ALIVIO MEDICAL CENTER INC: Form 990, tax year 2020

View the entire original 990 at ProPublica ↗

Organization
ALIVIO MEDICAL CENTER INC (EIN 36-3661051)
Tax period
2020-07-01 to 2021-06-30
Filed
2022-05-16
IRS object ID
202221369349310027
Schema version
2020v4.1
Note
A later return for the same period supersedes this one.
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)
Return2022-05-16T12:38:14-07:00ReturnTs
Tax Period End2021-06-30TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1Prado & Renteria CPAs Prof CorpBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line11837 S Michigan Ave 2nd FlAddressLine1Txt
CityChicagoCityNm
State AbbreviationILStateAbbreviationCd
ZIP60616ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2020-07-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN363661051EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1ALIVIO MEDICAL CENTER INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlALIVBusinessNameControlTxt
Phone3128296304PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1966 W 21ST STAddressLine1Txt
CityCHICAGOCityNm
State AbbreviationILStateAbbreviationCd
ZIP60608ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonESTHER CORPUZPersonNm
Person TitleCHIEF EXECUTIVE OFFICERPersonTitleTxt
Phone3128296304PhoneNum
Signature2021-05-03SignatureDt
Discuss With Paid PreparerYes (true)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstESTHERPersonFirstNm
Person LastCORPUZPersonLastNm

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonWENQIN ZHANGPreparerPersonNm
PTINP02152541PTIN
Phone3125671330PhoneNum
Preparation2022-05-16PreparationDt

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer3TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
Federated Assurance LevelFAL1FederatedAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2020TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Principal OfficerESTHER CORPUZPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line1966 West 21st StreetAddressLine1Txt
CityChicagoCityNm
State AbbreviationILStateAbbreviationCd
ZIP60608ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$30,687,313GrossReceiptsAmt
Group Return For AffiliatesfalseGroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressN/AWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation1988FormationYr
Legal Domicile StateILLegalDomicileStateCd
Activity Or MissionALIVIO 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 EXCLUSIONActivityOrMissionDesc
Voting Members Governing Body13VotingMembersGoverningBodyCnt
Voting Members Independent13VotingMembersIndependentCnt
Total Employee271TotalEmployeeCnt
Total Volunteers1TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$6,910,809PYContributionsGrantsAmt
CY Contributions Grants$18,452,257CYContributionsGrantsAmt
PY Program Service Revenue$8,867,291PYProgramServiceRevenueAmt
CY Program Service Revenue$8,448,272CYProgramServiceRevenueAmt
PY Investment Income$33,058PYInvestmentIncomeAmt
CY Investment Income$20,228CYInvestmentIncomeAmt
PY Other Revenue$2,652,975PYOtherRevenueAmt
CY Other Revenue$3,546,768CYOtherRevenueAmt
PY Total Revenue$18,464,133PYTotalRevenueAmt
CY Total Revenue$30,467,525CYTotalRevenueAmt
CY Grants And Similar Paid$0CYGrantsAndSimilarPaidAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$10,654,331PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$13,036,360CYSalariesCompEmpBnftPaidAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$231,986CYTotalFundraisingExpenseAmt
PY Other Expenses$7,013,693PYOtherExpensesAmt
CY Other Expenses$7,767,815CYOtherExpensesAmt
PY Total Expenses$17,668,024PYTotalExpensesAmt
CY Total Expenses$20,804,175CYTotalExpensesAmt
PY Revenues Less Expenses$796,109PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$9,663,350CYRevenuesLessExpensesAmt
Total Assets BOY$16,950,479TotalAssetsBOYAmt
Total Assets EOY$29,424,430TotalAssetsEOYAmt
Total Liabilities BOY$7,698,216TotalLiabilitiesBOYAmt
Total Liabilities EOY$10,186,787TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY$9,252,263NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY$19,237,643NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionTHE COMMUNITY HEALTH CENTER IS COMMITTED TO PROVIDING ACCESS TO QUALITY COST EFFECTIVE HEALTH CARE TO THE HISPANIC COMMUNITY, THE UNISURED, AND UNDERINSURED, NOT TO THE EXCLUSION OF OTHER CULTURES AND RACES.MissionDesc
Significant New Program SrvcfalseSignificantNewProgramSrvcInd
Significant ChangefalseSignificantChangeInd
Expense$9,295,415ExpenseAmt
Grant$0GrantAmt
Revenue$5,612,089RevenueAmt
DescTHE 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

Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp

FieldValueIRS element (for citing)
Expense$324,935ExpenseAmt
Grant$0GrantAmt
Revenue$0RevenueAmt
DescMENTAL HEALTHDesc

Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp

FieldValueIRS element (for citing)
Expense$304,687ExpenseAmt
Grant$0GrantAmt
Revenue$0RevenueAmt
DescCOOK COUNTY NAVIGATORDesc

Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp

FieldValueIRS element (for citing)
Expense$8,138,133ExpenseAmt
Grant$0GrantAmt
Revenue$2,763,387RevenueAmt
DescOTHER PROGRAM SERVICESDesc
FieldValueIRS element (for citing)
Total Other Prog Srvc Expense$8,138,133TotalOtherProgSrvcExpenseAmt
Total Other Prog Srvc Grant$0TotalOtherProgSrvcGrantAmt
Total Other Prog Srvc Revenue$2,763,387TotalOtherProgSrvcRevenueAmt
Total Program Service Expenses$18,063,170TotalProgramServiceExpensesAmt
Described In Section501c3Yes (true)DescribedInSection501c3Ind
Schedule B RequiredYes (true)ScheduleBRequiredInd
Political Campaign ActyfalsePoliticalCampaignActyInd
Lobbying ActivitiesfalseLobbyingActivitiesInd
Subject To Proxy TaxfalseSubjectToProxyTaxInd
Donor Advised FundfalseDonorAdvisedFundInd
Conservation EasementsfalseConservationEasementsInd
Collections Of ArtfalseCollectionsOfArtInd
Credit CounselingfalseCreditCounselingInd
Donor Rstr Or Quasi EndowmentsYes (true)DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (true)ReportLandBuildingEquipmentInd
Report Investments Other SecfalseReportInvestmentsOtherSecInd
Report Program Related InvstYes (true)ReportProgramRelatedInvstInd
Report Other AssetsfalseReportOtherAssetsInd
Report Other LiabilitiesYes (true)ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (true)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtfalseIndependentAuditFinclStmtInd
Consolidated Audit Fincl StmtfalseConsolidatedAuditFinclStmtInd
School OperatingfalseSchoolOperatingInd
Foreign OfficefalseForeignOfficeInd
Foreign ActivitiesfalseForeignActivitiesInd
More Than5000 K To OrgfalseMoreThan5000KToOrgInd
More Than5000 K To IndividualsfalseMoreThan5000KToIndividualsInd
Professional FundraisingfalseProfessionalFundraisingInd
Fundraising ActivitiesfalseFundraisingActivitiesInd
Gaming ActivitiesfalseGamingActivitiesInd
Operate HospitalfalseOperateHospitalInd
Grants To OrganizationsfalseGrantsToOrganizationsInd
Grants To IndividualsfalseGrantsToIndividualsInd
Schedule J RequiredYes (true)ScheduleJRequiredInd
Tax Exempt BondsfalseTaxExemptBondsInd
Engaged In Excess Benefit TransfalseEngagedInExcessBenefitTransInd
PY Excess Benefit TransfalsePYExcessBenefitTransInd
Loan OutstandingfalseLoanOutstandingInd
Grant To Related PersonfalseGrantToRelatedPersonInd
Business Rln With Org MemfalseBusinessRlnWithOrgMemInd
Business Rln With Fam MemfalseBusinessRlnWithFamMemInd
Business Rln With35 Ctrl EntfalseBusinessRlnWith35CtrlEntInd
Deductible Non Cash ContrifalseDeductibleNonCashContriInd
Deductible Art ContributionfalseDeductibleArtContributionInd
Terminate OperationsfalseTerminateOperationsInd
Partial LiquidationfalsePartialLiquidationInd
Disregarded EntityfalseDisregardedEntityInd
Related EntityfalseRelatedEntityInd
Related Organization Ctrl EntfalseRelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd OrgfalseTrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted PrtshpYes (true)ActivitiesConductedPrtshpInd
Schedule O RequiredYes (true)ScheduleORequiredInd
IRP Document0IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (true)BackupWthldComplianceInd
Employee271EmployeeCnt
Employment Tax Returns FiledYes (true)EmploymentTaxReturnsFiledInd
Unrelated Bus Incm Over LimitfalseUnrelatedBusIncmOverLimitInd
Foreign Financial AccountfalseForeignFinancialAccountInd
Prohibited Tax Shelter TransfalseProhibitedTaxShelterTransInd
Taxable Party NotificationfalseTaxablePartyNotificationInd
Nondeductible ContributionsfalseNondeductibleContributionsInd
Quid Pro Quo ContributionsYes (true)QuidProQuoContributionsInd
Quid Pro Quo Contri DisclYes (true)QuidProQuoContriDisclInd
Form8282 Property Disposed OffalseForm8282PropertyDisposedOfInd
Rcv Fnds To Pay Prsnl Bnft CntrctfalseRcvFndsToPayPrsnlBnftCntrctInd
Pay Premiums Prsnl Bnft CntrctfalsePayPremiumsPrsnlBnftCntrctInd
Form8899 FiledindfalseForm8899Filedind
Form1098 C FiledfalseForm1098CFiledInd
Indoor Tanning ServicesfalseIndoorTanningServicesInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members13GoverningBodyVotingMembersCnt
Independent Voting Member13IndependentVotingMemberCnt
Family Or Business RlnfalseFamilyOrBusinessRlnInd
Delegation Of Mgmt DutiesfalseDelegationOfMgmtDutiesInd
Change To Org DocumentsfalseChangeToOrgDocumentsInd
Material Diversion Or MisusefalseMaterialDiversionOrMisuseInd
Members Or StockholdersfalseMembersOrStockholdersInd
Election Of Board MembersfalseElectionOfBoardMembersInd
Decisions Subject To ApprovafalseDecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (true)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (true)MinutesOfCommitteesInd
Officer Mailing AddressfalseOfficerMailingAddressInd
Local ChaptersfalseLocalChaptersInd
Form990 Provided To Gvrn BodyfalseForm990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (true)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (true)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (true)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (true)WhistleblowerPolicyInd
Document Retention PolicyYes (true)DocumentRetentionPolicyInd
Compensation Process CEOYes (true)CompensationProcessCEOInd
Compensation Process OtherYes (true)CompensationProcessOtherInd
Investment In Joint VentureYes (true)InvestmentInJointVentureInd
Written Policy Or ProcedureYes (true)WrittenPolicyOrProcedureInd
States Where Copy Of Return Is FldILStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

FieldValueIRS element (for citing)
PersonEsther Corpuz CEOPersonNm
Phone3128296304PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line1966 WEST 21ST STREETAddressLine1Txt
CityCHICAGOCityNm
State AbbreviationILStateAbbreviationCd
ZIP60608ZIPCd
FieldValueIRS element (for citing)
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (22 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmtKey EmployeeKeyEmployeeIndHighest Compensated EmployeeHighestCompensatedEmployeeInd
Teresa Fraga
President1.00Yes (X)Yes (X)$0$0$0
Peter Martinez
First Vice President1.00Yes (X)Yes (X)$0$0$0
Elizabeth Aquino RN PhD
Second Vice President1.00Yes (X)Yes (X)$0$0$0
Scott Cruz Esq
Board Member1.00Yes (X)$0$0$0
Lourdes Diaz
Board Member1.00Yes (X)$0$0$0
Margarita Lopez
Board Member1.00Yes (X)$0$0$0
Alejandra Perez Tamayo MD
Board Member1.00Yes (X)$0$0$0
Tomy Sanchez
Board Member1.00Yes (X)$0$0$0
Jill Seidman
Board Member1.00Yes (X)$0$0$0
Francisca Tamayo
Board Member1.00Yes (X)$0$0$0
Alicia Rodriguez
Board Member1.00Yes (X)$0$0$0
Mark Kosanovich
Physician40.00Yes (X)$234,288$0$1,139Yes (X)
Esther Corpuz
CEO40.00Yes (X)$198,920$0$3,254Yes (X)
Jennifer Vargas
Medical Director40.00Yes (X)$197,164$0$3,321Yes (X)
Abdul Bhurgri
Physician40.00$181,356$0$14,346Yes (X)
Martha M Yanez
Physician40.00$161,143$0$8,742Yes (X)
Qian Wang
Physician40.00$150,814$0$12,603Yes (X)
Norma B Westervelt
Physician40.00$126,965$0$13,172Yes (X)
Virginia M Schmidt
Physician40.00$128,732$0$5,565Yes (X)
Edward Kirsh
Physician40.00$120,315$0$11,464Yes (X)
Fatima Saaduddin
Dentist40.00$121,564$0$8,906Yes (X)
Lorena Barragan
Family Physician40.00$116,580$0$2,585Yes (X)
FieldValueIRS element (for citing)
Total Reportable Comp From Org$1,737,841TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$85,097TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K11IndivRcvdGreaterThan100KCnt
Former Ofcr Employees ListedfalseFormerOfcrEmployeesListedInd
Total Comp Greater Than150 KYes (true)TotalCompGreaterThan150KInd
Compensation From Other SrcsfalseCompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt
Government Grants$18,383,727GovernmentGrantsAmt
All Other Contributions$68,530AllOtherContributionsAmt
Total Contributions$18,452,257TotalContributionsAmt

Program Service Revenue ProgramServiceRevenueGrp (5 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmtExclusionExclusionAmt
MEDICAID624100$2,549,266$0$0
SELF-PAY624100$1,373,825$0$0
MEDICARE624100$743,697$0$0
OTHER MANAGED CARE641000$2,836,183$0$0
OTHER THIRD PARTY641000$945,301$0$0
FieldValueIRS element (for citing)
Total Program Service Revenue$8,448,272TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$19,922TotalRevenueColumnAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$0ExclusionAmt

Gross Amount Sales Assets GrossAmountSalesAssetsGrp

FieldValueIRS element (for citing)
Securities$220,094SecuritiesAmt

Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp

FieldValueIRS element (for citing)
Securities$219,788SecuritiesAmt

Gain Or Loss GainOrLossGrp

FieldValueIRS element (for citing)
Securities$306SecuritiesAmt

Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp

FieldValueIRS element (for citing)
Total Revenue Column$306TotalRevenueColumnAmt
Related Or Exempt Func Income$0RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$306ExclusionAmt

Other Revenue Misc OtherRevenueMiscGrp (2 entries)

DescDescBusinessBusinessCdTotal Revenue ColumnTotalRevenueColumnAmtRelated Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmtUnrelated Business RevenueUnrelatedBusinessRevenueAmtExclusionExclusionAmt
340 B PHARMACY624100$3,544,108$3,544,108$0$0
OTHER900099$2,660$2,660$0$0
FieldValueIRS element (for citing)
Other Revenue Total$3,546,768OtherRevenueTotalAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$30,467,525TotalRevenueColumnAmt
Related Or Exempt Func Income$12,014,962RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$306ExclusionAmt

Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp

FieldValueIRS element (for citing)
Total$1,822,938TotalAmt
Program Services$1,716,119ProgramServicesAmt
Management And General$81,227ManagementAndGeneralAmt
Fundraising$25,592FundraisingAmt

Other Salaries And Wages OtherSalariesAndWagesGrp

FieldValueIRS element (for citing)
Total$9,352,498TotalAmt
Program Services$8,733,003ProgramServicesAmt
Management And General$464,833ManagementAndGeneralAmt
Fundraising$154,662FundraisingAmt

Pension Plan Contributions PensionPlanContributionsGrp

FieldValueIRS element (for citing)
Total$64,682TotalAmt
Program Services$60,892ProgramServicesAmt
Management And General$2,882ManagementAndGeneralAmt
Fundraising$908FundraisingAmt

Other Employee Benefits OtherEmployeeBenefitsGrp

FieldValueIRS element (for citing)
Total$953,829TotalAmt
Program Services$897,938ProgramServicesAmt
Management And General$42,501ManagementAndGeneralAmt
Fundraising$13,390FundraisingAmt

Payroll Taxes PayrollTaxesGrp

FieldValueIRS element (for citing)
Total$842,413TotalAmt
Program Services$700,335ProgramServicesAmt
Management And General$128,793ManagementAndGeneralAmt
Fundraising$13,285FundraisingAmt

Fees For Services Legal FeesForServicesLegalGrp

FieldValueIRS element (for citing)
Total$72,788TotalAmt
Program Services$64,843ProgramServicesAmt
Management And General$7,945ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$28,300TotalAmt
Program Services$0ProgramServicesAmt
Management And General$28,300ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$705TotalAmt
Program Services$0ProgramServicesAmt
Management And General$705ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Advertising AdvertisingGrp

FieldValueIRS element (for citing)
Total$37,396TotalAmt
Program Services$4,865ProgramServicesAmt
Management And General$20,362ManagementAndGeneralAmt
Fundraising$12,169FundraisingAmt

Office Expenses OfficeExpensesGrp

FieldValueIRS element (for citing)
Total$419,092TotalAmt
Program Services$230,278ProgramServicesAmt
Management And General$185,617ManagementAndGeneralAmt
Fundraising$3,197FundraisingAmt

Information Technology InformationTechnologyGrp

FieldValueIRS element (for citing)
Total$1,366,441TotalAmt
Program Services$1,230,336ProgramServicesAmt
Management And General$132,517ManagementAndGeneralAmt
Fundraising$3,588FundraisingAmt

Occupancy OccupancyGrp

FieldValueIRS element (for citing)
Total$385,483TotalAmt
Program Services$233,479ProgramServicesAmt
Management And General$152,004ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Travel TravelGrp

FieldValueIRS element (for citing)
Total$142,092TotalAmt
Program Services$94,921ProgramServicesAmt
Management And General$47,171ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Interest InterestGrp

FieldValueIRS element (for citing)
Total$238,346TotalAmt
Program Services$124,437ProgramServicesAmt
Management And General$113,909ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Depreciation Depletion DepreciationDepletionGrp

FieldValueIRS element (for citing)
Total$422,158TotalAmt
Program Services$17,601ProgramServicesAmt
Management And General$404,557ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Insurance InsuranceGrp

FieldValueIRS element (for citing)
Total$126,618TotalAmt
Program Services$40,349ProgramServicesAmt
Management And General$86,269ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Other Expenses OtherExpensesGrp (4 entries)

DescDescTotalTotalAmtProgram ServicesProgramServicesAmtManagement And GeneralManagementAndGeneralAmtFundraisingFundraisingAmt
Bad Debts$400,034$400,034$0$0
Staff Development / Education$9,526$9,526$0$0
Consumable supplies$2,632,522$2,628,010$0$4,512
Consultant Fees$679,302$337,478$341,141$683

All Other Expenses AllOtherExpensesGrp

FieldValueIRS element (for citing)
Total$807,012TotalAmt
Program Services$538,726ProgramServicesAmt
Management And General$268,286ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$20,804,175TotalAmt
Program Services$18,063,170ProgramServicesAmt
Management And General$2,509,019ManagementAndGeneralAmt
Fundraising$231,986FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$1,753,637BOYAmt
EOY$13,293,341EOYAmt

Savings And Temp Cash Invst SavingsAndTempCashInvstGrp

FieldValueIRS element (for citing)
BOY$3,510BOYAmt
EOY$3,510EOYAmt

Pledges And Grants Receivable PledgesAndGrantsReceivableGrp

FieldValueIRS element (for citing)
BOY$2,639,581BOYAmt
EOY$2,689,055EOYAmt

Accounts Receivable AccountsReceivableGrp

FieldValueIRS element (for citing)
BOY$3,138,438BOYAmt
EOY$3,841,309EOYAmt

Inventories For Sale Or Use InventoriesForSaleOrUseGrp

FieldValueIRS element (for citing)
BOY$35,657BOYAmt
EOY$35,657EOYAmt

Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp

FieldValueIRS element (for citing)
BOY$104,756BOYAmt
EOY$15,283EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$18,483,939LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$12,536,391LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$6,006,142BOYAmt
EOY$5,947,548EOYAmt

Investments Pub Traded Sec InvestmentsPubTradedSecGrp

FieldValueIRS element (for citing)
BOY$1,136,114BOYAmt
EOY$1,466,083EOYAmt

Investments Program Related InvestmentsProgramRelatedGrp

FieldValueIRS element (for citing)
BOY$2,132,644BOYAmt
EOY$2,132,644EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$16,950,479BOYAmt
EOY$29,424,430EOYAmt

Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp

FieldValueIRS element (for citing)
BOY$1,708,517BOYAmt
EOY$2,875,289EOYAmt

Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp

FieldValueIRS element (for citing)
BOY$5,909,454BOYAmt
EOY$7,231,253EOYAmt

Other Liabilities OtherLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$80,245BOYAmt
EOY$80,245EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$7,698,216BOYAmt
EOY$10,186,787EOYAmt
FieldValueIRS element (for citing)
Organization Follows FASB117Yes (X)OrganizationFollowsFASB117Ind

No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$7,915,289BOYAmt
EOY$9,252,262EOYAmt

Donor Restriction Net Assets DonorRestrictionNetAssetsGrp

FieldValueIRS element (for citing)
BOY$1,336,974BOYAmt
EOY$9,985,381EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$9,252,263BOYAmt
EOY$19,237,643EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$16,950,479BOYAmt
EOY$29,424,430EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$9,663,350ReconcilationRevenueExpnssAmt
Net Unrlzd Gains Losses Invst$322,030NetUnrlzdGainsLossesInvstAmt
Info In Schedule O Part XIIYes (X)InfoInScheduleOPartXIIInd
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or ReviewfalseAccountantCompileOrReviewInd
FS AuditedfalseFSAuditedInd
Audit CommitteefalseAuditCommitteeInd
Federal Grant Audit RequiredYes (true)FederalGrantAuditRequiredInd
Federal Grant Audit PerformedfalseFederalGrantAuditPerformedInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
HospitalYes (X)HospitalInd
Other Support Sum$0OtherSupportSumAmt
Public Support CY1700PublicSupportCY170Pct
Public Support Total509$0PublicSupportTotal509Amt
Public Support CY5090PublicSupportCY509Pct
Investment Income CY0InvestmentIncomeCYPct

Schedule B IRS990ScheduleB

Contributor Information ContributorInformationGrp

FieldValueIRS element (for citing)
ContributorRESTRICTEDContributorNum

Contributor Business Name ContributorBusinessName

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor US Address ContributorUSAddress

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Total ContributionsRESTRICTEDTotalContributionsAmt

Schedule D IRS990ScheduleD

CY Endwmt Fund CYEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,000,000BeginningYearBalanceAmt
End Year Balance$1,000,000EndYearBalanceAmt

CY Minus1 Yr Endwmt Fund CYMinus1YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,000,000BeginningYearBalanceAmt
End Year Balance$1,000,000EndYearBalanceAmt

CY Minus2 Yr Endwmt Fund CYMinus2YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,000,000BeginningYearBalanceAmt
End Year Balance$1,000,000EndYearBalanceAmt

CY Minus3 Yr Endwmt Fund CYMinus3YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,000,000BeginningYearBalanceAmt
End Year Balance$1,000,000EndYearBalanceAmt

CY Minus4 Yr Endwmt Fund CYMinus4YrEndwmtFundGrp

FieldValueIRS element (for citing)
Beginning Year Balance$1,000,000BeginningYearBalanceAmt
End Year Balance$1,000,000EndYearBalanceAmt
FieldValueIRS element (for citing)
Endowments Held Unrelated OrgfalseEndowmentsHeldUnrelatedOrgInd
Endowments Held Related OrgfalseEndowmentsHeldRelatedOrgInd

Land LandGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$471,567InvestmentCostOrOtherBasisAmt
Book Value$471,567BookValueAmt

Buildings BuildingsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$10,839,532InvestmentCostOrOtherBasisAmt
Depreciation$6,691,127DepreciationAmt
Book Value$4,148,405BookValueAmt

Leasehold Improvements LeaseholdImprovementsGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$1,280,195InvestmentCostOrOtherBasisAmt
Depreciation$551,103DepreciationAmt
Book Value$729,092BookValueAmt

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Investment Cost Or Other Basis$5,892,645InvestmentCostOrOtherBasisAmt
Depreciation$5,294,161DepreciationAmt
Book Value$598,484BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$5,947,548TotalBookValueLandBuildingsAmt

Invst Program Related Org InvstProgramRelatedOrgGrp

FieldValueIRS element (for citing)
DescINVESTMENT IN LIMITED LIABILITY COMDesc
Book Value$2,132,644BookValueAmt
Method ValuationCMethodValuationCd
FieldValueIRS element (for citing)
Total Book Value Program Rltd$2,132,644TotalBookValueProgramRltdAmt

Other Liabilities Org OtherLiabilitiesOrgGrp

FieldValueIRS element (for citing)
DescDEFFERED COMPDesc
Amt$80,245Amt
FieldValueIRS element (for citing)
Total Liability$80,245TotalLiabilityAmt

Supplemental Information Detail SupplementalInformationDetail (3 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Pt V, Line 4Fund of perpetual duration.
Pt XI, Line 4bProvision of bad debt is offset against patient service revenue per audited financial statements. For Form 990 purposes it is presented as an expense on Part IX, line 24a.
Pt XII, Line 4bProvision of bad debt is offset against patient service revenue per audited financial statements. For Form 990 purposes it is presented as an expense on Part IX, line 24a.

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Severance PaymentfalseSeverancePaymentInd
Supplemental Nonqual Rtr PlanfalseSupplementalNonqualRtrPlanInd
Equity Based Comp ArrngmfalseEquityBasedCompArrngmInd
Comp Based On Revenue Of Flng OrgfalseCompBasedOnRevenueOfFlngOrgInd
Comp Bsd On Rev Related OrgsfalseCompBsdOnRevRelatedOrgsInd
Comp Bsd Net Earns Flng OrgfalseCompBsdNetEarnsFlngOrgInd
Comp Bsd Net Earns Rltd OrgsfalseCompBsdNetEarnsRltdOrgsInd
Any Non Fixed PaymentsfalseAnyNonFixedPaymentsInd
Initial Contract ExceptionfalseInitialContractExceptionInd

Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (6 entries)

Base 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
Mark Kosanovich
$234,288$0$0$0$0$0$0$0$1,139$0$235,427$0$0$0
Esther Corpuz
$198,920$0$0$0$0$0$2,114$0$1,139$0$202,173$0$0$0
Jennifer Vargas
$197,164$0$0$0$0$0$2,181$0$1,139$0$200,484$0$0$0
Abdul Bhurgri
$181,356$0$0$0$0$0$2,873$0$11,473$0$195,702$0$0$0
Martha M Yanez
$161,143$0$0$0$0$0$898$0$7,844$0$169,885$0$0$0
Qian Wang
$150,814$0$0$0$0$0$1,212$0$11,391$0$163,417$0$0$0

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (7 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
Pt VI, Line 19The Organization makes all governing documents,conflict of interest policies and financial statements available upon request.
Pt VI, Line 12cThe 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.
Pt VI, Line 15aThe Board of Directors Reviews Annually, the compensation of the CEO.
Pt VI, Line 15bThe CEO Evaluates compensation of employees every two years.
Pt VI, Line 11bDue to time constrains, a copy of Form 990 will be provided to the board at the next board meeting.
Pt XII, Line 3bDue to implementation of ASC606 Revenue recognition, the organization needs more time to implement the new standard.
Form 990, Part III, Line 4dOTHER PROGRAM SERVICES 8138133. 0. 2763387.

Schedule R IRS990ScheduleR

Unrelated Org Txbl Partnership UnrelatedOrgTxblPartnershipGrp

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1MHN ACO LLCBusinessNameLine1Txt

US Address USAddress

FieldValueIRS element (for citing)
Address Line1939 W North Avenue Suite 875AddressLine1Txt
CityChicagoCityNm
State AbbreviationILStateAbbreviationCd
ZIP60642ZIPCd
FieldValueIRS element (for citing)
EIN300833127EIN
Primary ActivitiesHealth Care ServicesPrimaryActivitiesTxt
Legal Domicile StateILLegalDomicileStateCd
All Partners C3 SYes (true)AllPartnersC3SInd
Share Of EOY Assets$2,132,644ShareOfEOYAssetsAmt
General Or Managing PartnerfalseGeneralOrManagingPartnerInd
Ownership0.11111OwnershipPct

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