AMIDA CARE INC: Form 990, tax year 2015
View the entire original 990 at ProPublica ↗
- Organization
- AMIDA CARE INC (EIN 13-4154068)
- Tax period
- 2015-01-01 to 2015-12-31
- Filed
- 2016-11-07
- IRS object ID
- 201603129349300900
- Schema version
- 2015v2.1
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2016-11-07T08:30:05-06:00 | ReturnTs |
| Tax Period End | 2015-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 420714325 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RSM US LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1185 AVENUE OF THE AMERICAS | AddressLine1Txt |
| City | NEW YORK | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 100362602 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2015-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 134154068 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | AMIDA CARE INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | AMID | BusinessNameControlTxt |
| Phone | 6467577000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 14 PENN PLAZA NO 2ND FL | AddressLine1Txt |
| City | NEW YORK | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 10122 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DOUGLAS WIRTH | PersonNm |
| Person Title | CEO | PersonTitleTxt |
| Phone | 6467577000 | PhoneNum |
| Signature | 2016-10-31 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MARTIN GREIF | PreparerPersonNm |
| PTIN | P00029738 | PTIN |
| Phone | 2123721000 | PhoneNum |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2015 | TaxYr |
| Build TS | 2017-02-10 21:41:12Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | DOUGLAS WIRTH | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 14 PENN PLAZA NO 2ND FL | AddressLine1Txt |
| City | NEW YORK | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 10122 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $360,965,536 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.AMIDACARENY.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2000 | FormationYr |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Activity Or Mission | AMIDA CARE INC. IS A HEALTH MAINTENANCE ORGANIZATION FORMED TO OBTAIN A COMPREHENSIVE HIV SPECIAL NEEDS CERTIFICATE OF AUTHORITY IN ORDER TO PROVIDE OR ARRANGE FOR ALL MEDICAL ASSISTANCE SERVICES TO PERSONS ENROLLED IN THE PLAN AND FOR ASSISTING ENROLLEES IN THE PRUDENT SELECTION OF SERVICES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 9 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 9 | VotingMembersIndependentCnt |
| Total Employee | 277 | TotalEmployeeCnt |
| Total Volunteers | 11 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,240,607 | PYContributionsGrantsAmt |
| CY Contributions Grants | $690,094 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $307,993,102 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $343,625,217 | CYProgramServiceRevenueAmt |
| PY Investment Income | $7,010 | PYInvestmentIncomeAmt |
| CY Investment Income | $60,447 | CYInvestmentIncomeAmt |
| PY Other Revenue | -$9,726 | PYOtherRevenueAmt |
| CY Other Revenue | -$16,041 | CYOtherRevenueAmt |
| PY Total Revenue | $309,230,993 | PYTotalRevenueAmt |
| CY Total Revenue | $344,359,717 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $17,307,006 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $21,665,084 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $293,376,865 | PYOtherExpensesAmt |
| CY Other Expenses | $342,511,317 | CYOtherExpensesAmt |
| PY Total Expenses | $310,683,871 | PYTotalExpensesAmt |
| CY Total Expenses | $364,176,401 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$1,452,878 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$19,816,684 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $56,527,742 | TotalAssetsBOYAmt |
| Total Assets EOY | $59,119,433 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $34,465,688 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $56,914,529 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $22,062,054 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $2,204,904 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | AMIDA CARE INC. IS A MEDICAID HIV SPECIAL NEEDS MANAGED CARE PLAN THAT PROVIDES ASSISTANCE AND/OR ARRANGES FOR MEDICAL CARE AND NON-MEDICAL SUPPORT FOR PERSONS ENROLLED IN THE PLAN. IN 2014, THE PLAN EXPANDED ITS SERVICES INTO THE MEDICARE ADVANTAGE PROGRAM. STAFF ALSO ASSISTS ENROLLEES IN THE PRUDENT SELECTION OF SERVICES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $315,891,648 | ExpenseAmt |
| Revenue | $336,963,254 | RevenueAmt |
| Desc | AMIDA CARE IS A MEDICAID MANAGED CARE PLAN THAT PROVIDES ASSISTANCE AND/OR ARRANGES FOR MEDICAL CARE AND NON-MEDICAL SUPPORT FOR PERSONS ENROLLED IN THE PLAN. STAFF ALSO ASSISTS ENROLLEES IN THE PRUDENT SELECTION OF SERVICES. THE PLAN COVERED 72,036 MEMBER MONTHS IN 2015. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $7,405,261 | ExpenseAmt |
| Revenue | $6,661,963 | RevenueAmt |
| Desc | THE PLAN PROVIDES SERVICES THROUGH ITS CONTRACT WITH THE CENTERS FOR MEDICARE AND MEDICAID (CMS) TO RECIPIENTS ELIGIBLE TO PARTICIPATE IN ONE OF THE PLAN'S THREE MEDICARE ADVANTAGE PRODUCTS. THE PRODUCTS INCLUDE MEDICARE ADVANTAGE PRESCRIPTION DRUG PLAN, MEDICARE ADVANTAGE PRESCRIPTION DRUG CHRONIC CONDITION SPECIAL NEEDS PLAN, AND MEDICARE ADVANTAGE PRESCRIPTION DRUG DUAL ELIGIBLE SPECIAL NEED PLAN. STAFF ALSO ASSISTS ENROLLEES IN THE PRUDENT SELECTION OF SERVICES. THE PLAN COVERED 4,188 MEMBER MONTHS FOR MEDICARE IN 2015. | Desc |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Expenses | $323,296,909 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (1) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | Yes (1) | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 956 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 277 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 9 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 9 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | NY | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DOUGLAS WIRTH CEO | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6467577000 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 14 PENN PLAZA 2ND FLOOR | AddressLine1Txt |
| City | NEW YORK | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 10122 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (30 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| PAUL VITALE | ||||||||
| CHAIRPERSON | 0.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| EMMA DEVITO | ||||||||
| VICE CHAIR | 0.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| CHARLES KING | ||||||||
| SECRETARY | 0.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| TOMAS DEL RIO | ||||||||
| TREASURER | 0.50 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| HOLLY ARGENT-TARIQ | ||||||||
| MEMBER | 0.50 | Yes (X) | $0 | $0 | $0 | |||
| PAM MATTEL | ||||||||
| MEMBER | 0.50 | Yes (X) | $0 | $0 | $0 | |||
| JACQUELYN KILMER | ||||||||
| MEMBER | 0.50 | Yes (X) | $0 | $0 | $0 | |||
| DR MATTHEW WEISSMAN | ||||||||
| MEMBER | 0.50 | Yes (X) | $0 | $0 | $0 | |||
| ROMANO JOHNSON | ||||||||
| MEMBER | 0.50 | Yes (X) | $0 | $0 | $0 | |||
| WAYDE TOMAN | ||||||||
| MEMBER - FROM FEB. 2015 | 0.50 | Yes (X) | $0 | $0 | $0 | |||
| SABRINA JOHNSON | ||||||||
| MEMBER - THRU JAN. 2015 | 0.50 | Yes (X) | $0 | $0 | $0 | |||
| DOUGLAS WIRTH | ||||||||
| PRESIDENT & CEO | 40.00 | Yes (X) | $484,057 | $0 | $55,383 | |||
| JAMES CRAMER | ||||||||
| CHIEF OPERATING OFFICER | 40.00 | Yes (X) | $193,592 | $0 | $33,849 | |||
| JEROME A ERNST MD | ||||||||
| CHIEF MEDICAL OFFICER | 40.00 | Yes (X) | $287,865 | $0 | $38,372 | |||
| FELICE KUSSOY | ||||||||
| CHIEF FINANCIAL OFFICER | 40.00 | Yes (X) | $249,317 | $0 | $25,251 | |||
| MAURA MCGRATH | ||||||||
| CHIEF COMPLIANCE & PRIVACY OFFICER | 40.00 | Yes (X) | $189,876 | $0 | $34,332 | |||
| SUSAN CAPUTO | ||||||||
| EXECUTIVE VICE PRESIDENT | 40.00 | Yes (X) | $277,161 | $0 | $16,158 | |||
| TERRY LEACH | ||||||||
| VP OF PHARMACY | 40.00 | $237,365 | $0 | $26,978 | Yes (X) | |||
| LISA ELLEN KEEHN | ||||||||
| VP OF MEDICARE OPERATION | 40.00 | $224,220 | $0 | $40,855 | Yes (X) | |||
| OLADIPO ALAO MD | ||||||||
| MEDICAL DIRECTOR | 40.00 | $216,605 | $0 | $33,992 | Yes (X) | |||
| MARIA DASILVA | ||||||||
| VP OF RISK & NETWORK MGMT | 40.00 | $197,696 | $0 | $31,488 | Yes (X) | |||
| KATHY FRANK-KLEIN | ||||||||
| VP OF VENDOR MANAGEMENT | 40.00 | $188,838 | $0 | $44,474 | Yes (X) | |||
| STEPHANE HOWZE | ||||||||
| OMBUDSMAN | 40.00 | $177,810 | $0 | $38,734 | Yes (X) | |||
| JAMES MORRILL | ||||||||
| VP OF HUMAN RESOURCES | 40.00 | $181,600 | $0 | $29,186 | Yes (X) | |||
| KEVIN STEFFENS | ||||||||
| VP OF HEALTH SERVICES OPERATIONS | 40.00 | $155,571 | $0 | $18,572 | Yes (X) | |||
| DANIEL WARD | ||||||||
| SR DIR OF FINANCE | 40.00 | $165,195 | $0 | $15,787 | Yes (X) | |||
| KIEU DIEM STEPHENS | ||||||||
| DIRECTOR OF FINANCE | 40.00 | $161,626 | $0 | $10,156 | Yes (X) | |||
| VIRPI RANTA | ||||||||
| DIRECTOR OF CQI | 40.00 | $145,558 | $0 | $18,277 | Yes (X) | |||
| MARK FINTZ | ||||||||
| VP OF MEMBER SERVICES | 40.00 | $133,622 | $0 | $42,501 | Yes (X) | |||
| MICHELE PEDRETTI-MOSSALLY | ||||||||
| SR DIRECTOR OF BEHAVIORAL HEALTH | 40.00 | $148,524 | $0 | $45,801 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $4,016,098 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $600,146 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 41 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (5 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| STAR ADMINISTRATORS LLC | |||||
| 272 SW LANGELIER DRIVE | FORT WHITE | FL | 32038 | MANAGEMENT SERVICES | $2,176,317 |
| ROYAL HEALTH CARE | |||||
| 810 SEVENTH AVENUE STE 801 | NEW YORK | NY | 10019 | MANAGEMENT SERVICES | $857,050 |
| KEPRO ACQUISIONS INC | |||||
| 99 SE MIZNER BLVDSUITE 120 | BOCA RATON | FL | 33432 | UTILIZATION MGMT SERVICES | $789,251 |
| ROPES & GRAY LLP | |||||
| 800 BOYLSTON STREET SUITE 3600 | BOSTON | MA | 021993600 | LEGAL SERVICES | $549,225 |
| BEACON HEALTH STRATEGIES LLC | |||||
| 200 STATE STREET SUITE 302 | BOSTON | MA | 02109 | MANAGEMENT SERVICES | $313,500 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 9 | CntrctRcvdGreaterThan100KCnt |
| Fundraising | $141,822 | FundraisingAmt |
| All Other Contributions | $548,272 | AllOtherContributionsAmt |
| Total Contributions | $690,094 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| MEDICAID PAYMENTS | 900099 | $336,963,254 | $336,963,254 |
| MEDICARE PAYMENTS | 900099 | $6,661,963 | $6,661,963 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $343,625,217 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $65,517 | TotalRevenueColumnAmt |
| Exclusion | $65,517 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $16,584,708 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $16,589,778 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -$5,070 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$5,070 | TotalRevenueColumnAmt |
| Exclusion | -$5,070 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Contri Rpt Fundraising Event | $141,822 | ContriRptFundraisingEventAmt |
| Fundraising Direct Expenses | $16,041 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$16,041 | TotalRevenueColumnAmt |
| Exclusion | -$16,041 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $344,359,717 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $343,625,217 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $44,406 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,983,728 | TotalAmt |
| Management And General | $3,983,728 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,683,737 | TotalAmt |
| Management And General | $13,683,737 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $294,018 | TotalAmt |
| Management And General | $294,018 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,341,147 | TotalAmt |
| Management And General | $2,341,147 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,362,454 | TotalAmt |
| Management And General | $1,362,454 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,058,375 | TotalAmt |
| Management And General | $3,058,375 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $575,480 | TotalAmt |
| Management And General | $575,480 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $82,220 | TotalAmt |
| Management And General | $82,220 | ManagementAndGeneralAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,474 | TotalAmt |
| Management And General | $10,474 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,126,426 | TotalAmt |
| Management And General | $2,126,426 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $274,842 | TotalAmt |
| Management And General | $274,842 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,514,075 | TotalAmt |
| Management And General | $1,514,075 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,658,265 | TotalAmt |
| Management And General | $1,658,265 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,459,131 | TotalAmt |
| Management And General | $3,459,131 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $135,578 | TotalAmt |
| Management And General | $135,578 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $93,521 | TotalAmt |
| Management And General | $93,521 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $754,240 | TotalAmt |
| Management And General | $754,240 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $800,647 | TotalAmt |
| Management And General | $800,647 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $292,685 | TotalAmt |
| Management And General | $292,685 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| PHARMACY COSTS | $225,823,544 | $225,279,599 | $543,945 |
| MEDICAL SERVICES | $93,881,274 | $93,881,274 | |
| HEALTH ASSESSMENTS & SU | $4,136,036 | $4,136,036 | |
| UTILIZATION MANAGEMENT | $1,513,490 | $1,513,490 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,321,014 | TotalAmt |
| Management And General | $2,321,014 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $364,176,401 | TotalAmt |
| Program Services | $323,296,909 | ProgramServicesAmt |
| Management And General | $40,879,492 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,432,874 | BOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $15,553,616 | BOYAmt |
| EOY | $9,108,080 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $121,313 | BOYAmt |
| EOY | $200,084 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $35,162,637 | BOYAmt |
| EOY | $33,213,623 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $204,402 | BOYAmt |
| EOY | $532,095 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $4,732,470 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,769,452 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,951,124 | BOYAmt |
| EOY | $2,963,018 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $12,392,270 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,101,776 | BOYAmt |
| EOY | $710,263 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $56,527,742 | BOYAmt |
| EOY | $59,119,433 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,607,036 | BOYAmt |
| EOY | $37,878,959 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $5,000,000 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,625,000 | BOYAmt |
| EOY | $6,067,038 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,233,652 | BOYAmt |
| EOY | $7,968,532 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $34,465,688 | BOYAmt |
| EOY | $56,914,529 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,062,054 | BOYAmt |
| EOY | $2,204,904 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $22,062,054 | BOYAmt |
| EOY | $2,204,904 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $56,527,742 | BOYAmt |
| EOY | $59,119,433 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$19,816,684 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$40,466 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $804,111 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $758,965 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $920,185 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $1,240,607 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $690,094 | CurrentTaxYearAmt |
| Total | $4,413,962 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $88,329,851 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $218,214,600 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $263,795,280 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $307,993,102 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $343,625,302 | CurrentTaxYearAmt |
| Total | $1,221,958,135 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $89,133,962 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $218,973,565 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $264,715,465 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $309,233,709 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $344,315,396 | CurrentTaxYearAmt |
| Total | $1,226,372,097 | 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 | $1,226,372,097 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $81,306 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $7,413 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,867 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $7,010 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $65,517 | CurrentTaxYearAmt |
| Total | $165,113 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $81,306 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $7,413 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,867 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $7,010 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $65,517 | CurrentTaxYearAmt |
| Total | $165,113 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $89,215,268 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $218,980,978 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $264,719,332 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $309,240,719 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $344,380,913 | CurrentTaxYearAmt |
| Total | $1,226,537,210 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99990 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99980 | PublicSupportPY509Pct |
| Investment Income CY | 0.00010 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00020 | 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 D IRS990ScheduleD
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,059,812 | OtherCostOrOtherBasisAmt |
| Depreciation | $138,263 | DepreciationAmt |
| Book Value | $921,549 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,029,898 | OtherCostOrOtherBasisAmt |
| Depreciation | $1,192,641 | DepreciationAmt |
| Book Value | $837,257 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,642,760 | OtherCostOrOtherBasisAmt |
| Depreciation | $438,548 | DepreciationAmt |
| Book Value | $1,204,212 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $2,963,018 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| SUBVENTION PAYABLE TO 501(C) ORG | $6,233,652 |
| DEFERRRED RENT | $1,734,880 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $7,968,532 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $344,335,292 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$40,466 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | -$40,466 | RevenueNotReportedAmt |
| Revenue Subtotal | $344,375,758 | RevenueSubtotalAmt |
| Other Revenues Not Included | -$16,041 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | -$16,041 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $344,359,717 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $364,192,442 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $16,041 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $16,041 | ExpensesNotReportedAmt |
| Expenses Subtotal | $364,176,401 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $364,176,401 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (3 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | THE PLAN WAS INCORPORATED AS A NOT-FOR-PROFIT CORPORATION UNDER THE LAWS OF THE STATE OF NEW YORK AND IS EXEMPT FROM INCOME TAXES UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE. THEREFORE, THERE IS NO PROVISION FOR INCOME TAXES INCLUDED IN THE ACCOMPANYING FINANCIAL STATEMENTS. IN ADDITION, MANAGEMENT HAS ASSESSED WHETHER THERE WERE ANY UNCERTAIN TAX POSITIONS WHICH MAY GIVE RISE TO INCOME TAX LIABILITIES AND DETERMINED THAT WERE NO SUCH MATTERS REQUIRING RECOGNITION IN THE ACCOMPANYING FINANCIAL STATEMENTS. THE PLAN FILES INCOME TAX RETURNS IN THE U.S. FEDERAL JURISDICTION. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | FUNDRAISING EXPENSES NETTED AGAINST FUNDRAISING REVENUE -16,041. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | FUNDRAISING EXPENSES NETTED AGAINST FUNDRAISING REVENUE 16,041. |
Schedule G IRS990ScheduleG
Fundraising Event Information FundraisingEventInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Event1 | LIVE YOUR LIFE FUNDRAISER | Event1Nm |
| Gross Receipts Event1 | $141,822 | GrossReceiptsEvent1Amt |
| Charitable Contri Event1 | $141,822 | CharitableContriEvent1Amt |
| Other Direct Expenses Event1 | $16,041 | OtherDirectExpensesEvent1Amt |
| Gross Receipts Total | $141,822 | GrossReceiptsTotalAmt |
| Charitable Contributions Tot | $141,822 | CharitableContributionsTotAmt |
| Oth Direct Expnss Total Events | $16,041 | OthDirectExpnssTotalEventsAmt |
| Direct Expense Summary Events | $16,041 | DirectExpenseSummaryEventsAmt |
| Net Income Summary | -$16,041 | NetIncomeSummaryAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Survey | Yes (X) | CompensationSurveyInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (19 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DOUGLAS WIRTH | ||||||||||||||
| PRESIDENT & CEO | $398,697 | $0 | $85,000 | $0 | $360 | $0 | $28,051 | $0 | $27,332 | $0 | $539,440 | $0 | $0 | $0 |
| JAMES CRAMER | ||||||||||||||
| CHIEF OPERATING OFFICER | $179,614 | $0 | $12,950 | $0 | $1,028 | $0 | $9,898 | $0 | $23,951 | $0 | $227,441 | $0 | $0 | $0 |
| JEROME A ERNST MD | ||||||||||||||
| CHIEF MEDICAL OFFICER | $256,421 | $0 | $26,500 | $0 | $4,944 | $0 | $12,500 | $0 | $25,872 | $0 | $326,237 | $0 | $0 | $0 |
| FELICE KUSSOY | ||||||||||||||
| CHIEF FINANCIAL OFFICER | $226,319 | $0 | $22,500 | $0 | $498 | $0 | $11,778 | $0 | $13,473 | $0 | $274,568 | $0 | $0 | $0 |
| MAURA MCGRATH | ||||||||||||||
| CHIEF COMPLIANCE & PRIVACY OFFICER | $172,233 | $0 | $17,000 | $0 | $643 | $0 | $9,762 | $0 | $24,570 | $0 | $224,208 | $0 | $0 | $0 |
| SUSAN CAPUTO | ||||||||||||||
| EXECUTIVE VICE PRESIDENT | $261,169 | $0 | $15,000 | $0 | $992 | $0 | $0 | $0 | $16,158 | $0 | $293,319 | $0 | $0 | $0 |
| TERRY LEACH | ||||||||||||||
| VP OF PHARMACY | $221,484 | $0 | $15,400 | $0 | $481 | $0 | $3,645 | $0 | $23,333 | $0 | $264,343 | $0 | $0 | $0 |
| LISA ELLEN KEEHN | ||||||||||||||
| VP OF MEDICARE OPERATION | $208,974 | $0 | $15,050 | $0 | $196 | $0 | $11,786 | $0 | $29,069 | $0 | $265,075 | $0 | $0 | $0 |
| OLADIPO ALAO MD | ||||||||||||||
| MEDICAL DIRECTOR | $216,395 | $0 | $0 | $0 | $210 | $0 | $0 | $0 | $33,992 | $0 | $250,597 | $0 | $0 | $0 |
| MARIA DASILVA | ||||||||||||||
| VP OF RISK & NETWORK MGMT | $184,032 | $0 | $12,950 | $0 | $714 | $0 | $7,083 | $0 | $24,405 | $0 | $229,184 | $0 | $0 | $0 |
| KATHY FRANK-KLEIN | ||||||||||||||
| VP OF VENDOR MANAGEMENT | $175,998 | $0 | $12,600 | $0 | $240 | $0 | $9,870 | $0 | $34,604 | $0 | $233,312 | $0 | $0 | $0 |
| STEPHANE HOWZE | ||||||||||||||
| OMBUDSMAN | $172,017 | $0 | $5,550 | $0 | $243 | $0 | $8,994 | $0 | $29,740 | $0 | $216,544 | $0 | $0 | $0 |
| JAMES MORRILL | ||||||||||||||
| VP OF HUMAN RESOURCES | $169,369 | $0 | $11,900 | $0 | $331 | $0 | $4,646 | $0 | $24,540 | $0 | $210,786 | $0 | $0 | $0 |
| KEVIN STEFFENS | ||||||||||||||
| VP OF HEALTH SERVICES OPERATIONS | $151,357 | $0 | $4,027 | $0 | $187 | $0 | $4,758 | $0 | $13,814 | $0 | $174,143 | $0 | $0 | $0 |
| DANIEL WARD | ||||||||||||||
| SR DIR OF FINANCE | $157,127 | $0 | $7,500 | $0 | $568 | $0 | $4,000 | $0 | $11,787 | $0 | $180,982 | $0 | $0 | $0 |
| KIEU DIEM STEPHENS | ||||||||||||||
| DIRECTOR OF FINANCE | $156,867 | $0 | $4,650 | $0 | $109 | $0 | $6,717 | $0 | $3,439 | $0 | $171,782 | $0 | $0 | $0 |
| VIRPI RANTA | ||||||||||||||
| DIRECTOR OF CQI | $139,975 | $0 | $4,180 | $0 | $1,403 | $0 | $7,344 | $0 | $10,933 | $0 | $163,835 | $0 | $0 | $0 |
| MARK FINTZ | ||||||||||||||
| VP OF MEMBER SERVICES | $123,046 | $0 | $10,150 | $0 | $426 | $0 | $2,487 | $0 | $40,014 | $0 | $176,123 | $0 | $0 | $0 |
| MICHELE PEDRETTI-MOSSALLY | ||||||||||||||
| SR DIRECTOR OF BEHAVIORAL HEALTH | $143,597 | $0 | $4,800 | $0 | $127 | $0 | $4,097 | $0 | $41,704 | $0 | $194,325 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 7 | FormAndLineReferenceDesc |
| Explanation | THE FOLLOWING INDIVIDUALS, LISTED ON PART VII, RECEIVED A NON-FIXED PAYMENT IN THE FORM OF A BONUS DURING 2015: DOUGLAS WIRTH - $85,000 JAMES CRAMER - $12,950 JEROME A. ERNST, M.D. - $26,500 FELICE KUSSOY - $22,500 MAURA MCGRATH - $17,000 SUSAN CAPUTO - $15,000 TERRY LEACH - $15,400 LISA ELLEN KEEHN - $15,050 MARIA DASILVA - $12,950 KATHY FRANK-KLEIN - $12,600 STEPHANE HOWZE - $5,550 JAMES MORRILL - $11,900 KEVIN STEFFENS - $4,027 DANIEL WARD - $ 7,500 KIEU DIEM STEPHENS - $4,650 VIRPI RANTA - 4,180 MARK FINTZ - $10,150 MICHELE PEDRETTI-MOSSALLY - $4,800 | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | THE FORM 990 FOR 2015 IS REVIEWED IN DETAIL BY THE ORGANIZATION'S CFO. ANY QUESTIONS ARISING FROM THAT REVIEW WILL BE DISCUSSED WITH THE PREPARER OF THE RETURN. SUBSEQUENT TO THE DETAILED CFO REVIEW, THE FORM 990 IS REVIEWED BY THE ORGANIZATION'S CEO. ANY QUESTIONS ARISING FROM THAT REVIEW WILL BE DISCUSSED WITH THE CFO AND THE PREPARER OF THE RETURN, AS NEEDED. FOLLOWING CFO AND CEO REVIEW, THE FORM 990 IS REVIEWED BY THE BOARD OF DIRECTORS AT A REGULARLY SCHEDULED BOARD MEETING. THE CEO AND CFO WILL RESPOND TO ANY QUESTIONS RAISED BY THE BOARD MEMBERS. ONCE ALL QUESTIONS HAVE BEEN ANSWERED, THE BOARD, CEO AND CFO WILL APPROVE THE FINALIZATION AND FILING OF THE FORM 990. |
| FORM 990, PART VI, SECTION B, LINE 12C | DIRECTORS, OFFICERS AND KEY EMPLOYEES ARE REQUIRED ANNUALLY TO COMPLETE AND SIGN A DETAILED CONFLICT OF INTEREST DISCLOSURE STATEMENT. EMPLOYEES ARE REQUIRED TO PROMPTLY DISCLOSE ANY ACTUAL OR POTENTIAL CONFLICTS OF INTEREST TO HIS OR HER SUPERVISOR (OR IN THE CASE OF THE CEO TO THE CHAIR OF THE BOARD OF DIRECTORS). MEMBERS OF THE BOARD OF DIRECTORS ARE REQUIRED TO PROMPTLY DISCLOSE ANY REAL OR POTENTIAL CONFLICTS OF INTEREST TO THE CHAIR OF THE BOARD OF DIRECTORS (OR IN THE CASE THE CONFLICT IS REPORTABLE BY THE CHAIR THEN TO THE VICE CHAIR). THE CONFLICT OF INTEREST STATEMENTS ARE REVIEWED BY THE CHIEF COMPLIANCE & PRIVACY OFFICER, WHO RECORDS ANY POTENTIAL CONFLICTS AND MONITORS BUSINESS RELATIONSHIPS BETWEEN AMIDA CARE AND THE INDIVIDUAL REPORTING A POTENTIAL CONFLICT OR ANY ORGANIZATION THAT INDIVIDUAL MAY BE AFFILIATED WITH THAT DOES BUSINESS WITH AMIDA CARE. |
| FORM 990, PART VI, SECTION B, LINE 15A | THE ORGANIZATION'S BOARD OF DIRECTORS COMMISSIONED A CEO COMPENSATION STUDY TO ESTABLISH COMPENSATION PACKAGES FOR THE CEO. THE BOARD OF DIRECTORS CHAIR COMPLETES AN ANNUAL PERFORMANCE EVALUATION ON THE CEO AND RECOMMENDS ANY COMPENSATION ADJUSTMENTS TO THE BOARD FOR APPROVAL. THE ORGANIZATION'S CEO UTILIZES THE ASSOCIATION FOR COMMUNITY AFFILIATED PLAN ("ACAP") COMPENSATION STUDY TO ESTABLISH THE COMPENSATION OF THE MEDICAL DIRECTOR, CFO, COO, EXECUTIVE VICE PRESIDENT AND CHIEF COMPLIANCE & PRIVACY OFFICER ("CCPO"). ACAP IS AN ASSOCIATION OF NONPROFIT MEDICAID AND MEDICARE HEALTH PLAN ORGANIZATIONS. THE ORGANIZATION'S CEO COMPLETES AN ANNUAL PERFORMANCE EVALUATION OF THE CMO, CFO, COO, EVP AND CCPO. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES IT GOVERNING DOCUMENTS, FORM 990, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE FOR PUBLIC INSPECTION UPON WRITTEN REQUEST FOR THE SAME PERIOD OF DISCLOSURE AS SET FORTH IN SECTION 6104(D). |
| FORM 990 PART VI SECTION A - GOVERNING BODY AND MANAGEMENT, LINE 1A | NUMBER OF VOTING MEMBERS = 9. TWO OF THE TEN BOARD MEMBERS LISTED IN PART VII, SECTION A ARE FROM THE SAME ORGANIZATION AND SHARE ONE VOTE ON ALL MATTERS DISCUSSED. ALL MEMBERS PARTICIPATE IN BOARD MEETINGS AND VOTE ON ALL MATTERS, EXCEPT THOSE WHICH ASSESS A FINANCIAL CONTRIBUTION REQUIREMENT, IN WHICH CASE, ONLY BOARD MEMBERS WHO REPRESENT ORGANIZATIONS WHICH WOULD BE REQUIRED TO MAKE THE FINANCIAL CONTRIBUTION MAY VOTE. |