ALIVIO MEDICAL CENTER INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- ALIVIO MEDICAL CENTER INC (EIN 36-3661051)
- Tax period
- 2021-07-01 to 2022-06-30
- Filed
- 2024-12-20
- IRS object ID
- 202443559349301619
- Schema version
- 2021v4.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
- Return header
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule J
- Schedule L
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2024-12-20T16:56:02-06:00 | ReturnTs |
| Tax Period End | 2022-06-30 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 362938874 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | OSTROW REISIN BERK & ABRAMS LTD | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 455 N CITYFRONT PLAZA DR SUITE 1600 | AddressLine1Txt |
| City | CHICAGO | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60611 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-07-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 363661051 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ALIVIO MEDICAL CENTER INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | ALIV | BusinessNameControlTxt |
| Phone | 3128296304 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 966 W 21ST ST | AddressLine1Txt |
| City | CHICAGO | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60608 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ESTHER CORPUZ | PersonNm |
| Person Title | CHIEF EXECUTIVE OFFICER | PersonTitleTxt |
| Phone | 3128296304 | PhoneNum |
| Signature | 2024-12-19 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | JASON FLAHIVE | PreparerPersonNm |
| PTIN | P02079670 | PTIN |
| Phone | 3126707444 | PhoneNum |
| Preparation | 2024-12-19 | PreparationDt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2024-10-15 13:58:12Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Amended Return | Yes (X) | AmendedReturnInd |
| Principal Officer | ESTHER CORPUZ | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 966 W 21ST ST | AddressLine1Txt |
| City | CHICAGO | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60608 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $32,237,060 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1988 | FormationYr |
| Legal Domicile State | IL | LegalDomicileStateCd |
| Activity Or Mission | ALIVIO MEDICAL CENTER IS COMMITTED TO PROVIDING ACCESS TO QUALITY, COST EFFECTIVE HEALTH CARE TO THE HISPANIC COMMUNITY, THE UNINSURED, AND THE UNDERINSURED, NOT TO THE EXCLUSION OF OTHER CULTURES AND RACES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 11 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 11 | VotingMembersIndependentCnt |
| Total Employee | 355 | TotalEmployeeCnt |
| Total Volunteers | 11 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $15,823,506 | PYContributionsGrantsAmt |
| CY Contributions Grants | $18,524,841 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $9,229,713 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $12,243,082 | CYProgramServiceRevenueAmt |
| PY Investment Income | $68,100 | PYInvestmentIncomeAmt |
| CY Investment Income | $28,888 | CYInvestmentIncomeAmt |
| PY Other Revenue | $3,684,750 | PYOtherRevenueAmt |
| CY Other Revenue | $1,424,410 | CYOtherRevenueAmt |
| PY Total Revenue | $28,806,069 | PYTotalRevenueAmt |
| CY Total Revenue | $32,221,221 | 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 | $13,127,121 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $15,936,070 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $443,412 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $10,151,158 | PYOtherExpensesAmt |
| CY Other Expenses | $7,846,664 | CYOtherExpensesAmt |
| PY Total Expenses | $23,278,279 | PYTotalExpensesAmt |
| CY Total Expenses | $23,782,734 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $5,527,790 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $8,438,487 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $25,946,474 | TotalAssetsBOYAmt |
| Total Assets EOY | $28,719,171 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $12,301,540 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $6,497,266 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $13,644,934 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $22,221,905 | NetAssetsOrFundBalancesEOYAmt |
| Mission | ALIVIO MEDICAL CENTER IS COMMITTED TO PROVIDING ACCESS TO QUALITY, COST EFFECTIVE HEALTH CARE TO THE HISPANIC COMMUNITY, THE UNINSURED, AND THE UNDERINSURED, NOT TO THE EXCLUSION OF OTHER CULTURES AND RACES. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $18,932,817 | ExpenseAmt |
| Revenue | $13,667,492 | RevenueAmt |
| Desc | THE COMMUNITY HEALTH CENTER WAS ESTABLISHED TO PROVIDE QUALITY, AFFORDABLE HEALTH CARE TO THE LOCAL COMMUNITY. THE COMPREHENSIVE SERVICES INCLUDE PRIMARY OUTPATIENT MEDICAL CARE, OBSTETRICS, GYNECOLOGY, DIAGNOSTIC SERVICES, NUTRITION SERVICES, BEHAVIOR HEALTH SERVICES, EDUCATION AND PREVENTION PROGRAMS AS WELL AS OTHER SUPPORTING SERVICES. | Desc |
| Total Program Service Expenses | $18,932,817 | 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 | Yes (1) | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | Yes (1) | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | 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 | 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 | Yes (1) | 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 | Yes (1) | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 0 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 355 | 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 |
| 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 | 11 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 11 | 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 | Yes (1) | LocalChaptersInd |
| Policies Reference Chapters | Yes (1) | PoliciesReferenceChaptersInd |
| Form990 Provided To Gvrn Body | 0 | 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 | IL | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ESTHER CORPUZ | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 3128296304 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 966 W 21ST ST | AddressLine1Txt |
| City | CHICAGO | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60608 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (21 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 |
|---|---|---|---|---|---|---|---|
| TERESA FRAGA | |||||||
| PRESIDENT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| PETER MARTINEZ | |||||||
| FIRST VICE PRESIDENT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| ELIZABETH AQUINO RN PHD | |||||||
| SECOND VICE PRESIDENT | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| SCOTT CRUZ ESQ | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| LOURDES F DIAZ | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| SANTIAGO GARCIA | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| ANTONIO GUILLEN | |||||||
| BOARD MEMBER, TREASURY SECRETARY | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | |
| MARGARITA LOPEZ | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| ALEANDRA PEREZ TAMAYO MD | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| TOMY SANCHEZ | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JILL SIDEMAN | |||||||
| BOARD MEMBER | 1.00 | Yes (X) | $0 | $0 | $0 | ||
| JENNIFER VARGAS | |||||||
| CHIEF MEDICAL OFFICER | 40.00 | Yes (X) | $221,287 | $0 | $1,969 | ||
| ESTHER CORPUZ | |||||||
| CHIEF EXECUTIVE OFFICER | 40.00 | Yes (X) | $213,467 | $0 | $2,626 | ||
| MAHAMID KHAN | |||||||
| DENTAL SERVICES DIRECTOR | 40.00 | Yes (X) | $160,669 | $0 | $48 | ||
| PANKAJ NAGPAL | |||||||
| CHIEF FINANCIAL OFFICER | 40.00 | Yes (X) | $125,902 | $0 | $12,734 | ||
| JENNIFER GONZALEZ | |||||||
| CHIEF OPERATING OFFICER | 40.00 | Yes (X) | $100,591 | $0 | $7,199 | ||
| ABDUL BHURGRI | |||||||
| PHYSICIAN | 40.00 | $184,064 | $0 | $21,341 | Yes (X) | ||
| MARTHA YANEZ | |||||||
| PHYSICIAN | 40.00 | $160,589 | $0 | $13,151 | Yes (X) | ||
| VIRGINIA SCHMIDT | |||||||
| PHYSICIAN | 40.00 | $145,527 | $0 | $7,375 | Yes (X) | ||
| NORMA WESTERVELT | |||||||
| PHYSICIAN | 30.00 | $124,992 | $0 | $14,217 | Yes (X) | ||
| EDWARD KIRSH | |||||||
| PHYSICIAN | 28.00 | $119,550 | $0 | $19,408 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,556,638 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $100,068 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 14 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $16,394,927 | GovernmentGrantsAmt |
| All Other Contributions | $2,129,914 | AllOtherContributionsAmt |
| Noncash Contributions | $395,173 | NoncashContributionsAmt |
| Total Contributions | $18,524,841 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (4 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REVENUE | 900099 | $4,549,540 | $4,549,540 |
| CAPITATION REVENUE | 900099 | $3,911,615 | $3,911,615 |
| 340B CONTRACT PHARMACY REVENUE | 900099 | $2,948,736 | $2,948,736 |
| SHARED SAVINGS REVENUE | 900099 | $833,191 | $833,191 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $12,243,082 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $28,888 | TotalRevenueColumnAmt |
| Exclusion | $28,888 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $15,839 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $15,839 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $0 | SecuritiesAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| INCOME FROM INVESTMENT IN MHN ACO | 900099 | $1,121,588 | $1,121,588 |
| OTHER REVENUE | 900099 | $302,822 | $302,822 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $1,424,410 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $32,221,221 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $13,667,492 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $28,888 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $860,855 | TotalAmt |
| Program Services | $690,926 | ProgramServicesAmt |
| Management And General | $156,208 | ManagementAndGeneralAmt |
| Fundraising | $13,721 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,842,408 | TotalAmt |
| Program Services | $10,307,395 | ProgramServicesAmt |
| Management And General | $2,330,335 | ManagementAndGeneralAmt |
| Fundraising | $204,678 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $80,355 | TotalAmt |
| Program Services | $64,495 | ProgramServicesAmt |
| Management And General | $14,580 | ManagementAndGeneralAmt |
| Fundraising | $1,280 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,074,248 | TotalAmt |
| Program Services | $862,198 | ProgramServicesAmt |
| Management And General | $194,929 | ManagementAndGeneralAmt |
| Fundraising | $17,121 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,078,204 | TotalAmt |
| Program Services | $865,373 | ProgramServicesAmt |
| Management And General | $195,647 | ManagementAndGeneralAmt |
| Fundraising | $17,184 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $94,439 | TotalAmt |
| Program Services | $48,561 | ProgramServicesAmt |
| Management And General | $35,936 | ManagementAndGeneralAmt |
| Fundraising | $9,942 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $34,952 | TotalAmt |
| Program Services | $17,972 | ProgramServicesAmt |
| Management And General | $13,300 | ManagementAndGeneralAmt |
| Fundraising | $3,680 | FundraisingAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,602 | TotalAmt |
| Management And General | $12,602 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,573,772 | TotalAmt |
| Program Services | $919,858 | ProgramServicesAmt |
| Management And General | $539,238 | ManagementAndGeneralAmt |
| Fundraising | $114,676 | FundraisingAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $43,639 | TotalAmt |
| Program Services | $19,404 | ProgramServicesAmt |
| Management And General | $21,007 | ManagementAndGeneralAmt |
| Fundraising | $3,228 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $251,149 | TotalAmt |
| Program Services | $111,674 | ProgramServicesAmt |
| Management And General | $120,901 | ManagementAndGeneralAmt |
| Fundraising | $18,574 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,006,916 | TotalAmt |
| Program Services | $695,558 | ProgramServicesAmt |
| Management And General | $289,085 | ManagementAndGeneralAmt |
| Fundraising | $22,273 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,093,068 | TotalAmt |
| Program Services | $933,027 | ProgramServicesAmt |
| Management And General | $152,471 | ManagementAndGeneralAmt |
| Fundraising | $7,570 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $127,450 | TotalAmt |
| Program Services | $27,084 | ProgramServicesAmt |
| Management And General | $98,919 | ManagementAndGeneralAmt |
| Fundraising | $1,447 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,446 | TotalAmt |
| Program Services | $2,007 | ProgramServicesAmt |
| Management And General | $7,332 | ManagementAndGeneralAmt |
| Fundraising | $107 | FundraisingAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $200,219 | TotalAmt |
| Program Services | $180,527 | ProgramServicesAmt |
| Management And General | $18,374 | ManagementAndGeneralAmt |
| Fundraising | $1,318 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $513,556 | TotalAmt |
| Program Services | $465,972 | ProgramServicesAmt |
| Management And General | $43,987 | ManagementAndGeneralAmt |
| Fundraising | $3,597 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $111,020 | TotalAmt |
| Program Services | $100,733 | ProgramServicesAmt |
| Management And General | $9,509 | ManagementAndGeneralAmt |
| Fundraising | $778 | FundraisingAmt |
Other Expenses OtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | PROGRAM SUPPLIES | Desc |
| Total | $2,774,436 | TotalAmt |
| Program Services | $2,620,053 | ProgramServicesAmt |
| Management And General | $152,145 | ManagementAndGeneralAmt |
| Fundraising | $2,238 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $23,782,734 | TotalAmt |
| Program Services | $18,932,817 | ProgramServicesAmt |
| Management And General | $4,406,505 | ManagementAndGeneralAmt |
| Fundraising | $443,412 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,239,600 | BOYAmt |
| EOY | $14,136,185 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,510 | BOYAmt |
| EOY | $3,510 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,566,391 | BOYAmt |
| EOY | $1,401,518 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,239,260 | BOYAmt |
| EOY | $2,147,437 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $35,657 | BOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $33,883 | BOYAmt |
| EOY | $5,900 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $16,440,511 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $10,234,183 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,856,316 | BOYAmt |
| EOY | $6,206,328 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,472,376 | BOYAmt |
| EOY | $1,197,224 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,499,481 | BOYAmt |
| EOY | $3,621,069 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,946,474 | BOYAmt |
| EOY | $28,719,171 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,131,100 | BOYAmt |
| EOY | $1,998,461 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,674,656 | BOYAmt |
| EOY | $1,377,533 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,413,530 | BOYAmt |
| EOY | $3,121,272 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $82,254 | BOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,301,540 | BOYAmt |
| EOY | $6,497,266 | 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 | $12,004,488 | BOYAmt |
| EOY | $20,058,381 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,640,446 | BOYAmt |
| EOY | $2,163,524 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $13,644,934 | BOYAmt |
| EOY | $22,221,905 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $25,946,474 | BOYAmt |
| EOY | $28,719,171 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $8,438,487 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | -$282,236 | NetUnrlzdGainsLossesInvstAmt |
| Prior Period Adjustments | $420,720 | PriorPeriodAdjustmentsAmt |
| 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 | 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
CY Endwmt Fund CYEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,000,000 | BeginningYearBalanceAmt |
| Investment Earnings Or Losses | $121,791 | InvestmentEarningsOrLossesAmt |
| End Year Balance | $1,121,791 | EndYearBalanceAmt |
CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,000,000 | BeginningYearBalanceAmt |
| End Year Balance | $1,000,000 | EndYearBalanceAmt |
CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,000,000 | BeginningYearBalanceAmt |
| End Year Balance | $1,000,000 | EndYearBalanceAmt |
CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,000,000 | BeginningYearBalanceAmt |
| End Year Balance | $1,000,000 | EndYearBalanceAmt |
CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Beginning Year Balance | $1,000,000 | BeginningYearBalanceAmt |
| End Year Balance | $1,000,000 | EndYearBalanceAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Board Designated Balance EOY | 0.00000 | BoardDesignatedBalanceEOYPct |
| Prmnnt Endowment Balance EOY | 0.89140 | PrmnntEndowmentBalanceEOYPct |
| Term Endowment Balance EOY | 0.10860 | TermEndowmentBalanceEOYPct |
| Endowments Held Unrelated Org | 0 | EndowmentsHeldUnrelatedOrgInd |
| Endowments Held Related Org | 0 | EndowmentsHeldRelatedOrgInd |
Land LandGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $471,567 | OtherCostOrOtherBasisAmt |
| Book Value | $471,567 | BookValueAmt |
Buildings BuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $10,847,810 | OtherCostOrOtherBasisAmt |
| Depreciation | $7,073,730 | DepreciationAmt |
| Book Value | $3,774,080 | BookValueAmt |
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,256,622 | OtherCostOrOtherBasisAmt |
| Depreciation | $676,142 | DepreciationAmt |
| Book Value | $1,580,480 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,790,817 | OtherCostOrOtherBasisAmt |
| Depreciation | $2,483,532 | DepreciationAmt |
| Book Value | $307,285 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $73,695 | OtherCostOrOtherBasisAmt |
| Depreciation | $779 | DepreciationAmt |
| Book Value | $72,916 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $6,206,328 | TotalBookValueLandBuildingsAmt |
Invst Program Related Org InvstProgramRelatedOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | INVESTMENT IN LIMITED LIABILITY COMPANY | Desc |
| Book Value | $3,621,069 | BookValueAmt |
| Method Valuation | C | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Program Rltd | $3,621,069 | TotalBookValueProgramRltdAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $31,976,101 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | -$282,236 | NetUnrealizedGainsInvstAmt |
| Donated Services And Use Fclts | $49,718 | DonatedServicesAndUseFcltsAmt |
| Revenue Not Reported | -$232,518 | RevenueNotReportedAmt |
| Revenue Subtotal | $32,208,619 | RevenueSubtotalAmt |
| Investment Expenses Not Incld | $12,602 | InvestmentExpensesNotIncldAmt |
| Revenue Not Reported Fincl Stmt | $12,602 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $32,221,221 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $23,819,850 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $49,718 | DonatedServicesUseFcltsAmt |
| Expenses Not Reported | $49,718 | ExpensesNotReportedAmt |
| Expenses Subtotal | $23,770,132 | ExpensesSubtotalAmt |
| Investment Expenses Not Incld2 | $12,602 | InvestmentExpensesNotIncld2Amt |
| Expenses Not Rpt Fincl Stmt | $12,602 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $23,782,734 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE CENTER IS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE CODE). MANAGEMENT OF THE CENTER HAS DETERMINED THAT THE CENTER WAS NOT REQUIRED TO RECORD A LIABILITY RELATED TO UNCERTAIN TAX POSITIONS AS OF JUNE 30, 2022. | ExplanationTxt |
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 (6 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JENNIFER VARGAS | ||||||||||||||
| CHIEF MEDICAL OFFICER | $221,287 | $0 | $0 | $0 | $0 | $0 | $1,969 | $0 | $0 | $0 | $223,256 | $0 | $0 | $0 |
| ESTHER CORPUZ | ||||||||||||||
| CHIEF EXECUTIVE OFFICER | $183,467 | $0 | $30,000 | $0 | $0 | $0 | $2,626 | $0 | $0 | $0 | $216,093 | $0 | $0 | $0 |
| ABDUL BHURGRI | ||||||||||||||
| PHYSICIAN | $184,064 | $0 | $0 | $0 | $0 | $0 | $2,918 | $0 | $18,423 | $0 | $205,405 | $0 | $0 | $0 |
| MARTHA YANEZ | ||||||||||||||
| PHYSICIAN | $160,589 | $0 | $0 | $0 | $0 | $0 | $1,254 | $0 | $11,897 | $0 | $173,740 | $0 | $0 | $0 |
| MAHAMID KHAN | ||||||||||||||
| DENTAL SERVICES DIRECTOR | $160,669 | $0 | $0 | $0 | $0 | $0 | $48 | $0 | $0 | $0 | $160,717 | $0 | $0 | $0 |
| VIRGINIA SCHMIDT | ||||||||||||||
| PHYSICIAN | $145,527 | $0 | $0 | $0 | $0 | $0 | $963 | $0 | $6,412 | $0 | $152,902 | $0 | $0 | $0 |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp
Name Of Interested NameOfInterested
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | SCOTT CRUZ | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship Description | BOARD MEMBER | RelationshipDescriptionTxt |
| Transaction | $90,813 | TransactionAmt |
| Transaction | LEGAL SERVICES PAID TO UB GREENSFELDER | TransactionDesc |
| Sharing Of Revenues | 0 | SharingOfRevenuesInd |
Schedule M IRS990ScheduleM
Drugs And Medical Supplies DrugsAndMedicalSuppliesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 25 | ContributionCnt |
| Noncash Contributions Rpt F990 | $395,173 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | ESTIMATE WHOLESALE VALUE | MethodOfDeterminingRevenuesTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeldInd |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGiftsInd |
| Third Parties Used | 0 | ThirdPartiesUsedInd |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| AMENDED FORM 990 - UPDATES FROM ORIGINALLY FILED 990: | LINE G: GROSS RECEIPTS INCREASED FROM $27,114,327 TO $32,237,060. PART I, LINE 5: INCREASED FROM 273 TO 355. PART I, LINE 6: INCREASED FROM 0 TO 11. PART I, LINE 12: INCREASED FROM 27,114,327 TO 32,221,221. PART I, LINE 18: INCREASED FROM 23,432,771 TO 23,782,734. PART I, LINE 19: INCREASED FROM 3,681,556 TO 8,438,487. PART II: OFFICER NAME CHANGED FROM PAUL NAGPAL, CHIEF FINANCIAL OFFICER TO ESTHER CORPUZ, CHIEF EXECUTIVE OFFICER. PART III, 4A-4C: ONLY SHOW ONE PROGRAM SERVICE ACCOMPLISHMENT IN THIS SECTION ON AMENDED 990. EXPENSES AND REVENUES UPDATED TO REFLECT AUDITED FINANCIALS. PART IV, LINE 11E: CHANGED FROM YES TO NO. PART IV, LINE 12A: CHANGED FROM NO TO YES. PART IV, LINE 28A: CHANGED FROM NO TO YES. PART IV, LINE 29: CHANGED FROM NO TO YES. PART V, LINE 1A: DECREASED FROM 1 TO 0. PART V, LINE 2A: INCREASED FROM 273 TO 355. PART VI, SECTION B, LINE 10A: CHANGED FROM NO TO YES. PART VI, SECTION B, LINE 10B: CHANGED FROM NO TO YES. PART VI, SECTION B, LINE 16A: CHANGED FROM YES TO NO. PART VI, SECTION B, LINE 16B: CHANGED FROM YES TO BLANK. PART VII: NUMEROUS UPDATES TO NAMES, TITLES, POSITIONS, AND COMPENSATION AMOUNTS. PART VII, LINE 2: DECREASED FROM 16 TO 14. PART VIII: REVENUE AMOUNTS UPDATED TO REFLECT AUDITED FINANCIALS. PART IX: EXPENSES AMOUNTS UPDATED TO REFLECT AUDITED FINANCIALS. PART X: ASSETS, LIABILITIES, AND NET ASSETS UPDATED TO REFLECT AUDITED FINANCIALS. PART XI, LINE 5: DECREASED FROM -141,723 TO -282,236. PART XI, LINE 8: INCREASED FROM 0 TO 420,720. PART XII, LINE 2B: CHANGED FROM NO TO YES AND SEPARATE BASIS. PART XII, LINE 2C: CHANGED FROM NO TO YES. PART XII, LINE 3B: CHANGED FROM NO TO YES. SCHEDULE B: CONTRIBUTION INFORMATION UPDATED TO REFLECT AUDITED FINANCIALS. SCHEDULE D, PART V: UPDATED ENDOWMENT TOTAL OF 1,000,000 TO TIE TO AUDITED FINANCIALS TOTAL OF 1,121,791. SCHEDULE D, PART VI: INFORMATION UPDATED TO REFLECT AUDITED FINANCIALS. SCHEDULE D, PART VIII: UPDATED TO REFLECT AUDITED FINANCIALS. SCHEDULE D, PART VIII: UPDATED TO REFLECT AUDITED FINANCIALS. SCHEDULE D, PART XI: COMPLETED THIS SECTION. SCHEDULE D, PART XII: COMPLETED THIS SECTION. SCHEDULE D, PART XIII: COMPLETED THIS SECTION. SCHEDULE J, PART II: NUMEROUS UPDATES TO NAMES, TITLES, AND COMPENSATION AMOUNTS. SCHEDULE L: COMPLETED THIS SCHEDULE. SCHEDULE M: COMPLETED THIS SCHEDULE. SCHEDULE O, FORM 990, PART VI, SECTION B, LINE 11B: UPDATED FROM "DUE TO TIME CONSTRAINTS, A COPY OF FORM 990 WILL BE PROVIDED TO THE BOARD AT THE NEXT BOARD MEETING." TO "THE FORM 990 IS REVIEWED BY THE DIRECTOR OF FINANCE / CFO WITH THE CHIEF EXECUTIVE OFFICER (CEO) PRIOR TO FILING." |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 IS REVIEWED BY THE DIRECTOR OF FINANCE / CFO WITH THE CHIEF EXECUTIVE OFFICER (CEO) PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE MEMBERS MUST DISCLOSE IF THERE IS A CONFLICT OF INTEREST AT THE ANNUAL BOARD MEETING. THE BOARD MEMBERS COMPLETE AND SIGN A FORM DOCUMENTING THAT AT THE TIME THERE ARE NO CONFLICTS OF INTEREST. EACH YEAR THE BOARD MEMBERS SIGN A NEW FORM AND IF THERE IS A CONFLICT THE MEMBER ABSTAINS FROM VOTING. IF A BOARD MEMBER IS FOUND TO HAVE NOT DISCLOSED A CONFLICT, THE MEMBER WILL BE BROUGHT BEFORE THE EXECUTIVE COMMITTEE. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE BOARD OF DIRECTORS REVIEWS ANNUALLY, THE COMPENSATION OF THE CEO. THE CEO EVALUATES COMPENSATION OF EMPLOYEES EVERY TWO YEARS. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ALL GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICIES AND FINANCIAL STATEMENTS AVAILABLE UPON REQUEST. |
Schedule R IRS990ScheduleR
Unrelated Org Txbl Partnership UnrelatedOrgTxblPartnershipGrp
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MHN ACO LLC | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 939 W NORTH AVENUE SUITE 875 | AddressLine1Txt |
| City | CHICAGO | CityNm |
| State Abbreviation | IL | StateAbbreviationCd |
| ZIP | 60642 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 300833127 | EIN |
| Primary Activities | HEALTH CARE SERVICES | PrimaryActivitiesTxt |
| Legal Domicile State | IL | LegalDomicileStateCd |
| All Partners C3 S | Yes (1) | AllPartnersC3SInd |
| Share Of EOY Assets | $2,499,481 | ShareOfEOYAssetsAmt |
| Disproportionate Allocations | 0 | DisproportionateAllocationsInd |
| General Or Managing Partner | 0 | GeneralOrManagingPartnerInd |
| Ownership | 0.11110 | OwnershipPct |
Comments