CENTER FOR COMPREHENSIVE HEALTH PRACTICE INC: Form 990, tax year 2021
View the entire original 990 at ProPublica ↗
- Organization
- CENTER FOR COMPREHENSIVE HEALTH PRACTICE INC (EIN 13-3484329)
- Tax period
- 2021-01-01 to 2021-12-31
- Filed
- 2022-11-15
- IRS object ID
- 202213199349314871
- Schema version
- 2021v4.2
- Source
- Download XML · Original 990 at ProPublica
Every field in the e-filed return. Faint text is the IRS element name, for citing.
Return header ReturnHeader
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return | 2022-11-15T13:24:05-06:00 | ReturnTs |
| Tax Period End | 2021-12-31 | TaxPeriodEndDt |
Preparer Firm PreparerFirmGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Firm EIN | 271728945 | PreparerFirmEIN |
Preparer Firm Name PreparerFirmName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | PKF O'CONNOR DAVIES LLP | BusinessNameLine1Txt |
Preparer US Address PreparerUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 245 PARK AVENUE 12TH FLOOR | AddressLine1Txt |
| City | NEW YORK | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 10167 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Return Type | 990 | ReturnTypeCd |
| Tax Period Begin | 2021-01-01 | TaxPeriodBeginDt |
Filer Filer
| Field | Value | IRS element (for citing) |
|---|---|---|
| EIN | 133484329 | EIN |
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | CENTER FOR COMPREHENSIVE HEALTH | BusinessNameLine1Txt |
| Business Name Line2 | PRACTICE INC | BusinessNameLine2Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Control | CENT | BusinessNameControlTxt |
| Phone | 2123607893 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1900 2ND AVENUE 12TH FL | AddressLine1Txt |
| City | NEW YORK | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 10029 | ZIPCd |
Business Officer BusinessOfficerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person | MAX THOMPSON | PersonNm |
| Person Title | TREASURER | PersonTitleTxt |
| Phone | 2123607893 | PhoneNum |
| Signature | 2022-11-15 | SignatureDt |
| Discuss With Paid Preparer | Yes (1) | DiscussWithPaidPreparerInd |
Signing Officer SigningOfficerGrp
Person Full Name PersonFullName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Person First | MAX | PersonFirstNm |
| Person Last | THOMPSON | PersonLastNm |
| Field | Value | IRS element (for citing) |
|---|---|---|
| SSN | 999009999 | SSN |
Preparer Person PreparerPersonGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Preparer Person | EVA MRUK | PreparerPersonNm |
| PTIN | P00543254 | PTIN |
| Phone | 2122862600 | PhoneNum |
| Preparation | 2022-11-14 | PreparationDt |
Additional Filer Information AdditionalFilerInformation
Trusted Customer TrustedCustomerGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Trusted Customer | 3 | TrustedCustomerCd |
| Authentication Assurance Level | AAL1 | AuthenticationAssuranceLevelCd |
| Identity Assurance Level | IAL1 | IdentityAssuranceLevelCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Tax | 2021 | TaxYr |
| Build TS | 2022-09-23 18:48:47Z | BuildTS |
Form 990 IRS990
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Change | Yes (X) | AddressChangeInd |
| Principal Officer | ANN MENDELSOHN | PrincipalOfficerNm |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1900 2ND AVENUE 12TH FL | AddressLine1Txt |
| City | NEW YORK | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 10029 | ZIPCd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Gross Receipts | $7,972,810 | GrossReceiptsAmt |
| Group Return For Affiliates | 0 | GroupReturnForAffiliatesInd |
| Organization501c3 | Yes (X) | Organization501c3Ind |
| Website Address | WWW.CCHPHEALTHCARE.ORG | WebsiteAddressTxt |
| Type Of Organization Corp | Yes (X) | TypeOfOrganizationCorpInd |
| Formation | 1990 | FormationYr |
| Legal Domicile State | NY | LegalDomicileStateCd |
| Activity Or Mission | TO PROVIDE ACCESSIBLE COMMUNITY-BASED TREATMENT THAT INTEGRATES PRIMARY HEALTH CARE WITH SUBSTANCE USE AND BEHAVIORAL HEALTH SERVICES. | ActivityOrMissionDesc |
| Voting Members Governing Body | 10 | VotingMembersGoverningBodyCnt |
| Voting Members Independent | 10 | VotingMembersIndependentCnt |
| Total Employee | 81 | TotalEmployeeCnt |
| Total Volunteers | 10 | TotalVolunteersCnt |
| Total Gross UBI | $0 | TotalGrossUBIAmt |
| Net Unrelated Bus Txbl Incm | $0 | NetUnrelatedBusTxblIncmAmt |
| PY Contributions Grants | $4,940,610 | PYContributionsGrantsAmt |
| CY Contributions Grants | $4,428,649 | CYContributionsGrantsAmt |
| PY Program Service Revenue | $4,120,905 | PYProgramServiceRevenueAmt |
| CY Program Service Revenue | $3,534,974 | CYProgramServiceRevenueAmt |
| PY Investment Income | $345 | PYInvestmentIncomeAmt |
| CY Investment Income | $420 | CYInvestmentIncomeAmt |
| PY Other Revenue | $1,608 | PYOtherRevenueAmt |
| CY Other Revenue | $8,767 | CYOtherRevenueAmt |
| PY Total Revenue | $9,063,468 | PYTotalRevenueAmt |
| CY Total Revenue | $7,972,810 | CYTotalRevenueAmt |
| PY Grants And Similar Paid | $0 | PYGrantsAndSimilarPaidAmt |
| CY Grants And Similar Paid | $0 | CYGrantsAndSimilarPaidAmt |
| PY Benefits Paid To Members | $0 | PYBenefitsPaidToMembersAmt |
| CY Benefits Paid To Members | $0 | CYBenefitsPaidToMembersAmt |
| PY Salaries Comp Emp Bnft Paid | $6,109,664 | PYSalariesCompEmpBnftPaidAmt |
| CY Salaries Comp Emp Bnft Paid | $4,811,062 | CYSalariesCompEmpBnftPaidAmt |
| PY Total Prof Fndrsng Expns | $0 | PYTotalProfFndrsngExpnsAmt |
| CY Total Prof Fndrsng Expns | $0 | CYTotalProfFndrsngExpnsAmt |
| CY Total Fundraising Expense | $101,770 | CYTotalFundraisingExpenseAmt |
| PY Other Expenses | $2,417,421 | PYOtherExpensesAmt |
| CY Other Expenses | $2,079,481 | CYOtherExpensesAmt |
| PY Total Expenses | $8,527,085 | PYTotalExpensesAmt |
| CY Total Expenses | $6,890,543 | CYTotalExpensesAmt |
| PY Revenues Less Expenses | $536,383 | PYRevenuesLessExpensesAmt |
| CY Revenues Less Expenses | $1,082,267 | CYRevenuesLessExpensesAmt |
| Total Assets BOY | $1,818,590 | TotalAssetsBOYAmt |
| Total Assets EOY | $3,393,123 | TotalAssetsEOYAmt |
| Total Liabilities BOY | $1,484,744 | TotalLiabilitiesBOYAmt |
| Total Liabilities EOY | $1,981,855 | TotalLiabilitiesEOYAmt |
| Net Assets Or Fund Balances BOY | $333,846 | NetAssetsOrFundBalancesBOYAmt |
| Net Assets Or Fund Balances EOY | $1,411,268 | NetAssetsOrFundBalancesEOYAmt |
| Info In Schedule O Part III | Yes (X) | InfoInScheduleOPartIIIInd |
| Mission | THE CENTER FOR COMPREHENSIVE HEALTH PRACTICE, INC. PROVIDES ACCESSIBLE COMMUNITY-BASED TREATMENT THAT INTEGRATES PRIMARY HEALTH CARE WITH SUBSTANCE USE AND BEHAVIORAL HEALTH SERVICES FOR ALL CHILDREN, ADOLESCENTS, ADULTS AND FAMILIES RESIDING IN EAST HARLEM AND THE GREATER NEW YORK COMMUNITY. OUR APPROACH CREATES A LASTING HEALTH CARE PARTNERSHIP BETWEEN PATIENTS, FAMILIES AND PROFESSIONALS. | MissionDesc |
| Significant New Program Srvc | 0 | SignificantNewProgramSrvcInd |
| Significant Change | 0 | SignificantChangeInd |
| Expense | $2,952,073 | ExpenseAmt |
| Revenue | $1,862,908 | RevenueAmt |
| Desc | THE EXTENDED CARE PROGRAM IS A METHADONE MAINTENANCE PROGRAM THAT PROVIDES LONG-TERM OUTPATIENT CARE FOR PEOPLE WHO REQUIRE ONGOING TREATMENT IN ORDER TO BECOME OR REMAIN FREE FROM THE USE OF OPIOIDS. THE GOAL OF THE PROGRAM IS TO HELP PATIENTS MAINTAIN ABSTINENCE FROM ILLICIT DRUG USE WHILE ADDRESSING THEIR MEDICAL, MENTAL HEALTH, FAMILY, INTERPERSONAL, HOUSING, LEGAL AND VOCATIONAL NEEDS. TREATMENT IS TAILORED WITH ACTIVE PATIENT PARTICIPATION TO ENSURE THE BEST OPPORTUNITY FOR RECOVERY. DURING 2021, 563 PATIENTS WERE SERVED WITH 13,740 VISITS. IN 2021, CCHP MERGED TWO OTHER MEDICATION ASSISTED TREATMENT PROGRAMS INTO CCHP'S EXTENDED CARE PROGRAM, WHICH INCREASED OUR TOTAL NUMBER OF UNIQUE PATIENTS AND VISITS WITHIN THIS PROGRAM. | Desc |
Prog Srvc Accom Acty2 ProgSrvcAccomActy2Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,250,586 | ExpenseAmt |
| Revenue | $566,149 | RevenueAmt |
| Desc | THE FAMILY AND EMPLOYMENT SERVICES PROGRAM HELPS INDIVIDUALS AND FAMILIES OVERCOME SUBSTANCE USE ISSUES, STABILIZE FAMILY RELATIONSHIPS, EXPAND EMPLOYMENT OPTIONS AND IMPROVE OVERALL HEALTH AND MENTAL HEALTH STATUS. TREATMENT IS TAILORED WITH ACTIVE PATIENT PARTICIPATION TO ENSURE THE BEST OPPORTUNITY FOR RECOVERY. DURING 2021, 290 PATIENTS WERE SERVED WITH 9,041 VISITS. | Desc |
Prog Srvc Accom Acty3 ProgSrvcAccomActy3Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $1,184,140 | ExpenseAmt |
| Revenue | $1,094,805 | RevenueAmt |
| Desc | PRIMARY CARE HEALTH SERVICES EXTENDS BEYOND A ONCE A YEAR PHYSICAL WITH YOUR PRIMARY CARE PROVIDER. OUR TEAM OF PHYSICIANS, SPECIALISTS, COUNSELORS AND NURSES WORK TOGETHER TO ADDRESS THE MEDICAL, SOCIAL, AND EMOTIONAL AND CHILD DEVELOPMENT NEEDS OF FAMILIES. BY EMPHASIZING HEALTH EDUCATION, PREVENTION AND EARLY TREATMENT OF ILLNESSES, OUR TRAINED STAFF IS ABLE TO INTERVENE BEFORE MINOR ISSUES BECOME LIFE-THREATENING CONDITIONS. OUR PLAYROOMS PROVIDE A SPACE FOR EARLY CHILDHOOD DEVELOPMENT SERVICES, AS WELL AS ENABLING PARENTS TO HAVE A SAFE PLACE FOR THEIR CHILDREN DURING THEIR APPOINTMENTS. DURING 2021, 2,592 PATIENTS WERE SERVED WITH 13,361 VISITS. | Desc |
Prog Srvc Accom Acty Other ProgSrvcAccomActyOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Expense | $469,427 | ExpenseAmt |
| Revenue | $11,112 | RevenueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Other Prog Srvc Expense | $469,427 | TotalOtherProgSrvcExpenseAmt |
| Total Other Prog Srvc Revenue | $11,112 | TotalOtherProgSrvcRevenueAmt |
| Total Program Service Expenses | $5,856,226 | TotalProgramServiceExpensesAmt |
| Described In Section501c3 | Yes (1) | DescribedInSection501c3Ind |
| Schedule B Required | Yes (1) | ScheduleBRequiredInd |
| Political Campaign Acty | 0 | PoliticalCampaignActyInd |
| Lobbying Activities | 0 | LobbyingActivitiesInd |
| Subject To Proxy Tax | 0 | SubjectToProxyTaxInd |
| Donor Advised Fund | 0 | DonorAdvisedFundInd |
| Conservation Easements | 0 | ConservationEasementsInd |
| Collections Of Art | 0 | CollectionsOfArtInd |
| Credit Counseling | 0 | CreditCounselingInd |
| Donor Rstr Or Quasi Endowments | 0 | DonorRstrOrQuasiEndowmentsInd |
| Report Land Building Equipment | Yes (1) | ReportLandBuildingEquipmentInd |
| Report Investments Other Sec | 0 | ReportInvestmentsOtherSecInd |
| Report Program Related Invst | 0 | ReportProgramRelatedInvstInd |
| Report Other Assets | Yes (1) | ReportOtherAssetsInd |
| Report Other Liabilities | 0 | ReportOtherLiabilitiesInd |
| Include FIN48 Footnote | Yes (1) | IncludeFIN48FootnoteInd |
| Independent Audit Fincl Stmt | Yes (1) | IndependentAuditFinclStmtInd |
| Consolidated Audit Fincl Stmt | 0 | ConsolidatedAuditFinclStmtInd |
| School Operating | 0 | SchoolOperatingInd |
| Foreign Office | 0 | ForeignOfficeInd |
| Foreign Activities | 0 | ForeignActivitiesInd |
| More Than5000 K To Org | 0 | MoreThan5000KToOrgInd |
| More Than5000 K To Individuals | 0 | MoreThan5000KToIndividualsInd |
| Professional Fundraising | 0 | ProfessionalFundraisingInd |
| Fundraising Activities | 0 | FundraisingActivitiesInd |
| Gaming Activities | 0 | GamingActivitiesInd |
| Operate Hospital | 0 | OperateHospitalInd |
| Grants To Organizations | 0 | GrantsToOrganizationsInd |
| Grants To Individuals | 0 | GrantsToIndividualsInd |
| Schedule J Required | Yes (1) | ScheduleJRequiredInd |
| Tax Exempt Bonds | 0 | TaxExemptBondsInd |
| Engaged In Excess Benefit Trans | 0 | EngagedInExcessBenefitTransInd |
| PY Excess Benefit Trans | 0 | PYExcessBenefitTransInd |
| Loan Outstanding | 0 | LoanOutstandingInd |
| Grant To Related Person | 0 | GrantToRelatedPersonInd |
| Business Rln With Org Mem | 0 | BusinessRlnWithOrgMemInd |
| Business Rln With Fam Mem | 0 | BusinessRlnWithFamMemInd |
| Business Rln With35 Ctrl Ent | 0 | BusinessRlnWith35CtrlEntInd |
| Deductible Non Cash Contri | 0 | DeductibleNonCashContriInd |
| Deductible Art Contribution | 0 | DeductibleArtContributionInd |
| Terminate Operations | 0 | TerminateOperationsInd |
| Partial Liquidation | 0 | PartialLiquidationInd |
| Disregarded Entity | 0 | DisregardedEntityInd |
| Related Entity | 0 | RelatedEntityInd |
| Related Organization Ctrl Ent | 0 | RelatedOrganizationCtrlEntInd |
| Trnsfr Exmpt Non Chrtbl Rltd Org | 0 | TrnsfrExmptNonChrtblRltdOrgInd |
| Activities Conducted Prtshp | 0 | ActivitiesConductedPrtshpInd |
| Schedule O Required | Yes (1) | ScheduleORequiredInd |
| IRP Document | 21 | IRPDocumentCnt |
| IRP Document W2 G | 0 | IRPDocumentW2GCnt |
| Employee | 81 | EmployeeCnt |
| Employment Tax Returns Filed | Yes (1) | EmploymentTaxReturnsFiledInd |
| Unrelated Bus Incm Over Limit | 0 | UnrelatedBusIncmOverLimitInd |
| Foreign Financial Account | 0 | ForeignFinancialAccountInd |
| Prohibited Tax Shelter Trans | 0 | ProhibitedTaxShelterTransInd |
| Taxable Party Notification | 0 | TaxablePartyNotificationInd |
| Nondeductible Contributions | 0 | NondeductibleContributionsInd |
| Quid Pro Quo Contributions | 0 | QuidProQuoContributionsInd |
| Form8282 Property Disposed Of | 0 | Form8282PropertyDisposedOfInd |
| Rcv Fnds To Pay Prsnl Bnft Cntrct | 0 | RcvFndsToPayPrsnlBnftCntrctInd |
| Pay Premiums Prsnl Bnft Cntrct | 0 | PayPremiumsPrsnlBnftCntrctInd |
| Indoor Tanning Services | 0 | IndoorTanningServicesInd |
| Subj To Tax Rmnrtn Ex Prcht Pymt | 0 | SubjToTaxRmnrtnExPrchtPymtInd |
| Subject To Excs Tax Net Invst Inc | 0 | SubjectToExcsTaxNetInvstIncInd |
| Info In Schedule O Part VI | Yes (X) | InfoInScheduleOPartVIInd |
| Governing Body Voting Members | 10 | GoverningBodyVotingMembersCnt |
| Independent Voting Member | 10 | IndependentVotingMemberCnt |
| Family Or Business Rln | 0 | FamilyOrBusinessRlnInd |
| Delegation Of Mgmt Duties | 0 | DelegationOfMgmtDutiesInd |
| Change To Org Documents | 0 | ChangeToOrgDocumentsInd |
| Material Diversion Or Misuse | 0 | MaterialDiversionOrMisuseInd |
| Members Or Stockholders | 0 | MembersOrStockholdersInd |
| Election Of Board Members | 0 | ElectionOfBoardMembersInd |
| Decisions Subject To Approva | 0 | DecisionsSubjectToApprovaInd |
| Minutes Of Governing Body | Yes (1) | MinutesOfGoverningBodyInd |
| Minutes Of Committees | Yes (1) | MinutesOfCommitteesInd |
| Officer Mailing Address | 0 | OfficerMailingAddressInd |
| Local Chapters | 0 | LocalChaptersInd |
| Form990 Provided To Gvrn Body | Yes (1) | Form990ProvidedToGvrnBodyInd |
| Conflict Of Interest Policy | Yes (1) | ConflictOfInterestPolicyInd |
| Annual Disclosure Covered Prsn | Yes (1) | AnnualDisclosureCoveredPrsnInd |
| Regular Monitoring Enfrc | Yes (1) | RegularMonitoringEnfrcInd |
| Whistleblower Policy | Yes (1) | WhistleblowerPolicyInd |
| Document Retention Policy | 0 | DocumentRetentionPolicyInd |
| Compensation Process CEO | Yes (1) | CompensationProcessCEOInd |
| Compensation Process Other | 0 | CompensationProcessOtherInd |
| Investment In Joint Venture | 0 | InvestmentInJointVentureInd |
| States Where Copy Of Return Is Fld | NY | StatesWhereCopyOfReturnIsFldCd |
| Other Website | Yes (X) | OtherWebsiteInd |
| Upon Request | Yes (X) | UponRequestInd |
Books In Care Of Detail BooksInCareOfDetail
Business Name BusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | ANN MENDELSOHN | BusinessNameLine1Txt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Phone | 2123607893 | PhoneNum |
US Address USAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | 1900 2ND AVENUE 12TH FL | AddressLine1Txt |
| City | NEW YORK | CityNm |
| State Abbreviation | NY | StateAbbreviationCd |
| ZIP | 10029 | ZIPCd |
Form990 Part VII Section A Form990PartVIISectionAGrp (20 entries)
| TitleTitleTxt | Average Hours Per WeekAverageHoursPerWeekRt | Individual Trustee Or DirectorIndividualTrusteeOrDirectorInd | OfficerOfficerInd | Reportable Comp From OrgReportableCompFromOrgAmt | Reportable Comp From Rltd OrgReportableCompFromRltdOrgAmt | Other CompensationOtherCompensationAmt | Key EmployeeKeyEmployeeInd | Highest Compensated EmployeeHighestCompensatedEmployeeInd |
|---|---|---|---|---|---|---|---|---|
| BEN KUSMIN ESQ | ||||||||
| CHAIRPERSON | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| SARA STONE | ||||||||
| SECRETARY | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| BARBARA PAXTON | ||||||||
| TREASURER | 2.00 | Yes (X) | Yes (X) | $0 | $0 | $0 | ||
| ANDREW CHI | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| WILL GEORGE | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| BRENDA GRANDELL | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| DONNA LAZARUS ESQ | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| LESLIE STONE MD | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| ANGELA TU MD | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| MAX THOMPSON | ||||||||
| DIRECTOR | 1.00 | Yes (X) | $0 | $0 | $0 | |||
| ANN MENDELSOHN | ||||||||
| COO THRU 3/2021, CEO EFF. 3/2021 | 35.00 | Yes (X) | $169,849 | $0 | $27,644 | |||
| RAIN ZHANG | ||||||||
| CHIEF FINANCIAL OFFICER THRU 6/2021 | 35.00 | Yes (X) | $75,223 | $0 | $16,653 | |||
| SUSAN OHANESIAN | ||||||||
| CHIEF EXECUTIVE OFFICER THRU 3/2021 | 35.00 | Yes (X) | $82,436 | $0 | $529 | |||
| THOMAS NICOLICH | ||||||||
| CHIEF FINANCIAL OFFICER THRU 1/2021 | 35.00 | Yes (X) | $20,915 | $0 | $2,431 | |||
| TONIA ELVIN | ||||||||
| CHIEF FINANCIAL OFFICER EFF. 11/2021 | 35.00 | Yes (X) | $21,457 | $0 | $916 | |||
| MARIELY FERNANDEZ MD | ||||||||
| CHIEF MEDICAL OFFICER | 35.00 | $186,592 | $0 | $10,987 | Yes (X) | |||
| ANNA RENKIEWICZ | ||||||||
| PHYSICIAN | 35.00 | $154,348 | $0 | $54,295 | Yes (X) | |||
| MICHELLE GADOT | ||||||||
| CHIEF OPERATING OFFICER, EFF. 3/2021 | 35.00 | $105,215 | $0 | $16,633 | Yes (X) | |||
| OLIVIA ALCANTARA | ||||||||
| NURSING DIRECTOR | 35.00 | $105,178 | $0 | $7,407 | Yes (X) | |||
| RACHEL HEYMAN | ||||||||
| DIRECTOR BHAS | 35.00 | $100,712 | $0 | $7,234 | Yes (X) | |||
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Reportable Comp From Org | $1,021,925 | TotalReportableCompFromOrgAmt |
| Tot Reportable Comp Rltd Org | $0 | TotReportableCompRltdOrgAmt |
| Total Other Compensation | $144,729 | TotalOtherCompensationAmt |
| Indiv Rcvd Greater Than100 K | 6 | IndivRcvdGreaterThan100KCnt |
| Former Ofcr Employees Listed | 0 | FormerOfcrEmployeesListedInd |
| Total Comp Greater Than150 K | Yes (1) | TotalCompGreaterThan150KInd |
| Compensation From Other Srcs | 0 | CompensationFromOtherSrcsInd |
Contractor Compensation ContractorCompensationGrp (2 entries)
| Address Line1ContractorAddress/USAddress/AddressLine1Txt | CityContractorAddress/USAddress/CityNm | State AbbreviationContractorAddress/USAddress/StateAbbreviationCd | ZIPContractorAddress/USAddress/ZIPCd | ServicesServicesDesc | CompensationCompensationAmt |
|---|---|---|---|---|---|
| HERITAGE HOLDINGS LLC | |||||
| 135 PARK AVENUE SUITE 300 | NEW YORK | NY | 10035 | CONSTRUCTION SERVICES | $247,980 |
| ECLINICALWORKS LLC | |||||
| PO BOX 847950 | BOSTON | MA | 02284 | HEALTHCARE INFORMATION TECH | $145,589 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Cntrct Rcvd Greater Than100 K | 2 | CntrctRcvdGreaterThan100KCnt |
| Government Grants | $4,022,064 | GovernmentGrantsAmt |
| All Other Contributions | $406,585 | AllOtherContributionsAmt |
| Total Contributions | $4,428,649 | TotalContributionsAmt |
Program Service Revenue ProgramServiceRevenueGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | Related Or Exempt Func IncomeRelatedOrExemptFuncIncomeAmt |
|---|---|---|---|
| PATIENT SERVICE REV. | 621400 | $3,531,614 | $3,531,614 |
| PARENTING FEES | 621400 | $3,360 | $3,360 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Program Service Revenue | $3,534,974 | TotalProgramServiceRevenueAmt |
Investment Income InvestmentIncomeGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $420 | TotalRevenueColumnAmt |
| Exclusion | $420 | ExclusionAmt |
Other Revenue Misc OtherRevenueMiscGrp (2 entries)
| DescDesc | BusinessBusinessCd | Total Revenue ColumnTotalRevenueColumnAmt | ExclusionExclusionAmt |
|---|---|---|---|
| NYS UNCLAIMED FUNDS | 900099 | $7,350 | $7,350 |
| MISCELLANEOUS INCOME | 900099 | $1,417 | $1,417 |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Revenue Total | $8,767 | OtherRevenueTotalAmt |
Total Revenue TotalRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Revenue Column | $7,972,810 | TotalRevenueColumnAmt |
| Related Or Exempt Func Income | $3,534,974 | RelatedOrExemptFuncIncomeAmt |
| Unrelated Business Revenue | $0 | UnrelatedBusinessRevenueAmt |
| Exclusion | $9,187 | ExclusionAmt |
Comp Current Ofcr Directors CompCurrentOfcrDirectorsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $614,532 | TotalAmt |
| Program Services | $521,262 | ProgramServicesAmt |
| Management And General | $93,270 | ManagementAndGeneralAmt |
Other Salaries And Wages OtherSalariesAndWagesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $3,262,725 | TotalAmt |
| Program Services | $3,046,804 | ProgramServicesAmt |
| Management And General | $142,946 | ManagementAndGeneralAmt |
| Fundraising | $72,975 | FundraisingAmt |
Pension Plan Contributions PensionPlanContributionsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $111,937 | TotalAmt |
| Program Services | $102,310 | ProgramServicesAmt |
| Management And General | $7,284 | ManagementAndGeneralAmt |
| Fundraising | $2,343 | FundraisingAmt |
Other Employee Benefits OtherEmployeeBenefitsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $476,076 | TotalAmt |
| Program Services | $436,997 | ProgramServicesAmt |
| Management And General | $29,735 | ManagementAndGeneralAmt |
| Fundraising | $9,344 | FundraisingAmt |
Payroll Taxes PayrollTaxesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $345,792 | TotalAmt |
| Program Services | $314,391 | ProgramServicesAmt |
| Management And General | $25,146 | ManagementAndGeneralAmt |
| Fundraising | $6,255 | FundraisingAmt |
Fees For Services Legal FeesForServicesLegalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $72,594 | TotalAmt |
| Program Services | $1,700 | ProgramServicesAmt |
| Management And General | $70,894 | ManagementAndGeneralAmt |
Fees For Services Accounting FeesForServicesAccountingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $139,293 | TotalAmt |
| Program Services | $57,332 | ProgramServicesAmt |
| Management And General | $81,961 | ManagementAndGeneralAmt |
Fees For Services Other FeesForServicesOtherGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $205,061 | TotalAmt |
| Program Services | $156,131 | ProgramServicesAmt |
| Management And General | $48,856 | ManagementAndGeneralAmt |
| Fundraising | $74 | FundraisingAmt |
Office Expenses OfficeExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $78,288 | TotalAmt |
| Program Services | $37,311 | ProgramServicesAmt |
| Management And General | $35,541 | ManagementAndGeneralAmt |
| Fundraising | $5,436 | FundraisingAmt |
Information Technology InformationTechnologyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $287,425 | TotalAmt |
| Program Services | $285,481 | ProgramServicesAmt |
| Management And General | $1,944 | ManagementAndGeneralAmt |
Occupancy OccupancyGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $534,294 | TotalAmt |
| Program Services | $522,504 | ProgramServicesAmt |
| Management And General | $6,447 | ManagementAndGeneralAmt |
| Fundraising | $5,343 | FundraisingAmt |
Travel TravelGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $4,473 | TotalAmt |
| Program Services | $4,198 | ProgramServicesAmt |
| Management And General | $275 | ManagementAndGeneralAmt |
Depreciation Depletion DepreciationDepletionGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $41,855 | TotalAmt |
| Management And General | $41,855 | ManagementAndGeneralAmt |
Insurance InsuranceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $142,387 | TotalAmt |
| Program Services | $115,444 | ProgramServicesAmt |
| Management And General | $26,943 | ManagementAndGeneralAmt |
Other Expenses OtherExpensesGrp (4 entries)
| DescDesc | TotalTotalAmt | Management And GeneralManagementAndGeneralAmt | Program ServicesProgramServicesAmt |
|---|---|---|---|
| BAD DEBT | $278,352 | $278,352 | |
| MEDICAL SUPPLIES | $190,196 | $67 | $190,129 |
| REPAIRS AND MAINTENANCE | $81,891 | $41,007 | $40,884 |
| STAFF DEVELOPMENT | $8,252 | $8,252 |
All Other Expenses AllOtherExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $15,120 | TotalAmt |
| Program Services | $15,096 | ProgramServicesAmt |
| Management And General | $24 | ManagementAndGeneralAmt |
Total Functional Expenses TotalFunctionalExpensesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total | $6,890,543 | TotalAmt |
| Program Services | $5,856,226 | ProgramServicesAmt |
| Management And General | $932,547 | ManagementAndGeneralAmt |
| Fundraising | $101,770 | FundraisingAmt |
Cash Non Interest Bearing CashNonInterestBearingGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,188 | BOYAmt |
| EOY | $1,271,547 | EOYAmt |
Savings And Temp Cash Invst SavingsAndTempCashInvstGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,990 | BOYAmt |
| EOY | $1,269,699 | EOYAmt |
Pledges And Grants Receivable PledgesAndGrantsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $147,594 | BOYAmt |
| EOY | $59,368 | EOYAmt |
Accounts Receivable AccountsReceivableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,294,001 | BOYAmt |
| EOY | $220,158 | EOYAmt |
Prepaid Expenses Defrd Charges PrepaidExpensesDefrdChargesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $40,329 | BOYAmt |
| EOY | $99,394 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Land Bldg Equip Cost Or Other Bss | $707,112 | LandBldgEquipCostOrOtherBssAmt |
| Land Bldg Equip Accum Deprec | $433,553 | LandBldgEquipAccumDeprecAmt |
Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $171,707 | BOYAmt |
| EOY | $273,559 | EOYAmt |
Other Assets Total OtherAssetsTotalGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $161,781 | BOYAmt |
| EOY | $199,398 | EOYAmt |
Total Assets TotalAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,818,590 | BOYAmt |
| EOY | $3,393,123 | EOYAmt |
Accounts Payable Accr Expnss AccountsPayableAccrExpnssGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,349,275 | BOYAmt |
| EOY | $930,085 | EOYAmt |
Deferred Revenue DeferredRevenueGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| EOY | $551,770 | EOYAmt |
Mortg Notes Pybl Scrd Invst Prop MortgNotesPyblScrdInvstPropGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $100,000 | BOYAmt |
| EOY | $0 | EOYAmt |
Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $0 | BOYAmt |
| EOY | $500,000 | EOYAmt |
Other Liabilities OtherLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $35,469 | BOYAmt |
| EOY | $0 | EOYAmt |
Total Liabilities TotalLiabilitiesGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,484,744 | BOYAmt |
| EOY | $1,981,855 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Organization Follows FASB117 | Yes (X) | OrganizationFollowsFASB117Ind |
No Donor Restriction Net Assets NoDonorRestrictionNetAssetsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $333,846 | BOYAmt |
| EOY | $1,411,268 | EOYAmt |
Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $333,846 | BOYAmt |
| EOY | $1,411,268 | EOYAmt |
Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| BOY | $1,818,590 | BOYAmt |
| EOY | $3,393,123 | EOYAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Info In Schedule O Part XI | Yes (X) | InfoInScheduleOPartXIInd |
| Reconcilation Revenue Expnss | $1,082,267 | ReconcilationRevenueExpnssAmt |
| Other Changes In Net Assets | -$4,845 | OtherChangesInNetAssetsAmt |
| Info In Schedule O Part XII | Yes (X) | InfoInScheduleOPartXIIInd |
| Method Of Accounting Accrual | Yes (X) | MethodOfAccountingAccrualInd |
| Accountant Compile Or Review | 0 | AccountantCompileOrReviewInd |
| FS Audited | Yes (1) | FSAuditedInd |
FS Audited Basis FSAuditedBasisGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Separate Basis Fincl Stmt | Yes (X) | SeparateBasisFinclStmtInd |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Audit Committee | Yes (1) | AuditCommitteeInd |
| Federal Grant Audit Required | Yes (1) | FederalGrantAuditRequiredInd |
| Federal Grant Audit Performed | Yes (1) | FederalGrantAuditPerformedInd |
Schedule A IRS990ScheduleA
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Organization170 | Yes (X) | PublicOrganization170Ind |
Gifts Grants Contri Rcvd170 GiftsGrantsContriRcvd170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,527,891 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,912,975 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,000,421 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $4,958,096 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,426,318 | CurrentTaxYearAmt |
| Total | $17,825,701 | TotalAmt |
Total Calendar Year170 TotalCalendarYear170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $2,527,891 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $2,912,975 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $3,000,421 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $4,958,096 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $4,426,318 | CurrentTaxYearAmt |
| Total | $17,825,701 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Public Support Total170 | $17,825,701 | PublicSupportTotal170Amt |
Gross Investment Income170 GrossInvestmentIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $150 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $241 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $109 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $345 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $420 | CurrentTaxYearAmt |
| Total | $1,265 | TotalAmt |
Unrelated Business Net Incm170 UnrelatedBusinessNetIncm170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus3 Years | $5,220 | CurrentTaxYearMinus3YearsAmt |
| Total | $5,220 | TotalAmt |
Other Income170 OtherIncome170Grp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Current Tax Year Minus4 Years | $759,405 | CurrentTaxYearMinus4YearsAmt |
| Current Tax Year Minus3 Years | $16,504 | CurrentTaxYearMinus3YearsAmt |
| Current Tax Year Minus2 Years | $777 | CurrentTaxYearMinus2YearsAmt |
| Current Tax Year Minus1 Year | $2,564 | CurrentTaxYearMinus1YearAmt |
| Current Tax Year | $8,767 | CurrentTaxYearAmt |
| Total | $788,017 | TotalAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Support | $18,620,203 | TotalSupportAmt |
| Gross Receipts Rltd Activities | $23,503,234 | GrossReceiptsRltdActivitiesAmt |
| Public Support CY170 | 0.95730 | PublicSupportCY170Pct |
| Public Support PY170 | 0.95340 | PublicSupportPY170Pct |
| Thirty Thr Pct Suprt Tests CY170 | Yes (X) | ThirtyThrPctSuprtTestsCY170Ind |
Form990 Schedule A Part VI Form990ScheduleAPartVIGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | SCHEDULE A, PART II, LINE 10, EXPLANATION OF OTHER INCOME: | FormAndLineReferenceDesc |
| Explanation | PARENTING FEES - 2018 AMOUNT: $ 15,805. NYS UNCLAIMED FUNDS / REFUNDS - 2018 AMOUNT: $ 460. 2021 AMOUNT: $ 7,350. MEDICAL RECORDS FEE - 2018 AMOUNT: $ 239. 2019 AMOUNT: $ 160. 2020 AMOUNT: $ 240. HEALTH BENEFIT TERMINATION - 2017 AMOUNT: $ 705,897. OTHER REVENUE - 2017 AMOUNT: $ 39,500. 2019 AMOUNT: $ 617. 2020 AMOUNT: $ 2,324. 2021 AMOUNT: $ 1,417. OTHER REVENUE - INSURANCE - 2017 AMOUNT: $ 14,008. | ExplanationTxt |
Schedule B IRS990ScheduleB
Contributor Information ContributorInformationGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Contributor | RESTRICTED | ContributorNum |
Contributor Business Name ContributorBusinessName
| Field | Value | IRS element (for citing) |
|---|---|---|
| Business Name Line1 | RESTRICTED | BusinessNameLine1 |
Contributor US Address ContributorUSAddress
| Field | Value | IRS element (for citing) |
|---|---|---|
| Address Line1 | RESTRICTED | AddressLine1 |
| Address Line2 | RESTRICTED | AddressLine2 |
| City | RESTRICTED | City |
| State | RESTRICTED | State |
| ZIP Code | RESTRICTED | ZIPCode |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Contributions | RESTRICTED | TotalContributionsAmt |
Schedule D IRS990ScheduleD
Leasehold Improvements LeaseholdImprovementsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $35,145 | OtherCostOrOtherBasisAmt |
| Depreciation | $13,019 | DepreciationAmt |
| Book Value | $22,126 | BookValueAmt |
Equipment EquipmentGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $180,961 | OtherCostOrOtherBasisAmt |
| Depreciation | $110,304 | DepreciationAmt |
| Book Value | $70,657 | BookValueAmt |
Other Land Buildings OtherLandBuildingsGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Other Cost Or Other Basis | $491,006 | OtherCostOrOtherBasisAmt |
| Depreciation | $310,230 | DepreciationAmt |
| Book Value | $180,776 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Land Buildings | $273,559 | TotalBookValueLandBuildingsAmt |
Other Assets Org OtherAssetsOrgGrp
| Field | Value | IRS element (for citing) |
|---|---|---|
| Desc | SECURITY DEPOSIT | Desc |
| Book Value | $199,398 | BookValueAmt |
| Field | Value | IRS element (for citing) |
|---|---|---|
| Total Book Value Other Assets | $199,398 | TotalBookValueOtherAssetsAmt |
| Footnote Text | Yes (X) | FootnoteTextInd |
| Total Rev Etc Audited Fincl Stmt | $7,694,458 | TotalRevEtcAuditedFinclStmtAmt |
| Revenue Not Reported | $0 | RevenueNotReportedAmt |
| Revenue Subtotal | $7,694,458 | RevenueSubtotalAmt |
| Other Revenues Not Included | $278,352 | OtherRevenuesNotIncludedAmt |
| Revenue Not Reported Fincl Stmt | $278,352 | RevenueNotReportedFinclStmtAmt |
| Total Revenue Per Form990 | $7,972,810 | TotalRevenuePerForm990Amt |
| Tot Expns Etc Audited Fincl Stmt | $6,617,036 | TotExpnsEtcAuditedFinclStmtAmt |
| Other Expenses Included | $4,845 | OtherExpensesIncludedAmt |
| Expenses Not Reported | $4,845 | ExpensesNotReportedAmt |
| Expenses Subtotal | $6,612,191 | ExpensesSubtotalAmt |
| Other Expenses Not Included | $278,352 | OtherExpensesNotIncludedAmt |
| Expenses Not Rpt Fincl Stmt | $278,352 | ExpensesNotRptFinclStmtAmt |
| Total Expenses Per Form990 | $6,890,543 | TotalExpensesPerForm990Amt |
Supplemental Information Detail SupplementalInformationDetail (4 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| PART X, LINE 2: | THE ORGANIZATION RECOGNIZES THE EFFECT OF INCOME TAX POSITIONS ONLY IF THOSE POSITIONS ARE MORE LIKELY THAN NOT TO BE SUSTAINED. MANAGEMENT HAS DETERMINED THAT THE ORGANIZATION HAD NO UNCERTAIN TAX POSITIONS THAT WOULD REQUIRE FINANCIAL STATEMENT RECOGNITION OR DISCLOSURE. THE ORGANIZATION IS NO LONGER SUBJECT TO EXAMINATIONS BY THE APPLICABLE TAXING JURISDICTIONS FOR THE PERIODS PRIOR TO DECEMBER 31, 2018. |
| PART XI, LINE 4B - OTHER ADJUSTMENTS: | BAD DEBT ALLOWANCE NET WITH REVENUE ON FINANCIAL STATEMENTS 278,352. |
| PART XII, LINE 2D - OTHER ADJUSTMENTS: | BAD DEBT EXPENSE - GRANTS 4,845. |
| PART XII, LINE 4B - OTHER ADJUSTMENTS: | BAD DEBT ALLOWANCE NET WITH REVENUE ON FINANCIAL STATEMENTS 278,352. |
Schedule J IRS990ScheduleJ
| Field | Value | IRS element (for citing) |
|---|---|---|
| Compensation Committee | Yes (X) | CompensationCommitteeInd |
| Form990 Of Other Organizations | Yes (X) | Form990OfOtherOrganizationsInd |
| Board Or Committee Approval | Yes (X) | BoardOrCommitteeApprovalInd |
| Severance Payment | Yes (1) | SeverancePaymentInd |
| Supplemental Nonqual Rtr Plan | 0 | SupplementalNonqualRtrPlanInd |
| Equity Based Comp Arrngm | 0 | EquityBasedCompArrngmInd |
| Comp Based On Revenue Of Flng Org | 0 | CompBasedOnRevenueOfFlngOrgInd |
| Comp Bsd On Rev Related Orgs | 0 | CompBsdOnRevRelatedOrgsInd |
| Comp Bsd Net Earns Flng Org | 0 | CompBsdNetEarnsFlngOrgInd |
| Comp Bsd Net Earns Rltd Orgs | 0 | CompBsdNetEarnsRltdOrgsInd |
| Any Non Fixed Payments | Yes (1) | AnyNonFixedPaymentsInd |
| Initial Contract Exception | 0 | InitialContractExceptionInd |
Rltd Org Officer Trst Key Empl RltdOrgOfficerTrstKeyEmplGrp (3 entries)
| TitleTitleTxt | Base Compensation Filing OrgBaseCompensationFilingOrgAmt | Compensation Based On Rltd OrgsCompensationBasedOnRltdOrgsAmt | Bonus Filing OrganizationBonusFilingOrganizationAmount | Bonus Related OrganizationsBonusRelatedOrganizationsAmt | Other Compensation Filing OrgOtherCompensationFilingOrgAmt | Other Compensation Rltd OrgsOtherCompensationRltdOrgsAmt | Deferred Compensation Flng OrgDeferredCompensationFlngOrgAmt | Deferred Comp Rltd OrgsDeferredCompRltdOrgsAmt | Nontaxable Benefits Filing OrgNontaxableBenefitsFilingOrgAmt | Nontaxable Benefits Rltd OrgsNontaxableBenefitsRltdOrgsAmt | Total Compensation Filing OrgTotalCompensationFilingOrgAmt | Total Compensation Rltd OrgsTotalCompensationRltdOrgsAmt | Comp Report Prior990 Filing OrgCompReportPrior990FilingOrgAmt | Comp Report Prior990 Rltd OrgsCompReportPrior990RltdOrgsAmt |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| ANNA RENKIEWICZ | ||||||||||||||
| PHYSICIAN | $151,848 | $0 | $2,500 | $0 | $0 | $0 | $7,592 | $0 | $46,703 | $0 | $208,643 | $0 | $0 | $0 |
| MARIELY FERNANDEZ MD | ||||||||||||||
| CHIEF MEDICAL OFFICER | $184,092 | $0 | $2,500 | $0 | $0 | $0 | $9,205 | $0 | $1,782 | $0 | $197,579 | $0 | $0 | $0 |
| ANN MENDELSOHN | ||||||||||||||
| COO THRU 3/2021, CEO EFF. 3/2021 | $167,349 | $0 | $2,500 | $0 | $0 | $0 | $8,367 | $0 | $19,277 | $0 | $197,493 | $0 | $0 | $0 |
Supplemental Information Detail SupplementalInformationDetail
| Field | Value | IRS element (for citing) |
|---|---|---|
| Form And Line Reference | PART I, LINE 4A | FormAndLineReferenceDesc |
| Explanation | SUSAN OHANESIAN, CHIEF EXECUTIVE OFFICER THRU 3/17/21, RECEIVED A SEVERANCE PAYMENT OF $7,700. THE ORGANIZATION PAID DISCRETIONARY BONUSES TO CERTAIN EMPLOYEES REPORTED IN PART VII AND SCHEDULE J, WHICH WAS INCLUDED IN THEIR REPORTABLE COMPENSATION. | ExplanationTxt |
Schedule O IRS990ScheduleO
Supplemental Information Detail SupplementalInformationDetail (6 entries)
| Form And Line ReferenceFormAndLineReferenceDesc | ExplanationExplanationTxt |
|---|---|
| FORM 990, PART VI, SECTION B, LINE 11B | THE ORGANIZATION'S FORM 990 IS PREPARED BY AN OUTSIDE ACCOUNTING FIRM, AND IS PRESENTED TO MANAGEMENT AND THE AUDIT COMMITTEE. ONCE ALL QUESTIONS AND ISSUES HAVE BEEN ADDRESSED A COMPLETE COPY OF THE FORM 990 IS PROVIDED TO ALL MEMBERS OF THE BOARD FOR THEIR REVIEW PRIOR TO FILING WITH THE IRS. |
| FORM 990, PART VI, SECTION B, LINE 12C | THE ORGANIZATION HAS A CONFLICT OF INTEREST POLICY THAT APPLIES TO ALL DIRECTORS, OFFICERS, AND EMPLOYEES WHICH IS ENFORCED BY THE BOARD OF DIRECTORS. ALL OFFICERS AND MEMBERS OF THE BOARD ANNUALLY COMPLETE AND SIGN A DISCLOSURE FORM, DISCLOSING ANY POTENTIAL CONFLICTS THAT MAY EXIST. ANY PERSON WITH A POTENTIAL CONFLICT DISCLOSES ALL MATERIAL FACTS TO THE BOARD, COMMITTEE, OR CHAIR OF THE MEETING IN WHICH THE CONFLICT IS TO BE DISCUSSED. IF IT IS NOT CLEAR THAT A CONFLICT OF INTEREST EXISTS, THE CHAIR OR CHAIR'S DESIGNEE MAKES THE DETERMINATION. A PERSON WHO HAS A CONFLICT CANNOT PARTICIPATE IN OR HEAR THE BOARD'S OR COMMITTEE'S DISCUSSION OF THE MATTER EXCEPT TO DISCLOSE MATERIAL FACTS AND TO RESPOND TO QUESTIONS. THE EXISTENCE OF ALL SUCH CONFLICTS OF INTEREST AND THEIR RESOLUTIONS, AS WELL AS ANY ISSUES RELATING TO THEM, ARE DOCUMENTED IN THE MINUTES OF THE MEETING. |
| FORM 990, PART VI, SECTION B, LINE 15A | THE EXECUTIVE COMMITTEE REVIEWS AND APPROVES THE COMPENSATION OF THE CHIEF EXECUTIVE OFFICER ANNUALLY. THE PROCESS INCLUDES A REVIEW OF COMPENSATION DATA FROM FORMS 990 OF COMPARABLE ORGANIZATIONS, AND WAS LAST UNDERTAKEN IN 2021. THE DELIBERATIONS AND DECISIONS WERE CONTEMPORANEOUSLY DOCUMENTED. |
| FORM 990, PART VI, SECTION C, LINE 19 | THE ORGANIZATION'S FORM 990 IS AVAILABLE FOR PUBLIC INSPECTION AS REQUIRED UNDER SECTION 6104 OF THE INTERNAL REVENUE CODE. IT IS AVAILABLE ON GUIDESTAR.ORG AND SIMILAR TYPES OF WEBSITES. THE ORGANIZATION ALSO MAKES ITS FORM 990, GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY, AND FINANCIAL STATEMENTS AVAILABLE TO THE PUBLIC UPON REQUEST. |
| FORM 990, PART XI, LINE 9: | BAD DEBT EXPENSE - GRANTS -4,845. |
| FORM 990, PART XII, LINE 2C: | THE ORGANIZATION HAS A COMMITTEE THAT ASSUMES RESPONSIBILITY FOR OVERSIGHT OF THE AUDIT OF ITS FINANCIAL STATEMENTS AND SELECTION OF AN INDEPENDENT ACCOUNTANT. THIS PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR. |