HEALTHCARE IN ACTION INC: Form 990, tax year 2022
View the entire original 990 at ProPublica ↗
- Organization
- HEALTHCARE IN ACTION INC (EIN 87-1858798)
- Tax period
- 2022-01-01 to 2022-12-31
- Filed
- 2023-11-14
- IRS object ID
- 202343189349318459
- 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
- Form 990
- Schedule A
- Schedule B
- Schedule D
- Schedule I
- Schedule J
- Schedule L
- Schedule M
- Schedule O
- Schedule R
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2023-11-14T18:50:58-06:00 | ReturnTs |
| Tax Period End | 2022-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 861065772 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | DELOITTE TAX LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 50 SOUTH SIXTH STREET | AddressLine1Txt |
| City | MINNEAPOLIS | CityNm |
| State Abbreviation | MN | StateAbbreviationCd |
| ZIP | 55402 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2022-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 871858798 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HEALTHCARE IN ACTION INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | HEAL | BusinessNameControlTxt |
| Phone | 5629895100 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3800 KILROY AIRPORT WAY 100 | AddressLine1Txt |
| City | LONG BEACH | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 90806 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MICHAEL HOCHMAN | PersonNm |
| Person Title | CEO & PRESIDENT | PersonTitleTxt |
| Phone | 5629895100 | PhoneNum |
| Signature | 2023-11-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | MICHAEL | PersonFirstNm |
| Person Last | HOCHMAN | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IRS Responsible Prty Info Curr | 0 | IRSResponsiblePrtyInfoCurrInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | ANNA KOLAKALURI | PreparerPersonNm |
| PTIN | P01275237 | PTIN |
| Phone | 6123974000 | PhoneNum |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2022 | TaxYr |
| Build TS | 2023-04-26 12:10:37Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | MICHAEL HOCHMAN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3800 KILROY AIRPORT WAY 100 | AddressLine1Txt |
| City | LONG BEACH | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 90806 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $6,465,638 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.HEALTHCAREINACTION.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2021 | FormationYr |
| Legal Domicile State | CA | LegalDomicileStateCd |
| Activity Or Mission | WE PROVIDE HEALTHCARE FOR PATIENTS EXPERIENCING HOMELESSNESS, OLDER ADULTS, (SEE SCHEDULE O) AND OTHER VULNERABLE INDIVIDUALS WHO ARE EXPERIENCING HOMELESSNESS. WE SERVE PATIENTS EXPERIENCING HOMELESSNESS THROUGH AN INNOVATIVE "STREET MEDICINE" APPROACH BY CONTRACTING WITH MEDICARE AND MEDICAID HEALTH PLANS AS WELL AS HOSPITALS AND HEALTH SYSTEMS. | ActivityOrMissionDesc |
| Voting Members Governing Body | 5 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 0 | VotingMembersIndependentCnt |
| Total Employee | 28 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $2,000,000 | PYContributionsGrantsAmt |
| CY Contributions Grants | $4,922,412 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $0 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $1,085,844 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | -$18,005 | CYInvestmentIncomeAmt |
| PY Other Revenue | $30,000 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $2,030,000 | PYTotalRevenueAmt |
| CY Total Revenue | $5,990,251 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $165,000 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $1,653,000 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $451,393 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $1,584,252 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $616,476 | PYOtherExpensesAmt |
| CY Other Expenses | $1,291,012 | CYOtherExpensesAmt |
| PY Total Expenses | $1,232,869 | PYTotalExpensesAmt |
| CY Total Expenses | $4,528,264 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $797,131 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,461,987 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $2,628,621 | TotalAssetsBOYAmt |
| Total Assets EOY | $2,455,745 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,831,490 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $196,627 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $797,131 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $2,259,118 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | TO SERVE PATIENTS EXPERIENCING HOMELESSNESS THROUGH AN INNOVATIVE "STREET MEDICINE" APPROACH BY CONTRACTING WITH MEDICARE AND MEDICAID HEALTH PLANS AS WELL AS HOSPITALS AND HEALTH SYSTEMS. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $3,956,410 | ExpenseAmt |
| Grant | $1,653,000 | GrantAmt |
| Revenue | $1,085,844 | RevenueAmt |
| Desc | HEALTHCARE IN ACTION (HIA) PROVIDES MEDICAL, BEHAVIORAL HEALTH, ADDICTION, AND CASE MANAGEMENT SERVICES TO UNHOUSED RESIDENTS IN CALIFORNIA. HIA WAS ESTABLISHED IN 2021 AND HAS BEEN SERVING MEDICAID MANAGED CARE MEMBERS AS A MEDICAL SERVICES PROVIDER, AS WELL AS AN ENHANCED CARE MANAGEMENT AND COMMUNITY SUPPORT SERVICES PROVIDER, SINCE JANUARY OF 2022. ONE OF THE UNIQUE FEATURES OF HIA IS ITS MOBILE HEALTH SERVICES, WHICH TRAVELS TO DIFFERENT LOCATIONS IN THE COMMUNITIES TO PROVIDE HEALTHCARE SERVICES TO HOMELESS INDIVIDUALS WHERE THEY RESIDE. THE MOBILE CLINIC IS STAFFED BY HEALTHCARE PROFESSIONALS, INCLUDING MEDICAL PROVIDERS, NURSES, COMMUNITY HEALTH WORKERS, AND SOCIAL WORKERS, WHO PROVIDE CARE TO INDIVIDUALS IN NEED. THE OVERARCHING GOALS OF HIA INCLUDE IMPROVING THE HEALTH OF UNHOUSED (SEE SCHEDULE O) POPULATIONS AS WELL AS HELPING THEM OBTAIN SUSTAINABLE HOUSING.HEALTHCARE IN ACTION IS DIVIDED INTO TWO SERVICE LINES: ENHANCED CARE MANAGEMENT AND COMMUNITY SUPPORTS, WHICH INCLUDES ALL UNLICENSED SERVICES AIMED AT ADDRESSING THE SOCIAL DETERMINANTS OF HEALTH FOR HIA PATIENTS. THESE SERVICES INCLUDE CARE COORDINATION, HOUSING NAVIGATION, TRANSPORTATION, AND SUPPORT WHICH ADDRESS OBTAINING OTHER HEALTH-RELATED SOCIAL SERVICES SUCH AS SUBSIDIZED FOOD, DISABILITY, AND OTHER PUBLIC PROGRAMS. THESE SERVICES ARE LARGELY FUNDED THROUGH CONTRACTS WITH MEDICAID MANAGED CARE PLANS, SUPPORTED BY CALIFORNIA'S CALAIM PROGRAM. HIA'S UNLICENSED CASE MANAGEMENT PROVIDERS ARE EMPLOYED BY HEALTHCARE IN ACTION INC., A 501(C)(3) NON-PROFIT ORGANIZATION THAT IS A FULLY OWNED SUBSIDIARY OF THE SCAN GROUP. MEDICAL SERVICES, WHICH INCLUDES: GENERAL MEDICAL CARE, BEHAVIORAL HEALTH SERVICES, AND ADDICTION TREATMENT, PROVIDED BY LICENSED MEDICAL PROVIDERS. THESE SERVICES ARE SUPPORTED THROUGH A MIX OF PHILANTHROPIC FUNDING, MEDICAL SERVICE CONTRACTS WITH MEDICAID MANAGED CARE PLANS, AND DIRECT SERVICE CONTRACTS WITH A VARIETY OF HOSPITALS AND MUNICIPALITIES. HIA'S LICENSED MEDICAL PROVIDERS ARE EMPLOYED BY HEALTHCARE IN ACTION MEDICAL GROUP, A CALIFORNIA PROFESSIONAL MEDICAL CORPORATION OWNED BY HIA PHYSICIANS. IN 2022, SCAN HEALTH PLAN GRANTED HEALTHCARE IN ACTION, INC A $1,650,000 OPERATING GRANT TO SUPPORT THE START- UP COSTS TO DELIVER THE "STREET MEDICINE" MODEL OF CARE. HEALTHCARE IN ACTION, INC PROVIDED MENTAL HEALTH TRAINING TO ITS STAFF THROUGH VOLUNTEER MEDICAL PROFESSIONALS BY PAYING $3,000 IN HONORARIUMS AS A THANK YOU FOR THEIR SUPPORT. | Desc |
| Total Program Service Expenses | $3,956,410 | 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 | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | 0 | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (1) | 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 | Yes (1) | 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 | Yes (1) | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | Yes (1) | 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 | Yes (1) | RelatedEntityInd |
| Related Organization Ctrl Ent | Yes (1) | RelatedOrganizationCtrlEntInd |
| Transaction With Control Ent | Yes (1) | TransactionWithControlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 13 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 28 | 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 | 5 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 0 | 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 | Yes (1) | 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 | 0 | WhistleblowerPolicyInd |
| Document Retention Policy | 0 | 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 | CA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | VIRGINIA HAVAI | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 5629895100 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3800 KILROY AIRPORT WAY | AddressLine1Txt |
| City | LONG BEACH | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 908065616 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (7 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Key EmployeeKeyEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| JAIN MD SACHIN H | ||||||||
| DIRECTOR | 1.00 | 39.00 | Yes (X) | $0 | $3,006,034 | $2,020,160 | ||
| PLUMB MICHAEL | ||||||||
| DIRECTOR | 1.00 | 39.00 | Yes (X) | $0 | $943,395 | $618,386 | ||
| BATRA ROMILLA A | ||||||||
| DIRECTOR | 0.50 | 39.50 | Yes (X) | $0 | $822,330 | $460,603 | ||
| HOCHMAN MICHAEL | ||||||||
| PRESIDENT & CEO | 20.00 | 20.00 | Yes (X) | $225,178 | $199,264 | $125,247 | Yes (X) | |
| KAPPEL KEVIN M | ||||||||
| COO (END 5/2022) & TREASURER | 20.00 | 20.00 | Yes (X) | $147,420 | $166,041 | $96,376 | Yes (X) | |
| KROEKER KEVIN B | ||||||||
| SECRETARY | 0.50 | 39.50 | $0 | $785,900 | $525,156 | Yes (X) | ||
| SOLARES JESSICA BEG 12022 | ||||||||
| DIRECTOR CLINICAL OPERATIONS | 20.00 | 20.00 | $163,451 | $6,154 | $32,375 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $536,049 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $5,929,118 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $3,878,303 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 3 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp
Contractor Name ContractorName
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CROWELL & MORING LLC | BusinessNameLine1Txt |
Contractor Address ContractorAddress
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | PO BOX 75509 | AddressLine1Txt |
| City | BALTIMORE | CityNm |
| State Abbreviation | MD | StateAbbreviationCd |
| ZIP | 21275 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Services | LEGAL SERVICES | ServicesDesc |
| Compensation | $114,234 | CompensationAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 1 | CntrctRcvdGreaterThan100KCnt |
| Related Organizations | $3,300,000 | RelatedOrganizationsAmt |
| Government Grants | $500,000 | GovernmentGrantsAmt |
| All Other Contributions | $1,122,412 | AllOtherContributionsAmt |
| Noncash Contributions | $475,387 | NoncashContributionsAmt |
| Total Contributions | $4,922,412 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| HEALTHCARE RELATED REV | 900099 | $721,876 | $721,876 |
| MANAGEMENT FEE REVENUE | 561000 | $363,968 | $363,968 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $1,085,844 | TotalProgramServiceRevenueAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $457,382 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $475,387 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -$18,005 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$18,005 | TotalRevenueColumnAmt |
| Exclusion | -$18,005 | ExclusionAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,990,251 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,085,844 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | -$18,005 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,650,000 | TotalAmt |
| Program Services | $1,650,000 | ProgramServicesAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,000 | TotalAmt |
| Program Services | $3,000 | ProgramServicesAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $674,022 | TotalAmt |
| Program Services | $539,218 | ProgramServicesAmt |
| Management And General | $134,804 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $528,804 | TotalAmt |
| Program Services | $423,043 | ProgramServicesAmt |
| Management And General | $105,761 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $24,577 | TotalAmt |
| Program Services | $19,662 | ProgramServicesAmt |
| Management And General | $4,915 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $264,309 | TotalAmt |
| Program Services | $211,447 | ProgramServicesAmt |
| Management And General | $52,862 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $92,540 | TotalAmt |
| Program Services | $74,032 | ProgramServicesAmt |
| Management And General | $18,508 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $142,331 | TotalAmt |
| Program Services | $113,865 | ProgramServicesAmt |
| Management And General | $28,466 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $35,068 | TotalAmt |
| Program Services | $28,054 | ProgramServicesAmt |
| Management And General | $7,014 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $401,317 | TotalAmt |
| Program Services | $324,253 | ProgramServicesAmt |
| Management And General | $77,064 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $9,364 | TotalAmt |
| Program Services | $7,491 | ProgramServicesAmt |
| Management And General | $1,873 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $59,511 | TotalAmt |
| Program Services | $47,609 | ProgramServicesAmt |
| Management And General | $11,902 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $368,849 | TotalAmt |
| Program Services | $295,079 | ProgramServicesAmt |
| Management And General | $73,770 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,779 | TotalAmt |
| Program Services | $8,623 | ProgramServicesAmt |
| Management And General | $2,156 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $103,060 | TotalAmt |
| Program Services | $82,448 | ProgramServicesAmt |
| Management And General | $20,612 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,366 | TotalAmt |
| Program Services | $1,093 | ProgramServicesAmt |
| Management And General | $273 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $61,166 | TotalAmt |
| Program Services | $48,933 | ProgramServicesAmt |
| Management And General | $12,233 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $61,301 | TotalAmt |
| Program Services | $49,041 | ProgramServicesAmt |
| Management And General | $12,260 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| DUES AND SUBSCRIPTIONS | $30,968 | $24,774 | $6,194 |
| OTHER EXPENSES | $5,732 | $4,585 | $1,147 |
| FEDERAL, STATE, COUNTY | $200 | $160 | $40 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,528,264 | TotalAmt |
| Program Services | $3,956,410 | ProgramServicesAmt |
| Management And General | $571,854 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,433,623 | BOYAmt |
| EOY | $688,557 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $79,686 | BOYAmt |
| EOY | $1,344,253 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,484 | BOYAmt |
| EOY | $1,963 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $488,076 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $67,104 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $112,828 | BOYAmt |
| EOY | $420,972 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,628,621 | BOYAmt |
| EOY | $2,455,745 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,221,490 | BOYAmt |
| EOY | $196,627 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $610,000 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,831,490 | BOYAmt |
| EOY | $196,627 | 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 | $797,131 | BOYAmt |
| EOY | $2,259,118 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $797,131 | BOYAmt |
| EOY | $2,259,118 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,628,621 | BOYAmt |
| EOY | $2,455,745 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $1,461,987 | ReconcilationRevenueExpnssAmt |
| 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) |
|---|---|---|
| Consolidated Basis Fincl Stmt | Yes (X) | ConsolidatedBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org509a2 | Yes (X) | PubliclySupportedOrg509a2Ind |
Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | $2,000,000 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,922,412 | CurrentTaxYearAmt |
| Total | $6,922,412 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | $721,876 | CurrentTaxYearAmt |
| Total | $721,876 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | $2,000,000 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $5,644,288 | CurrentTaxYearAmt |
| Total | $7,644,288 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | $2,000,000 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,275,387 | CurrentTaxYearAmt |
| Total | $6,275,387 | TotalAmt |
Substantial Contributors Amt SubstantialContributorsAmtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | $2,000,000 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,275,387 | CurrentTaxYearAmt |
| Total | $6,275,387 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $1,368,901 | PublicSupportTotal509Amt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | $30,000 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $363,958 | CurrentTaxYearAmt |
| Total | $393,958 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | $2,030,000 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $6,008,246 | CurrentTaxYearAmt |
| Total | $8,038,246 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| First5 Years509 | Yes (X) | First5Years509Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: | MANAGEMENT FEE - 2021 AMOUNT: $ 30,000. 2022 AMOUNT: $ 363,958. |
| PART III, SHORT YEAR EXPLANATION: | THE ORGANIZATIONS INITIAL YEAR WAS A SHORT YEAR BEGINNING ON JULY 20, 2021 AND ENDING ON DECEMBER 31, 2021. THE ORGANIZATION'S TAX YEAR END IS DECEMBER 31. |
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
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $488,076 | OtherCostOrOtherBasisAmt |
| Depreciation | $67,104 | DepreciationAmt |
| Book Value | $420,972 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $420,972 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | UNDER FASB ASC 740, INCOME TAXES, THE COMPANY IS REQUIRED TO RECOGNIZE A LIABILITY FOR EACH UNCERTAIN TAX POSITION AT THE AMOUNT ESTIMATED TO BE REQUIRED TO SETTLE THE ISSUES. AS OF DECEMBER 31, 2022, THERE WERE NO LIABILITIES RECORDED FOR UNCERTAIN TAX POSITIONS. | ExplanationTxt |
Schedule I IRS990ScheduleI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Grant Records Maintained | Yes (1) | GrantRecordsMaintainedInd |
Recipient Table RecipientTable
Recipient Business Name RecipientBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HEALTHCARE IN ACTION MEDICAL GROUP | BusinessNameLine1Txt |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 3800 KILROY AIRPORT WAY SUITE 100 | AddressLine1Txt |
| City | LONG BEACH | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 90806 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Recipient EIN | 871942811 | RecipientEIN |
| Cash Grant | $1,650,000 | CashGrantAmt |
| Non Cash Assistance | $0 | NonCashAssistanceAmt |
| Purpose Of Grant | TO SUPPORT OPERATIONS OF HEALTHCARE IN ACTION MEDICAL GROUP. | PurposeOfGrantTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Org | 1 | TotalOtherOrgCnt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 2 | FormAndLineReferenceDesc |
| Explanation | HIA, INC MADE A RESTRICTED GRANT TO A RELATED ORGANIZATION SUBJECT TO A WRITTEN GRANT AGREEMENT. PER THE TERMS OF THE AGREEMENT, THE GRANTEE IS REQUIRED TO PROVIDE AN ANNUAL REPORT TO HIA DETAILING ALL EXPENDITURES MADE FROM THE GRANT. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (1) | 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 (7 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| JAIN MD SACHIN H | ||||||||||||||
| DIRECTOR | $0 | $976,619 | $0 | $2,022,492 | $0 | $6,923 | $0 | $2,006,845 | $0 | $13,315 | $0 | $5,026,194 | $0 | $1,425,000 |
| PLUMB MICHAEL | ||||||||||||||
| DIRECTOR | $0 | $496,761 | $0 | $424,202 | $0 | $22,432 | $0 | $590,423 | $0 | $27,963 | $0 | $1,561,781 | $0 | $424,202 |
| KROEKER KEVIN B | ||||||||||||||
| SECRETARY | $0 | $519,406 | $0 | $189,337 | $0 | $77,157 | $0 | $498,755 | $0 | $26,401 | $0 | $1,311,056 | $0 | $240,451 |
| BATRA ROMILLA A | ||||||||||||||
| DIRECTOR | $0 | $468,377 | $0 | $331,521 | $0 | $22,432 | $0 | $450,763 | $0 | $9,840 | $0 | $1,282,933 | $0 | $331,521 |
| HOCHMAN MICHAEL | ||||||||||||||
| PRESIDENT & CEO | $209,752 | $138,014 | $15,141 | $61,250 | $285 | $0 | $125,247 | $0 | $0 | $0 | $350,425 | $199,264 | $0 | $61,250 |
| KAPPEL KEVIN M | ||||||||||||||
| COO (END 5/2022) & TREASURER | $90,597 | $157,981 | $56,823 | $0 | $0 | $8,060 | $72,913 | $0 | $4,731 | $18,732 | $225,064 | $184,773 | $60,000 | $0 |
| SOLARES JESSICA BEG 12022 | ||||||||||||||
| DIRECTOR CLINICAL OPERATIONS | $153,847 | $6,154 | $9,586 | $0 | $18 | $0 | $32,079 | $0 | $296 | $0 | $195,826 | $6,154 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | COMPENSATION FOR MICHAEL HOCHMAN (CHIEF EXECUTIVE OFFICER AND PRESIDENT- HEALTHCARE IN ACTION, INC) WAS ESTABLISHED BY A RELATED ORGANIZATION, SCAN GROUP, AND PAID BY HEALTHCARE IN ACTION, INC. THE RELATED ORGANIZATION USED THE FOLLOWING TO ESTABLISH THE PRESIDENT'S COMPENSATION: 1) COMPENSATION COMMITTEE; 2) INDEPENDENT COMPENSATION CONSULTANT; 3) COMPENSATION SURVEY OR STUDY; 4) APPROVAL BY THE SCAN GROUP COMPENSATION COMMITTEE WITHIN THE AGREED TO PARAMATERS SET BY THE SCAN GROUP BOARD OF DIRECTORS |
| PART I, LINE 4B | SCAN GROUP AND SCAN HEALTH PLAN PROVIDE A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN TO OFFICERS SENIOR VICE PRESIDENTS, AND VICE PRESIDENTS VIA ITS SECTION 457(F) PLAN. FOR CONTRIBUTIONS MADE PRIOR TO DECEMBER 31, 2017, A PARTICIPANT BECOMES VESTED IN THE 457(F) PLAN UPON COMPLETION OF ONE OF THE CHOSEN VESTING OPTIONS: 1) FIVE YEARS OF SERVICE AND 62 YEARS OF AGE OR 2) 10 YEARS OF SERVICE. ON JANUARY 1, 2018, A NEW PLAN WAS ADOPTED, FOR CONTRIBUTIONS MADE ON OR AFTER THAT DATE, A PARTICIPANT BECOMES VESTED IN THE 457(F) PLAN FOLLOWING A 4 YEAR CLASS VESTING CYCLE. SUPPLEMENTAL NON-QUALIFIED PLAN PAYMENTS WERE MADE DURING THE YEAR THE FOLLOWING LISTED PERSONS IN PART VII: KEVIN KROEKER - $ 51,114 DEFERRED COMPENSATION FOR 2022, REPORTED ON SCHEDULE J, PART II, COLUMN B AND COLUMN C CONSISTS OF THE FOLLOWING: 1) 457(F) EMPLOYER CONTRIBUTIONS ARE SUBJECT TO VESTING TERMS AND CONDITIONS AS NOTED THE PLAN DOCUMENTS. BASED ON THESE VESTING TERMS THERE IS SUBSTANTIAL RISK OF FORFEITURE. 2) 457(B) IS A DEFERRED COMPENSATION PLAN THAT THE EMPLOYER AND EMPLOYEE CONTRIBUTE TO, UP TO THE SCAN GROUP AND SCAN HEALTH PLAN'S DEFINED AND IRS ANNUAL LIMITS. 3) 401(K) QUALIFIED RETIREMENT PLAN CONTRIBUTIONS (EMPLOYER MATCH AND SAFE HARBOR) UP TO THE IRS ANNUAL LIMITS. 4) SCAN GROUP, SCAN HEALTH PLAN AND HEALTHCARE IN ACTION, INC., PROVIDE AN INCENTIVE PLAN TO EMPLOYEES WITH VARYING TARGET PAYOUTS BASED ON LEVEL. THE INCENTIVE PLAN IS BASED ON ORGANIZATION AND INDIVIDUAL PERFORMANCE METRICS. PAYMENTS ARE MADE ON OR AROUND APRIL 1 OF THE SUBSEQUENT CALENDAR YEAR. |
Schedule L IRS990ScheduleL
Grnt Asst Bnft Interested Prsn GrntAsstBnftInterestedPrsnGrp
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | HEALTHCARE IN ACTION MEDICAL GROUP | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Relationship With Org | CONTROLLED ENTITY OF HIA INC. OFFICERS | RelationshipWithOrgTxt |
| Cash Grant | $1,650,000 | CashGrantAmt |
| Type Of Assistance | GRANT | TypeOfAssistanceTxt |
| Assistance Purpose | SUPPORT HIAMG DELIVERY OF MEDICAL SERVICES TO NEEDY INDIVIDUALS | AssistancePurposeTxt |
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| HEALTHCARE IN ACTION MEDICAL GROUP | |||
| CONTROLLED ENTITY OF HIA, INC. OFFICERS | $363,968 | MANAGEMENT FEE | 0 |
| HEALTHCARE IN ACTION MEDICAL GROUP | |||
| CONTROLLED BY ENTITY OF HIA, INC OFFICERS | $721,876 | HEALTHCARE SERVICE REVENUE | Yes (1) |
Schedule M IRS990ScheduleM
Securities Publicly Traded SecuritiesPubliclyTradedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | Yes (X) | NonCashCheckboxInd |
| Contribution | 8335 | ContributionCnt |
| Noncash Contributions Rpt F990 | $475,387 | NoncashContributionsRptF990Amt |
| Method Of Determining Revenues | COST OR SELLING PRICE | 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 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, COLUMN (B): | FormAndLineReferenceDesc |
| Explanation | THE NUMBER OF SHARES RECEIVED | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THE SOLE MEMBER OF THE ORGANIZATION IS SCAN GROUP, A CALIFORNIA NONPROFIT PUBLIC BENEFIT CORPORATION. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 IS PREPARED BY THE ACCOUNTING FIRM OF DELOITTE TAX, LLP WORKING IN CONJUNCTION WITH SCAN'S FINANCE DEPARTMENT. SCAN HEALTH PLAN'S DIRECTOR OF ACCOUNTING HAS DIRECT RESPONSIBILITY FOR THIS EFFORT, SUBJECT TO SUPERVISION BY THE VICE PRESIDENT AND CONTROLLER OF SCAN HEALTH PLAN. AFTER AN INITIAL DRAFT OF THE FORM 990 IS PREPARED, IT IS CIRCULATED FOR REVIEW AND COMMENT BY RELEVANT MEMBERS OF THE EXECUTIVE TEAM WHO HAVE RESPONSIBILITY FOR AND/OR KNOWLEDGE REGARDING THE VARIOUS MATTERS DISCLOSED AND/OR DESCRIBED IN THE FORM. THE GENERAL COUNSEL, IN PARTICULAR, REVIEWS THE FORM 990 FOR ACCURACY AND COMPLETENESS. THE FORM 990 IS PROVIDED TO THE HEALTHCARE IN ACTION'S BOARD FOR REVIEW AFTER IT IS PREPARED, BUT PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | HIA, INC ORGANIZATIONAL RESOLUTIONS ADOPTED SEPTEMBER 21, 2021 BY THE BOARD OF DIRECTORS SPECIFICALLY STATES THAT HIA, INC ADOPTED THE SCAN HEALTH PLAN CONFLICT OF INTEREST POLICY AND ARE REQUIRED TO COMPLY WITH ITS TERMS. HIA, INC, SCAN GROUP AND ALL ITS ENTITIES, FOLLOW SCAN HEALTH PLAN'S CONFLICT OF INTEREST PROCESSES. A DESCRIPTION OF THE PROCESS IS AS FOLLOWS: SCAN HEALTH PLAN REGULARLY AND CONSISTENTLY MONITORS AND ENFORCES COMPLIANCE WITH ITS CONFLICT OF INTEREST POLICY THROUGH ANNUAL CIRCULATION OF A CONFLICT OF INTEREST POLICY AND DISCLOSURE QUESTIONNAIRE WHICH ALL MEMBERS OF THE BOARD OF DIRECTORS, OFFICERS AND MEMBERS OF EXECUTIVE MANAGEMENT OF EVERY ENTITY UNDER SCAN GROUP ARE REQUIRED TO COMPLETE AND SIGN. IN ADDITION, THERE IS ANNUAL MANDATORY COMPLIANCE EDUCATION AND TRAINING AND SCAN'S COMPLIANCE DEPARTMENT IS RESPONSIBLE FOR ENFORCEMENT OF SCAN'S ROBUST COMPLIANCE PROGRAM, INCLUDING SCAN'S CODE OF CONDUCT AND COMPLIANCE-RELATED POLICIES AND PROCEDURES. MEMBERS OF ALL THE EXECUTIVE TEAMS ALSO HAVE RESPONSIBILITY FOR ENFORCEMENT. THE LEGAL DEPARTMENT OF SCAN GROUP REVIEWS ALL CONTRACTUAL RELATIONSHIPS ENTERED INTO BY THE ORGANIZATION AND GENERAL COUNSEL IS RESPONSIBLE FOR MONITORING THE CONFLICT OF INTEREST QUESTIONNAIRE. THE LEGAL DEPARTMENT OF SCAN GROUP MONITORS AND ENFORCES ADHERENCE TO THESE POLICIES ON AN ONGOING BASIS. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE PROCESS FOR DETERMINING COMPENSATION FOR MICHAEL HOCHMAN (CHIEF EXECUTIVE OFFICER AND PRESIDENT- HEALTHCARE IN ACTION, INC), IS CONDUCTED BY THE HUMAN RESOURCES DEPARTMENT OF SCAN GROUP AND BOARD CHAIR OF HEALTHCARE IN ACTION, INC WITH THE APPROVAL OF THE INDEPENDENT DIRECTORS OF HEALTHCARE IN ACTION, INC. IN DETERMINING THE CEO AND PRESIDENT'S COMPENSATION, THE HUMAN RESOURCES DEPARTMENT AND BOARD RELY ON THE PARAMATERS SET BY THE SCAN GROUP BOARD IN COLLABORATION WITH THE SCAN GROUP COMPENSATION COMMITTEE. THE COMPENSATION COMMITTEE WORKS WITH AND RELIES UPON THE COUNSEL AND EXPERTISE OF AN OUTSIDE COMPENSATION CONSULTANT WITH WELL-ESTABLISHED EXPERIENCE AND EXPERTISE IN THE AREA OF NONPROFIT HEALTH CARE ORGANIZATIONS, EXECUTIVE COMPENSATION, AND COMPLIANCE WITH THE INTERMEDIATE SANCTIONS REQUIREMENTS APPLICABLE TO SUCH COMPENSATION. THE CHIEF EXECUTIVE OFFICER (CEO) MAKES A RECOMMENDATION TO THE HIA INC BOARD OF DIRECTORS WITH RESPECT TO EACH EMPLOYEE'S COMPENSATION PACKAGE THE HIA INC BOARD MAKES A DECISION REGARDING THE COMPENSATION PACKAGE FOR SUCH EMPLOYEES FOR THE FOLLOWING YEAR. THE MINUTES OF THE HIA INC BOARD MEETING FOR THIS MEETING ARE PREPARED SUBSTANTIALLY CONTEMPORANEOUSLY AND SUBSTANTIATE SUCH DELIBERATION AND DECISIONS. THE OUTSIDE COMPENSATION CONSULTANT PROVIDING THE EXECUTIVE COMPENSATION REPORT AND GUIDANCE RELATED TO THE EXECUTIVE PAY FOR HEALTHCARE IN ACTION, INC. EXECUTIVES WAS FW COOK. |
| FORM 990, PART VI, SECTION C, LINE 19 | HEALTHCARE IN ACTION, INC'S GOVERNING DOCUMENTS ARE NOT MADE AVAILABLE TO THE PUBLIC. HEALTHCARE IN ACTION MAKES ITS FORM 990, WHICH CONTAINS FINANCIAL INFORMATION, AVAILABLE FOR PUBLIC INSPECTION. |
| FORM 990, PART VI, SECTION B, LINES 12, 13 AND 14 | IN 2021, WHEN FORMED, HEALTHCARE IN ACTION, INC. ADOPTED THE SCAN HEALTH PLAN CONFLICT OF INTERST POLICY. IN 2022, HEALTHCARE IN ACTON, INC. CURRENTLY OPERATES UNDER THE POLICIES THAT ARE MAINTAINED BY ITS SOLE MEMBER, SCAN GROUP. HEALTHCARE IN ACTION, INC. PLANS TO ADOPT THE FOLLOWING POLICIES OF SCAN GROUP: WHISTLEBLOWER POLICY, DOCUMENT RETENTION, AND DESTRUCTION POLICY. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (7 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| SCAN GROUP | |||||||||||
| 3800 KILROY AIRPORT WAY SUITE 100 | LONG BEACH | CA | 90806 | 953826037 | ADMIN SUPPORT | CA | 501(C)(3) | 12B, II | N/A | 0 | |
| THE SCAN FOUNDATION | |||||||||||
| 3800 KILROY AIRPORT WAY SUITE 100 | LONG BEACH | CA | 90806 | 450552845 | GRANT MAKING | CA | 501(C)(3) | 12B, II | Yes (1) | SCAN GROUP | |
| SCAN HEALTH PLAN | |||||||||||
| 3800 KILROY AIRPORT WAY SUITE 100 | LONG BEACH | CA | 90806 | 953858259 | MEDICARE ADVANTAGE | CA | 501(C)(3) | 10 | Yes (1) | SCAN GROUP | |
| SCAN HEALTH PLAN NEVADA INC | |||||||||||
| 3800 KILROY AIRPORT WAY SUITE 100 | LONG BEACH | CA | 90806 | 854288083 | MEDICARE ADVANTAGE | NV | 501(C)(4) | Yes (1) | SCAN GROUP | ||
| SCAN DESERT HEALTH PLAN INC | |||||||||||
| 3800 KILROY AIRPORT WAY SUITE 100 | LONG BEACH | CA | 90806 | 854275186 | MEDICARE ADVANTAGE | AZ | 501(C)(4) | Yes (1) | SCAN GROUP | ||
| SCAN HEALTH PLAN TEXAS INC | |||||||||||
| 3800 KILROY AIRPORT WAY SUITE 100 | LONG BEACH | CA | 90806 | 872944493 | MEDICARE ADVANTAGE | TX | 501(C)(4) | Yes (1) | SCAN GROUP | ||
| SCAN HEALTH PLAN NEW MEXICO INC | |||||||||||
| 3800 KILROY AIRPORT WAY SUITE 100 | LONG BEACH | CA | 90806 | 920651838 | MEDICARE ADVANTAGE | NM | 501(C)(4) | Yes (1) | SCAN GROUP | ||
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (14 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Direct Controlling NADirectControllingNACd | Entity TypeEntityTypeTxt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|
| SCAN HEALTHCHECK ASSESSMENT CENTERS INC | |||||||||
| 3800 KILROY AIRPORT WAY SUITE 100 | LONG BEACH | CA | 90806 | 462962358 | HEALTHCARE | CA | N/A | C | Yes (1) |
| ALIVE VENTURES INC | |||||||||
| 3800 KILROY AIRPORT WAY SUITE 100 | LONG BEACH | CA | 90806 | 852381694 | VENTURE STUDIO | CA | N/A | C | Yes (1) |
| HEALTHCARE IN ACTION MEDICAL GROUP | |||||||||
| 3800 KILROY AIRPORT WAY SUITE 100 | LONG BEACH | CA | 90806 | 871942811 | HEALTHCARE | CA | N/A | C | Yes (1) |
| PROSPER SERVICES LLC | |||||||||
| 3800 KILROY AIRPORT WAY SUITE 100 | LONG BEACH | CA | 90806 | 872979343 | HEALTHCARE | CA | N/A | C | Yes (1) |
| SCAN CALIFORNIA MANAGEMENT COMPANY | |||||||||
| 3800 KILROY AIRPORT WAY SUITE 100 | LONG BEACH | CA | 90806 | 462951831 | MANAGEMENT | CA | N/A | C | Yes (1) |
| WELCOME HEALTH INC | |||||||||
| 3800 KILROY AIRPORT WAY SUITE 100 | LONG BEACH | CA | 90806 | 863730275 | HEALTHCARE | CA | N/A | C | Yes (1) |
| WELCOME HEALTH MEDICAL GROUP | |||||||||
| 3800 KILROY AIRPORT WAY SUITE 100 | LONG BEACH | CA | 90806 | 872705807 | HEALTHCARE | CA | N/A | C | Yes (1) |
| WELCOME HEALTH OF CALIFORNIA INC | |||||||||
| 3800 KILROY AIRPORT WAY SUITE 100 | LONG BEACH | CA | 90806 | 920363899 | HEALTHCARE | CA | N/A | C | Yes (1) |
| PREVENT TRG HOLDINGS INC | |||||||||
| 3800 KILROY AIRPORT WAY SUITE 100 | LONG BEACH | CA | 90806 | 880965994 | HEALTHCARE | CA | N/A | C | Yes (1) |
| THE RESIDENTIALIST GROUP INC | |||||||||
| 3800 KILROY AIRPORT WAY SUITE 100 | LONG BEACH | CA | 90806 | 330969912 | HEALTHCARE | CA | N/A | C | Yes (1) |
| HOUSECALLS DOCTORS MEDICAL GROUP INC | |||||||||
| 3800 KILROY AIRPORT WAY SUITE 100 | LONG BEACH | CA | 90806 | 043644245 | HEALTHCARE | CA | N/A | C | Yes (1) |
| RESIDENTIALIST HOUSECALL MEDICAL GROUP PC | |||||||||
| 4190 CITY AVE SUITE 528 | PHILADELPHIA | PA | 19131 | 474053626 | HEALTHCARE | PA | N/A | C | Yes (1) |
| MYPLACE GREATER LA PACE INC | |||||||||
| 3800 KILROY AIRPORT WAY SUITE 100 | LONG BEACH | CA | 90806 | 881512241 | HEALTHCARE | CA | N/A | C | Yes (1) |
| MYPLACE SOUTH LA PACE INC | |||||||||
| 3800 KILROY AIRPORT WAY SUITE 100 | LONG BEACH | CA | 90806 | 923486437 | HEALTHCARE | CA | N/A | C | Yes (1) |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | 0 | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | Yes (1) | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | Yes (1) | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | 0 | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | 0 | DivRelatedOrganizationInd |
| Asset Sale To Other Org | 0 | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | 0 | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | 0 | AssetExchangeInd |
| Rental Of Facilities To Oth Org | 0 | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | 0 | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (1) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | 0 | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | 0 | SharingOfFacilitiesInd |
| Paid Employees Sharing | 0 | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (1) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | Yes (1) | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | 0 | TransferToOtherOrgInd |
| Transfer From Other Org | 0 | TransferFromOtherOrgInd |
Transactions Related Org TransactionsRelatedOrgGrp (7 entries)
| Transaction TypeTransactionTypeTxt | InvolvedInvolvedAmt | Method Of Amount DeterminationMethodOfAmountDeterminationTxt |
|---|---|---|
| SCAN HEALTH PLAN | ||
| C | $3,300,000 | BOOK VALUE |
| SCAN GROUP | ||
| P | $1,679,883 | BOOK VALUE |
| SCAN HEALTH PLAN | ||
| P | $160,459 | BOOK VALUE |
| HEALTHCARE IN ACTION MEDICAL GROUP | ||
| B | $1,650,000 | BOOK VALUE |
| HEALTHCARE IN ACTION MEDICAL GROUP | ||
| Q | $81,666 | BOOK VALUE |
| HEALTHCARE IN ACTION MEDICAL GROUP | ||
| L | $363,968 | BOOK VALUE |
| HEALTHCARE IN ACTION MEDICAL GROUP | ||
| L | $721,876 | BOOK VALUE |
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