STAYWELL HEALTH CARE INC: Form 990, tax year 2011
View the entire original 990 at ProPublica ↗
- Organization
- STAYWELL HEALTH CARE INC (EIN 22-3160873)
- Tax period
- 2011-07-01 to 2012-06-30
- Filed
- 2013-04-30
- IRS object ID
- 201341209349300144
- Schema version
- 2011v1.5
- 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) |
|---|---|---|
| Timestamp | 2013-04-30T13:34:01-05:00 | Timestamp |
| Tax Period End Date | 2012-06-30 | TaxPeriodEndDate |
Preparer Firm PreparerFirm
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 221478099 | EIN |
Preparer Firm Business Name PreparerFirmBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | COHNREZNICK LLP | BusinessNameLine1 |
Preparer Firm US Address PreparerFirmUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 180 GLASTONBURY BOULEVARD | AddressLine1 |
| City | GLASTONBURY | City |
| State | CT | State |
| ZIP Code | 06033 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnType |
| Tax Period Begin Date | 2011-07-01 | TaxPeriodBeginDate |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 223160873 | EIN |
Name Name
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | STAYWELL HEALTH CARE INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Control | STAY | NameControl |
| Phone | 2037568021 | Phone |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 80 PHOENIX AVENUE NO 201 | AddressLine1 |
| City | WATERBURY | City |
| State | CT | State |
| ZIP Code | 06702 | ZIPCode |
Officer Officer
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name | DONALD J THOMPSON JR | Name |
| Title | CHIEF EXECUTIVE OFFICER | Title |
| Phone | 2037568021 | Phone |
| Date Signed | 2013-04-22 | DateSigned |
| Authorize Third Party | 1 | AuthorizeThirdParty |
Preparer Preparer
| Field | Value | IRS element (for citing) |
|---|---|---|
| PTIN | P00852868 | PTIN |
| Phone | 8606333000 | Phone |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax Year | 2011 | TaxYear |
| Build TS | 2016-03-07 17:11:31Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Of Principal Officer Person | DONALD J THOMPSON JR | NameOfPrincipalOfficerPerson |
Address Principal Officer US AddressPrincipalOfficerUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 80 PHOENIX AVENUE | AddressLine1 |
| City | WATERBURY | City |
| State | CT | State |
| ZIP Code | 06702 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | 14361776 | GrossReceipts |
| Group Return For Affiliates | 0 | GroupReturnForAffiliates |
| Organization501c3 | X | Organization501c3 |
| Web Site | WWW.STAYWELLHEALTH.ORG | WebSite |
| Type Of Organization Corporation | X | TypeOfOrganizationCorporation |
| Year Formation | 1992 | YearFormation |
| State Legal Domicile | CT | StateLegalDomicile |
| Activity Or Mission Description | PROVIDE PRIMARY HEALTH CARE, DENTAL, MENTAL HEALTH, AND SOCIAL SERVICES, TO THE UNDERSERVED POPULATION OF THE GREATER WATERBURY COMMUNITY. | ActivityOrMissionDescription |
| Nbr Voting Members Governing Body | 10 | NbrVotingMembersGoverningBody |
| Nbr Independent Voting Members | 10 | NbrIndependentVotingMembers |
| Total Nbr Employees | 155 | TotalNbrEmployees |
| Total Nbr Volunteers | 38 | TotalNbrVolunteers |
| Total Gross UBI | 139 | TotalGrossUBI |
| Net Unrelated Business Txbl Income | 0 | NetUnrelatedBusinessTxblIncome |
| Contributions Grants Prior Year | 3170165 | ContributionsGrantsPriorYear |
| Contributions Grants Current Year | 3403013 | ContributionsGrantsCurrentYear |
| Program Service Revenue Prior Year | 9505293 | ProgramServiceRevenuePriorYear |
| Program Service Revenue CY | 10505285 | ProgramServiceRevenueCY |
| Investment Income Prior Year | 8749 | InvestmentIncomePriorYear |
| Investment Income Current Year | 5589 | InvestmentIncomeCurrentYear |
| Other Revenue Prior Year | -1268 | OtherRevenuePriorYear |
| Other Revenue Current Year | 282089 | OtherRevenueCurrentYear |
| Total Revenue Prior Year | 12682939 | TotalRevenuePriorYear |
| Total Revenue Current Year | 14195976 | TotalRevenueCurrentYear |
| Grants And Similar Amnts Prior Year | 0 | GrantsAndSimilarAmntsPriorYear |
| Grants And Similar Amnts CY | 0 | GrantsAndSimilarAmntsCY |
| Benefits Paid To Members Prior Year | 0 | BenefitsPaidToMembersPriorYear |
| Benefits Paid To Members CY | 0 | BenefitsPaidToMembersCY |
| Salaries Etc Prior Year | 9666634 | SalariesEtcPriorYear |
| Salaries Etc Current Year | 10780123 | SalariesEtcCurrentYear |
| Total Prof Fundrsng Exp Prior Year | 0 | TotalProfFundrsngExpPriorYear |
| Total Prof Fundrsng Exp CY | 0 | TotalProfFundrsngExpCY |
| Total Fundrsng Exp Current Year | 2565 | TotalFundrsngExpCurrentYear |
| Other Expense Prior Year | 2708412 | OtherExpensePriorYear |
| Other Expenses Current Year | 2836571 | OtherExpensesCurrentYear |
| Total Expenses Prior Year | 12375046 | TotalExpensesPriorYear |
| Total Expenses Current Year | 13616694 | TotalExpensesCurrentYear |
| Revenues Less Expenses Prior Year | 307893 | RevenuesLessExpensesPriorYear |
| Revenues Less Expenses CY | 579282 | RevenuesLessExpensesCY |
| Total Assets BOY | 9136341 | TotalAssetsBOY |
| Total Assets EOY | 10017874 | TotalAssetsEOY |
| Total Liabilities BOY | 2857273 | TotalLiabilitiesBOY |
| Total Liabilities EOY | 2609296 | TotalLiabilitiesEOY |
| Net Assets Or Fund Balances BOY | 6279068 | NetAssetsOrFundBalancesBOY |
| Net Assets Or Fund Balances EOY | 7408578 | NetAssetsOrFundBalancesEOY |
| Mission Description | PROVIDE PRIMARY HEALTH CARE, DENTAL, MENTAL HEALTH, AND SOCIAL SERVICES, TO THE UNDERSERVED POPULATION OF THE GREATER WATERBURY COMMUNITY. | MissionDescription |
| Significant New Program Services | 0 | SignificantNewProgramServices |
| Significant Change | 0 | SignificantChange |
| Expense | 7716012 | Expense |
| Revenue | 10787103 | Revenue |
| Description | MEDICAL 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 2012 WAS 86,418. | Description |
| Total Program Service Expense | 7716012 | TotalProgramServiceExpense |
| Described In501 C3 | 1 | DescribedIn501C3 |
| Schedule B Required | 1 | ScheduleBRequired |
| Political Activities | 0 | PoliticalActivities |
| Lobbying Activities | 0 | LobbyingActivities |
| Subject To Proxy Tax | 0 | SubjectToProxyTax |
| Donor Advised Funds | 0 | DonorAdvisedFunds |
| Conservation Easements | 0 | ConservationEasements |
| Collections Of Art | 0 | CollectionsOfArt |
| Credit Counseling | 0 | CreditCounseling |
| Term Or Permanent Endowments | 0 | TermOrPermanentEndowments |
| Report Land Bldg Equip | 1 | ReportLandBldgEquip |
| Report Invest Oth Securities | 0 | ReportInvestOthSecurities |
| Report Prog Rel Invest | 0 | ReportProgRelInvest |
| Report Other Assets | 0 | ReportOtherAssets |
| Report Other Liabilities | 0 | ReportOtherLiabilities |
| Report Fin48 Footnote | 1 | ReportFin48Footnote |
| Independent Audit Financial Stmt | 1 | IndependentAuditFinancialStmt |
| Consolidated Audit Financial Stmt | 0 | ConsolidatedAuditFinancialStmt |
| School | 0 | School |
| Foreign Office | 0 | ForeignOffice |
| Foreign Activities | 0 | ForeignActivities |
| More Than5000 K To Organizations | 0 | MoreThan5000KToOrganizations |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividuals |
| Professional Fundraising | 0 | ProfessionalFundraising |
| Fundraising Activities | 0 | FundraisingActivities |
| Gaming | 0 | Gaming |
| Hospital | 0 | Hospital |
| Grants To Organizations | 0 | GrantsToOrganizations |
| Grants To Individuals | 0 | GrantsToIndividuals |
| Schedule J Required | 1 | ScheduleJRequired |
| Tax Exempt Bonds | 0 | TaxExemptBonds |
| Excess Benefit Transaction | 0 | ExcessBenefitTransaction |
| Prior Excess Benefit Transaction | 0 | PriorExcessBenefitTransaction |
| Loan To Officer Or DQP | 0 | LoanToOfficerOrDQP |
| Grant To Related Person | 0 | GrantToRelatedPerson |
| Bsnss Rltnshp With Organization | 0 | BsnssRltnshpWithOrganization |
| Bsnss Rltnshp Thru Family Member | 0 | BsnssRltnshpThruFamilyMember |
| Officer Entity With Bsnss Rltnshp | 0 | OfficerEntityWithBsnssRltnshp |
| Deductible Non Cash Contributions | 1 | DeductibleNonCashContributions |
| Deductible Contributions Of Art | 0 | DeductibleContributionsOfArt |
| Terminated | 0 | Terminated |
| Partial Liquidation | 0 | PartialLiquidation |
| Disregarded Entity | 0 | DisregardedEntity |
| Related Entity | 1 | RelatedEntity |
| Related Org Controlled Entity | 1 | RelatedOrgControlledEntity |
| Transaction Related Entity | 1 | TransactionRelatedEntity |
| Transfers To Exempt Non Chrtbl Org | 0 | TransfersToExemptNonChrtblOrg |
| Activities Conducted Partnership | 0 | ActivitiesConductedPartnership |
| Schedule O Required | 1 | ScheduleORequired |
| Number Forms Transmitted With1096 | 63 | NumberFormsTransmittedWith1096 |
| Number W2 G Included | 0 | NumberW2GIncluded |
| Compliance With Backup Witholding | 1 | ComplianceWithBackupWitholding |
| Number Of Employees | 155 | NumberOfEmployees |
| Employment Tax Returns Filed | 1 | EmploymentTaxReturnsFiled |
| Unrelated Business Income | 1 | UnrelatedBusinessIncome |
| Form990-T Filed | 1 | Form990-TFiled |
| Foreign Financial Account | 0 | ForeignFinancialAccount |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTrans |
| Taxable Party Notification | 0 | TaxablePartyNotification |
| Non Deductible Contributions | 0 | NonDeductibleContributions |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributions |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOf |
| Funds To Pay Premiums | 0 | FundsToPayPremiums |
| Premiums Paid | 0 | PremiumsPaid |
| Indoor Tanning Services | 0 | IndoorTanningServices |
| Info In Schedule O Part VI | X | InfoInScheduleOPartVI |
| Nbr Voting Governing Body Members | 10 | NbrVotingGoverningBodyMembers |
| Number Independent Voting Members | 10 | NumberIndependentVotingMembers |
| Family Or Business Relationship | 0 | FamilyOrBusinessRelationship |
| Delegation Of Management Duties | 0 | DelegationOfManagementDuties |
| Changes To Organizing Docs | 0 | ChangesToOrganizingDocs |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuse |
| Members Or Stockholders | 0 | MembersOrStockholders |
| Election Of Board Members | 0 | ElectionOfBoardMembers |
| Decisions Subject To Approval | 0 | DecisionsSubjectToApproval |
| Minutes Of Governing Body | 1 | MinutesOfGoverningBody |
| Minutes Of Committees | 1 | MinutesOfCommittees |
| Officer Mailing Address | 0 | OfficerMailingAddress |
| Local Chapters | 0 | LocalChapters |
| Form990 Provided To Governing Body | 1 | Form990ProvidedToGoverningBody |
| Conflict Of Interest Policy | 1 | ConflictOfInterestPolicy |
| Annual Disclosure Covered Persons | 1 | AnnualDisclosureCoveredPersons |
| Regular Monitoring Enforcement | 1 | RegularMonitoringEnforcement |
| Whistleblower Policy | 1 | WhistleblowerPolicy |
| Document Retention Policy | 1 | DocumentRetentionPolicy |
| Compensation Process CEO | 1 | CompensationProcessCEO |
| Compensation Process Other | 1 | CompensationProcessOther |
| Investment In Joint Venture | 0 | InvestmentInJointVenture |
| States Where Copy Of Return Is Filed | CT | StatesWhereCopyOfReturnIsFiled |
| Upon Request | X | UponRequest |
The Books Are In Care Of TheBooksAreInCareOf
| Field | Value | IRS element (for citing) |
|---|---|---|
| Name Person | LULE TRACEY | NamePerson |
| Telephone Number | 2037568021 | TelephoneNumber |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 80 PHOENIX AVENUE SUITE 201 | AddressLine1 |
| City | WATERBURY | City |
| State | CT | State |
| ZIP Code | 06702 | ZIPCode |
Form990 Part VII Section A Form990PartVIISectionA (18 entries)
| TitleTitle | Average Hours Per WeekAverageHoursPerWeek | Individual Trustee Or DirectorIndividualTrusteeOrDirector | OfficerOfficer | Reportable Comp From OrganizationReportableCompFromOrganization | Reportable Comp From Related OrgsReportableCompFromRelatedOrgs | Other CompensationOtherCompensation | Key EmployeeKeyEmployee | Highest Compensated EmployeeHighestCompensatedEmployee |
|---|---|---|---|---|---|---|---|---|
| MIGDALIA ROSARIO | ||||||||
| CHAIRPERSON | 2.00 | X | X | 0 | 0 | 0 | ||
| MARK BRIGGS | ||||||||
| VICE CHAIR | 2.00 | X | X | 0 | 0 | 0 | ||
| ANGIE MEDINA | ||||||||
| SECRETARY | 2.00 | X | X | 0 | 0 | 0 | ||
| ARLENE M ARIAS LCSW | ||||||||
| TREASURER | 2.00 | X | X | 0 | 0 | 0 | ||
| SANDRA J SOREL-LEDUC | ||||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | |||
| TYRONE B WILLIAMSON | ||||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | |||
| REV CHRISTOPHER KING | ||||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | |||
| WALTER R MACHNICZ | ||||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | |||
| CAROLYN A HIGHSMITH | ||||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | |||
| LAURIE LOUMINGOU | ||||||||
| MEMBER | 2.00 | X | 0 | 0 | 0 | |||
| DONALD J THOMPSON JR | ||||||||
| CEO/PRESIDENT | 40.00 | X | 188905 | 0 | 63649 | |||
| LULE TRACEY | ||||||||
| CFO | 40.00 | X | 161376 | 0 | 44302 | |||
| SUNIL D'CUNHA | ||||||||
| CMO | 40.00 | 230093 | 0 | 29817 | X | |||
| AMIT PATEL | ||||||||
| DENTAL DIRECTOR | 40.00 | 191972 | 0 | 37792 | X | |||
| ANN ASUNTO | ||||||||
| INTERNIST | 40.00 | 130362 | 0 | 15869 | X | |||
| VASUDEV KANADE | ||||||||
| INTERNIST | 40.00 | 131021 | 0 | 14676 | X | |||
| MONIKA KAUL | ||||||||
| INTERNIST | 40.00 | 130154 | 0 | 28287 | X | |||
| ADNA SADIQ | ||||||||
| INTERNIST | 40.00 | 131896 | 0 | 32165 | X | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | 1295779 | TotalReportableCompFromOrg |
| Total Reportable Comp Frm Rltd Orgs | 0 | TotalReportableCompFrmRltdOrgs |
| Total Other Compensation | 266557 | TotalOtherCompensation |
| Number Individuals GT100 K | 8 | NumberIndividualsGT100K |
| Formers Listed | 0 | FormersListed |
| Total Comp GT150 K | 1 | TotalCompGT150K |
| Compensation From Other Sources | 0 | CompensationFromOtherSources |
Contractor Compensation ContractorCompensation (2 entries)
| Address Line1AddressOfContractor/AddressUS/AddressLine1 | CityAddressOfContractor/AddressUS/City | StateAddressOfContractor/AddressUS/State | ZIP CodeAddressOfContractor/AddressUS/ZIPCode | Description Of ServicesDescriptionOfServices | CompensationCompensation |
|---|---|---|---|---|---|
| AMARC BUILDERS LLC | |||||
| 691 ROXBURY ROAD | SOUTHBURY | CT | 06488 | CONSTRUCTION | 122679 |
| GEMINI DENTAL LABS | |||||
| 250 PORTER STREET SUITE 73 | WATERTOWN | CT | 06795 | DENTAL LAB SERVICES | 102077 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Number Of Contractors GT100 K | 2 | NumberOfContractorsGT100K |
| Federated Campaigns | 35000 | FederatedCampaigns |
| Government Grants | 3360515 | GovernmentGrants |
| All Other Contributions | 7498 | AllOtherContributions |
| Noncash Contributions | 494255 | NoncashContributions |
| Total Contributions | 3403013 | TotalContributions |
Program Service Revenue ProgramServiceRevenue (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| PATIENT SERVICE | 621400 | 10484493 | 10484493 |
| PHARMACY | 446110 | 20792 | 20792 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | 10505285 | TotalProgramServiceRevenue |
Investment Income InvestmentIncome
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 5589 | TotalRevenueColumn |
| Exclusion | $5,589 | ExclusionAmount |
Gross Rents GrossRents
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 166071 | Real |
Less Rental Expenses LessRentalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 165800 | Real |
Rental Income Or Loss RentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Real | 271 | Real |
Net Rental Income Or Loss NetRentalIncomeOrLoss
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 271 | TotalRevenueColumn |
| Unrelated Business Revenue | 139 | UnrelatedBusinessRevenue |
| Exclusion | $132 | ExclusionAmount |
Other Revenue Misc OtherRevenueMisc (2 entries)
| DescriptionDescription | Business CodeBusinessCode | Total Revenue ColumnTotalRevenueColumn | Related Or Exempt Function IncomeRelatedOrExemptFunctionIncome |
|---|---|---|---|
| MEANINGFUL USE INCENTI | 900099 | 276250 | 276250 |
| OTHER REVENUE | 900099 | 5568 | 5568 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Revenue | 281818 | TotalOtherRevenue |
Total Revenue TotalRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | 14195976 | TotalRevenueColumn |
| Related Or Exempt Function Income | 10787103 | RelatedOrExemptFunctionIncome |
| Unrelated Business Revenue | 139 | UnrelatedBusinessRevenue |
| Exclusion | $5,721 | ExclusionAmount |
Comp Current Officers Directors CompCurrentOfficersDirectors
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 738515 | Total |
| Program Services | 403336 | ProgramServices |
| Management And General | 335179 | ManagementAndGeneral |
Other Salaries And Wages OtherSalariesAndWages
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7183821 | Total |
| Program Services | 3923401 | ProgramServices |
| Management And General | 3260420 | ManagementAndGeneral |
Pension Plan Contributions PensionPlanContributions
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 492398 | Total |
| Program Services | 268920 | ProgramServices |
| Management And General | 223478 | ManagementAndGeneral |
Other Employee Benefits OtherEmployeeBenefits
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 1731701 | Total |
| Program Services | 945757 | ProgramServices |
| Management And General | 785944 | ManagementAndGeneral |
Payroll Taxes PayrollTaxes
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 633688 | Total |
| Program Services | 346085 | ProgramServices |
| Management And General | 287603 | ManagementAndGeneral |
Fees For Services Legal FeesForServicesLegal
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 7912 | Total |
| Management And General | 7912 | ManagementAndGeneral |
Fees For Services Accounting FeesForServicesAccounting
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 29850 | Total |
| Management And General | 29850 | ManagementAndGeneral |
Fees For Services Other FeesForServicesOther
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 859346 | Total |
| Program Services | 469327 | ProgramServices |
| Management And General | 390019 | ManagementAndGeneral |
Advertising Advertising
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 16964 | Total |
| Program Services | 9265 | ProgramServices |
| Management And General | 7699 | ManagementAndGeneral |
Office Expenses OfficeExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 124339 | Total |
| Program Services | 84661 | ProgramServices |
| Management And General | 39678 | ManagementAndGeneral |
Information Technology InformationTechnology
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 24731 | Total |
| Management And General | 24731 | ManagementAndGeneral |
Occupancy Occupancy
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 131919 | Total |
| Program Services | 97691 | ProgramServices |
| Management And General | 34228 | ManagementAndGeneral |
Travel Travel
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 30769 | Total |
| Program Services | 16804 | ProgramServices |
| Management And General | 13965 | ManagementAndGeneral |
Conferences Meetings ConferencesMeetings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 15751 | Total |
| Program Services | 8602 | ProgramServices |
| Management And General | 7149 | ManagementAndGeneral |
Interest Interest
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 58992 | Total |
| Program Services | 48087 | ProgramServices |
| Management And General | 10905 | ManagementAndGeneral |
Depreciation Depletion DepreciationDepletion
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 262429 | Total |
| Program Services | 174325 | ProgramServices |
| Management And General | 88104 | ManagementAndGeneral |
Other Expenses OtherExpenses (4 entries)
| DescriptionDescription | TotalTotal | Program ServicesProgramServices | Management And GeneralManagementAndGeneral |
|---|---|---|---|
| VACCINES | 494255 | 494255 | |
| CLINIC SUPPLIES | 314456 | 171738 | 142718 |
| EQUIPMENT RENTAL AND MA | 233983 | 129067 | 104916 |
| DUES, LICENSES, & MEMBE | 62545 | 34159 | 28386 |
All Other Expenses AllOtherExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 168330 | Total |
| Program Services | 90532 | ProgramServices |
| Management And General | 75233 | ManagementAndGeneral |
| Fundraising | 2565 | Fundraising |
Total Functional Expenses TotalFunctionalExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | 13616694 | Total |
| Program Services | 7716012 | ProgramServices |
| Management And General | 5898117 | ManagementAndGeneral |
| Fundraising | 2565 | Fundraising |
Cash Non Interest Bearing CashNonInterestBearing
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1163523 | BOY |
| EOY | 1856206 | EOY |
Savings And Temp Cash Investments SavingsAndTempCashInvestments
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2502602 | BOY |
| EOY | 2004489 | EOY |
Pledges And Grants Receivable PledgesAndGrantsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 48759 | BOY |
| EOY | 90449 | EOY |
Accounts Receivable AccountsReceivable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 790274 | BOY |
| EOY | 972010 | EOY |
Prepaid Expenses Deferred Charges PrepaidExpensesDeferredCharges
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 22983 | BOY |
| EOY | 182467 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Buildings Equipment Basis | 6573205 | LandBuildingsEquipmentBasis |
| Land Bldg Equipment Accum Deprec | 2021958 | LandBldgEquipmentAccumDeprec |
Land Buildings Equipment Basis Net LandBuildingsEquipmentBasisNet
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4183285 | BOY |
| EOY | 4551247 | EOY |
Other Assets Total OtherAssetsTotal
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 424915 | BOY |
| EOY | 361006 | EOY |
Total Assets TotalAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9136341 | BOY |
| EOY | 10017874 | EOY |
Accounts Payable Accrued Expenses AccountsPayableAccruedExpenses
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1583985 | BOY |
| EOY | 1337213 | EOY |
Grants Payable GrantsPayable
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 8317 | BOY |
| EOY | 8318 | EOY |
Deferred Revenue DeferredRevenue
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 118539 | BOY |
| EOY | 171343 | EOY |
Mort Notes Pybl Secured Invest Prop MortNotesPyblSecuredInvestProp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1146432 | BOY |
| EOY | 1092422 | EOY |
Total Liabilities TotalLiabilities
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 2857273 | BOY |
| EOY | 2609296 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Follow SFAS117 | X | FollowSFAS117 |
Unrestricted Net Assets UnrestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 4640468 | BOY |
| EOY | 5962355 | EOY |
Temporarily Restricted Net Assets TemporarilyRestrictedNetAssets
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 1638600 | BOY |
| EOY | 1446223 | EOY |
Total Net Assets Fund Balances TotalNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 6279068 | BOY |
| EOY | 7408578 | EOY |
Total Liab Net Assets Fund Balances TotalLiabNetAssetsFundBalances
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | 9136341 | BOY |
| EOY | 10017874 | EOY |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | X | InfoInScheduleOPartXI |
| Reconcilation Revenue Expenses | 579282 | ReconcilationRevenueExpenses |
| Reconcilation Other Changes | 550228 | ReconcilationOtherChanges |
| Info In Schedule O Part XII | X | InfoInScheduleOPartXII |
| Method Of Accounting Accrual | X | MethodOfAccountingAccrual |
| Accountant Compile Or Review | 0 | AccountantCompileOrReview |
| FS Audited | 1 | FSAudited |
| Audit Committee | 1 | AuditCommittee |
| Financial Statement Separate | X | FinancialStatementSeparate |
| Federal Grant Audit Required | 1 | FederalGrantAuditRequired |
| Federal Grant Audit Performed | 1 | FederalGrantAuditPerformed |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Publicly Supported Org170b1 Avi | X | PubliclySupportedOrg170b1Avi |
Gifts Grants Contrib Received170 GiftsGrantsContribReceived170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 3070656 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 3066787 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 3639556 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 3170165 | CurrentTaxYearMinus1Year |
| Current Tax Year | 3403013 | CurrentTaxYear |
| Total | 16350177 | Total |
Total170 Total170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 3070656 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 3066787 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 3639556 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 3170165 | CurrentTaxYearMinus1Year |
| Current Tax Year | 3403013 | CurrentTaxYear |
| Total | 16350177 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | 16350177 | PublicSupportTotal170 |
Gross Investment Income170 GrossInvestmentIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 32826 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus3 Years | 6332 | CurrentTaxYearMinus3Years |
| Current Tax Year Minus2 Years | 3860 | CurrentTaxYearMinus2Years |
| Current Tax Year Minus1 Year | 8749 | CurrentTaxYearMinus1Year |
| Current Tax Year | 5589 | CurrentTaxYear |
| Total | 57356 | Total |
Net UBI NetUBI
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | 3045 | CurrentTaxYearMinus4Years |
| Current Tax Year Minus2 Years | 3613 | CurrentTaxYearMinus2Years |
| Current Tax Year | 271 | CurrentTaxYear |
| Total | 6929 | Total |
Other Income170 OtherIncome170
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year | 5568 | CurrentTaxYear |
| Total | 5568 | Total |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | 16420030 | TotalSupport |
| Gross Receipts From Admissions Etc | 43683033 | GrossReceiptsFromAdmissionsEtc |
| Public Support Pertcentage170 | 0.99570 | PublicSupportPertcentage170 |
| Public Support Pertcent Prior Year | 0.99220 | PublicSupportPertcentPriorYear |
| Thirty Three Percnt Tests CY170 | X | ThirtyThreePercntTestsCY170 |
Schedule B IRS990ScheduleB
Contributor Info ContributorInfo
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor Number | RESTRICTED | ContributorNumber |
Contributor Name Business ContributorNameBusiness
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor Address US ContributorAddressUS
| 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) |
|---|---|---|
| Aggregate Contributions | RESTRICTED | AggregateContributions |
Schedule D IRS990ScheduleD
Land Land
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 384297 | OtherCostOrOtherBasis |
| Book Value | 384297 | BookValue |
Buildings Buildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 5239261 | OtherCostOrOtherBasis |
| Depreciation | 1279627 | Depreciation |
| Book Value | 3959634 | BookValue |
Equipment Equipment
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 913153 | OtherCostOrOtherBasis |
| Depreciation | 712687 | Depreciation |
| Book Value | 200466 | BookValue |
Other Land Buildings OtherLandBuildings
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | 36494 | OtherCostOrOtherBasis |
| Depreciation | 29644 | Depreciation |
| Book Value | 6850 | BookValue |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Of Book Value Land Buildings | 4551247 | TotalOfBookValueLandBuildings |
| Total Revenue | 14195976 | TotalRevenue |
| Total Expenses | 13616694 | TotalExpenses |
| Excess Or Deficit For Year | 579282 | ExcessOrDeficitForYear |
| Other | $550,228 | OtherAmount |
| Total Adjustments | 550228 | TotalAdjustments |
| Excess Or Deficit Per FS | 1129510 | ExcessOrDeficitPerFS |
| Tot Revenue Etc Audited Fincl Stmt | 14361776 | TotRevenueEtcAuditedFinclStmt |
| Other Revenues | 165800 | OtherRevenues |
| Revenue Not Rptd F990 | 165800 | RevenueNotRptdF990 |
| Revenue Subtotal | 14195976 | RevenueSubtotal |
| Revenue Not Rptd On Fin Stmt | 0 | RevenueNotRptdOnFinStmt |
| Total Revenue Per Form990 | 14195976 | TotalRevenuePerForm990 |
| Tot Expenses Etc Audited Fincl Stmt | 13782494 | TotExpensesEtcAuditedFinclStmt |
| Other Expenses Included | 165800 | OtherExpensesIncluded |
| Expenses Not Rptd F990 | 165800 | ExpensesNotRptdF990 |
| Expenses Subtotal | 13616694 | ExpensesSubtotal |
| Expenses Not Rptd On Fin Stmt | 0 | ExpensesNotRptdOnFinStmt |
| Total Expenses Per Form990 | 13616694 | TotalExpensesPerForm990 |
Form990 Schedule D Part XIV Form990ScheduleDPartXIV (4 entries)
| IdentifierIdentifier | Return ReferenceReturnReference | ExplanationExplanation |
|---|---|---|
| DESCRIPTION OF UNCERTAIN TAX POSITIONS UNDER FIN 48: | PART X: | THE CORPORATION HAS NO UNRECOGNIZED TAX BENEFITS AT JUNE 30, 2012. THE CORPORATION'S U.S. FEDERAL AND STATE INFORMATION RETURNS PRIOR TO FISCAL YEAR 2009 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 8 - OTHER ADJUSTMENTS: | TRANSFER OF TRALEE NET ASSETS UPON DISSOLUTION 550,228. | |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | RENT EXPENSES 165,800. | |
| PART XIII, LINE 2D - OTHER ADJUSTMENTS: | RENT EXPENSES 165,800. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | X | CompensationCommittee |
| Compensation Survey | X | CompensationSurvey |
| Board Or Committee Approval | X | BoardOrCommitteeApproval |
| Severance Payment | 0 | SeverancePayment |
| Supplemental Nonqual Retire Plan | 1 | SupplementalNonqualRetirePlan |
| Equity Based Comp Arrangement | 0 | EquityBasedCompArrangement |
| Comp Based On Revenue Of Filing Org | 0 | CompBasedOnRevenueOfFilingOrg |
| Comp Based On Revenue Related Orgs | 0 | CompBasedOnRevenueRelatedOrgs |
| Comp Based Net Earnings Filing Org | 0 | CompBasedNetEarningsFilingOrg |
| Comp Based Net Earnings Relate Orgs | 0 | CompBasedNetEarningsRelateOrgs |
| Any Non Fixed Payments | 0 | AnyNonFixedPayments |
| Initial Contract Exception | 0 | InitialContractException |
Form990 Schedule J Part II Form990ScheduleJPartII (6 entries)
| Base Compensation Filing OrgBaseCompensationFilingOrg | Comp Based On Related OrgsCompBasedOnRelatedOrgs | Bonus Filing OrgBonusFilingOrg | Bonus Related OrgsBonusRelatedOrgs | Other Compensation Filing OrgOtherCompensationFilingOrg | Other Compensation Related OrgsOtherCompensationRelatedOrgs | Deferred Comp Filing OrgDeferredCompFilingOrg | Deferred Comp Related OrgsDeferredCompRelatedOrgs | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrg | Nontaxable Benefits Related OrgsNontaxableBenefitsRelatedOrgs | Total Compensation Filing OrgTotalCompensationFilingOrg | Total Compensation Related OrgsTotalCompensationRelatedOrgs | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrg | Comp Report Prior990 Related OrgsCompReportPrior990RelatedOrgs |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| DONALD J THOMPSON JR | |||||||||||||
| 188905 | 0 | 0 | 0 | 0 | 0 | 25500 | 0 | 38149 | 0 | 252554 | 0 | 0 | 0 |
| LULE TRACEY | |||||||||||||
| 161376 | 0 | 0 | 0 | 0 | 0 | 9250 | 0 | 35052 | 0 | 205678 | 0 | 0 | 0 |
| SUNIL D'CUNHA | |||||||||||||
| 230093 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 29817 | 0 | 259910 | 0 | 0 | 0 |
| AMIT PATEL | |||||||||||||
| 191972 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 37792 | 0 | 229764 | 0 | 0 | 0 |
| MONIKA KAUL | |||||||||||||
| 130154 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 28287 | 0 | 158441 | 0 | 0 | 0 |
| ADNA SADIQ | |||||||||||||
| 131896 | 0 | 0 | 0 | 0 | 0 | 0 | 0 | 32165 | 0 | 164061 | 0 | 0 | 0 |
Form990 Schedule J Part III Form990ScheduleJPartIII
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Reference | PART I, LINE 4B | ReturnReference |
| Explanation | DONALD J. THOMPSON, JR, 457 (F), $25,500 LULE TRACEY, 457 (F), $9,250 | Explanation |
Schedule M IRS990ScheduleM
Drugs And Medical Supplies DrugsAndMedicalSupplies
| Field | Value | IRS element (for citing) |
|---|---|---|
| Non Cash Checkbox | X | NonCashCheckbox |
| Number Of Contributions | 1 | NumberOfContributions |
| Noncash Contribs Rptd F990 | 494255 | NoncashContribsRptdF990 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Any Property That Must Be Held | 0 | AnyPropertyThatMustBeHeld |
| Review Process Unusual NC Gifts | 0 | ReviewProcessUnusualNCGifts |
| Third Parties Used | 0 | ThirdPartiesUsed |
Schedule O IRS990ScheduleO
General Explanation GeneralExplanation (6 entries)
| Return ReferenceReturnReference | ExplanationExplanation | IdentifierIdentifier |
|---|---|---|
| FORM 990, PART VI, SECTION B, LINE 11 | EACH MEMBER OF THE BOARD RECEIVES A COPY OF THE 990 FOR REVIEW BEFORE FILING. | |
| FORM 990, PART VI, SECTION B, LINE 12C | DONALD 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 15 | INFORMATION 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 19 | ALL GOVERNING DOCUMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST. | |
| FORM 990, PART XI, LINE 5: | TRANSFER OF TRALEE NET ASSETS UPON DISSOLUTION 550,228. TOTAL TO FORM 990, PART XI, LINE 5: 550,228. | CHANGES IN NET ASSETS OR FUND BALANCES: |
| FORM 990, PART XII, LINE 2C: | THERE HAVE BEEN NO CHANGES IN THE OVERSIGHT OR SELECTION PROCESS DURING THE TAX YEAR. |
Schedule R IRS990ScheduleR
Form990 Schedule R Part II Form990ScheduleRPartII
Name Of Disregarded Entity NameOfDisregardedEntity
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | TRALEE INC | BusinessNameLine1 |
Address US AddressUS
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 80 PHOENIX AVE STE 201 | AddressLine1 |
| City | WATERBURY | City |
| State | CT | State |
| ZIP Code | 06702 | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 061594623 | EIN |
| Primary Activities | PROPERTY | PrimaryActivities |
| Legal Domicile State | CT | LegalDomicileState |
| Exempt Code Section | 501(C)(2) | ExemptCodeSection |
Direct Controlling Entity Name DirectControllingEntityName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | STAYWELL HEALTH CARE INC | BusinessNameLine1 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Controlled Org | 1 | ControlledOrg |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Receipt Of Int Ann Rents Royalties | 0 | ReceiptOfIntAnnRentsRoyalties |
| Gift Grant Or Cap Contr To Other Org | 0 | GiftGrantOrCapContrToOtherOrg |
| Gift Grant Or Cap Contr Fr Other Org | 0 | GiftGrantOrCapContrFrOtherOrg |
| Loans Or Guarantees To Other Org | 0 | LoansOrGuaranteesToOtherOrg |
| Loans Or Guarantees From Other Org | 0 | LoansOrGuaranteesFromOtherOrg |
| Sale Of Assets To Other Org | 0 | SaleOfAssetsToOtherOrg |
| Purchase Of Assets From Other Org | 0 | PurchaseOfAssetsFromOtherOrg |
| Exchange Of Assets | 0 | ExchangeOfAssets |
| Rental Of Facilities To Other Orgs | 0 | RentalOfFacilitiesToOtherOrgs |
| Rental Of Facilities Fr Other Orgs | 1 | RentalOfFacilitiesFrOtherOrgs |
| Perform Of Services For Other Orgs | 0 | PerformOfServicesForOtherOrgs |
| Perform Of Services By Other Orgs | 0 | PerformOfServicesByOtherOrgs |
| Sharing Of Facilities | 1 | SharingOfFacilities |
| Sharing Of Paid Employees | 1 | SharingOfPaidEmployees |
| Reimbursement Paid To Other Org | 0 | ReimbursementPaidToOtherOrg |
| Reimbursement Paid By Other Org | 0 | ReimbursementPaidByOtherOrg |
| Other Transfer To Other Org | 1 | OtherTransferToOtherOrg |
| Other Transfer From Other Org | 0 | OtherTransferFromOtherOrg |
Transactions Related Orgs Table TransactionsRelatedOrgsTable (2 entries)
| Transaction TypeTransactionType | Amount InvolvedAmountInvolved | Method Of Amt DeterminationMethodOfAmtDetermination |
|---|---|---|
| TRALEE INC | ||
| J | 30990 | ACTUAL COST |
| TRALEE INC | ||
| Q | 550228 | NET BOOK VALUE |
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