PACKARD HEALTH INC: Form 990, tax year 2024
View the entire original 990 at ProPublica ↗
- Organization
- PACKARD HEALTH INC (EIN 38-2269817)
- Tax period
- 2024-09-01 to 2025-08-31
- Filed
- 2026-03-24
- IRS object ID
- 202600839349301650
- Schema version
- 2024v5.5
- 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 | 2026-03-24T14:12:26-05:00 | ReturnTs |
| Tax Period End | 2025-08-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 382706146 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | YEO & YEO PC | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1450 Eisenhower Place | AddressLine1Txt |
| City | Ann Arbor | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 481083283 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2024-09-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 382269817 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Packard Health Inc | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | PACK | BusinessNameControlTxt |
| Phone | 7349711073 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5200 Venture Drive | AddressLine1Txt |
| City | Ann Arbor | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48108 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Raymond Rion | PersonNm |
| Person Title | Executive Director | PersonTitleTxt |
| Phone | 7349711073 | PhoneNum |
| Signature | 2026-03-23 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | 0 | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Brian R Dixon | PreparerPersonNm |
| PTIN | P01321580 | PTIN |
| Phone | 7347691331 | PhoneNum |
| Preparation | 2026-03-23 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2024 | TaxYr |
| Build TS | 2025-03-06 01:10:19Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Raymond Rion | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5200 Venture Drive | AddressLine1Txt |
| City | Ann Arbor | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48108 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $19,910,172 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | www.packardhealth.org | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1973 | FormationYr |
| Legal Domicile State | MI | LegalDomicileStateCd |
| Activity Or Mission | To provide the best possible care to our patients and community, including people whose economic, social or cultural conditions might otherwise prevent them from accessing health care. | ActivityOrMissionDesc |
| Voting Members Governing Body | 16 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 16 | VotingMembersIndependentCnt |
| Total Employee | 150 | TotalEmployeeCnt |
| Total Volunteers | 26 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $2,789,669 | PYContributionsGrantsAmt |
| CY Contributions Grants | $3,592,738 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $12,291,405 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $16,188,123 | CYProgramServiceRevenueAmt |
| PY Investment Income | $140,021 | PYInvestmentIncomeAmt |
| CY Investment Income | $126,469 | CYInvestmentIncomeAmt |
| PY Other Revenue | $45,539 | PYOtherRevenueAmt |
| CY Other Revenue | $2,842 | CYOtherRevenueAmt |
| PY Total Revenue | $15,266,634 | PYTotalRevenueAmt |
| CY Total Revenue | $19,910,172 | 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 | $9,844,397 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $11,110,445 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $326,505 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $6,099,602 | PYOtherExpensesAmt |
| CY Other Expenses | $8,159,721 | CYOtherExpensesAmt |
| PY Total Expenses | $15,943,999 | PYTotalExpensesAmt |
| CY Total Expenses | $19,270,166 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$677,365 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $640,006 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $18,061,803 | TotalAssetsBOYAmt |
| Total Assets EOY | $18,827,742 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $3,401,034 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $3,430,358 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $14,660,769 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $15,397,384 | NetAssetsOrFundBalancesEOYAmt |
| Mission | To provide the best possible care to our patients and community, including people whose economic, social or cultural conditions might otherwise prevent them from accessing health care. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $14,967,172 | ExpenseAmt |
| Revenue | $16,188,123 | RevenueAmt |
| Desc | Primary Health Services, including mental health care, pharmaceutical services, and health promotion to patients in the Washtenaw County area. | Desc |
| Total Program Service Expenses | $14,967,172 | 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 |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| 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 | 0 | 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 | 0 | 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 With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | Yes (1) | 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 | 5 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 150 | 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 |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 16 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 16 | 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 | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | MI | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | David Hoffman | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 7349711073 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 5200 Venture Drive | AddressLine1Txt |
| City | Ann Arbor | CityNm |
| State Abbreviation | MI | StateAbbreviationCd |
| ZIP | 48108 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (25 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|
| Margaret Calarco | |||||||
| Board Chair | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Molly Welch-Marahar | |||||||
| Vice Chair | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Tomasine Marx | |||||||
| Treasurer | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Nora Maloy DrPH | |||||||
| Secretary | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| Gary Boren | |||||||
| Trustee | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Rana Smith | |||||||
| Trustee | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Sharon Moore | |||||||
| Trustee | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Edd Snyder | |||||||
| Trustee | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Paula Lantz | |||||||
| Trustee | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Bryan Wagoner | |||||||
| Trustee | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Ruth Cassidy | |||||||
| Trustee | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Juan Marquez MPH MD | |||||||
| Trustee | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Joseph Kaplan | |||||||
| Trustee | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Phillip Rodgers MD | |||||||
| Trustee | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Paul Harkaway MD | |||||||
| Trustee | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Brandie Tyuse | |||||||
| Trustee | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| Raymond Rion | |||||||
| Executive Director | 40.00 | Yes (X) | $292,131 | $0 | $19,846 | ||
| Dr Ankoor Soni | |||||||
| Medical Director | 40.00 | Yes (X) | $213,222 | $0 | $29,315 | ||
| David Hoffman | |||||||
| CFO | 40.00 | Yes (X) | $145,365 | $0 | $7,281 | ||
| Neil B Kirst | |||||||
| CMO | 40.00 | Yes (X) | $268,969 | $0 | $31,551 | ||
| Ravi Vadlamudi | |||||||
| Physician | 40.00 | $232,588 | $0 | $30,817 | Yes (X) | ||
| Lindsey Kotagal | |||||||
| Physician | 40.00 | $183,705 | $0 | $9,249 | Yes (X) | ||
| Ronald Romero | |||||||
| Physician | 40.00 | $170,967 | $0 | $28,945 | Yes (X) | ||
| Joseph Thompson | |||||||
| Physician | 40.00 | $218,718 | $0 | $17,744 | Yes (X) | ||
| Holly Ross | |||||||
| Compliance Officer | 40.00 | $164,678 | $0 | $30,079 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,890,343 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $204,827 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 21 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| Nuvem 340Basics | |||||
| 311 Arsenal Street | Watertown | MA | 02472 | 340B Services | $383,866 |
| Athenahealth Inc | |||||
| 315 Madison Ave Ste 1804 | New York | NY | 10017 | Billing and AR | $204,881 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $1,537,885 | GovernmentGrantsAmt |
| All Other Contributions | $2,054,853 | AllOtherContributionsAmt |
| Noncash Contributions | $622,751 | NoncashContributionsAmt |
| Total Contributions | $3,592,738 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Patient Fees | 624100 | $7,758,821 | $7,758,821 |
| Pharmacy | 624100 | $4,316,075 | $4,316,075 |
| Contract Service Fees | 624100 | $3,752,364 | $3,752,364 |
| Capitation Fees | 624100 | $360,863 | $360,863 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $16,188,123 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $126,469 | TotalRevenueColumnAmt |
| Exclusion | $126,469 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | Other | Desc |
| Business | 624100 | BusinessCd |
| Total Revenue Column | $2,842 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $0 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $2,842 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $2,842 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $19,910,172 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $16,188,123 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $129,311 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $994,840 | TotalAmt |
| Program Services | $399,970 | ProgramServicesAmt |
| Management And General | $594,870 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,983,967 | TotalAmt |
| Program Services | $5,882,023 | ProgramServicesAmt |
| Management And General | $1,906,209 | ManagementAndGeneralAmt |
| Fundraising | $195,735 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $168,277 | TotalAmt |
| Program Services | $129,278 | ProgramServicesAmt |
| Management And General | $34,523 | ManagementAndGeneralAmt |
| Fundraising | $4,476 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,285,062 | TotalAmt |
| Program Services | $920,503 | ProgramServicesAmt |
| Management And General | $335,920 | ManagementAndGeneralAmt |
| Fundraising | $28,639 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $678,299 | TotalAmt |
| Program Services | $476,053 | ProgramServicesAmt |
| Management And General | $187,317 | ManagementAndGeneralAmt |
| Fundraising | $14,929 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $67,680 | TotalAmt |
| Program Services | $21,217 | ProgramServicesAmt |
| Management And General | $46,463 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $38,405 | TotalAmt |
| Management And General | $38,405 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,552,327 | TotalAmt |
| Program Services | $1,218,558 | ProgramServicesAmt |
| Management And General | $331,438 | ManagementAndGeneralAmt |
| Fundraising | $2,331 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $71,624 | TotalAmt |
| Fundraising | $71,624 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $257,674 | TotalAmt |
| Program Services | $177,795 | ProgramServicesAmt |
| Management And General | $77,302 | ManagementAndGeneralAmt |
| Fundraising | $2,577 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $144,519 | TotalAmt |
| Program Services | $99,718 | ProgramServicesAmt |
| Management And General | $43,356 | ManagementAndGeneralAmt |
| Fundraising | $1,445 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $76,626 | TotalAmt |
| Program Services | $75,895 | ProgramServicesAmt |
| Management And General | $707 | ManagementAndGeneralAmt |
| Fundraising | $24 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $87,846 | TotalAmt |
| Management And General | $87,846 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $383,992 | TotalAmt |
| Program Services | $207,356 | ProgramServicesAmt |
| Management And General | $172,796 | ManagementAndGeneralAmt |
| Fundraising | $3,840 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $34,696 | TotalAmt |
| Management And General | $34,696 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Medical Supplies | $4,852,055 | $4,852,055 | |
| Building and equipment | $243,618 | $243,151 | $467 |
| Other | $165,593 | $132,340 | $33,253 |
| Dues licenses and subsc | $94,538 | $70,175 | $24,363 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $88,528 | TotalAmt |
| Program Services | $61,085 | ProgramServicesAmt |
| Management And General | $26,558 | ManagementAndGeneralAmt |
| Fundraising | $885 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $19,270,166 | TotalAmt |
| Program Services | $14,967,172 | ProgramServicesAmt |
| Management And General | $3,976,489 | ManagementAndGeneralAmt |
| Fundraising | $326,505 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $975 | BOYAmt |
| EOY | $189,308 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $673,251 | BOYAmt |
| EOY | $446,796 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $192,516 | BOYAmt |
| EOY | $73,107 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,084,453 | BOYAmt |
| EOY | $2,716,479 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $331,248 | BOYAmt |
| EOY | $478,242 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $235,779 | BOYAmt |
| EOY | $183,170 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $10,171,941 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,360,394 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $8,996,155 | BOYAmt |
| EOY | $8,811,547 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,086,187 | BOYAmt |
| EOY | $5,630,785 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $461,239 | BOYAmt |
| EOY | $298,308 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,061,803 | BOYAmt |
| EOY | $18,827,742 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $844,158 | BOYAmt |
| EOY | $1,026,059 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $200,000 | BOYAmt |
| EOY | $171,643 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,885,287 | BOYAmt |
| EOY | $1,806,657 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $471,589 | BOYAmt |
| EOY | $425,999 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,401,034 | BOYAmt |
| EOY | $3,430,358 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,278,859 | BOYAmt |
| EOY | $15,182,402 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $381,910 | BOYAmt |
| EOY | $214,982 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $14,660,769 | BOYAmt |
| EOY | $15,397,384 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $18,061,803 | BOYAmt |
| EOY | $18,827,742 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $640,006 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $92,442 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $4,167 | 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 | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
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
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $1,295,809 | OtherCostOrOtherBasisAmt |
| Book Value | $1,295,809 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $7,700,599 | OtherCostOrOtherBasisAmt |
| Depreciation | $872,207 | DepreciationAmt |
| Book Value | $6,828,392 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $258,383 | OtherCostOrOtherBasisAmt |
| Depreciation | $175,027 | DepreciationAmt |
| Book Value | $83,356 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $917,150 | OtherCostOrOtherBasisAmt |
| Depreciation | $313,160 | DepreciationAmt |
| Book Value | $603,990 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $8,811,547 | TotalBookValueLandBuildingsAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp (2 entries)
| DescDesc | AmtAmt |
|---|---|
| Operating Lease | $306,798 |
| Medicaid cost settlement | $119,201 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $425,999 | TotalLiabilityAmt |
| Total Rev Etc Audited Fincl Stmt | $20,002,614 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $92,442 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | $92,442 | RevenueNotReportedAmt |
| Revenue Subtotal | $19,910,172 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $19,910,172 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $0 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $0 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $0 | TotalExpensesPerForm990Amt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| 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 | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Raymond Rion | ||||||||||||||
| Executive Director | $282,131 | $0 | $10,000 | $0 | $0 | $0 | $11,251 | $0 | $8,595 | $0 | $311,977 | $0 | $0 | $0 |
| Neil B Kirst | ||||||||||||||
| CMO | $268,969 | $0 | $0 | $0 | $0 | $0 | $10,347 | $0 | $21,204 | $0 | $300,520 | $0 | $0 | $0 |
| Ravi Vadlamudi | ||||||||||||||
| Physician | $232,168 | $0 | $420 | $0 | $0 | $0 | $9,314 | $0 | $21,503 | $0 | $263,405 | $0 | $0 | $0 |
| Dr Ankoor Soni | ||||||||||||||
| Medical Director | $208,102 | $0 | $5,120 | $0 | $0 | $0 | $7,224 | $0 | $22,091 | $0 | $242,537 | $0 | $0 | $0 |
| Joseph Thompson | ||||||||||||||
| Physician | $210,941 | $0 | $7,777 | $0 | $0 | $0 | $0 | $0 | $17,744 | $0 | $236,462 | $0 | $0 | $0 |
| Ronald Romero | ||||||||||||||
| Physician | $170,456 | $0 | $511 | $0 | $0 | $0 | $6,842 | $0 | $22,103 | $0 | $199,912 | $0 | $0 | $0 |
| Holly Ross | ||||||||||||||
| Compliance Officer | $161,363 | $0 | $3,315 | $0 | $0 | $0 | $6,587 | $0 | $23,492 | $0 | $194,757 | $0 | $0 | $0 |
| Lindsey Kotagal | ||||||||||||||
| Physician | $178,045 | $0 | $5,660 | $0 | $0 | $0 | $7,348 | $0 | $1,901 | $0 | $192,954 | $0 | $0 | $0 |
| David Hoffman | ||||||||||||||
| CFO | $145,365 | $0 | $0 | $0 | $0 | $0 | $5,380 | $0 | $1,901 | $0 | $152,646 | $0 | $0 | $0 |
Schedule M IRS990ScheduleM
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 1254 | ContributionCnt |
| Noncash Contributions Rpt F990 | $622,751 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | FMV | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | Yes (1) | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section B, line 11b | The 990 is reviewed by the CFO in detail, the 990 is also provided to the Executive Director, Treasurer and the Board for reveiw prior to filing. |
| Form 990, Part VI, Section B, line 12c | The Board revisits the conflicts of interest policy annually. |
| Form 990, Part VI, Section B, line 15 | The Board determines the compensation of the Executive Director based on performance and other factors. The Executive Director determines the compensation for officers & key employees. |
| Form 990, Part VI, Section C, line 19 | Documents are available upon request. |
| Form 990, Part XI, line 9: | Adjustment for prior year accounts receivable 4,167. |