2021-11-03T10:50:08-05:00 2020-12-31 221478099 COHNREZNICK LLP 1301 AVENUE OF THE AMERICAS NEW YORK NY 10019 990 2020-01-01 133595755 EZRAS CHOILIM HEALTH CENTER INC EZRA 8457823242 49 FOREST ROAD MONROE NY 10950 JOEL MITTELMAN EXECUTIVE DIRECTOR 8457823242 2021-11-01 1 JOEL MITTELMAN 999009999 LORI ROTHE YOKOBOSKY CPA P01273422 2122970400 2021-10-21 2 AAL1 IAL1 2020 2022-09-23 18:48:47Z JOEL MITTELMAN 49 FOREST ROAD MONROE NY 10950 39733167 0 X N/A X 1996 NY A FREESTANDING DIAGNOSTIC AND TREATMENT CENTER LICENSED UNDER ARTICLE 28 OF THE NEW YORK STATE PUBLIC HEALTH LAW. THE CENTER PROVIDES A BROAD RANGE OF HEALTH SERVICES TO A LARGELY MEDICALLY UNDERSERVED POPULATION. 11 11 343 0 0 0 3740787 9451605 33032291 30218745 -119080 2726 31357 60091 36685355 39733167 0 0 0 0 24403942 27131916 0 0 0 10522274 11344416 34926216 38476332 1759139 1256835 17816960 18646781 2730380 2303366 15086580 16343415 A FREESTANDING DIAGNOSTIC AND TREATMENT CENTER LICENSED UNDER ARTICLE 28 OF THE NEW YORK STATE PUBLIC HEALTH LAW. THE CENTER PROVIDES A BROAD RANGE OF HEALTH SERVICES TO A LARGELY MEDICALLY UNDERSERVED POPULATION. 0 0 33134795 30278836 TO PROVIDE HEALTHCARE SERVICES FOR A MEDICALLY UNDERSERVED POPULATION FOR 133,376 VISITS IN YEAR ENDED 12/31/20. 33134795 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 1 0 0 0 0 0 0 0 0 1 36 0 1 343 1 0 0 0 0 0 0 0 0 0 0 0 0 X 11 11 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 NY X JOEL MITTELMAN 8457823242 49 FOREST ROAD MONROE NY 10950 ABRAHAM WEIDER CHAIRMAN 1.00 X X 0 0 0 CHAIM NUCHEM WERTZBERGER SECRETARY 1.00 X X 0 0 0 ESTHER RUBINSTEIN BOARD MEMBER 1.00 X 0 0 0 ESTHER SRUGO BOARD MEMBER 1.00 X 0 0 0 ISRAEL SOFER BOARD MEMBER 1.00 X 0 0 0 MARTIN SCHLESINGER TREASURER 1.00 X X 0 0 0 MOSES GOLDSTEIN BOARD MEMBER 1.00 X 0 0 0 NOAMI RUTH WEISZ BOARD MEMBER 1.00 X 0 0 0 NUSEN WEINSTOCK BOARD MEMBER 1.00 X 0 0 0 PINCHUS KISH BOARD MEMBER 1.00 X 0 0 0 RONALD J COHEN BOARD MEMBER 1.00 X 0 0 0 CHAYA HALBERSTAM CFO 23.00 X 138384 0 9271 JOEL MITTELMAN EXECUTIVE DIRECTOR 40.00 X 605063 0 14018 TAMAR SKAIST DEPUTY EXECUTIVE DIRECTOR 40.00 X 299555 0 8858 ADAM POLINGER DIR PEDIATRICS/PEDIATRICIA 40.00 X 765421 0 12449 ADAM TILSON DIRECTOR OF INTERNAL MEDIC 40.00 X 399050 0 8858 ARIE SCHWARTZ DIRECTOR OB/GYN/OBSTETRICI 40.00 X 655402 0 11692 JOEL ALLEN OBSTETRICIAN 40.00 X 421983 0 8858 SEMA BANK OBSTETRICIAN 40.00 X 468662 0 16692 3753520 0 90696 58 0 1 0 COMPHEALTH PO BOX 972651 DALLAS TX 75397 OBSTETRICIAN 808470 MICHAEL K WEISBERG DDS PC 1 MARINER WAY MONSEY NY 10952 ORTHODONTIST 551016 FRANCIS MURPHY MD PC 367 WINDSOR HWY 197 NEW WINDSOR NY 12553 DERMATOLOGIST 229815 ALAN MANNING 56 WENDY RD MILFORD CT 06460 QUALITY IMPROVEMENT 168976 4 7201542 2250063 509141 9451605 MEDICAID MANAGED CARE 621110 13582078 13582078 MANAGED CARE WRAPAROUND 621110 9292136 9292136 NEW YORK STATE UNCOMPENSATED CARE 621110 2109719 2109719 OTHER THIRD-PARTY PAYORS 621110 1818256 1818256 MANAGED CARE INCENTIVES 621110 1233451 1233451 2183105 2183105 30218745 2726 2726 MISCELLANEOUS INCOME 900099 60091 60091 60091 39733167 30278836 0 2726 1075148 940740 134408 20916561 18301704 2614857 3490306 3053970 436336 1649901 1443641 206260 39530 39530 116241 116241 3328437 2755110 573327 131235 113313 17922 3303056 2778120 524936 27944 24128 3816 48644 40913 7731 845015 710722 134293 71492 60130 11362 CONSUMABLE SUPPLIES 2164986 1869331 295655 DONATED VACCINES 509141 509141 EQUIPMENT RENTAL & MAIN 281015 236355 44660 DUES & SUBSCRIPTIONS 115730 99926 15804 361950 197551 164399 38476332 33134795 5341537 0 4870382 3524332 4504542 5356345 491615 761374 3025422 4079757 49314 99886 11043204 6360598 4781298 4682606 94387 142481 17816960 18646781 2091640 1766645 142901 517316 270754 121424 123066 2730380 2303366 X 15086580 16343415 15086580 16343415 17816960 18646781 1256835 0 X X 0 1 X 1 1 1 X 2023933 2957882 5974013 3740787 9451605 24148220 25836626 27695797 29875305 33032291 30218745 146658764 27860559 30653679 35849318 36773078 39670350 170806984 0 0 0 170806984 433 889 1034 1627 2726 6709 433 889 1034 1627 2726 6709 45547 111261 56184 31357 60091 304440 27906539 30765829 35906536 36806062 39733167 171118133 0.99820 0.99770 0.00000 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: OTHER REVENUE - 2016 AMOUNT: $ 281. 2017 AMOUNT: $ 7,282. 2018 AMOUNT: $ 12,707. 2019 AMOUNT: $ 31,357. 2020 AMOUNT: $ 60,091. MEANINGFUL USE INCENTIVE - 2016 AMOUNT: $ 33,750. 2017 AMOUNT: $ 93,500. 2018 AMOUNT: $ 23,000. MEDICAL RECORDS - 2016 AMOUNT: $ 5,982. DBL INCOME - 2016 AMOUNT: $ 5,534. 2017 AMOUNT: $ 10,479. 2018 AMOUNT: $ 20,477. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 4054533 1273108 2781425 6273476 4994880 1278596 715195 92610 622585 4682606 DEFERRED RENT 123066 123066 X 39733167 0 39733167 0 39733167 38476332 0 38476332 0 38476332 PART X, LINE 2: THE CENTER HAS NO UNRECOGNIZED TAX BENEFITS AT DECEMBER 31, 2020. THE CENTER'S FEDERAL AND STATE INCOME TAX RETURNS PRIOR TO FISCAL YEAR 2017 ARE CLOSED AND MANAGEMENT CONTINUALLY EVALUATES EXPIRING STATUTES OF LIMITATIONS, AUDITS, PROPOSED SETTLEMENTS, CHANGES IN TAX LAW AND NEW AUTHORITATIVE RULINGS. THE CENTER RECOGNIZES INTEREST AND PENALTIES ASSOCIATED WITH TAX MATTERS AS OPERATING EXPENSES AND INCLUDES ACCRUED INTEREST AND PENALTIES WITH ACCRUED EXPENSES IN THE STATEMENT OF FINANCIAL POSITION. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBT X X X X 0 0 0 0 0 0 0 1 0 ADAM POLINGER DIR PEDIATRICS/PEDIATRICIA 688856 0 66380 0 10185 0 0 0 12449 0 777870 0 0 0 ARIE SCHWARTZ DIRECTOR OB/GYN/OBSTETRICI 652496 0 2906 0 0 0 0 0 11692 0 667094 0 0 0 JOEL MITTELMAN EXECUTIVE DIRECTOR 593347 0 3124 0 8592 0 0 0 14018 0 619081 0 0 0 SEMA BANK OBSTETRICIAN 463512 0 4340 0 810 0 0 0 16692 0 485354 0 0 0 JOEL ALLEN OBSTETRICIAN 415385 0 2890 0 3708 0 0 0 8858 0 430841 0 0 0 ADAM TILSON DIRECTOR OF INTERNAL MEDIC 383584 0 13419 0 2047 0 0 0 8858 0 407908 0 0 0 TAMAR SKAIST DEPUTY EXECUTIVE DIRECTOR 281536 0 13365 0 4654 0 0 0 8858 0 308413 0 0 0 PART I, LINE 7 CERTAIN INDIVIDUALS RECEIVED BONUSES BASED ON PERFORMANCE WHICH WERE VOTED ON BY THE BOARD OF DIRECTORS. THESE AMOUNTS WERE INCLUDED IN THE INDIVIDUALS W-2'S, AND ARE SHOWN ON SCH J, PART II, COLUMN B(II). X 1 509141 FMV 0 0 0 PART I, COLUMN (B): COLUMN B REPRESENTS THE NUMBER OF CONTRIBUTORS. FORM 990, PART IV, LINE 20A: THE ORGANIZATION IS LICENSED UNDER ARTICLE 28 OF NEW YORK STATE PUBLIC HEALTH LAW. HOWEVER, SUBSECTION 10 OF ARTICLE 28 EXCLUDES CERTAIN HEALTHCARE FACILITIES FROM THE DEFINITION OF GENERAL HOSPITAL. THEREFORE, THE ORGANIZATION IS NOT INCLUDING SCHEDULE H IN THE CURRENT YEAR FORM 990 AS THEY DO NOT MEET THIS DEFINITION. FORM 990, PART VI, SECTION B, LINE 11B THE 990 IS PREPARED BY INDEPENDENT ACCOUNTING FIRM AND REVIEWED BY MANAGEMENT. THE REVIEWED 990 IS THEN DISCUSSED AT A MEETING OF THE BOARD OF DIRECTORS PRIOR TO FILING WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION REGULARLY AND CONSISTENTLY MONITORS CONFLICTS OF INTEREST FOR BOARD MEMBERS AND OFFICERS. ANNUALLY EACH BOARD MEMBER SHALL SIGN A STATEMENT THAT AFFIRMS THEY HAVE READ THE POLICY AND DISCLOSED ALL POTENTIAL CONFLICTS OF INTEREST. FORM 990, PART VI, SECTION B, LINE 15A THE ORGANIZATION'S BOARD OF DIRECTORS IS RESPONSIBLE FOR ESTABLISHING AND APPROVING COMPENSATION FOR ITS EXECUTIVE DIRECTOR. THE GOVERNING BODY BASES ITS DECISION ON OTHER ORGANIZATIONS' FORM 990'S AND INDUSTRY STANDARDS. FORM 990, PART VI, SECTION C, LINE 19 GOVERNING DOCUMENTS AND POLICIES AND ORGANIZATION'S FINANCIAL STATEMENTS ARE MADE AVAILABLE TO THE PUBLIC UPON REQUEST, SUPERVISED BY MANAGEMENT. FORM 990, PART XII, LINE 2C: THE SELECTION AND OVERSIGHT PROCESS HAS NOT CHANGED FROM THE PRIOR YEAR.