Attach to Form 990 or Form 990-EZ.
Go to
www.irs.gov/Form990 for instructions and the latest information.
| (i) Name of supported organization | (ii) EIN | (iii) Type of organization (described on lines 1- 10 above (see instructions)) | (iv) Is the organization listed in your governing document? | (v) Amount of monetary support (see instructions) | (vi) Amount of other support (see instructions) | |
|---|---|---|---|---|---|---|
| Yes | No | |||||
|
Total |
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Calendar year
(or fiscal year beginning in)
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(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grant.") .. | ||||||
| 2 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf.... | ||||||
| 3 | The value of services or facilities furnished by a governmental unit to the organization without charge.. | ||||||
| 4 | Total. Add lines 1 through 3 | ||||||
| 5 | The portion of total contributions by each person (other than a governmental unit or publicly supported organization) included on line 1 that exceeds 2% of the amount shown on line 11, column (f) .. | ||||||
| 6 | Public support. Subtract line 5 from line 4. | ||||||
Calendar year
(or fiscal year beginning in)
![]() |
(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 7 | Amounts from line 4.. | ||||||
| 8 | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources... | ||||||
| 9 | Net income from unrelated business activities, whether or not the business is regularly carried on.. | ||||||
| 10 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.).. | ||||||
| 11 | Total support. Add lines 7 through 10 | ||||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 1 | Gifts, grants, contributions, and membership fees received. (Do not include any "unusual grants.") . | 400 | 1,249,304 | 2,024,076 | 1,118,636 | 311,698 | 4,704,114 |
| 2 | Gross receipts from admissions, merchandise sold or services performed, or facilities furnished in any activity that is related to the organization's tax-exempt purpose | 8,419,496 | 8,808,962 | 8,976,338 | 9,528,164 | 10,135,471 | 45,868,431 |
| 3 | Gross receipts from activities that are not an unrelated trade or business under section 513 ..... | ||||||
| 4 | Tax revenues levied for the organization's benefit and either paid to or expended on its behalf... | ||||||
| 5 | The value of services or facilities furnished by a governmental unit to the organization without charge | ||||||
| 6 | Total. Add lines 1 through 5 | 8,419,896 | 10,058,266 | 11,000,414 | 10,646,800 | 10,447,169 | 50,572,545 |
| 7a | Amounts included on lines 1, 2, and 3 received from disqualified persons | 0 | |||||
| b | Amounts included on lines 2 and 3 received from other than disqualified persons that exceed the greater of $5,000 or 1% of the amount on line 13 for the year. | 0 | |||||
| c | Add lines 7a and 7b.. | 0 | |||||
| 8 | Public support. (Subtract line 7c from line 6.) | 50,572,545 | |||||
Calendar year (or fiscal year beginning in) ![]() |
(a) 2017 | (b) 2018 | (c) 2019 | (d) 2020 | (e) 2021 | (f) Total | |
|---|---|---|---|---|---|---|---|
| 9 | Amounts from line 6... | 8,419,896 | 10,058,266 | 11,000,414 | 10,646,800 | 10,447,169 | 50,572,545 |
| 10a | Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources.. | 1,368 | 1,646 | 8,297 | 25,048 | 8,316 | 44,675 |
| b | Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975. | ||||||
| c | Add lines 10a and 10b. | 1,368 | 1,646 | 8,297 | 25,048 | 8,316 | 44,675 |
| 11 | Net income from unrelated business activities not included on line 10b, whether or not the business is regularly carried on. | ||||||
| 12 | Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) .. | 5,001 | 6,000 | 9,957 | 20,958 | ||
| 13 | Total support. (Add lines 9, 10c, 11, and 12.).. | 8,426,265 | 10,065,912 | 11,008,711 | 10,671,848 | 10,465,442 | 50,638,178 |
| Section A - Adjusted Net Income | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Net short-term capital gain | 1 | ||||
| 2 | Recoveries of prior-year distributions | 2 | ||||
| 3 | Other gross income (see instructions) | 3 | ||||
| 4 | Add lines 1 through 3 | 4 | ||||
| 5 | Depreciation and depletion | 5 | ||||
| 6 | Portion of operating expenses paid or incurred for production or collection of gross income or for management, conservation, or maintenance of property held for production of income (see instructions) | 6 | ||||
| 7 | Other expenses (see instructions) | 7 | ||||
| 8 | Adjusted Net Income (subtract lines 5, 6 and 7 from line 4) | 8 | ||||
| Section B - Minimum Asset Amount | (A) Prior Year |
(B) Current Year (optional) |
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| 1 | Aggregate fair market value of all non-exempt-use assets (see instructions for short tax year or assets held for part of year): | 1 | ||||
| a | Average monthly value of securities | 1a | ||||
| b | Average monthly cash balances | 1b | ||||
| c | Fair market value of other non-exempt-use assets | 1c | ||||
| d | Total (add lines 1a, 1b, and 1c) | 1d | ||||
| e |
Discount claimed for blockage or other factors (explain in detail in Part VI): |
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| 2 | Acquisition indebtedness applicable to non-exempt use assets | 2 | ||||
| 3 | Subtract line 2 from line 1d | 3 | ||||
| 4 | Cash deemed held for exempt use. Enter 0.015 of line 3 (for greater amount, see instructions). | 4 | ||||
| 5 | Net value of non-exempt-use assets (subtract line 4 from line 3) | 5 | ||||
| 6 | Multiply line 5 by 0.035 | 6 | ||||
| 7 | Recoveries of prior-year distributions | 7 | ||||
| 8 | Minimum Asset Amount (add line 7 to line 6) | 8 | ||||
| Section C - Distributable Amount | Current Year | |||||
| 1 | Adjusted net income for prior year (from Section A, line 8, Column A) | 1 | ||||
| 2 | Enter 85% of line 1 | 2 | ||||
| 3 | Minimum asset amount for prior year (from Section B, line 8, Column A) | 3 | ||||
| 4 | Enter greater of line 2 or line 3 | 4 | ||||
| 5 | Income tax imposed in prior year | 5 | ||||
| 6 | Distributable Amount. Subtract line 5 from line 4, unless subject to emergency temporary reduction (see instructions) | 6 | ||||
| Section D - Distributions | Current Year | |
|---|---|---|
| 1 Amounts paid to supported organizations to accomplish exempt purposes | 1 | |
|
2
Amounts paid to perform activity that directly furthers exempt purposes of supported organizations, in excess of income from activity |
2 | |
| 3 Administrative expenses paid to accomplish exempt purposes of supported organizations | 3 | |
| 4 Amounts paid to acquire exempt-use assets | 4 | |
| 5 Qualified set-aside amounts (prior IRS approval required - provide details in Part VI) | 5 | |
| 6 Other distributions (describe in Part VI). See instructions | 6 | |
| 7Total annual distributions. Add lines 1 through 6. | 7 | |
|
8
Distributions to attentive supported organizations to which the organization is responsive (provide details in Part VI). See instructions |
8 | |
| 9 Distributable amount for 2021 from Section C, line 6 | 9 | |
| 10 Line 8 amount divided by Line 9 amount | 10 | |
| Section E - Distribution Allocations (see instructions) |
(i) Excess Distributions |
(ii) Underdistributions Pre-2021 |
(iii) Distributable Amount for 2021 |
|
|---|---|---|---|---|
| 1 Distributable amount for 2021 from Section C, line 6 | ||||
|
2
Underdistributions, if any, for years prior to 2021 (reasonable cause required-- explain in Part VI). See instructions. |
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| 3 Excess distributions carryover, if any, to 2021: | ||||
| a From 2016....... | ||||
| b From 2017....... | ||||
| c From 2018....... | ||||
| d From 2019....... | ||||
| e From 2020....... | ||||
| fTotal of lines 3a through e | ||||
| g Applied to underdistributions of prior years | ||||
| h Applied to 2021 distributable amount | ||||
|
i
Carryover from 2016 not applied (see instructions) |
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| j Remainder. Subtract lines 3g, 3h, and 3i from line 3f. | ||||
| 4Distributions for 2021 from Section D, line 7: | ||||
| $ | ||||
| a Applied to underdistributions of prior years | ||||
| b Applied to 2021 distributable amount | ||||
| c Remainder. Subtract lines 4a and 4b from line 4. | ||||
|
5
Remaining underdistributions for years prior to 2021, if any. Subtract lines 3g and 4a from line 2. If the amount is greater than zero, explain in Part VI. See instructions. |
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|
6
Remaining underdistributions for 2021. Subtract lines 3h and 4b from line 1. If the amount is greater than zero, explain in Part VI. See instructions. |
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7 Excess distributions carryover to 2022. Add lines 3j and 4c. |
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| 8 Breakdown of line 7: | ||||
| a Excess from 2017..... | ||||
| b Excess from 2018..... | ||||
| c Excess from 2019..... | ||||
| d Excess from 2020..... | ||||
| e Excess from 2021..... | ||||
| Facts And Circumstances Test |
|---|
| Return Reference | Explanation |
|---|---|
| SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: | REFUNDS - 2017 AMOUNT: $ 5,001. 2018 AMOUNT: $ 6,000. 2021 AMOUNT: $ 9,957. |
| Software ID: | |
| Software Version: |
Attach to Form 990 or 990-EZ.
Go to www.irs.gov/Form990 for the latest information.
| Return Reference | Explanation |
|---|---|
| FORM 990, PART VI, SECTION A, LINE 6 | THE MEMBERSHIP OF STARNET EMERGENCY INC. CONSISTS SOLELY OF HEALTHSTAR NETWORK INC. D/B/A STELLARIS HEALTH NETWORK (THE "MEMBER"). |
| FORM 990, PART VI, SECTION A, LINE 7A | STARNET EMERGENCY SERVICES INC. IS AN AFFILIATE AND DIRECT SUBSIDIARY OF HEALTHSTAR NETWORK INC. D/B/A STELLARIS HEALTH NETWORK. EVERY MEMBER OF THE STARNET EMERGENCY SERVICES INC.'S BOARD OF DIRECTORS (GOVERNING BODY) SERVES AT THE DETERMINATION OF THE HEALTHSTAR NETWORK INC. AND ITS DISCRETION. |
| FORM 990, PART VI, SECTION A, LINE 7B | THE SOLE MEMBER, HEALTHSTAR NETWORK INC. SHALL APPROVE THE FOLLOWING DECISIONS: 1. THE ORGANIZATION'S OPERATING AND CAPITAL BUDGETS 2. AMENDMENTS TO THE BYLAWS OR THE CERTIFICATE OF INCORPORATION OF THE ORGANIZATION 3. ANY ASSUMPTION OF DEBT OF THE ORGANIZATION OVER $1 MILLION, WHICH SHALL BE DETERMINED IN THE AGGREGATE. |
| FORM 990, PART VI, SECTION A, LINE 8B | THERE ARE NO COMMITTEES TO ACT ON BEHALF OF THE GOVERNING BODY. |
| FORM 990, PART VI, SECTION B, LINE 11B | A COPY OF THE FORM 990 WAS PROVIDED TO EACH OF STARNET'S BOARD OF DIRECTORS AS WELL AS THE SOLE MEMBER. THE FORM 990 WAS REVIEWED BY EACH INDIVIDUAL FOR COMPLETENESS AND ACCURACY AND COMMENTS WERE PROVIDED TO THE ORGANIZATION'S TAX PREPARER. A COPY OF THE FINAL 990 WAS DISTRIBUTED VIA EMAIL TO EACH BOARD MEMBER PRIOR TO FILING. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE CONFLICT OF INTEREST POLICY IS APPLICABLE TO ALL BOARD MEMBERS, OFFICERS, AND KEY EMPLOYEES OF THE ORGANIZATION. ANY PERSON WHO BELIEVES THAT HE OR SHE HAS AN INTEREST THAT CREATES A CONFLICT WITH HIS OR HER ROLE AS A DIRECTOR OR OFFICER OF THE CORPORATION SHALL BE OBLIGATED TO DISCLOSE HIS OR HER INTEREST TO THE PRESIDENT OF BOARD OF DIRECTORS IN GOOD FAITH IN WRITING, AND PRIOR TO ANY ACTION BY THE BOARD OR COMMITTEE, THE MATERIAL FACTS CONCERNING SUCH INTEREST TO THE BOARD OR SUCH COMMITTEE WITH RESPECT TO SUCH RELATED PARTY TRANSACTION. UPON DISCLOSURE OF AN INTEREST AND/OR RELATED PARTY TRANSACTION, THE BOARD OF DIRECTORS, OR A COMMITTEE THEREOF SHALL MEET TO DISCUSS THE NATURE OF THE INTEREST AND ITS POTENTIAL IMPACT ON THE CORPORATION. NO INDIVIDUAL SHALL PARTICIPATE IN DELIBERATIONS OR VOTING RELATING TO A POTENTIAL RELATED PARTY TRANSACTION PERTAINING TO HIS OR HER INTEREST, BUT MAY ANSWER QUESTIONS OR GIVE BACKGROUND INFORMATION TO THE BOARD OF DIRECTORS OF THE CORPORATION OR ANY COMMITTEE THEREOF, AS APPLICABLE. THE COMMITTEE SHALL MAKE A RECOMMENDATION TO THE FULL BOARD OF DIRECTORS, BASED UPON ITS FINDINGS, AS TO WHETHER THE INTERESTED DIRECTOR OR INTERESTED OFFICER HAS AN INTEREST THAT CREATES A CONFLICT WITH HIS OR HER INTEREST AS A DIRECTOR OR OFFICER OF THE CORPORATION. IF AN INTERESTED DIRECTOR IS A MEMBER OF THE DELIBERATING COMMITTEE, HE OR SHE SHALL NOT PARTICIPATE IN THE COMMITTEE'S DELIBERATIONS OR DETERMINATION OF ITS FINDINGS WITH RESPECT TO THE INTERESTED DIRECTOR'S INTEREST AND/OR THE RELATED PARTY TRANSACTION AT ISSUE, AND THE BOARD OF DIRECTORS MAY SELECT ANOTHER DIRECTOR TO TEMPORARILY REPLACE THE INTERESTED DIRECTOR ON THE COMMITTEE FOR THE PURPOSE OF REVIEWING THE SUCH INTEREST AND/OR RELATED PARTY TRANSACTION AND SHALL TEMPORARILY REPLACE SUCH DIRECTOR IF ABSENT THE INTERESTED DIRECTOR, THE NUMBER OF DIRECTORS ON THE COMMITTEE WOULD BE LESS THAN THREE. IN ORDER TO DETERMINE WHETHER ANY PARTICULAR TRANSACTION IS A RELATED PARTY TRANSACTION, EACH DIRECTOR, OFFICER AND KEY EMPLOYEE OF THE CORPORATION SHALL SUBMIT TO THE BOARD OF DIRECTORS THROUGH THE SECRETARY, PRIOR TO SUCH PERSON'S INITIAL ELECTION, APPOINTMENT OR EMPLOYMENT, AS THE CASE MAY BE, AND ANNUALLY THEREAFTER, A SIGNED WRITTEN STATEMENT IDENTIFYING, TO THE BEST OF SUCH PERSON'S KNOWLEDGE: (I) ANY ENTITY OF WHICH SUCH PERSON IS AN OFFICER, DIRECTOR, TRUSTEE, MEMBER, OWNER OR EMPLOYEE, AND WITH WHICH THE CORPORATION HAS A RELATIONSHIP; AND (II) ANY TRANSACTION IN WHICH THE CORPORATION IS A PARTICIPANT AND IN WHICH SUCH PERSON MIGHT HAVE A CONFLICTING INTEREST. |
| FORM 990, PART VI, SECTION B, LINE 15 | HEALTHSTAR NETWORK INC. D/B/A STELLARIS HEALTH NETWORK ENGAGES AN EXECUTIVE COMPENSATION CONSULTANT TO DETERMINE THE COMPENSATION THE EXECUTIVE DIRECTOR OF WESTCHESTER EMS. THE CONSULTANT'S ANALYSIS INCLUDES DATA OF COMPENSATION PAID BY COMPARABLE ORGANIZATIONS AND TO OFFICERS SIMILARLY SITUATED (WITH SAME FUNCTIONS/JOBS RESPONSIBILITIES). COMPENSATION IS THEN REVIEWED, APPROVED AND DOCUMENTED BY A SEPARATE COMPENSATION COMMITTEE. DETERMINATION WAS DOCUMENTED IN A LETTER STATING THE SET COMPENSATION. OTHER THAN THIS INDIVIDUAL, HEALTHSTAR NETWORK INC. D/B/A STELLARIS HEALTH NETWORK DOES NOT HAVE ANY KEY EMPLOYEES AS DEFINED BY THE INTERNAL REVENUE SERVICE. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION MAKES ITS FORM 990 AND FORM 1023 AVAILABLE TO THE PUBLIC BY RETAINING A COPY OF EACH AT THE ADDRESS LISTED ON PAGE ONE OF THIS RETURN. ANY INDIVIDUAL REQUESTING A COPY OF THESE DOCUMENTS IS PROVIDED THAT COPY ON THE SAME BUSINESS DAY. THE ORGANIZATION'S GOVERNING DOCUMENTS AND CONFLICT OF INTEREST POLICY AND CONSOLIDATED FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST AND AT MANAGEMENT'S DISCRETION. |
| FORM 990, PART XII, LINE 2C: | THE SOLE MEMBER, HEALTHSTAR NETWORK INC. D/B/A STELLARIS HEALTH NETWORK, AUDIT COMMITTEE SHALL MONITOR THE ACCOUNTING AFFAIRS OF THE CORPORATION, AS FOLLOWS: (I) OVERSEE THE ACCOUNTING AND FINANCIAL REPORTING PROCESSES OF THE CORPORATION AND THE AUDIT OF THE CORPORATION'S FINANCIAL STATEMENTS; (II) ANNUALLY RETAIN OR RENEW THE RETENTION OF AN INDEPENDENT AUDITOR TO CONDUCT THE AUDIT OF THE CORPORATION'S FINANCIAL STATEMENTS AND, UPON COMPLETION THEREOF, REVIEW THE RESULTS OF THE AUDIT AND ANY RELATED MANAGEMENT LETTER WITH THE INDEPENDENT AUDITOR; |
| FORM 990, PART VI, LINES 13 AND 14: | THE ORGANIZATION OPERATES UNDER THE WHISTLEBLOWER POLICY AND DOCUMENT RETENTION POLICY OF ITS PARENT ORGANIZATION, HEALTHSTAR NETWORK INC. D/B/A STELLARIS HEALTH NETWORK INC. |
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