BETA

KNAPP MEDICAL GROUP: Form 990, tax year 2022

View the entire original 990 at ProPublica ↗

Organization
KNAPP MEDICAL GROUP (EIN 27-1619835)
Tax period
2022-01-01 to 2022-12-31
Filed
2023-11-15
IRS object ID
202303199349331275
Schema version
2022v5.0
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2023-11-15T21:06:08-06:00ReturnTs
Tax Period End2022-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN861065772PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1DELOITTE TAX LLPBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1695 TOWN CENTER DRIVE STE 1200AddressLine1Txt
CityCOSTA MESACityNm
State AbbreviationCAStateAbbreviationCd
ZIP92626ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2022-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN271619835EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1KNAPP MEDICAL GROUPBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlKNAPBusinessNameControlTxt
Phone9569695112PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11402 E 8TH STREETAddressLine1Txt
CityWESLACOCityNm
State AbbreviationTXStateAbbreviationCd
ZIP78596ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonSTEVE ALEMANPersonNm
Person TitleCFOPersonTitleTxt
Phone9569695112PhoneNum
Signature2023-11-15SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstSTEVEPersonFirstNm
Person LastALEMANPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN
FieldValueIRS element (for citing)
IRS Responsible Prty Info Curr0IRSResponsiblePrtyInfoCurrInd

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonJOHN SADOFF JRPreparerPersonNm
PTINP00540589PTIN
Phone7144367100PhoneNum

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer3TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2022TaxYr
Build TS2023-04-26 12:10:37ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerRENE LOPEZPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11402 E 8TH STREETAddressLine1Txt
CityWESLACOCityNm
State AbbreviationTXStateAbbreviationCd
ZIP78596ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$452,336GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.KNAPPCLINIC.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2008FormationYr
Legal Domicile StateTXLegalDomicileStateCd
Activity Or MissionTO PROVIDE RESIDENTS WITH ADEQUATE ACCESS TO PRIMARY HEALTH CARE BY EMPLOYING PHYSICIANS AND OPERATING CLINICS IN THE MEDICALLY UNDESERVED AREA OF THE RIO GRANDE VALLEY.ActivityOrMissionDesc
Voting Members Governing Body5VotingMembersGoverningBodyCnt
Voting Members Independent3VotingMembersIndependentCnt
Total Employee16TotalEmployeeCnt
Total Volunteers0TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$0PYContributionsGrantsAmt
CY Contributions Grants$19,399CYContributionsGrantsAmt
PY Program Service Revenue$692,517PYProgramServiceRevenueAmt
CY Program Service Revenue$432,937CYProgramServiceRevenueAmt
PY Investment Income$0PYInvestmentIncomeAmt
CY Investment Income$0CYInvestmentIncomeAmt
PY Other Revenue$44,989PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$737,506PYTotalRevenueAmt
CY Total Revenue$452,336CYTotalRevenueAmt
PY Grants And Similar Paid$0PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$609,454PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$244,461CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$612,950PYOtherExpensesAmt
CY Other Expenses$414,305CYOtherExpensesAmt
PY Total Expenses$1,222,404PYTotalExpensesAmt
CY Total Expenses$658,766CYTotalExpensesAmt
PY Revenues Less Expenses-$484,898PYRevenuesLessExpensesAmt
CY Revenues Less Expenses-$206,430CYRevenuesLessExpensesAmt
Total Assets BOY$382,268TotalAssetsBOYAmt
Total Assets EOY$311,094TotalAssetsEOYAmt
Total Liabilities BOY$14,665,046TotalLiabilitiesBOYAmt
Total Liabilities EOY$14,800,302TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY-$14,282,778NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY-$14,489,208NetAssetsOrFundBalancesEOYAmt
MissionTO PROVIDE RESIDENTS WITH ADEQUATE ACCESS TO PRIMARY HEALTH CARE BY EMPLOYING PHYSICIANS AND OPERATING CLINICS IN THE MEDICALLY UNDERSERVED AREA OF THE RIO GRANDE VALLEY.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$454,017ExpenseAmt
Revenue$432,937RevenueAmt
DescTO ESTABLISH PRIMARY HEALTHCARE CLINICS IN THE MID VALLEY AREA AND TO PROVIDE PHYSICIAN OUTREACH SERVICES.Desc
Total Program Service Expenses$454,017TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other AssetsYes (1)ReportOtherAssetsInd
Report Other LiabilitiesYes (1)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl Stmt0IndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtYes (1)ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To Individuals0GrantsToIndividualsInd
Schedule J RequiredYes (1)ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan Outstanding0LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related EntityYes (1)RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document9IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee16EmployeeCnt
Employment Tax Returns FiledYes (1)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft Cntrct0RcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft Cntrct0PayPremiumsPrsnlBnftCntrctInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members5GoverningBodyVotingMembersCnt
Independent Voting Member3IndependentVotingMemberCnt
Family Or Business Rln0FamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesYes (1)DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or StockholdersYes (1)MembersOrStockholdersInd
Election Of Board MembersYes (1)ElectionOfBoardMembersInd
Decisions Subject To ApprovaYes (1)DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower Policy0WhistleblowerPolicyInd
Document Retention Policy0DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonRENE LOPEZPersonNm
Phone9569735484PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11402 E 8TH STREETAddressLine1Txt
CityWESLACOCityNm
State AbbreviationTXStateAbbreviationCd
ZIP78596ZIPCd

Form990 Part VII Section A Form990PartVIISectionAGrp (6 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtOfficerOfficerInd
MICHEAL DECANDIA MD
BOARD MEMBER1.001.00Yes (X)$0$0$0
CHARLES M ZAREMBA MD
BOARD MEMBER1.001.00Yes (X)$0$0$0
DANIEL FARRAY MD
BOARD MEMBER1.0040.00Yes (X)$0$0$0
MICHAEL DAVIS
CFO (REGIONAL) / SEC. /TREAS.1.0040.00Yes (X)$0$192,073$41,658Yes (X)
RENE J LOPEZ
CEO/PRESIDENT (REGIONAL)1.0040.00Yes (X)$0$344,033$34,762Yes (X)
STEVE ALEMAN
PHF CFO1.008.00$0$0$0Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$536,106TotReportableCompRltdOrgAmt
Total Other Compensation$76,420TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (1)TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd

Contractor Compensation ContractorCompensationGrp

Contractor Name ContractorName

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1UNIVERSITY OF TEXAS RIO GRANDE VALLEYBusinessNameLine1Txt

Contractor Address ContractorAddress

US Address USAddress

FieldValueIRS element (for citing)
Address Line1PO BOX 733091AddressLine1Txt
CityDALLASCityNm
State AbbreviationTXStateAbbreviationCd
ZIP753733091ZIPCd
FieldValueIRS element (for citing)
ServicesPHYSICIAN SERVICESServicesDesc
Compensation$242,667CompensationAmt
FieldValueIRS element (for citing)
Cntrct Rcvd Greater Than100 K1CntrctRcvdGreaterThan100KCnt
Government Grants$19,399GovernmentGrantsAmt
Total Contributions$19,399TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescNET PATIENT REVENUEDesc
Business621500BusinessCd
Total Revenue Column$432,937TotalRevenueColumnAmt
Related Or Exempt Func Income$432,937RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$432,937TotalProgramServiceRevenueAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$452,336TotalRevenueColumnAmt
Related Or Exempt Func Income$432,937RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt
FieldValueIRS element (for citing)
Info In Schedule O Part IXYes (X)InfoInScheduleOPartIXInd

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$185,477TotalAmt
Program Services$185,477ProgramServicesAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total-$734TotalAmt
Program Services-$734ProgramServicesAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$38,076TotalAmt
Program Services$38,076ProgramServicesAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$21,642TotalAmt
Program Services$21,642ProgramServicesAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$266,020TotalAmt
Program Services$93,107ProgramServicesAmt
Management And General$172,913ManagementAndGeneralAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$180TotalAmt
Management And General$180ManagementAndGeneralAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$139TotalAmt
Management And General$139ManagementAndGeneralAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$11,265TotalAmt
Management And General$11,265ManagementAndGeneralAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$6,989TotalAmt
Program Services$6,989ProgramServicesAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$7,621TotalAmt
Management And General$7,621ManagementAndGeneralAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmt
BAD DEBT EXPENSE$97,662$97,662
MEDICAL SUPPLIES$11,798$11,798
TAXES AND LICENSES$6,425$6,425
OTHER OPERATING EXPENSE$6,206$6,206

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$658,766TotalAmt
Program Services$454,017ProgramServicesAmt
Management And General$204,749ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$97,346BOYAmt
EOY$2,127EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$112,284BOYAmt
EOY$109,101EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$2,646BOYAmt
EOY$2,646EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$1,246BOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$581,541LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$445,941LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$142,589BOYAmt
EOY$135,600EOYAmt

Other Assets Total OtherAssetsTotalGrp

FieldValueIRS element (for citing)
BOY$26,157BOYAmt
EOY$61,620EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$382,268BOYAmt
EOY$311,094EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$189,628BOYAmt
EOY$38,011EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$14,475,418BOYAmt
EOY$14,762,291EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$14,665,046BOYAmt
EOY$14,800,302EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY-$14,282,778BOYAmt
EOY-$14,489,208EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY-$14,282,778BOYAmt
EOY-$14,489,208EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$382,268BOYAmt
EOY$311,094EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss-$206,430ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Consolidated Basis Fincl StmtYes (X)ConsolidatedBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd

Schedule D IRS990ScheduleD

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$212,214OtherCostOrOtherBasisAmt
Depreciation$88,598DepreciationAmt
Book Value$123,616BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$23,571OtherCostOrOtherBasisAmt
Depreciation$13,438DepreciationAmt
Book Value$10,133BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$345,756OtherCostOrOtherBasisAmt
Depreciation$343,905DepreciationAmt
Book Value$1,851BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$135,600TotalBookValueLandBuildingsAmt

Other Assets Org OtherAssetsOrgGrp (2 entries)

DescDescBook ValueBookValueAmt
DUE FROM AFFILIATES$28,031
CONSTRUCTION IN PROGRESS$33,589
FieldValueIRS element (for citing)
Total Book Value Other Assets$61,620TotalBookValueOtherAssetsAmt

Other Liabilities Org OtherLiabilitiesOrgGrp (5 entries)

DescDescAmtAmt
DUE TO AFFILIATES$629
THIRD PARTY SETTLEMENTS$5,303
OTHER LONG-TERM LIABILITIES$4,939
INTERCOMPANY PAYABLE$14,422,226
DUE TO RELATED ENTITIES$329,194
FieldValueIRS element (for citing)
Total Liability$14,762,291TotalLiabilityAmt
Footnote TextYes (X)FootnoteTextInd

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationTHE LITERATURE RELATED TO UNCERTAIN TAX POSITIONS PRESCIRBES A RECOGNITION THRESHOLD AND MEASUREMENT PROCESS FOR ACCOUNTING FOR UNCERTAIN TAX POSITION AND ALSO PROVIDES GUIDANCE ON VARIOUS RELATED MATTERS SUCH AS DE-RECOGNITION, INTEREST, PENALTIES, AND DISCLOSURES REQUIRED. THE COMPANY DOES NOT HAVE ANY ENTITY-LEVEL UNCERTAIN TAX POSITIONS.ExplanationTxt

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance Payment0SeverancePaymentInd
Supplemental Nonqual Rtr Plan0SupplementalNonqualRtrPlanInd
Equity Based Comp Arrngm0EquityBasedCompArrngmInd
Comp Based On Revenue Of Flng Org0CompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related Orgs0CompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng Org0CompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd Orgs0CompBsdNetEarnsRltdOrgsInd
Any Non Fixed Payments0AnyNonFixedPaymentsInd
Initial Contract Exception0InitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (2 entries)

TitleTitleTxtBase Compensation Filing OrgBaseCompensationFilingOrgAmtCompensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmtBonus Filing OrganizationBonusFilingOrganizationAmountBonus Related OrganizationsBonusRelatedOrganizationsAmtOther Compensation Filing OrgOtherCompensationFilingOrgAmtOther Compensation Rltd OrgsOtherCompensationRltdOrgsAmtDeferred Compensation Flng OrgDeferredCompensationFlngOrgAmtDeferred Comp Rltd OrgsDeferredCompRltdOrgsAmtNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmtNontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmtTotal Compensation Filing OrgTotalCompensationFilingOrgAmtTotal Compensation Rltd OrgsTotalCompensationRltdOrgsAmtComp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmtComp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt
RENE J LOPEZ
CEO/PRESIDENT (REGIONAL)$0$305,406$0$25,000$0$13,627$0$27,000$0$7,762$0$378,795$0$0
MICHAEL DAVIS
CFO (REGIONAL) / SEC. /TREAS.$0$169,461$0$20,000$0$2,612$0$27,000$0$14,658$0$233,731$0$0

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART I, LINE 3FormAndLineReferenceDesc
ExplanationA RELATED ORGANIZATION USES THE FOLLOWING METHODS TO ESTABLISH COMPENSATION: WRITTEN EMPLOYMENT CONTRACT COMPENSATION SURVEY OR STUDY OFFICER COMPENSATION IS ESTABLISHED BY PRIME HEALTHCARE MANAGEMENT, INC IN ACCORDANCE WITH A MANAGEMENT AGREEMENT WITH KNAPP MEDICAL CENTER WHICH IS THE CONTROLLING MEMBER OF KNAPP MEDICAL GROUP. WRITTEN EMPLOYMENT CONTRACTS ARE FORWARDED TO THE FACILITY ONCE EXECUTED. COMPENSATION SURVEY OR STUDIES ARE UTILIZED.ExplanationTxt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (10 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 3THE ORGANIZATION IS BEING MANAGED BY PRIME HEALTHCARE MANAGEMENT, INC., AN AFFILIATE OF PRIME HEALTHCARE FOUNDATION, INC. (PHF). THE COMPANY PROVIDES MANAGEMENT AND ADMINISTRATIVE SERVICES TO THE FILING ORGANIZATION AND EACH OF THE HOSPITAL FACILITIES IN THE ORGANIZATION. SERVICES INCLUDE, MANAGEMENT, LEGAL, INFORMATION TECHNOLOGY AND REVENUE CYCLE MANAGEMENT. THE FOLLOWING OFFICERS LISTED ON PART VII ARE EMPLOYED BY THE MANAGEMENT COMPANY TO PROVIDE SERVICES TO A VARIETY OF HOSPITALS ON AN AS-NEEDED BASIS AND RECEIVED THE FOLLOWING AMOUNT OF COMPENSATION FROM THE MANAGEMENT COMPANY FOR SERVICES PROVIDED TO PRIME HEALTHCARE FOUNDATION AND ITS SUBSIDIARIES: STEVE ALEMAN - $66,108
FORM 990, PART VI, SECTION A, LINE 6KNAPP MEDICAL CENTER IS THE SOLE MEMBER OF KNAPP MEDICAL GROUP.
FORM 990, PART VI, SECTION A, LINE 7ATHE MEMBER SHALL APPOINT EACH SUCCESSION TO A DIRECTOR WHOSE TERM HAS EXPIRED.
FORM 990, PART VI, SECTION A, LINE 7BACTION RESERVED TO THE MEMBER: THE FOLLOWING MATTERS ARE RESERVED SOLELY TO THE MEMBER AND, FOLLOWING CONSULTATION WITH THE BOARD OF DIRECTORS SHALL REQUIRE THE AFFIRMATIVE ACTION OF THE MEMBER TO BE EFFECTIVE: (A) APPROVAL AND ADOPTION OF ANNUAL OPERATION AND CAPITAL BUDGETS OF THE CORPORATION; (B) ANY FINANCIAL EXPENDITURE WHICH DEVIATES FROM THE CORPORATION'S ANNUAL OPERATION AND CAPITAL BUDGETS IF THE SUM OF SUCH FINANCIAL EXPENDITURE AND THE SUM OF ALL PRIOR FINANCIAL EXPENDITURES WHICH THEMSELVES DEVIATE FROM THE CORPORATION'S ANNUAL AND CAPITAL BUDGETS, PER FISCAL YEAR, EXCEED $5,000,000 (C) THE SALE, LEASE, MORTGAGE, OR OTHER TRANSFER OR ENCUMBRANCE OF THE REAL PROPERTY OF THE CORPORATION; (D) ANY SALE, LEASE, MORTGAGE, OR OTHER TRANSFER OR ENCUMBRANCE (COLLECTIVELY, "TRANSFER") OF THE PERSONAL PROPERTY AND ASSETS OF THE CORPORATION, OUT OF THE ORDINARY COURSE OF BUSINESS OF THE CORPORATION, IF THE SUM OF SUCH TRANSFER AND THE SUM OF ALL PRIOR TRANSFERS, PER FISCAL YEAR, EXCEED $5,000,000 (E) ANY MERGER, ACQUISITION, CONSOLIDATION, OR DISSOLUTION OF THE CORPORATION; (F) BORROWING OR LENDING OF MONEY OR THE CREATION OF INDEBTEDNESS THROUGH THE GUARANTY OF ANOTHER'S DEBT OR SIMILAR ACTION; (G) GIVING OR SEEKING OF GRANTS; (H) SETTLEMENT OF CLAIMS OR LITIGATION; (I) APPOINTMENT AND REMOVAL OF DIRECTORS IN ACCORDANCE WITH ARTICLE 3 OF THESE BYLAWS; (J) APPOINTMENT AND REMOVAL OF OFFICERS IN ACCORDANCE WITH ARTICLE 4 OF THESE BYLAWS; (K) CREATION, OWNERSHIP OR ACQUISITION OF, OR AFFILIATION WITH, ANY OTHER ORGANIZATION; (L) APPROVAL OF ANY STRATEGIC PLAN, BUSINESS PLAN, OR MISSION PLAN OF THE CORPORATION; (M) CONTRACTS IN WHICH THE CORPORATION ASSUMES FINANCIAL RISK, INCLUDING BUT NOT LIMITED TO MANAGED CARE CONTRACTS, AND PHYSICIAN PRACTICE ACQUISITION CONTRACTS; AND (N) APPROVAL AND ADOPTION OF THE SALARIES, COMPENSATION AND OTHER BENEFITS TO BE PAID TO PHYSICIANS EMPLOYED BY THE CORPORATION.
FORM 990, PART VI, SECTION B, LINE 11BBEFORE FILING, FORM 990 IS REVIEWED BY A FOUNDATION'S BOARD MEMBER AND SECRETARY, THEN CIRCULATED TO THE BOARD CONTEMPORANEOUS WITH THE FILING OF THE FORM 990.
FORM 990, PART VI, SECTION B, LINE 12CTHE CONFLICT OF INTEREST POLICY IS MONITORED BY THE REVIEW OF QUESTIONNAIRES THAT OFFICERS, DIRECTORS, AND KEY EMPLOYEES COMPLETE ANNUALLY.
FORM 990, PART VI, SECTION B, LINE 15A RELATED ORGANIZATION USES THE FOLLOWING TO ESTABLISH COMPENSATION: WRITTEN EMPLOYMENT CONTRACT COMPENSATION SURVEY OR STUDY OFFICER COMPENSATION IS ESTABLISHED BY PRIME HEALTHCARE MANAGEMENT, INC IN ACCORDANCE WITH A MANAGEMENT AGREEMENT WITH KNAPP MEDICAL CENTER WHICH IS THE CONTROLLING MEMBER OF KNAPP MEDICAL GROUP. WRITTEN EMPLOYMENT CONTRACTS ARE FORWARDED TO THE FACILITY ONCE EXECUTED. COMPENSATION SURVEY OR STUDIES ARE UTILIZED.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART VI, SECTION B, LINES 13 AND 14ALTHOUGH THE ORGANIZATION HAS ANSWERED "NO" TO HAVING A WRITTEN WHISTLE BLOWER POLICY AND WRITTEN DOCUMENT RETENTION AND DESTRUCTION POLICY, THE ORGANIZATION FOLLOWS THE POLICIES OF THE RELATED ORGANIZATION AND SOLE MEMBER, KNAPP MEDICAL CENTER.
FORM 990, PART IX, LINE 11GOTHER FEES FOR SERVICES: PROGRAM SERVICE EXPENSES 93,107. MANAGEMENT AND GENERAL EXPENSES 172,913. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 266,020.

Schedule R IRS990ScheduleR

Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (9 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdExempt Code SectionExemptCodeSectionTxtPublic Charity StatusPublicCharityStatusTxtBusiness Name Line1DirectControllingEntityName/BusinessNameLine1TxtControlled OrganizationControlledOrganizationIndDirect Controlling NADirectControllingNACd
KNAPP MEDICAL CENTER
1401 E 8TH STWESLACOTX78596741393060HOSPITALTX501(C)(3)LINE 3PHF0
MID-VALLEY PHYSICIANS ASSOCIATION
1403 E 8TH STWESLACOTX78596742755150SUPPORTTX501(C)(3)LINE 12A, IKMC0
PRIME HEALTHCARE FOUNDATION INC
3300 E GUASTI ROAD SUITE 300ONTARIOCA91761208065139HOSPITAL/MGMTDE501(C)(3)LINE 30N/A
OHIO VALLEY HOME HEALTH SERVICES INC
425 W FIFTH STREETEAST LIVERPOOLOH43920341014198HEALTHCAREOH501(C)(3)LINE 9PHF-EAS LIV0
CITY HOSPITAL ASSOCIATION
425 W FIFTH STREETEAST LIVERPOOLOH43920340714583HOSPITALOH501(C)(3)LINE 3PHF-EAS LIV0
CALIFORNIA UNIVERSITY OF SCIENCE AND MED
3300 E GUASTI ROAD SUITE 300ONTARIOCA91761464141445EDUCATIONCA501(C)(3)LINE 2PHF0
MISSION HOSPITAL INC
900 SOUTH BRYAN ROADMISSIONTX78572742206635HOSPITALTX501(C)(3)LINE 3PHF-MISSION0
MISSION HOSPITAL FOUNDATION
900 SOUTH BRYAN ROADMISSIONTX78572542076455SUPPORTTX501(C)(3)LINE 12A, IMISSION HOSP0
MISSION DOCTORS GROUP
906 SOUTH BRYAN ROAD SUITE 209MISSIONTX78572742798500HEALTHCARETX501(C)(3)LINE 3MISSION HOSP0

Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (3 entries)

Address Line1USAddress/AddressLine1TxtCityUSAddress/CityNmState AbbreviationUSAddress/StateAbbreviationCdZIPUSAddress/ZIPCdEINEINPrimary ActivitiesPrimaryActivitiesTxtLegal Domicile StateLegalDomicileStateCdDirect Controlling NADirectControllingNACdEntity TypeEntityTypeTxtControlled OrganizationControlledOrganizationInd
SIGNATURE PAMPA MEDICAL GROUP
ONE MEDICAL PLAZAPAMPATX79065800458752PHYSICIAN SERVICESTXN/AC0
LANDMARK PHYSICIAN SERVICES
115 CASS AVEWOONSOCKETRI02895205025078PHYSICIAN SERVICESDEN/AC0
LANDMARK PHYSICIAN ASSOCIATES PC
115 CASS AVEWOONSOCKETRI02895050473637INACTIVEDEN/AC0
FieldValueIRS element (for citing)
Receipt Of Int Annts Rnts Rylts0ReceiptOfIntAnntsRntsRyltsInd
Gift Grnt Or Cap Contri To Oth Org0GiftGrntOrCapContriToOthOrgInd
Gift Grnt Cap Contri From Oth Org0GiftGrntCapContriFromOthOrgInd
Loans Or Guarantees To Other Org0LoansOrGuaranteesToOtherOrgInd
Loans Or Guarantees From Oth Org0LoansOrGuaranteesFromOthOrgInd
Div Related Organization0DivRelatedOrganizationInd
Asset Sale To Other Org0AssetSaleToOtherOrgInd
Asset Purchase From Other Org0AssetPurchaseFromOtherOrgInd
Asset Exchange0AssetExchangeInd
Rental Of Facilities To Oth Org0RentalOfFacilitiesToOthOrgInd
Rental Of Fclts From Oth Org0RentalOfFcltsFromOthOrgInd
Perform Of Services For Oth Org0PerformOfServicesForOthOrgInd
Perform Of Services By Other Org0PerformOfServicesByOtherOrgInd
Sharing Of FacilitiesYes (1)SharingOfFacilitiesInd
Paid Employees SharingYes (1)PaidEmployeesSharingInd
Reimbursement Paid To Other OrgYes (1)ReimbursementPaidToOtherOrgInd
Reimbursement Paid By Other Org0ReimbursementPaidByOtherOrgInd
Transfer To Other Org0TransferToOtherOrgInd
Transfer From Other Org0TransferFromOtherOrgInd

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