TY 2021 Form 990

(A) Name and business address	(B) Description of services	(C) Compensation
UNIVERSITY OF CHICAGO 950 E 61ST ST CHICAGO,IL606372644	PHYSICIAN SERVICES	1,153,556
MARTIN G LUKEN III MD SC 3400 N LAKE SHORE DR APT 4B CHICAGO,IL60657	NEUROSURGERY	400,000
MIDWEST NEUROLOGY ASSOCIATES PC 1100 JOLIET ST 201 DYER,IN46311	NEUROLOGY	351,250
PHYSICIAN CARE MIDWEST SC 2821 83RD ST DARIEN,IL60561	MEDICAL SERVICES	251,125
PMJ PRECISION NETWORK INC 4522 S PRAIRIE AVE CHICAGO,IL60653	OBSTETRICS AND GYNECOLOGY	205,920
2 Total number of independent contractors (including but not limited to those listed above) who received more than $100,000 of compensation from the organization 10

- TIN:

SCHEDULE A
(Form 990)

Department of the Treasury
Internal Revenue Service

Public Charity Status and Public Support

Complete if the organization is a section 501(c)(3) organization or a section 4947(a)(1) nonexempt charitable trust.
right arrow

Attach to Form 990 or Form 990-EZ.
right arrow

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public
Inspection

Name of the organization

Primary Healthcare Associates SC

Employer identification number

36-4132865

Part I

Reason for Public Charity Status (All organizations must complete this part.) See instructions.

The organization is not a private foundation because it is: (For lines 1 through 12, check only one box.)

A church, convention of churches, or association of churches described in section 170(b)(1)(A)(i).

A school described in section 170(b)(1)(A)(ii). (Attach Schedule E (Form 990).)

A hospital or a cooperative hospital service organization described in section 170(b)(1)(A)(iii).

A medical research organization operated in conjunction with a hospital described in section 170(b)(1)(A)(iii). Enter the hospital's name, city, and state:

An organization operated for the benefit of a college or university owned or operated by a governmental unit described in section 170(b)(1)(A)(iv). (Complete Part II.)

A federal, state, or local government or governmental unit described in section 170(b)(1)(A)(v).

An organization that normally receives a substantial part of its support from a governmental unit or from the general public described in section 170(b)(1)(A)(vi). (Complete Part II.)

A community trust described in section 170(b)(1)(A)(vi). (Complete Part II.)

An agricultural research organization described in 170(b)(1)(A)(ix) operated in conjunction with a land-grant college or university or a non-land grant college of agriculture. See instructions. Enter the name, city, and state of the college or university:

An organization that normally receives: (1) more than 33 1/3% of its support from contributions, membership fees, and gross receipts from activities related to its exempt functions—subject to certain exceptions, and (2) no more than 33 1/3% of its support from gross investment income and unrelated business taxable income (less section 511 tax) from businesses acquired by the organization after June 30, 1975. See section 509(a)(2). (Complete Part III.)

An organization organized and operated exclusively to test for public safety. See section 509(a)(4).

An organization organized and operated exclusively for the benefit of, to perform the functions of, or to carry out the purposes of one or more publicly supported organizations described in section 509(a)(1) or section 509(a)(2). See section 509(a)(3). Check the box on lines 12a through 12d that describes the type of supporting organization and complete lines 12e, 12f, and 12g.

Type I. A supporting organization operated, supervised, or controlled by its supported organization(s), typically by giving the supported organization(s) the power to regularly appoint or elect a majority of the directors or trustees of the supporting organization. You must complete Part IV, Sections A and B.

Type II. A supporting organization supervised or controlled in connection with its supported organization(s), by having control or management of the supporting organization vested in the same persons that control or manage the supported organization(s). You must complete Part IV, Sections A and C.

Type III functionally integrated. A supporting organization operated in connection with, and functionally integrated with, its supported organization(s) (see instructions). You must complete Part IV, Sections A, D, and E.

Type III non-functionally integrated. A supporting organization operated in connection with its supported organization(s) that is not functionally integrated. The organization generally must satisfy a distribution requirement and an attentiveness requirement (see instructions). You must complete Part IV, Sections A and D, and Part V.

Check this box if the organization received a written determination from the IRS that it is a Type I, Type II, Type III functionally integrated, or Type III non-functionally integrated supporting organization.

Enter the number of supported organizations ...............................

Provide the following information about the supported organization(s).

(i) Name of supported organization	(ii) EIN	(iv) Is the organization listed in your governing document?		(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)
(i) Name of supported organization	(ii) EIN	Yes	No	(v) Amount of monetary support (see instructions)	(vi) Amount of other support (see instructions)


Total

For Paperwork Reduction Act Notice, see the Instructions for
Form 990 or 990-EZ.

Cat. No. 11285F

Schedule A (Form 990) 2021

Page 2

Part II

Support Schedule for Organizations Described in Sections 170(b)(1)(A)(iv) and 170(b)(1)(A)(vi)
(Complete only if you checked the box on line 5, 7, or 8 of Part I or if the organization failed to qualify under Part III. If the organization failed to qualify under the tests listed below, please complete Part III.)

Section A. Public Support

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 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.

Section B. Total Support

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

Gross receipts from related activities, etc. (see instructions) ..................

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization, check this box and stop here ........................................ right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2021 (line 6, column (f) divided by line 11, column (f)) .........

Public support percentage for 2020 Schedule A, Part II, line 14 ...............

16a

33 1/3% support test—2021. If the organization did not check the box on line 13, and line 14 is 33 1/3 % or more, check this box
and stop here. The organization qualifies as a publicly supported organization ....................... right arrow

33 1/3% support test—2020. If the organization did not check a box on line 13 or 16a, and line 15 is 33 1/3% or more, check this
box and stop here. The organization qualifies as a publicly supported organization ..................... right arrow

17a

10%-facts-and-circumstances test—2021. If the organization did not check a box on line 13, 16a, or 16b, and line 14
is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here. Explain
in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly supported
organization ..................................................... right arrow

10%-facts-and-circumstances test—2020. If the organization did not check a box on line 13, 16a, 16b, or 17a, and line
15 is 10% or more, and if the organization meets the "facts-and-circumstances" test, check this box and stop here.
Explain in Part VI how the organization meets the "facts-and-circumstances" test. The organization qualifies as a publicly
supported organization ................................................ right arrow

Private foundation. If the organization did not check a box on line 13, 16a, 16b, 17a, or 17b, check this box and see
instructions ..................................................... right arrow

Schedule A (Form 990) 2021

Page 3

Part III

Support Schedule for Organizations Described in Section 509(a)(2)
(Complete only if you checked the box on line 10 of Part I or if the organization failed to qualify under Part II. If the organization fails to qualify under the tests listed below, please complete Part II.)

Section A. Public Support

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.") .				1,092,744	1,185,197	2,277,941
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	15,734,290	20,121,906	22,111,339	20,150,440	25,154,773	103,272,748
3	Gross receipts from activities that are not an unrelated trade or business under section 513 .....						0
4	Tax revenues levied for the organization's benefit and either paid to or expended on its behalf...						0
5	The value of services or facilities furnished by a governmental unit to the organization without charge						0
6	Total. Add lines 1 through 5	15,734,290	20,121,906	22,111,339	21,243,184	26,339,970	105,550,689
7a	Amounts included on lines 1, 2, and 3 received from disqualified persons	0	0	0	0	0	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	0	0	0	0	0
c	Add lines 7a and 7b..	0	0	0	0	0	0
8	Public support. (Subtract line 7c from line 6.)						105,550,689

Section B. Total Support

Calendar year (or fiscal year beginning in)		(a) 2017	(b) 2018	(c) 2019	(d) 2020	(e) 2021	(f) Total
9	Amounts from line 6...	15,734,290	20,121,906	22,111,339	21,243,184	26,339,970	105,550,689
10a	Gross income from interest, dividends, payments received on securities loans, rents, royalties and income from similar sources..						0
b	Unrelated business taxable income (less section 511 taxes) from businesses acquired after June 30, 1975.						0
c	Add lines 10a and 10b.	0	0	0	0	0	0
11	Net income from unrelated business activities not included on line 10b, whether or not the business is regularly carried on.						0
12	Other income. Do not include gain or loss from the sale of capital assets (Explain in Part VI.) ..	0	0	0	0	0	0
13	Total support. (Add lines 9, 10c, 11, and 12.)..	15,734,290	20,121,906	22,111,339	21,243,184	26,339,970	105,550,689

First 5 years. If the Form 990 is for the organization's first, second, third, fourth, or fifth tax year as a section 501(c)(3) organization,
check this box and stop here............................................. right arrow

Section C. Computation of Public Support Percentage

Public support percentage for 2021 (line 8, column (f) divided by line 13, column (f)) .........

100 %

Public support percentage from 2020 Schedule A, Part III, line 15 ...............

100 %

Section D. Computation of Investment Income Percentage

Investment income percentage for 2021 (line 10c, column (f) divided by line 13, column (f)) ......

0 %

Investment income percentage from 2020 Schedule A, Part III, line 17 .............

0 %

19a

331/3% support tests—2021. If the organization did not check the box on line 14, and line 15 is more than 33 1/3%, and line 17 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization ....... right arrow

33 1/3% support tests—2020. If the organization did not check a box on line 14 or line 19a, and line 16 is more than 33 1/3% and line 18 is not more than 33 1/3%, check this box and stop here. The organization qualifies as a publicly supported organization .... right arrow

Private foundation. If the organization did not check a box on line 14, 19a, or 19b, check this box and see instructions .... right arrow

Schedule A (Form 990) 2021

Page 4

Part IV

Supporting Organizations

(Complete only if you checked a box on line 12 of Part I. If you checked box 12a, of Part I, complete Sections A and B. If you checked box 12b, of Part I, complete Sections A and C. If you checked box 12c, of Part I, complete Sections A, D, and E. If you checked box12d, of Part I, complete Sections A and D, and complete Part V.)

Section A. All Supporting Organizations

Yes

Are all of the organization’s supported organizations listed by name in the organization’s governing documents?
If "No," describe in Part VI how the supported organizations are designated. If designated by class or purpose,
describe the designation. If historic and continuing relationship, explain.

Did the organization have any supported organization that does not have an IRS determination of status under section 509(a)(1) or (2)? If "Yes," explain in Part VI how the organization determined that the supported organization was described in section 509(a)(1) or (2).

Did the organization have a supported organization described in section 501(c)(4), (5), or (6)? If "Yes," answer lines 3b and 3c below.

Did the organization confirm that each supported organization qualified under section 501(c)(4), (5), or (6) and satisfied the public support tests under section 509(a)(2)? If "Yes," describe in Part VI when and how the organization made the determination.

Did the organization ensure that all support to such organizations was used exclusively for section 170(c)(2)(B) purposes? If "Yes," explain in Part VI what controls the organization put in place to ensure such use.

Was any supported organization not organized in the United States ("foreign supported organization")? If “Yes” and if you checked box 12a or 12b in Part I, answer lines 4b and 4c below.

Did the organization have ultimate control and discretion in deciding whether to make grants to the foreign supported organization? If “Yes,” describe in Part VI how the organization had such control and discretion despite being controlled or supervised by or in connection with its supported organizations.

Did the organization support any foreign supported organization that does not have an IRS determination under sections 501(c)(3) and 509(a)(1) or (2)? If “Yes,” explain in Part VI what controls the organization used to ensure that all support to the foreign supported organization was used exclusively for section 170(c)(2)(B) purposes.

Did the organization add, substitute, or remove any supported organizations during the tax year? If “Yes,” answer lines 5b and 5c below (if applicable). Also, provide detail in Part VI, including (i) the names and EIN numbers of the supported organizations added, substituted, or removed; (ii) the reasons for each such action; (iii) the authority under the organization's organizing document authorizing such action; and (iv) how the action was accomplished (such as by amendment to the organizing document).

Type I or Type II only. Was any added or substituted supported organization part of a class already designated in the organization's organizing document?

Substitutions only. Was the substitution the result of an event beyond the organization's control?

Did the organization provide support (whether in the form of grants or the provision of services or facilities) to anyone other than (i) its supported organizations, (ii) individuals that are part of the charitable class benefited by one or more of its supported organizations, or (iii) other supporting organizations that also support or benefit one or more of the filing organization’s supported organizations? If “Yes,” provide detail in Part VI.

Did the organization provide a grant, loan, compensation, or other similar payment to a substantial contributor (defined in section 4958(c)(3)(C)), a family member of a substantial contributor, or a 35% controlled entity with regard to a substantial contributor? If “Yes,” complete Part I of Schedule L (Form 990) .

Did the organization make a loan to a disqualified person (as defined in section 4958) not described on line 7? If “Yes,” complete Part I of Schedule L (Form 990).

Was the organization controlled directly or indirectly at any time during the tax year by one or more disqualified persons, as defined in section 4946 (other than foundation managers and organizations described in section 509(a)(1) or (2))? If “Yes,” provide detail in Part VI.

Did one or more disqualified persons (as defined on line 9a) hold a controlling interest in any entity in which the supporting organization had an interest? If “Yes,” provide detail in Part VI.

Did a disqualified person (as defined on line 9a) have an ownership interest in, or derive any personal benefit from, assets in which the supporting organization also had an interest? If “Yes,” provide detail in Part VI.

10a

Was the organization subject to the excess business holdings rules of section 4943 because of section 4943(f) (regarding certain Type II supporting organizations, and all Type III non-functionally integrated supporting organizations)? If “Yes,” answer line 10b below.

10a

Did the organization have any excess business holdings in the tax year? (Use Schedule C, Form 4720, to determine whether the organization had excess business holdings).

10b

Schedule A (Form 990) 2021

Page 5

Part IV

Supporting Organizations (continued)

Yes

Has the organization accepted a gift or contribution from any of the following persons?

A person who directly or indirectly controls, either alone or together with persons described on lines 11b and 11c below, the governing body of a supported organization?

11a

A family member of a person described on 11a above?

11b

A 35% controlled entity of a person described on line 11a or 11b above? If “Yes” to 11a, 11b, or 11c, provide detail in Part VI.

11c

Section B. Type I Supporting Organizations

Yes

Did the officers, directors, trustees, or membership of one or more supported organizations have the power to regularly appoint or elect at least a majority of the organization’s directors or trustees at all times during the tax year? If “No,” describe in Part VI how the supported organization(s) effectively operated, supervised, or controlled the organization’s activities. If the organization had more than one supported organization, describe how the powers to appoint and/or remove directors or trustees were allocated among the supported organizations and what conditions or restrictions, if any, applied to such powers during the tax year.

Did the organization operate for the benefit of any supported organization other than the supported organization(s) that operated, supervised, or controlled the supporting organization? If “Yes,” explain in Part VI how providing such benefit carried out the purposes of the supported organization(s) that operated, supervised or controlled the supporting organization.

Section C. Type II Supporting Organizations

Yes

Were a majority of the organization’s directors or trustees during the tax year also a majority of the directors or trustees of each of the organization’s supported organization(s)? If “No,” describe in Part VI how control or management of the supporting organization was vested in the same persons that controlled or managed the supported organization(s).

Section D. All Type III Supporting Organizations

Yes

Did the organization provide to each of its supported organizations, by the last day of the fifth month of the organization’s tax year, (i) a written notice describing the type and amount of support provided during the prior tax year, (ii) a copy of the Form 990 that was most recently filed as of the date of notification, and (iii) copies of the organization’s governing documents in effect on the date of notification, to the extent not previously provided?

Were any of the organization’s officers, directors, or trustees either (i) appointed or elected by the supported organization(s) or (ii) serving on the governing body of a supported organization? If "No," explain in Part VI how the organization maintained a close and continuous working relationship with the supported organization(s).

By reason of the relationship described in line 2 above, did the organization’s supported organizations have a significant voice in the organization’s investment policies and in directing the use of the organization’s income or assets at all times during the tax year? If "Yes," describe in Part VI the role the organization’s supported organizations played in this regard.

Section E. Type III Functionally-Integrated Supporting Organizations

Check the box next to the method that the organization used to satisfy the Integral Part Test during the year (see instructions):

The organization satisfied the Activities Test. Complete line 2 below.

The organization is the parent of each of its supported organizations. Complete line 3 below.

The organization supported a governmental entity. Describe in Part VI how you supported a government entity (see instructions)

Activities Test. Answer lines 2a and 2b below.

Yes

Did substantially all of the organization’s activities during the tax year directly further the exempt purposes of the supported organization(s) to which the organization was responsive? If "Yes," then in Part VI identify those supported organizations and explain how these activities directly furthered their exempt purposes, how the organization was responsive to those supported organizations, and how the organization determined that these activities constituted substantially all of its activities.

Did the activities described on line 2a, above constitute activities that, but for the organization’s involvement, one or more of the organization’s supported organization(s) would have been engaged in? If "Yes," explain in Part VI the reasons for the organization’s position that its supported organization(s) would have engaged in these activities but for the organization’s involvement.

Parent of Supported Organizations. Answer lines 3a and 3b below.

Did the organization have the power to regularly appoint or elect a majority of the officers, directors, or trustees of each of the supported organizations?If "Yes" or "No", provide details in Part VI.

Did the organization exercise a substantial degree of direction over the policies, programs and activities of each of its supported organizations? If "Yes," describe in Part VI. the role played by the organization in this regard.

Schedule A (Form 990) 2021

Page 6

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations

Check here if the organization satisfied the Integral Part Test as a qualifying trust on Nov. 20, 1970 (explain in Part VI). See instructions. All other Type III non-functionally integrated supporting organizations must complete Sections A through E.

	Section A - Adjusted Net Income		(A) Prior Year	(B) Current Year (optional)
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)
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):
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

Check here if the current year is the organization's first as a non-functionally-integrated Type III supporting organization (see instructions)

Schedule A (Form 990) 2021

Page 7

Part V

Type III Non-Functionally Integrated 509(a)(3) Supporting Organizations(continued)

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.
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)
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.
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.
7 Excess distributions carryover to 2022. Add lines 3j and 4c.
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.....

Schedule A (Form 990) (2021)

Schedule A (Form 990) 2021

Page 8

Part VI

Supplemental Information. Provide the explanations required by Part II, line 10; Part II, line 17a or 17b; Part III, line 12; Part IV, Section A, lines 1, 2, 3b, 3c, 4b, 4c, 5a, 6, 9a, 9b, 9c, 11a, 11b, and 11c; Part IV, Section B, lines 1 and 2; Part IV, Section C, line 1; Part IV, Section D, lines 2 and 3; Part IV, Section E, lines 1c, 2a, 2b, 3a and 3b; Part V, line 1; Part V, Section B, line 1e; Part V Section D, lines 5, 6, and 8; and Part V, Section E, lines 2, 5, and 6. Also complete this part for any additional information. (See instructions).

Facts And Circumstances Test

Return Reference	Explanation

Schedule A (Form 990) 2021

Additional Data

Software ID:	21014044
Software Version:	2021v4.2

- TIN:

Schedule B
(Form 990)

Department of the Treasury
Internal Revenue Service

Schedule of Contributors

Attach to Form 990, 990-EZ, or 990-PF.

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2021

Name of the organization

Primary Healthcare Associates SC

Employer identification number

36-4132865

Organization type (check one):

Filers of:

Section:

Form 990 or 990-EZ

501(c)( ) (enter number) organization

4947(a)(1) nonexempt charitable trust not treated as a private foundation

527 political organization

Form 990-PF

501(c)(3) exempt private foundation

4947(a)(1) nonexempt charitable trust treated as a private foundation

501(c)(3) taxable private foundation

Check if your organization is covered by the General Rule or a Special Rule.
Note: Only a section 501(c)(7), (8), or (10) organization can check boxes for both the General Rule and a Special Rule. See instructions.

General Rule

For an organization filing Form 990, 990-EZ, or 990-PF that received, during the year, contributions totaling $5,000 or more (in money or other property) from any one contributor. Complete Parts I and II. See instructions for determining a contributor's total contributions.

Special Rules

For an organization described in section 501(c)(3) filing Form 990 or 990-EZ that met the 33¹/3% support test of the regulations
under sections 509(a)(1) and 170(b)(1)(A)(vi), that checked Schedule A (Form 990 or 990-EZ), Part II, line 13, 16a, or 16b, and that received from any one contributor, during the year, total contributions of the greater of (1) $5,000 or (2) 2% of the amount on (i) Form 990, Part VIII, line 1h, or (ii) Form 990-EZ, line 1. Complete Parts I and II.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, total contributions of more than $1,000 exclusively for religious, charitable, scientific, literary, or educational purposes, or for the prevention of cruelty to children or animals. Complete Parts I, II, and III.

For an organization described in section 501(c)(7), (8), or (10) filing Form 990 or 990-EZ that received from any one contributor,
during the year, contributions exclusively for religious, charitable, etc., purposes, but no such contributions totaled more than $1,000. If this box is checked, enter here the total contributions that were received during the year for an exclusively religious, charitable, etc., purpose. Don't complete any of the parts unless the General Rule applies to this organization because it received nonexclusively religious, charitable, etc., contributions totaling $5,000 or more during the year ......... Arrow Bullet

Caution: An organization that isn't covered by the General Rule and/or the Special Rules doesn't file Schedule B (Form 990,
990-EZ, or 990-PF), but it must answer “No” on Part IV, line 2, of its Form 990; or check the box on line H of its Form 990-EZ
or on its Form 990PF, Part I, line 2, to certify that it doesn't meet the filing requirements of Schedule B (Form 990,
990-EZ, or 990-PF).

For Paperwork Reduction Act Notice, see the Instructions
for Form 990, 990-EZ, or 990-PF.

Cat. No. 30613XSchedule B (Form 990) (2021)

Schedule B (Form 990) (2021) Page 2

Name of organization Primary Healthcare Associates SC

Part I Contributors	Contributors (see instructions). Use duplicate copies of Part I if additional space is needed.
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
RESTRICTED	,	$ RESTRICTED	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
(a) No.	(b) Name, address, and ZIP + 4	(c) Total contributions	(d) Type of contribution
		$	Person Payroll Noncash (Complete Part II for noncash contributions.)
Schedule B (Form 990) (2021)

Schedule B (Form 990) (2021)

Page 3

Name of organization Primary Healthcare Associates SC		Employer identification number 36-4132865

Part II	Noncash Property (see instructions). Use duplicate copies of Part II if additional space is needed.
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
(a) No. from Part I	(b) Description of noncash property given	(c) FMV (or estimate) (See instructions)	(d) Date received
		$
Schedule B (Form 990) (2021)

Schedule B (Form 990) (2021)

Page 4


Name of organization Primary Healthcare Associates SC			Employer identification number 36-4132865
Part III Exclusively religious, charitable, etc., contributions to organizations described in section 501(c)(7), (8), or (10) that total more than $1,000 for the year from any one contributor. Complete columns (a) through (e) and the following line entry. For organizations completing Part III, enter the total of exclusively religious, charitable, etc., contributions of $1,000 or less for the year. (Enter this information once. See instructions.) $ Use duplicate copies of Part III if additional space is needed.

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

(a)
No. from Part I

(b) Purpose of gift

(d) Description of how gift is held

(e) Transfer of gift
Transferee's name, address, and ZIP 4	Relationship of transferor to transferee

Schedule B (Form 990) (2021)

Additional Data

Software ID:	21014044
Software Version:	2021v4.2

- TIN:

SCHEDULE D
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Financial Statements

Complete if the organization answered "Yes," on Form 990,
Part IV, line 6, 7, 8, 9, 10, 11a, 11b, 11c, 11d, 11e, 11f, 12a, or 12b.
SchDMd Bullet

Attach to Form 990.
SchDMd Bullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

Primary Healthcare Associates SC

Employer identification number

36-4132865

Part I

Organizations Maintaining Donor Advised Funds or Other Similar Funds or Accounts. Complete if the organization answered "Yes" on Form 990, Part IV, line 6.

		(a) Donor advised funds	(b) Funds and other accounts
1	Total number at end of year .........
2	Aggregate value of contributions to (during year)
3	Aggregate value of grants from (during year)
4	Aggregate value at end of year ........

Did the organization inform all donors and donor advisors in writing that the assets held in donor advised funds are the organization’s property, subject to the organization’s exclusive legal control? ............

Yes No

Did the organization inform all grantees, donors, and donor advisors in writing that grant funds can be used only for charitable purposes and not for the benefit of the donor or donor advisor, or for any other purpose conferring impermissible private benefit? ...................................

Yes No

Part II

Conservation Easements.
Complete if the organization answered "Yes" on Form 990, Part IV, line 7.

Purpose(s) of conservation easements held by the organization (check all that apply).

Preservation of land for public use (e.g., recreation or education) Preservation of an historically important land area

Protection of natural habitat Preservation of a certified historic structure

Preservation of open space

Complete lines 2a through 2d if the organization held a qualified conservation contribution in the form of a conservation easement on the last day of the tax year.


a	Total number of conservation easements ......................	2a
b	Total acreage restricted by conservation easements ....................	2b
c	Number of conservation easements on a certified historic structure included in (a) .....	2c
d	Number of conservation easements included in (c) acquired after 7/25/06, and not on a historic structure listed in the National Register ...	2d

Number of conservation easements modified, transferred, released, extinguished, or terminated by the organization during the
tax year SchDMd Bullet

Number of states where property subject to conservation easement is located SchDMd Bullet

Does the organization have a written policy regarding the periodic monitoring, inspection, handling of violations, and enforcement of the conservation easements it holds? ............

Yes No

Staff and volunteer hours devoted to monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Amount of expenses incurred in monitoring, inspecting, handling of violations, and enforcing conservation easements during the year
SchDMd Bullet

Does each conservation easement reported on line 2(d) above satisfy the requirements of section 170(h)(4)(B)(i) and section 170(h)(4)(B)(ii)? .............................

Yes No

In Part XIII, describe how the organization reports conservation easements in its revenue and expense statement, and
balance sheet, and include, if applicable, the text of the footnote to the organization’s financial statements that describes
the organization’s accounting for conservation easements.

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets.
Complete if the organization answered "Yes" on Form 990, Part IV, line 8.

If the organization elected, as permitted under FASB ASC 958, not to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide, in Part XIII, the text of the footnote to its financial statements that describes these items.

If the organization elected, as permitted under FASB ASC 958, to report in its revenue statement and balance sheet works of art, historical treasures, or other similar assets held for public exhibition, education, or research in furtherance of public service, provide the following amounts relating to these items:

(i)

Revenue included on Form 990, Part VIII, line 1 ......................... SchDMd Bullet

(ii)

Assets included in Form 990, Part X ............................... SchDMd Bullet

If the organization received or held works of art, historical treasures, or other similar assets for financial gain, provide the
following amounts required to be reported under FASB ASC 958 relating to these items:

Revenue included on Form 990, Part VIII, line 1 .......................... SchDMd Bullet

Assets included in Form 990, Part X ............................... SchDMd Bullet

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 52283D

Schedule D (Form 990) 2021

Page 2

Part III

Organizations Maintaining Collections of Art, Historical Treasures, or Other Similar Assets (continued)

Using the organization’s acquisition, accession, and other records, check any of the following that are a significant use of its collection items (check all that apply):

Public exhibition

Loan or exchange programs

Scholarly research

Other

Preservation for future generations

Provide a description of the organization’s collections and explain how they further the organization’s exempt purpose in
Part XIII.

During the year, did the organization solicit or receive donations of art, historical treasures or other similar
assets to be sold to raise funds rather than to be maintained as part of the organization’s collection?...

Yes No

Part IV

Escrow and Custodial Arrangements. Complete if the organization answered "Yes" on Form 990, Part IV, line 9, or reported an amount on Form 990, Part X, line 21.

Is the organization an agent, trustee, custodian or other intermediary for contributions or other assets not
included on Form 990, Part X? ....................................

Yes No


b	If "Yes," explain the arrangement in Part XIII and complete the following table:		Amount
c	Beginning balance .............................	1c
d	Additions during the year ............................	1d
e	Distributions during the year ..........................	1e
f	Ending balance ................................	1f

Did the organization include an amount on Form 990, Part X, line 21, for escrow or custodial account liability? ...

Yes No

If "Yes," explain the arrangement in Part XIII. Check here if the explanation has been provided in Part XIII ....

Part V

Endowment Funds.
Complete if the organization answered "Yes" on Form 990, Part IV, line 10.

		(a) Current year	(b) Prior year	(c) Two years back	(d) Three years back	(e) Four years back

1a	Beginning of year balance ....
b	Contributions ...
c	Net investment earnings, gains, and losses
d	Grants or scholarships ...
e	Other expenditures for facilities and programs ...
f	Administrative expenses ....
g	End of year balance ......

Provide the estimated percentage of the current year end balance (line 1g, column (a)) held as:

Board designated or quasi-endowment SchDMd Bullet

Permanent endowment SchDMd Bullet

Term endowment SchDMd Bullet

The percentages on lines 2a, 2b, and 2c should equal 100%.

Are there endowment funds not in the possession of the organization that are held and administered for the
organization by:

Yes

(i) Unrelated organizations .................

3a(i)

(ii) Related organizations .................

3a(ii)

If "Yes" on 3a(ii), are the related organizations listed as required on Schedule R? .........

Describe in Part XIII the intended uses of the organization's endowment funds.

Part VI

Land, Buildings, and Equipment.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11a. See Form 990, Part X, line 10.

Description of property		(a) Cost or other basis (investment)	(b) Cost or other basis (other)	(c) Accumulated depreciation	(d) Book value

1a	Land .....
b	Buildings ....
c	Leasehold improvements
d	Equipment ....	4,732,198	1,369,802	3,362,396
e	Other .....
Total. Add lines 1a through 1e. (Column (d) must equal Form 990, Part X, column (B), line 10(c).)..				3,362,396

Schedule D (Form 990) 2021

Page 3

Part VII

Investments - Other Securities.
Complete if the organization answered "Yes" on Form 990, Part IV, line 11b. See Form 990, Part X, line 12.

(a) Description of security or category (including name of security)	(b) Book value	(c) Method of valuation: Cost or end-of-year market value
(1) Financial derivatives.........
(2) Closely-held equity interests........
(3)Other
(A)
(B)
(C)
(D)
(E)
(F)
(G)
(H)
Total. (Column (b) must equal Form 990, Part X, col. (B) line 12.)

Part VIII

Investments - Program Related. Complete if the organization answered 'Yes' on Form 990, Part IV, line 11c. See Form 990, Part X, line 13.

(a) Description of investment	(b) Book value	(c) Method of valuation: Cost or end-of-year market value

(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 13.)

Part IX

Other Assets.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11d. See Form 990, Part X, line 15.

(a) Description				(b) Book value
(1)DUE FROM AFFILIATES				321,247
(1)
(2)
(3)
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 15.)...........				321,247

Part X

Other Liabilities.
Complete if the organization answered 'Yes' on Form 990, Part IV, line 11e or 11f. See Form 990, Part X, line 25.

1.(a) Description of liability	(b) Book value
(1) Federal income taxes
(4)
(5)
(6)
(7)
(8)
(9)
Total. (Column (b) must equal Form 990, Part X, col.(B) line 25.)	76,741,961
2. Liability for uncertain tax positions. In Part XIII, provide the text of the footnote to the organization's financial statements that reports the organization's liability for uncertain tax positions under FIN 48 (ASC 740). Check here if the text of the footnote has been provided in Part XIII

Schedule D (Form 990) 2021

Page 4

Part XI Reconciliation of Revenue per Audited Financial Statements With Revenue per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total revenue, gains, and other support per audited financial statements .......		1
2	Amounts included on line 1 but not on Form 990, Part VIII, line 12:
a	Net unrealized gains (losses) on investments ....	2a
b	Donated services and use of facilities .........	2b
c	Recoveries of prior year grants ...........	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d .....................		2e
3	Subtract line 2e from line 1..................		3
4	Amounts included on Form 990, Part VIII, line 12, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b .	4a
b	Other (Describe in Part XIII.) ...........	4b
c	Add lines 4a and 4b....................		4c
5	Total revenue. Add lines 3 and 4c. (This must equal Form 990, Part I, line 12.) ......		5

Part XII Reconciliation of Expenses per Audited Financial Statements With Expenses per Return. Complete if the organization answered 'Yes' on Form 990, Part IV, line 12a.
1	Total expenses and losses per audited financial statements ...........		1
2	Amounts included on line 1 but not on Form 990, Part IX, line 25:
a	Donated services and use of facilities .........	2a
b	Prior year adjustments ............	2b
c	Other losses ................	2c
d	Other (Describe in Part XIII.) ............	2d
e	Add lines 2a through 2d....................		2e
3	Subtract line 2e from line 1...................		3
4	Amounts included on Form 990, Part IX, line 25, but not on line 1:
a	Investment expenses not included on Form 990, Part VIII, line 7b ..	4a
b	Other (Describe in Part XIII.) ............	4b
c	Add lines 4a and 4b.....................		4c
5	Total expenses. Add lines 3 and 4c. (This must equal Form 990, Part I, line 18.) ......		5

Part XIII

Supplemental Information

Provide the descriptions required for Part II, lines 3, 5, and 9; Part III, lines 1a and 4; Part lV, lines 1b and 2b; Part V, line 4; Part X, line 2; Part XI, lines 2d and 4b; and Part XII, lines 2d and 4b. Also complete this part to provide any additional information.

Return Reference

Explanation

Schedule D, Part X, Line 2 FIN 48 (ASC 740) footnote

THE SYSTEM APPLIES THE PROVISIONS OF ASC TOPIC 740, INCOME TAXES, WHICH CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN INCOME TAXES RECOGNIZED IN A COMPANY'S FINANCIAL STATEMENTS. ASC 740 PRESCRIBES A MORE-LIKELY-THAN-NOT RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR THE FINANCIAL STATEMENT RECOGNITION AND MEASUREMENT OF A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN. UNDER ASC 740, TAX POSITIONS ARE EVALUATED FOR RECOGNITION, DERECOGNITION, AND MEASUREMENT USING CONSISTENT CRITERIA AND PROVIDE MORE INFORMATION ABOUT THE UNCERTAINTY IN INCOME TAX ASSETS AND LIABILITIES. AS OF JUNE 30, 2022 AND 2021, PRIMARY HEALTHCARE ASSOCIATES, SC DOES NOT HAVE AN ASSET OR LIABILITY RECORDED FOR UNRECOGNIZED TAX POSITIONS. PRIMARY HEALTHCARE ASSOCIATES, SC IS A NOT-FOR-PROFIT CORPORATION AS DESCRIBED IN SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (THE CODE) AND IS EXEMPT FROM FEDERAL INCOME TAXES ON RELATED INCOME PURSUANT TO SECTION 501(A) OF THE CODE.

Schedule D (Form 990) 2021

Additional Data

Software ID:	21014044
Software Version:	2021v4.2

- TIN:

Schedule J
(Form 990)

Department of the Treasury
Internal Revenue Service

Compensation Information

For certain Officers, Directors, Trustees, Key Employees, and Highest
Compensated Employees
SchJMediumBullet

Complete if the organization answered "Yes" on Form 990, Part IV, line 23.
SchJMediumBullet

Attach to Form 990.
SchJMediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

Primary Healthcare Associates SC

Employer identification number

36-4132865

Part I

Questions Regarding Compensation

Yes

Check the appropiate box(es) if the organization provided any of the following to or for a person listed on Form
990, Part VII, Section A, line 1a. Complete Part III to provide any relevant information regarding these items.

First-class or charter travel Housing allowance or residence for personal use

Travel for companions Payments for business use of personal residence

Tax idemnification and gross-up payments Health or social club dues or initiation fees

Discretionary spending account Personal services (e.g., maid, chauffeur, chef)

If any of the boxes on Line 1a are checked, did the organization follow a written policy regarding payment or reimbursement or provision of all of the expenses described above? If "No," complete Part III to explain .....

Did the organization require substantiation prior to reimbursing or allowing expenses incurred by all
directors, trustees, officers, including the CEO/Executive Director, regarding the items checked on Line 1a? ....

Indicate which, if any, of the following the filing organization used to establish the compensation of the
organization's CEO/Executive Director. Check all that apply. Do not check any boxes for methods
used by a related organization to establish compensation of the CEO/Executive Director, but explain in Part III.

Compensation committee Written employment contract

Independent compensation consultant Compensation survey or study

Form 990 of other organizations Approval by the board or compensation committee

During the year, did any person listed on Form 990, Part VII, Section A, line 1a, with respect to the filing organization or a related organization:

Receive a severance payment or change-of-control payment? .............

Yes

Participate in, or receive payment from, a supplemental nonqualified retirement plan? .........

Yes

Participate in, or receive payment from, an equity-based compensation arrangement? .........

If "Yes" to any of lines 4a-c, list the persons and provide the applicable amounts for each item in Part III.

Only 501(c)(3), 501(c)(4), and 501(c)(29) organizations must complete lines 5-9.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the revenues of:

The organization? ....................

Any related organization? .......................

If "Yes," on line 5a or 5b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization pay or accrue any
compensation contingent on the net earnings of:

The organization? ..................

Any related organization? ......................

If "Yes," on line 6a or 6b, describe in Part III.

For persons listed on Form 990, Part VII, Section A, line 1a, did the organization provide any nonfixed
payments not described in lines 5 and 6? If "Yes," describe in Part III ............

Yes

Were any amounts reported on Form 990, Part VII, paid or accured pursuant to a contract that was
subject to the initial contract exception described in Regulations section 53.4958-4(a)(3)? If "Yes," describe
in Part III ..........................

If "Yes" on line 8, did the organization also follow the rebuttable presumption procedure described in Regulations section 53.4958-6(c)? .........................

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50053T

Schedule J (Form 990) 2021

Page 2

Part II

Officers, Directors, Trustees, Key Employees, and Highest Compensated Employees. Use duplicate copies if additional space is needed.

For each individual whose compensation must be reported on Schedule J, report compensation from the organization on row (i) and from related organizations, described in the
instructions, on row (ii). Do not list any individuals that are not listed on Form 990, Part VII.
Note. The sum of columns (B)(i)-(iii) for each listed individual must equal the total amount of Form 990, Part VII, Section A, line 1a, applicable column (D) and (E) amounts for that individual.

(A) Name and Title		(B) Breakdown of W-2, 1099-MISC compensation, and/or 1099-NEC			(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)	(F) Compensation in column (B) reported as deferred on prior Form 990
(A) Name and Title		(i) Base compensation	(ii) Bonus & incentive compensation	(iii) Other reportable compensation	(C) Retirement and other deferred compensation	(D) Nontaxable benefits	(E) Total of columns (B)(i)-(D)
1MARK KOZLOFF MD PRESIDENT/VP/TREASURER/SECRETARY	(i) (ii)	508,872 ------------- 0	215,000 ------------- 0	0 ------------- 0	2,474 ------------- 0	30,891 ------------- 0	757,237 ------------- 0	0 ------------- 0
2RICHARD W SILVERIA FORMER CHIEF FINANCIAL OFFICER (THRU 4/22/21)	(i) (ii)	0 ------------- 250,773	0 ------------- 435,412	0 ------------- 1,220,688	0 ------------- 0	0 ------------- 21,121	0 ------------- 1,927,994	0 ------------- 514,033
3IVAN SAMSTEIN CHIEF FINANCIAL OFFICER	(i) (ii)	0 ------------- 692,648	0 ------------- 125,203	0 ------------- 37,077	0 ------------- 81,600	0 ------------- 43,485	0 ------------- 980,012	0 ------------- 0
4RICHARD HARRIS MD PHYSICIAN	(i) (ii)	467,308 ------------- 0	135,430 ------------- 0	0 ------------- 0	0 ------------- 0	30,346 ------------- 0	633,084 ------------- 0	0 ------------- 0
5KIMBERLY KRUCZEK DO PHYSICIAN	(i) (ii)	496,677 ------------- 0	74,490 ------------- 0	0 ------------- 0	2,920 ------------- 0	9,721 ------------- 0	583,809 ------------- 0	0 ------------- 0
6SRINIVASU KUSUMA MD PHYSICIAN	(i) (ii)	1,156,536 ------------- 0	0 ------------- 0	0 ------------- 0	0 ------------- 0	129 ------------- 0	1,156,665 ------------- 0	0 ------------- 0
7PHILLIP NIGRO MD PHYSICIAN	(i) (ii)	966,766 ------------- 0	0 ------------- 0	19,500 ------------- 0	0 ------------- 0	34,340 ------------- 0	1,020,606 ------------- 0	0 ------------- 0
8JAMES WALLACE MD PHYSICIAN	(i) (ii)	756,040 ------------- 0	0 ------------- 0	26,000 ------------- 0	0 ------------- 0	0 ------------- 0	782,040 ------------- 0	0 ------------- 0

Schedule J (Form 990) 2021

Page 3

Part III

Supplemental Information

Provide the information, explanation, or descriptions required for Part I, lines 1a, 1b, 3, 4a, 4b, 4c, 5a, 5b, 6a, 6b, 7, and 8, and for Part II. Also complete this part for any additional information.

Return Reference	Explanation
Schedule J, Part I, Line 4a Severance or change-of-control payment	IN CALENDAR YEAR 2021, RICHARD SILVERIA RECEIVED SEVERANCE PAYMENTS FOLLOWING HIS TERMINATION OF EMPLOYMENT ($1,080,964). SOME OF THESE AMOUNTS WERE PREVIOUSLY REPORTED ON A PRIOR FORM 990 AS DEFERRED COMPENSATION AS SET FORTH IN COLUMN (F) OF PART II.
Schedule J, Part I, Line 4b Supplemental nonqualified retirement plan	CERTAIN INDIVIDUALS LISTED IN SCHEDULE J, PART II PARTICIPATE IN A SUPPLEMENTAL NON-QUALIFIED RETIREMENT PLAN TO WHICH UCMC MAKES ANNUAL CONTRIBUTIONS. THESE CONTRIBUTIONS ARE AT RISK AND DO NOT BECOME VESTED AND PAYABLE UNLESS AND UNTIL THE INDIVIDUAL SATISFIES A SUBSTANTIAL FUTURE SERVICE REQUIREMENT. THE FOLLOWING INDIVIDUALS HAD CONTRIBUTIONS MADE TO THE PLAN IN JANUARY 2022 FOR CALENDAR YEAR 2021: IVAN SAMSTEIN NO INDIVIDUALS LISTED IN SCHEDULE J, PART II BECAME VESTED IN, NOR WERE TAXED ON, AMOUNTS PREVIOUSLY CREDITED UNDER THE PLAN TO THE INDIVIDUAL FOR SERVICES PROVIDED TO THE ORGANIZATION IN PRIOR YEARS. RICHARD SILVERIA RECEIVED A DISTRIBUTION FROM A SUPPLEMENTAL RETIREMENT PLAN FOLLOWING THEIR TERMINATION OF EMPLOYMENT, IN ACCORDANCE WITH THE GOVERNING PLAN DOCUMENT ($514,033 TO RICHARD SILVERIA). THESE DISTRIBUTIONS WERE REPORTED AS TAXABLE INCOME AND ARE INCLUDED IN THE COMPENSATION DISCLOSED IN SCHEDULE J IN THE REPORTED YEAR.
Schedule J, Part I, Line 7 Non-fixed payments	MOST BONUSES ARE PRODUCTIVITY BASED WITH A SET TARGET AND DOLLARS PAID OVER THAT TARGET, SIGNING BONUS, OR RETENTION BONUS.
Schedule J, Part II	TAXABLE INCOME REPORTED IN COLUMN (B) MAY INCLUDE PAYMENTS FROM THE SUPPLEMENTAL EXECUTIVE RETIREMENT PLAN (SERP). IN MOST CASES, THESE PAYMENTS WERE EARNED OVER MANY YEARS OF EMPLOYMENT AND THE AMOUNTS HAD PREVIOUSLY BEEN SUBJECT TO VESTING RULES. SERP PAYMENT AMOUNTS EARNED IN PRIOR YEARS WERE PREVIOUSLY REPORTED ON THE FORM 990 AS DEFERRED COMPENSATION AND ARE REPORTED IN THIS 2021 FORM 990 ON SCHEDULE J, PART II, COLUMN (F). THE INDEPENDENT COMPENSATION COMMITTEE OF THE BOARD CONDUCTS ITS REVIEW AND APPROVAL OF ALL EXECUTIVE COMPENSATION, INCLUDING THESE SERP AMOUNTS, IN A MANNER THAT QUALIFIES FOR THE REBUTTABLE PRESUMPTION OF REASONABLENESS UNDER FEDERAL TAX LAW. THIS IS A RIGOROUS REVIEW PROCESS DESIGNED FOR TAX-EXEMPT ORGANIZATIONS BY THE INTERNAL REVENUE SERVICE, AND IT MEANS THAT THE BOARD COMPENSATION COMMITTEE DOES NOT HAVE ANY CONFLICTS OF INTEREST, AND RELIES ON MARKET DATA COMPILED BY AN INDEPENDENT COMPENSATION CONSULTANT TO SUPPORT ALL EXECUTIVE PAY AS MARKET COMPETITIVE AND REASONABLE. FOR THE INDIVIDUALS LISTED ON SCHEDULE J, PART II THAT ARE IDENTIFIED AS FORMER OFFICERS OR KEY EMPLOYEES, THE COMPENSATION LISTED IS EITHER THE FAIR MARKET VALUE COMPENSATION PAID TO THEM FOR SERVICES THEY PERFORMED AS ACTIVE EMPLOYEES OF UCMC OR A RELATED ORGANIZATION (AND WAS NOT PAID TO THEM DUE TO THEIR FORMERLY HAVING BEEN LISTED AS OFFICERS OR KEY EMPLOYEES), OR AS COMPENSATION FOR A COMBINATION OF SERVICES AND SEVERANCE: RICHARD SILVERIA.

Schedule J (Form 990) 2021

Additional Data

Software ID:	21014044
Software Version:	2021v4.2

- TIN:

SCHEDULE O
(Form 990)

Department of the Treasury
Internal Revenue Service

Supplemental Information to Form 990 or 990-EZ

Complete to provide information for responses to specific questions on
Form 990 or 990-EZ or to provide any additional information.
MediumBullet

Attach to Form 990 or 990-EZ.
MediumBullet

Go to www.irs.gov/Form990 for the latest information.

OMB No. 1545-0047

2021

Open to Public
Inspection

Name of the organization

Primary Healthcare Associates SC

Employer identification number

36-4132865

Return Reference	Explanation
Form 990, Part III, Line 4d Description of other program services	(Expenses $ 17,498,926 including grants of $ 1,185,197)(Revenue $ 13,641,903) PRIMARY HEALTHCARE ASSOCIATES SC (PHA) IS THE PREMIER MEDICAL GROUP IN THE SOUTH SUBURBS FOR YOUR FAMILY'S HEALTHCARE NEEDS. PRIMARY HEALTH IS A MULTI-SPECIALTY GROUP OF PHYSICIANS AFFILIATED WITH UCM COMMUNITY HEALTH & HOSPITAL DIVISION, INC. THESE PHYSICIANS PRACTICE IN A VARIETY OF SPECIALTIES, INCLUDING: CARDIOLOGY, ENT CARE, ENDOCRINOLOGY, Nephrology, NEUROLOGY, INTERNAL MEDICINE, OBSTETRICS & GYNECOLOGY, AND PAIN MANAGEMENT.
Form 990, Part VI, Line 15a 15B	THE ORGANIZATION'S TOP MANAGEMENT OFFICIAL AND OTHER OFFICERS ARE COMPENSATED BASED ON THEIR EMPLOYMENT CONTRACTS AS PHYSICIANS OF THE ORGANIZATION.
Form 990, Part VI, Line 3 Delegation of management duties	AS OF 7/1/2021 THE DAILY OPERATIONS OF PRIMARY HEALTHCARE ASSOCIATES ARE MANAGED BY UNIVERSITY OF CHICAGO MEDICINE CARE NETWORK, LLC, A DISREGARDED ENTITY FOR TAX PURPOSES WHOSE SOLE MEMBER IS THE UNIVERSITY OF CHICAGO MEDICAL CENTER (UCMC). UNIVERSITY OF CHICAGO MEDICINE CARE NETWORK, LLC IS THE SOLE MEMBER OF CARE NETWORK MEDICAL GROUP, INC., WHICH THROUGH A SHAREHOLDER CONTROL AGREEMENT, HAS THE RIGHT TO APPROVE OR DIRECT SIGNIFICANT DECISIONS OF PRIMARY HEALTHCARE ASSOCIATES.
Form 990, Part VI, Line 6 Classes of members or stockholders	THE ORGANIZATION IS AN AFFILIATED TAX-EXEMPT PROFESSIONAL CORPORATION CONTROLLED BY UCM CARE NETWORK MEDICAL GROUP, INC. (CNMG), THROUGH A SHAREHOLDER CONTROL AGREEMENT WITH THE PHYSICIAN SHAREHOLDER. UNDER THE SHAREHOLDER CONTROL AGREEMENT, CNMG HAS THE EXCLUSIVE RIGHT TO APPROVE OR DIRECT SIGNIFICANT DECISIONS OF THE ORGANIZATION'S SHAREHOLDER. THE PHYSICIAN SHAREHOLDER HAS NO ECONOMIC RIGHTS TO ANY PROFITS OR DISTRIBUTIONS OF THE ORGANIZATION AND IS REQUIRED TO VOTE ON DECISIONS OF THE ORGANIZATION IN THE MANNER DIRECTED BY CNMG.
Form 990, Part VI, Line 7a Members or stockholders electing members of governing body	PLEASE SEE THE NARRATIVE FOR PART VI, LINE 6.
Form 990, Part VI, Line 7b Decisions requiring approval by members or stockholders	PLEASE SEE THE NARRATIVE FOR PART VI, LINE 6.
Form 990, Part VI, Line 8b Documentation of meetings held by committees of governing body	PRIMARY HEALTHCARE ASSOCIATES SC HAS NO COMMITTEES THAT HAVE AUTHORITY TO ACT ON BEHALF OF THE GOVERNING BODY; THEREFORE, THIS QUESTION IS NOT APPLICABLE BUT HAS BEEN ANSWERED NO IN ACCORDANCE WITH THE IRS FORM 990 INSTRUCTIONS.
Form 990, Part VI, Line 11b Review of form 990 by governing body	THE FORM 990 IS PREPARED INTERNALLY BY MANAGEMENT. THE FULL FORM 990, INCLUDING SUPPLEMENTAL SCHEDULES, WAS PRESENTED BY THE CHIEF FINANCIAL OFFICERS TO THE FINANCE COMMITTEE AT A COMMITTEE MEETING. THE FULL BOARD HAS GRANTED TO THE FINANCE COMMITTEE AUTHORITY TO APPROVE THE FORM 990. THE FULL BOARD WILL RECEIVE A REPORT FROM THE FINANCE COMMITTEE, DESCRIBING THE FINANCE COMMITTEE'S REVIEW PERFORMED. PRIOR TO FILING WITH THE IRS, THE FORM 990 WILL BE AVAILABLE AT THE ORGANIZATION'S BOARD MEETING FOR EACH MEMBER'S REVIEW.
Form 990, Part VI, Line 12c Conflict of interest policy	PRIMARY HEALTHCARE ASSOCIATES HAS A ROBUST CONFLICTS OF INTEREST POLICY FOR EMPLOYEES, OFFICERS, AND DIRECTORS. THE POLICY CONTAINS CERTAIN PROHIBITIONS AS WELL AS DISCLOSURE REQUIREMENTS, AND ENCOURAGES QUESTIONS DIRECTED TO THE COMPLIANCE OFFICE AND LEGAL AFFAIRS. DURING THIS TAX YEAR, PRIMARY HEALTHCARE ASSOCIATES CONTINUED ITS PRACTICE OF SURVEYING DIRECTORS, OFFICERS, MANAGERIAL EMPLOYEES, AND INFLUENTIAL MEDICAL STAFF MEMBERS, SEEKING DISCLOSURES OF VARIOUS RELATIONSHIPS, INCLUDING RELATIONSHIPS DISCLOSED IN THIS FORM 990. IN ADDITION, CERTAIN CHAIRS OF COMMITTEES, SUCH AS THE PHARMACY AND THERAPEUTICS COMMITTEE OF THE MEDICAL STAFF, AT MONTHLY MEETINGS ASK FOR ORAL DISCLOSURES OF POTENTIAL CONFLICTS. UPON REQUEST, THE COMPLIANCE OFFICER AND THE OFFICE OF LEGAL AFFAIRS PROVIDE EDUCATIONAL SESSIONS. UCMC NOTES THAT RESEARCHER CONFLICTS ARE MANAGED BY THE UNIVERSITY OF CHICAGO. THE CONFLICT OF INTEREST POLICY SPECIFICALLY REQUIRES DISCLOSURE, AND ABSTENTION OR RECUSAL AS NECESSARY, WHENEVER A DIRECTOR OR RELATED PARTY HAS A POTENTIAL CONFLICT OF INTEREST.
Form 990, Part VI, Line 19 Required documents available to the public	ALL DOCUMENTS ARE AVAILABLE UPON REQUEST.
Form 990, Part VIII, Line 2f Other Program Service Revenue	MISCELLANEOUS REVENUE - Total Revenue: 100963, Related or Exempt Function Revenue: 100963, Unrelated Business Revenue: , Revenue Excluded from Tax Under Sections 512, 513, or 514: ;
Form 990, Part XII, Line 3a Single Audit Act and OMB Circular A-133	The organization is subject to a Single Audit requirement for its fiscal year ending June 30, 2022. The organization began the process to undergo the required audit during its fiscal year ending June 30, 2023 and will file a Single Audit in conjunction with the University of Chicago by 3/31/2023.

For Paperwork Reduction Act Notice, see the Instructions for Form 990 or 990-EZ.

Cat. No. 51056K

Schedule O (Form 990) 2021

Additional Data

Software ID:	21014044
Software Version:	2021v4.2

- TIN:

SCHEDULE R
(Form 990)

Department of the Treasury
Internal Revenue Service

Related Organizations and Unrelated Partnerships

Complete if the organization answered "Yes" on Form 990, Part IV, line 33, 34, 35b, 36, or 37.
MediumBullet

Attach to Form 990.
MediumBullet

Go to www.irs.gov/Form990 for instructions and the latest information.

OMB No. 1545-0047

2021

Open to Public Inspection

Name of the organization

Primary Healthcare Associates SC

Employer identification number

36-4132865

Part I

Identification of Disregarded Entities. Complete if the organization answered "Yes" on Form 990, Part IV, line 33.

(a) Name, address, and EIN (if applicable) of disregarded entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Total income	(e) End-of-year assets	(f) Direct controlling entity

Part II

Identification of Related Tax-Exempt Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related tax-exempt organizations during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	(g) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Exempt Code section	(e) Public charity status (if section 501(c)(3))	(f) Direct controlling entity	Yes	No
(1)ARCH DEVELOPMENT CORPORATION 5555 S WOODLAWN AVENUE CHICAGO,IL60637 36-3485244	TECH TRANSFER	IL	501(c)(3)	Type I	UNIV CHICAGO		No
(2)ASIAN HEALTH COALITION 180 W WASHINGTON ST SUITE 1 CHICAGO,IL60602 31-1607193	HLTH ACCESS	IL	501(c)(3)	10	UNIV CHICAGO		No
(3)CHAPIN HALL CENTER FOR CHILDREN 1313 E 60TH STREET CHICAGO,IL60637 36-2167012	POL RES CTR	IL	501(c)(3)	7	NA		No
(4)CHICAGO TUMOR INSTITUTE 5801 S ELLIS AVENUE CHICAGO,IL60637 23-7136019	SUPP RESEARCH	IL	501(c)(3)	Type I	UNIV CHICAGO		No
(5)COURT THEATRE FUND 5535 S ELLIS AVENUE CHICAGO,IL60637 36-3203660	SUPP THE ARTS	IL	501(c)(3)	Type I	UNIV CHICAGO		No
(6)FERMI RESEARCH ALLIANCE LLC PO BOX 500 BATAVIA,IL60510 57-1239010	MANAGE LAB	IL	501(c)(3)	7	NA		No
(7)HYMEN MILGROM SUPPORTING ORGANIZATION 33 N LASALLE ST STE 2131 CHICAGO,IL60602 46-6789522	SUPP EDU RES	VA	501(c)(3)	Type III-O	NA		No
(8)INGALLS DEVELOPMENT FOUNDATION ONE INGALLS DRIVE HARVEY,IL60426 36-3189150	SUPPORT	IL	501(c)(3)	7	UCHHD		No
(9)INGALLS HEALTH VENTURES ONE INGALLS DRIVE HARVEY,IL60426 36-3239703	AMBULATORY	IL	501(c)(3)	Type I	UCHHD		No
(10)INGALLS HOME CARE ONE INGALLS DRIVE HARVEY,IL60426 36-3367939	HEALTHCARE	IL	501(c)(3)	10	IMH		No
(11)LAKE PARK ASSOCIATES 5801 S ELLIS AVENUE CHICAGO,IL60637 36-6111317	PROP HOLDG	IL	501(c)(2)		UNIV CHICAGO		No
(12)NATIONAL OPINION RESEARCH CENTER (NORC) 55 E MONROE AVENUE CHICAGO,IL60603 36-2167808	SO SCI SRVYS	IL	501(c)(3)	7	NA		No
(13)THE INGALLS MEMORIAL HOSPITAL ONE INGALLS DRIVE HARVEY,IL60426 36-2170866	HOSPITAL	IL	501(c)(3)	3	UCHHD		No
(14)THE JOHN CRERAR FOUNDATION 5730 S ELLIS AVENUE CHICAGO,IL60637 36-3155157	SUPP LIBRARY	IL	501(c)(3)	Type III-O	UNIV CHICAGO		No
(15)THE MARINE BIOLOGICAL LABORATORY 7 MBL STREET WOODS HOLE,MA02543 04-2104690	RES & EDU	MA	501(c)(3)	7	UNIV CHICAGO		No
(16)THE QUADRANGLE CLUB 5801 S ELLIS AVENUE CHICAGO,IL60637 36-1655190	SOCIAL CLUB	IL	501(c)(7)		UNIV CHICAGO		No
(17)THE UNIV OF CHICAGO FDN IN THE HONG KONG LTD	FUNDRAISING	HK			UNIV CHICAGO		No
(18)THE UNIVERSITY OF CHICAGO CLOISTERS CLUB 1212 E 59TH STREET CHICAGO,IL60637	SOCIAL CLUB	IL			UNIV CHICAGO		No
(19)UCHICAGO RESEARCH BANGLADESH LTD	RESEARCH	BG			UCH RS INTL		No
(20)UCHICAGO RESEARCH INTERNATIONAL LIMITED 5801 S ELLIS AVENUE CHICAGO,IL60637 26-2741573	RESEARCH	IL	501(c)(3)	Type I	UNIV CHICAGO		No
(21)UCM COMMUNITY HEALTH & HOSPITAL DIVISION ONE INGALLS DRIVE HARVEY,IL60426 36-3181170	MANAGEMENT	IL	501(c)(3)	Type I	UCMC		No
(22)UCMC TITLE HOLDING CORPORATION 5841 S MARYLAND AVE MC 1086 CHICAGO,IL60637 81-2126789	TITLE HOLD	IL	501(c)(3)	Type I	UCMC		No
(23)UCMC TITLE HOLDING CORPORATION II NFP 5841 S MARYLAND AVE MC 1086 CHICAGO,IL60637 82-1736040	TITLE HOLD	IL	501(c)(3)	Type I	UCMC		No
(24)UCM CARE NETWORK MEDICAL GROUP INC 5841 S MARYLAND AVE MC 1086 CHICAGO,IL60637 47-4221241	HEALTH SERVICE	IL	501(c)(3)	10	UCMC		No
(25)UNIV OF CHI BOOTH SCH OF BUS (SINGAPORE)	EDUCATION	SN			UNIV CHICAGO		No
(26)UNIV OF CHI BOOTH SCH OF BUS (UK)	EDUCATION	UK			UNIV CHICAGO		No
(27)UNIV OF CHICAGO CANCER RESEARCH FD 5801 S ELLIS AVENUE CHICAGO,IL60637 36-6056201	SUPP RESEARCH	IL	501(c)(3)	Type I	UNIV CHICAGO		No
(28)UNIV OF CHICAGO CENTER IN PARIS (FRANCE)	EDUCATION	FR			UNIV CHICAGO		No
(29)UNIV OF CHICAGO CHARTER SCHOOL CORP 5801 S ELLIS AVENUE CHICAGO,IL60637 36-4225812	EDUCATION	IL	501(c)(3)	2	UNIV CHICAGO		No
(30)UNIV OF CHICAGO PROPERTY HOLDING CO 5801 S ELLIS AVENUE CHICAGO,IL60637 36-6108743	PROP HOLDG	IL	501(c)(2)		UNIV CHICAGO		No
(31)UNIV OF CHICAGO RETIREE MEDICAL TRUST 5801 S ELLIS AVENUE CHICAGO,IL60637 36-3999692	MEDICAL TRUST	IL	501(c)(3)	Type I	UNIV CHICAGO		No
(32)UNIV OF CHICAGO SELF INSURANCE TRUST 5801 S ELLIS AVENUE CHICAGO,IL60637 36-3020034	MALPRAC TR	IL	501(c)(3)	Type I	UNIV CHICAGO		No
(33)UNIVERSITY OF CHICAGO MEDICAL CENTER 5841 S MARYLAND AVE MC 1086 CHICAGO,IL60637 36-3488183	HOSPITAL	IL	501(c)(3)	3	UNIV CHICAGO		No
(34)UNIVERSITY OF CHICAGO 5801 S ELLIS AVENUE CHICAGO,IL60637 36-2177139	EDUCATION	IL	501(c)(3)	2	NA		No
(35)UNIVERSITY OF CHICAGO TRUST (INDIA) L-9 East Wing Raheja Towers MG R BANGALORE,Karnataka560001 IN	FUNDRAISING	IN			UNIV CHICAGO		No
(36)CHICAGO HOME FOR THE INCURABLES 5801 S ELLIS AVENUE CHICAGO,IL60637 36-2169138	SUPP RESEARCH	IL	501(c)(3)	Type I	UNIV CHICAGO		No

For Paperwork Reduction Act Notice, see the Instructions for Form 990.

Cat. No. 50135Y

Schedule R (Form 990) 2021

Page 2

Part III

Identification of Related Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, because it had one or more related organizations treated as a partnership during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Predominant income(related, unrelated, excluded from tax under sections 512-514)	(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity		(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership
(1) INGALLS SAME DAY SURGERY CTR 6701 W 159TH ST TINLEY PARK,IL60477 36-3368549	SURGERY CENTER	IL	NA	N/A				No			No
(2) UCMC-SOLIS ON-CAMPUS MAMMOGRAPHY LLC 15601 DALLAS PARKWAY SUITE 500 ADDISON,TX75001 35-2641914	MAMMOGRAPHY	DE	NA	N/A				No			No
(3) UCMC-SOLIS OFF-CAMPUS MAMMOGRAPHY SERVICES LLC 15601 DALLAS PARKWAY SUITE 300 ADDISON,TX75001 38-4108853	MAMMOGRAPHY	DE	NA	N/A				No			No
(4) PABHS-UCM MSO JV LLC 2845 N SHERIDAN RD SUITE 6400 CHICAGO,IL60657 87-4074642	RADIOLOGY ONCOLOGY	IL	NA	N/A				No			No
(5) PABHS-UCM RADONC JV 2845 N SHERIDAN RD SUITE 6400 CHICAGO,IL60657 87-4057862	RADIOLOGY ONCOLOGY	IL	NA	N/A				No			No

Part IV

Identification of Related Organizations Taxable as a Corporation or Trust. Complete if the organization answered "Yes" on Form 990, Part IV, line 34 because it had one or more related organizations treated as a corporation or trust during the tax year.

(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	(i) Section 512(b)(13) controlled entity?
(a) Name, address, and EIN of related organization	(b) Primary activity	(c) Legal domicile (state or foreign country)	(d) Direct controlling entity	(e) Type of entity (C corp, S corp, or trust)	(f) Share of total income	(g) Share of end-of-year assets	(h) Percentage ownership	Yes	No
(1) CHARITABLE LEAD TRUST (0) 5801 S ELLIS AVENUE CHICAGO,IL60637	CHAR LEAD TRUST	IL	NA	Trust					No
(2) CHARITABLE REMAINDER TRUSTS (75) 5801 S ELLIS AVENUE CHICAGO,IL60637	CHAR RMDR TRUST	IL	NA	Trust					No
(3) INGALLS CASUALTY INSURANCE LTD ONE INGALLS DRIVE HARVEY,IL60426 98-0485714	LIAB INSURANCE	CJ	NA	C Corporation					No
(4) INGALLS HEALTH COUNCIL ONE INGALLS DRIVE HARVEY,IL60426 27-3226539	PURCHASING GROUP	IL	NA	C Corporation					No
(5) INGALLS PROVIDER GROUP ONE INGALLS DRIVE HARVEY,IL60426 36-3485578	INSURANCE SERVICE	IL	NA	C Corporation					No
(6) MEDCENTRIX INC ONE INGALLS DRIVE HARVEY,IL60426 36-3374228	BILLING & MGMT	IL	NA	C Corporation					No
(7) PHOENIX OVERLAY FUND LTD 401 N MICHIGAN AVE C/O INVST OFFICE CHICAGO,IL60611	INVESTMENT	CJ	NA						No
(8) POOLED INCOME FUND (1) 5801 S ELLIS AVENUE CHICAGO,IL60637	POOLED INCO FUND	IL	NA	C Corporation					No
(9) SC CURRICULUM INC 70 WEST MADISON ST CHICAGO,IL60602	SCNC CURRICULUM	IL	NA	C Corporation					No
(10) UCHICAGO (BEIJING) CONSULTING CO LTD	CONSULTING	CH	NA						No
(11) UCHICAGO CENTER IN INDIA PRIVATE LIMITED	CONSULTING	IN	NA	C Corporation					No
(12) TRULEN INSURANCE SPC LIMITED 98-1571288	LIAB INSURANCE	CJ	UCHHD						No
(13) EMPLOYED PHYSICIANS SP A SEGREGATED PORTFOLIO OF TRULEN INSURANCE SPC LTD 98-1571310	LIAB INSURANCE	CJ	UCHHD						No
(14) HPL-GL SP A SEGREGATED PORTFOLIO OF TRULEN INSURANCE SPC LTD 98-1571446	LIAB INSURANCE	CJ	UCHHD						No
(15) NON-EMPLOYED PHYSICIANS SP A SEGREGATED PORTFOLIO OF TRULEN INSURANCE SPC L TD 98-1571387	LIAB INSURANCE	CJ	UCHHD						No
(16) UCHICAGO MEDICINE NORTHWEST INDIANA INC 5841 S MARYLAND AVE CHICAGO,IL60637 92-2355855	HEALTHCARE	IN	UCMC	C Corporation					No

Schedule R (Form 990) 2021

Page 3

Part V

Transactions With Related Organizations. Complete if the organization answered "Yes" on Form 990, Part IV, line 34, 35b, or 36.

Note. Complete line 1 if any entity is listed in Parts II, III, or IV of this schedule.

Yes

1 During the tax year, did the orgranization engage in any of the following transactions with one or more related organizations listed in Parts II-IV?

a Receipt of (i) interest, (ii) annuities, (iii) royalties, or (iv) rent from a controlled entity .....................

b Gift, grant, or capital contribution to related organization(s) ............................

c Gift, grant, or capital contribution from related organization(s) ............................

d Loans or loan guarantees to or for related organization(s) ............................

e Loans or loan guarantees by related organization(s) ............................

f Dividends from related organization(s) ............................

g Sale of assets to related organization(s) ............................

h Purchase of assets from related organization(s) ............................

i Exchange of assets with related organization(s) ............................

j Lease of facilities, equipment, or other assets to related organization(s) .......................

k Lease of facilities, equipment, or other assets from related organization(s) ......................

Yes

l Performance of services or membership or fundraising solicitations for related organization(s) .....................

Yes

m Performance of services or membership or fundraising solicitations by related organization(s) .................

Yes

n Sharing of facilities, equipment, mailing lists, or other assets with related organization(s) ...................

Yes

o Sharing of paid employees with related organization(s) ............................

Yes

p Reimbursement paid to related organization(s) for expenses ............................

Yes

q Reimbursement paid by related organization(s) for expenses ............................

r Other transfer of cash or property to related organization(s) ............................

s Other transfer of cash or property from related organization(s) ............................

Yes

If the answer to any of the above is "Yes," see the instructions for information on who must complete this line, including covered relationships and transaction thresholds.

(a) Name of related organization	(b) Transaction type (a-s)	(c) Amount involved	(d) Method of determining amount involved

Schedule R (Form 990) 2021

Page 4

Part VI

Unrelated Organizations Taxable as a Partnership. Complete if the organization answered "Yes" on Form 990, Part IV, line 37.

Provide the following information for each entity taxed as a partnership through which the organization conducted more than five percent of its activities (measured by total assets or gross revenue) that was not a related organization. See instructions regarding exclusion for certain investment partnerships.

(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	(e) Are all partners section 501(c)(3) organizations?		(f) Share of total income	(g) Share of end-of-year assets	(h) Disproprtionate allocations?		(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	(j) General or managing partner?		(k) Percentage ownership
(a) Name, address, and EIN of entity	(b) Primary activity	(c) Legal domicile (state or foreign country)	Yes	No	(f) Share of total income	(g) Share of end-of-year assets	Yes	No	(i) Code V-UBI amount in box 20 of Schedule K-1 (Form 1065)	Yes	No	(k) Percentage ownership

Schedule R (Form 990) 2021

Page 5

Part VII

Supplemental Information

Provide additional information for responses to questions on Schedule R. See instructions.

Return Reference	Explanation

Schedule R (Form 990) 2021

Additional Data

Software ID:	21014044
Software Version:	2021v4.2

1	Briefly describe the organization’s mission or most significant activities: PRIMARY HEALTHCARE ASSOCIATES SC (PHA) WAS FORMED TO DIAGNOSE AND TREAT HUMAN AILMENTS AND INJURIES, WHETHER PHYSICAL OR MENTAL.
2	Check this box
3	Number of voting members of the governing body (Part VI, line 1a) ........	3	1
4	Number of independent voting members of the governing body (Part VI, line 1b) .....	4	0
5	Total number of individuals employed in calendar year 2021 (Part V, line 2a) ......	5	44
6	Total number of volunteers (estimate if necessary) .............	6	0
7a	Total unrelated business revenue from Part VIII, column (C), line 12 ........	7a	0
b	Net unrelated business taxable income from Form 990-T, Part I, line 11 .........	7b	0

		Prior Year	Current Year
8	Contributions and grants (Part VIII, line 1h) .........	1,092,744	1,185,197
9	Program service revenue (Part VIII, line 2g) .........	20,127,179	24,677,338
10	Investment income (Part VIII, column (A), lines 3, 4, and 7d ) ....		0
11	Other revenue (Part VIII, column (A), lines 5, 6d, 8c, 9c, 10c, and 11e)	23,261	477,436
12	Total revenue—add lines 8 through 11 (must equal Part VIII, column (A), line 12)	21,243,184	26,339,971
13	Grants and similar amounts paid (Part IX, column (A), lines 1–3 )...		0
14	Benefits paid to or for members (Part IX, column (A), line 4).....		0
15	Salaries, other compensation, employee benefits (Part IX, column (A), lines 5–10)	23,562,988	30,235,050
16a	Professional fundraising fees (Part IX, column (A), line 11e) .....		0
b	Total fundraising expenses (Part IX, column (D), line 25) 0
17	Other expenses (Part IX, column (A), lines 11a–11d, 11f–24e)....	12,286,797	15,454,685
18	Total expenses. Add lines 13–17 (must equal Part IX, column (A), line 25)	35,849,785	45,689,735
19	Revenue less expenses. Subtract line 18 from line 12.......	-14,606,601	-19,349,764
		Beginning of Current Year	End of Year
20	Total assets (Part X, line 16).............	3,794,694	5,158,471
21	Total liabilities (Part X, line 26).............	58,258,575	78,972,116
22	Net assets or fund balances. Subtract line 21 from line 20.....	-54,463,881	-73,813,645

Sign Here

	Signature of officer	Date

	Type or print name and title


4a	(Code: ) (Expenses $ 15,387,223 including grants of $ ) (Revenue $ 6,069,738 )
	PRIMARY CARE PRIMARY HEALTH SPECIALIZES IN PROVIDING CARE TO PATIENTS OF ALL AGES WITH ALL SORTS OF CONDITIONS. OUR FAMILY PHYSICIANS ARE SUITED TO PROVIDING PREVENTIVE CARE AS WELL AS MANAGING CHRONIC AND COMPLEX CONDITIONS. THIS INCLUDES: TREAT A WIDE RANGE OF MEDICAL ISSUES, COORDINATE CARE WITH OTHER MEDICAL PROFESSIONALS AND SPECIALISTS, PROVIDE PRIMARY CARE OF THE WHOLE PATIENT, INCLUDING MENTAL AND EMOTIONAL NEEDS, STRIVE TO BUILD LONG-TERM RELATIONSHIPS WITH THEIR PATIENTS, PROVIDE INFORMATION AND TECHNIQUES TO HELP PATIENTS TAKE CONTROL OF THEIR HEALTH, FOCUS ON PREVENTING, AS WELL AS TREATING, ILLNESS.

4b	(Code: ) (Expenses $ 5,573,090 including grants of $ ) (Revenue $ 1,927,606 )
	ONCOLOGY USING THE BEST MEDICAL INFORMATION AVAILABLE, PRIMARY HEALTH ONCOLOGISTS/HEMATOLOGISTS WORK CLOSELY WITH OTHER SPECIALISTS AND THE EXPERTS AT INGALLS CANCER CARE TO CREATE A PLAN OF CARE SPECIFICALLY DESIGNED FOR EACH INDIVIDUAL PATIENT THAT MAY INCLUDE: CHEMOTHERAPY, INCLUDING THE LATEST CANCER CLINICAL TRIALS, RADIATION THERAPY, CHEMOEMBOLIZATION, RADIOFREQUENCY ABLATION AND CRYOABLATION, SELECTIVE INTERNAL RADIATION THERAPY, CARE OF LONG-TERM CENTRAL CATHETERS, BIOLOGICAL RESPONSE MODIFIERS.

4c	(Code: ) (Expenses $ 5,030,182 including grants of $ ) (Revenue $ 4,700,724 )
	ORTHOPEDICS PRIMARY HEALTH OFFERS A FULL RANGE OF ORTHOPEDIC CARE FOR BONES, MUSCLES, AND JOINTS. OUR SURGEONS, SPORTS MEDICINE SPECIALISTS, THERAPISTS, AND NURSES WORK TOGETHER TO PREVENT, TREAT, AND REHABILITATE ORTHOPEDIC INJURIES AND ILLNESS. SERVICES INCLUDE: BONE FRAGILITY, BONE INFECTIONS, BONE & SOFT TISSUE SARCOMA, FOOT & ANKLE CARE, FRACTURE CARE, HAND & WRIST CARE, HIP CARE, KNEE CARE, PEDIATRIC ORTHOPEDIC SURGERY, SHOULDER AND ELBOW PAIN, SPINE CARE, SPORTS MEDICINE, TRAUMA ORTHOPEDICS, AND ORTHOPEDIC CLINICAL EFFECTIVENESS RESEARCH.

	(Code: ) (Expenses $ 17,498,926 including grants of $ 1,185,197 ) (Revenue $ 13,641,903 )
	PRIMARY HEALTHCARE ASSOCIATES SC (PHA) IS THE PREMIER MEDICAL GROUP IN THE SOUTH SUBURBS FOR YOUR FAMILY'S HEALTHCARE NEEDS. PRIMARY HEALTH IS A MULTI-SPECIALTY GROUP OF PHYSICIANS AFFILIATED WITH UCM COMMUNITY HEALTH & HOSPITAL DIVISION, INC. THESE PHYSICIANS PRACTICE IN A VARIETY OF SPECIALTIES, INCLUDING: CARDIOLOGY, ENT CARE, ENDOCRINOLOGY, Nephrology, NEUROLOGY, INTERNAL MEDICINE, OBSTETRICS & GYNECOLOGY, AND PAIN MANAGEMENT.

4d	Other program services (Describe in Schedule O.)
	(Expenses $ 17,498,926 including grants of $ 1,185,197 ) (Revenue $ 13,641,903 )
4e	Total program service expenses43,489,421

(A) Name and title	(B) Average hours per week (list any hours for related organizations below dotted line)	(C) Position (do not check more than one box, unless person is both an officer and a director/trustee)				(D) Reportable compensation from the organization (W-2/1099-MISC/1099-NEC)	(E) Reportable compensation from related organizations (W-2/1099-MISC/1099-NEC)	(F) Estimated amount of other compensation from the organization and related organizations
(A) Name and title
(1) MARK KOZLOFF MD PRESIDENT/VP/TREASURER/SECRETARY	40.0 ................. 2.0	X	X			723,872	0	33,365
(2) IVAN SAMSTEIN CHIEF FINANCIAL OFFICER	1.0 ................. 48.0		X			0	854,927	125,085
(3) JAMES WALLACE MD PHYSICIAN	40.0 ................. 1.0			X		782,040	0	0
(4) KIMBERLY KRUCZEK DO PHYSICIAN	40.0 ................. 1.0			X		571,167	0	12,641
(5) PHILLIP NIGRO MD PHYSICIAN	40.0 ................. 0			X		986,266	0	34,340
(6) RICHARD HARRIS MD PHYSICIAN	40.0 ................. 0			X		602,738	0	30,346
(7) SRINIVASU KUSUMA MD PHYSICIAN	40.0 ................. 0			X		1,156,536	0	129
(8) RICHARD W SILVERIA FORMER CHIEF FINANCIAL OFFICER (THRU 4/22/21)	0.0 ................. 0.0				X	0	1,906,873	21,121

1b	Sub-Total................
c	Total from continuation sheets to Part VII, Section A....
d	Total (add lines 1b and 1c)...........	4,822,619	2,761,800	257,028

1a	Federated campaigns..		1a
b	Membership dues..		1b
c	Fundraising events..		1c
d	Related organizations		1d
e	Government grants (contributions)		1e	1,185,197

f	All other contributions, gifts, grants, and similar amounts not included above		1f

g	Noncash contributions included in lines 1a - 1f:$		1g

h Total. Add lines 1a-1f.......		1,185,197

		Business Code
2a	NET PATIENT REVENUE	624100	22,373,775	22,373,775
b	ICN/ACO BONUS	900099	1,493,181	1,493,181
c	CAPITATION REVENUE	900099	521,071	521,071
d	ONCOLOGY CARE MODEL	900099	157,966	157,966
e	HOSPICE REVENUE	621610	30,382	30,382
f	All other program service revenue.		100,963	100,963	0	0
g	Total. Add lines 2a–2f .....		24,677,338

3 Investment income (including dividends, interest, and othersimilar amounts) ......
4 Income from investment of tax-exempt bond proceeds
5 Royalties...........
		(ii) Personal	(i) Real
6a	Gross rents			6a
b	Less: rental expenses			6b
c	Rental income or (loss)	0	0	6c
d	Net rental income or (loss).......
		(ii) Other	(i) Securities
7a	Gross amount from sales of assets other than inventory			7a
b	Less: cost or other basis and sales expenses			7b
c	Gain or (loss)	0	0	7c
d	Net gain or (loss).........
8a	Gross income from fundraising events (not including $ of contributions reported on line 1c). See Part IV, line 18 ....
			8a
b	Less: direct expenses ...		8b
c	Net income or (loss) from fundraising events..
9a	Gross income from gaming activities. See Part IV, line 19 ...
			9a
b	Less: direct expenses ...		9b
c	Net income or (loss) from gaming activities..
10a	Gross sales of inventory, less returns and allowances ..
			10a
b	Less: cost of goods sold ..		10b
c	Net income or (loss) from sales of inventory..
Business Code			Miscellaneous Revenue
11a	PSA REVENUE		624100	477,436	477,436
b
c
d	All other revenue ....			0	0	0	0
e	Total. Add lines 11a–11d ......			477,436
12	Total revenue. See instructions.....			26,339,971	25,154,774	0	0

1	Grants and other assistance to domestic organizations and domestic governments. See Part IV, line 21 ....
2	Grants and other assistance to domestic individuals. See Part IV, line 22 ...........
3	Grants and other assistance to foreign organizations, foreign governments, and foreign individuals. See Part IV, lines 15 and 16. .............
4	Benefits paid to or for members .......
5	Compensation of current officers, directors, trustees, and key employees ...........	506,706	506,706	0	0
6	Compensation not included above, to disqualified persons (as defined under section 4958(f)(1)) and persons described in section 4958(c)(3)(B) .........
7	Other salaries and wages........	25,017,227	24,588,816	428,411
8	Pension plan accruals and contributions (include section 401(k) and 403(b) employer contributions) ....	183,370	181,298	2,072
9	Other employee benefits .......	2,576,157	2,558,336	17,821
10	Payroll taxes ...........	1,951,590	1,918,816	32,774
11	Fees for services (non-employees):
a	Management ......
b	Legal .........
c	Accounting ...........
d	Lobbying ...........
e	Professional fundraising services. See Part IV, line 17
f	Investment management fees ......
g	Other (If line 11g amount exceeds 10% of line 25, column (A) amount, list line 11g expenses on Schedule O)	2,710,539	2,683,889	26,650	0
12	Advertising and promotion ....
13	Office expenses .......	290,072	187,169	102,903
14	Information technology ......	25,168	25,168
15	Royalties ..
16	Occupancy ...........	2,869,134	2,869,134
17	Travel ............	33,820	33,820
18	Payments of travel or entertainment expenses for any federal, state, or local public officials .
19	Conferences, conventions, and meetings ....	80,096	80,096
20	Interest ...........
21	Payments to affiliates .......
22	Depreciation, depletion, and amortization ..	511,102	511,102
23	Insurance ...	5,552,105	5,552,105
24	Other expenses. Itemize expenses not covered above (List miscellaneous expenses in line 24e. If line 24e amount exceeds 10% of line 25, column (A) amount, list line 24e expenses on Schedule O.)
a	MANAGEMENT FEE	1,589,683		1,589,683
b	MEDICAL SUPPLIES	1,373,472	1,373,472
c	AFFILIATE CHARGEBACKS	328,886	328,886
d	EQUIPMENT RENTAL	90,608	90,608
e	All other expenses	0	0	0	0
25	Total functional expenses. Add lines 1 through 24e	45,689,735	43,489,421	2,200,314	0
26	Joint costs. Complete this line only if the organization reported in column (B) joint costs from a combined educational campaign and fundraising solicitation. Check here if following SOP 98-2 (ASC 958-720).

1	Cash–non-interest-bearing ........				1
2	Savings and temporary cash investments .........				2
3	Pledges and grants receivable, net ......				3
4	Accounts receivable, net .............				4	1,355,710
5	Loans and other receivables from any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .......
				0	5	0
6	Loans and other receivables from other disqualified persons (as defined under section 4958(f)(1)), and persons described in section 4958(c)(3)(B) ...
				0	6	0
7	Notes and loans receivable, net ...........				7
8	Inventories for sale or use ............				8
9	Prepaid expenses and deferred charges ......			162,093	9	119,118
10a	Land, buildings, and equipment: cost or other basis. Complete Part VI of Schedule D	10a	4,732,198
b	Less: accumulated depreciation	10b	1,369,802	3,632,601	10c	3,362,396
11	Investments—publicly traded securities .				11
12	Investments—other securities. See Part IV, line 11 .....			0	12
13	Investments—program-related. See Part IV, line 11 ..			0	13
14	Intangible assets ...............				14
15	Other assets. See Part IV, line 11 ...........			0	15	321,247
16	Total assets. Add lines 1 through 15 (must equal line 33)...			3,794,694	16	5,158,471

17	Accounts payable and accrued expenses .....	2,813,689	17	2,230,155
18	Grants payable ...		18
19	Deferred revenue .........		19
20	Tax-exempt bond liabilities .........		20
21	Escrow or custodial account liability. Complete Part IV of Schedule D		21
22	Loans and other payables to any current or former officer, director, trustee, key employee, creator or founder, substantial contributor, or 35% controlled entity or family member of any of these persons .........
		0	22	0
23	Secured mortgages and notes payable to unrelated third parties ..		23
24	Unsecured notes and loans payable to unrelated third parties ..		24
25	Other liabilities (including federal income tax, payables to related third parties, and other liabilities not included on lines 17 - 24). Complete Part X of Schedule D	55,444,886	25	76,741,961
26	Total liabilities. Add lines 17 through 25..	58,258,575	26	78,972,116

	Organizations that follow FASB ASC 958, check here and complete lines 27, 28, 32, and 33.
27	Net assets without donor restrictions ..........	-54,463,881	27	-73,813,645
28	Net assets with donor restrictions ...........		28
	Organizations that do not follow FASB ASC 958, check here and complete lines 29 through 33.
29	Capital stock or trust principal, or current funds .....		29
30	Paid-in or capital surplus, or land, building or equipment fund ...		30
31	Retained earnings, endowment, accumulated income, or other funds		31
32	Total net assets or fund balances ...........	-54,463,881	32	-73,813,645
33	Total liabilities and net assets/fund balances ........	3,794,694	33	5,158,471