2020-10-30T10:10:58-05:00 2019-12-31 221478099 COHNREZNICK LLP 1301 AVENUE OF THE AMERICAS NEW YORK NY 10019 990 2019-01-01 132739694 CHARLES B WANG COMMUNITY HEALTH CENTER INC CHAR 2123796988 268 CANAL STREET NEW YORK NY 10013 KAUSHAL CHALLA CEO 2123796988 2020-10-13 1 LORI ROTHE YOKOBOSKY CPA P01273422 2122970400 2020-10-08 209.59.242.36 2020-10-13 11:40:07 ED P DA39A3EE5E6B4B0D3255BFEF95601890AFD80709 B0AD6F4DA9753D811CB14F2348605CBBEABD616D 2019 2021-01-29 14:40:06Z KAUSHAL CHALLA 268 CANAL STREET NEW YORK NY 10013 82670160 0 X WWW.CBWCHC.ORG X 1972 NY PROVIDE HIGH QUALITY AND AFFORDABLE HEALTH CARE TO THE UNDERSERVED, WITH A FOCUS ON ASIAN AMERICANS. 15 14 731 18 0 0 9956616 23642686 51043741 49091404 227435 1008391 3990292 4027809 65218084 77770290 0 29942664 0 0 48560513 52375997 0 0 0 14785101 15033768 63345614 97352429 1872470 -19582139 70153796 50711571 14286971 14110331 55866825 36601240 PROVIDE HIGH QUALITY AND AFFORDABLE HEALTH CARE TO THE UNDERSERVED, WITH A FOCUS ON ASIAN AMERICANS. 0 0 87749407 29942664 49849915 THE ORGANIZATION OPERATED A FEDERALLY QUALIFIED HEALTH CENTER, WHICH HAD 271,488 VISITS IN 2019. 87749407 1 1 0 0 0 0 0 0 0 0 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 0 1 0 1 0 0 0 0 0 1 0 0 1 0 0 0 0 1 1 0 0 0 1 28 0 1 731 1 0 0 0 0 0 0 0 0 0 0 0 0 X 15 14 0 0 0 0 0 0 0 1 1 0 0 1 1 1 1 1 1 1 0 0 NY X LYNN D SHERMAN 2123796988 268 CANAL STREET NEW YORK NY 10013 EMILY WOO BOARD MEMBER 2.00 X 0 0 0 IRENE CHU TREASURER 3.00 X X 0 0 0 JAMES WONG OUTGOING BOARD MEMBER 2.00 X 0 0 0 JEANNE LEE JACKSON BOARD MEMBER 2.00 X 0 0 0 JIMING LIANG VICE CHAIRPERSON 3.00 1.00 X X 0 0 0 KENNY CHIN ESQ BOARD MEMBER 2.00 X 0 0 0 LESLIE CHUANG MD BOARD MEMBER 2.00 X 0 0 0 MARIE LAM BOARD MEMBER 2.00 1.00 X 0 0 0 MARY AGNES PAN OUTGOING BOARD MEMBER 2.00 X 0 0 0 OWH KIAN ONG BOARD MEMBER 2.00 X 0 0 0 PAULINE TSE BOARD MEMBER 2.00 X 0 0 0 PHILIP CHONG JR BOARD MEMBER 2.00 X 0 0 0 ROBERT BELL OUTGOING BOARD MEMBER 2.00 X 0 0 0 SOPHIA TSAO SECRETARY 3.00 X X 0 0 0 STEPHANIE CHENG BOARD MEMBER 2.00 X 0 0 0 TIMOTHY HSU BOARD MEMBER 2.00 X 0 0 0 VICTOR LEE CHAIRPERSON 4.00 1.00 X X 0 0 0 YVONNE GHAW BOARD MEMBER 2.00 X 0 0 0 BETTY K CHENG EXECUTIVE VP & COO 35.00 X 275465 0 44425 DE YOUNG CHAN CFO 35.00 X 196438 0 19182 JANE T ENG ESQ PRESIDENT & CEO 34.00 1.00 X 382691 0 45756 LYNN D SHERMAN EXECUTIVE VP, FINANCE, IT 34.00 1.00 X 320899 0 44194 PERRY PONG MD EXECUTIVE VP & CMO 35.00 X 325844 0 44769 KENNETH SHIEH CHIEF STRATEGY OFFICER 35.00 X 215146 0 19705 ALLAN W HO MD CHIEF OF OBSTETRICS AND GY 35.00 X 435579 0 42986 CHRISTINE J SHEN MD SENIOR PEDIATRICIAN 35.00 X 377763 0 35578 DU CHU WU MD SENIOR INTERNIST 35.00 X 365700 0 36524 JIAN-PING CHEN MD MEDICAL DIRECTOR OF MENTAL HEALTH 35.00 X 345230 0 43084 JIE YING SHEN MD SENIOR PEDIATRICIAN 35.00 X 453344 0 38033 3694099 0 414236 11 0 1 0 EDELMAN SULTAN KNOX WOOD ARCHITECTS LLP 100 LAFAYETTE STREET SUITE 204 NEW YORK NY 10013 ARCHITECTURAL SERVICES 265534 COHNREZNICK LLP 1301 AVENUE OF THE AMERICAS 7TH FL NEW YORK NY 10019 AUDIT/TAX SERVICES 132480 2 8017824 15624862 1844024 23642686 NEW YORK STATE MEDICAID MANAGED C 621400 19861000 19861000 PRIVATE INSURANCE 621400 9781357 9781357 MANAGED CARE PLANS 621400 8846059 8846059 NEW YORK STATE UNCOMPENSATED CARE 621400 4192682 4192682 MEDICAID 621400 3499714 3499714 2910592 2910592 49091404 249235 249235 5659026 4899870 759156 759156 759156 HEALTH PLAN QUALITY DISTRIBUTION 900099 3269299 3269299 METROCARD REIMBURSEMENT 900099 277343 277343 MANAGEMENT SERVICES FEES 900099 238903 238903 242264 242264 4027809 77770290 53119213 0 1008391 29942664 29942664 1934014 1658314 275700 38289438 32831149 5458289 2176145 1865929 310216 6952498 5961395 991103 3023902 2592835 431067 25119 25119 151165 151165 782392 466273 316119 607338 520760 86578 4158998 3568057 590941 281709 174333 107376 232555 143914 88641 1349717 1157938 191779 156341 51443 104898 PHARMACEUTICALS 2119641 2119641 DONATED VACCINES 1844024 1844024 CONSUMABLE SUPPLIES 1159592 994829 164763 EQUIPMENT RENTAL AND MA 617035 542294 74741 1548142 1313615 234527 97352429 87749407 9603022 0 385239 458084 15509359 17470386 606391 2308214 7845349 6869085 572271 759032 31224839 19444981 32943874 11779858 6753752 4639966 5537561 6426946 70153796 50711571 8765133 7754564 200000 5321838 6355767 14286971 14110331 X 55856825 34712491 10000 1888749 55866825 36601240 70153796 50711571 -19582139 316554 0 X X 0 1 X 1 1 1 X 11801408 9296250 11305626 9956616 23642685 66002585 41847842 44047545 50998159 51043741 49091404 237028691 53649250 53343795 62303785 61000357 72734089 303031276 45000 134130 546000 725130 0 45000 134130 546000 725130 302306146 322058 190132 196358 241293 249235 1199076 322058 190132 196358 241293 249235 1199076 3411026 3601478 3664723 3990292 4027809 18695328 57382334 57135405 66164866 65231942 77011133 322925680 0.93610 0.93600 0.00370 0.00370 X SCHEDULE A, PART III, LINE 12, EXPLANATION OF OTHER INCOME: HEALTH PLAN QUALITY DISTRIBUTION - 2015 AMOUNT: $ 2,337,220. 2016 AMOUNT: $ 2,728,821. 2017 AMOUNT: $ 2,796,726. 2018 AMOUNT: $ 3,349,768. 2019 AMOUNT: $ 3,269,299. MEANINGFUL USE INCENTIVE - 2015 AMOUNT: $ 416,500. 2016 AMOUNT: $ 242,250. 2017 AMOUNT: $ 212,500. MANAGEMENT SERVICES FEES - 2015 AMOUNT: $ 243,654. 2016 AMOUNT: $ 250,573. 2017 AMOUNT: $ 259,436. 2018 AMOUNT: $ 264,939. 2019 AMOUNT: $ 238,903. METROCARD REIMBURSEMENT - 2015 AMOUNT: $ 364,095. 2016 AMOUNT: $ 316,674. 2017 AMOUNT: $ 319,091. 2018 AMOUNT: $ 306,053. 2019 AMOUNT: $ 277,343. MEDICAL RECORDS CHARGES - 2015 AMOUNT: $ 37,457. 2016 AMOUNT: $ 42,103. 2017 AMOUNT: $ 45,559. 2018 AMOUNT: $ 54,190. 2019 AMOUNT: $ 62,910. OTHER - 2015 AMOUNT: $ 12,100. 2016 AMOUNT: $ 21,057. 2017 AMOUNT: $ 31,411. 2018 AMOUNT: $ 15,342. 2019 AMOUNT: $ 179,354. RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 21013357 10000019 11013338 10211482 9444962 766520 11779858 SECURITY DEPOSITS 485995 DEFERRED COMPENSATION ACCOUNT 5940951 6426946 DEFERRED COMPENSATION PAYABLE 5940951 DEFERRED RENT 414816 6355767 X 78351229 316554 30207049 30523603 47827626 29942664 29942664 77770290 67847983 438218 438218 67409765 29942664 29942664 97352429 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 RECOGNIZE 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: RELATED ORGANIZATION REVENUE 30,207,049. PART XI, LINE 4B - OTHER ADJUSTMENTS: DONATIONS TO HEALTHVIEW CBWCHC INC. 29,942,664. PART XII, LINE 2D - OTHER ADJUSTMENTS: RELATED ORGANIZATION EXPENSES 438,218. PART XII, LINE 4B - OTHER ADJUSTMENTS: DONATIONS TO HEALTHVIEW CBWCHC INC 29,942,664. 1 HEALTHVIEW CBWCHC INC 268 CANAL STREET NEW YORK NY 10013 822560880 501(C)(3) 10000000 19942664 CAPITAL CAMPAIGN FOR CONSTRUCTION OF FEDERALLY QUALIFIED HEALTH CENTER 1 PART I, LINE 2: CONTRIBUTION MADE TO A RELATED PARTY, THEREFORE, THE BOARD IS ABLE TO MONITOR USE OF FUNDS. X X X X 0 0 0 0 0 0 0 0 0 BETTY K CHENG EXECUTIVE VP & COO 273750 0 0 0 1715 0 16699 0 27726 0 319890 0 0 0 DE YOUNG CHAN CFO 195406 0 0 0 1032 0 12065 0 7117 0 215620 0 0 0 JANE T ENG ESQ PRESIDENT & CEO 373116 0 7103 0 2472 0 16800 0 28956 0 428447 0 0 0 LYNN D SHERMAN EXECUTIVE VP, FINANCE, IT 319315 0 0 0 1584 0 16800 0 27394 0 365093 0 0 0 PERRY PONG MD EXECUTIVE VP & CMO 324812 0 0 0 1032 0 16800 0 27969 0 370613 0 0 0 KENNETH SHIEH CHIEF STRATEGY OFFICER 214786 0 0 0 360 0 13233 0 6472 0 234851 0 0 0 ALLAN W HO MD CHIEF OF OBSTETRICS AND GY 434547 0 0 0 1032 0 16800 0 26186 0 478565 0 0 0 CHRISTINE J SHEN MD SENIOR PEDIATRICIAN 377211 0 0 0 552 0 9294 0 26284 0 413341 0 0 0 DU CHU WU MD SENIOR INTERNIST 364668 0 0 0 1032 0 12805 0 23719 0 402224 0 0 0 JIAN-PING CHEN MD MEDICAL DIRECTOR OF MENTAL HEALTH 344198 0 0 0 1032 0 16800 0 26284 0 388314 0 0 0 JIE YING SHEN MD SENIOR PEDIATRICIAN 452312 0 0 0 1032 0 10189 0 27844 0 491377 0 0 0 CENTRE COURT HOLDINGS LLC IRENE CHU, BOARD MEMBER, HAS FINANCIAL INTEREST IN CENTRE COURT HLDNGS LLC 437616 RENT 0 X 1 1844024 FMV 0 0 0 PART I, COLUMN (B): COLUMN B REPRESENTS THE NUMBER OF CONTRIBUTORS. FORM 990, PART VI, SECTION B, LINE 11B COPIES OF THE FORM 990 ARE DISTRIBUTED THE BOARD OF DIRECTORS. IT IS REVIEWED BY SENIOR MANAGEMENT, INCLUDING THE CEO AND CFO, AND DISTRIBUTED TO THE BOARD OF DIRECTORS BEFORE IT IS FILED WITH THE IRS. FORM 990, PART VI, SECTION B, LINE 12C THE ORGANIZATION'S DIRECTORS, OFFICERS AND KEY EMPLOYEES SIGN DISCLOSURE STATEMENTS ANNUALLY. THE BOARD DEVELOPMENT COMMITTEE AND AUDIT COMMITTEE ARE RESPONSIBLE FOR MONITORING COMPLIANCE WITH THE CONFLICT OF INTEREST POLICY. IN THE EVENT A CONFLICT EXISTS, THE INDIVIDUAL WITH THE CONFLICT MUST RECUSE HIMSELF/HERSELF FROM ANY DELIBERATION AND VOTING REGARDING THE CONFLICT. FORM 990, PART VI, SECTION B, LINE 15A ANNUALLY, THE COMPENSATION COMMITTEE OF THE BOARD REVIEWS AND EVALUATES THE PRESIDENT AND CEO AND DECIDES ON COMPENSATION. INFORMATION FROM OUTSIDE CONSULTANTS ON COMPARABLE SALARIES OF SIMILAR ORGANIZATIONS MAY BE USED IN THEIR DETERMINATION. SALARIES FOR OTHER OFFICERS & KEY EMPLOYEES ARE DETERMINED BY THE PRESIDENT AND CEO, USING SALARY SURVEYS WITH INFORMATION FROM OTHER HEALTH CENTERS, AS WELL AS EMPLOYEE ANNUAL EVALUATIONS. FORM 990, PART VI, SECTION C, LINE 19 COPIES OF GOVERNING DOCUMENTS, CONFLICT OF INTEREST POLICY AND FINANCIAL STATEMENTS ARE AVAILABLE UPON REQUEST. FORM 990, PART XII, LINE 2C: NO CHANGE FROM PRIOR PERIOD PROCESS. HEALTHVIEW CBWCHC INC 268 CANAL STREET NEW YORK NY 10013 822560880 PROVIDE SUPPORT TO CHARLES B. WANG COMMUNITY HEALTH CENTER, INC. NY 501(C)(3) LINE 12A, I CHARLES B WANG COMMUNITY HEALTH CENTER INC 1 0 1 0 1 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0