OHIO PHYSICIANS HEALTH PROGRAM: Form 990, tax year 2016
View the entire original 990 at ProPublica ↗
- Organization
- OHIO PHYSICIANS HEALTH PROGRAM (EIN 34-1817218)
- Tax period
- 2016-01-01 to 2016-12-31
- Filed
- 2017-11-14
- IRS object ID
- 201713189349304731
- Schema version
- 2016v3.0
- 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 | 2017-11-14T11:45:30-06:00 | ReturnTs |
| Tax Period End | 2016-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 310800053 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Clark Schaefer Hackett & Co | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 4449 Easton Way Suite 400 | AddressLine1Txt |
| City | Columbus | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 43219 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2016-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 341817218 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | Ohio Physicians Health Program | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | OHIO | BusinessNameControlTxt |
| Phone | 6148419690 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 130 E Chestnut Street No 400 | AddressLine1Txt |
| City | Columbus | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 43215 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | KELLEY M LONG MBA | PersonNm |
| Person Title | EXECUTIVE DIRECTOR | PersonTitleTxt |
| Phone | 6148419690 | PhoneNum |
| Signature | 2017-11-14 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | Jane E Pfeifer | PreparerPersonNm |
| PTIN | P00014949 | PTIN |
| Phone | 6148852208 | PhoneNum |
| Preparation | 2017-11-14 | PreparationDt |
Filing Security Information FilingSecurityInformation
IP Address IPAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| I Pv4 Address | 74.62.104.2 | IPv4AddressTxt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| IP | 2017-11-14 | IPDt |
| IP Tm | 10:29:03 | IPTm |
| IP Timezone | ES | IPTimezoneCd |
| Filing License Type | P | FilingLicenseTypeCd |
| At Submission Creation Device Id | DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 | AtSubmissionCreationDeviceId |
| At Submission Filing Device Id | 5A179337D42813462D6C3CA42B6BCA8787F5A620 | AtSubmissionFilingDeviceId |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2016 | TaxYr |
| Build TS | 2017-02-10 21:41:12Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Principal Officer | KELLEY M LONG MBA | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 130 E Chestnut Street No 400 | AddressLine1Txt |
| City | Columbus | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 43215 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $1,206,825 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.OPHP.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1995 | FormationYr |
| Legal Domicile State | OH | LegalDomicileStateCd |
| Activity Or Mission | TO FACILITATE THE HEALTH & WELLBEING OF HEALTHCARE PROFESSIONALS IN ORDER TO ENHANCE PATIENT CARE AND SAFETY. | ActivityOrMissionDesc |
| Voting Members Governing Body | 13 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 13 | VotingMembersIndependentCnt |
| Total Employee | 8 | TotalEmployeeCnt |
| Total Volunteers | 100 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $697,565 | PYContributionsGrantsAmt |
| CY Contributions Grants | $716,432 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $149,173 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $167,025 | CYProgramServiceRevenueAmt |
| PY Investment Income | $57,974 | PYInvestmentIncomeAmt |
| CY Investment Income | $28,993 | CYInvestmentIncomeAmt |
| PY Other Revenue | $6,275 | PYOtherRevenueAmt |
| CY Other Revenue | $3,250 | CYOtherRevenueAmt |
| PY Total Revenue | $910,987 | PYTotalRevenueAmt |
| CY Total Revenue | $915,700 | 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 | $593,046 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $639,136 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $67,972 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $293,215 | PYOtherExpensesAmt |
| CY Other Expenses | $294,142 | CYOtherExpensesAmt |
| PY Total Expenses | $886,261 | PYTotalExpensesAmt |
| CY Total Expenses | $933,278 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $24,726 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | -$17,578 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $1,276,240 | TotalAssetsBOYAmt |
| Total Assets EOY | $1,276,777 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $59,157 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $36,273 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $1,217,083 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $1,240,504 | NetAssetsOrFundBalancesEOYAmt |
| Mission | TO FACILITATE THE HEALTH AND WELLBEING OF HEALTHCARE PROFESSIONALS IN ORDER TO ENHANCE PATIENT CARE AND SAFETY. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $722,581 | ExpenseAmt |
| Revenue | $170,275 | RevenueAmt |
| Desc | Confidential resource, monitoring and advocacy services, and educational outreach programs: The Ohio Physicians Health Program, Inc. (OPHP) is a nonprofit organization which offers confidential assistance to physicians and other healthcare professionals who may be affected by mental, emotional and behavioral illness, substance-related and addictive disorders, or other issues impacting their health and well-being. OPHP coordinates evaluation and treatment, facilitates interventions, provides comprehensive monitoring services, and delivers educational presentations throughout Ohio. In 2015, OPHP received 171 new referrals, had 466 active cases, and presented 17 educational outreach programs. | Desc |
| Total Program Service Expenses | $722,581 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Temp Or Permanent Endowments | 0 | TempOrPermanentEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | Yes (1) | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | 0 | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | 0 | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With Officer Ent | 0 | BusinessRlnWithOfficerEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 5 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Backup Wthld Compliance | Yes (1) | BackupWthldComplianceInd |
| Employee | 8 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | Yes (1) | QuidProQuoContributionsInd |
| Quid Pro Quo Contri Discl | Yes (1) | QuidProQuoContriDisclInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 13 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 13 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | Yes (1) | DocumentRetentionPolicyInd |
| Compensation Process CEO | 0 | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | KELLEY LONG | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 6148419690 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 130 E CHESTNUT STREET SUITE 400 | AddressLine1Txt |
| City | COLUMBUS | CityNm |
| State Abbreviation | OH | StateAbbreviationCd |
| ZIP | 43215 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (15 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt |
|---|---|---|---|---|---|---|
| RONALD L MILLER MD FACP | ||||||
| CHAIRMAN | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| CRAIG W ANDERSON MD | ||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |
| CHRISTINA DELOS-REYES MD | ||||||
| Vice-Chair | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| Melina E Ford DO | ||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |
| SYBIL MARSH MD | ||||||
| Secretary | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| Jonathan A Good | ||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |
| GEORGE HARDING IV MD | ||||||
| Trustee | 1.00 | Yes (X) | $0 | $0 | $0 | |
| Timothy L Kolb DVM | ||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |
| STEVEN W CRAWFORD MD | ||||||
| Treasurer | 1.00 | Yes (X) | Yes (X) | $0 | $0 | $0 |
| FRANK A LAZAR | ||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |
| Theresa C Novak MEd | ||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |
| Christopher C Phillips MD | ||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |
| James D Smith MD | ||||||
| TRUSTEE | 1.00 | Yes (X) | $0 | $0 | $0 | |
| KELLEY M LONG MBA | ||||||
| EXECUTIVE DIRECTOR | 40.00 | Yes (X) | $105,962 | $0 | $8,477 | |
| DAVID D GOLDBERG DO | ||||||
| MEDICAL DIRECTOR | 32.00 | Yes (X) | $181,500 | $0 | $21,944 | |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $287,462 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $30,421 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 2 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
| Cntrct Rcvd Greater Than100 K | 0 | CntrctRcvdGreaterThan100KCnt |
| All Other Contributions | $716,432 | AllOtherContributionsAmt |
| Total Contributions | $716,432 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| ADMINISTRATIVE FEES | 561000 | $129,928 | $129,928 |
| TOXICOLOGY FEES | 541380 | $37,097 | $37,097 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $167,025 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $30,855 | TotalRevenueColumnAmt |
| Exclusion | $30,855 | ExclusionAmt |
Gross Amount Sales Assets GrossAmountSalesAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $289,263 | SecuritiesAmt |
Less Cost Oth Basis Sales Expnss LessCostOthBasisSalesExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | $291,125 | SecuritiesAmt |
Gain Or Loss GainOrLossGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Securities | -$1,862 | SecuritiesAmt |
Net Gain Or Loss Investments NetGainOrLossInvestmentsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | -$1,862 | TotalRevenueColumnAmt |
| Exclusion | -$1,862 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | HONORARIA | Desc |
| Business | 900099 | BusinessCd |
| Total Revenue Column | $3,250 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,250 | RelatedOrExemptFuncIncomeAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $3,250 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $915,700 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $170,275 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $28,993 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $317,883 | TotalAmt |
| Program Services | $270,201 | ProgramServicesAmt |
| Management And General | $28,609 | ManagementAndGeneralAmt |
| Fundraising | $19,073 | FundraisingAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $321,253 | TotalAmt |
| Program Services | $273,065 | ProgramServicesAmt |
| Management And General | $28,913 | ManagementAndGeneralAmt |
| Fundraising | $19,275 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $1,590 | TotalAmt |
| Program Services | $1,303 | ProgramServicesAmt |
| Management And General | $239 | ManagementAndGeneralAmt |
| Fundraising | $48 | FundraisingAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,251 | TotalAmt |
| Program Services | $10,413 | ProgramServicesAmt |
| Management And General | $1,103 | ManagementAndGeneralAmt |
| Fundraising | $735 | FundraisingAmt |
Fees For Srvc Invst Mgmnt Fees FeesForSrvcInvstMgmntFeesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,006 | TotalAmt |
| Management And General | $13,006 | ManagementAndGeneralAmt |
Advertising AdvertisingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $2,394 | TotalAmt |
| Program Services | $2,394 | ProgramServicesAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $61,311 | TotalAmt |
| Program Services | $50,952 | ProgramServicesAmt |
| Management And General | $6,763 | ManagementAndGeneralAmt |
| Fundraising | $3,596 | FundraisingAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $34,157 | TotalAmt |
| Program Services | $29,034 | ProgramServicesAmt |
| Management And General | $3,074 | ManagementAndGeneralAmt |
| Fundraising | $2,049 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $35,997 | TotalAmt |
| Program Services | $30,597 | ProgramServicesAmt |
| Management And General | $3,240 | ManagementAndGeneralAmt |
| Fundraising | $2,160 | FundraisingAmt |
Conferences Meetings ConferencesMeetingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $12,899 | TotalAmt |
| Program Services | $10,964 | ProgramServicesAmt |
| Management And General | $1,161 | ManagementAndGeneralAmt |
| Fundraising | $774 | FundraisingAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $16,083 | TotalAmt |
| Program Services | $13,671 | ProgramServicesAmt |
| Management And General | $1,448 | ManagementAndGeneralAmt |
| Fundraising | $964 | FundraisingAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $13,474 | TotalAmt |
| Program Services | $11,453 | ProgramServicesAmt |
| Management And General | $1,213 | ManagementAndGeneralAmt |
| Fundraising | $808 | FundraisingAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Management And GeneralManagementAndGeneralAmt | Program ServicesProgramServicesAmt | FundraisingFundraisingAmt |
|---|---|---|---|---|
| CONTRACT LABOR | $52,263 | $52,263 | ||
| RESOURCE DEVELOPMENT | $18,300 | $313 | $417 | $17,570 |
| COMPUTER SERVICES | $9,243 | $832 | $7,856 | $555 |
| DUES AND SUBSCRIPTIONS | $3,230 | $3,230 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $7,944 | TotalAmt |
| Program Services | $7,031 | ProgramServicesAmt |
| Management And General | $548 | ManagementAndGeneralAmt |
| Fundraising | $365 | FundraisingAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $933,278 | TotalAmt |
| Program Services | $722,581 | ProgramServicesAmt |
| Management And General | $142,725 | ManagementAndGeneralAmt |
| Fundraising | $67,972 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $58,425 | BOYAmt |
| EOY | $17,372 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $49,372 | BOYAmt |
| EOY | $49,858 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,749 | BOYAmt |
| EOY | $24,327 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $12,901 | BOYAmt |
| EOY | $10,858 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $142,022 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $82,155 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $75,057 | BOYAmt |
| EOY | $59,867 | EOYAmt |
Investments Other Securities InvestmentsOtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,063,932 | BOYAmt |
| EOY | $1,111,080 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $3,804 | BOYAmt |
| EOY | $3,415 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,276,240 | BOYAmt |
| EOY | $1,276,777 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $59,157 | BOYAmt |
| EOY | $36,273 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $59,157 | BOYAmt |
| EOY | $36,273 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows SFAS117 | Yes (X) | OrganizationFollowsSFAS117Ind |
Unrestricted Net Assets UnrestrictedNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,195,269 | BOYAmt |
| EOY | $1,239,169 | EOYAmt |
Temporarily Rstr Net Assets TemporarilyRstrNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $21,814 | BOYAmt |
| EOY | $1,335 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,217,083 | BOYAmt |
| EOY | $1,240,504 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,276,240 | BOYAmt |
| EOY | $1,276,777 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Reconcilation Revenue Expnss | -$17,578 | ReconcilationRevenueExpnssAmt |
| Net Unrlzd Gains Losses Invst | $40,999 | NetUnrlzdGainsLossesInvstAmt |
| Other Changes In Net Assets | $0 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | 0 | FederalGrantAuditRequiredInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $484,533 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $470,778 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $578,234 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $697,565 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $716,432 | CurrentTaxYearAmt |
| Total | $2,947,542 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $484,533 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $470,778 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $578,234 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $697,565 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $716,432 | CurrentTaxYearAmt |
| Total | $2,947,542 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $2,947,542 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $35,379 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $28,637 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $31,885 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $28,490 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $30,855 | CurrentTaxYearAmt |
| Total | $155,246 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $10,200 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $3,783 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $5,100 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $6,275 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $3,250 | CurrentTaxYearAmt |
| Total | $28,608 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $3,131,396 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $711,233 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.94130 | PublicSupportCY170Pct |
| Public Support PY170 | 0.93500 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
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
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $2,200 | OtherCostOrOtherBasisAmt |
| Book Value | $2,200 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $139,822 | OtherCostOrOtherBasisAmt |
| Depreciation | $82,155 | DepreciationAmt |
| Book Value | $57,667 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Book Value | $0 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $59,867 | TotalBookValueLandBuildingsAmt |
Other Securities OtherSecuritiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | OTHER INVESTMENTS | Desc |
| Book Value | $1,111,080 | BookValueAmt |
| Method Valuation | F | MethodValuationCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Securities | $1,111,080 | TotalBookValueSecuritiesAmt |
| Total Rev Etc Audited Fincl Stmt | $956,699 | TotalRevEtcAuditedFinclStmtAmt |
| Net Unrealized Gains Invst | $40,999 | NetUnrealizedGainsInvstAmt |
| Revenue Not Reported | $40,999 | RevenueNotReportedAmt |
| Revenue Subtotal | $915,700 | RevenueSubtotalAmt |
| Revenue Not Reported Fincl Stmt | $0 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $915,700 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $933,278 | TotExpnsEtcAuditedFinclStmtAmt |
| Expenses Not Reported | $0 | ExpensesNotReportedAmt |
| Expenses Subtotal | $933,278 | ExpensesSubtotalAmt |
| Expenses Not Rpt Fincl Stmt | $0 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $933,278 | TotalExpensesPerForm990Amt |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | 0 | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | 0 | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | DAVID D GOLDBERG DO | PersonNm |
| Title | MEDICAL DIRECTOR | TitleTxt |
| Base Compensation Filing Org | $165,000 | BaseCompensationFilingOrgAmt |
| Compensation Based On Rltd Orgs | $0 | CompensationBasedOnRltdOrgsAmt |
| Bonus Filing Organization | $16,500 | BonusFilingOrganizationAmount |
| Bonus Related Organizations | $0 | BonusRelatedOrganizationsAmt |
| Other Compensation Filing Org | $0 | OtherCompensationFilingOrgAmt |
| Other Compensation Rltd Orgs | $0 | OtherCompensationRltdOrgsAmt |
| Deferred Compensation Flng Org | $14,520 | DeferredCompensationFlngOrgAmt |
| Deferred Comp Rltd Orgs | $0 | DeferredCompRltdOrgsAmt |
| Nontaxable Benefits Filing Org | $7,424 | NontaxableBenefitsFilingOrgAmt |
| Nontaxable Benefits Rltd Orgs | $0 | NontaxableBenefitsRltdOrgsAmt |
| Total Compensation Filing Org | $203,444 | TotalCompensationFilingOrgAmt |
| Total Compensation Rltd Orgs | $0 | TotalCompensationRltdOrgsAmt |
| Comp Report Prior990 Filing Org | $0 | CompReportPrior990FilingOrgAmt |
| Comp Report Prior990 Rltd Orgs | $0 | CompReportPrior990RltdOrgsAmt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (5 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| Form 990, Part VI, Section B, line 11b | THE RETURN IS PREPARED BY CLARK, SCHAEFER, HACKETT & CO. OHIO PHYSICIANS HEALTH PROGRAM RECEIVES A DRAFT COPY WHICH IS GIVEN TO ALL MEMBERS OF THE BOARD AND TO THE CHAIRMAN OF THE AUDIT/FINANCE COMMITTEE FOR REVIEW AND APPROVAL. ONCE APPROVED, A FINAL RETURN IS PREPARED AND FILED. |
| Form 990, Part VI, Section B, line 12c | ALL OFFICERS, DIRECTORS, OR TRUSTEES KEEP THE OPERATIONS MANAGER UPDATED OF ANY EMPLOYMENT, MEMBERSHIP, AND COMMITTEE INVOLVEMENT THAT COULD COMPROMISE THE CONFLICT OF INTEREST POLICY AT EACH BOARD MEETING OR AS NEEDED. |
| Form 990, Part VI, Section B, line 15 | THE ORGANIZATION HAS A COMPENSATION COMMITTEE WITHIN THE BOARD OF TRUSTEES. THESE INDIVIDUALS MEET AND DISCUSS ANY CHANGES OR ADJUSTMENTS THAT NEED TO BE MADE AND PROVIDE THE CHANGE TO THE OPERATIONS MANAGER. |
| Form 990, Part VI, Section C, line 19 | THE ORGANIZATION MAKES THEIR GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| Form 990, Part XII, Line 2c: | The process for oversight of the audit and review of the 990 has not changed from the prior year. |
Comments