MJHS MEDICAL ASSOCIATES PC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- MJHS MEDICAL ASSOCIATES PC (EIN 27-5273404)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-11-11
- IRS object ID
- 202233159349305873
- 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 | 2022-11-11T14:42:12-06:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | BDO USA LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 100 PARK AVENUE | AddressLine1Txt |
| City | NEW YORK | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 100175001 | 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 | 275273404 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | MJHS Medical Associates PC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % DR RUSSELL PORTENOY | InCareOfNm |
| Business Name Control | MJHS | BusinessNameControlTxt |
| Phone | 7184917208 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6323 Seventh Avenue | AddressLine1Txt |
| City | Brooklyn | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 11220 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | Russell Portenoy | PersonNm |
| Person Title | PRESIDENT | PersonTitleTxt |
| Phone | 7184917261 | PhoneNum |
| Signature | 2022-11-09 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | Russell | PersonFirstNm |
| Person Last | Portenoy | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Kristin Ruffini | PreparerPersonNm |
| PTIN | P00741491 | PTIN |
| Phone | 2128858000 | PhoneNum |
| Preparation | 2022-11-09 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 2 | TrustedCustomerCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | Russell Portenoy | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6323 Seventh Avenue | AddressLine1Txt |
| City | Brooklyn | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 11220 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $12,081,954 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | N/A | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2011 | FormationYr |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Activity Or Mission | TO PRACTICE THE PROFESSION OF MEDICINE FOR AFFILIATES OF METROPOLITAN JEWISH HEALTH SYSTEM, INC., WHICH PROVIDE MEDICAL AND HEALTH SERVICES IN BROOKLYN, NEW YORK. | ActivityOrMissionDesc |
| Voting Members Governing Body | 3 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 0 | VotingMembersIndependentCnt |
| Total Employee | 83 | TotalEmployeeCnt |
| Total Volunteers | 0 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $11,329 | PYContributionsGrantsAmt |
| CY Contributions Grants | $642,326 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $1,754,990 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $1,505,128 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | $0 | CYInvestmentIncomeAmt |
| PY Other Revenue | $10,819,775 | PYOtherRevenueAmt |
| CY Other Revenue | $9,934,500 | CYOtherRevenueAmt |
| PY Total Revenue | $12,586,094 | PYTotalRevenueAmt |
| CY Total Revenue | $12,081,954 | 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 | $11,090,811 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $10,463,311 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $1,279,543 | PYOtherExpensesAmt |
| CY Other Expenses | $816,960 | CYOtherExpensesAmt |
| PY Total Expenses | $12,370,354 | PYTotalExpensesAmt |
| CY Total Expenses | $11,280,271 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $215,740 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $801,683 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $1,712,694 | TotalAssetsBOYAmt |
| Total Assets EOY | $1,648,769 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,581,510 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,715,902 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | -$868,816 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$67,133 | NetAssetsOrFundBalancesEOYAmt |
| Mission | THE PURPOSE FOR WHICH THE CORPORATION IS FORMED IS TO PRACTICE THE PROFESSION OF MEDICINE FOR AFFILIATES OF METROPOLITAN JEWISH HEALTH SYSTEM, INC., WHICH PROVIDE MEDICAL AND HEALTH SERVICES IN BROOKLYN, NEW YORK. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $10,089,450 | ExpenseAmt |
| Grant | $0 | GrantAmt |
| Revenue | $11,439,628 | RevenueAmt |
| Desc | MJHS MEDICAL ASSOCIATES, PC COORDINATES PHYSICIAN SERVICES AND PRACTICES MEDICINE WITH A FOCUS ON PALLIATIVE CARE AND MEDICAL MANAGEMENT. THE PC HAS AGREEMENTS WITH MJHS HOSPICE AND PALLIATIVE CARE AND ELDERPLAN, INC, RELATED ORGANIZATIONS. IN 2021, THE MEDICAL PC PROVIDED APPROXIMATELY 2,640 PALLIATIVE CARE VISITS. IT ALSO PROVIDED 2080 MEMBER MONTHS OF MEDICAL MANAGEMENT SERVICES TO ELDERPLAN MEMBERS - THROUGH THE MJHS PLUS PROGRAM - AND 12,657 MEMBER MONTHS OF SERVICES TO NURSING HOME RESIDENTS - THROUGH THE ELDERPLAN ISNP. | Desc |
| Total Program Service Expenses | $10,089,450 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (true) | ScheduleBRequiredInd |
| Political Campaign Acty | false | PoliticalCampaignActyInd |
| Lobbying Activities | false | LobbyingActivitiesInd |
| Subject To Proxy Tax | false | SubjectToProxyTaxInd |
| Donor Advised Fund | false | DonorAdvisedFundInd |
| Conservation Easements | false | ConservationEasementsInd |
| Collections Of Art | false | CollectionsOfArtInd |
| Credit Counseling | false | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | false | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (true) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | false | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | false | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | false | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | Yes (true) | ConsolidatedAuditFinclStmtInd |
| School Operating | false | SchoolOperatingInd |
| Foreign Office | false | ForeignOfficeInd |
| Foreign Activities | false | ForeignActivitiesInd |
| More Than5000 K To Org | false | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | false | MoreThan5000KToIndividualsInd |
| Professional Fundraising | false | ProfessionalFundraisingInd |
| Fundraising Activities | false | FundraisingActivitiesInd |
| Gaming Activities | false | GamingActivitiesInd |
| Operate Hospital | false | OperateHospitalInd |
| Grants To Organizations | false | GrantsToOrganizationsInd |
| Grants To Individuals | false | GrantsToIndividualsInd |
| Schedule J Required | Yes (true) | ScheduleJRequiredInd |
| Tax Exempt Bonds | false | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | false | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | false | PYExcessBenefitTransInd |
| Loan Outstanding | false | LoanOutstandingInd |
| Grant To Related Person | false | GrantToRelatedPersonInd |
| Business Rln With Org Mem | false | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | false | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | false | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | false | DeductibleNonCashContriInd |
| Deductible Art Contribution | false | DeductibleArtContributionInd |
| Terminate Operations | false | TerminateOperationsInd |
| Partial Liquidation | false | PartialLiquidationInd |
| Disregarded Entity | false | DisregardedEntityInd |
| Related Entity | Yes (true) | RelatedEntityInd |
| Related Organization Ctrl Ent | false | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | false | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | false | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (true) | ScheduleORequiredInd |
| IRP Document | 11 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 83 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (true) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | false | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | false | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | false | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | false | TaxablePartyNotificationInd |
| Nondeductible Contributions | false | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | false | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | false | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | false | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | false | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | false | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | false | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | false | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 3 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 0 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | false | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | Yes (true) | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | false | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (true) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (true) | MinutesOfCommitteesInd |
| Officer Mailing Address | false | OfficerMailingAddressInd |
| Local Chapters | false | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (true) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (true) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (true) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (true) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (true) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (true) | DocumentRetentionPolicyInd |
| Compensation Process CEO | false | CompensationProcessCEOInd |
| Compensation Process Other | false | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | NY | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DR RUSSELL PORTENOY | PersonNm |
| Phone | 7184917208 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 6323 SEVENTH AVE | AddressLine1Txt |
| City | BROOKLYN | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 11220 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part VII | Yes (X) | InfoInScheduleOPartVIIInd |
Form990 Part VII Section A Form990PartVIISectionAGrp (8 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Average Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| RUSSELL PORTENOY | ||||||||
| President/Shareholder | 6.0 | 29.0 | Yes (X) | Yes (X) | $0 | $764,021 | $70,688 | |
| GILBERT BURGOS | ||||||||
| DIRECTOR | 6.0 | 29.0 | Yes (X) | $0 | $391,425 | $52,621 | ||
| BERNARD LEE | ||||||||
| SECRETARY TREAS/SHAREHOLDER | 6.0 | 29.0 | Yes (X) | Yes (X) | $0 | $302,586 | $57,377 | |
| Anna Kimelfeld | ||||||||
| AVP of I-SNP & GCC Clin Srvs | 35.0 | 0.0 | $215,315 | $0 | $40,212 | Yes (X) | ||
| Laura Paduano | ||||||||
| Dir of I-SNP Clini Srvs & QM | 35.0 | 0.0 | $214,642 | $0 | $14,588 | Yes (X) | ||
| Danielle Jacaruso-Mrkulic | ||||||||
| Nurse Practitioner | 35.0 | 0.0 | $179,676 | $0 | $42,303 | Yes (X) | ||
| Ashuwinder Singh | ||||||||
| Nurse Pract Mgr of clini prac | 35.0 | 0.0 | $175,788 | $0 | $44,516 | Yes (X) | ||
| Elena Frish | ||||||||
| Dir of I-SNP Clini Srvs & OM | 35.0 | 0.0 | $168,044 | $0 | $31,690 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $953,465 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $1,458,032 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $353,995 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 47 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| ACCN BILLING SERVICES INC | |||||
| 50 TICE BOULEVARD SUITE 190 | WOODCLIFF LAKE | NJ | 07677 | Billing Service | $264,900 |
| MJHS HOSPICE AND PALLIATIVE CARE | |||||
| 6323 7TH AVENUE | BROOKLYN | NY | 11220 | Medical Prof Service | $165,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $641,833 | GovernmentGrantsAmt |
| All Other Contributions | $493 | AllOtherContributionsAmt |
| Total Contributions | $642,326 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | NET PATIENT SERVICE REVENUE | Desc |
| Business | 621300 | BusinessCd |
| Total Revenue Column | $1,505,128 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $1,505,128 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $1,505,128 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Incm From Invest Bond Proceeds IncmFromInvestBondProceedsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Royalties Revenue RoyaltiesRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Rental Income Or Loss RentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | $0 | RealAmt |
| Personal | $0 | PersonalAmt |
Net Rental Income Or Loss NetRentalIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Fundraising Gross Income | $0 | FundraisingGrossIncomeAmt |
| Fundraising Direct Expenses | $0 | FundraisingDirectExpensesAmt |
Net Incm From Fundraising Evt NetIncmFromFundraisingEvtGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gaming Gross Income | $0 | GamingGrossIncomeAmt |
| Gaming Direct Expenses | $0 | GamingDirectExpensesAmt |
Net Income From Gaming NetIncomeFromGamingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Sales Of Inventory | $0 | GrossSalesOfInventoryAmt |
| Cost Of Goods Sold | $0 | CostOfGoodsSoldAmt |
Net Income Or Loss NetIncomeOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $0 | TotalRevenueColumnAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PREMIUM REVENUE | 900099 | $7,438,500 | $7,438,500 |
| PURCHASE SERVICE SALARY | 900099 | $2,496,000 | $2,496,000 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $9,934,500 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $12,081,954 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $11,439,628 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $0 | ExclusionAmt |
Grants To Domestic Orgs GrantsToDomesticOrgsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Grants To Domestic Individuals GrantsToDomesticIndividualsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Foreign Grants ForeignGrantsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Benefits To Members BenefitsToMembersGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Comp Disqual Persons CompDisqualPersonsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,408,193 | TotalAmt |
| Program Services | $7,915,739 | ProgramServicesAmt |
| Management And General | $492,454 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $404,180 | TotalAmt |
| Program Services | $380,508 | ProgramServicesAmt |
| Management And General | $23,672 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,005,758 | TotalAmt |
| Program Services | $946,852 | ProgramServicesAmt |
| Management And General | $58,906 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $645,180 | TotalAmt |
| Program Services | $607,393 | ProgramServicesAmt |
| Management And General | $37,787 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,756 | TotalAmt |
| Management And General | $7,756 | ManagementAndGeneralAmt |
Fees For Services Lobbying FeesForServicesLobbyingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Prof Fundraising FeesForServicesProfFundraising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $627,096 | TotalAmt |
| Program Services | $208,503 | ProgramServicesAmt |
| Management And General | $418,593 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $10,960 | TotalAmt |
| Management And General | $10,960 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $5,174 | TotalAmt |
| Management And General | $5,174 | ManagementAndGeneralAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,627 | TotalAmt |
| Program Services | $11,627 | ProgramServicesAmt |
Pymt Travel Entrtnmnt Pub Ofcl PymtTravelEntrtnmntPubOfclGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $32,363 | TotalAmt |
| Program Services | $3,925 | ProgramServicesAmt |
| Management And General | $28,438 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,865 | TotalAmt |
| Management And General | $11,865 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Management And GeneralManagementAndGeneralAmt | FundraisingFundraisingAmt | Program ServicesProgramServicesAmt |
|---|---|---|---|---|
| DUES AND SUBSCRIPTIONS | $23,563 | $23,563 | $0 | |
| TRAINING | $33,024 | $24,995 | $8,029 | |
| ALL OTHER | $15,804 | $15,804 | ||
| MEDICAL SUPPLIES | $37,728 | $30,854 | $6,874 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $11,280,271 | TotalAmt |
| Program Services | $10,089,450 | ProgramServicesAmt |
| Management And General | $1,190,821 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,000 | BOYAmt |
| EOY | $10,000 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $690,236 | BOYAmt |
| EOY | $822,021 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $978,335 | BOYAmt |
| EOY | $794,037 | EOYAmt |
Receivables From Officers Etc ReceivablesFromOfficersEtcGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Rcvbl From Disqualified Prsn RcvblFromDisqualifiedPrsnGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Oth Notes Loans Receivable Net OthNotesLoansReceivableNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Inventories For Sale Or Use InventoriesForSaleOrUseGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $8,005 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $85,646 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $73,768 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $23,743 | BOYAmt |
| EOY | $11,878 | EOYAmt |
Investments Pub Traded Sec InvestmentsPubTradedSecGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Investments Program Related InvestmentsProgramRelatedGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Intangible Assets IntangibleAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $10,380 | BOYAmt |
| EOY | $2,828 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,712,694 | BOYAmt |
| EOY | $1,648,769 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,298,289 | BOYAmt |
| EOY | $1,241,969 | EOYAmt |
Grants Payable GrantsPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Tax Exempt Bond Liabilities TaxExemptBondLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Escrow Account Liability EscrowAccountLiabilityGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Loans From Officers Directors LoansFromOfficersDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,283,221 | BOYAmt |
| EOY | $473,933 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,581,510 | BOYAmt |
| EOY | $1,715,902 | 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 | -$868,816 | BOYAmt |
| EOY | -$67,133 | EOYAmt |
Donor Restriction Net Assets DonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | -$868,816 | BOYAmt |
| EOY | -$67,133 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,712,694 | BOYAmt |
| EOY | $1,648,769 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | $801,683 | ReconcilationRevenueExpnssAmt |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | false | AccountantCompileOrReviewInd |
| FS Audited | Yes (true) | 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 (true) | AuditCommitteeInd |
| Federal Grant Audit Required | false | 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 Minus4 Years | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $0 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $0 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $11,329 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $642,326 | CurrentTaxYearAmt |
| Total | $653,655 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $9,193,543 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $10,094,576 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $10,439,907 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $12,574,765 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $11,439,628 | CurrentTaxYearAmt |
| Total | $53,742,419 | TotalAmt |
Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Tax Rev Levied Orgnztnl Bnft509 TaxRevLeviedOrgnztnlBnft509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Govt Furn Srvc Fclts Vl509 GovtFurnSrvcFcltsVl509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Total509 Total509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $9,193,543 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $10,094,576 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $10,439,907 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $12,586,094 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $12,081,954 | CurrentTaxYearAmt |
| Total | $54,396,074 | TotalAmt |
Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | 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) |
|---|---|---|
| Total | $0 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total509 | $54,396,074 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $327 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $888 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $0 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $0 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $1,215 | TotalAmt |
Post1975 UBTI Post1975UBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $327 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $888 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $0 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $0 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $1,215 | TotalAmt |
Net Income From Other UBI NetIncomeFromOtherUBIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Other Income509 OtherIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $62 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $0 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $61 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $0 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $123 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $9,193,932 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $10,095,464 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $10,439,968 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $12,586,094 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $12,081,954 | CurrentTaxYearAmt |
| Total | $54,397,412 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support CY509 | 0.99997 | PublicSupportCY509Pct |
| Public Support PY509 | 0.99996 | PublicSupportPY509Pct |
| Investment Income CY | 0.00002 | InvestmentIncomeCYPct |
| Investment Income PY | 0.00004 | InvestmentIncomePYPct |
| Thirty Thr Pct Suprt Tests CY509 | Yes (X) | ThirtyThrPctSuprtTestsCY509Ind |
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
| Field | Value | IRS element (for citing) |
|---|---|---|
| Art Public Exhibition Amounts | ArtPublicExhibitionAmountsGrp | |
| Held Works Art | HeldWorksArtGrp | |
| CY Minus3 Yr Endwmt Fund | CYMinus3YrEndwmtFundGrp | |
| CY Minus4 Yr Endwmt Fund | CYMinus4YrEndwmtFundGrp | |
| Land | LandGrp | |
| Buildings | BuildingsGrp | |
| Leasehold Improvements | LeaseholdImprovementsGrp |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $85,646 | OtherCostOrOtherBasisAmt |
| Depreciation | $73,768 | DepreciationAmt |
| Book Value | $11,878 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Land Buildings | OtherLandBuildingsGrp | |
| Total Book Value Land Buildings | $11,878 | TotalBookValueLandBuildingsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | DUE TO RELATED ORGANIZATIONS | Desc |
| Amt | $473,933 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $473,933 | TotalLiabilityAmt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | false | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | false | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | false | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | false | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | false | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | false | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (true) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (8 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 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| RUSSELL PORTENOY | ||||||||||||||
| President/Shareholder | $0 | $677,243 | $0 | $0 | $0 | $86,778 | $0 | $21,025 | $0 | $49,663 | $0 | $834,709 | $0 | $0 |
| BERNARD LEE | ||||||||||||||
| SECRETARY TREAS/SHAREHOLDER | $0 | $296,744 | $0 | $0 | $0 | $5,842 | $0 | $21,025 | $0 | $36,352 | $0 | $359,963 | $0 | $0 |
| Danielle Jacaruso-Mrkulic | ||||||||||||||
| Nurse Practitioner | $179,402 | $0 | $0 | $0 | $274 | $0 | $8,004 | $0 | $34,299 | $0 | $221,979 | $0 | $0 | $0 |
| Anna Kimelfeld | ||||||||||||||
| AVP of I-SNP & GCC Clin Srvs | $194,324 | $0 | $19,653 | $0 | $1,338 | $0 | $14,274 | $0 | $25,938 | $0 | $255,527 | $0 | $0 | $0 |
| Ashuwinder Singh | ||||||||||||||
| Nurse Pract Mgr of clini prac | $170,531 | $0 | $4,500 | $0 | $757 | $0 | $10,143 | $0 | $34,373 | $0 | $220,304 | $0 | $0 | $0 |
| Laura Paduano | ||||||||||||||
| Dir of I-SNP Clini Srvs & QM | $185,715 | $0 | $18,360 | $0 | $10,567 | $0 | $12,512 | $0 | $2,076 | $0 | $229,230 | $0 | $0 | $0 |
| Elena Frish | ||||||||||||||
| Dir of I-SNP Clini Srvs & OM | $160,219 | $0 | $2,500 | $0 | $5,325 | $0 | $9,112 | $0 | $22,578 | $0 | $199,734 | $0 | $0 | $0 |
| GILBERT BURGOS | ||||||||||||||
| DIRECTOR | $0 | $342,312 | $0 | $34,000 | $0 | $15,113 | $0 | $19,189 | $0 | $33,432 | $0 | $444,046 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART I, LINE 3 | THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL RECEIVED THEIR COMPENSATION FROM A RELATED ORGANIZATION, WHICH USED ONE OR MORE OF THE METHODS DESCRIBED TO ESTABLISH THE TOP MANAGEMENT OFFICIAL'S COMPENSATION. |
| PART 1, LINE 7 | BONUS ELIGIBILITY IS BASED ON THE EXTENT THAT EACH EXECUTIVE AND EMPLOYEE HAS ACHIEVED HIS/HER GOAL AND IS APPROVED BY THE EXECUTIVE COMMITTEE OF THE BOARD. |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (7 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, LINE 6: | RUSSELL PORTENOY, PRESIDENT, AND BERNARD LEE, SECRETARY/TREASURER, ARE THE NOMINEE SHAREHOLDERS. |
| FORM 990, PART VI, LINE 7A: | THE SHAREHOLDERS OF THE ORGANIZATION MUST BE APPROVED BY METROPOLITAN JEWISH HEALTH SYSTEM, INC. ("MJHS"), A RELATED ORGANIZATION. |
| FORM 990, PART VI, LINE 11B: | DRAFT OF THE COMPLETED RETURN IS REVIEWED BY THE BOARD. ANY COMMENTS ARISING FROM THEIR REVIEW ARE DISCUSSED AND, IF REQUIRED, CHANGES ARE MADE TO THE DRAFT. THE REVISED DRAFT WILL BE SUBMITTED BACK TO THE BOARD FOR ITS REVIEW AND APPROVAL. UPON APPROVAL IT WILL BE FILED WITH THE IRS. |
| FORM 990, PART VI, LINE 12C: | MJHS MEDICAL ASSOCIATES, PC ("PC") HAS ADOPTED A CONFLICT OF INTEREST POLICY AS PART OF ITS BYLAWS (ARTICLE V). THE PC MONITORS AND ENFORCES ITS POLICY AS FOLLOWS: THE BOARD OR COMMITTEE REVIEWS ALL ANNUAL CONFLICT OF INTEREST STATEMENTS. POSITIVE RESPONSES ARE REVIEWED AND ADDITIONAL INFORMATION IS GATHERED TO DETERMINE IF A CONFLICT EXISTS. IF A CONFLICT EXISTS, APPROPRIATE ACTION IS TAKEN TO ELIMINATE THE CONFLICT, INCLUDING SUCH STEPS AS REASSIGNMENT OF RESPONSIBILITIES. IF A MATTER INVOLVES A BOARD MEMBER OR OFFICER, APPROPRIATE ACTION, INCLUDING RECUSAL AND ADDITIONAL DISCLOSURES, WILL BE DETERMINED BY THE BOARD. |
| FORM 990, PART VI, SECTION B, LINE 15A: | MJHS MEDICAL ASSOCIATES, P.C. DOES NOT COMPENSATE ITS PRESIDENT REPORTED ON PART VII OF THE FORM 990. THE PRESIDENT IS PAID BY A RELATED 501(C)(3) ORGANIZATION, MJHS HOSPICE AND PALLIATIVE CARE, INC. ("HOSPICE"). THE PROCESSES USED TO DETERMINE THE PRESIDENT'S COMPENSATION IS DISCLOSED ON HOSPICE'S ANNUAL FORM 990. |
| FORM 990, PART VI, SECTION B, LINE 15B: | MJHS MEDICAL ASSOCIATES, P.C. DOES NOT COMPENSATE ITS OFFICERS AND DIRECTORS WHO ARE PAID BY A RELATED 501(C)(3) ORGANIZATIONS, MJHS HOSPICE AND PALLIATIVE CARE, INC. AND ELDERPLAN, INC. THE PROCESSES USED TO DETERMINE THE OTHER OFFICERS AND KEY EMPLOYEES' COMPENSATION IS DISCLOSED ON THOSE ANNUAL FORM 990S.THOSE ENTITIES RETAIN THE SERVICES OF A MAJOR EXECUTIVE COMPENSATION FIRM TO REVIEW MARKET PAY PRACTICES AND AVERAGE SALARY MOVEMENT AMONG SIMILARLY SITUATED EXECUTIVES. THE EXECUTIVE COMPENSATION FIRM IS ASKED TO DEVELOP A COMPARATIVE BASE THAT IS AS CLOSE AS POSSIBLE TO OUR ORGANIZATION. THIS MARKET ANALYSIS IS THEN REVIEWED BY THE HUMAN RESOURCES DEPARTMENT UNDER THE DIRECTION OF THE CHIEF HUMAN RESOURCES OFFICER IN CONJUNCTION WITH THE CEO, USING LOCAL SURVEYS TO ENSURE MARKET COMPETITIVENESS. THE BASIS FOR ITS DETERMINATION AND ALL DECISIONS MADE ARE CONTEMPORANEOUSLY DOCUMENTED IN MEETING MINUTES. |
| FORM 990, PART VI, LINE 19: | UPON REQUEST, THE ORGANIZATION WILL MAKE AVAILABLE ONLY THOSE DOCUMENTS REQUIRED TO BE DISCLOSED UNDER THE PUBLIC INSPECTION LAWS. |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (12 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|
| MENORAH HOME AND HOSPITAL FOR THE AGED A | ||||||||||
| 6323 7TH AVENUE | BROOKLYN | NY | 11220 | 111672777 | NURSING HOME | NY | 501(C)(3) | 3 | MJHS | false |
| SHOREFRONT GERIATRIC INC | ||||||||||
| 6323 7TH AVENUE | BROOKLYN | NY | 11220 | 113072153 | NURSING HOME | NY | 501(C)(3) | 10 | MJHS | false |
| METROPOLITAN JEWISH HOME CARE INC | ||||||||||
| 6323 7TH AVENUE | BROOKLYN | NY | 11220 | 320060822 | HOME CARE | NY | 501(C)(3) | 10 | MJHS | false |
| ELDERPLAN INC | ||||||||||
| 6323 7TH AVENUE | BROOKLYN | NY | 11220 | 112625096 | MEDICARE | NY | 501(C)(3) | 10 | MJHS | false |
| METROPOLITAN JEWISH HEALTH SYSTEM FOUNDA | ||||||||||
| 6323 7TH AVENUE | BROOKLYN | NY | 11220 | 111630753 | FUNDRAISING | NY | 501(C)(3) | 7 | MJHS | false |
| HOMEFIRST LHCSA INC | ||||||||||
| 6323 7TH AVENUE | BROOKLYN | NY | 11220 | 611501623 | HOME CARE | NY | 501(C)(3) | 12 TYPE I | MJHS | false |
| SHOREFRONT TOWERS HOUSING DEV FUND CORP | ||||||||||
| 6323 7TH AVENUE | BROOKLYN | NY | 11220 | 113200785 | HOUSING | NY | 501(C)(3) | 10 | MJHS | false |
| MJHS HOSPICE AND PALLIATIVE CARE INC | ||||||||||
| 6323 7TH AVENUE | BROOKLYN | NY | 11220 | 133438643 | HOSPICE | NY | 501(C)(3) | 3 | MJHS | false |
| METROPOLITAN JEWISH HEALTH SYSTEM INC | ||||||||||
| 6323 7TH AVENUE | BROOKLYN | NY | 11220 | 113538697 | ADMIN SVCS. | NY | 501(C)(3) | 7 | NA | false |
| Institute for Applied Gerontology | ||||||||||
| 6323 7th Avenue | Brooklyn | NY | 11220 | 113135751 | Research | NY | 501(c)(3) | PF | MJHS | false |
| ISABELLA GERIATRIC CENTER INC | ||||||||||
| 6323 7th Avenue | Brooklyn | NY | 11220 | 133623808 | NURSING HOME | NY | 501(C)(3) | 10 | MJHS | false |
| FIRST TO CARE HOME CARE INC | ||||||||||
| 6323 7TH AVENUE | BROOKLYN | NY | 11220 | 113300822 | HOME HEALTH | NY | 501(C)(3) | 10 | mjhs | false |
Id Related Org Txbl Corp Tr IdRelatedOrgTxblCorpTrGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt | Entity TypeEntityTypeTxt | Share Of Total IncomeShareOfTotalIncomeAmt | Share Of EOY AssetsShareOfEOYAssetsAmt | Controlled OrganizationControlledOrganizationInd |
|---|---|---|---|---|---|---|---|---|---|---|---|
| MJGC Corp | |||||||||||
| 6323 7th Avenue | Brooklyn | NY | 11220 | 113356665 | HOLDING COMPANY | NY | MJHS | C Corporation | $0 | $0 | false |
| MJHS SOLUTIONS INC | |||||||||||
| 6323 7TH AVE | BROOKLYN | NY | 11220 | 832479283 | HOLDING COMPANY | NY | MJHS Foundation | C CORPORATION | $0 | $0 | false |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Annts Rnts Rylts | false | ReceiptOfIntAnntsRntsRyltsInd |
| Gift Grnt Or Cap Contri To Oth Org | false | GiftGrntOrCapContriToOthOrgInd |
| Gift Grnt Cap Contri From Oth Org | false | GiftGrntCapContriFromOthOrgInd |
| Loans Or Guarantees To Other Org | false | LoansOrGuaranteesToOtherOrgInd |
| Loans Or Guarantees From Oth Org | false | LoansOrGuaranteesFromOthOrgInd |
| Div Related Organization | false | DivRelatedOrganizationInd |
| Asset Sale To Other Org | false | AssetSaleToOtherOrgInd |
| Asset Purchase From Other Org | false | AssetPurchaseFromOtherOrgInd |
| Asset Exchange | false | AssetExchangeInd |
| Rental Of Facilities To Oth Org | false | RentalOfFacilitiesToOthOrgInd |
| Rental Of Fclts From Oth Org | false | RentalOfFcltsFromOthOrgInd |
| Perform Of Services For Oth Org | Yes (true) | PerformOfServicesForOthOrgInd |
| Perform Of Services By Other Org | false | PerformOfServicesByOtherOrgInd |
| Sharing Of Facilities | Yes (true) | SharingOfFacilitiesInd |
| Paid Employees Sharing | Yes (true) | PaidEmployeesSharingInd |
| Reimbursement Paid To Other Org | Yes (true) | ReimbursementPaidToOtherOrgInd |
| Reimbursement Paid By Other Org | false | ReimbursementPaidByOtherOrgInd |
| Transfer To Other Org | false | TransferToOtherOrgInd |
| Transfer From Other Org | false | TransferFromOtherOrgInd |