ST JOSEPH HOME CARE NETWORK: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- ST JOSEPH HOME CARE NETWORK (EIN 68-0331084)
- Tax period
- 2015-07-01 to 2016-06-30
- Filed
- 2017-05-12
- IRS object ID
- 201701329349307065
- Schema version
- 2015v3.0
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule C
- Schedule D
- Schedule I
- Schedule J
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2017-05-12T17:08:08-05:00 | ReturnTs |
| Tax Period End | 2016-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ERNST & YOUNG US LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 18101 VON KARMAN AVE STE 1700 | AddressLine1Txt |
| City | IRVINE | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 92612 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 680331084 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ST JOSEPH HOME CARE NETWORK | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % VINCENT CASTALDO | InCareOfNm |
| Business Name Control | STJO | BusinessNameControlTxt |
| Phone | 9493814513 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1111 SONOMA AVE STE 308 | AddressLine1Txt |
| City | SANTA ROSA | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95405 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | VINCENT CASTALDO | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 7147127149 | PhoneNum |
| Signature | 2017-05-12 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | KARA ADAMS | PreparerPersonNm |
| PTIN | P01254678 | PTIN |
| Phone | 9497942300 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2021-01-29 14:40:06Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MARK PROVAN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1111 SONOMA AVE STE 308 | AddressLine1Txt |
| City | SANTA ROSA | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 95405 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $10,812,537 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.STJOSEPHHOMECARE.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1994 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | WE ARE COMMITTED TO EXTENDING THE TRADITION OF THE SISTERS OF ST. JOSEPH OF ORANGE BY CONTINUALLY IMPROVING THE HEALTH AND QUALITY OF LIFE IN THE COMMUNITIES WE SERVE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 0 | VotingMembersIndependentCnt |
| Total Employee | 93 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| PY Contributions Grants | $5,247 | PYContributionsGrantsAmt |
| CY Contributions Grants | $28,034 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $9,218,733 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $10,782,738 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,378 | PYOtherRevenueAmt |
| CY Other Revenue | $1,765 | CYOtherRevenueAmt |
| PY Total Revenue | $9,225,358 | PYTotalRevenueAmt |
| CY Total Revenue | $10,812,537 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $5,247 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $5,404 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $6,603,401 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $6,264,756 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $4,243,326 | PYOtherExpensesAmt |
| CY Other Expenses | $5,703,529 | CYOtherExpensesAmt |
| PY Total Expenses | $10,851,974 | PYTotalExpensesAmt |
| CY Total Expenses | $11,973,689 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$1,626,616 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$1,161,152 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $2,216,475 | TotalAssetsBOYAmt |
| Total Assets EOY | $2,501,597 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $11,261,145 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $12,803,032 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$9,044,670 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$10,301,435 | NetAssetsOrFundBalancesEOYAmt |
| Mission | WE ARE COMMITTED TO EXTENDING THE TRADITION OF THE SISTERS OF ST. JOSEPH OF ORANGE BY CONTINUALLY IMPROVING THE HEALTH AND QUALITY OF LIFE IN THE COMMUNITIES WE SERVE. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $9,370,957 | ExpenseAmt |
| Grant | $5,404 | GrantAmt |
| Revenue | $10,784,503 | RevenueAmt |
| Desc | THE PRIMARY SERVICE PROVIDED BY THE AGENCY IS HOME CARE SERVICES IN THE FORM OF NURSING, PHYSICAL THERAPY, OCCUPATIONAL THERAPY, SPEECH THERAPY, SOCIAL WORK AND AID SERVICES. | Desc |
| Total Program Service Expenses | $9,370,957 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (true) | 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 | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | 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 | Yes (true) | 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 | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (true) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (true) | TransactionWithControlEntInd |
| 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 | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 93 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| 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 |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 0 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | Yes (true) | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (true) | 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 | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | CA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | VINCENT CASTALDO | PersonNm |
| Phone | 7147127149 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 200 W CENTER STREET PROMENADE STE | AddressLine1Txt |
| City | ANAHEIM | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 92805 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (22 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd | Former Ofcr Director TrusteeFormerOfcrDirectorTrusteeInd |
|---|---|---|---|---|---|---|---|---|---|
| MARY BARTLEY | |||||||||
| TRUSTEE | 2.0 | 50.0 | Yes (X) | $0 | $180,273 | $31,383 | |||
| JAYNIE BOREN | |||||||||
| TRUSTEE | 2.0 | 57.0 | Yes (X) | $0 | $427,709 | $32,872 | |||
| ROBERT DIEHL | |||||||||
| TRUSTEE (PART YEAR) | 2.0 | 50.0 | Yes (X) | $0 | $311,271 | $58,694 | |||
| MAUREEN DISBOT | |||||||||
| TRUSTEE | 2.0 | 50.0 | Yes (X) | $0 | $435,398 | $23,741 | |||
| DANIEL DWYER | |||||||||
| TRUSTEE | 2.0 | 53.0 | Yes (X) | $0 | $318,745 | $41,808 | |||
| KEVIN KLOCKENGA | |||||||||
| CHAIRMAN/TRUSTEE | 5.0 | 45.0 | Yes (X) | $0 | $1,021,111 | $33,602 | Yes (X) | ||
| WALTER MICKENS | |||||||||
| VICE CHAIRMAN/TRUSTEE | 4.0 | 51.0 | Yes (X) | $0 | $610,506 | $58,983 | Yes (X) | ||
| DR JAMES NEEL | |||||||||
| TRUSTEE | 2.0 | 50.0 | Yes (X) | $0 | $320,180 | $0 | |||
| DAVID O'BRIEN | |||||||||
| TRUSTEE | 2.0 | 52.0 | Yes (X) | $0 | $692,274 | $42,772 | |||
| MARK PROVAN | |||||||||
| EXECUTIVE DIRECTOR/TRUSTEE | 27.0 | 25.0 | Yes (X) | $0 | $141,086 | $12,157 | Yes (X) | ||
| MICHEL RICCIONI | |||||||||
| TRUSTEE | 2.0 | 50.0 | Yes (X) | $0 | $752,852 | $46,110 | |||
| OLUYEMI ADEYANJU | |||||||||
| SECRETARY | 2.0 | 58.0 | $0 | $166,282 | $2,087 | Yes (X) | |||
| VINCENT CASTLADO | |||||||||
| CHIEF FINANCIAL OFFICER | 25.0 | 25.0 | $0 | $229,501 | $49,004 | Yes (X) | |||
| SUE SQUIBB | |||||||||
| INTERIM EXEC. DIRECTOR (PT YR) | 50.0 | 0.0 | $0 | $0 | $0 | Yes (X) | |||
| KATHY NEIL | |||||||||
| INTAKE ASSESSMENT RN | 50.0 | 0.0 | $121,769 | $0 | $23,522 | Yes (X) | |||
| JOHN REBER | |||||||||
| HOME HEALTH RN II | 50.0 | 0.0 | $137,409 | $0 | $33,057 | Yes (X) | |||
| KIM LE BLANC | |||||||||
| PHYSICAL THERAPIST | 50.0 | 0.0 | $107,694 | $0 | $35,188 | Yes (X) | |||
| MAUREEN MALONEY | |||||||||
| HOME HEALTH RN II | 50.0 | 0.0 | $106,987 | $0 | $16,363 | Yes (X) | |||
| KUANYAN FRANZ | |||||||||
| PHYSICAL THERAPIST | 50.0 | 0.0 | $103,465 | $0 | $18,266 | Yes (X) | |||
| LINDA GLOMP | |||||||||
| FORMER EXECUTIVE DIRECTOR | 0.0 | 50.0 | $0 | $288,620 | $37,650 | Yes (X) | |||
| JOSEPH ROGERS | |||||||||
| FORMER OFFICER/TRUSTEE | 0.0 | 0.0 | $0 | $159,991 | $0 | Yes (X) | |||
| KRISTY NICKOLS | |||||||||
| FORMER STAFF RN - CNA | 0.0 | 50.0 | $0 | $107,151 | $26,566 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $577,324 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $6,162,950 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $623,825 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 6 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | Yes (true) | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (3 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| MEDICAL STAFFING NETWORK | |||||
| PO BOX 840292 | DALLAS | TX | 752840292 | MEDICAL STAFFING | $2,114,191 |
| THE CORRIDOR GROUP | |||||
| 6405 METCALF SUITE 108 | OVERLAND PARK | KS | 66202 | MANAGEMENT SERVICES | $604,013 |
| DAYMARK LLC | |||||
| 605 METCALF SUITE 108 | OVERLAND PARK | KS | 66202 | CODING SERVICES | $167,731 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 3 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $22,630 | RelatedOrganizationsAmt |
| All Other Contributions | $5,404 | AllOtherContributionsAmt |
| Noncash Contributions | $0 | NoncashContributionsAmt |
| Total Contributions | $28,034 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PATIENT REVENUE | Desc |
| Business | 621610 | BusinessCd |
| Total Revenue Column | $10,782,738 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $10,782,738 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $10,782,738 | 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 |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | MISCELLANEOUS REVENUE | Desc |
| Business | 561110 | BusinessCd |
| Total Revenue Column | $1,765 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,765 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $1,765 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $10,812,537 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $10,784,503 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | 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 |
| Program Services | $0 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,404 | TotalAmt |
| Program Services | $5,404 | ProgramServicesAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $322,131 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $322,131 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,060,739 | TotalAmt |
| Program Services | $3,745,197 | ProgramServicesAmt |
| Management And General | $315,542 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $186,292 | TotalAmt |
| Program Services | $171,816 | ProgramServicesAmt |
| Management And General | $14,476 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,352,655 | TotalAmt |
| Program Services | $1,247,546 | ProgramServicesAmt |
| Management And General | $105,109 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $342,939 | TotalAmt |
| Program Services | $316,291 | ProgramServicesAmt |
| Management And General | $26,648 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $743,988 | TotalAmt |
| Program Services | $587,751 | ProgramServicesAmt |
| Management And General | $156,237 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,411 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $24,411 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $812 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $812 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,410,115 | TotalAmt |
| Program Services | $2,667,172 | ProgramServicesAmt |
| Management And General | $742,943 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,915 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $4,915 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $164,233 | TotalAmt |
| Program Services | $387 | ProgramServicesAmt |
| Management And General | $163,846 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $203,817 | TotalAmt |
| Program Services | $158,977 | ProgramServicesAmt |
| Management And General | $44,840 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $190,233 | TotalAmt |
| Program Services | $125,949 | ProgramServicesAmt |
| Management And General | $64,284 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Fundraising | $0 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $22,451 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $22,451 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $0 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $247,064 | TotalAmt |
| Program Services | $192,710 | ProgramServicesAmt |
| Management And General | $54,354 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $21,852 | TotalAmt |
| Program Services | $0 | ProgramServicesAmt |
| Management And General | $21,852 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| DUES AND SUBSCRIPTION | $427,090 | $589 | $426,501 | $0 |
| MEDICAL SUPPLIES | $151,168 | $151,168 | $0 | $0 |
| LICENSES AND TAXES | $29,045 | $0 | $29,045 | $0 |
| OTHER EXPENSES | $62,335 | $0 | $62,335 | $0 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,973,689 | TotalAmt |
| Program Services | $9,370,957 | ProgramServicesAmt |
| Management And General | $2,602,732 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Total Joint Costs TotalJointCostsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $38,209 | BOYAmt |
| EOY | $91,311 | 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 | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,562,514 | BOYAmt |
| EOY | $2,013,253 | 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 | $22,456 | BOYAmt |
| EOY | $21,864 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $1,327,576 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $952,407 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $593,296 | BOYAmt |
| EOY | $375,169 | 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 | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,216,475 | BOYAmt |
| EOY | $2,501,597 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $702,311 | BOYAmt |
| EOY | $836,672 | 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 | $0 | BOYAmt |
| EOY | $0 | 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 | $10,558,834 | BOYAmt |
| EOY | $11,966,360 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $11,261,145 | BOYAmt |
| EOY | $12,803,032 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$9,081,479 | BOYAmt |
| EOY | -$10,301,435 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $36,809 | 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 | -$9,044,670 | BOYAmt |
| EOY | -$10,301,435 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,216,475 | BOYAmt |
| EOY | $2,501,597 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$1,161,152 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $0 | NetUnrlzdGainsLossesInvstAmt |
| Donated Services And Use Fclts | $0 | DonatedServicesAndUseFcltsAmt |
| Investment Expense | $0 | InvestmentExpenseAmt |
| Prior Period Adjustments | $0 | PriorPeriodAdjustmentsAmt |
| Other Changes In Net Assets | -$95,613 | OtherChangesInNetAssetsAmt |
| 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) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| 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) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $99,869 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $5,276 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $5,345 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $5,247 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $28,034 | CurrentTaxYearAmt |
| Total | $143,771 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $9,628,278 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $9,571,481 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $9,482,156 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $9,218,733 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $10,782,738 | CurrentTaxYearAmt |
| Total | $48,683,386 | TotalAmt |
Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Tax Rev Levied Orgnztnl Bnft509 TaxRevLeviedOrgnztnlBnft509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Govt Furn Srvc Fclts Vl509 GovtFurnSrvcFcltsVl509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $9,728,147 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $9,576,757 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $9,487,501 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $9,223,980 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $10,810,772 | CurrentTaxYearAmt |
| Total | $48,827,157 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $48,827,157 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $125 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $0 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $0 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $0 | CurrentTaxYearMinus1YearAmt |
| Total | $125 | TotalAmt |
Post1975 UBTI Post1975UBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $125 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $0 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $0 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $0 | CurrentTaxYearMinus1YearAmt |
| Total | $125 | TotalAmt |
Net Income From Other UBI NetIncomeFromOtherUBIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus2 Years | $1,248 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,378 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $1,765 | CurrentTaxYearAmt |
| Total | $4,391 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $9,728,272 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $9,576,757 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $9,488,749 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $9,225,358 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $10,812,537 | CurrentTaxYearAmt |
| Total | $48,831,673 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99991 | PublicSupportCY509Pct |
| Public Support PY509 | 1.00000 | PublicSupportPY509Pct |
| Investment Income CY | 0.00000 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00000 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Grassroots Lobbying | TotalGrassrootsLobbyingGrp | |
| Total Direct Lobbying | TotalDirectLobbyingGrp | |
| Total Lobbying Expend | TotalLobbyingExpendGrp | |
| Other Exempt Purpose Expend | OtherExemptPurposeExpendGrp | |
| Total Exempt Purpose Expend | TotalExemptPurposeExpendGrp | |
| Lobbying Nontaxable Amount | LobbyingNontaxableAmountGrp | |
| Grassroots Nontaxable | GrassrootsNontaxableGrp | |
| Tot Lbbyng Grassroot Mns Non Tx | TotLbbyngGrassrootMnsNonTxGrp | |
| Tot Lbby Expend Mns Lbbyng Non Tx | TotLbbyExpendMnsLbbyngNonTxGrp | |
| Volunteers | false | VolunteersInd |
| Paid Staff Or Management | false | PaidStaffOrManagementInd |
| Media Advertisements | false | MediaAdvertisementsInd |
| Media Advertisements | $0 | MediaAdvertisementsAmt |
| Mailings Members | false | MailingsMembersInd |
| Mailings Members | $0 | MailingsMembersAmt |
| Publications Or Broadcast | false | PublicationsOrBroadcastInd |
| Publications Or Broadcast | $0 | PublicationsOrBroadcastAmt |
| Grants Other Organizations | false | GrantsOtherOrganizationsInd |
| Grants Other Organizations | $0 | GrantsOtherOrganizationsAmt |
| Direct Contact Legislators | false | DirectContactLegislatorsInd |
| Direct Contact Legislators | $0 | DirectContactLegislatorsAmt |
| Rallies Demonstrations | false | RalliesDemonstrationsInd |
| Rallies Demonstrations | $0 | RalliesDemonstrationsAmt |
| Other Activities | Yes (true) | OtherActivitiesInd |
| Other Activities | $812 | OtherActivitiesAmt |
| Total Lobbying Expenditures | $812 | TotalLobbyingExpendituresAmt |
| Not Described Section501c3 | false | NotDescribedSection501c3Ind |
| Form4720 Filed4912 Tax | false | Form4720Filed4912TaxInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE C, PART II-B, LINE 1I | FormAndLineReferenceDesc |
| Explanation | LOBBYING ACTIVITIES DURING THE YEAR, ST. JOSEPH HEALTH SYSTEM CONDUCTED ADVOCACY EFFORTS WHICH INCLUDED SOME LOBBYING ACTIVITIES. THESE ACTIVITIES INCLUDED MEETING WITH LOCAL, STATE AND FEDERAL LEGISLATORS, THEIR STAFF AND OTHER GOVERNMENTAL OFFICIALS, AS WELL AS COMMUNICATION TO LEGISLATORS ADVOCATING POSITIONS ON LEGISLATION. THE LOBBYING EXPENDITURES REPORTED REPRESENTS THE PORTION OF DUES ALLOCATED TO ST. JOSEPH HOME CARE NETWORK. | ExplanationTxt |
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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Book Value | $0 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Book Value | $0 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $38,259 | OtherCostOrOtherBasisAmt |
| Depreciation | $14,028 | DepreciationAmt |
| Book Value | $24,231 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,289,317 | OtherCostOrOtherBasisAmt |
| Depreciation | $938,379 | DepreciationAmt |
| Book Value | $350,938 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Land Buildings | OtherLandBuildingsGrp | |
| Total Book Value Land Buildings | $375,169 | TotalBookValueLandBuildingsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | INTERCOMPANY DUE TO AFFILIATES | Desc |
| Amt | $11,966,360 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $11,966,360 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE D, PART X, LINE 2 | FormAndLineReferenceDesc |
| Explanation | FIN 48(ASC740) Footnote ACCOUNTING STANDARDS CODIFICATION (ASC 740), INCOME TAXES, CLARIFIES THE ACCOUNTING FOR INCOME TAXES BY PRESCRIBING A MINIMUM RECOGNITION THRESHOLD THAT A TAX POSITION IS REQUIRED TO MEET BEFORE BEING RECOGNIZED IN THE FINANCIAL STATEMENTS. ASC 740 ALSO PROVIDES GUIDANCE ON DERECOGNITION, MEASUREMENT, CLASSIFICATION, INTEREST AND PENALTIES, DISCLOSURE, AND TRANSITION. THE GUIDANCE IS APPLICABLE TO PASS-THROUGH ENTITIES AND TAX-EXEMPT ORGANIZATIONS. NO SIGNIFICANT TAX LIABILITY FOR TAX BENEFITS, INTEREST OR PENALTIES WAS ACCRUED AT JUNE 30, 2016 OR 2015. | ExplanationTxt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (true) | GrantRecordsMaintainedInd |
Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Type | SJHS Wellness Grant | GrantTypeTxt |
| Recipient | 42 | RecipientCnt |
| Non Cash Assistance | $5,404 | NonCashAssistanceAmt |
| Valuation Method Used | FMV | ValuationMethodUsedDesc |
| Non Cash Assistance | MED SUPP & GROCERIES | NonCashAssistanceDesc |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE I, PART I, LINE 2 | FormAndLineReferenceDesc |
| Explanation | ST. JOSEPH WELLNESS GRANTS ARE USED TO HELP PATIENTS GET WELL BY PROVIDING PATIENTS WITH GROCERY VOUCHERS, GAS VOUCHERS, MEDICAL SUPPLIES, AND DURABLE MEDICAL EQUIPMENT ON BEHALF OF THE PATIENTS. THE ADMINISTRATIVE ASSISTANT PURCHASES VOUCHERS, SUPPLIES, AND EQUIPMENT AS NEEDED. THE CASE MANAGERS OR SOCIAL WORKERS DISTRIBUTE TO PATIENTS, AND SIGNED RECEIPTS ARE REQUIRED. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | Yes (true) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | 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 (17 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| OLUYEMI ADEYANJU | ||||||||||||||
| SECRETARY | $0 | $124,705 | $0 | $30,000 | $0 | $11,577 | $0 | $0 | $0 | $2,087 | $0 | $168,369 | $0 | $0 |
| MARY BARTLEY | ||||||||||||||
| TRUSTEE | $0 | $153,814 | $0 | $22,447 | $0 | $4,012 | $0 | $12,355 | $0 | $19,028 | $0 | $211,656 | $0 | $0 |
| JAYNIE BOREN | ||||||||||||||
| TRUSTEE | $0 | $289,266 | $0 | $110,871 | $0 | $27,572 | $0 | $10,600 | $0 | $22,272 | $0 | $460,581 | $0 | $0 |
| VINCENT CASTLADO | ||||||||||||||
| CHIEF FINANCIAL OFFICER | $0 | $187,526 | $0 | $36,221 | $0 | $5,754 | $0 | $23,231 | $0 | $25,773 | $0 | $278,505 | $0 | $0 |
| ROBERT DIEHL | ||||||||||||||
| TRUSTEE (PART YEAR) | $0 | $216,007 | $0 | $66,474 | $0 | $28,790 | $0 | $15,579 | $0 | $43,115 | $0 | $369,965 | $0 | $0 |
| MAUREEN DISBOT | ||||||||||||||
| TRUSTEE | $0 | $296,147 | $0 | $109,625 | $0 | $29,626 | $0 | $4,396 | $0 | $19,345 | $0 | $459,139 | $0 | $0 |
| DANIEL DWYER | ||||||||||||||
| TRUSTEE | $0 | $225,566 | $0 | $68,514 | $0 | $24,665 | $0 | $8,612 | $0 | $33,196 | $0 | $360,553 | $0 | $0 |
| KEVIN KLOCKENGA | ||||||||||||||
| CHAIRMAN/TRUSTEE | $0 | $626,686 | $0 | $314,627 | $0 | $79,798 | $0 | $13,250 | $0 | $20,352 | $0 | $1,054,713 | $0 | $0 |
| WALTER MICKENS | ||||||||||||||
| VICE CHAIRMAN/TRUSTEE | $0 | $380,841 | $0 | $181,303 | $0 | $48,362 | $0 | $12,831 | $0 | $46,152 | $0 | $669,489 | $0 | $0 |
| DR JAMES NEEL | ||||||||||||||
| TRUSTEE | $0 | $320,180 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $0 | $320,180 | $0 | $0 |
| DAVID O'BRIEN | ||||||||||||||
| TRUSTEE | $0 | $425,145 | $0 | $200,374 | $0 | $66,755 | $0 | $16,228 | $0 | $26,544 | $0 | $735,046 | $0 | $0 |
| MARK PROVAN | ||||||||||||||
| EXECUTIVE DIRECTOR/TRUSTEE | $0 | $70,501 | $0 | $58,100 | $0 | $12,485 | $0 | $5,662 | $0 | $6,495 | $0 | $153,243 | $0 | $0 |
| MICHEL RICCIONI | ||||||||||||||
| TRUSTEE | $0 | $374,936 | $0 | $141,096 | $0 | $236,820 | $0 | $18,347 | $0 | $27,763 | $0 | $798,962 | $0 | $181,755 |
| LINDA GLOMP | ||||||||||||||
| FORMER EXECUTIVE DIRECTOR | $0 | $212,125 | $0 | $49,029 | $0 | $27,466 | $0 | $15,671 | $0 | $21,979 | $0 | $326,270 | $0 | $0 |
| KRISTY NICKOLS | ||||||||||||||
| FORMER STAFF RN - CNA | $0 | $107,110 | $0 | $0 | $0 | $41 | $0 | $9,871 | $0 | $16,695 | $0 | $133,717 | $0 | $0 |
| JOHN REBER | ||||||||||||||
| HOME HEALTH RN II | $137,409 | $0 | $0 | $0 | $0 | $0 | $11,274 | $0 | $21,783 | $0 | $170,466 | $0 | $0 | $0 |
| JOSEPH ROGERS | ||||||||||||||
| FORMER OFFICER/TRUSTEE | $0 | $0 | $0 | $0 | $0 | $159,991 | $0 | $0 | $0 | $0 | $0 | $159,991 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE J, PART I, LINE 3 | COMPENSATION REVIEW THE ORGANIZATION'S EXECUTIVE DIRECTOR IS PAID BY A TAX EXEMPT RELATED ORGANIZATION, SANTA ROSA MEMORIAL HOSPITAL, AND IS DISCLOSED AS A PERSON PAID BY A RELATED ORGANIZATION. THE BOARD CHAIR IN CONSULTATION WITH HEALTH SYSTEM HUMAN RESOURCES ANNUALLY REVIEWS MARKET INFORMATION FROM VARIOUS SOURCES TO SET EXECUTIVE DIRECTOR COMPENSATION. SCHEDULE J, PART I, LINE 4A THE FOLLOWING INDIVIDUAL RECEIVED A SEVERANCE PAYMENT DURING THE YEAR: JOSEPH ROGERS - $159,991 |
| SCHEDULE J, PART I, LINE 4B | BEGINNING IN JULY 2015, NEW EXECUTIVES PARTICIPATE IN A NON-QUALIFIED SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN. THE PLAN PROVIDES FOR EMPLOYER CONTRIBUTIONS BASED ON A PERCENTAGE OF EXECUTIVE BASE SALARY AND ARE SUBJECT TO A FIVE YEAR OR AGE 65 VESTING SCHEDULE. EXECUTIVES PREVIOUSLY PARTICIPATED IN ANOTHER NON-QUALIFIED DEFERRED COMPENSATION PLAN THAT WAS FROZEN EFFECTIVE DECEMBER 2007, AFTER WHICH TIME NO FURTHER CONTRIBUTIONS WERE PERMITTED. THIS FROZEN PLAN WILL CEASE TO EXIST ONCE ALL BENEFITS HAVE BEEN DISTRIBUTED IN ACCORDANCE WITH PROVISIONS OF THE PLAN. THE FOLLOWING INDIVIDUAL RECEIVED 457(F) PAYMENTS DURING THE YEAR: MICHEL RICCIONI: $181,755. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (18 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART I, LINE 4 | BOARD MEMBER INDEPENDENCE PER THE BYLAWS OF ST. JOSEPH HOME CARE NETWORK, TRUSTEES ARE EMPLOYEES OF EITHER THE REPORTING ORGANIZATION OR A RELATED ORGANIZATION. AS THEY RECEIVE COMPENSATION FOR THEIR EMPLOYMENT, THEY ARE NOT CONSIDERED TO BE INDEPENDENT. |
| FORM 990, PART V, LINE 1 | ST. JOSEPH HEALTH SYSTEM (SJHS) PAYS ALL VENDORS FOR SJH ENTITIES UNDER SJH AP SHARED SERVICES. THEREFORE, SJHS ISSUES FORM 1099-MISC UNDER ITS TAX ID. SJHS COMPLIES WITH BACKUP WITHHOLDING RULES FOR REPORTABLE PAYMENTS TO VENDORS. |
| FORM 990, PART VI, LINE 3 | DELEGATION OF CONTROL OVER MANAGEMENT DUTIES INTERIM EXECUTIVE DIRECTOR WAS A CONSULTANT FOR JULY, AUGUST, AND ONE HALF OF SEPTEMBER 2015. THE CONSULTANT PERFORMED EXECUTIVE MANAGEMENT SERVICES, INCLUDING MANAGING DAILY OPERATIONS. THE CONSULTANT WAS FROM THE CORRIDOR GROUP. COMPENSATION PAID FOR THESE SERVICES DURING THIS PERIOD WAS $52,500. |
| FORM 990, PART VI, LINE 6 | DESCRIPTION OF MEMBERS OF STOCKHOLDERS THE CORPORATE MEMBERS FOR ST. JOSEPH HOME CARE NETWORK ARE ST. JOSEPH HOSPITAL OF EUREKA, REDWOOD MEMORIAL HOSPITAL, QUEEN OF THE VALLEY MEDICAL CENTER AND SANTA ROSA MEMORIAL HOSPITAL. |
| FORM 990, PART VI, LINE 7A | DESCRIPTION OF CLASSES OF PERSONS AND THE NATURE OF THEIR RIGHTS ALL NOMINEES SHALL BE APPOINTED TO THE CORPORATION'S BOARD OF TRUSTEES BY THE CORPORATE MEMBERS, SUBJECT TO APPROVAL OF ST. JOSEPH HEALTH SYSTEM, EXCEPT THOSE NOMINEES WHO ARE MEMBERS OF THE SISTERS OF ST. JOSEPH OF ORANGE WHO SHALL BE NOMINATED BY THE CORPORATE MEMBER OF ST. JOSEPH HEALTH SYSTEM AND SHALL REQUIRE NO FURTHER APPROVAL. |
| FORM 990, PART VI, LINE 7B | DESCR CLASSES OF PERSONS, DECISIONS REQ APPR & TYPE OF VOTING RIGHTS THE RESERVED RIGHTS IN OUR TIERED GOVERNANCE STRUCTURE CONTEMPLATE APPROVAL BY THE CORPORATE MEMBERS OF FINANCING, BUDGETS, UNBUDGETED EXPENDITURES OF DEFINED AMOUNTS, STRATEGIC PLAN, APPOINTMENT OF AUDITORS, CREATION OR INVESTMENT IN A LEGALLY RECOGNIZED ENTITY, JOINT VENTURES, PURPOSES, SALE OR DISPOSITION OF REAL PROPERTY, MERGER OR SALE OF SUBSTANTIALLY ALL ASSETS, APPOINTMENT AND REMOVAL OF TRUSTEES, ADOPTION OR AMENDMENT OF ARTICLES OR BYLAWS. THE CORPORATE MEMBERS FOR ST. JOSEPH HOME CARE NETWORK ARE ST. JOSEPH HOSPITAL OF EUREKA, REDWOOD MEMORIAL HOSPITAL, QUEEN OF THE VALLEY MEDICAL CENTER AND SANTA ROSA MEMORIAL HOSPITAL. |
| FORM 990, PART VI, LINE 11B | PROCESS USED BY MANAGEMENT AND/OR GOVERNING BODY TO REVIEW 990 THE FORM 990 IS PREPARED BY THE FINANCE DEPARTMENT BASED ON INFORMATION RECEIVED FROM VARIOUS DEPARTMENTS OF THE ORGANIZATION, AS APPLICABLE. THE FORM 990 IS THEN REVIEWED BY AN OFFICER OF THE ORGANIZATION. A COPY OF THE FORM 990 FILING IS DISTRIBUTED TO ALL VOTING MEMBERS OF THE BOARD FOR THE MAY 2017 MEETING. DURING THE FULL BOARD MEETING, MEMBERS OF THE FINANCE DEPARTMENT ARE PRESENT AND DISCUSS CERTAIN DISCLOSURES AND INFORMATION INCLUDED IN THE FORM 990. |
| FORM 990, PART VI, LINE 12C | OFFICERS, TRUSTEES AND KEY EMPLOYEES ARE REQUIRED TO DISCLOSE THE EXISTENCE AND NATURE OF ANY ACTUAL, APPARENT, OR POTENTIAL CONFLICTS OF INTEREST HE/SHE MAY HAVE THAT MIGHT RESULT IN OR HAVE THE APPEARANCE OF A CONFLICT IN CONNECTION WITH THAT INDIVIDUAL SATISFYING THEIR FIDUCIARY OBLIGATIONS TO THE ORGANIZATION. DISCLOSURES SHALL BE MADE PROMPTLY ANY TIME AN ACTUAL, APPARENT OR POTENTIAL CONFLICT OF INTEREST ARISES AND BEFORE THE CONSUMMATION OF ANY CONTRACT, TRANSACTION OR ARRANGEMENT THAT IS THE SUBJECT OF THE POTENTIAL CONFLICT OF INTEREST. WITH GUIDANCE FROM THE ST. JOSEPH HEALTH SYSTEM CHIEF COMPLIANCE OFFICER (CCO), THE CHIEF EXECUTIVE AND/OR THE GOVERNING BOARD CHAIRPERSON, AS APPROPRIATE, CONSIDERS THE MATTER INITIALLY. IF THE MATTER CANNOT BE RESOLVED AT THAT LEVEL, THE MATTER IS ESCALATED TO THE CCO. THE CCO, IN CONSULTATION WITH THE ST. JOSEPH HEALTH SYSTEM GENERAL COUNSEL, REVIEWS THE MATTER AND PRESENTS RECOMMENDATIONS TO THE GOVERNING BOARD AND/OR BOARD COMMITTEE, AS APPROPRIATE, FOR DISCUSSION AND VOTE. THE INDIVIDUAL WHOSE POTENTIAL CONFLICT IS BEING REVIEWED MAY BE REQUESTED TO BE PRESENT DURING ANY MEETING IN WHICH THE BOARD OR BOARD COMMITTEE CONDUCTS ITS EVALUATION BUT SHALL BE EXCUSED FOR ANY DISCUSSION OR VOTE. ONCE ALL NECESSARY INFORMATION HAS BEEN OBTAINED, THE COMMITTEE CONDUCTS ITS EVALUATION AND FORWARDS ITS FINDINGS AND RECOMMENDATIONS TO THE SJHS CHIEF COMPLIANCE OFFICER. IF THE COMMITTEE DETERMINES AN UNRESOLVED CONFLICT OF INTEREST EXISTS, THE COMMITTEE WILL EVALUATE AND RECOMMEND CONFLICT MITIGATION STRATEGIES. THE SJHS CHIEF COMPLIANCE OFFICER, IN CONSULTATION WITH SJHS GENERAL COUNSEL, WILL REVIEW THE COMMITTEE FINDINGS, RECOMMENDATIONS, AND MITIGATION STRATEGIES, AND PRESENT RECOMMENDATIONS TO THE BOARD FOR DISCUSSION AND VOTE. |
| FORM 990, PART VI, LINE 15A & 15B | PROCESS FOR DETERMINING COMPENSATION THE ORGANIZATION'S EXECUTIVE DIRECTOR IS PAID BY A TAX EXEMPT RELATED ORGANIZATION, SANTA ROSA MEMORIAL HOSPITAL, AND IS DISCLOSED AS A PERSON PAID BY A RELATED ORGANIZATION. ALL EXECUTIVES ARE COMPENSATED BY RELATED ORGANIZATIONS. EXECUTIVE COMPENSATION IS APPROVED BY THE RESPECTIVE ORGANIZATION'S EXECUTIVE MANAGEMENT COMMITTEE, WHICH IS COMPRISED OF INDEPENDENT PERSONS. THE COMMITTEE REVIEWS COMPARABILITY DATA PREPARED FOR AND COMPILED BY THE ST. JOSEPH HEALTH SYSTEM WORKLIFE COMMITTEE, A COMMITTEE OF THE ST. JOSEPH HEALTH SYSTEM BOARD OF TRUSTEES COMPRISED OF INDEPENDENT MEMBERS. THE ST. JOSEPH HEALTH SYSTEM WORKLIFE COMMITTEE ACTS IN ACCORDANCE WITH A COMMITTEE CHARTER APPROVED BY THE ST. JOSEPH HEALTH SYSTEM BOARD OF TRUSTEES AND AN EXECUTIVE COMPENSATION PHILOSOPHY. THE CHARTER DIRECTS THE ST. JOSEPH HEALTH SYSTEM WORKLIFE COMMITTEE TO ADMINISTER THE EXECUTIVE COMPENSATION PROGRAM AND TO APPROVE PROGRAM CHANGES, AS NECESSARY, TO ENSURE ALIGNMENT WITH THE STATED PHILOSOPHY AND ENSURE CONTINUED COMPLIANCE WITH FEDERAL AND STATE REGULATIONS ON BEHALF OF THE ST JOSEPH HEALTH SYSTEM BOARD OF TRUSTEES. OVERALL, THE PHILOSOPHY IS INTENDED TO REWARD A BROAD SPECTRUM OF HIGH ORGANIZATIONAL AND INDIVIDUAL PERFORMANCE EXPECTATIONS, AS WELL AS RETENTION OF KEY MANAGEMENT TALENT. THE EXECUTIVE COMPENSATION PHILOSOPHY DEFINES THE MARKET FOR ADMINISTERING COMPENSATION AS A COMPARABLE SET OF THE PROFIT AND NOT-FOR-PROFIT HEALTH CARE DELIVERY SYSTEMS. ST. JOSEPH HEALTH SYSTEM PROVIDES COMPENSATION TO ITS EXECUTIVES IN THE FORM OF BASE SALARY, AN ANNUAL INCENTIVE PROGRAM, AND BENEFITS. TO ENSURE COMPENSATION PHILOSOPHY ADHERENCE AND GENERAL FAIR MARKET VALUE COMPENSATION, THE COMMITTEE REGULARLY REVIEWS INFORMATION FROM MULTIPLE SOURCES OF MARKET DATA AND ENGAGES LEGAL COUNSEL AND CONSULTING SUPPORT, AS NEEDED. THEY USE THIS INFORMATION TO SUPPORT ONGOING EFFECTIVENESS AND ADMINISTRATION OF THE PROGRAM. THE ST. JOSEPH HEALTH SYSTEM WORKLIFE COMMITTEE MEETS AT LEAST 3 TIMES A YEAR AND TAKES ACTION IN EXECUTIVE SESSION. THESE ACTIONS ARE DOCUMENTED IN DETAILED MINUTES AND APPROVED IN SUBSEQUENT MEETINGS. A FULL COMPENSATION REVIEW IS CONDUCTED ON A BIENNIAL BASIS AND THE LAST REVIEW WAS PERFORMED IN JUNE 2016. DURING THE YEAR, THE SRM ALLIANCE HOSPITAL SERVICES EXECUTIVE MANAGEMENT COMMITTEE REVIEWED AND APPROVED ANY CHANGES IN COMPENSATION FOR KEY EXECUTIVES PREDICATED ON THE ANALYSIS AND RECOMMENDATION BY AN INDEPENDENT THIRD PARTY CONSULTING FIRM WITH EXPERTISE IN HEALTHCARE EXECUTIVE COMPENSATION. IN ADDITION, ANNUAL INCENTIVE AWARDS ARE REVIEWED AND APPROVED PRIOR TO PAYMENT CONSISTENT WITH THE MOST RECENT COMPENSATION BIENNIAL REVIEW AND IN ACCORDANCE WITH THE PLAN DOCUMENT. THESE ACTIONS ARE DOCUMENTED IN DETAILED MINUTES WHICH ARE SUBSEQUENTLY APPROVED AT THE COMMITTEE MEETING. |
| FORM 990, PART VI, LINE 19 | AVAIL OF GOV DOCS, CONFLICT OF INTEREST POLICY & FIN STMTS TO GEN PUBLIC THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. THE SJHS COMMUNITY BENEFIT REPORTS, FINANCIAL REPORTS, AND PHILANTHROPY REPORTS ARE ALSO AVAILABLE ON THE SJHS INTERNET SITE |
| FORM 990, PART XI, LINE 9 | OTHER CHANGES IN NET ASSETS EQUITY TRANSFER TO ST. JOSEPH HEALTH SYSTEM FOR CIP PROJECTS ($95,613) |
| FORM 990 PART IX LINE 11G | DESCRIPTION:MEDICAL PHYSICIANS TOTAL FEES:10011 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:CONSULTING TOTAL FEES:510715 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:CONTRACT LABOR REGISTRY NURSE TOTAL FEES:739696 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:CONTRACT LABOR PHYS THERAPIST TOTAL FEES:1660858 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:CONTRACT LABOR OCC THERAPIST TOTAL FEES:249485 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:CONTRACT LABOR TOTAL FEES:124904 |
| FORM 990 PART IX LINE 11G | DESCRIPTION:PURCHASED SERVICES TOTAL FEES:114446 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (33 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| COVENANT HEALTH NETWORK INC | ||||||||||
| 3345 MICHELSON DRIVE STE 100 | IRVINE | CA | 92612 | 461259908 | HEALTHCARE | CA | 501(C)(3) | 11,III | SJHS | Yes (true) |
| COVENANT ACO | ||||||||||
| 3615 19TH STREET | LUBBOCK | TX | 79410 | 611573313 | HEALTHCARE | TX | 501(C)(3) | 11,I | CHS | Yes (true) |
| COVENANT HEALTH SYSTEM | ||||||||||
| 3615 19TH STREET | LUBBOCK | TX | 79410 | 752765566 | HEALTHCARE | TX | 501(C)(3) | 3 | SJHS | Yes (true) |
| COVENANT HEALTH SYSTEM FOUNDATION | ||||||||||
| 3623 22ND PLACE | LUBBOCK | TX | 79410 | 752897026 | HEALTHCARE | TX | 501(C)(3) | 7 | CHS | Yes (true) |
| COVENANT MEDICAL GROUP | ||||||||||
| 3420 22ND PLACE | LUBBOCK | TX | 79410 | 752743883 | HEALTHCARE | TX | 501(C)(3) | 3 | CHS | Yes (true) |
| COVENANT HEALTH PARTNERS | ||||||||||
| 3615 19TH STREET | LUBBOCK | TX | 79410 | 463516417 | HEALTHCARE | TX | 501(C)(3) | 11,I | CHS | Yes (true) |
| HMTS INC | ||||||||||
| 1 HOAG DRIVE | NEWPORT BEACH | CA | 92658 | 453583707 | HEALTHCARE | CA | 501(C)(3) | 11,I | HMHP | Yes (true) |
| HOAG CHARITY SPORTS | ||||||||||
| 330 PLACENTIA AVE | NEWPORT BEACH | CA | 92663 | 452982422 | SUPPORT | CA | 501(C)(3) | 7 | HHF | Yes (true) |
| HOAG HOSPITAL FOUNDATION | ||||||||||
| 330 PLACENTIA AVE | NEWPORT BEACH | CA | 92663 | 953222343 | FUNDRAISING | CA | 501(C)(3) | 7 | HMHP | Yes (true) |
| HOAG MEMORIAL HOSPITAL PRESBYTERIAN | ||||||||||
| 1 HOAG ROAD BOX 6100 | NEWPORT BEACH | CA | 92663 | 951643327 | HEALTHCARE | CA | 501(C)(3) | 3 | CHN | Yes (true) |
| HOME CARE PARTNERS | ||||||||||
| 1165 MONTGOMERY DR | SANTA ROSA | CA | 95405 | 680318656 | INACTIVE | CA | 501(C)(3) | 3 | SRMH | Yes (true) |
| HOSPICE OF LUBBOCK | ||||||||||
| 3702 21ST STREET | LUBBOCK | TX | 79410 | 752133781 | HEALTHCARE | TX | 501(C)(3) | 9 | CHS | Yes (true) |
| LUBBOCK METHODIST HOSPITAL FOUNDATION | ||||||||||
| 3615 19TH STREET | LUBBOCK | TX | 79410 | 752220963 | HEALTHCARE | TX | 501(C)(3) | 7 | CHS | Yes (true) |
| METHODIST CHILDREN'S HOSPITAL | ||||||||||
| 4015 22ND PLACE | LUBBOCK | TX | 79410 | 752428911 | HEALTHCARE | TX | 501(C)(3) | 3 | CHS | Yes (true) |
| METHODIST HOSPITAL LEVELLAND | ||||||||||
| 1900 COLLEGE AVENUE | LEVELLAND | TX | 79336 | 752246348 | HEALTHCARE | TX | 501(C)(3) | 3 | CHS | Yes (true) |
| METHODIST HOSPITAL PLAINVIEW | ||||||||||
| 2601 DIMMITT ROAD | PLAINVIEW | TX | 79072 | 752426010 | HEALTHCARE | TX | 501(C)(3) | 3 | CHS | Yes (true) |
| MISSION HOSPITAL REGIONAL MEDICAL CTR | ||||||||||
| 27700 MEDICAL CENTER ROAD | MISSION VIEJO | CA | 92691 | 951643360 | HEALTHCARE | CA | 501(C)(3) | 3 | CHN | Yes (true) |
| QUEEN OF THE VALLEY MEDICAL CENTER | ||||||||||
| 1000 TRANCAS STREET | NAPA | CA | 94558 | 941243669 | HEALTHCARE | CA | 501(C)(3) | 3 | SJHS | Yes (true) |
| REDWOOD MEMORIAL FOUNDATION | ||||||||||
| 3300 RENNER DRIVE | FORTUNA | CA | 95540 | 942779313 | HEALTHCARE | CA | 501(C)(3) | 7 | RMH | Yes (true) |
| REDWOOD MEMORIAL HOSPITAL | ||||||||||
| 3300 RENNER DRIVE | FORTUNA | CA | 95540 | 941384665 | HEALTHCARE | CA | 501(C)(3) | 3 | SJHS | Yes (true) |
| SANTA ROSA MEMORIAL HOSPITAL | ||||||||||
| 1165 MONTGOMERY DR | SANTA ROSA | CA | 95405 | 941231005 | HEALTHCARE | CA | 501(C)(3) | 3 | SJHS | Yes (true) |
| SISTERS OF ST JOSEPH OF ORANGE | ||||||||||
| 480 S BATAVIA | ORANGE | CA | 92868 | 951643383 | RELIGIOUS ORG | CA | 501(C)(3) | 1 | NA | false |
| SRM ALLIANCE HOSPITAL SERVICES (PVH) | ||||||||||
| 400 NORTH MCDOWELL BLVD | PETALUMA | CA | 94954 | 680395200 | HEALTHCARE | CA | 501(C)(3) | 3 | SRMH | Yes (true) |
| ST JOSEPH HEALTH MINISTRY | ||||||||||
| 3345 MICHELSON DRIVE STE 100 | IRVINE | CA | 92612 | 271666576 | RELIGIOUS ORG | CA | 501(C)(3) | 1 | SSJO | false |
| ST JOSEPH HEALTH SYSTEM | ||||||||||
| 3345 MICHELSON DRIVE STE 100 | IRVINE | CA | 92612 | 953589356 | HEALTHCARE | CA | 501(C)(3) | 11, I | SJHM | false |
| ST JOSEPH HEALTH SYSTEM FOUNDATION | ||||||||||
| 3345 MICHELSON DRIVE STE 100 | IRVINE | CA | 92612 | 330143024 | HEALTHCARE | CA | 501(C)(3) | 7 | SJHS | Yes (true) |
| ST JOSEPH HOSPITAL OF EUREKA | ||||||||||
| 2700 DOLBEER STREET | EUREKA | CA | 95501 | 941156596 | HEALTHCARE | CA | 501(C)(3) | 3 | SJHS | Yes (true) |
| ST JOSEPH HOSPITAL OF ORANGE | ||||||||||
| 1100 WEST STEWART DRIVE | ORANGE | CA | 92868 | 951643359 | HEALTHCARE | CA | 501(C)(3) | 3 | CHN | Yes (true) |
| ST JUDE HOSPITAL YORBA LINDA | ||||||||||
| 200 WEST CENTER ST PROMENADE | ANAHEIM | CA | 92805 | 330185031 | HEALTHCARE | CA | 501(C)(3) | 3 | SJHS | Yes (true) |
| ST JUDE HOSPITAL INC | ||||||||||
| 101 EAST VALENCIA MESA DRIVE | FULLERTON | CA | 92635 | 951643324 | HEALTHCARE | CA | 501(C)(3) | 3 | CHN | Yes (true) |
| ST MARY MEDICAL CENTER | ||||||||||
| 18300 HIGHWAY 18 | APPLE VALLEY | CA | 92307 | 951914489 | HEALTHCARE | CA | 501(C)(3) | 3 | CHN | Yes (true) |
| ST MARY OF THE PLAINS HOSPITAL FDN | ||||||||||
| 4000 24TH STREET | LUBBOCK | TX | 79410 | 751653181 | HEALTHCARE | TX | 501(C)(3) | 7 | CHS | Yes (true) |
| TALLER SAN JOSE | ||||||||||
| 801 NORTH BROADWAY | SANTA ANA | CA | 92701 | 593816355 | WORK DEVELOPM | CA | 501(C)(3) | 2 | SSJO | Yes (true) |
Id Related Org Txbl Partnership IdRelatedOrgTxblPartnershipGrp (15 entries)
| Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Predominant Income TypePredominantIncomeTypeTxt | Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN |
|---|---|---|---|---|---|---|---|---|
| COVENANT LONG-TERM CARE LP | ||||||||
| HEALTHCARE | TX | NA | N/A | |||||
| HERITAGE INVESTMENT GROUP | ||||||||
| INVESTMENTS | CA | NA | N/A | |||||
| HOAG ORTHOPEDIC INSTITUTE | ||||||||
| HEALTHCARE | CA | NA | N/A | |||||
| LUBBOCK SURGERY CENTER LTD | ||||||||
| HEALTHCARE | TX | NA | N/A | |||||
| METHODIST DIAGNOSTIC IMAGING | ||||||||
| HEALTHCARE | TX | NA | N/A | |||||
| MISSION AMBULATORY SURGICENTER | ||||||||
| HEALTHCARE | CA | NA | N/A | |||||
| NEWPORT IMAGING CENTER | ||||||||
| HEALTHCARE | CA | NA | N/A | |||||
| SHA LLC | ||||||||
| HEALTHCARE | TX | NA | N/A | |||||
| ST JOSEPH PHYSICIAN VENTURES | ||||||||
| REAL ESTATE | CA | NA | N/A | |||||
| ST JOSEPH HLTH SYS HOME CARE | ||||||||
| HOME HEALTH | CA | NA | N/A | |||||
| ST JOSEPH HLTH SYS HOME HLTH | ||||||||
| HOME HEALTH | CA | NA | N/A | |||||
| THE INNOVATION INSTITUTE | ||||||||
| HEALTHCARE | DE | NA | N/A | SEE PART VII | SANTA ROSA | CA | 95404 | 262299255 |
| NORTH BAY ENDOSCOPY CENTER | ||||||||
| HEALTHCARE | CA | NA | N/A | |||||
| ADVANCED SURGERY INSTITUTE | ||||||||
| HEALTHCARE | CA | NA | N/A | |||||
| MISSN VIEJO PHSCN PRTNRS I LLC | ||||||||
| HEALTHCARE | CA | NA | N/A | |||||
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (10 entries)
| Address Line1ForeignAddress/AddressLine1Txt | CityForeignAddress/CityNm | CountryForeignAddress/CountryCd | Foreign PostalForeignAddress/ForeignPostalCd | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile Foreign CountryLegalDomicileForeignCountryCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Legal Domicile StateLegalDomicileStateCd |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| AMERICAN UNITY GROUP LTD | |||||||||||||
| 90 PITTS BAY ROAD | PEMBROKE | BD | HM08 | CAPTIVE INSURANCE | BD | NA | C-CORP | ||||||
| COASTAL MANAGEMENT SERVICES ORGANIZATION | |||||||||||||
| HEALTHCARE | NA | C-CORP | 1 HOAG DRIVE BOX 6100 | NEWPORT BEACH | CA | 92658 | 330676831 | CA | |||||
| DATU HEALTH INC | |||||||||||||
| IT SVCS | NA | C-CORP | 16150 MAIN CIRCLE DR SUITE 250 | CHESTERFIELD | MO | 63017 | 463070062 | DE | |||||
| HOAG MANAGEMENT SERVICES INC | |||||||||||||
| HEALTHCARE | NA | C-CORP | 1 HOAG DRIVE BOX 6100 | NEWPORT BEACH | CA | 92658 | 330731587 | CA | |||||
| LUBBOCK METHODIST HOSP PRACTICE MGMT | |||||||||||||
| INACTIVE | NA | C-CORP | 2107 OXFORD STREET STE 300 | LUBBOCK | TX | 79410 | 752578995 | TX | |||||
| LUBBOCK METHODIST HOSPITAL SVCS | |||||||||||||
| HEALTHCARE | NA | C-CORP | PO BOX 1201 | LUBBOCK | TX | 79410 | 752118585 | TX | |||||
| MISSION VIEJO MEDICAL VENTURES | |||||||||||||
| HEALTHCARE | NA | C-CORP | 27800 MEDICAL CENTER RD 354 | MISSION VIEJO | CA | 92691 | 330212905 | CA | |||||
| ST JOSEPH HEALTH | |||||||||||||
| HOLDING COMPANY | NA | C-CORP | 3345 MICHELSON DRIVE SUITE 100 | IRVINE | CA | 92612 | 462340232 | CA | |||||
| ST JOSEPH HEALTH SOURCE INC | |||||||||||||
| HEALTHCARE | NA | C-CORP | 3345 MICHELSON DRIVE SUITE 100 | IRVINE | CA | 92612 | 461900168 | CA | |||||
| ST JOSEPH PROF SVCS ENTERPRISES INC | |||||||||||||
| HEALTHCARE | NA | C-CORP | 3345 MICHELSON DRIVE SUITE 100 | IRVINE | CA | 92612 | 330155323 | CA | |||||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (true) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (true) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | Yes (true) | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | false | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | false | SharingOfFacilitiesInd |
| Paid Employees Sharing | false | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (true) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (4 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| SANTA ROSA MEMORIAL HOSPITAL | ||
| p | $1,095,641 | ACCRUAL |
| ST JOSEPH HEALTH SYSTEM HOME HEALTH AGENCY | ||
| p | $405,052 | ACCRUAL |
| SANTA ROSA MEMORIAL HOSPITAL | ||
| k | $92,798 | ACCRUAL |
| SANTA ROSA MEMORIAL HOSPITAL | ||
| q | $322,131 | ACCRUAL |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE R, PART III | FormAndLineReferenceDesc |
| Explanation | IDENTIFICATION OF RELATED ORGANIZATIONS TAXABLE AS A PARTNERSHIP COVENANT LONG-TERM CARE, LP EIN: 20-5033419 ADDRESS: 4000 24TH STREET, LUBBOCK, TX 79410 HERITAGE INVESTMENT GROUP I, LLC EIN: 27-1000061 ADDRESS: 500 S. MAIN STREET, STE 1000, ORANGE, CA 92868 HOAG ORTHOPEDIC INSTITUTE EIN: 61-1588294 ADDRESS: 1 HOAG DRIVE, BOX 6100, NEWPORT BEACH, CA 92658 LUBBOCK SURGERY CENTER, LTD. EIN: 75-2177401 ADDRESS: 4000 24TH STREET, LUBBOCK, TX 79410 METHODIST DIAGNOSTIC IMAGING EIN: 75-2343261 ADDRESS: 4005 24TH STREET, LUBBOCK, TX 79410 MISSION AMBULATORY SURGICENTER, LTD EIN: 33-0355575 ADDRESS: 27800 MEDICAL CENTER ROAD, STE 362, MISSION VIEJO, CA 92691 NEWPORT IMAGING CENTER EIN: 33-0191776 ADDRESS: 360 SAN MIGUEL, NEWPORT BEACH, CA 92660 SHA, LLC EIN: 75-2569094 ADDRESS: 12940 NORTH HIGHWAY 183, AUSTIN, TX 78750 ST. JOSEPH PHYSICIAN VENTURES I, LLC EIN: 45-4521884 ADDRESS: 1100 WEST STEWART DRIVE, ORANGE, CA 92868 ST. JOSEPH HEALTH SYSTEM HOME CARE SERVICES EIN: 33-0307672 ADDRESS: 1845 W. ORANGEWOOD AVENUE, STE 100, ORANGE, CA 92868-2012 ST. JOSEPH HEALTH SYSTEM HOME HEALTH AGENCY EIN: 33-0282945 ADDRESS: 1845 W. ORANGEWOOD AVENUE, STE 200 ORANGE, CA 92868-2012 THE INNOVATION INSTITUTE EIN: 90-0745066 ADDRESS: 1 CENTERPOINTE DRIVE SUITE 200, LA PALMA, CA 90623-1052 NORTH BAY ENDOSCOPY CENTER, LLC EIN: 61-1559876 ADDRESS: 1383 N. MCDOWELL BLVD SUITE 110, PETALUMA, CA 94954 MISSION VIEJO PHYSICIAN PARTNERS I LLC EIN: 47-1559873 ADDRESS: 27700 MEDICAL CENTER ROAD, MISSION VIEJO, CA 92691 ADVANCED SURGERY INSTITUTE LLC EIN: 26-2299255 ADDRESS: 1739 4TH STREET, SANTA ROSA, CA 95404 | ExplanationTxt |