2026-06-11T12:45:38-05:00 2025-07-31 331374517 PKF O'CONNOR DAVIES ADVISORY LLC 245 PARK AVENUE 12TH FLOOR NEW YORK NY 10167 990 2024-08-01 942918600 LUMETRA HEALTHCARE SOLUTIONS LUME 5163267767 CO IPRO 300 JERICHO QUADRANGLE 3 JERICHO NY 11753 ALAN WOGHIN DIRECTOR 5163267767 2026-06-11 1 1 EVA MRUK P00543254 2122862600 2026-06-11 2024 2025-03-06 01:10:19Z X X JOHN A FRIEDMAN MD C/O IPRO 300 JERICHO QUADRANGLE 300 JERICHO NY 11753 4023962 0 X LUMETRASOLUTIONS.COM X 1983 CA TO DRIVE THE ADVANCEMENT OF THE HEALTHCARE BUSINESS THROUGH EVIDENCE-BASED, RELIABLE SOLUTIONS AND TECHNOLOGY. X 7 3 4 7 0 0 0 0 1072754 288161 3 0 2498 3735801 1075255 4023962 0 0 0 0 576371 230362 0 0 0 1101292 455617 1677663 685979 -602408 3337983 2127353 0 5465336 0 -3337983 0 X TO DRIVE THE ADVANCEMENT OF THE HEALTHCARE BUSINESS THROUGH EVIDENCE-BASED, RELIABLE SOLUTIONS AND TECHNOLOGY. 0 1 DURING THE TAX YEAR, THE ORGANIZATION CEASED ALL OPERATIONS AND COMPLETED THE DISSOLUTION PROCESS IN ACCORDANCE WITH APPLICABLE STATE LAWS. AS A RESULT, ALL PROGRAM ACTIVITIES WERE TERMINATED, AND THE ORGANIZATION'S REMAINING ASSETS WERE DISTRIBUTED IN ACCORDANCE WITH ITS GOVERNING DOCUMENTS AND APPLICABLE FEDERAL AND STATE REQUIREMENTS. 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 0 0 1 0 0 1 40 0 4 1 0 0 0 0 0 0 0 0 X 7 3 0 0 0 0 1 1 0 1 1 0 0 1 1 1 1 1 1 0 0 0 CA X NAOMI VAYNER 5162095560 300 JERICHO QUADRANGLE SUITE 300 JERICHO NY 11753 THEODORE O WILL EXECUTIVE VICE PRESIDENT 0.10 42.00 X X 0 831483 126265 JOHN A FRIEDMAN MD PRESIDENT 0.10 0.58 X X 250 10750 0 PAUL J ROWLAND TREASURER 0.10 0.50 X X 250 7550 0 JEAN ANN SEAGO PHD DIRECTOR 0.10 0.00 X 0 0 0 CLARE BRADLEY POLLET MD DIRECTOR 0.10 40.00 X 0 559445 57253 ALAN WOGHIN DIRECTOR 0.10 40.00 X 0 430796 95161 MATTHEW W ROBERTS DIRECTOR 0.10 40.00 X 0 277852 57199 CECILIA RAMOS EXECUTIVE DIRECTOR 40.00 0.00 X 0 174202 26835 PATRICIA DANIEL VP CLINICAL SERVICES 20.00 0.00 X 108089 19251 1742 108589 2311329 364455 1 0 1 0 0 CLINICAL SERVICES 541900 288161 288161 288161 FORGIVENESS OF BAD DEBT 900099 3734205 3734205 OTHER REVENUE 900099 1596 1596 3735801 4023962 0 0 4023962 X 213941 6571 103 9747 1558 101389 44001 22663 1355 842 2929 ALLOCATED EXPENSES 153229 ALLOCATED SALARIES 73722 BAD DEBT EXPENSE 44640 DUES AND SUBSCRIPTIONS 9289 685979 1840245 0 0 0 273803 0 0 0 0 0 13305 0 0 0 0 0 0 0 2127353 0 150843 0 5314493 0 5465336 0 X -3337983 0 -3337983 0 2127353 0 3337983 0 X 0 1 X 1 0 0 X 171005296 167055696 167055696 3949600 74362 74362 4023962 92137656 92302539 92302539 -164883 850862 850862 685979 PART X, LINE 2: THE CORPORATION RECOGNIZES THE EFFECT OF TAX POSITIONS ONLY WHEN THEY ARE MORE LIKELY THAN NOT TO BE SUSTAINED. MANAGEMENT HAS DETERMINED THAT THE COMPANY HAD NO UNCERTAIN TAX POSITIONS THAT WOULD REQUIRE FINANCIAL STATEMENT RECOGNITION OR DISCLOSURE. THE COMPANY IS NO LONGER SUBJECT TO EXAMINATIONS BY TAXING JURISDICTIONS FOR PERIODS PRIOR TO JULY 31, 2022. PART XI, LINE 2D - OTHER ADJUSTMENTS: REVENUE ATTRIBUTABLE TO CONSOLIDATED ENTITY 167,055,696. PART XI, LINE 4B - OTHER ADJUSTMENTS: ELIMINATING ENTRIES 74,362. PART XII, LINE 2D - OTHER ADJUSTMENTS: EXPENSES ATTRIBUTABLE TO CONSOLIDATED ENTITY 92,302,539. PART XII, LINE 4B - OTHER ADJUSTMENTS: ELIMINATING ENTRIES 850,862. 0 1 0 THEODORE O WILL EXECUTIVE VICE PRESIDENT 0 524841 0 228272 0 78370 0 54428 0 71837 0 957748 0 46181 CLARE BRADLEY POLLET MD DIRECTOR 0 342646 0 154256 0 62543 0 53548 0 3705 0 616698 0 35702 ALAN WOGHIN DIRECTOR 0 248672 0 117592 0 64532 0 43238 0 51923 0 525957 0 55316 MATTHEW W ROBERTS DIRECTOR 0 227687 0 49397 0 768 0 13968 0 43231 0 335051 0 0 CECILIA RAMOS EXECUTIVE DIRECTOR 0 164853 0 9043 0 306 0 7423 0 19412 0 201037 0 0 PART I, LINE 3 THE EXECUTIVE DIRECTOR'S COMPENSATION IS DETERMINED BY ISLAND PEER REVIEW ORGANIZATION'S BOARD OF DIRECTORS. THE BOARD REGULARLY USES EXTERNAL DATA FOR COMPARISONS AND CONTRACTS. MEMBERS OF THE BOARD ARE INFORMED OF SALARY INCREASE RECOMMENDATIONS, WHICH THEY REVIEW, DISCUSS, AND APPROVE. SALARY INCREASES ARE THEN IMPLEMENTED. CONTEMPORANEOUS SUBSTANTIATION OF THE DELIBERATIONS AND DECISIONS ARE MAINTAINED. PART I, LINE 4B EXECUTIVE VICE PRESIDENT, THEODORE O. WILL, DIRECTOR, CLARE BRADLEY POLLET, AND DIRECTOR, ALAN WOGHIN, ARE EMPLOYEES OF A RELATED ORGANIZATION, ISLAND PEER REVIEW ORGANIZATION, INC. (IPRO) THROUGH WHICH THEY PARTICIPATE IN A SUPPLEMENTAL NONQUALIFIED RETIREMENT PLAN. THE AMOUNTS CONTRIBUTED BY IPRO ON THEIR BEHALF IN CALENDAR YEAR 2024 ARE: THEODORE O. WILL: $23,400; CLARE BRADLEY POLLET, MD: $29,320; ALAN WOGHIN: $26,000. THESE AMOUNTS ARE INCLUDED IN THE AMOUNTS REPORTED IN COLUMN (C). THE AMOUNT OF DISTRIBUTION RECEIVED FROM THE NONQUALIFIED RETIREMENT PLAN IN CALENDAR YEAR 2024 IS: THEODORE O. WILL: $46,181; CLARE BRADLEY POLLET: $35,702; ALAN WOGHIN: $55,316. THESE AMOUNTS ARE INCLUDED IN THE AMOUNTS REPORTED IN COLUMN (B)(III). CASH, CONTRACT SERVICES RECEIVABLE, AND PREPAID EXPENSES 2025-07-31 2192763 BOOK VALUE 112662689 ISLAND PEER REVIEW ORGANIZATION INC 1979 MARCUS AVENUE SUITE 105 NEW HYDE PARK NY 11042 501(C)(3) 1 1 0 0 1 1 1 1 0 PART I, LINE 2E: PERSON(S) INVOLVED: THEODORE O. WILL; CLARE BRADLEY POLLET, MD; ALAN WOGHIN; MATTHEW W. ROBERTS; JOHN A. FRIEDMAN, MD; PAUL J. ROWLAND PART I, LINE 2E: EXPLANATION OF INVOLVEMENT: THE RECIPIENT ORGANIZATION IS THE SOLE MEMBER AND PARENT ORGANIZATION OF THE DISSOLVED ENTITY. UPON DISSOLUTION, SUBSTANTIALLY ALL REMAINING ASSETS WERE TRANSFERRED TO THE PARENT ORGANIZATION IN SETTLEMENT OF INTERCOMPANY OBLIGATIONS. THE PARENT ORGANIZATION IS THE SUCCESSOR ORGANIZATION TO THE DISSOLVED ENTITY.THE FOLLOWING INDIVIDUALS REPORTED IN PART VII OF FORM 990 SERVED AS EMPLOYEES OR MEMBERS OF THE BOARD OF DIRECTORS OF THE RECIPIENT ORGANIZATION DURING THE TAX YEAR:- THEODORE O. WILL - EMPLOYEE - CLARE BRADLEY POLLET, MD - EMPLOYEE - ALAN WOGHIN - EMPLOYEE - MATTHEW W. ROBERTS - EMPLOYEE - JOHN A. FRIEDMAN, MD - BOARD DIRECTOR- PAUL J. ROWLAND - BOARD DIRECTOR PART I, LINE 1: UPON DISSOLUTION, THE ORGANIZATION TRANSFERRED SUBSTANTIALLY ALL OF ITS REMAINING ASSETS, CONSISTING PRIMARILY OF CASH, CONTRACT SERVICES RECEIVABLE, AND PREPAID EXPENSES, WITH AN AGGREGATE FAIR MARKET VALUE OF $2,192,763, TO ITS RELATED ORGANIZATION. AT THE TIME OF DISSOLUTION, THE ORGANIZATION HAD TOTAL LIABILITIES OF $5,907,972, INCLUDING ACCOUNTS PAYABLE AND ACCRUED EXPENSES, ACCRUED COMPENSATION, NOTES PAYABLE TO RELATED PARTIES, AND INTERCOMPANY PAYABLES DUE TO AFFILIATES. THE TRANSFER OF ASSETS WAS MADE IN SETTLEMENT OF OUTSTANDING INTERCOMPANY BALANCES AND OBLIGATIONS OWED TO THE RELATED ORGANIZATION. NO NET ASSETS REMAINED AVAILABLE FOR DISTRIBUTION FOLLOWING SATISFACTION AND SETTLEMENT OF LIABILITIES. FORM 990, PART III, LINE 3 DURING THE TAX YEAR, THE ORGANIZATION CEASED ALL OPERATIONS AND COMPLETED THE DISSOLUTION PROCESS IN ACCORDANCE WITH APPLICABLE STATE LAWS. AS A RESULT, ALL PROGRAM ACTIVITIES WERE TERMINATED, AND THE ORGANIZATION'S REMAINING ASSETS WERE DISTRIBUTED IN ACCORDANCE WITH ITS GOVERNING DOCUMENTS AND APPLICABLE FEDERAL AND STATE REQUIREMENTS. FORM 990, PART IV, LINES 13 & 14: THE REPORTING ORGANIZATION HAS ADOPTED THE WHISTLEBLOWER AND DOCUMENT RETENTION AND DESTRUCTION POLICIES OF ITS SOLE MEMBER, ISLAND PEER REVIEW ORGANIZATION, INC. FORM 990, PART VI, SECTION A, LINE 6 ISLAND PEER REVIEW ORGANIZATION, INC. ("IPRO") IS THE SOLE MEMBER OF LUMETRA HEALTHCARE SOLUTIONS. FORM 990, PART VI, SECTION A, LINE 7A AS THE SOLE MEMBER OF LUMETRA HEALTHCARE SOLUTIONS, IPRO HAS THE AUTHORITY TO ELECT THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 11B THE ORGANIZATION HAS ITS FORM 990 PREPARED BY AN OUTSIDE ACCOUNTING FIRM. THE CFO, VP - OPERATIONS AND EXECUTIVE DIRECTOR REVIEWS THE FORM 990 BEFORE SENDING THE RETURN TO THE FINANCE COMMITTEE FOR REVIEW. THE FINAL FORM 990 IS PRESENTED TO THE FINANCE COMMITTEE AND THEN DISTRIBUTED TO THE ENTIRE BOARD OF DIRECTORS BEFORE IT IS FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION CURRENTLY HAS IN PLACE A CONFLICT OF INTEREST POLICY THAT APPLIES TO ALL OFFICERS, DIRECTORS, AND OTHER KEY PERSONS, WHICH IT ANNUALLY MONITORS AND ENFORCES. THE BOARD MANDATES THAT ALL KEY PERSONS COMPLETE A FINANCIAL DISCLOSURE FORM ANNUALLY AND DISCLOSE ANY POTENTIAL OR ACTUAL CONFLICTS THAT MAY EXIST. THE COMPLETED FINANCIAL DISCLOSURE FORM MUST BE SUBMITTED TO THE SECRETARY. IN CONNECTION WITH ANY ACTUAL OR POSSIBLE CONFLICT OF INTEREST, AN INTERESTED PERSON MUST DISCLOSE THE EXISTENCE OF SUCH INTEREST AND BE GIVEN THE OPPORTUNITY TO DISCLOSE ALL MATERIAL FACTS TO THE BOARD. AN INTERESTED PERSON MAY MAKE A PRESENTATION AT THE BOARD MEETING TO ANSWER ANY QUESTIONS, BUT AFTER THE PRESENTATION, HE/SHE MUST LEAVE THE MEETING DURING THE DISCUSSION OF, AND THE VOTE ON, THE TRANSACTION OR ARRANGEMENT INVOLVING THE POSSIBLE CONFLICT OF INTEREST. THE REMAINING BOARD MEMBERS MUST DECIDE IF A CONFLICT OF INTEREST EXISTS. THE MINUTES OF THE BOARD AND ALL COMMITTEES WITH BOARD DELEGATED POWERS MUST CONTAIN: (I) THE TERMS APPROVED, (II) THE NAMES OF THOSE INDIVIDUALS WHO PARTICIPATED IN THE DISCUSSION AND VOTE ON THE TRANSACTION, (III) THE NAMES OF ANY INDIVIDUALS WHO WERE RECUSED FROM THE DISCUSSION AND VOTE, (IV) THE COMPARABILITY DATA OBTAINED AND RELIED UPON, (V) IF THE APPROVED TERMS DIFFER MATERIALLY FROM THOSE OF THE OBTAINED COMPARABILITY DATA, AN EXPLANATION OF THE BOARD OR AUTHORIZED BOARD COMMITTEE'S DETERMINATION THAT THE TRANSACTION WAS NEVERTHELESS APPROPRIATE, AND (VI) CONSIDERATION OF ANY ALTERNATIVE TRANSACTIONS. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION MAKES ITS GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. THE FORM 990 IS ALSO AVAILABLE ON GUIDESTAR.ORG AND OTHER SIMILAR TYPES OF WEBSITES. FORM 990, PART IX, LINE 11G PAYROLL SERVICE FEES 519. OTHER PROFESSIONAL FEES 630. PHYSICIAN ADVISORS 100,240. ISLAND PEER REVIEW ORGANIZATION INC 300 JERICHO QUADRANGLE SUITE 300 JERICHO NY 11753 112662689 HEALTHCARE PROGRAMS NY 501(C)(3) LINE 10 N/A 0 IPRO NATIONAL MEDICAL REVIEW LTD 300 JERICHO QUADRANGLE SUITE 300 JERICHO NY 11753 061169524 INACTIVE NY N/A C 0 0 0 0 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 0