HOUSECALL PROVIDERS PC: Form 990, tax year 2018
View the entire original 990 at ProPublica ↗
- Organization
- HOUSECALL PROVIDERS PC (EIN 82-1663503)
- Tax period
- 2018-01-01 to 2018-12-31
- Filed
- 2019-11-12
- IRS object ID
- 201923169349306572
- Schema version
- 2018v3.1
- 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 | 2019-11-12T17:58:56-06:00 | ReturnTs |
| Tax Period End | 2018-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KPMG LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1918 Eighth Avenue Suite 2900 | AddressLine1Txt |
| City | Seattle | CityNm |
| State Abbreviation | WA | StateAbbreviationCd |
| ZIP | 98101 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2018-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 821663503 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Housecall Providers PC | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| In Care Of | % TERESA KENNEDY LEARN CFO | InCareOfNm |
| Business Name Control | HOUS | BusinessNameControlTxt |
| Phone | 5034164100 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 315 SW 5TH AVE | AddressLine1Txt |
| City | PORTLAND | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97204 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TERESA KENNEDY LEARN | PersonNm |
| Person Title | CFO | PersonTitleTxt |
| Phone | 5034161415 | PhoneNum |
| Signature | 2019-11-12 | SignatureDt |
| Discuss With Paid Preparer | Yes (true) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | LISA M MEYER MANAGER | PreparerPersonNm |
| PTIN | P01490170 | PTIN |
| Phone | 2069134000 | PhoneNum |
| Preparation | 2019-11-04 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 167.68.102.5 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Federal Original Submission Id | 91023620193165000001 | FederalOriginalSubmissionId |
| Federal Original Submission Id | 2019-11-12 | FederalOriginalSubmissionIdDt |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | 19EB1119B4759CFA3C643FCF82952710ED290056 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | EB55F1ACF13E24CD52E23D2115178F104C737B6C | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2018 | TaxYr |
| Build TS | 2020-04-17 16:48:07Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | TERESA K LEARN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 315 SW 5TH AVE | AddressLine1Txt |
| City | PORTLAND | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97204 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $5,209,133 | GrossReceiptsAmt |
| Group Return For Affiliates | false | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.HOUSECALLPROVIDERS.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 2017 | FormationYr |
| Legal Domicile State | OR | LegalDomicileStateCd |
| Activity Or Mission | Housecall Providers, PC is a home based primary care service providing medical care integrating & coordinating primary & palliative services for homebound members. | ActivityOrMissionDesc |
| Voting Members Governing Body | 5 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 0 | VotingMembersIndependentCnt |
| Total Employee | 0 | TotalEmployeeCnt |
| Total Volunteers | 37 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $1,149,778 | PYContributionsGrantsAmt |
| CY Contributions Grants | $0 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $1,734,870 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $5,209,008 | CYProgramServiceRevenueAmt |
| PY Investment Income | $0 | PYInvestmentIncomeAmt |
| CY Investment Income | $125 | CYInvestmentIncomeAmt |
| PY Other Revenue | $0 | PYOtherRevenueAmt |
| CY Other Revenue | $0 | CYOtherRevenueAmt |
| PY Total Revenue | $2,884,648 | PYTotalRevenueAmt |
| CY Total Revenue | $5,209,133 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $296 | 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 | $3,847,960 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $7,824,945 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $0 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $663,413 | PYOtherExpensesAmt |
| CY Other Expenses | $939,717 | CYOtherExpensesAmt |
| PY Total Expenses | $4,511,669 | PYTotalExpensesAmt |
| CY Total Expenses | $8,764,662 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | -$1,627,021 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$3,555,529 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $2,483,210 | TotalAssetsBOYAmt |
| Total Assets EOY | $2,416,567 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $2,110,220 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $3,099,106 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $372,990 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | -$682,539 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | SEE SCHEDULE O. | MissionDesc |
| Significant New Program Srvc | false | SignificantNewProgramSrvcInd |
| Significant Change | false | SignificantChangeInd |
| Expense | $7,197,074 | ExpenseAmt |
| Revenue | $5,209,008 | RevenueAmt |
| Desc | PATIENT REVENUE - SEE SCHEDULE O | Desc |
| Total Program Service Expenses | $7,197,074 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (true) | DescribedInSection501c3Ind |
| Schedule B Required | false | 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 |
| Temp Or Permanent Endowments | false | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | false | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | false | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | false | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (true) | ReportOtherAssetsInd |
| Report Other Liabilities | Yes (true) | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (true) | 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 With Officer Ent | false | BusinessRlnWithOfficerEntInd |
| 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 | 28 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (true) | BackupWthldComplianceInd |
| Employee | 0 | EmployeeCnt |
| 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 | 5 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 0 | IndependentVotingMemberCnt |
| Family Or Business Rln | false | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | false | DelegationOfMgmtDutiesInd |
| Change To Org Documents | Yes (true) | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | false | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | Yes (true) | MembersOrStockholdersInd |
| Election Of Board Members | false | 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 | Yes (true) | CompensationProcessCEOInd |
| Compensation Process Other | Yes (true) | CompensationProcessOtherInd |
| Investment In Joint Venture | false | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | OR | StatesWhereCopyOfReturnIsFldCd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | TERESA KENNEDY LEARN CFO | PersonNm |
| Phone | 5034161415 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 315 SW 5TH AVENUE | AddressLine1Txt |
| City | Portland | CityNm |
| State Abbreviation | OR | StateAbbreviationCd |
| ZIP | 97204 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (11 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 |
|---|---|---|---|---|---|---|---|---|
| AMIT R SHAH | ||||||||
| BOARD VICE CHAIRMAN/CMO | 2.0 | 38.0 | Yes (X) | Yes (X) | $0 | $349,789 | $24,009 | |
| TERESA K LEARN | ||||||||
| BOARD OF DIRECTOR/TREASURER | 0.29 | 39.71 | Yes (X) | Yes (X) | $0 | $272,031 | $33,325 | |
| WILLIAM J KENNEDY | ||||||||
| BOARD OF DIRECTOR/SR MED DIR | 19.0 | 21.0 | Yes (X) | Yes (X) | $0 | $278,918 | $47,658 | |
| REBECCA RAMSAY | ||||||||
| ADMINISTRATIVE OFFICER/VP | 20.73 | 19.27 | Yes (X) | Yes (X) | $0 | $228,120 | $46,507 | |
| PAMELA MINER | ||||||||
| MEDICAL DIRECTOR | 40.0 | 0.0 | Yes (X) | Yes (X) | $0 | $247,232 | $42,853 | |
| ERIN FAIR TAYLOR | ||||||||
| SECRETARY | 0.16 | 39.84 | Yes (X) | $0 | $231,111 | $25,633 | ||
| JEAN-CLAUDE KG PROVOST | ||||||||
| ASSOCIATE MEDICAL DIRECTOR | 40.0 | 0.0 | $0 | $165,988 | $21,695 | Yes (X) | ||
| MOLLY W ANDERSON | ||||||||
| PHYSICIAN | 40.0 | 0.0 | $0 | $154,484 | $14,674 | Yes (X) | ||
| ANDREW G SPERLIN | ||||||||
| PHYSICIAN | 40.0 | 0.0 | $0 | $150,872 | $26,147 | Yes (X) | ||
| ROBIN SHEA | ||||||||
| NURSE PRACTITIONER | 40.0 | 0.0 | $0 | $129,273 | $9,049 | Yes (X) | ||
| AMY LONG | ||||||||
| NURSE PRACTITIONER | 40.0 | 0.0 | $0 | $125,476 | $19,961 | Yes (X) | ||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $0 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $2,333,294 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $311,511 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 0 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | false | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (true) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | false | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| Total Contributions | $0 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| Patient Revenue | 621610 | $4,865,952 | $4,865,952 |
| OTHER HEALTHCARE SERVICES | 621610 | $343,056 | $343,056 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $5,209,008 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $125 | TotalRevenueColumnAmt |
| Exclusion | $125 | ExclusionAmt |
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 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $0 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $5,209,133 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $5,209,008 | RelatedOrExemptFuncIncomeAmt |
| Exclusion | $125 | 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 | $588,445 | TotalAmt |
| Program Services | $564,807 | ProgramServicesAmt |
| Management And General | $23,638 | ManagementAndGeneralAmt |
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 | $5,611,252 | TotalAmt |
| Program Services | $4,948,431 | ProgramServicesAmt |
| Management And General | $662,821 | ManagementAndGeneralAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $379,518 | TotalAmt |
| Program Services | $337,151 | ProgramServicesAmt |
| Management And General | $42,367 | ManagementAndGeneralAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $847,092 | TotalAmt |
| Program Services | $759,798 | ProgramServicesAmt |
| Management And General | $87,294 | ManagementAndGeneralAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $398,638 | TotalAmt |
| Program Services | $342,894 | ProgramServicesAmt |
| Management And General | $55,744 | ManagementAndGeneralAmt |
Fees For Services Management FeesForServicesManagementGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $186,801 | TotalAmt |
| Program Services | $12,983 | ProgramServicesAmt |
| Management And General | $173,818 | ManagementAndGeneralAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,717 | TotalAmt |
| Management And General | $2,717 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,174 | TotalAmt |
| Management And General | $2,174 | 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 | $950 | TotalAmt |
| Management And General | $950 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $152,200 | TotalAmt |
| Program Services | $57,493 | ProgramServicesAmt |
| Management And General | $94,707 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,274 | TotalAmt |
| Program Services | $478 | ProgramServicesAmt |
| Management And General | $12,796 | ManagementAndGeneralAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $62,341 | TotalAmt |
| Program Services | $11,492 | ProgramServicesAmt |
| Management And General | $50,849 | ManagementAndGeneralAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $136,632 | TotalAmt |
| Program Services | $6,329 | ProgramServicesAmt |
| Management And General | $130,303 | ManagementAndGeneralAmt |
Royalties RoyaltiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $99,066 | TotalAmt |
| Program Services | $1,668 | ProgramServicesAmt |
| Management And General | $97,398 | ManagementAndGeneralAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $70,108 | TotalAmt |
| Program Services | $67,453 | ProgramServicesAmt |
| Management And General | $2,655 | ManagementAndGeneralAmt |
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 | $20,454 | TotalAmt |
| Program Services | $18,058 | ProgramServicesAmt |
| Management And General | $2,396 | ManagementAndGeneralAmt |
Interest InterestGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $44,030 | TotalAmt |
| Management And General | $44,030 | ManagementAndGeneralAmt |
Payments To Affiliates PaymentsToAffiliatesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,266 | TotalAmt |
| Management And General | $13,266 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $60,427 | TotalAmt |
| Program Services | $6,454 | ProgramServicesAmt |
| Management And General | $53,973 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (3 entries)
| DescDesc | TotalTotalAmt | Program ServicesProgramServicesAmt | Management And GeneralManagementAndGeneralAmt |
|---|---|---|---|
| Patient Related Expenses | $42,808 | $42,808 | |
| Dues and Subscriptions | $20,138 | $12,118 | $8,020 |
| ALL OTHER EXPENSES | $12,331 | $6,659 | $5,672 |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $8,764,662 | TotalAmt |
| Program Services | $7,197,074 | ProgramServicesAmt |
| Management And General | $1,567,588 | ManagementAndGeneralAmt |
| Fundraising | $0 | FundraisingAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part X | Yes (X) | InfoInScheduleOPartXInd |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $673,494 | BOYAmt |
| EOY | $198,040 | 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 | $1,487,363 | BOYAmt |
| EOY | $1,556,620 | 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 | $9,361 | EOYAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | 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 | $322,353 | BOYAmt |
| EOY | $652,546 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,483,210 | BOYAmt |
| EOY | $2,416,567 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $103,829 | BOYAmt |
| EOY | $37,567 | 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 | $2,006,391 | BOYAmt |
| EOY | $3,061,539 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,110,220 | BOYAmt |
| EOY | $3,099,106 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $372,990 | BOYAmt |
| EOY | -$682,539 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $0 | EOYAmt |
Permanently Rstr Net Assets PermanentlyRstrNetAssetsGrp
| 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 | $372,990 | BOYAmt |
| EOY | -$682,539 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $2,483,210 | BOYAmt |
| EOY | $2,416,567 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | -$3,555,529 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | $2,500,000 | OtherChangesInNetAssetsAmt |
| 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 | $1,149,778 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $0 | CurrentTaxYearAmt |
| Total | $1,149,778 | TotalAmt |
Gross Receipts Admissions GrossReceiptsAdmissionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus1 Year | $1,734,870 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,865,952 | CurrentTaxYearAmt |
| Total | $6,600,822 | TotalAmt |
Gross Receipts Non Unrlt Bus GrossReceiptsNonUnrltBusGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | $343,056 | CurrentTaxYearAmt |
| Total | $343,056 | 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 | $0 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $0 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $0 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,884,648 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $5,209,008 | CurrentTaxYearAmt |
| Total | $8,093,656 | 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 | $8,093,656 | PublicSupportTotal509Amt |
Gross Investment Income509 GrossInvestmentIncome509Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Post1975 UBTI Post1975UBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | TotalAmt |
Investment Income And UBTI InvestmentIncomeAndUBTIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $0 | 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) |
|---|---|---|
| Total | $0 | TotalAmt |
Total Support Calendar Year TotalSupportCalendarYearGrp
| 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 | $2,884,648 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $5,209,008 | CurrentTaxYearAmt |
| Total | $8,093,656 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| First5 Years509 | Yes (X) | First5Years509Ind |
| Public Support CY509 | 0.00000 | PublicSupportCY509Pct |
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 | |
| Other Land Buildings | OtherLandBuildingsGrp |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | INTERCOMPANY RECEIVABLES | Desc |
| Book Value | $652,546 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $652,546 | TotalBookValueOtherAssetsAmt |
| Federal Income Tax Liability | $0 | FederalIncomeTaxLiabilityAmt |
Other Liabilities Org OtherLiabilitiesOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | INTERCOMPANY LIABILITIES | Desc |
| Amt | $3,061,539 | Amt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Liability | $3,061,539 | TotalLiabilityAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | Part X, Line 2 | FormAndLineReferenceDesc |
| Explanation | THE ORGANIZATION RECOGNIZES THE TAX BENEFIT FROM UNCERTAIN TAX POSITIONS ONLY IF IT IS MORE LIKELY THAN NOT THAT THE TAX POSITION WILL BE SUSTAINED ON EXAMINATION BY THE TAX AUTHORITIES, BASED ON THE TECHNICAL MERITS OF THE POSITION. THE TAX BENEFIT IS MEASURED BASED ON THE BENEFIT THAT HAS A GREATER THAN 50% LIKELIHOOD OF BEING REALIZED UPON ULTIMATE SETTLEMENT. THE ORGANIZATION RECOGNIZES INTEREST AND PENALTIES RELATED TO INCOME TAX MATTERS IN INTEREST EXPENSE AND OTHER ADMINISTRATIVE EXPENSES, RESPECTIVELY. | ExplanationTxt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Club Dues Or Fees | Yes (X) | ClubDuesOrFeesInd |
| Written Policy Ref T And E Expnss | Yes (true) | WrittenPolicyRefTAndEExpnssInd |
| Substantiation Required | Yes (true) | SubstantiationRequiredInd |
| Severance Payment | false | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | Yes (true) | 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 | false | AnyNonFixedPaymentsInd |
| Initial Contract Exception | false | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (9 entries)
| TitleTitleTxt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt |
|---|---|---|---|---|---|---|
| AMIT R SHAH | ||||||
| BOARD VICE CHAIRMAN/CMO | $332,552 | $15,737 | $1,500 | $19,150 | $4,859 | $373,798 |
| TERESA K LEARN | ||||||
| BOARD OF DIRECTOR/TREASURER | $257,297 | $14,734 | $18,637 | $14,688 | $305,356 | |
| WILLIAM J KENNEDY | ||||||
| BOARD OF DIRECTOR/SR MED DIR | $268,436 | $9,902 | $580 | $18,236 | $29,422 | $326,576 |
| REBECCA RAMSAY | ||||||
| ADMINISTRATIVE OFFICER/VP | $219,877 | $7,943 | $300 | $16,228 | $30,279 | $274,627 |
| PAMELA MINER | ||||||
| MEDICAL DIRECTOR | $242,825 | $4,407 | $15,359 | $27,494 | $290,085 | |
| ERIN FAIR TAYLOR | ||||||
| SECRETARY | $221,882 | $7,729 | $1,500 | $15,459 | $10,174 | $256,744 |
| JEAN-CLAUDE KG PROVOST | ||||||
| ASSOCIATE MEDICAL DIRECTOR | $164,559 | $1,202 | $227 | $10,250 | $11,445 | $187,683 |
| MOLLY W ANDERSON | ||||||
| PHYSICIAN | $152,157 | $1,127 | $1,200 | $9,576 | $5,098 | $169,158 |
| ANDREW G SPERLIN | ||||||
| PHYSICIAN | $149,795 | $1,077 | $8,849 | $17,298 | $177,019 | |
Supplemental Information Detail SupplementalInformationDetail (2 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Part I, Line 1a | HOUSECALL PROVIDERS, PC REIMBURSED HEALTH CLUB DUES FOR WILLIAM KENNEDY, MEDICAL DIRECTOR, IN THE AMOUNT OF $280. THIS REIMBURSEMENT WAS INCLUDED AS TAXABLE COMPENSATION TO THIS INDIVIDUAL. |
| Part I, Line 1B | WILLIAM KENEDY PARTICIPATES IN A 457B PLAN |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (10 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART III, LINE 1 | ORGANIZATION'S MISSION ---------------------- HOUSECALL PROVIDERS IS DEDICATED TO PROVIDING QUALITY HOME-CENTERED MEDICAL CARE, INTEGRATING PRIMARY, PALLIATIVE AND HOSPICE SERVICES FOR HOMEBOUND MEMBERS OF OUR COMMUNITY. WE OFFER COMPASSIONATE PHYSICAL, EMOTIONAL AND SPIRITUAL SUPPORT THROUGH LIFE'S JOURNEY. |
| PART III, LINE 4A | STATEMENT OF PROGRAM SERVICE ACCOMPLISHMENTS -------------------------------------------- SINCE 1995, HOUSECALL PROVIDERS, PC HAS BEEN THE SOLUTION FOR OVER 8,000 COMMUNITY MEMBERS WHOSE MEDICAL NEEDS COULD NOT BE MET IN A TRADITIONAL CLINICAL SETTING. THESE CHRONICALLY ILL PEOPLE, MANY OF WHOM ARE HOMEBOUND, ARE OFTEN FORCED TO RELY ON EMERGENCY ROOM VISITS AND HOSPITALIZATIONS TO MANAGE THEIR MULTIPLE CHRONIC ILLNESSES. THESE TRIPS TAKE THEIR TOLL ON AN ALREADY OVER-BURDENED BODY AND ARE INCREDIBLEY COSTLY TO OUR HEALTH CARE SYSTEM. HOUSECALL PROVIDERS, PC HAS BEEN A TRUSTED SOURCE FOR DELIVERING HOME-BASED PRIMARY CARE THROUGHOUT THE PORTLAND METRO AREA. SINCE OUR MODEST BEGINNINGS, WE HAVE GROWN TO SERVE MORE THAN 2,000 PATIENTS AND FAMILIES A YEAR AND EXPANDED OUR SERVICES TO INCLUDE TRANSITION AND PALLIATIVE CARE SERVICES. BY TRAINING OUR DOCTORS, NURSE PRACTITIONERS, AND PHYSICIAN ASSISTANTS TO IMPLEMENT TEAM-BASED, PROACTIVE PRIMARY MEDICAL CARE WHERE OUR PATIENTS LIVE, WE HELP PREVENT THOSE EXPENSIVE TRIPS TO THE HOSPITAL AND UNNECESSARY SKILLED NURSING FACILITY STAYS. NOT ONLY DOES THIS SET A NEW STANDARD FOR THE QUALITY OF CARE PATIENTS CAN EXPECT AT HOME, IT IMPROVES PATIENT HEALTH OUTCOMES AND LOWERS HEALTH CARE COSTS. THROUGH OUR SIX-YEAR INVOLVEMENT IN THE MEDICARE DEMONSTRATION PROJECT, INDEPENDENCE AT HOME, HOUSECALL PROVIDERS, PC ALONG WITH 14 OTHER PROGRAM SITES ACROSS THE U.S., IS HELPING TO PROVE TO THE CENTERS FOR MEDICARE AND MEDICAID SERVICES ("CMS") THAT VALUE-BASED REIMBURSEMENT, NOT FEE-FOR-SERVICE, IS THE APPROPRIATE PAYMENT MODEL TO PROVIDE HOME-BASED MEDICAL CARE FOR THE VULNERABLE POPULATION WE SERVE. WHEN HOUSECALL PROVIDERS, PC JOINED THE CAREOREGON FAMILY IN MAY OF 2017, WE WELCOMED THE ADVANCED ILLNESS CARE TEAM INTO OUR CONTINUUM OF HOME-BASED MEDICAL CARE. UNIFYING THESE SERVICES HAS MADE CARE TRANSITIONS SMOOTHER, CUT DOWN ON PATIENT WAIT TIMES AND MADE COMMUNICATION MORE EFFICIENT. THE TEAM INCLUDES NURSES, SOCIAL WORKERS, OUTREACH SPECIALISTS, A CHAPLAIN, AND A PHARMACIST WHO ALL HAVE THE FLEXIBILITY TO MAKE HOME, CLINIC AND HOSPITAL VISITS. THE ADVANCED ILLNESS CARE TEAM WORKS CLOSELY WITH PROVIDERS AND HEALTH CARE TEAMS TO FOCUS ON THE PATIENT'S GOALS OF CARE, SYMPTOM MANAGEMENT AND CARE COORDINATION. HOUSECALL PROVIDERS, PC EMPLOYEES ALSO PROVIDE HEALTHCARE SUPPORT TO OTHER CAREOREGON ENTITIES. |
| PART VI, LINE 4 | SIGNIFICANT CHANGES TO GOVERNING DOCUMENTS ------------------------------------------ HOUSECALL PROVIDERS, PC IS A PROFESSIONAL CORPORATION ORGANIZED ON MAY 25, 2017 WITH BYLAWS ADOPTED ON MAY 29, 2017. AMENDED AND RESTATED BYLAWS WERE ADOPTED ON OCTOBER 1, 2018. THE AMENDED BYLAWS INCREASED THE MAXIMUM NUMBER OF BOARD MEMBERS FROM 3 TO 5, AND ADDED TREASURER AS AN ADDITIONAL OFFICER POSITION. |
| PART VI, LINE 6 | ORGANIZATION MEMBERS OR STOCKHOLDERS ------------------------------------ HOUSECALL PROVIDERS, PC IS 51% OWNED BY AMIT SHAH, MD AND 49% OWNED BY CAREOREGON. |
| PART VI, LINE 11B | FORM 990 TO GOVERNING BODY -------------------------- HOUSECALL PROVIDERS, PC'S FORM 990 GOES THROUGH MULTIPLE LAYERS OF REVIEWS BEFORE IT IS REVIEWED BY THE BOARD TREASURER OF HOUSECALL PROVIDERS, PC (WHO IS ALSO THE CFO OF CAREOREGON) AND THE BOARD OF DIRECTORS BEFORE IT IS FILED. ALL REVIEWERS ARE GIVEN TIME TO RESPOND WITH ANY REVISIONS. AFTER INCORPORATION OF ALL REVISIONS, THE FORM 990 IS REDISTRIBUTED TO THE REVIEWERS FOR FINAL REVIEW PRIOR TO FILING. |
| PART VI, LINE 12C | EXPLANATION OF MONITORING AND ENFORCEMENT OF CONFLICTS ------------------------------------------------------ FOR FINANCIAL REPORTING AND ACCOUNTING PRACTICES, THE FINANCIAL STATEMENTS OF HOUSECALL PROVIDERS, PC ARE CONSOLIDATED INTO THE CONSOLIDATED FINANCIAL STATEMENTS OF CAREOREGON. AS SUCH, HOUSECALL PROVIDERS, PC IS GOVERNED BY THE POLICIES OF CAREOREGON AS APPLICABLE INCLUDING THE CONFLICT OF INTEREST POLICY OF CAREOREGON, WHICH IS APPLICABLE TO ALL OF CAREOREGON'S SUBSIDIARIES WHICH HAVE NOT ADOPTED A SEPARATE CONFLICT OF INTEREST POLICY. THIS CONFLICT OF INTEREST POLICY IS DISTRIBUTED TO THE BOARD MEMBERS ANNUALLY. IT APPLIES TO DIRECTORS, OFFICERS AND KEY EMPLOYEES (ON THE BASIS OF TESTS SET FORTH IN IRS FORM 990), AND ANY OTHER INDIVIDUAL IN A POSITION TO EXERCISE SIGNIFICANT INFLUENCE OVER A DECISION HAVING MATERIAL ECONOMIC IMPACT FOR HOUSECALL PROVIDERS, PC, COLLECTIVELY DEFINED AS "COVERED PERSONS". THE CONFLICT OF INTEREST POLICY IS REVIEWED AND APPROVED ANNUALLY BY THE CAREOREGON BOARD. AN ANNUAL CONFLICT OF INTEREST DECLARATION AND INDEPENDENCE QUESTIONNAIRE IS DISTRIBUTED TO ALL COVERED PERSONS. THROUGH THE DISTRIBUTED DOCUMENT, EACH COVERED PERSON SIGNS AND ACKNOWLEDGES THEIR COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY AND REPORTS FAMILY AND BUSINESS RELATIONSHIPS THAT ARE USED TO DETERMINE THE INDEPENDENCE OF A DIRECTOR PURSUANT TO THE DEFINITION AND TESTS SET FORTH IN IRS FORM 990. THE BOARD OF DIRECTORS REVIEWS THE RESPONSES TO THE ANNUAL QUESTIONNAIRE FOR HOUSECALL PROVIDERS, PC COVERED PERSONS AND MAKES RESOLUTIONS OR ACTIONS REQUIRED TO MITIGATE ANY CONFLICT OF INTEREST. FOR 2018, THERE WERE NO CONFLICTS OF INTEREST REQUIRING RESOLUTIONS OR ACTIONS. IF FOR A SPECIFIC MATTER REQUIRING BOARD ACTION, A CONFLICT OF INTEREST EXISTS, AS DETERMINED BY THE BOARD, AN INTERESTED PERSON MAY MAKE A PRESENTATION AT THE MEETING, DISCLOSING THE EXISTENCE OF HIS OR HER INTEREST AND SHALL DISCLOSE ALL MATERIAL FACTS. FOLLOWING THE PERSON'S DISCLOSURE AND AFTER A DISCUSSION WITH THE BOARD, THE INDIVIDUAL LEAVES THE MEETING WHILE THE BOARD INDEPENDENTLY DISCUSSES THE MATTER BEFORE IT VOTES ON THE PROPOSED TRANSACTION OR ARRANGEMENT INVOLVING THE CONFLICT OF INTEREST. IF THERE IS A REASONABLE QUESTION ABOUT THE APPROPRIATENESS OF THE PROPOSED TRANSACTION OR ARRANGEMENT, THE CHAIR SHALL APPOINT A DISINTERESTED PERSON OR COMMITTEE TO INVESTIGATE ALTERNATIVES TO THE PROPOSED TRANSACTION OR ARRANGEMENT. AFTER EXERCISING DUE DILIGENCE, THE BOARD SHALL EVALUATE THE RESULTING ALTERNATIVES PRESENTED BY THE APPOINTED PERSON OR COMMITTEE. IF AN APPROPRIATE CONFLICT-FREE ALTERNATIVE IS NOT REASONABLY ATTAINABLE, THE BOARD SHALL DETERMINE BY MAJORITY VOTE OF THE DISINTERESTED DIRECTORS WHETHER THE ORIGINAL TRANSACTION OR ARRANGEMENT IS IN HOUSECALL PROVIDERS, PC'S AND CAREOREGON'S BEST INTERESTS, FOR HOUSECALL PROVIDERS, PC'S AND CAREOREGON'S OWN BENEFIT, WHETHER THE TRANSACTION IS FAIR AND REASONABLE TO HOUSECALL PROVIDERS, PC AND CAREOREGON, AND WHETHER THE TRANSACTION IS IN COMPLIANCE WITH ALL APPLICABLE LAWS AND REGULATIONS. THE BOARD SHALL THEN VOTE WHETHER TO ENTER INTO THE TRANSACTION OR ARRANGEMENT IN CONFORMITY WITH THE EVALUATION OF THE FOREGOING. |
| PART VI, LINE 15A AND 15B | COMPENSATION REVIEW & APPROVAL PROCESS - CEO & TOP MANAGEMENT ------------------------------------------------------------- MARKET DATA ON THE TOTAL COMPENSATION PACKAGE FOR EXECUTIVE POSITIONS (CEO, COO, CFO, CLO AND CMO), IS PROVIDED ANNUALLY BY AN OUTSIDE INDEPENDENT COMPENSATION CONSULTANT USING COMPARABLE ORGANIZATIONS BY INDUSTRY, PROFIT/NON-PROFIT STATUS AND REVENUE SIZE. THE COMPENSATION COMMITTEE, CONSISTING OF A MAJORITY OF INDEPENDENT BOARD MEMBERS, REVIEWS MARKET DATA, EVALUATES CEO PERFORMANCE AND REVIEWS CEO RECOMMENDATIONS FOR COMPENSATION FOR OTHER EXECUTIVE OFFICERS. THE COMMITTEE PRESENTS ITS RECOMMENDATIONS FOR CEO TO THE BOARD. DECISIONS ARE MADE IN A BOARD MEETING. THE BOARD REVIEWS THE RECOMMENDATION FOR THE COMPENSATION OF ALL OTHER EMPLOYEES AS PART OF THE BUDGET APPROVAL PROCESS. THE PROCESS OF DETERMINING THE COMPENSATION OF TOP MANAGEMENT OFFICIALS AND KEY OFFICERS INCLUDES A REVIEW OF AN INDEPENDENT CONSULTANT'S REPORT OF COMPARABLE SALARIES OF SIMILAR ORGANIZATIONS AND IS GUIDED BY WRITTEN COMPENSATION PRACTICES. WITH THE CEO AND ALL OTHER OFFICERS ABSENT FROM THE MEETINGS, THE BOARD APPROVES THE SALARY OF THE CEO. THIS PROCESS WAS LAST UNDERTAKEN ON MARCH 8, 2019 FOR THE CEO, AND THE CEO'S RECOMMENDATIONS FOR OTHER OFFICERS. THERE IS CONTEMPORANEOUS DOCUMENTATION OF THIS PROCESS AND THE RESULTS. |
| PART VI, LINE 18 AND LINE 19 | PUBLIC INSPECTION ----------------- THE TAX RETURN INFORMATION IS AVAILABLE UPON REQUEST. WHILE NO REQUIREMENT TO MAKE ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC EXISTS, HOUSECALL PROVIDERS, PC WILL CONSIDER ALL REQUESTS FOR THESE DOCUMENTS ON A CASE-BY-CASE BASIS. |
| PART X, LINE 33 | TOTAL NET ASSETS OR FUND BALANCES -------------------------------------------- IN APRIL 2019, CAREOREGON MADE AN ADDITIONAL EQUITY TRANSFER OF $3,500,000 TO FUND OPERATIONS. THIS EQUITY TRANSFER ELIMINATED THE DEFICIT IN NET ASSETS. |
| PART XI, LINE 9 | OTHER CHANGES IN NET ASSETS OR FUND BALANCES -------------------------------------------- EQUITY TRANSFER FROM CAREOREGON $ 2,500,000 ------------------ TOTAL PART XI, LINE 9 $ 2,500,000 |
Schedule R IRS990ScheduleR
Id Related Tax Exempt Org IdRelatedTaxExemptOrgGrp (2 entries)
| Address Line1USAddress/AddressLine1Txt | CityUSAddress/CityNm | State AbbreviationUSAddress/StateAbbreviationCd | ZIPUSAddress/ZIPCd | EINEIN | Primary ActivitiesPrimaryActivitiesTxt | Legal Domicile StateLegalDomicileStateCd | Exempt Code SectionExemptCodeSectionTxt | Public Charity StatusPublicCharityStatusTxt | Direct Controlling NADirectControllingNACd | Controlled OrganizationControlledOrganizationInd | Business Name Line1DirectControllingEntityName/BusinessNameLine1Txt |
|---|---|---|---|---|---|---|---|---|---|---|---|
| CAREOREGON INC | |||||||||||
| 315 SW 5TH AVENUE | PORTLAND | OR | 97204 | 930933975 | MEDICAID | OR | 501(C)(3) | 10 | N/A | false | |
| HEALTH PLAN OF CAREOREGON INC | |||||||||||
| 315 SW 5TH AVENUE | PORTLAND | OR | 97204 | 463264330 | MEDICARE | OR | 501(C)(3) | 10 | false | CAREOREGON | |
| 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 | Yes (true) | 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 | Yes (true) | TransferFromOtherOrgInd |
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