLICY. IT IS THE POLICY TO PROHIBIT ITS EMPLOYEES AND OTHER ASSOCIATES FROM ENGAGING IN ANY ACTIVITY, PRACTICE, OR ACT WHICH CONFLICTS WITH, OR APPEARS TO CONFLICT WITH, THE INTERESTS OF THE ORGANIZATION. EMPLOYEES ARE EXPECTED TO CONDUCT THE BUSINESS OF SHMG TO THE BEST OF THEIR ABILITY AND FOR THE BENEFIT OF SHMG AND ITS PATIENTS. THE POLICY ALSO REQUIRES BOARD MEMBERS, OFFICERS, SENIOR LEADERS, MEDICAL STAFF LEADERS, COMMITTEE MEMBERS AND OTHER INDIVIDUALS AS APPROPRIATE TO DISCLOSE ANY POTENTIAL CONFLICT OF INTEREST THEY OR THEIR IMMEDIATE FAMILY MAY HAVE ON AN ANNUAL BASIS. SURVEYS ARE DISTRIBUTED ANNUALLY AND TIMELY RECEIPT IS MONITORED BY THE HOSPITAL'S COMPLIANCE DEPARTMENT.
FORM 990, PART VI, LINES 15A & 15BIT IS THE POLICY OF SHMG TO PAY EMPLOYEES FAIR AND COMPETITIVE WAGES. SHMG HAS ADOPTED A WAGE AND SALARY PROGRAM TO ENSURE THAT ALL EMPLOYEES ARE PAID IN RELATION TO THE VALUE OF THE WORK THEY PERFORM. THIS PROGRAM IS REVIEWED ANNUALLY. EXECUTIVE COMPENSATION IS SUBJECT TO A MORE COMPREHENSIVE REVIEW, INCLUDING AN ANNUAL BENCHMARKING ANALYSIS.
FORM 990, PART VI, LINE 19SHMG MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST.
FORM 990, PART XI, LINE 9EQUITY TRANSFER FROM STAMFORD HOSPITAL DEBT FORGIVENESS $40,789,134

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationInd
STAMFORD HEALTH INC
ONE HOSPITAL PLAZA PO BOX 9317STAMFORDCT06904222476636PARENTCT501(c)(3)12Bnafalse
THE STAMFORD HOSPITAL FOUNDATION
ONE HOSPITAL PLAZA PO BOX 9317STAMFORDCT06904222478748FUNDRAISINGCT501(c)(3)10SHIYes (true)
THE STAMFORD HOSPITAL
ONE HOSPITAL PLAZA PO BOX 9317STAMFORDCT06904060646917HOSPITALCT501(c)(3)3SHIYes (true)

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp

Related Organization Name RelatedOrganizationName

FieldValueIRS element (for citing)
Business Name Line1Healthstar Indemnity Co LimitedBusinessNameLine1Txt

Foreign Address ForeignAddress

FieldValueIRS element (for citing)
Address Line1Wellesley Hse South 1st Floor 90 PiAddressLine1Txt
CityPembrokeCityNm
Province Or StateBERMUDAProvinceOrStateNm
CountryBDCountryCd
Foreign PostalHM08ForeignPostalCd
FieldValueIRS element (for citing)
Primary ActivitiesSelf InsurancePrimaryActivitiesTxt
Legal Domicile Foreign CountryBDLegalDomicileForeignCountryCd

Direct Controlling Entity Name DirectControllingEntityName

FieldValueIRS element (for citing)
Business Name Line1TSHBusinessNameLine1Txt
FieldValueIRS element (for citing)
Entity TypeC CorpEntityTypeTxt
Share Of Total Income$0ShareOfTotalIncomeAmt
Share Of EOY Assets$0ShareOfEOYAssetsAmt
Ownership0.00000OwnershipPct
Controlled OrganizationYes (true)ControlledOrganizationInd
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts RyltsfalseReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth OrgfalseGiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth OrgfalseGiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other OrgfalseLoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth OrgfalseLoansOrGuaranteesFromOthOrgInd
Div Related OrganizationfalseDivRelatedOrganizationInd
Asset Sale To Other OrgfalseAssetSaleToOtherOrgInd
Asset Purchase From Other OrgfalseAssetPurchaseFromOtherOrgInd
Asset ExchangefalseAssetExchangeInd
Rental Of Facilities To Oth OrgfalseRentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth OrgYes (true)RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth OrgfalsePerformOfServicesForOthOrgInd
Perform Of Services By Other OrgfalsePerformOfServicesByOtherOrgInd
Sharing Of FacilitiesfalseSharingOfFacilitiesInd
Paid Employees SharingYes (true)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgfalseReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other OrgfalseReimbursementPaidByOtherOrgInd
Transfer To Other OrgfalseTransferToOtherOrgInd
Transfer From Other OrgYes (true)TransferFromOtherOrgInd

Transactions Related Org TransactionsRelatedOrgGrp (4 entries)

Transaction TypeTransactionTypeTxtInvolvedInvolvedAmtMethod Of Amount DeterminationMethodOfAmountDeterminationTxt
Stamford Health Inc
k$701,688Book Value
The Stamford Hospital
k$686,775Book Value
The Stamford Hospital
s$40,789,494Book Value
The Stamford Hospital
o$164,775Book Value