GARY AND MARY WEST SENIOR SERVICES INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- GARY AND MARY WEST SENIOR SERVICES INC (EIN 82-0635784)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-11-15
- IRS object ID
- 202223199349329297
- Schema version
- 2021v4.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-11-15T18:43:02-06:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 330885895 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | LINDSAY & BROWNELL LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4225 EXECUTIVE SQUARE SUITE 1150 | AddressLine1Txt |
| City | LA JOLLA | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 92037 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 820635784 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GARY AND MARY WEST SENIOR SERVICES INC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | GARY | BusinessNameControlTxt |
| Phone | 7602802230 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1706 DESCANSO AVE | AddressLine1Txt |
| City | SAN MARCOS | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 92078 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TIMOTHY LASH | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 7602802230 | PhoneNum |
| Signature | 2022-11-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | TIMOTHY | PersonFirstNm |
| Person Last | LASH | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | MARY H MCGROARTY | PreparerPersonNm |
| PTIN | P00735101 | PTIN |
| Phone | 8585589200 | PhoneNum |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
Doing Business As Name DoingBusinessAsName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | GARY AND MARY WEST PACE | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | TIMOTHY LASH | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1706 DESCANSO AVE | AddressLine1Txt |
| City | SAN MARCOS | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 92078 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $19,915,431 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | HTTPS://WESTPACE.NET/ | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2017 | FormationYr |
| Legal Domicile State | DE | LegalDomicileStateCd |
| Activity Or Mission | PRIMARILY TO OPERATE A HIGH-QUALITY, AFFORDABLE OUTPATIENT CLINIC FOR THE MEDICAL (CONT.) CARE OF SENIORS UNDER A FEDERAL AND STATE GOVERNMENTAL PROGRAM KNOWN AS PACE, IN ORDER TO ENABLE SENIORS TO LIVE IN THEIR COMMUNITIES AS INDEPENDENTLY AS POSSIBLE. | ActivityOrMissionDesc |
| Voting Members Governing Body | 3 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 3 | VotingMembersIndependentCnt |
| Total Employee | 88 | TotalEmployeeCnt |
| Total Volunteers | 3 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $283,706 | PYContributionsGrantsAmt |
| CY Contributions Grants | $930,630 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $10,258,757 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $18,984,801 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $10,542,463 | PYTotalRevenueAmt |
| CY Total Revenue | $19,915,431 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $3,263,908 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $5,127,959 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $7,439,487 | PYOtherExpensesAmt |
| CY Other Expenses | $11,555,284 | CYOtherExpensesAmt |
| PY Total Expenses | $10,703,395 | PYTotalExpensesAmt |
| CY Total Expenses | $16,683,243 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$160,932 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $3,232,188 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $7,378,666 | TotalAssetsBOYAmt |
| Total Assets EOY | $11,843,166 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,554,503 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $2,786,815 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $5,824,163 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $9,056,351 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | PRIMARILY TO OPERATE A HIGH-QUALITY, AFFORDABLE OUTPATIENT CLINIC FOR THE MEDICAL CARE OF SENIORS UNDER A FEDERAL AND STATE GOVERNMENTAL PROGRAM KNOWN AS PACE, IN ORDER TO ENABLE SENIORS TO LIVE IN THEIR COMMUNITIES AS INDEPENDENTLY AS POSSIBLE. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $15,611,699 | ExpenseAmt |
| Revenue | $18,984,801 | RevenueAmt |
| Desc | GARY AND MARY WEST SENIOR SERVICES, DOING BUSINESS AS GARY AND MARY WEST PACE (GMWP), ENABLES SENIORS TO SUCCESSFULLY AGE IN PLACE AND MAINTAIN THEIR HIGHEST LEVEL OF INDEPENDENCE THROUGH THE SERVICES OF THEIR PACE (PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY) PROGRAM. AFTER A PERIOD OF CONSTRUCTION, PROGRAM SETUP, REGULATORY APPROVAL AND HIRING PROCESSES, THE FIRST PARTICIPANTS WERE WELCOMED TO OUR PACE PROGRAM IN 2019. WHEN A PARTICIPANT QUALIFIES AND ENROLLS IN OUR PACE PROGRAM, GMWP ASSUMES RESPONSIBILITY FOR PROVIDING 100% OF THE MEDICAL NEEDS OF THE ENROLLED INDIVIDUAL. THESE SENIORS ARE TYPICALLY VERY FRAIL, WITH LIMITED FINANCIAL RESOURCES AND IN NEED OF HELP IN COORDINATING THEIR ACCESS TO CARE. GMWP MEETS THESE NEEDS THROUGH A HIGHLY MANAGED CLINIC-BASED APPROACH, WHERE OUR OWN PHYSICIANS, MEDICAL, SOCIAL SERVICES AND OTHER STAFF SEE PARTICIPANTS FREQUENTLY, COORDINATING CARE AT EVERY LEVEL. SOME OF THE UNIQUE INCLUDED SERVICES ARE TRANSPORTATION, SOCIAL PROGRAMS, NUTRITIONAL ASSISTANCE, HOME CARE, AND ADULT DAY SERVICES, AMONG OTHERS. MANY OF THESE SERVICES WOULD NOT TYPICALLY BE PAID FOR BY EITHER MEDICARE OR MEDICAID BUT HAVE PROVEN TO BE VERY EFFECTIVE IN HELPING THE PARTICIPANT REMAIN AS HEALTHY AND INDEPENDENT AS POSSIBLE. IN 2019, GARY AND MARY WEST PACE ALSO WELCOMED A NON-PROFIT SENIOR DENTAL PROVIDER AS A TENANT IN OUR SPACE ALSO GIVING OUR PARTICIPANTS CONVENIENT ACCESS TO DENTAL CARE. | Desc |
| Total Program Service Expenses | $15,611,699 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | Yes (1) | 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 | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | Yes (1) | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 11 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 88 | 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 | 3 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 3 | IndependentVotingMemberCnt |
| Family Or Business Rln | Yes (1) | 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 | Yes (1) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | Yes (1) | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (1) | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | CA | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | ROBIN JENSEN | PersonNm |
| Phone | 7602802230 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1706 DESCANSO AVE | AddressLine1Txt |
| City | SAN MARCOS | CityNm |
| State Abbreviation | CA | StateAbbreviationCd |
| ZIP | 92078 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| No Listed Persons Compensated | Yes (X) | NoListedPersonsCompensatedInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (13 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | OfficerOfficerInd | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| MICHAEL M CAPONETTO | ||||||||
| DIRECTOR/CHAIRMAN | 5.00 | Yes (X) | $0 | $0 | $0 | |||
| CHARLES V SEDERSTROM | ||||||||
| DIRECTOR | 5.00 | Yes (X) | $0 | $0 | $0 | |||
| PAMELA B SMITH | ||||||||
| DIRECTOR | 5.00 | Yes (X) | $0 | $0 | $0 | |||
| TIMOTHY LASH | ||||||||
| OFFICER/PRESIDENT | 5.00 | $0 | $0 | $0 | Yes (X) | |||
| JON ZIFFERBLATT | ||||||||
| SECRETARY | 5.00 | $0 | $0 | $0 | Yes (X) | |||
| DR ZIA AGHA | ||||||||
| TREASURER | 5.00 | $0 | $0 | $0 | Yes (X) | |||
| RENATA R SMITH | ||||||||
| EXECUTIVE DIRECTOR | 40.00 | $247,556 | $0 | $12,071 | Yes (X) | |||
| DR ROSS E COLT | ||||||||
| MEDICAL DIRECTOR | 40.00 | $370,815 | $0 | $33,344 | Yes (X) | |||
| ROBIN JENSEN | ||||||||
| DIRECTOR OF BUSINESS AND FINANCE | 40.00 | $173,080 | $0 | $20,210 | Yes (X) | |||
| MELANIE CLARK | ||||||||
| HR DIRECTOR | 40.00 | $104,859 | $0 | $10,222 | Yes (X) | |||
| SAMAR HIREISH | ||||||||
| CLINIC DIRECTOR | 40.00 | $139,666 | $0 | $16,591 | Yes (X) | |||
| KANNAMMA KANNAN | ||||||||
| DIRECTOR OF QUALITY AND COMPLIANCE | 40.00 | $101,787 | $0 | $5,039 | Yes (X) | |||
| BRITTANY SUMEREL | ||||||||
| PHYSICIAN ASSISTANT | 40.00 | $142,380 | $0 | $11,809 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,280,143 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $109,286 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 7 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (3 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| NINETY-NINE TEN BUSINESS SOLUTIONS LLC | |||||
| 5800 ARMADA DRIVE SUITE 100 | CARLSBAD | CA | 92008 | IT SERVICES | $185,813 |
| SYNERGI PARTNERS INC | |||||
| PO BOX 5599 | FLORENCE | SC | 29502 | CONSULTING FEES FOR CARES ACT APPLICATIO | $123,145 |
| SCATENA DANIELS COMMUNICATIONS | |||||
| 5694 MISSION CENTER RD 602-310 | SAN DIEGO | CA | 92108 | PR AND MARKETING CONSULTANT | $112,449 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 3 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $820,968 | GovernmentGrantsAmt |
| All Other Contributions | $109,662 | AllOtherContributionsAmt |
| Total Contributions | $930,630 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (3 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| CAPITATION REVENUE | 621400 | $16,957,890 | $16,957,890 |
| RESEARCH REVENUE | 541700 | $2,000,000 | $2,000,000 |
| DENTAL CENTER RENT | 621400 | $26,911 | $26,911 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $18,984,801 | TotalProgramServiceRevenueAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $19,915,431 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $18,984,801 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $812,134 | TotalAmt |
| Program Services | $714,678 | ProgramServicesAmt |
| Management And General | $97,456 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,499,706 | TotalAmt |
| Program Services | $3,100,121 | ProgramServicesAmt |
| Management And General | $399,585 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $122,155 | TotalAmt |
| Program Services | $108,317 | ProgramServicesAmt |
| Management And General | $13,838 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $373,303 | TotalAmt |
| Program Services | $331,015 | ProgramServicesAmt |
| Management And General | $42,288 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $320,661 | TotalAmt |
| Program Services | $284,336 | ProgramServicesAmt |
| Management And General | $36,325 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $97,520 | TotalAmt |
| Program Services | $55,757 | ProgramServicesAmt |
| Management And General | $41,763 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $30,075 | TotalAmt |
| Management And General | $30,075 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,139,477 | TotalAmt |
| Program Services | $851,930 | ProgramServicesAmt |
| Management And General | $287,547 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $131,500 | TotalAmt |
| Program Services | $116,342 | ProgramServicesAmt |
| Management And General | $15,158 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $131,961 | TotalAmt |
| Program Services | $116,749 | ProgramServicesAmt |
| Management And General | $15,212 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $486,596 | TotalAmt |
| Program Services | $460,658 | ProgramServicesAmt |
| Management And General | $25,938 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,842 | TotalAmt |
| Program Services | $1,705 | ProgramServicesAmt |
| Management And General | $1,137 | ManagementAndGeneralAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $20,820 | TotalAmt |
| Program Services | $18,420 | ProgramServicesAmt |
| Management And General | $2,400 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $442,553 | TotalAmt |
| Program Services | $418,963 | ProgramServicesAmt |
| Management And General | $23,590 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $134,242 | TotalAmt |
| Program Services | $127,086 | ProgramServicesAmt |
| Management And General | $7,156 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| THIRD PARTY CONTRACTED | $8,417,722 | $8,417,722 | |
| EQUIPMENT & SUPPLIES | $371,398 | $356,449 | $14,949 |
| LICENSES & PERMITS | $125,330 | $110,883 | $14,447 |
| DUES & SUBSCRIPTIONS | $23,248 | $20,568 | $2,680 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,683,243 | TotalAmt |
| Program Services | $15,611,699 | ProgramServicesAmt |
| Management And General | $1,071,544 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $963,720 | BOYAmt |
| EOY | $4,836,125 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,062,290 | BOYAmt |
| EOY | $2,927,353 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $89,897 | BOYAmt |
| EOY | $204,735 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $4,895,439 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $1,148,996 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $4,144,261 | BOYAmt |
| EOY | $3,746,443 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $81,223 | BOYAmt |
| EOY | $91,235 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $37,275 | BOYAmt |
| EOY | $37,275 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,378,666 | BOYAmt |
| EOY | $11,843,166 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,554,503 | BOYAmt |
| EOY | $2,786,815 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,554,503 | BOYAmt |
| EOY | $2,786,815 | 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 | $5,824,163 | BOYAmt |
| EOY | $9,056,351 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $5,824,163 | BOYAmt |
| EOY | $9,056,351 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $7,378,666 | BOYAmt |
| EOY | $11,843,166 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $3,232,188 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Hospital | Yes (X) | HospitalInd |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | FORM 990, PART IV, LINE 20A: | FormAndLineReferenceDesc |
| Explanation | ALTHOUGH THE ORGANIZATION HAS BEEN DETERMINED BY THE INTERNAL REVENUE SERVICE TO BE DESCRIBED IN INTERNAL REVENUE CODE SECTION 170(B)(1)(A)(III) BECAUSE IT PROVIDES OUTPATIENT MEDICAL SERVICES, IT IS NOT REQUIRED BY ITS STATE OF OPERATION TO BE LICENSED AS A HOSPITAL. THEREFORE, IT IS NOT REQUIRED TO PROVIDE SCHEDULE H. | ExplanationTxt |
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 C IRS990ScheduleC
| Field | Value | IRS element (for citing) |
|---|---|---|
| Political Expenditures | $0 | PoliticalExpendituresAmt |
| Volunteer Hours | 0 | VolunteerHoursCnt |
| Section4955 Organization Tax | $0 | Section4955OrganizationTaxAmt |
| Section4955 Managers Tax | $0 | Section4955ManagersTaxAmt |
Total Direct Lobbying TotalDirectLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Total | $0 | FilingOrganizationsTotalAmt |
Total Lobbying Expend TotalLobbyingExpendGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Total | $0 | FilingOrganizationsTotalAmt |
Total Exempt Purpose Expend TotalExemptPurposeExpendGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Total | $0 | FilingOrganizationsTotalAmt |
Lobbying Nontaxable Amount LobbyingNontaxableAmountGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Total | $0 | FilingOrganizationsTotalAmt |
Grassroots Nontaxable GrassrootsNontaxableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Filing Organizations Total | $0 | FilingOrganizationsTotalAmt |
Schedule D IRS990ScheduleD
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $4,258,878 | OtherCostOrOtherBasisAmt |
| Depreciation | $825,598 | DepreciationAmt |
| Book Value | $3,433,280 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $232,430 | OtherCostOrOtherBasisAmt |
| Depreciation | $125,899 | DepreciationAmt |
| Book Value | $106,531 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $404,131 | OtherCostOrOtherBasisAmt |
| Depreciation | $197,499 | DepreciationAmt |
| Book Value | $206,632 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $3,746,443 | TotalBookValueLandBuildingsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $19,930,431 | TotalRevEtcAuditedFinclStmtAmt |
| Donated Services And Use Fclts | $15,000 | DonatedServicesAndUseFcltsAmt |
| Revenue Not Reported | $15,000 | RevenueNotReportedAmt |
| Revenue Subtotal | $19,915,431 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $19,915,431 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $16,698,243 | TotExpnsEtcAuditedFinclStmtAmt |
| Donated Services Use Fclts | $15,000 | DonatedServicesUseFcltsAmt |
| Expenses Not Reported | $15,000 | ExpensesNotReportedAmt |
| Expenses Subtotal | $16,683,243 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $16,683,243 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART X, LINE 2: | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION IS GENERALLY EXEMPT FROM INCOME TAXES AS AN ORGANIZATION DESCRIBED UNDER SECTIONS 501(C)(3), 509(A)(1), AND 170(B)(1)(A)(III) OF THE TAX CODE AND SECTION 23701(D) OF THE CALIFORNIA REVENUE AND TAXATION CODE, EXCEPT FOR TAXES ON NET UNRELATED BUSINESS INCOME. SINCE THE ORGANIZATION HAD NO UNRELATED BUSINESS INCOME IN 2021 AND 2020, NO PROVISION FOR INCOME TAXES HAS BEEN RECORDED. IN ACCORDANCE WITH FASB ASC 740, ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES, THE ORGANIZATION EVALUATES ANNUALLY ANY UNCERTAIN TAX POSITIONS TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN BY APPLYING A THRESHOLD OF MORE-LIKELY-THAN-NOT FOR RECOGNITION. MANAGEMENT EVALUATED ITS TAX POSITIONS AND DETERMINED THAT IT HAS NO UNCERTAIN TAX POSITIONS AT DECEMBER 31, 2021 AND 2020. THERE HAVE BEEN NO RELATED TAX PENALTIES OR INTEREST, WHICH WOULD BE CLASSIFIED AS TAX EXPENSE IN THE STATEMENTS OF ACTIVITIES. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Written Employment Contract | Yes (X) | WrittenEmploymentContractInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (5 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DR ROSS E COLT | ||||||||||||||
| MEDICAL DIRECTOR | $317,625 | $0 | $53,190 | $0 | $0 | $0 | $14,500 | $0 | $18,844 | $0 | $404,159 | $0 | $0 | $0 |
| RENATA R SMITH | ||||||||||||||
| EXECUTIVE DIRECTOR | $198,416 | $0 | $49,140 | $0 | $0 | $0 | $10,079 | $0 | $1,992 | $0 | $259,627 | $0 | $0 | $0 |
| ROBIN JENSEN | ||||||||||||||
| DIRECTOR OF BUSINESS AND FINANCE | $153,880 | $0 | $19,200 | $0 | $0 | $0 | $7,957 | $0 | $12,253 | $0 | $193,290 | $0 | $0 | $0 |
| SAMAR HIREISH | ||||||||||||||
| CLINIC DIRECTOR | $131,249 | $0 | $8,417 | $0 | $0 | $0 | $6,845 | $0 | $9,746 | $0 | $156,257 | $0 | $0 | $0 |
| BRITTANY SUMEREL | ||||||||||||||
| PHYSICIAN ASSISTANT | $140,213 | $0 | $2,167 | $0 | $0 | $0 | $7,049 | $0 | $4,760 | $0 | $154,189 | $0 | $0 | $0 |
Schedule L IRS990ScheduleL
Bus Tr Involve Interested Prsn BusTrInvolveInterestedPrsnGrp (2 entries)
| Relationship DescriptionRelationshipDescriptionTxt | TransactionTransactionAmt | TransactionTransactionDesc | Sharing Of RevenuesSharingOfRevenuesInd |
|---|---|---|---|
| GARY AND MARY WEST HEALTH INSTITUTE | |||
| COMMON DIRECTOR & COMMON OFFICER | $2,000,000 | FUNDS RECEIVED TO RESEARCH THE METHODS AND MEANS FOR IMPLEMENTING A PACE PROGRAM WITH SUBSTANTIALLY EXPANDED SERVICES FOR PARTICIPANTS BEYOND THOSE REQUIRED BY FEDERAL AND STATE GOVERNMENTAL AGENCIES. | 0 |
| GARY AND MARY WEST FOUNDATION | |||
| COMMON DIRECTOR & COMMON OFFICER | $95,786 | FUNDS RECEIVED TO COVER A PORTION OF THE EXPENSES OF OPERATING THE COMMUNITY BASED COVID VACCINATION SITE. | 0 |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (9 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 2 | JON ZIFFERBLATT, SECRETARY OF GARY AND MARY WEST SENIOR SERVICES, IS ALSO EMPLOYED BY THE GARY AND MARY WEST MANAGEMENT COMPANY. CHARLES SEDERSTROM ACTS AS A DIRECTOR OF THE BOARD FOR BOTH GARY AND MARY WEST SENIOR SERVICES AND GARY AND MARY WEST MANAGEMENT COMPANY. |
| FORM 990, PART VI, SECTION A, LINE 6 | GARY AND MARY WEST SENIOR SERVICES HAS THREE MEMBERS WHO ALSO SERVE AS DIRECTORS. |
| FORM 990, PART VI, SECTION A, LINE 7A | ADDITIONAL OR SUCCESSOR MEMBERS OF THE BOARD OF DIRECTORS SHALL BE ELECTED BY THE MEMBERS AS NECESSARY TO FILL EXPIRING, VACANT OR ADDITIONAL POSITIONS, AT THE APPLICABLE ANNUAL MEETING OF THE MEMBERS OR AT A SPECIAL MEETING OF THE MEMBERS CALLED FOR SUCH PURPOSE. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE BYLAWS REQUIRE THAT AMENDMENTS TO THE BYLAWS AND ARTICLES OF INCORPORATION MADE BY THE ORGANIZATION ARE SUBJECT TO APPROVAL BY THE MEMBERS OF THE ORGANIZATION. |
| FORM 990, PART VI, SECTION B, LINE 11B | THE FORM 990 INFORMATION WAS COMPILED FROM THE ORGANIZATION'S ACCOUNTING RECORDS. THE COMPLETED FORM 990 WAS REVIEWED BY THE ORGANIZATION'S PRESIDENT, THE DIRECTOR OF FINANCE AND OUTSIDE LEGAL COUNSEL. UPON SATISFACTORY COMPLETION OF THE REVIEW PROCESS, A DRAFT OF THE FORM 990 WAS CIRCULATED TO THE ORGANIZATION'S GOVERNING BODY FOR REVIEW. THE FORM 990 WAS THEN FILED WITH THE INTERNAL REVENUE SERVICE. |
| FORM 990, PART VI, SECTION B, LINE 12C | EACH PRINCIPAL OFFICER, BOARD MEMBER AND MEMBER OF A COMMITTEE WITH BOARD-DELEGATED POWERS SIGNS A STATEMENT ANNUALLY WHICH AFFIRMS THAT PERSON HAS RECEIVED, UNDERSTANDS AND AGREES TO COMPLY WITH THE CONFLICT OF INTEREST POLICY. |
| FORM 990, PART VI, SECTION B, LINE 15 | THE OFFICERS OF THE CORPORATION SHALL BE ENTITLED TO SUCH REASONABLE COMPENSATION FOR THEIR SERVICES AS IS APPROVED BY THE BOARD OF DIRECTORS AND TO THE REIMBURSEMENT OF REASONABLE EXPENSES, IF ANY, INCURRED BY THEM AS OFFICERS, IF APPROVED BY THE BOARD OF DIRECTORS, AND NOTHING HEREIN SHALL BE CONSTRUED TO PRECLUDE AN OFFICER FROM SERVING THE CORPORATION IN ANY OTHER CAPACITY AND RECEIVING COMPENSATION FOR SUCH OTHER SERVICES. COMPENSATION FOR THE EXECUTIVE DIRECTOR AND ANY KEY EMPLOYEES OF THE ORGANIZATION ARE DETERMINED BASED ON CURRENT COMPENSATION SURVEYS COMPILED BY AN INDEPENDENT FIRM. COMPENSATION IS APPROVED BY AN OFFICER OF THE ORGANIZATION IN ADVANCE OF PAYMENT. RECORDS OF RELATED SURVEYS AND APPROVALS ARE MAINTAINED IN PERSONNEL FILES. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON THE REQUEST OF SUCH DOCUMENTS. THE RETURN IS REVIEWED BY THE DIRECTOR OF FINANCE, LEGAL COUNSEL, AND PRESIDENT OF THE ORGANIZATION. |
| FORM 990, PART XII, LINE 2C | THE AUDITED FINANCIAL STATEMENTS WERE REVIEWED AND APPROVED BY THE AUDIT COMMITTEE OF THE BOARD OF DIRECTORS. UPON SATISFACTORY COMPLETION OF THE REVIEW PROCESS, A DRAFT OF THE AUDITED FINANCIAL STATEMENTS WAS CIRCULATED TO THE ORGANIZATION'S GOVERNING BOARD FOR REVIEW. |