2020-09-17T07:36:14-05:00 2019-12-31 221478099 COHNREZNICK LLP 1301 AVENUE OF THE AMERICAS NEW YORK NY 10019 990 2019-01-01 133595755 EZRAS CHOILIM HEALTH CENTER INC EZRA 8457823242 49 FOREST ROAD MONROE NY 10950 JOEL MITTELMAN EXECUTIVE DIRECTOR 8457823242 2020-09-16 1 LORI ROTHE YOKOBOSKY CPA P01273422 2122970400 2020-08-30 209.59.242.22 2020-09-16 15:08:37 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 6C9B1A35775087DBDB8A6D25ECA509C7F6C27838 2019 2021-01-29 14:40:06Z JOEL MITTELMAN 49 FOREST ROAD MONROE NY 10950 36806062 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 11 323 0 0 0 5974013 3740787 29875305 33032291 -46052 -119080 56184 31357 35859450 36685355 0 0 0 0 22889969 24403942 0 0 0 8562593 10522274 31452562 34926216 4406888 1759139 16536725 17816960 3209284 2730380 13327441 15086580 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 29432804 32917917 TO PROVIDE HEALTHCARE SERVICES FOR A MEDICALLY UNDERSERVED POPULATION FOR 151,312 VISITS IN YEAR ENDED 12/31/19. 29432804 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 25 0 1 323 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 BAILA HIRSCH CFO 28.00 X 174230 0 10534 JOEL MITTELMAN EXECUTIVE DIRECTOR 40.00 X 558494 0 16193 TAMAR SKAIST DEPUTY EXECUTIVE DIRECTOR 40.00 X 264737 0 10238 ADAM POLINGER DIR PEDIATRICS/PEDIATRICIAN 40.00 X 741554 0 13645 ADAM TILSON DIRECTOR OF INTERNAL MEDICINE/PHYSICIAN ASSISTANT 40.00 X 394395 0 10238 ARIE SCHWARTZ DIRECTOR OB/GYN/OBSTETRICIAN 40.00 X 630410 0 12917 JOEL ALLEN OBSTETRICIAN 40.00 X 424500 0 10238 SEMA BANK OBSTETRICIAN 40.00 X 408660 0 17917 3596980 0 101920 48 0 1 0 COMPHEALTH PO BOX 972651 DALLAS TX 75397 OBSTETRICIAN 652193 MICHAEL K WEISBERG DDS PC 1 MARINER WAY MONSEY NY 10952 ORTHODONTIST 391616 FRANCIS MURPHY MD PC 367 WINDSOR HWY 197 NEW WINDSOR NY 12553 DERMATOLOGIST 243341 3 2523883 1216904 542065 3740787 MEDICAID MANAGED CARE 621110 14120281 14120281 MANAGED CARE WRAPAROUND 621110 10821216 10821216 OTHER THIRD-PARTY PAYORS 621110 2243863 2243863 MEDICAID 621110 1863086 1863086 NEW YORK STATE UNCOMPENSATED CARE 621110 1474795 1474795 2509050 2509050 33032291 1627 1627 120707 -120707 -120707 -120707 MISCELLANEOUS INCOME 900099 31357 6333 25024 31357 36685355 32917917 0 26651 1034425 892202 142223 18363565 15838762 2524803 3535456 3049366 486090 1470496 1268318 202178 33617 33617 117663 117663 2861506 2338112 523394 124948 89211 35737 2878498 2421035 457463 69808 49842 19966 40469 34037 6432 957647 805454 152193 63623 53512 10111 CONSUMABLE SUPPLIES 1830749 1307125 523624 DONATED VACCINES 542065 542065 EQUIPMENT RENTAL & MAIN 255971 215291 40680 BAD DEBT 215583 215583 530127 312889 217238 34926216 29432804 5493412 0 5821469 4870382 2482915 4504542 903705 491615 1970835 3025422 59902 49314 10298575 5517277 5297899 4781298 0 94387 16536725 17816960 2068733 2091640 930283 517316 210268 121424 3209284 2730380 X 13327441 15086580 13327441 15086580 16536725 17816960 1759139 0 X X 0 1 X 1 1 1 X 1802182 2023933 2957882 5974013 3740787 16498797 22444061 25836626 27695797 29875305 33032291 138884080 24246243 27860559 30653679 35849318 36773078 155382877 0 0 0 155382877 164 433 889 1034 1627 4147 164 433 889 1034 1627 4147 112973 45547 111261 56184 31357 357322 24359380 27906539 30765829 35906536 36806062 155744346 0.99770 0.99740 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. MEANINGFUL USE INCENTIVE - 2015 AMOUNT: $ 102,000. 2016 AMOUNT: $ 33,750. 2017 AMOUNT: $ 93,500. 2018 AMOUNT: $ 23,000. MEDICAL RECORDS - 2015 AMOUNT: $ 5,870. 2016 AMOUNT: $ 5,982. DBL INCOME - 2015 AMOUNT: $ 5,103. 2016 AMOUNT: $ 5,534. 2017 AMOUNT: $ 10,479. 2018 AMOUNT: $ 20,477. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 4034953 1051543 2983410 6075614 4391624 1683990 188008 74110 113898 4781298 DEFERRED RENT 121424 121424 X 36590479 -215583 -215583 36806062 -120707 -120707 36685355 34831340 120707 120707 34710633 215583 215583 34926216 PART X, LINE 2: THE CENTER HAS NO UNRECOGNIZED TAX BENEFITS AT DECEMBER 31, 2019. THE CENTER'S FEDERAL AND STATE INCOME TAX RETURNS PRIOR TO FISCAL YEAR 2016 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 XI, LINE 2D - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBT -215,583. PART XI, LINE 4B - OTHER ADJUSTMENTS: LOSS ON DISPOSAL OF FIXED ASSETS -120,707. PART XII, LINE 2D - OTHER ADJUSTMENTS: LOSS ON DISPOSAL OF FIXED ASSETS 120,707. PART XII, LINE 4B - OTHER ADJUSTMENTS: PROVISION FOR BAD DEBT 215,583. X X X X 0 0 0 0 0 0 0 1 0 BAILA HIRSCH CFO 162131 0 11829 0 270 0 0 0 10534 0 184764 0 0 0 JOEL MITTELMAN EXECUTIVE DIRECTOR 534033 0 19757 0 4704 0 0 0 16193 0 574687 0 0 0 TAMAR SKAIST DEPUTY EXECUTIVE DIRECTOR 257113 0 3171 0 4453 0 0 0 10238 0 274975 0 0 0 ADAM POLINGER DIR PEDIATRICS/PEDIATRICIAN 666593 0 65046 0 9915 0 0 0 13645 0 755199 0 0 0 ADAM TILSON DIRECTOR OF INTERNAL MEDICINE/PHYSIC 388507 0 3711 0 2177 0 0 0 10238 0 404633 0 0 0 ARIE SCHWARTZ DIRECTOR OB/GYN/OBSTETRICIAN 627321 0 3089 0 0 0 0 0 12917 0 643327 0 0 0 JOEL ALLEN OBSTETRICIAN 417615 0 3177 0 3708 0 0 0 10238 0 434738 0 0 0 SEMA BANK OBSTETRICIAN 404590 0 3260 0 810 0 0 0 17917 0 426577 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 542065 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.