2018-05-14T18:39:40-05:00 2017-06-30 946214841 Armanino LLP 12657 Alcosta Blvd Ste 500 San Ramon CA 945834600 990 2016-07-01 943101464 On Lok Inc ONLO 4152928888 1333 Bush Street San Francisco CA 94109 Gary P Campanella CFO 4152928888 2018-05-11 1 Katy Brown P00650274 9257902600 2018-05-11 2016 2022-09-23 18:48:47Z Grace Li Harper 1333 Bush Street San Francisco CA 94109 23084889 0 X www.onlok.org X 1989 CA Develop & support health care models for the well-being and dignity of elderly & chronically ill. 14 13 80 4 -796213 -796213 566992 425863 8109187 9102735 501093 305618 -1397719 -1056367 7779553 8777849 750000 401635 0 0 6349182 6632893 0 0 146980 4002565 3644821 11101747 10679349 -3322194 -1901500 14175878 16521682 1284733 1172936 12891145 15348746 Develop & support health care models for the well-being and dignity of elderly & chronically ill. 0 0 8900988 401635 8850352 Provide various management support services (such as executive oversight, strategic planning, financial management and accounting, human resources management, information systems, fundraising) to affiliated 501(c)(3) nonprofit organizations, which provide housing and comprehensive health care to the frail elderly and other services to individuals age 60 and older. 160673 252383 Provide technical assistance and administrative support services to organizations developing or operating a PACE (Program of All-inclusive Care for the Elderly) program. 9061661 1 1 0 0 0 0 0 0 0 0 1 0 1 0 0 1 0 1 0 0 0 0 0 0 1 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 1 82 0 1 80 1 0 0 0 0 0 0 0 0 0 0 X 14 13 0 0 0 0 0 0 0 1 1 0 0 0 1 1 1 1 1 1 1 0 CA X Gary P Campanella 4152928888 1333 Bush Street San Francisco CA 94109 Wellman Tsang MD Chair 2.00 2.00 X X 0 0 0 Irene Riley Vice Chair 2.00 0.00 X X 0 0 0 John Jenks Treasurer 2.00 2.00 X X 0 0 0 Kevin Gerber Secretary 2.00 1.00 X X 0 0 0 Joseph Barbaccia MD Director 1.00 1.00 X 0 0 0 Gregory Chun Director 1.00 1.00 X 0 0 0 Elizabeth Ferguson Director 1.00 2.50 X 0 0 0 Eric Harrison Director 1.00 0.50 X 0 0 0 William Lock Director 1.00 0.00 X 0 0 0 Tom Rundall PhD Director 1.00 2.00 X 0 0 0 Candy Rupp Director 1.00 3.00 X 0 0 0 Sharon Yow Director 1.00 0.50 X 0 0 0 Cynthia Yee ex-officio Director 1.00 0.00 X 0 0 0 Grace Li Harper CEO, On Lok Inc. 40.00 5.00 X X 271451 72255 16196 Gary Campanella CFO 40.00 X 172188 0 7359 Jay Luxenberg Chief Medical Officer 20.00 20.00 X 0 295582 18756 Neil Wright CIO 40.00 X 226097 0 9723 Ian N Kennedy Dir of Infra Eng & Arch 40.00 X 147696 0 0 Michele C Forge Controller 40.00 X 146836 0 15907 Robert T Jenkins Dir Fin Plan & Bus Analysis 40.00 X 139150 0 16743 Roy M Alojado Marketing Director 40.00 X 130432 0 3228 Robert Edmondson Former CEO (end 03/2016) 40.00 X 352358 0 30790 1586208 367837 118702 13 1 1 0 The Travelers Companies 91287 Collections Center Drive Chicago IL 60693 Insurance 1417947 iT1 Source LLC 1860 W University Drive Suite 100 Tempe AZ 85281 Software 704118 Randstad North America LP 27 Maiden Lane San Francisco CA 94108 Contract Service 293750 Mainline Information Systems Inc 1700 Summit Lake Drive Tallahassee FL 32317 Contract Service 233677 Denovo Ventures LLC 6328 Monarch Park Place Niwot CO 80503 Computer Consultants 163877 9 317272 108591 425863 Mgmt Support Contract 561000 8850352 8850352 Other Program Revenue 900099 137396 137396 Technical Assistance 541900 114987 114987 9102735 181267 181267 14171237 14046886 124351 124351 124351 0 317272 260154 -260154 -260154 S-Corp Income 621610 -796213 -796213 -796213 8777849 9102735 -796213 45464 401635 401635 1252350 1096457 155893 3849467 3567515 31837 250115 140561 88314 50284 1963 636041 382361 229348 24332 754474 434922 275288 44264 1353145 1149037 199405 4703 73332 73332 133553 55062 78491 33801 33801 1219451 1126948 54624 37879 75849 69660 3907 2282 272234 268714 3520 78052 78052 Other Expenses 665558 309183 318299 38076 Fundraising event expen -260154 -260154 10679349 9061661 1470708 146980 524442 830720 30055 25214 2345043 4441373 334200 366246 2273542 719713 1308020 1553829 8080778 7750960 1553340 1553340 14175878 16521682 1265233 1161436 19500 11500 1284733 1172936 X 12861042 15321857 10103 6889 20000 20000 12891145 15348746 14175878 16521682 X -1901500 562886 3796213 X X 0 1 X 1 0 X 237840 363544 382366 566992 425863 1976605 237840 363544 382366 566992 425863 1976605 18168 1958437 176161 78718 223991 220232 181267 880369 383279 383279 3240253 36229392 0.60440 0.50060 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 20073 20073 20016 57 20073 20000 16 20016 0 0 52606 49479 3127 1963813 650874 1312939 257123 19360 237763 1553829 Investment in Care at Home 1553340 F 1553340 X 13397102 562886 3000000 3562886 9834216 -1056367 -1056367 8777849 10939503 0 10939503 -260154 -260154 10679349 Part V, Line 4: Endowment funds are intended to generate investment income to be used for operating support, according to the board's discretion. Part X, Line 2: The Organization is exempt from income taxes under Section 501(a) subsection (c)(3) of the Internal Revenue Code and section 23701(d) of the California Revenue and Taxation Code whereby only unrelated business income, as defined by Section 512(a)(1) of the Internal Revenue Code and similar code sections of the California Revenue and Taxation code is subject to income tax. Accordingly, no provision for income taxes has been provided for in the accompanying financial statements. The Organization is required to file annual informational returns with the Internal Revenue Service and the California Franchise Tax Board. Management has evaluated its current tax position and has concluded as of June 30, 2017, the Organization does not have any significant uncertain tax positions for which a reserve would be necessary. The tax returns are subject to examination by the taxing authorities generally for three years and four years for federal and state, respectively, starting with the date of filing or the due date of the tax return, whichever is later. Part XI, Line 2d - Other Adjustments: Transfer from related organization 3,000,000. Part XI, Line 4b - Other Adjustments: Fundraising Expenses -260,154. S-corp passthrough loss -796,213. Part XII, Line 4b - Other Adjustments: Fundraising Expenses -260,154. Spring Banquet 183154 183154 6140 37762 6300 75290 Friends of On Lok 52173 52173 1750 6336 5916 2 81945 81945 81066 3600 35994 317272 317272 1750 6140 125164 9900 117200 260154 -260154 0 On Lok Day Services 1333 Bush Street San Francisco CA 94109 943101292 501(c)(3) 400000 General program support 1 0 X X X 0 0 0 0 0 0 0 0 0 Grace Li Harper CEO, On Lok Inc. 271451 72255 0 0 0 0 5620 2330 6026 2220 283097 76805 0 0 Gary Campanella CFO 172188 0 0 0 0 0 0 0 7359 0 179547 0 0 0 Jay Luxenberg Chief Medical Officer 0 295582 0 0 0 0 0 7950 0 10806 0 314338 0 0 Neil Wright CIO 226097 0 0 0 0 0 1638 0 8085 0 235820 0 0 0 Michele C Forge Controller 146836 0 0 0 0 0 4568 0 11339 0 162743 0 0 0 Robert T Jenkins Dir Fin Plan & Bus Analysis 139150 0 0 0 0 0 3629 0 13114 0 155893 0 0 0 Robert Edmondson Former CEO (end 03/2016) 352358 0 0 0 0 0 7950 0 22840 0 383148 0 0 0 Form 990, Part VI, Section B, line 11b REVIEW OF THE FORM 990 HAS BEEN DELEGATED TO THE CHIEF FINANCIAL OFFICER OF ON LOK, INC. AFTER REVIEW AND APPROVAL, THE 990 WAS PROVIDED TO ALL MEMBERS OF THE BOARD OF DIRECTORS BEFORE FILING. Form 990, Part VI, Section B, line 12c The Conflict of Interest policy is distributed annually to directors, officers and senior management, along with annual disclosure of conflict of interest forms which are required to be completed, signed and returned to the compliance officer each year. These forms are reviewed carefully by the compliance officer and the Chief Executive Officer so that any potential conflicts are handled appropriately. Form 990, Part VI, Section B, line 15 The Executive Committee determines the compensation of the CEO and CFO of the organization, based on comparability data provided by a firm specializing in compensation. In addition to the base compensation, the Executive Committee may also establish incentive compensation at a pre-determined level based on specific goals to be achieved by year-end. Form 990, Part VI, Section C, line 19 Available upon request. Form 990, Part XI, line 9: Transfer from related organization 3,000,000. S-corp passthrough income not recorded in financial statements 796,213. Form 990, Part XII, Line 2c: THE PROCESS HAS NOT CHANGED FROM PRIOR YEAR. ON LOK SENIOR HEALTH SERVICES 1333 Bush Street San Francisco CA 94109 942162549 MEDICAL & SUPPORTIVE CARE FOR FRAIL ELDERLY CA 501(c)(3) Line 10 On Lok Inc 1 ON LOK DAY SERVICES 1333 Bush Street San Francisco CA 94109 943101292 VARIOUS SERVICES FOR SENIORS CA 501(c)(3) Line 10 On Lok Inc 1 ON LOK COMMUNITY HOUSING INC 1333 Bush Street San Francisco CA 94109 943053383 HOUSING FOR LOW-INCOME SENIORS CA 501(c)(3) Line 10 On Lok Inc 1 ON LOK HOUSE 1333 Bush Street San Francisco CA 94109 942326678 HOUSING FOR LOW-INCOME FRAIL ELDERLY CA 501(c)(3) Line 7 On Lok Inc 1 Care at Home Inc 1333 Bush Street San Francisco CA 94109 770578465 Assist with Adult and pediatric care within the patient's home CA On Lok Inc S -796263 1047992 1.00000 1 0 1 1 0 0 0 0 0 0 0 1 1 1 0 1 0 1 0 0 On Lok Day Services B 400000 CASH On Lok Senior Health Services C 3000000 Cash On Lok Community Housing Inc K 164740 CASH On Lok Senior Health Services K 60000 Cash Care At Home L 144670 CASH On Lok Community Housing Inc L 136408 CAsh On Lok Senior Health Services L 8367729 CASH On Lok Day Services L 181535 CASH On Lok Community Housing Inc M 37415 CASH On Lok Senior Health Services M 42765 CASH On Lok House Inc O 84582 CASH On Lok Senior Health Services Q 40667 CASH