2024-05-07T15:02:23-05:00 2023-06-30 946214841 ARMANINO LLP 2700 CAMINO RAMON STE 350 SAN RAMON CA 945835004 990 2022-07-01 942162549 ON LOK SENIOR HEALTH SERVICES ONLO 4152928888 1333 BUSH STREET SAN FRANCISCO CA 94109 CARL GERLACH CFO 4152928888 2024-05-03 1 CARL GERLACH 999009999 1 MATTHEW PETROSKI P00853132 9257902600 2024-05-03 2 AAL1 IAL1 2022 2023-04-26 12:10:37Z GRACE LI HARPER 1333 BUSH STREET SAN FRANCISCO CA 94109 279485067 0 X WWW.ONLOK.ORG X 1971 CA PROVIDE COMPREHENSIVE HEALTH AND LONG-TERM CARE SERVICES TO THE ELDERLY. ESPECIALLY THOSE WITH LANGUAGE, CULTURAL, OR FINANCIAL BARRIERS. 11 10 1046 11 0 0 272960 2133289 205330089 226678262 4025054 1469679 2177563 3001386 211805666 233282616 0 0 0 0 89326826 100922680 0 0 0 111905454 129405741 201232280 230328421 10573386 2954195 192120006 209521113 53912193 60958982 138207813 148562131 PROVIDE COMPREHENSIVE HEALTH AND LONG-TERM CARE SERVICES TO THE ELDERLY, ESPECIALLY THOSE WITH LANGUAGE, CULTURAL OR FINANCIAL BARRIERS. 0 0 208165941 226678262 ON LOK SENIOR HEALTH SERVICES PROVIDED A COMPLETE PACKAGE OF MEDICAL AND LONG-TERM CARE SERVICES TO THE FRAIL ELDERLY THROUGH ON LOK LIFEWAYS, A MODEL OF CARE CALLED PACE (PROGRAM OF ALL-INCLUSIVE CARE FOR THE ELDERLY). SERVICES WERE PROVIDED BY PHYSICIANS, OTHER HEALTH PROFESSIONALS AND PARA-PROFESSIONALS AND CONTRACTED SPECIALISTS/FACILITIES. OVER 1,600 ELDERS WERE SERVED DURING THE YEAR. 208165941 1 1 0 1 0 0 0 0 0 1 1 1 0 0 1 1 1 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 1 550 0 1 1046 1 0 0 0 0 0 0 0 0 0 0 0 0 X 11 10 0 0 0 0 1 1 1 1 1 0 0 1 1 1 1 1 1 0 0 0 CA X CARL GERLACH 4152928888 1333 BUSH STREET SAN FRANCISCO CA 94109 X STEPHEN HESTER CHAIR 2.00 X X 0 0 0 ROBIN FLAGG PHD VICE CHAIR 2.00 X X 0 0 0 CANDY RUPP TREASURER 2.00 1.90 X X 0 0 0 MARY LANIER SECRETARY 2.00 X X 0 0 0 LINDA EDELSTEIN DIRECTOR 2.00 X 0 0 0 ANNE FABINY MD DIRECTOR 0.80 X 0 0 0 ELIZABETH FERGUSON DIRECTOR 2.00 2.00 X 0 0 0 DEXTER LOUIE MD DIRECTOR 2.00 X 0 0 0 MIKE NEUMANN DIRECTOR 2.00 1.50 X 0 0 0 SHARON YOW DIRECTOR 2.00 1.00 X 0 0 0 ALBERT YU MD DIRECTOR (LEFT 01/23) 1.20 0.40 X 0 0 0 GRACE LI HARPER CEO, OLI 5.00 44.00 X X 0 658952 30180 CARL GERLACH INTERIM CFO (START 10/22) 0.00 40.00 X 0 0 0 JAY S LUXENBERG CHIEF MEDICAL OFFICER (LEFT 01/22) 40.00 X 119130 0 4376 YEE-BUN B LUI CHIEF MEDICAL OFFICER 40.00 X 435371 0 55156 KANWAR SINGH CHIEF FINANCIAL OFFICER (LEFT 10/22) 1.00 40.00 X 0 456736 23569 EILEEN M KUNZ CHIEF OF GOVT AFF & COMPL 40.00 X 301701 0 25985 NICOLE M TORRES CHIEF OPERATING OFFICER 40.00 X 330694 0 25145 JESSICA AUDRY ENG MEDICAL DIRECTOR 40.00 X 359690 0 18200 TERESA PHAM ASSOCIATE MED DIRECTOR 40.00 X 375758 0 40010 NAMITA SAHAI ASSOCIATE MED DIRECTOR 40.00 X 338086 0 28650 FAITH WELLS ASSOCIATE MED DIRECTOR 40.00 X 321196 0 10720 LAI W TAM RN LEAD 40.00 X 339469 0 19270 SUNNY K PAK ASSOCIATE MED DIRECTOR 40.00 X 320074 0 10904 3241169 1115688 292165 221 0 1 0 INSTITUTE ON AGING 3575 GEARY BLVD SAN FRANCISCO CA 94612 HEALTH SERVICES 22619608 PHARMASTAR LLC 228 STRAWBRIDGE DRIVE MOORESTOWN NJ 08057 HEALTH SERVICES 12717213 CA PACIFIC MEDICAL CENTER PO BOX 742412 LOS ANGELES CA 90074 HEALTH SERVICES 3428221 JC CARE INC 1250 HAYES ST SAN FRANCISCO CA 94117 HEALTH SERVICES 3261376 OCONNOR HOSPITAL PO BOX 888407 LOS ANGELES CA 90088 HEALTH SERVICES 1818160 97 544 1432802 699943 2133289 MEDI-CAL PREMIUM 524114 168051963 168051963 MEDICARE PREMIUM 524114 57429037 57429037 PRIVATE PREMIUM 524114 1197262 1197262 226678262 3467830 3467830 369437 0 369437 369437 369437 44204300 46202451 -1998151 -1998151 -1998151 EXPENSE REIMBURSEMENTS 900099 2020076 2020076 INSURANCE REIMBURSEMEN 900099 565652 565652 MISCELLANEOUS INCOME 900099 46221 46221 2631949 233282616 226678262 0 4471065 1654401 896111 758290 79904713 72163988 7740725 2012030 1802372 209658 11629580 10590249 1039331 5721956 5149480 572476 89599799 81963202 7636597 138594 138594 54000 54000 528197 528197 93561 93561 6800438 6206227 594211 1046337 995532 50805 978594 963501 15093 3024887 2856762 168125 1335722 1186604 149118 PRESCRIPTION COSTS 14128347 14128347 SUPPLIES 6774709 6352185 422524 4902556 2911381 1991175 230328421 208165941 22162480 0 843 843 10148862 13059954 140525 287766 14286690 18928562 3360009 3512403 70425985 26397251 31567724 44028734 104311010 102635187 17031894 17580683 11272449 9486981 192120006 209521113 22709230 23155299 73139 5311747 27284294 26779283 3845530 5712653 53912193 60958982 X 135200585 145154355 3007228 3407776 138207813 148562131 192120006 209521113 2954195 7148080 252043 0 X 0 1 X 1 0 X 1287833 329685 1755966 272960 2133289 5779733 166990649 182130448 191490483 205330089 226678262 972619931 168278482 182460133 193246449 205603049 228811551 978399664 0 0 0 978399664 3335328 3990847 2891817 2929043 3837267 16984302 3335328 3990847 2891817 2929043 3837267 16984302 1784680 1388419 1745168 1808126 2631949 9358342 173398490 187839399 197883434 210340218 235280767 1004742308 0.97380 0.96900 0.01690 0.02110 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 384016 384016 229944405 230328421 1000000 250000 0 0 1000000 1000000 1000000 1000000 4000000 6000000 132564 398117 341007 384016 1255704 250000 250000 250000 250000 1000000 1500000 2537897 132766 79246 2591417 2806298 -191407 76994 2537897 2404846 474346 72894 2806298 2451552 32317 79023 2404846 2458746 60822 68016 2451552 0.00000 0.34160 0.65840 1 0 12307430 12307430 29026994 9298219 19728775 11489889 5476697 6013192 16458900 11622335 4836565 1142772 1142772 44028734 HEDGE FUNDS 17580683 F 17580683 PAYABLE TO OLI 4046270 PAYABLE TO OLCHI 19633 OPERATING LEASE LIABILITY 1646750 5712653 X 240154542 7148080 252043 7400123 232754419 528197 528197 233282616 229800224 0 229800224 528197 528197 230328421 PART V, LINE 4: OLSHS' ENDOWMENT CONSISTS OF ENDOWMENT FUNDS WITH DONOR RESTRICTIONS. THE ENDOWMENT FUNDS ARE INTENDED TO GENERATE INVESTMENT INCOME TO BE USED FOR OPERATING SUPPORT. PART X, LINE 2: OLSHS IS EXEMPT FROM INCOME TAXES UNDER SECTION 501(A) SUBSECTION (C)(3) OF THE INTERNAL REVENUE CODE AND SECTION 23701(D) OF THE CALIFORNIA REVENUE AND TAXATION CODE WHEREBY ONLY UNRELATED BUSINESS INCOME, AS DEFINED BY SECTION 512(A)(1) OF THE INTERNAL REVENUE CODE AND SIMILAR CODE SECTIONS OF THE CALIFORNIA REVENUE AND TAXATION CODE IS SUBJECT TO INCOME TAX. ACCORDINGLY, NO PROVISION FOR INCOME TAXES HAS BEEN PROVIDED FOR IN THE ACCOMPANYING FINANCIAL STATEMENTS. OLSHS IS REQUIRED TO FILE ANNUAL INFORMATIONAL RETURNS WITH THE INTERNAL REVENUE SERVICE AND THE CALIFORNIA FRANCHISE TAX BOARD. MANAGEMENT HAS EVALUATED ITS CURRENT TAX POSITION AND HAS CONCLUDED AS OF JUNE 30, 2023, THAT OLSHS DOES NOT HAVE ANY SIGNIFICANT UNCERTAIN TAX POSITIONS FOR WHICH A RESERVE WOULD BE NECESSARY. X 1 0 0 0 0 0 0 1 0 GRACE LI HARPER CEO, OLI 0 558952 0 100000 0 0 0 20350 0 9830 0 689132 0 0 YEE-BUN B LUI CHIEF MEDICAL OFFICER 400371 0 35000 0 0 0 29650 0 25506 0 490527 0 0 0 KANWAR SINGH CHIEF FINANCIAL OFFICER (LEFT 10/22) 0 256736 0 0 0 200000 0 4930 0 18639 0 480305 0 0 TERESA PHAM ASSOCIATE MED DIRECTOR 375758 0 0 0 0 0 29650 0 10360 0 415768 0 0 0 JESSICA AUDRY ENG MEDICAL DIRECTOR 339690 0 20000 0 0 0 18200 0 0 0 377890 0 0 0 NAMITA SAHAI ASSOCIATE MED DIRECTOR 338086 0 0 0 0 0 28650 0 0 0 366736 0 0 0 LAI W TAM RN LEAD 339469 0 0 0 0 0 9150 0 10120 0 358739 0 0 0 NICOLE M TORRES CHIEF OPERATING OFFICER 304449 0 26245 0 0 0 9150 0 15995 0 355839 0 0 0 FAITH WELLS ASSOCIATE MED DIRECTOR 321196 0 0 0 0 0 360 0 10360 0 331916 0 0 0 SUNNY K PAK ASSOCIATE MED DIRECTOR 310074 0 10000 0 0 0 839 0 10065 0 330978 0 0 0 EILEEN M KUNZ CHIEF OF GOVT AFF & COMPL 275978 0 25723 0 0 0 15865 0 10120 0 327686 0 0 0 PART I, LINE 4A DURING 2022, KANWAR SINGH, CFO RECEIVED A SEVERANCE PAYMENT OF $200,000. PART I, LINE 7 OLI'S SENIOR LEADERS ARE ELIGIBLE FOR AN ANNUAL INCENTIVE REWARD. THE REASONABLENESS AND APPROPRIATENESS OF THE ANNUAL INCENTIVE PLAN DESIGN AND SPECIFIC GOALS AND REWARDS ARE ASSESSED BY THE EXECUTIVE COMMITTEE OF THE BOARD EACH YEAR. THE INCENTIVE PLAN, WHICH IS ALIGNED WITH THE ORGANIZATION'S FISCAL YEAR, HAS SPECIFIED ORGANIZATIONAL AND INDIVIDUAL GOALS LINKED TO THE ANNUAL BUSINESS AND FINANCIAL PLANS AND PREDEFINED FINANCIAL REWARD OPPORTUNITIES ARE SET FOR EACH GOAL. A MINIMUM, TARGET AND MAXIMUM INCENTIVE REWARD OPPORTUNITY IS ESTABLISHED FOR EACH SENIOR LEADER. FOR THE CEO AND CFO, THE EXECUTIVE COMMITTEE OF THE BOARD SETS THE CEO'S AND CFO'S GOALS AND RELATED GOAL WEIGHTS AT THE BEGINNING OF THE FISCAL YEAR AND DETERMINES THE APPROVED DEGREE OF GOAL ATTAINMENT AND RELATED REWARDS EARNED AT FISCAL YEAR END. THE CEO FOLLOWS THE SAME PROCESS FOR HER DIRECT REPORTS AND SHARES HER FINAL DECISIONS WITH THE EXECUTIVE COMMITTEE. A CALIFORNIA HEALTH FACILITIES FINANCING AUTHORITY 521643828 13032UYK8 2020-11-19 28449117 REFUND PRIOR LOAN, FUND ACQUISITION 0 0 0 A 642759 28449117 4590726 1527111 546442 3622623 18404249 2024 1 0 1 1 A 0 0 0 0 0 0 0 A 0 1 0 0 0 0 0 0 0 A 0 PART 1, LINE A THIS BOND ISSUE WAS MADE TO BOTH ON LOK SENIOR HEALTH SERVICES (OLSHS) AND ON LOK COMMUNITY HOUSING, INC. (OLCHI), ITS RELATED ORGANIZATION. THE FULL AMOUNT OF THE ISSUE IS $45,810,008 WHICH WAS USED TO REFUND ITS 2014 BOND ISSUE AND TO INCREASE FACILITIES. 62.10% OF THE PROCEEDS ARE ALLOCATED TO OLSHS, AND 37.90% ARE ALLOCATED TO OLCHI. FORM 990, PART VI, SECTION A, LINE 6 ON LOK, INC, THE PARENT ORGANIZATION, IS THE SOLE MEMBER. FORM 990, PART VI, SECTION A, LINE 7A AS THE SOLE MEMBER, ON LOK, INC, HAS THE RIGHT TO ELECT AND REMOVE DIRECTORS. FORM 990, PART VI, SECTION A, LINE 7B AS THE SOLE MEMBER, ON LOK, INC, ALSO HAS THE RIGHT TO APPROVE KEY DECISIONS, SUCH AS ANNUAL OPERATING AND CAPITAL BUDGETS AND THE INCURRENCE OF LONG-TERM DEBT. FORM 990, PART VI, SECTION B, LINE 11B REVIEW OF THE FORM 990 HAS BEEN DELEGATED TO THE CHIEF FINANCIAL OFFICER OF ON LOK, INC. AFTER REVIEW AND APPROVAL, THE 990 WAS PROVIDED TO ALL MEMBERS OF THE BOARD OF DIRECTORS BEFORE FILING. FORM 990, PART VI, SECTION B, LINE 12C THE CONFLICT OF INTEREST POLICY IS DISTRIBUTED ANNUALLY TO DIRECTORS, OFFICERS AND SENIOR MANAGEMENT, ALONG WITH ANNUAL DISCLOSURE OF CONFLICT OF INTEREST FORMS WHICH ARE REQUIRED TO BE COMPLETED, SIGNED AND RETURNED TO THE COMPLIANCE OFFICER EACH YEAR. THESE FORMS ARE REVIEWED CAREFULLY BY THE COMPLIANCE OFFICER AND THE CHIEF EXECUTIVE OFFICER SO THAT ANY POTENTIAL CONFLICTS ARE HANDLED APPROPRIATELY. FORM 990, PART VI, SECTION B, LINE 15 THE EXECUTIVE COMMITTEE OF ON LOK SENIOR HEALTH SERVICES DETERMINES THE COMPENSATION OF THE CEO OF THE ORGANIZATION, BASED ON THE COMPARABILITY DATA PROVIDED BY A FIRM SPECIALIZING IN COMPENSATION. IN ADDITION TO THE BASE COMPENSATION, THE EXECUTIVE COMMITTEE MAY ALSO ESTABLISH INCENTIVE COMPENSATION AT A PRE-DETERMINED LEVEL BASED ON SPECIFIC GOALS TO BE ACHIEVED BY YEAR-END. FORM 990, PART VI, SECTION C, LINE 19 AVAILABLE UPON REQUEST. FORM 990, PART VI: THE CEO IS A FULL-TIME EMPLOYEE OF ON LOK, INC., THE PARENT ORGANIZATION, AND SERVES AS THE CEO OF ON LOK SENIOR HEALTH SERVICES AND OTHER RELATED ON LOK ORGANIZATIONS. ON LOK INC 1333 BUSH STREET SAN FRANCISCO CA 94109 943101464 SUPPORTING SERVICE FOR AFFILIATES, MAINTAIN HEALTH CARE MODEL CA 501(C)(3) LINE 7 0 ON LOK DAY SERVICES 1333 BUSH STREET SAN FRANCISCO CA 94109 943101292 VARIOUS SERVICES FOR SENIORS CA 501(C)(3) LINE 10 ON LOK INC 0 ON LOK HOUSE INC 1333 BUSH STREET SAN FRANCISCO CA 94109 942326678 HOUSING FOR LOW-INCOME FRAIL ELDERLY CA 501(C)(3) LINE 7 ON LOK INC 0 ON LOK COMMUNITY HOUSING INC 1333 BUSH STREET SAN FRANCISCO CA 94109 943053383 HOUSING FOR LOW-INCOME SENIORS CA 501(C)(3) LINE 12A, I ON LOK INC 0 0 0 0 0 0 0 0 0 0 1 1 0 1 1 0 0 1 0 0