2017-01-16T00:00:00-06:00 2016-06-30 946214841 Armanino LLP 12657 Alcosta Blvd Ste 500 San Ramon CA 945834600 990 2015-07-01 943101464 On Lok Inc ONLO 4152928888 1333 Bush Street San Francisco CA 94109 Gary P Campanella CFO 4152928888 2017-01-16 1 JOHN PANETTA P00365375 9257902600 2015 2021-01-29 14:40:06Z Grace Li Harper 1333 Bush Street San Francisco CA 94109 12650951 0 X www.onlok.org X 1989 CA Develop & support health care models for the well-being and dignity of elderly & chronically ill. 14 13 75 250 -1105456 -1105456 382366 566992 6756601 8109187 672286 501093 -79350 -1397719 7731903 7779553 0 750000 0 0 5298893 6349182 0 0 1429788 3289062 4002565 8587955 11101747 -856052 -3322194 14639434 14175878 2065105 1284733 12574329 12891145 Develop & support health care models for the well-being and dignity of elderly & chronically ill. 0 0 7830146 750000 7025323 Provide various management support services (such as executive oversight, strategic planning, financial management and accounting, human resources management, information systems, fundraising) to affiliated 501(c)(3) nonprofit organizations, which provide housing and comprehensive health care to the frail elderly and other services to individuals age 60 and older. Approximately $3.3 million ($1.7 million in foundation grants and contributions and $1.6 million in city grants) was raised that went directly to these affiliated organizations. 1072127 1083864 Provide technical assistance and administrative support services to organizations developing or operating a PACE (Program of All-inclusive Care for the Elderly) program. 8902273 1 1 0 0 0 0 0 0 0 0 1 0 1 0 0 1 0 1 0 0 0 0 0 0 1 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 75 0 1 75 1 0 0 0 0 0 0 0 0 0 0 X 14 13 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 CA X Gary P Campanella 4152928888 1333 Bush Street San Francisco CA 94109 Wellman Tsang MD Chair 2.00 2.00 X X 0 0 0 Irene Riley Vice Chair 2.00 X X 0 0 0 John Jenks Treasurer 2.00 2.00 X X 0 0 0 Kevin Gerber Secretary 2.00 1.00 X X 0 0 0 Joseph Barbaccia MD Director 1.00 1.00 X 0 0 0 Gregory Chun Director 1.00 1.00 X 0 0 0 Elizabeth Ferguson Director 1.00 2.50 X 0 0 0 Eric Harrison Director 1.00 0.50 X 0 0 0 William Lock Director 1.00 X 0 0 0 Tom Rundall PhD Director 1.00 2.00 X 0 0 0 Candy Rupp Director 1.00 3.00 X 0 0 0 Sharon Yow Director 1.00 0.50 X 0 0 0 Cynthia Yee ex-officio Director 1.00 X 0 0 0 Grace Li Harper CEO, On Lok Inc. (Start 4/1/16) 40.00 5.00 X X 0 283655 16315 Robert Edmondson CEO, On Lok Inc. (Thru 3/31/16) 40.00 7.00 X X 424354 0 37944 Gary Campanella CFO (Start 5/16/16) 40.00 X 0 0 0 Kelly Walsh CFO (Thru 1/22/16) 40.00 X 267464 0 10664 Jay Luxenberg Chief Medical Officer 20.00 20.00 X 304627 0 17939 Robert Novelli Director of Marketing 40.00 X 273855 0 11943 Deborah L Stuart-Middleton Director of Human Resources 40.00 X 159518 0 13069 Robert E Connors Director of Alcara 40.00 X 132620 0 7926 Michele C Forge Controller 40.00 X 128899 0 10212 Ian Mccuaig Director of Development 40.00 X 122633 0 8250 1813970 283655 134262 13 0 1 0 The Travelers Companies 91287 Collections Center Drive Chicago IL 60693 Insurance 1151297 TEK Systems 221 Main Street San Francisco CA 94105 Employment Agency 468377 Resources Global Professionals 90 New Montgomery Street San Francisco CA 94104 Consulting 354504 Oracle America Inc 110 Allen Road Basking Ridge NJ 07920 Software Support 238889 Armanino LLP 44 Montgomery Street San Francisco CA 94104 Audit / Tax Preparation 120415 6 334836 232156 566992 Mgmt Support Contract 561000 7381328 7381328 Other Program Revenue 900099 516279 516279 Technical Assistance 541900 211580 211580 8109187 220232 220232 4586711 273285 4579135 0 7576 273285 280861 280861 0 334836 292263 -292263 -292263 S-Corp Income 621610 -1105456 -1105456 -1105456 7779553 8109187 -1105456 208830 750000 750000 1337922 1059794 278128 3269447 2855928 111474 302045 75417 69281 3257 2879 1328086 1237434 63744 26908 338310 299424 17534 21352 1491168 704062 26353 760753 101998 93881 8117 84373 84373 24500 24500 75043 58632 5069 11342 462369 361254 31234 69881 185819 145183 12552 28084 1101703 986459 87892 27352 81536 81536 178569 162587 15982 75723 68978 6745 Other Expenses 139764 49376 17232 73156 11101747 8902273 769686 1429788 1008126 524442 9413 30055 1133546 2345043 488322 334200 2255296 947276 606572 1308020 9840115 8080778 1553340 1553340 14639434 14175878 2042655 1265233 22450 19500 2065105 1284733 X 12551626 12861042 2703 10103 20000 20000 12574329 12891145 14639434 14175878 X -3322194 -466446 4105456 X X 0 1 X 1 0 X 522528 237840 363544 382366 566992 2073270 522528 237840 363544 382366 566992 2073270 190007 1883263 183954 176161 78718 223991 220232 883056 422068 383279 805347 3761673 32399186 0.50060 0.44000 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 20016 57 20073 20000 16 20016 1.00000 0 0 86271 82132 4139 1270818 860744 410074 898207 4400 893807 1308020 Investment in Care at Home 1553340 F 1553340 X 11710826 -466446 3000000 2533554 9177272 -1397719 -1397719 7779553 11394010 0 11394010 -292263 -292263 11101747 Part V, Line 4: Endowment funds are intended to generate investment income to be used for operating support, according to the board's discretion. Part X, Line 2: The Organization is exempt from income taxes under Section 501(a) subsection (c)(3) of the Internal Revenue Code and section 23701(d) of the California Revenue and Taxation Code whereby only unrelated business income, as defined by Section 512(a)(1) of the Internal Revenue Code and similar code sections of the California Revenue and Taxation code is subject to income tax. Accordingly, no provision for income taxes has been provided for in the accompanying financial statements. The Organization is required to file annual informational returns with the Internal Revenue Service and the California Franchise Tax Board. Management has evaluated its current tax position and has concluded as of June 30, 2016, the Organization does not have any significant uncertain tax positions for which a reserve would be necessary. The tax returns are subject to examination by the taxing authorities generally for three years and four years for federal and state, respectively, starting with the date of filing or the due date of the tax return, whichever is later. Part XI, Line 2d - Other Adjustments: Transfer from related organization 3,000,000. Part XI, Line 4b - Other Adjustments: Fundraising Expenses -292,263. S-corp passthrough loss -1,105,456. Part XII, Line 4b - Other Adjustments: Fundraising Expenses -292,263. Spring Banquet 186705 186705 149000 22974 Golf Classic 67125 67125 24900 22083 3 81006 81006 500 11825 26563 34418 334836 334836 500 185725 26563 79475 292263 -292263 0 On Lok Day Services 1333 Bush Street San Francisco CA 94109 943101292 501(c)(3) 750000 General program support 1 0 X X X 0 0 0 0 0 0 0 0 0 Grace Li Harper CEO, On Lok Inc. (Start 4/1/16) 0 283655 0 0 0 0 0 8157 0 8158 0 299970 0 0 Robert Edmondson CEO, On Lok Inc. (Thru 3/31/16) 424354 0 0 0 0 0 25950 0 11994 0 462298 0 0 0 Kelly Walsh CFO (Thru 1/22/16) 267464 0 0 0 0 0 2826 0 7838 0 278128 0 0 0 Jay Luxenberg Chief Medical Officer 304627 0 0 0 0 0 7950 0 9989 0 322566 0 0 0 Robert Novelli Director of Marketing 273855 0 0 0 0 0 323 0 11620 0 285798 0 0 0 Deborah L Stuart-Middleton Director of Human Resources 159518 0 0 0 0 0 4911 0 8158 0 172587 0 0 0 Form 990, Part VI, Section B, line 11 REVIEW OF THE FORM 990 HAS BEEN DELEGATED TO THE CHIEF FINANCIAL OFFICER OF ON LOK, INC. UPON REVIEW AND APPROVAL, THE 990 WILL BE PROVIDED TO ALL MEMBERS OF THE BOARD AND DIRECTORS AFTER FILING. Form 990, Part VI, Section B, line 12c The Conflict of Interest policy is distributed annually to directors, officers and senior management, along with annual disclosure of conflict of interest forms which are required to be completed, signed and returned to the compliance officer each year. These forms are reviewed carefully by the compliance officer and the Chief Executive Officer so that any potential conflicts are handled appropriately. Form 990, Part VI, Section B, line 15 The Executive Committee determines the compensation of the CEO and CFO of the organization, based on comparability data provided by a firm specializing in compensation. In addition to the base compensation, the Executive Committee may also establish incentive compensation at a pre-determined level based on specific goals to be achieved by year-end. Form 990, Part VI, Section C, line 19 Available upon request. Form 990, Part XI, line 9: Transfer from related organization 3,000,000. S-corp passthrough income not recorded in financial statements 1,105,456. Form 990, Part XII, Line 2c: THE PROCESS HAS NOT CHANGED FROM PRIOR YEAR. ON LOK SENIOR HEALTH SERVICES 1333 Bush Street San Francisco CA 94109 942162549 MEDICAL & SUPPORTIVE CARE FOR FRAIL ELDERLY CA 501(c)(3) Line 9 On Lok Inc 1 ON LOK DAY SERVICES 1333 Bush Street San Francisco CA 94109 943101292 VARIOUS SERVICES FOR SENIORS CA 501(c)(3) Line 9 On Lok Inc 1 ON LOK COMMUNITY HOUSING INC 1333 Bush Street San Francisco CA 94109 943053383 HOUSING FOR LOW-INCOME SENIORS CA 501(c)(3) Line 9 On Lok Inc 1 ON LOK HOUSE 1333 Bush Street San Francisco CA 94109 942326678 HOUSING FOR LOW-INCOME FRAIL ELDERLY CA 501(c)(3) Line 7 On Lok Inc 1 Care at Home Inc 1333 Bush Street San Francisco CA 94109 770578465 Assist with Adult and pediatric care within the patient's home CA On Lok Inc S -1105515 540387 1.00000 1 0 1 1 0 0 0 0 0 0 0 1 1 1 0 1 0 0 0 0 On Lok House Inc L 65059 Cash On Lok Community Housing Inc K 164740 CASH On Lok Community Housing Inc M 37415 CASH On Lok Community Housing Inc L 136534 CAsh On Lok Senior Health Services L 6746702 CASH On Lok Senior Health Services M 87982 CASH On Lok Senior Health Services C 3000000 Cash On Lok Day Services B 750000 CASH On Lok Day Services L 171614 CASH