STAYWELL HEALTH CARE INC: Form 990, tax year 2012

View the entire original 990 at ProPublica ↗

Organization
STAYWELL HEALTH CARE INC (EIN 22-3160873)
Tax period
2012-07-01 to 2013-06-30
Filed
2014-02-24
IRS object ID
201430559349300718
Schema version
2012v2.1
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

FieldValueIRS element (for citing)
Timestamp2014-02-24T14:27:28-06:00Timestamp
Tax Period End Date2013-06-30TaxPeriodEndDate

Preparer Firm PreparerFirm

FieldValueIRS element (for citing)
EIN221478099EIN

Preparer Firm Business Name PreparerFirmBusinessName

FieldValueIRS element (for citing)
Business Name Line1COHNREZNICK LLPBusinessNameLine1

Preparer Firm US Address PreparerFirmUSAddress

FieldValueIRS element (for citing)
Address Line1180 GLASTONBURY BOULEVARDAddressLine1
CityGLASTONBURYCity
StateCTState
ZIP Code06033ZIPCode
FieldValueIRS element (for citing)
Return Type990ReturnType
Tax Period Begin Date2012-07-01TaxPeriodBeginDate

Filer Filer

FieldValueIRS element (for citing)
EIN223160873EIN

Name Name

FieldValueIRS element (for citing)
Business Name Line1STAYWELL HEALTH CARE INCBusinessNameLine1
FieldValueIRS element (for citing)
Name ControlSTAYNameControl
Phone2037568021Phone

US Address USAddress

FieldValueIRS element (for citing)
Address Line180 PHOENIX AVENUE NO 201AddressLine1
CityWATERBURYCity
StateCTState
ZIP Code06702ZIPCode

Officer Officer

FieldValueIRS element (for citing)
NameDONALD J THOMPSON JRName
TitleCHIEF EXECUTIVE OFFICERTitle
Phone2037568021Phone
Date Signed2014-02-24DateSigned
Authorize Third Party1AuthorizeThirdParty

Preparer Preparer

FieldValueIRS element (for citing)
PTINP00852868PTIN
Phone8606333000Phone
FieldValueIRS element (for citing)
Tax Year2012TaxYear
Build TS2015-11-30 17:44:51ZBuildTS

Form 990 IRS990

FieldValueIRS element (for citing)
Name Of Principal Officer PersonDONALD J THOMPSON JRNameOfPrincipalOfficerPerson

Address Principal Officer US AddressPrincipalOfficerUS

FieldValueIRS element (for citing)
Address Line180 PHOENIX AVENUEAddressLine1
CityWATERBURYCity
StateCTState
ZIP Code06702ZIPCode
FieldValueIRS element (for citing)
Gross Receipts13782914GrossReceipts
Group Return For Affiliates0GroupReturnForAffiliates
Organization501c3XOrganization501c3
Web SiteWWW.STAYWELLHEALTH.ORGWebSite
Type Of Organization CorporationXTypeOfOrganizationCorporation
Year Formation1992YearFormation
State Legal DomicileCTStateLegalDomicile
Activity Or Mission DescriptionPROVIDE PRIMARY HEALTH CARE, DENTAL, MENTAL HEALTH, AND SOCIAL SERVICES, TO THE UNDERSERVED POPULATION OF THE GREATER WATERBURY COMMUNITY.ActivityOrMissionDescription
Nbr Voting Members Governing Body12NbrVotingMembersGoverningBody
Nbr Independent Voting Members12NbrIndependentVotingMembers
Total Nbr Employees173TotalNbrEmployees
Total Nbr Volunteers8TotalNbrVolunteers
Total Gross UBI-992TotalGrossUBI
Net Unrelated Business Txbl Income-496NetUnrelatedBusinessTxblIncome
Contributions Grants Prior Year3403013ContributionsGrantsPriorYear
Contributions Grants Current Year3873910ContributionsGrantsCurrentYear
Program Service Revenue Prior Year10505285ProgramServiceRevenuePriorYear
Program Service Revenue CY9578320ProgramServiceRevenueCY
Investment Income Prior Year5589InvestmentIncomePriorYear
Investment Income Current Year4124InvestmentIncomeCurrentYear
Other Revenue Prior Year282089OtherRevenuePriorYear
Other Revenue Current Year146715OtherRevenueCurrentYear
Total Revenue Prior Year14195976TotalRevenuePriorYear
Total Revenue Current Year13603069TotalRevenueCurrentYear
Grants And Similar Amnts Prior Year0GrantsAndSimilarAmntsPriorYear
Grants And Similar Amnts CY0GrantsAndSimilarAmntsCY
Benefits Paid To Members Prior Year0BenefitsPaidToMembersPriorYear
Benefits Paid To Members CY0BenefitsPaidToMembersCY
Salaries Etc Prior Year10780123SalariesEtcPriorYear
Salaries Etc Current Year10365110SalariesEtcCurrentYear
Total Prof Fundrsng Exp Prior Year0TotalProfFundrsngExpPriorYear
Total Prof Fundrsng Exp CY0TotalProfFundrsngExpCY
Total Fundrsng Exp Current Year0TotalFundrsngExpCurrentYear
Other Expense Prior Year2836571OtherExpensePriorYear
Other Expenses Current Year3162194OtherExpensesCurrentYear
Total Expenses Prior Year13616694TotalExpensesPriorYear
Total Expenses Current Year13527304TotalExpensesCurrentYear
Revenues Less Expenses Prior Year579282RevenuesLessExpensesPriorYear
Revenues Less Expenses CY75765RevenuesLessExpensesCY
Total Assets BOY10017874TotalAssetsBOY
Total Assets EOY9616179TotalAssetsEOY
Total Liabilities BOY2609296TotalLiabilitiesBOY
Total Liabilities EOY2131836TotalLiabilitiesEOY
Net Assets Or Fund Balances BOY7408578NetAssetsOrFundBalancesBOY
Net Assets Or Fund Balances EOY7484343NetAssetsOrFundBalancesEOY
Mission DescriptionPROVIDE PRIMARY HEALTH CARE, DENTAL, MENTAL HEALTH, AND SOCIAL SERVICES, TO THE UNDERSERVED POPULATION OF THE GREATER WATERBURY COMMUNITY.MissionDescription
Significant New Program Services0SignificantNewProgramServices
Significant Change0SignificantChange
Expense9490607Expense
Revenue9705820Revenue
DescriptionMEDICAL CLINIC, HEALTHY START, AND DENTAL CLINIC WHICH PROVIDE MEDICAL, PRENATAL, AND CHILDCARE FOR INNER CITY RESIDENTS AND UNINSURED RESIDENTS AND RESTORATIVE DENTAL CARE FOR INNER CITY CHILDREN. THE TOTAL NUMBER OF VISITS DURING FISCAL YEAR 2013 WAS 79,023.Description
Total Program Service Expense9490607TotalProgramServiceExpense
Described In501 C31DescribedIn501C3
Schedule B Required1ScheduleBRequired
Political Activities0PoliticalActivities
Lobbying Activities1LobbyingActivities
Subject To Proxy Tax0SubjectToProxyTax
Donor Advised Funds0DonorAdvisedFunds
Conservation Easements0ConservationEasements
Collections Of Art0CollectionsOfArt
Credit Counseling0CreditCounseling
Term Or Permanent Endowments0TermOrPermanentEndowments
Report Land Bldg Equip1ReportLandBldgEquip
Report Invest Oth Securities0ReportInvestOthSecurities
Report Prog Rel Invest0ReportProgRelInvest
Report Other Assets0ReportOtherAssets
Report Other Liabilities0ReportOtherLiabilities
Report Fin48 Footnote1ReportFin48Footnote
Independent Audit Financial Stmt1IndependentAuditFinancialStmt
Consolidated Audit Financial Stmt0ConsolidatedAuditFinancialStmt
School0School
Foreign Office0ForeignOffice
Foreign Activities0ForeignActivities
More Than5000 K To Organizations0MoreThan5000KToOrganizations
More Than5000 K To Individuals0MoreThan5000KToIndividuals
Professional Fundraising0ProfessionalFundraising
Fundraising Activities1FundraisingActivities
Gaming0Gaming
Hospital0Hospital
Grants To Organizations0GrantsToOrganizations
Grants To Individuals0GrantsToIndividuals
Schedule J Required1ScheduleJRequired
Tax Exempt Bonds0TaxExemptBonds
Excess Benefit Transaction0ExcessBenefitTransaction
Prior Excess Benefit Transaction0PriorExcessBenefitTransaction
Loan To Officer Or DQP0LoanToOfficerOrDQP
Grant To Related Person0GrantToRelatedPerson
Bsnss Rltnshp With Organization0BsnssRltnshpWithOrganization
Bsnss Rltnshp Thru Family Member0BsnssRltnshpThruFamilyMember
Officer Entity With Bsnss Rltnshp0OfficerEntityWithBsnssRltnshp
Deductible Non Cash Contributions1DeductibleNonCashContributions
Deductible Contributions Of Art0DeductibleContributionsOfArt
Terminated0Terminated
Partial Liquidation0PartialLiquidation
Disregarded Entity0DisregardedEntity
Related Entity0RelatedEntity
Related Org Controlled Entity0RelatedOrgControlledEntity
Transfers To Exempt Non Chrtbl Org0TransfersToExemptNonChrtblOrg
Activities Conducted Partnership0ActivitiesConductedPartnership
Schedule O Required1ScheduleORequired
Number Forms Transmitted With109672NumberFormsTransmittedWith1096
Number W2 G Included0NumberW2GIncluded
Compliance With Backup Witholding1ComplianceWithBackupWitholding
Number Of Employees173NumberOfEmployees
Employment Tax Returns Filed1EmploymentTaxReturnsFiled
Unrelated Business Income1UnrelatedBusinessIncome
Form990-T Filed1Form990-TFiled
Foreign Financial Account0ForeignFinancialAccount
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTrans
Taxable Party Notification0TaxablePartyNotification
Non Deductible Contributions0NonDeductibleContributions
Quid Pro Quo Contributions0QuidProQuoContributions
Form8282 Property Disposed Of0Form8282PropertyDisposedOf
Funds To Pay Premiums0FundsToPayPremiums
Premiums Paid0PremiumsPaid
Indoor Tanning Services0IndoorTanningServices
Info In Schedule O Part VIXInfoInScheduleOPartVI
Nbr Voting Governing Body Members12NbrVotingGoverningBodyMembers
Number Independent Voting Members12NumberIndependentVotingMembers
Family Or Business Relationship0FamilyOrBusinessRelationship
Delegation Of Management Duties0DelegationOfManagementDuties
Changes To Organizing Docs0ChangesToOrganizingDocs
Material Diversion Or Misuse0MaterialDiversionOrMisuse
Members Or Stockholders0MembersOrStockholders
Election Of Board Members0ElectionOfBoardMembers
Decisions Subject To Approval0DecisionsSubjectToApproval
Minutes Of Governing Body1MinutesOfGoverningBody
Minutes Of Committees1MinutesOfCommittees
Officer Mailing Address0OfficerMailingAddress
Local Chapters0LocalChapters
Form990 Provided To Governing Body1Form990ProvidedToGoverningBody
Conflict Of Interest Policy1ConflictOfInterestPolicy
Annual Disclosure Covered Persons1AnnualDisclosureCoveredPersons
Regular Monitoring Enforcement1RegularMonitoringEnforcement
Whistleblower Policy1WhistleblowerPolicy
Document Retention Policy1DocumentRetentionPolicy
Compensation Process CEO1CompensationProcessCEO
Compensation Process Other1CompensationProcessOther
Investment In Joint Venture0InvestmentInJointVenture
States Where Copy Of Return Is FiledCTStatesWhereCopyOfReturnIsFiled
Upon RequestXUponRequest

The Books Are In Care Of TheBooksAreInCareOf

FieldValueIRS element (for citing)
Name PersonLULE TRACEYNamePerson
Telephone Number2037568021TelephoneNumber

Address US AddressUS

FieldValueIRS element (for citing)
Address Line180 PHOENIX AVENUE SUITE 201AddressLine1
CityWATERBURYCity
StateCTState
ZIP Code06702ZIPCode

Form990 Part VII Section A Form990PartVIISectionA (21 entries)

TitleTitleAverage Hours Per WeekAverageHoursPerWeekIndividual Trustee Or DirectorIndividualTrusteeOrDirectorReportable Comp From OrganizationReportableCompFromOrganizationReportable Comp From Related OrgsReportableCompFromRelatedOrgsOther CompensationOtherCompensationOfficerOfficerHighest Compensated EmployeeHighestCompensatedEmployee
MIGDALIA ROSARIO
MEMBER2.00X000
MARK BRIGGS
CHAIRPERSON2.00X000X
ANGIE MEDINA
SECRETARY2.00X000X
ARLENE M ARIAS LCSW
MEMBER2.00X000
SANDRA J SOREL-LEDUC
VICE CHAIR2.00X000X
LAURIE LOUMINGOU
MEMBER2.00X000
TYRONE WILLIAMSON
MEMBER2.00X000
REV CHRISTOPHER KING
MEMBER2.00X000
WALTER R MACHNICZ
MEMBER2.00X000
CAROLYN A HIGHSMITH
TREASURER2.00X000X
JUDY A ACOSTA
MEMBER2.00X000
THOMAS JOHNSON
MEMBER2.00X000
DONALD J THOMPSON JR
CEO/PRESIDENT40.00211393073945X
LULE TRACEY
CFO40.00169041048483X
SUNIL D'CUNHA
CMO40.00246555056599X
CHRISTINE BIANCHI
CDO40.00129412030134X
AMIT PATEL
DENTAL DIRECTOR40.00196981045610X
MONIKA KAUL
INTERNIST40.00137734031804X
ADNA SADIQ
INTERNIST40.00146627033732X
LUIS LEON
INTERNIST40.00148454022673X
RANTNEKER MANDAVA
DENTIST37.30134277030704X
FieldValueIRS element (for citing)
Total Reportable Comp From Org1520474TotalReportableCompFromOrg
Total Reportable Comp Frm Rltd Orgs0TotalReportableCompFrmRltdOrgs
Total Other Compensation373684TotalOtherCompensation
Number Individuals GT100 K17NumberIndividualsGT100K
Formers Listed0FormersListed
Total Comp GT150 K1TotalCompGT150K
Compensation From Other Sources0CompensationFromOtherSources

Contractor Compensation ContractorCompensation (2 entries)

Address Line1AddressOfContractor/AddressUS/AddressLine1CityAddressOfContractor/AddressUS/CityStateAddressOfContractor/AddressUS/StateZIP CodeAddressOfContractor/AddressUS/ZIPCodeDescription Of ServicesDescriptionOfServicesCompensationCompensation
GEMINI DENTAL LABS
250 PORTER STREET SUITE 73WATERTOWNCT06795DENTAL LAB SERVICES115240
UNIVERSITY OF CT HEALTH CENTER FOR PEDIA
263 FARMINGTON AVEFARMINGTONCT06488PEDIATRIC DENTISTRY104520
FieldValueIRS element (for citing)
Number Of Contractors GT100 K2NumberOfContractorsGT100K
Federated Campaigns39576FederatedCampaigns
Fundraising Events12625FundraisingEvents
Government Grants3050859GovernmentGrants
All Other Contributions770850AllOtherContributions
Noncash Contributions768762NoncashContributions
Total Contributions3873910TotalContributions

Program Service Revenue ProgramServiceRevenue (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncome
PATIENT SERVICE62140091595009159500
PHARMACY446110418820418820
FieldValueIRS element (for citing)
Total Program Service Revenue9578320TotalProgramServiceRevenue

Investment Income InvestmentIncome

FieldValueIRS element (for citing)
Total Revenue Column4124TotalRevenueColumn
Exclusion$4,124ExclusionAmount

Gross Rents GrossRents

FieldValueIRS element (for citing)
Real171244Real

Less Rental Expenses LessRentalExpenses

FieldValueIRS element (for citing)
Real172236Real

Rental Income Or Loss RentalIncomeOrLoss

FieldValueIRS element (for citing)
Real-992Real

Net Rental Income Or Loss NetRentalIncomeOrLoss

FieldValueIRS element (for citing)
Total Revenue Column-992TotalRevenueColumn
Unrelated Business Revenue-992UnrelatedBusinessRevenue
FieldValueIRS element (for citing)
Gross Income Fundraising Events6605GrossIncomeFundraisingEvents
Cntrbtns Rprtd Fundraising Events12625CntrbtnsRprtdFundraisingEvents
Fundraising Direct Expenses7609FundraisingDirectExpenses

Net Income From Fundraising Events NetIncomeFromFundraisingEvents

FieldValueIRS element (for citing)
Total Revenue Column-1004TotalRevenueColumn
Exclusion-$1,004ExclusionAmount

Other Revenue Misc OtherRevenueMisc (2 entries)

DescriptionDescriptionBusiness CodeBusinessCodeTotal Revenue ColumnTotalRevenueColumnRelated Or Exempt Function IncomeRelatedOrExemptFunctionIncomeExclusionExclusionAmount
MEANINGFUL USE INCENTIVE900099127500127500
OTHER REVENUE90009921211$21,211
FieldValueIRS element (for citing)
Total Other Revenue148711TotalOtherRevenue

Total Revenue TotalRevenue

FieldValueIRS element (for citing)
Total Revenue Column13603069TotalRevenueColumn
Related Or Exempt Function Income9705820RelatedOrExemptFunctionIncome
Unrelated Business Revenue-992UnrelatedBusinessRevenue
Exclusion$24,331ExclusionAmount

Comp Current Officers Directors CompCurrentOfficersDirectors

FieldValueIRS element (for citing)
Total910371Total
Program Services617334ProgramServices
Management And General293037ManagementAndGeneral

Other Salaries And Wages OtherSalariesAndWages

FieldValueIRS element (for citing)
Total7469749Total
Program Services5065334ProgramServices
Management And General2404415ManagementAndGeneral

Other Employee Benefits OtherEmployeeBenefits

FieldValueIRS element (for citing)
Total1320469Total
Program Services895427ProgramServices
Management And General425042ManagementAndGeneral

Payroll Taxes PayrollTaxes

FieldValueIRS element (for citing)
Total664521Total
Program Services450620ProgramServices
Management And General213901ManagementAndGeneral

Fees For Services Legal FeesForServicesLegal

FieldValueIRS element (for citing)
Total10372Total
Management And General10372ManagementAndGeneral

Fees For Services Accounting FeesForServicesAccounting

FieldValueIRS element (for citing)
Total34800Total
Management And General34800ManagementAndGeneral

Fees For Services Lobbying FeesForServicesLobbying

FieldValueIRS element (for citing)
Total15000Total
Management And General15000ManagementAndGeneral

Fees For Services Other FeesForServicesOther

FieldValueIRS element (for citing)
Total921605Total
Program Services624952ProgramServices
Management And General296653ManagementAndGeneral

Advertising Advertising

FieldValueIRS element (for citing)
Total45747Total
Program Services31022ProgramServices
Management And General14725ManagementAndGeneral

Office Expenses OfficeExpenses

FieldValueIRS element (for citing)
Total35672Total
Program Services24190ProgramServices
Management And General11482ManagementAndGeneral

Information Technology InformationTechnology

FieldValueIRS element (for citing)
Total5371Total
Management And General5371ManagementAndGeneral

Occupancy Occupancy

FieldValueIRS element (for citing)
Total185935Total
Program Services164404ProgramServices
Management And General21531ManagementAndGeneral

Travel Travel

FieldValueIRS element (for citing)
Total49325Total
Program Services33448ProgramServices
Management And General15877ManagementAndGeneral

Conferences Meetings ConferencesMeetings

FieldValueIRS element (for citing)
Total23635Total
Program Services16027ProgramServices
Management And General7608ManagementAndGeneral

Interest Interest

FieldValueIRS element (for citing)
Total56432Total
Program Services53664ProgramServices
Management And General2768ManagementAndGeneral

Depreciation Depletion DepreciationDepletion

FieldValueIRS element (for citing)
Total248600Total
Program Services207071ProgramServices
Management And General41529ManagementAndGeneral

Insurance Insurance

FieldValueIRS element (for citing)
Total28178Total
Program Services24745ProgramServices
Management And General3433ManagementAndGeneral

Other Expenses OtherExpenses (4 entries)

DescriptionDescriptionTotalTotalProgram ServicesProgramServicesManagement And GeneralManagementAndGeneral
VACCINES761812761812
CLINIC SUPPLIES412768280270132498
EQUIPMENT RENTAL AND MA15716811029446874
OTHER991718211617055

All Other Expenses AllOtherExpenses

FieldValueIRS element (for citing)
Total70603Total
Program Services47877ProgramServices
Management And General22726ManagementAndGeneral

Total Functional Expenses TotalFunctionalExpenses

FieldValueIRS element (for citing)
Total13527304Total
Program Services9490607ProgramServices
Management And General4036697ManagementAndGeneral
Fundraising0Fundraising

Cash Non Interest Bearing CashNonInterestBearing

FieldValueIRS element (for citing)
BOY1856206BOY
EOY1147528EOY

Savings And Temp Cash Investments SavingsAndTempCashInvestments

FieldValueIRS element (for citing)
BOY2004489BOY
EOY2257654EOY

Pledges And Grants Receivable PledgesAndGrantsReceivable

FieldValueIRS element (for citing)
BOY90449BOY
EOY240833EOY

Accounts Receivable AccountsReceivable

FieldValueIRS element (for citing)
BOY972010BOY
EOY849597EOY

Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges

FieldValueIRS element (for citing)
BOY182467BOY
EOY177305EOY
FieldValueIRS element (for citing)
Land Buildings Equipment Basis6838863LandBuildingsEquipmentBasis
Land Bldg Equipment Accum Deprec2324891LandBldgEquipmentAccumDeprec

Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet

FieldValueIRS element (for citing)
BOY4551247BOY
EOY4513972EOY

Other Assets Total OtherAssetsTotal

FieldValueIRS element (for citing)
BOY361006BOY
EOY429290EOY

Total Assets TotalAssets

FieldValueIRS element (for citing)
BOY10017874BOY
EOY9616179EOY

Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses

FieldValueIRS element (for citing)
BOY1337213BOY
EOY979848EOY

Grants Payable GrantsPayable

FieldValueIRS element (for citing)
BOY8318BOY
EOY7653EOY

Deferred Revenue DeferredRevenue

FieldValueIRS element (for citing)
BOY171343BOY
EOY110101EOY

Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp

FieldValueIRS element (for citing)
BOY1092422BOY
EOY1034234EOY

Total Liabilities TotalLiabilities

FieldValueIRS element (for citing)
BOY2609296BOY
EOY2131836EOY
FieldValueIRS element (for citing)
Follow SFAS117XFollowSFAS117

Unrestricted Net Assets UnrestrictedNetAssets

FieldValueIRS element (for citing)
BOY5962355BOY
EOY5931961EOY

Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets

FieldValueIRS element (for citing)
BOY1446223BOY
EOY1552382EOY

Total Net Assets Fund Balances TotalNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY7408578BOY
EOY7484343EOY

Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances

FieldValueIRS element (for citing)
BOY10017874BOY
EOY9616179EOY
FieldValueIRS element (for citing)
Reconcilation Revenue Expenses75765ReconcilationRevenueExpenses
Reconcilation Other Changes0ReconcilationOtherChanges
Info In Schedule O Part XIIXInfoInScheduleOPartXII
Method Of Accounting AccrualXMethodOfAccountingAccrual
Accountant Compile Or Review0AccountantCompileOrReview
FS Audited1FSAudited

FS Audited Basis FSAuditedBasis

FieldValueIRS element (for citing)
Financial Statement SeparateXFinancialStatementSeparate
FieldValueIRS element (for citing)
Audit Committee1AuditCommittee
Federal Grant Audit Required1FederalGrantAuditRequired
Federal Grant Audit Performed1FederalGrantAuditPerformed

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org170b1 AviXPubliclySupportedOrg170b1Avi

Gifts Grants Contrib Received170 GiftsGrantsContribReceived170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years3066787CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years3639556CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years3170165CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year3403013CurrentTaxYearMinus1Year
Current Tax Year3880515CurrentTaxYear
Total17160036Total

Total170 Total170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years3066787CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years3639556CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years3170165CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year3403013CurrentTaxYearMinus1Year
Current Tax Year3880515CurrentTaxYear
Total17160036Total
FieldValueIRS element (for citing)
Public Support Total17017160036PublicSupportTotal170

Gross Investment Income170 GrossInvestmentIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus4 Years6332CurrentTaxYearMinus4Years
Current Tax Year Minus3 Years3860CurrentTaxYearMinus3Years
Current Tax Year Minus2 Years8749CurrentTaxYearMinus2Years
Current Tax Year Minus1 Year5589CurrentTaxYearMinus1Year
Current Tax Year4124CurrentTaxYear
Total28654Total

Net UBI NetUBI

FieldValueIRS element (for citing)
Current Tax Year Minus3 Years3613CurrentTaxYearMinus3Years
Current Tax Year Minus1 Year271CurrentTaxYearMinus1Year
Total3884Total

Other Income170 OtherIncome170

FieldValueIRS element (for citing)
Current Tax Year Minus1 Year5568CurrentTaxYearMinus1Year
Current Tax Year148711CurrentTaxYear
Total154279Total
FieldValueIRS element (for citing)
Total Support17346853TotalSupport
Gross Receipts From Admissions Etc46319916GrossReceiptsFromAdmissionsEtc
Public Support Pertcentage1700.98920PublicSupportPertcentage170
Public Support Pertcent Prior Year0.99570PublicSupportPertcentPriorYear
Thirty Three Percnt Tests CY170XThirtyThreePercntTestsCY170

Schedule B IRS990ScheduleB

Contributor Info ContributorInfo

FieldValueIRS element (for citing)
Contributor NumberRESTRICTEDContributorNumber

Contributor Name Business ContributorNameBusiness

FieldValueIRS element (for citing)
Business Name Line1RESTRICTEDBusinessNameLine1

Contributor Address US ContributorAddressUS

FieldValueIRS element (for citing)
Address Line1RESTRICTEDAddressLine1
Address Line2RESTRICTEDAddressLine2
CityRESTRICTEDCity
StateRESTRICTEDState
ZIP CodeRESTRICTEDZIPCode
FieldValueIRS element (for citing)
Aggregate ContributionsRESTRICTEDAggregateContributions

Schedule C IRS990ScheduleC

FieldValueIRS element (for citing)
Volunteers0Volunteers
Paid Staff Or Management0PaidStaffOrManagement
Media Advertisements0MediaAdvertisements
Mailings Members0MailingsMembers
Publications Or Broadcast0PublicationsOrBroadcast
Grants Other Organizations0GrantsOtherOrganizations
Direct Contact Legislators1DirectContactLegislators
Direct Contact Legislators$15,000DirectContactLegislatorsAmount
Rallies Demonstrations0RalliesDemonstrations
Other Activities0OtherActivities
Total Lobbying Expenditures IIB15000TotalLobbyingExpendituresIIB
Not Described In501c30NotDescribedIn501c3

Form990 Schedule C Part IV Form990ScheduleCPartIV

FieldValueIRS element (for citing)
IdentifierEXPLANATION OF LOBBYING ACTIVITIES:Identifier
Return ReferencePART II-B, LINE 1:ReturnReference
ExplanationPAID $15,000 TO LEVIN, POWERS & BRENNAN LLCExplanation

Schedule D IRS990ScheduleD

Land Land

FieldValueIRS element (for citing)
Other Cost Or Other Basis384297OtherCostOrOtherBasis
Book Value384297BookValue

Buildings Buildings

FieldValueIRS element (for citing)
Other Cost Or Other Basis5480337OtherCostOrOtherBasis
Depreciation1508587Depreciation
Book Value3971750BookValue

Equipment Equipment

FieldValueIRS element (for citing)
Other Cost Or Other Basis974229OtherCostOrOtherBasis
Depreciation816304Depreciation
Book Value157925BookValue
FieldValueIRS element (for citing)
Total Of Book Value Land Buildings4513972TotalOfBookValueLandBuildings
Footnote In Part XIIIXFootnoteInPartXIII
Tot Revenue Etc Audited Fincl Stmt13782914TotRevenueEtcAuditedFinclStmt
Other Revenues179845OtherRevenues
Revenue Not Rptd F990179845RevenueNotRptdF990
Revenue Subtotal13603069RevenueSubtotal
Revenue Not Rptd On Fin Stmt0RevenueNotRptdOnFinStmt
Total Revenue Per Form99013603069TotalRevenuePerForm990
Tot Expenses Etc Audited Fincl Stmt13707149TotExpensesEtcAuditedFinclStmt
Other Expenses Included179845OtherExpensesIncluded
Expenses Not Rptd F990179845ExpensesNotRptdF990
Expenses Subtotal13527304ExpensesSubtotal
Expenses Not Rptd On Fin Stmt0ExpensesNotRptdOnFinStmt
Total Expenses Per Form99013527304TotalExpensesPerForm990

Form990 Schedule D Part XIII Form990ScheduleDPartXIII (3 entries)

IdentifierIdentifierReturn ReferenceReturnReferenceExplanationExplanation
DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48:PART X, LINE 2:THE CORPORATION HAS NO UNRECOGNIZED TAX BENEFITS AT JUNE 30, 2013. THE CORPORATION'S U.S. FEDERAL AND STATE INFORMATION RETURNS PRIOR TO FISCAL YEAR 2010 ARE CLOSED AND MANAGEMENT CONTINUALLY EVALUATES EXPIRING STATUTES OF LIMITATIONS, AUDITS, PROPOSED SETTLEMENTS, CHANGES IN TAX LAW AND NEW AUTHORITATIVE RULINGS. IF THE CORPORATION HAS UNRELATED BUSINESS INCOME TAXES, IT RECOGNIZES INTEREST AND PENALTIES ASSOCIATED WITH ANY TAX MATTERS AS PART OF THE INCOME TAX PROVISION AND INCLUDE ACCRUED INTEREST AND PENALTIES WITH THE RELATED TAX LIABILITY IN THE STATEMENTS OF FINANCIAL POSITION.
PART XI, LINE 2D - OTHER ADJUSTMENTS:RENT EXPENSES 172,236. DIRECT FUNDRAISING EXPENSES 7,609.
PART XII, LINE 2D - OTHER ADJUSTMENTS:RENT EXPENSES 172,236. DIRECT FUNDRAISING EXPENSES 7,609.

Schedule G IRS990ScheduleG

Events Information EventsInformation

FieldValueIRS element (for citing)
Name Of Event1FUNDRAISINGNameOfEvent1
Gross Receipts Event119230GrossReceiptsEvent1
Charitable Contributions Event112625CharitableContributionsEvent1
Gross Revenue Event16605GrossRevenueEvent1
Rent Facility Costs Event16500RentFacilityCostsEvent1
Food And Beverage Event1189FoodAndBeverageEvent1
Entertainment Event1600EntertainmentEvent1
Other Direct Expenses Event1320OtherDirectExpensesEvent1
Gross Receipts Total19230GrossReceiptsTotal
Charitable Contributions Total12625CharitableContributionsTotal
Gross Revenue Total Events6605GrossRevenueTotalEvents
Rent Facility Costs Total Events6500RentFacilityCostsTotalEvents
Food And Beverage Total Events189FoodAndBeverageTotalEvents
Entertainment Total Events600EntertainmentTotalEvents
Other Direct Expenses Total Events320OtherDirectExpensesTotalEvents
Direct Expense Summary Events7609DirectExpenseSummaryEvents
Net Income Summary-1004NetIncomeSummary

Schedule J IRS990ScheduleJ

FieldValueIRS element (for citing)
Compensation CommitteeXCompensationCommittee
Compensation SurveyXCompensationSurvey
Board Or Committee ApprovalXBoardOrCommitteeApproval
Severance Payment0SeverancePayment
Supplemental Nonqual Retire Plan1SupplementalNonqualRetirePlan
Equity Based Comp Arrangement0EquityBasedCompArrangement
Comp Based On Revenue Of Filing Org0CompBasedOnRevenueOfFilingOrg
Comp Based On Revenue Related Orgs0CompBasedOnRevenueRelatedOrgs
Comp Based Net Earnings Filing Org0CompBasedNetEarningsFilingOrg
Comp Based Net Earnings Relate Orgs0CompBasedNetEarningsRelateOrgs
Any Non Fixed Payments0AnyNonFixedPayments
Initial Contract Exception0InitialContractException

Form990 Schedule J Part II Form990ScheduleJPartII (9 entries)

TitleTitleBase Compensation Filing OrgBaseCompensationFilingOrgComp Based On Related OrgsCompBasedOnRelatedOrgsBonus Filing OrgBonusFilingOrgBonus Related OrgsBonusRelatedOrgsOther Compensation Filing OrgOtherCompensationFilingOrgOther Compensation Related OrgsOtherCompensationRelatedOrgsDeferred Comp Filing OrgDeferredCompFilingOrgDeferred Comp Related OrgsDeferredCompRelatedOrgsNontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgNontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgsTotal Compensation Filing OrgTotalCompensationFilingOrgTotal Compensation Related OrgsTotalCompensationRelatedOrgsComp Report Prior990 Filing OrgCompReportPrior990FilingOrgComp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs
DONALD J THOMPSON JR
CEO/PRESIDENT21139300000255000484450285338000
LULE TRACEY
CFO1690410000092500392330217524000
SUNIL D'CUNHA
CMO2465550000000565990303154000
CHRISTINE BIANCHI
CDO1294120000000301340159546000
AMIT PATEL
DENTAL DIRECTOR1969810000000456100242591000
MONIKA KAUL
INTERNIST1377340000000318040169538000
ADNA SADIQ
INTERNIST1466270000000337320180359000
LUIS LEON
INTERNIST1417040675000000226730171127000
RANTNEKER MANDAVA
DENTIST1342770000000307040164981000

Form990 Schedule J Part III Form990ScheduleJPartIII

FieldValueIRS element (for citing)
Return ReferencePART I, LINE 4BReturnReference
ExplanationDONALD J. THOMPSON, JR, 457 (F), $25,500 LULE TRACEY, 457 (F), $9,250Explanation

Schedule M IRS990ScheduleM

Drugs And Medical Supplies DrugsAndMedicalSupplies

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
Number Of Contributions1NumberOfContributions
Noncash Contribs Rptd F990761812NoncashContribsRptdF990

Other Non Cash Contributions Table OtherNonCashContributionsTable

FieldValueIRS element (for citing)
Non Cash CheckboxXNonCashCheckbox
DescriptionMISCELLANEOUSDescription
Noncash Contribs Rptd F9906950NoncashContribsRptdF990
FieldValueIRS element (for citing)
Any Property That Must Be Held0AnyPropertyThatMustBeHeld
Review Process Unusual NC Gifts0ReviewProcessUnusualNCGifts
Third Parties Used0ThirdPartiesUsed

Schedule O IRS990ScheduleO

General Explanation GeneralExplanation (5 entries)

Return ReferenceReturnReferenceExplanationExplanation
FORM 990, PART VI, SECTION B, LINE 11THE 990 WILL BE REVIEWED AND ACCEPTED BY THE BOARD BEFORE STAYWELL SUBMITS.
FORM 990, PART VI, SECTION B, LINE 12CDONALD THOMPSON, CEO, MONITORS CONFLICT OF INTEREST POLICY BY REVIEWING AND ADDRESSING ANY POTENTIAL CONFLICTS AND FOLLOWING UP EACH YEAR FOR ANY CHANGES.
FORM 990, PART VI, SECTION B, LINE 15INFORMATION FROM NATIONAL AND STATEWIDE SURVEYS ARE USED AS CRITERIA TO DETERMINE THE SALARY OF THE CEO. THIS INFORMATION IS GIVEN TO THE PERSONNEL COMMITTEE FOR REVIEW. THE PERSONNEL COMMITTEE NEGOTIATES AND APPROVES THE SALARY OF THE CEO.
FORM 990, PART VI, SECTION C, LINE 19ALL GOVERNING DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST.
FORM 990, PART XII, LINE 2CTHERE HAVE BEEN NO CHANGES IN THE OVERSIGHT OR SELECTINO PROCESS DURING THE TAX YEAR.

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