2022-05-06T11:52:14-05:00 2021-06-30 042571780 AAFCPAS INC 50 WASHINGTON STREET WESTBOROUGH MA 01581 990 2020-07-01 042544151 MATTAPAN COMMUNITY HEALTH CENTER INC MATT 6172960061 1575 BLUE HILL AVENUE MATTAPAN MA 02126 GUALE VALDEZ PRESIDENT & CEO 6175222766 2022-05-02 1 GUALE VALDEZ XXX-XX-XXXX SORIE KABA CPA P01317106 5083669100 2022-05-02 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z GUALE VALDEZ 1575 BLUE HILL AVENUE MATTAPAN MA 02126 13861589 0 X WWW.MATTAPANCHC.ORG X 1974 MA IMPROVE THE HEALTH AND WELL-BEING OF DIVERSE POPULATIONS IN MATTAPAN AND SURROUNDING COMMUNITIES BY PROVIDING EXCEPTIONAL COMPREHENSIVE INTEGRATED HEALTH SERVICES. 10 10 103 10 123744 24594 4336498 7008749 4647394 5903150 3291 2111 959323 947579 9946506 13861589 0 0 0 0 6126932 6443540 0 0 39886 4996982 5990586 11123914 12434126 -1177408 1427463 28792060 28895449 7388594 5344520 21403466 23550929 X IMPROVE THE HEALTH AND WELL-BEING OF DIVERSE POPULATIONS IN MATTAPAN AND SURROUNDING COMMUNITIES BY PROVIDING EXCEPTIONAL COMPREHENSIVE INTEGRATED HEALTH SERVICES. 0 0 5872876 4376085 PRIMARY CARE - PROVIDES SERVICES SUCH AS ADULT MEDICINE, PEDIATRICS, OB/GYN, NUTRITION AND HIV SERVICES TO INDIVIDUALS FROM THE MATTAPAN, DORCHESTER, ROXBURY, AND HYDE PARK NEIGHBORHOODS OF BOSTON, AS WELL AS THE ADJACENT BOSTON SUBURBS OF BROCKTON, RANDOLPH, STOUGHTON, AND MILTON, MASSACHUSETTS. MCHC SERVICES POPULATION PRIMARILY CONSISTING OF BLACK/AFRICAN AMERICANS, INCLUDING AN INCREASINGLY LARGE PERCENTAGE OF CARIBBEAN IMMIGRANTS. MCHC SERVED 11,420 PRIMARY CARE PATIENTS THROUGH 36,436 VISITS FOR THE FISCAL YEAR ENDING JUNE 30, 2021. 1155856 644140 DENTAL SERVICES - PROVIDES DENTAL SERVICES TO INDIVIDUALS FROM THE MATTAPAN, DORCHESTER, ROXBURY, AND HYDE PARK NEIGHBORHOODS OF BOSTON, AS WELL AS THE ADJACENT BOSTON SUBURBS OF BROCKTON, RANDOLPH, STOUGHTON, AND MILTON, MASSACHUSETTS. MCHC SERVED 2,435 DENTAL PATIENTS THROUGH 6,065 VISITS FOR THE FISCAL YEAR ENDING JUNE 30, 2021. 687881 642666 .BEHAVIORAL HEALTH - PROVIDES MENTAL HEALTH SERVICES TO INDIVIDUALS FROM THE MATTAPAN, DORCHESTER, ROXBURY, AND HYDE PARK NEIGHBORHOODS OF BOSTON, AS WELL AS THE ADJACENT BOSTON SUBURBS OF BROCKTON, RANDOLPH, STOUGHTON, AND MILTON, MASSACHUSETTS. MCHC SERVED 618 BEHAVIORAL HEALTH PATIENTS THROUGH 6,065 VISITS FOR THE FISCAL YEAR ENDING JUNE 30, 2021. 1234339 240259 OTHER PROGRAM SERVICES INCLUDE PREVENTIVE HEALTH, SOCIAL SERVICES, PATIENT SUPPORT AND PHARMACY 1234339 240259 8950952 1 1 0 0 0 0 0 0 0 0 1 0 0 0 1 1 1 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 1 15 0 1 103 1 1 1 0 0 0 0 0 0 0 0 0 0 0 X 10 10 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 1 0 MA X REGINA IZMAYLOVA CFO 6172960061 1575 BLUE HILL AVENUE MATTAPAN MA 02126 GLENOLA MITCHELL BOARD CHAIR 1.00 X X 0 0 0 ENO MONDESIR BOARD VICE CHAIR 1.00 X X 0 0 0 CHRISTOPHER BRANDON BOARD TREASURER 1.00 X X 0 0 0 MONET BLAND BOARD SECRETARY 1.00 X X 0 0 0 DELORES RICHARDSON BOARD MEMBER 1.00 X 0 0 0 THOMAS HAWKINS BOARD MEMBER 1.00 X 0 0 0 AUDREY THOMAS-MILLER BOARD MEMBER 1.00 X 0 0 0 VASPER GIBBS BARNES BOARD MEMBER 1.00 X 0 0 0 GEORGETTE COPELAND BOARD MEMBER 1.00 X 0 0 0 CHERYL LINDSAY BOARD MEMBER 1.00 X 0 0 0 GUALE VALDEZ CHIEF EXECUTIVE OFFICER 40.00 X 194688 0 11606 JORDINA SHANKS CHIEF OPERATING OFFICER 40.00 X 170000 0 8225 REGINA IZMAYLOVA CHIEF FINANCIAL OFFICER 40.00 X 109094 0 1911 ANUBHAV KAUL CHIEF MEDICAL OFFICER 40.00 X 183518 0 4411 NEENA CHATURVEDI INTERNIST 40.00 X 168008 0 0 RAYMOND SAMUELS DENTAL DIRECTOR 40.00 X 130445 0 3353 JOSE CARIZ INTERNIST 32.00 X 139869 0 0 LAURA LIVADITIS PEDIATRICIAN 40.00 X 160000 0 3692 DEBBIE M BROWN DIRECTOR OF HUMAN RESOURCES 40.00 X 117000 0 21356 1372622 0 54554 15 0 1 0 BU FAMILY MEDICINE ASSOCIATES 930 COMMONWEALTH AVENUE BOSTON MA 02215 CONTRACTED PROVIDER 725070 CPA MEDICAL BILLING LLC 20-1 THOMPSON ROAD BRANFORD CT 06405 OUTSOURCED BILLING 305609 OCHIN INC PO BOX 5426 PORTLAND OR 97228 IT SERVICES 245572 CALL 4 HEALTH 2855 S CONGRESS AVE DELRAY BEACH FL 33445 MEDICAL ANSWERING SERVICE 240761 K9 MERCANTILE PROTECTION INC 491 WAREHAM ST MIDDLEBOROUGH MA 02346 SECURITY SERVICES 199427 2 5874677 1134072 7008749 NET PATIENT SERVICE REVENUE 621400 5662890 5662890 PHARMACY REVENUE 446110 240260 240260 5903150 2111 2111 936706 0 936706 936706 123744 812962 MISCELLANEOUS INCOME 900099 10873 10873 10873 13861589 5903150 123744 825946 X 551078 220431 330647 5126714 3888387 1238327 342457 178425 164032 423291 294772 128519 44826 44826 53450 53450 1638368 1455064 183304 45797 45797 438226 354756 83470 555316 285089 269482 745 6847 6847 194388 150884 39908 3596 926723 467107 448483 11133 108042 19777 88265 FACILITY ALLOCATION 1074203 833795 220534 19874 PROGRAM SUPPLIES 847578 780660 62851 4067 REPAIRS AND MAINTENANCE 40339 10682 29657 MISCELLANEOUS 16483 11123 4889 471 12434126 8950952 3443288 39886 1981251 2661527 100000 100000 1076317 1397715 72904 72105 32054684 7625988 25316964 24428696 244624 235406 28792060 28895449 854750 888823 4346149 4184269 2121898 265385 65797 6043 7388594 5344520 X 21089604 23318121 313862 232808 21403466 23550929 28792060 28895449 X 1427463 720000 X X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 5179729 5179729 23377732 5216067 18161665 433356 121374 311982 2501268 1918737 582531 562599 369810 192789 24428696 DEFFERED COMPENSATION 6043 6043 X 14581589 720000 720000 13861589 0 13861589 12434126 0 12434126 0 12434126 PART X, LINE 2: MCHC ACCOUNTS FOR UNCERTAINTY IN INCOME TAXES IN ACCORDANCE WITH ASC TOPIC, INCOME TAXES. THIS STANDARD CLARIFIES THE ACCOUNTING FOR UNCERTAINTY IN TAX POSITIONS AND PRESCRIBES A RECOGNITION THRESHOLD AND MEASUREMENT ATTRIBUTE FOR THE COMBINING FINANCIAL STATEMENTS REGARDING A TAX POSITION TAKEN OR EXPECTED TO BE TAKEN IN A TAX RETURN. MCHC HAS DETERMINED THAT THERE ARE NO UNCERTAIN TAX POSITIONS WHICH QUALIFY FOR EITHER RECOGNITION OR DISCLOSURE IN THE COMBINING FINANCIAL STATEMENTS AT JUNE 30, 2021. MCHC'S INFORMATION RETURNS ARE SUBJECT TO EXAMINATION BY THE FEDERAL AND STATE JURISDICTIONS. PART XI, LINE 2D - OTHER ADJUSTMENTS: FORGIVENESS OF DEBT 720,000. X X 0 0 0 0 0 0 0 0 0 GUALE VALDEZ CHIEF EXECUTIVE OFFICER 194188 0 500 0 0 0 4717 0 6889 0 206294 0 0 0 ANUBHAV KAUL CHIEF MEDICAL OFFICER 182268 0 1250 0 0 0 4411 0 0 0 187929 0 0 0 JORDINA SHANKS CHIEF OPERATING OFFICER 169500 0 500 0 0 0 4119 0 4106 0 178225 0 0 0 NEENA CHATURVEDI INTERNIST 167008 0 1000 0 0 0 0 0 0 0 168008 0 0 0 LAURA LIVADITIS PEDIATRICIAN 157560 0 2440 0 0 0 3692 0 0 0 163692 0 0 0 FORM 990, PART VI, SECTION B, LINE 11B THE FORM 990 WILL BE REVIEWED AND APPROVED BY THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 12C BOARD MEMBERS SIGN THE CONFLICT OF INTEREST AND CONFIDENTIALITY FORMS ANNUALLY. IF BOARD MEMBERS ASSIST MCHC AS A CONSULTANT, FULL DISCLOSURE IS REPORTED TO THE ENTIRE BOARD PRIOR TO THE WORK BEING PERFORMED. FORM 990, PART VI, SECTION B, LINE 15 THE PRESIDENT AND CEO'S COMPENSATION, AS WELL AS ANY CHANGES MADE TO COMPENSATION, IS REVIEWED BY THE EXECUTIVE COMMITTEE OF THE BOARD OF DIRECTORS FOLLOWING ANY CONSULTATION WITH AN INDUSTRY EXPERT. THE MASSACHUSETTS LEAGUE OF COMMUNITY HEALTH CENTERS HAS A LIST OF AVAILABLE CONSULTANTS. A RECOMMENDATION IS SUBMITTED TO THE FULL BOARD FOR REVIEW AND APPROVAL. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS, CONFLICT OF ITNEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC UPON REQUEST. THE FORM 990 IS AVAILABLE ON THE INTERNET THROUGH GUIDESTAR.ORG. FORM 990, PART IX, LINE 11G CONTRACTED SERVICES: PROGRAM SERVICE EXPENSES 1,455,064. MANAGEMENT AND GENERAL EXPENSES 183,304. FUNDRAISING EXPENSES 0. TOTAL EXPENSES 1,638,368. FORM 990, PART XI, LINE 9: FORGIVENESS OF DEBT 720,000. FORM 990, PART XII, LINE 2C: THIS PROCESS HAS NOT CHANGED BETWEEN YEARS.